cture. Thus we must claim that all those so-called functional
disturbances like neurasthenia and hysteria, fixed ideas and obsessions,
phobias and dissociations of the personality, as well as the typical
insane states of the maniac or paranoiac have their basis in a
pathological change of the anatomical structure of the brain. This
postulate cannot be influenced by the fact that the microscope has been
unable to detect the character of most of these changes.

Of course all this does not exclude its being perfectly justifiable to
separate those diseases for which a definite destruction of the brain
parts can be detected, as in paralysis of the brain, from those where
that is impossible. We may also expect that those disturbances in the
brain which we cannot as yet make visible, may allow more easily an
organic repair and thus a restoration to the normal functions. Just as a
disjointed arm may be brought to function quickly again, a broken arm
slowly, an amputated arm never, each brain cell too may suffer lesions
which are reparable in different degrees. But it is evident that it
remains then an entirely empirical question whether the invisible damage
allows repair or not. We have no right to say that where the
destruction cannot be seen under the microscope there is no organic
change and the disturbance is therefore only a psychical one and can be
removed by mental means. All changes are physical and experience has to
decide whether they are accessible to psychological influences or not.
States like epilepsy may not allow any recognition of definite brain
destruction and are yet on the whole inaccessible to mental influence,
while many a brain disturbance with visible alterations, resulting
perhaps from anaemia or hyperaemia, may be caused to disappear. If on the
other hand we say that we can cure with psychotherapeutic means only the
functional brain diseases and define as functional simply those diseases
which can be cured by such means, we move, of course, in the most
obvious circle and yet just that is the too frequent fate of the
discussions in certain quarters.

Every psychical disturbance is organic inasmuch as it is based on a
molecular change which deranges the function. Some of these changes are
beyond restitution; some can be brought back to a well-working structure
by strictly physical agencies like drugs or electricity; others can be
repaired by physiological stimuli which reach directly the higher brain
ce