The neurotic constitution; outlines of a comparative individualistic psychology and psychotherapy

Front matter

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National Committee | Y. M. C. A.

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Preface

After I had made the attempt to investigate in the "Studie iiber Minderwertigkeit von Organen," the structure and tectonic of organs in association with their genetic basis, their functional capability and destiny, I proceeded, supporting myself upon already available data as well as upon my own experience, to apply the same method in the study of psychopathology. In the book before us are embraced the most important results of my comparative, individualpsychologic studies of the neuroses.

As was the case in the theory of somatic inferiority, an empiric basis is made use of in comparative individual-psychology for the purpose of establishing a fictive standard of normality in order to enable one to measure and compare with it grades of deviation from it. In both of these scientific endeavors, the comparative method of study reckons with the origin of phenomena, dismisses from consideration the present and seeks to outline from them the future. This method * of approach leads us to view the compulsion of evolution and the pathological elaboration as the result of a conflict which breaks forth in the f

PREFACE

f organic sphere for the purpose of attaining equi- • poise, functional capability and adaptation; the same struggle in the psychic sphere is under the ' command of a fictitious idea of personality whose "influence dominates the development of the 'neurotic character and symptoms. If in the organic sphere, "the individual develops into a unit mass in which all of the individual parts cooperate toward a common goal" (Virchow), if the various abilities and tendencies of the individual tend toward a purposefully directed, unitpersonality, then we may look upon every single manifestation of life as if in its past, present and future there are contained traces of a dominating, guiding idea.

In this way it has appeared to the author of this book, that the most minute trait of psychic life is permeated by a purpose-force. Comparative, individualistic psychology sees in every psychic event the impress, so to speak, or symbol of a uniformly directed plan of life which only comes more clearly to light in the neuroses and psychoses.

The result of such an investigation of the neurotic character should furnish proof of the value and utility of our method of comparative, individualistic psychology in the problems of mental life. THE AUTHOR.

Vienna, February, 1912.

SENECA, Epist. 78, 13.

The study of the neurotic character is an essential part of neuro-psychology. Like all other psychic phenomena it can only be understood when taken in connection with the entire psychic life. A cursory knowledge of the neuroses suffices to enable one to discover that which is peculiarly characteristic in them and all writers who have studied the problem of nervousness have laid particular stress upon certain peculiar traits of character. The opinion was a general one that thfLJieuxptic shows a series of sharply pjrmlmsiEpd traits of phflrartpr wforh pvpppri the normal standard. The marked sensitiveness, the irritable debility, the suggestibility, the egotism, the penchant for the fantastic, the estrangement from reality, but also more special traits! such as tyranny, malevolence, a self-sacrificing \ virtue, coquetry, anxiety and absent-mindedness ri INTRODUCTION

are met with in the majority of case histories and it would be necessary to detail all writers who have thoroughly studied the subject in order to endorse their contributions. Of the more recent ones, Janet, who has carried on the traditions of the famous French school and who has brought to light some very important and ingenious analyses, must be especially mentioned. His £tnphasis of the neurotic's ^sentiment d'incompletilde" particularly, is so wholly in harmony wittt the results offered by me that I am justified in seeing in my work an extension of this most important fundamental fact of the mental life of the neurotic.

No matter where one begins with the analysis of psychogenic disorders, one and the same phenomenon forces itself upon one's attention after the briefest observation, namely, that the entire picture of fog penrosis as well as all its symptoms are influenced by, nay, even wholly provoked by ap imaginary fictitious goal. This final purpose has a creative, directive and adjustjye power. The potency of this "goal idea" is revealed to us by the trend and evaluation of the pathological phenomena and should one attempt to dispense with this assumption there remains nothing but a confusing mass of impulses, trends, components, debilities and anomalies which has made the obscurity of the neurosis impenetrable to some, while

INTRODUCTION vii

others have undertaken bold exploratory journeys into this field.

Pierre Janet has certainly recognized this relationship as is shown in his classical descriptions of the "Hysterical Psyche," 1894,1 but he avoided a detailed description. He expressly maintains, "I have until now only described general and simple traits of character which by means of their association and under the influence of definite extraneous circumstances may produce all kinds o curious behavior and conduct." It is entirely of place here to enter into a detailed discussion of Janet's description for this treatise would then resemble more a moral romance than a clinical study. Having adhered to this attitude even up to his latest contributions on the subject, Janet, notwithstanding his keen insight into the relationship between the psychology of the neuroses and moral philosophy, never entered the road, to synthesis.

It remained for JosephJBreuer, a man well versed in current German philosophy, to discover the gem which lay in his path. He directed his attention to the meaning of the symptoms and undertook to ascertain the source and purpose of the same from the only one who could give them — from the patient. In so doing the author founded a method which seeks to explain indi-

i Translated by Dr. Max Kahane.

vm vidual psychological phenomena historically and genetically with the assistance of a preliminary hypothesis, i.e., that of the determinism of psychic phenomena. The manner in which this method has been extended and improved upon by SigimmciJB]r§u^Lwith the host of problems and attempted solutions therewith connected belongs to contemporaneous history and has met with both recognition and contradiction. Less for the purpose of following a critical bent than for the purpose of making clear my own position I beg leave to separate from the fruitful and valuable contributions of Freudrehree of his fundamental vjews ag erroneous inasmuch as they threaten to impede

Jrogress in the understanding of the neuroses, he first objection is directed against the view that the IjbidQ iff tl^e motive force.behinf? the phenomena of the neurosis. On the contrary it is the neurosis which shows more clearly than does normal psychic conduct how by means of this neurotic positing of a "final purpose," the apperception of pleasure, its selection and power are all driven in the direction of this final purpose so that the neurotic can really only follow the allurement of the acquisition of pleasure with his healthy psychic force, so to speak, while for the neurotic portion only "higher" goals are of value. The ne4jrotic_goal (Zwecksetzung) has repealed itself to us jrrthe heightgied_ego-£OTisdous-

INTRODUCTION ix

(Personlichkeitsgefiihl) wjipse simplest foi> mula is tQ be recognized yj an exaggerated "m#sculine protest" (Mannlichen Protest). This formula: "I wish to be a complete man" is Jlje guiding fiction in every neurosis, claiming higher reality values than even the normal psyche. The libido, the sex-impulses and the tendencies to sexual perversions arrange themselves in accordance with this guiding principle, no matter whence they originate. Nietzsche's "Will to) power" and "Will to seem" embrace many of our\ , views, which again resemble in some respects the/ views of Fere and the older writers, according toi whom the sensation of pleasure originates in a) feeling of power, that of pain in a feeling of fee- 1 eness (Ohnmacht).

second objection is directed against Freud's fundamental view of the gpynfll ptinlngy nf the neuroses, a view which Pierre Janet approached very closely when he asked, "Is sexual feeling then the center around which all other psychological syntheses are built up?" The applicability of the sexual picture deceives the normal person and especially the neurotic. But it must not deceive the psychologist. The sexual content in the" neurotic phenomenon originates primarily in the I imaginary antithesis: "Masculine-feminine" andj is evolved through a change of form of the "masculine protest." The sexual trend in the fantasy x INTRODUCTION

and life of the neurotic follows the direction of the "masculine goal," and is really not a trend, but a compulsion. The whole picture of the sexual neurosis is nothing more than a portrait depicting the distance which the patient is removed from the imaginary masculine goal and the manner in which he seeks to bridge it. It is strange that Freud, a skillful connoisseur of the symbolic in life, was not able to discover the sym-

t bolic in "sexual apperception," to recognize the

-J sexiiaLas a jaTgon.^ajnody^icendL But we can

• 1L7 understand this when we taEe into consideration

the more extensive basic error, i.e., the assumption

that the neurotic is under the influence of infan^

tilfi wig^pp which come to life nightly (Dream

theory) as well as in connection with certain oc-

casions in life. In reality these infantile wishes

(already stand under the cQjnpulsion_of the imagr.

'inary goal and themselves usually bear the char-

f acter of a_gmding thought sujtably arrayed, and adapt themselves to symbolic expression purely • 4/or reasons of thought economy. A sickly girl <K'Vho during her entire childhood in her consciousness of an unusual insecurity leans upon her father and in so doing strives to become superior to her mother, may comprehend this psychic constellation in the form of an incest, as if she wished to be the wife of her father. Thereby the goal is both attained and effective; her insecurity is

INTRODUCTION xi

only abolished when she is with her father. Her developed psycho-motor intelligence, her unconsciously active memory combats all feelings of uncertainty with the same aggression, with the adequate expedient, to take refuge in the father as if she were his wife. There she finds that heightened ego-consciousness which she has set for her goal, which she has borrowed from the masculine ideal of childhood, from the over-compensation of her feeling of inferiority. If she recoils from a proffer of love or marriage, threatening her as they do with a fresh lowering of her ego-consciousness, she acts symbolically, and all her defensive resources and her predispositions become arrayed against a female destiny and make her seek security where she has always found it, with her father. She utilizes an expedient, behaves in accordance with a senseless fiction, but is nevertheless certain of attaining her goal. The greater her feeling of uncertainty, the more firmly this girl clings to her fiction, endeavors to take it quite literally and since human thinking favors symbolic abstraction the patient with a little effort (and also the analyst) is successful in the longing of neurotics, namely, to find security, to gain a foothold in the symbolic picture of incestuous emotion.

Freud was obliged to see in this purposeful manifestation a reanimation of infantile wishes xii INTRODUCTION

because according to him the latter are to he looked upon as motive forces. We recognize in this infantile mode of procedure, in the extensive use of safety-devices (Hilfsconstructionen), in which light the neurotic fiction is to be regarded, in the many-sided motor preparedness which reaches into the remote past, in the strong tendency to abstraction and symbolization, the most useful expedient of the neurotic, who strives toward security, toward a maximation of his ego, toward the masculine protest.

If we attach to these critical remarks the question of how the neurotic phenomena come into being, why the patient wills to be a man and constantly seeks to adduce proof thereof, whence hg has the stronger necessity,for ego-consciousness, why he makes such strong endeavors to gain security, in short, if we inquire into the final reasons for these devices of the neurotic psyche, we may conjecture that which is revealed by every analysis, namely, that ajtjl^onsetofithe development of a neurosis there standstHreaieningly the feeling of uncertainty and inferiority and demands insistently a guiding, assuring and tranquilizing positing of a goal in order to render life bearable. Among these are especially prominent safety 4e.vices and fictions in thought, action and volition.

It is clear that this sort of psyche, directed as it

INTRODUCTION xiii

is with especial force toward a heightening of the ego, will, aside from specific neurotic symptoms, make itself conspicuous in society because of its evident inability to adapt itself. The consciousness of the weak point dominates the neurotic to such a .degree that often without knowing it hef

with all hi> might ing superstructure,. Along with this hi& sensj-f fareness becomes more acute Jb.e learns to pay attention to relationships which still escape others,* he exaggerates his cautiousness, begins to antici-f pate all sorts of disagreeable consequences in starting out to do something or in experiencing an injury, he endeavors to hear further and to seef further, belittles himself, becomes insatiable, eco-. nomical, constantly strives to extend the boundaries of his influence and power over space and timef and at the same time loses that peace of mind and freedom from prejudice which above all guaran-l tee mental health. His misfoust of himself ajid others, his envy and maliciousness, become gradually n\gre pionQUBeed^-^ggTessive and cruel tendencies which are to secure for him supremacy over his environment, gain the upper hand, £r_ he endeavors to captivate and conquer others by means of greater o]?edjence. submission and humility which not infrequently degenerate into masochistic traits; thus bothheightenedac^tiytty?

as well as increased passivity are expedients' C--C_-^ .— >_ — £--—*• — J t_^-v— J£-*c— xiv INTRODUCTION

ushered in by the fictitious goal of an increased power, of a desire to be above, of the masculine protest.

Thus we have arrived at those psychic phenomena, at the. neurotic character, the discussion of i^^^^^wj^^p^r_3BjBS?r''''^j3^^^^^^*'*'*

which forms the content of this book. J^one of the neurotic's traits of character are essentially new. He shows no single trait which cannot likewise be demonstrated in the healthy individual, although at times it becomes understandable for the physician as well as the patient only through x analysis. It is uninterruptedly "s^jiti^gcl," thrust forward like an outpost, and represents the sounding of the environment and the future. The knowledge of these psychic dexterities, which protrude far and wide, like sensitive antennae, first makes possible the understanding of the neurotic's struggle with his fate, of his stimulated aggressive tendency, his unrest and impatience. For these antenna? test all the phenomena of the environment and examine them constantly for their advantages and disadvantages with regard to the assumed goal. They create the kgen sense foj. estimate anjd comparison, awaken, by means of the attention active in them, f$ar, hope, dgubt, expectations oj: ajl sorts and seek to ensure the psyche against surprise and against a lowering of the ego-consciousness. They put forth the most accessible motor dexterities, ever mobile,

INTRODUCTION xv

ever ready to prevent a degradation of the person. TKe forces of internal and external experience are active in them, they are filled with memory-rests of fear — inspiring as well as consoling experiences, the reminiscences of which they have changed into dexterities. Categorical J imperatives of the second rank, they do not serve to bring about their own existence, but in the last analysis cause an elevation of the ego-consciousness and they attempt this by making possible the discovery in the unrest and uncertainty of life, of guiding principles, by facilitating the differentiation between right and wrong, up and down, right and left. The accentuated traits of character are to be found already in the neurotic disposition where they give rise to peculiarities and perversions of conduct.^These become nouocedwhen^fter a more severe attack or the emergence of a contradiction in the masculine protest, the craving for security ( Sicherungstendenz) asserts itself and simultaneously calls forth symptoms as new, effective expedients. They are largely constructed after models and patterns and have for their object the initiation in every new situation of the struggle for the preservation ^, of the ego and victory for it. In their influence lies the reason for the e^^gerjLJbed^^eclivity and lowered threshold of stimulation in contrast with 9 t normal individuals. It goes without saying that

XVI the neurotic character, too, develops out of material already at hand, out of psychic impulses and metamorphosing experiences of the somatic functions.

All these psychic dexterities, standing as they do in close contact with the outside world, bgcqme neurotic only when an inner want p™wifnntpg the graving for security which in turn more effectively constructs and mobilizes the traits of character only when the fictitious object of life operates more dogmatically and strengthens those secondary guiding principles which are in accord with the traits of character. It is then that the nf t^f «^>QT,QptfT OAfo in, its transformation f r,ojn a means t£ af goaj. leads to an independence of existence and a sort of deification nds to.it unchaflffreability ^an^l _ eternal worth. *The neurotic character is thus incapable of adjusting itself to reality because it is always striving toward an impossible ideal. It is a product and instrument oiL a cautious psyche which strengthens its guiding principle for the purpose of ridding itself -of a feeling of inferiority, an attempt which is destined to be wrecked as a consequence of inner contradiction, on the barriers of civilization or on the rights of others. Analogous to the groping gestures, pose in facing the rear, to the bodily attitude in the act of aggression, like mimicry as a form of expression and inxvn strument of motility, so the traits of character, especially the neurotic ones, serve as a psychic means and form of expression for the purpose of entering into an account with life, for the purpose of assuming an attitude, of gaining a fixed point in the vicissitudes of life, for the purpose of reaching that security-giving goal, the feeling of superiority.

ItHas not sprung up independently out of any sort of biological or constitutional primitive force, but has received direction and motivation from the compensatory superstructure and the schematic guiding principle. Its ejnergence^took pl^ce^jjiide^jtjje^r^surjg^of jmcejrj^unty, its tendency to personify itself is the doubtful success of tjie^r^vjn^j£OTjecurijfcy. This course of the neurotic character has received through the positing of a final purpose its destination which is the masculine main principle and thus every neurotic tendency betrays to us by its direction that it is impregnated with_t^f jnasculine protest whjch seekjrTxTmake of it an unffliljnff instruM^nt for the purpose oT exyludingr from experience every permanent degradation.

In ftreT practical part of this book will be shown by means of a series of cases how the "neurotic xviii INTRODUCTION

scheme" calls forth special psycho-pathological constellations, namely, through the apperception of experiences by means of the neurotic character.

Since the inception of the psychoanalytic movement its students have shown a remarkable activity in applying the principles of interpretation originally enunciated by Freud over a wide field of human endeavor, and thus not only have the neurotic and the psychotic come under the critical survey of the analyst, but the whole course of cultural development has been subjected to inquiry along these lines. In addition to this growth in the extent of the movement it has manifested what seems to me to be a very healthy tendency, namely, it has shown an inclination to put forth suggestions as to new methods of approach to the problems, represented here and there by groups of workers who have the most stimulating and valuable points of view which have been developed in this way is that of Alfred Adler, of Vienna, a translation of whose work on the characteristics of the neurotic character is offered in the following pages.

The distinctive feature of Adler's approajcji to thgjproblem of the neurotic character traits is that dappf^acj^e^tom. tti^Qr^arjiuijratlie^^tiiaiL from tKe Functional side and in this way, I think, •™rdf' ia""wfrjr'yiaijiofrig An>Wprm2t becaiise_Jit tends tf> bring together the organicist and the

XIX xx INTRODUCTION

functionalist, who have been too long separated nyj, h f rm spnn fifrpt j nn__nj_ i rr^r njnril n.HlF~?ti ff prences between mind and body. No small part of thlTopposfEion to the whole psychological movement, as represented in psychoanalysis, has come from the inability of the man who has been brought up to look at things from the point of view of the internist to be able to accept many of the clinical observations which were offered and which tended to show the development of clearly organic disorders as a result of a disturbance in the psyche. Adler's approach to the psychoanalytic problems is admirably calculated to break down such prejudices.

In this book, however, the working out of the significance of the various neurotic character traits has been by ringing the changes on the basic formulation of what Adler calls the masculine protest. It is as if the neurotic said to himself, " I wish to be a complete man." This protest arises on the basis of a feeling of inferiority and an effort upon the part of the neurotic to correct this feeling, which he does by so ordering his life, so regulating his every act that he may find that security of which the feeling of inferiority has robbed him. This is the fictitious goal of the neurotic and the fundamental and ultimate cause of his symptoms when he is no longer able to succeed, when failure threatens in his efforts to deal with reality.

For Adler the neurosis or the psychosis is comparable to the work of art, but has been built up in response to a fictitious goal which

INTRODUCTION xxi

collects and unites into a group those psychic elements of which it can make use, collecting only those which promise results in the effort at the attainment of security. The attempt to attain to the maximation of his ego fails because directed along a false path. The_neurosis-jarpsychosis js_ therefore. a. ™HsJTnrtiVfr <*EqationT a. comensation product, which, howeyjer» lajfls__be=.

itfl falsft Hirertion.

All this is very psychological and does not bear out what I have said about it to the effect that Adler's approach is from the organic side. This particular book, however, stresses the psychological formula. In his earlier work on organ inferiority 1 tljg m^nir ^° ci' ° of this psychological formulation is founded. The feeling of inferiority, which underlies the masculine protest, has its raison d'etre in an inferior organ.

In this work he has gone to considerable extent in working over the psychological characteristics of persons who have had demonstrably inferior organs, either clinically evident or showing up at autopsy. From this work he believes he has been able to show that the predominant traits of character are the result of an effort on the part of the individual to overcome a feeling of inferiority resulting from an inferior organ. Many examples might be given, and in fact they come within the ken of every one, which demonstrate the validity of this point of view. A classical example is that of Demosthenes, a stam-

1 Translation in preparation, as Number 24 of the Nervous and Mental Disease Monograph Series.

xxii INTRODUCTION

merer, who became the greatest orator of Greece. Adler believes that defects of this sort nucleate, so to say, the feeling of inferiority and force the individual to make supreme efforts to overcome his particular defect and in this way, as a result of these efforts, the inferior organ, by the development of a highly differentiated nervous superstructure, may actually become supernormal, a result which we are familiar with, for example, in the remarkable facility with which blind people gain information through their supersensitized touch organs. In other words, to use the language of current psychoanalysis, the organ iru^eriority i§_tbe Jbiasic factor of what the jSeptians tefer to a& the conflict f These two works of Adler's, therefore, give ; the organic basis and the psychological elabora- ) tion of his opinions. The neurotic constitution founds in an inferior organ, the inferior organ produces a feeling of inferiority, the feeling of inferiority — the masculine protest — becomes the fictitious goal of the neurotic, whose symptoms result from an effort to mould reality along this false pathway.

To those who follow Adler through the various ramifications of his hypothesis, who read sympathetically his numerous case reports which he offers to substantiate his views, there can be no doubt but that the angle from which he looks at the problem of the neuroses and the psychoses lets us see new aspects of these phenomena which are exceedingly helpful to us in our effort to grasp their meanings. It will also be perfectly

INTRODUCTION xxiii

evident that the helpfulness of the Adler theories is in the orientation which the physician gets towards the problem presented by the patient, whether he approach it from the point of view of the internist or of the psychologist. Adler's theories are admirably calculated to help the internist to grasp the possibilities of organ inferiority as tvey may affect the psyche and to help the psychoanalyst to grasp the origin and meanings of the neurosis as he sees it at the psychological level and perhaps to see more clearly upon what his limitations are based. In any event the two groups of physicians, heretofore separated all too far, both in theory and practice, may find in Adler's views a common ground upon which to meet.

WILLIAM A. WHITE.

SAINT ELIZABETH'S HOSPITAL,

WASHINGTON, D. C.

October 23, 1916.

Contents

CHAPTER FACE

PREFACE iii

THEORETICAL PART INTRODUCTION . v

Chapter I

THE ORIGIN AND DEVELOPMENT OF THE FEELING OF INFERIORITY AND THE CONSEQUENCES THEREOF

THE facts established through my study of somatic inferiority (vide Studie, I.e.) concerned themselves with the causes, the behavior, the manifestations and altered mode of activity of inferiority developed organs and has led me to assume the idea of "QgDipensation through the central neryous_ system" with which were linked certain discussions of the subject of psychogenesis. ^

• . • 4^

There came to light a remarkable relationship between somatic inferiority and psychic overcompensation, so that I gained a fundamental viewpoint, namely, that tbe^jeajigationjp£ somatic inferiority by the individual becomes for him a piejm^nen^jnipjgllin^ force £QT tl^e development of his psyche.

Physiologically there results from this a reenf orcement of the nerve tracts, both quantitatively and qualitatively, whereby a concomitant original inferiority of these tracts is enabled to reveal in a composite picture its tectonic and functional peculiarities.

The psychic phase of this compensation and overcompensation can only be disclosed by means of psychologic investigation and analysis.

As I have given a detailed description of organ-inferiority as the etiology of the neuroses in my former contributions, especially in the "Studie," in the "Aggressionstrieb," in "Psychischen Hermaphroditismus," in the "Neurotischen Disposition" and in the "Psychischen Behandlung der Trigeminusneuralgie," I may in the present description confine myself to those points which promise a further elucidation of the relationship between somatic-inferiority and psychic compensation and which are of importance in the study of the neurotic character.

Sumqrarizjiig, >I lay stress on the fact that organ-inferiomv/as described by me, includes the incompleteness in such organs, the frequently demonstrable arrests of development or functional maturity, the functional failure in the postfetal period and the fetal character of organs and systems of organs; on the other hand the accentuation of their developmental tendency in the presence of compensatory and coordinating forces and the frequent bringing about of increased functional activity. One may easily detect in every instance from observation of the child and from the anamneses of the adult that possession of definitely inferior organs is refflected upon the psyche — and in such a way as to jlower the self-esteem, to raise the child's psychological uncertainty; but it is just out of this I lowered self-esteem that there arises the struggle •for self-assertion which assumes forms much more I intense than one would expect. As the compensated inferior organ gains in the scope of activity both qualitatively and quantitatively and acquires protective means from itself as well as from the entire organism/ 4he predisposed child in his sense iof inferiority selects out of his psychic resources • expedients for the raising of his own value which ^ are frequently striking in nature and among which may be noted as occupying the most prom- , inent places those of a neurotic and psychotic s character.

dejis^^erningjmi^ predispo-

sition, and constitutional weakness ma^be jound even jnjhejvery beginnings of ^cjej^tiJficjnej^c In leaving out of discussion here many noteworthy contributions, although they frequently contained fundamental viewpoints, we do so solely because the relationship between organic and psychic disease states, albeit dwelt upon, was never explained. In this class belong all viewpoints of pathology which are founded upon a general assumption of degeneracy. S^ijler's theory of the asthenic habitus goes considerably further and almost attempts to establish etiological relationships. Apton's compensation theory confines itself all too closely to correlation systems within the central nervous system; nevertheless, he, as well as his talented pupil, Otto Gross, have made noteworthy attempts to bring about on this basis a clearer understanding of certain psychotic states. Hpuchajrd's bradytrophy, the exudative diathesis described by Ppnflick, Escherich, Czemy, Moro andjjjjtrjimpel. and interpreted by them as a disease-producing diathesis, Comby's infantile arthritism, Kreibich's angio-neurotic diathesis, IJeubner's lymphatism, Pjoltauf 's status thymico-lymphaticus, Escherich's spasmophilia and Hejss-Eppinger's vagotonia aje^jsuccessful attgmpts_pf recent decades to describe disease

All of them refer to heredity and infantile characteristics. /But, although the vague and inconstant limits of the predispositions in question are emphasized by the authors themselves, the impression is not to be ignored that certain conspicuous ty_pes Hs.Ye been isolated which in. the course of time will be brought within one large group, namely, that of the minus^yaj]aj\ts^ Of extreme importance for the understanding of congenital inferiority and predisposition to disease are the researches into the glands of internal secretion in which morphologic as well as functional deviations have been discovered, e.g., the thyroids, the parathyroids, the sex glands, the chromaffin system and the hypophysis. Considered from the standpoint of their organ-inferiorities the orientation of the composite picture becomes easier and the relationship to compensation and correlation in the economy of the entire body becomes clearer. Among the remaining investigators who took as the basis for their views not a primum-movens, ljut $ combined influence of various organ-inferiorities and mutual interaction of the same, JVJartius, above all, must be mentioned. /In my contribution on "The Inferiority of Organs" (1907), the idea of the coordination of the coexisting inferiorities likewise appears prominently. /The fact is not to be lightly evaluated that the ^'wltfln^nnsly pviqtinff organ-inferiorities st^nd in relation fn nnp anntfrpr as j'f united by a secret bond.