DR. JOHN T. MACCURDY, New York, read a joint paper (with DR. W. T. TREADWAY) entitled "Constructive Delusions."[2]
[2] Published in the August-September number, p. 153, of this Journal.
DISCUSSION.
DR. WILLIAM A. WHITE, Washington, D. C., spoke of his interest in the paper and his agreement with it. He suggested that it might be quite proper to use the term "archaic" in speaking of this type of delusions. He also commented on the recurrence of the excitement in the case of the last patient quoted which, he suggested, might represent a physical periodicity as the individual had a homosexual component in his make-up, so that it might be reasonable to suppose that this was fundamentally sex periodicity.
PRESIDENT HALL: Sex periodicity in males is very interesting. A student of mine many years ago kept his own record for some years and published it anonymously in my journal, as did another some ten years ago, and the twenty-eight day cycle seemed very marked in the first and somewhat so in the last of these papers. They are certainly interesting to the geneticist. We now often speak of dreams as protectors of sleep. I am inclined to think that a good many delusions are protectors of sanity in much the same way, and I am not at all sure that we cannot say that we shall ere long see that this is to a great extent true for the imagination. If this patient had a less vivid fancy perhaps his delusions would have been kept less fluid and his sanity would have been better protected. Is there not a relation between floridness of fancy which passes easily over to delusions (just as creative geniuses are allied to artists), but may there not be an inverse correlation between great liveliness and activity of fancy and liability to fixed delusions? At any rate, from the normal standpoint we are seeing more and more that man lives on a genetic scale. This might be illustrated by the many cases, some of them pretty well analyzed, of cat-phobias. The greatest enemies of mankind were once the felidae, and the theory now is that this type is made up of very definite elements, viz., sharp claws, stealthy tread, eyes that shine in the dark, power to leap far and suddenly, a uniquely developed voice, etc. Now the cat-phobiacs generally focus on some one of these traits in consciousness, but analysis seems to show that the rest of them reinforce the one that experience happens to thrust forward into the center of the field of consciousness. In general it seems to me that it is a great educational advantage to keep open the experiences that connect us with the past of the race, and it may have a psychotherapeutic value which we do not now dream. Years ago a New York paper investigated, with the aid of many of its reporters, and found hundreds of people fishing off the wharves of New York on Sunday, very few of whom caught any fish, and many who did threw them back. They were reverting to the old piscatorial stage, feeling again the old thrill of a nibble on the hook, and went home refreshed, even if they had not had a bite, because they had been able to drop back into an ancient stratum of the soul which was sound, so that they came back to the hard reality of the next day refreshed. Play in general, too, we now regard as reversionary, and I cannot but believe that many delusions are precisely the same.
DR. TOM A. WILLIAMS, Washington, D. C: Dr. Hall has cited the cat-phobia in illustration that the belief that Dr. MacCurdy developed may be one in which there may be philogenetic reasons for the phenomena. It seems to me that before we use such data we need analyses more complete than has been given for any of them. His citation brought to my mind a case I am working with now, a cat-phobia. The cat does not represent sharp eyes and claws. The cat is a definite symbol of definite sexual occurrences in childhood. I should like to ask whether it would be here desired to draw philogenetic conclusions. I think not without the further analysis which would be necessary. I have a very strong distrust of the efforts which Jung and Abrahams have made, followed by some of us, to draw analogy between the morphological changes and the psychological experiences of the race as reproductions in the life history of the individual.
DR. E. E. SOUTHARD: I should be inclined to feel that much of the disturbance in the constructive delusion group would be structurally founded upon normal or abnormal conditions in the parietal lobe. At any rate cases with hyperphantasia in my recent Dementia Praecox series (American Journal of Insanity, 1914-15) appear to be correlated with parietal lobe anomalies and atrophies. It is a curious thing that such subjects with hyperphantastic delusions are very often good institutional workers. Although a delusion of persecution by poison is an exceedingly simple delusion, it is in a sense far more harmful to the organism and may be often far more productive of motor results in a patient than an elaborate psuedo-scientific theory such as constructed by Dr. MacCurdy's patient. It is obvious that the degree of disease does not vary directly with the simplicity of the delusion.
It seems to me that Dr. MacCurdy's work has not only theoretical interest but also practical importance from the standpoint of prognosis.
DR. WALTER B. SWIFT, Boston: I often wonder if we are not a little inclined to go too far back for explanations. In football it is recognized that the men on the field have two sets of reflexes out of which they play under different circumstances. One is a set that they have learned in the lower schools; and the other is the reflex circle that they use after they have been trained differently in college. When these men get tired it is a psychological observation that they go back to those first learned reflex mechanisms. That is, when tired, they play the football of the secondary schools. Something similar occurs in stammering. When a case is trained to have a higher reflex vocalization, and they learn to vocalize spontaneously, it inhibits their stammering. But when they get tired they revert again. In the subject under discussion are we not reaching too far back for sources? Should we not go to infancy or early childhood (to the old reflex circle there) rather than to ones we suppose are inherited?
DR. TOM A. WILLIAMS, Washington, D. C.: My remarks do not apply to the contents of the delusions, of course, but to the cerebral capacities merely which were susceptible of the formation of such delusions.