MENTAL DISORDERS

Evening Star, Issue 19763, 13 January 1928, Page 14

MENTAL DISORDERS

CAUSE OF MANY ILLS FAMOUS PHYSICIAN'S VIEWS An address on ‘Medicine and'the Church,’ the annual oration before the York Medical Society, was given by Sir Farquhar- Buzzard, K.C.V.0., M.D. (Oxford), F.R.C.P. (London), physician extraordinary to His Majesty tho King, and physician to St. Thomas’s Hospital. The address is reported in full in tho ‘Lancet,’ from which we take tho following - “ It has been customary to describe disease as being either ‘ organic ’ or ‘functional’ in origin. The use of the adjective ‘ organic ’ indicates that the disease Is associated with some physical alteration of tissues which we are able to detect. The use of the adjective ‘functional’ indicates that the disease or disorder described is attributed to a disturbance in the function of an organ without a physical change of structure such as wo arc able to detect. “It is clear that these two varieties of disease may be closely associated in many ways. For instance, a disorder of function in an organ may be the result of a physical or organic disease. On the other hand, there may bo organic disease without obvious disorder of function. Again, an organic affection of one organ may lead to a functional disturbance in another, or a disturbance of function in one part of the body may manifest itself by disorder of function in another. GROUPS OF MENTAL DISORDER “ What has modern psychological medicine taught ns in regard to tijo practical application of these truths? “ 1. There is a largo group of men tal disorders associated frequently with disturbances of health in the form of pain, insomnia, mental and physical fatigue, disorders of digestion, circulation, etc., and sometimes with grave disabilities such as paralysis, deafness, dumbness, blindness, and other apparently serious symptoms. The characteristics of this group may be briefly summarised: (a) Expert knowledge is required to distinguish them from diseases of organic origin with similar symptoms. (b) The primary cause of tho disorder lies in the mind, and if the mind is relieved all other symptoms and disabilities disappear. (c) They are amendable to treatment by suggestion, some kind of faith, in God or man, being a necessary prelude to success, (d) They provide the largo bulk of miraculous cures.

“2. Another group comprises mental disorders which are commonly called the insanities and, although not necessarily permanent, aro practically uninfluenced by suggestion, faith, spiritual healing, or any form of psychotherapy. _ “3. A third group includes all cases in which disorders of mind, as manifested by changes in character, personality, and conduct are associated with, and the result of, structural changes in the brain itself. Unless the structure of the brain can be restored to health, the mental disorders cannot bo relieved. Here again suggestion, faith, or any form of psychotherapy is useless.

“4. In the last group wo find a somewhat heterogeneous collection of mental disorders, of varying degrees of severity, .of which tho prime cause is to be found, not in thq brain itself, but in some distant organ. Once more, tho mind can only regain its health if tho source of. its ill-health .can bo detected and dealt with. “It is hardly necessary to point out that tho task of allocating a particular patient to his appropriate group—and this is tho first essential of successful treatment—is one which may well baffle the experienced physician, even when he is able to call upon colleagues who aro experts in chemistry, bacteriology, or radiology, for their skilled assistance.

“ Before going further let me bring forward two facts well _ recognised by those who have to do with mental disorders, the significance of which cannot be overlooked when wo consider the relationship of mind and matter. “An epidemic disease which has been prevalent during tho last ton years and which has claimed thousands of the population as its victims, 'is essentially an inflammation of the brain resulting from the invasion of that organ by some form of microbe. _ As the result of this disease many patients have been paralysed or otherwise disabled.

‘On the other hand, there are many who have escaped physical _ disabilities, but have been left entirely altered in personality. Some have lost all moral sense and yet retained a considerable degree of intelligence. In other words, a change in tho structure, of the brain matter has been definitely associated with an alteration in character. In such cases all attempts to restore a moral sense by means of education, training, or suggestion have generally proved useless. “ Secondly, there is a common form of temporary mental disorder, of which one of the features may be a complete loss of religious faith. This disorder overtakes the faithful as well as tho faithless, and it is remarkable that no amount of suggestion, persuasion, or spiritual healing avails to restore faith in God, or comfort in prayer, until health returns. “Enough has been said to indicate some of the obstacles which beset tho patli of anyone who ventures into tho field of psychological medicine unequipped with such scientific knowledge as can only bo acquired by years of specialised study and experience. . DISTURBANCES OF MIND. “ There can he little doubt that more than half the ills to which man is prone originate in disturbances of the mind. There can bo no doubt that they are more difficult to recognise, to classify, and to treat than those of purely bodily origin, and that the dangers attached to unskilled practice in that department of medicine are at least equal to those associated with ignorant interference in any other. “ A smattering of modern psychology unbacked by any knowledge nf general medicine constitutes no valid certificate of fitness to solve the problems presented by the vagaries and disorders of tho human brain.”