as explanation. These causes are, fortunately, rapidly
being removed. We are entering upon an era in which psychiatry will be
recognized as one of the most important specialties in medicine, an era
that will demand alliance and close communion among psychiatrists,
internists, and the representatives of the various medical and surgical
specialties.
The internist and the psychiatrist will ever have a common interest in
the obscure problems of etiology and pathogenesis of diseases and
anomalies that are accompanied by abnormalities of thought, feeling, and
behavior. Progress in this direction is bound to be slow for the studies
are exceptionally complex and there are many impediments to be removed.
Though the problems are deep and difficult, they are doubtless soluble
by the mind of man, and they exert an uncommon fascination upon those
who visualize them. Causes may be internal or external, and are often a
combination of both. The tracing of the direct and indirect
relationships between these causes and the abnormal cerebral functioning
upon which the disturbances of psychobiological adjustment seem to
depend is the task of pathogenesis. The internist who has studied the
infantile cerebropathies with their resulting imbecilities, syphilis
followed by general paresis, typhoid fever and its toxic delirium,
chronic alcoholism with its characteristic psychoses, cerebral
thrombosis with its aphasias, agnosias, and apraxias, thalmic syndromes
due to vascular lesions with their unilateral pathological feeling-tone,
frontal-lobe tumors with joke-making, uncus tumors with hallucinations
of taste and smell, lethargic encephalitis with its disturbance of the
general consciousness and its psychoneurotic sequelae (lesions in the
globus pallidus and their motor consequences), pulmonary tuberculosis
with its euphoria, and endocrinopathies like myxoedema and exophthalmic
goitre with their pathological mental states, is encouraged to proceed
with his clinical-pathological-etiological studies in full assurance
that they will steadily contribute to advances in psychiatry. The
eclectic psychiatrist who is examining mental symptoms and
symptom-complexes ever more critically, who is seeking for parallel
disturbances in physiological processes and who considers both
psychogenesis and somatogenesis in attempting to account for
psychobiological maladjustments will welcome, we can feel sure, any help
that internal medicine and general and special
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