diseased has once been given a case of mental suffering in hand—one whose investigations have led him as accurately as possible to differentiate it from the truly alienated cases that can only be cared for in protective institutions—he is at once often confronted with conditions that tax his insight perseverance and skill, not only to an almost unwonted degree, but far beyond the comprehension and consequently the sympathy of his employers. Frequently, also, he has to contend with varied and numerous and unexpected misleadings and coverings up of facts which may be mostly owing to a previous false diagnosis; or, he finds the patient's normal ideation more or less in a state of irrecoverable atrophy or decay; or, that there is perverted emotionalism quite beyond understanding and of a continuously disastrous nature; or that the will power has been so frequently strained and wrongly directed that it can be relied upon for scarcely any good effort at all; or, so frequently, all these in most perplexing combination. In fact, the case is always one where the whole organism is more or less under the spell of the mental distress, and consequently has a minimum of recuperative forces at command. Even almost every physical function is apt to be so lowered and perverted that, in turn, they may contribute to the disease of mind and to the resistance to be overcome. In fact, the case is one of "sickness all through"; and the remedy and management must be based upon this comprehensive vision, or failure will almost inevitably result.
Hence the wise remedialist will never neglect to at once institute every sort of hygienic, sanitary and therapeutic measure, which may be rationally indicated. Failure here is folly unmitigated; and no assumed "special" or "exceptional" ability that presumes to get along without due attention to the physical as well as mental functioning can make it otherwise, try and promise as one may.
Having first, then, given due consideration to the conditions and needs of the entire case, the wise ministrant to the mind diseased will next, and at once, seek to understand in detail the changes from the normal psychology which are the immediate sources of the distress. Here, again, ability to investigate with a penetration and thoroughness that only the trained scientist can comprehend is the next great duty which he owes both to his patient and to himself. To accomplish this, he will bring all that his life, his reading, his special training and experience have taught him; will exercise all the mental and moral qualities of which he is possessed; will devote himself in every manner practicable, not only to relieving the present distress, but to arousing such latent and stifled mental functions as will in due season contribute of themselves to help to overcome that which is abnormal, and substitute normal thoughts and feelings in its stead. In all this he will need and should have the full confidence and intelligent help of those who are
