he says were more concerned with the
recommendation of a favorite remedy than with the natural history of the
disease, "as if," he says, "the treatment of every disease without
accurate knowledge of its symptoms involved in it neither danger nor
uncertainty," and he quotes the following maxim of Dr. Gault: "We cannot
cure diseases by the resources of art, if not previously acquainted with
their terminations, when left to the unassisted efforts of nature."
Exclusive attention to the physical condition and factors, or to the
mental condition and factors, or concentration on one theory or one form
of treatment to the exclusion of all others is sure to lead to neglect
of that careful general inquiry into the whole personality of the
patient, into the conditions out of which his disorder arose, and into
all the manageable factors in the situation which is so essential to
intelligent and effective treatment. Notwithstanding the great benefit
which has been derived from physical measures in the study and
treatment of mental disorders, and the well-founded hopes of greater
advances in this direction, the main task still continues to be what
Pinel calls the management of the mind. Experience and increasing
knowledge show that this is a task which can only be successfully
performed by the physician and by means of organized resources which are
under medical direction and control. The hospital for mental disorders
furnishes the means of providing social as well as individual treatment.
It is a medical mechanism and for its proper management and use it is
required of physicians that they accept the burden of much executive
work and give their attention to many subjects and activities that may
interfere seriously with what they have been taught to regard as more
strictly professional interests. Like Pinel, one must be willing to
forget the empty honor of one's titular distinction as a physician, and
do whatever may be necessary to make the institution a truly medical
agency for the healing of the sick. Considerable progress has been made
in developing executive assistants to relieve the physicians of much of
the administrative work which requires little or no medical supervision
and direction. Special provision for the training of such executives
has, however, received insufficient attention. This question might, with
great advantage, be taken up by the hospitals and colleges. Nothing
would add more to the quality of the service whic