MEDICAL PSYCHOLOGY, RIENZI ROBINSON, M.D., DANIELSON. Feeling the need of the greater study and the more practical application of the principles of psychology in the every-day work of the general practitioner of medicine, I have chosen the above subject for my theme. We live in an age of positive demonstration and tangi- . ble entities. The student strives to find some ultimate thing that can be seen microscopically if need be, or weighed and measured, however infinitesimal the atom. We are looking for the unit of size, weight and force, with the view of demonstrating it as a veritable thing, endowed with an individuality of its own. We look forward to the time when we may even measure that something, which in lieu of a better term we call vital force; that something which thus far has baffled the most expert physicist and discounted his most elaborate cal culations. In the treatment of disease we are never able to measure accurately that which carries one patient through a critical illness and fails lamentably in another. We are never able to estimate with any degree of certainty the force of will that at times tyrannizes, as one might say, over the physiological activities of the different organs of the body, stimulating the one, and depressing the other. We have yet to study and understand better the psychological influences of mind over organic function and the power of inheritance and environment over mind itself. Everything that bears upon the life of the individual becomes the province of the physician and needs the most careful study and training upon the part of the student and practitioner. He must not only be grounded in the fundamental branches of medical science but he must understand the ethics and principles of physiological and pathological psychology. Here is something that cannot be expressed in mathematical formulae, yet is as essential to success as the demonstration of a chemical reaction. You have only to think a moment and questions without limit force themselves upon the waiting physician. The few I may mention only hint at the many that might be brought forward. In a state where ten to fifteen per cent. of all marriages are afterward annulled in the divorce courts, who can measure in positive terms the amount of nervous disease growing out of this domestic infelicity? In a state where murders and suicides are as common as in the half-civilized territory of New Mexico, who can express by any mathematical terms the underlying forces that have led men and women into that insane state of mind which compels them to kill themselves or others? In a state where degenerates are allowed to marry and reproduce themselves without limit, who can count the number of imbeciles and diseased criminals that come from such unions? In a state where alcoholism and lust furnish our jails and prisons with ninety per cent. of their inmates, who but the physician is competent to connect the crime with some diseased condition of inheritance and early life? In a state where our ever enlarging insane asylums are unable to cope with our ever increasing insane population, who but the physician, and the broad minded one at that, can study successfully the thousand and one psychological factors that drive to the wall these sickly waifs? You may say that the insane criminal belongs to the criminal courts and the insane invalid to the alienist, but before the insane criminals bring up at the bar of justice or the insane invalids come into the hands of the alien ist they are mentally, morally and physically diseased and under the care of the family physician. The criminal judge and the alienist come in contact with the cases, as a rule, only after they have reached an advance stage of development and the diagnosis of criminality or insanity is easily made and easily apparent to the non-professional. The general practitioner, though not an expert in nomenclature and technical terms, takes note of them in the incipient stage, and dates the beginning of the disease far back of the alienist, back of the time when the immediate friends detect any mental twist. It is here that the family physician needs all the acumen of the expert and something more in tracing those little peculiarities, insignificant in themselves, yet leading to such dire results. In times gone by when the doctrine of "free will" was a settled conviction, it was an easy matter to divide all men into two classes, the wills and the wonts, and to judge them accordingly. Then came a time when it was a question whether a man had any will in the matter at all; some going so far as to claim that given a certain inheritance and a certain environment, it was easy to predict the resultant. This made man a victim of two forces, inheritance and environment, over neither of which he had any control, buffeted by either; a mere automaton. It is a well known fact that the larger half of our practice is made up of nervous troubles; not the result of germs and tangible entities, but growing out of things innumerable which cannot be weighed and measured in the laboratory. They must be studied from the empirical and speculative side, and each individual presents a problem of its own, which must be worked out along lines of general principles, specifically applied. There is a large field for this kind of work in which the general practitioner finds himself and baffled is he who |