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A Plea for the Conjoined Study of Mental Science and Practice. Being the Introductory Lecture to a Course of Medical Psychology

Published online by Cambridge University Press:  19 February 2018

Thomas Laycock*
Affiliation:
Practice of Medicine and of Clinical Medicine, and Medical Psychology and Mental Diseases in the University of Edinburgh

Extract

In this university the study of medical psychology and mental diseases is wholly voluntary. None of the faculties require candidates for degrees to attend the course I deliver, or examine them in the subjects discussed. Doubtless the faculties of arts, theology, and law, might reasonably object to so great an encroachment upon vested interests and established traditions; but it is different with the faculty of medicine, because moral philosophy has only been added to the curriculum of medical studies since I commenced to deliver this course. I have therefore thought it would be expedient (and suggested it, indeed) to permit students of medicine going up for their degrees to choose between medical psychology and moral philosophy; nevertheless the course is still without even this modified recognition. Nor do any of the other medical boards of examiners of the United Kingdom require it. The Senate of the University of London has, however, very lately recommended the practical study of mental diseases to candidates for medical degrees; but valuable and important as this step is, yet, inasmuch as it excludes medical psychology, it falls very far short of what must ultimately be required in the interests of society of all students seeking general culture or to enter any of the learned professions. I entertain a deep-rooted conviction that mental science, in the modern and practical sense of the term, will sooner or later be forced on the attention of political economists and statesmen as one of the needs of the time; and I am equally convinced that no such science is possible except by the observation and study of morbid mental states. I therefore propose on this occasion to plead for the general study of medical psychology or mental science developed according to this method in this classroom, and although I may not hope to be successful in my pleading, I trust I shall at least encourage you who engage in the study voluntarily to pursue it ardently, as offering its own full reward for any labour you may bestow upon it.

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1866 

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References

I refer above to the following views of my friend Dr. Lander Lindsay, of Murray's Asylum, near Perth, and which I quote from this Journal of April last, p. 143 :— “In truth, there can be no classification [of mental diseases] absolutely correct and scientific, inasmuch as the phases of abnormal mentalisation are as infinite, as varied and varying, as contradictory or capricious, as the phases of human nature, of normal mentalisations, of emotional exhibition, of the play or display of the passions. Neither normal or abnormal mind has been or can be accurately defined so as to delude all the phenomena of the one and exclude all those of the other. I believe a scientific definition to be impossible. The principles of nomenclature and classification, as applied to such sciences as botany and zoology, are inapplicable, cannot be carried out, at least into the details of species and varieties, without sacrifice of truth; and while this is so all attempts at such classifications are simply mischievous and absurd, leaving the subject more confused than they found it, rendering the science (?) called Medical psychology' a bugbear to the student, a butt for satire and abuse by the lawyer, a subject of . suspicion to the public.” I need hardly remark that if such objections had been effectually raised against the cultivation and classifications of botany and zoology when those sciences were still in their infancy, there would have been no such sciences now in existence. A scientific classification is a concise and simple expression of the known facts and generalisations of the science, and is perfect or imperfect just as such knowledge is perfect or imperfect. As knowledge in any science advances, its classifications change, but no classification whatever can be perfect (as Dr. Lindsay demands that of medical psychology shall be before it be allowed at all) until the knowledge be perfect. In the absence of this perfection in the classification of mental diseases, Dr. Lindsay thinks that there is no nosology so practically useful as “the old one of half a century ago,” which has only the five simple heads of mania, monomania, melancholia, dementia, and amentia, and which consequently represents at least the extent of that century's knowledge. But what is the nosological position of the case to which Dr. Lindsay has thought it expedient to append his criticisms above quoted, even if we go back half a century ? He terms it a case of “temporary insanity” simply because the patient, a female servant, liad a temper-delirium for a few hours, in a way with which the police and hospital staffs of our large towns are very familiar. Now, a transitory delirium cannot be classed with any form of insanity under any nosology, without confounding states of mental disorder essentially different as to causes, course, and treatment. It is not surprising, therefore, that Dr. Lindsay proceeded to make arrangements for placing his delirious patient in a hospital for lunatics, and that she happily escaped so serious an infliction by a rapid recovery.Google Scholar

The other class of objections is well illustrated by the opinions expressed in a recent number (October, 1861) of the ‘British and Foreign Medico-Chirurgical Review,’ in an article on certain medical introductory lectures. The late Mr. Grainger, in his introductory lecture, delivered October, 1860, at St. Thomas's Hospital, expressed his entire assent to an important and fundamental principle of medical psychology, namely, “that even in the subtle operations of the mind no thought arises without exhausting a portion, however minute, of the gray nervine of the brain,” and “that there is no pure manifestation of life apart from matter.” It is a statement of a fact or two in mental chemistry which the reviewer could fairly question or correct. But he prefers to fling “materialism” at the mental chemist and assert his beliefs. “Materialistic or not,” says the critic, “this localising of thought in the cineritious structure of the double brain, this amalgamation of logic and pure mathematics” by equivalents,’ with corresponding infinitesimal atoms of gray matter, always appeared to our limited apprehension as materialism burlesqued or materialism under mystification.Google Scholar

Thought in the double mind of the double brain ! Thought in the pineal gland ! Thought in this, that, or other pulpy morsel ! Everywhere revealed, let us seek it nowhere. Thought is not a thing of bits and pieces. Thought is a presence, without a place” The writer of this absurd denial of one of the most important groups of facts in mental science is probably materialistic enough himself to believe in ghosts that tweak your nose (safely in the dark) or break your head with a tambourine.—T. L.Google Scholar

‘Mind and Brain or the Correlations of Consciousness and Organization’ vol. i, part iii, p. 217.Google Scholar

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