roduce pain or any bodily defects
which produce blanks in the content of consciousness; the pain of
sciatica or of rheumatism, or the defect of the blind or of the deaf,
certainly interferes in a disturbing way with the perfect harmony of
psychophysical activities. But here also belongs the suffering which
results from conditions in the surroundings, the loss of a friend, a
disappointment in life, any source of worry and grief. Social and bodily
conditions alike may thus work to break up the equilibrium. The pain
sensation interferes with the normal flow of mental life and the grief
may undermine the mental interests. The psychotherapeutic effort may be
directed toward removing the source of the disturbance, bringing the
patient under other conditions, curing the diseased organ, and where
that is not possible, may work directly on the psychophysical state,
inhibiting the pain, suppressing the emotion, substituting pleasant
ideas, distracting the whole mind, filling it with agreeable feelings,
until the normal equilibrium is restored.

The psychophysical system itself was not really harmed by such
influences. In the following groups, such is no longer the case. We here
think at first of those severe injuries which have their sources in
abnormal processes outside of the brain. The anaemia of the patient or
the low state of his nutrition or the fever heat of his blood impairs
the harmony of the mental functions. Another and for the psychotherapist
much more important group is that in which the impairment results from
toxic influences. Alcohol, morphine, cocaine, tobacco, and many other
drugs may have been misused and may have produced a most marked
alteration in the mind-brain system. Desires may have developed which
completely destroy the balance of the normal functions and yet the
satisfaction of which increases the poisoning effect. But here belongs
further the effect of poisons which the body itself produces: the toxic
disturbance of uraemia or the coma in diabetes, or especially the grave
disturbances resulting from the abnormal action of the thyroid gland,
the source of cretinism. Many indications suggest that a near future
will consider this group much larger than we are really justified in
doing today, probably soon connecting a number of other mental diseases
like dementia praecox with toxic effects of bodily origin. Experience
shows that in this group not a few chances exist for successful
psychotherapeutic influ