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MINDS IN DISTRESS 
 
 A PSYCHOLOGICAL STUDY OF THE 
 MASCULINE AND FEMININE MIND 
 IN HEALTH AND IN DISORDER 
 
 BY | 
 A. E. BRIDGER “ 
 B.A, B.Sc., M.D., F.R.S. (EpIn.) 
 
 Fellow of the Royal College of Physicians of Edinburgh ; Fellow of the 
 Royal Society of Medicine of London 
 
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PREFACE 
 
 HERE are two points from which 
 humanity may be viewed, the bodily 
 and the mental. 
 
 Hitherto, and for various reasons, medicine 
 has concerned itself almost solely with the 
 physical side of man. 
 
 The result has been disappointing, for, 
 necessary as it is to be acquainted with the 
 bodily structure in health and in disease, 
 the changes that occur in the latter only 
 represent the physical results of a process, 
 and not the means by which the damage is 
 done.. 
 
 Now the duty of the physician is like that 
 of the pilot; to bring his patient safely into 
 port, availing himself of every agency with 
 that one object in view. 
 
 Therefore, Mind, in the fullest and widest 
 sense, must be one of his chief studies. 
 
 vii 
 
Vill MINDS IN DISTRESS 
 
 But the subject, when we try to confine 
 it within rules, presents great and special 
 difficulties, and only principles that are of 
 universal acceptance, free of speculative 
 theory and reducible to the simplest terms, 
 are likely to be of any practical utility. 
 
 Of these, I formulate two: 1st, That 
 mental comfort depends on a state of balance 
 between two main factors in the human 
 mind. 2nd, That all minds are divisible 
 into two great types according as the reason- 
 ing or the instinctive faculties predominate. 
 I call them, respectively, the masculine 
 and feminine types.of mind. I avoid the 
 words male and female, since the line of 
 division is not one solely dependent on 
 Sex. 
 
 In the following pages I shall define the 
 above propositions, and show that upon 
 them depend the functional nervous dis- 
 orders that afflict humanity, the obscu- 
 rity of whose origin is attested by the 
 great variety of names, ¢.g., Neurasthenia, 
 Psychasthenia, Hysteria, Hypochondriasis, 
 
PREFACE 1x 
 
 Neuroses, etc., etc., under which the text- 
 books treat of them. 
 
 As my appeal is one to the common ex- 
 perience of humanity I shall make use of 
 the simplest language at my command, and 
 as my thesis is—as far as I know—an entirely 
 novel one, I shall not refer to well-known 
 writers on the subject as they all approach 
 it from an entirely different point of view. 
 
 FoLgy LODGE, 
 5 LANGHAM STREET, 
 PORTLAND PLACE, 
 Lonpon, W. 
 

 

 
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 MENTAL FORMULA ; t : 168 
 
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‘* Das ist’s ja was den Menschen zieret, 
 Und dazu ward ihm der Verstand, 
 Das er im innern Herzen spiiret 
 Was er erschafit mit seiner Hand.” 
 
 SCHILLER 
 
 
 
MINDS IN DISTRESS 
 
 CHAPTER I 
 THE NORMAL MIND AND MENTAL BALANCE 
 
 E must first get a clear and concise 
 general idea of Mind. 
 
 Many of my readers probably have read 
 the shorter treatises on Psychology by 
 William James, Titchener, Wundt and 
 others. If so, they will have been struck, 
 as I have, by the fact that, when dealing 
 with detached and strictly physiological 
 _ problems, such as can easily be verified by 
 experiment, the writers are much at home, 
 but that when these have been exhausted, 
 and the stage of generalization has been 
 reached, when the reader is on the tiptoe of 
 expectation, eager for a new and cogent 
 definition of Mind as a going process, the 
 author becomes vague and drifts away 
 into a discussion on Monism, Atomism, Oc- 
 casionalism, Spiritualism, etc.; in short, he 
 
 I I 
 
2 MINDS IN DISTRESS 
 
 trembles, so to speak, on the confines of 
 Metaphysics, and there he perforce leaves us. 
 
 And the reason for this is simple. Body 
 and mind are one and indivisible, but two 
 views of the same entity. 
 
 Keep as conscientiously as you may 
 to the physiological, the biochemical and 
 the mechanical, reject every proposition 
 that is not valid in science, yet you come 
 inevitably to a wall, more solid and repellent 
 the stricter you have been with yourself, 
 which bars all further progress, and have to 
 acknowledge with Karl Pearson in his 
 admirable Grammar of Science that the 
 search for ultimate truth on scientific lines 
 leads but eventually to self-contradiction. 
 You start with X as representing the un- 
 known, the vital or the psyche; you work on 
 and seem to get fair representation values 
 in physiology for certain components of X, 
 but you never reach a solution, change 
 your method as you may. Only on the 
 material side are you happy, for with so 
 many data in hand, and such an army of 
 skilled collaborating investigators, you in- 
 stinctively feel that, in a sensible future, 
 nearly every tissue and function will be 
 
THE NORMAL MIND 3 
 
 ranged and measured, and the body of man, 
 as stationary and inert, fixed in time and 
 space, will come to be represented by a 
 chemico-mechanical formula of great com- 
 plexity but of definite accuracy, and that, 
 as a final triumph, you may even reasonably 
 expect a day when there will be made a 
 synthetic protoplasm that shall live. 
 
 But that will not have solved the problem. 
 You will only have supplied a further 
 instance of what we all know, that when . 
 Mind demands anything imperatively, out 
 somewhere from the environment comes 
 tissue to clothe the idea, to give it what we 
 call a material basis, to do, in short, what 
 evolution—whether consciously or not, who 
 shall decide?—has been doing down all the 
 ages and what she is doing daily in the field 
 of physiology, not only by adding and de- 
 veloping new function and tailoring it, but 
 by causing to degenerate and disappear 
 that for which she has no present use. You ~ 
 will have given further proof that Mind, 
 whether represented in the person of modern 
 ‘man armed with weapons of precision, or as 
 a vague creative force omnipresent in all 
 that we call nature, is the great generator, 
 
4 MINDS IN DISTRESS 
 
 the real causa causans, and that matter is 
 ever an obedient servant that faithfully 
 carries out her commands. 
 
 You will have made life and mind. No; 
 you will have made both possible.. A great 
 achievement indeed in the popular view 
 though the idea that a great barrier divides 
 the living from the non-living is a purely 
 arbitrary one. None of the roads leads to 
 a real conception of mind in its essence. 
 We measure the force and rate of certain 
 minor functions of the brain, those of the 
 special senses in particular which lend them- 
 selves to the process readily, and we work 
 unremittingly onwards to a more intimate 
 knowledge of the cell structure through 
 which mind acts, but only to find the mystery 
 deepening and to realize the enormous gap 
 that exists in this matter between know- 
 ledge and understanding. 
 
 To obtain any useful basis from which to 
 classify and study mind we have to depend 
 on certain anatomical and physiological 
 facts just as far as they carry us and then to 
 study these in the light of wide experience. 
 Only thus shall we find practical guides in 
 our work and obtain any useful general rule 
 
THE NORMAL MIND 5 
 
 that will command the acceptance of all 
 thoughtful men. 9 
 
 The Human Mind.—This is best classified 
 according to its duties into three great 
 parts: the conscious, the subconscious and 
 the reflex, automatic or organic. Acting 
 all together as in normal persons they con- 
 stitute the Ego. But they must not be 
 thought of as separate except as a matter 
 of convenience in speaking. True, in the 
 average life of man each keeps its place in 
 function, and we thus come to view them as 
 distinct; but there are no fixed and real 
 boundaries, and directly circumstances be- 
 come unusual the order of this relationship 
 is overthrown and they invade each other’s 
 department and provide us with many 
 extraordinary phenomena. f Some minds, 
 being more active than others, or propor- 
 tioned differently, show this intermingling 
 of function early and under slight stress, and 
 in them—as we shall see—it may reach 
 easily a great development, and indeed with 
 a little trouble, and by arranging our en- 
 _ vironment, we can induce artificially, and 
 even in persons who are in the enjoyment 
 of normal health, many of these abnormal 
 
6 MINDS IN DISTRESS 
 
 phenomena as we see in hypnotism and 
 spiritualism. 
 
 This contiguity—this close relationship— 
 throughout the body of the three great de- 
 partments of mind is a matter of importance 
 and must be kept in view, and though we 
 speak anatomically of ‘“‘ mapped-out areas 
 of the brain,’ and of the “ great special 
 centres’ therein, we do this largely as a 
 matter of convenience, for it is not even 
 certain that within the brain reside all the 
 functions of thought; and Dr Charlton 
 Bastian, amongst other authorities, holds 
 that the great ganglia of the sympathetic 
 system, which are chiefly in the abdomen, 
 “have a large share in the conscious life 
 of the individual and lead more or less 
 directly to a series of voluntary actions,” 
 whilst the most extensive and destructive 
 disease in the brain, as subsequently viewed 
 in post-mortems, has been present with 
 a practically unimpaired intellect of the 
 sufferer. It is therefore safer to keep in 
 mind the three great mental departments 
 without tying these down at all strictly 
 to special areas in the brain. 
 
 At present the conscious department 
 
THE NORMAL MIND 7 
 
 alone concerns us and we shall deal with it 
 on the broadest principles of experience. 
 
 Mental Balance.—One arm of this balance 
 is what we may call Common Sense. This 
 consists of our general store of knowledge, 
 a register of our conclusions to date, and 
 though it is being perpetually modified in 
 composition by such new ideas as we accept 
 and absorb, yet is the more stable arm of the 
 balance. It is constantly being kept in a 
 state of general average with other minds 
 by means of contact with the current opinion 
 of the day, a point that is of great practical 
 importance in life, for when an individual, 
 or even a whole group of persons, as in a 
 profession, isolates himself and fails to keep 
 in touch with the world in general, he is in 
 great danger of mental distress, for his 
 standard is lost and with it his sense of pro- 
 portion. This is one of the great causes of 
 many mental and nervous disorders. 
 
 The other arm of the balance, for so we must 
 call it, is made up of the mew impressions 
 which in countless variety and from all 
 _ sources, from our internal organs and from 
 the outside world, reach and are presented 
 to the common sense as to a standard. If 
 
8 MINDS IN DISTRESS 
 
 the latter be kept active and well stored by 
 incessant readjustment with the world-mind, 
 and if the nerve tissue on which mind rests 
 as its material basis be healthy and adapt- 
 able, very rarely indeed will any fresh im- 
 pression remain unbalanced, but unnoticed, 
 and I may say almost automatically, find 
 a place in and become a part of the common 
 sense, while even if the new circumstance 
 with its impressions cannot be thus at once 
 and directly assimilated it will create no 
 disorder, for the mind will ‘‘ throw out a 
 balance,’ as it is called in philosophic 
 language, will adopt a theory that will for 
 the time being bring the two arms of the 
 balance into equilibrium. This state is 
 called ‘‘ making up one’s mind.” 
 
 Now all this may appear too common- 
 place to require formal statement, yet on 
 this balancing of the two factors—the nor- 
 mal impression with the common sense— 
 mental comfort depends, and from a want 
 of it far-reaching mental distress arises. 
 
 Note how much depends on the soundness 
 and stability of the common sense. If all 
 minds were compounded in exactly similar 
 proportions of the three constituent parts— 
 
THE NORMAL MIND 9 
 
 the conscious, subconscious and automatic— 
 if all nerve tissue were always in a state of 
 similar activity, and if the environment of 
 everyone were equally restricted and exactly 
 alike, then, at least at equal ages, people 
 would all possess an equal common sense, 
 and any serious difficulty from the failure 
 to reach a balance could rarely arise; but 
 there is a wide variation in all the above 
 factors, and consequently an enormous differ- 
 ence in the response to unusual or novel 
 sensations; and the result of this failure 
 to reach an equilibrium is to give rise to 
 phenomena of disorder altogether incom- 
 prehensible to persons of different mental 
 capacity and to the world at large, and 
 leads to grave misunderstanding, the failure 
 to balance being wrongly ascribed to some 
 vague agent of disease attacking the body 
 from without, when all the time it is due 
 simply to the fact that the mind (the com- 
 mon sense) of the patient is of different 
 composition to that of the observer and is 
 merely responding in a way normal to 
 itself. 
 
 For that reason it is essential to closely 
 study the mental composition of the sufferer 
 
10 MINDS IN DISTRESS 
 
 from mental distress so as to be able to 
 interpret the symptoms observed, which will 
 usually be found to be only natural under the | 
 circumstances and not due to some sup- 
 posed malignant external agency. Then by 
 effecting a change in the environment, by 
 adapting the latter as closely as possible 
 to the individual needs and requirements, 
 health may often be easily restored, and 
 measures having been taken to effect a 
 constant healthy contact of the sufferer 
 with the general world-mind, a stable 
 and lasting condition of mental com- 
 fort under all ordinary circumstances of 
 life may be secured. Therefore the 
 very simple, elementary balance of which 
 I have spoken must ever be kept in 
 mind. 
 
 Now, in the event of novel experience, the 
 throwing out of a balance by the mind to 
 effect an equilibrium in the person of good 
 sound common sense, who lives in free con- 
 tact with the world-mind, is a simple process 
 leading to no distress. The provisional 
 theory adopted is either affirmed by ex- 
 perience, or if not, the theory is rejected 
 and another conformable to general ideas 
 
BWei OM Ce! 
 
 THE NORMAL MIND 11 
 
 is adopted. But when the common sense 
 is not of an average and sound order, by 
 reason of the isolation in life of its possessor, 
 or because his mental composition is not 
 in the usually relative proportions, or 
 when the mind is of extreme sensitiveness 
 by inheritance, impressions quite ordinary 
 of their kind and easily balanced in the 
 former may lead in the latter to the adop- 
 tion of a theory that, while it appears quite 
 right to the individual, is widely at variance 
 with the ordinary world-mind of the day, 
 and for that reason—even independently 
 of isolation—be extremely difficult to cor- 
 rect. Of this nature are the so-called 
 “Obsessions” and ‘“ Phobias” of the 
 Neurasthenic, the grievances to which some 
 persons seem so pertinaciously to cling and 
 the distorted views of the Hysterical. These 
 appear weird and unreal to the man of the 
 world, or even as evidence of a diseased 
 mind, whereas, when all the circumstances 
 of the case are known, they are easily 
 seen to have had a simple origin and 
 to be natural theories, efforts made by 
 a common sense for some reason out of 
 touch with the ordinary mind of the day 
 
12 MINDS IN DISTRESS 
 
 but perfectly sound, though often highly 
 sensitive. 
 
 These wandering ghosts of ideas that have 
 thus taken their rise, these theories formed 
 naturally to effect a mental balance, become 
 in time accepted more or less as real, and, 
 instead of being corrected by a common 
 sense in contact with the living moving 
 world, themselves become so uppermost in 
 the mind as to pervert it; so that you get the 
 picture of a man who is strictly sane, and 
 indeed very logical, but all whose arguments, 
 with the consequences that flow from them, 
 are founded on an initial theory which he 
 has never been able to displace, and which 
 has grown and blossomed by isolation and 
 introspection. He has been the victim of 
 self-suggestion, of a disorder of the attention, 
 and can only be cured, as we shall see, by 
 one who will completely unravel the tangle 
 and at the same time place and keep the 
 sufferer in the active, moving world of 
 normal minds. 
 
 The aforesaid process has nothing in com- 
 mon with the genesis of the Insane mind; 
 the latter is generally due to a poisoning of 
 the brain tissue by some failure in the de- 
 
THE NORMAL MIND 13 
 
 fensive powers of the body and the conse- 
 quent absorption into the blood of poisons 
 generated usually in the bowel. In fact 
 the brain, like the rest of the body, is singu- 
 larly tolerant of mere mishandling such as 
 occurs in the cases I have sketched, and 
 organic disease is a most unusual conse- 
 quence thereof, though degeneration may, 
 in later life, be one of the sequences. Thus 
 it happens that Neurasthenia and Hysteria, 
 and other mere failures of mental balance, 
 may be completely recovered from after 
 a course of many years, and are indeed 
 often automatically cured by the choice 
 advent of some overmastering idea, es- 
 pecially by some very strong distressing 
 experience. 
 
 Mental balance between the common 
 sense (the formed individual conscious mind) 
 and all novel experience that is presented to 
 it thus-means mental comfort, and the want 
 of it mental distress that may, if favoured 
 by circumstance, be of a most far-reaching 
 kind. 
 
 Such, in the simplest of language, is the 
 psychic basis from which mental suffering 
 of a functional order takes its rise. The 
 
14 MINDS IN DISTRESS 
 
 symptoms that ensue depend, as to their 
 character chiefly on the class of mind pos- 
 sessed by the patient, and as to their extent 
 on his or her circumstances in life, especially 
 as to a free or a restricted contact with 
 other normal minds; the active world of 
 working life being the great agent that 
 moulds the human mind, the common sense, 
 and maintains in it a healthy circulation 
 of thought and that fits it for doing its best 
 work. | 
 
 The following simple illustrations will help 
 to make clear my statements. 
 
 A. sees a ghostly figure at night. He 
 knows that it is.merely a shadow picture 
 thrown by a magic-lantern and is uncon- 
 cerned. Or he does not know of the magic- 
 lantern and is upset. His friends persuade 
 him that it is an optical delusion, and as he 
 finds that these are fairly common he 
 accepts the theory and is at rest. Or he 
 cannot accept that theory, but regards 
 the figure as the ghost of a departed 
 friend sent as a warning, consults spiritu- 
 alists, who advise a recourse to séances to 
 clear up the mystery. He agrees and is 
 soon in astate of advancing ‘“‘ abnormality.” 
 
THE NORMAL MIND 15 
 
 His common sense is being progressively 
 perverted. 
 
 B., a bank clerk leading a routine life and 
 therefore in mental isolation, has a sudden 
 _ attack of depression with fear of loss of self- 
 control. It is due to a cause unknown to 
 him but really quite simple, an acute liver 
 congestion. Instead of consulting a doctor, 
 who would have told him that such attacks 
 are quite common and what they arise from, 
 and that a blue pill, a Turkish bath, a little 
 care in diet, and an occasional game of golf, 
 would correct matters and keep him free of 
 such experiences, he adopts the theory of 
 incipient insanity, and by reading up the 
 latter subject persuades himself that he is 
 right. He gets sick-leave and further 
 isolates himself. The false theory is fol- 
 lowed out logically in all directions and he 
 becomes at last, by incessant thought on 
 the subject, and by association with sym- 
 pathizers, a miserable hypochondriac. 
 
 These examples make clear two facts of 
 great importance, viz., that novel impres- 
 sions which concern ourselves closely have 
 a far greater effect than others in disturbing 
 our mental comfort and balance, and that 
 
16 MINDS IN DISTRESS 
 
 isolation favours introspection and often 
 leads to the adoption of a theory which 
 appears to others out of all reasonable pro- 
 portion to the symptoms, for the standard 
 of the isolated man is a falsified one. 
 
CHAPTER II 
 
 THE MASCULINE TYPE OF MIND 
 
 N conversation about the ordinary 
 
 affairs of life, and more especially in 
 discussions on formal topics, whether of 
 politics, ethics, or art in any form, you will 
 remark that educated people may readily be 
 divided into two main classes: the one very 
 practical, who demand proof before they 
 accept a conclusion and rely only on facts, 
 evidently regarding a so-called fact as a final 
 truth; the other class who live in a different 
 plane of thought altogether, who assert that 
 the effect will be so-and-so, who see the end 
 to be attained and seem to be little concerned 
 with the process by which it is reached, 
 and much devoted to ideals. Among the 
 former will be found the plodding, steady 
 people who achieve financial success, or at 
 least stability; among the latter the bril- 
 liant, artistic, creative and the spiritual. 
 The genius is of the latter class. 
 
 2 17 
 
18 MINDS IN DISTRESS 
 
 Of course the dividing line between the 
 two classes is not a hard-and-fast one; some 
 have mental characteristics that are a blend 
 of both types in various proportion. The 
 first class is that endowed with the Mascu- 
 line type of mind. Speaking generally the 
 Englishman, the Lowland Scot and the 
 North-Country Irishman are good speci- 
 men proofs of this order, and many even 
 of their womenfolk are thus mentally 
 constructed. Science in all its branches 
 and business in all its forms are served by 
 individuals of this type of mind, and legal 
 and political affairs of necessity depend 
 upon it. 
 
 It is the mind of the vast majority of 
 men in this country. Without having 
 studied formal logic they are logical and 
 rely on the relation of cause and effect, con- 
 sidering that the one and only criterion of 
 sane judgment. They can conceive of no 
 other valid process of thought and utilize 
 it alone in all their transactions and dis- 
 cussions, 
 
 Now what would you expect to find, if 
 the balance of mind be disturbed in anyone 
 of the masculine type? A series of reasoned 
 
THE MASCULINE MIND ig 
 
 arguments as to their state. This is what 
 you find in the Hypochondriacal type of 
 Depression, the Neurasthenia of the text- 
 books. Throughout all his complaints the 
 sufferer reasons and reasons. 
 
 Let me give an instance: 
 
 B., at. forty, up to three years ago engaged 
 in very routine office work in the Civil 
 Service. Four years ago was attacked with 
 dyspeptic symptoms and occasional sick- 
 ness, followed later on by an irritating rash. 
 Consulted advertisement in papers and 
 medical books. Decided it was _ blood- 
 poisoning of some most unusual kind for 
 no doctor could give it a name. Searched 
 his memory and thought that he must on 
 one occasion have swallowed an infected 
 blood clot. Advised a rest cure at first, 
 and being unrelieved, gave up his work in 
 order to devote his whole mind to his com- 
 plaint. Attended hospitals diligently, and 
 when I saw him was covered with sulphur 
 ointment, which had induced very naturally 
 a general state of eczema. He presented 
 me with quite a treatise on his complaint. 
 Founded on the theory of the blood clot he 
 had built up by strict reasoning a whole 
 
20 MINDS IN DISTRESS 
 
 series of the consequences to be expected, 
 and, partly by mental suggestion and partly 
 by the absurd skin treatment given him by 
 doctors sick of his loquacity, he had in part 
 achieved most of them. The case looked 
 unpromising for the whole mind was con- 
 centrated on self. 
 
 Though,not strictly apropos, I will give 
 the result. I accepted, provisionally, the 
 theory of the blood clot, wrote my decided 
 opinion that I could cure him, and, having 
 ascertained what he would accept as proof 
 thereof, got rid of the eczema, put him on a 
 vegetarian diet, and insisted, before I would 
 proceed further, on his return to work. He 
 was taken back and given an active out- 
 door job by my advice. I gave him a mild 
 subcutaneous injection of arsenic, which 
 impressed him, and put him on his word 
 of honour to consult no one, not even 
 myself, and to read no medical book, for 
 six months. The man is now in perfect 
 health and quite sees how his former 
 hypochondriasis was produced. But he 
 maintains that without a definite written, 
 closely-argued opinion and a written pro- 
 mise of complete cure, he would never have 
 
THE MASCULINE MIND — 21 
 
 succeeded in fighting his way out of the 
 tangle. 
 
 F., a prosperous city merchant, came to 
 tell me that he was becoming, if indeed he 
 was not actually, insane. Why the theory 
 of insanity? Because he was haunted with 
 an idea so absurd that no practical and 
 sane mind could harbour it. He had stolen 
 a pot of jam thirty years ago, but had for- 
 gotten all about it, and this was the idea 
 that had resurged in his mind and would 
 not go. First of all I pointed out to him that 
 the theft was a fact, not a delusion at all; 
 that all his proofs of insanity, 7.e., some 
 trifling loss of memory, extra sensitiveness, 
 some sleeplessness, etc., are not complained 
 of, though often present, in insanity and 
 were evidently in his case induced by self- 
 suggestion. Finally, that the memory of 
 the theft was part of a train of thought 
 induced by the words of a man in a 
 heated discussion and who had. said, “F., 
 you were always a thief.’ Quite un- 
 deserved, this insult had rankled, and the 
 word ‘ always ’’ was especially dwelt upon. 
 I pointed out to him that every event of his 
 past life he had recalled, balanced by his 
 
22 MINDS IN DISTRESS 
 
 mind and put to rest, but the idea of this 
 one little theft, actual and real, never dis- 
 covered and never forgiven, had remained 
 behind, isolated and unbalanceable, and 
 for that reason, and just because he was a 
 just and conscientious man, the idea of this 
 theft stood out prominently. It was simply 
 a very sane idea. 
 
 It were easy to give instances innumerable, 
 all with the same sequence. A novel idea 
 or impression; a theory based thereon; 
 long, logical arguments based on that theory, 
 producing by their mental influence a series of 
 symptoms, taken to be proofs of the theory; 
 further. arguments based on these false 
 proofs, and the end a tangle of reasoning 
 through which cause and effect, effect and 
 cause, appear and reappear in everysentence ; 
 all the result of an active, sane, masculine 
 type of mind struggling, by the only process 
 it knows, to account to itself for a novel, and 
 therefore disturbing, mental impression. 
 
 Yet the reader will see that two other 
 influences have an effect on the result. The 
 sufferer in the first case had not only the 
 masculine type of mind but an abnormally 
 active one, and his great mistake at the be- 
 
THE MASCULINE MIND — 23 
 
 ginning was to tsolate himsel}, to settle down 
 to think out, to discuss with himself, his 
 theory. Had he but fortified his common 
 sense by a more active communion with his 
 fellow-men, had he thrown himself with 
 greater fervour into work and taken on new 
 forms of work, he would soon have recovered 
 in one way or another his balance of mind 
 and with it his mental composure. 
 
 And when we come to Neurasthenia we 
 - shall see that it is the specially active, the 
 high-class, and therefore the naturally iso- 
 lated, kind of masculine mind that usually 
 falls a victim and why it is that so-called 
 rest cures or abstention from work aggravate 
 the evil by favouring that isolation, thus 
 rendering more remote the chances of a 
 speedy cure. 
 
CHAPTER III 
 
 THE FEMININE TYPE OF MIND 
 
 HIS type is extremely difficult to 
 
 describe. It is indeed inscrutable to 
 its possessor. Its limits are not confined to 
 what is usually styled the conscious brain. 
 In addition to the reasoning faculty which 
 it possesses in common with the masculine 
 type, but upon which it by no means like 
 the latter exclusively relies, it depends 
 largely on intuition, on instinct, that, like 
 the homing instincts of birds and animals, 
 lead it aright across spaces that are appa- 
 rently destitute of any guide or pathway. 
 The vast majority of women have this class 
 of mind, and we recognize in their deep in- 
 stincts, such as that of maternity, in their 
 unselfish love, in certain of their intuitive 
 decisions, and in their quick insight into 
 character, a faculty that guides them to a 
 knowledge in which reason and experience 
 
 play no part. Other and entirely non- 
 24 
 
THE FEMININE MIND 25 
 
 sexual instincts are present in both men and 
 women who are of this mental type, creative, 
 decorative, imaginative, spiritual in kind. 
 Genius is of this order. It is there, standing 
 unsupported as it were and quite escaping 
 the ring-fence of any verbal definition 
 founded on cause and effect. It is said to 
 be a gift, another word for instinct but not 
 an explanation thereof. The great ideas 
 that in history have moved mankind and 
 swayed destinies are products of high-class 
 feminine types of mind, and while in a region 
 of ultimates, where there can exist no 
 standards, one cannot accord priority of 
 rank, yet one may legitimately entertain 
 a “‘strong doubt” as to whether the 
 feminine is not the higher. The two types 
 are often said to be complementary one of 
 the other, though there is not much sense 
 or finality in the remark. But there it is, 
 the type so common in all women, and in 
 both sexes of the Latin and Celtic races, and 
 its existence lies at the very root of the 
 great differences of opinion—the causa 
 causans of the wide chasm—that prevent 
 a perfect understanding between peoples. 
 The masculine and feminine types when in 
 
26 MINDS IN DISTRESS 
 
 different sexes blend admirably, but never in 
 different nations who perpetually fail to do 
 justice to each other’s motives because of 
 the mental medium by which alone they 
 can judge being essentially different in 
 colour. 
 
 What about this wider, deeper, feminine 
 type of mind, this mind that does not de- 
 pend solely on the grey matter of the brain 
 as its basis but embraces the unconscious 
 portions—and remember we have no right 
 to rank either part as a higher one—when 
 it loses balance? 
 
 Not the ordered argument, not the re- 
 cords of hours and days devoted to intro- 
 spection, to a logical ordering of each section 
 of a mental problem; not the reliance on 
 cause and effect as with the masculine 
 type, but an upheaval of wide extent, a 
 volcanic eruption, a mingling of capricious 
 thought and of disordered or convulsive 
 action. That is what you would expect, 
 that is what you get, and it is called 
 Hysteria. 
 
 At this point again I must add, to avoid 
 possible misunderstanding, that though, for 
 the sake of clearness, I describe the two 
 
THE FEMININE MIND 27 
 
 types of mind as widely separate yet in 
 actual life they are often blended, scarcely 
 ever perhaps in equal proportion; one type 
 is usually recognizable as predominant but 
 instances of pure type are by no means 
 rare. 
 
 How does the great rule of mental balance 
 affect the feminine type of mind? In the 
 masculine type we had a comparatively 
 simple problem that lent itself kindly to 
 definition. Simple reason, as codified by 
 formal logic and as applied every day in 
 our business occupations and our scientific 
 studies, in a state of distress, seeking by a 
 fundamental rule of the mind to recover 
 the balance of health and borrowing a 
 counterbalance, 7.e., throwing out a theory, 
 to that end, but often coming to grief by 
 an excessive reliance on its own strong 
 virtue, pure reason; the wanderer being 
 further confused by the extravagant terms 
 and theories of the guides to whom he 
 applies for direction, like Sganarelle in 
 his interview with Pancrace, doctor zz 
 utrogue jure, in the “ Mariage forcé”’ of 
 Molicre. 
 
 The feminine type of mind is, like the 
 
28 MINDS IN DISTRESS 
 
 masculine, and like every human mind, the 
 result of a balance between the two parts 
 thereof; an individual mind made up of 
 impressions and ideas constantly being 
 formed and a common mind (common 
 sense) which represents the sum of acquired 
 knowledge, plus certain instincts, the latter 
 being the main element in the feminine type 
 and which may be said to permeate it. 
 
 Under natural conditions, that is under 
 such as afford scope for its full satisfaction 
 and development, the feminine type of mind 
 passes through life in a state of health. Its 
 equilibrium is always a more delicate one 
 than in the other type but small disturbances 
 are rectified by the emotions acting as safety 
 valves. How often do we not see a flow of 
 tears in a woman or in a man of the Latin 
 race bring relief to mental tension of the 
 most varied kinds. 
 
 The disequilibration of the feminine type 
 which we have later to study under the name 
 of Hysteria varies of course as widely in 
 its forms as the mind from which it has 
 sprung, and will be seen to arise usually from 
 two great causes—a repression of instincts 
 and an exaggeration of self. 
 
THE FEMININE MIND 29 
 
 Now instincts are never clear in conscious- 
 ness. Take the maternal instinct: many 
 women are never conscious of it, others feel 
 it only as a vague impulse towards some 
 end, and very few women ever devote serious 
 thought to it, as they would to a problem in 
 science. In civilized countries, where the 
 masculine type of mind almost alone makes 
 the laws and largely the social customs, all 
 instincts have to be somewhat repressed, if 
 they threaten to obtrude themselves unduly 
 on public attention; for reasoning power 
 must always have the most prominent 
 position as controlling agent; and this is 
 beneficial, for the mind, like the body, 
 gtows in strength as it grows in ordered 
 self-control. 
 
 For if the bringing-up of a girl has been 
 such that all the trivial cravings of the child 
 mind for the indulgence of self have been 
 unchecked; if in adolescence wealth has 
 gratified every one of the increasing, though 
 in essence natural, desires for excitement, 
 for self-adornment, for self-advancement 
 and self-prominence in every shape; if 
 the Ego has been thus allowed to take the 
 chief, almost the only, place in the woman’s 
 
30 MINDS IN DISTRESS 
 
 common sense (7.¢., common mind), what is 
 the inevitable result? 
 
 The common mind is stored with all that 
 relates to self and takes up readily (in the 
 balance) only those impressions and ideas 
 which relate to self; and you have a com- 
 pletely self-centred individual, a mind iso- 
 lated because it does not find in the world 
 those with which it can, or cares to, com- 
 municate. | 
 
 Though in no sense of the word an insane 
 mind, its vision of everything (when the 
 mind makes itself up) is distorted. It 
 honestly does its best often to see, to be 
 persuaded to other people’s views, but, like 
 a person with bad astigmatism, it cannot 
 with the best will in the world see straight 
 lines where others see them. 
 
 To such an egoist comes suddenly a grave 
 disappointment. That which it ardently 
 desired is out of reach or is lost; the balance 
 is disturbed. Not only the reasoning 
 faculty, as in Neurasthenia, but the sub- 
 conscious and unconscious portions of the 
 mind are thrown into violent disorder; the 
 weakened moral powers, the debilitated, 
 insufficiently exercised intuitive powers of 
 
THE FEMININE MIND 31 
 
 the mind give way and disorganization 
 reigns through every part of the body. 
 
 And, pathetic as it is, you can often see 
 in the midst of this mental and physical 
 chaos the old pampered Ego fighting hard 
 for first place. 
 
 Such is the genesis of Hysteria. The un- 
 balancing of the feminine type of mind, of 
 the mind that has as its physical basis not 
 only the grey matter that envelops the 
 hemispheres of the brain, with which acute 
 active consciousness is associated, and which 
 is concerned mainly in the weighing of 
 cause and effect; but also the white matter 
 beneath it, with which the instinctive and 
 more spiritual mind is connected, disturb- 
 ance of which, if great, may involve even the 
 centres of the lower brain and bring under its 
 deranged mental control many functions 
 which, in ordinary life, are beyond will 
 power .and automatic in their action. I 
 have seen a hysterical patient at will reduce 
 in five minutes the action of her heart from 
 88 to 18 beats a minute; and another take 
 a large bowl of bread and milk and, at my 
 command, arrest the food at the end of the 
 cesophagus and return it at a signal, un- . 
 
32 MINDS IN DISTRESS 
 
 altered, into a basin; or, if I ordered it, allow 
 the food to pass direct into the stomach and 
 at a given signal reject it, altered by the acid 
 secretion of the stomach. Under strict 
 conditions precluding imposture I have seen 
 the body temperature sent up as much as 
 7 degrees in the course of half an hour, 
 whilst paralysis and wasting, phantom 
 tumours and a close imitation of every 
 known disease, are quite the commonplace 
 phenomena in hysterical patients at every 
 hospital. Through one and all of these 
 manifestations the prevailing egoism of 
 the patient is generally apparent, and this 
 has led to the belief, now known to be 
 erroneous, that wilful effort is always con- 
 scilously at work. This is not so; the 
 patient is always herself deceived, though 
 she may consciously add to her symptoms 
 in her craving for attention and sympathy. 
 
 The one instance to which space restricts 
 me is that of a man whom I knew as a 
 patient for nearly thirty years. 
 
 In business, and aged about thirty when 
 I first met him, he had considerable artistic 
 taste, was emotionally religious, had some 
 literary pretensions, was always en pose, 
 
THE FEMININE MIND 33 
 
 and was fond of asking people what, from 
 his appearance, they would judge him to be, 
 delighted always if the reply was a doctor, 
 an editor, or a clergyman. Vain and self- 
 important, he was always having his char- 
 acter written and quoting the laudatory 
 paragraphs. He would discuss himself and 
 his symptoms for hours, with gusto. He 
 had, in succession, partial blindness, com- 
 plete deafness and functional paralysis of 
 several kinds. If he were crossed in any way 
 he would have violent hysterical convulsions 
 with aimless violence ; while he took business 
 reverses (he failed more than once) with 
 placidity. After one of his later reverses 
 he travelled round the world en prince, 
 leaving his family to work their way out 
 of his financial troubles. He lectured, and 
 even wrote books about his travels, and, to 
 his delight, obtained later a small literary 
 post. -He then had thoughts of purchasing 
 a D.D. or LL.D. of some moribund Ameri- 
 can university. His end was characteristic. 
 In a hysterical seizure he drew a penknife 
 across his neck (not the first time he had 
 inflicted superficial wounds on himself), and, 
 though the cut was insignificant, it sufficed 
 3 
 
34 MINDS IN DISTRESS 
 
 to open the external jugular vein and he 
 died of an air embolus in consequence. 
 
 He interested me greatly because, being 
 intelligent and observant, he could give me 
 —and did it with great delight—a good 
 description of his various mental states. 
 He was never hypochondriacal, and never 
 alarmed about insanity, although he was 
 conscious that his mind was occasionally 
 out of accord with those of others. That to 
 him was proof of superiority. He kept an 
 exact register of all his thoughts, feelings 
 and motives, especially of those that led 
 up to and accompanied an acute attack. 
 They would have filled several volumes 
 and showed the possession of remarkable 
 intuition in estimating the characters of 
 others and many traces of real genius. He 
 was an only child of very emotionably 
 religious people, who destined him for the 
 ministry and encouraged him, when a youth, 
 to compose hymns and write sermons, and 
 this early exaltation of his Ego unbalanced 
 an otherwise fair specimen of the feminine 
 mind type. 
 
 Resumé.—Under the simple analogy of 
 a balance we see the fundamental process 
 
 , 
 
THE FEMININE MIND 35 
 
 concerned in making up one’s mind, and how 
 essential it must be for mental health and 
 comfort that our common sense should be 
 fed with the impressions and ideas gathered 
 from as wide a range of experience as pos- 
 sible. If the mind be nourished—as a 
 result of faulty upbringing or by the force 
 of circumstances—by an undue proportion 
 of ideas that have relation to the self and 
 its gratification, or indeed by one set of ideas 
 of any kind, it falls unconsciously more and 
 more out of touch with the general mind of 
 the day (the Zeitgeist) and becomes isolated 
 and may be keenly conscious of such isola- 
 tion from which it cannot, unaided, escape. 
 
 When in this condition if it be balked in 
 any of its extravagant and selfish aims, or 
 even if the most natural of its instincts be 
 denied to it, the result in the wide feminine 
 mind type will show itself in extensive and 
 manifold derangements (Hysteria), while in 
 the reasoning masculine type any novel and 
 unbalanceable idea or impression will pro- 
 duce a “theory ” on which reason will 
 construct a superstructure of dreads and 
 terrors (Neurasthenia). 
 
 And I purpose to show in the following 
 
36 MINDS IN DISTRESS 
 
 chapters that the line of treatment is to take 
 possession of—to impose one’s will upon— 
 the isolated mind and by suggestion (which 
 may operate through various agents) to lead 
 it back to contact with the general mind of 
 humanity. That efficiently done, the cure 
 
 will complete itself. | 
 
 
 
CHAPTER IV 
 NEURASTHENIA 
 
 z.e., loss of balance in the masculine type of mind 
 
 (Synonyms :—Hypochondriasis, Psychasthenia, Nervous 
 Debility, Nervous Breakdown, Depression, etc.) 
 
 HAVE adopted on the lucus a non lucendo 
 
 principle and with a sole view to clear- 
 ness, the best known of the above question- 
 begging designations, Neurasthenia; for, as 
 we have seen, the disorder is not due to 
 nervous weakness but to the strictly normal 
 activity of the mind in efforts to restore 
 the balance in which mental health and 
 comfort consist. 
 
 For-just as the body maintains its balance 
 in health by the ordered co-operation of all 
 its organs, and, health being lost, sets in 
 action certain phenomena (known as the 
 symptoms of functional disease) with the 
 sole object of the restoration of its equili- 
 brium (which tendency used to be called the 
 
 37 
 
38 MINDS IN DISTRESS 
 
 Vis Medicatrix Nature), so the mind in a 
 like state of instability directs her activities 
 to a like end, 7.e., a restoration of balance. 
 In the mind, as we have seen, the cause 
 of disturbance must be some circumstance, 
 represented by impressions or ideas, to which 
 the mind is unaccustomed and which it 
 cannot therefore readily balance. These 
 are either sensations which generally take 
 their rise in some one of the abdominal 
 organs, such as the liver, stomach or sexual 
 apparatus, which have but very indirect 
 connection with the highest brain centres, 
 
 or certain strange ideas, that have a bearing © 
 
 on one’s welfare, and which, because of their 
 novelty, cannot be connected with any of 
 our usual trains of thought and assimilated, 
 1.€., balanced. 
 
 Predisposing Causes of Neurasthenia.—The 
 books give to heredity a prominent position 
 among these, but its influence, according 
 to my own statistics of about 800 cases, is 
 negligible in Neurasthenia. The mistake 
 has, I think, arisen from the common con- 
 fusion of this disorder with Hysteria, in 
 which a hereditary predisposition to in- 
 stability is a strongly-marked feature. 
 
NEURASTHENIA 39 
 
 As regards overwork, I unhesitatingly 
 affirm that the influence of genuine, whole- 
 some, all-round work will be found, on 
 critical examination, to be very slight; 
 though it is the favourite cause assigned by 
 the patient. The classes of work that are 
 baneful, even in moderation, are those that 
 keep the individual out of active communion 
 with his fellow-man, or that actually deprive 
 the brain of work; such are routine employ- 
 ments, and those that offer no sufficient 
 prize as stimulus to individual thought and 
 enterprise, and those which necessitate the 
 long habitual use of one or a few only of 
 the mental faculties. To be health-giving, 
 work must be varied, must necessitate free 
 intercourse with other minds, and must 
 provide that carrot in front of the donkey 
 which alone can make it progress with alac- 
 rity. To the deadening effect of unsuitable 
 work; even more than to the want of physi- 
 cal exercise, breakdowns are due. Co-opera- 
 tion from the active interest it generates 
 in the workers’ minds seems to me to have 
 great possibilities in the prevention of all 
 varieties of nervous disorder. What about 
 worry? Its effect depends much on the 
 
40 MINDS IN DISTRESS 
 
 situation and the personality. I have 
 known cases in which it had a curative effect 
 as a stimulant, a way in which some great 
 disaster will often act—pulling a man to- 
 gether, deciding him to new and more 
 vigorous effort. But in blind alley employ- 
 ments, and there are many such, worry 
 may act as the final straw to the over- 
 burdened camel; but, as I have said, it is 
 not possible to lay down any rule for every- 
 thing depends on the kind of worry and the 
 predisposition of the mind. Whatever tends 
 to produce isolation of mind is the one great 
 antecedent condition to Neurasthenia. As 
 long as even the most unstable of minds 
 keeps itself among the crowd and is “ in and 
 of the world ”’ it is on safe ground and in the 
 most favourable state to regain any foot- 
 hold temporarily lost. In proportion as 
 you fail in contact with general humanity 
 you admit self to too large a share in 
 the common sense (common mind), every 
 day opening the door wider to the Ego till 
 at last it becomes master therein; and when 
 that is the case the most trivial of impres- 
 sions and ideas, as long as they have any 
 bearing on self, become magnified in im- 
 
 sg 
 
Byes iON COLLEGE: 
 
 Pett ene) y . y 
 CHESTNU i iii WASS 
 
 NEURASTHENIA re 
 
 portance until more or less everything that 
 takes place comes to be regarded as having 
 direct reference to self. This is the hermit 
 mind, and it is the mind of nearly all 
 Neurasthenics and of all Hysterics. I 
 have known a man of splendid physique 
 and accustomed to command rendered 
 so self-conscious by prolonged isolation 
 as to experience acute feelings of self- 
 abasement in passing chattering workmen 
 who were, as he imagined, engaged in 
 criticizing his appearance and motives. 
 Every reader who has suffered at all from 
 Neurasthenia will understand how such a 
 state of matters can come about. Most of 
 the men who pass as proud and distant are 
 sufferers from some form of Neurasthenia. 
 They feel their isolation keenly but have 
 become so abnormally sensitive that they 
 cannot face the only remedy, the health- 
 giving plunge into the great sea of humanity. 
 Yet this isolation, which has such painful 
 consequences, is rarely the fault of the 
 sufferer, for, exclusive of those in whom it is 
 engendered by the nature of their employ- 
 ment, it is usually the outcome of close 
 application to study and most men of letters 
 
42 MINDS IN DISTRESS 
 
 and science experience it to some degree. 
 / Uheir devotion to a special line of work 
 [ leads them unconsciously into the back- 
 \ waters of life, and thus we often observe 
 < that really great men are exceedingly 
 | shy and reserved simply because they are 
 neurasthenic, while the lesser fry, who have 
 as motto “‘ Ad majorem Mei gloriam,”’ and 
 ~self-advertisement as their object, tend to 
 Hysteria quite as often as to Neurasthenia 
 when their minds are off balance as a 
 / result of isolation. Thus Neurasthenia 
 has come to be viewed as the malady 
 -of superior intellect. ‘Spiritus altos 
 frangit et generosos,’”’ said old Burton, and 
 in truth its victims among the thoughtless 
 and uneducated are by comparison very 
 few. 
 - Strain and Stress must be reckoned among 
 the predisposing influences. Puberty and 
 the climacteric are the great natural periods 
 of strain, and, as we shall see, sexual 
 Neurasthenia is one of the most common 
 disorders of young and vigorous men, while 
 the many mental disturbances attending 
 puberty and the climacteric in women 
 assume, according to the type of mind of 
 
NEURASTHENIA 43 
 
 the sufferer, the form either of Neurasthenia 
 or of Hysteria. 
 
 Thus nerve weakness and mind weakness 
 are in their whole development course and 
 termination the very opposites of what we 
 see in the diseases that still, in borrowed 
 Greek garb, pass under their names, for 
 nervous weakness involves real prostration, 
 as you see in the worst stages of such acute 
 diseases as typhoid fever and pneumonia, 
 while mental weakness—Psychasthenia in a 
 literal sense—is the characteristic of ad- 
 vanced brain disease and of senility. The 
 Neurasthenic, using the term in our sense as 
 indicative of mental instability, will indeed 
 volubly assure you that he cannot stand 
 upright; that he falls down after walking a 
 few steps; that he cannot concentrate his 
 mind on work; that the labour even of 
 dressing himself is a formidable one; that 
 he cannot recollect sometimes the most 
 familiar names; in short, that his mind 
 is going if not actually gone; but if you 
 measure his total output of energy you will 
 always find it 7m excess of the average, but 
 extravagantly used, misdirected and dis- 
 sipated in irrelevancies of thought and 
 
44 MINDS IN DISTRESS 
 
 action, tangled and confused to such a 
 degree that endless patience and full know- 
 ledge of the individual and of his environ- 
 ment, and above all tact, are essential to the 
 adviser who would undertake the responsi- 
 bility of his direction. Is not the sufferer 
 also perverse? Yes, and adverse to such a 
 degree that a learned German has recently 
 issued a pamphlet on Neurasthenia and 
 kindred mental states, entitled Zur theorie 
 des Schizophrenen Negativismus. Schizo- 
 phrenic Negativism! What a name for the 
 negative attitude which, by the way, is, 
 under the circumstances, the only logical 
 one in Neurasthenia as seen from the 
 patient’s standpoint. Resting, as we are all 
 bound to do in unusual experiences, on the 
 best theory he could find, he has logically 
 built thereon a superstructure of disease, 
 ‘has generated by this mental bias many 
 symptoms which tend to confirm him in the 
 truth of his original theory, and, running 
 in such grooves, he is suddenly countered by 
 the blunt statement that he is altogether 
 wrong by a doctor who thinks to carry the 
 aforesaid strong position by a direct frontal 
 attack. Try such strategy on the one-idea 
 
 ~ 
 
NEURASTHENIA 45 
 
 man (the faddist) or on the doctrinaire socia- 
 list who dreams of a stable social balance, 
 not knowing that in individual mind as in 
 nations the very oscillations of the balance 
 are life itself, and you will find plenty of 
 Negativismus. No; if you are to prevail 
 with the settled Neurasthenic you cannot 
 expect often to succeed by a coup de matin 
 but must be content with some slower pro- 
 cess, such as that of “‘ running a parallel,” 
 after having first carefully mastered the 
 processes that have led to his present 
 state, and appraised the strength and dis- 
 position of the forces in opposition to you. 
 Let me give an instance of the use of such 
 a parallel. A man, about thirty, a noted 
 athlete, in perfect physical condition, in 
 low, solemn tones complained of Syphilis. 
 His conscience was clear but he had a pimple 
 on his leg which he pointed to as the seat 
 of infection. His physical strength was 
 his great asset and his mind always directed 
 toits maintenance. Having had to undergo 
 medical examination in view of some ap- 
 pointment, the examiner had remarked that 
 the pimple looked like the initial character- 
 istic papule of Syphilis. Mercurial treat- 
 
46 MINDS IN DISTRESS 
 
 ment was started, and, aided by self-sug- 
 gestion and vigorous skin friction with blue 
 ointment, an eczematous state of the skin 
 soon ensued. This, with other trivial symp- 
 toms, confirmed the patient in his fears. 
 It was impossible to shake them. I then 
 wrote on a piece of paper that I proposed to 
 deceive him, placed it in a sealed envelope 
 and gave it to a friend of the patient who 
 accompanied him, telling him to keep it and 
 return it to me unopened when I demanded 
 it. I then said to the patient: “A clear 
 case of rag-picker’s disease (anthrax), in- 
 fection probably arising from contamination 
 of your clothing in some country laundry; 
 if you read up the disease you will see that 
 I am right. You will get quite well.” In 
 the absence of the mercurial frictions the 
 eczema disappeared promptly, but a vigo- 
 rous cough (a minor symptom of rag-picker’s 
 disease) developed. In a month, when the 
 idea of Syphilis aroused only indignation in 
 the patient’s mind, I asked his friend to 
 hand me the sealed letter. The patient 
 read it and was delighted. He remained 
 well and readily forgave the innocent 
 deception. Was I not justified by my 
 
NEURASTHENIA 47 
 
 Hippocratic graduation oath, a paragraph 
 of which runs thus: ‘“‘ Et quoad potero, 
 omnia ad egrotorum corporis salutem 
 conducentia cum fide procuraturum ’’? 
 It is a characteristic of Neurasthenia 
 that the victims are generally in excellent 
 physical health. Organic disease is rare 
 even in inveterate cases, and when present 
 has no part in the production of the mental 
 complaint; a statement strictly true and 
 easily explained, for although the patient 
 is keenly concerned about his health, this 
 concern is concentrated only on such dis- 
 turbances of it as he cannot account for, and 
 in these only can his mind reach no condition 
 of equilibrium. Those which are visible, 
 tangible and comprehensible, such as the 
 organic diseases, not only does he meet with 
 ordinary courage but often with indifference. 
 Indeed, with the advent of organic disease 
 Neurasthenia and Hysteria take their tem- 
 porary departure, and so generally recog- 
 nized is this that I have several times 
 been asked by patients to inoculate them 
 with the microbe of some definite disease 
 because they preferred known dangers to 
 the ghosts and shadows of disease that 
 
48 MINDS IN DISTRESS 
 
 haunted their minds. Influenza is often 
 cited as an example to the contrary, but 
 that disease is itself often vague in its 
 symptoms and thus might legitimately come 
 under the heading of novel impressions that 
 are recognized causes of Neurasthenia; but, 
 as a fact, the muscular and nervous debility 
 that accompany and follow Influenza can 
 but rarely be justly styled a real Neuras- 
 thenia with its attendant bogies and multi- 
 form complications. 
 
 There is no more common disorder than 
 Neurasthenia, but it occurs so frequently 
 in mild and transient forms, and seems to 
 the victim so unreal and so inexplicable, 
 that he hesitates to consult his friends, or 
 even the doctors, and its existence is known 
 only to himself, for, strange as it may seem, 
 the Neurasthenic, later to haunt to his 
 detriment many consulting-rooms, at first 
 puts little faith in physic. There may be 
 several reasons for this. I speak with the ex- 
 perience of a sufferer from this malady from 
 thirteen to forty-one years of age, and of 
 one who up to twenty-six years of age spent 
 very considerable sums in fees, seeking relief 
 therefrom and with very unsatisfactory 
 
 
 
NEURASTHENIA 49 
 
 results. I longed to explain and to be under- 
 stood, but was barely listened to. The 
 diagnoses varied widely, from imagination, 
 whatever that might mean, and liver dis- 
 turbance, to incipient insanity, and the treat- 
 ment was uniformly one with tonics, such as 
 Strychnine, Quinine and Phosphorus, all of 
 which aggravated my symptoms. One 
 -only—and he a homceopath—gave me a 
 white crystalline powder, evidently, from 
 what I now know, a bromide, which did 
 relieve remarkably, but he demanded such 
 an extravagant sum for the prescription that 
 it was beyond my power to purchase it. In 
 the midst of my worst attacks I was always 
 in excellent general health and capable of 
 walking thirty milesaday. It left me finally 
 when I had the misfortune to be infected by 
 a hospital patient, on my right index finger, 
 with a severe and very chronic disease, and 
 I can truly say that the exchange of diseases 
 was a pleasant experience. 
 
 Many of the mild cases get well spontane- 
 ously, and even many of the severe ones pass 
 off quickly under the restorative effect of 
 the hard work that is required of most 
 
 men in this world. Some find the power to 
 4 
 
50 MINDS IN DISTRESS 
 
 endure it till it vanishes by some change in 
 their life or by some sudden adversity—for 
 adversity however great is tangible and 
 therefore steadies the mind. Courage and 
 fortitude are of enormous assistance in 
 recovery. 
 
 One charming old lady, for forty years 
 the re-elected head of a religious community, 
 gave me an account of the exceptionally 
 severe and prolonged sufferings she had 
 formerly endured. When I inquired as to 
 treatment she replied simply that being 
 the Will of God she had bowed to it and 
 gone ahead at her work. She had found the 
 philosopher’s stone. 
 
 So important is it for the patient to re- 
 member that in work, even severe work, 
 lies the best road to recovery, in all but a 
 very few cases, that I need offer no apology 
 for quoting one more individual experience. — 
 
 In 188— I had a severe attack; the feeling 
 of isolation from the rest of humanity, the 
 sense of “‘ unreality ” in surrounding objects 
 being most keen. The fear that I should 
 suddenly lose self-control was ever with me, 
 my special bogy being a fear lest I should 
 be forced against my will to commit suicide 
 
NEURASTHENIA 51 
 
 or some crime of violence. (To this obses- 
 sion of suicide is, I find, traceable the 
 popularity achieved by the safety razor.) 
 Like most sufferers I slept and ate well. 
 An eminent neurologist advised a walking 
 tour down the Loire. I went, and for the 
 three weeks it lasted suffered untold agonies, 
 often begging the friend who accompanied 
 me to place me safe in an asylum. I re- 
 turned to London looking ill and worried, 
 and was told by the same consultant to 
 take at least six months’ rest, and on no 
 account to return to practice. My assistant, 
 when informed of this, replied that I could 
 take that holiday only when I had seen a 
 number of people waiting to consult me. 
 The next ten days were days of almost cease- 
 less night and day work, but I was absolutely 
 well ere they passed and remained perfectly 
 free from any return for several years. 
 Nothing is more frequently seen in the 
 daily papers than the statement that severe 
 depression had preceded an attempt at 
 suicide, and the idea has become quite 
 general that neurasthenic states (nervous 
 breakdowns) may lead to a tragedy. No- 
 thing is further from the truth. Melan- 
 
52 MINDS IN DISTRESS 
 
 cholia, an insane state marked by delusions, 
 silence, and general mental torpor, is of 
 course a frequent precursor of suicide, 
 but Melancholia is the very opposite of 
 Neurasthenia, and of anything that can 
 legitimately come under the latter designa- 
 tion. To clear this point, in which I was 
 myself secretly interested, I made it a duty 
 to interview several people who had made 
 determined, but fortunately ineffectual, 
 efforts at self-destruction. Strange to say 
 all were, after recovery, willing to explain 
 their state antecedent to the attempt. 
 There were five such cases and in not one 
 had there been any prior fear of the act nor 
 any neurasthenic condition of mental suffer- 
 ing. Two said that they were dazed and 
 oppressed, and neither thought nor cared 
 about the consequence of their act; the 
 other three that the act seemed at the time 
 quite the most natural thing to do. I have 
 never known of a case in which Neurasthenia 
 or any allied condition led to self-destruction. 
 The fear of it in the Neurasthenic is indeed 
 keen but is the dread of a dread, though 
 when, as sometimes happens, some drug 
 habit has been contracted by the sufferer 
 
NEURASTHENIA 53 
 
 he may deliberately destroy himself. This 
 however is due to an unwise attempt to 
 suddenly and completely break the bonds 
 of drug slavery, and the consequent unen- 
 durable suffering, or to despair at his failure. 
 In Hysteria, as we shall see later on, the 
 drama of suicide is often enacted as a 
 comedy but may be overdone and end in 
 tragedy. | 
 
 The Bogy (or Obsession) in Neurasthenta.— 
 
 The most outstanding feature in Neuras- 
 
 thenia is the dogy (the phobia of the text- 
 books). Given an intimate knowledge of 
 the patient’s modes of thought and general 
 life, his bogy may be foretold with accuracy. 
 Nothing impresses a sufferer more than this 
 proof of the doctor’s foreknowledge. It is 
 arrived at very simply, for it represents, of 
 course, that which is most abhorrent to the 
 particular patient, being in its essence only 
 a supreme dread. The bogy represents 
 the theory (the counter-weight adopted 
 for purposes of mental balance) formed to 
 account for novel impressions and ideas of 
 which the causation is not apparent to the 
 mind, or some logical deduction from that 
 theory, and it always relates to self. Injury 
 
54 MINDS IN DISTRESS 
 
 to mind or body, to self-love or reputation 
 is the basis. The Bogy of insanity has its 
 source in forms of mental discomfort such 
 as the dream-like or fog-like sensation, or 
 the feeling of isolation, or the apparently 
 threatened loss of self-control and conse- 
 quent involuntary suicide or crime. One 
 form of train fear and ship fear is based on 
 this. The Bogy of sudden and violent death 
 is connected with fear of open or of confined 
 spaces, of water and of fire. The Bogy of 
 disease 1s not quite of the same class. 
 Suffering or disfiguration, and the risk 
 of becoming abhorrent to humanity, are 
 dreaded, but any fear of death in the ordi- 
 nary way is rarely acknowledged by Neu- 
 rasthenics, and, whatever be the disease to 
 which they eventually succumb, it must be 
 acknowledged that they meet death with 
 calmness, failing to realize that it can be 
 unaccompanied by the horrors which in 
 imagination they have attached to it. 
 One of the worst cases I ever attended—a 
 man who for years varied his bogy almost 
 every week though all had the fear of some 
 disease as foundation—when dying of dropsy 
 due to heart disease of old standing, loudly 
 
NEURASTHENIA 55 
 
 intermitted the remark, ‘That is d 
 nonsense,’ when the clergyman referred 
 to him in prayer by his bedside as “ our 
 dying brother.” The Bogy of injury to 
 self-esteem is at the bottom of that jealousy 
 which haunts some Neurasthenics even 
 while they carefully explain the baselessness 
 of the obsession which they cannot shake 
 off. The Bogy of loss of good repute is 
 often put in some one of the following 
 ‘ways: “‘Suppose I were to enter a rail- 
 way carriage and an old man were to 
 get in at the last moment and I were to 
 lose self-control and attack him. Imagine 
 my disgrace as a commercial traveller known 
 all down the line.”’ Or, “ Suppose a clerk in 
 my office happened to be in the Strand at 
 a moment that I turned round and that 
 he thought I was looking at a loose woman. 
 Imagine the ridicule at my place of busi- 
 ness.” - Or, “‘Suppose I, in a sudden loss 
 of self-control, put poison into a water- 
 bottle in a public waiting-room, and that 
 it killed someone, and that my act had been 
 observed. Imagine my situation as a pro- 
 minent member of the Bar.” Far-fetched 
 and absurd as such fears may seem to the 
 
 
 
56 MINDS IN DISTRESS 
 
 sound and healthy they are quite ordinary 
 forms of self-torment to men of intellect 
 and who are perfectly and absolutely sane 
 but Neurasthenic. 
 
 A large volume might be written solely 
 on the hues assumed by different bogies. 
 They are as various as the occupations and 
 minds of the sufferers, but never are they 
 in any sense of the word delusions but 
 always and only fears founded on theory. — 
 There is a special prominence given to the 
 numbers 3 and 7 by many neurasthenic 
 minds and which is difficult adequately to 
 account for, but the origin of the idea is 
 probably theological and based on the 
 Trinity, the seven mortal sins, and the 
 Seven cardinal virtues. 
 
 And here, for the relief of any Neurasthenic 
 reader, [ may answer a question often put 
 to me in great anxiety: “ But what would 
 happen to me if I actually lost my self- 
 control?’’ The answer is, an hysterical 
 paroxysm. The feminine mind, never 
 acutely concerned about consequences, 
 makes no effort, in the condition of strain 
 felt so acutely by neurasthenic masculine 
 minds, to inhibit or restrain itself, but simply 
 
 
 
NEURASTHENIA = 
 
 lets itself go and explodes in tears, shrieks 
 or muscular contortions before the stress 
 becomes unendurable, while the masculine 
 mind in Neurasthenia, dreading possible 
 disaster, or at least ridicule, keeps a firm 
 hand on its strange impulses and suffers 
 acutely in consequence. The feeling is like 
 that experienced in a trotting race when you 
 require all your muscular power to keep the 
 horse from breaking into a gallop and fear 
 every moment that he will overpower you. 
 
 I have more than once seen this state of 
 tension end in hysterical sobbings and con- 
 vulsions in emotional Neurasthenics, and 
 have remarked that it brought quick relief; 
 but one cannot recommend it in treatment 
 since self-control is a rare enough virtue 
 and one to be encouraged most of all in the 
 victims of such mental disequilibration as 
 we are discussing. 
 
 But-the reader must not conclude that all 
 cases of Neurasthenia or of Hysteria are 
 typical like those I have selected for illus- - 
 tration. In minds more or less com- 
 pounded in varying proportions of the 
 masculine and feminine types of mind 
 Neurasthenia and Hysteria may touch or 
 
58 MINDS IN DISTRESS 
 
 even overlap at certain points, but no two 
 disorders in pure mind types are in their 
 leading characters more distinct. 
 
 A clear and intimate knowledge of the un- 
 derlying causations and the many ramifica- 
 tions of Neurasthenia is essential to the man 
 who would treat the disease with success, 
 and only the doctor who has himself suffered 
 can fully understand the language of the 
 patient and appreciate the sufferings that 
 attend this, the most painful, and, in its 
 origin, the least understood of disorders. 
 
 
 
CHAPTER V 
 
 THE TREATMENT, ETC., OF 
 NEURASTHENIA 
 
 HE following are the essential points: 
 
 First and foremost, no time or pains 
 must be spared in obtaining a clear mental 
 picture of the patient, avoiding of course 
 all irrelevant details. A good plan is to 
 shut the eyes and to let the patient talk, 
 even if he consumes an hour or two in 
 the process. Nothing 1s unimportant. Ap- 
 parently trivial matters often furnish useful 
 guides. You thus obtain a map of the 
 disorder, and view its source, and all that 
 has contributed to its development. You 
 further note the points on which your attack 
 may be directed. 
 
 It is a mistake to stop the patient; let 
 him unburden himself and give, unchecked, 
 his opinions. By so doing you learn his 
 motives and his reasons and note the way in 
 which his mind naturally works, and as you 
 
 59 
 
60 MINDS IN DISTRESS 
 
 will have to work with him, it is essential 
 to obtain this knowledge so that your treat- 
 ment may commend itself to his judgment. 
 We must have no more Negativismus than 
 we can help. 
 
 Secondly, having pumped him quite dry, 
 a most careful physical examination must 
 be made and full notes thereof taken; no- 
 thing should be left out lest the omitted 
 part assume later on to the anxious patient’s 
 mind the probable place of origin of his 
 malady. Often in past days has the 
 patient said, ‘‘ You have taken no blood 
 for analysis,’ adding significantly, “I 
 think you will find the disease there.’ 
 Therefore, however apparent be the under- 
 lying cause of his complaint to yourself, 
 you cannot afford to skip any part of the 
 examination. 
 
 I always take my own specimens and 
 submit them to well-known skilled analysts, 
 and ask the patient to post them, allowing 
 the report to be sent direct to him if 
 any preference for that course be shown. 
 Neurasthenics, without meaning any offence, 
 are often very suspicious. 
 
 In three or four days, when the reports 
 
 
 
 4 
 ‘ 
 7 
 7 
 q 
 
NEURASTHENIA 61 
 
 have come in and been considered, I ask the 
 patient to call and hand him my written 
 opinion. 
 
 This written opinion—with the reasons 
 on which each conclusion is based—is the 
 keynote of treatment. It shows the 
 patient that you are sure of yourself, and 
 in the present day, with our many aids to 
 diagnosis, a careful man is fully justified in 
 self-confidence. This document is a great 
 stay to the patient in the moments that are 
 sure to come when old doubts will reappear. 
 I have had proof of its efficacy in the many 
 cases in which the decided tone of the 
 opinion has alone kept the patient to the 
 line of safety when verbal advice had faded. 
 One lady indeed thus reproached me: 
 “Why didn’t you write that letter at first 
 instead of saying, ‘In my opinion you will 
 get well.’’”’ Even long after they have re- 
 covered patients will keep such a letter and 
 feel a security against relapse in its occasional 
 reperusal. 
 
 Thirdly, deal with the Bogy. To: fore- 
 tell the bogy to the patient is to rob it of 
 much of its importance and appearance of 
 solidity. But though you may thus sap 
 
62 MINDS IN DISTRESS 
 
 its credit you must not at once proceed to a 
 direct attack on its person. On the con- 
 trary, sometimes you must run a counter- 
 attraction, a rival; sometimes you may 
 pull the bogy to pieces bit by bit, or again 
 you may dig the ground from under it. 
 Charge it in the open, as hypnotists so 
 often do, and you will come off a very bad 
 second, and you cannot afford any reverse. 
 Many cases of Neurasthenia are of a very 
 chronic type and in them the bogy may 
 be too firmly “set”’ to yield to any of the 
 aforesaid measures. In these I find great 
 help from an “ Infallible.’’ Now an Infallible 
 is a medicine that cures without being taken, 
 a formula of great mental potency, but com- 
 posed of real drugs capable of actually and 
 really displacing the enemy, but which it 
 would be unadvisable for the patient to 
 take regularly. Therefore the prescription 
 is marked “‘ Emergency only,” and is care- 
 fully guarded by the verbal direction: 
 “Take a dose of this only if you feel that 
 you have come to your last ditch.” Now 
 the typical Neurasthenic, being an anxious 
 man, says to himself in an emergency: “I 
 will not take this medicine lest it should 
 
 
 
NEURASTHENIA 63 
 
 injureme. The doctor told me that, though 
 certain in effect, it was a little risky by reason 
 of its potency.” Or again: “If I take a 
 dose and it fail my last hope will be gone, 
 I will reserve it for a still worse attack;”’ 
 and one peculiarity of all crises in which 
 the bogy plays the principal part is that 
 they cease just before they become absolutely 
 insupportable. The following will illustrate 
 this point. A friend and patient agreed to 
 undertake, by my strong advice, a voyage 
 to Japan, but though in excellent physical 
 health—despite a stay for months in various 
 northern nursing homes which had converted 
 a passing Neurasthenia, to which he was 
 subject, into a confirmed state of auto- 
 suggestion with threatening paralysis as 
 the bogy—he was most nervous about 
 leaving London. He was given an Infallible 
 with the usual directions, and on returning 
 to England he placed the bottle, still sealed, 
 on my mantelpiece with the remark: “‘ That 
 medicine cured me though I never drew the 
 cork.” 
 
 Fourthly, work must be insisted on. A 
 man’s usual occupation, if it be at all con- 
 genial to him, and if it provide abundant 
 
64 MINDS IN DISTRESS 
 
 means of meeting and conversing with his 
 fellows, is the best. It should be of a kind 
 that, once started, means compulsory regu- 
 larity and attention. All other measures 
 will fail until you have secured this essential 
 to success. In nine cases out of ten it is the 
 only treatment necessary. Of course you 
 will find it hard to persuade the patient to 
 this salutary course. He will object, ‘ You 
 make me well and I will return to work,” 
 putting the cart before the horse; or, “I 
 shall die if I work,” but ‘‘I will work if I 
 die,” is the view that you must insist on. 
 The benefit of work is so obvious that one 
 is puzzled to account for the “rest cure’”’ 
 fad unless it arise from a refusal of battle for 
 the sake of the adviser’s peace and quiet. 
 Eminent writers from the dawn of litera- 
 ture, most of them sufferers, are absolutely 
 unanimous on the benefit of work in all 
 neurasthenic states. ‘“‘In idleness alone 
 is there perpetual despair,’ said Carlyle. 
 Galen called idleness “‘ Maximum animi 
 nocumentum.” ‘“‘ This body of ours, when 
 it is idle and knows not how to bestow itself, 
 macerates and vexes itself with cares, griefs, 
 false fears, discontents and suspicions, and 
 
 
 
NEURASTHENIA 65 
 
 is never at rest,” adds Burton, and one 
 might continue similar quotations ad 
 infinitum. 
 
 You may very occasionally meet a Neu- 
 rasthenic who may need rest for some good 
 reason, and rest will usually fatten, but for 
 the vast majority whose minds are only 
 - disorientated, and who are free from any 
 organic disease that could benefit by such 
 measures, rest is absolutely the one thing to 
 be avoided, the one condition, especially 
 if combined with isolation, that may be 
 relied on to seriously aggravate their state. 
 For those whose only occupation in life is 
 the so-called pursuit of pleasure, who ignore 
 that pleasure depends little on externals, 
 and is in any case restricted to narrow limits 
 of capacity in man, and that games, hobbies 
 and foreign travel are but poor substitutes 
 for regular work, for such the outlook in 
 Neurasthenia is a serious one. 
 
 Truisms indeed, but how often forgotten! 
 
 Fifthly, seek out the ambition latent 
 in all of us. The patient at his first inter- 
 view will give the clue, and it is for the doctor 
 to make of it a lever. But “a stout heart 
 for a stiff brae,’’ and the patient must creep 
 
 5 
 
66 MINDS IN DISTRESS 
 
 to the goal of his special desire if he cannot 
 run; he must at once get a move on in any 
 case. Most of us know by experience how 
 small the prize when it is won, but we all 
 remember how useful was the spur of hope 
 that kept us to the way. More neglected 
 truisms! 
 
 Sixthly. Under this heading we may 
 place all other agents. Of these Hypnotism 
 is but suggestion “ writ large,’ and on sug- 
 gestion in some form reliance must be placed 
 throughout all the treatment of Neuras- 
 thenia. In my experience it is rarely 
 wise or even useful to place the patient 
 under full hypnotic influence ; suggestions 
 implanted in the trance state never long 
 survive the awakening, for their impression 
 is not on the conscious mind. They are like 
 branches carelessly tied, not grafted, to a 
 tree trunk and they early wither. Marvel- 
 lous results were ascribed to Hypnotism by 
 Dr Charcot in the old days at La Salpétriére, 
 but the disease was Hysteria, and the innate 
 tendency of the Hysteric to take a leading 
 part in any function was forgotten, and, as 
 recognized later on when the patients overdid 
 the game, the doctors were either the victims 
 
 
 
NEURASTHENIA 67 
 
 of deception, or failed, as I think, to fully 
 interpret the phenomena. 
 
 Food as an agent may be of great utility, 
 especially where the original disturbing im- 
 pressions are located in some one of the 
 digestive organs. In them the results of a 
 reduced dietary are most gratifying. My 
 rule, in such cases, is to reduce nourishment 
 to the point at which the weight, if a fairly 
 normal one, can just be maintained. Ifthe 
 patient be obese, weight should be taken off 
 by a graduated dietary, plus exercises; the 
 latter never to be omitted from the plan. 
 For the Neurasthenic in good physical con- 
 dition, and over thirty years of age, two 
 meals a day—a good breakfast and a good 
 late dinner—usually suffice. For the first 
 fortnight a few sandwiches or biscuits and a 
 cup of black coffee may be allowed at mid- 
 day. If there be present active dyspeptic 
 symptoms, half a pint of very hot and weak 
 China tea (boiling water poured on a closed 
 infusing-spoon till a pale shade of the fluid 
 is produced, when the spoon is withdrawn) 
 with a slice of lemon may advantageously 
 be ordered at Ir a.m. and 5p.m. It is as 
 efficient as, and much more agreeable than, 
 
68 MINDS IN DISTRESS 
 
 the plain hot water usually advised. Maté 
 
 may be substituted for the China tea. 
 Indian teas, unless very fine, are not 
 good, and milk and sugar as additions 
 are anathema to all real tea-lovers. 
 
 Yet, since you-should never—oppose a 
 Neurasthenic\if you can honestly meet him, 
 and as many are shocked at the idea of but 
 two simple meals a day, so often have they 
 been assured of the benefits of “ feeding 
 up,’ you must now and then have re- 
 course to a diet fad, and when you have to 
 reduce the amount of food Vegetarianism 
 is the best system to select. There is no 
 food system that can be good—or even 
 safe—for every one and everywhere, and I 
 do not promiscuously advise Vegetarianism, 
 but in suitable cases I must confess that I 
 have seen great and durable benefit from its 
 adoption, not only in nervous disorders but 
 in gout, dyspepsia, rheumatism and many 
 other diseases. Its effect, when beneficial, 
 is chiefly due in my opinion to simple all- 
 round reduction in the amount of food 
 assimilated, for chemical analysis abund- 
 antly proves that, until the digestive organs 
 can accommodate themselves to the altered 
 
 
 
NEURASTHENIA 69 
 
 circumstances, much of the vegetable 
 material eaten (satisfactory as seems the 
 chemistry of its elements on paper) is 
 thrown off by the bowel. Incidentally this 
 makes for regularity of evacuation. Like 
 all other reduced food systems it tends to 
 lessen the desire for alcohol and the craving 
 for tobacco, and a few glasses of good light 
 
 wine and half a dozen cigarettes a day should | 
 be the limit in Neurasthenia. No novel” 
 food system, least of all the ones that restrict 
 their votaries to fruits or to meat, should 
 ever be undertaken unless some instructed 
 and responsible person be taken as judge 
 of its effects, for all abstinence and fasting 
 so clear the mind, and the result is so cheer- 
 ing and delightful, that actual damage to 
 bodily health may easily ensue ere the 
 patient be aware of his danger. Tuber-~ 
 culosis is a special risk in this connection. | 
 Persons who speak of drugs as if they be- 
 longed to some special order in nature, 
 marked off by definite lines from foods, are 
 misinformed. No such water-tight com- 
 partments are known to chemistry; neither 
 is there any standard of health by relation 
 to which substances can be classed as good 
 
70 MINDS IN DISTRESS 
 
 or bad. That only is beneficial which ade- 
 quately supplies a need in the particular 
 person. Even such things as common salt, 
 oxygen or ozone, are deadly poisons when 
 used in excess. Thus drugs whose full 
 action is known have their use in certain 
 eventualities, if not employed merely to 
 mask a symptom at the expense of possible 
 subsequent mischief. 
 
 Mental exercises are during the course of 
 an attack very useful, but they should, as 
 formal exercises, be stopped directly the 
 patient has got over his attack, for our minds 
 are so constituted that strict affirmations 
 readily call up a negative picture. I wel- 
 come the recent rise in London of a school 
 of mental exercise and mind culture, for the 
 benefits to be expected of wise schooling in 
 concentration and regulation of thought are 
 of incalculable value to the community in 
 general, and to business and professional 
 men in particular; even the general physical 
 health may be improved thereby. 
 
 The mental exercises of use in Neuras- 
 thenia are of a very simple order and should 
 consist in a series of practical resolutions, 
 said out loud, with the mind concentrated 
 
 
 
NEURASTHENIA a1 
 
 on the thoughts, each morning when at 
 rest. Thus, “I will get up at 8 am., I 
 will breakfast at 9,” and so on with the 
 simple duties of the day, and a quarter of an 
 hour should be devoted, in quietude, each 
 evening to a review of the result attained. 
 Space prevents me from giving more than 
 an outline of a system that, simple as it is, 
 if faithfully carried out, is productive of 
 much good. Life is thereby regularized 
 and habit soon makes such regularity easy 
 and natural. 
 
 Finally, there is one most important point. 
 It is always foolish for anyone to make 
 health a subject of concern, for discussions 
 about disease may by suggestion produce 
 actual disorder. In Neurasthenia it is 
 specially pernicious, and the patient must 
 be put on his honour not to consult doctors, 
 to read medical books, suggestive advertise- 
 ments, or even articles on health in the press, 
 and he must learn to check, and expel 
 resolutely from his mind, any doubts, or even 
 any thoughts, about his own health. The 
 physician must lend his aid in the same 
 direction, and, unless under special circum- 
 stances, should not see the patient after his 
 
-3 MINDS IN DISTRESS 
 
 written opinion with full directions has been 
 given for at least six weeks or longer, and 
 then only on condition that the simple 
 measures advised shall have all been fairly 
 observed. Any difficulty that may arise 
 in the interval is best dealt with by letter. 
 The one aim of all treatment should be to 
 make the patient independent of the doctor, 
 and no cure is worthy the name that does 
 not secure this end. 
 
 ‘ Sexual Neurasthenia.—The matter is so 
 important, and in some of its aspects so mis- 
 understood, and moreover sexual Neuras- 
 thenia itself gives such a perfect example 
 of the origin and growth of all Neurasthenic 
 states, that I need little excuse for making 
 brief reference to the subject. 
 
 We all know that boys at the impression- 
 able age at which they attend school are 
 apt to be mentally contaminated by evil 
 companionship; the boy himself being un- 
 aware of the consequences that will ensue 
 later on when he wakes to the full conscious- 
 ness of life—at from twenty to twenty-six 
 years of age. At that age, under the strain 
 of indoor work and of the natural perturba- 
 tions that attend on the development of a 
 
 
 
 itil iii ee atl al i 
 
 — = = 
 
NEURASTHENIA 73 
 
 function in its meaning more racial than 
 individual, he becomes listless and self- - 
 centred, and in that state may incidentally 
 drop across some quack advertisement or 
 some specious book that, under the benign 
 guise of giving advice to young men, hides 
 the most damnable attempts on his health 
 and purse. Insanity, brain softening, con- 
 sumption, fits, and especially a failure or Joss 
 of virility are, according to the writers, but 
 a few of the dire consequences of certain bad 
 habits. All lies! for the habits referred to, 
 objectionable as they are, have no power to 
 produce any of these consequences, and 
 beyond abasing the youth unduly in his 
 own estimation, and at the worst producing 
 a transient and easily-curable local hyper- 
 sensitiveness and some functional disturb- 
 ance of the sympathetic nervous system, 
 do no harm whatever. 
 
 But sexual Neurasthenia has been started, 
 and though any experienced doctor could 
 readily prove to the sufferer that neither 
 physical disease nor insanity are even 
 possible consequences of his acts, yet the 
 impeachment of his virility makes a bogy 
 hard to overcome. Any practical test is 
 
74 MINDS IN DISTRESS 
 
 out of the question, and if tried would, by 
 reason of the nervous doubts implanted, 
 probably fail, and thus confirm the prognosis 
 of the quack and establish the bogy more 
 firmly in hisseat. Nor is it easy to reassure 
 the patient, even when his local symptoms 
 have been cured, to his entire satisfaction. 
 Rigid censorship must, of course, be estab- 
 lished over evil thoughts, a regime which, 
 hard at first, is found, if persevered in, to 
 be attainable; while everything that may 
 prove suggestive must be taboo. These 
 measures may re-establish the sufferer in his 
 own estimation, but the question of loss of 
 virility will often remain behind to rankle 
 in the breast, and break out anew into 
 a blaze of fear if and when marriage is 
 contemplated. The mind of the sufferer, 
 long the seat of sensuality, takes quite an 
 erroneous view of the aims and duties of 
 matrimony, and, being unable to realize the 
 picture of a pure and simple love, free of even - 
 the knowledge or thought of evil, still less of 
 desire, pictures the future bride as a sensual 
 ogress to be appeased. In many cases the 
 neurasthenic man, knowing little of woman’s 
 instinctive nature, has not even the wisdom 
 
 
 
NEURASTHENIA 75 
 
 to keep his fears to himself, and the wife be- 
 comes distressed by her husband’s nervous- 
 ness, the foundation of which she cannot 
 fathom. Fortunately, in the worst cases, 
 those that do not get well of themselves, a 
 doctor, by his knowledge of the innate 
 negativism of Neurasthenia, and by appli- 
 cation thereof in merely forbidding any 
 attempt for a month and by taking the 
 wife into his confidence, can secure a satis- 
 factory result. In justice I should add 
 that the foregoing condition of matters 
 may arise in any neurotic man and with- 
 out any antecedent evil practices at all. 
 
 If the doctor knows of the bogy in 
 advance he may forestall its evil machi- 
 nations as the following case will show. 
 
 A gentleman in perfect physical health 
 but in a very neurasthenic state consulted 
 me. It was many years ago and I had not 
 learnt then what I now know. He sug- 
 gested for six weeks prior to his marriage a 
 daily subcutaneous injection of strychnine 
 as a tonic, and I fell in with his views. All 
 seemed to go well till a few hours before the 
 ceremony, when he came to me in a state of 
 such extreme nervousness that I feared he 
 
76 MINDS IN DISTRESS 
 
 would never face the marriage at all. At 
 my wits’ end I said, “‘ Well, in any case you 
 had better have the last injection.” He 
 consented, with supreme indifference and 
 in profound gloom. My last tabloid of 
 strychnine was gone, and, doubting the 
 wisdom of informing him of the fact lest 
 thereby I should increase his fears, I dis- 
 solved a tabloid of 5th grain of morphia and 
 injected it. The dose was, I knew, too 
 small to do any harm, but I had no fore- 
 knowledge of the actual result. He came 
 in boisterously to see me some weeks later 
 and remarked, ‘I don’t know what you 
 gave me but I would have married forty 
 women that morning if necessary.” 
 
 Then it dawned on me that a sedative 
 was what he had all along wanted; not an 
 excitant such as strychnine. The morphia 
 simply allayed all doubts, and, as he was 
 quite unaccustomed to the drug, the effect 
 lasted for two or three days. 
 
 Such is sexual Neurasthenia, the most 
 typical and amenable to cure of all the 
 varieties if once it be treated reasonably, 
 but it must be remembered that every local 
 functional disorder must be always put to 
 
 
 
RS wes 
 
 NEURASTHENIA 77 
 
 rights before the mental state will yield to 
 any treatment. 
 
 General Considerations in the Treatment of 
 all Cases of Neurasthenia.—Complete sym- 
 pathy and understanding between doctor 
 and patient must exist in any successful 
 treatment of Neurasthenia. In fact, the 
 doctor must be the confidant and trusted 
 friend of the sufferer, and, by his accu- 
 rate memory of details and his readiness 
 to respond by letter to any query, prove 
 that he is keeping the patient and his 
 difficulties ever before his mind’s eye. A 
 mental state in the patient must be met by 
 the exercise of mental faculties on the side 
 of the adviser. Frequent interviews, as I 
 have elsewhere said, are never advisable, 
 and as a practical physician I have often 
 recognized the evil effect, in all sickness, of 
 unnecessary visits and their bad influence 
 in leading a doctor, at the call of some in- 
 sistent but unimportant symptom, to depart 
 from that strict line of treatment which a 
 first careful examination of the patient has 
 determined as the path towards cure. In 
 Neurasthenia the patient is abnormally 
 observant and critical in his study of the 
 
78 MINDS IN DISTRESS 
 
 physician’s character and knowledge, and 
 brusqueness, so often adopted as the cloak 
 of ignorance, will raise opposition, ridicule 
 and contempt in the patient’s mind; 
 while the “ Cheer up, old fellow” attitude 
 must be justly condemned as foolish. In 
 Neurasthenia it is definitely the first step 
 that counts, and if it be a false one the 
 patient may be landed on the slope of 
 a terrible descent. We have all met 
 chronic and now hopeless cases of this 
 disease in which honest but faulty methods 
 adopted in the early treatment have been 
 responsible for the final disaster. I could 
 name several now living who still hug the 
 bogy of a paralysis that has never materi- 
 alized, and who, like the nervous lady look- 
 ing under the bed for the burglar, daily 
 search for signs of its coming, and, incredible 
 as it may sound, one of them was urged to 
 give up a prosperous, active life and devote 
 himself to “‘a garden in the suburbs,” be- 
 cause one day, for some unaccountable 
 reason, he felt a dread in passing a certain 
 house; another, a prosperous dentist, be- 
 cause several times he had felt anxious about 
 his breathing if more than three people 
 
 
 
eee 
 
 NEURASTHENIA 79 
 
 were together in a room; while a third, 
 formerly an active city merchant, was 
 condemned because he developed, by way 
 of bogy, an unreasonable fear of bank- 
 ruptcy and the workhouse; all specimens, 
 as every Neurasthenic knows, of the most 
 ordinary obsessions, which would have 
 passed away in the active work of life, but 
 were now rooted and nourished by constant 
 self-analysis in the only occupation, ‘‘ com- 
 plete rest,’ advised by some indifferent or 
 thoughtless doctor who suggested insanity 
 as the probable consequence of perseverance 
 inwork. Now thatitis too late these people 
 are miserably sane, occupied only with self- 
 study and the discussion of fancied griev- 
 ances ; for let us remember that to the active 
 mind rest is impossible, and that, in default 
 of larger interests with which to concern 
 itself, it will turn over and over—magni- 
 fying im the process—the most trivial 
 concerns of a small household. Even the 
 comparative mercies of insanity, with the 
 oblivion of its fixed but false balance, is 
 denied to these poor sufferers. 
 
 I admit, of course, that there are rare 
 instances in which, for very special reasons, 
 
80 MINDS IN DISTRESS 
 
 rest may legitimately be advised in the early 
 stages of Neurasthenia, and I know that 
 certain organic brain diseases, in their be- 
 ginnings, may present symptoms that can 
 sometimes be mistaken for functional mental 
 disorder, z.e., for a mere loss of balance. As 
 a young man I made such mistakes myself 
 and have seen others make them, but the 
 early symptoms of such organic diseases 
 as general paralysis of the insane and ~ 
 disseminated cerebro-spinal sclerosis, very, 
 very, rarely take the form of Neurasthenia, 
 
 for the loss of balance which they simulate 
 
 is that which is characteristic of the wider 
 disturbance seen in the disordered feminine 
 mind; namely, Hysteria. 
 
 
 
CHAPTER VI 
 HYSTERIA 
 
 t.é., loss of balance in the feminine type of mind 
 Part I.—A Stupy oF THE FEMININE TYPE oF MIND 
 
 F Neurasthenia be an inappropriate word 
 
 to denote disequilibration in the masculine 
 type of mind, what shall we say of Hysteria 
 as adapted to the same phenomenon in the 
 feminine one, for its very derivation denotes 
 womb disorder pure and simple, though men 
 of the Latin race are frequently the sufferers 
 from an advanced form of it, and it is by no 
 means uncommon, though usually in a milder 
 variety, among males in the United States 
 and in Great Britain. But we have practi- 
 cally no choice of names for the vast symp- 
 tom-complex with which we have to deal is 
 known all the world over only as Hysteria. 
 
 I gave in my third chapter a brief sketch 
 of the feminine type of mind. Volumes 
 would be required to do full justice to it, 
 
 and behind these volumes would have to 
 6 81 
 
82 MINDS IN DISTRESS 
 
 be a mind of wide comprehension and great 
 impartiality, stored with a varied experience 
 of the most intimate sides of humanity. 
 Therefore, if my description falls short, I 
 fail in large company and because of my 
 necessary limitations. 
 
 That mind is in a sense represented in 
 the brain there can be no doubt. How it 
 is represented, what is the relationship be- 
 tween the two, no one can say, though there 
 is scarcely a philosopher that has not con- 
 sidered himself within touch of the answer, 
 and the physiologist of my younger days 
 felt sure that he possessed a simple and 
 complete one. A clearer day has dawned 
 and the modern man of science confesses 
 that he can but state, to quote almost his 
 identical words, that in some way mind 
 makes matter, and that, from what to us is 
 the void, a function calls for an organ and 
 the necessary organ, adapted to the desir- 
 
 able function, is made: that physiology ~ 
 
 makes anatomy and not vice versa. It is 
 the old “ Fiat Lux” coming into its own 
 again. 
 
 But these altitudes concern us little; 
 what we have to understand is that accord- 
 
 
 
 - 4 A) = 
 
HYSTERIA 83 
 
 ing to accurate observations certain portions 
 of the brain act as transmitters of certain 
 functions of the mind, that in general the 
 cortex or upper segment of the cerebral 
 hemispheres acts thus with regard to the 
 reasoning faculties and the lower segment 
 with what is called the subconscious or 
 subliminal mind; not that we need attach 
 any special value in this connection to the 
 word reason, nor underrate the subcon- 
 scious position of the mind because its 
 pred-a-terre is the lower brain segment, for 
 it is the seat of the emotions, of the wonder- 
 ful and incomprehensible instincts and of 
 genius. 
 
 The feminine type of mind occupies a 
 much greater area of the brain than does 
 the masculine, and presumably that is the 
 explanation of its wider range, its greater 
 capacity and its relative incomprehensi- 
 bility ; -but it has the defects of its qualities, 
 and in that lies its weakness. More rarely 
 do we find a perfect feminine type, and far 
 more often, because its complexity implies 
 greater tendency to instability, do we find 
 complete freedom from some disturbance; 
 for it is a rule throughout nature that the 
 
84 MINDS IN DISTRESS 
 
 greater the complexity the greater the in- 
 stability, the tendency on slightly adverse 
 conditions to larger disturbance, and thus it 
 happens that the feminine type of mind, 
 though higher in facility and more extensive 
 in its powers than the masculine, is but 
 rarely seen in perfection; that imperfect 
 types are the rule, and the imperfections 
 more glaring to view and more numerous 
 and more disastrous in effect than such as 
 follow on imperfect forms of the masculine 
 type. It is easy to sum up all the possible 
 disabilities and failures of the latter; those 
 of the former are as numerous as are its 
 varieties of normal function. No region of 
 the body, and not one of its functions, is 
 safe from perversion when the feminine mind 
 loses its hold over balance; not even what 
 are known as the automatic and reflex 
 powers are safe from interference. Per- 
 mutations and combinations, to use a mathe- 
 matical term, are then the rule of the day. 
 
 I do not propose to treat you to a com- 
 pendium of the many strange efforts that 
 have been made to define Hysteria, some 
 of them extravagant and all conflicting. 
 What is to be said of the unconscious 
 
 7 
 
Sr &® iv 
 
 CHESTN: 
 
 HYSTERIA 85 
 
 humorist who, defining woman as an 
 “organism revolving around a womb,” 
 proceeds gravely to show how the orbit 
 may be disturbed by pathological uterine 
 states; or of his colleagues who assert that 
 the functions of the womb are “ strictly 
 mechanical,” and that it is certain outlying 
 nerve centres that are answerable, by radia- 
 tion, for all evil consequences; or of the 
 grave physician who thinks he has really 
 solved the whole problem when he calls 
 Hysteria “‘an explosion,’ but deigns to 
 add, out of charity for weaklings or pos- 
 sibly scoffers, ‘‘ Nature having no outlet for 
 superfluous energies, the whole system be- 
 comes disordered ”’ ; or again, of the Viennese 
 professor who finds the solution in the 
 “sundering of consciousness,” as if ideas 
 were tied like faggots into bundles; or of 
 the American professor who sagely re- 
 marks, “‘ Hysteria is essentially a psychosis 
 as distinguished from Neurasthenia, which 
 is a neurosis,” precisely, just as the world is 
 not a spinning globe but a globe that is 
 spinning. In one matter they all agree, 
 namely, in an equal anxiety about the 
 pathology. Now pathology is a resultant, 
 
— 
 
 86 MINDS IN DISTRESS 
 
 a physical change, not the process that 
 instigated it. It is asif the pilot, neglecting 
 navigation and the law of storms, and refus- 
 ing to apply his mind to anything but to 
 defects, spent his time exclusively in 
 examining his craft for signs of damage 
 and refused to take any measures of pre- 
 caution in times of danger till he had dis- 
 covered them, and ascribed some crowning 
 disaster solely to the started planks or the 
 rusty bolts previously found, or, failing such, 
 adopted the theory of an explosion. 
 
 One of the medical philosophers, however, 
 puts his finger on a very sore place. When 
 speaking of the so-called ‘“‘neuromimesis”’ 
 in Hysteria, he very pertinently asks: “ How 
 can memory set up a disease it has never 
 seen? The disease (Hysteria) must be in 
 psychic centres, but unconsciously; possibly 
 a disease of cesthesodic cells of the cerebral 
 hemispheres.” The least critical of readers 
 
 will rub his eyes. Memory of course is out — 
 
 of the question and must be dismissed, with 
 costs against the writer, from the suit; as 
 for disease being existent in a psychic 
 centre, disease a post hoc existing as an 
 ante hoc and in a psychic centre, 7.¢., in an 
 
 . 
 
HYSTERIA 87 
 
 abstraction! I give the quotation as a use- 
 ful and very bad example of the false coin 
 that finds currency in some circles. There 
 is no real mystery at all, and the answer is 
 extremely simple. Hysteria, being a loss 
 of balance in the feminine type of mind, 
 is a disorder of the whole brain, of the 
 whole mind, and will therefore involve 
 any or every function and throw any or. 
 every organ of the body upon the de- 
 fensive; for functional disorder (the only 
 kind in which Hysteria develops itself) is, 
 as translated by its symptoms, but the 
 natural effort made by any organ, for the 
 sake of the maintenance of the general bodily 
 equilibrium of health, to keep itself to the 
 point of due co-operation with all other 
 organs. That is why we may have any 
 and every functional disorder in Hysteria. 
 The difficulties of the medical casuists are 
 easily solved if studied on the ordinary 
 principles of science and if we free our- 
 selves from the tyranny of theory-begging 
 words. It brings to mind the nursery 
 couplet— 
 
 “QO what a tangled web we weave 
 When first we practise to deceive ”— 
 
88 MINDS IN DISTRESS 
 
 but without, of course, ascribing to anyone 
 voluntary deception. Real science concerns 
 herself with simplification, not with com- 
 plication, and in keeping to simple lines we 
 shall save ourselves many a self-deception. 
 Disorder and disturbance in any and every 
 function of the body is what we then reason- 
 ably expect, and what we get, in every case 
 of Hysteria, while as to the form and kind 
 it will assume that will depend upon the 
 individual patient’s special bent of mind and 
 upon surrounding circumstances: it may be 
 blindness, deafness or muteness; loss of the 
 power to move by will any one or more of 
 the voluntary muscles and thus take the 
 shape of a motor paralysis; or, leaving 
 movement unimpaired, we may have the 
 symptoms of a sensory paralysis, loss of the 
 sense of touch, of temperature, of weight or 
 of pain confined to a limb or a portion of a 
 limb, or scattered promiscuously over the 
 whole body; or we may have spasmodic 
 contractions or absolute rigidities, dis- 
 colorations or blanching of the skin, wasting 
 due to local nutritional interferences, con- 
 vulsions that may be quite partial, unilateral 
 or general; or perversions of function may 
 
 
 
HYSTERIA 89 
 
 be a prominent feature and the secretions of 
 various organs may be altered in different 
 Ways; or, again, the will-power may ex- 
 tend its accustomed sway and obtain 
 partial control over the usually automatic 
 and reflex powers; or, strangest of all, 
 psychic phenomena of a marvellous order 
 may develop, in which the mind may seem 
 to project itself, to partially disengage itself 
 from its physical basis in the brain, as we 
 see in certain spiritualistic performances, 
 the best mediums for which are those that 
 are endowed with a feminine type of mind, 
 whatever their sex. That the absence of 
 light is an essential to success in these 
 demonstrations does not, in itself, prove 
 them to be the result of imposture, conscious 
 or unconscious, for it is possible that light 
 may have some definite and intimate re- 
 lationship to mind. While many of the 
 demonstrations I have seen have been be- 
 yond my powers of explanation, I have 
 witnessed none that I could assert were 
 decisively superhuman or due to agencies 
 other than of the human order, while the 
 constant and irritating intermixture of 
 most phenomena with imposture—pro- 
 
90 MINDS IN DISTRESS 
 
 bably not wilful in many cases—tends to 
 confirm the candid observer in his views as 
 to their dependence on subconscious human 
 agency, for were it otherwise the question ‘4 
 would arise: Why spoil a genuine and 
 wonderful manifestation of psychic power 
 by imposture unless you accept the theory ; 
 that evil and lying infra-human spirits take 
 a Puck-like part in the game, careless of the 
 
 loss of credit involved in the adoption of 
 such devices? 
 
 As a strictly impartial critic I can only 
 regard spiritualistic manifestations as ex- 
 cellent examples of a _ feebly-developed 
 feminine mind-type in a state of disorder, 
 induced, as disorder in all of that type 
 can easily be induced, by self-suggestion 
 or by the suggestions of place, time and 
 other minds. The audience, the dramatic 
 setting and the suggestion are the three 
 essentials in all hysterical as in all spiri- 
 tualistic performances, and the reason of ~ 
 this is to be found in a special develop- 
 ment of the Ego, the self, which, as we 
 found when dealing with Neurasthenia, is 
 also the chief factor in the long series of 
 trouble in that complaint. Why should 
 
 
 
HYSTERIA gt 
 
 the mental isolation form of this exag- 
 geration of the self be productive of so 
 much mischief? It is a practical matter 
 and sufficiently important to demand our 
 notice. 
 
 The Ego.—We know experimentally that 
 in certain animal communities there is such 
 a perfect unity of purpose as regards the 
 well-being of the society and the perpetua- 
 tion of the race that the life of the individual 
 is if necessary sacrificed, without com- 
 punction, to those ends. We may take the 
 bees and ants as examples of such perfect 
 communes, and, as is well known, you cannot 
 long keep an isolated individual, separated 
 from his society, alive and well, however 
 favourable be the environment you may 
 arrange. When itis a question of gregarious 
 animals living in moderate-sized flocks and 
 with a more restricted community sense, 
 such as the parrots, starlings and other 
 flock-forming birds, you may indeed rear 
 a single individual if captured while young, 
 but failure often ensues, and in any case, if 
 the captive be liberated after even a short 
 confinement, he is not again received into 
 the flock. Even in animals, then, a certain 
 
92 MINDS IN DISTRESS 
 
 ‘ 
 
 development of what I call the “ common 
 mind’ is seen under most conditions of 
 life in common, and the animal that would 
 live a happy normal life, or indeed any life 
 at all, has to subordinate his Ego to the 
 general mind of his community, which 
 latter acts in some of the most mate- 
 rial affairs of life,, such, for instance, as 
 migration in birds, and the formation of 
 regular armies for attack, or even for a 
 deliberate campaign, as in the ants, with 
 one purpose as one mind. For this and 
 other good reasons we may conclude that 
 animals possess the same kind of mind, 
 but of course much smaller in amount 
 and more restricted in its range of ideas, 
 as ourselves, and that therefore such of 
 them as live habitually only in flocks and 
 herds each possess a common mind (a 
 share of the community mind), as well as 
 a purely individual one. If isolation be 
 then obviously in some way harmful to them 
 we can readily understand that it will lead 
 to far greater mischief in the human item 
 of our modern communities, and indeed we 
 actually witness among ourselves the same 
 phenomena as in animals, namely the ex- 
 
 
 
HYSTERIA | 93 
 
 pulsion from society of individuals that do 
 not conform to its general spirit, such as 
 criminals, tramps, beggars and loafers, who 
 are often free from intentional and deliberate 
 desire to be bad and often possess many ex- 
 cellent individual qualities. These examples 
 of this our human jetsam, as Lombroso and 
 others who have closely studied them show, 
 develop, after expulsion, a progressively 
 anti-social spirit, becoming mentally more 
 and more abnormal; though it is well to 
 remark that in spite of their habits and 
 unfavourable surroundings they do not in 
 undue proportion become insane. Among 
 the well-to-do and those fed and maintained 
 by Christian charity an over-cultivation 
 of the self leads to a similar perversion of 
 the common mind (the latter then contain- 
 ing in its elements too large a proportion of 
 the Ego), and, unless this is checked by the 
 freest association in work and active com- 
 petition, it necessarily becomes more and 
 more perverted until the Ego occupies the 
 whole mind when mental isolation is com- 
 plete and severe forms of Hysteria develop. 
 It is true the public rarely come across such 
 individuals, for they are kept sedulously 
 
94 MINDS IN DISTRESS 
 
 from view by sensitive and kind friends 
 and relations, and only doctors know from 
 experience in what large numbers they 
 exist. 
 
 In the active masculine type of mind, 
 a type limited almost strictly to conscious 
 functions, this isolation is also keenly felt, 
 and forms, as we saw in a previous chapter, 
 its chief distress, and just because it is so 
 keenly appreciated the fear of insanity is the 
 commonest of the theories (bogies) based 
 thereupon; but in the feminine type, with 
 its far wider basis of consciousness, instinct 
 and other powers, its relation to a far larger 
 area of brain, consciousness plays a much less 
 conspicuous part, and not only is no bogy 
 formed, and upon it no salutary dread which 
 may act as a drag on her downward path 
 superadded, but the patient has little or 
 no saving sense of isolation and even no 
 knowledge of many of her actions. The 
 hysteric cannot inhibit because one must, 
 of course, be conscious of an impending 
 action before one can take any seme to 
 prevent it. 
 
 Keeping then clearly in mind the normally 
 wide range of the feminine mind-type, its 
 
 is] 
 » hen ee eed Pes 
 
HYSTERIA 95 
 
 complexity and consequent tendency to 
 instability, and knowing that it is subject, 
 like the other type, to the same law of 
 balance between its two parts (the individual 
 and the common mind or common sense) 
 for the maintenance of mental health and of 
 mental comfort, we begin to understand how 
 important it is that its possessor should above 
 all things be brought up in surroundings 
 that will secure the widest and freest human 
 intercourse and contact with the outside 
 world; that all the great principles of religion 
 and morals which are fixed and serve as a 
 final court of appeal within us should be 
 early implanted and which, as founded on 
 love, are readily absorbed by the feminine 
 mind; that, in short, each and every of the 
 faculties and instincts should be so de- 
 veloped that the individual, at the period 
 of his or her real entry into the society of 
 the world, should possess a well-stocked 
 and wholesome common sense (common 
 mind) fitted to deal with every ordinary 
 and likely impression and idea, 1.e., with 
 every item of the individual portion of 
 the mind that may be brought to its 
 notice. 
 
96 MINDS IN DISTRESS 
 
 Given a reasonably good heredity a 
 feminine mind, thus wisely educated, will 
 present to the world the very highest 
 attainable type of mental development, 
 a range of vision, a clearness of faith, a 
 conception and love of ideals, a rapidity 
 of perception, a breadth of judgment, a 
 love and appreciation of the beautiful; all 
 under the control of a reasoning power not 
 slavishly tied to material possessions, never 
 accepting the narrow and practical as the 
 only view but beautifying by idealizing 
 even the most carnal and sensual of our 
 appetites. ‘‘ A little lower than the angels ”’ 
 may this orderly type of the perfect feminine 
 mind be styled; while, by way of contrast 
 and comparison, it is hard to say more than 
 “a little higher than the brute ’”’ of many of 
 the pure specimens of the masculine mind, 
 which, beyond some perfection of the 
 mathematical faculty in its application to 
 money, a certain regularity of action de- 
 pendent on the same faculty, and a per- 
 tinacity and fidelity which it shares un- 
 equally with the bull-dog, has little or 
 nothing to distinguish it from the higher 
 animals, with which indeed, with much 
 
 
 
HYSTERIA 97 
 
 persistence, it claims a distant relation- 
 ship. 
 
 Please remember the absence of any sex 
 line. Most men who achieve renown and 
 inspire affection and respect, and all men 
 of fine character, brilliancy or genius, 
 have, if not the perfect feminine type of 
 mind, a large admixture of it, whilst the 
 comparative absence of masculine charac- 
 teristics in the great majority of women 
 is often discounted in our admiration and 
 respect by a conspicuous weakness in some 
 of the best attributes that belong exclusively 
 to the feminine mind-type, and as the fall is 
 greater the consequences are more evident 
 and more deplorable. 
 
 And the great enemy to the formation of 
 the perfect mind being in both types the 
 Ego, and as woman by her very position in 
 society, by the ingrained habit of centuries, 
 by her surroundings, by suggestion ever 
 ringing in her ears, and above all by her 
 restriction to self-adornment in sexual com- 
 petition, is by every artificial and natural 
 means provoked to its magnification, it 
 can be no matter for surprise if she thereby 
 comes frequently to grief, 
 
98 MINDS IN DISTRESS 
 
 But apart from her special environment 
 there are in women other causes at work 
 that gravely endanger her mental stability. 
 The question of mental balance is simple 
 in aman; he has, as arule, only his reasoning 
 powers to bring into line with his individual 
 propensities, but in the woman you have 
 deep instincts firmly implanted in her 
 that call for gratification. Take but the 
 principal one, the maternity instinct, with 
 all that it implies of unselfish love of 
 the helpless, of a comfortable home of 
 which she is mistress, of the companion- 
 ship of, and reliance on, a mate. Here you 
 have indeed a weight on one side of the 
 balance, and if you cannot find the natural 
 counterpoise, the gratification of the in- 
 stinct, you will have indeed a hard task to 
 find anything to put in place of it. The 
 problem is complicated by the fact that 
 being an instinct the possessor of it is un- 
 conscious, or but half conscious, of its pos- 
 session and influence and cannot therefore 
 readily help herself. 
 
 It would be easy to name other mental 
 faculties, all instinctive in their character, 
 that also frequently complicate the main- 
 
 
 
HYSTERIA 99 
 
 tenance of balance in the feminine type of 
 mind in both sexes. 
 
 The problem of balance therefore in the 
 feminine type of mind, and in those persons 
 whose mental constitution contains a con- 
 siderable admixture of it, is one that calls for 
 the most careful thought. 
 
 The great point is to understand it and 
 in your calculations to adequately allow for 
 it. Otherwise, you may very often be 
 faced with a problem that seems insoluble, 
 and may be tempted in a feeble manner to 
 imitate the octopus in emptying your ink 
 bag the better to conceal your discomfiture 
 and retreat. 
 
 The better to obtain a clear picture of the 
 situation it will be instructive to devote a 
 short space to the effects, in other depart- 
 ments of life than medicine, of the mis- 
 understandings and false situations that 
 arise from the habit, dear to the masculine 
 mind, of translating all phenomena, mental 
 and physical, in terms of himself, and it 
 must be remembered that this one-sided and 
 false point of view is the outcome of the 
 fact that, by reason of its concentration on 
 the practical and material sides of life, the 
 
100 MINDS IN DISTRESS 
 
 masculine type has obtained the control | 
 
 of all the great political, legal and scientific 
 systems and therefore holds at its sole 
 discretion all the coercive powers, the mili- 
 tary, naval and police, and most of the 
 scientific, and a large share of the literary 
 powers of the day. 
 
 Its standards are therefore the usually- 
 accepted standards in all civil and military 
 concerns, and, though it cannot bring under 
 its dominion the spiritual side of man, it is 
 engaged in an incessant warfare with it. 
 Selecting from religion only those maxims, 
 such as justice and truth, and, with one 
 eye on the voting booths, the material 
 side of charity, which suit its purpose and 
 act as pillars and foundations to its plan, 
 it rejects the wider spiritual view of 
 charity, the real and original and only 
 strict meaning of the term, the love of God 
 and in the second place of your neighbour 
 because he is a creature of God, so perverts 
 this virtue into a_ socio-politico-material 
 monstrosity that takes form in the work- 
 house, the relieving officer and the hospital, 
 that truth, shrouding her keenest hits in 
 proverbial form, has been provoked to the 
 
 
 
 ae tal le A ee bt 
 
 
 
HYSTERIA IOI 
 
 satirical expression ‘‘as cold as charity.” 
 The pure masculine type of mind with its 
 one talent, reason, but reason carefully 
 restricted in definition to its purely mathe- 
 matical side in argument and its material 
 possessions and powers in evidence, puts an 
 unrelenting heel on every opponent, on 
 every advocate of wider, and presumably 
 higher, conceptions, runs the world and 
 throws a none too loving eye on the older 
 universities that are rightly suspected of 
 harbouring, in their theological and philo- 
 sophical faculties, a spirit of wider range 
 and establishing, as rivals to them, mere 
 examining institutions, and, when these are 
 discredited, modern universities in industrial 
 centres, in which it fondly hopes that the 
 material and the practical may hold almost 
 undisputed sway. 
 
 Because so much higher in constitution 
 and so much more prone to disintegration, 
 because so much more individual in 
 character and so much weaker in combina- 
 tion, the feminine mind-type, where mere 
 counting of heads decides the day, can make 
 but a poor fight, and while she pricks the 
 thick hide of the enemy with her keen rapier 
 
102 MINDS IN DISTRESS 
 
 of wit and satire, and holds him up to public 
 ridicule by her subtlety of discernment, 
 cannot secure the reins of power and there- 
 fore prove her capacity to mend the rents 
 and tears in the garment of society. Have 
 we not at the present moment three excel- 
 lent examples of this strife of mind-types 
 in the political and religious arenas! The 
 Celt in Ireland, and even after years of 
 residence in other lands, loathed and de- 
 spised the material system adopted by 
 England in her desire to assist him, just as 
 he loathed her materialistic religion with its 
 soup-kitchens and other venal temptations 
 in times of famine, and, not comprehending 
 the type of masculine mind that honestly 
 considers the material as the only valuable 
 and real, suspected all her best and purest 
 motives, exalting above England’s first 
 statesmen the most gaseous degenerate of 
 her own feminine type, provided he had 
 wit and a certain speciousness; selecting 
 often out of pure malice those which in her 
 heart she least esteemed to represent her 
 in Parliament so only that they might prove 
 sharp thorns in the side of her enemy. But 
 now that Irish self-government is within 
 
HYSTERIA 103 
 
 sight the loudest threats are not heard from 
 her feminine lips but from the masculine 
 type resident in the North, who fear-— 
 perhaps without real cause — an attack 
 on their money-bags and possessions, and 
 yet Home Rule, if secured for Ireland, 
 will have been done so only by her re- 
 presentatives having at length seen the 
 wisdom of silence and of copying the 
 ways and means of political success of 
 
 Englishmen, typical of the purely mas- 
 culine line of action: practical, practical, 
 practical! ! 
 
 And the Suffragist movement supplies an 
 equally good and similar example. Like 
 the Irish, the women in this country had a 
 strong case in their demand that the feminine 
 mind-type should be allowed some share in 
 
 _ ruling the land they inhabited, and who shall 
 justly grudge them some satisfaction of this 
 claim when we remember how patiently they 
 bore with the deprivation until the real dan- 
 ger to them of an extended male franchise, 
 with its influx of low-class masculine type in 
 large numbers, arose. Then woman spoke, 
 but, like the Celt, quickly perceived that 
 mere protest would secure no rapid success 
 
1o4 MINDS IN DISTRESS 
 
 and that her chance might be gone for many 
 years if the male franchise were extended 
 ere she secured the vote. Then she made 
 the same mistake as the Celt. Instead of 
 proceeding in the way that alone carries 
 weight with the masculine mind, by silent 
 combination and by strictly - reasoned 
 speeches, she bubbled over and lost control 
 of her more degenerate or less-balanced 
 colleagues, always, as I have said, a large 
 class in the feminine type, and emotion in its 
 wilder forms and action of the most dis- 
 orderly character, precisely as in the Irish 
 situation, assumed that prominence loved by - 
 the hysterical, who cares nothing for its 
 disastrous effect on a cause sustainable by 
 many valid arguments and making a strong 
 appeal to fair play, provided she is only 
 well in the limelight. And the religious 
 world furnishes us with a last parallel. 
 Fifty years ago the Church of England was 
 sunk in a lazy indifference, when her sleep 
 was broken in upon by that truly feminine 
 spirit, the ritualist movement, which taunted 
 her with her betrayal of the real Christian 
 spirit, parading before her indignant eyes 
 some of the beautiful symbolic ceremony of 
 
HYSTERIA 105 
 
 pre-Reformation days, reminding her in- 
 sistently that her rubrics claimed continuity 
 with the early and medizval Church full of 
 spirituality and self-denial, and lastly— 
 worst cut of all—demonstrated, by the 
 example of high-minded, self-sacrificing and 
 devoted men, that higher ideals were still, 
 as ever, capable of reaching and influencing 
 for good the most hopeless and heart-broken 
 of the human dust heap, and that poverty, 
 humility and charity were more ennobling 
 to the character than respectability and 
 material possessions though located in the 
 seats of the mighty. Even the Bashi- 
 Bazouks of the campaign, who, as in the 
 Irish and Suffragist movements, were of 
 course early on the scene and did much to 
 embarrass it by their hysterical antics and 
 their unrestrained language, could not arrest 
 its current, which has now attained such 
 _ volume.as to sweep nearly all that represents 
 the old masculine type of mind in the Church 
 of England away. And the result has not 
 been what was confidently predicted of it, 
 a splitting up of the Church, but rather a re- 
 welding together of an old fabric that was 
 tending by neglect to fall into ruin, a 
 
106 MINDS IN DISTRESS 
 
 rebreathing of a better spirit into dry 
 bones. 
 
 Personally I may be allowed to explain 
 that I am by conviction a strong anti in 
 regard to the questions of Home Rule, Female 
 Suffrage and Anglicanism in any shape, but 
 this does not hinder me from fairly stating 
 the pro-case as I conceive it, conscious as 
 I am that the Almighty Dollar and the mere 
 gratification of our senses, our present chief 
 standards of success, are unworthy and base, 
 and hoping that, by a fresh infusion of mind, 
 our ideals may be elevated and a wider and 
 a better outlook secured for humanity; and 
 we may be fortified in the face of possible 
 fears by what science and philosophy tell 
 us, that all the phenomena of life and 
 nature are but the pieces of a puzzle partly 
 broken up and rearranged by successive 
 generations as new facts are discovered 
 and wider combinations attained, and 
 that each reconstructed puzzle is con- 
 fidently viewed as the one real and final 
 solution. 
 
 I have endeavoured to give in a pictorial 
 way an idea of the feminine mind-type, 
 and if only the reader can gather from my 
 
 
 
HYSTERIA 107 
 
 description of its many and elusive elements 
 a fair general conception of its whole he will 
 find the study of its derangements, which 
 has puzzled many, quite easy to follow and 
 to comprehend. 
 
CHAPTER VII 
 HYSTERIA 
 
 z.c., the loss of balance in the feminine type of mind 
 
 Part II].—TuE SYMPTOMS AND TREATMENT OF 
 HYSTERIA 
 
 Special predisposing influences in the production of 
 Hysteria 
 HESE may all be grouped under two 
 headings, which for simplicity I will 
 call the exalted Ego, meaning thereby all 
 that tends to over-cultivation of self, and 
 the starved instinct, which includes all 
 checks to the proper gratification of normal 
 instincts, for such are the two great under- 
 lying causes of every hysterical development. 
 
 We must, however, also make allowance 
 for three different types of feminine mind 
 commonly met with, which we may thus 
 classify: 
 
 (1) The pure feninine mind-type. Though 
 occasionally men, and very charming ones, 
 fall, under this heading, it contains, as we 
 should expect, a high percentage of women, 
 
 and may therefore be spoken of in the femi- 
 108 
 
 
 
HYSTERIA 109 
 
 nine gender. Femininity is apparent in all 
 her works and ways; she is a real “‘ female 
 woman ”’ ever and everywhere. 
 
 (2) The weak feminine mind-type, a pro- 
 duct often of unstable mental heredity, in 
 which the balance is visibly unsteady. 
 Many men belong to this class. 
 
 (3) The med type, having many pro- 
 perties of the masculine mind. The ordi- 
 nary Englishwoman and the business French 
 and Belgian woman may be regarded as 
 fair examples of it. 
 
 Now each one of these three classes will 
 react very differently in similar circum- 
 stance. The first will be stable in her very 
 instability, exhibiting in ordinary life, by 
 the active play of her emotions, the oscilla- 
 tions of a sensitive balance tending to re- 
 equilibration ; but under gross and prolonged 
 mismanagement, or under some severe or 
 sudden check to some one of her deep in- 
 stincts, such as love, may be expected to 
 exhibit the widest functional perversions, 
 the most perfect example of the disorder in 
 its fullest range, the Hysteria major or 
 malignant Hysteria of the text - books, 
 The second type, a very large one, weak from 
 

 
 IIO MINDS IN DISTRESS 
 
 the start, and reacting to the ordinary 
 stimuli of life always abnormally ; essentially 
 unstable during her whole life, excitable, 
 weakly emotional, selfish, indolent, unless 
 goaded to exertion by the lure of self- 
 gratification; always ailing and sick because 
 her various organs, for want of regularized 
 nerve control, are ever at fault in their 
 functional duties; receptive to any idea 
 that can titivate her emotions, throwing 
 herself literally into each new movement in 
 which she sees a new mental stimulant; 
 unable to be straightforward but exaggerat- 
 ing and colouring her every statement, un- 
 reliable and untruthful; of shallow intellect 
 but often smart and quick by fits and starts, 
 she forms the backbone of every anti-move- 
 ment, of every fad, of every new system, and 
 specially delights in those that have a trace 
 of sexual piquancy. We are all familiar 
 with the type, and most of all can re- 
 cognize it at a glance by certain physical 
 characteristics. It is from this type that 
 the largest number of Hysterics arerecruited ; 
 they do not often rise to great heights even 
 in this disorder but are rarely for long free 
 altogether from some taint of it. The 
 
HYSTERIA III 
 
 third type comprises the great bulk of 
 ordinary middle and lower-class English- 
 women, slow in thought, safe from temp- 
 tation because void of imagination, adopt- 
 ing the current standards without concern 
 for any great principles, unambitious and 
 docile, good mothers, and generally pattern 
 Wives, steady and, above all, reliable be- 
 cause mentally the most stable of the three 
 types. In this class may be ranged quite 
 a considerable number of males who, under 
 the stimulus of a wider life than that of 
 women, exhibit often artistic taste and skill 
 of a high order. It is the women belonging 
 to this class who alone of their sex are fitted 
 to battle with the world and compete with 
 men in the duties of life that call for steady 
 application to uninteresting and routine 
 work, and unless under the sense of grave 
 disappointment, or handicapped by the times 
 of stress that belong specially to their sex, 
 they rarely fall victims to any serious form 
 of Hysteria. In all women the menstrual 
 cycle tends somewhat to lower the standard 
 of stability, though too much of this has 
 been made as a factor, and indeed it is open 
 to question whether its effect has not been 
 
112 MINDS IN DISTRESS 
 
 increased by the attention paid to it by 
 the medical profession and by the quite 
 unnecessary precautions recommended at 
 such times in the case of the average woman. 
 The same applies to puberty and the 
 climacteric. If women were left more alone 
 in these matters, and only the real organic 
 diseases treated when necessary by surgical 
 procedure, as is the case with men, it is 
 certain that, beyond those blights of frus- 
 trated maternal function called fibroid 
 tumours, and the disorders which follow 
 on infections, that the law should do more to 
 render impossible, a long list of disorders 
 peculiar to women would disappear from 
 the world. An immense improvement in 
 this respect has taken place within my 
 memory, but superstitions die hard and 
 many a woman’s life is still wrecked by her 
 attention being wrongly concentrated on 
 the sexual apparatus, and the result is seen 
 in the Nemesis that waits on self-concentra- 
 tion—Hysteria. She does not become im- 
 moral, but morbid. The most scathing con- 
 demnation of such malpractice I have ever 
 heard came from the lips of one of thegreatest 
 medical experts in this special department 
 
 
 
HYSTERIA 113 
 
 at the present day. Too much so-called 
 sexual physiology as a subject of instruction 
 for young girls is also to be strongly depre- 
 cated as tending in the same direction, and 
 one has only to read the advertisement 
 columns, especially of some of the pseudo- 
 religious prints of the day, tosee that there 
 are, as we saw was the case in young men, 
 plenty of vampires ready to magnify a 
 function into a mystery and to batten on 
 this special form of anxiety, though the 
 Book which they expcund with so much 
 unction wisely refers the sex to “the law 
 of her mother and the covenant of her 
 God”’ as the surest of guides. 
 
 Hysteria: What it 1s and what it 1s not.— 
 Emotion, even if it appear to the more 
 phlegmatic to be in excess, is not Hysteria, 
 for in many persons of both sexes who are 
 perfectly stable, the natural outlet to the 
 strain of adverse circumstances takes the 
 form of tears, sobs, prolonged laughter, 
 tremors and other muscular actions, flushing 
 or great volubility. Nor under great pro- 
 vocation should a convulsion, or even a 
 succession of them, be thus branded but be 
 read as a physiological effort to restore the 
 
 8 
 
114 MINDS IN DISTRESS 
 
 mental equilibrium on the natural lines of 
 least resistance and proof only of a healthy 
 tendency in a sensitive nature even if they 
 occasionally pass beyond voluntary control ; 
 for there is no fixed boundary in Nature 
 between health and functional disorder, the 
 first is physiology in normal circumstances, 
 the second physiology in abnormal ones, and 
 both have one common goal, the mainte- 
 nance of life. But nevertheless we shall be 
 safe in adopting as a general rule that all 
 symptoms beyond our conscious and volun- 
 tary self-control are those of disease and 
 apply this rule to Hysteria. 
 
 The Symptoms of Hysteria.—The feminine 
 mind-type being in its fullest development 
 co-relative with the whole brain, the signs 
 and evidence of its disorder will be co- 
 terminous with the body, each organ whereof 
 is represented in some part of the brain by a 
 centre of direction. The list of symptoms 
 will be therefore necessarily a very extensive 
 one, and, to prevent confusion, the best plan 
 will be to consider in broad groups the main 
 psychical functions and give instances of 
 their perversions. 
 
 The higher brain is of course an artificial 
 
HYSTERIA 115 
 
 division, for we have no certain data on 
 which to found any strict boundaries, but 
 we may understand by the term that part 
 of the brain that is en rapport with conscious 
 thought. Perversions of consciousness are 
 very common in Hysteria, and indeed it may 
 be said that every case of real Hysteria 
 involves some impairment of it, and the 
 interesting and often-debated question there- 
 fore presents itself: Are Hysterics fully re- 
 sponsible for their thoughts and apparently 
 voluntary actions? And the answer is: 
 Control of them is always weak and often 
 apparently wanting. The same is true 
 of their memory regarding them. Then 
 is not Hysteria a form of Insanity? The 
 dividing line in bad cases is a fine one, but 
 there is such a line, and if you carefully 
 study a severe case you will find that the 
 mental balance is never in Hysteria “ off 
 the pivot,” as in Insanity, and that the oscil- 
 lations, though so vigorous and rapid as 
 scarcely to be followed by the observer, are 
 nevertheless present and, though they lack 
 rhythm and equality, are, as always, sure 
 evidence that the jeopardized balance is still 
 in working order. And one of the best 
 
116 MINDS IN DISTRESS 
 
 proofs of this fact is that recovery may take 
 place quite suddenly even in the most violent 
 of attacks, a phenomenon never seen—or 
 seen so very rarely as not to invalidate the 
 rule—in Insanity. There therefore always re- 
 mains in Hysteria some control power in the 
 higher mind, some consciousness and some 
 memory, however dim, and even in those 
 cases in which the Psyche, as it is called, is 
 split up, when each hemisphere of the brain 
 appears to act independently of the other, 
 and when the patient asserts that each half 
 constitutes an entirely independent self, you 
 will, on careful examination, find proof of 
 it. I knew some twenty years ago a lady 
 who while talking, reciting or playing could 
 simultaneously write a good and original 
 essay on any selected subject, and this with- 
 out looking at the writing hand, which did 
 its work equally well on a pad placed on or 
 under the table at which this lady was seated. 
 She said that the writing was beyond her 
 control. Much of it was emotional and 
 foolish, and parts distinctly obscene, showing 
 that some of the lower instinctive mental 
 faculties were at work. One manuscript 
 was a false and lurid account of a parturition 
 
 
 
HYSTERIA 117 
 
 (the lady was young, single and of blameless 
 life), with illustrations of terrible hooked 
 instruments with spear points; the whole 
 production very realistic. When I sug- 
 gested that circlets should be added to 
 complete the picture, a series of large con- 
 necting rings was automatically added. 
 This patient also claimed the power to throw 
 herself into a cataleptic state, and in that 
 condition to be able to send her soul on 
 errands of inquiry into the past and future. 
 The result of any information thus obtained 
 consisted only of vague generalities that 
 might fit almost any case, or be adapted to 
 it, no clearer details in the way of a test for 
 truth being ever obtainable. One could 
 not fail to remark how eagerly even intelli- 
 gent members of the audience sought to 
 adapt the predictions and statements to 
 themselves or their friends, and how un- 
 popular it was to be critical. This lady did 
 not use her powers for purposes of making 
 money and only for the kudos it brought 
 her. 
 
 I have also frequently witnessed in 
 hysterical persons instances of pseudo- 
 double personality, two very opposite 
 
118 MINDS IN DISTRESS 
 
 voles in life being played in succession, 
 but this was never the real dual person- 
 ality of psychic forms of Epilepsy, for 
 the patient could always be recalled to 
 her former self promptly by some simple 
 means. 
 
 In cataleptic states the appearance of 
 the patient may be so changed as to be 
 scarcely recognizable. Generally there is 
 great pallor, with large immovable pupils, a 
 cadaveric rigidity of the facial muscles with 
 slowing of the heart and the respirations; 
 in fact, both the latter may appear to 
 be on the point of cessation. All the 
 vital functions seem lowered, and one 
 can well understand how long periods 
 of fasting with but slight diminution of 
 weight are possible in these mental 
 states. 
 
 The results of these exhibitions on the 
 patient herself are harmful, and the tendency 
 to instability increases markedly by repeti- 
 tion, so that at last a look, a word, or ten 
 drops of Indian hemp in water, is sufficient 
 to induce the scene. We cannot, however, 
 linger over this very interesting subject, 
 instances of which are of common occurrence 
 
 
 
 
 
HYSTERIA 119 
 
 and objects of surprise to non-medical and 
 wonder-seeking onlookers; yet even the 
 most sympathetic of observers cannot help 
 being often shocked by what must seem to 
 be intentional deception so unwisely and 
 unnecessarily added to phenomena re- 
 markable enough in themselves and they 
 naturally ask the question: “‘ Why this moral 
 obliquity? May not the whole demonstra- 
 tion have been carefully studied and re- 
 hearsed with the sole view to deception? ”’ 
 The correct answer is to be probably found 
 in a study of the mental equation (see 
 Chapter IX), and in the conscious resist- 
 ance to some one of the moral faculties 
 having fallen with a corresponding rise in 
 others, and to view the matter thus pictori- 
 ally will help us to visualize what other- 
 wise could be expressed only in abstract 
 terms. It gives us a percept instead of a 
 concept. 
 
 The middle brain, again a division not 
 meant to be anatomical, the ped-a-terre 
 of the subconscious or subliminal mind, 
 the seat of the instincts and the habits, 
 sometimes called the ‘“‘ acquired reflexes,”’ 
 next concerns us, and a host of dis- 
 
120 MINDS IN DISTRESS 
 
 orders of many shades is rendered pos- 
 sible by its perversions from the normal. 
 In comparison with the higher brain it is 
 subject in health to fewer oscillations, for 
 the impressions it directly receives are less 
 in number. The sexual instinct, which in 
 women is mainly maternal in hue, shows 
 curious and sometimes revolting alterations, 
 but of such a matter it suffices us to say that 
 their direction is not towards open vice 
 but to psychical exaltations of the sex in- 
 stinct, with which certain practices are some- 
 times combined, and in connection with 
 which we may often acquit the victim of 
 any knowledge of conscious wrong. The 
 perverted maternity instinct is seen in an 
 extreme devotion to animals, or even to 
 inanimate objects, and in the various ways 
 of “mothering,” in a weak, silly manner 
 and productive of little good, the heathen, the 
 drunkard, and especially the vicious who are 
 its objects, often harming them and bring- 
 ing ridicule upon otherwise lofty causes. 
 Other instincts, such as the artistic, may 
 undergo similar aberration with deteriora- 
 tion or improvement in ability, and I have 
 known a mere dauber become converted 
 
 
 
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 epee See dete Pe A eS 
 
 “¥ begs? 
 
 an) nl ee 
 
HYSTERIA 121 
 
 into a painter of considerable taste and merit 
 when suffering from a severe general form of 
 Hysteria. There is practically no limit to 
 the strange phenomena that may be seen 
 when this same subconscious mind is per- 
 turbed. It may then throw to the surface 
 words, expressions and conceptions that 
 lay buried therein, or make its oscillations 
 the basis—as I have explained in Chapter 
 ViI—of endless mimicries of disease. The 
 habits or acquired reflexes exhibit a like 
 disorder and may be broken up, combined 
 in fantastic fashion, or, for the time being, 
 obliterated; the methodical man or woman 
 may become careless of time and place,— 
 night as the time of wakefulness and activity 
 ' may be substituted for day—and a confirmed 
 smoker, or even opium-eater, may absolutely 
 forget the existence of these narcotics. I 
 have known instances of all. There is no 
 _ hard-and-fast line in Hysteria as there are no 
 real frontiers in the brain, and all sorts and 
 varieties of disorder may be mingled to- 
 gether in one single hysterical individual, 
 the conscious mind, as I have said, being 
 always one of the parties to it. Occasion- 
 ally, however, what may look like isolated 
 
122 MINDS IN DISTRESS 
 
 hysterical symptoms appear, and these are 
 always the most puzzling to the physician. 
 I can recall a highly-emotional man who 
 had the “ gift of tongues.” If he met with 
 opposition in any cherished design, or were 
 influenced by suggestion in any form, he 
 would forthwith deliver himself of a stream 
 of gibberish which varied on each occasion 
 and had a specious resemblance to language, 
 by the emphasis and modulation given to 
 parts of it. He would argue in it or preach 
 in it. It contained many Latin and Greek 
 words, and yet he professed an entire ignor- 
 ance of both those tongues. He was not 
 insane, and explained the process by saying 
 that he felt an irresistible impulse to act 
 as he did, but his flow of speech could 
 always be arrested by loud laughter or 
 ridicule from his audience, or by any 
 sudden and, to him, impressive incident. 
 Eventually he lost the “ gift,” but was 
 left with an impulse to it, which he could 
 restrain, whenever anything upset him 
 gravely. He was always a copious shedder 
 of tears on the least provocation, and 
 equally on occasions of joy, sorrow or 
 anger. 
 
HYSTERIA 123 
 
 The lower brain and spinal cord and 
 sympathetic centres, that are in psychic re- 
 lationship with the function of organs and 
 their secretions and excretions, with the 
 control of the blood supply, the many 
 functions of the skin, the rhythmic move- 
 ments of the heart and lungs, and the peris- 
 taltic movement of the intestines, make up 
 our last grouping. Disturbances by excess 
 or diminution may occur in any one or more 
 of them, and may be restricted to them or 
 accompanied by evidences of Hysteria in 
 higher centres. Perhaps an example best 
 appreciated by the laity is seen in the case 
 of the liver. I knew an hysterical woman 
 who in any opposition to her special form 
 of self-esteem invariably developed jaundice, 
 and not only was the output of bile into the 
 bowel brought to a standstill but the actual 
 amount secreted by the liver was much 
 reduced. Another lady, who nourished 
 herself on the sympathies that attach to 
 invalidism, told me that her heart was so 
 weak that the ascent of the smallest hill 
 brought on palpitation and irregular action, 
 and this was, as I found, an actual result. 
 One day I took her after dark up a hill, the 
 
124 MINDS IN DISTRESS 
 
 slope of which was obscured by the darkness 
 and conversation, and her heart remained 
 quite unaffected, but when told of the ruse 
 next day it became at once so disordered 
 that her friends requested me, for the sake 
 of their own comfort, not again to try such 
 an experiment. I have seen a sharp attack 
 of spasmodic asthma follow immediately 
 on a wound to the self-love. Great exaggera- 
 tion of the muscular reflexes is a general 
 accompaniment of Hysteria, but again they 
 may be decreased almost to the point of 
 extinction. Great dilatation of the pupils 
 of the eye and failure of reflex response to 
 light or distance are not unfrequently seen, 
 and sometimes the pupils may become un- 
 equal on the two sides or ovoid in shape. 
 Perhaps the most astounding of phenomena 
 is one that has been witnessed in more than 
 one hospital; a reversal of direction in the 
 peristaltic muscular action of the coats of 
 the intestine, which in health gradually 
 works food slowly through the coils of bowel 
 towards the outlet; while reversal of this 
 direction occurs only in complete stoppage 
 and, when unrelieved, is accompanied by 
 another and grave symptom, feecal vomiting. 
 
 
 
HYSTERIA 125 
 
 But Hysteria has provided a parallel even 
 to this. Not long ago in an East-end 
 hospital there resided a patient who had on 
 three previous occasions, by reason of these 
 symptoms, undergone operations, nothing 
 wrong being found in any of them, and she 
 was prepared to again submit to a like pro- 
 cedure; but her past history having come to 
 life she was saved from the experience and 
 recovered. Now it is hardly conceivable 
 that any element of fraud could have been 
 present in this case, nothing was to be gained 
 by facing a grave surgical risk. But, on the 
 other hand, and about the same time, but 
 in another hospital, a woman, recognized 
 as a victim to Hysteria in many shapes, 
 had also fecal vomiting, but on careful 
 observation she was discovered to be arti- 
 ficially bringing about the process; yet even 
 in this case, knowing the possible wide 
 variations in the mental equation seen in 
 Hysteria and the horrible procedure to which 
 she had recourse, it may fairly be doubted 
 whether the imposture was as consciously 
 deliberate as it appears, for the moral 
 sense is always blunted in Hysteria, and 
 there is an absence of shame on exposure 
 
126 MINDS IN DISTRESS 
 
 such as is never witnessed in similar people 
 in health. Let me then ere we leave the 
 question of Hysteria once more ask the 
 reader to pause before he thoughtlessly 
 ascribes Insanity or fraud to any hysteric 
 case. However grave the symptom in 
 Hysteria, it can be stopped at once by some 
 sufficiently strong counter-emotion, and if 
 either of the women with fecal vomiting 
 had been told that a favourite child was 
 lying at home in danger of death the vomit- 
 ing would almost certainly have ceased and 
 the patient forthwith have re-found the 
 power of returning to her home; but re- 
 member carefully it must be an abnormally 
 strong counteracting emotion, whereas, in 
 a normal state of mental health, sufficient 
 inducement to recovery in emotional states 
 would have been found in some common 
 and everyday emotion ; while in Insanity no 
 emotion, however powerful, would have any 
 effect. The difference in the three situations 
 is therefore a very real one and must be 
 kept in mind. 
 
 The foregoing is intended not as a detailed 
 description of Hysteria in its protean shapes 
 but more as an effort to provide a mental 
 
 
 
 7 
 

 
 c of the Ba siide so that the reader 
 n and retain a clear view of the i 
 L fot hs laws that underlie Hysteria © ie 
 on the effects of which its symptoms cae 
 
 
 
 
 
 
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 CHAPTER VIII 
 HYSTERIA 
 
 t.e., loss of balance in the feminine type of mind 
 ParT III.—Tue TREATMENT OF HYSTERIA 
 
 HE treatment of Hysteria is a battle 
 
 but not on the solid earth, a combat of 
 
 minds between patient and adviser, and the 
 weapons of the latter are not those of the 
 pharmacy nor of science, for these must be 
 kept carefully in the background and re- 
 served as mechanical aids after the real 
 victory has been secured, as props and stays 
 on the stony road that has to be travelled 
 after the patient is on her feet and before 
 she can walk with assurance on the broad 
 highway of humanity. Therefore the first 
 essential to success is to: 
 
 (1) Understand and control the patient. 
 Not only is it necessary to get on good terms 
 with the patient—that is easily effected, for 
 she will at first regard you as a probable 
 
 ally, as one to become in the near future a 
 128 
 
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 3 
 
 aa 
 
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 Ca 
 comer 4 
 
 HYSTERIA 129 
 
 follower in her train—the first look she 
 throws at you under half-shut lids, and with 
 eyes that affect to be tired and indifferent, 
 is but the first stage in that ‘‘ summing 
 up” of you which, translated into words, 
 would often take some such form as this: 
 “ Another ass that thinks he is going to 
 control me; we shall see!’ But the doctor 
 must not, in foolish self-assurance, despise 
 the enemy, an attitude so often assumed and 
 about which the patient is sure to be informed 
 however far from the sick-room it may be 
 expressed, whether in signs or words. Like 
 a skilful gambler the doctor’s look must 
 conceal his thoughts, and at the earliest 
 opportunity, and after he has made himself 
 master of all necessary details from friends, 
 who rarely or never can give any useful clue 
 to the mystery, he should dismiss the latter 
 to have a heart-to-heart talk with the 
 patient: Now, and just in proportion to 
 his knowledge and skill, he will obtain real 
 information. No real active organic disease 
 will be found, for as in Neurasthenia so in 
 Hysteria all the vagaries seen are but the 
 oscillations of a healthy mind in a state of 
 stress and blindly seeking a balance, and 
 
130 MINDS IN DISTRESS 
 
 
 
 would vanish of their own accord in face of 
 tangible disease. Some quiescent organic 
 mischief, having no part in the production 
 of the present symptoms, may be found, but 
 even this is rare, while, almost invariably, 
 some trivial displacement of a kidney or 
 uterus, ovary or stomach, or some func- 
 tional derangement, evidenced by headache, 
 flatulency, etc., will be brought with great 
 formality to the doctor’s notice, and he 
 will be told—and not truthfully—that Dr — 
 So-and-so considered it a most important 
 disease, one that would take years to cure 
 and which required the utmost care and 
 attention if death itself, or chronic invalidity, 
 were not to be the result. The wise man 
 will not contradict, still less will he remark 
 that such-and-such an organ could be 
 stitched into position by surgical operation, 
 for unlike the Neurasthenic, who has the 
 practical mind and dreads operations, be- 
 
 cause he fears the possible consequences, _ 
 
 the Hysteric would promptly fall in with the 
 suggestion and, even if the doctor failed to 
 carry it out, he would find himself for ever 
 quoted as an authority, and styled an expert 
 or specialist, who strongly advised a serious 
 
 
 
HYSTERIA 131 
 
 operation as the one and only cure, and 
 who, but for the fact that she (the patient) 
 was at death’s door at that time, would at 
 once have performed it. For a marked 
 characteristic of the hysterical mind is that 
 it has pluck, if courage can be ascribed to 
 one who lives mainly for the sympathies 
 of the day and has little thought, or fear, 
 of the morrow. The doctor’s next step is, 
 under assurance of the strictest secrecy 
 (which he must most honourably observe 
 both in the spirit and in the letter), to obtain 
 from the patient a real and complete mental 
 history, showing by his intercalated observa- 
 tions that he fully understands and can 
 sympathize with all her grievances and 
 contrarieties, and that he reckons none of 
 them as trivial since they are of importance 
 to her; the real test. If the doctor be him- 
 self in the widest sense a man of under- 
 
 _ standing he will rarely fail to get the whole 
 
 truth, and the picture thus obtained will 
 be very dissimilar to that which even the 
 nearest and dearest of the patient’s friends 
 would ever have dreamt of. He will hear 
 of cherished desires frustrated, secret am- 
 bitions balked, keen emotions and feelings 
 
132 MINDS IN DISTRESS 
 
 chilled; in short, he will see that the 
 patient has been musunderstood, no silly 
 phrase but one representing the real and 
 deep wound of a sensitive and often a really 
 high and fine nature whose legitimate and 
 normal Ego has been dwarfed, and her 
 instincts starved or blighted. He will, 
 further, be astonished to find that the 
 patient, if she meets a kindred, or at least a 
 comprehending, soul, can be truthful, and 
 
 that her deceit and lack of truth previously ~ 
 
 noted is but what she conceived as necessary 
 to play the only véle left her in life—that of 
 a debilitated and sympathy-craving invalid. 
 “Tout comprendre est tout pardonner,” 
 and in the doctor’s case one may often 
 add “‘tout pouvoir.’’ How extraordinary is 
 such a confession; what a totally different 
 person and character you have presented to 
 view, and if you shut your eyes the better to 
 construct your mental picture you may be 
 
 startled on again opening them at the con- - 
 
 trast that presents itself. How little we 
 really know of human life, and how far it is 
 from the picture that casual and even in- 
 timate observation often provides for us, 
 though it would obviously never do to wear 
 
 
 
 fe oe” 
 
 5 
 4’ 
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 f 
 
 ' 
 
 f 
 
 
 
HYSTERIA 133 
 
 always one’s real mind or heart on one’s 
 sleeve; and even if we did, it would only 
 be our mind as viewed and appraised by 
 itself. 
 
 One cheering result I have gained from 
 such disclosures is the conviction that there 
 are few intentionally and maliciously bad 
 people in the world, but there are a host of 
 weak and feeble persons, and that very few 
 of them have any compass that points to 
 any definite magnetic north; conventions, 
 bitterly hated by many a woman who out- 
 wardly affects to worship them, there are in 
 plenty, and some feeble principles, mere 
 wisps of thought touched by a faint hope 
 as by asun ray, and chiefly used as counters 
 in the game ‘of life. Instincts deep and 
 broad there are which, controlled and guided 
 by the reason and allowed due gratification, 
 could make life sane and tolerable, but to 
 make it consistent, satisfying to the higher 
 mind, and occasionally really happy, you 
 must have much more: an unshakable con- 
 -viction that there is an end in which the soul 
 can rest withevery longing satisfied and every 
 inequality of life made straight. Science 
 cannot fill the gap; she starts with a nescio 
 
134 MINDS IN DISTRESS 
 
 and ends of necessity with the same; her 
 duty being confined to the reduction of 
 phenomena to the order that best fits the 
 Zeitgeist, the simplification of a problem 
 not its solution, and the vdéle of philosophy 
 is to co-ordinate her conclusions into wider 
 generalizations. Both are of inestimable 
 use as training-grounds for the mind, but 
 neither makes any pretence of a final 
 definition. 
 
 To say more would be to exceed the limits 
 of my subject and my remarks are merely 
 the thoughts that must arise in all reflecting 
 minds brought face to face with the pro- 
 blems of life as set by the nude mind; and 
 it is not for the doctor to do more than 
 quietly regret this absence in the life of 
 sufferers of any guiding star that would be 
 of assistance to him in giving direction to 
 his efforts. Indeed, not long ago a chronic 
 Hysteric rose from her bed and interested 
 
 
 
 herself again in life at the instigation of — 
 
 Christian science, and a lady in the north of 
 London, after years spent as an invalid 
 with hysterical paralysis of both legs, was in 
 a few minutes cured by a revivalist preacher 
 who had taken up faith-healing. She heard 
 
HYSTERIA 135 
 
 of his powers, was impressed, sent for him 
 and was cured. These cases show the pro- 
 found influence even of very third-rate 
 ideals on minds not necessarily of small 
 calibre but untrained in habits of clear 
 thought, and I was most careful to offer no 
 opposition in either case; a half loaf being 
 not only better than no bread but the 
 quantity often better suited to a feeble 
 digestion. Astotheresult. It was durable 
 in the first and not in the second patient, 
 who could not be made to comprehend, 
 when the pastor subsequently proved to be 
 morally a friable vessel, that such fact had 
 nothing whatever to do with herself, and 
 that a leper may show you the right road 
 though he has not the strength himself to 
 ~ walk along it. 
 
 The question of all mental treatment is 
 so important, and the subject so interesting, 
 that a strong temptation to extend the 
 theme arises in my mind, but I feel that 
 sufficient has been said to give all that I can 
 here pretend to supply; the direction in 
 which treatment to be successful should 
 be carried out, with the one objective before 
 the mind, the restoration of the patient to 
 
136 MINDS IN DISTRESS 
 
 normal life and activity. One fallacy— 
 dear to the masculine mind and afforded a 
 prominent place in many an official text- 
 book—I wish to condemn, namely, that 
 the deprivation of sexual congress is the 
 great if not the only thorn in the flesh of the 
 sufferer and the one which incessantly vexes 
 and disturbs her spirit. In fact, more than 
 one writer goes so far as to say that the 
 thoughts connected therewith are to be 
 screwed out of her by hypnotism, or other 
 form of suggestion, and met by the installa- 
 tion in her mind of negative ideas; and if 
 these statements are disputed one is met 
 by the remark, “‘Oh, you can’t deny the 
 truth for the patient herself acknowledges 
 it.”’ Quite so, it is precisely the idea that 
 an Hysteric would concur in, just as she con- 
 curred with Dr Charcot in his acceptance 
 of the idea that disease could be transmitted 
 by a magnet or even by a glass of water. 
 
 “Fooling him to the top of his bent” is - 
 
 precisely the game of games for her, why I 
 know not, unless it be that she thereby ex- 
 presses her contempt for the masculine type 
 of mind and her insight into some of its 
 inherent weaknesses. Marriage doubtless 
 
ua 
 
 eh 
 ae = 4 
 
 ; ee: + CHESTNG| 
 4 HYSTERIA 137 
 
 often cures a woman, but chiefly by respond- 
 ing to the demand of her instincts for un- 
 selfish love with its idea of self-immolation, 
 but any want of response to affection will 
 bring a relapse into Hysteria even after 
 marriage. Maternity is the best cure of 
 all. There are few women, outside the 
 ranks of the degenerate and perverted, to 
 whom crude sensuality alone is a potent 
 appeal, though most women are quite willing 
 that men should believe the contrary, and 
 bad ones of every grade encourage the idea 
 because their profit arises from this misunder- 
 standing, while among intimates they laugh 
 heartily at it all the time. That there is a 
 vein of weak psychic immorality in many 
 types of Hysteria one cannot help recog- 
 nizing, but this is as a rule shrouded in noble 
 sentiments that doubtless are regarded as its 
 excuse or justification. As evidence that 
 this disorder cannot usually have sensual 
 gratification as its chief foundation, I may 
 add that, for a series of years, I attended 
 several communities of religious women, 
 and amongst them never witnessed any 
 trace of Hysteria; and this also I find is the 
 experience of other doctors, even in silent 
 
 ow 
 
 4 
 cA . ’ 
 
 ‘ ‘ Cit 4 ¢ 
 ie jews iv © 
 ie 
 
138 MINDS IN DISTRESS 
 
 and purely contemplative orders who are 
 not engaged in active outdoor work, and I 
 am certain therefore that a well-directed, 
 pure and high type of love amply suffices to 
 meet all the instinctive requirements of the 
 order to which I refer. Not only is Hysteria 
 rare in nuns, but amongst no other class 
 of women have I known such gaiety, con- 
 tent and generally sound mental and 
 physical equilibrium. 
 
 Having then first of all secured a perfect — 
 picture of the patient’s mind, of her real 
 self, the doctor’s aim will be to sketch a 
 path along which she can safely travel to- 
 wards health, and as a first step thereto he 
 will seek: 
 
 (2) To alter her surroundings to her 
 benefit. Friends, books, rooms, medicines, 
 everything and everyone have been moulded | 
 by the patient to serve as supports of, and 
 a setting to, her state of invalidism, and all 
 have become, in consequence, active agents _ 
 of suggestion. This atmosphere must be 
 changed. The patient’s muscles are weak 
 from want of exercise, her digestion enfeebled 
 by misuse, her mind restricted in range and 
 concentrated on trivialities; in short, the 
 
3 
 
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 v er sate 
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 es 
 
 TOO Me a 
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 HYSTERIA 139 
 
 difficulties seem to be almost unsurmount- 
 able, and yet as both mind and body are in 
 constitution sound, both will be found to 
 have retained their elasticity and capability 
 of a rebound to health and vigour if only 
 the suggestive obstacles thereto can be 
 removed. And here one of the sanest 
 methods, that of Dr Weir Mitchell, comes 
 to our aid. Its drawbacks are its quite 
 unnecessary expense and the measure of 
 discredit that has accrued to it from its 
 application to unsuitable cases. Probably 
 its novelty was for a time its greatest asset, 
 for it has dropped considerably out of a 
 favour which it did much to deserve. A 
 grasp of the situation, common sense, a 
 wise sympathy and gentle firmness, are the 
 virtues of an efficient Weir-Mitchell nurse, 
 for she is the great agent of cure. Visitors 
 and letters and all exciting outside news are 
 taboo for the first week or more, according 
 to the patient’s conditions and needs. The 
 doctor himself is often best out of sight, 
 available at call if both nurse and patient 
 agree in wishing to see him, but not unless, 
 if everything is going well. I need not 
 enter into details as to diet; this should be 
 
140 MINDS IN DISTRESS 
 
 a very full one in the emaciated and re- 
 stricted but varied in the corpulent. Simple 
 or galvanic massage of the forehead and 
 back of the neck late in the evening is a 
 useful aid to repose. If that fail, the general 
 hot pack or the local hot pack over the 
 stomach should be resorted to. Real 
 insomnia is not common, but in cases in 
 which it is of occasional recurrence, and a 
 source of trouble, I recommend a plan which 
 I have found a specific for persons endowed 
 with a vivid imagination. I simply in- 
 struct the patient how to tell herself, silently, 
 a story. This story is reserved only as an 
 inducement to sleep; any theme that in- 
 terests her may be selected, and she herself 
 should be the central figure. In a week or 
 less, a habit of picking up the story at the 
 point at which it was dropped and continu- 
 ing it, is developed, and the patient soon 
 becomes thoroughly interested in the vari- 
 ous fancied situations that arise. I know - 
 many not hysterical sufferers who have 
 used this simple plan for years, and who, 
 once they have picked up the thread of 
 their story, fall asleep in a very short time; 
 it acts, moreover, by keeping all disturbing 
 
 * 
 

 
 HYSTERIA r41 
 
 and unpleasant thoughts out of the mind. 
 I find in men that military campaigns are 
 selected as the favourite subject, and the 
 same story in its various developments 
 
 may extend over years. A much-worried 
 
 business man wrote to say that he had 
 followed my plan for fifteen years and that 
 he felt sure that it alone had kept him out 
 of the asylum, and though absolutely in- 
 credulous at first even as to its possibility, 
 he had found it easy and pleasant after 
 a short perseverance. I adopted it for 
 patients as a cure for sleeplessness thirty 
 years ago, after remarking its utility in a 
 highly-nervous family of children, and I 
 have since found that story-telling aloud 
 or to oneself is quite in familiar use as a 
 sleep-producer in many nurseries. It is 
 instructive to remark that, while the worst 
 cases of Hysteria can and do avail themselves 
 of the system, I have never known an insane 
 person capable of doing so. 
 
 The strict Weir-Mitchell system may be 
 relaxed as the patient improves, but a 
 mere increase in weight—often regarded as 
 positive proof of a cure—must not in itself 
 be taken as an advancement, for the cure of 
 
 % 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 142 MINDS IN DISTRESS 
 
 the mind is the great object in view and 
 this must be directed towards some form’ of — 
 activity suitable and possible to the patient’s | ¥ 
 age and social status. Often one of the ’ 
 colonies may be used as a lure, but the doctor — 
 should never advise at random, but obtain, — 
 if he does not possess it, a sure and certain — 
 knowledge of the suitability of any place — 
 recommended and necessary introductions, 
 etc., for the patient. am 
 Many cases of Hysteria occur among thea 
 working classes, generally in men after an 4 
 accident that has frightened them severely. $ 3 
 They are not malingerers ; the paralysis— — Be 
 for that is the form in which it is generally — 
 seen—is real and beyond the control of the © 
 will-power, though still only functional. It — 
 is produced by the suggestion that several 
 injury has resulted from the accident, and — 
 is matured by the sympathies and sugges- __ 
 tive allusions of neighbours. I have seen x 
 many bad instances of it. Here also it is” 
 essential to alter the surroundings of thea 
 patient and to assure him of his ability ere 3 
 long to return to work, an end which the ~ 
 patient himself is often most desirous of oy 
 attaining. 4 
 
HYSTERIA 143 
 
 (3) Endeavour to find systematic embploy- 
 ment for the mind. If you have carried out 
 the first of my recommendations and really 
 know the natural bent of her mind—and 
 without this you will effect nothing at all— 
 you are in a position to advise with effect. 
 A child, even an adopted one if need be, 
 for the childless is a sovereign remedy. 
 For the woman who craves for marriage 
 and the sympathy and love that attend it, 
 a place in some colony which will give her 
 a wider world to live in and a better oppor- 
 tunity to marry than in England. For the 
 woman tied to routine house duties and 
 unmarried, some outdoor work is best, for 
 home industries are bad. For the woman 
 with a little money and some adaptability 
 the stage is one of the very best of employ- 
 ments. I shall never forget the case of a 
 young lady of small income with inveterate 
 Hysteria, who, on her parents’ death, took 
 up that profession, and how quickly it made 
 a cheerful, healthy and young woman out of 
 a worn and sickly-looking invalid. I need 
 not give a list of possible occupations, but. 
 only say that they should be such as the 
 patient feels specially drawn to and that 
 
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 a 
 4 
 
 144 MINDS IN DISTRESS 
 
 offer a decent remuneration for work done. 
 Let not the silly bogy of nervous break- 
 down obstruct anyone. In reality the 
 
 hysterical woman is a little too full of ner- — 
 
 vous energy which only wants direction into 
 useful and desirable channels to produce 
 excellent fruit; and the doctor may safely 
 assure doubting relatives and friends that 
 he will cheerfully take all risks if the patient 
 will follow his advice strictly and will 
 persevere. 
 
 The above remarks apply to the still 
 young and vigorous Hysteric, such as have 
 not wilted through the years till they have 
 become so irrevocably crooked, selfish and 
 self-absorbed as to seem beyond the reach 
 
 of any mental remedy; yet even of these © 
 
 some recover. The most hopeless of all 
 
 are the wealthy and elderly spinsters whose | 
 
 susceptibilities none of their entourage dares 
 to offend; but even for them the doctor who 
 will not play the 7éle of a mere parasite can 
 often do more than he at first thinks pos- 
 sible; for behind all their mental and physi- 
 cal obliquities more of discernment and 
 judgment may remain than the casual on- 
 looker would give credit for. I recall such 
 

 
 
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 S X 
 
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 Da eee ee oe ee ee 
 
 Su + 
 
 
 
 
 
 Le ee ee 
 
 HYSTERIA 145 
 
 a chronic case of inveterate Hysteria, in 
 _ which the patient announced the onset of 
 a new disease by telegram at intervals of 
 every few days, and who, in his (for the sex 
 _ was male) intervals of relief from functional 
 
 paralysis, would, to excite attention and 
 sympathy, go into the garden and bah like 
 
 a sheep, or plaintively mew like a kitten, or 
 
 shower pebbles on the neighbours’ windows. 
 He had summoned from London at various 
 times every physician of name to minister 
 to his symptoms, and always listened with 
 apparent appreciation to their soothing 
 
 platitudes, though he never took a dose of 
 
 their physic nor followed one of their rules. 
 To him, in my absence from town and by 
 inadvertence, a very clever young surgeon 
 was sent who, after a careful examination 
 and a subsequent ink sketch of the organs 
 with the handle of a pen on the patient’s 
 abdomen, replied to the usual question, 
 “ Now, what is your opinion of me?” with 
 
 “You are the d——est fool I have seen for 
 
 along time.” Instead of taking offence at 
 this observation, the patient appreciated 
 it, and long after used laughingly to say, 
 
 “That is the most honest man I have ever 
 10 
 
146 MINDS IN DISTRESS 
 
 seen, though of course one could not live 
 long on terms of the d——est fool with any- 
 one.” I do not cite this example as any 
 commendation of either the attitude of 
 mind, or the special language, adopted by 
 the surgeon, but to show that, in the worst 
 cases, there is usually, though in quiescence, 
 a certain sanity of observation which it 
 should be the doctor’s aim to bring to the 
 surface for use as his chief agent in the 
 permanent cure of the invalid. In this 
 case it was possible not only to do so, but 
 to play also upon the patient’s love of 
 wealth and of financial reputation, and thus 
 gradually to wean him from the state of 
 abject self-concentration into which he, a 
 really capable man, had gradually sunk from 
 taking the wrong road at the commence- 
 ment of his disorder; in this case by retiring 
 from active work in the City in order to 
 make himself a literary reputation, a line 
 recommended to him, because he had suf- 
 fered from “ globus hystericus ” as a result 
 of a sharp disappointment. 
 
 I have always found it of the greatest 
 advantage to address the hysterical sufferer, 
 with whom I have established good terms, 
 

 
 HYSTERIA 147 
 
 from whom I have obtained a real life 
 history, on the plane of his or her sound and 
 actual self, and not on that of his or her 
 hysterical and false personality. To ex- 
 plain and emphasize this most important 
 point let us take a supposititious case: 
 “A” has been in bed for two years with a 
 “phantom abdominal tumour,” areas of 
 skin insensibility and bouts of hysterical 
 vomiting, living in an atmosphere of pity 
 and crowned with the halo of martyrdom. 
 You have elicited the real history, and 
 know the causes underlying it, and have 
 agreed with the patient to “keep up 
 appearances”’ with her friends for the 
 present, but to work in conjunction with 
 her for the satisfaction of what you know 
 to be her special ambitions and desires; 
 you have convinced her that you do 
 
 not regard her as a malingerer and that 
 
 you recognize clearly that her symptoms, 
 though functional, are actual experiences to 
 herself and beyond her power, by any simple 
 act of good-will, to banish; that you have 
 decided to place her in circumstances that 
 will cease to hypnotize her and confirm her 
 in the present disorder, and that when, by 
 
148 MINDS IN DISTRESS 
 
 such measures and aided by her collabora- 
 tion, she has obtained efficient self-control, 
 you will do your best to arrange that her 
 life shall in future be adapted to the natural 
 calls of her mind, to her instincts, her am- 
 bitions and her special capacities. Now, 
 having established this most desirable 
 mutual understanding, you must no longer 
 treat her, when alone, as an _ hysterical 
 invalid, but on the same level as you would 
 
 sy 
 
 a patient with a broken limb, an attack of — 
 
 broncho-pneumonia, or other temporary ail- 
 ment which is sure to get better, and dis- 
 cuss the plans for her future advancement 
 and success in life; not ignoring completely 
 the tumour or vomiting, but referring to 
 them as present inconveniences that are 
 certain to pass away spontaneously as she 
 becomes more normal. 
 
 In short, as you are conspiring together 
 to help her out of a mental prison, your 
 
 conversation should naturally turn on the — 
 
 pleasures of liberty. 
 
 The foregoing recommendation, though 
 not in any treatise in Hysteria that I know 
 of, is not a trivial one, but I think recom- 
 mends itself to sound judgment and com- 
 
 | 
 ee ss 
 

 
 HYSTERIA 149 
 
 mon sense and is the outcome of a long 
 __ practical experience. Its one aim is to 
 extract all that is mentally good and 
 ; sound in the patient, and to build up 
 - on that foundation a new and healthy 
 mental life. 
 
 (4) Dramatic mental appeals and sug- 
 gestions. These sudden appeals to the 
 imagination of the patient are rarely in 
 the power of the doctor to command or to 
 make use of. Faith cures, hypnotism, etc., 
 are of this class, and the setting is as neces- 
 Sary, even more so, than the actual pro- 
 cedure. Thus,if you decide to avail your- 
 self of any one of them, you must look to it 
 that there is as large an audience as possible 
 and that the réclame to follow shall be 
 loud and far-reaching. Personally, I have 
 always fought shy of them, while never 
 opposing the patient’s inclination if it be 
 firmly set on the trial, for the proportion of 
 temporary successes is small, and that of 
 permanent cures even less, since you cannot 
 often keep up the effect when you have 
 secured it. 
 
 A typical “bed case”’ of several years’ 
 duration went, in charge of a doctor, to 
 
 ; 
 : 
 r 
 ; 
 i 
 7 
 3 . 
 - 
 oS 
 = 
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 b, 
 
 / 
 
 . 
 
 
 
150 MINDS IN DISTRESS 
 
 Nancy to undergo a course of hypnotism. 
 The enthusiasm of her companion, and the 
 novelty of the situation and of the treat- 
 ment, brought about so much improvement 
 that she spent a subsequent month alone 
 at a bright seaside home, walking about 
 and apparently well. She was, later on, 
 brought back to her own house by the 
 doctor, looking remarkably well and walking 
 with confidence, for her Hysteria had taken 
 
 the form of paralysis of both legs. After — 
 
 the doctor’s departure she returned to her 
 room and bed within an hour, and to my 
 knowledge remained there for several years, 
 in spite of every effort to again rouse her to 
 activity. These brilliant cures effected by 
 hypnotism rarely stand the wear and tear 
 even of a sheltered normal life, for the want 
 of any system of following them up, any 
 subsequent systematic adaptation to their 
 environment, and it must never be forgotten 
 
 that no Hysteric who is not fitted by treat- 
 
 ment to respond to the normal stimuli of 
 life, z.e., to the ordinary conditions of life, 
 can be regarded as cured. That is the only 
 real test of recovery and nothing in the way 
 of cure can be accepted in place of it. The 
 
HYSTERIA 151 
 
 truth of this is before our eyes in the ana- 
 logous condition of Alcoholism, which, like 
 Hysteria, has in many cases a real and 
 distinctive mental origin and dependence. 
 The inebriates’ reformatories have proved 
 a failure in the experience of those very 
 practical judges, the London police magis- 
 trates, and even a three years’ residence 
 therein has resulted in failure, although, as 
 I am assured by keen observers who have 
 had charge of such institutions, the inmate 
 had absolutely lost all temptation to take 
 alcohol and all craving for its exciting effect 
 for at least a year prior to her release; and 
 could she only have been kept under some 
 supervision when outside, provided with 
 easy work and sheltered—as she was when 
 in the institution—from the worries and 
 anxieties of life, she would certainly have 
 experienced no difficulty in a lifelong 
 abstinence. One system of cure for 
 Alcoholism must be referred to, for it has 
 proved itself a success in America—and I 
 do not give the name because I do not 
 wish to advertise it—by wisely founding its 
 plan upon a knowledge of human nature. 
 First of all, it possesses an alluring name. 
 
1s2 MINDS IN DISTRESS 
 
 Secondly, it impresses the patient further 
 by allowing him when in the home to order 
 and drink what alcohol he chooses, assuring 
 him at the same time that the “ cure” is so 
 certain that it will succeed, in spite of every- 
 thing, in eradicating in four or five days the 
 craving, or even the desire, for drink. On 
 the first day nothing special is done, but on 
 the second and subsequent days an emetic, 
 nearly always tartar emetic or apomorphia, 
 both of which are tasteless and very soluble, 
 is placed in the alcohol, or given hypoder- 
 mically, in such gradually-increasing dosage 
 that the alcohol excites ever more nausea 
 and repugnance till, if persisted in, such 
 severe vomiting results that it has perforce 
 to be declined. The proof of the pudding 
 is in the eating, and the patient, knowing 
 nothing of the actual cause of his vomiting, 
 ascribes it to the super-excellence of the 
 treatment and is duly impressed. But, and 
 
 this is a masterpiece of foresight, when, after _ 
 
 his six weeks or so of residence, the patient 
 is sent home, he is put in touch with a 
 local club, where he meets old patients, all 
 talking about the wonders of the cure and 
 burning with enthusiasm, a band of allies 
 
 y 
 Beh. 
 
 ‘ 
 ~ 
 
HYSTERIA 153 
 
 and heroes whom it would be shameful to 
 desert; in short, the stimuli of enthusiasm 
 and success are behind the cured one, while 
 the special disgrace of black treachery holds 
 in front of him a restraining hand. By 
 a similar wise plan the Salvation Army 
 secures its potential backsliders from drop- 
 ping back into the mire. 
 
 With the Alcoholic as with the Hysteric, 
 any sudden shock may cure even perma- 
 nently. Many years ago I knew an Aberdeen 
 bailie who, after years of addiction to the 
 wine of his country, was so intensely shocked 
 one morning, after copious libations to 
 Bacchus, on finding that he had broken all 
 his windows and lost a valuable watch and 
 other things overnight, that he gave way 
 to a copious flood of tears and never again— 
 and he lived for many years—took alcohol 
 in any shape or form. While two years 
 later a lady who had been bedridden for 
 years, and about whose actual state doctors 
 had differed widely, some thinking that she 
 had organic nerve disease, on losing her 
 entire fortune in the failure of the Australian 
 Banks, rose and went straight out to the 
 Antipodes to a brother, whose active and 
 
 7. inane ils ateaaillaaad Se 
 _ . 
 
154 MINDS IN DISTRESS 
 
 competent housekeeper she became hence- 
 forward. 
 
 But, in general, the rule holds good that 
 in Hysteria, in order to really cure it, to make 
 the sufferer normal in her response to the 
 normal stimuli of everyday life, you must 
 not lose sight of the patient till you have 
 seen her comfortable, contented and happy 
 in suitable surroundings. 
 
 And since your first and only duty is to 
 
 cure your patient, cito, tuto et jucunde, — 
 
 according to the old formula, you must not 
 despise faith-healing and similar measures. 
 Nor must you be disturbed for one moment 
 by thoughtless remarks about the absurdity 
 and fraud of miracles, and the dishonesty 
 of those who make use of them or venture 
 to defend them in modern days. Such 
 remarks show a confusion of thought, and 
 
 you may be simultaneously on the side of | a 
 
 science and that of the angels if you desire 
 
 it, for science tells us that it is our minds 
 
 that interpret, if indeed they do not make, © 
 
 the external world. Let the blood but 
 
 contain a novel ingredient so slight as to 
 
 escape even the microscopist and the 
 chemist, and, lo and behold! sight, sound. 
 
 
 
HYSTERIA 155 
 
 touch, taste and smell may all so alter that 
 a garden of Eden or a Gehenna may come 
 into existence. A poison, you say. There 
 are no poisons as such in nature, and the 
 new ingredient need not even be deleterious ; 
 it only need be different to the usual run of 
 blood ingredients to produce a miracle in 
 the partaker; and ifit were so widely diffused 
 that all absorbed it, then the world would 
 be changed for all of us, and with it even our 
 present conceptions of time and space, nay, 
 even the simplest facts of arithmetic might 
 cease to hold good. We have abundant 
 proof of this in the taker of Indian hemp, 
 of opium, of cocaine and of other drugs, or 
 even of alcohol in excess, and in the wide 
 divergence of views in different nations and 
 at different epochs in history. A China- 
 man in New Zealand once told me that he 
 had his heaven with him and exhibited a 
 chunk of crude opium. You have only to 
 imagine a race of men without the sense of 
 sight to whom a man with vision would be 
 one with miraculous faculties, since no one 
 else could conceive of the possibility of sight. 
 Is one single historical fact better sustained 
 than the common existence of dragons 
 
156 MINDS IN DISTRESS 
 
 formerly in Europe? Where are they? 
 Our ancestors must have been great liars, 
 a very uncharitable thought, or very credu- 
 lous, scarcely possible considering that grants 
 of land even in England were made for 
 killing the monsters and much proof would 
 be exacted ere such a reward were given. 
 It is after all but an extension of the moral 
 of the primrose by the river’s brim: to one 
 it is nothing more, to another it represents 
 a different world and train of thought. The 
 lesson to be learnt is that there are many 
 mental faculties possible, of which the 
 ordinary man cannot conceive; though of 
 course this should not lead us to accept 
 the reality of wonders without the closest 
 scrutiny of which we are capable. 
 
 But I have digressed shamelessly and 
 must pass on. 
 
 (5) Medicinal, electro-therapeutic and me- 
 
 chanical agents. I have never seen a 
 case of Hysteria cured by any of the above 
 agents, though urgent symptoms have been 
 arrested. The rules I would lay down 
 regarding them are as follows: In the 
 beginning of a treatment, if you have 
 assured yourself that it is within your 
 
Pas Sf ee ee ee ee 
 * , , i 
 i 
 
 
 
 ep Ss ae eT 
 
 
 
 
 
 HYSTERIA 157 
 
 _ power to cure the patient by the mental 
 means I have already enumerated, never 
 use any of these agents unless it be with the 
 _ well-understood reservation that they are 
 
 recommended only as palliatives and do 
 not enter into your scheme of cure. Other- 
 wise, when they have failed you, as they 
 are sure to do, you will be credited with 
 having shot your best bolt, and any line 
 of treatment you may subsequently adopt 
 will be regarded as in the nature of an after- 
 thought. 
 
 In chronic cases in which, for some 
 sufficient reason, you have decided that 
 
 a radical cure is impossible, drugs and 
 
 electricity alone are left to you, and then 
 the best possible must be done with them. 
 As in the case of Neurasthenia, tonics in 
 Hysteria almost invariably do harm, if 
 they have any action at all, by increasing 
 the already over-stimulated and hyper- 
 active nervous energy. Therefore those 
 of the nature of strychnia, nux vomica, 
 caffeine and phosphorus are absolutely 
 
 taboo. If a blood examination shows the 
 
 presence of anemia, a mild form of iron may 
 be used, and it is best in that case to combine 
 
1s8 MINDS IN DISTRESS 
 
 it with arsenic. The latter drug, indeed, 
 alone of all the tonics, is ever of real value. 
 It is not stimulating, and it has the effect, if 
 given in very small doses and continuously 
 for months, of improving the physical con- 
 dition. Bromides are often of service, and 
 if the patient has any objection to the 
 salts of bromide in common use, I order 
 bromide of gold in doses of 4 to rzth grain 
 in pill form, or hydrobromic acid with syrup 
 of lemons. Orange-flower water, greatly 
 in repute in France, may also be given. No 
 hypnotic should ever be ordered unless great 
 care is taken that it cannot be repeated 
 without the doctor’s sanction, for hysterical 
 persons are absolutely reckless in their use 
 of drugs, and often so careless about the 
 amount ordered that danger is never far 
 
 away if several doses of any hypnotic drug — 
 
 are at their command. 
 
 Most habitual morphino-maniacs and 
 cocaine fiends have started as hysterical 
 patients to whom, incautiously, morphia, 
 opium or cocaine has been administered by 
 a doctor or taken in some patent medicine. 
 
 Chlorodyne is a great offender in this 
 connection, as are some of the preparations 
 

 
 ae ee ee 
 7, pa a 7 " . 
 
 
 
 HYSTERIA 159 
 
 of heroin on the market, and coca wine. 
 And the fact remains that opium and its 
 derivatives, alone of all drugs, seem to have 
 the actual power of curing Hysteria in many 
 cases but at the expense of a far worse dis- 
 ease, the opium habit. That drug stimu- 
 lates the Ego in a direct way, and amongst 
 its many other drawbacks, converts its 
 victims into the most terrible of egoistic 
 bores. Twenty years ago a lady, whose 
 “ dollop,” as she styled it, varied from 100 
 to 150 grains of extract of opium a day, 
 was a source of real terror when she came 
 to consult me. She would wait to see me 
 till she was the last of all the patients, and 
 
 _ then, calculating my lunch or dinner hour, 
 
 beg for all the intermediate time. On the 
 temptation of a conditional promise of 
 matriage from a gentleman to whom she 
 was attached, and who knew of her weak- 
 ness, she made heroic efforts to conquer 
 the drug, and eventually reduced it to a 
 trivial dose, which she never exceeded. 
 Her previous history is too instructive to 
 omit. As a girl of eighteen she took to her 
 bed, and at twenty-four had both ovaries 
 removed as a means of cure, but obtained no 
 
160 MINDS IN DISTRESS 
 
 relief whatever. One day a local doctor 
 happened to call, and promising to cure her, 
 ordered one grain of extract of opium every 
 twelve hours. The first dose removed all her 
 symptoms, a result by no means uncommon. 
 The moral is, never give the drug in 
 Hysteria. Cocaine is nearly equal in 
 efficacy, but far and away more dangerous 
 and terrible in its ultimate effects. The 
 habit, common a few years ago, of taking 
 coca wine often produced hysterical symp- 
 toms when the wine was discontinued, 
 and I have been more than once, in former 
 days, puzzled by a sudden and severe attack 
 of Hysteria developing without any discover- 
 able cause in one who had been taking it. 
 One gentleman, who had a bad attack with 
 general tremor, told me that he had been 
 in the habit for some weeks of taking as 
 
 much as a whole bottle of the wine each > 
 
 evening, feeling “‘ like a god” afterwards. 
 He had no idea that he had been doing 
 a very foolish thing; in fact the wine had 
 been recommended to him as the best 
 
 remedy for the weakness that follows on © 
 
 influenza. 
 Laxatives and purgatives should be 
 
 [ , : 
 te ae at 
 

 
 HYSTERIA 161 
 
 avoided in all diseases as they gravely 
 _ derange the ordered muscular action of the 
 - intestinal walls, and there is reason to think 
 _ that their too frequent use is responsible 
 for much of the appendicitis that is now 
 
 seen. The covered 4lb. or 6lb. cannon ball, 
 allowed to roll its way back and forwards . 
 over the surface of the abdomen for about 
 five minutes every morning before rising, 
 is the best remedy for constipation. 
 
 Unfortunately in Hysteria we cannot 
 avail ourselves of the “ Infallible,”’ that 
 medicine of such marvellous (mental) power 
 in Neurasthenia; for one of the most striking 
 features in which the two disorders differ is 
 in the attitude of the patients towards 
 drugs, which are loved by the Hysteric and 
 dreaded by the Neurasthenic. 
 
 Résumé. The cure of Hysteria depends 
 
 in general on the personality of the doctor, 
 
 on his knowledge, firmness, judicious sym- 
 pathy, and above all on the confidence he 
 
 _ inspires. Other mental forms of treatment 
 
 are of occasional service, but drugs should 
 be avoided, and electric treatment used only 
 as a form of ‘“‘ passive exercise ’’ in chronic 
 
 “bed cases,” to maintain the nutrition of 
 It 
 
162 MINDS IN DISTRESS 
 
 the muscles and nerves and the circulation 
 of the blood. 
 
 Disorders mistaken for Neurasthema and 
 Hysteria 
 
 Lying outside my definitions of Neuras- 
 thenia and Hysteria there is a state of 
 mental collapse that both in men and women 
 may follow on want of sleep, on prolonged 
 anxiety, and on any protracted struggle 
 against adverse condition; and which is 
 marked by insomnia, irritability, restless- 
 ness, depression, inability to make up one’s 
 mind in any important matter or to act with 
 decision. 
 
 That is Nervous Breakdown, and I dealt 
 with it several years ago in a book called 
 Depression, for that state is always one 
 
 of its leading symptoms. Its underlying — 
 
 cause is simple exhaustion of the nervous 
 mechanism and a consequent temporary 
 arrest of the mental faculties, a natural 
 protest by the body against gross misuse 
 and an urgent demand for rest, and sleep. 
 It is to be met at once by absolute rest, and 
 recovery is often aided by the administra- 
 tion of a few doses of bromide of ammonium, 
 
 »~ 
 
 
 
HYSTERIA 163 
 
 which calms the mind and thus permits of 
 natural sleep. After good sleep has been 
 procured, and the patient is restored to fair 
 comfort, it is well to advise him, after first 
 putting his business affairs into order, to 
 take a holiday at some resort where golf, or 
 other suitable diversions, can be enjoyed. 
 Unless there be some special indication to 
 the contrary, he should not be pursued by 
 doctors or by physic, lest his sensitive mind 
 be turned to thoughs of self and Neurasthenia 
 be brought on. If there be cause to suspect 
 any tendency that way it is well to give 
 him an “ Infallible’”? as a stand-by. He 
 must be steered clear of nursing-homes, or 
 of boarding-houses where the conversation 
 chiefly turns on disease, for this variety of 
 Nervous Breakdown is chiefly of importance 
 because it is frequently, if not judiciously 
 treated, the first step on the road to 
 Neurasthenia. 
 
 Hypochondriasis, which is often carelessly 
 used as an alternative name for Neuras- 
 thenia, should be restricted to its real place, 
 that of a term to connote a well-known 
 variety of Insanity in which delusions as 
 to the bodily state exist. It presents a 
 
164 MINDS IN DISTRESS 
 
 specious likeness to some kinds of Neuras- 
 thenia, while really it is a variety of Melan- 
 cholia, 7.¢., of Insanity. It is of great 
 interest to students of Psychology, because 
 the mental condition which it represents 
 is dependent. on organic change in some one 
 or more of the abdominal organs, and thus 
 furnishes us with evidence of a statement 
 which I have made elsewhere; that every 
 cell in the human body probably contributes 
 to mind, and may be potentially conscious 
 under certain abnormal conditions, even 
 such as under the usual conditions of life 
 contribute to automatic mind, 7.e., to the 
 reflex functions, chiefly or solely. One 
 cannot, of course, in the present state of 
 our knowledge be dogmatic on this point, 
 though it has always seemed to me that 
 researches into the causation of some forms 
 
 of Epilepsy, and most varieties of Melan- — 
 
 cholia, tend more and more to support my 
 hypothesis. The present fashionable idea 
 in medicine is that the connection between 
 diseased bodily cells and the conscious 
 brain is vid the blood, and the result of a 
 toxemia; but if this were so it should be 
 within the powers of science to demonstrate 
 
 ee kh 
 
HYSTERIA 165 
 
 the presence of toxic material in the blood 
 in Epilepsy and in such of the Insanities 
 as have no cerebral morbid anatomy. 
 
 The hypochondriac, unlike the Neuras- 
 thenic, rests in a delusion. It is a fact to 
 
 him and he will not bandy words about it. 
 
 He is not only insensible to, but intolerant 
 of, any argument. “I’ve got to put up 
 with it and I ought to know all about it,” 
 is his pet phrase. His face and manner too 
 are characteristic; for he looks ill, has a 
 set expression and a furtive manner; he is 
 suspicious of everyone, and you never get 
 to really know him; whereas the Neuras- 
 thenic is only too willing to unburden his 
 very soul before you, and is anxious that not 
 one single of his many symptoms shall be 
 left out of the reckoning. 
 
 But the essential difference between 
 Hypochondriasis and Neurasthenia is that 
 the former is a grave mental disease, rarely 
 recovered from; the victim of which may be 
 fitly compared to a ship in which the cargo 
 has shifted and which has a permanent and 
 dangerous list even in calm weather; whilst 
 the latter is a mere group of symptoms 
 which arise in a xorma/ individual when the 
 
166 MINDS IN DISTRESS 
 
 surrounding conditions are abnormal; and 
 the sufferer from it is like a well-found ship 
 in a gale, the rolling and tossing of which are 
 but oscillations round a centre of gravity, and 
 essential to its safety under those conditions, 
 and which will, when the storm has abated; 
 again sail calmly over the sea, carrying 
 little or but slight trace of the terrible com- 
 motion through which it has passed. 
 
 The Neuroses of the Alcoholic and of drug 
 habitués may sometimes simulate Neuras- 
 thenia, especially those that are seen when 
 the victim is making an effort to overcome 
 his weakness, but the history of the case, the 
 absence of any “ bogy,” together with the 
 extreme prostration and listlessness, soon 
 undeceive an observer. This stage of dis- 
 tress in recovery from great alcoholic excess 
 and drug-taking is one not devoid of danger 
 to life, and the mental depression that ac- 
 companies it is not only extreme but liable 
 
 to sudden exacerbations. I say this because. 
 
 it is a popular delusion that Alcoholics and 
 others, by some act of will, can at once re- 
 form, and may expect a rapid improvement 
 in their health by so doing. Such is not 
 the case. If the person has become more 
 
 . 
 = 
 
 a a 
 

 
 HYSTERIA 167 
 
 or less immune to the substance taken, he 
 may enjoy good and even excellent health 
 whilst indulging himself, and must be warned 
 not to be daunted by the months of ill-health 
 that will succeed to his most commendable 
 resolve to free himself of the tyranny. 
 
 The above are the disorders that are 
 occasionally brought to me, even by doctors, 
 as cases of Neurasthenia, and the absurd 
 nomenclature of use in medicine is alone 
 responsible for the confusion. By reason 
 of such misunderstanding, I have found 
 myself compelled to refer to them, though 
 they are quite outside the scope of this book 
 and are not breaches of the principles laid 
 down in my Preface and earlier chapters, 
 
CHAPTER IX 
 MENTAL FORMULA: 
 
 IND as a term is undefinable and as 
 
 a process unthinkable. We simply 
 have to accept it, to assume it, and to make 
 the best effort possible to classify its various 
 powers, always keeping in mind that, though 
 its control centres have their freds-a-terre 
 in the brain, yet each cell of the body adds 
 its quota to the product, and, like the private 
 soldier, makes the army of which the direc- 
 tion is in the hands of comparatively few 
 specially-trained men. Its division, made 
 solely for convenience, into conscious, sub- 
 conscious and unconscious, is even artificial, 
 since there is a free communication between 
 them all. How then can we assign values; 
 and how are the values to be expressed ; and 
 how are we to allow for the essential fluidity 
 of mind and for the consequent perpetual 
 shifting of our values? The problem is 
 
 insoluble. 
 168 
 
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 ae SD tay 
 Vat «Sr, 
 
 . ee ¥ 
 
 MENTAL FORMULA 169 
 
 Yet it would be useful and instructive 
 to have some plan, however elementary, to 
 enable us to visualize the way in which, as 
 far as we can judge, the mind works when it 
 is “made up,” when its balance has been 
 effected; and therefore I venture to make 
 the attempt. 
 
 The environment supplies the energy 
 with which we have to do mental work, and 
 this energy is utilized in two ways; it is either 
 inlubited and stored as memory or reserve 
 energy of some kind; or exhibited and used 
 in the production of thought and new com- 
 binations of ideas, or in action of some kind. 
 
 What decides the relative proportion of 
 this division? The Will, but if you ask 
 me further to give the origin of this faculty 
 of Will I can only answer, that it must be 
 viewed either as a direct emanation from 
 a higher mind (the Heilige Geist), or as the 
 outcome of the varying forces, exerted by 
 the general opinion of the day (the Zeitgeist 
 or Weltgeist), upon the mind of each one 
 of us; the pressure and direction of public 
 opinion, as the newspapers would phrase it. 
 That the individual Will can also, under 
 certain conditions and to a limited extent, 
 
170 MINDS IN DISTRESS 
 
 _be directly and potently affected by another 
 mind we see in hypnotism, in spiritualism, 
 and in the result of a stern word of command 
 on wavering troops in battle; but we also 
 seem ourselves to possess in some undefin- 
 able way a power of control and direction 
 over it. 
 
 We will assume that the three usual 
 divisions of the mind are valid ones, for both 
 observation and experiment incline us to 
 the acceptance of this as a general truth; 
 and selecting quite arbitrarily the number 
 roo as the sum of mental energy in the 
 mind, we will try and assign such a due pro- 
 portion of it to each division as we should 
 expect to find in a normal masculine and a 
 normal feminine mind; and then we shall 
 be able to understand why the conditions 
 underlying Neurasthenia and Hysteria 
 inevitably lead to the increase of activi- 
 ties in certain directions and to their 
 necessary decrease in others; in short, we 
 shall thus see why the Neurasthenic must 
 veason and why the Hysteric must show 
 explosive activities in one direction and a 
 more or less complete loss of activity in 
 others. 
 
 
 
* ane. 
 t= 
 
 oo.) Sem 
 
 MENTAL FORMULA 
 
 NorRMAL AVERAGE MASCULINE TYPE oF MIND 
 
 Determined by effect of wt// and habit 
 
 Environment Total Amount 
 
 Conscious Portion 
 
 A. Ideas relating to self. 30 
 _B. Ideas relating to others 15 
 C. Sensations (impressions) 15 
 
 Subconscious Portion 
 D. Instincts : : ‘ 10 
 EK. Impulses and intuitions 10 
 
 Unconscious Portion 
 
 G. Reflex muscular and secre- 
 -tory impulsions ; 20 
 
 LOO 
 
 171 
 
 Distribution 
 
 Inhibited Exhibited 
 
 15 
 
 Io 
 
 5 
 
 oo 
 
 8 
 
 54 
 
 55 
 5 
 
 Io 
 
 12 
 
 46 
 
 The above is taken as representative of 
 the ordinary average distribution of energy 
 as determined by the effect of will and by 
 habit. Habit is not a separate faculty, 
 but merely a line of least resistance, the 
 outcome of frequent use in one direction. 
 
 In NEURASTHENIA 
 
 Environment Total Amount 
 
 Conscious Portion 
 
 A(+) . 40 
 —“B(-) . ae j 
 
 C (- in general impres- 
 
 sions ; + in suchas 
 
 relate to self); 15 
 
 Distribution 
 
 Inhibited Exhibited 
 
172 MINDS IN DISTRESS 
 
 Environment Total Amount Distribution 
 Inhibited Exhibited 
 
 Subconscious Portion 
 
 Bats ; . ; : 10 8 2 
 S's ; ; : 10 8 2 
 
 Unconscious Portion 
 os : : ‘ ; 20 8 12 
 100 42 58 
 
 The normal proportions are seen to be 
 upset, and 42% of the activities of the 
 conscious mind is exhibited as reasoning 
 activity in place of the normal 307%, while 
 only 15% instead of 30% is stored as 
 memory or diverted into other channels. 
 It is necessary, moreover, to remember 
 that the will power is presumably weakened 
 by the increase of pressure on it at A, and, 
 since the mind is exceedingly fluid, or, to 
 use a better term, elastic, unduly increased 
 in resistance elsewhere. In short, endless 
 disturbance of mental energy is apparently 
 possible, but in the masculine mind the 
 conscious division is so predominant in 
 power that the greatest variation from the 
 normal will be seen there, and this masks 
 the other and minor disturbances which are 
 always present in Neurasthenia if looked 
 for. The great excess in activity of the 
 

 
 MENTAL FORMULA 173 
 
 reasoning power is so outstanding a feature 
 in Neurasthenia that the casual observer 
 fails to remark such phenomena as dilatation 
 and sluggishness of the pupils, increased 
 activity of the reflexes, distaste for muscular 
 exertion, partial loss of control over memory 
 (not loss of memory), etc. etc., which one or all, 
 with many others, accompany the disorder. 
 
 We now pass to the picture of the feminine 
 mind, viewed first as it is in the normal 
 state, and then as we should expect to see 
 it when in functional disarray. 
 
 NORMAL AVERAGE FEMININE TYPE OF MIND 
 Determined by effect of w#// and hadit 
 Environment Total Amount Distribution 
 
 : ; Inhibited Exhibited 
 Conscious Portion 
 
 A. Ideas relating to self . 20 10 IO 
 B. Ideas relating to others 5 2 3 
 C. Sensations (impressions) _—_10 5 5 
 Subconscious Portion 
 D. Instincts’. ee 3° aa : a] 5 
 E. Impulses and intuitions 15 10) 828.5 5 
 Unconscious Portion g a 
 G. Reflex muscular and secre- 
 tory impulsions . ; 20 8 12 
 100 55 45 
 
 3 There is here noticeable a tension in the 
 
174 MINDS IN DISTRESS 
 
 subconscious portion, a division in which 
 the repressive effects of the Zeitgeist, which 
 is largely the product of the masculine mind 
 as expressed in society, and above all in the 
 press and literature of the day, is evident 
 as a check. The relative proportions of 
 the inhibited and exhibited amounts is 
 thus kept back under ordinary conditions of 
 life so as nearly to be identical with that 
 seen in the masculine type of mind. 
 
 The reader will also note in the above 
 
 formula that a larger proportion of the total 
 
 output of mental energy is assigned to the 
 instincts and impulses of the subconscious 
 mind, and a smaller amount to the conscious 
 mind, than in the masculine mind type. I 
 think that he will agree with me that such 
 a proportionate allowance is in accordance 
 with general experience. 
 
 In HYSTERIA 
 
 Environment Total Amount Distribution 
 : ; Inhibited Exhibited 
 Consctous Portion 
 
 yk . : . 27 5 22 
 ). 3 3 ° 
 in aie as relate to 
 others; + in such as 
 relate to self) . ; 5 I 4 
 
 
 
 7 
 { 
 : 
 
oe eee ee eee ee ae 
 
 MENTAL FORMULA 175 
 
 Environment Total Amount Distribution 
 , Inhibited Exhibited 
 
 Subconscious Portion 
 
 DD. . : ; ‘ 30 10 20 
 
 E 15 I 14 
 Unconscious Portion 
 
 G. ; f ‘ : 20 8 12 
 
 100 28 72 
 
 The barrier made by subservience to 
 predominant masculine popular opinion has 
 gone, broken down as one of the conse- 
 quences of the disorganization of the for- 
 mula of health which has arisen largely from 
 an over-development of the self idea, re- 
 presented by A, and the consequent dis- 
 turbances of proportionate output. 
 
 Again I must ask the reader to remember 
 that these formulz have no pretence what- 
 ever to any exactitude and are introduced 
 only to show graphically, 1st, The general 
 effect of environment; 2nd, The difference 
 in mental constitution between the masculine 
 and feminine minds; 3rd, The disturbance 
 that must ensue chiefly as the result of 
 isolation, of an over-development of self, 
 as a factor in the environment; 4th, The 
 place of will in determining the proportion 
 
176 MINDS IN DISTRESS 
 
 in which the mental output of each portion 
 shall be allotted, what part of it shall be 
 stored and what part be expended in mental 
 or physical activities. The part arrested 
 and stored representing the fund of reserve 
 energy always present in the brain and 
 mind. What no formula can represent is 
 the ever-varying power and direction of the 
 will, and the influence of this, and of the 
 environment, in increasing activities in 
 certain directions and paralysing them in 
 others. 
 
 What it is desired to teach is that, by 
 studying the environment throughout life, 
 and by training the will, especially in early 
 life, we may avoid, unless possibly much 
 predisposed thereto, the mental and physi- 
 cal troubles that follow on a neglect of 
 those all-important indications. 
 
 To forestall, I hope, all criticism I beg 
 the reader to regard the above objects as a 
 valid excuse for presenting him with such 
 elementary formule. With the assistance 
 of a friend I some time ago endeavoured 
 to construct more pretentious ones on a 
 wider basis and with the values represented 
 mathematically in considerable detail, but 
 
MENTAL FORMULA 177 
 
 the result, though interesting, was even 
 still devoid of any scientific accuracy, while 
 it became so perplexing as to render 
 it unintelligible to any but the mathe- 
 matical mind and would have been quite 
 out of place in such a book as the present 
 one. 
 
 I2 
 

 
INDEX 
 
 ALCOHOL, craving, 151, 166 
 — cure of habit, 151 
 Ambitions, 65 
 
 Anzemia, 157 
 
 Analysis of secretions, etc., 60 
 Animals and a common mind, 92 
 Arsenic, 158 
 
 Atomism, I 
 
 BALANCE, mental, 7, 15, 28, 37 
 
 Bashi-Bazouks, 105 
 
 Bastian, Dr Charlton, 6 
 
 Bogies, see Phobias and Obses- 
 sions 
 
 — can be foretold, 53 
 
 — how generated, 53 
 
 — treatment of, 62, 75 
 
 — varieties of, 53 ef seg. 
 
 Brain, divisions of, 114, I19, 
 123 
 
 — pied-a-terre of mind, 82 
 
 Bromides, 49, 158 
 
 Burton, Robert, 65 
 
 CANNON-BALL, I61 
 Carlyle, 64 
 Catalepsy, 118 
 
 Celt, 25, 102, 104 
 Charcot, 66 
 
 Charity, 100 
 
 China tea, 67 
 Chlorodyne, 158 
 Christian Science, 134 
 Church of England, 104 
 Climacteric, 112 
 
 Coca wine, 160 
 Cocaine, 160 
 Common sense, 7, 95 
 
 179 
 
 Conventions, 133, 173 
 Courage in hysteria, 131 
 
 DEFINITIONS, faulty, 86 
 Delusions, 52, 163, 165 
 Depression, 162 
 
 Disease, organic, 47 
 Disseminated sclerosis, 80 
 Distress, mental, 8, 13, 114 
 Double personality, 117 
 Dramatic appeals, 149 
 Drugs, 69 
 
 — abuse of, 158 
 
 — habitués, 166 
 
 EGO, 5, 31, 91, 97, 132 
 Electro-therapy, 156, 161 
 Emergency medicine, 62 
 Emotions, 126 
 
 Energy in Hysteria, 144 
 
 — in Neurasthenia, 43 
 Environment, 10, 169, I71, 173 
 Epilepsy, 118, 164 
 Examination of patient, 60 
 
 FACTS, 17 
 
 Faddists, 45 
 
 Faith-healing, 154 
 
 Fasting, 118 
 
 Feminine mind type, 24 ef seq., 
 81 ef seq. 
 
 — best type, 83, 96 
 
 — effects of, in history, 25 
 
 — failures of balance in, 84, 99 
 
 — mental formula of, 173 
 
 — three main varieties of, 108 
 
 Fibroid tumours, 112 
 
 Food fads, 68 
 
180 
 
 Food fads in Neurasthenia, 67 
 
 Functional disease, a re-equili- 
 bration, 37 
 
 — and health, 114 
 
 Functions of mind, 5 
 
 GALEN, 64 
 
 General paralysis, 80 
 Gift of tongues, 122 
 Grammar of science, 2 
 
 HABIT, 171, 173 
 
 Health topics, to be avoided, 71 
 
 Heart-beat reduced, 31 
 
 Heart-to-heart talk, 129 
 
 Heilige Geist, 169 
 
 Hermit mind, 41 
 
 Home Rule, 103 
 
 Hypnotism, 66, 149 
 
 Hypochondriasis, 19, 163 
 
 — not Neurasthenia, 165 
 
 Hysteria, 26, 31, 56, 81, 108 
 él seq. 
 
 — causes of, 31 
 
 — contrasted with Insanity, 115 
 
 — disequilibration, 28, 81, 95 
 
 — disorder of entire brain, 87 
 
 — major, 109 
 
 — suicide in, 33 
 
 — symptoms of, 114 
 
 — treatment of, 36, 128 e7 seg. 
 
 Hysterical cases, 32, 116, 123, 
 134, 144, 150 
 
 IMPOSTURE in Hysteria, 115, 
 125, 136 
 
 — in Spiritualism, 90 
 
 Indian hemp, 118 
 
 Infallible medicines, 62, 163 
 
 Insanity, 12, 115, 164 
 
 — result of toxzemia, 12 
 
 Insomnia, cure of, 146 
 
 Instincts, 29, 98, 133 
 
 — perverted 120 
 
 — starved, 108 
 
 Intuition, 24 
 
 Isolation, effects of, 23, 40, 
 94 
 
 MINDS IN DISTRESS 
 
 JAMES, William, 1 
 Jaundice in hysteria, 123 
 
 KNOWLEDGE, contrasted with 
 understanding, 4 
 
 LiFE, backwaters of, 42 
 Logic, 18, 22 
 Lombroso, 93 
 
 MALINGERING, 124, 142 
 
 Mapped areas of brain, 6 
 
 Marriage, 136 
 
 Masculine mind, 17 é¢ seg. 
 
 — inferiority of, 96 
 
 — predominance of, 18, 100 
 
 Melancholia, 52, 164 . 
 
 Mental balance, 7, 13, 27 
 
 — comfort, 8, 9, 15 
 
 — composition, 9 
 
 — equation, 119, 168 
 
 — exercises, 70 
 
 Mind, balance of, I e¢ seg. 
 
 — conscious, 5, 171, 173 
 
 — divisions of, 114, 119, 123 
 
 — great divisions of, 17; 24 
 
 — insane, 12 
 
 — isolation of, 40 
 
 — one and indivisible, 2, 168, 
 171 
 
 — organic (reflex), 5, 171, 173 
 
 — the generator, 3 
 
 — throws out a balance, 8, 10 
 
 Misunderstood persons, 132 
 
 Monism, I 
 
 Morphia, 76, 158 
 
 NEGATIVISM, 44 
 Nervous breakdown, 162 
 Nervous debility, 43 
 
 Neurasthenia, absence of organic 
 
 disease in, 47 
 — a disequilibration, 81 
 — a functional disorder, 37 
 — class of mind affected in, 23 
 — disorders mistaken for, 162 
 
 — energy in, 43 
 — foods in, 67 
 
 
 
 
 
 > a a Pp 
 
 = 
 
INDEX 
 
 Neurasthenia, examples of, 49, 
 50, 63, 73, 79 
 
 — sexual, 72 
 
 — suicide in, 51 
 
 — symptoms of, 37 ef seg. 
 
 — treatment of, 44, 59 ef seq., 
 
 77 
 Numbers three and seven, 56 
 Nuns, hysteria rare in, 138 
 
 OBSESSIONS, see Bogies 
 
 — how generated, I1, 53 
 Opinions, written, 61 
 Opium, Chinese taker of, 155 
 — in hysteria, 159 
 Overwork, 39 
 
 PARALLEL, running of a, 45 
 
 Pearson, Dr Karl, 2 
 
 Phobias, II, 53 
 
 Phosphorus, 49, 157 
 
 2 ipa parent of anatomy, 
 2 
 
 Practical views, IOI 
 Protopiasm, synthetic, 3 
 Psychasthenia, 43 
 
 Psychic immorality, 116, 137 
 Puberty, 112 
 
 Purgatives, 160 
 
 QUACKS, 73 
 Quinine, 49, 76 
 
 RacEs of different mind-type, 18, 
 25 
 
 Reason, 101 
 
 Reflex functions disturbed, 84, 
 121, 173 
 
 Responsibility in hysteria, 115 
 
 181 
 
 Rest cures, bad, 65, 78, 79 
 — good in nervous breakdown, 
 162 
 
 Scots, Lowland, 18 
 Sensuality, 74 
 
 Sexual congress, 136 
 — neurasthenia, 72 
 — physiology, 113 
 Shock as cure, 153 
 Spiritualism, 89 
 Strain and stress, 42 
 Strychnine, 49, 76, 157 
 Suffragist movement, 103 
 Suicide, 33, 51, 52 
 Sympathetic ganglia, 7 
 Syphiliphobia, 45 
 
 THEORIES as counterbalances, 
 8, 27, 35, 53 
 
 Tobacco, 69 
 
 Tonics, 157 
 
 Toxzemia, 164 
 
 Traumatic hysteria, 142 
 
 VEGETARIANISM, 68 
 Virility, loss of, 73 
 
 Vis Medicatrix Nature, 38 
 Vomiting, fecal, 124 
 
 WEIR-MITCHELL system, 139 
 
 Will, 169 
 
 Women, kind fitted for work, 
 III 
 
 Work, 39, 50, 63, 142 
 
 Worry, 39 
 
 ZEITGEIST, 134, 169 
 — defined, 35 
 

 
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 - Books may be kept for two weeks and may 
 be renewed for the same period, unless re- 
 
 ~ 
 
 served. 
 
 Two cents a C:y is charged for each book 
 
 kept overtime. 
 
 If you cannot find what you want, ask the 
 Librarian who will be glad to help you. 
 
 The borrower is responsible for books drawn 
 on his card and for all fines accruing on the 
 
 same. 
 
a 
 A a Se OA = a rm 
 eee 
 = —— - nn a 
 
 eee ance task a 
 Se 
 SSS ee 
 = ie 
 = 
 
 6 
 SENS ee ee ea 
 Sea = eae ry ee 
 Pete orp on tamara ree rt 
 
 aumanaeek ee = ~~ use estan ee 
 eee Te eee 
 nes Rote ine aeetteee eae a anna 
 
 a neta ere