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The advent of psycho-analysis is said to have 'ended the era of therapeutic
nihilism in psychiatry'. Great differences still separate psychiatry from general medicine, and it should be a first task of physicians to observe and evaluate emotional reactions. Suggested treatment must utilize not only physical, chemical and mechanical agencies, but psychological agencies as well. A plea is made for a more extensive application of the psychiatric approach along the lines of those recently undertaken at the Institute of Psychoanalysis in Chicago and at the Presbyterian Hospital in New York.
It is suggested that Freud's theory of a self-destructive tendency gives a point of view that will help to reconcile differences of opinion between psychiatrists and general practitioners. An extension of the theory to organic diseases has not definitely been made by Freud, but they may possibly be 'illustrations' too. The physician throws the weight of his knowledge on the side of the embattled life-instinct, and by so doing diverts his own destructive tendencies, then saving his life by losing it. The older concepts of medical science, in terms of man versus environment, induced 'more naïve assumptions, false optimism and easy discouragement' than Freud's hypothesis.