The Third Maudsley Lecture

Extract

We are met to fulfil the behest of one of the most distinguished physicians of psychological medicine of recent times. Maudsley was a leader in his lifetime, and he lit a lamp for research which it is our duty and that of the generations which follow after to keep burning. He was a man with a great insight and practical withal, for he has left behind him benefactions which are endowed by his inspiration and which must live with increasing benefit to mankind. The acuteness of Maudsley's vision is demonstrated by the method in which he founded these lectures; he perceived, and perceived rightly, that mental disorder was not purely a medical problem, but that there was a lay side to it which was of vital importance, and in consequence he directed that in alternate years a scientific and a popular lecture should be given. He wrote that “there are not many natures predisposed to insanity but might be saved from it were they placed in their earliest days in exactly those circumstances and subjected to exactly that training most fitted to counteract that innate infirmity.” No doubt this connotes much, and to some it may seem an overwhelming task. For it would appear to include a full appreciation of how mental disorder is brought about; what, if any, are the precursory indications, and what symptoms, when present, should be regarded as potentially dangerous to the future welfare of the mind of an individual. The inquiry is a fascinating one, and the problem can be more quickly unravelled by the working of physician, psychologist and educationalist in close collaboration. Mental disorder unfortunately, as things are at present, only becomes a medical matter when it has advanced a considerable distance, but this must be changed, and it must be our endeavour as physicians to control its very beginnings. Whilst it is right to devote time and energy to examine scientifically every means by which the recovery or the alleviation of mental disorder may be brought about and to use them to the full, in the end the return for these labours must be limited; to control its gateways and to prevent its occurrence far out-rivals any treatment of disorder that has once become established. In fact it is doubtful whether a complete recovery ever does take place in the sense that the patient is free from any scarring from the experience he has passed through. Preventive medicine is the side of medical science which is most attractive, offering as it does benefits of infinite value both to the individual and to the nation. Investigation tends more and more to establish the view that many disorders have their inception in childhood and experience confirms that this is true of the more common types of mental disturbance. It is on this account that I have decided to take as my subject for this lecture “Some Aspects of Education and Training in Relation to Mental Disorder.” The term “education” will be used in its widest sense and will connote the instruction and upbringing of the child both at home and in the school.