going
on about him.

A picture like this may readily arouse the suspicion that we are dealing
with a malingerer, and, indeed, some very prominent German psychiatrists
have reported as malingerers cases similar to this. The trained
psychiatrist, if unfamiliar with this class of cases, will find himself
at a loss to know under what known group of mental disorders to place
this condition, as it will at once become apparent to him that it does
not fit into any of the well-known psychoses.

In defense of the genuineness of the psychotic manifestations of these
patients, I would recall again the transitory mental disturbances of
students undergoing examinations. The genuine loss of all knowledge of
well-known facts which the old-time strict and severe schoolmasters
frequently provoked in school children, differs very little from the
pseudo-dementia with which we are dealing here. It concerns a similar
total blocking and inhibition of all thought processes, and, like all
psychogenetic disorders, has a tendency to disappear upon the removal of
the causative factor.

Still, nobody would think for one moment that the child malingers when
it is unable to answer questions, though these might concern well-known
facts. The consequences of failure to recognize this acute
prison-psychotic-complex as a genuine mental disorder may prove to be
very disastrous when we remember to what extent the symptomatology of
these psychoses is dependent upon environmental conditions.

THE DEGENERATIVE PSYCHOSES

I have considered thus far those psychogenetic mental disorders, the
etiologic factor of which consisted of a single, more or less isolated
emotional occurrence. We have seen that the majority of these patients
showed very little, if anything, in their past life which was in any way
incompatible with leading a more or less successful existence in the
community in which they lived. These patients, we might say, would never
have been brought to the attention of the psychiatrist had it not been
for the occurrence in their life of an experience which provoked a
mental breakdown.

I will now consider a group of cases, in whom the degenerative soil is
so prominent that they have been properly called "Psychoses of
Degeneracy." They should, however, be considered here, because the
various psychotic manifestations of these individuals are purely
psychogenetic in nature, and evoked by a certain milieu in which the
individual was placed. As my