296 PSYCHIATRY 



but when there is constitutional weakness the power of resistance is 

 less. The functional elements of the organism, all working together, 

 constitute combinations of community- work of extreme complexity; 

 these elements being unequally reduced in efficiency the "clinical 

 types" are very much varied. A method of analysis of symptoms 

 with the endeavor to estimate their functional values and their 

 relations to their physiological sources will appear under the follow- 

 ing topics: 



The functional psychoses constituting the main group of non-deteri- 

 orating affections pathologically regarded as insanities, all have 

 a basis of some kind or degree of asthenic reduction of functional 

 efficiency; as already indicated, these may include the whole range 

 of degrees from simple cases of nervous exhaustion downward 

 through the simple and pronounced cases of melancholia and mania, 

 including all varieties of phases and combinations of the symptom- 

 elements; also including the more actively induced exhaustion 

 psychoses and confusional deliria. Functionally considered, it is 

 proper to regard all these cases as "functional psychoses" until 

 proved to the contrary. Function comes first as the present criterion ; 

 organic change is a result. Cases carefully diagnosticated character- 

 istically tend to recovery. The designations, neurasthenia, melan- 

 cholia, mania, etc., are simply valuable descriptive terms; they are 

 Jthus not correct names of diseases as clinical types and we have yet 

 to study broadly the genesis and development of these conditions. 

 By the functional method we have merely advanced, as yet, little 

 beyond the general fact that two classifications may be made of the 

 psychoses the non-deteriorating, and the deteriorating. By the 

 morphological, clinical-type method there is a singular lack of success 

 in adopting principles of valuation of symptoms by which men of 

 good minds can reach like conclusions. We are not yet ready to 

 determine species; this should be aided by the study of the genetic 

 character of the symptom-elements. 



The significance of the unifying characters of the non-deteriorating 

 range of psychoses may be made much clearer by grouping them 

 according to the functional sources of the symptoms and their own 

 natures. The symptom-factors thus fall into natural groups, which 

 should be studied with complete freedom from preconceptions of 

 "disease-forms." No more is attempted here than to harmonize 

 these groups with the elementary postulates of psychology, and with 

 the general physiological facts heretofore cited. 



(1) Feeling. (The feelings and emotions.) The emotional varia- 

 tions that are pathologically persistent are in close relation with the 

 changes of bodily states which are represented in the central nervous 

 system by the organic, kinesthetic, and general sensations; the sum 

 of these has, physiologically, a strong influence upon mental feeling, 



