294 PSYCHIATRY 



mental aspects. The interest of this to psychiatry is that compara- 

 tively little attention has been given to this inner sensory field of the 

 sources of conscious experiences; yet, it may be said, here are the 

 conditions and the very material of bodily and mental stimulations 

 and sensations with which the mental work is done. These explaining 

 principles have been almost wholly omitted from the accepted 

 formulae of the conceptions of modern advanced psychiatry which 

 has chiefly concerned itself with the motor aspects of mental life and 

 expression. These physiological references are needed to explain 

 many of the symptoms of the psychoses and should have their full 

 value in the formulation of the principles of mental physiology and 

 psychiatry. 



A functional conception of mental pathology 1 directs observa- 

 tion to the first and smallest departures from normal action, upon 

 the principle that all variations of a pathological character are sub- 

 ject to the laws of normal function acting under abnormal condi- 

 tions. The study of the development of symptoms is equivalent to 

 noting the genesis and progress of the conflict between the func- 

 tional energies and the abnormal conditions. Symptoms as func- 

 tional modifications are the results in changes of action, organic 

 effects are the results in changes of structure ; by the genetic method 

 the sequences of functional phenomena are noted; in the functional 

 psychoses there are variations of functional efficiency manifested 

 by its reductions and recoveries. The following characterization 

 in outline of the psychoses is an application of the functional prin- 

 ciples referred to in the foregoing pages. For the purpose of tracing 

 the several orders of symptom-factors from their genesis in func- 

 tional sources they can be considered most simply under the divi- 

 sions of the mental elements intellect, feeling, and will, as these 

 terms are used in modern psychology for purposes of classification. 



Characterization of the Psychoses according to Functional Principles 



1. THE FUNCTIONAL PSYCHOSES. A study of the large group of 

 cases of non-deteriorating mental disorder yields certain general 

 conclusions as to what may result to the normal well-endowed 

 individual w r hen subjected to the effects of use, disuse, overuse, and 

 stress. Beginning with the least degrees of decline of functional 

 vigor, below normal fatigue, there is no point in the declension where 

 a line can be drawn definitely marking a change from one named 



1 Cf. Barker, L. F., Methods in Medicine, Boston Med. & Surg. Jour., June, 

 1905. Referring to the value of a functional conception of pathology, it is also 

 said that "as medicine has become more scientific the mind has ceased to be 

 satisfied with such descriptive classifications as the clinical symptoms and syn- 

 dromes represent and with ' clinical types' set up, and is ever on the alert to replace 

 them by classifications of a developmental or genetic character." Quoted from an 

 address before the Mass. Med. Soc. published while this paper was in manuscript. 



