RELATIONS TO OTHER SCIENCES 257 



as neurasthenias, hysterias, phrenasthenias, obsessions, impulsive 

 manias, and mild melancholic and hypochondriac states. These 

 patients now fall into the hands of the general practitioner, who is 

 wearied and unimpressed by them, and who fails from lack of interest 

 to study them, or into the hands of specialists who treat their reflexes, 

 generally without avail, or into the hands of neurologists who deal 

 with them generally as having a temporary neurosis instead of a 

 psychosis or the thing out of which one may grow. It is to be hoped 

 and expected that the follower of internal medicine and the neuro- 

 logist will study the cases more seriously, and from the point of 

 view of the psychiatrist especially. In this way we shall be able to 

 learn the very earliest symptoms that suggest the oncoming of mania 

 and dementia praecox; we will learn better the type of infancy and 

 childhood out of which it grows; we shall learn how to check and 

 to prevent it. 



An illustration of such help of neurology and syphilology to psych- 

 iatry is already shown in the development of our knowledge of 

 general paresis. This disease was recognized a hundred years ago. Its 

 etiology was not even distinctly suspected till fifty years ago. An 

 established connection of its relation to lues is hardly more than ten 

 years old, this being worked out by the cooperation of the syphilo- 

 grapher, the neurologist, and the psychiatrist. New features of its 

 course, particularly the physical symptoms and early symptoms, have 

 been derived within a few years largely through the help of psych- 

 iatrists, neurologists, and syphilographers working together, until 

 now the onset of disease is recognized almost before it is present. By 

 reason of this its course has been checked, and it is my belief that 

 cases have been permanently arrested in their progress, so that we 

 may now say that paresis may sometimes be aborted, if not cured. 

 All this has been done through the cooperation of alienists, neuro- 

 logists, and syphilographers. 



So it seems to me a like cooperation will enable us some day to cope 

 with mania melancholia, chronic melancholia, and the precocious 

 dementias. In this work we must have the help of the practitioner 

 of children's diseases, of the general practitioner, and of the educator 

 who studies the growing child. 



A great deal of work has already been done in measuring children, 

 studying their growth, their mental activity and reactions, but not 

 much has yet been formulated which is helpful to us as psychiatrists, 

 to foresee a coming psychosis. 



'This field needs further study from the anthropologist and the 

 doctor of infancy and childhood. We do not want to know alone that 

 a child is nervous, excitable, easily febrile, a bad sleeper, and a noisy 

 dreamer. But what are the special symptoms which may lead us to 



