PSYCHIATRY IN THE FUNCTIONAL PSYCHOSES 299 



(4) Organic Sensations and States. (General and kinesthetic 

 sensations.) The importance has been shown of these function-factors 

 of the "somatic group of senses/' in respect to the representations 

 they bring into conscious experiences concerning the inner physical 

 life of the body. In health the sensory and motor reactions of our 

 bodies, and our conscious experiences, are adjusted to contacts with 

 the environment within normal limits; the organic and kinesthetic 

 senses normally contribute to the general welfare with only salutary 

 interferences, and these being mostly unnoticed we habitually ignore 

 their existence. It is in disordered physical conditions that the 

 abnormal influences arise and interfere with and derange the expe- 

 riences of the mental life; they are general and vague in character, 

 but are of essential significance, though only described as subjective 

 experiences. The phenomena of changes of excitability and loss of 

 function are well known and variously described; an interference 

 with the functions of any one system will disturb the normal func- 

 tional equilibrium that must of necessity exist in the action of the 

 whole. 1 The principle of localized variations of irritability, as in the 

 neuroses, applies to all functioning groups of cellular mechanisms; 

 the threshold of excitation may be raised or lowered in any of the 

 sensory, motor, or central and psychical parts of the reflex mechan- 

 isms. Upon these changes may be predicated all the phenomena of 

 psycho-sensory and psycho-motor excitation and retardation, con- 

 ditions that appear in some kind or degree in the whole range of the 

 functional psychoses. These variations may be ascribed to reduc- 

 tions of the nutritional maintenance of the vital energies. Hyper- 

 esthesia and hyperkinesis are the complementary manifestations 

 that betoken fatigue, or equivalent weakness from some cause, of the 

 physiological inhibitory energy; this condition is often associated 

 with anesthesia of the fatigue-sense in the same case. 



It should be noted that the changes of feeling-tone, of motility, 

 and of control do not run parallel to each other; hence the differ- 

 ences of the clinical pictures presented by typical melancholia 

 and mania, and the so-called "mixed cases ; " melancholia pre- 

 sents two principal types emotional depression with excitation 

 and retardation; mania presents emotional exaltation with ex- 

 citation, and sometimes there are painful states of consciousness 

 and the acute reductions of function in exhaustion and stupor. There 

 are numerous phases in the unified melancholia and mania as con- 

 stituting one general group of variations of functional disorders 

 presenting clinical phenomena apparently widely divergent as 

 "clinical types," but falling into harmonious relations when ex- 

 plained consistently with their developmental and genetic char- 

 acter. 



1 Cf. Mott, F. W., The Degeneration of the Neuroses. 



