FOOTNOTES:

Felix qui potuit rerum cognoscere causas,Atque metus omnes, et inexorabile fatum,Subject pedibus, strepitumque Acherontis avari.[2]

Felix qui potuit rerum cognoscere causas,

Atque metus omnes, et inexorabile fatum,

Subject pedibus, strepitumque Acherontis avari.[2]

FOOTNOTES:[1]See Chapter “Psychopathic Reflexes” in my volume “The Causation and Treatment of Psychopathic Diseases.”[2]Happy is he who knows the causes of things, who can trample on fear, inexorable fate, and the horrors of death.

[1]See Chapter “Psychopathic Reflexes” in my volume “The Causation and Treatment of Psychopathic Diseases.”

[2]Happy is he who knows the causes of things, who can trample on fear, inexorable fate, and the horrors of death.

An individual limited in intelligence, leading a narrow life, is specially subject to fear suggestions which can be easily aroused. Inhibitions of the personal self are produced by stimulation of the fear instinct with consequent easy access, by means of fear suggestions, to man’s subconscious fear instinct, thus inducing various forms of morbid mental life.

When a person is limited in his interests, when he is ignorant and full of prejudices and superstitions, his critical, personal sense is embryonic, and the predisposition to fear suggestions is specially pronounced. He easily falls a victim to all kinds of bizarre beliefs and absurd superstitions, such as the mysticism which obsesses uncultured classes of all ages.

The optimistic, “metaphysical” beliefs, rampant in this country, are all due to the beggarly intelligence subconsciously obsessed by innumerable fear suggestions. Neurotic adherents cling to their irrational optimism in order to assuage the pangs, caused by the fear instinct, from which they are unable to free themselves.

In the embryonic personality of the child, as well as in the undeveloped or narrowed individuality of the adult, the sense of the strange, of the unknown, and of the mysterious, is apt to arouse the fear instinct. In fact, the unfamiliar arouses the fear instinct even in the more highly organized mind.

“Any new uncertainty,” says Bain, “is especially the cause of terror. Such are the terrors caused by epidemics, the apprehensions from an unexperienced illness, the feeling of a recruit under fire. The mental system in infancy is highly susceptible, not merely to pain, but to shocks and surprises. Any great excitement has a perturbing effect allied to fear. After the child has contracted a familiarity with the persons and things around it, it manifests unequivocal fear on the occurrence of anything strange. The grasp of an unknown person often gives a fright. This early experience resembles the manifestations habitual to the inferior animals.”

In another place Bain rightly says, “Our position in the world contains the sources of fear. The vast powers of nature dispose of our lives and happiness with irresistible might and awful aspect. Ages had elapsed ere the knowledge of law and uniformity prevailing among those powers was arrived at by the human intellect. The profound ignorance of the primitive man was the soil wherein his early conceptions and theories sprang up; and the fear inseparable from ignorance gave them their character.The essence of susperstition is expressed by the definition of fear.”

Compayré, in speaking of the fear of the child, says, “In his limited experience of evil, by a natural generalization, he suspects danger everywhere like a sick person whose aching body dreads in advance every motion and every contact. He feels that there is a danger everywhere, behind the things that he cannot understand, because they do not fit in with his experience.

“The observations collected by Romanes in his interesting studies on the intelligence of animals throw much light on this question; they prove that dogs, for instance, do not fear this or that, except as they are ignorant of the cause. A dog was very much terrified one day when he heard a rumbling like thunder produced by throwing apples on the floor of the garret; he seemed to understand the cause of the noise as soon as he was taken to the garret, and became as quiet and happy as ever.

“Another dog had a habit of playing with dry bones. One day Romanes attached a fine thread which could hardly be seen, to one of the bones, and while the dog was playing with it, drew it slowly towards him; the dog recoiled in terror from the bone, which seemed to be moving of its own accord. So skittish horses show fright as long as the cause of the noise that frightens them remains unknown and invisible to them.

“It is the same with the child. When in the presence of all the things around him, of which he has no idea, these sounding objects, these forms, these movements, whose cause he does not divine, he is naturally a prey to vague fears. He is just what we should be, if chance should cast us suddenly into an unexplored country before strange objects and strange beings—suspicious, always on thequi vive, disposed to see imaginary enemies behind every bush, fearing a new danger at every turn in the road.”

Similarly, Sully says, “The timidity of childhood is seen in the readiness with which experience invests objects and places with a fear-exciting aspect, in its tendency to look at all that is unknown as terrifying, and in the difficulty of the educator in controlling these tendencies.”

Sully is right in thinking that education tends greatly to reduce the early intensity of fear. “This it does by substituting knowledge for ignorance, and so undermining that vague terror before the unknown to which the child and the superstitious savage are a prey, an effect aided by the growth of will power and the attitude of self-confidence which this brings with it.” An uncultivated personality with a limited mental horizon, with a narrow range of interests, a personality trained in the fear of mysterious agencies, is a fit subject for obsessions.

In certain types of functional psychosisand neurosis the patient has an inkling of the fear instinctin his dread of objects, or of states of mind, lack of confidence, blushing, expectations of some coming misfortune and some mysterious evil, but he is not aware of the fear instinct as developed in him by the events and training of early childhood.The fears of early childhood are subconscious.At any rate, the patient does not connect them with his present mental affection.

In other types of psychopathic affections the patient is entirely unaware of the whole situation, he is engrossed by the symptoms which he regards as the sum and substance of his trouble; the fear is entirely subconscious. Frights, scares, dread of sickness, instructions associated with fear of the mysterious and unseen, injunctions with fear of punishment or failure in moral standards, enforcement of social customs with dread of failure and degradation,—all go to the cultivation of the fear instinct which in later life becomes manifested asfunctional psychosisorneurosis.

Functional psychosis or neurosis is an obsession, conscious and subconscious, of the fear instinct.Thus one of my patients became obsessed with fear of tuberculosis, manifesting most of the symptoms of “consumption,” after a visit to a tubercular friend. Another patient was obsessed by the fear of death after visiting a sick relative of his in one of the city hospitals. Another became obsessed with the fear of syphilis after having been in contact witha friend who had been under antiluetic treatment. Still another of my patients, in addition to the fear of darkness, became obsessed with the fear of stars, and also with a fear of comets, regarded by some people as poisoning the air with noxious gases.

In all such cases anxiety and dread were present, but in none of the patients have I found an insight into the real state of the mind. In all of them the fear was traced to early childhood, to early experiences of the fear instinct, fostered and fortified by unfavorable conditions. In all of those fears there was a long history of a well-developedsubconscious fear instinct.

I may assert without hesitation that in all my cases of functional psychosis, I find the presence of the fear instinct to be the sole cause of the malady.Take away the fear and the psychosis or neurosis disappears.

The fear instinct arises from the impulse of self-preservation without which animal life cannot exist. The fear instinct is one of the most primitive and most fundamental of all instincts. Neither hunger, nor sex, nor maternal instinct, nor social instinct can compare with the potency of the fear instinct, rooted as it is in self-preservation,—the condition of life primordial.

When the instinct of fear is at its height, it sweeps before it all other instincts. Nothing can withstand a panic. Functional psychosis in its full developmentis essentially a panic,—it is the emergence of the most powerful of all instincts, the fear instinct.

Functional psychosis or neurosis is a veiled form of the fear of death, of destruction, of loss of what is deemed as essential to life, of fear of some unknown, impending evil. How many times has it fallen to my share to soothe and counteract the fear instinct of panic-stricken psychopathic patients! A psychogenetic examination of every case of functional psychosis brings one invariably to the fundamental fear instinct.

Conflicts, repressions, imperfections, sex-complexes, sex-aberrations, and others do not produce psychopathic symptoms or neurotic states. It is only when mental states become associated with an exaggerated impulse of self-preservation and an intensified fear instinct that neurosis arises.

A close study of every neurotic case clearly discloses theprimaryaction of those two important factors of life activity,—self-preservation and fear instinct.

The function of fear is quite clear. Fear is the guardian instinct of life. The intensity of the struggle for existence and the preservation of life of the animal are expressed in the instinct of fear. The fear instinct in its mild form, when connected with what is strange and unfamiliar, or with what is really dangerous to the animal, is of the utmost consequence to the life existence of the animal. What is strange and unfamiliar may be a menace to life, and it is a protection, if under such conditions the fear instinct is aroused.

Again, it is of the utmost importance in weak animals, such as hares or rabbits, to have the fear instinct easily aroused by the slightest, strange stimulus: the animal is defenseless, and its refuge, its safety, is in running. The unfamiliar stimulus may be a signal of danger, and it is safer to get away from it; the animal cannot take chances.

On the other hand, animals that are too timid, so that even the familiar becomes too suspicious, cannot get their food, and cannot leave a progeny,—they become eliminated by the process of naturalselection. There is a certain amount of trust that nature demands even of its most defenseless and timid children.

Animals in whom the fear instinct can be aroused to a high degree become paralyzed and perish. Under such conditions the fear instinct not only ceases to be of protective value, but is the very one that brings about the destruction of the animal possessed by it. Intense fear paralyzes the animal.

“One of the most terrible effects of fear,” says Mosso, “is the paralysis which allows neither of escape nor defense. Not all the phenomena of fear can be explained on the theory of natural selection. In their extreme degree they are morbid phenomena, indicating imperfection of the organism. One might almost say that nature had not been able to find a substance for brain and spinal cord which should be extremely sensitive, and yet should never, under the influence of exceptional or unusual stimuli, exceed in its reactions those physiological limits which are best adapted to the preservation of the animal.” Mosso quotes Haller to the effect that “phenomena of fear common to animals are not aimed at the preservation of the timid, but at their destruction.”

The fear instinct is no doubt one of the most fundamental and one of the most vital of animal instincts, but when it rises to an extreme degree, or when associated with familiar instead of strange and unfamiliar objects, then we may agree with Hallerthat the phenomena are not aimed at the preservation of the animal, but at its destruction; or, as Darwin puts it, are of “disservice to the animal.” This is just what is found in the case of psychopathic or neurotic affections. The fear instinct, when aroused and cultivated in early childhood, becomes associated in later life with particular events, objects, and special states.

When the instinct of fear is aroused in connection with some future impending misfortune, the feeling of apprehension with all its physiological changes, muscular, respiratory, cardiac, epigastric, and intestinal, goes to form that complex feeling of anxiety so highly characteristic of the acute varieties of psychopathic maladies. When fear reaches its acme, the heart is specially affected; circulatory and respiratory changes become prominent, giving rise to that form of oppression which weighs like an incubus on the patient,—the feeling known as “precordial anxiety.”

The fear instinct is the ultimate cause of functional psychosis,—it is the soil on which grow luxuriantly the infinite varieties of psychopathic disturbances. The body, sense, intellect, and will are all profoundly affected by the irresistible sweep of the fear instinct, as manifested in the overwhelming feeling of anxiety. The fear instinct and its offsprings—hesitation, anxiety, conflicts and repressions—weaken, dissociate, and paralyze the functionsof the body and mind, producing the various symptoms of psychopathic diseases. The fear instinct keeps on gnawing at the very vitals of the psychopathic patient.

Even at his best the psychopathic patient is not free from the workings of the fear instinct, from the feeling of anxiety which, as the patients themselves put it, “hangs like a cloud on the margin or fringe of consciousness.” From time to time he can hear the distant, threatening rumbling of the fear instinct. Even when the latter is apparently stilled, the pangs of anxiety torment the patient like a dull toothache.

Montaigne, writing of fear, says, “I am not so good a naturalist (as they call it) as to discern by what secret springs fear has its motion in us; but be this as it may, it is a strange passion, and such a one as the physicians say there is no other whatever that sooner dethrones our judgment from its proper seat; which is so true, that I myself have seen very many become frantic through fear; and even in those of the best settled temper, it is most certain that it begets a terrible confusion during the fit. Even among soldiers, a sort of men over whom, of all others, it ought to have the least power, how often has it converted flocks of sheep into armed squadrons, reeds and bullrushes into pikes and lances, and friends into enemies....

“The thing in the world I am most afraid of is fear. That passion alone, in the trouble of it, exceedingall other accidents. Such as have been well banged in some skirmish, may yet, all wounded and bloody as they are, be brought on again the next day to the charge; but such as have once conceived a good sound fear of the enemy will never be made so much as to look the enemy in the face. Such as are in immediate fear of losing their estates, of banishment or of slavery, live in perpetual anguish, and lose all appetite and repose. And the many people who, impatient of perpetual alarms of fear, have hanged or drowned themselves, or dashed themselves to pieces, give us sufficiently to understand that fear is more importunate and insupportable than death itself.”

A well known writer, who is a psychopathic sufferer, writes: “Carlyle laid his finger upon the truth, when he said that the reason why the pictures of the past were always so golden in tone, so delicate in outline, was because the quality of fear was taken from them. It is the fear of what may be and what must be that overshadows present happiness; and if fear is taken from us, we are happy. The strange thing is that we can not learn not to be afraid, even though all the darkest and saddest of our experiences have left us unscathed; and if we could but find a reason for the mingling of fear with our lives, we should have gone towards the solving of the riddle of the world.”

Anxiety states of neuroses and psychoses areessentially clue to the awakening of the fear instinct, normally present in every living being. The fear instinct is a fundamental one; it is only inhibited by the whole course of civilization and by the training and education of life. Like the jinn of the “Arabian Nights,” it slumbers in the breast of every normal individual, and comes fully to life in the various neuroses and psychoses.

Kraepelin and his school lay special stress on the fact that “Fear is by far the most important persistent emotion in morbid conditions.... Fear is manifested by anxious excitement and by anxious tension.” “Experience,” says Kraepelin, “shows an intimate relationship between insistent psychosis and the so-called ‘phobias,’ theanxiety stateswhich in such patients become associated with definite impressions, actions, and views.” The states are associated with the thought of some unknown danger. Violent heart action, pallor, a feeling of anxiety, tremor, cold sweat, meteorisms, diarrhœa, polyuria, weakness in the legs, fainting spells, attack the patient, who may lose control of his limbs and occasionally suffer complete collapse.

“These states,” says Kraepelin, with his usual insight into abnormal mental life, “remind one of the feeling of anxiety which in the case of healthy people may, in view of a painful situation or of a serious danger, deprive one of the calmness of judgment and confidence in his movements.”

Thus, we find from different standpoints that the feeling of anxiety with its accompanying phenomena is one of the most potent manifestations of animal instincts, the fear instinct, which is at the basis of all psychopathic, neurotic maladies.

The fear instinct, as the subtle and basic instinct of life, is well described by Kipling:—

Very softly down the glade runs a waiting, watching shade,And the whisper spreads and widens far and near;And the sweat is on thy brow, for he passes even now—He is Fear, O Little Hunter, he is Fear!Ere the moon has climbed the mountain, ere the rocks are ribbed with light,When the downward dipping trails are dank and drear,Comes a breathing hard behind thee—snuffle—snufflethrough the night—It is Fear, O Little Hunter, it is Fear!On thy knees and draw the bow; bid the shrilling arrow go:In the empty, mocking thicket plunge the spear;But thy hands are loosed and weak, and the blood has left thy cheek—It is Fear, O Little Hunter, it is Fear!When the heat-cloud sucks the tempest, when the slivered pine trees fall,When the blinding, blaring rain-squalls lash and veer;Through the war gongs of the thunder rings a voice more loud than all—It is Fear, O Little Hunter, it is Fear!Now the spates are banked and deep; now the footless boulders leap—Now the lightning shows each littlest leaf-rib clear;But thy throat is shut and dried, and thy heart against thy sideHammers: Fear, O Little Hunter,—This is Fear!

Very softly down the glade runs a waiting, watching shade,

And the whisper spreads and widens far and near;

And the sweat is on thy brow, for he passes even now—

He is Fear, O Little Hunter, he is Fear!

Ere the moon has climbed the mountain, ere the rocks are ribbed with light,When the downward dipping trails are dank and drear,Comes a breathing hard behind thee—snuffle—snufflethrough the night—It is Fear, O Little Hunter, it is Fear!

Ere the moon has climbed the mountain, ere the rocks are ribbed with light,

When the downward dipping trails are dank and drear,

Comes a breathing hard behind thee—snuffle—snufflethrough the night—

It is Fear, O Little Hunter, it is Fear!

On thy knees and draw the bow; bid the shrilling arrow go:In the empty, mocking thicket plunge the spear;But thy hands are loosed and weak, and the blood has left thy cheek—It is Fear, O Little Hunter, it is Fear!

On thy knees and draw the bow; bid the shrilling arrow go:

In the empty, mocking thicket plunge the spear;

But thy hands are loosed and weak, and the blood has left thy cheek—

It is Fear, O Little Hunter, it is Fear!

When the heat-cloud sucks the tempest, when the slivered pine trees fall,When the blinding, blaring rain-squalls lash and veer;Through the war gongs of the thunder rings a voice more loud than all—It is Fear, O Little Hunter, it is Fear!

When the heat-cloud sucks the tempest, when the slivered pine trees fall,

When the blinding, blaring rain-squalls lash and veer;

Through the war gongs of the thunder rings a voice more loud than all—

It is Fear, O Little Hunter, it is Fear!

Now the spates are banked and deep; now the footless boulders leap—Now the lightning shows each littlest leaf-rib clear;But thy throat is shut and dried, and thy heart against thy sideHammers: Fear, O Little Hunter,—This is Fear!

Now the spates are banked and deep; now the footless boulders leap—

Now the lightning shows each littlest leaf-rib clear;

But thy throat is shut and dried, and thy heart against thy side

Hammers: Fear, O Little Hunter,—This is Fear!

It is interesting to learn what a practical and thoughtful surgeon, such as George Crile, has to say on the matter of fear. Dr. Crile lays stress on the facts that in his researches he finds evidence that the phenomena of fear have a physical basis similar to those morphological changes in the brain cells observed in certain stages of surgical shock and in fatigue.... That the brain is definitely damaged by fear may be proved by experiments.

“According to Sherrington the nervous system responds in action as a whole, and to but one stimulus at a time.... Under the influence of fear or (fear of) injury the integration of the common path is most nearly absolute.... Hence fear and injury (or fear of injury) drain the cup of energy to the dregs....

“We can understand why it is a patient consumed by fear suffers so many bodily impairments, (so many functional disturbances) and diseases even. We can understand the grave digestive and metabolic disturbances under strain of fear.... We can understand the variations in the gastric analyses in a timid patient alarmed over his condition and afraid of the hospital. The patient is integratedby fear, and since fear takes precedence over all other impulses, no organ can function normally (under the influence of fear)” ... Dr. Crile arrives at the conclusion that “Fear dominates the various organs and parts of the body....”

Dr. Crile lays special stress on the pathological character of the fear instinct: “That the brain is definitely influenced, damaged even, by fear has been proved by the following experiments: Rabbits were frightened by a dog, but were neither injured nor chased. After various periods of time the animals were killed and their brain cells compared with the brain cells of normal animals, wide-spread changes were seen (in the brain cells of the animals affected by fear). The principal clinical phenomena expressed by the rabbits were rapid heart, accelerated respiration, prostration, tremors, and a rise in temperature. The dog showed similar phenomena, excepting that, instead of such muscular relaxation as was shown by the rabbit, it exhibited aggressive muscular action.”

Animals in which the fear instinct can be aroused to a high degree become paralyzed and perish. The animal mechanism is by no means perfect. A stab in the heart, a rip in the abdomen, a cut of the carotids, a prick in the medulla, a scratch of a needle infected with anthrax, or tetanus bacilli, a drop of hydrocyanic acid, an arrow tipped with curare,extinguish every spark of life. Organic material may be delicate and complex, but for that reason it is highly imperfect and vulnerable.

Living matter is the feeblest material in nature, and is as fragile as a delicate crystal vase. Protoplasm, or living matter, may be wonderful material, but it can be crushed with a pebble. The most beautiful colors may be displayed by a thin, delicate bubble, but it bursts at the least touch. Living matter is like a bubble, like foam on the ocean. Perhaps no better material is available for the functions of life.

Meanwhile it remains true that the flimsiness of living material makes it easily subject to decay and destruction. It is a profound error, having its root in prejudice, that nature always helps, and that the processes going on in the organism are always of benefit to the individual. Nature is as ready to destroy life as to protect it.

Preservation or destruction of a particular individual depends on the fact as to whether or no normal or pathological processes predominate in the total economy of the organism. This holds true of the fear instinct. The fear instinct is a delicate mechanism, and when its action is slightly intensified, the animal is on the way to destruction. For the cosmic forces are careless of the creatures which keep on pouring forth in generous profusion from the lap of nature.

Living matter, or protoplasm can only exist under special, restricted conditions,—the least variation means death. The more complicated, and more organized protoplasm is, the more restricted are the conditions of its existence. A rise of a couple of degrees of temperature or a fall means disease and death. The same holds true of the rise and fall of quantity and quality of bodily secretion of glands and of other organs. Protoplasm can only exist in anoptimumenvironment. Any change spells disease and death.

The fear instinct, being at the heart of highly organized life activities, is delicately responsive to any changes and variations from theoptimum, requisite for the proper functioning of the organism. Any deviation from theoptimumenvironment, external or internal, produces corresponding changes in the fear instinct with consequent pathological changes in the organism.

The fear instinct like a delicate indicator is the first to get deranged, with harmful results to the organism as a whole. We can thus realize the importance of keeping the fear instinct in good condition. We can understand the significance of Plato’s doctrine of rational guidance of the fear instinct. “What to fear and what not to fear” is at the basis of all organized life, individual and social.[3]

FOOTNOTE:[3]See my work “The Source and Aim of Human Progress.”

[3]See my work “The Source and Aim of Human Progress.”

If we examine closely the symptoms of fear, we invariably find the symptoms of functional psychosis or neurosis. Fear affects the muscular and sensory systems, the vasomotor system, the respiratory system, the sudorific glands, the viscera, the heart, the intestines, all organs and functions of the organism.

Bain, in describing the emotions of fear or terror, says, “Terror on the physical side shows both a loss and a transfer of nervous energy. The appearances may be distributed between the effects of relaxation and effects of tension. The relaxation is seen, as regards the muscles, in the dropping of the jaw, in the collapse overtaking all organs not specially excited, in trembling of the lips and other parts, and in the loosening of the sphincters. Next, as regards the organic processes and viscera. The digestion is everywhere weakened; the flow of saliva is checked, the gastric secretion arrested (appetite failing), the bowels deranged; the respiration is enfeebled. The heart and circulation are disturbed; there is either a flushing of the face or a deadly pallor. The skin shows symptoms—the cold sweat, thealtered odor of the perspiration, the creeping action that lifts the hair. The kidneys are directly or indirectly affected. The sexual organs feel the depressing influence. The secretion of milk in the mother’s breast is vitiated.”

Darwin gives the following description of fear:—

“The frightened man at first stands like a statue, motionless and breathless, or crouches down as if to escape observation. The heart beats quickly and violently, but it is very doubtful if it then works more efficiently than usual so as to send a greater supply of blood to the body; for the skin instantly becomes pale, as during incipient faintness. The paleness of the surface, however, is probably in large part or is exclusively due to the vasomotor center being affected in such a manner as to cause the contraction of the small arteries of the skin. That the skin is much affected under the sense of great fear we see in the marvelous manner in which the perspiration immediately exudes from it. This exudation is all the more remarkable as the surface is then cold, and hence the term, a cold sweat; whereas the sudorofic glands are properly excited into action when the surface is heated. The hairs also on the skin stand erect, and the superficial muscles shiver. In connection with the disturbed action of the heart the breathing is hurried. The salivary glands act imperfectly; the mouth becomes dry and is often opened and shut. I have also noticed that under slight fear there is a slight tendency to yawn. Oneof the best symptoms is the trembling of all the muscles of the body. From this cause and from the dryness of the mouth, the voice becomes husky or indistinct, or may altogether fail.”

If we turn now to the manifestations of psychopathic maladies, we meet with the same fear symptoms:—

(a) The attacks may be muscular, involving symptoms such as trembling, shaking, paresis, paralysis, or rigidity; there may be affection of locomotion or of muscular co-ordination.

(b) There may be sensory disturbances,—anesthesia, paresthesia, analgesia, or hyperalgesia as well as affection of muscular sense and kinesthesia.

(c) There may be skin disturbances, such as arrest of perspiration or profuse perspiration, especially under the influence of emotions, worry, and fatigue; such perspiration may also occur at night, and in some cases the fear of tuberculosis may be associated with such conditions.

(d) The lungs may become affected functionally, and there may occur respiratory disturbances; coughing, hawking, apnea, dyspnea, and asthmatic troubles.

(e) The heart becomes affected, bringing about precordial pain; palpitation of the heart, bradycardia, tachycardia, and cardiac arrhythmia.

(f) The stomach and intestines become affected,indigestion and vague fugitive soreness and pain may be experienced all over or in special regions of the abdomen; constipation or diarrhea may ensue.

(g) The renal apparatus may become affected and its activity arrested, or, as is more often the case in the milder forms of psychopathic troubles, there may be present an alteration in the amount or frequency of micturition, such as is found in the conditions of anuria and polyuria.

(h) Menstruation becomes disturbed, and we may meet with conditions of dysmenorrhea, amenorrhea, menorrhagia, and other disturbances of the tubes, ovaries, and uterus.

(i) There are disturbances of the nervous system, such as headache and a general dull sensation of fatigue and paresis of all mental functions, with dizziness and vertigo.

On the mental side we find in the psychopathies the following disturbances:—

(a) Affections of perceptual activity,—illusions and hallucinations.

(b) Affections of intellectual activity,—argumentativeness in regard to insignificant things.

(d) Affections of religious life,—fear of commission of sins and terror of punishment.

(e) Affections of social life,—timidity, blushing, etc.

(f) Affections in regard to objects, such as astrophobia, acmephobia, agoraphobia, claustrophobia, etc.

(g) Affections of conceptual life,—insistent ideas.

(h) Affections of the attention,—aprosexia.

(i) Affections of the will,—states of aboulia, indecision, discord, conflicts, and uncontrollable impulses.

(j) Affections of the memory,—amnesic and paramnesic states.

(k) General mental fatigue.

(l) Affections of sexual life,—impotence, perversion, and inversion.

(m) Affections in regard to marital relations.

(n) Affections in regard to personal life,—diffidence, self-condemnation, self-depreciation.

(o) Affections of apparent loss of personality,—feeling of self gone.

(p) Formation of new personalities,—dual and multiple personality.

In connection with all such neurotic affections we find invariably present a feeling of unrest, hesitation, doubt, conflict, discord, uneasiness, a feeling of anxiety,conscious or subconscious, feeling of some impending evil. In all such affections we find the brooding spirit of the most powerful of all animal instincts,—the fear instinct.Neurosis is a disease of self-preservation and fear.

A brief outline of a classification of nervous and mental diseases, made by me in my various works, may be of help towards a clear understanding of neurotic disturbances.

The different forms of nervous and mental diseases may be classified intoOrganicandFunctional.

Byorganicaffections I mean to indicate pathological modifications of the neuron and its processes taking place in the very structure (probably the cytoreticulum) of the nerve cell. Under this category come such maladies as general paresis, dementia praecox, all mental and nervous affections of a degenerative and involutionary character. Such diseases are termed by meOrganopathies, orNecropathies.

Byfunctionalaffections I mean to indicate all neuron changes in which the functions of the neuron and its reactions to external and internal stimulations are involved in the pathological process without, however, affecting the anatomical structure of the nerve cell. The pathological changes are not permanent,—recovery of normal function is possiblewith the restitution of favorable conditions of nutrition and elimination.

Functional nervous and mental diseases are in turn subdivided intoNeuropathiesandPsychopathies.

Neuropathic diseases are disturbances of functioning activity, due to defective neuron matabolism, brought about by external stimuli, and more specially by harmful internal stimuli—glandular secretions, hormones, toxic and autotoxic agencies. The pathological, neuropathic process produces few, if any anatomical, changes in the structure of the neuron. The pathology of neuropathic diseases, (probably of the cytoplasm) is essentiallychemico-physiologicalin nature.

Neuropathic diseases include maladies in which the neuron undergoes degenerative changes. At first there is an apparent increase, then an inhibition, and finally a complete suspension of neuron function, not terminating in the destruction of the neuron. Neuron restitution is possible.

Such affections are produced by mild poisons, organic, or inorganic, by autotoxic products, by hyposecretion or hypersecretion, or by absence of hormones in the economy of the organism. Here belong all the temporary, or recurrent maniacal, melancholic, delusional states, puerperal mania, epileptic insanity, the mental aberrations of adolescent and climacteric periods, periodic insanity, alternatinginsanities, and in general all the mental affections known under the description of manic-depressive insanity.

Where the disease depends on theinterrelationof neurons in a complex group, onassociation of systemsof neurons, the condition ispsychopathicin nature.

In psychopathic troubles the neuron itself may remain unaffected, may be perfectly normal and healthy. The disorder is due to association with systems of neurons which are usually not called into action by the function of that particular neuron system.

ByOrganopathiesorNecropathiesI indicate a group of psychophysiological symptoms, accompanied by structural, necrotic changes of the neuron, terminating in the ultimate death of the neuron systems, involved in the pathological process.

ByNeuropathiesI indicate a group of psychophysiological manifestations due to pathological functional neuron modifications, capable of restitution through normal metabolism.

ByPsychopathiesI designate pathological phenomena of psychophysiological dissociation and disaggregation of neuron systems and their functions in clusters, the neuron itself and its special function remaining undamaged.

The psychopathies are further subdivided intoSomatopsychosesandPsychoneurosesorNeuropsychoses.

TheSomatopsychoses are characterized by somatic symptoms, by disturbances of bodily functions, such as paralysis, contractures, convulsions, anesthesia, analgesia, hyperalgesia, and other sensory disturbances, as well as by intestinal, cardiac, respiratory, and genito-urinary troubles.

Thepsychoneuroses or Neuropsychoses are characterized by mental symptoms. The patient’s whole mind is occupied with mental troubles.

Such conditions are found in obsessions, fixed ideas, imperative impulses, emotional compulsions, and other allied mental and nervous maladies.

Somatopsychoses simulate physical and organic nervous troubles. Thus, many “hysterical” forms simulate tabes, or paralysis agitans, hemiplegia, paraplegia, or epilepsy, while many of the neurasthenic, hypochondriacal, and their allied states may simulate tumor, cancer, intestinal and glandular derangements, cardiac, laryngeal, pneumonic, hepatic, splanchnic ovarian, tubal, uterine, renal, and other bodily afflictions.

The neuropsychoses or psychoneuroses simulate all forms of mental disease, beginning with melancholia and mania, and ending with general paresis and dementia.

Psychoneurosisandsomatopsychosisare diseasesof the subconscious; in the former mental, in the latter physical symptoms predominate.

Psychopathic states should be rigidly differentiated from other disturbances, such as neuropathies and organopathies, or necropathies.The following diagram may be of help:

Nervous and Mental DiseasesDIAGRAM I

In my work on “Sleep” I report a series of interesting experiments carried out by me on guinea pigs, rabbits, cats, dogs, children, and adults.[4]I discovered one of the most important states of animal life, a state which I termedhypnoidal.

The study shows that in almost every animal, from the lowest to the highest, from frog to man, a somewhat sudden change of the usual environment deprives that animal of its activities and its functions. If the change is not too intense and prolonged, the animal merges into the hypnoidal state in which the lost functions are restored. During this hypnoidal state the functions are weakened, the animal may be regarded in a state of invalidism, its reactions being enfeebled, practically speaking, paretic.

Perhaps it is advisable to approach the phenomena from their more striking aspect. In seizing a triton, salamander, or frog, and stretching it on the table, one will observe with surprise that theanimal remains in the same position given it. The most uncomfortable and bizarre position may be given to the limbs, and still the animal will not move. Testing the extremities one finds them rigid and resisting. Something similar we find in the hypnotic condition, when under the suggestion that the extremities are rigid, and they cannot be moved by the subject. The same can be done with a lobster and other animals of the same type.

Everyone has heard of theexperimentum mirabilemade by Kirchner in the seventeenth century. A rooster or hen is seized, the legs are tied with a string and the bird is put on the ground. A piece of chalk is passed over the beak,—the chalk tracing a line from beak to some distant point on the ground. When the bird is released, it remains in the same position. Some explain that the animal is kept prisoner, because it “imagines” that it is bound by the line of chalk. The chalk, however, is unnecessary. The animal may be seized, shouted in its ear, or kept down forcibly, and the same result will happen. This state has been termed by Preyer “cataplexy.” The phenomenon can also be produced in insects, in mollusca.

Many investigators have been interested in this phenomenon. I have devoted a good deal of work to this condition which is also found in mammals in which it is induced by the fear instinct. In mammals, however, the state of cataplexy is not necessarilyaccompanied by rigidity, although it may be present, but there is a complete loss of voluntary activity. Horses tremble violently and become paralyzed at the sight of a beast of prey, such as a tiger or a lion. At the sight of a serpent, monkeys are known to be in such an intense state of fear that they are unable to move, and thus fall easy victims to the reptile.

Under similar conditions birds are so paralyzed by fear that they are unable to fly away from the source of danger, and fall a prey to the threatening serpent. The birds resemble very much the hypnotized subject in a state of catalepsy. Although the gibbons are the most agile of all the simians, they are easily taken by surprise, and captured without any resistance,—they are paralyzed by fear. Seals when pursued on land become so frightened that they are unable to offer any opposition to their pursuers, and let themselves easily be captured and killed.

In large cities one can often witness nervous people affected suddenly by the presence of danger; they remain immobile, in the middle of the street, becoming exposed to fatal accidents. The fear instinct paralyzes their activities, they are petrified with terror.

I was told by people who have experienced the effects of earthquakes, that during the time of theearthquakes they were unable to move, and the same condition was observed in animals, especially in young dogs. It is hard to move cattle and horses from a burning stable, on account of the fear of fire which obsesses the animals, so that they become paralyzed, suffocated and burnt to death. So vital is the fear instinct that the least deviation from the normal state is apt to play havoc with the safety of the individual.

The fear instinct is the most primitive, the most fundamental, and the most powerful of all instincts. When the fear instinct is let loose, the animal succumbs. We should not wonder, therefore, that with the aberration of the fear instinct, the life guardian of the individual, all orientation is lost, the animal becomes demoralized, and the organism goes to destruction. No other instinct can surpass the fear instinct in its fatal effects.

The more one studies the facts, the more one examines various psychopathic, functional maladies, without going into any speculations and without being blinded by foregone conclusions and pseudo-scientific hypotheses, the more one is driven to the conclusion that the fear instinct is at the bottom of all those nervous and mental aberrations, conscious and subconscious.

The infinite varieties of functional psychopathic diseases are the consequences of some abnormal associationwith the fear instinct which alone gives rise to the infirmities characteristic of functional mental maladies.

President Stanley Hall accepts my view of the subject. In a recent paper he writes: “If there be a vital principle, fear must be one of its close allies as one of the chief springs of the mind”.... In spite of his former psychoanalytic inclinations President Hall asserts now that “Freud is wrong in interpreting this most generic form of fear as rooted in sex.Sex anxieties themselves are rooted in the larger fundamental impulse of self-preservation with its concomitant instinct of fear.” This is precisely the factor and the teaching which I have been expounding in all my works on Psychopathology.

So deeply convinced is Professor Stanley Hall of the primitive and fundamental character of the fear instinct, that he refers to the facts that “if the cerebrum is removed, animals, as Goltz and Bechterev have proved, manifest very intense symptoms of fear, and so do human monsters born without brains, of hemicephalic children, as Sternberg and Lotzko have demonstrated.”

The fear instinct is of such vital importance that it is found in animals after decerebration, and persists in animals after spino-vago-sympathetic section. Sherrington found the fear instinct present in dogs after section of the spinal cord and also after complete section of the vago-sympatheticnerves, thus removing all sensations coming from the viscera, muscles, and skin, below the shoulder, leaving only the sensations from the front paws, head and cerebral activity. The dog was a sort of cerebral animal. The whole body below the shoulder, skin, muscle, viscera, were all anaesthetic, and yet the fear instinct remained intact.

On the other hand, after complete ablation of the cerebral hemispheres of the dog, so that the animal became spinal, all cerebral functions being totally wiped out, Goltz invariably found that the fear instinct remained unimpaired.The fear instinct is inherent in animal life—existence. As long as there is life, there is fear.

So potent, all embracing, and all pervading is the fear instinct, that the physician must reckon with it in his private office, in the hospital, and in the surgical operating room. In a number of my cases psychognosis, the study and examination of mental states, clearly reveals the fact that even where the neurosis has not originated in a surgical trauma, surgical operations reinforced, developed, and fixed psychopathic conditions.

The fear instinct is one of the most primitive and most fundamental of all instincts. Neither hunger, nor sex, nor maternal instinct, nor social instinct can compare with the potency of the fear instinct, rooted as it is in the conditions of life primordial.

When the instinct of fear is at its height it sweepsbefore it all other instincts. Nothing can withstand a panic. Functional psychosis in its full development is essentially a panic. A psychogenetic examination of every case of functional psychosis brings one invariably to the basic instinct of life, self preservation and the fear instinct.

As Whittier puts it:

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