Page:Popular Science Monthly Volume 82.djvu/187

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PSYCHOLOGICAL MEDICINE
183

surpass in psychological interest the smaller group of neurotic conditions that do not regularly come under institutional care.

It is not now easy to say how this latter group of cases will to any extent be brought under the observation of the psychologist. Except in isolated instances, the material of private practise may be systematically observed only by the physician who treats it. For our psychological understanding of these cases, we shall presumably remain dependent upon such studies as the specially interested physician is able to make in the course of his practise. These researches should improve in number, if not also in quality, as medical students acquire more knowledge of psychopathological problems, and of the means by which to approach them. The case is more favorable with that part of this material than is seen in general hospitals, or in small private institutions, but the obvious economic difficulty of providing for the systematic psychological study of this material is one which it has not yet been attempted to meet. If these conditions are thus less accessible as a group, it is partly compensated for by their greater accessibility as individuals, owing to the generally better preservation of the intellect and cooperative faculties, so far as these enter. In the comparative study of the neuroses and psychoses, these factors to some extent balance each other.

The most practical means to further the accessibility of psychopathological material for psychological research, has been through the establishment of research positions in the institutions whose facilities are adequate to them. The past decade has witnessed the inception of a considerable amount of this work, under various state and private auspices. The conspicuous success of Franz at Washington and of Goddard at Vineland may be mentioned. These positions have been regularly filled by persons of the university training in psychology, who are expected to devote their time to original investigation. Whatever the special character of the material investigated, the main responsibility for psychopathological investigation will rest—and perhaps it may be added that it ought to rest—with the men in these positions, relieved of the perpetual penalty of therapeutic promise. As the success of these positions depends upon the men whom they will draw, and this in turn upon the opportunities they offer, it may be well to briefly analyze from both standpoints the external conditions under which this work is done.

Institutions that make scientific appointments are presumably ready to devote themselves in some measure to work of a purely research character, the immediate practical realization of whose benefits is likely to be a matter of more than ordinary good fortune. The creation of such positions therefore implies in the administration a fair degree of sympathy with scientific motives. Institutions inadequate to this de-