The treatment of the physical condition is always according to the nature of the bodily symptoms, and the treatment of the mental con dition must take into consideration the involve ment of the higher or psychological levels of the personality and give as much analysis as pos sible, in order to reconstruct the social relations if that can in any way be done. Prevention of this disease is one of the most important ends that could be achieved by civilization, and is primarily attained through eugenic methods, lacking which the only means at present known lie in the correction of all irregularities of char acter as early as may be observed in child hood and an absolutely frank and scientific handling of the question of sex, the source of much that is anomalous in human character.
A division of infection and exhaustion psychoses comprises those resultant upon fever, exhaustion or collapse and upon typhoid fever. While all these diseases have mental aspects, the treatment of them is so essentially in ac• cordance with the disease of which they are themselves virtually only the symptoms that they need not be described here in detail. There is a special form of mental reaction following the over-indulgence in alcohol, in opium, cocaine; bromides, carbon monoxide, lead, mercury or from uremia, diabetes mellius, pellagra and certain gastrointestinal diseases. In none of the mental diseases is the matter of individual psychology more important than in alcoholism, as the reasons for drinking which are assigned by people in general are merely rationalizations. (See MECHANISMS, MENTAL). The real cause why people drink to an extent which harms them is that their neural constitution craves the gratification which they get from this source alone. The very fact that a man or woman cannot stop drinking therefore stamps them at once as having a weakness in their nervous constitution. The alcoholic takes his peculiar way in creating an artificial balance, so to speak, in order to make up for the loss of bal ance between his neural constitution and the demands made upon it by his environment. It is his way of taking the cash and letting the credit go. Alcohol is the quickest path for some persons to shut out the world of reality, which has been found too arduous, and to open up the world of fantasy, the fact that the individual is unable to face reality being the really important point. Accordingly it is not surprising to find that ordinarily the alcoholic is in other respects, aside from his alcoholism, an example of general inefficiency. His uncon scious appreciation of his essential inferiority is partly what leads him to flee from the world of reality to the world of intoxication fan tasy. That alcoholism is an indication of a deep physiological weakness, too, is to be in ferred from the high mortality in pneumonia and other diseases among alcoholics.
The same remarks could be made about the mental aspects of over-indulgence in opium, morphine, cocaine and other poisonings. The amount that any given individual can stand de pends, as is well known, on the individual's constitution. The more he can stand, the stronger the constitution; but from another point of view, the greater need he has for some drug to change, through its effect upon himself, the nature of his relations with the external world, the weaker he is as a mechanism and the less suited he is for the field of activity in which he finds himself. In all of these drug indulgences the treatment of the patient by means of other drugs is merely palliative and does not go to the root of the matter. The
only hope of doing this is through psycho analysis, after the acute disturbance has ceased. There are psychoses, too, associated with or ganic diseases such as apoplexy, chorea, paral ysis, multiple sclerosis, polyneuritis and heart disease; also with presenile, senile and arterio sclerotic conditions.
Finally feeble-mindedness, idiocy, imbecil ity, regarded as defects in personal endowment or development, have the mental aspect that they cannot live in society acceptably to the degree of being either self-supporting, or of supporting anyone else. The economic im portance of these defective classes is being recognized and the more as psychological methods have been devised for grading all individuals into the classes which show char acteristic differences parallel with the differen ces between children of ages between 1 and 14 years of age. Very extensive researches by Binet, Simon, Goddard and Terman have shown that the general intelligence grows steadily up to age 14, while above that age there are roughly three groups, the low, average and high adult intelligence. What is meant by feeble-mindedness, imbecility and idiocy can be given a very exact form in a table like the following: Mental age Capabilities Class Under 1 year. Helpless Low class idiot 1 year Feeds self. Eats every thing Middle class idiot 2 years ... Eats discriminatingly . High class idiot 3 year.... No work. Plays little Low class imbecile 4 years.... Tries to help Low class imbecile 5 years .. Only simplest tasks Middle class im becile 6 years .... Tasks of short duration Washes dishes Middle class im becile.
7 years.... Little errands in house Dusts High class imbecile 8 year Errands, light work; makes beds Low class moron 9 year.... Heavier work. Scrubs, mends, lays bricks, cares for room Low class moron 10 years.... Good institution helpers.
Routine work Middle class moron II year.... Fairly complicated work with only occasional oversight Middle class moron 12 years .. . Uses machinery. Cares for animals. No super vision. Cannot plan High class moron The advantages of these so-called intelligence tests, so clearly shown in the organization of the national army, are of further advantage in finding out whether a mental defect is inherite or acquired, because in the inherited mental defects a termination of the individual's abalitt to go through the tests is quite even. He can do all of the tests of ages one to seven, for example, but cannot do any of those above that age. On the other hand the case is not so clean cut with acquired defects, the individual being able to do some but not all of those tests several years' above his mental age and net all of them below it.
In conclusion it should be emphasized that the mind and the body are one unity and what ever affects the one is not without effect upon the other, that it is almost if not quite impos sible to draw the line between mental and bod ily disorders, and that the ultimate truth will be found in the statement that ntind is but the function of body and body but the perceptible expression of mind. Therefore few diseases can be regarded as exclusively mental and few as exclusively physical. Consult jab& and White, (Diseases of the Nervous System' (3d ed., 1919) ; and White and Jelliffe, 'Modern Treatment of Nervous and Mental Disease' (VoL II, 1915).