Review of H. Maudsley's 'Pathology of Mind', and E. Kräpelin's 'Psychologische Arbeiten'

The Pathology of Mind. A study of its distempers, deformities and disorders. By HENRY MAUDSLEY, M.D. London: Macmillan and Co., 1895. Pp. xi., 571.

Psychologische Arbeiten. Von EMIL KRAEPELIN. Band I, Heft IV. Leipzip: Wm. Engelmann, 1895.

DR MAUDSLEY describes his book as virtually new though retaining the same name as that published in 1879. The general arrangement of the book has been much altered; the chapters on sleep and hypnotism with which the former book began, have been omitted, though many of the facts in those chapters find their place as illustrations throughout the book. The whole subject is treated in a more general way, and the author avoids as much as possible the division of mental disease into definite groups with assigned names, retaining, however, the main lines of classification usually adopted in this country. One new feature is that those cases which in the former edition were described as examples of monomania, are treated as insane deformities of mind, and this idea of malformity of mind is developed at some depth.

The descriptions of the chief types of insanity are, as in previous editions, the most interesting feature of the book; the author brings in a series of vivid word-pictures which are in themselves sufficient make the work a classic. There is however a definite doctrine running through the whole work which, advanced by so distinguished an authority as Dr Maudsley, may do much to retard the study of insanity in this country. Dr Maudsley endeavours at every opportunity to persuade his readers to disregard the psychological aspect of mental disease and to look solely at its material aspect as brain disorganisation. The following extract is a typical example of teaching which is constantly recurring: ‘No one can ever understand the real nature of these examples of decomposed will who, viewing them from the standpoint of mind in disorder, tries to discover a mental explanation of them and to set it forth in the language of psychology. The truth is that psychology has no terms for them, and that its principles exclude their existence. Let him view them from the standpoint of a physical disorganisation which causes a disintegration of mind, substituting the informing conception of a definite mental organisation for the barren notion of abstract mind, and he will then be in the right way to perceive what they really are and what decomposition of will means’ (page 245). Dr Maudsley does not seem to recognise the possibility of a scientific psychology to be developed side by side with our knowledge of brain structure, which may be mutually helpful, each advance on one side throwing light upon the other. Moreover when we turn to the chapter on the morbid anatomy of insanity we find that the author confesses that little light is thrown on the symptoms by our knowledge of the disorders of brain structure; he says ‘The intimate chemical and molecular changes which are presumably the conditions of mental disorder go on in a domain of nature the subtilties of which yet far exceed the subtilties of observation’ (page 515). It seems as if the general tendency of the book must be to discourage the scientific study of mental pathology in any direction, and to encourage a state of satisfaction with the loose classification and metaphorical description which characterise so largely the pathological branch of mental science. Experimental psychology is barely mentioned, although it is probable that here we may find a clue to the solution of some of those problems which Dr Maudsley regards as insoluble, and the second book mentioned at the head of this notice represents an attempt to throw light on mental disease by methods which in the first are regarded as impracticable.

Professor Kraepelin is one of very few investigators who combine the study of experimental psychology with the case of the insane. He has a laboratory in connexion with the asylum at Heidelberg and proposes now to issue a series of ‘Psychologische Arbeiten,’ in which the methods which his great experience in the systematic investigation of mental capacity has led him to adopt, will be applied by himself and by his pupils. The chief feature of the first number is an introduction by Prof. Kraepelin, in which he describes the principles and methods according to which the researches will be conducted

The author recognises that any method of examining the mental capacity of the insane must first be tried on one normal individual very thoroughly with the view of discovering all the factors likely to influence the investigation; it must then be tried on a number of normal individuals, especially with the view of discovering the influence of personal idiosyncrasy, and, finally, the method may be proved on normal individuals under the influence of various abnormal conditions. The researches in the present number are devoted to these preliminary inquiries, and it is probable that many of those to follow will have a similar aim.

Dr Kraepelin calls attention to the fact that the mental diseases in their early and most instructive stage of development do not often come under the hands of the physician, or if they do, are not in a condition to make exact investigation practicable, and he proposes to supply this deficiency by investigation of the effects on mental capacity of such influences of fatigue and drugs. These are not only frequent factors in the causation of insanity, but produce even in moderate amounts mental effects which are identical in nature with those of many forms of incipient insanity. This is a line of research in which the author has already done much valuable work which will be continued in the present series.

In the introduction the chief experimental methods to be employed and the kinds of mental capacity to be investigated are also considered. The former include the measurement of the time taken by various mental operations such as counting, adding numbers, learning syllables in the method developed by Ebbinghaus; the formation of associations, a method of investigating the insane first put in practice by Galton in comparative experiments on normal and imbecile children; reading and writing;- and for the exact study of the latter Dr Kraepelin has devised a special ingenious apparatus.

The time taken by these various mental operations is to a certain extent regarded as a guide to mental capacity, but special attention is also paid to such facts as false reactions and degree of accuracy of the work done, and it will doubtless be one of the chief aims of the series to determine the deviations which are of most value as indications of disordered mind.

The kinds of mental capacity which the author regards as within the scope of experimental inquiry are chiefly included under the three heads of capacity for the perception of sensory stimuli, for the association of ideas, and for the voluntary movement. The influence of practice and the persistence of the effects of practice, the influence of fatigue and the capacity for recovery from fatigue, the depth of sleep and the capacity for concentration and deviation of attention are among the conditions which have been investigated, and a scheme is given by which many of these points may be tested in a large number of individuals.

The present number contains two other papers; on by A Oehrn, ‘Experimentelle Studien xur Individualpsychologie’; the other by S. Bettmann, ‘Ueber die Beeingflussung einfacher psychischer Vorgänge durch körperliche und geistige Arbeit.’ The scope of the latter is indicated by its title; the former is a dissertation which has been reprinted because it affords a typical instance of the kind of investigation which Dr Kraepelin intends to publish in the series, and as a good example of the application of his methods. Several of the methods are employed on a number of individuals with the view of eliciting the presence of personal idiosyncrasy, and the author brings out several points of interest, for instance some results on the different capacity for mental work in different individuals in the morning and evening. The systematic investigation of the mental constitution of different individuals is much wanted; it is a line of research which can be best carried out by physicians who are familiar with the differences of physical as well as mental constitution, and this branch of his work alone would justify Prof. Kraepelin in undertaking to issue his series of ‘Psychologische Arbeiten’.