Another noteworthy principle here emphasized and illustrated is that the relationship between “functional” (hysterical, neurasthenic, migrainoid) symptoms and the signs (or symptoms) of organic processes is clinically important and worthy of much further study. This is a matter which, in a general sense, has interested me for many years. Above and over the “organic” hovers always the “functional,” as representing the first indication of the marvelous tendency to repair, or substitution, for which the resources of nature are so vast. Yet this functional tendency also has its laws, of which, in their turn, the organic processes display the action in quasi diagrammatic form. Hysteria, neurasthenia, migraine, etc., do not arise de novo in each case, but conform to typical, though not rigid, formulas, susceptible of description. I have recently had the opportunity to study in detail an analogous series of transitions between the movements (and emotions) indicative of apparently purposeless myoclonic movements (on an epileptoid basis) and the movements of surprise, engrossment, purposeful effort, the excitement and joy by which the former were excited and into which they shaded over.
Taken altogether, this book represents work and thought in which, for amount and kind, the neurologists of Boston may take just pride.
James J. Putnam.
St. Hubert’s, Keene Valley, New York.
August, 1917.
Me miserable! which way shall I fly
Infinite wrath and infinite despair?
Which way I fly is Hell; myself am Hell;
And, in the lowest deep, a lower deep
Still threatening to devour me opens wide,