THE WILL IN SO-CALLED CHRONIC RHEUMATISM
"I should do it
With much more ease; for my good will is to it."
_The Tempest_.
In popular estimation, rheumatism is one of the commonest of
affections. When a physician asks a patient, especially if the patient
is over forty years of age, "Have you ever suffered from rheumatism?"
the almost invariable response is, "Yes", though but little further
inquiry is needed to show that what the patient means is that he has
suffered from some painful conditions in the neighborhood of his
joints, or that his muscles have been sore or inclined to ache in
rainy weather, or that he has undergone some other vague discomforts
connected with dampness. Chronic rheumatism is a term that includes a
great many of the most varied conditions. True rheumatism, that is,
acute articular rheumatism, is now recognized as an infectious disease
which runs a definite course, usually with {241} fever, for some ten
days to ten weeks, and requires confinement to bed usually for a month
or more. Very rarely will any connection be found between this
affection, which presents always Galen's four classic symptoms of
inflammation, swelling, redness, heat and pain (_tumor, rubor, color,
et dolor_), and the usual conditions which are broadly characterized
as rheumatism. Just as soon as patients are asked if their rheumatism
included these symptoms there is denial, yet the idea of their having
had rheumatism remains.
As a matter of fact, there are a number of sore and painful conditions
in connection with muscles and particularly in and around joints that
have, without any scientific justification at least, been called
chronic rheumatism. Any painful condition that is worse in rainy
weather is sure to be so named. As old dislocations, sprains and
wrenches of joints, broken bones, as well as muscular conditions of
all kinds, including flat foot and other yielding of joints, all
produce this effect, it is easy to understand that there is an immense
jumble of all sorts of painful conditions included under the term
"chronic rheumatism." Some of them, particularly in older people,
produce lameness or at least inability to walk {242} distances without
showing the disability; a great many of them produce distinct painful
conditions during the night following the use of muscles and often
disturb patients very much, because they arouse the dread that they
are going to be crippled as they grow older.
Indeed, one of the most serious effects of these recurring painful
conditions is the dread produced lest they should cause such
progressive affections in and around joints as would eventually make
the patients bed-ridden. There are a certain number of cases of
so-called rheumatoid arthritis which produce very serious changes in
joints with inevitable crippling and quite beyond all possibility of
repair. These cases are often spoken of as chronic rheumatism and it
is the solicitude produced by the dread of them that makes the worst
part of the discomfort in many a so-called chronic rheumatic case. If
their affection is to be progressive, then the patients foresee a
prolonged confinement to bed in the midst of severe pain, hopeless of
ultimate cure. It may be said at once that these cases of rheumatoid
arthritis have nothing to do with rheumatism, represent a special
acute infection, are never a sequela of any of the rheumatic
conditions and are {243} fortunately very rare. This assurance of
itself is quite sufficient to make ever so much better a great many
patients who feel that they suffer from rheumatism.
The painful conditions that are described under the term chronic
rheumatism would seem to be quite beyond any power of the will to
affect. They are at least supposed to represent very definite changes
in the tissues, usually of chronic character and therefore not
amenable to any remedies except those of physical influence. Besides,
they are so frequent that surely if there were any question of the
will being able to control them or bring relief for them, most
sufferers would discover this fact for themselves and apply the remedy
from within. It is not to be expected that a very great many people
would suffer pains and aches that are worse in rainy weather if all
that was needed was the exertion of their will power either to throw
off the affection or to perform such exercises and activities as would
gradually make their conditions better. In general it is felt that
painful conditions of this kind cannot be affected by the will and
that distinctly material and not psychic therapeutics must be looked
to for their relief.
Now it so happens that the best illustration {244} of the power of the
will to "cure" people, that is, to relieve them completely of their
affections and start them afresh in life with the feeling that they
are no longer handicapped by disease, is to be found exactly in the
group of cases that have almost from time immemorial been called
chronic rheumatisms. We have had more "cures" of various kinds
announced for these--chemical, electrical, physical, hydriatic,
movement therapy and so forth--than for almost any other group of
diseases. More irregular practitioners of medicine all down the ages
have made a reputation by curing these affections than have won renown
by treating any other set of ills to which humanity is heir. Like the
poor, these ills are still with us, in spite of all the "cures" and
probably nowhere is the expression of the old French physician that
"the therapeutics of any generation is always absurd to the second
succeeding generation" better illustrated than in regard to them.
These cases serve to emphasize very clearly, however, the fact that
the pains and aches of mankind are largely under the control of the
will.
The more one studies these cases of so-called chronic rheumatism the
easier it is to {245} understand how they become the signal "cures"
which attract attention to the quacks and charlatans who promise much,
but do nothing in particular, though they may give medicines or
treatment of some kind or another. They only arouse the patient's will
to be better and the determination to use his will with confidence,
now that the much praised treatment is doing something which will
surely make him better. Cases of this kind have constituted a goodly
part of the clientele of the great historic impostors who succeeded in
making large sums of money out of curing people by methods that in
themselves had no curative power. A review of some of the chapters of
that very interesting department of human history, the history of
quackery, is extremely suggestive in that regard. The only way to get
a good idea of the basic significance of these cases is to realize by
what they were cured and by whom they were cured.
One of the most interesting illustrations of that phase of human
credulity is the story of Greatrakes, the Irish adventurer who had
been a soldier in Flanders, and who when his campaigns were over set
up to be a healer of mankind. He chose his opportunity during {246}
the time while Cromwell, as Lord Protector of Great Britain, had
refused to continue the practice of touching the ailing which the
Kings of England had pursued for hundreds of years since the
Confessor's time. Cromwell did not impugn the efficacy of the Royal
Touch but he refused to have anything to do with it himself.
Greatrakes found it an opportune moment to announce that for three
nights in succession he had been told in a dream by the Holy Spirit
that in the absence of the King he was to touch people and cure them.
One might possibly think that with no better credentials than this and
no testimony except his own claim in the matter Greatrakes would
receive but scant attention. Any one who thinks so, however, does not
understand human nature. It was not long before some of the people who
had been sufferers for longer or shorter periods went to Greatrakes
and allowed him to try his hand at healing them. They argued that at
least if it did them no good it could do them no harm, and it was not
long before some of them declared that they had been benefited by his
ministrations. Very soon then he was able to furnish what seemed to be
abundant evidence of Divine Mission in the cures {247} that were
worked by his more than magic touch. Above all, people who had been
sufferers for prolonged periods, who had gone the rounds of
physicians, who had tried all sorts of popular remedies, and some of
whom had been declared incurable were healed of their ills after a
series of visits to Greatrakes. No wonder then that patients came more
and more frequently, until his name went abroad in all the country and
in spite of the difficulties of travel people came from long distances
just to be treated by him.
All that he did was to ask the patient to expose the affected part and
then Greatrakes would stroke it with his hand, assure the patient that
a wonderful new vitality would go into them because of his Mission
from on High and promise them that they would surely get better,
explaining of course that betterment would be progressive and that it
would start from this very moment. The stroking was the important part
of the cure and so he is known in history as "Greatrakes the Stroker."
It may be said in passing that while those who were touched by the
English kings in the exercise of the prerogative of the Royal Touch
were usually presented with a gold coin which had been particularly
{248} coined for that purpose as a memorial, a corresponding gold
piece, a sovereign as a rule, in Greatrakes' method of treatment
passed from the patient to the healer. It was a case of metallotherapy
with extraction of the precious metal from the patient, as is always
the case under such circumstances.
Here in America we had a similar experience, though ours had science
as the basis of the superstition in the case instead of religion. The
interest aroused by Galvani's experience with the twitching of frogs'
legs when exposed nerve and muscle were touched by different metals
led Doctor Elisha Perkins to invent a pair of tractors which would
presumedly apply Galvani's discovery to therapeutics. These were just
plain pieces of metal four or five inches long, shaped more or less
like a lead pencil and tapering to a blunt point. With these, as
Thatcher, one of our earlier historians of medicine, tells us, Perkins
succeeded in curing all sorts of ailments, but particularly many
different kinds of painful conditions. He was most successful in the
treatment of "pains in the head, face, teeth, breast, side, stomach,
back, rheumatism and so forth." In a word, he cured the neuralgias and
the rheumatic pains and the chronic {249} rheumatisms which are the
source of so much trouble--and especially complaint--for the old, and
which so often physicians, in any time of the world's history, have
been unable to cure.
For a time his success was supposed to be due to some curious
electrical power that he was using. Learned pamphlets were issued to
show that animal magnetism or animal electricity or Galvanism was at
work. Professors at no less than three universities in America gave
attestations in favor of its efficacy. Time has of course shown that
there was absolutely no physical influence of any kind at work. The
only appeal was to the mind. Elisha Perkins was a Yale man of
education and impressive personality, "possessing by nature uncommon
endowments both bodily and mental ", and he succeeded in impressing on
his patients the idea that they would surely be cured; he thus
overcame the dreads, released the will power, gave new hope and a
tonic stimulus to appetite, created a desire for exercise, and then
the will kept this up and before long the patient was cured.
When animal magnetism, as it was called about the middle of the
nineteenth century, {250} was practised without apparatus, one of its
most important claims to the consideration of physicians was founded
on its power to heal chronic painful affections which had previously
resisted all therapeutic efforts. The power of neuro-hypnotism, as it
came to be designated, to accomplish this, will be best appreciated
from the fact that this state was being used as a mode of anaesthesia
for surgical operations. When the news of the use of ether to produce
narcosis for surgical purposes at the Massachusetts General Hospital
first came to England, it did not attract so much attention as would
otherwise have been the case, because English physicians and surgeons
were just then preoccupied with the discussion of neuro-hypnotic
anaesthesia, and those who believed in it thought that ether would not
be necessary, while those who refused to believe thought the report
with regard to ether just another of these curious self-delusions to
which physicians seemed to be so liable.
Perkins' declarations of the curative value of his tractors were,
after all, only a succeeding phase of what Mesmer had called to the
attention of the medical profession and the public in Paris not quite
a generation before. Mesmer seated his patients around a tub {251}
containing bottles filled with metallic materials out of which wires
were conducted and placed in the hands of patients seated in a circle
around it. Mesmer called this apparatus a _baquet_ or battery and it
was thought to have some wonderful electric properties. A great many
people who received the treatment were cured of chronic pains and
aches that had sometimes lasted for years. So many prominent people
were involved that the Government finally ordered an investigation to
be made by French scientists with whom, because he was the Minister
from the colonies at the time, our own Benjamin Franklin was
associated. They declared that there was not a trace of electricity or
any other physical force in Mesmer's apparatus. He was forbidden to
continue the treatment and there was a great scandal about the affair,
because a large number of people felt that he was doing a great deal
of good.
When hypnotism came in vogue again at the end of the nineteenth
century, it was a case of chronic rheumatism that gave it its first
impetus in scientific circles. Professor Bernheim of Nancy had tried
in vain all of his remedies in the treatment of a patient suffering
from lumbago. The patient disappeared {252} for a time and when
Bernheim next saw him, he was cured. Bernheim had treated him futilely
for months and was curious to know how he had been cured. The patient
told him that he had been cured by hypnotism as practised by Liebault.
This brought Bernheim to investigate Liebault's method of hypnotism
and made him a convert to its practice. It was the interest of the
school of Nancy in the subject that finally aroused Charcot's
attention and gave us the phase of interest in hypnotism which
attracted so much public attention some thirty years ago. Many other
cases of those very refractory affections--lumbago and sciatica--have
been cured by hypnotism when they have resisted the best directed
treatment of other kinds over very long periods.
It is these chronic rheumatisms, so called, the chronic pains and
aches in muscles in the neighborhood of joints, that were cured by the
Viennese astronomer, Father Maximilian Hoell, in the eighteenth
century. He simply applied the magnet and saw the result, and felt
sure that there must be some physical effect, though there was none.
His work was taken up by Pfarrer Gassner of Elwangen who, after using
the magnets for a time, found {253} that there was no need of their
application, provided the patients could by prayer and other religious
means be brought into a state of mind where they were sure that they
were going to get better. They then proceeded to use their muscles
properly in spite of the pain that might result for a time, and as a
result it was not long before they were cured of their affections. The
Church forbade his further practise because of his expressed idea that
pain came from the power of evil and dropped from men when they turned
to God, which was the eighteenth-century anticipation of Eddyism.
Dowie's cures were largely of similar affections, and patients
sometimes dropped their crutches and walked straight who could not
walk before.
A great many of the so-called chronic rheumatisms are really the
result of dreads to use muscles in the proper way because for the
moment something has happened to make their use painful. A direct
injury, a wrench, or some incident causes a joint for a time to be
painful when used. In sparing it, the muscles around it are used
differently than before and as a consequence become sensitive and
painful. It is quite easy, then, for people to form bad habits which
they cannot break {254} because they have not the strength of will to
endure the sore and tender condition which develops when they try to
use muscles properly once more. The young athlete who wants to get his
muscles in good condition knows that he must pass through a period of
soreness and tenderness, sometimes of almost excruciatingly painful
character. He does so, however, and does not speak of his condition as
involving pains and aches but only soreness and tenderness.
Older people, however, who have to get their muscles back into good
condition after a period of disuse following an injury or some
inflammatory disturbance, find this period of discomfort very
difficult to bear and so keep on using their muscles somewhat
abnormally and at mechanical disadvantage. As a consequence, these
muscles remain tender, are likely to ache in rainy weather and often
give a good deal of discomfort. Until the sufferers can be brought to
use their wills properly, so as to win back their muscles to normal
use, they will not get well. An application of magnets or a Leyden jar
or Mesmer's battery of the eighteenth century, or Perkins' tractors,
or neuro-hypnotism, or animal magnetism, or later hypnotism, or {255}
Dowie's declaration of their cure, enables them to use their will in
this regard and then they proceed to recover. It is surprising how
many presumedly intelligent people--at least they have received
considerable education--have been cured of conditions that they have
endured for years by some remedy or mode of treatment that actually
had no physical effect.
St. John Long, the English charlatan who has been mentioned in the
chapter on tuberculosis, also succeeded in making a name for himself
in connection with the chronic rheumatisms and the so-called rheumatic
pains and aches of older people. Between consumption and these
conditions, he caught both the young and the old, and thus rounded out
his clientele. For consumption he provided an inhalant; for rheumatic
conditions, a liniment. This liniment became very famous in that
generation for its power to relieve the pains and aches, both acute
and chronic, of mankind. So many people were cured by it and above
all, so many of them were people of distinction--lords and ladies and
the relatives of the nobility--that Parliament was finally petitioned
in the interests of suffering humanity to buy the secret of the {256}
liniment from its inventor and publish it for the benefit of the
world. I believe that a substantial sum, representing many, many
thousands of dollars in our time, was actually voted to St. John Long
and the recipe for his liniment was published in the British
pharmacopeia. In composition, it was, I believe, only a commonplace
turpentine liniment made up with yolks of eggs instead of oil, as had
been the custom before. Just as soon as this fact became known, the
wonderful cures which had occurred in connection with its use ceased
to a great extent, for distinguished members of the nobility and their
relatives would not be cured by so common-place a medium as an
ordinary turpentine liniment. St. John Long was even accused of not
having sold his real secret to the Government, but there was no reason
at all to think that. He had been producing his cures not by his
liniment but by the strong effect of his prestige and reputation as a
healer upon the minds of his patients and the consequent release of
will power which enabled them to do things which they thought they
could not do before. We have had many wonderful curative oils of
various kinds since then, with all sorts of names from Alpha to Omega
and {257} very often called after a saint,--though St. John Long was
as far as possible from being a saint in the ordinary acceptance of
that word. These modern curative oils and liniments have been merely
counter-irritants, but at times, owing to a special reputation
acquired, they have been counter-irritants for the mind and stimulants
for the will which have enabled old people to persist through the
periods of soreness and tiredness until they reacquired the proper use
of their muscles.
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