The immediate dealing with mental disease as generally recognized merges imperceptibly in several directions into the handling of vari ous psychological situations which are recog nized as being more or less abnormal. For ex ample, in the rehabilitation of the injured and crippled soldier the psychological problems in volved arc most important and strike at the very foundations of the capacity for social ad justment. The crippled hero is not easily go ing to he inducted back to the hum-drum drudg ery of the shops, nor is the employer easily go ing to he induced to hire a man who is severely crippled when he can just as easily get one who is not. The method of approach to these prob lems is psychological and in the case of the at titude of the soldier at least approaches, if it does not overstep, the limits of the normal.
In the same way numerous problems of de fective psychological adjustment are arising in other directions. The highly trained, exquisitely sensitive flying men not only require a most careful and frequent sizing up of their physical resources, but it is beginning to he appreciated that they need the same kind of attention to their psychological resources and that perhaps a number of the accidents which happened in this branch of the service could have been avoided if this sizing up had been effectively done.
The psychological examination of recruits in large numbers introduced methods of sifting out defectives, but in addition to that it intro duced methods which serve as measuring rods of efficiency. So that the hundreds of thou sands of men who went into the service were measured in a way in which the population has never before been measured, with a result that methods are growing up which will serve more and more effectively to fit the individual to his job and also to pick out all manner of defects in the usual way of accomplishing this end.
The army is proving to be a great piece of efficiency machinery which demands certain pretty-well defined results and the line officers and the scientific men are working side by side, not for the sole purpose of weeding out the unfit or treating those who have become ill but with the added purpose of saving those that are misfits by making readjustments in their relations to the army machine either by trans fers to other branches of the service, certain re educational adaptations, or what not, which will render it possible for them to stay in the army and render good service in accordance with their capacities. Undoubtedly this great ex
perience will be projected into the civil popula tion after the war with the result that the problems of psychiatry, of mental illness, or social adjustability, will all be viewed in a much broader aspect and be much more wisely dealt with.
In addition to the above definite efforts are being made along other lines which at first perhaps seem to have no relation to mental ill ness but which really are closely related thereto, specifically the efforts in the direction of social hygiene, namely, the prevention of the high in cidence of venereal disease which is so usual in military organizations. When it is appre ciated that syphilis is responsible for upwards of 10 per cent of the cases of mental disease confined in our public institutions it will be also appreciated how efforts at limiting the in cidence of this disease go directly to the root of the problem of the prevention of mental disease. A co-ordinate activity addressed in the same direction is the effort at providing adequate recreation and suitable occupation dur ing the leisure hours for soldiers in camp. These are all efforts in the direction of mental hygiene and as such are addressed to the pres ervation of mental health and the prevention of mental illness and, therefore, come within the scope of psychiatry in its widest meaning. The prevention of any material percentage of ve nereal disease in the military organization by such methods as are addressed directly or in directly to their prevention or cure will ulti mately have an enormous effect upon the gen eral health throughout the country when the sol diers return to civil life and to their various pursuits. Ordinarily they bring back into civil life an enormous amount of potential suffering and disaster in the shape of venereal infection, an unknown portion of which must necessarily result in mental illness of themselves and others. Venereal prophylaxis and methods of mental hygiene will serve to curtail this danger very materially.