-. MEDICAL SCIENCES - PROGRAM AND POLICY-- PSYCIIIA'PRY

WHAT IS PSYCHIATRP?

@a -1

by

Alan Gregg

December 3, 19-41

WHAT IS PSYCHIATlIY?

u. GYC 77

It has been my experience that apart from an imaginative minority

most people have either had close contact with what is called mental disease
through having seen a relativc or friend attackcd by some form of it,  or,
on the other hand, they have virtually no interest in psychiatry but merely
an ignorance enhanced by aversion and evasion.  Close contact even for one
day with a friend who has bccome insane is an expcrience which beggars any
argument for the inportance of psychiatry, and only those who have never
seen mental disease at close range can shrup; their normal  shoulders with
undonoern or with umuffled resignation assume the adequacy of the nearest
asylum.

     Whereas the usual physical ills concern the inade2uate performance
of heart, lungs, stomach or some other organ in tho service it renders to
the rest of the body, psychiatric diseases must in thc min still be defined
in terms of inadequate performmce of an individual human being vis   vis
other human beings.  Psychiatrists study and treat human beings who are
inadequate or actually dangerous in their behavior as members of society:
and so it happens that psychiatry as the study of disordered conduct is
intimate to an almost suspicious degree with cthics , with cultural anthro-
pology, with socioloF;y, with motayhysics, xith rcligion, with artistic
activities -- and this despite the fact that the behavior of R human in-
dividual as a whole should be as soundly understood in terms  of medicine
as the behavior or function of any of his component organs.  To understand
mcntal disease calls for medical art aid science but also for a wide knowl-
edge of the society and culture to which each of us must lcarn to adjust.

Vhile your attention is still at the optirmun let me offer you bvo

ideas of cardinal importance to your understanding diat psychiatry is 8
first, that tho psychiatrist atQdies the function and the influence of
mental processes and emotional states in the v.hole vast range from incurable
disease to optimum health; and, second, that the psychiatrist seldom handles
conditions which he can describe without reference to the demands of society
upon the individual.. As the f'unctions of an automobile are not the functions
of its carburetor or its gears,  so the functions of man as a whole individual
not only transocnd but differ radically from the functions of any of his
component organs or systems.
vith the nervous system, it is quite natural, for the function of the nervous
system is to coordinate, to integrate, to adjust, to harmonize, to administer
the services of all the organs of the individual and to perpetuate his
identity as a person through a finite but extremely long series of changing
environments -- dangers and difficulties and defeats, as well as resting
periods, comforts and delightful s~cce8ses.

If psyohiatry has especially closc connections

     I should not be satisfied with the definition of psychiatry as
that specialty of medicine thhich deals with mental disorders.
nevrspaper hcadline, such a definition confines while condensing and mis-
represents by oversi-plifying.  Psychiatry deals also with the emotional

Like a bad

mid social life of man, merely his reasoning mental operations. Insofar
as experience has shown you that enotional thinking is different from logical
reasoning, the whole purvicw and range of psychiatry is evidently extended.
Indeed, the province of psychiatry is the conduct of man, his reactions, his
behavior as an indivisible sentient being with other such beings.
recently attention has bcen given only to grossly disordered cofiduct -- to
pcrsons locked up in asylums -- but now the field is  far more inclusive because
it reaches into the anxieties, the fatipes, the instabilities, the adjustnents,
thc disturbances of nor-ml everyday living, and also bccause it iricludes the
cffccts of mental and emotional functions upon the component organs of the body
QC well as the effects of disordors of these organs upon the functions of thc
human being as a whole.

Until

Let us make the position of psychiatry a little clearcr by distin-

pishinp; it from neurology and. from psychoanalysis.
of the nervous system; more specifically, the discases of the nervous systen.
Olx-iviusly there is much overlapping between neurology and psychiatry trr!icn de-
fects or diseascs of the brain, spinal cord and peripheral cervcs are involved.
But neurology points toward the functions of the nervous system as serving the
efficiency of the individual nachine, while psychiatry directs its attention
to conduct -- that blend of mental and emotional functions, dependent, it is
true, largely upon the nervous system but involving more than the serviceability
of that system to the individual RS a whole. The location, structure and func-
tion of the nerves ar-d thc paths taken by nerve irqulses are the basic icnowledCe
of the neurologist.  The neurologist learns to dctect vfiiere injury or infection
is located along a large variety of nerve tracts.  'io the studies of gunshot
injuries of the nervous system Arierican rieurology axes its beginninpJs during
the Ciril liar.
loss of sensation due to ncrve injury, is the task of R neurologist, not a
psychiatrist. Lfost neurologists practise psychiatry because whai  lie laymin
calls "nervousness is not an affair of nerve tracts but is riue to emotional
conflicts or other psychiatric disturbances o Fsgchiatric disorders are much more
numerous Lhan neurolorical disorders.

Kcurology is the study

The location of' a brain tumor, or the cause of a paralysis or

11

Indeed, the psychiatrist' ti domain is almost bafflingly large, for

it includes derarieements of conduct or behavior often discernible only in term
of the patient's relationships with other human beings in some givcn intellec-
tual or cultural or social or moral system.
cble knowledge of language, of custom, of tradition, of tlie culture arid mores
that surround the yttient.
be responsikle, and. for thcir correction an equally varied acsortmcnt of treat-
ments my Le effective. Indeed, so complicated and numerous are the components
of norm1 l-iwnmi conduct that it Iias tallen years of study of abcorrnalities  t.o
arrive at cveri a tentative list 02 vhat had hitherto escaped recognition because
of its constant prescnce in normal persons.  As a figure of speech we say,  "It
sticks out like u sore thumb."  In the sm.e way normal behavior renaiiis incon-
spicuous until Ziseasc calls attention to its numerous components. Psychiatry
has had to  Lukt.: the long road. to recoEnition of o. f'unctiori through the conspic-
uousness of' its absence.

         And that presupposcs a consider-

For these deracgcmcnts a wide gamut of causes may

Let ne offer some oxa.nples of such functions of the persoriality

suddenly made concpicuous

3.

       A man receives a severe blow on the head.
corifused, ~~5th or without knowing that he has lost touch with reality.
he nay lose consciousness or lose his mcmory for the events imediately pre-
ceding the blow.
be conscious and have memory intact.

IIe may be dazed or

                                          Or


Thus ne see that the normal man should know where he is,

A soldier may receive a bullet which traverses a part of his brain.

The permanent after-effects Ray be a loss of initiative amountin& to the general
apathy of ti purely vegetative life.
of a nan.

Such placidity is riot Ihe normal condition

     Alcohol in excess produces effects which would seem Roro remarkable
if they werc less familiar -- a sense of self-confidence and vrell-being -- as
William James said, the mood of "saying yes to everything" -- a loss of discrc-
tion and self-control, and in extreme cases sensation, emotion and mental activ-
ity erased in stuporous and dangerously insensate sleep.

You will note that the phenomena ~r9 of the order of derangements of

conduct of the individual as a person, and that it is sometimes hard to separate
psychiatric symptoms from immorality.

A malrrourished patient vi& pellagra exhibits irritability,  eclotional

instability and a sense of fatigue.
accompanies high fever suff crs from delusions, believing perhaps that his at-
tendants are soor. to be his assassins, tmd reacts accordingly.
of either sex as they approach the fifties  or sixties often pass through a year
or so of depressed spirits and show a morbid concern for their health but emerge
on the other  side of that too little recognized slough of despond with a seren-
ity end. good chesr vhich comfort in equal neasure themselves arid their friends.
An elderly marl whose hardened arteries supplying thc brain givc insufficicnt
service there shows child-like temper taritrums arid enbittered pigheadedness --
the tragic fatc I think of Woodrow t'lilson.

A patient with the delirium which often

                Human beings

A tumor of the frontal lobe may show its first symptoms  ir, an in-

ordinate vreakncss for making puns on2 jests of doubtful propriety.  An infection
of the brain with the spirochete of syjjhilis often results in delusions of gran-
dew and self-importance vhich are no less disastrous for hnving an insidious
and unrecognized beg imiiip; .

     Kovr you will note that each of the symptoms  I have meritioncd relates
to conduct ond yet each vas differert.
symptoms resulted from conditions afflicting a p-cviously vel1 person,  and are
accompanied by physical or chemical events in the body which car1 be stated in
other terms than those of conduct. There ~VRS a bruise on the scalp, a bullet
hole, alcohol in thc blood, inadequate vitamins, high fever, a reduction of
sex hormones, a tumor, deficient blood su;iply in the brain, or positive Wasser-
mam in thc spinal fluid.

Also, please note that these psychiatric

But psychiatrists must; deal also with aberrations from normal conduct

in pcrsons ivho ncver were normal -- with idiots whose heads never grow larger
than a crapefruit, v:i th cretins vhose brains have been irreparably handicappcd
by lack of iodino, witk congenital epileptics and other hereditary or congenital

disease -- but in each of these conditions the essential and pressing fact is
that  in terms of their relationship vdth normal human bcin,gs these paticnts
are obviously incapable of the expected conduct.

       Thus far the conditions mentioned have involved in thc first place
disorders of reaction, conduct or behavior which are at the same time recog-
nizable by characteristic changes in body structure or body chcmistry.  These
are the conditions more easily recognized -0 where fuiiction and structure are
both at variance with the normal.

     There remains a much morc difficult group of diseases where up to now
we can merely say that conduct and types of reactior, are disordered but no  struc-
tural or chemical variation is knovrn to accompany in characteristic fashion the
all too obvious symptoms of social, moral, and intellcctual inadequacy. In this
category falls every gradation of disintegrated personality,  from the uncon-
trollablG manias of the madhouse to the trivial fears and the virtually harmless
mannerisms or petty foibles of everyday life. In this catecory, too, fall most
of the psychiatrist's cases -- L&e schizophrenics with their characteristic
inaccessibility arid remote rejection of emotional exchange with normal persons,
the manic  depressives vdth their unreasonable melancholia or equally irrational
elatiori and overactivity, the feebleminded, arid the lone; list of psychoneurotics
with their hysterias, anxieties, obsessions, and states of inexplicable fatigue
and indecision.
companiment which can be detected by the present methods of laboratory examina-
tion, and for these conditions the methods of the psychiatrist are only accurate
description of the patient's reaction and conduct, together with an elaborate and
meticulous history or narrative of the development of the disorder.

None of these conditions has any characteristic physical ac-

It is here that we may describe psychoanalysis as one of the methods

of eliciting from a patient the narrative and the nature of his intellectual
and emotional growth.
of interpretation of human conduct.  It is one of the nore illuminating methods
used in psychiatry bul; not-affective in curing many psychiatric diseases.  It
is an elaborate and relatively reqe   ssembly of theories or postulates,  based
upon the study of all that the pat5    ays in oft repeated interviews with the
analyst regarding his memories, his attitudes, his daydream and phantasies, -
his dreams, his motional life, his sins and peccadillos. There is an element
of the confessional in such recitals and a relief obtained by discussing sub-
jects previously repressed.  Psychoanalysis postulates the immense importance
of the unconscious and assumes a duality in human behavior, a conscious, ac-
ceptable, idealistic force often in conflict with unconscious primitive animal
desires, and psychoanalysis further attaches great importance to the successive
anc? complete changes necessary in the growth of an infant from a completely de-
pendent, amoral animal to an ethically passable adult.  By many it is overrated
as an exclusive form of treatment, but by even more it is underrated as a pre-
requisite for many types of treatment.
but they arc applied in treatment.
experience; even more than on abdominal operation it calls for a cautious operator
illhose knowledge and cxperience should exceed his enthusiasm to get to work.
emphasis which Freud attached to the role of sex seems at times fantastic, but,
on the other hand, equally extraordinary would be the assumption that so essential

Psychoanalysis is only one of the methods and forms

  Anatomy and physioloey are not treatment
And certainly psychoanalysis is not a casual

                              The

5.

a function throughout plant and animal life can be adequately understood or
directed by pious moralizinp,, rattled evasion, and stern taboo.
from the essay On Instincts by William Morton Fjheeler, whom Whitehead char-
acterized as the only man he had ever known who would have been both vrorthy
and able to sustain a conversation vsith Aristotle.

Let me read

  Similar cbnsiderations have led me recently to read some
twenty volumes of psychoanalytic literature comprising the wrks
of beud, June, Brill, Adler, Ernest Jones, Ferenzci, Bjerre, and
We A. White, with the result that I feel as if I had been taking
a course of svrimming lessons in a veritable cesspool of learninc.
As I have not since had an opportunity to take a spiritual shower-
bath you will understand why my remarks throughout this paper lack
the oustomary refinement of a Sunday evening discourse.

1 should, of course, be vrandering entirely off my beat if I

atempted seriously to discuss psychoanalysis, but I cannot refrain
from recording a few personal impressions of what I believe to be
one of the most extraordinary and tar-reaching, contributions to
t
and at the'nowbiologtsts vho have handled instinct, I now see my
opgorhuiity to get under the ski-n of the pEychologists.  After
perusing during the past twenty years a small library of rose-water
psychologies of the academic type and notioing how their authors
igqors QP merely hint at the existence of such stupendous and f'un-
damental bio1op;ical phenomena as those of hunger, sex, and fear, I
should not disagree with, let us say, an imaginary critic recently
arrived from Mars, who should express the opinion khat many of
these works read as if they had been composed by beings that had
been born and bred in a belfry, castrated in early infancy, and
fed continually for fifty years through a tube with a stream of
liquid nutriment of constant chemical composition.
tically, most of our traditional p6yChOlOgieS are about as useful
for purposes Qf understanding the human mind as an equal number of
dtssbrtations on Greek statuary would be to a student eager for a
kuowledge of anatomy.  Such a student atomslearns khat the object
of' his investigation, tho human animail body, is very largely com-
posed.of parts offensive to the aesthetic sense, but this does not
deter him from studying them as thoroup;hly as other parts.  The
ty$A psychologist, vho might be expected to study his material
in the same scientific spirit, does nothing of the kind, but con-
fines his attention to the head and the upper extremities and drapes
or ignores the other parts.

5.

IIabily: had a flir4 at fiearly all'the types of biologists

To puC it dras-

Now I believe that the psychoanalysts arc getting down to brass

tacks.
seems to consist in sitting dom together or with the philosophers
and seeing who can halluoinate fastest or most subtly and clothe
the results in the beet English, is not helping us very much in
solving the terribly insistent problems of life.  They have had the
courage to dig up the subconscious, that hotbed of all the egotism,

They have discovered that the psychologist's game which

b.

greed, lust, pugnacity, cowardice, sloth, hate, and er,vjr vinich every
single one of us carries about as his inheritance from the animal
world.  f'hese are all ethically end aesthetically very unpleasant
phenomena but they are just as real and fundamcntal as our entrails,
blood, and reproductive organs. In this matter, I am glad to admit,
the theologims, with their doctrine of total depravity, seem to me
to be nearer the truth than the psychologists.
that our depravity is only about 85 to 9C$.

I should say, however,

   In nothinf: is the courage of the psychoanalysts better seen than
in their use of the biogenetic law.  They certainly employ that great
biological slogar, of tne nineteenth century with a fearlessness that
makes thc timid twentieth-century biologist gasp. But making all due
allowance for the extravagant statements of Freud end Jug and their
disciples, afiy fair-minded student of human nature is compelled to
admit that there is a very considerable residuum of accurate obscrva-
tion and inference jri their accounts of Lhe dream, of the perversions
of thc nutritive ond scxual instincts, of the erotio conflicts and
repressions, and of the surviving infantilism.. . . . .

   To mc ono of the most striking indications that the psychoanalysts
are on the right road is the fact that mrcy of their theories have such
a broad biological basis that they can be applied, erceptis excipiendis,
to a group of animals so remote from man as the insects.
escaped Jurqy, who calls atLention to the striking ma1op;ies between
the nutritive caterpillar stage R~LI human infancy, the chrysalis and
the period of latency,  and thc imaginal butterfly and pubcrty in man.
Thcre are even cases of repression and sublination as in the workers
of social insects, an2 did tine permit I could cite exmplos of mul-
tiple persocality or of infantilisms, that is, larval traits vhich
survive or reappcar in the adults of m-y species.  Insects undoubt-
edly sleep. Do they dream?  If thcy do, what a pity that we shall
never be able to apply the Freudian analysis to the dreamG of that sym-
bol of sexual repression and scblimation,  the worker ant!

This has not

But these are trivial considerations.

                         The great fact remains
that the work of thc psychiatrists is bcginning to have its effect even
on such hidebound institutions as ethics, religion, cducation, and
jurisprudence, and that the knowledge that is being gained of the work-
ings of` our subconscious must eventually profoundly affect animal no
less than human psychology, since the subconscious - is the animal mind.

NOOM let us turn to one other field close to that of psychiatry, vhero

differences from psychiatry may serve for the purpose of deficition.
is to the practice of medicine, psychology is -- or should be -- to the practice
of psychiatry.
not precede the study of the abnormal.
the exception illustrates the rule.
normal function of the organism has received much from psychiatry.
whole method of experinentation insofar as it creates artificial conditions pro-
duces in some degree illuminating abcarnalities.
abnormal precedes the normal.

As physiology

In the hisLory of medicine the investigatioll of the normal did

            SiTilarly, psychology as thc study of the
                                       Indeed the

                   As a source of knowledge the

The abnormal has revealed the normal as

7.

There are psychiatrists who woulc! be content to describe psychiatry

as medical psychology just as there are physicians who  insist that medicine
is physiology applied to disease.
this role and thus be the handmaiden to psychiatry,  she is in reality a very
green hired girl with almost as much to unlearn as to acquire before  she be-
comes indispecsable to the psychiatrist,  Patienoe rather than dismissal is
indicated for even now psychology, especially when well grounded in biology
and physiology, is valuable.
service in mental testing, conditioned reflex research, localization studies
and in certain seloctivc procedures like the Rorschaoh test.

Though in theory psychology should play

Already psychology gives real though limited

To summarize the foregoing:

liman beings are not merely collections

or assemblies of collaborating organs.
characteristic of organisms as a whole and appropriate for individuals living
ir2 indispensable contact and collaboration with other human beings.  That they
do we call oonduot or behavior (and equally important what they manap to keep
from doing).  Psychiatry is the field of study which concerris a very wide
raqp of disorders, defeots or inadequacies of behavior of these  individuals.
It has been wisely said that Life's aim is an act, not a thought,,  In the
same sense it is not merely mental phenomena that constitute the material of
psyohiatry, but that blend of instincts, emotions, thoughts and feelings and
physiological states which eventuates in oonduct -- in action or the inhibi-
tion of action.
cal or other disturbances in some part of the machinery of thcbody,  e.gr,
bullet wounds, motabolic disorder, alcohol, bacterial disease. But it is also
tr~e that we witness disturbances for which we can find as yot no  cause so
simgle and objective, whcre mood and motivation, emotions and instincts, and
the faculties of adjustment to reality appear to be in conflict or disordar,
and these derangements also are the task of ttle psychiatrist.

They have functions and capacities

It is true that conduct will Le affected by physical,  chemi-

     XOW for a few conunents upon the status of psychiatry and I am done.
Since 1880 medicine as a whole has profited immeasurably from tvro broad lines
of study, bacteriology and cellular pathology.
diseases as due to invading micro-oTganisms,  the other desoribod in analytic
terms of separate organs and organic disease the phenomena shown by sicktpeople.
There has been for the past fifty years, however, something approaching neglect
of thc patient as a person.
Ilarmnan of Ea1 t imor e .

The one explained a host of

Let me quote from a first-rate physician -- Louis

   To the specialist, psychiatry is another specialty operating
in a contiguous but separate domain.  To the internist, it is a
vital and intcgral part of his work.  Indeed I find it impossible
to formulate a clear expression of the relation of psychiatry to
medioine, so intimately and inextrioably are they bound together.
The physician studies and practices psychiatry continuously,  even
when hc protests that he has not the least knowledge of formal
psychiatry.
he may practice it unoonsciouslg......

It is the chief instrument of his suocets, even though

In spite of this growing importance it is the subject about

which medical students know least and the one in vihioh their training
is most deficient.
chiatry are many; I can mention only a few of the outstanding ones.

The reasons for this slighting treatment of psy-

8.

    1.
the Subject.
okjects of ridioule and contumely, riot of serious study and sp-
pathy. 'l'he patient with no gross lesion to justify his mmy com-
plaints was neglected aid avoided.
cast at a fellow student was to call him neurasthenic. Uter care-
ful obscrmtion  had csta5lishcd thc fact that a patient had no or-
ganic disease professional relations were supposed to be Et an exid
and he vas dismissed with some such reassuring renark as, 'There is
nothing whatsocvcr wrong I;ith you; your troublcs arc imginnry; go
on and forget them,' or ever1 nore curtly xith a placebo and the
ardent hope that he would never return.  Kith the passaze of years
this brusque atti tudc has bccone somcwliat softened mid yet essentially
it is still the attitude of many physicians. The mind always seeks
precise classification and is never more pleased than when experience
can be snugly labcled.. . . . .

Thc General Lack of Appreciation of the Importance of

When I v:as a medical student psychoncurotics wcre

The worst irisulL that could 5e

   In order to furnish tangi3le evidence of the important part
psyc!iiatric problems play in the practice of medicine I have revie:yed
the records of 500 consecutive patients 1~110 consulted me. To rive
the Meres any value I must explair. that my practice covers  the whole
field of internal medicine aid thst patients come to me or are sent
to me chiefly for diagnosis.  I have 110 reputaLiou as a psychiatrist
nor am I even suspected of having unusual interest or talent in that
field. Lot one of the 500 patients consulted me on account of an overt
psychiatric  condition.. . o . .

  Among thc 500 paticnts therc vcre 116 (23 per cent) without my
discoverable organic cause for the symptoms of which they complained.
~n adtiition, *ere were SG (11 per cent) presenting rzinor organic lesions
but with symptom which could riot possibly Le explained by the lcsions
alone. In a word, one-third of the patients suFfered solely or pre-
dor!iinantly from functional disorders.

  Strictly spedrinc it might be stretching a point to say that all of
'illuse filnctional disturbmccs were due primarily to psychiatric disorrlers.
IJevertheless, if you are vSil1i.q to define the province of psychiatry as
the broad field T hare outlined, then surely the problem of these patients
are of interest and concern to psychiatrists.  For instmice, a man other-
wise xell and coqetent; suffers from very distressing digestive s~pptorns
whenevcr he is worried, nr for other reasons under nerwus strain. Shall
ne corisider this o. psychiatric problem?
here psychic influences play the chief role in di.sturbing the balance of
thc vegetative nervous systm.
invades the psychiatric field :narc promincntl:: than it does thc gastro-
onterolozi cal .

I think ve undoubtedly must,  since

Y&at is commonly called the spastic colon

Li Lh steady insistence psychiatrists iiavc laid strcss upon the whole

personality of any wid evely patient --  their mm mci thosc in cvcry medical
specialty. Psychiatrists, des2ite their isolation in asylums, despite inferior
recruitment to their ranks aid the taboo and horror associated with insanity,
desuite the time required for making their diagnoses, arid despite their isola-
tion from cxpcrizental methods and the fact that laboratory animals do not appear
to develop psycliiatric contiitions (except .Pavlov' s experimental neuroses), ciesrite
all these handicaps psychiatrists are nearer to adequate discharge of their duties

9.

than they have ever been before.
dispassionately and in terms of cause and effect; - not devils axid disasters.
Cannon's work upon the physiology of the emotions, the exceptional growth of
neuro-physiology, thanks to Sherrington and to new instruments of registering the
changes of electrical potential in ncrves, thc stimlus of Preudian thcory, of
Yavlov's work on reflex behavior,  and the steady extension of scientific mthods
of study of psychiatric patients are sone of the factors in the progress of psy-
chiatry.

For Lhc first time man studies his own conduct

1hCh renains to be done. Kolb of' the United States Public iiealth

Service reported that in 1939 $200,000,000 was spent 011 menkal diseases, yet not
1 per cent of it for research.
some tiKe of his life be hospitalized for mental diseaso, and mother child in
the same 20 vSill at sone time be psychiatrically disablcd but iiot hospitalizcd.
l'hcre are probably 6,000,000 feeble-ninded persons of all trades ir the United
States, 80 to 95 per cent at large in the population, 100,000 alcoholics and
drug addicts, betwoen 800,000 and a million mentally discased and 400,000 egi-
leptics.  There are more hospital beds devoted to psychiatric cases than to all
other forms of disease. Jinety 2er cent of the cost is at public expense. hr,d
in the face of the dislocation, loss and sorrow in the families of' the mentally
disordcrcd the statistician remains mtc.

One child in evsry 20 in this country vrill at

Addendum

Answering a90 inquiry of the Chairman, ILr. Stcrvrnrt, as to the plans of

thc I'edical Sciences in Psychiatry:
ment of Psychiatry has been and would continue to be in three general categories.
The first and most important type of aid is directed to the improverlent in the
teaching of Psychiatry to medical students. The seconc! form of support is in
grants for research work in psychiatry, neurology, psychology , neurophysiology
ar,d other fields essential to the progress of psychiatry.
seeks to improve i;he care of mental patients im-ediately ant1 directly, working
195th the present personnel and actual conditions of the present day.

Rockefeller Foundation aid for the develop-

'hc third form of aid

      As cxamplcs  of aid to t2.c teaching of Psychiatry The liockefeller Founda-
tion is suppor tirig departnents of Psychiatry at Yale, Iiarvard, *Gashirigtori Univer-
sity, St. Louis, Chicago, Duke arid %lane wid is 1are;el.y respomiblo ?or their
initiatim.
the
tributing substantially to departmental expense.

At Johns Hopkins , Columbia (neurology), the University of Pennsylvania,

University of Illinois and the Iiniversity of Colorado the Foundation is con-

     Research granks have been numerous md more widely scattered, i.e., in-
cluding the Ehudsley Hospital in London, the Uiiiversity of Kdinburgh,  and Uni-
versities in ;lorway, Sweden, Holland, Belgium, Sxcitzerland, Canada and Australia.

Funds used Tor khe irnprovernent of psychiatric institutions would in-

clude grants for holding postgraduate assemblies of psychiatrists in state nental
hospital work, aid for psychiatric nursing,  aid for a symposium on mental disease
under the auspices of the American Association for the Advancenent of Science,
etc .

10.

     A record of support during the years 1931-1941 of Psychiatry, lkurology,
and Closely Related Subjects, prepared for the meeting in Decenber, 1941, but not
presented is appended.