MASSACHUSETTS Eclectic Medical Journal. Vol. 3. Boston, February, 1883. No. 2. ORIGINAL COMMUNICATIONS. PSYCHOLOGY, PSYCHIATRY AND PSYCH AL FORCE. BY ALEXANDER WILDER, 51. D., NEWARK, N.J. I was greatly pleased at the sentiment expressed by Dr. C. E. Miles in the Journal of November, 1882, in regard to Confi- dence in the Curative Action of Medicines. It is correct enough for dogma, besides permitting a wider range for our thinking. The moral effect upon a patient, when the medical adviser imperiously commands the swallowing of a drug or compound, having little confidence in it all the time, is easy to apprehend. Such medicine might be of itself specific, yet the unfaith of the prescriber would be very likely to pervert the effects or render it inert. Indeed, he has done an immoral act, and is conscious of being a hypocrite, unworthy of confidence ; and hence he becomes prone to speak slightingly of those who are more sincere and successful. The worthy writer, as though to demonstrate an impregnable basis for the physician's confidence, refers us to the theory that gicen medicines, at all times, under similar conditions, have a like action upon the body, and hence concludes that if curative once, they will be so again and always. This is good argument, and hard to dispute, from its apparent mathematical exactness. 50 Massachusetts Eclectic Medical 'Journal. Nevertheless, it is not easy to feel quite satisfied ; some further understanding is needed. There is a materialistic seeming to it, which tends to compress thought and forbid inquiry. I would fain search for a reason which might show why virtues exist in these substances. An Homoeopathic professor whom I used to know had the ex- planation for the prescribing of a particular medicine-"because it is the right remedy." It is not easy to breathe a full breath when one is so dogmatically circumscribed. I may be willing to recognize the Unknown, but hardly the Unknowable. Van Helmont, who is in many essential particulars the Father of Modern Medicine, has a profounder conception of the matter. In certain respects he may perhaps be considered as visionary ; nevertheless this is more easy to say than to show. He taught that material nature derived her forms and energies from above, and that heaven in turn received an invisible potency from below ; both which outflows are in an individual. Somewhat of this sen- timent pervaded his writings upon the healing art. He consid- ered it to be in the power of individuals, through the suggestion and force of the imagination to transmit energy and properties to others, and to inanimate objects. Many herbs, he asserted, acquire through the imagination of those who gather them, an extraordinary power. This would seem to explain why cer- tain medicines are potent in the hands of one practitioner and ineffective with others. His presence was frequently sufficient, he informs us, to cure the sick ; and he further states that he not only operated on others by his will, but even imparted through it a peculiar virtue to medicines. It is the province of the philosophical investigator to examine these matters. It may be wise enough to disregard whatever is absurdly fanciful as well as what is grossly materialistic. No discovery or phenomenon which can afford any light, however, can be honestly ignored or despised. We want a substantial foundation, and as far as practicable, a scientific reason. Our physical senses may give their testimony and the logical faculty do its proper work. Nevertheless, both are limited in their scope. " Beyond the vail of the seen," says Professor George Barker, "science may not penetrate."* He also declares that * Address delivered before the American Association for the Advancement of Science, at its annual meeting in Boston, August 25,1880, on retiring from the office of President. Massachusetts Eclectic Medical 'Journal' 51 whether a living organism be plant or animal, the whole of its energy must come from without itself, being either- absorbed directly or stirred up in the food. We propose to make inquiry respecting this energy. The properties of an organism consist of it ; and at the same time the hypothesis of Van Helmont is not incompatible. For example, to know disease well and pre- scribe for it aright, will show familiarity with physiological science ; but in order to be a good and competent physiologist it is imperative to make a careful study of the mind, its functions and operations. There is something which makes the adminis- tering of medicine or other remedial expedient, more or less uncertain. It is by no means a problem of mathematical pre- ciseness. Two patients that are apparently disordered alike are not benefitted alike by similar measures. Methods and agents which are successful in the hands of one person are liable to be unavailing with another. In order to understand such discrepancies, it will be necessary to push inquiry farther. The mechanism of the human body will not disclose the laws which control it; nor will our chemical and empirical knowledge of drugs suffice to explain their influ- ence upon functional activity. No intelligent individual for a moment supposes that the gases and earthy material which the manipulations of chemistry evolve from a medicinal substance are the containers of its virtues; the constituents of foods and poisons are often not greatly different. The properties pertain to the something beyond. This fundamental fact underlies them all. In an analogous manner, the will, the moods, the emotive con- ditions, of an individual transform the very elements of the body, and change the properties and operations of food and medicine. Faith or the want of it is known to be all-potent. "As a man thinketh, so is he." Psychological knowledge is the complement of the healing art. In saying this, there is not meant the disjoining of the mental and psychic from the material nature. This mundane life of ours is a condition of their interblending as a unity, and this so per- fectly that many plausible arguments can be advanced to prove that the corporeal substance includes the whole. I can not go so far; I have evidence which assures me otherwise. Yet it is 52 Massachusetts Elecctic Medical 'Journal. necessary to consider every thing, as far as it is in our power from the scientific point of view. There are so many facilities for doing this, at the present day, that we may the more easily keep within the scientific pale. Only, we should not consent to be empounded there. There is a theory of Psychiatry now in vogue which not only contemplates all neuroses and mental aberrations as comprised in its department, but as virtually constituting the whole of it. Many writers seem to have no other conception of the meaning of Psychological Science. It is one of the unfortunate outcomes of the materialism which to a great degree has obscured the intel- lectual sky. We may not, however, doubt that insanities as well as the other diseases of the nervous system, should be regarded as phe- nomena closely associated with pathological conditions of the body. Indeed, I would go farther, I think, than our principal accepted authorities; making but minor account of brain-lesions and disorganization of nerve-centres of that department of the organism, but much of certain other deteriorations. Changes may occur sufficient to cause the most acute disorder, or even to destroy life, and yet be so subtile as not to be demonstrable to the senses. At a certain lunatic asylum, in England, a considerable percentage of inmates, insane to all appearance while living, dis- closed upon necropsy, no sign or evidence of altered brain-struc- ture. I do not consider any hypothesis of an individual's sanity as tenable, which is based upon the fact of no discoverable affec- tion of the cerebral substance; and I feel very certain that insanity is not a disease of the brain primarily or essentially. Physical debility is at the bottom of. mental disorder, and none of the aberrations entitled insane are exceptions to this fact. The disturbance of the emotive nature is inseparable from an abnormal condition of the ganglionic nervous centres. The morbid influ- ence upon the brain is a sequence to this, and the skillful psychi- atrist will act upon that suggestion. The nearest proposition that has come forth from the permitted sources is the hypothesis of Psychic Force. It ought to be received with welcome as a small favor conceded to the outside world of observers. Professor W. Crookes, the editor of the Massachusetts Eclectic Medical Journal. 53 London 'Journal of Science, a man of known scientific ability and an honesty transcending it, has defined this as a hitherto unrecognized form of force, the existence of which is not a matter of opinion with him, but of absolute knowledge. As it is clearly impossible to place him under the ban of irregu- larity and apply the epithet of unscientific, which is a little stale in this country at least, the endeavor has been made to show that the psychic force in not derived from any ulterior spiritual source, but is inherent in the muscles and nerves of the human body. It is a curious fact, however, that this explanation corresponds pretty accurately with that of the nerve-spirit or nervengeist, described by the Scherin von Prevorst. Without commenting further on the matter, it is enough to remark that the great pains to shuffle off all consideration of the subject, to ridicule and hiss down every evidence, and to exclude it from the scientific circle, indicate fear and moral cowardice rather than a manly love for real knowledge. There are breaches in the wall, however, and the light will shine through, bedimming the lustre of all the candles. The force inherent in nerves and muscles is essentially a part of the selfhood of the individual, and this fact carries our study of physiology over inevitably into the realm of psychology. Human science and medical learning in particular, will not be complete, or even practical in character, except with this culmin- ation. Nor is it in any legitimate sense a novelty or a new departure. Ancient teachers of the healing art all recognized it as the essential principle, to which their methods were subordi- nate. It is no more visionary to accept this doctrine, than to recognize the fact that the human body holds together while per- vaded with life, and dissolves after that agency disappears. The late Professor John W. Draper distinctly affirmed that there is a psycho-physiological science. "There animates the machine a self-conscious and immortal principle-the Soul," he declares. "In the most enlarged acceptation, it would fall under the province of physiology to treat of this immortal principle." The place foi' such instruction is in the medical curriculum. The practitioner must know his art or he is liable to failure in his endeavors. That art depends upon the science that exists behind it, and yet more upon the philosophy that embraces all knowledge 54 Massachusetts Eclectic Medical journal. and sets it in order. It is the proletarian of leechcraft that ignores this and is wedded to the drugs and routine of the medical trade. The liberal physician perfects his knowledge of disease and the means for its remedy, by researches into the depths and explora- tions into the zenith of anthropological learning. He does not hesitate to discern the spirits as well as the ashes. Life is more than a tale told by an idiot, full of sound and fury signifying nothing. It is a drama rehearsed in a temple, with all the denizens of the universe for an audience. It everywhere depicts the sublime discontent which impels the soul. If psychological study evolves religion as well as philosophy, what matters it? The theories, the trend of which is to dethrone and embrute man are so many attempts to despoil him of his heritage. The animals of a higher order always employ those parts of their nervous structure which are superadded to those of lower races, subordinating the inferior to the nobler. So may the expert in psychological lore be authorized to transcend the methods which are most esteemed by those who have not became matriculants into the school of profounder knowledge. Indeed, it will be per- ceived by the intelligent, that this is science and technic, and not the romance of medical learning. 565 Orange Street.