t and remaining fundamentally unaltered,
although possibly much modified gradually by added experiences from
within and without, depends on the maintenance of a harmonious balance
between stimuli received and emotional reaction and motor response to
those stimuli so that the feeling of well-being may arise.

If from any cause there occurs a failure to appreciate the stimuli
clearly, if the emotional reactivity be disturbed, if the sense of value
becomes biassed in one direction or another so that the response is
recognized by the patient as abnormal there will result a disharmony and
a feeling of ill-being of the organism. Under these conditions the
processes of facilitation along certain definite lines and inhibition of
all other lines--processes which are essential to clear
consciousness--will become difficult or perhaps impossible and a mental
illness will develop. In the slighter degrees the disharmony may be
known to the patient without there being any outward manifestation to
betray the conflict going on within. In the severe degrees the mental
activity of the patient may be under the control of some dominant
emotional state so that it may be impossible for him to adapt himself to
his surroundings in a normal manner although his behavior may not appear
so irrational when we know the stimuli affecting him. Within these
extremes we discover all degrees of disturbance, and all varieties of
signs and symptoms may be encountered.

But the signs which become obvious to superficial observation are, to a
large extent, secondary products. The primary symptoms are felt by the
patient as a disturbance of the capacity to perceive, to think, to feel,
to judge, and to act, and with these disabilities there will be
associated a certain degree of confusion and anxiety which cannot fail
to appear as the result of such alterations of function.

The obvious signs may represent merely a more intense degree of the
primary affection, disturbed capacity together with some confusion and
anxiety; or they may represent efforts on the part of the patient to
overcome or to escape from the disturbance or to explain it to himself.
And now the total lack of knowledge of the processes on which mental
activity depends, the altered standard of judgment due to some degree of
dissociation, and the necessity of obtaining relief in some way or other
will have much to do with determining the character of the symptoms with
which we are all familiar. S