Though it has seldom been fully realized and has probably never been

appreciated as in our time, one of the most important factors in

therapeutics, in every period of the history of medicine, has been the

personal influence of the physician. Therapeutic fashions have come

and gone, new drugs have been introduced, have had their day and then

been relegated to the limbo of worn-out ideas. At all times, however,

physicians have succeeded in doing good, or at least using, with

apparent success, the therapeutic means of their own time, however

crude and inadequate these afterwards proved to be. They have

succeeded in shortening the progress of disease as well as increasing

the patient's resistive vitality and thus enabled him not infrequently

to survive where otherwise a fatal termination might have occurred.

All unsuspected during most of the time, it was the personal influence

of the physician that counted for most in all of the historical

vicissitudes of therapeusis. It mattered not that the means he

employed might seem absurd to the second succeeding generation, as was

so often, indeed almost invariably, the case, his personal influence

has at all times overshadowed his available therapeutic auxiliaries.

In spite of all our advance in scientific medicine, to a considerable

degree this remains true even at the present time, and to fail

properly to use this important auxiliary is to cripple medical

practice.

Place of Personal Influence.--When the antitoxins and directly

curative serums seemed about to make for themselves a place in

therapeusis, it looked for a time as though this personal element

might be entirely superseded. It seemed that all other therapeutic

factors must give way to definitely accurate doses of antitoxic

principles, directly opposed to the toxins of disease and {70} capable

of conquering it. With the success of diphtheria serum, the prospects

for scientific therapeutics from the biological standpoint became very

promising. Unfortunately, our further experience with antitoxins and

therapeutic sera of various kinds has not been satisfactory, and now

the medical world is looking elsewhere for progress in therapeutics.

This throws us back once more on the old-time therapeutics, and we

have to learn to use all their elements. One of the most important of

these, if not, as we have suggested, absolutely the most important,

the one that in all the many variations of therapeusis has maintained

itself, is the personal influence of the physician by which he is able

to soothe the patient's fears, allay his anxieties, make him face the

situation calmly so that he may not use up any of his vital force in

useless worry, but on the contrary employ all his available psychic

energy in helping nature to overcome whatever disturbance there is

within the organism. This personal influence was for several centuries

spoken of as personal magnetism, not merely in the figurative sense in

which we now employ that term, but in a literal sense. The implication

was that some men possessed within themselves a reservoir of

superfluous energy, vital in character, but thought to be related to

the force exhibited by the magnet, when it attracted bodies to itself,

and made metals for a time magnetic like itself, and which actually

passed over from the physician to his patient. We have gotten away

from the idea of any physical force flowing from physician to patient,

but we know very well that certain physicians are much more capable

than others of arousing the vital energies of the patient, sometimes

to the extent of making him feel, after treatment, that he has more

force than before. The patient feels that something must have been

added to his natural powers, though he has only been brought into a

state of mind where he can better use his own powers.

It is the men whose presence created this impression in patients, an

impression that is justified by the fact that somehow he enabled them

to vitalize themselves better than before, who have been most

successful in the treatment of patients. In all ages the men of

reputation for healing have had this. A careful study of their lives

shows that this counted for more in many of the experiences of their

healing than the drugs and remedies which they employed. The men who

have been the most sought by patients have not as a rule left us great

therapeutic secrets; on the contrary, they have only employed the

conventional remedies of their times with reasonable common-sense and

have added to them their own personal influences. On the other hand,

the men who have made discoveries in therapeutics, and in medicine,

have not always been popular as physicians. They have known too much

of their own lack of knowledge to be quite confident in their use of

remedies, and this has hurt something of their personal influence over

patients.

IMPRESSIVE PERSONALITY

As a matter of fact, it is easy to comprehend, even from the

comparatively scanty details that we have of habits and methods of the

great physicians, that their effect upon their patients was always

largely a matter of impressive personality. Any one who, from a

pharmaceutical standpoint, knows how {71} inefficient were many of the

remedies that great physicians depended on, yet how effective they

seemed to be to their patients, and even to themselves, will

appreciate the factor of personal magnetism that entered into their

employment. It is not alone in the olden time that great physicians

have been almost worshiped. For their patients they have at all times

been men of exalted knowledge, masters of secrets and comforters of

the afflicted, just as was the first great physician of whom we have

any account, I-em-Hetep, in Egypt nearly six thousand years ago. Such

men as Hippocrates, as Galen, as Sydenham and Boerhaave, and Van

Swieten, accomplished curative results far beyond the therapeutics of

their time. The loving admiration of patients and of their disciples

shows how strong were their personalities and gives us, almost better

than the writings they have left to us, the secret of their successes

as practitioners of medicine.

A Great Modern Physician's Influence.--It is interesting to study in

the lives of great physicians the details which illustrate their

personal influence, their consciousness of it and how deliberately

they used it. A typical example very close to us, whose reputation was

still fresh while I was at the University of Paris, was Professor

Charcot. He had made great discoveries in nervous pathology. To a

great extent he had revolutionized our knowledge of nervous diseases

and added many new chapters to this rather obscure department of

medicine. Far from making the treatment of nervous diseases easier

than before, or giving more assurance to the physician who dealt with

them, his discoveries, however, had just the opposite effect. His work

emphasized that practically all of the so-called nervous diseases were

due to degenerations in the central nervous system, which no medicine

could be expected to relieve in any way, and which nothing short of

the impossible re-creation of damaged parts could ever cure. His

studies included organic degenerations of other organs, and in his

treatise on "Diseases of the Old" it is made clear that many of the

symptoms of old age are due to organic lesions for which no cure can

ever be expected. This would seem to discourage treatment, yet somehow

Charcot became a great practicing physician as well as a medical

scientist and pathologist.

His success was due to his personal influence over his patients. In

spite of the unfavorable prognosis that he had to give in so many

cases, he was able by suggestion to help many patients with regard to

their course of life, and to reassure them, so that many adventitious

neurotic symptoms not due to their underlying nervous disease, but to

their solicitude about themselves, disappeared. Very few people who

came to him went away without feeling that his advice had been very

valuable to them and without experiencing, as a rule, after they had

followed his advice, that they were much better than they had been

before. It was for the neurotic conditions associated with nervous

affections that Charcot's personal influence over patients was of the

greatest therapeutic significance.

He himself recognized this and did not hesitate to use it to its

fullest extent. Towards the end of his life, the method by which his

patients were presented to him was calculated to make their relation

to him, above all, a very personal one, and to give his influence the

fullest weight. Nervous patients who came to see him, were each in his

turn invited from the general waiting-room into a small ante-room just

outside of Charcot's office and {72} there, in silence and dim light,

asked to await the summons of the physician himself. When the time

came for him to call them in, the folding doors between the rooms

opened and he stood in a blaze of light inviting them to enter. Many a

neurotic patient despairing of relief for symptoms that had lasted

long in spite of the treatment of many other physicians, felt at once

that here, in this kindly, gentle-voiced man standing so prominently

in the light, was surely the long looked-for physician who would heal

whatever ills there were. They came fully impressed with his power to

heal, and all the valuable influence of auto-suggestion was enlisted

on the side of their physician.

What is true in the regular practice of medicine can be seen much more

clearly in the history of those who were not physicians, but who,

nevertheless, by personal magnetism, succeeded in curing various ills,

or at least in lifting up patients so that they used their own natural

powers of recovery to much better advantage than would have been

possible if left unaided.

Every successful healer has had this same personal influence, personal

magnetism, call it what we will, which his patients have thought

helpful to them through some direct communication, but which he

himself, if he seriously studied it, and which every other thorough

student of the question must realize, was due only to his power to

call out the latent vitality of his patients. The mystery is not one

of teledynamics, a transfer of energy from the operator, but one of

awakening dormant faculties in the subject. Just why they should be

dormant, since the patient so much wants to use them if he only could,

is hard to understand. They do, however, lie dormant until the call of

another strong personality wakens them to activity. Many people are so

constituted that they cannot do effective work except under the

direction of others. They lack initiative, though they may fill

secondary places very well, indeed, much better often than the man of

initiative who so frequently lacks capacity for details. In the same

way many people are not able to bring out to the full all their own

energies, even for their own bodily needs, unless under the guidance

and influence of others; hence the stories of the healers that we have

all down the centuries, and who have a definite place in the history

of humanity and of medicine.

A Modern Healer.--A typical instance of the really marvelous power of

mental influence over the minds of sufferers from many kinds of ills,

is found in the career of the well-known Father Kneipp. For more than

twenty-five years he had attracted the attention of Europe, and had

made the little town of Woerishofen well known all over the world

because of the cures effected there by him. The exactly proper phrase

is effected _by him_ because it is clear to anyone who has studied the

therapeutic methods he employed, that it was not these, or at least

not these alone, that enabled him to cure so many ailments which had

resisted the efforts of some of the best physicians in Europe. It was

his magnetic personality which won patients to the persuasion that

they must get better because he said so, and then to the following out

of certain very simple natural rules of life, and certain quite as

simple remedial measures, which acted as alteratives and enabled

patients to tap reservoirs of vitality, of which they themselves were

unconscious, but which, supplying energies to overcome tendencies to

various symptomatic conditions, brought about cures.

{73}

Pfarrer Kneipp had himself suffered from consumption, had been

practically given up and then, as is the case of many another, had

taken himself in hand, had secured much more outdoor air than before,

and more abundant nutrition, until gradually his ailment was overcome.

It is true that he used various hydrotherapeutic measures, some of

them, as he confessed afterwards, to an excess, both as regards the

temperature of water and the length of the application of it, that

might have seriously hurt him if he had been less robust, but it was

not so much his hydrotherapy as his own determination to get better

and to live a little closer to nature that led to his cure. Then he

became the apostle of cold water and of many natural remedial

measures, and as a consequence, healer of all forms of ills in the

many thousands who flocked to consult him in the little South German

town. He made his patients get up early in the morning, get out in the

air shortly after rising, the excuse, or, as he declared it, the

reason being that they were to walk with bare feet in the dewy grass.

After this he had them eat heartily of simple food, of such variety

and in such quantity as relieved them of constipation, made them use

water, internally and externally, in abundance, and after a time, sent

most of them on their way rejoicing that they had been cured from

chronic ills.

Some of the highest in Europe came to him; the Empress of Austria was

his patient, and he was asked to prescribe for the Pope; reigning

princes and all the lesser order of the nobility were included among

his patients. Several of the Rothschild family went to him and where

they went, of course, others flocked. Very few failed to be benefited.

People less educated, and less rich in the world's goods than these,

came also, and went away relieved. After a time Kneipp societies were

founded all over Europe and even spread through America. These

consisted of organizations of men and women who encouraged each other

to keep up the Kneipp practices. With his death there has come a

decline in interest in Kneipp methods. He, himself, was sure that his

remedies and recommendations were the important curative factors. Now

it has become clear that it was mainly his forceful personality, his

power to lift patients above their ills, and enable them to use mental

resources or vital forces that they could not use until encouraged by

him with the thought that they would surely get better. In the

atmosphere he thus created, they seemed to borrow something of his

overmastering personality. It can not be too often repeated that this

is the secret of the success of the great world healers. They do not

transfer force to others, but they enable others to use their _own_

forces more successfully.

An Ancient Healer.--Let us compare some of the details of the career

of Father Kneipp with the story we have of one Aristides, who, as the

result of dreams that came to him while practicing the cult of

AEsculapius and the injunctions contained in these dreams, was cured

of many ills, and afterward delivered a series of sacred orations.

Aristides is one of the first of the large group of literary men, much

interested in their own health and their own ills, whose writings have

been preserved for us. He was intensely proud of the number and

variety of his ills, and he was perhaps conceited about the curious

ways in which some of them had been cured. Traveling in the winter

time he caught a chill; then he suffered from earache and in the midst

of a storm developed fever, asthma and toothache. Arrived in Rome, he

had severe internal sufferings, shivering fits and want of breath.

Treatment by the Roman {74} doctor only aggravated his sufferings. A

stormy voyage home made him worse. When, at last, he arrived in

Smyrna, the doctors gathered round him, and were astonished at the

manifold nature of the disease. They could do nothing for him.

Suffering from all these ills (which remind one of a modern literary

man who has got his mind on his stomach and his body on his mind),

Aristides went to a number of the old temple hospitals and received

suggestions in sleep from AEsculapius. These he has described in what

are called his sacred orations. In them we have every phase of modern

therapy that has the strong element of suggestion in it. Like Pfarrer

Kneipp, he tried very cold baths and was benefited by them. Walking in

the dewy grass in his bare feet was another recommendation that had

come to him in a dream. Occasionally he would run rapidly for a

considerable distance, and then when heated plunge into a cold bath.

We have many complaints of his fever and stomach troubles. Mud-baths

were also recommended to him and, of course, tried with benefit for a

time. Sand baths later proved to be beneficial. For rheumatism a cold

bath, after running almost naked in the cold north wind, proved

successful when other remedies failed. Aristides wrote out his

experiences, and his writings had great influence over generations of

patients and maintained the influence of the old Greek temples as cure

houses long after the general acceptance of Christianity. As the

result of his writings, no matter how bizarre a dream might be, some

interpretation of a therapeutic nature was found from it.

Constancy of the Law of Personal Influence.--Indeed, there has

apparently never been a time when some strong character, full of

religious enthusiasm and of high purpose, strong in the confidence of

men, has not succeeded in accomplishing wonderful curative results by

the reassurance that comes from a renewal of faith in the goodness of

Providence. There are, for instance, a number of stories which show

John Wesley's power to help men to tap the reservoir of surplus energy

that all of us have within us, but that somehow we do not succeed in

making use of, unless some strong mental influence is brought to bear

on us. Practically every religious man who has had the love and the

veneration and the respect of those around him has succeeded in

accomplishing the cures that many people in recent years have been

prone to regard as rather novel phenomena in the history of

psychology. Men like St. Philip Neri, St. Francis Xavier, and St.

Francis of Assisi, and St. Bernard, have many stories told of them

which show how much they were able to help fellow mortals by enabling

them to make use, even in a physical way, of their own highest and

best powers. Their lives show how much more they did.

Nor is this power confined to men. In nearly every century we have the

story, also, of wonderfully strong women, leaders of their time, who

inspired the profound confidence and veneration of those around them,

and who were enabled, by their own strength of character, to help

people physically as well as morally. The Life of St. Catherine of

Siena is full of such instances. She spent her life mainly in caring

for the sick and the distressed at the hospital in Siena, and the

beautiful hospital there was completed largely as a monument to her.

During her lifetime marvelous cures occurred that in many cases were

evidently due to her power over the minds of people. The {75} life of

St. Teresa has a number of similar examples, and Joan of Arc, in her

lifetime, lifted many a dispirited man into vigorous strength because

of her own abounding personality and the physical reaction which

contact with her enthusiasm brought.

Modern Examples.--Nor did such occurrences come only in older and less

sophisticated centuries than ours. John Wesley is close enough to our

time to negative any such impression, but there are many other

examples. There is Pastor Gassner, whose cures remind Prof.

Muensterberg of the Emanuel movement at the present time, but there are

also a number of strong, religious characters whose influence was

exercised in the alleviation of physical ills during the nineteenth

century. The name of Father Matthew, the Irish "Apostle of

Temperance," as he was called, is mainly connected with wonderful

cures of the worst forms of alcoholic addiction. Physicians know how

difficult such cases are to cure, yet there are many thousands of what

were apparently hopeless cases to Father Matthew's credit. It may be

remarked that this is one of the ills that modern mental treatment

claims most success with. Besides these morbid habits there are,

however, other cases, told in detail, in which Father Matthew's

influence enabled people to shake off headaches, to get rid of

illusions, to overcome hysteria, and even to relieve other and much

more physical affections. Animal magnetism was the subject of much

thought in his lifetime (nineteenth century), so that it is not

surprising that Mr. John Francis McGuire, a member of the English

Parliament, who wrote Father Matthew's life in 1864, declared that

"Father Matthew possessed in a large degree the power of animal

magnetism, and great relief was afforded by him to people suffering

from various affections; and in some cases I was satisfied that

permanent good was effected by his administrations."

Another strong man of this same kind was Prince Alexander of

Hohenlohe. Though a prince he had become a clergyman and spent his

life in the service of the poor. Shortly after he became a priest he

went through a great epidemic, fearlessly caring for his poor people,

and as a consequence inspired them with so much confidence that ever

after they came to him with all their ills. He was able to help, not

only the poor, but also many of the nobility. Some of the things

reported as accomplished through his influence show extraordinary

power. His usual method was to endeavor to inspire in the people who

came to him a faith in their cure, and then after a time the cure was

actually accomplished.

During the recent troubles in Russia, attention was called to the fact

that the famous Father John of Cronstadt, the hero of Bloody Sunday,

was looked up to with so much respect and veneration that many people

found themselves helped physically by contact with him. There are a

number of interesting stories of cures of ills of various kinds, some

of them exclusively mental, but many of them fundamentally physical,

which took place as a consequence of the new spirit of hope infused

into people because of their confidence in Father John. His subsequent

history seems to indicate that this was evidently due to the forceful

personality of the man rather than to any special religious influence.

His influence was not limited to the ignorant masses in Russia, for

some of the cures reported occurred in families of the better class,

thoroughly capable of judging the character of the man apart from his

religion.

{76}

SUCCESS IN HEALING

We have any number of examples, then, of this power of the healer in

history. Over and over again we find that it was the personality of

the man and the suggestive value of the means that he employed that

enabled patients to cure themselves, that is, to use all the vital

force which they had for curative purposes. This force had hitherto

been inhibited by their own doubts of themselves and their doubts of

the value of all ordinary means of cure which had been previously

employed in their cases. This is the secret of the success of the

healer, and this secret is much more valuable for therapeusis than any

remedy which has come down to us from the olden time. It has,

unfortunately, been neglected, and thus an important benefit to

humanity has been lost. Now that we are able to review frankly and

deliberately the conditions that obtained in the past, it is time to

set about making use of this oldest secret in medicine, now no longer

a secret, as a strong factor in the treatment not of disease but of

patients.

Healers are at all times strong characters who are helpful to others

because of their own superabundant strength. The world is made up of

two classes of people, lifters and leaners, and the leaners constitute

by far the larger class. Most men and women are the subjects of doubts

and dreads and difficulties with regard to their health, and the more

time they have for introspection, the more are they likely to suffer.

Unable to overcome them by themselves, they need the help of others.

What they need, above all, is the reassurance that a trained strong

mind can give them. The exercise of this mental influence over them,

is only what corresponds to leadership in all the affairs of life.

Most people need to be led and to be guided. The place of the

physician is that of guide and director. The family physician of the

olden time had a precious amount of influence that accrued to him from

his character, and it was used to magnificent purpose. Most of his

drug treatment would be looked upon as quite absurd at the present

time, yet he did a great good work by lifting people up to their own

highest possibilities of resistive vitality. That means more for the

conquest of disease, even now, in most cases, than any remedies we

possess.

Often men do not realize how much their personal influence counts for.

They think it is their method of treatment, or some new discovery in

drugs or remedial measures, or some new phase of psychology they have

hit upon, that is producing results. This makes it difficult to

determine, in given cases, just what are the actual influences at

work. Many men supposing themselves to be discoverers of some novel

force, are merely exploiting that old-time influence of one mind over

another that can be observed all down the centuries.

It is interesting to study the careers of men who thought they were

employing on their patients some new psychological method, when all

they were exploiting was the old-fashioned influence of suggestion

from a stronger personality to a weaker. A dozen times in history

hypnotism has been announced as a wonderful curative agent. At present

no one thinks it so, but, on the contrary, if used frequently, we

think that it is much more likely to do harm than good. We went

through a phase of interest in hypnotism a quarter of {77} a century

ago and there are now signs of the possibility of its return in

another form. In recent years we have heard much of psycho-analysis,

of dominant ideas, of the auto-suggestion that comes from this, and

how much benefit can be conferred on the patient by removing such

ideas or revealing their unfavorable influence and so neutralizing

them.

The patients that come for treatment and to whom psychotherapy is of

special benefit, are not, as a rule, those suffering from acute

diseases or injuries, though even in these cases the attitude of mind

is always an important therapeutic factor. The patients are mainly

those suffering from chronic ailments, and from minor affections

which, while they do not confine them to bed, often prove the source

of such serious disturbance as makes them very miserable. The

suffering in the world is out of all proportion to the actual disease.

Many people who have little disease suffer a great deal, partly from

over-sensitiveness, partly from concentration of mind on their

ailments, and partly from such ignorance of whatever pathological

condition is present that they grow discouraged and morbid over it.

The role of psychotherapy is particularly to help patients of this

kind. This does not mean that its main purpose is to treat imaginary

disease, or disease which exists only in the mind of patients, for in

nearly all of these cases there is a definite physical element in the

affection. Even where the disease is quite imaginary, though that term

has been so sadly abused that it is perhaps better to speak of

affections as purely mental in origin, psychotherapy is important. As

has been well said, a patient not having something physical the matter

who thinks that there is something the matter, is in a worse state

than one who really has something the matter. There are a great many

such cases. If the principles of psychotherapy can relieve them and

cure many of them, then it has a large place in human life.

In order that the individual patient may be benefited, a thorough

understanding must be established between physician and patient. This

must take on the character of a personal relationship. The patient

must feel that the physician has a personal interest in him--that

there are certain individual features in his ailment which make his

case mean something much more than ordinary to his physician. Some

physicians have the power to make their patients feel this personal

relationship to a marked degree. They are the eminently successful

practitioners of medicine. Their patients sound their praises, and

even though they may not be distinguished scientists, they acquire a

large practice. Some of them are thoroughly scientific men. All of us

know them and, while we may not be able to understand just how it is

done, we recognize their power.

CHAPTER XI

FAITH CURES

The series of phenomena that may be grouped under the term "faith

cures" represent the oldest, the most frequent, universal, and

constantly recurring examples of the influence of the mind over the

body for the healing of ills. Whenever men have believed deeply and

with conviction that some other being {78} was able to help them, many

of their ills, or at least the conditions from which they suffered

severely, have dropped from them and their complaints, real or

imaginary have disappeared. This was true whether it was the touch of

another human being supposed to have some wonderful power that was the

agent, or some persuasion of the interference of the supernatural that

appealed to them. Religions of all kinds have always had their cures,

and one of the main reasons why men have accepted the various

religions has nearly always been because of the weight of these

healing phenomena. Apparently it does not matter how debased the form

of religion may be, whether it is exercised by the medicine man of a

savage tribe with methods that appeal only to barbarous instincts, or

by a highly cultured priest of a form of religion appealing to the

loftiest feeling and the profoundest intellectuality, cures take place

whenever devotees have complete and absolute faith in the possibility

of divine or supernatural interference in their behalf. The very

earliest history that we have tells us of such cures, and the daily

papers bring us reports of them from all quarters among the high and

the low, the educated and the uneducated.

The phenomenon is universal and we come logically to the belief that

the Supreme Being intended that confidence in Him, and above all

recognition of the fact that somehow the world with all its ills has a

meaning for good, should be rewarded. The argument that religion is a

natural revelation should then apparently be extended to include also

the thought of a healing power in connection with it. Many of the

founders of religions that have meant much for uplift to mankind, have

made healing a principal portion of their message to man--the proof of

their missions. Indeed, there actually seems to be an extension of

power, above what is natural, to those who in profound confidence in

Divinity, turn to this source of strength for relief from the ills

that flesh is heir to. In any of these cases, definite inquiry as to

the significance of the particular incident is needed, and not any

general principle of either acceptance or rejection. Faith healing is

a fact, its meaning is of the greatest importance for psychotherapy

and its phenomena deserve that specific study which alone can give any

certainty in the matter.

Accessories of Faith Cures.--From the earliest dawn of history we have

definite records of faith cures. It is true that they were usually

associated with certain physical factors besides the mere act of the

mind. In ancient Egypt the physicians were also priests, and while

they administered various remedies, these had the added advantage of

being supposed to be the result of divine inspiration, or suggestion,

or to be in some way connected with religion. Among these men there

were many strong personalities, contact with whom brought healing.

Dreams and premonitions and hallucinations all had a definite place in

their therapeutics because of their supposed connection with religion,

or at least with the beings of another world. Spiritualism, itself a

form of religion, is very old, and communications from spirits, real

or supposed, were easily thought to have therapeutic significance.

Miracles.--In most cases of faith healing, faith acts through the

definite conviction that there is to be a direct interference with the

ordinary course of nature in the patient's behalf. Some of the

evidence for such direct interference on the part of Providence is so

strong as to carry conviction even to serious and judicious and

judicial minds. When the circumstances are such {79} that an exception

to the laws of nature would not involve an absurdity, there is no good

reason why its occurrence should be absolutely put out of the

question. It may well be urged that we know so little about the laws

of nature that we cannot determine absolutely what are and what are

not exceptions to those laws. There is in itself, however, no

absurdity in what is called a miracle, and unless one is ready to

reject Christianity entirely, or to declare it absolutely impossible

that the God who made the universe should have any personal care for

it, or above all any interest in particular individuals in it, their

possibility must be admitted. The attitude of utter negation and

incredulity often assumed at the present day is only a reflection of a

certain ignorance of philosophy, and too great dependence on a

superficial knowledge of physical science, so characteristic of

narrowly trained minds. After a visit to Lourdes and careful study of

_"La clinique de Lourdes,"_ I am convinced that miracles happen there.

There is more than natural power manifest.

In a great many cases it is easy to see that the agents involved in

the faith cures, and the circumstances surrounding them, are quite

unworthy of any supposition that the Deity should have interfered.

Where there is anything irrational, or sordid, or eminently selfish

about the faith-healing, then any appeal to a supposed interference

from on high is absurd. Horace said in another matter, but it will

bear application here: "Nec deus intersit nisi dignus vindice nodus."

Do not let a god intervene unless there is a set of circumstances

worthy of him. In many of the faith-healing phenomena claimed to be

connected with religion there are a number of absurdities. It may be

suggested that any one person must not set himself up as the judge of

such absurdity. When it is evident, however, that the ailing are being

exploited for the benefit of one or of a few persons, or when there

are certain manifestly irrational conditions in the circumstances of

healing, then it is fair to conclude that what we have to do with are

only examples of healing by means of strong mental influence. But it

would be quite wrong on account of these abuses to dismiss the whole

subject of miracle healing as all imposture or merely mental

influence.

The Royal Touch.--Probably the most interesting chapter in the history

of faith cures is that of the touch of the King of England for

scrofula, or, as it was known, the King's Evil. His touch was also

supposed to be efficacious in epilepsy. English historians usually

trace the origin of the custom to Edward the Confessor. Aubrey remarks

that "the curing of the King's Evil by the touch of the King does much

puzzle our philosophers, for whether our Kings were of the house of

York or Lancaster, it did the cure for the most part."

Even the change of religion in the time of Henry VIII and Elizabeth

made no difference. Some people who hesitated about submitting to

Elizabeth as queen lost their hesitancy when they heard that the

queen's touch was successful in curing. James I wanted to drop it, but

was warned not to, as it was a prerogative of the crown with which he

had no right to interfere. Charles I was particularly successful.

Charles II, whose licentious life apparently would quite unfit him for

the exercise of any such power, was perhaps the English king who

devoted most time to healing. While he was in exile in the

Netherlands, many people crossed over to the Low Countries in order to

be touched by him, and they returned cured of many different diseases.

{80} This effectively prepared the minds of many for his return. Under

scrofula were included most of the wasting diseases, and under

epilepsy many neurotic conditions as well as many organic

disturbances. It is easy to understand how great was the room for the

successful employment here of mental influence.

Queen Anne continued the practice, and many cures were reported in her

time as late as the eighteenth century. William of Orange, when he

ascended the throne with Mary, refused to believe that there was any

special power for good in his touch. On one occasion he touched a

person who came to him, saying as he did so: "God give you better

health and more sense." In spite of this skeptical attitude his touch

is said to have healed that particular person. In the next reign,

however. Queen Anne resumed the practice, and Dr. Samuel Johnson, as a

boy of five, was touched by her with some hundreds of others in 1712.

No cure was effected in his case, but as the gruff old doctor lived to

a round age in rather sturdy health, doubtless some would raise the

question as to whether, if he had early scrofula, it was not greatly

modified for the better.

The circumstances connected with the royal touch were all calculated

to be curative of the affections for which this practice had a

therapeutic reputation. There were certain times in the year,

particularly in the spring after Easter, when the king touched people

for their ills. Ordinarily preparations would be made for some time

before, and the patients would have all the benefit of expectancy.

Then there came the journey to London to the king's presence, and as

it was usually known that these ailing folks were on their way to the

king, they received particular care from the people of the towns

through which they passed. Then came the day of the touch itself, and

the presentation of a coin, the so-called coin of the king's touch,

which the patient was supposed to preserve. On the way home they were

once more subjects of solicitude, and they had the royal coin to

assure them every now and then that they had been touched by the

king's hand, and that they ought to get well--for had not many others

been thus cured? All this favorable suggestion, with the outing and

the better food, was eminently calculated to cure the so-called

scrofular conditions, under which term was grouped many vague forms of

malnutrition and the milder epilepsies and pseudo epilepsies, for the

cure of which the touch was famous.

Cramp Rings.--Scarcely less famous than the king's touch for

nutritional and neurotic conditions were the "cramp rings," which were

blessed by the Queens of England and were supposed to cure all sorts

of cramps. The power attached to them for this form of ailment was

similar to that which the king's touch had for scrofula or the king's

evil. Cramps seemed to be the "queen's evil." Whenever a queen died

there was a great demand for these rings, because no more could be

obtained until a new queen was crowned. The efficiency of these and

the cures which they performed can be readily understood. Many of the

hysterical conditions within the abdomen are cramplike in character.

Hysteria will imitate nearly every form of cramp, including even those

due to gallstone and kidney calculus. Any strong mental influence will

do more for hysterical pain than our strongest medicines. On the other

hand, many of the cramplike conditions within the abdomen may be

relieved by concentration of mind on some distracting thought, and

feelings of discomfort in the intestines may thus be relieved.

{81}

Mental Healers.--When the king was absent from England during

Cromwell's time, the touching for the king's evil was sadly missed. If

Cromwell himself had announced that he would touch for the diseases

that used to come to the king, a number of cures would undoubtedly

have been reported. As it was, Greatrakes, the Irish soldier

adventurer, dreamt that he was commissioned from on high to touch for

the same diseases as formerly had gone to the king, and, having begun

it, cures followed until probably many more came to him every year

than usually went to the sovereign in the olden times. He worked at

least as great a proportion of cures. Greatrakes had many imitators,

some of them doubtless quite sincere, but they were people of more or

less deranged intellect, the kind who easily get the idea that they

are commissioned for some purpose that sets them above the common

people. Indeed, the story of the mental healers is probably, more than

anything else, a chapter in the history of insanity, and the power of

those with delusions to lead others to share their delusions. This is

not a slur upon human nature, and especially upon some of the

inspirations and aspirations that lift it up to do great things, but a

literal statement of the view of these phenomena that seems forced

upon us by modern advances in the knowledge of the psychology of

mental influence and of psychic contagion.

Most of the influence that was acquired by men who in the course of

history claimed to have a heavenly mission has been due, as with

healers heretofore referred to, to reputed cures made by them. Trace

the story of this among the Eastern nations in the old time. The

pseudo-Messiahs of the Jews always advanced as one evidence their

healing power, but so did the founders of religions among all the

other nations of antiquity. It must be borne in mind, however, that

many of the queer religions of after times were founded by men who

claimed to have a Messiahship, and put forth, as the evidence of a

divine commission, their power to cure the afflicted. Sometimes the

men who made these claims were good men. In many cases they were

apparently self-deceived. Very often, however, they had no claim to

goodness in the commonly accepted meaning of that term, for they

counseled the violation of moral precepts, made exceptions, for their

own benefit, to general laws, and exploited their followers for

selfish reasons. Provided their followers had confidence in them,

however, they continued to work cures, so that even reasonable people

were likely to be led to the thought that there must be something

supernatural about their activities. In every century there have been

two or three men who have thus secured a following, and apparently

healed many diseases.

The phenomena of faith-healing as the result of belief in the heavenly

mission of special men, are as common now as at any time. Dr. Cutten

in his "Three Thousand Years of Mental Healing" (_Scribners_, 1911)

has a chapter on "Healers of the Nineteenth Century," which shows how

many phenomena of faith-healing can be studied in recent generations.

Some of the men and the women who are mentioned secured wide

reputations throughout our own country.

These faith-healing movements have particularly affected the New

England portion of our population, and many of our most prominent

healers have been born in the New England States. Wherever the new

cults flourished, it is usually found that some of the most prominent

members are descendants of {82} the old New Englanders. It has been

suggested that this is due to the gradual loss of belief in great

religious truths by New Englanders, and a definite tendency toward

reaction against this loss of the religious sense, which, as is usual

with reactions, easily becomes exaggerated. From lack of belief they

jump to excess of belief. Men without trust in Providence find the

trials of life hard to bear, and they dread the development of

physical ill so much that they exaggerate their feelings, or even

create symptoms. Men are happier with the feeling that the

supernatural powers surrounding them are interested in them directly

and personally, and that somehow things, even in an incomprehensible

world, are arranged, if not for the best, at least for such good as

makes ills stepping-stones to new benefits. Whenever they are led far

away from that thought, there is likely to be an exaggerated reaction

back to it. The stronger minded apparently can get on without

religion, but to the great mass of men a strong religious sense is

needed to enable them to overcome the lack of self-confidence that is

the root of dreads, doubts, difficulties of many kinds, and which is

also the source of many symptoms as well as the cause of the

exaggeration of many ailments.

As a rule, modern healers have been founders of new religions, or at

least they have broken away from old-established sects, and have

formed congregations for themselves. They have sprung up in every part

of the country. East, North, South, West, and among all the differing

nationalities of our population. We cannot console ourselves with the

idea that they affect especially the foreigners, for the native-born

people have proved to be quite as susceptible to them. These healers

have, as a rule, abused the medical profession and the use of drugs,

and have taught that disease, if it really existed at all, was from

the devil: that what one needed, in order to secure relief from pains

and ills, was faith in God--but always through _them_. Many of these

men and women have probably been serious and earnest and have deceived

themselves first. Most of them have undoubtedly been more or less

disequilibrated, though they have practically all exhibited the power

to accumulate large amounts of money from their followers. The people

who have gone to them have not been the ignorant among our population,

but particularly those who read the newspapers, and who look upon

themselves as well informed. The intelligence of the disciples of

these healers, as we ordinarily estimate intelligence, has been a

little above the average, rather than below it.

_Schlatter and Dowie._--Probably the most disillusioning phenomena

with regard to the complacent idea that the diffusion of information

prevents manifestations of superstition are stories of the healers

Schlatter and Dowie. At the end of the nineteenth century both of them

attracted widespread attention. Schlatter was probably not quite sane.

He wandered through the deserted portions of the Southwest, hatless,

unkempt, with clothing torn and without shoes. In July, 1895, he first

attracted attention as a public healer in New Mexico. After a reputed

forty-day fast he went to Denver, where people flocked from all parts

of the country to him. Files of people formed--sometimes five or six

thousand--to be touched, and healed, by him. His reputation was due to

the cures that were reported. Dowie was another of these healers. Just

at the beginning of the twentieth century he organized a great new

church of his own, and announced himself as Elijah, the prophet,

returned to life. {83} Nearly 20,000 persons are claimed to have been

healed during the first ten years of his healing career. Toward the

end of his life he declared that he treated, and cured, over 50,000 a

year. An abundance of crutches, canes and every form of surgical

appliance for the ailing hung on the walls of his church at Zion City,

Chicago, left by people who, having been healed, had no further use

for them.

{84}

GENERAL PSYCHOTHERAPEUTICS

SECTION II

_GENERAL CONSIDERATIONS_

CHAPTER I

INFLUENCE OF MIND ON BODY

The power of mind over body for the relief of symptoms has been

recognized, not only by physicians, but by the generality of men at

all times. Every one has had experiences of aches, or actual pains, or

discomfort quite annoying while one is alone, but that disappear while

in pleasant company or occupied in some absorbing occupation. Many a

headache that was painful enough to disturb us seriously while we

tried to apply ourselves to something of little interest, and became

almost unbearable if we tried to do something disagreeable, and

actually intolerable if the occupation of the moment was a drudgery,

disappeared, at least for the time, when we turned to a pleasant game

of cards or indulged in some other favorite pastime. Our relief was

not, however, from an imaginary ill, for the symptoms usually

reasserted themselves when we got through with the pleasant

occupation, showing that they have been there all the time and that we

have only turned our mind away from them, and hence have ceased to

feel them. This is so familiar it seems almost too commonplace to

repeat, yet it constitutes the special phenomenon that lies at the

base of psychotherapeutics, or the mental healing of physical ills.

It is not alone the slighter, more or less negligible aches or pains,

nor the vague discomforts that thus disappear when our attention is

occupied, but even quite severe and otherwise unbearable pain may be

modified to a great extent. A toothache that is bearable, though it

nags at us constantly and never lets us forget its presence while we

are occupied with many other things during the evening, may become a

positive torture when we get to bed. This is not only because of

physical conditions modifying the pain, for there seems no doubt that

the warmth induced by the preliminaries for sleep and the bed-covering

have a tendency to increase congestion, but it is mainly because as we

doze off we are able, less and less, to inhibit our attention, or

divert it from the pain that is present, and so this is emphasized

until we have to do something for it or lose hours of sleep. This lack

of inhibition, which characterizes the dozing hours, represents the

state of mind in which people are who have no interest in their

occupations, and who have ceased to find recreation in the ordinary

pleasures of life, when pain of any kind comes to them.

Cabanis, at the beginning of the nineteenth century, under the title

of {85} "The Influence of the Moral on the Physical," discusses what

we would now call mental influence on the body. He says:

The great influence of what one may call the moral or mental on what

may be called the physical is an incontestible fact. Examples

without end confirm it every day. Every man capable of making

observations finds proofs of it thousands of times in himself. Many

physiologists and psychologists as well as moralists, have collected

the evidence that brings out clearly this power of the intellectual

operations and emotions on the different organs and the diverse

functions of the living body. All of us could add new illustrations

to these collections. Men who are rude and credulous talk of the

effect of the imagination, and if they are not themselves its

playthings and its victims, at least they know how to observe its

effects In others.

As a matter of fact, the action of our organs can be in turn

excited, suspended, or totally inhibited, according to the state of

mind, the change of ideas, the affections and the emotions.

A vigorous, healthy man has just made a good meal. In the midst of

the feeling of satisfaction which diffuses itself over all his body,

his food is digested with energy and without any bother. The

digestive juices perform their work steadily and without causing any

annoyance. But let such a man receive some bad news; let some sudden

emotion come to excite him, and especially to shock him into

profound sadness, and at once his stomach and intestines cease to

act upon the food which they inclose, or they at best perform their

functions badly. The digestive juices, by which the food materials

were gradually being dissolved, are suddenly stricken with

inactivity. What might seem to be a stupor comes over the digestive

tract, and while the nervous influence which determines digestion

ceases entirely, that which tends to bring about the expulsion of

material from the digestive tract may become more active and all the

material contained in the digestive viscera may, in a short time, be

expelled.

Relief in Severe Injuries.--Even extremely severe injuries, which

inflict serious organic lesions that ordinarily would produce shock

and collapse, quite apart from the pain induced, may at moments of

excitement pass unnoticed. A soldier often does not know that he is

wounded until the flow of blood calls his attention to it, or perhaps

a friend points it out to him, or loss of blood causes him to faint.

The prostrating effects of even fatal wounds may thus be overcome for

a considerable time in the excitement of battle, or because of a

supreme occupation by a surpassing sense of duty. There is the

well-known story of the young corporal detailed to make a report to

Napoleon at a very important crisis of one of his great battles, who

made the report with such minute accuracy that it called forth a

compliment from Bonaparte, for it involved a very special exercise of

memory for details, yet who was actually on the verge of death when he

delivered the message. As his duty was accomplished the Emperor,

noticing his extreme pallor, said: "But you are wounded, my lad." The

young soldier replied, as if, now that duty was done, the

consciousness of his wound had just come to him, "No, Sire, I am

killed," dropping dead at the Emperor's feet as he uttered the words.

In all of the great theater fires examples of this kind are recorded.

A woman who barely escaped with her life from a theater fire some

years ago had an ear torn off, very probably by some one grasping it

in the crowd. She knew nothing of this until it was called to her

attention after she got out of the theater, and then she promptly

fainted from the pain and shock. Under such circumstances men walk

with broken legs or limp even with dislocations, utterly unconscious

that anything serious has happened to them. Men have been known to be

unaware of a broken bone or even more serious conditions, {86}

ordinarily quite painful and disabling, while laboring to help others

in an accident.

Suppression of Reaction.--This side of the influence of the mind on

the body is so interesting that its effects have often been noted and

studied. While we do not quite understand the mechanism by which it

accomplishes its marvels of anesthesia and even of motility under

apparently impossible conditions, there is no doubt that severe pain

may utterly fail to reach the consciousness, though the nervous system

is uninterruptedly carrying the messages just as it did before. The

lack of attention suppresses the ordinary effect upon the personality.

Evidently the messages originate and are carried to the nerve centers,

but find no attention available for them, and so pass unnoticed. The

study of phases of this phenomenon of suppression of reaction forms a

good basis for the use of mental influence, and shows its marvelous

power to overcome disturbing physical factors.

Amputation Stump Aches.--An interesting example of the influence of

mind over body, when circumstances favor its exercise or emphasize it,

and at the same time a striking illustration of the potency of

suggestion in the cure of discomfort, is found in the stories that are

so common of cases of pains in amputation stumps. Any number of weird

tales are told of men who complain of feeling cramps in the toes of an

amputated limb after this portion of their body had been buried. The

discomfort is common enough. In the special stories, however, the

limbs have been dug up, the toes straightened out--according to the

story, they were always found cramped in some way--and then the

patient is at once restored to ease. In the good old times they

probably believed in some direct connection between the straightening

out of the toes of the amputated member and subsequent relief of pain.

For us it is but an example of the power of suggestion. It is not the

sort of suggestion that one likes to think of employing, though it has

a certain dramatic quality which adds efficiency to suggestion.

The Mind and Motility.--We have spoken thus far almost exclusively of

painful conditions as relieved by suggestion or mental influence, but

disturbance of motor function may also be favorably affected. There

are any number of cases on record in which patients who had been

utterly unable to walk were restored to motility by a shock. Many such

patients have, in the midst of the excitement of a fire, or the scare

caused by the presence of a burglar, got up and walked quite as well

as ever, though sometimes they have been for years previously confined

to bed. The San Francisco earthquake is said to have exerted such an

effect on a number of patients, and, while such unusual disturbances

cannot often be provided for the cure of these ailments, there can be

no doubt at all of the power of a shock to the mind to overcome

functional incapacity that has resisted every possible form of

treatment.

Ailments of this kind, which involve inability of the will to control,

or rather to initiate, movements of the body, receive their best

explanation on the neuron or neuroglia theory. (See the chapter on the

Mechanism of Suggestion.) The central neurons become either quite

separated from certain of the peripheral neurons, or at least the

connections are not made with that nice adjustment necessary for the

proper passage of nerve impulses. The shock communicated to the

nervous system by fright is sufficient, however, to restore these

connections, and consequently to enable the patient once more to

exercise motor functions that have been in abeyance for some time.

{87}

_Astasia-abasia._--Any one who has had to deal with the cases for

which the French have invented the rather impressive Greek name of

astasia-abasia--how much better it would be to call the condition

simply what we know it to be, nervous inability to stand or

walk!--appreciates how almost a miracle is needed to improve them. The

incapacity for station or movement to which the disease owes its name

is so complete in many cases, and the patients' lack of confidence in

self so absolute, that no ordinary remedial measure is capable of

doing any good. These cases are usually a severe trial to the

patients' friends. Indeed, the patients themselves maintain their

nutrition so well and, as a rule, enjoy such good health, or, as has

been said, enjoy their bad health so well, that it is for their

attendants the physician feels most commiseration. Yet generally he is

quite unable to do anything. It is certain, however, that with care

and authoritative suggestion there would not need to be an earthquake,

or a fire, or even a burglary, as a therapeutic measure in these

cases. As a matter of fact, their cure when it occurs is always

brought about by some strong mental influence.

Mental Influence on Organs.--_The Heart_.--The influence of mind can

be noted on practically every organ of the body in a concrete way. It

might be thought that the heart, the first living thing in the animal

being, the pulsations of which begin before there is any sign of the

nervous system, might be free from this influence. On the contrary,

the heart is so readily affected by mental states that, taking effect

for cause, the old popular, and even scientific idea with regard to

it, was that it was the organ of the emotions. The heart is stimulated

more by favoring circumstances, and suffers more from depression, than

almost any other organ. In the melancholic states it usually beats

less frequently and is sluggish. When individuals are tired out and

the heart has become weakened in its action, new courage will first be

noted as having its effect upon the heart action. As the whole

muscular system is much influenced by the mental state and, as the

control of the arterial system depends on the muscles in the arteries,

it is easy to understand how much the general bodily condition may by

mental influence be modified for good and ill.

_Digestive Tract_.--The stomach and intestines, though their functions

might be presumed to be dependent entirely on physical conditions, are

almost completely under the control of the mental state. At moments of

depression, just after bad news has been received, the appetite is

absent, or is very slight and digestion itself proceeds slowly and

unsatisfactorily. On the other hand, when there is mental good feeling

appetite is vigorous and digestion is usually quite capable of

disposing of all that is eaten. If after a period of rejoicing in the

midst of which food is taken abundantly bad news is brought, the

mental influence on digestion can be seen very well. It is not alone

that depression interferes with digestive processes, but apparently

some favorable factors for digestion consequent upon the previous

state of mind are withdrawn, and now what would have been a proper

amount of food proves to be an excess and the digestive organs find it

difficult to deal with it..

Nervous Inhibition.--The mind can actually inhibit certain of the

involuntary processes of the body by thinking about them, and, above

all, by dwelling on the thought that they are going wrong. This

becomes easier to understand when we recall how, in the same way, we

may disturb many habitual and more or less unconscious actions that we

have grown accustomed to. There {88} are any number of actions

requiring careful attention to details which become so habitual that

we do not have to think of them at all. Not infrequently it happens

when we try to explain to others how we do them, we disturb the

facility of performance and have to repeat the acts several times

before we succeed in performing successfully what a moment before we

did without any thought. The story of the centipede who was asked how

he walked with all his hundred legs, and who tried to describe how

easy it was and got so mixed up that he was unable to move at all, is

a whimsical symbol of conscious attention disturbing actions which go

on quite well of themselves if only we do not allow ourselves to think

consciously of each and every phase of them.

How much the mind may influence the body under certain conditions when

trance-like states either assert themselves or are brought on, has

often been noted. Lombroso in his book "After Death What?" [Footnote

11] says of Eusapia Paladino the "medium," that "when she is about to

enter the trance state the frequency of the respiratory movements is

lessened just as is the case with the Indian fakirs. Before the trance

she will have been breathing eighteen to twenty times a minute; as the

trance begins the number of respirations is gradually reduced to

fifteen; when the trance is fully developed she breathes twelve times

a minute or less. On the other hand, at the same time the heart beats

increase. Normally her pulse is about seventy, but during the early

trance stage it rises to ninety, while during the course of a deep

trance, it may go as high even as one hundred and twenty. The passing

from a more or less rigid state to that of active somnambulism is

marked by yawns and sobs and spontaneous perspiration on the

forehead." The observation of these phenomena is, of course, entirely

apart from any theory one may hold with regard to mediumistic

manifestations, and it provides evidence of mental influence that is

very striking.

[Footnote 11: Small, Maynard & Co.. Boston, 1909.]

Imaginary Drug Effects.--Drug effects may be produced through the

imagination. Physicians know that when patients are persuaded that

certain effects are to be expected from a particular medicine, the

effects may follow all the same in sensitive, imaginative people, if

that medicine is replaced by some inert compound. Many a physician who

has used bread pills or other placebos to replace a drug that he did

not want the patient to acquire a habit for, has thus been able to

allow good effects to go on without interruption, where the stoppage

of medicine had previously interfered with the continuance of the good

habit that had been formed. Very few physicians have not seen the

effect of a hypodermic of pure water when a hypodermic of morphine is

demanded, and when the patient would not sleep without having the

hypodermic injection. Sleeping powders of various kinds can sometimes

with distinct advantage be replaced by inert materials, because the

patient's mind is fixed upon the idea of sleep coming after a certain

time and they, in consequence, compose themselves to rest.

The Nerves and Tissues.--Cases occur where disturbances of vitality

are noted as a consequence of nervous affections, though no gross

lesion of the nervous system is demonstrated. Certain nervous people

suffer from ulcerative conditions of their hands, and it is evident

that in some the nervous impulses {89} that would ordinarily keep the

skin surface in good, healthy condition are insufficient. Some people

who use a typewriter have no difficulty at all with the ends of their

fingers, while others are subject even to loss of skin or ulcerative

conditions that make it almost impossible for them to go on with their

work. In some this is true in the winter, in others in the summer.

There are a number of skin conditions which are due to nervous factors

and these evidently point to the influence of the central nervous

system in keeping the forces of our body in such health, and resistive

vitality, as will enable us to carry on whatever work we may wish to.

This is, of course, a very individual matter. Some people chap very

easily, some suffer from chilblains, or are frost-bitten even on

slight exposure, and these peculiarities are evidently dependent on

the intensity of the nervous impulses as well as the tone of the

circulation, which itself depends on the nerves to a great extent.

It is evident that some of these disturbances are not enduring, but

are only temporary and therefore are due to functional disturbances of

the nervous system. Physicians often see hysterical patients suffering

from intense pain that requires an injection of morphine, yet after a

series of such incidents, the physician is able to give an injection

of plain water and produce just as good an anodyne effect. In these

cases some influence of the will is enough to correct the painful

disturbances. Occasionally a single member loses sensation, or motion,

or both, yet the fact that its nutrition does not suffer shows that

there is only disturbance in the motor connections between it and the

central nervous system and not in the sensory nor trophic tracts, and

that this functional defect may be restored by some favorable

influence.

_Nerve Supply and Health_.--We know now that when a part of the body

is cut off from its connections with the central nervous system, it

begins at once to be lowered in vitality and gradually tends to

dissolution. This will be true in spite of the fact that the

circulation continues as actively as before. It is not necessary,

indeed, that the nerve trunk to a part should be cut, if it is

sufficiently compressed its function is stopped and various

disturbances begin to appear in the vitality of the part which it

supplies. A typical example is to be seen in certain fractures of the

clavicle, where a fragment presses on one of the nerves leading to the

arm. After a time pains develop in the arm, a burning feeling is

noticed in the skin, which becomes shiny and cold and of distinctly

lowered vitality. Even a slight injury to the arm will now produce a

serious ulcerative condition. There are evidently important influences

for life that flow down through the nerves from the central nervous

system, quite as important in their way as the nutritional elements

which flow through the blood.

How these influences of the mind on the body are accomplished is a

portion of that larger mystery of the influence of mind, or soul, or

principle of life, on the material elements of which our body is

composed. Why a man receives a shock of lightning or a charge of

electricity at high voltage, and without a mark on his body or a

change in any cell that we can make out, be dead, though he was living

an instant before, is another of these mysteries too familiar for

discussion. There is no change in the weight of the body, nothing

physical has happened, but what was living matter with the power to

accomplish the functions of living things is now simply dead material,

unable to resist the invasion of saprophytic micro-organisms which

will at once, {90} unhampered, proceed to tear it down, though the

preceding moment resistive vitality was completely victorious. The

mystery remains, but the mechanism of the influence can now at least

be studied with much more satisfaction than was the case a few years

ago.

Death and the Mind.--The extent to which the mind can be made to

influence the body is apparently without limit. While the doctor is

frequently disturbed by the fact that death occurs when there is no

adequate physical reason for it, just because the patient has looked

forward to it with complete preoccupation of mind, there is no doubt

that occasionally death may be put off in the same way. We talk about

people living on their wills. This is a literal expression of what

actually occurs in certain cases. On the other hand, without the will

to live, it is sometimes extremely difficult to keep alive patients

who are in a run down condition. If one of an old married couple dies

when the other is ill, we conceal the sad news very carefully from the

survivor. This is done not alone to put off the shock and sorrow for a

time, but because often, under such circumstances, there will be no

will to live.

When the vital forces have run down to such a degree that it seems

impossible, so far as ordinary medical reason goes, to look for

anything but dissolution, patients still cling to life if there is

some reason why they want to live until a definite time. It does not

happen so much with the acute diseases but is quite common in chronic

cases. Patients will live on expectant of seeing a friend who is known

to be hurrying to them, or for some other purpose on which they very

strongly set their minds. In the life of Professor William Stokes, the

Irish physician, to whom we owe the introduction of the stethoscope to

the English medical world, and many other important contributions to

medicine, there is a striking story that illustrates this power of the

will to maintain life until a definite moment.

An old pensioner, a patient of Stokes' in the Meath Hospital whose

life was despaired of, and whose death was hourly expected, was one

morning distressed and disappointed at observing that Stokes, who

believing that the man was unconscious at the time, and that it was

useless to attempt anything further as his condition was hopeless,

was passing by his bed. The patient cried out: "Don't pass me by,

your honor, you must keep me alive for four days." "We will keep you

as long as we can, my poor fellow," answered Stokes; "but why for

four days particularly?" "Because," said the other, "my pension will

be due then, and I want the money for my wife and children; don't

give me anything to sleep for if I sleep I'll die." On the third day

after this, to the amazement of Stokes and all the class, the

patient was still breathing. On the morning of the fourth day he was

found still breathing and quite conscious, and on Stokes' coming

into the ward, he saw the patient holding the certificate which

required the physician's signature in his hand. On Stokes

approaching him, the dying man gasped out. "Sign, sign!" This was

done, the man sank back exhausted, and in a few minutes after

crossed both hands over his breast and said, "The Lord have mercy on

my soul," and then passed quietly away.

_Dread and Death_.--Dr. Laurent in his little book, "La Medecine des

Ames," [Footnote 12] has a story of similar kind but from a very

different motive:

[Footnote 12: Paris, Maloine, 1804.]

They brought to the prison infirmary one day an old burglar, an

incorrigible offender, who was undergoing a long sentence. He was

suffering from cancer of the stomach, and was already in a very

advanced stage of the affection. The poor devil seemed to realize

his condition very well, and felt that it was only a question of a

short time until he should die. He had made up his mind to that with

the {91} resignation which so often characterizes people of this

kind. Only one thing put him out very much, and that was the fear of

dying in prison.

"I know well that I have to pass in my checks," he said over and

over again; "but I do not want to die here. I do not want to be cut

up after I am dead."

He still had two months of his sentence to undergo. Every day the

disease made notable progress. His cachexia became more profound.

Life was passing from him drop by drop. At the end of five weeks he

was scarcely more than a living skeleton. Every morning we expected

to find him dead, or at least in his last agony. Nevertheless, every

morning, by an effort, he was able to recognize me and a little life

shone out of his sharp, small eyes that seemed like those of a bird

of prey.

One morning he said to me: "Oh! you need not watch me. You shall not

have my carcass. I do not want to die in prison. I shall not die

here." He lived on till the end of his sentence. The morning of his

freedom he said to me, "I told you that I did not want to die here,

and that I would not die here."

By an effort of his will he aroused himself enough so that his

friends were able to take him out of the prison. It was the last bit

of energy he had, however. His will power was at an end. A few hours

after his arrival in the house of his son he went off into a

profound depression, and would not talk even to his own. Then his

death agony came on, and he died that same evening. The strange and

surprising struggle of this man against death, the marvelous force

of physiological resistance which the fear of autopsy, if he died,

gave him, struck me vividly at the time. What intimate and

mysterious bond connects mind and matter that the one is able to

react in so much energy upon the other. How wonderful to think that

the fear, lest his abandoned body should be cut up, should actually

keep body and mind together until after the danger of that dreaded

event was passed.

_Suggestion and Death._--On the other hand, there are many stories

that show us how the giving up of hope of life seems to even hasten

death. We have many stories of the death on the same day of husband

and wife, or of brothers and sisters who thought very much of each

other. Some of these are mere coincidences, but there are too many to

be all explained on the score of coincidence. It seems clear that the

living one, on hearing of the death of the other, feels that now there

is nothing more to live for, and gives up the struggle. Hence the

important rule in medical practice that a seriously ill patient should

not be told of an accident, and, above all, of the death of a near

relative.

On the other hand, strong expectation of death at a definite time,

especially if accompanied by suggestions with some physical signs, may

bring about actual dissolution. We have a number of well authenticated

stories to illustrate this.

_Renewal of Hope._--How much energy even the slightest hope may

furnish, when apparently all power of effort is exhausted, is well

illustrated by what happens to men who are lost at sea or in a desert.

After the lapse of a certain length of time human nature seems utterly

incapable of further effort and they sink down exhausted. The

appearance of a light at a distance, a hail, any communication that

gives them even the slightest hope will renew their energy and enable

them to draw on unsuspected stores of vitality after the end seemed

inevitable. It may be said that the exhaustion in these cases is more

apparent than real, that discouragement prevents the release of even

the energy that is present, and might be used under more favorable

circumstances, but that is exactly the argument which favors the

deliberate employment of psychotherapeutic motives to enable patients

to use the energies which they possess. In the midst of disease, or

the struggle for life, when vitality is {92} being sapped, hope is

lost or obscured, just as it is when a man is alone in the desert or

struggling far from help on the ocean. If we can prevent this

discouragement from sapping his powers there will always be a

prolongation of life, and often this will be sufficient to enable

vital resistance to overcome exhausting disease.

Law of Reserve Energy.--Prof. William James [Footnote 13] called

particular attention to the law of reserve energy which recent studies

in psychology have emphasized. This law of reserve energy is a

conclusion from certain facts which are very familiar to men and have

been observed as long as the memory of man runs, yet the full

significance of which has never been read quite aright. Applied to a

very limited range of actions, it has been applied only half-heartedly

in ordinary life, and to its full extent only under the pressure of

absolute necessity. This law holds out the best promise to

psychotherapy. It shows that there are reservoirs of surplus energy in

man which, if they can be successfully tapped, present possibilities

of resistance to fatigue--and fatigue in many more ways than we used

to think resembles disease. Besides, this law represents a very

wonderful capacity for withstanding pains and aches and conquering

disinclination that would otherwise seem impossible. If it can be made

to apply to ordinary life as well as it does to extraordinary events,

then the conscious deliberate use of psychotherapy or mental

suggestion should prove to have wonderful remedial power. Prof. James

said:

[Footnote 13: _American Magazine_, Sept., 1908.]

Everyone knows what it is to start a piece of work, either

intellectual or muscular, feeling stale--or "cold," as an Adirondack

guide once put it to me. And everybody knows what it is to warm up

to his job. The process of warming up gets particularly striking in

the phenomena known as second wind. On usual occasions we make a

practice of stopping an occupation as soon as we meet the first

effective layer (so to call it) of fatigue. We have then walked,

played, or worked enough, so we desist. That amount of fatigue is an

efficacious obstruction on this side of which our usual life is

cast.

But if an unusual necessity forces us to press onward, a surprising

thing occurs. The fatigue gets worse up to a certain critical point,

when gradually it passes away, and we are fresher than before. We

have evidently tapped a level of new energy, masked until then by

the fatigue obstacle usually obeyed. There may be layer after layer

of this experience. A third and fourth wind may supervene. Mental

activity shows the phenomenon as well as physical, and in

exceptional cases we may find, beyond the very extremity of fatigue

distress, amounts of ease and power that we never dreamed ourselves

to own--sources of strength habitually not taxed at all, because

habitually we never push through the obstruction, never pass those

early critical points.

He then states what has come to be called the law of reserve energy.

_It is evident that our organism has stored up reserves of energy

that are ordinarily not called upon, but that may be called upon;

deeper and deeper strata of combustion or explosible material,

discontinuously arranged, but ready for use for any one who probes

so deep, and repairing themselves by rest as well as do the

superficial strata_.

There is, then, a marvelous reserve power in men and women which can

be used in emergencies and in times of severe strain, to enable men

and women to accomplish what looks impossible and which has often

contradicted the prognosis of the physician. History is full of

applications of this law which, however, does not come into action,

unless especially called. Men and women {93} may die simply because

they give up the struggle. Men and women who _will not give up_ seem

able to overcome severe illness that would take away ordinary people.

It has often been said that tuberculosis takes only the quitters and

that men of character constitute the typically favorable patients for

tuberculosis sanatoria. Psychology is now getting at the explanation

of many events that were formerly quite inexplicable. The science has

come to recognize the reservoir of reserve energy in human nature

which may be tapped under special favoring circumstances. The

physicians of the past have often succeeded in tapping it deliberately

as well as unconsciously. There is large room, however, for the

further development of medicine along this line, to the great

advantage of therapeutics and probably the most promising field at the

present time in view in therapy lies in this direction. Hence the

necessity for more deliberate conscious use of it in every possible

suitable form.

CHAPTER II

UNFAVORABLE MENTAL INFLUENCE

Much as may be accomplished by psychotherapeutics through favorable

mental influence--the modifying of the mental attitude towards

disease, diversions of mind from aches and pains, concentration of

attention on subjects apart from ailments--much more may be done by

removing any unfavorable mental influence. This of itself produces

symptoms either by interfering with normal processes through

surveillance of them, or by so exaggerating, through attention to

them, slight symptoms that may be present that patients are made quite

miserable, though there is no adequate physical cause for their

condition. Perhaps the most striking example that we have of

unfavorable mental influence as productive of the persuasion that

disease is present, is familiar to every physician who is close to

medical students when they are first introduced to the symptoms of

disease. It is almost a rule that certain members of the class

immediately conclude that they are suffering from one or more of the

symptoms which they are studying, and that, therefore, they must have

the diseases with which the symptoms are associated. If at this time

they walk on the shady side of a street on an autumn day and have a

little shivery feeling, or when they get into the sun they feel a

glow, these two very normal feelings are exaggerated into chilliness

and fever, and the student has to go to his professor to have his

mental malaria or typhoid treated. To the student, his symptoms are

for the moment very real, and unless someone in whom he has confidence

reassures him, his discomfort will probably continue for some time.

Pathological Suggestion.--In a word, suggestions of disease are much

easier to take than is usually imagined, and if people read or hear

much about diseases they are likely to jump to the conclusion that

they are sufferers. Under present conditions there are many more such

sinister suggestions put before people than used to be the case. The

newspapers are constantly reporting curious cases and rare diseases,

and usually those of absolutely unfavorable prognosis and inevitably

fatal termination are particularly dilated on. Pathology has become a

source of many sensations, until the community {94} generally has come

to eke out the thrills of the day's news by reading about fatal

diseases and fatal injuries, whenever murder and suicide sensations

fail. As a consequence, many become persuaded that they are suffering

from forms of disease of which they have not a symptom, and, not

infrequently, the wonderful cures that are reported in the newspapers

consist of nothing more than recoveries from these imaginary ills into

which people have suggested themselves as the result of reading about

morbid states.

A typical illustration of the power of the mind to influence the body

unfavorably is recognized in many of the comic stories that have had a

vogue in recent years. Their underlying thought is that if a man is

only told often enough, and by a number of different people, that he

does not look well, or if he is even asked a little solicitously as to

whether he feels well or not, he will almost invariably begin to

persuade himself that there must be something the matter with him.

After a time, under the influence of this unfavorable suggestion, he

begins to feel tired and is likely to think that he cannot go on with

his work. When meal time comes his appetite fails him. A victim has

been even known to go home and send for the doctor, persuaded that

there is something the matter, simply because a series of friends, for

a joke, or sometimes through a mistake, have insisted on asking him

questions that called attention to his state of health. Few men are

strong enough to stand the influence of unfavorable suggestion of this

kind, if it is frequently repeated. More direct forms of suggestion of

disease have, of course, even greater effects. Many a man goes to a

quack only feeling a little out of sorts and wanting to reassure

himself, but easily becomes persuaded that there is something serious

the matter with him.

Unfavorable Suggestion in Ancient Times.--This unfavorable influence

of the mind on the body, even to the extent of the production of

disease by means of suggestion, was recognized by the ancients. They

knew and wrote of hypochondriasis and, indeed, they invented the term.

In many of these cases the seat of auto-suggestion is supposed to be

the digestive organs and the localization of the discomfort is in the

hypochondria, that is, in the upper abdominal region. The Grecian

writers seemed to recognize clearly that the symptoms were the result

of thinking over much about self and concentration of attention upon

unfavorable suggestions.

Plato, in the "Republic," says:

In former days the guild of Asclepius did not practice our present

system of medicine, which may be said, he declares, to educate

diseases. He cites the example of Herodicus who, "being a trainer

(of gymnasts) and himself of a sickly constitution, by a happy

combination of training and doctoring, came to the invention of

lingering death; for he had a mortal disease, which he perpetually

tended, and, as recovery was out of question, he passed his entire

life as a valetudinarian." Plato, finishing the description, makes

us recognize the hypochondriac when he says: "He could do nothing

but attend upon himself, and he was in constant torment whenever he

departed in anything from his usual regimen, and so dying hard, by

the help of science he struggled on to old age."

The picture of the neurasthenic, or hypochondriac, who has educated

himself, as Plato says, into disease, is an interesting parallel to

modern conditions in this matter.

Nowhere more than in this matter of knowledge of disease, can weight

{95} be attached to Pope's dictum that a little knowledge is a

dangerous thing, and that one must drink deep or touch not the Pierian

Spring of medical information. The teaching of pathology under the

guise of physiology, now so common in our schools, is likely to do

more harm than good. Various pathological conditions, such as those

produced by alcohol and tobacco, have been emphasized to such an

extent as to produce unfavorable suggestions in the pupils' minds with

regard to the untoward events that may happen in their insides, and

the serious lasting pathological changes that may occur, though all

unconsciously, to the sufferer as the result of indiscretions. The

study of the morbid changes produced in the mucous membranes of the

digestive tract by the use of stimulants, impresses ideas on the mind

that are readily transferred to other abuses in eating or drinking.

The rather vivid pictures and descriptions of the pathological

conditions that may develop, become a portion of the acquired

consciousness as to internal conditions, and this consciousness acts

as an unfavorable suggestive factor whenever there are any digestive

symptoms.

Bacteriphobia.--The development of bacteriology has had a similar

effect, especially because periodicals and newspapers like to take up

only the sensational side of biological discoveries. Most physicians

who have had anything to do with nervous diseases have seen cases of

misophobia, the fear of dirt, which in our day has taken on the

special character of fear of microbes. Those who are sensitive to the

possibility of contamination learn of the almost sacrificial

precautions that surgeons take to avoid wound infection, and conclude

that practically everything they handle must fairly reek with

microbes. They hesitate about touching the door knob or latch, and

invent all sorts of excuses to wait for a moment outside the door in

order to have someone else open it. Especially are they timorous about

touching the door knobs of a physician's residence, or the chairs in

his waiting room, or even to shake hands with him. Hospital walls and

doors become an abomination to them. These cases emphasize how much of

unfavorable suggestion there has been in the present spread of popular

knowledge with regard to microbes.

A writer on popular science once said that every time we spread a

piece of bread of the size of the hand with butter, we scatter over

its surface as many microbes as there are inhabitants in the United

States. The expression has gone the rounds, producing its effect on

sensitive people, occasionally causing even a disgust for so important

an article of diet as butter, more often giving rise to an extreme

sensitiveness with regard to any special savor that butter may have,

and it may have many according to the prevailing food of the cow.

There has been much emphasis laid on the potentialities for harm of

the microbes, and very little on the important part which they play in

the production of many forms of food materials. Most people know and

dread the fact that microbes produce disease. Very few seem to realize

that while we know many thousands of different kinds of microbes,

scarcely more than a score of them are known to be seriously

pathogenic, while all the others are either indifferent or, as we know

of very many, are actually benefactors of mankind.

People have heard much of the flora of the digestive tract, until they

have come to think with anxiety of the almost infinite number and

multitudinous variety of the minute plant life that finds a habitat in

the human intestine. Most people think that all of these are, in

tendency at least, {96} harmful, and are only kept from being

positively dangerous by the overwhelming vital activity of the mucous

membrane and the secretions which keep them from exerting their malign

activity. Very few appreciate the fact that the intestinal flora, far

from being a disturbing factor, are often an aid to digestion, and

that the equilibrium established among them favors many biological and

chemical processes which help in the preparation of food and in the

breaking up of waste products that might be dangerous if reabsorbed

during their stay in the intestinal tract. Microbes we have always

with us and always will have, and men have lived to round old age, not

only in spite of them, but very probably partially because of them.

They are part of that beneficent mystery of nature of which as yet, in

spite of scientific progress, we know comparatively little.

_Opposing Favorable Suggestion_,--A recent striking change of

sentiment with regard to one form of food material furnishes a good

example of how little we know about the real effect of bacterial life

within the digestive tract. There was a time, not so long since, when

sour milk was supposed to be especially harmful, or at least only

likely to do good to those of particularly strong digestive vitality.

Metchnikoff's work on the influence of sour milk on the digestive

tract, however, has brought a complete reversal of opinion in this

matter. Now most physicians are convinced that the bacillus of sour

milk, acts in the intestinal tract to inhibit the reproduction and

growth of other, and possibly more disturbing, bacterial agents. Sour

milk is looked upon as one of the things that, by neutralizing certain

unfortunate bacterial processes in the digestive tract, lead to

longevity. There seems no doubt at all, that those who consume a great

deal of it, live longer lives than the average, and many old men have

taken to its use with a consequent amelioration of digestive

annoyances.

The popularization of bacteriology, then, has been one of those

moments of unfavorable suggestion that have affected a large number of

people. Such influences do not mean much for people of phlegmatic

temperament. For others, however, they have a weighty significance and

make every symptom, or more properly every sensation, that is at all

unusual in the digestive tract, seem of ominous import. Certain

sensations inevitably accompany digestion. The peristaltic movements

are usually said to be unfelt, but even a slight exaggeration brings

them into the sphere of sensation. Where attention is given to the

abdominal region and its contents, feelings that ordinarily are not

noticed at all come to be perceived. With the unfavorable suggestion

derived from the unfortunate diffusion of a superficial knowledge of

pathology and of bacteriology instead of hygiene and the science of

beneficent microbiology, these feelings produce a bad effect upon the

individual.

Familiar Examples of Unfavorable Suggestion.--There are many familiar

examples of the discomfort that may be produced by the mental

persuasion that something will disagree with us, or that certain

feelings have a significance quite beyond that which ought to be

attributed to them. Everyone knows how qualmy may be the feeling

produced by being told that something eaten with a relish contained

some unusual material, or was cooked under unclean conditions. Food

that agrees quite well with people, so long as they do not know too

much about it, often fails to be beneficial after they see how it has

been prepared. It is often said that people would not relish the food

{97} placed before them if they were aware how lacking in cleanliness

was the place of its preparation, and how negligent those who had

charge of it. Occasionally a peep at the kitchen of a boarding house

effectually takes away appetite, or disturbs the equanimity with which

food must be taken, if there is to be that undisturbed digestion which

makes for healthy nutrition.

It is, indeed, with regard to digestion that the influence of the mind

on the body, favorable as well as unfavorable is, perhaps, most

effectively exercised. Unfortunately the unfavorable influence is even

more pronounced than its opposite. Some people are much more sensitive

than others in this respect, and even the thought of certain defects

in the preparation of their food seriously disturbs them. Everyone has

had the experience of seeing sensitive persons leave the table because

some one insisted on telling a nauseating tale. Anyone who has seen

the effect of talking of blood sausage or fried brains with black

butter sauce at a table on shipboard, when some practical joker was

exercising his supposed wit, knows how much the imagination can

disturb, not only appetite but digestion. The attitude of mind means

much, and especially are such unfavorable suggestions likely to

produce serious effects in inhibiting digestion.

_Suggestion and Seasickness_.--Seasickness illustrates the place of

unfavorable suggestion in digestion. The nausea, consequent upon the

movement of a vessel at sea, is due to a disturbance of the

circulation within the skull, and particularly of the circulation in

the semi-circular canals. The organ of direction of the body is

disturbed by the over-function demanded of it, consequent upon the

continuous movement of the vessel. This is, however, only a

predisposing element. A strong additional factor is the firm

persuasion many people have that they will suffer from nausea and

seasickness, and the unfavorable expectancy thus aroused. Most people

have to give their dole to Neptune. Those who for weeks before have

been expecting and dreading it usually pay a heavy tribute. Probably

the best remedy for seasickness is the suggestion that there is no

necessity for losing more than a meal or two, if even that much,

provided there is simplicity of diet and proper predisposition of body

by gentle opening of the bowels, and lack of the over-feeding that

sometimes comes from dinners given before departure. I have known many

people who, after suffering severely not in one but in many voyages,

have, by means as simple as this, been saved from days of seasickness

even in rough weather.

Most of the cures for seasickness that have been suggested have

depended principally on the suggestive element. For instance, there is

no doubt that many people are relieved by wearing dark glasses, and

this remedy does good for train sickness and other afflictions of a

similar kind. There is, however, no good physical reason why wearing

dark glasses should help except through their constant physical

suggestion. A simple remedy that has helped many through seasickness

is the wearing of a sheet of glazed paper, usually some heavy

writing-paper, immediately over the skin of the abdominal region. This

of itself has no physical effect, but the sensation of its presence

constantly obtrudes itself, and by making people feel that they must

be better because a great many other people have declared that they

were bettered by this remedy, they actually suffer less from nausea

and vomiting. Many of the internal remedies employed for seasickness

are directed to the stomach and intestines. {98} As the seat of the

difficulty is not here but within the skull, the reputation which

these remedies have acquired has been due largely to the suggestive

effect of taking them rather than to any physical qualities they

possessed, though of course they have served to set at rest stomachs

disturbed by unfavorable expectancy.

Disease Groups and Suggestion.--Labeling groups of ailments with a

single term gives rise to many unfortunate conclusions and dreads with

regard to what a particular condition really is. The word

"indigestion" is commonly used for any stomach discomfort or

disturbance, especially that occurring after eating, from the slight

distress because too much has been eaten, or the uncomfortable feeling

of fullness because too much liquid has been taken, or the discomfort

due to an unsuitable mixture of food materials, to such serious

conditions as develop when there is motor insufficiency of the

stomach, followed by dilatation, with delay of the food for long

periods and with consequent fermentation, distress and bad breath.

Whenever the word "indigestion" is mentioned, the patient may think of

the worst cases that he has seen or heard of with this label, and

concludes that while his ailment may not be very serious just now, it

is only a question of time until it becomes so, and that unless he can

get rid of his uncomfortable feeling he is destined to have one of the

forms of "indigestion" that are productive of such serious discomfort,

with probably ever increasing torment, until some fatal complication

develops. The initial symptoms of gastric ulcer and cancer have been

labeled indigestion, and people, often recalling the serious

consequences that followed in such cases, fear for themselves.

_Fearing the Worst_.--This looseness of terms is noted with regard to

many other forms of disease. Rheumatism calls up the picture of

advanced arthritis deformans, with the awful deformed joints and

bed-riddenness, which should not bear the term rheumatism at all, but

which the patient has heard called so. Catarrh is the simplest of

inflammatory processes, meaning merely an increase of secretion,

functional in character and without any serious disturbance of an

organic character beneath it, but many people have heard the

foul-smelling ozena called catarrh, at least popularly, and so the

mental picture of such a repulsive progressive process as beginning in

them is suggested. It is important, therefore, when using words that

have such wide connotation as these, to explain exactly what is meant,

and perhaps, better still, not to use the words, but to employ some

more specific term that does not carry a cloud of dreads with it.

Indigestion can be a very simple passing set of symptoms, but once

certain people get the notion that they are troubled with indigestion,

their minds dwell on it to such an extent that they are likely to

limit their eating more than they should, and to disturb digestive

processes by thinking about them and using up in worry nervous energy

that should be allowed to flow down to actuate digestion.

So-called Incurability.--Patients are likely to hear entirely too much

of the incurability of disease. To the doctor and patient this word,

incurability, often has an entirely different meaning. The doctor

means only that the diseased tissues cannot be restored to their

previous condition by any of our known remedies, and that the effects

of the deterioration are likely to be felt to some degree for the rest

of the patient's life. To the patient it means, as a rule, not only

that the doctor can do nothing for him, which is usually {99} quite

untrue, for much can be done for his symptoms even though the

underlying disease may be intractable, but also that the symptoms are

to grow constantly worse. This is often quite without foundation, for

nature's compensatory powers are very wonderful and seldom fail to

afford relief. In a great many cases fatal termination comes, not from

the original affection, but through intercurrent disease. Above all,

incurable means to many patients that finally the victim is to become

more and more subject to the pains and ills of his "incurable" ailment

until he becomes perhaps a pitiable object. Incurability, when we

recall that patients are so likely to mistranslate this term in the

way indicated, must be a word little used. Etymologically it is never

true, for _cura_ means care, and we can always care for and relieve

the patient. In every chronic case there is room for hope of much

relief through accustomedness, various remedies, nature's compensatory

methods, and, above all, the modification of the state of mind.

There is probably no incurable disease that is ever quite as serious

as it is pictured by its victim when he first hears this word

pronounced. When we recall the chances of life, and that in any given

case, almost as a rule, the patient will live to hear of the deaths of

men and women who were in perfect good health when his ailment was

pronounced incurable, there is much of consolation to be derived from

conditions as they are. It seldom happens that a physician sees a

sufferer from tuberculosis, whose affection is running a somewhat

chronic course, without being able to find out that since the first

symptoms of the disease manifested itself, one or more of the

patient's near relatives have died because of exposure incident to

their abounding health. Pneumonia, appendicitis, typhoid fever,

accidents of various kinds, take off the healthy relatives, while the

tuberculous patient, constantly obliged to care for his health, lives

on, and often is able to accomplish a good deal of work. It is

important to impress facts of this kind upon these "incurable" cases,

for they represent the light in the desert, or the shout, or the

whistle at sea, that give renewed energy when nature seems about to

give up the struggle.

Thinking Health.--Hudson in "The Law of Mental Medicine" [Footnote 14]

suggests that we should think health and talk health on all suitable

occasions, remembering that under the law of suggestion health, as

well as disease, may be made contagious. This expression probably

represents an important element for the prophylaxis of disease under

all conditions. Under present conditions people talk entirely too much

about disease and have too many suggestions of pathological

possibilities constantly thrown around them by our newspapers, our

magazines and by popular lecturers as well as by our free public

libraries. People have learned to think and talk disease rather than

health. This predisposes them to exaggerate the significance of their

feelings, if it does not actually, on occasion, lower their resistive

vitality because of solicitude. The medical student torments himself

with the thought that he is suffering from the diseases that he

studies, and we cannot expect that the general public will be even as

sensible as he is in this matter. On the contrary, people generally

are much more liable to exaggerate the significance of their feelings,

hence the necessity for healthy suggestions rather than innuendoes of

disease.

[Footnote 14: McClurg, Chicago, 1903.]

In recent years, to paraphrase Plato's expression, people are much

more {100} inclined to educate themselves in disease than in health.

The result has been a storehouse of unfavorable suggestion, from which

ideas are constantly being taken to make whatever symptoms that may be

present seem unduly important. Consequently people look for the worst,

and suggest themselves into conditions where not only are they

exaggerating their symptoms, but they are absolutely preventing the

flowing down of such nervous impulses as will enable them to overcome

affections that are present. Whenever anything turns up that lessens

their tendency to unfavorable auto-suggestion, their health improves.

Hence the taking, with confidence, of any quack medicine, no matter

what its constituents, cures them; hence the success of the numerous

and very varied forms of mental treatment. New Thought, Eddyism,

osteopathy, and the like, attain most of their successes because of

the removal of unfavorable suggestions, and the setting up in their

stead of favorable suggestion. In psychotherapy the first duty of the

physician is to undo all the unfavorable suggestion at work, and, if

successful in that, great therapeutic triumphs are possible.

CHAPTER III

THE INFLUENCE OF BODY ON MIND

While trying to take advantage of the influence of the mind on the

body for therapeutics, it is important to remember that the body has a

great influence on the mind. There are many states of mind that are

dependent on states of body, and that can be modified only by first

modifying the body. Body changes can at least greatly help. In order

to use the mind in the therapeutics of conditions in which it would

help in the awakening of such vitality as is necessary for the cure,

particularly of many of the chronic affections, it is necessary first

to dispose the body so that it will not constantly be adding to, or at

least emphasizing, an unfavorable state of mind. For this purpose it

is important to study definitely and practically the influence that

various attitudes, expressions and external manifestations may have in

changing the internal feelings. This factor seems trivial when viewed

from the standpoint of health, but it is one of the trifles that are

very helpful in the predisposition of the patient to get better.

Alteratives in medicine, while we have not been able to say just what

their effect was, have done much for us, and the influence of body on

mind is just such an alterative.

Even those who have insisted most strenuously on the independence of

mind from body have always recognized not only the influence of the

mind on the body, but also of the body on the mind. Perhaps the most

familiar example of this is the well-known liability to dream after

eating things that disturb digestion and seem to interfere, probably

by congestive tendencies, with the circulation of the brain during

sleep. It has always been recognized that mental operations are

sluggish for some time after eating, and that a period of depression

is likely to follow any excess. The Romans feared the consequences of

indigestion so much that, occasionally after they had surfeited

themselves with rich food, they took such direct mechanical means as a

feather or a finger in the throat to relieve their overloaded stomach,

in order that they {101} might not suffer the after consequences, but

especially the depression and irritability of mind.

Disposition and Digestion.--The relation of the body to the mind in

many other besides the purely animal digestive functions has always

been realized. It has always been felt that the disposition of an

individual depended to a great extent on his nutrition. Men were not

usually approached for favors before their meals, and especially after

a long fast, but, as far as possible, requests were made shortly after

meals. It has always been recognized that the best time for men to get

together in council is, at least so far as amiability goes, shortly

after meals. Tiredness was also felt to be an important element in

affecting the mind. The tired man, even though he may be hungry, can

only eat a hearty meal at the risk of serious disturbance of

digestion, for, as a consequence of the fatigue of the body being

communicated to the mind, the mental influence which predisposes to

good digestion is lacking, and it is easy for serious digestive

disturbances to be set up. In a word, body and mind are inextricably

involved in all that concerns not only health but good feeling, and

these two terms are practically convertible.

Feeling and Expression.--In nothing is the influence of the body on

the mind more clear than in the influence of expression upon the

disposition. Actors know that if they want to well express a certain

feeling, they must arouse that feeling deeply, and the easiest, surest

and most direct method of doing so is to fix the features in the

expressions that would ordinarily indicate the presence within of

these feelings. If we insist on putting our features into the shape

which ordinarily expresses sadness, that will be reflected internally,

and we shall become as sad as our expression. On the other hand, if

the features are drawn, even by force of will, into the state that

ordinarily expresses joy or lightness of heart, we shall be tempted

more and more to feel that way, until at last even internal melancholy

may be dissipated. In the oldest book in the world, "The Instruction

of Ptah Hotep," written about 3,000 years before Christ, the old

father giving advice to his sons says: "Let thy face be bright what

time thou livest," and the literature of every time since then

emphasizes the same idea.

This influence of the expression on the mind is an extremely important

element in psychotherapy. Men and women must be taught to shake off

inner sadness, and over-occupation of mind, by training their facial

muscles of expression as far as possible to occupy positions

expressive of good feeling, but above all not to let them be fixed in

positions indicative of ill feeling. It makes a great difference for

the mental state whether a man has the corners of his mouth drawn down

or up, or whether they are pulled straight across the face to give the

severe, austere expression that some people seem to cultivate. If the

corners of the mouth are allowed to droop the glumness and depression

is likely to grow deeper. If the lips are curled upward and smile,

even though it may be a forced smile, the inner feeling will soon

yield to it. Actors are able to counterfeit the reality, but much more

than this, as we have said, they realize that, by imitating the

externals of the feeling, they awaken the feeling itself within them.

This is true for anger and loathing, and for many of the more serious

dispositions as well as for those that might be thought more

superficial, and hence more controlled by the external muscles.

{102}

_The Mouth_.--It is interesting to realize how different are the

expressions of the face as a consequence merely of control of the

sphincter of the mouth and its associated muscles. Physiological

psychologists have often called attention to the fact that only a few

lines are necessary to picture the characteristic human expressions of

sadness, joy and severity. If a little droop is given to the line that

represents the lips, melancholy is at once expressed, while the upward

curve expresses joy, and the straight line severity. These types of

human expression are easy to control, and the internal effect of each

is soon felt where there is deliberate, or indeliberate, perseverance

in its maintenance.

[Illustration: Fig. 1. Three abstract faces.]

_The Eyes_.--A typical example of the influence of the mind on the

body is to be found in the use of the eye muscles, especially the

oblique muscles. Of definite and important use for many purposes, they

are especially employed to attract attention by means of the eyes.

Coquetry has used them to express various phases of sex attraction. We

all know the picture of the young woman who "makes eyes." It is

interesting, however, to set solemn people imitating these exercises

of the oblique eye muscles. For most people it is practically

impossible to use these muscles without a corresponding quasi-demure

setting of the features, commonly associated with those who use them

most. There is even likely to be a certain attitude of mind aroused

corresponding to the setting of the features in a particular way.

While this is true for almost any other expressive state of the

countenance, it is not so easy to demonstrate as is this.

The use of the superior recti muscles has also a definite effect upon

the disposition. One of the pleasures of walking in a well-kept forest

where the trees meet high overhead, is that the eyes are inevitably

attracted upward to range among them, and there is a corresponding

elevation of feeling. Bernard Shaw once said that it was impossible to

enter a Gothic church without an elevation of the spirit, because the

eyes were surely attracted upward by the height of the nave, and a

corresponding uplift of feeling ensued. During a period of glumness it

is apparently impossible to keep the eyes raised. People who are

depressed and "cast down," as the expression is, invariably keep their

eyes downward, and just as soon as a man "looks up and not down" there

is a lifting of the depression. Even such apparently trivial muscular

actions as this may influence the mind, and thus react upon the

physical system generally.

_Wrinkles_.--Many influences of the body on the mind group themselves

in the muscles of expression around the eyes. Wrinkles, for instance,

are originally a habit of mind, and then the emphasis of this, in the

muscles of the face, is reflected back to deepen still further the

dejection or nervous unrest that originally causes them. It is

surprising to see what an influence it has on patients who go round

much with wrinkled foreheads, to have them give over the practice and

discipline themselves to appear with uncorrugated superciliary

muscles. St. Ignatius Loyola, the founder of the Jesuits, and one of

{103} the wisest managers of men that ever lived, has emphasized in

one of his rules that "wrinkles on the forehead and still more on the

nose" are a sign of interior disquiet and must not be seen. He

realized that the interior feelings could be influenced by suggestion

at least, by having those who indulged in wrinkles keep their

foreheads and noses smooth. Most of the expression of the face is

concerned with the eyebrows and neighboring regions, and people should

occasionally be asked to look at themselves in the glass, so as to rid

themselves of habits of expression indicative of a disturbed mind, for

this will do much to help to relieve the mental disturbance.

Attitudes and the Mind.--With regard to the influence of the body on

the mind, and the stimulating mental reaction that follows even a pose

of well-being and good feeling, perhaps nothing affords more striking

evidence than the effect of assuming the expressions and attitudes

usually associated with various states of mind and then noting the

results. If a man throws his shoulders back, and takes in long breaths

of air, expanding his chest and stimulating his circulation, his whole

body as well as his mind feels the effect. A slow walk with bowed

shoulders and head, while one moodily turns over all the possibilities

for ill in the life around, does very little good, while a brisk walk

with head thrown back, shoulders erect, brings a man home with mind

and body both ready to throw off temporary obstacles of all kinds, and

in addition to the fact that the mental depression has disappeared, to

some extent at least, all the physical functions will be accomplished

better than before.

Tears and Feeling.--Some of the usual translations of the meaning of

external expressions are not justified by what we know of their actual

purpose and effects. For instance, tears are supposed to be a sign of

deep grief. Except in the very young they are not, as a rule, to be

thus understood. As we grow older they are much more frequently a sign

of deep feeling that is usually quite pleasurable. It is almost

impossible for a human being to be touched deeply without a glistening

of the eyes that readily runs over into tears. A mother who is proud

of something that her children have done is quite sure to have tears

in her eyes. If she is present at a successful musical or dramatic

performance given by a son or a daughter, especially where there is

something of a triumph for them, she is sure to have tears in her

eyes. There are few mothers who fail to be moved in this way when

their children take prizes, or when some one writes to tell them how

well their children are doing. Tears, indeed, far from being a sign of

sadness, usually in adults indicate profound joy.

Tears, then, instead of being discouraged, should rather be

encouraged, unless when indulged in to excess. We realize how trying

to health and strength is the stony grief that does not melt into

tears. The mother who faints over the sudden death of her child, and

who wakes to silent consciousness, is in a dangerous condition until

the solace of tears comes to her. Until there are tears, we fear for

the effect upon her mind of the grief. The sufferer from melancholia

is sad, but a good outburst of tears will, indeed, often mean the end

of a prolonged period of melancholia. In the trials of life tears are

a consolation rather than an addition to sorrow. In the olden times

men wept as well as women, and Homer's heroes thought it not at all

beneath their dignity to be seen in tears. Over and over again, the

physician learns that while people have been going to "shows" that

were supposed to make them {104} laugh and so divert their minds, the

best possible effect is derived not from trivial laughter, but from a

serious play that touches the heart deeply and makes all who go to it

melt a little. Many nervous patients never feel better than after they

have had a good quiet cry.

The influence of the serious things of life in producing favorable

states of mind is not sufficiently appreciated, or at least has come

to be neglected in our day. There is a seeking far and wide for

pleasure and diversion that should be obtained near home, through the

simple joys of domestic life or intimate contact with others who need

us in some way. As has been well said, it is not far-fetched pleasure,

but simple joys that are more needed in our time. Nothing so enables

the patient to get his, and above all her, mind off self as care for

others. This must be expressed, however, in external acts accomplished

by ourselves for others to have any deep effect. Doing things for

other people deepens the feeling of sympathy, and so makes the mind

much more ready to respond to increase of these feelings so profoundly

as to displace selfish considerations. Exercise is valuable, but

exercise undertaken for a worthy motive, constantly before the mind

during the time it is taken, means ever so much more in awakening all

the sources of energy that there are in men and women to make life

worth living for themselves and others.

Application of Principles.--The best possible source of relief from

that combination of mental despondency, and the lack of bodily

vitality which so often accompanies it, and which, if not interrupted,

may lead to a serious breakdown of mental health, is the discipline of

work; above all, work for the benefit, of others, to which one forces

one's self gradually but persistently, not with, long intervals, but

day after day. The discipline of the asylum and the sanatorium is

probably the most efficient curative agent when these cases are at

their worst. When the symptoms are beginning, a discipline of a milder

character, yet resembling that of the institution, but appealing to

higher motives and leading to frequently repeated actions for the

benefit of others, will undoubtedly do much to prevent worse

developments or make the future condition of the patient less serious

than it would otherwise be. Undoubtedly some of the old monastic

regulations were efficient in preventing the more serious developments

of despondency when the danger to himself and others of the

melancholic was not so well recognized as at present.

_Laughing Cures_.--Every now and then the newspapers announce that

some physician has invented a laughing cure, or a smiling cure, or

something of the kind. Sometimes these reports are founded on actual

occurrences; oftener, perhaps, they are the invention of a reporter

suffering from a dearth of news. There is, however, no doubt that a

smiling cure will do much to make people, even those who have serious

reasons to be depressed, feel better. Every physician knows that if

melancholic patients of the milder type can be amused quietly, their

depression is modified for the better. Accordingly, we advise them to

see farces or lively comedy, and we try to pick out cheerful nurses

for them. The depression consequent upon some serious illness can be

better relieved in this way than by any tonics or stimulants. For the

depression, for instance, that so often follows a stroke of apoplexy,

the employment of a nurse with a good human sense of humor and a large

sympathy with the humorous side of things in life will do more to

arouse a man from the lethargy into which he settles than almost

anything else.

{105}

With regard to laughing, there is, of course, another element that

must be remembered. A hearty laugh moves the diaphragm up and down

vigorously, empties and ventilates the lungs, stimulates the heart

mechanically by its action upon the intra-thoracic viscera, and is one

of the best tonics that we have for the circulation in the abdominal

cavity, and probably also for the important nervous mechanisms

centered there. Its action upon the lungs is readily recognized. Its

influence upon the heart is usually not so much thought of, but

deserves even a more prominent place. It is now well known that when

patients have gone into coma or the apneic condition that sometimes

follows shock, or the administration of an anesthetic, when the heart

ceases to beat, the only effectual means of resuscitation is by

directly irritating the organ. It has been suggested that if the

abdominal cavity is open the surgeon's hands should be passed up and

should squeeze the heart through the diaphragm. It has even been

proclaimed that tapping on the chest vigorously over the precordium

may arouse a heart that has for the moment stopped beating. It is easy

to understand, then, that a hearty laugh, by stirring up all the

intra-thoracic viscera, stimulates the heart mechanically and sets it

beating more vigorously than before. This is one of the reasons why

people feel so well after a hearty laugh.

Even slight swallows of water act as a distinct heart stimulant. When

people have fainted, a succession of swallows of water, each of them

acting as a heart tonic, is one of the best methods that we have of

stimulating the heart's action. It is usually said that this action is

a consequence of the reflex from the terminal filaments of the vagus

nerve running back and reflected down again to the heart. To me it has

always seemed that the swallowing action had a direct mechanical

effect upon the heart, because the esophagus passes so close to it in

the thoracic cavity.

Man is the only animal that laughs, and, as the old philosophers point

out, he might very well be defined as _animal risibile_ with just as

much truth as by the words _animal rationale_. It requires reason in

order to have a sense of humor. The higher the reason, the more the

humor. Peasants and the uneducated have, as a rule, a very undeveloped

sense of humor. It is the highly educated man of deep intellectual

powers who catches all the humor of a situation, and, though his

expression of it may not be loud, it is deep and helpful at moments of

depression. Humor is, of course, very different from wit, which is

biting and which seems almost to be shared by the animals, if we can

judge from the fact that they appear, occasionally, to play practical

jokes upon one another.

It seems almost absurd that a physician should tell patients that it

will do them good to practice smiling, to take every possible

opportunity to laugh, and even to take frequent glances into a looking

glass, to see that they are not pulling long faces. The difference

between a feeling of melancholy and one of gladness consists mainly in

the position of the outer angles of the mouth. The putting into

practice of the maxim, not to let the sad lines dominate the

countenance, but to insist on keeping the others there as far as

possible, means much for the correction of internal feelings of

depression and discouragement that may be badly interfering with the

flow of nerve impulses from the brain to the body.

Mouth Breathing.--Since Meyer's discovery of the overgrowth of the

{106} lymphoid tissue in the pharynx, we have learned to appreciate

how important is mouth breathing, even for the intellectual life. We

all knew before, and indeed from time immemorial it was well

understood, that, as a rule, people who went around with their mouths

open were of low grade intelligence. All sorts of methods were used to

teach these young people to keep their mouths shut. They were reminded

of it at home, they were told about it at school, and, if they

married, their wives tried to keep them from this apparent

manifestation of lack of intelligence. Of course, they were not, as a

rule, able to carry out the well-meant intentions of their friends and

advisors. The mouths were kept open because they could not breathe

normally through their noses, and so respiration had to be

accomplished by the only other available avenue. As a consequence of

the open mouth, the lips were inclined to roll out somewhat, and

certain indications of the human physiognomy were supposed to be

associated with these thick lips.