Benign Stupors: A Study of a New Manic-Depressive Reaction TypeHoch, August
Science
Benign Stupors: A Study of a New Manic-Depressive Reaction Type
Hoch, August
Manic-depressive illness; Stupor
The fact that psychiatry lags in development and recognition behind
other branches of medicine is due in part to the crudity of its clinical
methods. The evolution of interest in science is from simple, obvious
and tangible problems to more intricate and impalpable researches.
Refined laboratory work has been done in psychiatric clinics,
particularly along histopathological lines, but clinical studies follow
antiquated methods. The internist does not say, “The patient has sugar
in his urine, therefore he has diabetes and therefore he will die.” He
finds a glycosuria and looks for its cause. If this symptom is found to
be related to others in such a way as to justify the diagnosis of
diabetes, a therapeutic problem arises, that of adjusting the chemistry
of the body. The prognosis depends not on the disease but the
interreaction of the organism and the morbid process. Both in diagnosis
and treatment an individual factor, the patient’s metabolism, is of
prime importance. Now in psychiatry, although the personality is
diseased, this personal factor has been almost entirely neglected.
Text-books furnish us with composite pictures which are called diseases,
not with descriptions of reactions brought about by the interplay of
personal and environmental factors. Educated people are not satisfied
with novels that fail to depict real characters. Clinical psychiatry,
however, has been content with the dime-novel type of character
delineation. This is all the more disappointing, inasmuch as the study
of insanity should contribute largely to our knowledge of everyday life.
This defect can only be remedied by looking on every case as a problem
in which the origin of each symptom is to be studied and its relation
traced to all other symptoms and to the personality as a whole. This is
an ambitious task and we do not pretend to any great achievement, merely
to a beginning.
Public-domain text, read in full here on John Shaqi.
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