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as being 'worn out,' it is in attributing purposes where there are only ends. When people used to speak of the 'purposes' of Nature, as though Nature were conscious of its ends and deliberately planned them, they were open to the charge—for instance, that the 'purpose of the April showers is to germinate the seed, or that Nature gives the animal its coloration in order that it might be hidden. The principle of ‘natural selection' now prevents our saying this. But that does not prevent us from observing the fact that the actual result of the April showers is the germination of the seed, nor that the actual end of certain impulses given free and full development normally and naturally end in reproduction. Nor does it deny the fact that these are the natural ends, even though, owing to immaturity, perversion, or otherwise, the end is not actually achieved. A ‘purpose' is a consciously conceived end (like the word 'aim? or 'goal'); an ‘end’ is merely an observed result, and it is in this sense that I use it when I speak of impulses whose natural end is reproduction.

But Dr Glover, admitting the teleological point of view by his use of the term “goal,' would still object to my definition of the sexual in terms of reproduction in that this is not the psychological end, but only an end as we intellectually conceive it. To this, the ‘biological' criterion, he opposes the psychological goal,' namely, the actual appropriate situation which brings its drive to an end.

The situation, he says, which in hunger brings satisfaction is the act of eating, which is, therefore, its psychological goal. Let us for a moment adopt this criticism. The situation which brings to an end the drive of the exhibitionist's impulse is exposing himself. According to this view, then, we should distinguish this activity as psychologically completely different from an activity in which coitus is the appropriate situation which brings its drive to an end. On these psychological lines then, we have no right to call them both sexual.

But, in point of fact, Dr Glover, whilst advocating the 'psychological point of view, abandons it in favour of the 'genetic. We call early tendencies sexual because they exhibit psychological identity with later tendencies admittedly sexual. I raise no objection to the genetic point of view any more than I object to the psychological; but surely this genetic standpoint is open to exactly the same objection as the one brought against the 'biological,' namely that it describes a tendency as sexual in that it demonstrably subserves some intellectually apprehended result. But the “genetic' point of view is also intellectually apprehended and conceived. The only difference is that the biological or teleological tells us how an impulse ends, whereas the genetic tells us how it begins: origin

in both cases it is only as we intellectually conceive it. The individual is not necessarily aware that the sex impulse leads to reproduction; nor is he aware that it originated in defæcation or other autoerotic tendencies in childhood. It is only we who have intellectually apprehended that those early experiences are the forerunners of adult sexuality, just as it is we who have recognised that certain impulses naturally end in reproduction. If we object to the biological criterion that it is only as we intellectually apprehend it, we must also rule out the genetic on the same score.

But further, when the psychoanalyst calls these earlier tendencies 'sexual' because they develop into later tendencies admitted sexual, he is pursuing exactly the opposite of the 'genetic method; for he does not read the later in terms of the earlier, but puts earlier experiences in terms of later, and calls them sexual. That is to say, his method is not genetic but really teleological!

But, after all, this does not rule out the validity of the 'psychological' point of view. I take it that whilst the so-called “biological point of view stresses the end, as we conceive it, and the 'genetic' the

as we conceive it, the 'psychological' regards it as the individual himself experiences it. In defining the sexual instinct we should then have to try and discover what common characteristics in the actual experience of the individual are shared by all those experiences we call sexual. The first thing that strikes us is that they are all sensuous, but unfortunately this will not do as a criterion of the sexual, because it is also common to many non-sexual and purely egoistic activities like ordinary sucking at the breast. I confess that if anyone were to produce a satisfactory definition of the sexual from the purely “psychological point of view I should be the first to welcome it, I was hoping that Mr Shand would do so, as he adheres to this criterion—but at present there is none.

In conclusion, we are still left without an answer to the question as to what the Freudian means by sexuality. We are told, with emphasis, that we “know thoroughly well what Freud means by the sexual.”

be said to know, when we are left in doubt as to whether by the sexual the Freudians mean all activities involving sensuous gratification

Only those which are sought for the gratification alone? This question I propounded in my paper as being fundamental, and to this question there has been no reply. For in truth whichever way the question is answered it will be found that it involves us in difficulties with regard

the distinction between the sex instincts and ego instincts.

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MANIC-DEPRESSIVE INSANITY1

BY WILLIAM MCDOUGALL.

EXCITEMENT and depression are general conditions of the organism that are commonly regarded as opposites, as opposite ends of a scale the middle part of which represents the normal waking condition. This accepted psychiatric usage is a little unfortunate. The true opposite of excitement is the state of calm, rest, or indifference. The degree of excitement of any moment is a function of the instinctive energies; whenever circumstances bring into play one or more of the instinctive dispositions, the organism is in a state of excitement; and the excitement is more intense, the more strongly the instinctive disposition is working and the greater the number of such dispositions active at the same time. That is to say, the degree of excitement expresses the quantity of free energy or neurokyme in the brain at the moment. The excitement may be diffuse and chaotic, or controlled and concentrated; and the outward manifestations are very different in the two cases: in the former, chaotic varying signs of mixed and conflicting emotions with ineffective shifting bodily movements; in the latter, the excitement may express itself in an impressive stillness, broken only, if at all, by highly controlled movements directed effectively towards some well-defined goal. Such controlled excitement may imply either the complete domination of the organism by some one instinct (as in the case of an animal stalking its prey) or the strong voluntary control that is possible only as a result of discipline and the development of character.

The conventional opposition of excitement to depression comes from the modern recognition that the two states called ‘mania’ and 'melancholia,' and formerly regarded as two distinct mental diseases, are in reality (in very many cases if not in all) two phases of one disorder process. This process accordingly is now generally called (following Prof. Kraepelin) manic-depressive insanity.

Most of us, perhaps all of us, are liable to mild alternations of this kind, moods of 'excitement' and of depression. Some of us are more liable than others to these moods, suffer them either more frequently or more acutely than others do. When the liability to such alternations is well marked the personality is said to be of the cyclo-thymic types.

1 A chapter from a forthcoming volume, Outline of Abnormal Psychology. 2 Cp. E. Kretschmer, Physique and Character, London, 1925.

It would seem that the alternations of the excited and depressed phases of the manic-depressive patient are but exaggerations of these changes of mood. If we provisionally accept this view, we may obtain, by reflection upon our own experience of such moods, a suggestion for a theory of the manic-depressive disorder. I put forward this theory with all due sense of its tentative nature; I should call it rather a suggestion towards a working hypothesis. My own experience with such cases is slight; but I venture to think the hypothesis is deserving of trial by those who have opportunities of studying many such cases.

Mania and depression were commonly regarded by the psychiatrists of the nineteenth century as organic disorders, in accordance with the prevailing tendency of the time. It was attempted to discover corresponding or causative brain lesions; or to discover microbic infections or toxines produced within the body that might account for the two conditions. And, with the rise of a new interest in the influence of chemical factors on our mental life that has come from the new knowledge of internal secretions, endocrines and hormones, the hope of finding purely chemical explanations of these two states has been renewed. But up to the present time the great amount of industry devoted to research along these lines has remained without definite result?. And, with the rise of the hormic psychology, and with the increasing successes of the psycho-genetic interpretations and the psycho-therapeutic methods of treatment, there has appeared an increasing tendency to regard manic-depressive disorder as primarily and essentially psychogenetic or at least as interpretable in psychological rather than purely physiological terms.

We may, I think, lay down a general principle of some value in guiding us to distinguish between mental disorders that are primarily due to physical disease and those that are psycho-genetic. The disorders due to physical disease or lesions of the brain are of two types: First, those due to a localised lesion, such as may be produced by a gun-shot wound or the rupture of an artery. In these cases we find some disability in respect of some special function or functions (such as local paralysis, an agraphia, a psychic blindness, etc.) the more general mental functions remaining unimpaired. Secondly, there are the diffuse brain lesions, such as those of general paresis produced by the syphilitic infection of the brain, and those of Korsakow's disease in which chronic alcoholism has led to diffuse brain injury. In these the mental symptoms are apt to be entirely chaotic (as in the former) or to affect only the integrity of associative memory (as in the latter).

1 There are enthusiasts who, like Dr Timmins, claim to find the etiology of most mental disorders in microbic infections and others, who, like Dr L. Berman, claim to find them in disorders of internal secretion. It would be rash to affirm that such factors are of no importance: it is probable that in many cases they play some part in the genesis and maintenance of mental disorders: but the view that they are the primary factors is not widely accepted. Kretschmer inclines to the view that the cyclo-thymic temperament' is a function of some unknown endocrine factors.

When we find disorder that seems to express, seems to be rooted in, some lack of due balance and proportion between the affective tendencies, then, whether it affects only some particular aspect of the patient's life (as in the delusion of jealousy) or affects nearly all his thinking and feeling, as in highly systematised delusions of persecution or of grandeur, we may accept this as an indication of the psychogenetic nature of the disorder. When this criterion is applied to manicdepressive disorder it favours the psycho-genetic or functional view of it.

Let us return now to consider how the common experience of moods may suggest a working hypothesis for the interpretation of the manicdepressive phases. When we are in a depressed mood, when we take a gloomy view of life in general, we take a gloomy view of ourselves. It may occur that peculiar circumstances, such as a serious physical disorder, may lead a man to take a gloomy view of himself at the same time that he views the world in general optimistically. That would be due to an appreciation and evaluation predominantly intellectual. It would differ from the mood that colours all our thinking and feeling, in that in such mood one views oneself gloomily, and the gloomy view of things in general is secondary to and derived from this gloomy view of oneself. This attitude may be expressed in the words, “The world may be a decent enough sort of place, but what good is it to me? I am a poor incompetent creature, incapable of playing a proper part in it, of enjoying it: my efforts to accomplish something of value lead to nothing, all the world knows that I am a poor creature.”

On the other hand, in the bright, active, joyous mood one views the world joyously because one feels strong and capable, ready to grapple with any emergency or difficulty, confident of success. Even though on intellectual grounds a man may regard the world as a poor thing, a ‘rotten show,' in which there is little ground for rejoicing, yet, in the mood I speak of, he contemplates it with equanimity or positive satisfaction, regarding it either cynically as an egg to be cracked and sucked by himself or altruistically as a field for his activities, a scene of disorder to be put to rights by his efforts.

If we imagine these two opposite moods intensified and prolonged,

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