Never laugh at or with them.  Be truthful.  Meet them with respect.  Act kindly toward them in their presence.  If these measures fail, coercion if necessary.  Tranquillizing chair.  Strait waistcoat.  Pour cold water down their sleeves.  The shower bath for fifteen or twenty minutes.  Threaten them with death.  Chains seldom and the whip never required.  Twenty to forty ounces of blood, unless fainting occurs previously; ... etc.”

To-day an understanding of the life history, of the patient’s somatic and functional assets and problems, likes and dislikes, the problem presented by the family, etc.!

So much for the change within and for psychiatry.  How about psychiatry’s contribution beyond its own narrower sphere?  It has led us on in philosophy, it has brought about changes in our attitude to ethics, to social study, to religion, to law, and to life in general.  Psychiatric work has undoubtedly intensified the hunger for a more objective and yet melioristic and really idealistic philosophical conception of reality, such as has been formulated in the modern concept of integration.

Philosophical tradition, logic, and epistemology alike had all conspired to make as great a puzzle as possible of the nature of mental life, of life itself, and of all the fundamental principles, so much so that as a result anything resembling or suggesting philosophy going beyond the ordinary traditions has got into poor repute in our colleges and universities and among those of practical intelligence.  The consequence is that the student and the physician are apt to be hopeless and indifferent concerning any effort at orderly thinking on these problems.[3]

Most of us grew up with the attitude of a fatalistic intellectual hopelessness.  How could we ever be clear on the relation of mind and body?  How could mind and soul ever arise out of matter?  How can we harmonize strict science with what we try to do in our treatment of patients?  How can we, with our mechanistic science, speak of effort, and of will to do better?  How can we meet the invectives against the facts of matter on the part of the opposing idealistic philosophies and their uncritical exploitations in “New Thought”—­i.e., really the revival of archaic thought?  It is not merely medical usefulness that forced these broad issues on many a thinking physician, but having to face the facts all the time in dealing with a living human world.  The psychopathologist had to learn to do more than the so-called “elementalist” who always goes back to the elements and smallest units and then is apt to shirk the responsibility of making an attempt to solve the concrete problems of greater complexity.  The psychiatrist has to study individuals and groups as wholes, as complex units, as the “you” or “he” or “she” or “they” we have to work with.  We recognize that throughout nature we have to face the general principle of unit-formation, and the fact that the new units need not be like a