Obituary Sir Frederick Mott
(Sir Frederick was one of the Vice-Presidents of the C.A.M.W. from 1919 until his death.) By Dr F. L. Golla. The cause of the Association for Mental Welfare, no less than the scientific aspect of psychiatry, has suffered a great loss by the death of Sir Frederick Mott. This is no place to deal in detail with the purely scientific side of his activities, but some knowledge of their general tendency is required in order to assess the great influence that he exercised on our conceptions of the treatment of insanity. The work of Mott, beginning with broad fundamental studies of the physiology of the nervous system, progresses in a logical order to the examination of the structure on which physiological activity depends, next to the pathological disorders of structure, later to the concomitant evidences of functional disorder attending it, and finally to considerations of the psychological implications of pathological disturbances in the nervous mechanisms. His earliest work was to attempt to localise the motor functions in the brain and spinal cord, and later followed much work on the sensory functions of the central nervous system and the sensory mechanisms for the control of bodily movement. From these physiological experiments Mott turned his attention to the minute anatomy of the nervous system and laid the foundations of our knowledge of some of the principal paths by which sensory impulses reach the cerebrum. Mott had already made a great name in physiology when he accepted the post of Pathologist to the Central Laboratory of the London County Asylums. MENTAL WELFARE. 71 To turn from a career full of promise of professional success to a purely scientific post involved considerable sacrifices. He felt, however, that his great talent for scientific investigation demanded freedom from the burden of an increasing practice. With characteristic directness he dealt first with the one form of insanity which in those days was recognised as undoubtedly associated with gross changes of the central nervous system. Krafft-Ebbing had already proclaimed the syphilitic origin of General Paralysis, but his views were only accepted by a minority of psychiatrists in this country, and, as Mott pointed out in his epoch-making paper on the Etiology of General Paralysis, the word syphilis did not even find a place in the index of Bevan Lewis’ standard textbook on psychiatry. By the analyses of a vast amount of clinical and anatomical evidence, nearly all of which was collected and prepared in his laboratory, the syphilitic origin of General Paralysis was once and for all irrefutably demonstrated in days before the Wassermann reaction had made the path of investigation comparatively easy. Mott’s great work on the relation of syphilis to insanity and tabes was published in the first volume of the Archives of Neurology, which he founded and continued to edit. In the successive volumes of the Archives appeared numerous studies on the various aspects of the pathology of the nervous system in the psychoses, all tending to establish more and more firmly the correlation of structural change in the nervous system with disorders of conduct. At the beginning of the present century, Mott had already accomplished a vast amount of work on the investigation of the nervous system by physiological and anatomical methods, but he was quick to perceive their limitations, and he became convinced that the future of pathology was to be to a great extent in the hands of the biochemist and physicist. Although he recognised that these more specialised investigations required an entirely new orientation, he attacked the problem with conspicuous courage, and the outcome of this work was published in his Croonian Lectures on the chemistry of nervous degeneration. The importance of the study of the vegetative nervous system and the ductless glands engrossed him later. He perceived that the mechanisms of the affective states were likely to be of supreme importance in the understanding of disorders of conduct. He proceeded to concentrate his attention on the pathological histology of the secretory structures and the vegetative nervous system. His studies on the endocrine organs and the sympathetic system in dementia prcecox are of epoch-making importance. It is in a great measure due to this work that whatever view we may take of the origin of the psychical symptomatology of dementia prcecox, it is possible to trace much of the disordered conduct to a definite and widely-spread bodily change. The bodily aspect of mental disorders is very far from being recognised by psychiatrists at the present time. By a confusion of thought, many psychiatrists imagine that to attempt to establish a bodily basis to mental disorders implies an attempt to translate mental processes in terms of mechanism. Mott was very far from entertaining any such ideas. His thesis was that just as the profound bodily changes affect the mechanism of conduct in General Paralysis, so similar, though less marked, changes may be found in the other psychoses. With the ultimate metaphysical implications, he held that it was not for him to deal. He was, however, in no sense a materialist of the old school, but held rather to the monism of Mach. It is not, however, only in the investigation of mental disease that his influence is felt in every mental hospital. The hygienic condition of the mental hospitals was, thirty years ago, very far behind the standard which obtains to-day, but Mott threw himself whole-heartedly into the work of reform. He had in the early days to encounter great obstacles and to overcome much ill-formed 72 MENTAL WELFARE. opposition, but it is to his enquiries into the bacteriology of hospital dysentery and tuberculosis and the reforms which he advocated that an enormous reduction of the mortality from these diseases was achieved in the mental hospitals. As an educationalist he did much to raise the standard of psychiatry among the younger staff of the mental hospitals, and at the Maudsley Hospital he founded a school for advanced studies, in which he lectured to the end. It is too early to say much of the man himself. With his wide culture and great kindliness he was a valued friend of all his colleagues, and his accessibility and simplicity of character attracted the younger generation to seek his advice and help in their scientific and professional work.
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