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In psychopathology there are two conditions in which words have assumed a leading rôle: in those cases of schizophrenia where speech has become affected by the disease and in mania.
One can make a definite assertion that the central problem of the disease in both cases is to be approached through the investigation of the special significance of words. It is therefore tempting to compare speech in the two conditions, but that would go beyond the limits of this paper. I shall therefore restrict myself to a consideration of schizophrenic speech-disorders.
For this purpose it is best, if possible, to deal with the first modifications of schizophrenic speech, because one often notices that they very soon undergo secondary elaboration, which to a certain extent places them outside the range of our understanding.
A twenty-eight-year-old man was very much under the influence of his brother, two years older, and did everything which he told him to do. The patient often experienced anxiety if the brother came near him. Finally the brother thought out a complicated fraud. Our patient was to submit himself to a medical examination for the purpose of taking out a workman's compensation insurance, and one of them—it has never been clear to me which—would then cut off his finger, in some distant town, so that he could collect a sum of money. It did not proceed so far, because anxiety caused the patient to draw back. Some time after these events, five months before he was brought into the institution, he had an attack of noises in the ear. He was taken to the ear-clinic and fourteen days later had another similar attack. These attacks caused him to think about certain things which he told me about later on. He noticed how people avoided him, how children ridiculed him, and how people tapped on the windows of his house, etc. His brother was behind it all and was setting these people against him. The brother had a congenital malformation of the penis, which had been cured t