TRANSCRIBER’S NOTE

Footnote anchors are denoted by [number], and the footnotes in a chapter have been placed at the end of that chapter.

Some minor changes to the text are noted at the [end of the book.]

WORKS BY BORIS SIDIS

Nervous Ills, Their Cause and Cure.

The Foundations of Normal and Abnormal Psychology.

Symptomatology, Psychognosis, and Diag­nosis of Psychopathic Diseases.

The Causation and Treatment of Psycho­pathic Diseases.

Human Progress.

The Psychology of Suggestion.

Multiple Personality.

Psychopathological Researches.

An Experimental Study of Sleep.

Philistine and Genius.

The Psychology of Suggestion.

A Study of Galvanometric Deflections.

The Nature and Causation of the Galvanic Phenomenon.

NERVOUS ILLS

THEIR CAUSE AND CURE

BY

BORIS SIDIS, M.A., Ph.D., M.D.

MEDICAL DIRECTOR, THE SIDIS PSYCHO-
THERAPEUTIC INSTITUTE, PORTS-
MOUTH, NEW HAMPSHIRE

Author of “The Foundations of Normal and Abnormal Psychology,” “The Causation and Treatment of Psychopathic Diseases,” “Symptomatology, Psychognosis and Diagnosis of Psychopathic Diseases,” etc., etc.

BOSTON

RICHARD G. BADGER

THE GORHAM PRESS

Copyright, 1922, by Richard G. Badger

All Rights Reserved

Made in the United States of America

Press of J. J. Little & Ives Company, New York, U. S. A.

“The thing in the world I am most afraid of is fear.”

Montaigne.

[INTRODUCTION]

In this volume I give a brief, popular account of some of my work in Psychopathology, or Abnormal Psychology for the last quarter of a century. I do not refer to my work on psychopathic reflexes, moment-consciousness, moment-thresholds, multiple personality and other subjects. The reader will find all these subjects in my other works. In this volume I make an attempt to simplify matters. I lay stress on the main factors and principles of that part of Abnormal Psychology that deals with the subject of nervous ills.

It is to be regretted that some physicians, and among them many neurologists of excellent standing, hesitate to accept the work accomplished in the domain of Psychopathology, confusing the latter with what parades at present under the name of psychoanalysis. Thus a well known physician writes to me:

“I think that the majority of men in general work (medical) do not separate Psychopathology from Psychoanalysis. Freud’s theories and the whole trend of psychoanalysis have been so turned into channels of distorted and perverted sexual life that it has blinded people to the fact that there are many dominant phases in mental life which are not sexual. The ordinary, healthy minded, and vigorous practitioner sees a lot of motives in life that are not sexual, and where everything is twisted and turned to one side, to one ‘complex,’ he becomes indignant and disgusted, and condemns the whole broad subject of Psychopathology.” I think that the physician is right in his attitude.

As a matter of fact psychoanalysis, by which Freud and his adherents have baptized their sexual theories and metaphysical wish-speculations, should be regarded as savage and barbaric. Psychoanalysis is a sort of Astrology, full of superstitious symbolizations, dream vagaries, and idle interpretations, foisted on the credulous, on those obsessed by sexual inclinations, and on those suffering from sexual perversions. It is idle and credulous to search in adults for “unconscious” memories of babies a few months old. Many take up psychoanalysis as a sort of mental masturbation which in the long run is sure to play havoc with their nerve and mind.

Psychoanalysis excites the curiosity of the vulgar just as for thousands of years Astrology held the interest of semi-civilized nations to the detriment of the science of Astronomy. Psychoanalysis belongs to the class of dangerous superstitions, harmful to health, both social and individual. Psychoanalysis, like Palmistry or Oneiroscopy, that is, “interpretation of dreams,” imposes on the uncritical sense of the credulous public. Freudian psychoanalysis should be openly declared as a fraud.

Lecky points out that superstitions are not destroyed by discussion. To start a discussion in an earnest way a common ground is required. What common ground is there between science and superstition? Superstition should be left alone to die of inanition. There is no common ground between psychoanalysis and psychopathology. That is why it is just as impossible to argue with a psychoanalyst as with a Mormon or a Mohammedan. Anyone who does not accept the dogmas and superstitions of psychoanalysis is accused of “resistance of hidden complexes,” just as pious believers accuse sceptics of evil thoughts.

A famous professor of a well known eastern college asked me to continue my “good work” against psychoanalysis. But criticism of psychoanalysis is a thankless task. It is futile to discuss psychological and medical matters with psychoanalysts. For psychoanalysts care for nothing else but the fulfillment of sexual wishes. It is useless to argue with psychoanalysts, who as a rule possess no more critical sense than Mormon saints. Psychoanalysis is a sort of Mormonism. In the far West psychoanalysis is preached from the pulpits in churches. Psychoanalysis is a sex religion. One should combat it with ridicule and scorn. Psychoanalysis needs a Voltaire, a Molière, or a Swift.

The so-called present civilized humanity, and especially our populace, lives in an age of vulgarity. Success per se is the sole aim in life. Books by the thousands tell how to achieve “success,” how to fool the nerves, or how to deceive the mind. “Efficiency” and “success” fill home and school with all sorts of lucubrations and advertisements. Mental tests are supposed to help to success. Business success is the slogan. And success is only to the mediocre and the vulgar. Mediocrity writes for mediocrity, and is applauded by mobs of mediocrity. To teach the truth is a great privilege, but to deceive the ignorant and to debauch the young and inexperienced is a serious offence.

When science, literature, and art sink to the movie stage, why wonder at their triviality? When Government experts take seriously Freudian “Sublimation,” why blame the credulity of the layman? When the Bureau of Education spreads far and wide pamphlets on mental tests, why wonder at the gullibility of the populace?

The tendency towards the rule of mediocrity in the twentieth century was observed by Tolstoy:

“About twenty years ago Matthew Arnold wrote a beautiful article on the purpose of criticism. According to his opinion, it is the purpose of criticism to find what is most important and good in any book whatever, wherever, and whenever written, and to direct the reader’s attention to what is important and good in them.

“Such a criticism seems to me indispensable in our time of newspapers, periodicals, books, and advertisements. Such a criticism is requisite for the future of the cultured world.

“Printing has for some time served as the chief instrument for the diffusion of ignorance among the well-to-do (the middle classes, especially the so-called new women).

“Books, periodicals, especially the newspapers, have in our time become great financial undertakings for the success of which the largest possible number of purchasers is needed. The interests and tastes, however, of the largest possible number of purchasers are always low and vulgar. For the success of the press it is necessary that the productions should respond to the demands of the great majority of the purchasers, that is, that they should touch upon the low interests and correspond to the vulgar tastes. The press fully satisfies these demands, which it is quite able to do, since among the number of workers for the press there are many more people with the same low interests and vulgar tastes as the public than men with high interests and refined taste.

“The worst thing about it is that the reading of poor works corrupts the understanding and taste. Good works can no longer be appreciated.

“In proportion as newspapers, periodicals, and books become more and more disseminated, the value of what is printed falls lower and lower, and the class of the so-called cultured public sinks more and more into a most hopeless, self-contented, incorrigible ignorance....

“A striking example is that of the English prose writers. From the great Dickens we descend at first to George Eliot, then to Thackeray, to Trollope; and then begins the indifferent manufacture of a Rider Haggard, Kipling, Hall Caine, and so forth.

“Still more striking is this fall noticed in American literature. After the great galaxy, Emerson, Thoreau, Lowell, Whittier, and others, everything breaks off suddenly, and there appear beautiful editions with beautiful illustrations and with beautiful stories and novels which are impossible to read on account of absence of all meaning.

“The ignorance of the cultured crowd of our times has reached such a pass that great thinkers and writers of former times no longer satisfy the highly refined demands of new men (and new women).

“The last word of philosophy is the immoral, coarse, inflated, disconnected babbling of Nietzsche. Senseless, artificial conglomeration of words of decadent poems is regarded as poetry of the highest rank. The theatres give dramas, the meaning of which is not known to any one, not even to the author.”

What would Tolstoy have said had he witnessed the full blown art of our movies?

What the movies and literature accomplish in the world of art and letters, that is what psychoanalysis and mental tests achieve in normal and abnormal psychology.

The mediocrity of the modern man is akin to the vulgarity of the ancient freedman, so well described by Petronius in his type of Trimalchio. Both, the greedy freedman and the “efficient” freeman, have the same deleterious influence on the course of civilization.

Our age is not the age of Democracy, but of Mediocrity. It is in such an age that sensationalism, movies, and psychoanalysis are apt to flourish like green bay trees.

The reader will find that I often turn to Social Psychology. This is requisite. As I carry on my work on nervous ills I become more and more convinced that a knowledge of Social Psychology is essential to a clear comprehension of nervous ills.

The number of cases given in the volume will, I am sure, be of great help to the reader. For the concrete cases, carefully studied by me, bring out distinctly the mechanism, the factors, and the main principles of nervous ills.

I address this volume to the reader who wishes to learn the truth, not to those who are in search for ever new amusements, or for the “best seller” of the year. I hope that this work will prove of value to the thoughtful physician and of interest to the cultured layman.

I further hope that my reader will not be offended by my statements about superstitions. I address myself to the liberal-minded reader who does not care to follow the herd.

Boris Sidis

Maplewood Farms,
Portsmouth, New Hampshire.

[CONTENTS]

NERVOUS ILLS

THEIR CAUSE AND CURE

NERVOUS ILLS

[CHAPTER I]
SELF-PRESERVATION AND FEAR

The impulse of self-preservation is at the basis of all animal life. From the simplest lump of protoplasm constituting a microbe to the highest form of life, such as man, one meets with the same primitive life tendency,—the impulse of self-preservation. Throughout all animal creation one important purpose runs, and that is the preservation of life.

When a creature is launched into the world, it is animated with one central, innate mission,—to live; and to fight for its living. For this purpose,—if purpose it really be, the creature, however small and insignificant, is provided with a rich arsenal of armour for defense and attack. When a biologist demonstrated the anatomical structure of a caterpillar, a bystander exclaimed in surprise: “Why, I always thought that a caterpillar was nothing but skin and squash!”

The simple living creatures, swarming in the waters of stagnant ponds and murky pools, the bits of living matter, inhabiting by the million the little world of a hanging drop of water, are supplied with the most complicated reactions, mechanical and more especially chemical, for the maintenance of their life existence. Simple as a cell, a minute particle of protoplasm, may appear, it is none the less a most wonderful laboratory where toxins, anti-toxins, and an infinite variety of secretions, highly poisonous and protective, are being produced, for the keeping in existence of that insignificant, microscopic bit of living matter. Self-preservation is the central aim of all life-activities.

The tendency of all organic processes is the maintenance of the life of each particular individual organism. It is this aspect that I wish to impress on the minds of my readers. Self-preservation is the nucleus of organic life. It is the mainspring of organic activities and functions. The tendency of life is not the preservation of the species, but solely the preservation of each individual organism, as long as it is in existence at all, and is able to carry on its life processes.

Every living thing, from the ultra-microscopic to the highest and most complex multicellular organism, man included, has only one fundamental tendency, the maintenance and defense of its individual existence. The claim that the individual counts for little or nothing, and that the species is everything, is not true to facts. “Nature cares not for the individual, but for the species” is a glittering generality of a metaphysical character.

It is the maintenance of its individual existence and the struggle for this individuality and its preservation, whether in defense or aggression, that form the main object of organic life in all its aspects. The aim of life activities is the individual, the species is a secondary matter. It is only when we keep this fundamental truth in mind that we begin to understand life in general, and human life in particular.

The struggle for existence of which so much is heard in modern science, theoretical or applied, means really the preservation of the individual organism, or the self-preservation of individuality. We may say that the struggle for existence in the biological and social worlds means nothing else but the Struggle for Individuality.

Wherever the organism forms a whole as to its vitality, whether it be an amoeba or a man, the struggle is for the maintenance of that whole or of that particular individual organism. All the structures and functions go to the preservation of that individuality, or of that individual organic self, constituting the impulse of self-preservation in the total activity of the particular individual organism. The great number of physico-chemical and mechanical processes, adaptations and adjustments of inner structures and functions, as well as the different reactions to the stimuli of external environment, even in the lowest of micro-organisms, are for the whole of the individuality.

When organisms take to forms of social life the fundamental aim is still the protection or self-preservation of the individual. The community is an additional defense of the individual against a hostile environment. Thus the herds of Damara cattle, or of social aggregates of other animals, offer greater protection to each individual animal. The individual wolf running in packs has more power for attack and defense. The individual man has more forces for aggression and for protection by living in a social medium which provides the individual with more sensory organs for observation of danger and with more organs for defense and attack, than in isolated states. The herd, the pack, the horde, the society are for the self-preservation of the individual.

It has been shown on good grounds that the very sense of external reality has become intensified in the individual by his capacity of living in a social aggregate. The social aggregate strengthens each individual member of the group. The individual is not for the group, but the group is for self-preservation of the individual. Should the individual lose his self-protection, or even have his impulse of self-preservation lowered, the whole aggregate faces ultimate destruction. That is why when in a social aggregate the impulse of self-preservation becomes limited, inhibited, and lowered by tyranny of social commandments, society is sure to decline, degenerate, and finally dissolve; or fall a victim to an external invader,—the fate of tribes, communities, and nations in the past and the present. The moving power of life is self-preservation of the individual.

A close study of life in general and of animal life in particular brings one to the inevitable conclusion that life in all its forms has self-preservation as its fundamental principle. Self-preservation is the main impulse, the prime mover of life. The prime mover of life is not the impulse of species preservation, or of sex, but the impulse of self-preservation of the individual organism.

Self-preservation has two aspects, the positive and the negative. In the positive form the primitive impulse is to keep the individual alive, to keep the functions and structure in normal condition, to conduce to the full development and harmonious activity of the individual. The negative form of the preservative impulse is the preservation from injury, degeneration, destruction, and death. This negative aspect of the impulse of self-preservation expresses itself in the higher animals in the form of fear.

The fear instinct is an essential constituent of the impulse of life. We may call the fear instinct the guardian of all sentient being. Wherever there is the least scent or even the least suggestion of danger, there the instinct of fear is aroused. Fear is the companion following close on the heels of the impulse of self-preservation.

Since every animal is always surrounded by enemies, and since every strange thing or strange occurrence is a menace or possible signal of danger, the fear instinct is aroused on all strange occasions. The fear instinct requires the slightest stimulus to start into function.

While most of the instincts require special conditions, and are usually periodic, the fear instinct is ever present and can be awakened on all occasions, and under any circumstances. Anything unfamiliar,—darkness, a state of exhaustion, weakness, fatigue, arouses the fear instinct, startling the animal into running, hiding, crouching, and preparation for attack or defense.

The fear instinct stays with us, and watches over us day and night. It follows us closely in our active, waking life, attends us in our resting hours, and watches over us in our sleeping periods. The fear instinct is the last to fall asleep, and the first to awake. The fear instinct follows us like our shadow, with the only difference that it constantly affects our actions, hardly ever leaves us alone, and keeps steady vigilance over our life activities. The reason for this apparently strange companionship is the fact that the fear instinct is the primitive instinct of the life impulse, the impulse for self-preservation.

The overwhelming intensity of the fundamental impulse of self-preservation is well described by the great writer Dostoevsky, whose insight into the psychology of human life and especially into abnormal mental life transcends that of any other writer: “Where is it I have read that someone condemned to death says or thinks, an hour before his death, that if he had to live on some high rock, on such a narrow ledge that he had only room to stand, and the ocean, everlasting darkness, everlasting solitude, everlasting tempest around him, if he had to remain standing on a square yard of space all his life, a thousand years, eternity, it were better to live so than to die at once! Only to live, to live, and live! Life whatever it may be!”

Just as the touch and pain nerves enmesh closely our body, warning us against hurtful stimulations, so we may say that fear, through our distant receptors of sight, hearing and smell, surrounds us, warning us against enemies, or inimical, suspicious objects, and forces. Were it not for the fear instinct, directly awakened, the animal threatened with danger would not have the time and the strong impulse to get ready for defense or for escape, by running or by hiding.

The fear instinct is of the utmost importance in animal life. Looked at from this standpoint the fear instinct is as important in animal economy as the skin which covers our body, which, by pain and hurts, warns of external injurious objects, and has an important function of warding off incessant invasion of disease-bearing organisms. In nervous ills we find the same fundamental factors:—self-preservation and the fear instinct.

[CHAPTER II]
STAGES OF FEAR

The fear instinct in its course of development passes through three stages:

In its milder forms when the fear instinct is but nascent, it serves as a sort of trigger to the activities of the organism. The animal may for a moment stop whatever activities and pursuits in which it happens to be engaged, and have its interest turn in the direction of the particular new stimulus, whether it be of an auditory, visual, or olfactory character. The fear instinct is just strong enough to suspend present interests, and direct its activities to the new source of the unknown stimulus.

When the source is unfamiliar, the animal becomes prepared for action. The energies are aroused for attack, or for hiding, freezing, or running, according to the mode of defense to which the animal has been adapted in its adjustments to the stimulations of its environment. The lion, the tiger, the skunk, the snake, the bird, the rabbit, the squirrel will act differently, according to their natural disposition in response to external objects and stimuli.

While the motor system may react differently in various animals, the fear instinct is alike in all of them. This stage of the fear instinct should be regarded as the healthy physiological reaction to strange and new stimuli, and is essentially protective, inasmuch as it serves for the arousal of energy and proper reactions of self-defense, characteristic of the particular individual.

In its milder forms the fear instinct is normal, physiological, and healthy in its reactions. In fact, the absence of it is rather pathological. It is quite natural that under the influence of some danger, the organism may feel the urging of this vital instinct, the consequent of the fundamental life impulse, and feel it as a stimulus rather than as a deterrent experience, feel fear as the key for the unlocking of energies in defense or attack. Such a reaction is healthy and strictly requisite in the total economy of life.

When I advanced the theory that the fear instinct is at the bottom of functional psychosis, or of psychopathic maladies, some jumped to the conclusion that I regarded the fear instinct as abnormal, giving rise to pathological states under all conditions and circumstances. This is not correct. The fear instinct in its initial stages is perfectly normal, and is as indispensable to life as hunger and thirst. It is only in the more advanced and extreme stages that the fear instinct becomes pathological, and is apt to give rise to psychopathic states.

In the arrestive or inhibitory state, the innervation of the voluntary and the involuntary muscular systems is arrested, or weakened. There is tremor and even convulsive contractions, the voluntary reactions are affected, and are carried out with some difficulty; there is cardiac arrhythmia, the respiration is irregular; there may be chattering of the teeth; the various bodily secretions are interfered with, and the vaso-motor nerves as well as the general vascular structures are thrown into disorder. Peristalsis, intestinal secretions, and the innervation of the sympathetic nervous system may become affected, first by inhibition, and then by irregular functioning. Associative mental or cerebral activity becomes arrested, confused; memory is disturbed, and the whole personality or individuality appears in a state of dissociation, accompanied by a lack of precision and lack of exactness of neuromuscular adaptations. The delicate reactions and adaptations are specially affected.

If this stage of fear instinct does not become intensified, the organism recovers its control,—many of the disturbances pass away, and the following reaction may come with a greater release of energy, developing a greater output of activity than under normal conditions. In short, the fear instinct may still serve as a stimulation to greater effort, but the chances of such a result are far smaller than in the first stage, which is essentially of a stimulating, useful, and healthful character.

The second stage of the fear instinct is the possibility of a pathological state, and, if persistent, leads directly to the third stage with consequent paralysis and danger of destruction. The first stage of fear is fully normal, helpful, and self-defensive. The second stage is harmful, but with the possibility of recovery and restitution of normal function. The third stage leads to destruction and death.

In the third stage there is paralysis of function of most of the muscular, secretory, excretory, circulatory, intestinal, and nervous systems. The animal is petrified with fear, and falls into a state of paralysis, rigidity, cataplexy, or in a state simulating death. This last stage of the effects of the fear instinct is pathological, and instead of conducing to the good of the individual, really leads to his destruction and death. The fear instinct in its extreme cases is not a help to the organism, but is distinctly a hindrance, and is felt as such by the organism which experiences it.

The fear instinct, which originally is a stimulating agent for self-defense, when in excess becomes a danger hastening the dissolution of the animal organism into its constituent parts. The intensity of the fear instinct is the expression of the fact that the organism is in imminent danger of destruction. The fear instinct in its extreme state is decidedly to the disadvantage of the animal.

Of course, it may be claimed that the paralysis and inhibition stages might have been of service or of protective value in the lower forms of life, when mimicking death or freezing prevented the animal from being noticed. This may possibly hold true in the cases of lower forms, but in the higher forms the fear instinct in its third stage, by bringing about inhibitions and paralysis of the vital functions, is decidedly of disservice to the organism, and leads to its destruction and death.

[CHAPTER III]
THE PRIMACY OF FEAR

The fear instinct is intimately related to the innermost principle, characteristic of all life, namely the impulse of self-preservation. When, however, the fear instinct becomes deranged by being too intense, and especially when reaching the extreme stage, the instinct becomes pathological, and its functioning leads to degeneration, destruction, and death. Even in its initiatory stages the fear instinct may become abnormal, when associated with objects, situations, and sensori-motor reactions which are otherwise normal and beneficial, or actually requisite in the total economy of life activity of the particular organism. Under such conditions the fear instinct is decidedly pathological.[1]

In fact we may say that the fear instinct is the main source of functional, psychopathic diseases. This also holds true of the individual in his aggregate capacity. If the impulse of self-preservation is at the basis of life, the fear instinct is its intimate companion. We may unhesitatingly assert that the fear instinct is one of the most primitive instincts of animal life. We are sometimes apt to overlook the power of fear, because our life is so well guarded by the protective agencies of civilization that we can hardly realize the full extent, depth, and overwhelming effects of the fear instinct. Fear is rooted deep in the nature of animal life, in the impulse of self-preservation.

The fear instinct is the earliest instinct to appear in child life. Preyer observed definite manifestations of the fear instinct on the twenty-third day after birth. Perez and Darwin put its appearance somewhat later. In my observations of child life I found the manifestation of the fear instinct during the first couple of weeks, Ribot and other psychologists regard the fear instinct as “the first in chronological order of appearance.”

“The progress from brute to man,” says James, “is characterized by nothing so much as the decrease in the frequency of the proper occasion for fear. In civilization in particular it has at last become possible for large numbers of people to pass from the cradle to the grave without ever having had a pang of genuine fear. Many of us need an attack of mental disease to teach us the meaning of the word. Hence the possibility of so much blindly optimistic philosophy and religion. (James refers here to the blind optimism and cheerful metaphysical mysticism handed out to the uncultured classes.) Fear is a genuine instinct, and one of the earliest shown by the human child.”

The fear of the unknown, of the unfamiliar, of the mysterious, is of the utmost consequence in the life history of children, savages, and barbaric tribes, and even in the social life of civilized nations. The fear of coming mysterious, unknown evil is a source of great anxiety to the young, or to the untrained, uncultivated minds. All taboos of primitive societies, of savages, of barbarians, and also of civilized people take their origin, according to anthropological research, in the perils and salvation of the soul, or in the fear of impending evil. As an anthropologist puts it: “Men are undoubtedly more influenced by what they fear than by what they love.”

The civilized nations of antiquity used to be terrorized by omens, by occurrences of an unfamiliar character, such as storms, thunders, lightnings, comets, meteors, meteorites, and eclipses. Affairs of states and wars were guided by superstitions of fear. Whole armies used to throw away their weapons and run panic-stricken at the appearance of meteorites, meteors, and especially of comets. Even the ancient Athenians were influenced by strange, meteorological phenomena. On the appearance of a solar eclipse Pericles saved his ship by throwing his mantle round the helmsman, telling him that that was all that an eclipse was, and that there was no reason to be scared by the veiling of the sun from us. The father of pragmatic history, the great Thucydides, in his history of the Peloponnesian wars, puts the appearance of comets among national disasters.

The fear of the mysterious, the unknown, and the unfamiliar is a source of anxiety and distress in the young, or in the untrained and uncultured minds. Fear may become fixed and morbid when taking place in early childhood, when not inhibited by the course of further development, and, all the more so, when kept up by further events of life.

In most people the instinct of fear is controlled, regulated by education, and inhibited by the relatively secure life led in the herd, pack, group, and society generally. The instinct of fear, however, is but dormant and requires the opportune moment such as a social, mental epidemic, a “group-panic,” to become manifested in its full intensity, giving rise to a morbid state of the “group-mind,” or “herd-mind.”

There are again cases when even under ordinary conditions fear becomes developed in the individual from early childhood either by lack of inhibitory training or by accidents in early child life. In all such cases the fear instinct becomes morbid, giving rise in later life to various forms of mental disease known as psychopathies, or recurrent morbid states.

We can, therefore, realize the full significance of the principle laid down by one of the greatest thinkers of humanity, Plato, that to learn “What to fear and what not to fear” is of the utmost consequence to the individual, both in his private and social activities.

Throughout the whole domain of the animal kingdom anything strange and unfamiliar is an occasion for the awakening of the fear instinct. The strange, the unfamiliar may be detrimental to the organism, and the animal recoils from meeting it directly. There must be exploration made before the reaction of approach can be effected. We find the same tendency in children and savages who run in terror of anything unusual.

On the whole escape is probably the safest course, since the unfamiliar may prove of great danger. The well known saying “Familiarity breeds contempt” has its significance in that the familiar does not arouse the fear instinct, and can be approached without risk. Reactions to a familiar object or known situation run in well established, habitual grooves.

In man the sense of familiarity may be acquired by the use of intelligence, by observations of various forms of unfamiliar situations and strange objects. Reason, leading to the understanding of the causes of things, turns the strange and unfamiliar into the familiar and the known, and thus dispels the terrors and horrors of the fear instinct.

The function of the intellect is to conquer the world by making man at home and familiar in this “wild universe.” This is the course of human progress. “The aim of knowledge,” says Hegel, “is to divest the objective world of its strangeness, and to make us more at home in it.” In the words of the ancient poet:

Felix qui potuit rerum cognoscere causas,

Atque metus omnes, et inexorabile fatum,

Subject pedibus, strepitumque Acherontis avari.[2]

FOOTNOTES:

[1] See Chapter “Psychopathic Reflexes” in my volume “The Causation and Treatment of Psychopathic Diseases.”

[2] Happy is he who knows the causes of things, who can trample on fear, inexorable fate, and the horrors of death.

[CHAPTER IV]
FEAR AND SUPERSTITION

An individual limited in intelligence, leading a narrow life, is specially subject to fear suggestions which can be easily aroused. Inhibitions of the personal self are produced by stimulation of the fear instinct with consequent easy access, by means of fear suggestions, to man’s subconscious fear instinct, thus inducing various forms of morbid mental life.

When a person is limited in his interests, when he is ignorant and full of prejudices and superstitions, his critical, personal sense is embryonic, and the predisposition to fear suggestions is specially pronounced. He easily falls a victim to all kinds of bizarre beliefs and absurd superstitions, such as the mysticism which obsesses uncultured classes of all ages.

The optimistic, “metaphysical” beliefs, rampant in this country, are all due to the beggarly intelligence subconsciously obsessed by innumerable fear suggestions. Neurotic adherents cling to their irrational optimism in order to assuage the pangs, caused by the fear instinct, from which they are unable to free themselves.

In the embryonic personality of the child, as well as in the undeveloped or narrowed individuality of the adult, the sense of the strange, of the unknown, and of the mysterious, is apt to arouse the fear instinct. In fact, the unfamiliar arouses the fear instinct even in the more highly organized mind.

“Any new uncertainty,” says Bain, “is especially the cause of terror. Such are the terrors caused by epidemics, the apprehensions from an unexperienced illness, the feeling of a recruit under fire. The mental system in infancy is highly susceptible, not merely to pain, but to shocks and surprises. Any great excitement has a perturbing effect allied to fear. After the child has contracted a familiarity with the persons and things around it, it manifests unequivocal fear on the occurrence of anything strange. The grasp of an unknown person often gives a fright. This early experience resembles the manifestations habitual to the inferior animals.”

In another place Bain rightly says, “Our position in the world contains the sources of fear. The vast powers of nature dispose of our lives and happiness with irresistible might and awful aspect. Ages had elapsed ere the knowledge of law and uniformity prevailing among those powers was arrived at by the human intellect. The profound ignorance of the primitive man was the soil wherein his early conceptions and theories sprang up; and the fear inseparable from ignorance gave them their character. The essence of susperstition is expressed by the definition of fear.”

Compayré, in speaking of the fear of the child, says, “In his limited experience of evil, by a natural generalization, he suspects danger everywhere like a sick person whose aching body dreads in advance every motion and every contact. He feels that there is a danger everywhere, behind the things that he cannot understand, because they do not fit in with his experience.

“The observations collected by Romanes in his interesting studies on the intelligence of animals throw much light on this question; they prove that dogs, for instance, do not fear this or that, except as they are ignorant of the cause. A dog was very much terrified one day when he heard a rumbling like thunder produced by throwing apples on the floor of the garret; he seemed to understand the cause of the noise as soon as he was taken to the garret, and became as quiet and happy as ever.

“Another dog had a habit of playing with dry bones. One day Romanes attached a fine thread which could hardly be seen, to one of the bones, and while the dog was playing with it, drew it slowly towards him; the dog recoiled in terror from the bone, which seemed to be moving of its own accord. So skittish horses show fright as long as the cause of the noise that frightens them remains unknown and invisible to them.

“It is the same with the child. When in the presence of all the things around him, of which he has no idea, these sounding objects, these forms, these movements, whose cause he does not divine, he is naturally a prey to vague fears. He is just what we should be, if chance should cast us suddenly into an unexplored country before strange objects and strange beings—suspicious, always on the qui vive, disposed to see imaginary enemies behind every bush, fearing a new danger at every turn in the road.”

Similarly, Sully says, “The timidity of childhood is seen in the readiness with which experience invests objects and places with a fear-exciting aspect, in its tendency to look at all that is unknown as terrifying, and in the difficulty of the educator in controlling these tendencies.”

Sully is right in thinking that education tends greatly to reduce the early intensity of fear. “This it does by substituting knowledge for ignorance, and so undermining that vague terror before the unknown to which the child and the superstitious savage are a prey, an effect aided by the growth of will power and the attitude of self-confidence which this brings with it.” An uncultivated personality with a limited mental horizon, with a narrow range of interests, a personality trained in the fear of mysterious agencies, is a fit subject for obsessions.

In certain types of functional psychosis and neurosis the patient has an inkling of the fear instinct in his dread of objects, or of states of mind, lack of confidence, blushing, expectations of some coming misfortune and some mysterious evil, but he is not aware of the fear instinct as developed in him by the events and training of early childhood. The fears of early childhood are subconscious. At any rate, the patient does not connect them with his present mental affection.

In other types of psychopathic affections the patient is entirely unaware of the whole situation, he is engrossed by the symptoms which he regards as the sum and substance of his trouble; the fear is entirely subconscious. Frights, scares, dread of sickness, instructions associated with fear of the mysterious and unseen, injunctions with fear of punishment or failure in moral standards, enforcement of social customs with dread of failure and degradation,—all go to the cultivation of the fear instinct which in later life becomes manifested as functional psychosis or neurosis.

Functional psychosis or neurosis is an obsession, conscious and subconscious, of the fear instinct. Thus one of my patients became obsessed with fear of tuberculosis, manifesting most of the symptoms of “consumption,” after a visit to a tubercular friend. Another patient was obsessed by the fear of death after visiting a sick relative of his in one of the city hospitals. Another became obsessed with the fear of syphilis after having been in contact with a friend who had been under antiluetic treatment. Still another of my patients, in addition to the fear of darkness, became obsessed with the fear of stars, and also with a fear of comets, regarded by some people as poisoning the air with noxious gases.

In all such cases anxiety and dread were present, but in none of the patients have I found an insight into the real state of the mind. In all of them the fear was traced to early childhood, to early experiences of the fear instinct, fostered and fortified by unfavorable conditions. In all of those fears there was a long history of a well-developed subconscious fear instinct.

I may assert without hesitation that in all my cases of functional psychosis, I find the presence of the fear instinct to be the sole cause of the malady. Take away the fear and the psychosis or neurosis disappears.

The fear instinct arises from the impulse of self-preservation without which animal life cannot exist. The fear instinct is one of the most primitive and most fundamental of all instincts. Neither hunger, nor sex, nor maternal instinct, nor social instinct can compare with the potency of the fear instinct, rooted as it is in self-preservation,—the condition of life primordial.

When the instinct of fear is at its height, it sweeps before it all other instincts. Nothing can withstand a panic. Functional psychosis in its full development is essentially a panic,—it is the emergence of the most powerful of all instincts, the fear instinct.

Functional psychosis or neurosis is a veiled form of the fear of death, of destruction, of loss of what is deemed as essential to life, of fear of some unknown, impending evil. How many times has it fallen to my share to soothe and counteract the fear instinct of panic-stricken psychopathic patients! A psychogenetic examination of every case of functional psychosis brings one invariably to the fundamental fear instinct.

Conflicts, repressions, imperfections, sex-complexes, sex-aberrations, and others do not produce psychopathic symptoms or neurotic states. It is only when mental states become associated with an exaggerated impulse of self-preservation and an intensified fear instinct that neurosis arises.

A close study of every neurotic case clearly discloses the primary action of those two important factors of life activity,—self-preservation and fear instinct.

[CHAPTER V]
THE POWER OF FEAR

The function of fear is quite clear. Fear is the guardian instinct of life. The intensity of the struggle for existence and the preservation of life of the animal are expressed in the instinct of fear. The fear instinct in its mild form, when connected with what is strange and unfamiliar, or with what is really dangerous to the animal, is of the utmost consequence to the life existence of the animal. What is strange and unfamiliar may be a menace to life, and it is a protection, if under such conditions the fear instinct is aroused.

Again, it is of the utmost importance in weak animals, such as hares or rabbits, to have the fear instinct easily aroused by the slightest, strange stimulus: the animal is defenseless, and its refuge, its safety, is in running. The unfamiliar stimulus may be a signal of danger, and it is safer to get away from it; the animal cannot take chances.

On the other hand, animals that are too timid, so that even the familiar becomes too suspicious, cannot get their food, and cannot leave a progeny,—they become eliminated by the process of natural selection. There is a certain amount of trust that nature demands even of its most defenseless and timid children.

Animals in whom the fear instinct can be aroused to a high degree become paralyzed and perish. Under such conditions the fear instinct not only ceases to be of protective value, but is the very one that brings about the destruction of the animal possessed by it. Intense fear paralyzes the animal.

“One of the most terrible effects of fear,” says Mosso, “is the paralysis which allows neither of escape nor defense. Not all the phenomena of fear can be explained on the theory of natural selection. In their extreme degree they are morbid phenomena, indicating imperfection of the organism. One might almost say that nature had not been able to find a substance for brain and spinal cord which should be extremely sensitive, and yet should never, under the influence of exceptional or unusual stimuli, exceed in its reactions those physiological limits which are best adapted to the preservation of the animal.” Mosso quotes Haller to the effect that “phenomena of fear common to animals are not aimed at the preservation of the timid, but at their destruction.”

The fear instinct is no doubt one of the most fundamental and one of the most vital of animal instincts, but when it rises to an extreme degree, or when associated with familiar instead of strange and unfamiliar objects, then we may agree with Haller that the phenomena are not aimed at the preservation of the animal, but at its destruction; or, as Darwin puts it, are of “disservice to the animal.” This is just what is found in the case of psychopathic or neurotic affections. The fear instinct, when aroused and cultivated in early childhood, becomes associated in later life with particular events, objects, and special states.

When the instinct of fear is aroused in connection with some future impending misfortune, the feeling of apprehension with all its physiological changes, muscular, respiratory, cardiac, epigastric, and intestinal, goes to form that complex feeling of anxiety so highly characteristic of the acute varieties of psychopathic maladies. When fear reaches its acme, the heart is specially affected; circulatory and respiratory changes become prominent, giving rise to that form of oppression which weighs like an incubus on the patient,—the feeling known as “precordial anxiety.”

The fear instinct is the ultimate cause of functional psychosis,—it is the soil on which grow luxuriantly the infinite varieties of psychopathic disturbances. The body, sense, intellect, and will are all profoundly affected by the irresistible sweep of the fear instinct, as manifested in the overwhelming feeling of anxiety. The fear instinct and its offsprings—hesitation, anxiety, conflicts and repressions—weaken, dissociate, and paralyze the functions of the body and mind, producing the various symptoms of psychopathic diseases. The fear instinct keeps on gnawing at the very vitals of the psychopathic patient.

Even at his best the psychopathic patient is not free from the workings of the fear instinct, from the feeling of anxiety which, as the patients themselves put it, “hangs like a cloud on the margin or fringe of consciousness.” From time to time he can hear the distant, threatening rumbling of the fear instinct. Even when the latter is apparently stilled, the pangs of anxiety torment the patient like a dull toothache.

Montaigne, writing of fear, says, “I am not so good a naturalist (as they call it) as to discern by what secret springs fear has its motion in us; but be this as it may, it is a strange passion, and such a one as the physicians say there is no other whatever that sooner dethrones our judgment from its proper seat; which is so true, that I myself have seen very many become frantic through fear; and even in those of the best settled temper, it is most certain that it begets a terrible confusion during the fit. Even among soldiers, a sort of men over whom, of all others, it ought to have the least power, how often has it converted flocks of sheep into armed squadrons, reeds and bullrushes into pikes and lances, and friends into enemies....

“The thing in the world I am most afraid of is fear. That passion alone, in the trouble of it, exceeding all other accidents. Such as have been well banged in some skirmish, may yet, all wounded and bloody as they are, be brought on again the next day to the charge; but such as have once conceived a good sound fear of the enemy will never be made so much as to look the enemy in the face. Such as are in immediate fear of losing their estates, of banishment or of slavery, live in perpetual anguish, and lose all appetite and repose. And the many people who, impatient of perpetual alarms of fear, have hanged or drowned themselves, or dashed themselves to pieces, give us sufficiently to understand that fear is more importunate and insupportable than death itself.”

A well known writer, who is a psychopathic sufferer, writes: “Carlyle laid his finger upon the truth, when he said that the reason why the pictures of the past were always so golden in tone, so delicate in outline, was because the quality of fear was taken from them. It is the fear of what may be and what must be that overshadows present happiness; and if fear is taken from us, we are happy. The strange thing is that we can not learn not to be afraid, even though all the darkest and saddest of our experiences have left us unscathed; and if we could but find a reason for the mingling of fear with our lives, we should have gone towards the solving of the riddle of the world.”

Anxiety states of neuroses and psychoses are essentially clue to the awakening of the fear instinct, normally present in every living being. The fear instinct is a fundamental one; it is only inhibited by the whole course of civilization and by the training and education of life. Like the jinn of the “Arabian Nights,” it slumbers in the breast of every normal individual, and comes fully to life in the various neuroses and psychoses.

Kraepelin and his school lay special stress on the fact that “Fear is by far the most important persistent emotion in morbid conditions.... Fear is manifested by anxious excitement and by anxious tension.” “Experience,” says Kraepelin, “shows an intimate relationship between insistent psychosis and the so-called ‘phobias,’ the anxiety states which in such patients become associated with definite impressions, actions, and views.” The states are associated with the thought of some unknown danger. Violent heart action, pallor, a feeling of anxiety, tremor, cold sweat, meteorisms, diarrhœa, polyuria, weakness in the legs, fainting spells, attack the patient, who may lose control of his limbs and occasionally suffer complete collapse.

“These states,” says Kraepelin, with his usual insight into abnormal mental life, “remind one of the feeling of anxiety which in the case of healthy people may, in view of a painful situation or of a serious danger, deprive one of the calmness of judgment and confidence in his movements.”

Thus, we find from different standpoints that the feeling of anxiety with its accompanying phenomena is one of the most potent manifestations of animal instincts, the fear instinct, which is at the basis of all psychopathic, neurotic maladies.

The fear instinct, as the subtle and basic instinct of life, is well described by Kipling:—

Very softly down the glade runs a waiting, watching shade,

And the whisper spreads and widens far and near;

And the sweat is on thy brow, for he passes even now—

He is Fear, O Little Hunter, he is Fear!

Ere the moon has climbed the mountain, ere the rocks are ribbed with light,

When the downward dipping trails are dank and drear,

Comes a breathing hard behind thee—snuffle—snuffle through the night—

It is Fear, O Little Hunter, it is Fear!

On thy knees and draw the bow; bid the shrilling arrow go:

In the empty, mocking thicket plunge the spear;

But thy hands are loosed and weak, and the blood has left thy cheek—

It is Fear, O Little Hunter, it is Fear!

When the heat-cloud sucks the tempest, when the slivered pine trees fall,

When the blinding, blaring rain-squalls lash and veer;

Through the war gongs of the thunder rings a voice more loud than all—

It is Fear, O Little Hunter, it is Fear!

Now the spates are banked and deep; now the footless boulders leap—

Now the lightning shows each littlest leaf-rib clear;

But thy throat is shut and dried, and thy heart against thy side

Hammers: Fear, O Little Hunter,—This is Fear!

It is interesting to learn what a practical and thoughtful surgeon, such as George Crile, has to say on the matter of fear. Dr. Crile lays stress on the facts that in his researches he finds evidence that the phenomena of fear have a physical basis similar to those morphological changes in the brain cells observed in certain stages of surgical shock and in fatigue.... That the brain is definitely damaged by fear may be proved by experiments.

“According to Sherrington the nervous system responds in action as a whole, and to but one stimulus at a time.... Under the influence of fear or (fear of) injury the integration of the common path is most nearly absolute.... Hence fear and injury (or fear of injury) drain the cup of energy to the dregs....

“We can understand why it is a patient consumed by fear suffers so many bodily impairments, (so many functional disturbances) and diseases even. We can understand the grave digestive and metabolic disturbances under strain of fear.... We can understand the variations in the gastric analyses in a timid patient alarmed over his condition and afraid of the hospital. The patient is integrated by fear, and since fear takes precedence over all other impulses, no organ can function normally (under the influence of fear)” ... Dr. Crile arrives at the conclusion that “Fear dominates the various organs and parts of the body....”

Dr. Crile lays special stress on the pathological character of the fear instinct: “That the brain is definitely influenced, damaged even, by fear has been proved by the following experiments: Rabbits were frightened by a dog, but were neither injured nor chased. After various periods of time the animals were killed and their brain cells compared with the brain cells of normal animals, wide-spread changes were seen (in the brain cells of the animals affected by fear). The principal clinical phenomena expressed by the rabbits were rapid heart, accelerated respiration, prostration, tremors, and a rise in temperature. The dog showed similar phenomena, excepting that, instead of such muscular relaxation as was shown by the rabbit, it exhibited aggressive muscular action.”

Animals in which the fear instinct can be aroused to a high degree become paralyzed and perish. The animal mechanism is by no means perfect. A stab in the heart, a rip in the abdomen, a cut of the carotids, a prick in the medulla, a scratch of a needle infected with anthrax, or tetanus bacilli, a drop of hydrocyanic acid, an arrow tipped with curare, extinguish every spark of life. Organic material may be delicate and complex, but for that reason it is highly imperfect and vulnerable.

Living matter is the feeblest material in nature, and is as fragile as a delicate crystal vase. Protoplasm, or living matter, may be wonderful material, but it can be crushed with a pebble. The most beautiful colors may be displayed by a thin, delicate bubble, but it bursts at the least touch. Living matter is like a bubble, like foam on the ocean. Perhaps no better material is available for the functions of life.

Meanwhile it remains true that the flimsiness of living material makes it easily subject to decay and destruction. It is a profound error, having its root in prejudice, that nature always helps, and that the processes going on in the organism are always of benefit to the individual. Nature is as ready to destroy life as to protect it.

Preservation or destruction of a particular individual depends on the fact as to whether or no normal or pathological processes predominate in the total economy of the organism. This holds true of the fear instinct. The fear instinct is a delicate mechanism, and when its action is slightly intensified, the animal is on the way to destruction. For the cosmic forces are careless of the creatures which keep on pouring forth in generous profusion from the lap of nature.

Living matter, or protoplasm can only exist under special, restricted conditions,—the least variation means death. The more complicated, and more organized protoplasm is, the more restricted are the conditions of its existence. A rise of a couple of degrees of temperature or a fall means disease and death. The same holds true of the rise and fall of quantity and quality of bodily secretion of glands and of other organs. Protoplasm can only exist in an optimum environment. Any change spells disease and death.

The fear instinct, being at the heart of highly organized life activities, is delicately responsive to any changes and variations from the optimum, requisite for the proper functioning of the organism. Any deviation from the optimum environment, external or internal, produces corresponding changes in the fear instinct with consequent pathological changes in the organism.

The fear instinct like a delicate indicator is the first to get deranged, with harmful results to the organism as a whole. We can thus realize the importance of keeping the fear instinct in good condition. We can understand the significance of Plato’s doctrine of rational guidance of the fear instinct. “What to fear and what not to fear” is at the basis of all organized life, individual and social.[3]

FOOTNOTE:

[3] See my work “The Source and Aim of Human Progress.”

[CHAPTER VI]
FEAR AND DISEASE

If we examine closely the symptoms of fear, we invariably find the symptoms of functional psychosis or neurosis. Fear affects the muscular and sensory systems, the vasomotor system, the respiratory system, the sudorific glands, the viscera, the heart, the intestines, all organs and functions of the organism.

Bain, in describing the emotions of fear or terror, says, “Terror on the physical side shows both a loss and a transfer of nervous energy. The appearances may be distributed between the effects of relaxation and effects of tension. The relaxation is seen, as regards the muscles, in the dropping of the jaw, in the collapse overtaking all organs not specially excited, in trembling of the lips and other parts, and in the loosening of the sphincters. Next, as regards the organic processes and viscera. The digestion is everywhere weakened; the flow of saliva is checked, the gastric secretion arrested (appetite failing), the bowels deranged; the respiration is enfeebled. The heart and circulation are disturbed; there is either a flushing of the face or a deadly pallor. The skin shows symptoms—the cold sweat, the altered odor of the perspiration, the creeping action that lifts the hair. The kidneys are directly or indirectly affected. The sexual organs feel the depressing influence. The secretion of milk in the mother’s breast is vitiated.”

Darwin gives the following description of fear:—

“The frightened man at first stands like a statue, motionless and breathless, or crouches down as if to escape observation. The heart beats quickly and violently, but it is very doubtful if it then works more efficiently than usual so as to send a greater supply of blood to the body; for the skin instantly becomes pale, as during incipient faintness. The paleness of the surface, however, is probably in large part or is exclusively due to the vasomotor center being affected in such a manner as to cause the contraction of the small arteries of the skin. That the skin is much affected under the sense of great fear we see in the marvelous manner in which the perspiration immediately exudes from it. This exudation is all the more remarkable as the surface is then cold, and hence the term, a cold sweat; whereas the sudorofic glands are properly excited into action when the surface is heated. The hairs also on the skin stand erect, and the superficial muscles shiver. In connection with the disturbed action of the heart the breathing is hurried. The salivary glands act imperfectly; the mouth becomes dry and is often opened and shut. I have also noticed that under slight fear there is a slight tendency to yawn. One of the best symptoms is the trembling of all the muscles of the body. From this cause and from the dryness of the mouth, the voice becomes husky or indistinct, or may altogether fail.”

If we turn now to the manifestations of psychopathic maladies, we meet with the same fear symptoms:—

(a) The attacks may be muscular, involving symptoms such as trembling, shaking, paresis, paralysis, or rigidity; there may be affection of locomotion or of muscular co-ordination.

(b) There may be sensory disturbances,—anesthesia, paresthesia, analgesia, or hyperalgesia as well as affection of muscular sense and kinesthesia.

(c) There may be skin disturbances, such as arrest of perspiration or profuse perspiration, especially under the influence of emotions, worry, and fatigue; such perspiration may also occur at night, and in some cases the fear of tuberculosis may be associated with such conditions.

(d) The lungs may become affected functionally, and there may occur respiratory disturbances; coughing, hawking, apnea, dyspnea, and asthmatic troubles.

(e) The heart becomes affected, bringing about precordial pain; palpitation of the heart, bradycardia, tachycardia, and cardiac arrhythmia.

(f) The stomach and intestines become affected, indigestion and vague fugitive soreness and pain may be experienced all over or in special regions of the abdomen; constipation or diarrhea may ensue.

(g) The renal apparatus may become affected and its activity arrested, or, as is more often the case in the milder forms of psychopathic troubles, there may be present an alteration in the amount or frequency of micturition, such as is found in the conditions of anuria and polyuria.

(h) Menstruation becomes disturbed, and we may meet with conditions of dysmenorrhea, amenorrhea, menorrhagia, and other disturbances of the tubes, ovaries, and uterus.

(i) There are disturbances of the nervous system, such as headache and a general dull sensation of fatigue and paresis of all mental functions, with dizziness and vertigo.

On the mental side we find in the psychopathies the following disturbances:—

(a) Affections of perceptual activity,—illusions and hallucinations.

(b) Affections of intellectual activity,—argumentativeness in regard to insignificant things.

(c) Affections of the moral sense,—scrupulousness, over-conscientiousness, not living up to ideal states.

(d) Affections of religious life,—fear of commission of sins and terror of punishment.

(e) Affections of social life,—timidity, blushing, etc.

(f) Affections in regard to objects, such as astrophobia, acmephobia, agoraphobia, claustrophobia, etc.

(g) Affections of conceptual life,—insistent ideas.

(h) Affections of the attention,—aprosexia.

(i) Affections of the will,—states of aboulia, indecision, discord, conflicts, and uncontrollable impulses.

(j) Affections of the memory,—amnesic and paramnesic states.

(k) General mental fatigue.

(l) Affections of sexual life,—impotence, perversion, and inversion.

(m) Affections in regard to marital relations.

(n) Affections in regard to personal life,—diffidence, self-condemnation, self-depreciation.

(o) Affections of apparent loss of personality,—feeling of self gone.

(p) Formation of new personalities,—dual and multiple personality.

In connection with all such neurotic affections we find invariably present a feeling of unrest, hesitation, doubt, conflict, discord, uneasiness, a feeling of anxiety, conscious or subconscious, feeling of some impending evil. In all such affections we find the brooding spirit of the most powerful of all animal instincts,—the fear instinct. Neurosis is a disease of self-preservation and fear.

[CHAPTER VII]
FORMS OF NEUROSIS

A brief outline of a classification of nervous and mental diseases, made by me in my various works, may be of help towards a clear understanding of neurotic disturbances.

The different forms of nervous and mental diseases may be classified into Organic and Functional.

By organic affections I mean to indicate pathological modifications of the neuron and its processes taking place in the very structure (probably the cytoreticulum) of the nerve cell. Under this category come such maladies as general paresis, dementia praecox, all mental and nervous affections of a degenerative and involutionary character. Such diseases are termed by me Organopathies, or Necropathies.

By functional affections I mean to indicate all neuron changes in which the functions of the neuron and its reactions to external and internal stimulations are involved in the pathological process without, however, affecting the anatomical structure of the nerve cell. The pathological changes are not permanent,—recovery of normal function is possible with the restitution of favorable conditions of nutrition and elimination.

Functional nervous and mental diseases are in turn subdivided into Neuropathies and Psychopathies.

Neuropathic diseases are disturbances of functioning activity, due to defective neuron matabolism, brought about by external stimuli, and more specially by harmful internal stimuli—glandular secretions, hormones, toxic and autotoxic agencies. The pathological, neuropathic process produces few, if any anatomical, changes in the structure of the neuron. The pathology of neuropathic diseases, (probably of the cytoplasm) is essentially chemico-physiological in nature.

Neuropathic diseases include maladies in which the neuron undergoes degenerative changes. At first there is an apparent increase, then an inhibition, and finally a complete suspension of neuron function, not terminating in the destruction of the neuron. Neuron restitution is possible.

Such affections are produced by mild poisons, organic, or inorganic, by autotoxic products, by hyposecretion or hypersecretion, or by absence of hormones in the economy of the organism. Here belong all the temporary, or recurrent maniacal, melancholic, delusional states, puerperal mania, epileptic insanity, the mental aberrations of adolescent and climacteric periods, periodic insanity, alternating insanities, and in general all the mental affections known under the description of manic-depressive insanity.

Where the disease depends on the interrelation of neurons in a complex group, on association of systems of neurons, the condition is psychopathic in nature.

In psychopathic troubles the neuron itself may remain unaffected, may be perfectly normal and healthy. The disorder is due to association with systems of neurons which are usually not called into action by the function of that particular neuron system.

By Organopathies or Necropathies I indicate a group of psychophysiological symptoms, accompanied by structural, necrotic changes of the neuron, terminating in the ultimate death of the neuron systems, involved in the pathological process.

By Neuropathies I indicate a group of psychophysiological manifestations due to pathological functional neuron modifications, capable of restitution through normal metabolism.

By Psychopathies I designate pathological phenomena of psychophysiological dissociation and disaggregation of neuron systems and their functions in clusters, the neuron itself and its special function remaining undamaged.

The psychopathies are further subdivided into Somatopsychoses and Psychoneuroses or Neuropsychoses.

The Somatopsychoses are characterized by somatic symptoms, by disturbances of bodily functions, such as paralysis, contractures, convulsions, anesthesia, analgesia, hyperalgesia, and other sensory disturbances, as well as by intestinal, cardiac, respiratory, and genito-urinary troubles.

The psychoneuroses or Neuropsychoses are characterized by mental symptoms. The patient’s whole mind is occupied with mental troubles.

Such conditions are found in obsessions, fixed ideas, imperative impulses, emotional compulsions, and other allied mental and nervous maladies.

Somatopsychoses simulate physical and organic nervous troubles. Thus, many “hysterical” forms simulate tabes, or paralysis agitans, hemiplegia, paraplegia, or epilepsy, while many of the neurasthenic, hypochondriacal, and their allied states may simulate tumor, cancer, intestinal and glandular derangements, cardiac, laryngeal, pneumonic, hepatic, splanchnic ovarian, tubal, uterine, renal, and other bodily afflictions.

The neuropsychoses or psychoneuroses simulate all forms of mental disease, beginning with melancholia and mania, and ending with general paresis and dementia.

Psychoneurosis and somatopsychosis are diseases of the subconscious; in the former mental, in the latter physical symptoms predominate.

Psychopathic states should be rigidly differentiated from other disturbances, such as neuropathies and organopathies, or necropathies. The following diagram may be of help:

Nervous and Mental Diseases
DIAGRAM I

[CHAPTER VIII]
FEAR AND THE HYPNOIDAL STATE

In my work on “Sleep” I report a series of interesting experiments carried out by me on guinea pigs, rabbits, cats, dogs, children, and adults.[4] I discovered one of the most important states of animal life, a state which I termed hypnoidal.

The study shows that in almost every animal, from the lowest to the highest, from frog to man, a somewhat sudden change of the usual environment deprives that animal of its activities and its functions. If the change is not too intense and prolonged, the animal merges into the hypnoidal state in which the lost functions are restored. During this hypnoidal state the functions are weakened, the animal may be regarded in a state of invalidism, its reactions being enfeebled, practically speaking, paretic.