Page:The Modern Treatment of Mental and Nervous Disorders.djvu/12

— 10 — worries, anxieties and emotions? This is no mere academic question, because upon the answer given to it is absolutely dependent the line of treatment we shall be called upon to adopt. Treatment consists in discovering and removing causes, and our procedure will be totally different according as we believe those causes to be of physiological or psychological order. For example, we should treat weeping due to the explosion of a tear-shell by administering substances which eliminate the poisonous gas, while we should strive to comfort the patient weeping for the loss of a loved relative. Merely to comfort the first patient would be as useless as to administer lotions to the second. Take another example. Insomnia is a symptom which may be due to many different causes. It may be due to kidney disease, and is then best combated by remedies directed to the organs which are at fault. Or it may be due, as it often is in shell-shock patients, to the existence of tormenting thoughts and fears, which crowd into the patient's mind as he lies in bed, and make absolutely impossible the mental composure necessary for sleep. Treatment here will endeavour to remove the thoughts and fears which are responsible for the condition, and this can only be done by the employment of psychological methods.

It must be observed that in this last instance the cause immediately responsible for the insomnia is probably the same in both cases, some particular condition of the brain or blood vessels. But, so far as treatment is concerned, we are not mainly interested in this immediate cause, but in those ultimate