Consciousness

Psychiatry, History of Medicine

Also known as: Awareness, Cognition

Historical document, translated for reference. It reflects medical knowledge of the 1920s–30s and is not medical advice.

Summary

This article from the 1930s Soviet medical encyclopedia presents consciousness as a product of highly organized matter, developed through historical materialism and dialectical materialism. It explores the relationship between subject and object, the formation of the 'I' concept, and the social origins of consciousness through labor and practice.

Encyclopedia article (1928–1936)

CONSCIOUSNESS. In empirical psychology, C. is understood as such a connection of simultaneous and successive psychical processes, which leads to the cognition of reality and the regulation of the relationship of the personality with the surrounding world (for insufficiency of this definition, see below). Of all the psychical processes of a given moment, C., while maintaining a general connection, gives preference to, selects from others, based on previous experience and the general situation in the surroundings, individual images, which enter consciousness especially clearly and distinctly and are called the 'fixation point of consciousness', or the 'center of consciousness'. These selected by C. and central images are immersed in the mass of other current nearby images, which have less intensity, are less clearly separated from each other, and are called the 'overtones' of consciousness (James), and their entire aggregate represents the 'field of vision', the 'sphere of consciousness', located in zones of decreasing distinctness, which is why one speaks of 'levels' of consciousness. The appearance of any image in the field of C. is called rising above the 'threshold' of C., and its disappearance—falling below the threshold of C. The state accompanying the selection of contents, which are given preference, is characterized by a special feeling of tension and is called 'attention' (see), and the process of preferential perception—apperception. What remains in the field of consciousness but is not in its center is called the perceived consciousness by forming an image. Actually, every content of C. exerts some influence on attention, but the transition of a certain content to the center of C. is accompanied by a feeling of special tension, which is why active apperception and passive perception are distinguished. The state of consciousness given at a certain moment either follows directly without interruption from states that existed in previous moments, or, being connected with new sensations, is still in some relation to those previously present. Individual psychical processes constantly disappear, fall below the threshold of C., their place is taken by new ones, but their connection and general unity are constantly preserved, which is why psychology speaks of the 'continuous stream of consciousness'. Some psychical processes are experienced entirely as 'mine', others are experienced as mine only insofar as my attention is directed to them, and otherwise they are experienced as 'given to me from outside'. They are only the object of my C. (Gegenstandsbewusstsein). E.g., if my attention is directed to a tree, I perceive it, I represent it, I receive pleasure from its beauty, these representations (images of the object), experiences are the content of my C., while the tree itself is only the 'given to me' object of my C. The object of my C. can also be my own psychical experiences, if I direct attention to them. All psychical processes occurring in C. are accompanied by feelings of pleasure, displeasure, confidence, doubt, etc.; these feelings, together with previous experience, prepare the direction of attention to certain elements of the stream of C. according to the guiding principle of the attitude or 'determining tendency', the activity of our personality. The preservation of the unity of the stream of C. in time, the activity connected with previous experience in apperception, the difference in the experience of 'mine' and 'given to me' states of C.—all this leads to the formation of the concept of the 'I'-subject-as the constant basis of C. Clarifying the essence and origin of 'I', its relation to individual psychical processes, intellect, emotions, drives, behavior (scope of 'I'), relation to surrounding objects (objects), to other 'I's, is the main problem in understanding C., a problem which, as Engels expressed it, is 'the sublime question of all philosophy, the question of the relation of thinking to being...'. Around this problem, the problem of the subject-object relation, a fierce struggle is constantly waged, and this problem is basically resolved materialistically by some, idealistically by others. The basic positions on which understanding of C. is built in Soviet psychology (see Psyche) are the positions of the theory of dialectical materialism, developed in the works of Marx-Engels-Lenin-Stalin. 'The existence of matter does not depend on sensation. Matter is primary. Sensation, thought, consciousness is the highest product of matter specially organized' (Lenin, Works, vol. XIII, p. 45). 'The forms of being, thinking (resp. consciousness) can in no way create and derive from itself, but only from the external world..., principles turn out not to be the starting point, but the final result of research...' (Engels, Anti-Dühring, in the book Marx and Engels, Works, vol. XIV, p. 36). 'Consciousness from the very beginning is a social product and remains so as long as people exist at all... Consciousness (das Bewusstsein) can never be anything other than being-conscious (das bewusste Sein), and the being of people is the real process of their life' (Marx and Engels, Works, vol. IV, pp. 21 and 16). The emergence of the 'I'-subject can only be understood historically. The history of the earth shows that the object existed much earlier than the subject appeared; what we call the object, at a certain stage of development, does not need the subject and exists 'in itself' in the absence of a knowing subject. Only at a further stage being is enriched with a new quality—consciousness, and 'being in itself' of matter passes into 'being for itself' of a self-conscious subject. In isolation from the material world, the subject does not exist; 'I', detached from the object—is an abstraction; only the subject-object has real force. C. as the highest product, a special quality of highly organized matter, presupposes a long path of development of matter from simplest to most complex forms, from lower to higher forms. Animals evolved, changing their natural organs under the influence of nature, by natural selection. The final stage of animal evolution was the division of functions between hand and foot in the monkey. 'The development of the specific functions of the hand—wrote Engels—means the appearance of a tool, and a tool means specifically human activity, the transforming reverse effect of man on nature, production...' (Marx and Engels, Works, vol. XIV, p. 487). At first there was human work, human practice, the forms of communication arising from it and for it, speech; this practice led man to oppose himself to things existing outside him, to become aware of the possibility of affecting them. From this opposition arose the distinction between objects and my 'I', the distinction of individual phenomena, their distribution according to significance for 'my' activity. 'My relation to my environment is my consciousness,' says Marx. Thus, the effective 'I', organizing its environment for itself, conscious of it, appeared only as a result of human labor activity: 'Only now, after we have already considered the four moments, the four sides of the original historical relations, do we find that man also possesses 'consciousness'. But he also does not possess it from the very beginning in the form of 'pure consciousness'' (Marx and Engels, Works, vol. IV, p. 20). 'Consciousness is, of course, first of all the awareness of the nearest sensory environment and the awareness of the limited connection with other persons and things outside the individual beginning to be conscious of himself; at the same time it is the awareness of nature, which initially confronts people as something completely alien, all-powerful and inaccessible force... this is purely animal awareness of nature (natural religion). Here it is immediately evident that this natural religion or this definite attitude to nature is conditioned by the social form, and conversely... on the other hand, there appears the awareness of the necessity to enter into relations with surrounding individuals, the beginning of the awareness that man generally lives in society. This beginning has as much an animal character as the social life at this stage; it is purely herd consciousness, and man differs here from a sheep only in that consciousness replaces instinct for him, or else that his instinct is conscious. This sheep or herd consciousness receives its further development due to the increase in productivity, the growth of needs and the underlying population growth. Along with this, the division of labor develops... Division of labor becomes real division only from the moment when the division of material and spiritual labor appears. From this moment consciousness can really imagine that it is something other than the consciousness of existing practice, that it can really represent something to itself without representing something real—from this moment consciousness is able to emancipate itself from the world and pass to the formation of 'pure' theory, theology, philosophy, morality, etc... However, it is completely indifferent what consciousness will undertake by itself... 'ghosts', 'connections', 'higher being', 'concept', 'doubt' are only the idealist, spiritual expression, the imaginary representation of the isolated individual, a representation of very empirical bonds and limits within which the mode of production of life and the form of communication connected with it move' (Marx and Engels, Works, vol.

IV, p. 21-22). "...people who develop their material production and their material intercourse change, along with this given reality, also their thinking and the products of their thinking. It is not consciousness that determines life, but life that determines consciousness" (ibid., p. 17). "The actual spiritual wealth of the individual depends entirely on the wealth of his actual relations..." (ibid., p. 27). Materialist understanding, in contrast to idealist understanding, "...does not explain practice from ideas, but explains ideological formations from material practice, and for this reason arrives at the result that all forms and products of consciousness can be destroyed not by spiritual criticism..., but only by the practical overthrow of real social relations; ...that not criticism, but revolution is the driving force of history" (ibid., p. 28). "The existence of revolutionary ideas in a certain epoch presupposes the already existing revolutionary class,..." (ibid., p. 37). "The sum of productive forces, capitals, and forms of social intercourse which each individual and each generation find as something given, is the real basis which the philosophers represented to themselves as the 'substance' and as the 'essence of man'..." (ibid., p. 29). Thus the founders of Marxism Marx-Engels (see mainly "The German Ideology") set forth the origin and evolution of C. Each economic formation thus develops a type of C characteristic of it. Only historically determined C. of a historically determined person actually exists. "Quantitatively different activity creates and qualitatively different form of the subject, as the form of labor activity." In class society, regardless of his will, every person is a product of class existence, and his consciousness is concretely determined by the historical existence of that class to which he actually belongs. Marx saw the most important shortcoming of materialist views before Feuerbach in that materialism considered "...reality, sensibility... only in the form of the object or contemplation, and not as sensuous-human activity, practice; not subjectively" (Marx on Feuerbach in the book: Marx and Engels, Works, vol. IV, p. 589). C. of man was born in his practice. and throughout all history it preserves its objectivity and significance only through its close connection with the practice that gave rise to it and constantly reproduces it. The basic root of every 'empty consciousness' idealism lies in its separation from the real historical material activity of people. Lenin with no less force emphasizes the active role of human C. C. is not limited to perception, thinking, but also emotions-"the flaming inclination" of Marx, transformed by C. into interest-are one of the most important components of C. If at the lowest stage of development of the psyche in animals emotions are the subjective side of instinctual inclination, are the main instance biologically adapting animals to the environment, then in man emotions, formed by class existence, give C. new possibilities for using thinking for the benefit of practice. "Without human emotions there never has been and cannot be human search for truth" (Lenin). This means that without passion there cannot be class struggle, there cannot be ideology-"the form in which people become aware of social conflicts and in which they fight" (Marx). But one cannot rely only on spontaneity, emotionality. Decisive for the specific qualitative nature of human C. is its goal-setting, planning activity in the labor process, figuratively depicted by Marx in his comparison of the labor of an architect and the building activity of bees. "The more spontaneous the rise of the masses, the wider the movement becomes, the incomparably faster grows the demand for mass consciousness in both theoretical and political and organizational work of social democracy" (Lenin, What Is To Be Done?, Works, vol. IV, p. 401). Marxism thus emphasizes the active role of human C. in contrast to contemplativeness. Finally it must be said that Stalin has the greatest merit in the further development of the teaching about C. of Marx-Engels-Lenin, the development of a new chapter about socialist C. Each economic formation develops a type of C characteristic of it, and here is what Stalin says about C. of the builders of socialism: "Only the blind do not see," says Stalin, "that in the psychology of the masses and in their attitude toward labor there has been a tremendous turn, fundamentally changing the appearance of our factories and plants"... "The most remarkable thing in the competition is that it produces a fundamental revolution in people's views on labor, for it transforms labor from a disgraceful and heavy burden, as it was considered before, into a matter of honor, into a matter of glory, into a matter of valor and heroism" [Stalin, Political Report of the CC to the XVI Congress of the CPSU(b), in the book Questions of Leninism, 9th ed., pp. 533 and 534] "...The reality of our program is living people, it is you and I, our will to labor, our readiness to work in a new way, our determination to fulfill the plan" (Stalin, The New Situation-New Tasks of Economic Construction, ibid., p. 603). Such importance does the architect of socialist construction attach to the change in C. The XVII Party Conference and the XVII Congress of the party, on the report of V. M. Molotov, set as the main program of the second five-year plan: "...overcoming the survivals of capitalism in the economy and in the consciousness of people, transforming the entire working population of the country into conscious and active builders of a classless socialist society" [Resolution of the XVII Conference of the CPSU(b)]. To dialectics-the materialist teaching of Marx-Engels-Lenin on the origin and essence of C.-are opposed the teachings of idealists (for a historical account of the development of philosophical views in psychology in general see Psychology). Their basic position is the position of the primary givenness of spirit, which creates the world. Things, according to Berkeley, are "a collection of ideas," under which Berkeley means the qualities given by sensations. Esse of sensible objects is their percipi. "Not-I" is "posited" by our "I," "I" and "not-I" are always together and there can be no environment without some "I" for which this environment is an environment. Kant, who occupies, in the expression of Engels, a wavering middle position between materialism and idealism, recognizes the existence of a world of things outside us, but considers that things in themselves, the world of "noumena," are unknowable (that is why Engels calls Kant and Hume "agnostics"), the objects of the external world only "affect" (produce) the phenomena ("phenomena") of our C., but do not reveal themselves in them, and C. itself according to its own laws builds the world of phenomena knowable to us. The basis for constructing this world of consciousness are "a priori ideas," which cannot be derived from experience, but are known only by contemplation (Anschauung) by our inner sense, resp. intuitively. On the basis of these a priori ideas C. distributes the chaos of sensory phenomena-"the material" of C.-in a certain order, gives form to the phenomena of C. The unity of C. is created by the unity of the originally given a priori forms. The main a priori forms, which in themselves are devoid of content, are space and time, with space being the form in which only the order of sensations of the "external" senses is given, and time, being the form of "inner sense," enters into all contents. Such a priori forms are also the determining laws of thinking "categories": quantity, quality, causality, etc. The objects of our C. are only a collection of sensory qualities, distributed in the order of a priori forms. Our knowledge always remains within the limits of the forms of C. But from C. only knowledge proceeds, all practical action proceeds from the universal ability not knowable by any forms of C.-will, to which the a priori forms (e.g. causality) of C. do not apply. Kant's dualism in the division of theoretical and practical reason led to the construction of special philosophical systems creating separate mystical forces beyond C: in Fichte in the form of the imperative-will, which leads to nature becoming for man material for carrying out the duty preordained by divine will, in Schopenhauer-in the form of the world-guiding "world will," which creates representations and then must return to its general unconscious being, in Hartmann-in the form of the unconscious, which is antilogical and governed only by mood. On the other hand, the striving to overcome Kant's dualism, recognizing the reality of "things in themselves" and logical categories as the basis of C., led to the creation of systems of idealist monism, denying the independent, not deducible from idea existence of the objective world and recognizing C. as the single creator of all that exists. The philosophy of absolute idealism, deriving the entire world from pure absolute idea, creating in its dialectical development both things and consciousness, is the philosophy of Hegel. All phenomena of the life of nature and the development of human consciousness-moments of the logical development of absolute idea. Material things-not an "object" in the usual sense of the word, but absolute idea expressing itself in one form or another for self-determination and self-knowledge."

It is incorrect that the forms of Consciousness are merely a means for application, incorrect that it is a form for content rather than content itself. Hegel demands Consciousness, logic, in which forms would be full of living, real content, the content of being. The beginning is the undeveloped, contentless idea, the concept of pure being, which, devoid of any attributes and definitions, does not differ in the least from pure nothingness. The first general concept cannot be held in its rigidity, it inevitably transitions dialectically into its opposite: being becomes nothing, but since it is thought, it becomes being (thinkable). The truth is thus not in one or the other of the two opposite terms, but in what they have in common, in the concept of transition, process, 'becoming'; truth is not in static being or nothingness, but in the process. Every object is first determined in its generality, then divided into the multiplicity of its moments, and finally through this self-differentiation closes in on itself as a whole. The absolute idea must pass through its 'otherness', through externality or the dissolution of its moments in natural material being; the absolute idea by inner necessity 'releases external nature from itself', logic transitions into the philosophy of nature. But then, proceeding from the singular to the complex, nature and idea increasingly penetrate each other, and in the consciousness, the rational thinking of the human individual, the absolute idea, from its otherness, enriched with the fullness of real-concrete determinations acquired in the cosmic process, returns to itself. Thus the absolute idea successively in a series of moments reveals its eternal content to finite spirit, Consciousness, and to itself. Hegel did not recognize subject and object as two separate things; according to Hegel, in the true process of being and thinking substance becomes subject or spirit, being one. Hence the characteristic demand of Hegelianism that the idea justify its truth through realization in reality. The truth of knowledge is determined, according to Hegel, as the identity of thinking and reality and is subject to constant and complete verification by empirical correctness. The system of dialectical development developed by Hegel was borrowed by Hegel and Marx-Engels. The latter however did not simply adopt it: in Marx's expression, he put Hegel's dialectic from its head onto its feet, since Hegel's dialectic was based on the development of the absolute idea, while the founders of Marxism brilliantly synthesized it with philosophical materialism, taking from Hegel the idea that things and their reflections in Consciousness must be understood not in their isolation, not in a static state, not dead, but in their mutual connection, in their concatenation, in their movement, origin and disappearance, in the mutual penetration of their opposites, as a creative, constructive process having as its consequence the formation of new qualitative features of matter. Another form of idealistic monism, devoid of the idea of development and proceeding from the fixed forms of the logic of Kantian logical categories, is the immanent philosophy of Schuppe. From Schuppe's point of view objects do not exist 'in themselves', they are products of thought. To conceive of the conceivable (object) without the conscious subject ('I'), according to Schuppe, is absurd. The unclear, borrowed from spatial relations, applicable only to the sensory sphere concept of boundaries separating the 'inner' psychic world from the 'outer' world of objects is the source of our erroneous conclusion that thinking is purely a subjective activity, never going beyond the boundaries of the 'single thinking I'. Thinking does not relate to sensory phenomena, it is the relation between the conceivable and the conscious, between the content of Consciousness and the subject. The essence of Consciousness consists precisely in this specific relation, the members of which are not subordinated but coordinated with each other: to exist means to be in possession of Consciousness (in Bewusstsein haben). The real world is immanent (lies within) Consciousness. The world is one with the knowing subject. Thus the 'I' in Schuppe's subjective idealism expands to all-encompassing dimensions, completely loses the form of personality and activity, which are transferred to the sphere of the content of world Consciousness; subject-object merge in this world Consciousness into one, turn out to be abstract moments of the single 'consciousness in general' (Bewusstsein iiber-haupt) with its fixed laws of logic. Thus the criterion of proof for the reality of the sensory world, already outlined by Berkeley, that this world is common to different individual Consciousnesses and therefore for all is the result of one supreme cause, in Schuppe is embodied in his supreme world 'consciousness in general'. By asserting this concept, Schuppe comes to denying the significance even of 'internal' experience in understanding Consciousness, to denying psychology. Truth can be derived only from understanding the laws of logic, 'consciousness in general'. As V. I. Lenin proved, a mixture of subjectively-idealist premises with individual materialist moments is also empiriocriticism of Mach-Avenarius, which, dressed as if in the objectively scientific form of modern physics and mathematics, gives as if a modern natural-scientific interpretation of the relations of 'I' and world and is still used with great success by some natural scientists. Empiriocriticism promises to discard as idle all metaphysical concepts, the concept of substance, the concept of a priori forms. The entire inner and outer world consists of a small number of homogeneous elements, and the selection of bodies and 'I' from them has only practical significance. Science is only one of the methods of man's adaptation to the world, the choice of those functional interconnections of elements which are most useful. The basis of science should be pure experience, freed from the admixture of evaluations of 'I', anthropomorphic apperception and a priori concepts of substantiality, causality, etc. The goal of science is the investigation of the diverse dependence of elements on each other. All that exists is a complex of sensations. There is an inseparable coordination between 'I' and environment. Changes in the environment, not things, cause changes in our Consciousness; objective research consists in the most complete accumulation of empirical data on the relation of 'I' and these changes. But in constructing his system of relationships, the system of 'independent life series', introducing into it as the central element the 'potential central member of Consciousness' (cerebrum), Avenarius in the end comes to the conclusion that 'thought is as true a form of experience as sensory perception, and thus comes to the hackneyed argument of subjective idealism that 'thought and reality are inseparable' and 'the connection and inseparability between the members of his system: external irritation (R) and perception (E) in fact give only our 'I'' (Lenin). In his book 'Materialism and Empiriocriticism' V. I. Lenin completely exposes the coincidence of views of Mach-Avenarius with the views of subjective idealists Berkeley and Schuppe and thus proves that they are deeply reactionary. Even more sharply than in Schuppe, idealistic monism is expressed in the representatives of the Marburg neo-Kantian school (Cohen, Natorp, Cassirer), who do not coordinate Consciousness and being, but as consistent students of Kant subordinate being to Consciousness. The task of Cohen's transcendental philosophy is to comprehend and connect in a system the a priori elements of Consciousness that produce 'reality', which are 'logical templates'. The way out of Kant's dualism, which derived sensory multiplicity from a source other than Consciousness, Cohen sees in that he also considers sensory 'data' as data of Consciousness and thinking, as they are given to synthesis and its unity. Objects are not given, but 'posited', they are also obtained as a result of the activity of Consciousness directed toward the systematization of the world, just as concepts are. What is thought as an 'object' at the first stage of thinking, at the highest stage becomes a 'concept'. There is no absolutely subjective contemplation, just as there is no trans-subjective-object. The object is the isolation by thinking of systematic unity: something in sensation is transformed by Consciousness into a real united system-'something'. Every answer gives rise to further questions, and the consciousness of the object is not a finished goal, but a method, a method of creative isolation of systems. All objects are functions, concepts of connections and relations, the creation of logical systems of the world. Cohen includes biological concepts in the sphere of his construction. An organism for example is a certain concrete whole, a unified system of organs, but each organ in its structure is determined not only by the relation of its parts as a system, but also by its relation to the whole. The organism as a whole is not something self-sufficient, but is included in its generic group, and these system groups in turn enter into the unified system of the living world. Thus Consciousness is transformed in Cohen into a certain logical moment, and 'I' is only an empirical fact which represents nothing that would reign over the multiplicity of experiences. Subject-object are only abstract moments of a single chain, and consciousness is only a purely phantom state, denoting only that simple truth that the content of experience is known (consciousness-Bewusstheit).

The philosophy of Cohen and Mach-Avenarius found great reflection in the philosophy of bourgeois medicine. Thus, one of the most complete philosophical concepts in medicine, the philosophy of F. Kraus (see Kraus's doctrine), is almost entirely under the influence of these teachings, deriving all biological regularities from the logical constructions of series of concepts. - Understanding C. in the philosophy of Cohen caused interesting corrections and additions to the philosophical direction of the Würzburg school (Husserl, Stumpf, Ach, Bühler), the 'psychology of acts and intentions (see)'. The actual essence of C., according to Husserl, consists in 'intentional' experiences. The Würzburg school distinguishes two types of experiences: phenomena and 'consciousness' (Bewusstsein); phenomena have a visual character, are localized in space, 'consciousness' is experienced directly, can be perceived without symbols; visual experiences are connected with sensations, are experienced as something existing in C., as content of C., 'consciousness' is experienced as acts, intentionally directed at an object, while the object itself remains transcendent. When 'consciousness' arises, reproduction has not yet occurred, but the path along which thought will proceed has already been outlined. Ach calls this tendency of directionality the 'determining tendency'; it does not depend on external irritations and associative influences, but on the state of C. (Bewusstseinslage): the nature of the general task (attitude), doubt, certainty, discernment of rules and relationships. C. is the actual totality of intentional experiences, acts; C., which contains only sensations, would not be able to interpret them objectively, judge them, rejoice in them, etc. But intentional presence is by no means a real relationship between object and subject, but only what is subjectively 'imagined', it cannot be observed objectively and only the internal empathy of the researcher or the self-description of the experiencing person can give a concept of this (phenomenological description). In psychiatry, intentional experiences in the pathology of C. were given great importance by Jaspers, as well as Bertsche, Mayer-Gross, K. Schneider (see Psychiatry-phenomenological direction in psychiatry), believing that only empathy into the subjective experiences of the patient, and not the statements of the patient and his behavior, can reveal the essence of the subjective dynamics of the patient's C., and consequently the genesis of changes in his C. Some valuable moments were given by the considerations of the Würzburg school for understanding the construction of thinking (see), although due to the definitely idealistic origin of the basic theories of the Würzburg school, its individual constructions must be accepted with extreme criticism. The philosophy of Husserl and the Würzburg school with its transcendent dynamism to a certain degree approaches the philosophical schools of 'intuitionists' (Bergson), who point out that C. has two sides-mind and instinct. Mind is only a technical tool of action: both perception and thinking and memory are only 'directed' at action, while true penetration into 'things in themselves' is possible only through instinct. - Mind is only knowledge of form, of the separate, the immobile, while life is originally given 'impulse' (elan vital), the essence of which is understood but cannot only be expressed by instinct. - Such are the main points in understanding the origin and structure of consciousness, the subject-object relationship in the new idealistic philosophy. The basic propositions of idealism-the initial givenness of C., leading to fideism and popishness, reduction of the problem of C. to experience, separation of C. from practice, separation from the data of natural science-are directly opposite to the views of dialectical materialism and must be rejected. But besides eliminating idealistic teachings about C., dialectical materialism cannot accept without elevating to a higher stage the mechanistic materialistic teachings that deny the subjective side of the psyche-consciousness, ignoring historical development, social regularities and reducing C. to reflexes, 'behavior', to anatomical mechanisms of the brain (see Behaviorism, Reflexology). The first consistent materialistic theories were mechanistic. 'The materialism of the past (18th) century was predominantly mechanical, because among all the natural sciences only mechanics had reached a certain completeness by that time... In the eyes of the 18th-century materialists, man was a machine...' and this '...constitutes the first specific inevitable trait of the limitation of classical French materialism. The second specific trait of the limitation of this materialism lies in its inability to look at the world as a process, as matter that is in continuous development. This trait corresponded to the state of natural science at that time... Such a representation was then inevitable' (Engels, Ludwig Feuerbach, in the book Marx and Engels, Works, vol. XIV, p. 647 and 648). But at the present time we must expand the mechanistic materialism of the natural scientists to dialectical historical materialism. In no way can one agree, for example, with the position of the American behaviorist psychologist Watson: 'Consciousness with its structural units, elementary sensations, sensory tones, attention, perception, representation-all these are only indefinite expressions'. C. cannot be reduced to a set of reflexes or to reactions of the organism (Kornilov), 'since both concepts are based on the theory of equilibrium between the individual and the environment and ignore the problem of self-movement, a) they deal with processes of 'behavior in general', of the behavior of an abstract, not historical man, b) they assume a mechanistic reduction of all the most complex psychical processes to the simplest responses to irritations of the environment' (Resolution of the discussion in the Institute of Psychology, Pedology and Psychotechnology). For neurology and psychiatry, the doctrine of the localization of individual functions in the brain is of great importance. The position that '...consciousness and thinking are generated by a material organ, a part of our body-the brain...' (Engels, Ludwig Feuerbach, in the book Marx and Engels, Works, vol. XIV, p. 647), is one of the basic propositions of materialism. Outlined already by Hippocrates and Galen in antiquity, again indicated by Descartes in the 17th century, Hobbes, Locke, Hume, developed in the doctrine of associations (see Associationism) by J. S. Mill, this doctrine reached especially great development and experimental substantiation in the second half of the 19th century. At the end of the 19th century, Wernicke made an attempt to create a complete scheme of the localization of all psychical processes of a healthy and sick person in the cerebral cortex, trying to establish a complete parallel between the physiological anatomy of the brain and the constructions of contemporary associationist psychology. He distinguished between the disease of the projection system, on the basis of which motor deficits, hallucinations arise, as phenomena of irritation of the corresponding centers, and diseases of association fibers-psychical diseases; the transition between them consisted of aphasic disorders. The path from perception to the target representation and action was constructed by Wernicke according to the scheme of a simple reflex, breaking down into sensory, intrapsychic and motor parts; each of these departments can become ill in the sense of increase and decrease and change of its function. All diseases are therefore divided into 3 types: directed at the outside world, one's own personality or one's own body-allo-, auto-, somatopsychic diseases. Affectivity, according to Wernicke, is also connected with the paths of representations, but develops as a secondary quality. Delirium is a change in the images of memories (intrapsychic part). In progressive paralysis, paralyses are explained by the loss of motor representations, delusions of grandeur-phenomena of irritation of the images of memories, hypochondriacal ideas-destruction of the representations of one's own body. Thus, consciousness broke down into separate cell groups in the brain-separate abilities. At the beginning of the 20th century, relatively to emotions, it was clarified that they are in a close relationship with metabolism, the chemistry of the blood and internal secretion, that all these processes are regulated by the vegetative and animal nervous systems, the centers of which are in the subcortical ganglia (thalamus, striopallidum), midbrain, diencephalon and medulla oblongata, especially around the third ventricle. Theories developed that the processes of C. occur not at all in the cortex-the cortex gives only the content of C., but the source of psychomotor impulses and psychical activity (Külppers, Reichardt and others) is around the third ventricle. There 'the seat of the soul-consciousness'. Animal vegeto-endocrine processes were understood not as the biological prerequisite of C, but as the very essence of the latter. Hence the ideas of the 'deep personality' (Tiefenperson). Only this deep personality is closely connected, according to Kraus, with nature and understands its essence, has an idea common with the whole world, giving 'vegetative Stömungen' to the whole personality. Individual perceptions, originating from individual areas of the cortex, and their associative connections, giving logical thinking, perceive only individual moments, and therefore there is no complete connection between logical thinking and reality. Thus the mechanistic theories of anatomy.

The brain's consciousness settled into the swamp of overt and hopeless idealism. The inability of natural scientists to directly and immediately rise from metaphysical (resp. mechanistic) materialism to dialectical materialism always leads, as V. I. Lenin pointed out, to the sliding of the natural scientist into idealism. Thinking and consciousness are products of the human brain, but the psychic is a different quality, distinct from the physical, not reducible to the physical, to the physiological, possessing its own specific regularity. All physiological-morphological formations are merely mechanisms, apparatuses, quantitative factors in the determination of consciousness. We must understand consciousness in its historical development, not as a separate 'individual' one, detached from the life of all other people, but as historically determined consciousness, a product of the concrete-historical existence of that class to which the given specific person belongs. Pathology of consciousness. In psychiatry, when speaking of disorders of consciousness, the term consciousness is usually understood very narrowly, mainly in the sense of the ability to perceive external impressions, to orient oneself in place and time. Bleuler contrasts states of disorder of consciousness with the state of 'making sense of the surrounding environment,' when 'orientation is good, affects do not lead to complete insanity or to stupor.' Jahrreiss (Jahrreiss) points out that when speaking of disorders of consciousness, the psychiatrist understands by consciousness 'the proper degree of clarity of the processing of perceptions, the proper tempo of the course of psychic processes, a state when a person is in a waking state, inwardly meaningful and orderly in behavior.' Rosenfeld defines consciousness as a state when 'a normal contact with the surrounding environment is maintained.' Actually, in each case of mental illness there is some change in the ability to form psychic processes into a unified whole, there is a disturbance of one or another psychic function, i.e., there is a change in consciousness, however, the clinical psychiatrist speaks of the preservation of the personality, of the preservation of consciousness even in a deeply paralytic imbecile, if he retains elementary perception of the surrounding environment; the psychiatrist speaks of 'formal preservation of consciousness' in a schizophrenic immersed in himself, who pays no attention to the surrounding environment and does not participate in social life. Usually in psychiatry three main forms of disturbance of consciousness are distinguished: 1) clouding (Benommenheit), dimming of consciousness; 2) clouding of consciousness (Trubung) and 3) pathological narrowing of consciousness, 'disturbance of the continuity of the stream of consciousness,' according to Mayer-Gross. At the same time, Jahrreiss points out that in the clinic these forms are rarely observed in their pure form, they usually mix with each other and without sharp boundaries are found within one disease. Gruhle, understanding consciousness somewhat more broadly, divides disorders of consciousness into the following groups: 1) disturbance of perception of the surrounding environment; 2) disturbance of connecting individual perceptions into structures; 3) narrowing of the volume of consciousness; interruption of the stream of consciousness; 4) disturbance of the relation of the content of consciousness to the 'I'; 5) disturbance of self-consciousness. I. Under clouding is understood a lowering of the threshold of consciousness, the threshold of perception of external irritations. The highest degree of clouding of consciousness is the comatose state, when even the strongest irritations are not perceived; here one usually speaks of a complete dimming of consciousness (see). If a strong irritation can at least temporarily bring one out of the state of complete dimming of consciousness, such a state is called soporose. Usually the state of coma and sopor is observed in severe organic lesions of the brain (trauma, brain tumors), severe disturbances of its blood circulation, epileptic seizures, severe infections, intoxications, and often these states are life-threatening. Psychic shock, affective experiences of excessive strength, mild disturbance of blood circulation can cause brief fainting states with loss of consciousness. II. Less acute, less severe infectious and intoxication processes lead to the so-called cloudings of consciousness. Here one should first of all distinguish: a) delirious states (see Delusion, delirium). The ultimate form of delirious state is chronic hallucinosis, when hallucinations, often leading to wandering, exist with 'formally clear consciousness,' with correct orientation in time and place and elementary orderly behavior, b) The next form of clouding of consciousness is the amnestic state (see Amnesia), resp. state of confusion of consciousness. Gruhle points out that in these cases the patient is actually even more sensitive to external irritations and therefore it is not quite correct to speak of clouding of consciousness, resp. perception. Here, in Gruhle's opinion, the matter is mainly about a lack of ability to order, to shape impressions into a whole; individual perceptions are poorly processed, incorrectly formed into series and interwoven with fragments of internal experiences. Mayer-Gross also says that in the amnestic state there is no clouding of consciousness, but insufficient synthesis, 'disintegrating consciousness,' the regulation of connections disappears, the action of determining tendencies is limited, but despite the 'confusion' of consciousness, the coordination between affect and representation is not disturbed. III. The next form of pathology of consciousness are 'twilight states' (Dämmerzustände). This form, Jaspers and Mayer-Gross, in contrast to the amnestic form, where they speak of disintegration of consciousness, refer to as 'altered consciousness,' and Bumke calls it 'narrowed consciousness.' Gruhle also defines twilight states as 'narrowing of consciousness on a certain circle of perceptions, disturbance of connection with the constant stream of experiences, interruption of the stream of consciousness.' According to the old description by Westphal—these are states 'lasting from minutes to hours and days, during which consciousness is so disturbed that the patient is in one circle of ideas, which is as if detached from his normal consciousness and on the basis of which, as well as the associated emotions and volitional excitations, the patient performs actions completely foreign to the usual content of his thinking and having no relation to it, however without loss of ability to perform actions connected with each other and to a certain extent following in a certain order.' A feature of twilight states is that they usually begin and end suddenly or at any case more or less sharply. Here, as Gruhle points out, it is not the clarity of consciousness that is disturbed, but its volume, the wholeness of the continuity of the personality (Kontinuität- (durée) de la Personnalité), which is why twilight states fall out of the patient's memory, since they are not connected with the general stream of consciousness, and this falling out of memory is the main and basic sign of twilight states. Rosenfeld compares twilight states with those states that develop under the influence of strong affects, for example in a moment of danger (Affektdämmerzustand), when consciousness is concentrated on a narrow circle of experiences with the exclusion from consciousness of everything that does not relate to the given moment of danger. And indeed, patients in a twilight state are often absorbed in feelings of fear, happiness or religious ecstasy or the strongest sexual drives, and under the influence of these affectively colored experiences, which have separated from the rest of the content of consciousness and completely possess the patients, they can perform senseless and dangerous actions for the surroundings and themselves. The degree of twilightness varies both in duration and in depth. The deepest twilight states are usually also characterized by considerable clouding, so that for example Kraepelin believes that in twilight states 'clarity' (threshold) of consciousness is lowered, and most external, as well as internal irritations form only weak or unclear formations; hallucinations and: states of excitement, and lack of synthesis are possible in such cases, and in such cases the distinction between twilight, delirious and amnestic components becomes difficult. Some authors, according to the degree of admixture of these components to the twilight state, divide them into the following types: a) somnambulism, b) dreamy state with clouding, c) delirious twilight state, d) affective-delusional twilight states, e) twilight states with orderly behavior; some authors add to this expansive twilight states, psychomotor twilight states, twilight states of drives (triebhafte). Bleuler divides twilight states into oriented and disoriented. According to the degree of clouding of consciousness, Raecke considers it possible also to compose a whole scale of twilight states. The degree of clouding depends on the possibility of external influence on the patient. According to pathogenesis, organic and psychogenic twilight states are distinguished, and apparently the degree of clouding is closely connected with the degree of organicity in the pathogenesis of the twilight state. Ziehen divides twilight states according to their pathogenesis into angiospastic, migraineous, neuralgic, affective and traumatic. Twilight states are observed especially frequently in epilepsy, in organic lesions of the brain (trauma), in intoxications, as well as in psychogeneses (hysteria).

Kleist speaks of episodic twilight states as a special type of degenerative predisposition that arise autochthonously but are often associated with sleep disturbances, headaches, neuralgias, intestinal disorders, etc. In addition to the above states, Grulé identifies two more groups of disorders of consciousness. IV. Disorder of the relationship between the content of consciousness and the 'I'. We always attribute all our psychic functions to our 'I', all experiences each person considers 'my' experiences, 'my' actions, but in certain pathological states this connection between individual aspects of the content of consciousness and the 'I' can be lost: we begin to experience certain states as alien to our 'I', as having appeared in consciousness from outside. According to Grulé, these are states of so-called 'inspiration', when a thought 'that came from nowhere' suddenly emerges, then these are states of religious ecstasy, and finally those states of schizophrenic depersonalization, when the patient considers that the thoughts appearing to him are not his but someone else's, that someone is reading his thoughts or forcibly implanting them in him (see Schizophrenia). The genesis of these states remains unexplained to this day, although recently some authors have begun to express the view that schizophrenic phenomena are associated with organic lesions of the interparietal area and disruption of the 'body schema' (see). Grulé also includes impulsive actions (see) in the disorder of the relationship between the content of consciousness and the 'I', actions that are not connected with the general direction of consciousness and are performed involuntarily. Here, according to Grulé, a rupture occurs between the intentions of the 'I' and what is being done. V. Finally, Grulé rather vaguely speaks of a disorder of the subject-object relationship: a state when the subject loses self-awareness and does not separate his experiences from the surrounding world. As an example of such a state, Grulé cites ecstatic states of non-being (esochia) induced in themselves by mystics, and perhaps some schizophrenic states. Disorders of individual psychic functions—memory, thinking, the course of associations, mood disorders—if they are not combined with disturbances in clarity of perception, orientation, have usually not been included in the pathology of consciousness by clinical psychiatry. In general, in the interpretation of psychopathological symptoms in psychiatry, too much importance was attached to lower mechanisms, temperament, instincts; many authors (Freud, Kretschmer, etc.) attributed to them a determining significance for the form of thinking, the direction of consciousness. Even in relation to so-called neuroses, psychogenies, which many considered to reveal the 'social inadequacy of the personality', there was almost no attempt to connect their understanding with the social conditions that shape consciousness, and if attempts were made in this direction (Adler), then the concept of social was stripped of its class historical content and turned into an empty phrase about the feeling of community (Gemeinschaftsgefühl). Psychopathological theories (see Psychopathology) in psychiatry, although they do not constitute a coherent system, the constructions of individual authors are based on a certain philosophical understanding of the origin and development of the psyche, consciousness, which to this day is mainly of an idealistic nature. This in no way contradicts the admixture to the above views of various morphological-mechanistic views. This naturally sharply affects the construction of the pathology of consciousness. As for the systematic application of Marxist-Leninist methodology in the understanding of psychopathology in general and the pathology of consciousness in particular, here, although there are individual experiments in this direction, Soviet psychiatry has not yet directly addressed these questions, and this task remains the most pressing and necessary task of the near future.

The pathology of consciousness, in the broad sense of the word, includes all mental disorders, but in a narrower sense, it refers only to disorders of the highest integrative functions of the psyche, which are expressed in a disturbance of the relationship between the subject and the object, in a disruption of the unity of psychic life. The most complete and systematic presentation of the pathology of consciousness was given by Grulé, who distinguishes five main groups of disorders of consciousness: I. Clouding of consciousness (Bewusstseinstrübung). This includes all states in which there is a general decrease in the clarity and distinctness of psychic processes, a narrowing of the field of consciousness, with a relative preservation of automatic activities. Grulé subdivides these states into: a) simple clouding, which can be mild (drowsiness, sopor) or severe (stupor); b) delirious clouding, characterized by the appearance of delirium, often of a fantastic character; c) oneiroid clouding, characterized by the predominance of dream-like images; d) confusional clouding, characterized by a complete disorganization of psychic life. II. Twilight states (Dämmerzustände). These are states characterized by a sharp narrowing of the field of consciousness with a relative preservation of automatic activities and the appearance of complex, often purposeful actions. Grulé subdivides these states into: a) twilight states with a predominance of automatic activities; b) twilight states with a predominance of delusional experiences; c) twilight states with a predominance of dream-like images. III. Transient states of consciousness. These include: a) ecstasy, characterized by a complete absorption in one idea or feeling; b) rapture, characterized by an elevation of mood with a narrowing of the field of consciousness; c) ecstasy of mystics, characterized by a complete loss of self-awareness and a feeling of unity with the universe; d) pathological intoxication, characterized by a sudden onset of excitement with a narrowing of the field of consciousness; e) pathological drunkenness, characterized by a sudden onset of excitement with a narrowing of the field of consciousness and a predominance of automatic activities; f) pathological lying, characterized by a tendency to lie without any apparent motive; g) pathological stealing, characterized by a tendency to steal without any apparent motive; h) pathological fire-setting, characterized by a tendency to set fires without any apparent motive; i) pathological gambling, characterized by a tendency to gamble without any apparent motive; j) pathological sexual perversions, characterized by a tendency to engage in sexual acts without any apparent motive. IV. Disorders of the relationship between the content of consciousness and the 'I'. These include: a) states of so-called 'inspiration', when a thought 'that came from nowhere' suddenly emerges; b) states of religious ecstasy; c) states of schizophrenic depersonalization, when the patient considers that the thoughts appearing to him are not his but someone else's. V. Disorders of the subject-object relationship. These include: a) ecstatic states of non-being (esochia) induced in themselves by mystics; b) some schizophrenic states. The pathology of consciousness, in the narrow sense of the word, is a complex and multifaceted problem that requires further study. Soviet psychiatry has not yet fully addressed this problem, but it is clear that a Marxist-Leninist approach to the study of consciousness is necessary for a correct understanding of its pathology.

Footnote: Yudin.

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“Consciousness.” Soviet Medical Encyclopedia. English translation of Bolshaya Meditsinskaya Entsiklopediya, 1st ed. (Moscow, 1928–1936), ed. N. A. Semashko. https://sovietmedicalencyclopedia.pages.dev/article/consciousness/