The lectures of Prof. Kraepelin, as presented to us in Dr. Johnstone's excellent translation, form a fascinating study. Yet it is probable that with respect to some of them a reader is apt to rise from their perusal with a certain amount of mental confusion. His descriptions, from a clinical standpoint, are delightful reading, and lucid in the highest degree; but when, with the help of new terms, which really only express old familiar facts up to this otherwise expressed, he casts into new groupings cases which have two or three features in common, although differing considerably in their course and in the varying phases of mental disturbance which they present, there is a difficulty in following him. And any scheme of classification founded on a more or less casual and fortuitous similarity as far as a few symptoms are concerned, while ignoring important points of difference, cannot do anything else than create confusion. No doubt Kraepelin's object, so far as we can judge of it, is to group cases of insanity in such a way as to constitute a real help to diagnosis, and, what is of more importance, to prognosis, in the multitudinous phases of mental derangement which come under our notice, and this object is, so far, a meritorious one. But is the object attained by this method? Is it attainable? The fallacy—for it is nothing else but a fallacy—of regarding any mere grouping of symptoms of insanity as a distinct disease entity is apparent throughout. Insanity is protean in its manifestations, and the symptoms in any particular case may at one point of its course resemble those of one of the so-called varieties, and at another they may correspond with those of quite a different grouping. This fact alone would seem to indicate the futility and uselessness of founding any system of classification of insanity on symptomatology. The endeavour to do so can only be regarded as an impossible feat, a feat which is nevertheless being constantly attempted with a persistent fondness which is quite pathetic by most classifiers, who seem anxious to rival the punitive labours of Sisyphus or the daughters of Danaus, with similar fruitless results.
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