personality is definitely checked. In spite of an apparently gapless causal chain of psychological events leading from the normal into the pathological, one can never disregard the possibility that in certain cases a change of metabolism (in the sense of Kraepelin) may be primary, whereby the accidental newest and last complex "clots" or "curdles," and thus inherently determines the symptoms. Our experience does not as yet reach far enough to warrant the exclusion of this possibility.
Summary of the First Chapter.
This anthology from the literature, in my judgment, shows quite distinctly that all the views and investigations which among themselves hardly exhibit any apparent connection nevertheless converge to the same point. The observations and intimations plucked from the different realms of dementia præcox point above all to the idea of a real central disturbance which is designated by different names, such as apperceptive dementia (Weygandt), dissociation, abaissement du niveau mental (Janet, Masselon), disintegration of consciousness (Gross), disintegration of personality (Neisser et al.). Then there arose the idea of tendency towards fixation (Masselon, Neisser) and from this Neisser adduces the emotional dementia. Freud and Gross find the important fact of the presence of split-off series of ideas. To Freud, however, belongs the credit of being the first to show in a case of paranoid dementia præcox the "principle of conversion" (repression and indirect reappearance of the complexes). Nevertheless the mechanisms of Freud do not reach so far as to explain why there originates a dementia præcox and not a hysteria; hence it must be postulated that for dementia præcox there is a specific resultant manifestation of affects (toxins?) which causes the definite fixation of the complex by injuring the sum total of the psychic functions. However, the possibility cannot be disputed that the "intoxication" may appear primarily from "somatic" causes and seize the accidentally remaining complex and change it pathologically.
