Of the second group, that of cases of apparently organic disease, the
case of insanity was taken out of an insane asylum by Christian
Science friends, but apparently is still insane; the diseased jaw
slowly recovered, as such cases sometimes do, without any treatment.
The same is very possibly true of the case of tuberculosis of the
bowels (peritoneum), though the diagnosis is not certain. The cuts,
bruises, and breaks healed rather slowly under ordinary surgical
treatment in a hospital. Of the locomotor ataxia, the rupture, and the
loose elbow-joint, nothing more can be said without knowing whether
the diagnoses were correct--a point on which no opinion can be formed,
owing to the scantiness of the facts recorded.
_Unreliability of "Home-Made Diagnoses"_
In the analyses of these cases I am guided by my experience with
the diagnoses naively given by patients entering my office for
treatment--diagnoses based either upon their own unguided observation
or upon what they suppose their own physician to have said to them.
In such instances there is no possible motive for deception or for
exaggeration; the patient is saying exactly what he believes; and
yet, I have rarely found his statement to be even approximately
correct. For example, when a patient comes to me with the statement
that he has "kidney and bladder trouble," I generally find both
the kidneys and the bladder sound. The patient has pain in his back
in the region where he supposes his kidneys to be; he interprets
his symptoms in the light of what he has read in the newspaper
advertisements and what he has been told by his kind friends, and
arrives at what is (to his mind) a perfectly solid conclusion. He
has no doubts of the diagnosis, states it as a fact, and asks only
for treatment.
So it is with patients coming for "spinal trouble," "hardening of the
spine," "inflammation of the spine," or "spinal meningitis." They
almost always turn out, on careful examination, to be suffering from
some form of nervous prostration. In the interpretation of their
sufferings and in the names which they attach to them they have been
guided quite innocently by hearsay.
Similarly when patients come to me for what they call "heart trouble"
and turn out on examination to be suffering from pain in the left side
of the chest without any heart trouble at all, I accuse them of no
deception but only of incapacity for the accurate appreciation of the
value of evidence.
Certain other statements recur very often in the histories given in
all good faith by patients, whether in the doctor's office or in a
Christian Science experience meeting. I will quote some of these:
"I have had a great many doctors, and each has made a different
diagnosis."
"I am suffering from a complication of diseases, Bright's disease,
liver and lung complaint, and other ailments too numerous to
mention."
"I have had a great many operations performed on me."
Experience shows us that when a person has had many doctors, many
diagnoses, many "diseases," or many operations, he usually turns out
to be suffering from nervous prostration or some other form of
functional nervous trouble. For these troubles are just those which
most often puzzle the physician, leading him to change his diagnosis
and the patient to change his doctor very frequently. Again, it is
just these functional nervous disorders which, affecting as they do
every part of the body and every organ, give rise to the false idea of
"many diseases"--an idea based on the patient's multitudinous
sufferings.
Organic disease often runs its course accompanied by very little
suffering, or with a very definite localization of the malady in one
part of the body. The patient with a genuine complication of diseases
does not often live to tell the story in a doctor's office or in a
Christian Science experience meeting. In the majority of the reported
cases the complication is in the patient's mind, not in his diseases.
For a similar reason the patient who has had "many operations" is
usually one whose (nervous) sufferings are so manifold and so various
that physicians are driven to seek relief by one measure after
another, and finally by a variety of surgical procedures.
It is a striking fact that, as one listens to the recital of
Christian Science "cures," one hears little or nothing of the great
common organic diseases, such as arterio-sclerosis, phthisis,
appendicitis--and still less of the common acute diseases, such as
pneumonia, malaria, apoplexy. Chronic nervous (that is, mental)
disease is the Christian Scientist's stock in trade.
_Similarity of Christian Science Testimony_
No one can study the printed records of Christian Science cures
without noting a remarkable similarity running through many hundreds
of them, a similarity in style, in phraseology, and in the general
structure of the letters.
For example, Mrs. Eddy's name was mentioned _within five lines of the
end_ in fifty-six out of seventy-five letters which I have recently
examined. I have excluded here all cases in which Mrs. Eddy's name was
mentioned earlier in the letter. It seems hardly likely that all these
writers would spontaneously bring in the name of their leader
precisely in this position in the letter.
In twelve out of seventy-five letters the rather unusual phrase
_materia medica_ occurs.
The price of treatment under Christian Science and under the previous
medical care is mentioned in a large proportion of these letters.
Not one of these letters mentions the name of any doctor connected at
any time with the case. From personal experience with similar stories
heard from my own patients and from the lips of Christian Scientists,
I know that doctors' names are usually mentioned. It seems unlikely
that in one hundred consecutive testimonies the physicians' names
should have been spontaneously omitted.
For these reasons one cannot help believing either that these letters
have been liberally edited, or that their writers have been much
influenced by reading or hearing of similar cases. This does not
necessarily imply any charge of intentional deception, but weakens
very considerably their value as evidence.
_"Natural Selection" in the Christian Science Clinic_
The persistence of Christian Scientists in the belief that they can
cure organic disease, a belief which I consider genuine in the
majority of cases, is probably due to the following reason: By a
curious process of "natural selection," a patient suffering from
organic disease rarely consults a Christian Scientist, just as he
rarely consults an osteopath. Being ignorant of diagnosis, the
Christian Scientist is not aware of this fact and supposes that he is
treating, not a selected group of cases of functional disease, but all
disease. This mistake is all the more natural because the Christian
Scientist, with the natural credulity of the half-educated, accepts
the patient's own diagnosis at its face value or trusts the hearsay
report of what some doctor is supposed to have said.
The same interesting process of "natural selection" accounts for the
fact that Christian Scientists are so rarely the cause of death to
those whom they treat. It is undoubtedly true that deaths occasionally
occur (for example, from diphtheria) which are directly traceable to
the fatal inactivity and ignorance of a Christian Scientist. But such
deaths are in my opinion rare. They are pretty sure to give rise to
newspaper notoriety and so to become widely known, yet one does not
hear of many such in the course of a year, for common sense steers the
great majority of sufferers from organic disease away from the parlors
of the Christian Scientist.
"_Doctors Who Flood the World with Disease_"
It is impossible to study the evidence for and against the so-called
Christian Science cures without crossing the track of many an
incapable doctor. Indeed, there can be no candid criticism of
Christian Science methods that does not involve also an arraignment of
existing medical methods. It is not difficult to perceive, as one
studies the testimonies recorded in the _Christian Science Journal_,
that many patients have been driven into Christian Science by a
multitude of shifting and mistaken diagnoses, by the gross abuse of
drugs, especially of morphine, and by the total neglect of rational
psychotherapy on the part of many physicians. No doubt these causes
account only for a certain fraction of the desertions to Christian
Science. There are many patients who have so little patience and so
much credulity that they desert their doctors for no good reason
whatever; but I believe that these cases are in the minority, and that
the success of the Christian Science movement is due largely to the
ignorance and narrow-mindedness of a certain proportion of the medical
profession.
I can see some foundation even for such an exaggerated charge as that
the doctors "are flooding the world with disease"--a favorite
expression of Mrs. Eddy's. No one who has seen much of the nervous or
hysterical affections following railway accidents and of the methods
not infrequently used, not only by lawyers, but by doctors, to make
the sufferers believe that they are sicker than they really are, can
deny that there is some truth in Mrs. Eddy's charge. Even in her
irrational denunciations of hygiene, one cannot help seeing some grain
of truth when one reads or hears of the multitude of petty prudences
and "old womanish" superstitions not infrequently exploited by school
teachers, parents, and teachers of physical culture, under the name of
"hygiene."
_The Classic Methods Used by Christian Science_
Believing, then, as I do, that most Christian Science cures are
genuine--genuine cures of functional disease--the question arises
whether the special methods of mental healing employed by Christian
Scientists differ from other methods of mental healing, such as are
employed by the best neurologists, both in this country and in
Europe.
Of the classical methods of psychotherapeutics, namely, explanation,
education, psychoanalysis, encouragement, suggestion, rest-cure and
work-cure, the Christian Scientists use chiefly suggestion, education,
and work-cure, though each of these methods is colored and shaped by
the peculiar doctrines of the sect.
The quack who sells magic handkerchiefs supposed to be endowed with
miraculous healing powers by the touch of his sacred hand, the priests
who exploit the "healing springs" at Lourdes, and the doctor who gives
a bread pill or a highly diluted homeopathic drug, may cure a patient
by what is known as "suggestion," that is, by producing in the patient
a strong belief that he will get well. Christian Science suggestion
takes the form of "silent treatment" and "absent treatment," in which
the patient is influenced by the auto-suggestions of health which the
silent pressure of the "practitioner" or the knowledge of the "absent
treatment" leads him to make.
Christian Science education consists in the reading of "Science and
Health," of the Bible, as interpreted by Mrs. Eddy (after Quimby), and
of the teachings received at the hands of Christian Science
practitioners. Although there is much that is false and harmful in the
education thus received, I believe that a good many warped minds do
find in it the corrective twist which they need--just as a certain
type of crooked spine may be helped by a violent twist in the other
direction.
Work-cure is, I think, the sanest and most helpful part of Christian
Science, as of all other types of psychotherapy. The Christian
Scientists do set idle people to work and turn inverted attention
outward upon the world. This is a great service--the greatest, I
think, that can be done to a human being. By setting their patients to
the work of healing and teaching others, Christian Scientists have
wisely availed themselves of the greatest healing power on earth.
I believe that suggestion, education, and work-cure can be used in far
safer and saner ways by physicians, social workers, and teachers or
clergymen properly trained for the work than by the Christian
Scientists. Heretofore these last have held the field of psychotherapy
largely without competition. American physicians have confined
themselves mostly to physical and chemical methods (diet, drugs, and
surgery), which have a place in the cure of functional disease, but
not, I think, the chief place.
Now that scientific psychotherapy is being taken up by physicians,
social workers, and educators (including the clergy), not instead of,
but in conjunction with physical and chemical treatment, I think it is
reasonable to expect that Christian Science will have to stick closer
to the truth if it is to hold its ground in competition.