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 OF THE 
 
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 A. T. SCHOFIELD 
 
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UNCONSCIOUS THERA- 
 PEUTICS^ or, THE 
 PERSONALITY OF THE PHYSI- 
 CIAN. By ALFRED T. SCHOFIELD, 
 M.D., M.R.C.S., &c., Hon. Physician to 
 Friedenheim Hospital, Author of 'The Un- 
 conscious Mind ' ' The Force of Mind ' &c. 
 
 ' Ottly a good man can be a good 
 doctor: — Prof. Nothnagel 
 
 SECOND EDITION 
 
 LONDON : J. & A. CHURCHILL 
 7 GREAT MARLBOROUGH STREET 
 1906 
 
PRINTED BY 
 
 SPOTTISWOODE AND CO. LTD., NEW-STREET SQUARE 
 LONDON 
 
5c/i 4 u. £ 
 
 DE. J. MITCHELL BEUOE 
 
 IN GBATEFUL RECOGNITION 
 OF THE HELP HE HAS GIVEN TO THE CAUSE OP 
 RATIONAL THERAPEUTICS 
 
 THIS BOOK IS DEDICATED 
 
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Digitized by the Internet Archive 
 in 2015 
 
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PEEFAGE 
 
 TO 
 
 THE SECOND EDITION 
 
 In this edition some important additions have been 
 made to the text, and Chapter VI. has been con- 
 siderably altered. It is gratifying to know that 
 interest in this subject is everywhere increasing, 
 and it will, I trust, before long be regularly taught 
 in our schools. 
 
 6 Ha RLE Y Street, W. 
 Jamiary 1906. 
 
PEEFACE 
 
 TO 
 
 THE FIEST EDITION 
 
 My prefaces are mostly apologias, writing as I 
 do on subjects largely of a character somewhat 
 different from ordinary medical matters. I shall 
 never add to the innumerable books on these 
 subjects, having neither competency to entitle me 
 nor ambition to urge me to do so. Psycho- 
 therapeutics, however, comes under a different 
 category, the literature concerning it within the 
 ranks of the profession being exceedingly scanty. 
 And yet the necessity for good books upon it — books 
 far better than any I can hope to write — seems 
 to me very pressing, and perhaps never quite so 
 much so as to-day. 
 
 In saying this I allude to two factors which 
 largely sway men's thoughts at this time. The 
 one is the great psychic wave, mainly of American 
 origin, that, besides disgusting most thoughtful 
 
X UNCONSCIOUS THEEAPEUTICS 
 
 minds with its extravagances and carrying away 
 thoughtless minds with its pretensions, contains 
 sundry deep underlying and notable truths. The 
 other is the great advance of thought and speech 
 transference now possible through the slightest 
 and almost imperceptible material agencies — a 
 simple diaphragm and wire in the telephone, and 
 a tiny cylinder and wire in the marconigram — the 
 power that spans the space being in either case 
 etheric waves, guided in the telephone from one 
 brain to the other along a given track by a wire ; 
 in wireless telegraphy spreading through space in 
 free circles (or even spheres ?) till through its 
 medium brain touches brain. 
 
 These latter-day wonders have undoubtedly 
 not only whetted men's appetites for greater 
 marvels, but have led them, not unreasonably, to 
 expect such within the near future. Why not, 
 therefore, in medicine ? 
 
 But there are at least two other reasons for 
 writing on psychotherapeutics which seem to me 
 to appeal yet more forcibly to the medical pro- 
 fession ; and they are certainly the two reasons 
 that have induced me to write this book. 
 
 It appears to me that all who have the progress 
 of medicine at heart, and whose eyes are not alto- 
 
PEEPACB TO THE PIEST EDITION xi 
 
 gether blinded by the glittering achievements of 
 science, must feel, as I do, both annoyed and 
 ashamed at the double spectacle of the rampant 
 progress of quackery and the impotent futility of 
 our opposition to it. In Chapter X. I have quoted 
 the latest utterance (by Dr. Hutchison at the 
 London Hospital) on the subject. Let those who 
 think * impotent futility ' too strong language read 
 that address for themselves ; while those who 
 would measure the amount of annoyance the pre- 
 sent position of quackery causes to thoughtful 
 minds should study Sir James Paget's letter with 
 which my last appeal The Force of Mind ') on 
 this subject opens. 
 
 As to the remedy I suggest, those must judge 
 of its efficacy who have patience enough to read 
 this book ; but I maintain that, whatever opinions 
 may be held of the value of the cure, there can be 
 no doubt as to the urgency of the case. 
 
 One last point I should like to urge. Once it is ^ 
 decided that there is a power for good in un- 
 conscious therapeutics (and really I think few"" 
 are hardy enough to deny it), is it not clear that • 
 no medical training can be complete that does not : 
 teach it ? In the last chapter, under seven heads, ■ 
 I have shown how wide is the scope, and how great 
 
xii UNCONSCIOUS THEEAPEUTICS 
 
 the interest, of the subject, and throughout the 
 book I have urged its being systematically taught. 
 
 And now to close with the usual explanations, 
 which are specially needed here. 
 
 Having but one subject to write about, and 
 being forced to ring the changes on it, the reader 
 will find at least two things to complain of in this 
 book. The one is, that I quote a good deal from 
 myself ; and the other, that over and over again 
 I say the same thing in different words. 
 
 But I care not what faults of style, what sins of 
 repetition and reiteration, I am charged with, so 
 long as I drive my point home ; and I know well 
 the force of saying the same thing fifty times over 
 in compelling thought on the subject. And it is 
 this last that is the measure of my success ; for 
 this book is no bid for fame, no commercial ven- 
 ture, no academic expression of philosophic doubt, 
 but an earnest, though I fear inartistic, attempt 
 to get into the minds of the profession what I 
 very much want them to know, and that is — that 
 \ I there is one great branch of therapeutics they still 
 /^ignore, to their own great loss and to their 
 I enemies' advantage. 
 
 ALFRED T. SGHOPIELD. 
 
 6 Harley Street, W. 
 A^pril 1904. 
 
CONTENTS 
 
 CHAPTER PAGE 
 
 Preface to the Second Edition . . . vii 
 Preface to the First Edition . . . ix 
 I. The Mind in Therapeutics . . . . 1 
 
 II. Value and Varieties of Mental Thera- 
 
 peutics 20 
 
 III. The Vis Medicatrix Naturae . . . . 55 
 
 IV. The Personality of the Physician . . 77 
 
 V. Other Therapeutical Influences . . . 117 
 
 VI. From a Patient's Point of View . . . 130 
 VII. The Practice of Unconscious Therapeutics 153 
 
 VIII. The Secret of Success in Practice . . 198 
 
 IX. The Action of Unconscious Therapeutics . 224 
 
 X. On the Study of Unconscious Therapeutics 244 
 
 List of Writers and their Works re- 
 ferred TO 279 
 
 Index . 285 
 
UNCONSCIOUS THERAPEUTICS 
 
 OR THE 
 
 PERSONALITY OF THE PHYSICIAN 
 
 CHAPTEE I 
 
 THE MIND IN THEEAPEUTICS 
 
 * Psychotherapy owes its position of chief import- Onpsycho- 
 ance among the general therapeutic agencies . . . 
 to the better comprehension on the part of the 
 physician of the influence which he is able to 
 exert upon the minds of his patients, and through 
 that upon their bodily processes.' ^ 
 
 These words, from a well-known New York 
 physician in an important work on the nervous 
 system, show us what a different position is ac- 
 corded to this branch of therapeutics in the States 
 rTroin that which obtains here. And this is all America 
 4k the more noteworthy in that it comes from a wlti7^^ 
 country that is overrun with every form of per- 
 version and misuse of psychotherapy in countless 
 varieties of quackery ; so that were it not for the 
 
 ^ Dr. J. Collins, Treatrnent of Diseases of the Nervous System, 
 p. 136. 
 
2 UNCONSCIOUS THEEAPEUTICS 
 
 inherent value of these therapeutics and their 
 ubiquitous nature, physicians of good standing 
 might well be shy of handling them. But Dr. 
 Collins and his work are well known as of the 
 \first rank; and the occurrence of such a sentence 
 in such a book, from such a (][uack-ridden country, 
 is more significant than at first sight appears, 
 when we consider that in our own country the 
 very name of ' psychotherapy ' is often enough, 
 and more than enough, to prevent further investi- 
 gation. There can be no doubt that prejudice, 
 deep-rooted and unreasoning prejudice, as opposed 
 to the spirit of free inquiry, rules far more strongly 
 over here than with our cousins. 
 The The subtitle of this work, * The Personality of 
 
 personality , -^.1 • • » • t i • i 
 
 of the the Physician, is, I think, a somewhat novel one to 
 physician. prof ossion in England, where with that modesty 
 which so often conspicuously clothes our country- 
 men personally, if not nationally, the medical man 
 is somewhat unaccustomed to bestow much thought 
 upon his own attractions ; and still less to put 
 himself on a level with anything in the pages of 
 the British Pharmacopoeia as of distinctly thera- 
 peutic value : in force equal, let us say, though 
 not similar in action, to aloes or calomel. 
 
 The title itself, too, ' Unconscious Thera- 
 peutics,' has rather a weird and even sinister 
 
THE MIND IN THBEAPEUTICS 3 
 
 sound to medical ears ; for it must be admitted Uncon- 
 scious 
 
 that calomel and aloes are generally administered ^^^ra.. 
 
 ^ *^ peutics. 
 
 when both doctor and patient are in a conscious 
 state. The meaning, however, of this subtlety 
 will be unfolded in the next chapter. 
 
 The general connection of mind and body is 
 perhaps too trite a subject to be descanted upon 
 here at any length ; for it is now generally accepted 
 in theory, however little it may be used in practice. 
 ' Not a thought,' says Dr. Moore,^ ' not an idea, not Dr. Moore 
 an act of will, not an affection or a feeling of the power of 
 
 the mind. 
 
 mmd, can be excited without positive change in the 
 brain, and thence in the blood and the secretions ; 
 for every variation in the state of the whole or any 
 portion of the nervous system is of course accom- 
 panied by a correspondent change in those organs 
 and functions which it furnishes with energy ; so 
 that the mind and body are in a constant course of 
 action and reaction on each other as long as life 
 and consciousness continue.' 
 f Therapeutics generally have been divided into Four 
 %^four classes : chemical (antitoxins, drugs, &c.) ; of thera- 
 
 i physical (food, electricity, baths, climate, &c.) ; 
 ^^ mechanical (massage, exercises, rest, &c.) ; and 
 j mental (through the unconscious mind directly 
 / » Dr. Moore, The Poiver of the Soul over the Body^ p. 301. 
 
 B 2 
 
4 UNCONSCIOUS THERAPEUTICS 
 
 and indirectly). I presume this division of 
 therapeutics is not devoid of meaning even now ; 
 but it is a little singular to notice how entirely the 
 science and teaching in our profession are con- 
 centrated upon the chemical, the mechanical, and 
 the physical, to the dire neglect of the mental. 
 
 It seems to me, therefore, that whereas pro- 
 found apologies may be rightly expected from those 
 who thoughtlessly add to the interminable lists of 
 books upon these first three classes (unless, indeed, 
 they have some distinct advance to record), none 
 whatever is needed for an attempt to bring the 
 fourth (the mental) a little more into line with the 
 rest ; although we may include many points that 
 are well known, and not advance any very startling 
 novelties. 
 
 Sir W. W. Gull ^ tells us, as his own opinion, 
 that ' the education and connections of the psychic 
 force are worthy of all attention.' Quite so ; but, 
 though it is now some years since Sir W. W. Gull 
 said this, I venture to think this education is 
 still conspicuous by its absence, and the connections 
 (with cures) alluded to are but little known. 
 
 We have high authority for the virtue con- 
 nected with *a single eye,' and there can be no 
 ^ Sir H. Aoland, Memoirs of Sir W, W, Gull, p. liii. 
 
THE MIND IN THEEAPEUTICS 5 
 
 doubt that this^ has been cultivated in the pro- a single 
 
 eye. 
 
 fession for the last thirty years to an alarming 
 extent. The single eye, which alone illumines 
 so many medical minds now, is scientific, me- 
 chanical, practical, observant, and accurate. 
 
 But after all, though a single eye has the great 
 advantage over two that it cannot squint, or be dis- 
 tracted by looking at two things at once, it has the 
 enormous disadvantage of not possessing stereo- stereo- 
 scopic vision ; which in medicine, by obtaining two 'flat' 
 
 . fl 1 . 1 . vision. 
 
 different views of the patient at the same time, sees 
 him as a solid living entity of three dimensions, 
 instead of viewing him on the flat as a troublesome 
 adjunct to his disease in two dimensions. The 
 single eye can of course see the body at one time, 
 and can also see the mind at another, if the gaze 
 be turned thither ; but it cannot view both at 
 the same moment, and combine them in the 
 one picture of the living man. ^Now there is 
 such a thing as stereoscopic thinking — the view- 
 ing subjects, as well as objects, with our two 
 eyes ; ' ^ and we must look and think stereoscopically 
 
 * By ' this ' it is obvious that I refer to the sight of one eye, 
 and not, as is often meant by the expression, the single vision of 
 two eyes as opposed to diplopia. 
 
 2 Dr. John Brown, Horce SubsecivcBj 1st Series, art. * Locke 
 and Sydenham,' p. xxiii. 
 
6 UNCONSCIOUS THEEAPBUTICS 
 
 We must 
 see with 
 two eyes. 
 
 False 
 limitation 
 of mind to 
 conscious- 
 ness. 
 
 Little 
 power of 
 the con- 
 scious mind 
 over the 
 body. 
 
 if we would ever see or know the truth. One eye on 
 the mind and one on the body ; one eye philosophic 
 and imaginative, and one scientific and observant ; 
 one theoretic and one practical, one seeing the 
 invisible and one the visible, constitute the double 
 vision that has ever characterised the leaders in 
 every profession, and specially all really great 
 physicians. In a future chapter I shall produce 
 abundant evidence to prove this : at present I am 
 content to state it. 
 
 To return to the action of the mind upon the 
 body. One great reason undoubtedly for its neglect 
 as a subject for medical study is the complete 
 limitation of mind, till lately, to that part of it where 
 consciousness is found. This may be a useful 
 limitation when the study of its conscious powers 
 and faculties is the question, but is peculiarly 
 disastrous in the present case, when its relation 
 with the body is the point ; for not only does there 
 seem no possible connection between our conscious 
 reasoning powers and, say, neuralgia of the spine, 
 but as a matter of fact, if we try to connect them 
 by either endeavouring to produce or remove this 
 affection by the mind or will, we are as a rule 
 doomed to failure. Sir James Paget made the 
 strongest efforts to affect his body by his mind, but 
 found he had no power to do so. In fact, conscious 
 
THE MIND IN THEEAPBUTICS 7 
 
 efforts in this direction are mostly futile, and even 
 where effective the range of action is extremely 
 limited. It is this error that leads to much of the 
 gross exaggeration that abounds. The public are 
 led to believe that cures can be effected by conscious 
 will and direct suggestion in nearly every case of 
 sickness. Now, though there is no case of sickness 
 where the mind does not play some part, such a 
 statement is misleading and incorrect. 
 
 It is obvious, therefore, that any teaching that 
 limits mind to its conscious part, ipso facto places 
 a great barrier to any study of the relations of 
 mind and body. 
 
 For this study our psychology must be widened. Conception 
 and the extent of mind must not depend upon the must be 
 
 widened. 
 
 amount of its action that we can see by the light 
 
 of consciousness, but upon the amount we can trace 
 
 from the results that ensue. If I see a watch, I 
 
 see mind impressed on metal ; as in a vase, on 
 
 china. A hut on a desert island is as much a proof 
 
 that a reasoning mind has been there, as even a 
 
 footprint on the sand. My mind is not limited to Mind 
 
 what I see of it, any more than my body, parts of hjli^^^^ 
 
 which I never see at all. That portion of the p^"^^^^*^' 
 
 mind that lies beyond the light of consciousness 
 
 some call * the subconscious mind,' or the subliminal Subliminal 
 
 self. 
 
 self ; others, ' that part of the conscious mind of 
 
8 UNCONSCIOUS THEEAPEUTICS 
 
 which we are not conscious ; ' while physiologists as 
 a rule prefer the non-committal but meaningless 
 terms of ^ Nature,' ' Physiology,' * Unconscious 
 Cerebration,' and the like. I think, however, * un- 
 conscious mind ' is the simplest and most expres- 
 sive term. 
 
 Apologia It may not be out of place here briefly to give 
 
 pro libro 
 
 meo. my ^ apologia ' for interfering in psychological 
 matters so far as to write a book with such a 
 daring title as ' The Unconscious Mind, ' ^ and 
 I think I shall be able to show that in my case 
 it was no question of choice, but a matter of 
 necessity. 
 
 Early In my student days I wondered much what 
 
 training. *^ 
 
 might be the meaning of the phrases * Nature did 
 this,' and * Nature controls that,' that I found in 
 my physiological text-books ; and in Kirkes' 
 
 * Physiology ' I got some answer in a much-valued 
 chapter (V.) on the ^ Eelation of Life to other 
 Forces,' a chapter that was still extant in the 
 tenth edition, but omitted subsequently, I believe, in 
 these more scientific days. But, like Oliver Twist, 
 I wanted more, and commenced some elementary 
 studies in psychology. Dr. Sutton's remarkable 
 philosophic teaching at the London Hospital helped 
 me further, together with Dr. Lionel Beale's theories 
 
 * The Unconscious Mindy 3rd edition. Hodder & Stoughton, 
 
THE MIND IN THEEAPEUTICS 9 
 
 on Life and Protoplasm. But it was not until I had Problem of 
 
 hysteria. 
 
 been in practice for some time, and found that my 
 work began to gravitate more and more to nervous 
 cases, that I came face to face with the real problem 
 for solution. Cases of hysteria — or, better, * neuro- 
 mimesis ' — somehow never seemed to try my 
 patience, as I found they did that of others ; not 
 because I possessed more, but because from the first 
 I was fully convinced that the sufferings were real. 
 Experience, reading, and converse with friends soon 
 showed me that in the aetiology of neuromimesis 
 the profession seemed veritably on the horns of a 
 dilemma, a position of proverbial discomfort. This 
 situation quite accounted to me for any impatience, 
 as well as any contempt, that might be displayed. 
 The dilemma was this. 
 
 Finding no organic basis for the symptoms Mentally 
 
 caused, and 
 
 displayed and the pain complained of, in the yet not 
 
 consciously 
 
 supposed disease (say of the knee-joint), doctors caused, 
 were compelled to attribute these to mental ideas 
 and call this disease 'neuromimesis' or hysteria. 
 Now if the mind be bounded by consciousness, 
 such ideas and such symptoms of disease must 
 be conscious ideas, and symptoms formed with 
 the knowledge and will of the patient ; and 
 such symptoms must, if produced by mind at 
 all, be consciously produced. But the conscious 
 
10 UNCONSCIOUS THEEAPEUTICS 
 
 representation or imitation of what does not 
 exist, constitutes fraud or malingering, not neuro- 
 mimesis or hysteria ; unless, indeed, as many- 
 supposed, and perhaps some do still suppose, 
 that the one is synonymous with the other. 
 Those therefore who were driven to consider the 
 disease mental, were also logically, by reason 
 of their psychological teaching, driven to con- 
 sider it fraudulent. If it were not fraudulent, to 
 them it could not be mental. Now I, doubtless 
 with many others, felt certain that it was mental 
 therefore and yet not fraudulent. But how mental? For 
 
 caused 
 
 uncon- here was another difficulty. Could the conscious 
 
 sciously: 
 
 mind by any effort produce the heat and redness 
 and swelling in exact simulation of an inflamed 
 knee that I have seen in hysterical joint disease ? 
 Could the will by any power, consciously exercised, 
 contract a part of the rectus abdominis muscle, 
 or isolate and distend a section of the bowel, on one 
 side in exact simulation of an abdominal tumour, 
 or produce capricious anaesthesias, hyperaesthesias, 
 or temperatures in various parts of the body ? 
 never by Certainly not. The powers of the conscious 
 
 the con- 
 scious mind are exceedingly limited. And yet neuro- 
 
 mind. 
 
 mimesis is a mental disease. Clearly, then, there 
 must be another mind, or another part of the 
 mind, in far closer touch with the body, and with 
 
THE MIND IN THEEAPBUTICS 11 
 
 far greater powers over it, and also wholly un- 
 conscious in its action. Being driven to postulate 
 this out of sheer necessity, I began to think : 
 ' Perhaps this is my old friend Nature " out of 
 the physiologies, who was said to work such 
 wonders there.' Still, it seemed rather daring to 
 start an ' unconscious mind ' on such slender 
 bases. I therefore looked again at the psycho- 
 logies, not only English, but German, American, 
 and French, and I found abundant warrant for 
 believing in the existence of this mind. One after 
 another declared that psychical processes pro- 
 ceeded out of consciousness, just as they did 
 within it. I found, as far back as 1888, a 
 very learned society, * the Aristotelian,' definitely Aristo. 
 deciding that * mind was not synonymous with s^ddety on 
 consciousness.' I found that the most conserva- 
 tive of my old psychological friends themselves 
 left loopholes everywhere for the intruder, in 
 showing that mental processes did go on ^ beneath 
 the threshold ' of consciousness, or in its * back- 
 ground ' or * dim regions.' 
 
 Professor White, in 'Mind,'^ points out that Professor 
 
 T. White 
 
 * the facts of physiology have at length led psycho- on mind, 
 logists to see that the states of consciousness form 
 only a portion of the mental life, and have as 
 
 ^ Dr. T. White, Mind, vol. vi. p. 506, 
 
12 UNCONSCIOUS THEEAPEUTICS 
 
 background subconsciousness and unconscious- 
 ness.' 'At first,' he continues, 'it seems like a 
 contradiction to speak of facts of unconsciousness 
 as belonging to psychology ; but when it is con- 
 sidered that the same changes in the nervous 
 system may be accompanied by consciousness or 
 some subconscious change, it is evident that mind 
 must consist of other elements than those which 
 appear in consciousness. The study of physiology 
 was necessary to bring out clearly the conception 
 of unconscious feelings as facts in mental pheno- 
 mena.' 
 
 We have I felt, therefore, that the term ' unconscious 
 
 not two 
 
 minds. mind,' though somewhat new in England, was the 
 best to describe this mind that rules the body. 
 Had we, then, two minds, or even more ? I 
 thought not ; for it seemed to me that the proof 
 that the unconscious mind was mind consisted in 
 the fact that its operations were similar in 
 character to those carried on in consciousness. 
 Once, therefore, displace, as I said at the start, 
 consciousness from being in any way a defining 
 limit of mind, and let the definition be based 
 rather on the character of its action, and it is 
 seen that the mind is one and indivisible ; part, 
 indeed (the conscious), illumined by conscious- 
 ness, and part (the unconscious) left in darkness ; 
 
THE MIND IN THEEAPEUTICS 13 
 
 a tract between the two (the subconscious region) 
 being sometimes in light, and sometimes in ob- 
 scurity. Great efforts are made to call the 'un- 
 conscious ' the * subconscious.' Now, though one 
 would not trouble about words as a rule, such lan- 
 guage is misleading. The unconscious means what 
 can never be brought into our consciousness, to 
 which alone we refer ; and it is useless to say it 
 may have a consciousness of its own. 
 
 The subconscious means that part just out of 
 our consciousness which may by effort be brought 
 within it. The distinction should be observed. 
 
 May I also be allowed to say in passing, for Beiigious 
 the benefit of some of my readers, that I found soived,^^ 
 this fact of an unconscious mind threw a great 
 light on the problems of religion, where a new 
 spiritual force is believed to enter the man wholly 
 unconsciously ; also on ethics, where the character 
 is formed unconsciously ; on conduct, where action 
 results from unconscious impulses ; on child- 
 hood, where education from environment proceeds 
 unconsciously ; and on art, where genius acts from 
 entirely hidden springs ? 
 
 So, not in my practice alone, nor even in medi- as well as 
 
 . many 
 
 cme generally, but in the whole range of study, I others, 
 found much that had been obscure become simple 
 and clear, once the meaning of the word ' mind ' 
 
14 UNCONSCIOUS THEEAPEUTICS 
 
 Sydenham 
 on 
 
 hysteria. 
 
 Dr. J. 
 
 Collins 
 on cortical 
 excitation. 
 
 included the whole, and not a part. But in 
 hysteria or neuromimesis, clearly though the 
 action of this unconscious mind now fully accounted 
 for the phenomena, it evidently was not in a 
 normal and healthy condition, but abnormal and 
 
 Sydenham, who was the first to recognise 
 hysteria, said it was the most common of all 
 known diseases, and depended on ' ataxia ' ot 
 disturbance of the * animal spirits ' (or ' the breath 
 of the soul' of Galen) — a very near approach to 
 disorder of the unconscious mind. 
 
 The most recent work on hysteria says : ^ 
 
 * Cortical excitation, no matter how it may be 
 awakened, . . . may be assumed to be capable 
 of producing both functional and organic diseases 
 of the nervous system, and in a less degree of all 
 other tissues of the body.' 
 
 This ' ataxia ' of Sydenham or ' excitation ' of 
 Collins producing disease, is clearly an abnormal 
 action of the unconscious mind. 
 
 As a result of these various considerations, I 
 accepted * the unconscious mind,' not, let me repeat, 
 as a separate mind from that hitherto known to 
 psychology, but as a further part of it, never 
 
 ' Dr. J. Collins, Treatment of Diseases of the Nervous 
 System, p. 138. 
 
THE MIND IN THEEAPEUTICS 15 
 
 illumined wholly by consciousness ; and related, as 
 I found, curiously enough, to the highest and 
 lowest parts of my being— the conscious mind 
 seemingly, like the spectrum or thermometer, to The 
 
 spectrum 
 
 occupy the middle range, with unmarked tracts andther- 
 
 mometerj 
 
 extending beyond consciousness above and below. 
 Conscious will, I found, could hardly affect the 
 body at all by any direct effort, however strong ; 
 whereas indirectly, through, as I believe, the 
 medium of the unconscious mind, its powers were 
 most extensive, and produced not only functional 
 symptoms, but others organic in character, as I 
 shall show hereafter. 
 
 I was, of course, hardly surprised when I found causes of 
 that my book on the subject excited strong opposi- to the uT 
 tion, partly, it seemed, because this extension of mind, 
 mind tended to throw down the intellectual barrier 
 between man and the lower animals, and partly 
 because it tended to exalt what might, after all, be 
 but sensori-motor reflexes into mental processes. 
 
 The former objection is, perhaps, hardly worth 
 combating ; and with regard to the latter, there 
 are in the body, and specially in the spinal cord, 
 innumerable natural reflexes of a low order that Natural 
 seem to postulate no mental action. But these acquired 
 
 refiexeSa 
 
 reflexes were never intelligently performed, as is 
 the case with all acquired reflexes. The position 
 
16 UNCONSCIOUS THERAPEUTICS 
 
 is no longer possible that the same intelligent and 
 purposive action ceases to be mental whenever 
 it, or any part of it, is performed unconsciously. 
 The new psychology, in the able hands of Wundt ^ 
 and others, has already obtained such a sufficient 
 hearing, that to make mind now synonymous with 
 consciousness is a questionable proceeding; while 
 even in 1898 to say otherwise was in certain 
 circles, as I well know, anathema ! 
 Voices in It is truo there were many voices crying 
 ness. in the wilderness ; but they were unheeded. 
 
 Eomanes, Fritz Schultze, Paulsen, and many 
 others taught that our unconscious presentations, 
 sensations, and volitions all pertained to our 
 psychic life; and that, indeed, the field of this 
 unconscious mental action was far more extensive 
 than that in consciousness. 
 No real But WO must ovor remember the two provinces 
 
 marcab^^^^ are intimately connected, and are separated by no 
 sharp line of demarcation. An unconscious pre- 
 sentation may become conscious at any moment ; 
 while, if our attention be withdrawn from it, it at 
 once disappears again into unconsciousness. 
 
 ^ Wilhelm Wundt, of Leipzig, is perhaps the ablest living 
 psychologist, and in his lectures on human and animal psycho- 
 logy he has conclusively proved that the theatre of these most 
 important psychic processes is in the unconscious soul. See 
 Wundt, Beitrdge zur Theorie der Sinnes Vermehrung, pp. 169, 
 375, 436, 488. Also Physiological PsycJwlogyy Introd. p. 5. 
 
THE MIND IN THBEAPEUTICS 17 
 
 But, as I have said, this enlargement of mind, 
 though not perhaps ridiculed now, is still but little 
 understood ; and, for want of it, the interaction of 
 mind and body is most obscure. That the signifi- 
 cance of this mutual dependence of one on the 
 other is overlooked, * one illustration,' says Dr. J. 
 Collins,^ 'will make clear. It is customary for Pain is 
 
 never ' ima- 
 
 many physicians to speak of a pain ... as ginary.' 
 imaginary." The only purely imaginary symptom 
 without a physical basis is one that a patient 
 describes when he is not telling the truth. If a 
 patient possesses a symptom as a mental content 
 . . . there is an underlying physical process con- 
 nected with the cellular contents of the cortex.' 
 Setting aside, however, incautious expressions 
 which survive from erroneous and perhaps ex- 
 ploded ideas of the past, there can be no doubt of 
 the practical advance in the recognition of the Psycho- 
 mind in therapeutics by the modern physician. Idvancld, 
 I do not allude to the up-to-date young man 
 just cram-full of the science of the schools, very 
 largely undigested ; for he has as yet had no 
 leisure to think at all — at any rate, in a direction 
 so contrary to his text-books and about a subject 
 so ' visionary ' as mental therapeutics. 
 
 ^ Dr. J. Collins, Treatment of Diseases of the Nervous 
 System, p. 137. 
 
 C 
 
18 UNCONSCIOUS THBEAPEUTICS 
 
 and No ! I refer to the physician who is sobered 
 
 physicians 
 
 also. and widened by experience of men (and, shall I 
 specially add, women ?), and who has perforce 
 been driven to own the extraordinary ubiquity of 
 mind as a factor in bodily affections. He deserves 
 great praise in proportion as he takes the mind 
 into account when treating the body; from the 
 simple fact that he has never been systematically 
 taught to do so in school or hospital, and therefore 
 he owes his knowledge of mind and body entirely 
 to his observation and common sense; and his 
 power of treating or helping the one through the 
 other, to his own skill and tact, and in no way to 
 his medical training. 
 
 Great honour is surely due to men who success- 
 fully practise what they have never been taught. 
 
 Dualist I* will be clear to those who have followed me 
 
 monists. SO far that I definitely take up the position of a 
 dualist — a believer in a mind and in a body. It 
 is not a little remarkable in this connection that 
 such men as Kant, Virchow, Du Bois-Eeymond, 
 W. Wundt, and G. E. Baer all began to write as 
 monists, and all in later life, with more experience, 
 became dualists. 
 
 And yet, notwithstanding my belief in the mind 
 
THE MIND IN THBEAPEUTICS 19 
 
 and body, one great object of this monograph is to Man in a 
 
 unity, 
 
 enforce the truth that the two (or the three) are 
 but as one — that a man is a unity, and that, 
 although body be body and soul soul, nevertheless 
 in our experience during life the one never moves 
 without the other. This fact, if accepted and 
 pondered over, will perhaps bring home to every 
 reader of these pages the somewhat dangerous 
 position of a man, a member of a learned pro- 
 fession, who sets out to deal with men in their 
 most critical moments in life with a profound study 
 of the body, and, to say the least, a very incom- 
 plete knowledge of the mind. 
 
 Of course, there is nothing wrong in it, if you can 
 treat the disease apart from the man, or the body 
 apart from the mind ; but what is becoming more and aii 
 
 points of 
 
 and more evident is that you cannot do this, and this unity 
 
 must be 
 
 each year medical men are waking to this fact, studied 
 that has long been ably insisted on by such 
 physicians as Weir Mitchell, Sutton, Eeynolds, 
 Paget, Gull, Clark, and many others. 
 
 Perhaps this book may lead some to consider 
 seriously the essential connection between success- 
 ful practice and the great truth of the unity of 
 man. 
 
 c 2 
 
20 UNCONSCIOUS THEEAPEUTICS 
 
 CHAPTEE II 
 
 VALUE AND VARIETIES OF MENTAL THERAPEUTICS 
 
 The value Before entering upon the varieties of mental thera- 
 
 of uncon- 
 scious the- peutics and showing how and in what way the 
 
 rapeutics. 
 
 term ^ Unconscious Therapeutics ' may often be 
 applied to them, I should like for a moment to say 
 a word or two about their value — first of all on 
 their own account, and, secondly, on account of 
 their great importance in successful practice. 
 
 In the first place I need not stop here to prove 
 the existence of mental therapeutics. In a previous 
 work I have done this at length,^ and, indeed, one 
 has only to consider how many diseases are pro- 
 Mind can duced by the mind, to be led to the legitimate 
 
 cure 
 
 diseases it doduction that what can be mentally produced can 
 
 produces. 
 
 probably be mentally cured. And yet, simple as 
 this conclusion appears, for years men have sought 
 to cure with drugs alone, diseases confessedly 
 of mental origin. I do not object to drugs as 
 » The Force of Mind, 2nd edit. J. & A. Churchill. 
 
VALUE OF MENTAL THEEAPEUTICS 21 
 
 adjuvants in these cases : for the truth remains No disease 
 
 is purely 
 
 that no disease is purely mental, any more than physical, 
 any disease is purely physical. Hence material 
 and mental remedies, not only empirically but 
 scientifically, go well together, 
 ^ ■ Mental therapeutics, however, not only co-exist Ordinary 
 
 -K^ jr 7 7 J therapeu- 
 
 %ith material, but may be of greater importance, tics often 
 
 *^ ■«- symptom- 
 
 Drugs are sometimes given to relieve symptoms ^^i^. 
 
 only, and symptoms moreover that might be 
 
 nSeneficial. Mental therapeutics are not aimed at Mental the- 
 
 1 rapeutics 
 
 ""^H^niptoms, but generally attack the root of the deal with 
 
 I' ? & J the cause. 
 
 '.disease, or at any rate its mental root. Alteratives 
 for the mind are generally more important and 
 efficacious than alteratives for the body. There 
 are mental analogues to iodide of potassium. Again, 
 not only are mental therapeutics ever a great 
 resource and adjunct in ordinary medicine, but 
 there are some forms of disease where they con- 
 stitute the only remedy that is effectual. 
 
 De Fleury, with his poetical pen, paints a glow- De Fieury 
 
 on mental 
 
 mg picture of what may result from the intelligent thera- 
 peutics. 
 
 use of mental therapeutics by the profession. He 
 says : ^ * As a Marcel-Desprez disciplines tides and 
 cataracts, the forces of blind nature ; so the sound 
 medical moralist might be able to double the 
 » Maurice de Fleury, Medicine and the Mind, p. 224. 
 
22 UNCONSCIOUS THEEAPEUTICS 
 
 Uncon- 
 scious the- 
 rapeutics. 
 
 Probable 
 advance 
 in mental 
 medicine. 
 
 amount of voluntary energy and moral strength in 
 us all. And perhaps it is already possible to fore- 
 cast the means by which he will make a channel 
 for those undulating waves [in the minds of] weak 
 human beings, whereby they may take form and 
 consistence, and be no more scattered and lost/ 
 He also points out that,^ *Now that the path is 
 open, there is no real reason why psychological 
 therapeutics should not make the same progress 
 that we admire so much when antiseptic surgery 
 or microbes are in question. As a matter of fact, 
 medicine for the mind has partially existed for 
 ages ; all those who have endeavoured to relieve 
 the nervous have practised it, often unknown to 
 themselves' It is here we get the idea of our 
 title, ' Unconscious Therapeutics.' * The Church, 
 with its rules of life, its abstinence, its food 
 regimen, and other health laws, has ever been a 
 great hygienist.' 
 
 With due allowance for French poetry, there is 
 no doubt that a great advance is impending in the 
 profession in this direction ; an advance which 
 will at first be encumbered with many mistakes, 
 but which will eventually be of the most solid 
 benefit to both patient and doctor. 
 
 ^ Maurice de Fleury, Medicine and the Mind, p. 372. 
 
VALUE OP MENTAL THEEAPEUTICS 23 
 
 I have already alluded in the ' Force of 
 Mind ' to a remarkable letter from Sir James 
 Paget to Sir H. Acland, which plainly shows the 
 need for this advance. Translated into bald prose, Letter from 
 
 Sir James 
 
 it sets forth ' that the disgrace of the writer, of Paget. 
 Sir H. Acland, and of other eminent colleagues is 
 to be expected, owing to the power possessed by 
 some ^' bold quack " to cure an attractive patient 
 of Sir James Paget's through her mind by mere 
 "force of assertion;" the process of cure appa- 
 rently consisting of the lady being juggled out 
 of her maladies." ' 
 
 Such an unconscious revelation of the thoughts 
 of a great and powerful teacher demands our 
 closest attention ; and an analysis will be found to 
 well repay the time it may require. 
 
 The general picture it presents is at first sight An 
 
 amazing 
 
 absolutely amazmg. We see these justly distin- picture, 
 guished men sitting down, and calmly awaiting 
 their inevitable disgrace (with a fatalism worthy of 
 Hindoo fakirs), at the hands of ' some bold quack,' 
 in the cure of this * clever and charming lady ' 
 whom they all seem powerless to help. 
 
 Try to realise for a moment the horrid con- 
 ceit of the ' bold quack ' who reads this letter, and 
 
24 UNCONSCIOUS THEEAPEUTICS 
 
 whose powers over this 'widely known lady' are 
 thus accredited by the leaders of the medical pro- 
 fession, themselves paralysed by impotence. 
 Something We must feel instinctively that ' something is 
 
 very wrong i a v. a. 
 
 somewhere. Very wrong somewhere, for such a grotesque pic- 
 ture to be possible ; and the pathos is that it 
 should have to be drawn by the pen of such a man 
 as Sir James Paget.' 
 Great loss The aggregate loss to the profession in prestige 
 lect of men- and money alone from the neglect of mental 
 peutics. therapeutics must be enormous ; to say nothing 
 of the pernicious effect of allowing quacks to cure 
 patients that we could very well cure ourselves, 
 if we were wise enough to use all the instruments 
 placed in our hands for the purpose. But philo- 
 sophy in medicine is not in fashion just now.^ 
 The sternly practical and scientific character of 
 the medical school training, the mechanical and 
 chemical plane on which our physiologies move, 
 the strictly material nature of modern pathology, 
 all tend to foster the false belief that consideration 
 of the psychic in medicine is archaic in character 
 and futile in result. 
 
 Let us, however, remember that medicine is 
 * Force of Mindf 2nd edit. p. 10. 
 
VALUE OP MENTAL THEEAPEUTICS 25 
 
 not only a science, but an art. The two have been 
 suggestively contrasted as follows : ^ 
 
 In Medicine 
 Art 1 Science Medicine 
 
 as a science 
 
 has a method, i has a system, 
 
 looks to function rather 
 than structure, 
 
 acts, 
 is unconscious, 
 uses one eye. 
 
 looks to structure 
 rather than function, 
 speaking, 
 is conscious, 
 uses the other eye. 
 
 Wisdom in Medicine 
 uses both eyes, discerns solidity as well as surface, 
 and seeing both sides uses mind and body for the 
 cure of the one man. 
 
 The part played by the mind in medicine, 
 curiously enough, is often more recognised by the 
 laity than by the profession, or at any rate its 
 younger members, fresh as they are from scientific 
 schools, which so largely ignore psychological 
 teaching. 
 
 There is even a greater hindrance than this to Sir w. 
 
 Gairdner 
 
 the spread of the truth. Sir William Gairdner ^ on the per- 
 nicious des- 
 
 > See Dr. John Brown, Horce SiibsecivcB, 1st Series, art. ^^g^-^j^e^ 
 ' Locke and Sydenham,' p. 196. 
 
 2 Sir William Gairdner, The Physician a Naturalist) p. 66. 
 
26 UNCONSCIOUS THEEAPEUTICS 
 
 speaks of * the pernicious despotism which has been 
 exercised over the art of medicine by the fetters of 
 dead orthodoxies,' and never was there a truer 
 saying ; for the ' dead hand ' still lies heavy on the 
 profession. 
 
 But there is a growing number of emancipated 
 minds in whom a wise instinct has wrought 
 Simplicity simplicity in practice. And yet the simple is not 
 
 is not shal- r J r j r 
 
 lowness. the shallow. The study of Nature's methods leads 
 to simplicity; but it also leads to depths more 
 profound than pharmacy. There is also everywhere 
 a growing reliance on what we may call natural 
 medicines, rather than on drugs. Change of air, 
 earth, and water, and a great variety of physical 
 exercises and influences, are used more largely in 
 practice every day. 
 
 Sir w. w. Sir W. W. Gull, as quoted by Sir H. Acland, 
 
 Gull on 
 
 * a warm of Oxford, went so far as to say in favour of 
 
 bed.' 
 
 natural remedies : ' There are a good many general 
 practitioners : there is only one universal prac- 
 titioner — a warm bed.' I have already claimed 
 that mental therapeutics play some curative part in 
 every disease, and it appears this claim may, on the 
 above authority, be extended also to * warm beds.' 
 But there are many others who do not treat 
 
 A patient 
 
 as^a motor- ^j^^ ^^q^u as a man ; but, as I have pointed out in 
 
VALUE OF MENTAL THEEAPEUTICS 27 
 
 my first chapter, too often treat him mechanically, 
 as they would a motor-car out of order. 
 
 For^ to the materialist the invalid has for 
 therapeutic purposes no more mind than the car ; 
 while, even if the medical man credits himself 
 with any mental force, he does not for a moment 
 suppose it can assist his patient, any more than it 
 can matter to the motor-car who the mechanic is 
 that repairs it, provided the right means are used. 
 
 I am aware the simile is not very apt, but it 
 may be effective enough for my purpose. 
 
 Has it, then, ever occurred to our materialistic Cars can 
 
 not, like 
 
 medico to ask how it is that the human motor-car men, be 
 
 repaired 
 
 is often perfectly repaired by means which to him by psychic 
 
 means. 
 
 are ludicrously inadequate — having often little that 
 is material about them ; or, on the other hand, 
 what is equally puzzling, how it comes to pass 
 that the same bolts and nuts put in by one 
 mechanic repair the machine, while exactly the 
 same process fails in the hands of another ? Such 
 questions, fairly pondered over, would go far to 
 demonstrate the disturbing action of the mental 
 factor in every disease as well as in every cure. 
 
 Human life is the life of a being that ever sir j. r. 
 
 Reynolds 
 
 combines the mental with the material, the on human 
 
 life. 
 
 1 The Force of Mind, p. 153. 
 
28 UNCONSCIOUS THEEAPEUTICS 
 
 spiritual with the natural. Of it Sir J. Eussell 
 Eeynolds nobly says : ^ ' It is to be studied in the 
 silent and solitary depths of your own conscious- 
 ness, as well as in the lecture theatre and dis- 
 secting room ; you must see it in the minds and 
 hearts of your patients as well as in their limbs 
 and viscera; you have to deal not merely with 
 that which may be analysed, experimented upon, 
 cauterised, bandaged, or cut off and cast away ; 
 you have to do not only with those pains which 
 may rack the body or disturb the mind ; you have 
 for your study not only the material fabric which 
 is so mysterious in its facts and processes ; but 
 
 The mys- you havo also for your study its still more mys- 
 terious . . . . , 
 tenant. terious tenant. 
 
 An interesting fact in connection with the 
 ' mysterious tenant ' in disease, is that the nature 
 of the mind is sometimes seen more clearly in 
 disease than in health. Paget says : ^ * Per- 
 sonal characteristics are revealed, not concealed, 
 by disease.' 
 
 Varieties of It is obvious that the term ' Unconscious Thera- 
 sdous the- peutics ' is, as I have said, capable of various 
 rapeutics. jj^^t^j^pj^^tg^tiong^ These would include therapeutics 
 
 ^ Sir J. Russell Reynolds, Essays and Addresses^ p. 43. 
 2 See Quain's Dictionary of Medicine^ 1894, vol. ii, p. 315. 
 
VALUE OP MENTAL THEEAPEUTICS 29 
 
 used by the physician unconsciously, though well 
 known consciously to the patient; and we shall 
 see as we go on what a range this covers. They 
 would also include methods used consciously by 
 the doctor, but unconsciously to the patient, either 
 by his not knowing they are being used at all, or 
 at any rate by his being completely ignorant as to 
 the mode of their action. 
 
 And, again, they would include therapeutics 
 acting unconsciously to both doctor and patient. 
 Very few mental therapeutics, indeed, act as cures Very few 
 consciously to both doctor and patient ; one or other rapeutics 
 is generally unconscious of them, and often both, scious. 
 
 There are at least four ways by which mental Four ways 
 
 of applying 
 
 therapeutics can be applied to disease : tiiem. 
 y^'Tr By the direct instinctive power of the i-. By the 
 ^4jinconscious mind inherent in itself, which is riiedicatrix 
 
 naturcB. 
 
 \ generally called the vis medicatrix naticrce, the 
 
 range of whose action will be spoken of in the 
 
 next chapter. This action is at present generally 
 
 unconscious to both patient and doctor. 
 
 2. By the unconscious mind, influenced directly 2. By envi- 
 ronment. 
 
 by surrounding forces or other unconscious agencies 
 acting as suggestions. This, too, is generally un- 
 conscious to both doctor and patient, though not 
 always so to the former. 
 
30 UNCONSCIOUS THEEAPEUTICS 
 
 3. By indi- 
 rect sug- 
 gestion. 
 
 4. By 
 
 direct sug- 
 gestion. 
 
 Bernheim 
 on double 
 brain 
 action. 
 
 3. By indirect suggestion to the unconscious 
 mind through consciousness, made by the doctor 
 by drugs and various agencies and methods that 
 he uses. These generally are consciously used by 
 the doctor, but the patient is unconscious of their 
 action. These differ from those of the second class 
 by being purposely employed. 
 
 4. By the unconscious mind indirectly acted 
 on by the conscious, stimulated directly on the 
 part of the patient by a determination to get well, 
 to shake off illness, ignore pain, &c. These are 
 therapeutic means of which the patient is neces- 
 sarily always conscious, but the doctor often 
 unconscious. 
 
 We will now proceed to look a little, first of all, at 
 those mental therapeutics connected with suggestion. 
 
 Professor Bernheim accepts the theory of 
 Herbert Spencer and of many psychologists that 
 in the brain there are two sorts of mental and 
 nervous actions — the one instinctive and uncon- 
 scious, the other rational, volitional, and conscious. 
 y^he man in whom the conscious predominates is 
 less liable to be acted upon by environment, or 
 suggestion, or external impressions generally, and 
 is less a creature of impulse than the one in whom 
 the unconscious and instinctive is predominant. 
 
VALUE OF MENTAL THEEAPEUTICS 31 
 
 \ The more our actions are the result of impulse, 
 and are moved by unconscious springs, the more 
 susceptible are we to all our surroundings, and to 
 \ all varieties of suggestive therapeutics ; but there 
 is xio class on whom they do not act to some 
 extent. A thoughtful reader will note that here 
 we have one of those subjects that are well worthy a subject 
 of careful study in the medical curriculum. of^carSui^*^ 
 
 study. 
 
 The rational form of mental therapeutics in 
 treatment by suggestion in the conscious state is 
 certainly gaining ground everywhere and becoming 
 better understood. It has a negative and a positive Conscious 
 
 ^ suggestion 
 
 side. The former consists chiefly in removing bad 
 influences from the patient's mind, whether they 
 be objective influences from the world around, or 
 subjective, arising from the patient's own dis- 
 ordered thoughts within. 
 
 The latter consists in infusing into the patient's 
 mind various curative mental influences, such as 
 faith and hope and rational ideas, which tend to 
 counteract the unsound mental action. 
 
 All these mental therapeutics act on the un- Direct and 
 
 . . indirect 
 
 conscious mmd, but m two ways — directly, and action, 
 indirectly (through the conscious). The latter 
 action is illustrated in all treatment that appeals 
 to the patient's reason—methods that he sees and 
 
32 UNCONSCIOUS THEEAPEUTICS 
 
 1. By the 
 reason. 
 
 By means 
 ostensibly 
 physical. 
 
 2. Apart 
 from 
 
 By hypno- 
 tism. 
 
 feels, that he knows are intended to cure him, 
 that impress him with their power. He is con- 
 scious of their effects. He feels better for their 
 application, though all the time he is wholly 
 unconscious that they have benefited him through 
 the mind and not through the body. If he knew 
 this, in many cases no cure would result, for 
 material remedies are in favour at a heavy 
 premium, while mental medicine is in the shade 
 at a large discount. 
 
 It is for this reason that most suggestions that 
 are successful must be made indirectly, not osten- 
 sibly addressed to the mind at all, though scientific 
 analysis shows that it is solely through this 
 channel that they are efficacious. 
 
 But the unconscious mind can also be reached 
 therapeutically directly,^ without any conscious 
 process whatever ; and this in two ways. 
 
 Hypnotism is one — a power that abolishes con- 
 sciousness and addresses suggestions directly to 
 the unconscious mind, which is in this condition 
 easily reached and powerfully affected. 
 
 It can be made in the hypnotic state to act 
 
 • The terms * directly ' and ' indirectly ' may be a little con- 
 fusing, and need further explanation. By * directly ' we mean 
 an action of which the patient is not conscious at all, and by 
 ' indirectly ' one of which he is conscious in part. 
 
VALUE OF MENTAL THEEAPEUTICS 33 
 
 directly on the body and produce gross organic 
 changes in a way that would be incredible if it 
 were not established by innumerable experiments. 
 
 But, apart altogether from this method, which I Or without 
 in no way recommend for general practice, even 
 were all doctors competent to use it, there is 
 another way of directly acting on the unconscious 
 mind of the patient, and that is through the 
 mental personality of the physician. 
 
 It is perhaps best that the patient should in this a physician 
 
 should not 
 
 case be only conscious of the good results rather be ignorant 
 
 of his own 
 
 than of their cause ; but the physician, while power, 
 never morbidly self-conscious, should certainly 
 know all that can be known of the power that he is 
 wielding every day, in being what he is, and look- 
 ing and speaking as he does. 
 
 As a matter of fact, useful therapeutical sug- 
 gestions can perfectly well be made in many ways 
 naturally without hypnotism. At present hypno- Hypnotism 
 
 good for 
 
 tism is perhaps of the greatest use in affording a diagnosis, 
 unique means for investigating obscure psychic 
 phenomena. In this direction it is far more ] 
 successful than in therapeutics. One illustration 
 of the value of such investigation is in the dis- 
 covery that in hypnotic as in hysterical sub- 
 jects the range of perceptible sensations is much 
 
 D 
 
34 UNCONSCIOUS THEEAPEUTICS 
 
 inei-eased, so that in both states, feelings, signals, 
 and faint impressions are perceived that otherwise 
 do not enter consciousness, showing in hysteria 
 and hypnotism analogous conditions, which is in 
 both the bringing of the unconscious regions of 
 the mind temporarily into consciousness, 
 fionf with- ^ therefore, for therapeutical purposes, 
 
 ti^m gene' suggcstious without hypnotism are not only more 
 rally useful, ^g^f^} q^^^ movB easily applied, but are much more 
 likely to be employed generally by the profession, 
 which still rightly or wrongly looks askance upon 
 hypnotism. 
 
 - - Those who are sceptical as to the value of these 
 therapeutics may study with advantage the in- 
 numerable cases where disease has been produced 
 by the same processes. Indeed, the list of such 
 suggestion-produced diseases includes many of the 
 graver lesions, such as cancer, diabetes, paralysis, 
 Dr. Lloyd and the like. Dr. Lloyd Tuckey remarks,^ not 
 ^ugt'ti^s^ion. without reason, that the action of the mind may 
 explain the numerous cases where medical men 
 have fallen victims to diseases of the organ which 
 has been their especial study, as Trousseau died 
 of cancer of the stomach, &c. It is exceedingly 
 
 ' Dr. C. Lloyd Tuckey, Hypnotism and Stiggestion, 4th 
 edition, p. 11. 
 
VALUE OF MENTAL THEEAPEUTICS 35 
 
 probable, and I think proved, that the mind 
 continuously fixed on any one part of the body 
 naturally alters the nutrition of that part, and so 
 may be a predisposing factor to disease. 
 
 Suggestion may take the form of recalling past Suggestion 
 
 from past 
 
 impressions, as in those cases recorded by Mr, impres- 
 
 sioiis. 
 
 Woodhouse Braine, the anaesthetist, where an 
 ether mask without ether has produced narcosis in 
 patients that have taken ether before, the recollec- 
 tion of the effects of the drug alone producing the 
 result. 
 
 But the same phenomenon has occurred with Anassthe- 
 
 tics with' 
 
 those narcotised for the first time. One anaesthetist out gas. 
 to a large dental hospital often pretends to give 
 gas without doing so, and finds many patients 
 become anaesthetic when he simply places the mask 
 over the face and tells them to breathe deeply and 
 go to sleep. Anaemic girls appear the best subjects 
 for this harmless deception, as might naturally 
 be expected from the weakness of their conscious 
 reasoning powers, partly owing to the malnutrition 
 of the brain. 
 
 The mask without ether has its analogue in all 
 treatment, the therapeutical value of which goes 
 far beyond anything that can be attributed to its 
 direct effects on the organs or tissues ; showing 
 
 p2 
 
36 UNCONSCIOUS THEEAPEUTICS 
 
 clearly that its curative power must mainly be 
 exerted through the medium of the unconscious 
 mind. 
 
 g'- Dr. Herman, for example, speaks of the ' occu- 
 
 Herman on x ' x 
 
 vilue of Potion ' of the patient's mind by massage and 
 remedies, electricity, and says, * The mystery of electricity 
 satisfies the patient that something powerful is 
 being done, and gives her confidence.' But Dr. 
 Herman would be the last to deny that massage 
 and electricity have both their direct efi'ect on the 
 tissues as well as their suggestive effect on the 
 mind. 
 
 Buzzard on ' Buzzard again points out that in hysterical 
 
 the same, paraplegia the kind of treatment is of little con- 
 sequence, so that it is profoundly impressive 
 (hereby showing the main value is suggestive 
 and psychic) ; and further he insists that mental 
 remedies are prima facie appropriate to mentally 
 caused disease. He says, 'In the suggestion of 
 paralysis we get a depressed asthenic emotional 
 state ending in the paralysis ; in the cure we 
 require a sthenic state, and the exaltation of all 
 the vital powers/ Such treatment is strictly 
 scientific. 
 
 Are such ^nd now it is time, no doubt, that the ques- 
 
 meanB 
 
 morally ^^qj^ which has gradually arisen in the mind of the 
 
 legitimate? *' 
 
VALUE OF MENTAL THEEAPEUTICS 37 
 
 medical reader who has got so far, must be asked. 
 * What is the exact moral position of a medical man 
 who attempts to practise on these lines, and uses 
 means that he knows are physically largely inert ? ' 
 
 I must take a little pains in my answer to if not, do 
 this question, because on its answer depends much themf^ 
 of the value of this book ; for if there remains a 
 lurking suspicion that all is not above board and 
 genuine, and consistent with the highest morality, 
 in the practice of mental therapeutics by the 
 medical profession, I for one would say, let it go 
 by the board ; and would, I trust, be the last to 
 advocate it. 
 
 But such, I assert with the utmost confidence. But they 
 
 J ii n 1 ji • maybe 
 
 IS not the case ; all such therapeutics are every more legi- 
 
 , timate 
 
 whit as legitimate, genuine, and straightforward than drugs. 
 
 (indeed, I thmk, in some respects more so), as the 
 
 most nauseous draught or pill ever concocted. The The diffi- 
 
 culty is in 
 
 difficulty and doubt lie solely in the fact that oi^rigno- 
 
 ranee. 
 
 the medical mind is unfamiliar with the idea of 
 mental therapeutics as an integral part of the 
 regular practice of legitimate medicine, and with 
 its modus operandi through the medium of the 
 unconscious mind ; and it is because these thera- 
 peutics are so largely practised unwittingly ^ that 
 
 ' Somewhat like the Athenians' worship on Mars' hill, which, 
 
38 UNCONSCIOUS THEEAPEUTICS 
 
 Remedies 
 are seldom 
 purely 
 psychical. 
 
 Placebos 
 are legiti- 
 mate. 
 
 I here declare them to the profession, and am 
 obliged to term them ' unconscious therapeutics,' a 
 title which I do not think will be as applicable to 
 the same extent after this little work has been 
 read, as it is at present. 
 
 And now to the defence of these therapeutics. 
 In the first place, as we have said, they are largely 
 practised everywhere by every physician — un- 
 consciously. Of this we shall say more in future 
 chapters. 
 
 In the second, the remedies used are seldom or 
 never physically * inert ' and purely psychical ; they 
 are seldom of the nature of a mere * placebo,' 
 against which Sir P. Semon has inveighed so 
 strongly,^ and which I have ventured to vindicate 
 if administered for the good of the patient, and not 
 for the good of the doctor. Placebos may be given 
 consistently with the highest ethics, and have been 
 constantly used in all ages by the leaders of our 
 profession. 
 
 A fortiori, means which have a certain positive 
 direct physical value in themselves, besides their in- 
 direct psychical effect through the unconscious mind, 
 
 it will be remembered, was addressed to an unknown god, but 
 constituted really an ' ignorant worship ' of the true God. 
 ' See Force of Mind, 2nd edit. p. 263. 
 
VALUE OF MENTAL THEEAPEUTICS 39 
 
 are perfectly legitimate, such as massage, electricity, 
 and other powerful methods of cure. 
 
 We shall show indeed that these quasi-mental Quasi- 
 
 mental 
 
 remedies embrace the whole pharmacopoeia of remediea 
 
 ^ ^ still more 
 
 drugs in some part or other of their action. ^o. 
 
 The uneasiness the doctor feels in dabbling 
 in mental therapeutics is not, however, entirely 
 dissipated by these remarks. He feels he is 
 only on unassailable ground when he can trace 
 the direct action of his remedies on the diseased 
 part — either the process physiologically, or the 
 result empirically, well attested by previous 
 cases. 
 
 But consider, if I give a patient a remedy and Empirical 
 
 medicines 
 
 that remedy relieves him, it does not cease to be are legiti- 
 mate. 
 
 legitimate if in my present state of knowledge I 
 cannot trace the physiological and the psycho- 
 logical chain from his eyes that see the remedy, 
 his ears which hear it spoken of, his senses which 
 feel it, or taste it, or smell it, and his internal 
 organs which it may be suffer from it, and assimi- 
 late it, through his conscious to his unconscious 
 mind, and thence through those mysterious chan- 
 nels through which eventually the diseased part 
 is beneficially stimulated and healed ; nor is it 
 made more legitimate if I can succeed in doing so, 
 
40 UNCONSCIOUS THEEAPEUTICS 
 
 Mind ac- 
 tion is as 
 genuine as 
 body 
 actioii. 
 
 ' Good ' 
 practice 
 must 
 recognise 
 mental 
 thera- 
 peutics. 
 
 High- 
 minded 
 purists. 
 
 and prove that the chain consists only of physio- 
 logical links and not of psychological. 
 
 Psychological links cannot be classed as frauds, 
 and physiological links as alone genuine. Mind 
 action on body must be recognised as legitimate 
 and natural as it is wellnigh universal, and its 
 beneficial excitement to curative action by mental 
 therapeutics is not only legitimate on the part of 
 every physician, but essential to all good practice. 
 A corollary to this might well be added that that 
 practice is very doubtfully legitimate, and certainly 
 not in the best interests of the patient, that wholly 
 or partially ignores any means of cure on the 
 ground that they are psychical and not physical. 
 
 If I discover that electricity, a course of mineral 
 waters, or of movements and baths at Nauheim 
 produce their undoubted beneficial effects, not 
 wholly physiologically as I had thought, but partly 
 psychologically, am I therefore as a high-minded 
 purist forced to despise them and cease to use 
 them, or at any rate am I bound to explain their 
 newly discovered modus operandi to my patient ? 
 Certainly not. My place is to do neither the one 
 nor the other. 
 
 If I can cure a patient by mental thera- 
 peutics, it is indeed generally more tuto, cito, et 
 
VALUE OP MENTAL THEEAPEUTICS 41 
 
 jucunde than by material processes, often less 
 empirical, and every whit as legitimate. 
 
 The real sore point, as we have shown, is that Sore 
 
 point IS 
 
 mental therapeutics have been so miworthily ex- t^^eir 
 
 ^ ^ unworthy 
 
 ploited by humbugs, and so largely used outside ^^^e. 
 the profession by * quacks.' 
 
 I suggest it is only the position of the former 
 that raises a question of ethics ; that of the latter 
 is a question rather of trade-unionism. The two 
 terms are doubtless often interchanged, but really 
 signify very different things. A ' quack,' I presume, Quacks 
 
 and 
 
 IS a man who, without a proper medical education, humbugs, 
 takes the place of a medical man, or of one with 
 a medical education who practises by unprofes- 
 sional methods ; but a ^ humbug ' or a ' charlatan ' 
 is a man who acts immorally, not merely unprofes- 
 sionally ; and between the two there is a gulf fixed. 
 He is a man who deceives others for his own Both 
 
 defined. 
 
 advantage ; one who accumulates unjust gain by 
 lies ; one who knowingly lives by falsehood. A 
 man may be a quack and do none of these things. 
 In my opinion the noble science of mental thera- 
 peutics would never have been associated with 
 such people in the way it has been, were it not for 
 the apathy and dislike with which it has been 
 treated by the medical profession. 
 
42 UNCONSCIOUS THEEAPEUTICS 
 
 Eemedies "We have spoken of suggestion by massage, &c., 
 psychical, fout the Hst of therapeutic agencies that act, par- 
 tially at any rate, through the unconscious mind 
 is a long one, and includes drugs, climates, 
 isolation, special feeding, baths, waters, minor 
 operations, dietaries, special occupations, varied 
 environments, mental alteratives painful and 
 pleasurable, physical or mental shocks, emotional 
 incentives, object-lessons, imitations, commands, 
 ethical and religious influences, dress, gymnastics, 
 travel, study, ambitions, sexual influences, social 
 influences, &c., and indeed all means that can 
 form fresh idea paths in the brain, causing disuse 
 of the old ruts along which ran the vicious trains 
 of thought that caused or kept up the disease on 
 its mental side. 
 Psychic But we must go a little more fully into the 
 
 drugs. psychic action of drugs, which is not so well 
 understood as most of the other agencies we have 
 enumerated. And we will here repeat a little what 
 we have said elsewhere.^ 
 All drugs All drugs, or rather compounded medicines, 
 
 have two- 
 fold value, have a twofold value — one physical, and the other 
 
 psychical. Sir S. Wilks thinks more of the latter. 
 
 ' I do not say,' he observes, ' that drugs are not 
 
 ^ See Force of Mind, 2nd edit. p. 212. 
 
VALUE OP MENTAL TIIEEAPEUTICS 43 
 
 useful in a moral sense.' Sir William Gull's pre- 
 scriptions frequently consisted of sacch. list,, a 
 purely psychic medicine. His followers are legion 
 — all of them regular practitioners, who scorn 
 * quackery ' ! 
 
 The increasing disbelief in the physical value 
 of drugs has led to a great growth in the use of (Growth of 
 
 natural 
 
 natural and physiological remedies as opposed to I'emedies. 
 pharmacy ; and these physical agencies are greatly 
 to be preferred to the attitude of pure expectation 
 or nihilism, to which at one time the physician 
 was wellnigh reduced. 
 
 Turning to the psychical value of drugs, in 
 1771 Unzer remarked: 'The expectation of the T^e value 
 
 ^ of expecta- 
 
 action of a remedy often causes us to experience 
 its operation beforehand.' New remedies have 
 thus a greater effect when first introduced than 
 afterwards. 
 
 It is extraordinary how little the disturbing 
 influence of the mind on the action of drugs, of 
 which I have given some instances, is taken 
 account of by the average physician. So great is 
 it, that the testing of new drugs must be done 
 secretly, or the results will be vitiated by the 
 mental action of the patient. Many of the diffi- Difficulty 
 
 , , of testing 
 
 culties and uncertainties of pharmacy really arise new drugs. 
 
44 UNCONSCIOUS THEEAPEUTICS 
 
 from this mental factor. As long as medicine is 
 powerful in psychic qualities it cures readily ; 
 when it falls into disrepute or out of fashion, and 
 the halo goes, it loses much of its psychic, and there- 
 fore of its real, value. Many will recall the rise 
 and fall of certain remedies as illustrations of this. 
 Physical Moreovor, as the supposed rational action of 
 
 action is 
 
 morecer- drugs breaks down under modern searching 
 
 tain than 
 
 psychic. investigation, their use becomes more and more 
 empirical. 
 
 Still, certain drugs triumphantly assert their 
 physical powers in spite of latter-day scepticism. 
 No mind force is quite on a par for certainty of 
 action with Mag. Sulph., Pulv. Jalapae, Croton Oil, 
 or Apomorphia. 
 Good In serious organic diseases in advanced stages 
 
 drugs often 
 
 inert the powor of the mind can do little ; but then it is 
 
 through 
 
 the mind, also true that drugs at such a time can often do 
 even less. We must not underrate the role which 
 ordinary therapeutics may play in curing the 
 disease and in building up the system ; but it may 
 all fail when there is some mental drawback, 
 which a little judicious advice might remove, and 
 thus change the whole situation. 
 Miiner The wiU, as has been pointed out by Milner 
 
 on the^wiii. Pothergill, is a great agent both for killing and 
 
VALUE OP MENTAL THEEAPEUTICS 45 
 
 curing. He says : ' ' Many cases can only be ex- 
 plained by the mental impressions the material 
 agent employed has made, and through the mind 
 the body is reached. Conceit can kill and con- 'Conceit' 
 
 can kill or 
 
 ceit can cure," is an old North-country saying as cure, 
 to the effect of faith in remedies in some morbid 
 conditions. The will in acute diseases is in many 
 cases potent. If the patient has no motive to live, 
 the struggle is soon over, for the resistance is 
 feeble. If a sick person, really ill, becomes con- 
 vinced that the grave is the only prospect for him, 
 the desired or dreaded result is almost always 
 brought about.'^ Where there exists a strong 
 motive to live, no matter whether selfish or un- 
 selfish, a successful struggle is often the result.' 
 
 Dr. Weir Mitchell strongly advises those of us Dr. w. 
 
 „ . Mitchell 
 
 who wish to go more fully mto examples of mental on Cardau 
 
 of Milan. 
 
 cures to read the * Life of Dr. Jerome Cardan of 
 Milan,' by Henry Morley. He was a remarkable 
 physician, who wrote no fewer than 242 books. 
 He first asserted the value of a good clock to 
 ensure punctuality in treatment, and to form good 
 and healthful habits. 
 
 ' Dr. J. Milner Fothergill, The Will Power, pp. 169, 170. 
 
 2 This is intelligible, if we accept Sir B. Ward Richardson's 
 calculation, that one in every 3,000 is inoriturus, or so feeble 
 as to be ready to die at any time. 
 
46 UNCONSCIOUS THEEAPBUTICS 
 
 Dr. Dr. Bennett, amongst others, points out that 
 
 Bennett 
 
 on inert many drugs and systems of treatment are (phar- 
 
 drugs. 
 
 maceutically) mert, or uncertain in their action, 
 though supposed to act through the blood ; whereas, 
 in fact, their successful operation is due to exciting 
 expectant ideas, and through these (by the un- 
 conscious mind) acting indirectly upon the dis- 
 ordered parts. 
 
 Use of A curious case of the mental effect of drugs is 
 
 mercury in 
 
 1733. found in the letter of a patient, dated from the 
 Navy Office, May 12, 1733, which says he found 
 himself transformed from the condition of a con- 
 firmed dyspeptic into a * pretty good state of health 
 by swallowing one ounce of crude mercury twice a 
 day for six weeks ! ' 
 
 But let us turn from drugs to spas and other 
 agencies, and eventually to the drug-giver, the 
 physician himself. I may here repeat a part of 
 what I have written elsewhere.^ 
 
 * Cures 'at * What about the ''cures" at home and Con- 
 
 Spas. 
 
 tinental Spas, with their eternal round of sulphur 
 and iron waters and baths ? 
 
 ' Does any medical man in his heart of hearts 
 believe that all the cures to which in these cases 
 he cheerfully certifies, are effected solely by the 
 
 1 The Force of Mind, 2nd edit. Churchill. 
 
VALUE OF MENTAL THEEAPEUTICS 47 
 
 waters, or even by the waters and the diet, or even 
 
 by the waters and the diet and the air ; or does Are they 
 
 ^ partly 
 
 he not think there must be a something else " as psychic? 
 well? And to come nearer home and into the 
 centre of all things, and the chamber of all his 
 secrets : 
 
 *In his own consulting room and in his own 
 practice, is not the physician brought face to 
 face with cures, aye and diseases too, the cause 
 of which he cannot account for ; and is he not 
 often surprised to find a continuation of the same ' cures ' by 
 
 consult- 
 
 treatment originated by the local practitioner is, ants, 
 when continued by his august self, efficacious? 
 And is not the local practitioner not only sur- 
 prised but disgusted as well to find that such is 
 the case ? 
 
 'But I have asked hard questions enough. 
 I will ask an easy one. "What is, in fact, the 
 effectual agency in all these cures ? 
 
 * After allowing fully for the intrinsic value of The 
 the remedy, for the mystic formula3, and for the aiiis 
 
 the uncon- 
 
 lull value of real B.P. drugs, I must answer — It scious 
 
 • 1 T . , mind. 
 
 IS mamly and primarily the power of the un- 
 conscious mind over the body. It is this, and this 
 pre-eminently ; that is, the unconscious therapeutic 
 power ; and it is this, and also this pre-eminently. 
 
48 UNCONSCIOUS THERAPEUTICS 
 
 that is everywhere so ignored, however much other 
 minor factors in the cure may be extolled.' 
 
 Value of go far we have been engrossed with the needs 
 
 the ^ 
 
 mind^^^^^'^ of the patient, and with the deficiency of our 
 training in reference to him ; but is there not also 
 a mind in the physician as well as in the patient ; 
 and may not one mind have some power over 
 another mind, as well as mind over the body ? In 
 other words, may mind not be used in therapeutics 
 objectively by the doctor as well as subjectively by 
 the patient? It is now admitted as a scientific 
 truism, says the ' British Medical Journal,' that the 
 direct influence of mind on mind is powerful and 
 subtle. 
 
 Curiously enough, this question is, as a rule, 
 neither asked nor answered in our schools, text- 
 books, hospitals, or consulting rooms ; and yet it 
 is as certain that mind touches mind and influences 
 it, as that drug touches cell and alters it. No 
 doubt, there lurks in the mind of every doctor who 
 reads these pages a suspicion that he has a some- 
 thing about him which is of value to his patient 
 He may do over and beyond the outward and visible sign of 
 Siai^his^^ his faith in drugs, as obscurely manifested in the 
 tion«!^^^ crabbed hieroglyphics on his prescriptions. And 
 
VALUE OP MENTAL THEEAPEUTICS 49 
 
 there is a consciousness, too, in every actual or 
 potential patient who may scan these lines, that 
 there is a something about his doctor that does 
 him more good than his medicines, which, indeed, 
 he often forgets. And the doctor he likes is the 
 one he sends for, in spite of the fact that the other 
 doctor in the town has a greater scientific reputa- 
 tion, and a longer string of letters after his name. 
 
 Maurice de Fleury says : ^ * Unknown to them- De Fieury 
 
 on the doc- 
 
 selves, perhaps, very simple practitioners — not tor's value. 
 
 taking able psychologists into consideration — have 
 
 already effected moral cures in a great many cases. 
 
 For my own humble part — and therefore it is that 
 
 I write — I have cured some idlers, who certainly 
 
 did not come to consult me because a plate on my 
 
 door under my name announced : 
 
 * Cures feeble minds ajicl faltering loills' 
 
 But the personality of the physician does far 
 more than cure feeble minds and faltering wills. 
 It assists or retards the cure of every disease he 
 encounters. The fact is, the most materialistic 
 medicine-man going uses constantly with his 
 patients mcilgre soi, and wholly unconsciously, 
 therapeutics which consist in invoking the curative 
 
 ^ Dr. M. de Fleury, Medicine and the Mind, p, 221. 
 
 B 
 
50 UNCONSCIOUS THEEAPEUTICS 
 
 The influence of the patient's mind. His very cocksure- 
 doctor's 
 
 dogmatism ness —to use a favourite expression of a well-known 
 
 cures. 
 
 specialist, * I am not only sure, I am cock-sure ' — 
 his exactitude, his dogmatism, and his no-nonsense 
 manner, all profoundly impress the patient, and 
 produce a confidence and a belief in his powers 
 that cures quite as much as any means that he 
 may use. 
 
 Psychotherapeutics are unconsciously made use 
 of by all with reputation in the medical profession. 
 The doctor himself, his prescription (often in pro- 
 portion to its illegibility), his fee (in proportion 
 to its magnitude), his room and instruments are all 
 valuable therapeutic agents. 
 De Fieury De Fleury says : * In describing the action of 
 
 on the 
 
 value of a remedy, the doctor of to-day— the incorririble 
 
 big words. ' ^ / ^ 
 
 of Moliere's comedy — instinctively resorts to big 
 words as a dwarf to high heels ! No doubt these 
 big words have also much value, though they may 
 have little meaning,' Have we not all heard 
 of the soothing power of *that blessed word Meso- 
 potamia'? 
 
 But the doctor's face is worth more than his 
 words, and no doctor ever knows how keenly it is 
 The studied. It would be well worth while to write a 
 uce. book on the medical face, first, as seen in the 
 
VALUE OF MENTAL THERAPEUTICS 51 
 
 patient as a diagnostic sign of physical and mental 
 disease ; and secondly, as seen in the doctor as a 
 power for good or evil. 
 
 Dr. Leahy writes : ' Without the full confidence some last 
 
 1 • • 1 1 T . words of 
 
 of the patient, no physician should continue to Dr. sutton 
 attend his patient.' One of the last words of 
 Henry Gawen Sutton, my teacher of pathology 
 and medicine at the London Hospital, was, * Don't 
 underrate the influence of your own personality. 
 Learn to give confidence to your patients.' A pre- 
 sence is of course felt in proportion to its power. 
 
 '0 lole, how did you know Hercules was a 
 god? Because I was content, the moment my 
 eyes fell on him — he conquered, whether he stood, 
 or walked, or sat.' 
 
 The value of the old style of apprenticeship 
 was great in forming the character of the doctor 
 in style, manners, and management, all of which, 
 of such importance therapeutically, are left un- 
 taught to-day. Not only the food we eat and 
 the air we breathe act upon the nervous system, 
 but so does every impression conveyed to it 
 through our senses. We may think it of little 
 consequence whether we say certain words to a 
 patient or not. We think they will soon be for- 
 gotten, or the damage done by them repaired. But 
 
 B 2 
 
52 UNCONSCIOUS THEEAPEUTICS 
 
 All impres- no impressioii on anything in nature can be done 
 
 sions are 
 
 permanent, awaj with, not even the impression of the faintest 
 
 particle of light. 
 How The fact that manner and method tend to 
 
 quack effect a cure in part, largely through their effect 
 
 cures. 
 
 on the mind of the patient, m no way detracts 
 from them as tangible therapeutic measures. On 
 the contrary, it is all the more reason for their 
 use. The more confidently they are employed, 
 the less frequent will be the reports of cures 
 by Christian Scientists, faith healers, osteopaths, 
 and other fakirs and mystery-mongers.^ Dr. 
 Mitchell Bruce says : ^ * Whilst women are fanci- 
 ful, unreasonable, insusceptible of convincement 
 as compared with men, they are perfectly amenable 
 to the influence of an intelligent, competent prac- 
 titioner.' 
 
 I do not myself entirely endorse either of the 
 above statements, though I am in accordance with 
 Lancet their general tenor. The * Lancet ' (January 1883) 
 
 on pfsychic 
 
 remedies, says : ' A fuU recognition of the value rightly 
 attaching to the mental treatment of physical ail- 
 ments will improve the usefulness of the physician ; 
 
 ^ See Dr. J. Collins, Treatiimit of Diseases of the Nervous 
 System, p. 420. 
 
 2 Dr. Mitchell Bruce, Practice of Therapeutics, p. 179. 
 
VALUE OP MENTAL THEEAPEUTICS 53 
 
 give him a higher place in the affections of his 
 patients, and materially assist in promoting their 
 return to health when suffering from very various 
 diseases functional or organic' 
 
 But this treatment requires more time as well 
 as more skill than the mere scribbling off of a 
 prescription. A physician who has neither the 
 time nor the inclination to devote sufficient care 
 and attention to the nerve patient should say so. 
 While the physician who feels he is discharging 
 his duty by telling the patient that his sufferings 
 are an imaginary mental trifle, can scarcely be 
 said to have the modern conception of neuroses, 
 and is, therefore, not fitted to deal with them. 
 
 But of these varieties of mental therapeutics Dangerous 
 
 uncon- 
 
 the physicians who use them are as a rule pro- sdousness 
 
 ^ *^ ^ of the 
 
 foundly unconscious — they do not know where doctor, 
 their power lies, or even that they have any. Sir 
 James Paget tells us ^ that John Hunter was un- 
 conscious of his mental power. He wrote himself, 
 * There never was a man that wanted to be a great 
 man that was a great man.' . 
 
 Not only is the doctor unconscious of the good 
 he does, but the patient also is unconscious of the 
 
 * Sir James Paget, Scientific Essays^ p. 199. 
 
54 UNCONSCIOUS THEEAPEUTICS 
 
 good he may do. Dr. Weir Mitchell says to a 
 patient : ^ ' You selfishly enjoy his visit, not suspect- 
 ing that you, too, are ignorantly helpful. He has 
 been in sadder homes to-day, has been sorely tried, 
 has had to tell grim truths, is tired, mind and 
 body. The visit he makes you is for him a pleasant 
 oasis ; for not all convalescents are agreeable, and 
 he goes away refreshed.' 
 
 ' Dr. Weir Mitchell, Doctor and Patient, p. 59. 
 
55 
 
 CHAPTER III 
 
 THE VIS MEDICATRIX NATURE 
 
 I promised in this chapter to speak of a mental The vis 
 
 •Diedicatrix 
 
 therapeutic that is purely natural and generally natur(^ 
 wholly unconscious both to the doctor and patient 
 — the vis medicatrix naturce. 
 
 This therapeutic agency has such a unique 
 power that it is essential to all recoveries, what- 
 ever other therapeutics may be employed or 
 omitted. It is absolutely indispensable to the 
 patient's cure if the disease tend to death, for 
 whatever therapeutics may be used the patient can 
 never recover in the absence of this natural and 
 unconscious force ; and, further, every disease 
 tends to death where this therapeutic power is 
 wholly absent. 
 
 It acts also quite apart from the will or know- is wholly 
 
 outside 
 
 ledge of the patient ; in fact, the power is wholly ^^g^^^"^"^" 
 outside consciousness, and is yet mental in cha- 
 racter, being purposive, conservative, and having 
 
56 UNCONSCIOUS THERAPEUTICS 
 
 the power apparently of choice ; and it is capable 
 also of acting rightly in entirely novel emer- 
 gencies. It is the manifestation of the action of 
 the unconscious mind in the tissues and organs of 
 the body. If some of my more conservative 
 psychological readers still prefer, however, to call 
 this force ' Nature,' it alters nothing of its power, 
 nor of the necessity we physicians lie under of 
 closely studying and observing it, if we rightly 
 fulfil our duties to our patients. 
 Psychic Since hypnotism has demonstrated that ' the 
 
 action does 
 
 influence unconscious mind ' mentally stimulated can pro- 
 
 organic 
 
 processes, duco redness, swelling, oedema, rise of temperature, 
 and other physical effects, it is no longer a matter 
 of doubt as to whether psychic action can directly 
 influence organic processes ; and every day in 
 every hospital this action is being demonstrated 
 wholly apart from hypnotism. The vis medicatrix 
 natitrcd, or best of all the unconscious mind, is 
 active daily in all cures ; and this can be said of 
 no other therapeutic agent whatever. 
 
 Powers In contrast with its wondrous force, it is well 
 
 of the 
 
 conscious to noto how Small and limited are the powers of 
 
 mind are 
 
 small. the conscious mind in relation to disease. The 
 conscious mind cannot directly cause (without the 
 agency of the unconscious mind) any disease what- 
 
THE VIS MEDICATEIX NATUE^ 57 
 
 ever save malingering, which, after all, is not a 
 true disease ; nor can it by its own unaided powers 
 cure any disease ; for though it appears able 
 to do so, it is only of use as it acts indirectly 
 through the unconsciaus mind. Malingering, I 
 may say in passing, is of some interest in this ^^^{^.^^^^^^^ 
 connection, as I believe it is the only ' disease ' i^g- 
 in which the unconscious mind plays no direct 
 part whatever. The main agency, then, of all 
 cures is the unconscious mind, which operates 
 always naturally with vis meclicatrix naturce, 
 but may also be further stimulated artificially by 
 other mental therapeutics. 
 
 In every disease its ordinary action by the vis The ' vis ' 
 
 , ^ is the 
 
 medicatrix natitrce is at once evident, whether in action of 
 
 the uncon- 
 
 pouring out lymph round a broken bone, in sealing scious 
 up an abscess with an impenetrable wall, in digging 
 out new vascular channels in a diseased limb, in 
 extracting the gouty poison by the cells of the 
 convoluted kidney tubes, or in quickly eliminating 
 CO2 by rapid expiration. The term vis medi- 
 catrix naturcB was really invented by Dr. Cullen, 
 but the thought comes down from the earliest 
 ages. 
 
 * Nature,' says St. Augustine, ^ is the will of 
 God.' Hippocrates, whose genius reigned without 
 
58 UNCONSCIOUS THEEAPEUTICS 
 
 Hippo- a rival for twenty-three centuries, says : ^ vovacov 
 spea^^s of (^vcreLs IrfTpoi {' our natures are the physicians of our 
 diseases '). All his teaching and practice centres 
 in the aphorism of the sixth book of Epidaurus, 
 ' Nature the healer of our diseases.' It is the final 
 exposition of a truth for all time. 
 Mitcheu^on ^' ^^1^ Mitchell, speaking of Hippocrates, 
 
 Hippo- observes : ^ ' His system led him to assist Nature, 
 to support her when enfeebled, and to the coercion 
 of her when she was outrageous.' [The meaning of 
 this we shall see as we go on.] 
 
 vTTTjpsTTjs (f)V(rscos laTpos^ * The physician is 
 the minister of Nature,' is the language of Galen 
 and Aristotle, also of Sydenham and Boerhaave. 
 Galen ^ adds, ' The expression physician " applies 
 only to the healer " and not to the " druggist." ' 
 Ascie- The chief opponent of Hippocrates' veneration 
 
 as^oppo- of Nature (in other words, of the recognition of the 
 mppa- value of the unconscious mind) seems, curiously 
 enough, to have been a semi-quack who lived in 
 Eome in the first century, called Asclepiades, and 
 who was the inventor of the well-known phrase, 
 Tuto^ citOf et juGunde. He held that Nature killed 
 
 ^ See De Morbis V^tlgaribus, lib. vi. sect. v. 
 
 2 Dr. S. Weir Mitchell, Doctor and Patient, p. 21. 
 
 ^ Galen, Ojj. (edit. Kiihu) lib. xv. 309, xvi. 35. 
 
THE VIS MEDICATEIX NATUEiE 59 
 
 the man, and it was the doctor's part to shove 
 Nature out of the way, and thus deserve and claim 
 all the credit ! Ambroise Fare's ' Je le pansay et 
 Dieu le guarit,' shows his appreciation of the vis 
 medicatrix, 
 
 Sydenham saw Nature working hard for a cure Sydenham 
 
 recognises 
 
 underneath every disease. He followed Nature, the 'vis: 
 and said it was this that made Hippocrates' fame. 
 Sydenham's weakness was that, while fully alive 
 to the philosophy of disease in connection with 
 the vis medicatrix naturce^ he shut the other eye 
 and was blind to its scientific study by physio- 
 logical and pathological experiment. 
 
 Is it not a little curious, in the revolution of 
 the wheel of time, that the eye that Sydenham 
 kept so open and active is the one that is now 
 shut ; and the ' other eye ' — the scientific eye — 
 which was then closed, is at its utmost keenness 
 of vision ? All we ask is that both eyes should be open both 
 widely open, that our treatment of disease may be 
 neither exclusively philosophic nor scientific, but 
 wise — which combines both. 
 
 Thomas Sydenham does not appear, as is often Syden- 
 the case, to have been as philosophic in his actions personal 
 as in his theories ; for I greatly fear that it is 
 true that he was one of those doctors who deserted 
 
60 UNCONSCIOUS THEEAPEUTICS 
 
 their duties. In the Great Plague of London he 
 stood, indeed, the first shock of the pestilence, but 
 was soon afterwards persuaded by his friends to 
 accompany them into the country for safety. 
 Dr. Dr. Mitchell Bruce worthily continues the 
 
 Mt Bruc6 
 
 on the great line of the intelligent exponents of * Nature ' 
 
 * vis.* 
 
 in disease. On his work, as on that of Sydenham, 
 might well be written the motto of Bacon : * Non 
 fingendum aut excogitandum sed inveniendimi 
 quid Natitra faciat aut ferat ' (* We have not to 
 imagine or to think out, but to find out, what 
 Nature does or produces '). 
 
 Dr. Bruce says : ^ * The body as a whole, and 
 in each of its constituent parts, possesses and 
 employs, with or without success, certain pro- 
 visions for dealing with the causes of disease, so 
 as to prevent, arrest, and counteract disease.' 
 
 Dr. Bruce treads in Sydenham's steps with all 
 the added light and knowledge that medicine in 
 the present day enjoys over that of 250 years 
 ago ! 
 
 Sir William Gull, in his day, was equally clear, 
 and perhaps rather too enthusiastic, in his praise. 
 He said that medicine was once given even for 
 * fractures ; but disease is not cured by drugs. It 
 ^ Dr. Mitchell Bruce, Practice of Theraimitics, p. 49. 
 
THE VIS MEDICATEIX NATUEiE 61 
 
 is the power of Nature that cures disease, and the 
 duty of the medical man is not to give drugs, but 
 to assist Nature. 
 
 Sir W. S. Church speaks of ' Nature ' as a 
 therapeutic agent, and asks : * Did they not them- 
 selves conduce to credulity on the part of the laity 
 in speaking of ^' curing " diseases ? With few 
 exceptions, they did not cure the disease any more 
 than they cicred a broken leg. They placed the 
 patient in the best circumstances for Nature " to 
 restore the health of the ailing person or the 
 bones of the broken leg.' This utterance of Sir 
 William Church'a comes very near to charging 
 our august body generally with quackery, of which 
 ' conducing to credulity ' is one of the chief features. 
 
 Were it needed and had I time, in addition to 
 these I might cite Carter, Wilkinson, Laycock, 
 Clouston, Wendell Holmes, Weir Mitchell, Lauder 
 Brunton, Potter, Sir A. Clark, and a host of 
 others in support of the vis medicatrix. Dr. A. 
 Charren, in ' Les Defenses Naturelles de I'Orga- 
 nisme,' gives the most details of its actions ; whilst 
 Dr. Mitchell Bruce, in his ' Practice of Therapeu- 
 tics,' best gives its value to the physician. I 
 think, however, those I have given, added to 
 what has been observed by myself, are enough to 
 
62 UNCONSCIOUS THERAPEUTICS 
 
 convince any who can be convinced of the value 
 of the great, unconscious, and yet intelligent, 
 therapeutic agent, the vis medicatrix naturce. In 
 all the writings of these men the modern reader 
 will, for the hypothetical goddess * Nature ' which 
 figures so beneficently with all these writers, do 
 well to substitute the words * unconscious mind,' 
 as being at least intelligently descriptive of a pro- 
 cess which is confessedly unconscious, and of a 
 force that is not material. 
 
 The * vis ' keeps the body in health by enabling 
 it to resist pathogenetic influences, and tends to 
 restore it to health by removing these, or by re- 
 adjusting itself in consequence of them. Adapta- 
 tion is an accurate reaction to varying demands 
 Bizzozero directed by the unconscious mind. Bizzozero 
 
 on the 
 
 powers m thinks that the capacity of organs for adapta- 
 
 the cell. . . 
 
 tion resides ultimately m the cell.^ 
 
 Against this theory of adaptation, which I en- 
 dorse as showing the unconscious and yet truly 
 mental character of the action of ' Nature ' or the 
 vis medicatrix naturce^ it has been stated that 
 Nature does not act by choice or design in the 
 cure of disease, because her operations are constant 
 and uniform, and she shows no power of choice. 
 1 See British Medical Journal, 1894, vol. i. p. 732. 
 
THE VIS MEDICATEIX NATUEiE 63 
 
 This opinion the ' British Medical Journal ' The 
 
 British 
 
 apparently endorses in a leader on Sir P. Treves's ad- Medical 
 
 Journal 
 
 dress at Liverpool on Sir Thomas Browne's ^ Eeligio agamst the 
 
 beneficent 
 
 Medici,' which says that *it is true the processes action of 
 
 ' *^ ^ ^ the ' vts: 
 
 of acute inflammation promote the saving of life, 
 and may, indeed, be the most benevolent of angels 
 ever entertained unawares," though we must desire 
 their visitations to be, like angels' visits, few and 
 far between." But there is no benevolence of this 
 sort in malignant disease, valvular disease of the 
 heart, embolism, diabetes, epilepsy, and all de- 
 generative changes of the brain and cord. These 
 are diseases that are destroying angels, set on 
 putting us out of work or out of the world. Death 
 and life are one plan ; and cancer, with its insidious 
 advance and infection of the neighbouring glands, 
 is just as intentional as a circumscribed abscess.' 
 (The word ' little ' should evidently be read before 
 ' intentional,' as the entire passage tends to dis- 
 credit purposive action.) 
 
 The whole argument, it seems to me, is ir- itsargu- 
 
 ment'is 
 
 relevant. It is as if I denied there was a principle irrelevant, 
 of self-preservation in man because I saw that he 
 met with accidents and injuries in his journey 
 through life. It is also particularly inapt in a day 
 when nearly every disease here enumerated is 
 
64 UNCONSCIOUS THEEAPEUTICS 
 
 Phagocyto- 
 sis proves 
 purpose. 
 
 Is affected 
 by mental 
 influences. 
 
 believed to be the direct result of invasion by some 
 pathogenic microbe, and in no way due to some 
 malignant * vis ' within. It may be that the 
 microbe is as purposive in its destructive force 
 as the vis is in its conservative power; but the 
 one in no way negatives the other. I only 
 quote the argument to show that it has no weight 
 in disproving the beneficial action of the vis. 
 
 Phagocytosis carefully traced displays the ele- 
 ments of purpose and choice. Metchnikoff, Bizzo- 
 zero, and others prove that the individual cell 
 possesses and exercises a power of self-defence and 
 self-preservation that can be used apparently at 
 will, and can choose rightly when placed for the 
 first time in novel circumstances ; and it teaches, 
 as Dr. Bruce observes further,^ * that the destruc- 
 tion of the cause of the disease is a fundamental 
 indication of treatment,' being the method of cure 
 always aimed at by * Nature.' 
 
 Mental influences affect phagocytosis. Depres- 
 sion alters the action of phagocytes. Diversion or 
 distraction is thus a powerful therapeutic agent in 
 such cases. 
 
 Napoleon pointed out that life is a fortress, and 
 said : ' Why throw obstacles in the way of its 
 • Dr. Mitchell Bruce, Practice of Tlierapeutics, p. 38. 
 
THE VIS MEDICATEIX NATUE^ 65 
 
 defence ? Its own means are superior to all the 
 apparatus of your laboratories.' 
 
 * Immunity,' amongst other phenomena, power- 
 fully supports this, being a protective condition 
 that no artificial means can secure. 
 
 Galen points out that Nature cures disease, and Gaien on 
 
 the * vis.' 
 
 adds, ' So do physic and the physician and his" 
 instruments ; but Nature is the chief efficient 
 cause of health.' 
 
 The ' Novum Organum ' opens with ' Homo 
 Naturae minister ' (Man the servant of Nature) ; 
 which is, indeed, the physician's true place. 
 
 Sir William Gull was so impressed with this 
 that he goes so far as to say : * What shall doctors 
 do ? Best and be still. The workman that made i^^st, and 
 
 be still. 
 
 the machine can repair it.' 
 
 Dr. Bruce says : ^ * The belief in the vis medi- 
 catrix naturce teaches the wise physician to 
 throw himself into the struggle for health and 
 existence on the side of natural resistance — con- 
 trolling and turning to the most advantage every 
 provision for resistance in the body that he can 
 affect.' 
 
 The most, then, that a doctor can do is to assist i^octors 
 
 sliould ever 
 
 the body in making use of this great power, which ff^^^]^^ 
 
 * Dr. Mitchell Bruce, Practice of Therajoeutics, p. 50. 
 
 F 
 
66 UNCONSCIOUS THEEAPEUTICS 
 
 Morbid 
 processes 
 arrested 
 solely by 
 the * ws.' 
 
 Details of 
 its action. 
 
 is the natural preservative action of the organism 
 by means of the unconscious mind. The ' vis ' is 
 a fine example of the power of the mental factor in 
 pathology, if not in medicine. So great, indeed, 
 is its natural power that not the most skilled 
 combination of drugs is (as I have said) of avail 
 without its aid ; while the most haphazard remedies 
 and the purest empiricism can accomplish marvels 
 if backed by this ever-present force. 
 
 But for the action of the unconscious mind in 
 guarding the organism by the skilled direction of 
 the forces at its disposal, a morbid disturbance, 
 once set up, would inevitably continue to the point 
 of annihilation ; for treatment directed to the living 
 body is, as I have said, absolutely meaningless 
 except as an appeal to such powers of resistance as 
 a patient possesses. When these powers of the 
 unconscious mind fail, as in the closing scenes of 
 any fatal illness, it is idle to expect anything from 
 treatment, as, of course, we all know that death in 
 its last analysis is the final failure of the vis medi- 
 catrix natures — of the recuperative power of mind. 
 
 Coming to a few details, and seeking, as far as 
 possible, to avoid repeating those already given in 
 a previous work,^ I may note that purpose and 
 
 ' The Force of Mind. 
 
THE VIS MEDIOATEIX NATUE^ 67 
 
 choice appear to be manifested throughout, and 
 particularly in repairing such diseases of growth 
 and nutrition as rickets, rheumatic fever, &c. 
 
 The marshalling and direction of the phagocyte Phagocyte 
 
 armies 
 
 armies against the microbe mvaders, when fully have a 
 
 directing 
 
 understood, as it will soon be, afford one of the head, 
 most remarkable displays of intelligence and 
 choice that can be seen anywhere ; and the selec- 
 tive and purposive movements displayed are no 
 more inherent properties of matter than love 
 and hate. 
 
 The vis medicatrix naturce has been traced in 
 its action in some detail by Dr. M. Bruce. He 
 gives as instances various 'safety-valve' actions 'Safety- 
 
 valve' 
 
 in the body, e.g, the relief of cardiac dilatation and actions in 
 
 the body. 
 
 distension by relaxation of the arterial walls by 
 depression of the circulation. If this fails we may 
 get angina pectoris, which in its turn is relieved 
 by nitrite of amyl, distending the capillaries artifi- 
 cially, in imitation of this action of ' nature.' 
 
 Again : ' Anorexia in gastric catarrh and hepatic 
 disturbance gives the organs physiological rest.' 
 Dr. Bruce points out that in contracted kidney In con- 
 
 , tracted 
 
 the increased arterial pressure favours diuresis, kidney, 
 and empties the veins ; so that the body here 
 modifies the influence it cannot overcome, and 
 
 F 2 
 
68 UNCONSCIOUS THEEAPEUTICS 
 
 Sir 
 
 F. Treves 
 on the 
 ' vis.' 
 
 In the 
 case of 
 wounds. 
 
 tries to remove the effects, if it cannot touch the 
 cause. 
 
 I will quote a few instances of the therapeutic 
 action of the unconscious mind in the body, as 
 given by Sir F. Treves in his Liverpool address, 
 to which I have already alluded. He says : ^ 
 
 ' As another example may be cited the case of 
 a man who accidentally wounds his finger. The 
 instrument which inflicted the wound is soiled 
 with septic matter, and introduces the same into 
 the tissues. An intense and painful inflammation 
 follows, and suppuration is in due course esta- 
 blished. The disease (so called) is distressing 
 enough, but the manifestations are no mere out- 
 come of a malign purpose. They are well-intending, 
 and have for their object the protection of the body 
 from further parasitic invasion on the one hand, 
 and the elimination of such septic matter as is 
 already introduced on the other. But for inflam- 
 mation and suppuration every neglected septic 
 prick would be fatal. The ancient surgeon who 
 endeavoured to exorcise inflammation, as if it were 
 the vilest of evil spirits, was directing his wrath 
 against the most benevolent of angels who was 
 ever entertained unawares. 
 ^ Sir F. Treves, in British Medical Journal, October 18, 1902. 
 
THE VIS MEDIOATEIX NATUE^ 69 
 
 ' This matter may be followed out a little more Action in 
 
 appendi- 
 
 in detail in connection with the symptoms of the dtis. 
 disease familiar by the uncouth name of appendi- 
 citis. In this malady a trouble occurs in the 
 appendix. The wall of the little tube becomes 
 perforated, and an acrid poison finds its way into 
 the sensitive cavity of the abdomen. This, at 
 least, is the essential calamity in many instances. 
 The perforation is sudden, is accidental, and may 
 be preceded by no warning sign of any kind. Here 
 again the disease proper may be without a single 
 symptom. The manifestations which follow the 
 perforation are termed the symptoms of peritonitis. 
 They are distressing and urgent, but they are vaineof 
 all benevolent in intent, and are the outcome of 
 Nature's vigorous effort to minimise the calamity 
 and save the patient's life. The intense pain and 
 collapse impose upon the victim absolute rest, and, 
 more than that, enforce rest in the most advan- 
 tageous posture, that, namely, of recumbency. He 
 is rendered helpless at a moment when any move- 
 ment may be attended by disaster. The sickness 
 and the utter nausea which attends it secure some 
 emptying of the alimentary canal, and forbid the 
 introduction of any fresh material into an intestine 
 which is best placed for recovery when it is least 
 
70 UNCONSCIOUS THEEAPEUTICS 
 
 occupied. The skin of the abdomen becomes 
 acutely sensitive, and so protects the damaged 
 parts from disturbance and pressure, and this 
 most necessary end is further secured by another 
 symptom— the remarkable rigidity of the abdo- 
 minal wall. Even should the affected area be 
 accidentally pressed upon, the firmly contracted 
 muscles which cover it will shield it like a protect- 
 ing cuirass. 
 
 Restessen- ^ Thus is brought about that state of absolute 
 repair. rost which IS ossential as the very first step 
 towards the repair of the injury, and let it be 
 noted that this life-saving end is secured by what 
 are termed the deplorable symptoms of disease. 
 At the same time the condition of the circulation 
 is so modified as to render absorption of septic 
 matter from the affected district as little ready as 
 possible. 
 
 Peritonitis 'Within the abdomen the manifestations of 
 peritonitis are appearing. Peritonitis has com- 
 monly been spoken of as one of the most deadly 
 and most malignant of calamities. Never was a 
 condition more unjustly abused. The phenomena 
 of peritonitis should be hailed with thankfulness. 
 Peritonitis is concerned only in effecting good. It 
 is in every instance a beneficent process. It is 
 
 as a friend, 
 
THE VIS MEDICATEIX NATUE^ 71 
 
 Nature's method of bringing about a cure, and is 
 successful in millions of instances. But for peri- and a life- 
 
 saving 
 
 tonitis every intra-abdominal wound and a multi- process, 
 tude of intra-abdominal lesions would be inevitably 
 fatal. So far as the abdomen is concerned peri- 
 tonitis is the great life-saving process, and should 
 its possibility be denied to mankind, the human 
 race would be threatened with extinction. There 
 is, indeed, no terror in peritonitis, although a world 
 of alarm may well attend the calamity that calls it 
 forth. 
 
 ' Its mode of action is admirable in its simplicity. 
 It induces an immediate paralysis of the ever- 
 moving intestine. With the cessation of these 
 now most dangerous movements the essential state 
 of rest is secured. More than that, it pours out a 
 plastic lymph which glues adjacent coils of bowel 
 together, and, in an incredibly short time, isolates isolates 
 and encloses the damaged area. It forms a barrier area, 
 around the seat of the mischief, and upon that 
 barrier the life of the patient depends. An abscess 
 forms, but, thanks to an active peritonitis, the 
 matter contained therein is shut off, is rendered for 
 the time innocuous, and is placed in a favourable 
 condition to be discharged from the body. 
 
 ' It has been the custom of many surgeons in 
 
72 UNCONSCIOUS THEEAPEUTICS 
 
 the past to speak of peritonitis as if it were the 
 very hand of fate, an impending horror which 
 spreads only disaster and death. In actual truth 
 peritonitis is the operating surgeon's best friend. 
 He who condemns it is like the man whose house 
 is in flames, and who execrates the torrent of water 
 which is poured upon the burning fabric, 
 other iiiiis- * Many of the symptoms of disease, instead of 
 
 trations. 
 
 being pounded out of the body by violence as 
 wholly pernicious, should rather be regarded as 
 means for guiding the physician in the treatment 
 he should adopt. Treatment has to be for the 
 most part imitative of natural processes, and 
 the imitation is founded upon the much-abused 
 symptoms of the malady concerned. 
 
 * The man who swallows a poison is sick, and 
 the treatment which suffices best in such a case 
 is the fullest development of that symptom — 
 namely, the washing out of the stomach. 
 ^ , ' The abscess tries to find a way of escape, and 
 
 Good 
 
 treatment t^e sur2[eon's Imifo but carries out the suggestion 
 
 imitates ^ 
 
 natural forced uDon him by the evident intention of the 
 
 symptoms. ^ 
 
 pus. The cough which is so marked a feature in 
 bronchitis tends to rid the bronchi of material 
 which must needs be got rid of ; and the physician, 
 acting upon the hint, promotes such elimination. 
 
THE VIS MEDICATEIX NATUE^ 73 
 
 In older days effort was made to stay the cough, 
 because it was a symptom of disease, and therefore 
 must needs cease. 
 
 ' The difference between the old creed and the 
 new in this particular of treatment is well illus- 
 trated by the treatment of aneurysm. As soon as Aneurysm, 
 an aneurysm has reached certain proportions, a clot 
 is found to be forming in it layer by layer. The 
 surgeon who first approached the operative treat- 
 ment of this condition advised the cutting out of 
 the clot. He regarded the clot as a malignant 
 product, because he considered all the phenomena 
 of disease to be malign. Indeed, he went so far 
 as to consider the laminated clot to be the cause 
 of the whole trouble, and therefore he advised 
 that it should be excised at all costs. A later 
 pathology taught that the clot formation repre- Cure by 
 
 clot. 
 
 sented Nature's method of cure, and that in it 
 lay the saving of the patient's life. The modern 
 surgeon, therefore, not only does not disturb this 
 product, but he adopts every measure to ensure 
 its formation. 
 
 * The most successful treatment of aneurism, 
 indeed, professes nothing more than an encourage- 
 ment of a natural process, and is based upon the 
 imitation of a prominent symptom of disease.' 
 
74 UNCONSCIOUS THEEAPEUTICS 
 
 Ordinary Ordinary inflammation is combated naturally 
 
 inflamma- 
 tion, by phagocytosis actively, and passively by exuda- 
 tion, conferring immunity, followed by repair and 
 removal of the diseased products. A wise physician 
 imitates these processes in his practice. 
 
 The ' vis ' produces a natural readjustment of 
 disorganised parts by rearranging of vessels or 
 forming supplementary vessels ; or by hypertrophy 
 of one lung in disease of the other, by compensat- 
 ing curves of the s^ine, &c. 
 
 The natural formation of antitoxins — and anti- 
 toxins, moreover, against toxins that have never 
 previously invaded the organism — is a marvellous 
 instance of the action of unconscious mind. 
 Dr. Barker Dr. Barker has observed that medical art has 
 
 on the 
 
 ' ^^s.' less power and ^ Nature ' more in acute disease 
 than in chronic, a.nd we believe this to be gene- 
 rally, though certainly not universally, true. 
 
 So far I have merely considered the ' vis ' as 
 the natural action of the unconscious mind for the 
 good of the body ; but we must not forget that the 
 
 ,"^^5 'can 'vis' can be utilised by physicians : for they can 
 
 be aided by J r J ? j 
 
 the doctor, promote its accuracy and extend its range by 
 exercise and training,^ by checking it when in 
 
 * Sir John Forbes, M.D., wrote * On Nature and Art in the 
 Cure of Disease,' to enforce this as the true office of the doctor. 
 
THE VIS MEDICATEIX NATUE^ 75 
 
 excess, by relieving it from unreasonable or ex- 
 cessive strain, or unyielding obstacles, and by 
 stimulating it through the unconscious mind when 
 needed directly or indirectly. The mind can be so 
 concentrated upon a physiological process as to 
 stimulate that process to unusual activity, and 
 thus produce curative effects ; and even to super- 
 abundant activity, so as to produce pathological 
 effects or disease. 
 
 Though, therefore, the * vis ' is ever active for Though 
 
 ever activ 
 
 good m a healthy person, the process can be for good, 
 stimulated and quickened or hindered and retarded. 
 A consensus of all medical belief and practice is 
 that a cheerful and hopeful frame of mind, and a 
 strong and affirming will, assist the recuperative 
 process, while despondency, doubt, and a feeble or 
 perverse will just as surely hinder Nature's benign 
 efforts at cure. 
 
 I must not leave this subject of the ^vis ' with- The'i;^s' 
 
 n T T • n 1 • hysterii 
 
 out alludmg to the condition of hysteria where 
 the unconscious mind is obviously affected and 
 produces or simulates pathological processes in a 
 marvellous way. I have spoken fully of this 
 in another place,' and therefore do no more than 
 ' Nerves in Disorder, chaps, i. & ii. Hodder & Stoughton. 
 
76 UNCONSCIOUS THEEAPEUTICS 
 
 The action allude to it here, as it is not now the subiect 
 
 and powers " 
 
 of the before us. 
 
 * vis 
 
 should be J cannot do better in conclusion than to 
 
 taught. 
 
 press again what I have so earnestly urged in 
 the Preface, and that is, that every practitioner 
 should make himself more familiar with all of 
 Nature's natural processes of cure, that this sub- 
 ject should be prominently and clearly taught 
 in the lectures on Medicine and on Therapeutics 
 in our schools, and all the means clearly pointed 
 out through which this ^ vis ' may be artificially 
 stimulated by the physician, and its processes still 
 more beneficially directed for the patient's welfare. 
 
77 
 
 CHAPTEE IV 
 
 THE PERSONALITY OF THE PHYSICIAN 
 
 In this chapter I reach my sub-title, and I ven- a walking 
 
 pharmaco- 
 
 ture to think that after it is perused those who poeia. 
 read it will feel some surprise, perhaps mixed with 
 no little incredulity, when they find what com- 
 prehensive pharmacopoeias they are in themselves. 
 The question, indeed, almost suggests itself : Why 
 carry even a portable medicine-chest, if it be true 
 that the physician, with his engaging smile and 
 bedside manner, is such an unconscious medicine 
 in himself ? 
 
 I only trust that what I write will not 
 make any reader too painfully self-conscious of 
 his defects, as he tries in vain before a mirror 
 to produce on his face that indescribable look 
 which is to inspire faith and hope in his patients 
 on his morning round, or practises on his wife 
 that ferocious brusqueness which he reads, in 
 some cases, is of such inestimable therapeutic value. 
 On the other hand, there is the danger that 
 
78 UNCONSCIOUS THEEAPEUTICS 
 
 Should 
 
 avoid 
 
 conceit. 
 
 Psychic 
 value of 
 fees. 
 
 Vein of 
 truth in 
 this 
 
 chapter. 
 
 those who are the conscious and proud possessors 
 of these valuable personal qualities may be filled 
 with overweening conceit as they find how greatly 
 their patients benefit by them. This chapter is 
 full of pitfalls for the unwary or enthusiastic 
 reader ; for it is undoubtedly a temptation, when 
 a doctor is assured on such eminent authority that 
 the amount of his fee has an appreciable con- 
 nection with his therapeutic success, to increase 
 his half-yearly accounts, and his charges generally, 
 solely in the patient's interest. The plain, matter- 
 of-fact man, on the other hand, who stands no 
 nonsense, and to whom a blue pill and a black 
 draught, or some modern equivalent, is a cure-all, 
 will find his temper sorely tried by the, to him, 
 ridiculous details entered on here — if, indeed, such 
 a one takes up the book at all. And yet, one 
 reflects with pain, it is always the men who need 
 wise counsels most, who are the most chary in 
 reading books that contain them. 
 
 The reader, being thus forewarned, is, I trust, 
 also forearmed ; and if —behind and underneath all 
 he may find to object to in the chapter — he discerns 
 a vein of truth which hitherto he has but little 
 noticed, he will perhaps pardon what he deems 
 the superfluous or the frivolous. 
 
THE PEESONALITY OP THE PHYSICIAN 79 
 
 Let us, first of all, glance for one moment at Antiquity 
 
 of 
 
 the antiquity of the physician's art. Medical medicine, 
 science in Egypt ranked so high that specialists 
 abounded even there, and the physician did not 
 practise surgery nor the surgeon medicine. There 
 were oculists and dentists, alienists and specialists 
 who diagnosed obscure complaints, and there are 
 papyri extant which treat of these diseases. For 
 a long time the physician held the field, to the 
 exclusion of the surgeon, and it was not until the 
 great European wars brought the latter to the 
 front that he became of any repute. 
 
 In England, however, the process was slower. Physicians 
 
 superior to 
 
 The physician, although two hundred years ago he surgeons, 
 was constantly held up to ridicule as a quack, cer- 
 tainly, on the whole, held a superior position to the 
 surgeon-barber of the time. A medical author of 
 the date of Elizabeth writes : ' How many chirur- 
 geons shall a man find . . . that have learning ? 
 For the most part they are ignorant and void of 
 all learning, and know almost no part of anatomy, 
 which is most necessary for a chyrurgeon ? ' 
 
 But the statute 18 Geo. 11. cap. xv. provided 
 that the art and science of surgery should no 
 longer be practised by the Company of Barbers ; 
 and thenceforth surgeons were raised to comparative 
 
80 UNCONSCIOUS THERAPEUTICS 
 
 physicians. 
 
 professional equality with the physician. The 
 second section, however, is far from flattering. It 
 sets forth that ' although the most part of the 
 persons of the craft of chirurgeons had small 
 Avarice of cunning, yet they would take great sums of money 
 surgeons. lii^lQ therefor, by reason whereof they 
 
 oftentimes impaired and hurt their patients, instead 
 of doing them good.' 
 Superiority Ii^ the middle of the eighteenth century the 
 o^ surgeons ^^^q^:^^^ ^^iB physician was at a low ebb; and 
 at this time they compare unfavourably with 
 surgeons, and even with quacks. In a curious 
 book called ' Doctors and Doctors,' by Graham 
 Everett, we read : ' What an expose of the state of 
 medical science in England in 1737 ! Well might 
 Lord Hervey say : How natural it is to deplore 
 the situation of those whose safety depends on the 
 sagacity of these professors [of medicine], and how 
 reasonable to despise those who put their trust in 
 such aids ! " Not that I am so unjust as to put the 
 science of surgery upon the same footing with 
 physic' Only imagine hernia treated by 'four 
 of the best physicians in the land with blisters 
 and the lancet, with Daffy's Elixir, mint-water, 
 usquebaugh, snake-root, and Sir Walter Ealeigh's 
 cordial. The College of Physicians might hold up 
 
THE PEESONALITY OP THE PHYSICIAN 81 
 
 a warning finger against Joshua Ward's (a noted 
 quack) drop and pill ; and yet it seems to us that 
 Joshua Ward, ex-footman and quack, might hold 
 his own with the best of them.' 
 
 And it is from this hoary background, and Humble 
 
 1 T 1 . . origin of 
 
 with such a mediaeval dubious reputation, that medical 
 
 men. 
 
 the medical man of to-day is evolved. Surely, 
 when we consider this humble origin, and 
 view the skilled scientist of the twentieth cen- 
 tury, we are driven to contemplate with awe 
 what he may yet become when the balance is 
 held more truly, and all that bears upon his 
 calling is given its due weight, and taught with- 
 out fear or prejudice. 
 
 Let us listen for a moment to one or two 
 descriptions of the ideal physician. In the first 
 
 ^ physician. 
 
 series of the ' Horse Subsecivae,' by Dr. John 
 Brown, written many years ago, we read : ^ * The 
 physician's is a tentative art, to succeed in which 
 demands a quickness of eye, thought, tact, and 
 invention, which are not to be learned by study, 
 nor, unless by connatural aptitude, to be acquired 
 by experience.' It is the possession of this sense, 
 exercised by a patient observation and fortified by 
 al just reliance on the vis medicatrix naturcB, the 
 
 * See pp. 4 , 46 of the work. 
 
 G 
 
82 UNCONSCIOUS THERAPEUTICS 
 
 self-adjusting tendency of nature, that constitutes 
 
 the true physician or healer. 
 F^reves Trevos speaks of ' the equipment of the 
 
 on the medical man ' at length ; and out of it I extract 
 
 medical ^ 
 
 the following : — 
 Trust- ' The second need in the equipment of the 
 
 oAhe^^^^ medical man is absolute fidelity. All those who 
 profess to attend upon the sick undertake a solemn 
 trust which needs to be observed with punctilious 
 care. The sick man must place implicit faith in 
 his doctor or no faith at all. The fulness and 
 simplicity of this confidence are the measure of 
 the scrupulous honesty with which it must be 
 received. In accepting this trust every physician 
 takes upon himself a grave responsibility, and he 
 who is the most exact in the right observance of 
 this confidence has the greatest claim to be worthy 
 of his calling. The burden of such a trust is little 
 appreciated beyond the confines of the medical 
 profession, and every physician of any experience 
 has had to learn with some bitterness how much 
 self-denial and self-effacement this trust implies, 
 how little the responsibility of it is appreciated, 
 and how much injustice to the doctor its honest 
 acceptance may involve. 
 
 ' The public are apt to talk glibly of medical 
 
THE PEESONALITY OP THE PHYSICIAN 83 
 
 etiquette," and to assume that it is founded upon 
 some special code of ethics, and based upon a 
 system of morals especially constructed for the 
 advantage of the medical profession. Such criti- 
 cism is unjust, as criticism usually is which is 
 based upon imperfect knowledge. It is needless to 
 say that there is no precept in medical etiquette " 
 which is other than the outcome of the simplest 
 justice, the simplest right-doing, and, above all, 
 the truest care for the interests of the patient. 
 
 * The third article in such part of the Eeligio His kind- 
 
 ness and 
 
 Medici" as bears upon the qualifications of the sympathy, 
 physician is this. He must be kind. He must 
 needs be a man of wide sympathies, and possessed 
 of that rare qualification which enables him to put 
 himself in the patient's place. There need be little 
 art in this. Genuine sympathy cannot be assumed, 
 or, if assumed, its artificiality is too apparent to 
 deceive even a child. 
 
 * In the mere treatment of the sick a simple 
 kindliness of heart is an essential factor, and 
 it can never be replaced by any assumption of 
 manner, however elaborate, or however precisely 
 mimicked.' 
 
 Dr. Stirling ^ says : ' Such being the high ideal 
 
 * Dr. Stirling, British Medical Journal, October 18, 1902. 
 
84 UNCONSCIOUS THEEAPEUTICS 
 The phy- set before medical students, it is incumbent on all 
 
 sician a 
 
 gentleman, to see that any one desiring to enter its ranks 
 should, in addition to acquiring the necessary 
 technical instruction to pursue his profession, 
 possess those qualities that are summed up in the 
 word '^gentleman." Mere knowledge or purely 
 professional attainments are not sufficient ; other 
 qualities of the heart are necessary — he must be 
 not only a gentleman in manners, but also a man 
 of tender feeling, and sympathetic withal. John 
 Gregory, Professor of Medicine in Edinburgh, in 
 his Observations on the Duties and Offices of a 
 Physician," first published in 1770, but republished 
 in a more correct form by the author in 1772, drew 
 the fine word-picture of a physician : " The true 
 dignity of physic is to be maintained by the superior 
 learning and abilities of those who profess it, by 
 the liberal sentiments of gentlemen, and by that 
 openness and candour which disdain all artifice, 
 which invite a free inquiry, and which by this 
 means boldly bid defiance to all that illiberal 
 ridicule and abuse which medicine has been so 
 much exposed to." ' 
 
 Dr. Green Dr. Green tells us, with great truth and dis- 
 
 on the true 
 
 doctor. crimination : ^ * To act m the spmt of science, 
 * J. H. Green, F.K.S., Mental Dynamics, pp. 41, 42. 
 
THE PEESONALITY OF THE PHYSICIAN 85 
 
 where I can ; by the mere light of experience with- 
 out scientific insight, when I must ; but with the 
 uniform avoidance and contempt of quackery in all 
 cases, this is, or ought to be, the moral code for 
 every practitioner. In short, to form that senti- 
 ment of honour and gentlemanly feeling in which 
 the moral life of the individual breathes as in the 
 natural atmosphere, with an unconsciousness which 
 gives the charm of unaffected manners and con- 
 duct.' 
 
 Dr. Bruce observes : ■ ' Those precious faculties Dr. 
 known as acumen, insight, and personal influence, Bruce on 
 
 * precious 
 
 which have so highly distinguished some of the faculties/ 
 greatest masters of medicine and surgery, and 
 made their patients' minds like glass to them — 
 these are faculties in part innate, in part acquired ; 
 which are the more carefully to be cultivated the 
 less liberally they have been bestowed on the 
 practitioner by Nature.' 
 
 The writer of ' The Young Practitioner ' (de Angeis and 
 Styrap) allows no medium in a doctor between the medicine, 
 angel and devil. He says : ' For our career must 
 be one of two — either the skilled and disciplined 
 mind seeking like a god the welfare of mankind 
 and the relief of suffering humanity, or the ignorant 
 * Dr. M. Bruce, Practice of Therapeutics, p. 182, 
 
86 UNCONSCIOUS THEEAPEUTICS 
 
 and hypocritical pretender concealing behind the 
 ambush of fair words and smiling face a heart of 
 guile and a soul of bitterness ! ' 
 
 I feel sure that while few of my readers 
 would aspire to answer in full to the first character, 
 they one and all would indignantly repudiate the 
 second. Indeed, did I not know otherwise, I 
 should have thought, so crude is the picture, that 
 ' The Young Practitioner ' had written the book 
 himself. 
 
 Obvious ' The Young Practitioner ' is on safer ground 
 
 platitudes, ^^ien he indulges in platitudes, as follows : ^ The 
 personal appearance, the walk, the movements, the 
 language, the gestures and natural mode of inter- 
 course of some practitioners are winning and 
 attractive ; of others, rude, harsh, and repelling to 
 the sick.' There can obviously be no doubt here 
 as to which class my readers belong to, for surely 
 no doctor believes himself to be rude, harsh, or 
 repellent ; such could probably term themselves 
 candid, straightforward, and independent. 
 
 A little further on our young practitioner makes 
 a rather sapient remark, though couched, as is his 
 wont, in a painfully platitudinous style. * If you 
 Be yourself chance to inherit any genuine idiosyncrasy, it will 
 picuiiar. doubtless be noticed, and, if not an unpleasing one, 
 
THE PEESONALITY OP THE PHYSICIAN 87 
 
 will probably aid you much. Never, however, Never 
 
 assume 
 
 assume one, for the counterfeit is easily detected manners 
 by all sensible people (fortunately these are 
 sometimes rare amongst our patients) ; act your 
 own natural character at all times and in all 
 places. In addition to making himself ridiculous, a 
 doctor who assumes a fictitious or borrowed manner 
 must either be wrong-hearted or weak-headed.' 
 This advice is good, and should be laid to heart. 
 
 I will now turn to another point connected 
 with a doctor's success ; and would urge — to come 
 much lower down than style or manner — that 
 whether he be wrong in the heart or weak in the 
 head, or both, he must be well dressed. * The Be weii 
 Young Practitioner ' is quite alive to this, and 
 ventures ^ on the safe observation that people in 
 general are not only more disposed to seek advice 
 from a well-dressed doctor, and repose greater 
 confidence in him, than in a shabbily attired one ; 
 and he earnestly impresses on us, as he says, 
 in homely ' language,' ' that clean hands, a well- 
 shaved face or neatly trimmed beard, polished 
 boots, spotless cuffs, well-fitting gloves, fashionable 
 clothing, and an unimpeachable hat, not only 
 severally indicate gentility (hateful word) and 
 ^ De Styrap, The Young Practitioner, 
 
88 UNCONSCIOUS THEEAPEUTICS 
 
 self-respect, but impart a pleasurable self-conscious- 
 ness of being well dressed and presentable.' 
 
 barrister's is now, knee-breeches and Hessian boots, 
 white necktie and white frilled shirt, ruffles at the 
 wrists, and a cane with a camphor-box at the top. 
 He was distinctly a gentleman whom everyone recog- 
 nised as a doctor. There is no doubt the very special 
 close personal contact into which a doctor is often 
 brought with a patient requires a careful nicety in 
 clean linen and dress which, while incumbent upon 
 every gentleman, is absolutely essential in his case. 
 Neglect of this may produce positive aversion and 
 a prejudice that no amount of skill can neutralise. 
 
 This is true, but with regard to appearance 
 generally, no reader must imagine that I lay as 
 
 Personal!- great stress on dress as on the personality which it 
 than dress, clothes. It is after all a secondary consideration ; 
 
 but though secondary, not therefore to be either 
 
 neglected or put in the first place. 
 
 There are, and have been, many great men 
 whose personality so overshadowed all else, that it 
 was little matter how they were dressed ; or, rather, 
 whatever they did, or however they were dressed, 
 the action or the style actually derived a value 
 
 Dress in 
 the old 
 days. 
 
 Certainly in olden times great regard was had for 
 the physician's attire. He wore a coat cut as a 
 
THE PBESONALITY OF THE PHYSICIAN 89 
 
 because it was connected with them. Such a 
 one, for instance, was Thomas Carlyle, in spite of 
 * Sartor Eesartus.' 
 
 Then, again, there are surroundings where the The 
 frock-coat of medicine would be an outrage, and f^ock-coat. 
 where the truest instinct leads the doctor to dress 
 in better harmony with his environment. What, 
 indeed, could be a better illustration of this than 
 Ian Maclaren's highland doctor ? I will give Maciaren's 
 
 highland 
 
 his portrait. doctor. 
 
 * The sight of him put courage into sinking 
 hearts. But this was not by the grace of his 
 appearance, or the advantage of a good " bedside " 
 manner. A tall, gaunt, loosely made man, without 
 an ounce of superfluous flesh on his body, his face 
 burned a dark brick colour by constant exposure 
 to the weather, red hair, and beard turning grey, 
 honest blue eyes that looked you ever in the face, 
 huge hands with wrist-bones like the shank of a 
 ham, and a voice that hurled its salutations across 
 two fields — he suggested the moor rather than the 
 drawing-room. . . . Blacks " he wore once a year 
 on Sacrament Sunday, and if possible at a funeral ; 
 top-coat or waterproof 7iever. His jacket and waist- 
 coat were rough homespun of Glen Urtach wool, 
 which threw off the wet like a duck's back ; and 
 
90 UNCONSCIOUS THERAPEUTICS 
 
 below he was clad in shepherd's tartan trousers 
 which disappeared into unpolished riding-boots. 
 His shirt was grey flannel, and he was uncertain 
 about a collar, but certain as to a tie which he 
 never had, his beard doing instead ; and his hat 
 was soft felt of four colours and seven different 
 shapes. His point of distinction in dress was the 
 trousers, and they were the subject of unending 
 speculation. There was not much of the check 
 left, but all agreed that when they see thae breeks 
 comin' in " they knew that if human power could 
 save the life it would be done.' ^ 
 
 The general appearance, apart from mere dress, 
 is of moment. Hippocrates remarks that ' a phy- 
 Doctors sician should have a healthy look, so as to show he 
 have^a is fit to havo charge of the health of others. He 
 ^healthy gj^^^^j^j prudeut and moral.' 
 
 In * Hints to Doctors,' by E. Gersany, we notice : 
 ' That should the doctor have been walking fast, or 
 running upstairs, from the moment of entering 
 Always the sick room to that of leaving it he must always 
 unflurried. appear calm and unflurried, with his whole atten- 
 tion concentrated on the patient.' I have felt the 
 wisdom of this, for I have a vivid recollection of a 
 locum left in charge disgusting one of my best 
 ' Ian Maclaren, A Doctor of the Old School, pp. 33, 37. 
 
THE PBESONALITY OF THE PHYSICIAN 91 
 
 patients by rushing into the sick room, sitting 
 down on the bed, and heartlessly recounting while 
 panting for breath — to the great disgust of my 
 patient — his grievance against a coal agent he had 
 quarrelled with that morning ; so that one knows 
 the counsel is needed at times. 
 
 Turning to another point, there can be no doubt 
 of the value of a hobby to a doctor, also the perusal 
 of varied literature and the cultivation of a wide 
 interest in men and things. We are thus better 
 equipped, and come with brightness and freshness 
 when we approach the bedside of the sick and 
 suffering. But we must heed Gersany, who tells 
 us : ' The wise physician, who is fond of etching or Keep 
 
 hobbies in 
 
 botany, the brush or the chisel or the pen, or who the back- 
 ground. 
 
 is given to science, does well to keep these things 
 a little in the background until he is securely seated 
 in the saddle of professional success.' This, too, is 
 wise counsel, as I have found personally in my love 
 and pursuit of hygiene. At one time I pushed it Personal 
 
 experi- 
 
 sofar as considerably to injure my practice; so many ences. 
 finding it difficult to believe that a man could prac- 
 tise medicine who gave so much attention to siphon 
 * traps ' and disconnected ' overflows.' My experi- 
 ence, indeed, goes farther than our mentor's ; for I 
 care not how firm the seat may be in the saddle, it 
 
92 UNCONSCIOUS THEEAPEUTICS 
 
 is well that all should know that the profession of 
 medicine is to you the first and foremost. 
 
 I have some general comments to make upon 
 all this good advice we have had, but will postpone 
 it yet a moment, while we look first a little more at 
 the doctor's manners, and then at some of those 
 personal qualities of the physician that lie be- 
 neath both the dress and manner. 
 
 * Some manners ^ are desirable, and though not 
 truly essential, yet help or hurt the doctor much. 
 Whether he is gentle and well-mannered, is socially 
 agreeable, or, as to this, negative, influences much 
 the choice of the woman on whom, as a rule, comes 
 finally the decision of who her family physician 
 shall be. Too often she is caught by the outside 
 show of manners, and sets aside an abler and 
 plainer man, who has more really the true manner 
 of the heart, yet lacks the power to make him- 
 self pleasant. It is desirable, of course, to be 
 what so many of the best physicians have been, 
 refined and tactful gentlemen, and also charming 
 companions^ But a man may be a most competent, 
 clear-headed, honest, scrupulously careful doctor, 
 and yet fail because he is too plain, ill-dressed and 
 uninteresting ; and all this is as well to understand.' 
 ' Dr. B. Weir Mitchell, Doctors and Patients, p. 53. 
 
THE PEESONALITY OF THE PHYSICIAN 93 
 
 Yes ; and I would add as well, also to be spoken a subject 
 
 for the 
 
 of and corrected in the schools in a way that is schools, 
 never done at present ; for much may be taught 
 as to manner, though true refinement is ever 
 innate, and springs from the spirit within. 
 
 There are, of course, successful ^ bears ' in our Successful 
 
 * bears.' 
 
 profession — and perhaps it is better to be a bear 
 than a dancing-master ; but it is not necessary to 
 be either. It is also well to remember that the 
 bears are not successful because of their rudeness, 
 but in spite of it, and in virtue of their genius. 
 Indeed, geniuses have often a weakness for re- 
 sembling bears and other animals, which seems an 
 unworthy ambition. 
 
 Dr. Green beautifully says : ^ * As the forms in 
 all organic existence, so must all true and living 
 knowledge (and of manners) proceed from within ; 
 that it may be trained, supported, fed, excited, is 
 true, but it can never be infused or impressed.' 
 
 Dr. Cathell says : ^ ^ Your personality and Dr. Catheii 
 deportment in the presence of patients will have manners, 
 much to do with your success. A cold or cheerless 
 manner toward people ; an austere, studied, or 
 sanctimonious isolation of oneself from them 
 
 * Dr. J. H. Green, F.R.S., Mental Dynamics, p. 14. 
 - Dr. D, W, Cathell, The Physician himself, p. 41. 
 
94 UNCONSCIOUS THEEAPEUTICS 
 
 socially ; a failure to recognise would-be friends 
 in the streets and elsewhere, as if from a proud 
 independence, or as if they were inferior mortals 
 and beneath you, often gives unmeant offence, 
 destroys all warmth toward a physician, and 
 usually causes their possessor to fail to inspire 
 either friendly likings or faith ; and a physician 
 who cannot in some way make friends or awaken 
 faith in himself cannot fail to fail. The reputa- 
 A'very tion even of being a ''very nice man" makes 
 
 nice man. *^ 
 
 friends of everybody, and is even more potent 
 with many than skill. Tact, delicacy of per- 
 ception, the power of winning the patient's con- 
 fidence, of allaying his fears, and comforting him 
 in pain, and, at the same time, keeping clear of 
 his prejudices, are essentialities of vital import- 
 ance, and should be assiduously cultivated ; for 
 both personal appearance and manners are much 
 in medicine, and a power in practice, and worthy of 
 a serious consideration they seldom get.' 
 Your face Dr. Cathell also advises us further : ^ * School 
 betoyyo^u. yourself till you can prevent your thoughts, 
 embarrassments, and opinions from showing in 
 your countenance during anxiety and emergen- 
 cies ; and, above all, discipline your features and 
 
 ^ Dr. Cathell, The Physician himself, p. 149. 
 
THE PBESONALITY OP THE PHYSICIAN 95 
 
 manners, so that the nervous and patients who 
 are very ill cannot detect in you unfavourable 
 reflections about themselves which you wish to 
 conceal. 
 
 ^ Self-reliance and self-possession are very im- Seif-reii- 
 
 ance leads 
 
 portant elements of success. Nothing will cause to success, 
 people to rely on you more readily and steadfastly 
 than to see that you rely on yourself. Be not arro- 
 gant or self-conceited, but always endeavour to con- 
 ceal your doubts, hesitancies, and apprehensions.' 
 
 The manner must vary with the class of disease ; 
 what suits one does not in the least suit another. 
 In many organic diseases a sympathetic manner 
 is most helpful ; in many functional diseases it 
 is prejudicial ; while in some nerve diseases the 
 manner should be absolutely mechanical. 
 
 The question of the truthfulness of physicians The tmth- 
 
 1 • p • T m fulness of 
 
 IS one that is often raised. The fact is, that physicians, 
 when one is absolutely candid it is common for 
 patients to put on so large a percentage to the 
 doctor's words that they grossly exaggerate what 
 he really does say. This troubles consultants far 
 more than it does the family doctor, who often 
 leaves to the former the invidious task of telling 
 the necessary, but unpalatable, truth ; and not a 
 few doctors have stood face to face with the 
 
96 UNCONSCIOUS THEEAPEUTICS 
 
 Its real 
 difficulty. 
 
 Patient's 
 interests 
 come first. 
 
 True 
 
 sympathy 
 essential. 
 
 alternative of concealing the truth or losing the 
 patient. 
 
 Many do not understand the real difficulties 
 that beset the upright physician in this matter, for 
 nearly every patient has his or her standard of 
 truth by which to try the veracity of the perplexed 
 doctor. 
 
 There is no doubt that the paramount duty of 
 the physician is to do all he can to help and never 
 to injure his patient ; and, while telling no lies, he 
 is perfectly consistent in only telling as much of 
 the truth as it is good for his patient to know ; and 
 of this, rightly or wrongly, he must be the judge. 
 
 The next point one would make in connection 
 with the physician (in spite of much that has been 
 written, and against the practice of some noted 
 neuropaths) is that one of the first conditions of 
 success in practice is sympathy, and one of the 
 chief causes of failure is the want of it. Of 
 course, many have it to excess, as a young physi- 
 cian had, who burst into tears at the sight of a 
 burnt child, and was practically useless to help her. 
 Some, indeed, have had to abandon the profession 
 from a too great sympathy with their suffering 
 patients. ' We have,' says Dr. S. Weir Mitchell,^ ' a 
 * Dr. S. Weir Mitchell, Doctors and Patients^ p. 46. 
 
THE PEESONALITY OF THE PHYSICIAN 97 
 
 certain gentle disrespect among us for the doctor 
 who is described as ^*0h, so sympathetic!" — the 
 man who goes about his work with a pocketful of 
 banal phrases calculated to soothe the cravings of 
 the wretched. The sick and feeble take gladly 
 these imitation crumbs cast from the full table of ' imitation 
 
 crumbs' 
 
 the strong. But sometimes people of firm cha- for the 
 
 sickj 
 
 racter revolt at such petty and economical charity.' 
 
 I do not therefore say that sympathy need be 
 always, or even frequently shown ; but, believing 
 as I do in the response of one unconscious mind to 
 another when in harmony, I have no doubt (as I 
 have pointed out in * The Force of Mind ') that 
 wherever real sympathy exists it is always felt by 
 the physician for the sufferer, though it be not 
 shown, the proof being that it gives the patient a 
 confidence in the doctor's skill and a restful feeling 
 of being understood, which is no mean factor in 
 a cure. 
 
 To feel this sympathy one must have the Put your- 
 
 self in his 
 
 faculty of putting oneself in the patient's place, place, 
 and one must believe, especially in cases of func- 
 tional nerve disease, in the reality of the sufferings 
 of the patient, and dismiss absolutely the bhght of 
 suspected malingering. One must grasp the truth 
 of the brilliant dictum of Sir James Paget, who 
 
 H 
 
98 UNCONSCIOUS THEEAPEUTICS 
 
 declared that while the patient says she * cannot,' 
 and the nurse that she * will not/ the truth is that 
 she ' cannot will.' ^ 
 Firm and Closely connected, again, with this is the 
 firm. question of firmness. Curious as it may seem, it 
 is easy to be too firm, still easier not to be firm 
 enough. The path of success here undoubtedly 
 lies in the golden mean between the two. Be 
 inflexible as cast-iron in things essential ; flexible 
 as steel in all matters non-essential ; and never, as 
 is so common, inflexible from mere doggedness, but 
 always intelligently. This gives confidence, brings 
 success, and avoids friction with patients and 
 friends. 
 
 * As I correct these proofs I come across a terrible ease of a 
 lighted life of needless suffering, simply from utter want of 
 understanding on the part of an otherwise clever and successful 
 doctor. He kept pooh-poohing her symptoms and urging her to 
 do what she had no strength to perform, though she had 
 every desire ; and thoroughly made her feel she had only herself 
 to blame for her illness. So accustomed are doctors, trained 
 only in the schools, to ignore functional nerve symptoms that, 
 from mere habit, they often pooh-pooh signs of organic disease 
 in mistake, if these be mixed up with them. It was so in this 
 distressing case ; indeed the patient despaired of all cure, owing 
 to the feeling of beating against a closed door when telling her 
 troubles to a doctor. For four years she remained in a hopeless 
 state, suffering all the time from severe cervical erosion (of long 
 standing), and nearly three stone below her weight. I would 
 earnestly press on every doctor who reads these pages to make 
 his patients feel he understands their sufferings ; and also to be 
 most careful not to neglect any organic trouble, because overlaid 
 with functional symptoms. 
 
THE PEESONALITY OP THE PHYSICIAN 99 
 
 A strong face always inspires confidence. The Vaiue 
 
 of the 
 
 ancients well understood the value of the doctor's doctor's 
 
 face. 
 
 face in disease, and with them agree also the wiser 
 of the moderns. 
 
 Listen to Dr. Oliver Wendell Holmes, when he '^j^-^- 
 
 Holmes on 
 
 appraises its commercial value : ^ A smile may be ^^^^^^^^ 
 worth 5,000 dollars a year to a man.' I presume ^^^"^^'^ 
 he means a smile a visit, or at least one a day ; one 
 put on and taken off at will, though the latter is Put on or 
 
 a, n , . ^ 1 , . , taken off 
 
 often forgotten. Or, perhaps, he may picture a at win. 
 smile commenced with the professional career and 
 continuing, in storm and calm, unruffled through- 
 out its course — a smile that illumines the consult- 
 ing-room when you are waiting a whole morning 
 for patients that do not come — the sort of smile you 
 go to bed in ! 
 
 But, joking apart, which is cheap and easy, the smiic 
 value of the smile is very great, particularly if by natural, 
 any means, in one who has to use it so much as a 
 doctor, it does not get worn thin, but remains 
 natural and spontaneous. If what is natural can 
 be called * an art,' this is a great one. Only, 
 however charming it may be, we should much 
 prefer to appraise its value by its therapeutic 
 power to our patients than by the possible dollars 
 or shekels that may accrue to us from it. 
 
 H 2 
 
100 UNCONSCIOUS THEEAPEUTICS 
 
 I wonder if physicians, as a rule, have really 
 any conception of the power of the face over the 
 patient ; how closely it is watched, and how much 
 more is deduced from the aspect and manner than 
 from the words. In fact, at the close of a con- 
 sultation you may use pretty well what form of 
 words you like ; their meaning to the friends is 
 interpreted by the way you say them. 
 Evil of a The man of cheerful countenance restores the 
 
 depressing 
 
 manner. patient by his helpful, buoyant spirit, while others 
 who are constitutionally grave and desponding 
 depress and distress him. These often unwittingly 
 hinder the cure they are anxious to promote. 
 Indeed, so great is the mental factor in thera- 
 peutics that it is not too much to say that inferior 
 medical skill, with a good and assuring manner, 
 is more likely to effect a cure than a superior skill 
 with a different and depressing personality. 
 
 Sympathy is, indeed, a powerful drug in the 
 hands of a skilful administrator ; for, after all, 
 patients think much more of the doctor than of 
 his prescriptions, while he— poor man — generally 
 thinks his hieroglyphics all, and himself nothing. 
 
 Hypo- A short time ago I was calling at a patient's 
 
 chondria 
 
 caused by house, and while waiting to see her entered into 
 
 doctor's 
 
 manner. conversation with her eldest son. He had on his 
 
THE PEESONALITT OP THE PHYSICIAN 101 
 
 part many questions to ask me bearing on his own 
 state of health, and the eager, nervous way in 
 which they were put, as well as their nature, 
 showed me I had to do with a case of hypochondria 
 in a fine young sportsman of twenty-five. I spoke 
 to his mother a few days afterwards as to what 
 I feared was the young man's condition, and she 
 told me that it all dated from several visits he had 
 paid to a physician for some local ailment. This 
 doctor — a clever, good man, well known to me — is 
 himself an invalid, and has at times to use 
 medicines or lotions in consulting hours for his 
 own relief. He has also a very depressing, nervous 
 manner, and an anxious, desponding look, and told 
 the young man, as he shook his head, it would be 
 a long time before he would be right. A few visits 
 of this sort started the practice of morbid intro- 
 spection, which the young fellow had been pur- 
 suing since. 
 
 Not far from him another doctor lives of a iiiustra- 
 different type, also known to me. The sister of a benefit of 
 
 . T I ' o ^ cheerful 
 
 patient of mme has been under his care for a short manner, 
 time, and she writes as follows in a letter I was 
 permitted to see : — 
 
 * I often think of him and his kindness to me 
 through those long dreary weeks— not only what 
 
102 UNCONSCIOUS THEEAPEUTICS 
 
 he did, but what he was. Some people help one 
 more than they know by just being themselves — 
 I mean by their own living personality. Don't 
 you agree with me? A bright smile on a dark 
 day takes so much of the darkness away ! Oh, it 
 is the little things that mean so much, the small 
 things that are so great ! ' 
 
 Here, then, are sketches from life of two equally 
 estimable men. Of the two, the former is probably 
 the abler doctor, and holds the higher position 
 amongst his medical colleagues. 
 Evil done And yet how little he knows and understands 
 ignorance, of the evil he does so unconsciously, so ignorantly ! 
 
 For this young man was no solitary case — I have 
 heard of others since. He injures patients with 
 the sole desire of benefiting them, for want of 
 knowledge ; he has never been taught — and there 
 are hundreds like him. Is it any wonder that this 
 book is written ? And is no such teaching needed ? 
 
 I will now give one or two illustrations from 
 real life of the many and valuable precepts we 
 have been listening to. But before doing so I should 
 like to say a little more upon this important, and 
 yet almost never considered, question of the un- 
 conscious therapeutical value to the patient of the 
 physician's personality. 
 
THE PEESONALITY OF THE PHYSICIAN 103 
 
 I am writing for doctors ; and, while I a doctor 
 
 should 
 
 deprecate earnestly too much introspection, and know the 
 
 efEect of 
 
 know well that, with regard to charm of manner, t^is pereon 
 
 aUty. 
 
 style of speech, and many other things, the truly 
 unconscious should never become the conscious, 
 nevertheless it is of great importance that a doctor 
 should have a clear idea of all the branches of 
 therapeutics at his disposal when he goes to a 
 case. I trust, therefore, that after reading this 
 book he will ever remember that perhaps not the 
 least active agent in cure may be himself in his 
 own personality. I know this sounds strange 
 doctrine and savours of conceit, and scant reference 
 will be found to it in learned and weighty tomes ; 
 but it is none the less true because never spoken 
 of in the schools, save, perchance, in that futile 
 opening address at the commencement of the Oniy 
 
 ^1 . 1 . T T alluded to 
 
 session m October, when the practical-mmded in October 
 
 . - _ , addresses. 
 
 student feels nauseated with the idealism and plati- 
 tudes that are poured forth, if he be bold enough 
 to sit in judgment upon their august author. 
 
 It will be observed I do not here in the 
 least take up the money side of the question — 
 that is, the bearing of the physician's person- 
 ality on his professional success by his attractive 
 graces — (that I shall refer to later on) ; and 
 
104 UNCONSCIOUS THEEAPEUTICS 
 
 herein differ from many I have quoted, to whom 
 this seems the chief object. I consider such a 
 point alien to and outside the scope of our 
 inquiry at present, which is the loftier and more 
 altruistic one of our own therapeutic value to 
 our patients. 
 
 The mind * The mind casts a shadow just like the body ' 
 sh^^ow is a pregnant sentence that dropped on my ears, 
 theVody. ycars ago, from the lips of an aged and sleepy 
 parson in a sermon to a sparse and drowsy con- 
 gregation as I sat in a mouldy pew in a small 
 and decaying private chapel attached to a country 
 house ; and it has echoed in my mind ever since. 
 The mind The mind of the doctor, in itself, and in its 
 
 is shown in ' p j i' • i i n i 
 
 all the sur- manifestation m conduct, manner, face, dress, 
 roundmgs. ^^^yg^ connected with him, must, ipso 
 
 facto, incessantly affect his patient for good or ill. 
 
 This is, of course, true of all men ; but a 
 doctor's personality affects his patient in a way 
 that none others do. He is so connected with 
 the issues of life and death, and is to the family 
 such an oracle, that all about him, unconsciously 
 to himself, and often unconsciously to his patient, 
 has a profound power. 
 
 The judgment of the laity passed upon him 
 from the effect of his personality is often sounder 
 
THE PEESONALITY OP THE PHYSICIAN 105 
 
 than his own. His medical education has, on the 
 whole, taught him rather to despise the man 
 within him in favour of the doctor ; and he is 
 in some danger, as the witty Frenchman said, of 
 having inscribed upon his tombstone : * He was 
 born a man ; he died a doctor.' 
 
 And not only so, but his special education has Experts 
 
 . seldom 
 
 thrown other thmgs out of focus. He is an expert have well- 
 
 . . balanced 
 
 in medicine, and therefore probably is anything minds, 
 but an expert in manners. All experts lose balance ; 
 hence the law of England has never yet been 
 persuaded to place the issues of life and death in 
 criminal matters in the expert's hands, even of a 
 judge, but rather in the stolid common sense of 
 twelve British jurymen. 
 
 On the other hand, in insisting on neglected Do not 
 
 lose sense 
 
 points in practice, we must not lose our sense of of propor- 
 tion. 
 
 proportion. We must remember, while magnifying 
 the value of face and dress, and words and good 
 manners, how little is seen of any of them when 
 it is a question of a grave or mortal illness, or 
 some major operation in surgery. The coat goes 
 off, the suavity disappears, the words are few, and 
 all trivialities vanish. In view of such a time it 
 does seem almost trifling to give them such a 
 therapeutic value. 
 
106 UNCONSCIOUS THEEAPEUTICS 
 
 And yet it is not so. The greater part of our 
 patients' lives are not passed in stress or storm, 
 and our intercourse with them is not, as a rule, 
 conducted without our coats or manners. Usually 
 our patients are in a condition greatly to be in- 
 fluenced by various externals or shadows of our 
 Avoid arti- Hiinds. The danger, of course, is not so much 
 ficiahty. ^Y^^^ overvaluing the therapeutic power of per- 
 sonality, as that of introducing artificiality into 
 our expression or manners. On the whole, it is far 
 better to continue with what is defective than to 
 try and improve it by substituting what is obviously 
 artificial. 
 
 When I began practice I asked an old and 
 wise doctor near how I should look when I entered 
 a sick room. His reply was, ^As much like an 
 
 The ^ 
 
 '.ii^spired inspired idiot as you can.' And I have often 
 thought since this describes very well the aspect of 
 a man who tries to appear what he is not. Certain 
 conspicuous medical vices may, however, be safely 
 named without leading any reader to such an un- 
 happy expression of countenance in trying to correct 
 Qualities them. Amongst these may be enumerated fear, hesi- 
 pat^enti!'^'^ tancy, depression, ill-temper, pomposity, verbosity, 
 levity, too much solemnity, artificiality, hurry, im- 
 patience, carelessness, forgetfulness, and vanity. 
 
THE PEESONALITY OF THE PHYSICIAN 107 
 
 As contraries may be briefly named, amongst Qualities 
 
 that bene- 
 
 unconscious therapeutics, dignity, simplicity, bre- fit patients, 
 vity, decision, interest, sympathy, candour, natural- 
 ness, certainty, cheerfulness, hopefulness, good 
 temper, courage, carefulness, patience, and firm- 
 ness. Patience in hearing and listening, distinct- 
 ness in speech and orders, quickness and observation 
 in seeing, and firmness and gentleness in touch, are 
 also helpful adjuncts. 
 
 But enough, for the moment, of sermonising. 
 Let us look at a pleasing picture or two. 
 
 Sir Thomas Watson ^ laid no claim to genius ; sir t. 
 
 Watson as 
 
 he made no great discovery, and yet he was a model 
 
 physician. 
 
 by universal consent regarded as the completest 
 illustration of the highest type of physician. 
 His moral as well as his intellectual qualities 
 had much to do with this. His faculties were 
 well balanced, his mind fair. He took a wide 
 view of every question. His flexibility of mind, 
 his quick perception alike gave him a great 
 ascendency. 
 
 Of Dr. Begbie Sir Dyce Duckworth writes : * He Begbie 
 
 described 
 
 had a charming manner perfectly natural to him, ^^^^^ 
 in which decision, firmness, cheerfulness, and ^^^rth. 
 tenderness were exquisitely combined. Hence it 
 
 ^ Dr. C. West, in Medical Times and Gazette, 1882. 
 
108 UNCONSCIOUS THEEAPEUTICS 
 
 Inner life 
 of Sir 
 James 
 Paget. 
 
 Descrip- 
 tion of 
 Sir James 
 Simpson. 
 
 often happened that, even when a case was hope- 
 less, his genial presence and sympathy soothed the 
 sufferer, and conquered the hearts henceforth of 
 sorrowing friends/ Dr. William Barton says of 
 the same man that when he entered a ward a new 
 light seemed to shine on the faces of the sick. 
 The very way in which he put his hand on a 
 patient's shoulder seemed to give the invalid com- 
 fort and strength. 
 
 With regard to Sir James Paget his son says,^ 
 * One thinks of that yet deeper life which more than 
 any other power made him what he was. Only 
 those who were nearest to him could ever guess 
 at the intensity and simplicity of that inner life.' 
 
 Sir James Simpson^ availed himself fully of 
 the unbounded confidence placed in him by his 
 patients. The charm of his personality was one of 
 the greatest factors of his success in practice. 
 The sympathy he had was a real sympathy, not a 
 thin professional veneer, and was manifested by 
 deed as well as by word. It aroused in his 
 patient, quite unconsciously to both, a feeling that 
 this man, above all other men, understood his 
 complaint; that he, the sufferer, was the chief 
 
 ^ Me7mir of Sir James Paget) p. 429. 
 
 2 Masters in Medicine : Sir James Simpson, p. 166. 
 
THE PEESONALITY OF THE PHYSICIAN 109 
 
 object, the only object, of his thoughtful care. It 
 was said over and over again of him that his word 
 and look did more good than all his physic — (not 
 on account, be it noted, of the poverty of his pre- 
 scriptions, but because of the power of his per- 
 sonality) — so able a wielder was he of that healing 
 power which reaches the body through the mind. 
 His patients followed unconsciously the ancient 
 command of the * Talmud ' when it says, * Honour 
 your physician before you have need of him ; ' and 
 they went to him full of respect and fired by faith. 
 What good it does one to look at pictures like such men 
 these ! One feels, after reading the lives of such inspiring, 
 worthies, that the man is indeed more than his 
 physic, and that the science of unconscious thera- 
 peutics stands on unassailable grounds in the 
 presence of such illustrious examples. 
 
 These brief notices remind me of some lines Lines on a 
 I once saw sent with a vase to a medical friend by 
 a patient : 
 
 * May this vase be a symbol of the friendship 
 which contains things pleasant, beautiful, and of 
 sweet savour ! May the bright water that it holds 
 be a picture of the healing streams that flow from 
 a helping heart and hand to a suffering world, and 
 of the living water dispensed to fevered souls ! ' 
 
110 UNCONSCIOUS THEEAPEUTICS 
 
 To turn to another point. People invariably 
 applaud boldness ; indeed, a bold, prompt act, 
 that strikes the nail on the head, done with un- 
 wavering steadiness of mind and nerve, if suc- 
 cessful, often leads almost to idolatry. 
 Snapshot If you know a patient's ailments so well as to 
 
 diagnosis. 
 
 sit down and tell him and his friends exactly how 
 he feels better than he can tell you, he will be apt 
 to believe all you afterwards say or do. And yet 
 
 Dangers in this practico lies the great danger which we have 
 alluded to of suggesting to a patient ailments he 
 does not as yet possess, but which he may speedily 
 develop from our suggestions. All such statements 
 therefore should be extremely guarded and always be 
 less than the patient believes about himself, and never 
 more, and they should never be mere guess-work. 
 
 Besides being a student of character the doctor 
 should be many-sided, possess flexibility of manner, 
 self-command, quick discernment, address, ready 
 knowledge of human nature, and the happy genius 
 of accommodating himself to varying circum- 
 stances, and to all people. 
 
 Physician Dr. Broussais observes : ^ The real physician 
 
 or 
 
 naturalist? IS the one who cures ; the observation, which does 
 not teach the art of healing, is not that of a 
 physician, it is that of a naturalist.' 
 
THE PEESONALITY OP THE PHYSICIAN 111 
 
 Jean Paul Eichter tells us : * The first rule 
 to be observed by any one who will give something 
 is, that he must himself have it. In other words, 
 it is useless to attempt to light the fire with an un- 
 lighted match/ (or to cheer a patient without a 
 cheerful heart). 
 
 Dr. Cathell says : ^ * Cultivate a cheerful 
 temperament ; gentle cheerfulness is a never-failing 
 source of influence. It is a nerve tonic and stimu- 
 lant ; it cheers the timorous, encourages the de- 
 spondent, and comforts the despairing.' 
 
 Sir Henry Holland says : ^ ^ The influence of sir h 
 
 Holland on 
 
 the countenance, the manner and language on the manners, 
 feelings and thoughts is great in the bodily welfare 
 of the patients. A few simple words of comfort 
 and hope in many cases effect a positive good 
 which no medicine could equally produce.' 
 
 The natural or assumed manner of the physician 
 (cheerful, austere, or eccentric) may arouse in the 
 patient feelings and ideas capable of bringing about 
 changes in the different systems of the body, par- 
 ticularly the digestion and circulation, that con- 
 tribute to the equilibrium of nutrition. 
 
 The doctor who is educated and tactful, with Some 
 
 doctors are 
 
 * Dr. Cathell, The Physician himself, p. 42. ^^^^ tonics 
 
 2 Sir H. Holland, Medical Notes, pp. 389, 390. 
 
112 UNCONSCIOUS THERAPEUTICS 
 
 wide artistic and mental sympathies, brings a strong 
 breezy freshness of the outer world with him into 
 the monastic life of the sick-room. 
 
 When a doctor chances to be a patient, he soon 
 finds this out, and longs to keep such a doctor at 
 his side, and decoy him into a protracted stay. 
 
 There can be no doubt that, up to the very gates 
 of death, a sanguine, cheerful, and hopeful expecta- 
 tion is infinitely more useful and more warrantable 
 on the part of the physician, than a brutal candour 
 which may cut the slender thread that holds the 
 vital powers together. 
 Person- In somo branches of the medical profession the 
 
 ality not 
 
 of the same unconscious thorapoutics connected with the per- 
 
 importance 
 
 in all cases, sonality is of less moment than in others. On the 
 whole I should think it is of least importance with 
 those surgeons who are most confined to surgical 
 operations under anaesthetics, and with some 
 specialists, as for throat and ear. 
 Of great With Consultants generally, however, it is of 
 in con- the first importance ; and, indeed, it may be said 
 
 sultants. , . , . . , , , 
 
 that a consultmg physician as a rule does more by 
 his personality than any other doctor. I have a 
 case in my mind in the North where I can only 
 trace the good the doctor did to his having come 
 all the way from London to do it. 
 
THE PEESONALITY OF THE PHYSICIAN 113 
 
 The anticipated arrival of a well-known con- 
 sultant at a country house is often the occasion for 
 the exercise of the most lively and curative faith, Curative 
 
 faith. 
 
 that may arrest a disease that has long baffled the 
 able but familiar therapeutics of the family doctor. 
 Sir William Dalby quotes ^ the utterance of a 
 brilliant diplomat on such an occasion: ^ Here is 
 the man that God Almighty has created to make 
 me well ! ' The most utter sceptic in mental 
 therapeutics who reads these pages must discern 
 the curative value of such a faith. 
 
 The fact is, a doctor is weighed in the balance Doctors 
 
 are daily 
 
 as no other man is. Every act of his, every weighed 
 word he drops, is seed which will surely produce balance, 
 fruit. All he does has a double force. He is in 
 more intimate relations with people in their real 
 characters than any other person. 
 
 Coleridge considered him the best physician 
 who inspired most hope ; and, as I have said 
 before, the laity as a rule are conscious of the 
 value of the doctor's personality in a general 
 way, and value it far more than the doctor does 
 himself. 
 
 Just as with our material science and physical J^'.^® ^51^*°^ 
 
 ^ himself 
 
 skill we seek by drugs and other aejencies to , 
 
 ^ ^ mmd, and 
 
 ' Sir William Dalby, Medicine as a Career, p. 61. ^^^^^ 
 
 J body. 
 
114 UNCONSCIOUS THEEAPEUTICS 
 
 influence the body for good, so invariably (as 
 I have said) does the physician's mind uncon- 
 sciously influence that of the patient through the 
 various media I have described. 
 
 But, apart from all this, there is, I believe. 
 Is there in somo men a powerful influence for good pro- 
 heaiing *?^^ ceediug unconsciously from their minds to their 
 patients ; so that a few minutes passed in their 
 presence acts as a tonic in a way that affection, 
 admiration, or esteem will not account for. 
 Two And this * gift of healing ' is not confined to 
 
 instances. ^_ « . » , • , n -i i-i 
 
 the profession. An artist called on me the other 
 day in some distress because it was being forced 
 home upon him more and more that he possessed 
 it ; for so many of his friends felt his presence 
 not only as a general tonic, but as being able to 
 remove a headache, relieve a pain, produce an 
 appetite, &c., and he gave me so many instances, 
 that I could not doubt that some influence pro- 
 ceeded from him. The late lamented Sir Kenneth 
 Barrington told me of a friend of his, not medical, 
 in South America, who had this 'gift' to a 
 marvellous extent, so that through his rooms in 
 the hotel at certain times a constant stream of 
 sick came to be benefited by his touch or look. 
 He received no money, and took no steps to make 
 
THE PEESONALITY OP THE PHYSICIAN 115 
 
 his power known ; and it was as much a source of 
 mystery and surprise to himself as it was to his 
 friends. 
 
 I have heard patients say, referring to a single Benefit 
 interview with a doctor of perhaps ten minutes, single 
 that they felt they were getting better all the time. 
 Of course, I am principally referring to nervous 
 affections, though I am convinced that organic 
 diseases are also benefited. 
 
 This purely unconscious psychic quality, about 
 which at present little or nothing is known, can, 
 like other natural gifts, undoubtedly be largely 
 increased in power by use ; and differs totally from Healing 
 
 power 
 
 all influence consciously exerted by physicians increased 
 
 by use. 
 
 over patients which requires effort, and is possibly 
 allied in some measure to hypnotism. 
 
 To return to the doctor's manners. The patient 
 may even resist the power for good, or, on the 
 other hand, may strive against the depression 
 caused by the doctor's bad manners or gloomy looks, 
 and may combat them actively with his reason ; 
 but they will yet have their effect for good or evil, 
 malgre hci, on the body through the unconscious 
 mind or * instinct.' 
 
 And yet, of all this power, on which we have Of aii this 
 
 personal 
 
 dwelt at some length, the doctor is at present power 
 
 nothing is 
 -i 2 taught. 
 
116 UNCONSCIOUS THEEAPEUTICS 
 
 taught nothing scientifically. What little he 
 suspects he arrives at intuitively, and feels 
 half ashamed of, as he resolutely sets his face 
 towards the material, and turns his back on the 
 psychical. 
 
 This, however, alters nothing; and patients 
 are helped or hindered, diseases cured or aggra- 
 vated, however confirmed an agnostic thd doctor 
 may be, by the psychic therapy he unconsciously 
 uses. 
 
 Two There are two mighty powers for good in every 
 
 powers for physician worthy of the name — what he knows 
 
 good. 
 
 and what he is ; but, alas ! as a rule, he only 
 values the former. This book, as well as a former 
 one, is written that he may better understand the 
 worth of the latter. 
 
117 
 
 CHAPTEE V 
 
 OTHER THERAPEUTICAL INFLUENCES 
 
 Most works on therapeutics, writing of conscious Thera- 
 
 • 1 T 1 1 • 1 T peutics 
 
 therapeutics only, include under this heading include 
 
 what the 
 
 solely what the doctor does or can do for his doctoris, 
 
 has, and 
 
 patient. In my present work I have sought, does 
 writing of unconscious therapeutics, to point out 
 the value of what the doctor is or may he ; and 
 in this chapter I shall go a little further, and 
 include in unconscious therapeutics what the 
 doctor has or may have. Looking, then, com- 
 prehensively at the question of therapeutics, one 
 may say that it includes what the doctor is and 
 has and does ; that the two former are mainly 
 unconsciously used, and the latter consists prin- 
 cipally of conscious therapeutics. 
 
 We will, therefore, consider here some further Further 
 therapeutical influences that unconsciously affect scious 
 the patient, or are wholly or partly unconsciously peutics. 
 
118 UNCONSCIOUS THEEAPEUTICS 
 
 Innumera- 
 ble forces 
 affect us. 
 
 We con- 
 sider the 
 more 
 obvious. 
 
 Enumera- 
 tion of 
 these. 
 
 used by the doctor, and, as a rule, but little 
 thought of. 
 
 The forces that beat from every side on the 
 unconscious mind, both directly and through the 
 medium of consciousness, are wellnigh innumer- 
 able, and are, as we well know, both depressing 
 and elevating, aggravating and in some cases even 
 causing disease, and in others, again, lessening 
 and even curing it. In their ultimate analysis 
 they mu^t, of course, include every agent that in 
 any way reaches the brain through the medium of 
 one of the external senses. But it will be suffi- 
 cient for our purpose if we take a brief survey of 
 a few of the more obvious favourable influences 
 that fall upon the nervous system during illness. 
 Few though they may be, they have to be carefully 
 noted and weighed, not only because they may 
 help to neutralise the depressing effects of the 
 other class, but in order that they may be turned 
 to good account by the physician, and yet wisely 
 controlled, lest by their excess they prove injurious 
 instead of beneficial. 
 
 They include the sense of relief from pains 
 and other forms of suffering, which is effected by 
 successful treatment; reassurance in general as 
 regards the immediate and remote results, and 
 
OTHEE THBEAPEUTICAL INFLUENCES 119 
 
 the duration of illness and incapacity ; they in- 
 clude hope, the assurance and the consciousness 
 of improvement, and, as collateral influences of 
 a favourable kind, the attention and devotion 
 generally of friends, nurse, and doctor ; the 
 pleasing sense of relaxation and change from the 
 serious work of life to light occupation of a literary 
 or artistic kind; indulgence in innocent amuse- 
 ments, hobbies, and habits — ever in moderation — 
 such as smoking; and, along with the incom- 
 parable delight of a sense of convalescence, the 
 pleasure from release from the bed and from the 
 sick-room, the return to the open air, change of 
 scene, and, finally, the resumption of congenial 
 work with full consciousness of fitness. 
 
 In this connection there is also to be men- Time is 
 tioned the mental calm and resignation which peutic 
 
 agent. 
 
 mercifully comes to all sufferers from disease, 
 however severe, by simple lapse of time — the 
 becoming accustomed to illness. 
 
 The patient must, above all, receive the full Never 
 
 , suggest 
 
 benefit of hope. If he be a man cast in common death to 
 
 a patient 
 
 mould as regards love of life and dread of death, 
 expressions must never be given to our fears 
 in any form. The bare suggestion of death to 
 such a man may turn the scale against recovery ; 
 
120 UNCONSCIOUS THEEAPEUTICS 
 
 but always 
 reassure 
 him as far 
 as possible. 
 
 Agreeable 
 surround- 
 ings are 
 uncon- 
 scious 
 thera- 
 peutics. 
 
 and, I may add, has apparently done so, to my 
 knowledge. 
 
 In cases also of less gravity — that is, in treat- 
 ment generally — it is ever a part of the duty of 
 the physician, and one of the best methods of 
 turning nervous influences to useful account in 
 treatment (as we have seen in the previous 
 chapter), to inspire the patient with fortitude and 
 cheerfulness. 
 
 The wise physician reassures him with respect 
 to the duration and result of the illness and his 
 ability to relieve distress ; and he is careful to 
 dwell upon the more favourable features of the 
 case and to acknowledge every improvement. 
 
 The mere presence of the doctor at the bedside 
 in alarming emergencies may be of paramount 
 service by inspiring confidence, as in cases of 
 various hemorrhages and of heart disease, and 
 may thus be included rightly as unconscious 
 therapeutics. 
 
 The immediate surroundings of the patient 
 should be all made as pleasing as possible. Pood 
 and medicine should be given in the most agree- 
 able forms consistent with usefulness, and the 
 same kind of attention paid to every method of 
 treatment employed. In the treatment of diseases 
 
OTHBE THEEAPEUTICAL INFLUENCES 121 
 
 of the eye, for instance, as Brudenell Carter says, a 
 bandage is better than a dark room, which deprives 
 a man of companionship, and is more depressing 
 in its effects in many other ways. 
 
 Efforts may often be made by the doctor to Let 
 
 patients 
 
 re-establish peace of mind in the matter of busi- feei they 
 
 are getting 
 
 ness and in social and family affairs. Advantage on. 
 may be taken of the smallest progress in the right 
 direction to grant a little liberty as a practical 
 assurance of advance. * It does him so much 
 good,' the friends tell us, ' to do a little and feel 
 that he is getting on.' 
 
 It may be noted here that the half -involuntary Our organs 
 
 are good 
 
 organs are good servants but very bad masters ; servants 
 
 but bad 
 
 and the more they are indulged the more peremp- masters, 
 tory do they become. They should be educated 
 to subserviency ; and the earlier in adult life that 
 their education is begun the more complete will 
 it be. 
 
 If they are fairly healthy, any one with a They 
 resolute will may easily teach them. It is common educated, 
 to hear healthy people say, and sometimes as if it 
 were praiseworthy, that they cannot sleep on this 
 side or that, or without an extra pillow or some 
 such help. 
 
 In some of these cases there may be just 
 
122 UNCONSCIOUS THEEAPEUTICS 
 
 They reason for the peculiarities complained of ; but in 
 
 acquire 
 
 bad habits, the greater number they are mere habits grown out 
 of a want of will power to resist some discomfort. 
 If such people would resolutely pass some hours, 
 or a night or two, without sleep, sheer fatigue would 
 insure their sleeping in any posture whatever. 
 
 And others, many of whom are healthy, tell 
 us that, unless they have their meals at regular 
 and fixed times, they cannot digest them. 
 
 There are few of these who may not safely 
 resolve that they will not regard fixed times, but 
 will breakfast and dine whenever they please or 
 when circumstances make it most convenient. 
 
 Do not Their digestive organs will submit to their 
 
 allow long 
 
 lists of dis- wills after a brief struggle, if their wills do not 
 
 abilities. 
 
 submit to them. That condition cannot be con- 
 sidered as perfectly healthy which is not able to 
 endure any reasonable disturbance of the usual 
 habits of life. In short, every effort should be 
 made to reduce the list of the things a patient 
 cannot do to nil ; or, if this cannot be effected, at 
 any rate to make it as brief as possible. 
 Pursue I wish there were as much ambition for really 
 
 health 
 
 rather than good health as there is for athletic strength or 
 
 strength. 
 
 courage, and that as much pains were taken to 
 secure it. When one thinks of the strenuousness 
 
OTHEE THEEAPEUTICAL INFLUENCES 123 
 
 and long continuance of discipline and effort in 
 athletic training, one sees what pains are taken to 
 reach the desired end, and what success can be 
 attained. If we only grasped in the same way the 
 necessity of turning such power to conquering those 
 peculiarities and bad habits that are such draw- 
 backs to the pleasures of life, and that so often 
 seriously handicap us in following its business, 
 what valuable results we might achieve ! But we 
 are looking now at our subject rather from the 
 patient's standpoint than from the doctor's, and 
 this is not our intention here. 
 
 In the next chapter I hope to give a descrip- Next 
 
 chapter 
 
 tion of therapeutical influences, written by a patient written by 
 
 a patient. 
 
 and entirely from her point of view, as we think 
 such a chapter introduced into a medical work is 
 not only a novelty, but gives us such an opportu- 
 nity, as a physician seldom gets, ^ of seeing our- 
 selves as others see us.' It may also contain some 
 hints that will prove of real service to many. 
 
 At present we will consider very briefly a few The 
 of the minor therapeutical influences connected entiroL^ 
 with environment. We will first look at the 
 patient's environment, and then at the doctor's. 
 
 A clever doctor not only hears patiently and 
 quietly all the patient has to say about himself. 
 
124 UNCONSCIOUS THEEAPEUTICS 
 
 but he surveys him from head to foot — his build, 
 complexion, expression, and manner — he examines 
 him in every possible way ; but if he stops here 
 he still does not know enough of him for successful 
 must be treatment. The consideration of a man's case 
 considered. ^^^^^ trom his environment is folly. The imme- 
 diate domestic, as well as the social and business, 
 surroundings of the patient must always be studied 
 and reckoned with ; and then, when all this in- 
 formation has been collected, the doctor still feels, 
 as it were, but on the surface of the case.^ 
 iiiustra- Let me give an illustration of this from an 
 
 tion of 
 
 this. assurance office. Some years ago a brawny Scotch- 
 man underwent a medical examination at a London 
 life assurance company, and passed with flying 
 colours, assuring his life at the lowest rates, being 
 
 The strong apparently perfectly sound. After him came a 
 
 Scotchman 
 
 and the little, round-backed, flat-chested doctor from South- 
 weak 
 
 doctor, wark to be also passed for life assurance. The 
 physician of the company shook his head a bit 
 when he listened to his heart and lungs, and said 
 he did not quite know what to do. But at length, 
 in view of the fact that the candidate was himself 
 a doctor, he gave him the benefit of the doubt, 
 and let him through, but with very different feel- 
 
 * See Dr. Mitchell Bruce, Practice of Thera;peiiticSy p. 182 
 
OTHBE THEEAPEUTIOAL INFLUENCES 125 
 
 ings from his predecessor. In six months the 
 Scotchman was dead, and the company had to pay 
 the money, simply because their doctor never 
 carried out Mitchell Bruce's advice, and failed to 
 take into account the man's environment as well 
 as the man himself. The fact was, the Scotchman Evils of 
 
 transplant- 
 was a Highland gamekeeper, who was suddenly mg. 
 
 transplanted from the moors and heather to squalid 
 
 London lodgings and very confined work ; and he 
 
 died of the change. The little, consumptive-looking 
 
 Southwark doctor was born and bred there — and 
 
 his father was there before him; and he was 
 
 thoroughly in harmony with his surroundings, bad 
 
 as they were, and continued to live on in his 
 
 doubtful health because he was not transplanted. 
 
 Probably to make a gamekeeper of him would 
 
 have killed him. No man, I am persuaded, can 
 
 really be a clever doctor who does not give the full 
 
 value to a man's environment. 
 
 The stimulation of a healthful environment Environ- 
 ment is a 
 
 may be profitably employed by the wise doctor, strong 
 
 thera- 
 
 No physician should consider himself above using peutic 
 
 agent, 
 
 these natural aids to the restoration of health. 
 
 Environment, it must be ever remembered, is 
 not confined to the physical, but includes all the 
 forces that bear on body, spirit, soul. 
 
126 UNCONSCIOUS THEEAPEUTICS 
 
 and Psychological influences form ever a part of 
 
 includes 
 
 mental the natural environment of a patient, and of the 
 
 environ- 
 ment, artificial environment prescribed by the doctor.^ 
 
 I consider, personally, that in treating any 
 difficult nerve case, therefore, a doctor can come 
 to a much better judgment about it if he sees it 
 growing in its own garden, as it were — that is, in 
 its own natural environment — than if he is con- 
 fronted with the patient for a stiff quarter of an 
 hour in his consulting-room. 
 Value of But now consider the other side, for there is 
 
 the doc- 
 tor's envi- no doubt that, if a sight of the patient's environ- 
 
 ronment. 
 
 ment helps the doctor, a sight of the doctor's 
 environment helps the patient. 
 
 This environment of the doctor is, no doubt, 
 even less thought of than that of the patient ; but 
 its unconscious therapeutic value is great. It is 
 not alone the doctor's personality that affects the 
 patient powerfully for good or evil, but all con- 
 nected with him has also its therapeutic action — 
 his house, his waiting and consulting rooms, his 
 general reputation, his other patients, and perhaps 
 other things as well. 
 
 Our old friend — if we may call * The Young 
 
 * See Dr. J. Collins, Treatment of Diseases of the Nervous 
 System, p. 136. 
 
OTHER THEEAPEUTICAL INFLUENCES 127 
 
 Practitioner ' so— says : * The arrangement and ' The 
 
 Young 
 
 general tone, so to speak, of your consulting-room f^^^f^; 
 should also receive special consideration, for not a speaks, 
 few patients are sensibly impressed and influenced 
 thereby.' 
 
 All this is, after all, only reasonable and 
 rational, once we admit the influence of the per- 
 sonality ; for to a certain extent, in proportion to 
 its individuality, the personality of the man is 
 stamped upon all these details — indeed, upon all 
 that he has. 
 
 Then, with regard to natural physical measures Physical 
 
 measures 
 
 of cure, they are often to be recommended, even may act 
 
 psychic- 
 
 when they can have but little direct therapeutic aiiy. 
 value. *They strengthen the patient's faith in 
 the physician,' says Dr. Collins,^ * (if wisely ordered), 
 and they constitute a material basis upon which 
 the physician can build his suggestions. The 
 mental effect of the physical agent on the patient 
 is ample warrant for faith in such therapeutics.' 
 
 ' In electricity,' he points out,^ * the belief '^'^^ 
 
 instance, 
 
 seems to be growing that its power for good de- electricity 
 pends largely upon its effect in making a psychical 
 
 * Dr. J. Collins, Treatment of Diseases of the Nervous 
 System, p. 142. 
 2 Ibid, p. 414. 
 
128 UNCONSCIOUS THEEAPEUTICS 
 
 appeal to the patient. The force that appeals 
 most powerfully to the patient's emotions, and 
 that is given from the most complicated and 
 elaborate apparatus, according to the most studied 
 plan and with the greatest care, is the one that 
 will have the best effects.' It would, however, be 
 most untrue to limit the effect of even the ordi- 
 nary faradic current to its psychical influences. 
 In four- still, if such an authority as Moebius asserts 
 
 fifths of 
 
 the cases, that four-fifths of all electrical cures have been 
 effected in cases where electricity (directly) could 
 not have been of the slightest avail, it may be 
 seen that the mental factor has a large sphere for 
 its influence.^ 
 
 Psychic A recent instance of a popular remedy that 
 
 action of ...... 
 
 electric is largely psychic m its action is the electric light 
 
 light baths. , 
 
 bath cure. Before it was known to be used by 
 the King, and believed to be a cause of his wonder- 
 ful health, it dragged on rather a lingering exist- 
 ence. I took pains at this time to find out what 
 therapeutic powers it was credited with, and a 
 doctor who had large ones of his own was very 
 lukewarm in their praise, and agreed with my view 
 that, seeing the light was incandescent and con- 
 
 ^ Dr. J. Collins, TreaUnent of Diseases of the Nervous 
 System, p. 142. 
 
OTHEE THEEAPEUTICAL INFLUENCES 129 
 
 tained no actinic or chemical rays, like the sun or 
 arc light, any good effects were probably due to 
 the heat generated. Since, however, its royal 
 patronage, doctors have rightly discovered it has 
 much greater powers than it possessed before ; and 
 the baths are crowded with eager patients, not only 
 seeking, but obtaining, relief from these baths. 
 This agrees with what I have mentioned else- 
 where, that the value of a medicine depends to Medicine 
 
 and fame. 
 
 some extent on its popularity and fame ; in other 
 words, upon its psychic powers or unconscious 
 therapeutical force. 
 
 Many other indirect therapeutic influences 
 might be enumerated ; but I have no wish, even 
 if I had the power, to fill in every detail of my 
 subject. My desire is to stimulate thought rather 
 than to satisfy it, and to indicate the scope of my 
 subject rather than to exhaust it. 
 
 K 
 
130 UNCONSCIOUS THEEAPEUTICS 
 
 CHAPTEE VI 
 
 FEOM A patient's POINT OF VIEW 
 
 The My subject is the personality of the physician from 
 fears. the patieiit's point of view ; and I hope I shall be 
 pardoned if I chance to wander in my remarks, 
 in a feminine manner, into some side issues. 
 
 In the first place, it strikes me that, before the 
 personality of the physician, comes, in order of 
 time, his waiting-room ; but ere we inspect this 
 the question arises whether, after all, a visit there 
 is the best thing for a nerve patient. 
 Should the And here at once is a most important point, that 
 
 patient 
 
 call or be is rarely, if ever, raised by the doctor, and this is 
 
 visited ? 
 
 whether it would not be better for him to pay the 
 first visit rather than the patient. 
 New I submit that, could the patient always be 
 
 patient 
 
 should be visited iiistoad of visiting (at any rate, the first 
 
 visited. 
 
 time), the benefit to both doctor and patient would 
 be immense. And why? Here and throughout 
 our inquiry let us take as our motto, ' Put yourself 
 
FEOM A PATIENT'S POINT OF VIEW 131 
 
 in his place ' — a motto to be written on the heart 
 of every physician. 
 
 What do we find? Generally, and especially The 
 
 , . 1 . ... 1 patient 
 
 m nerve cases, a shrinking, over-sensitive, shy, described, 
 often sullen or protesting mortal. This shivering 
 creature suffers, perhaps, either from alarm born 
 of complete ignorance as to medical treatment, or 
 from the painful experience of 'suffering many 
 things of many physicians,' and rather growing 
 worse in consequence. 
 
 The first difficulty with regard to a visit in The 
 
 , . . . T T arrival in 
 
 town is that the patient, if not living m London, London, 
 has probably come there specially for this con- 
 sultation; and, if so, is possibly in disadvan- 
 tageous and novel surroundings, with, perhaps, un- 
 unaccustomed noise, bustle, and heat. The patient 
 finds herself in grand, dreary hotel rooms, or stuffy, 
 comfortless lodgings, where nocturnal cats, hard 
 beds, bad cooking, and enormous prices, under the 
 name of 'extras,' form irritants that have, even in 
 a day or two's stay, increased the nerve trouble. 
 
 But having — perhaps by means of some local Evils of a 
 doctor or friend — selected, rightly or wrongly, a visit. ^ 
 fresh adviser, our wretched hero or heroine must 
 sally forth to visit the physician at that time which, 
 for a nerve sufferer, is often so important to be a 
 
 £ 2 
 
132 UNCONSCIOUS THEEAPEUTICS 
 
 Effects of 
 the door- 
 bell. 
 
 Maid- 
 servants, 
 not men- 
 servants. 
 
 quiet one — the forenoon. The patient starts, then, 
 at an unwonted hour, possibly without making any 
 appointment (we are in each detail taking the 
 gloomiest outlook, and working from that). She 
 (let us say) arrives at the house. The very door- 
 bell sends a fresh thrill through the strung-up 
 nerves ; at the same time the symptoms of which 
 the patient was about categorically to complain dis- 
 appear most mysteriously for the time, leaving 
 nothing but a sensation of being about to write, 
 or rather talk, herself down a humbug— that bug- 
 bear of the nerve sufferer. 
 
 To the patient on the doorstep appears a maid- 
 or man-servant. And here be it said that, in 
 at least some feminine nerve cases, a great and 
 special shrinking from the male sex is often ex- 
 perienced — maybe from the feeling that nerves are 
 extra abhorrent to men ; maybe from the often 
 brusque manner of male relatives or plain-spoken 
 acquaintances as to any exhibition or talk of this 
 curse of present-day humanity ; maybe from the 
 outrages of womanly feeling in former necessary 
 medical questions, &c.^ Also, the most sym- 
 pathetic and discreet butler can have but little 
 
 * The obvious question that arises here is, ' Why not consult 
 a lady doctor ? ' Our experience of women, however, tells ug 
 
FEOM A PATIENT'S POINT OF VIEW 133 
 
 soothing influence on a lady; and these form so 
 large a percentage of this class of patients that 
 we may think primarily of female sufferers. The 
 advantages of a maid, and that an elderly, 
 discreet, sympathetic, and pleasant-looking, yet 
 sensible woman, are, undoubtedly, very great. 
 
 And now we are inside, inquiring, perhaps Eesuits of 
 
 not making 
 
 airily, for the great man (we are considering an appoint- 
 ment. 
 
 nerve consultants here), with whom we have no 
 appointment, foolishly supposing him to be im- 
 mediately accessible. Let me give an instance. I 
 have known a patient go thus after eighteen 
 months of torture from nerve trouble, accen- 
 tuated and largely caused by circumstances, after 
 ineffective, though never unfriendly, experiences 
 with various general practitioners. She had, a case in 
 in her extreme state of suffering, said good-bye 
 to a friend under the idea of being possibly 
 immediately immured in an asylum, mistaking, 
 as is so commonly done, brain exhaustion for 
 mental disease. To please a relative she had 
 forced herself to see one more doctor — this 
 time a specialist — but had tied his hands as to 
 cure by deciding to pay but one visit, simply 
 
 that, even allowing for all this shrinking, the ordinary doctor is 
 preferred in nine cases at least out of ten to one of the other sex. 
 
134 UNCONSCIOUS THEEAPEUTICS 
 
 for him to declare whether or not her brain were 
 affected. Arrived in a mental agony, and without 
 appointment, she was told that the doctor was 
 engaged (naturally) the whole morning, and could 
 not see her before two days hence. Only her feeling 
 for the aforesaid relative ever got her there again, 
 and her sufferings meanwhile may be imagined. 
 The doctor Now, granting her carelessness, such a thing 
 
 should see 
 
 new should not be possible. Surely, out of a room 
 
 patients 
 
 first. full of patients some are not first-comers, and hence 
 must be better fit to sustain the trials of waiting, 
 or even of postponement for that day, than a 
 nervous patient at her first visit. Not only, there- 
 fore, would I admit our unfortunate subject, but I 
 would see her (or even him) as soon as possible.^ 
 
 But it is time to enter upon our consideration 
 of the waiting-room. 
 
 ^ In various countries different plans obtain of seeing 
 patients from the ordinary method of appointments here. In 
 some they are seen in order of arrival ; in others certain days 
 are set apart for new cases ; while, in hospitals, all new cases 
 have special and generally prior attention. In practice it is 
 found impossible to carry out such an idea as is here suggested, 
 admirable though it be in theory. Patients themselves come at 
 all sorts of times, and those who are too careless to make an 
 appointment, and especially for a first visit, which cannot be 
 hurried, must of necessity suffer some inconvenience. At the 
 same time it is, no doubt, important never to keep new cases 
 waiting any longer than is absolutely necessary. The hint is 
 certainly of value. 
 
FROM A PATIENT'S POINT OF VIEW 135 
 
 First, is there anything so objectionable to Evils of 
 
 waiting. 
 
 mankind as waiting, and that inactively ? Ask the 
 soldier, the lover, the condemned criminal — any- 
 body ! How much more, then, the person before 
 us, and at the time and under the circumstances 
 named ? But — there is always a * but ' — even these 
 distressing conditions may be mitigated. This 
 mitigation largely may lie where we, perhaps, least 
 expect, and at present fail to find it, namely, m 
 the loaiting-room itself. But let us look at it as The 
 
 waiting- 
 it exists to-day in the houses of most consultants, room as it 
 
 is : 
 
 Is this room, I ask, a place calculated to inspire 
 cheerfulness, patience, soothing, or encouragement? 
 A large, lofty dining-room, often in a house of an 
 early Victorian date, with gloomy windows, too Gloomy, 
 
 tasteless, 
 
 heavy to have been opened so as to produce really and de- 
 pressing. 
 
 fresh air in the room — a fact that weighs much 
 against a nerve patient. The walls are disfigured 
 sometimes with a paper of twenty years ago, 
 sombre, hideous ; often covered with prints of an 
 uninteresting if not a gloomy character. The 
 mantel-piece holds the usual heavy and seldom 
 tasteful bronze ornaments on each side of the 
 central clock of fate. In the centre is a large 
 table, round which are seated the waiting crowd, 
 making hateful to themselves the cheerful pages 
 
136 UNCONSCIOUS THBEAPEUTICS 
 
 of ^ Punch,' and papers of all kinds, by asso- 
 ciation of what can seldom if ever be a pleasant 
 experience, however helpful ; to say nothing of the 
 reminder of hours spent in a similar environment 
 at the dentist's. Moreover, the sufferer, besides 
 the ordeal of an uncertain and generally protracted 
 suspense, and the irritation as well as heart-sickness 
 of hope deferred, must watch similar sufferers and 
 be further depressed by seeing the cheerless surface 
 of her own symptoms mirrored in others, as well 
 as by the conviction that her case probably rouses 
 in them the half contempt, half irritation produced 
 in her own mind towards any waiting patient 
 exhibiting any symptoms like her own.^ 
 
 What are the consequences ? The doctor, who 
 recognises the inestimable value of first impres- 
 sions, will probably find his patient in a state very 
 different from that at a first interview in her own 
 room at a given hour, or even in an environment 
 v/hich we will describe later. Irritated, tired, 
 depressed, probably terrified, possibly hungry, and 
 suffering, further, often in a way we need not put 
 into words, but one especially trying to a nerve 
 
 * This passage describes feelings that perhaps a doctor 
 knows little of, as it is very rare to get our waiting-rooms and 
 the feehngs they inspire described by any of our patients. 
 
FEOM A PATIENT'S POINT OP VIEW 137 
 
 patient, in whom, it will be remembered, her state 
 often produces further brain irritation or ex- 
 haustion, the patient is seen at her worst. It may 
 be well that this should be so at some future time ; 
 but the first impression should surely be one of the 
 normal diseased condition.^ Moreover, it is im- Patient is 
 
 abnormal. 
 
 portant that the patient should be able as clearly 
 and calmly as possible to explain or corroborate 
 special circumstances, sometimes of great difficulty 
 and complication ; occasionally even, as I have 
 known, having to try to remove a misconception in 
 the doctor's mind, sown by a well-meaning but 
 misunderstanding friend, which mistake he may 
 otherwise not recognise until it is too late. 
 
 If such be the results of the present system, ^^1® 
 
 ^ ^ reformed 
 
 who can tell what beneficial effects, present and waiting- 
 
 ^ room. 
 
 future, bodily and mentally, might not flow from a 
 waiting-room something after this fashion? Let 
 the dining-room still be used, but see that it be 
 
 ^ I may mention that I have just returned from a journey of 
 nearly 300 miles, undertaken solely by the wish of a very wise 
 father, in order that I might see his daughter in her normal state, 
 and so form a right judgment on her condition. She was quite 
 able to travel, but I am convinced the father was right, and that 
 in this instance a visit to me would have been futile. I simply 
 mention this case to show the wisdom of our writer's remarks, 
 and to prove that, in some cases, a visit to a patient in her home 
 is essential to a right diagnosis. 
 
138 UNCONSCIOUS THEEAPEUTICS 
 
 Its cheer- 
 ful yet 
 quiet walls. 
 
 Its tmy 
 tables and 
 judicious 
 screens. 
 
 Its light 
 refresh- 
 ments. 
 
 thoroughly airy and warm, without being oppres- 
 sive; cheerfully bright without glare. If lights 
 are needful, use, preferably, well-managed lamps or 
 candles. Have as little in the room, and on walls, 
 &c., as is compatible with your own comfort, needs, 
 and tastes ; and endeavour to make it as unlike 
 the past and generally present dining-room as 
 possible. A cheerful yet quiet paper ; coverings 
 and curtains of some bright pattern : if you must 
 have pictures, then of an attractive kind, cheerful 
 and tasteful, and flowers about everywhere. The 
 dining-table pushed aside, and a comfortable chair 
 or two near it, and with a few papers and books, &c., 
 not aggressively evident. Here and there a few 
 tiny tables, with chairs near, and one or two with 
 folding screens near to give semi-privacy if wished. 
 Some work or other things left about will give a 
 homely air. The maid might show the patient a 
 room where she may obtain some light refreshment, 
 such as a glass of milk or a biscuit, if needed ; or, if 
 there be no second room, something of the sort 
 might be placed on the sideboard. The maid should 
 also be easily summoned if wished for at anytime.^ 
 
 * The whole of this passage shows how easy destructive 
 criticisms are compared with helpful suggestions. We are sure 
 the patient has done her best, and yet when we have made what 
 
FEOM A PATIENT'S POINT OP VIEW 139 
 
 The doctor would thus have some chance of Even here 
 
 the waiting 
 
 seeing the sufferer in a fairly normal condition ; shouid^not 
 but the patient will never be quite herself, for, 
 given all these precautions, still shyness, fear, and 
 an unavoidable amount of waiting will have done 
 their work. But lohy so much waiting ? The 
 cases of no appointment being made are seldom due 
 to common carelessness. They may spring from 
 some such distress of mind as before described, 
 which is an agony to the patient, and when any 
 delay can hardly be borne. 
 
 Or the casualness, captiousness, and laissez- 
 faire and unpracticalness belonging to nervous 
 disease, may cause this otherwise blameworthy 
 procedure. Its indulgence and more has been 
 pleaded. Patients rarely understand that an ap- Reasons 
 
 why ap- 
 
 changes are feasible, how little is our dining-room altered! pointments 
 Certainly hardly enough to make any material difference. We ^^d'e^^ 
 think the suggestions as to food, screened corners, and bright 
 cheerful pictures are good, and that these latter are best when 
 they are good water-colours of pretty places. The real difficulty 
 in London houses and in large towns is that the drawing-room 
 (which would in every way be more suitable and cheerful as a 
 waiting-room) is on the first floor, and patients have an almost 
 insuperable objection to mounting a flight of stairs. Still, it 
 might be possible and beneficial, where a doctor's patients are 
 legion, to give them the choice between the drawing-room with 
 the stairs, and the dining-room without them. At any rate, the 
 whole subject is worth further consideration. 
 
140 UNCONSCIOUS THEEAPEUTICS 
 
 pointment often can be made for the late afternoon, 
 at the doctor's private residence, if not at his 
 official one ; and this plan I would earnestly 
 advocate, for reasons already stated, always except- 
 ing the * better way ' of a home interview. 
 Evils of Now take the average 'wait.' The appoint- 
 
 unpunc- 
 
 tuaiity. naent is made for eleven, a favourite hour. But 
 does the doctor always see the patient then ? Not 
 a bit of it ! No more than does the dentist or 
 the dressmaker. The doctor, therefore, names a 
 quarter — even half an hour — too early as a mere 
 matter of self-defence. So be it, then. But — 
 success being your ultimate aim for you and your 
 
 to^rshouid P^*^^^* — would suggest that few patients would 
 
 be candid, reseut being told that previous cases have taken 
 longer than was anticipated, and being asked to 
 return in half an hour ; or, as a counsel of per- 
 fection, if the hour be advanced, some light 
 refreshment could, as I have said, be served to 
 them, preferably in a separate room. 
 
 But what shall we say to waiting for one, or 
 even one and a half, hours ? The consequences 
 have been described. The cause now occupies us. 
 
 Doctor Few, if any, people will have come without ap- 
 
 over- 
 
 crowded pointments. But the fashionable doctor may have 
 
 patients. 
 
FEOM A PATIENT'S POINT OF VIEW 141 
 
 his morning already full, so two extra patients must 
 be squeezed in where they can. Or the first patient 
 is late ; several eases are long ones ; and so the 
 ball rolls on. Each medical reader will know his 
 special reasons and difficulties.^ This waiting 
 business is so undoubtedly important that I will Hurry 
 
 injures the 
 
 go on to hint at its harm as regards the personality «^octor. 
 of the physician himself. This should have for 
 its chief factors calmness, cheerfulness, and entire 
 absence of fuss or hurry ; also — especially in nerve 
 cases — that influence which comes largely from a 
 vitality partly personal, partly 'magnetic' This 
 wonderful gift, for it is no less, must suffer from 
 the stress or haste caused by a multitude of 
 patients, &c. &c. How much patients lose by this 
 is incalculable, the more that the presence or 
 absence of the ' vril,' as Bulwer Lytton would call 
 it, is to the doctor generally unconscious. May a y^iueofan 
 
 ' o ./ J interval 
 
 mere patient suggest, not only a more leisurely ge^ing^^ 
 
 ' I fear that most of my medical readers will sincerely wish p^^^^^^ 
 that these difficulties were theirs. The squeezing in of extra 
 patients into a full morning is a bad practice of which they are 
 seldom guilty. Advice how better to fill their rooms would be of 
 more value to most ; and the long waiting here spoken of is far 
 more common among dentists than doctors. There are, of 
 course, a few to whom every word applies ; but these are the en- 
 vied leaders of our profession. The majority, at any rate, cannot 
 be charged with aggravating patients' sufferings by long waiting. 
 
142 UNCONSCIOUS THEEAPEUTIOS 
 
 morning, but a deliberate rest of, say, seven 
 minutes between each interview (or five at least), 
 accompanied, if needful, by bodily refreshment or 
 exercise, or the mental rest of a non-professional 
 book or pleasant letter-writing ? Any doctor, who 
 is also a Christian, I may perhaps remind as to 
 the refreshment and recreation — in its deepest 
 sense— of prayer.^ 
 
 With regard to the consultation, leaving 
 general suggestions, let me confine myself to 
 details which I have found to militate against the 
 benefit of the first interview. 
 See I have alluded to possible misunderstanding 
 
 patients 
 
 before see- through provious explanations by friends. The 
 
 ing friends. 
 
 doctor must consider if it is sometimes wise to see 
 the patient first, so as to receive her without pre- 
 conceived ideas. 
 On lady And here a word as to the question of lady 
 
 doctors, from a nerve patient's point of view. I do 
 not believe in women taking up this profession, 
 
 ^ This short rest between successive cases, though not always 
 obtainable in practice, is an excellent suggestion, and at least 
 something to be aimed at. In too many cases, as I have pointed 
 out, it is the paucity, not the plethora, of patients that tries the 
 doctor's nerves ; and the mornings are more often too leisurely 
 than too crowded. 
 
FEOM A PATIENT'S POINT OF VIEW 143 
 
 though their tact, deep feeling, resourcefulness, and, 
 above all, their experienced sympathy for and 
 knowledge of a woman's sufferings, bodily and 
 mental, should be invaluable. Against that we 
 have this fact, that most women are naturally ex- 
 ceedingly sympathetic and kind, and feel for and 
 with others to a degree that would be in a doctor 
 harmful to himself and his patient. But from 
 temperament, habit, or disposition, and in the case 
 of lady doctors, through resistance to their natural 
 feelings, women are apt to fly to the other 
 extreme. We all know that when a woman is hard 
 — well, she is hard ; and nothing hardens her Adverse 
 
 judgment 
 
 like believing m hardness as a duty, for duties are by a lady 
 
 patient. 
 
 what women are most apt to exaggerate. If a 
 woman believes it her duty to be cold, hard, severe, 
 or merciless — woe to the victim ! With the best 
 intentions, be she doctor or no, she often may 
 reduce her suffering fellow-woman to agonies bodily 
 and mental, to which the disease is preferable, and 
 even less harmful. Nor does she usually possess 
 (though I cannot cite an instance) the balanced, 
 comprehensive judgment of a man, his strength of 
 mind and purpose, nor win the confidence this 
 engenders in the patient. 
 
IM UNCONSCIOUS THERAPEUTICS 
 
 The The next consideration is the doctor's manner. 
 
 doctor's 
 
 manner. Many a doctor will deliberately put on a winning 
 smile, a hand-pressure, and a manner which shall 
 appear at once paternal, friendly, and encouraging, 
 yet dignified and scientific. ^ The success of this 
 depends ' (I quote Sir P. Treves) ^ on whether 
 he really feels the sentiments he is trying to 
 show.' If not, he will only appear to many 
 a patient either insincere, affected, impertinent, 
 patronising — perhaps entirely exasperating ; or, 
 perhaps worst of all — ridiculous ! We have, for 
 instance, the ' bear ' type (that, however, is hardly 
 assumed) which deals (I hear) in brutal frank- 
 story of a ness and even rudeness. One very gruff speci- 
 men told a timid lady to insert an artificial 
 drum in her ear, and when she meekly replied 
 she did not know how to make one, roundly 
 told her roughly she was * an old goose.' He had 
 never seen her before. Against this we find 
 the gentleman who greets you with a smile and 
 voice would-be pleasant, but only oily, and says : 
 * And how are we to-day ? ' There is he who calls 
 you a ^ young lady ' at forty-five ; he who adopts 
 a playful manner suitable to a lunatic ; he who 
 talks in six syllables larded with technical terms, 
 
PEOM A PATIENT'S POINT OP VIEW 145 
 
 or tells incidentally how many titled patients he has 
 
 just been to see. Of course it is impossible to Oncemore, 
 
 Be natural. 
 
 please everybody. Still, I would suggest your 
 simply expressing what you feel ; at first with a 
 due reserve, and remembering that to the patient 
 you — at least at this interview — probably represent 
 merely a disagreeable necessity. A fatal thing is 
 to forget, now or ever, that a nerve patient is 
 generally clever, but is frequently also possessed 
 by a fear of madness, and of being thought mad. 
 If, therefore, after discussion you say to her : ' You 
 are clever at argument, at any rate ! ' she will 
 think, though she may not say : ^ So I have come 
 to this, have I ? ' 
 
 But I would point out another trait which I Follow the 
 
 ' golden 
 
 have noticed as likely to do harm. This is, the mean 'in 
 
 details. 
 
 want of medium in stating detail, and especially 
 as to orders. A doctor will often give an order 
 without thought or inquiry as to how far he 
 is understood ; maybe the very terms are a 
 puzzle to the patient, who is probably too shy 
 to inquire. Or, on the other hand, he (or I have 
 known this in a lady doctor) may overwhelm you 
 with details. 
 
 I would urge for the first interview to be as 
 
 L 
 
146 UNCONSCIOUS THERAPEUTICS 
 
 First long as possible : an hour would not be too much, 
 
 interview 
 
 should last if feasible, but this is unlikely in the morning. 
 
 one hour. 
 
 For the first quarter of it your patient is not 
 herself ; the less so in that she may feel this 
 to be a crucial time, and should that time be the 
 usual twenty minutes, she may be in such an agony 
 to make the most of it before judgment is pro- 
 nounced, as to destroy all explicitness and benefit.^ 
 Do not Now, having sifted your evidence, you get the 
 
 diagnosiT^ facts from her and the friend or nurse, and con- 
 ment?* sider if you have enough to take any steps, or if 
 you should wait for more light. A nerve case 
 being generally complicated by circumstances, 
 painful or at best awkward, it is wellnigh impera- 
 tive to know much of the facts and characters 
 involved before the case can be properly judged. 
 
 But we must remember the enormous disad- 
 vantage of * marking time,' than which, I suppose, 
 nothing is more depressing, aggravating, and harm- 
 ful to a patient, especially if the case is of some 
 but give standing. Some relief should be at once suggested, 
 immediate be it only sugar-and-water ! But the doctor who 
 
 relief. 
 
 ^ This, we fear, save in a visit to the patient in her own 
 home, is, to most, a counsel of perfection that can seldom be 
 followed. 
 
PEOM A PATIENT'S POINT OP VIEW 147 
 
 hurries his patient on a journey or into a Home, 
 without feeHng certain he has grasped the whole 
 bearing of the case, is taking a grave risk. 
 
 At last, however, you have fathomed the case 
 as far as in you lies, and have to consider where 
 the patient should be placed. 
 
 What is the natural place — where are the natural Hom®, , 
 
 ^ snould be, 
 
 people — to form a fit environment for a delicate thg^g^^^.^*' 
 person ? Why, ho7ne — home with a little * h ' ! p^^^^- 
 You rightly say that the home is precisely the hot- 
 bed of nerves ; that what almost every patient 
 needs is to go from home : nay, that the home 
 life, home people are in many cases the * exciting 
 cause ' if not the ' predisposing ' one also. Alas, 
 too true ! But is it impossible for the doctor who, 
 thank Heaven ! is as a rule a true worker in the 
 cause of science and humanity ; is it impossible, 
 I say, for him to alter this frightful state of 
 things ? 
 
 Not necessarily by societies, books, or theories, But 
 though all are helpful. His words (even chance m^fht^ 
 ones), his influence, may work wonders even in tSs!^^^ 
 ordinary professional intercourse if he but has this 
 knowledge and the wish to impart it. He thus 
 might help in all relationships — mother, father, 
 
 L 2 
 
148 UNCONSCIOUS THEEAPEUTICS 
 
 wife, husband, brother, or sister ; and so all might 
 be rendered not only innocuous but beneficial to 
 the patient, instead of, as often, the reverse.^ 
 Mean- B^t, till this happj consummation, and in our 
 
 what^? present case, the environment must be changed ; 
 and here comes in judgment as to treatment. 
 
 Every doctor is at least partly aware of the 
 faults, foibles, weaknesses, disadvantages, and 
 dangers of nurses, homes, hotels, lodgings, visits, 
 solitude, companionship, town, country, idleness, 
 work, silence, talk, emotion, love, indifference, 
 selfishness, philanthropy, extreme religion, non- 
 religion. With such confusing alternatives the 
 doctor must arrive at a wise decision as to treat- 
 ment, and that, maybe, in ten minutes' time or 
 less ! Truly, with such dilemmas a doctor's life is 
 A doctor's never an easy and not always a happy one — 
 
 life is not 
 
 a happy though a more glorious mission it is difficult to 
 
 one. 
 
 conceive, especially if he endeavours to minister, 
 not only to the poor body, not only even to the 
 
 1 Perhaps so ; yet even an ideal home is seldom the best place 
 for a serious case of neurasthenia or neuromimesis. The un- 
 conscious mind, exhausted in the one case and astray in the other, 
 gets injury and not help from the sympathy that surrounds it, 
 or, if this be changed to harshness, the case is worse.- The fact 
 is, the fresh and novel environment, with a wise and watchful in- 
 difference reigning round, is one of the chief factors in the cure. 
 
FEOM A PATIENT'S POINT OF VIEW 149 
 
 poorer mind, but to that which is when sick often 
 the poorest of all — the soul. 
 
 Where a doctor does not run his own Home, Doctors 
 
 imposed 
 
 he can have no conception what pain it often is to o^- 
 the patient in bed to see how completely he may 
 be hoodwinked by the various officials, and yet she 
 dare not enlighten him ? 
 
 The personality of the nurse is a far more The per- 
 complicated problem than is generally thought, the nurse, 
 and the selection of the right one, too, largely 
 depends upon the doctor's knowledge of character. 
 I would here most deeply impress the danger of a 
 little-known nurse or masseuse, especially for a 
 girl, or an impressionable older woman. I do not 
 mean in an actually bad or dishonest sense, though 
 this first is, I know, possible where the nurse is 
 *on her own ' and so not passed through the sieve 
 of a matron's recommendation. And I have known 
 various small but wrong attempts at influencing, 
 according to a nurse or masseuse's own pleasure, 
 convenience, or theories of life. No mother should 
 consent to her young daughter being left alone 
 with a masseuse unless intimately known to 
 matron or doctor — and this is rare. Not for one 
 moment do I mean that any harmful influence. 
 
150 UNCONSCIOUS THEEAPEUTICS 
 
 either from nurse or masseuse, is not an exception. 
 But this also must be remembered : that women 
 have long tongues. A doctor may command 
 silence for the patient. Will it be carried out? 
 Well, * hardly ever.' And remember, too, that 
 nurse and masseuse lead necessarily a restricted 
 and narrow life as to time for gaining ideas 
 besides their own everyday concerns and troubles, 
 and mild gossip. How then can any, save 
 some rare exceptions, provide conversation that 
 will do other than sadden, irritate, or dwarf the 
 mental outlook of the patient ? I yield to none in 
 my honour for nurses and masseuses, but you can- 
 not make bricks without straw. One, I repeat, 
 cannot expect anyone under an habitual strain of 
 responsibility, generally of over-work, frequently of 
 under-finance, and often with overstrung or ex- 
 hausted nerves, to be a helpful conversationalist. 
 Therefore, better have little talk, and — indeed this 
 is what the patient generally requires — a freedom 
 from 'the strife of tongues.' Take a rest cure. 
 By the time the patient has had meals, special 
 treatment, medicine, visits from the doctor, mas- 
 seuse, and matron, and even one hour's sleep, how 
 much of the day remains for that conscious rest 
 
FEOM A PATIENT'S POINT OF VIEW 151 
 
 which is the very kernel of the cure ? If to all 
 this you add much gossip, and, perhaps worse, the 
 puzzle is to find the rest (cure) ! 
 
 The best nurse in nerve cases is often a lady 
 who is neither a hospital -trained nurse of either 
 kind, nor a personal friend. 
 
 Finally, when you turn your patient back to her Make the 
 own environment, then is really her critical time, manent. 
 and yours. 
 
 Have you thoroughly impressed upon her, by 
 words, by all that should make up your personality, 
 all which you would have her to know? Have 
 you gauged her difficulties and the troubles of her 
 daily life generally, and guarded her against them ? 
 Have you brought her peace of mind, decision of 
 character, calmness of speech and action, altruism, 
 varied interests, and, above all, moderation as to 
 conscience, and as to everything besides ? Have 
 you guarded her by every means in your power 
 against relapse ? No ? Then do not leave her 
 till you have done so, directly or indirectly. 
 
 Always try to feel yourself what you desire her Once 
 
 again, Be 
 
 to feel, otherwise all will ring false; in other words, natural. 
 he natural, which really means, forget yourself 
 and even your patient, as to cojiscious words and 
 
152 UNCONSCIOUS THEEAPEUTICS 
 
 manner, whenever you can. Lastly, it is impossible, 
 even if desirable, one knows, for any busy doctor 
 to keep as friends, all, or nearly all, of his patients. 
 If, therefore, he be a Christian man, and desire to 
 help them through life, he can only pray for them 
 only ' ? ^ 
 
 * Although some parts of this sketch are not quite within the 
 scope of this book, the hints it contains are often so good that 
 I have inserted it almost in full, and feel convinced that few 
 doctors can read it without getting practical hints that will help 
 in some way. 
 
153 
 
 CHAPTEE VII 
 
 THE PRACTICE OF UNCONSCIOUS THERAPEUTICS 
 
 In this chapter I have ventured still to call those what 'un- 
 conscious 
 
 therapeutics * unconscious ' which, not comprised in , 
 
 peutics 
 
 the usual list of curative measures found in text- 
 books, act without the consciousness either of the 
 physician, or of the patient, or of both. As will be 
 seen, it is supposed in a very great number of cases 
 the physician is conscious of these means of cure, 
 and the whole tendency of this book is to make him 
 more conscious of them : not that consciousness of ^ncon- 
 
 ' sciousness 
 
 what we are naturally unconscious of is always an advanta^e^ 
 advantage, but generally the reverse. 
 
 But it is necessary, if we are to progress in any 
 science, that we should be conscious of the laws 
 and facts of that science ; and there can be no 
 doubt that, instead of the wholly unconscious and 
 haphazard use of these remedies by the physician, 
 their intelligent direction and practice would im- 
 mensely increase the value of unconscious thera- 
 
154 UNCONSCIOUS THEEAPEUTICS 
 
 The testi- 
 mony of 
 Sokhit- 
 ni-onkh, 
 
 fifty-five 
 centuries 
 ago. 
 
 * I never do 
 any one 
 any harm.' 
 
 peutics. This scientific use of means hitherto 
 neglected is quite possible to the doctor without 
 engendering any morbid introspection or self- 
 consciousness. 
 
 One point must be insisted on, which we will 
 make clear. Dr. Whittington, in his * Medical 
 History of the Earliest Times,' has recently 
 described the tomb of Sokhit-ni-onkh, a gentleman 
 whose name figured largely in the medical history 
 of some fifty-five centuries ago ! As a matter of 
 fact, he is the earliest known medical man. And 
 he writes these words : * I worship the great King, 
 and I pray every god for Sahura, for he knows me 
 and mine. Thus every wish from the mouth of 
 His Majesty is realised for me, for the god 
 (Anubis) has granted him to excel in medical 
 affairs, because of the great veneration that he has 
 for him more than for every other god. Oh, you 
 who love Ea, pray to every god for Sahura, who 
 confers these benefits upon me, for I am his trusty 
 servant. I never do any one any harm' Now it 
 is impossible for any doctor, however careful in 
 his prescriptions and use of remedies, to utter this 
 last sentence if he remains ignorant of the power 
 of these unconscious therapeutics. 
 
 I have given an instance of serious harm being 
 
IN PEACTICE 
 
 155 
 
 done through a bad manner (Chapter IV.) by an Many 
 
 uncon- 
 
 exceedingly wise and otherwise careful man ; sciousiy do 
 
 harm now. 
 
 and innumerable instances could be given where 
 incautious suggestions of evil from the lips of 
 great men, as well as little men, ignorant of 
 unconscious therapeutics, have produced disease — 
 or, at any rate, symptoms of it ; have aggravated 
 disease ; and have apparently been a cause of 
 death as well. 
 
 A good deal, of course, depends on the spirit in 
 which we practise, as to whether we will or will 
 not take the trouble to acquaint ourselves some- 
 what with the theory and practice of this neglected 
 branch of therapeutics. 
 
 Dr. Mark Wardle, I observe, in his address last Dr. Mark 
 
 Wardle on 
 
 year on the ethics of the profession,^ thinks there the ethics 
 
 of the 
 
 has been great deterioration as to this. He says : profession. 
 
 * I remember when I entered the profession, 
 some thirty-five years ago, it was an accepted 
 axiom that to be a doctor was to be a gentleman, 
 to pursue our work with a whole-hearted endea- 
 vour, to act in accordance with the best traditions 
 of our noble calling, to devote ourselves to the 
 saving of life and the alleviation of suffering, to be 
 
 * Dr. Mark Wardle in British Medical Joimialy September 27, 
 1902. 
 
156 UNCONSCIOUS THEEAPEUTICS 
 
 actuated by higher and better motives than the 
 instincts of a tradesman. Can we honestly say 
 Is a doctor that such a condition of things is the rule at the 
 
 now neces- 
 sarily a present day ? I grieve to say we cannot. I shall 
 
 gentle- 
 man ? never forget, so long as I remember anything, the 
 
 remarks that were made to me by the late Sir 
 
 John Fife, whose memory still lives in Newcastle, 
 
 when I was taken to him to be bound apprentice 
 
 by indenture, after the old-fashioned custom, for 
 
 five years. He said : If you are entering the 
 
 medical profession from a desire to devote yourself 
 
 to a very noble calling, and are prepared to face a 
 
 life of hard work and great self-denial, with very 
 
 often scant gratitude in return, I say * Go on ; ' but 
 
 if you look upon it simply as a means of making 
 
 money, from a business point of view, I say ' Stop 
 
 before it is too late,' for in the former case you will, 
 
 in the long run, succeed, in the latter you will 
 
 fail." I cannot doubt that he expressed the opinion 
 
 that was held by the great majority of the men of 
 
 his day. I cannot fail to recognise how sadly we 
 
 have fallen from that high standard during the 
 
 time that has since elapsed.' 
 
 But should all this be true, which we rather 
 
 doubt, even on grounds of self-interest the study 
 
 we advocate will repay its students. 
 
IN PEACTICE 
 
 157 
 
 * The physician/ says Dr. Hooker^ (for I must Dr. w. 
 
 Hooker 
 
 confess, though I have been reproved for it, I often . , , 
 
 ^ ^ physician s 
 
 prefer to give my thoughts in the language of 
 others rather than in my own), * should be some- 
 thing more than a mere doser of the body ; mental 
 influences are amongst the most important means 
 of cure. A physician should not only have a full 
 knowledge of mental philosophy, but he should 
 acquire practical skill in applying its principles. 
 The possession of this skill is one of the most 
 valuable endowments of the medical art.' 
 
 I venture to add that I think that the hindrance Pursuit of 
 
 science 
 
 to this does not so much lie in the sordid depths rather 
 
 than cure. 
 
 to which the medical profession is said to have 
 fallen, as in the tendency to the pursuit of science, 
 which with some doctors seems almost the end 
 in view, rather than, primarily, the cure of the 
 patient. 
 
 It is true that Sir William Gull says : ' In Con- 
 
 T- in ni . demned by 
 
 cnmcal medicme the welfare of the patient, and sirw. w. 
 not scientific aims, is alone before the physician.' 
 But we fear that this is hardly true of all who 
 practise medicine. 
 
 Once this is really pressed home upon a man's 
 mind, he does not stop to quibble or carp at 
 
 * Dr. W. Hooker, Physician and Patient, p. 214, 
 
158 UNCONSCIOUS THEEAPEUTICS 
 
 efficacious means as being unusual or outside his 
 scientific boundaries. He understands that he has 
 to enlarge these for the good of his patients, and 
 to train his own mind to use its greatest powers 
 for good both to the bodies and minds of the sick. 
 De Fieury ' The culturo of our minds,' says Dr. de Fleury,^ 
 
 on mind- 
 
 cuiture. < is to be Compared exactly with the training of 
 the muscles. The start is, in truth, the only 
 difficult task, the only painful moment ; but the 
 continuity of exertion carries with it, instead of 
 exhaustion, the pleasure of action, of force legiti- 
 mately expended, of balance regained. Training 
 is, above everything, the possibility of action with- 
 out becoming weary, and afterwards the intense 
 satisfaction of performing deeds of which others 
 are incapable. The moral and mental management 
 of the sick is often much more difficult than the 
 physical. A close study of the moral forces and 
 of mental therapeutics in affections connected with 
 the brain and nervous system is one of the neces- 
 sities that the regular profession is still extremely 
 deficient in.' 
 
 Dr. Hooker < The judicious physician,' says the * judicious' 
 
 on the 
 
 judicious Hooker,^ * experiences much gratification in the 
 
 physician. 
 
 ^ Dr. M. de Fieury, Medicine and the Mind, p. 248. 
 2 Dr. W. Hooker, Physician and Patient, p. 299. 
 
IN PEACTICE 
 
 159 
 
 mental management of the sick. I refer to all 
 those multiplied and various mental influences 
 which he exerts so silently, but so effectually, even 
 in ordinary cases of sickness.' 
 
 A doctor can, at any rate, make a point of so 
 disciplining and training himself as to infuse at 
 least three ideas into the patient's mind at every 
 visit : 
 
 1. That the case has his whole and undivided Three 
 
 2. That he thoroughly understands it ; and 
 
 3. That he believes he can cure it, or, at any 
 rate, takes a hopeful view of it. 
 
 There are, of course, in every doctor's expe- 
 rience sad occasions when the third, and some- 
 times even the second, is impossible. But these 
 are rare. 
 
 To this we may add some touching and noble Nobie 
 
 * The science of medicine, contrary to the Practi- 
 
 general belief, is not a gloomy, ascetic profession, 
 but a bright, cheerful one. In alleviating pain, 
 curing some and relieving other poor fellow* 
 creatures, and ministering hope and comfort to 
 their minds, you will be able to realise in some 
 degree the great good, material and moral, which 
 
 attention ; 
 
 ideas for 
 the patient 
 to grasp. 
 
 platitudes from ' The Young Practitioner : ' 
 
 platitudes 
 from ' The 
 Young 
 
 tioner,* 
 
160 UNCONSCIOUS THEEAPEUTICS 
 
 which may 
 do good. 
 
 Value of 
 directions 
 as to 
 details. 
 
 Great 
 minds 
 often fail 
 in this. 
 
 your noble, humane, and beneficent profession 
 enables you to confer on suffering humanity.' 
 
 The reiteration of true and pleasing common- 
 places is not without its effect in calling afresh to 
 our minds some needed but forgotten truths. But 
 it must be remembered that ^ ministering hope and 
 comfort to minds ' includes a little more than 
 merely writing a prescription. 
 
 In the first place, but few doctors really under- 
 stand the amount of hope and comfort that careful 
 directions as to the details of life give. This 
 power of attention to details is not always found 
 in minds broad enough to grasp the case as a 
 whole. Minds, as has been pointed out, are 
 generally characterised hj observation or imagi- 
 nation ; and, our critics will say, ardent followers 
 of mental therapeutics are pre-eminently gifted 
 with the latter. The former quality gives accuracy 
 in details, the latter broad and wide views. The 
 combination is rare, and those who possess it are 
 generally masters of their profession ; and in nerve 
 diseases this union is of especial value, because 
 we must here, at any rate, have the broad as well 
 as the accurate mind. The doctor who knows and 
 sees that his patient is not disturbed at night after 
 the last massage; who gives exact orders as to 
 
IN PRACTICE 
 
 161 
 
 her detailed routine throughout the day ; who 
 
 ascertains she is not roused and agitated by the 
 
 noisy cleaning of grate and room early in the 
 
 morning, will do much to ensure the general 
 
 success of his elaborate treatment. 
 
 A capacity for taking pains and for arranging 
 
 details of treatment may turn the scale from failure 
 
 to success in a doubtful case. 
 
 Another point about * ministering health and 'Unpro- 
 fessional' 
 
 comfort ' is that it leads a wise doctor to pay many profes- 
 sional 
 
 visits where no prescription is written, and where visits, 
 the conversation is not necessarily confined to 
 strictly professional topics. It is in these visits 
 the doctor learns and does so much, as the un- 
 conscious mind of the patient displays itself with- 
 out effort before him. 
 
 It is thus that a family physician who knows Family 
 
 how to use his unrivalled opportunities has the has liu- 
 
 greatest opening in the first instance for mental oppor'tuni- 
 
 ties. 
 
 treatment. His blue pill may be useful, but his 
 tact in encountering and discounting false notions 
 and instilling healthy ideas is the most powerful 
 remedial agent he possesses. 
 
 A healthy mind, like a healthy body, diffuses A healthy 
 health in a sick room. diffuses 
 
 Another qualification in the physician is 
 
 health. 
 
162 UNCONSCIOUS THEEAPEUTICS 
 
 VaiuG of patience, and this, I think, is different from mere 
 
 patience. 
 
 endurance, and really depends upon the first qua- 
 lity — sympathy. It is only those who know the 
 tortures undergone by functional nerve sufferers 
 — the pariahs and outcasts amongst patients and 
 doctors — and who feel for their sufferings, that can 
 possibly put up with the trying nature of the 
 sufferer and his multifarious and often apparently 
 incurable troubles. 
 
 The lack of this virtue in doctors fills our 
 holiday and health resorts abroad with patients 
 sent there because the doctor could not stand 
 the strain at home, and, recognising his result- 
 ing impotence, ordered travel as the best way 
 out. 
 
 Value of Perhaps this question really depends upon the 
 next great virtue, without which neurasthenics 
 cannot be successfully treated, and that is * tact.' 
 Tact is the unconscious mental touch, the tactus 
 emditus, by which one mind feels another, and 
 can convey to it, physically or mentally — skill, 
 decision, and sympathy ; and just as a physician's 
 physical tactile sense is educated to discern much 
 by mere touch, so can mental tact help the nerve 
 doctor immensely along his difficult path. Take, 
 for instance, the one question of whether to make 
 
IN PEACTICB 
 
 163 
 
 light of any particular symptom or to treat it quite 
 seriously. 
 
 The answer does not in a neurasthenic in the 
 least depend, as the doctor may naturally think, 
 upon the amount of obvious physical bases upon 
 which that symptom may rest, but on the effect on 
 the patient's mind of his levity or gravity ; and 
 to ascertain this effect beforehand is the highest 
 outcome of tact. 
 
 Some little time ago, at Leamington, in connec- sir d. 
 tion with this subject. Sir Dyce Duckworth gave an on manage- 
 admirable address ^ on the value of manner and sick, 
 management in therapeutics, from which I will 
 make a few extracts : 
 
 * The management of a patient includes treat- 
 ment in all its forms. It is possible to prescribe 
 for, without being able to manage, the sick, but 
 the results in such a case are not satisfactory. 
 The patient may often be readily managed, but the 
 practitioner fails to conduct him well through his 
 illness. Again, the patient may be difficult to 
 manage, and yet the practitioner, by tact and skill 
 in management, may accomplish all that is needed 
 ijiicunde). This quality of clinical management 
 has been of late facetiously termed a bedside 
 
 » See Lancet, October 17, 1896. 
 
 M 2 
 
164 UNCONSCIOUS THEEAPEUTICS 
 
 A good manner," and it is not misnamed so lon^ as it 
 
 * bedside' , , ^ ^ 
 
 manner. implios both correctness of mien and an absence 
 of affectation. It may be affirmed with confidence 
 that the most successful practitioners of medicine 
 are those who best manage their patients. In 
 discussing this subject we may first consider the 
 characteristics of divers classes of patients, and, 
 secondly, note the qualities that make for success- 
 ful management of them in the practitioner. . . . 
 
 Sometimes ' The fact is, that we have to teach ourselves to 
 
 artificial ; 
 
 manage our patients. Some men may carry into 
 practice the precepts, and others may perhaps 
 imitate the manners or peculiarities of their 
 teachers. The latter proceeding may, however, 
 very ill become the individuality of the imitator, 
 and make him simply ridiculous. Many of us 
 have witnessed, and laughed at, the actors in our 
 profession who play such parts. Again, with much 
 professional knowledge, some of us may fail alto- 
 gether to acquire the power of managing our 
 patients, and I much fear that examples of such in- 
 ability are nowhere far to seek. Some general pro- 
 positions relating to this subject may be laid down. 
 As I have remarked, each of us has gradually to 
 acquire the art of managing patients. . . . 
 
 * Therein lies part of the splendid catholicity 
 
IN PEACTICE 
 
 165 
 
 of our profession, and in all departments of oux 
 Hospital Schools of Medicine the student should 
 learn good manners as well as good physic from 
 his teachers. 
 
 *In considering, secondly, the qualities that sometimes 
 
 natural. 
 
 command successful management of patients at 
 
 our hands, I shall direct attention to such as I 
 
 conceive to be important, if not essential. I lay 
 
 particular stress upon a natural aptitude for the 
 
 occupation of treating the sick. To practise it well 
 
 a man must have an inherent love of his profession. 
 
 I assume that the practitioner has been soundly 
 
 trained in all branches of his art. I wish I could 
 
 equally assume that his earlier and preliminary 
 
 education had been in all ways adapted for his 
 
 readier comprehension, not only of the difficult 
 
 problems of medicine, but of many that relate to 
 
 management. . . . 
 
 *One almost always derives inspiration and In favour 
 . , , . . of consul- 
 
 satisfaction from consultations, and it is well to tation. 
 
 show that we have no fear of our work being 
 
 reviewed by those whom we should regard as able 
 
 to criticise it. Confirmation of our opinion can 
 
 only increase our patient's confidence in us, and 
 
 help us to conduct our cases more satisfactorily in 
 
 all respects. To share responsibility, too, in the 
 
166 UNCONSCIOUS THEEAPEUTIOS 
 
 Unreason- 
 ableness 
 of rich 
 patients. 
 
 Dignity 
 must be 
 main- 
 tained. 
 
 treatment of grave cases is always a relief to men 
 duly impressed with the seriousness of their 
 calling. One hears of faults on the side of con- 
 sultants. I do not say they do not exist, but I 
 feel sure the consultant who commits them de- 
 liberately will have but a short-lived reputation in 
 that sphere in which it should be his best ambition 
 to shine — viz. amongst his professional brethren. 
 
 ' It is not always easy to steer clear of diffi- 
 culties with the better classes of patients. Many 
 of them are disloyal to their advisers, and use 
 them as much or as little as they choose. The loss 
 is theirs, since they forfeit the best sympathies 
 and efforts of their attendants, but they discover 
 this too late. It is hard, too, to be patronised by 
 the wealthy, who may be effusive and gushing 
 when in sore trouble, but haughty and imperious 
 when restored to health. Our course is to main- 
 tain our dignity and to remember always what is 
 due to us as members of a great profession. It is 
 not for us to fawn in any servile fashion, nor yet to 
 submit to any measure of indignity. We must 
 exhibit always the courage of our opinions, and 
 stand firmly by what we believe to be right against 
 all allurements and any fear of giving offence. We 
 shall then hold our own and command respect. 
 
IN PRACTICE 
 
 167 
 
 This will demand tact, but with this, supported by 
 good breeding and well-controlled temper, we shall 
 certainly win the day. We have to learn to be 
 *'all things to all men," without making any 
 sacrifice of right principle. This can be done, and 
 it is done every day by those who have well 
 acquired the art of managing their patients. 
 
 ^ It is often a great advantage to be skilled and Solemn 
 
 medical 
 
 interested in matters outside our own sphere of drudges 
 
 do not 
 
 work. Such knowledge and dexterity themselves succeed, 
 often open the door to men whose professional 
 knowledge may not be of the highest, but who 
 commend themselves honestly and pleasantly on 
 other grounds to their patients. They will often 
 succeed better than the solemn medical drudge 
 who is learned in the last new methods and reads 
 little beyond medical journals and medical litera- 
 ture, old and new.' 
 
 Not seldom do we meet with scepticism as to Cause of 
 
 scepticism. 
 
 the value of remedies and therapeutics. I regard 
 such a condition {ainaTLa) either in respect of 
 worldly or spiritual concerns as a mental flaw 
 somewhat akin to colour-blindness. We find some 
 persons rejoicing in their disability, while others 
 bitterly regret it. In any case, our duty is to 
 act tenderly and to exhibit more, and not less, 
 
168 UNCONSCIOUS THEEAPEUTICS 
 
 robustness of belief in our own skill and our 
 art. 
 
 Do nofc Such conduct on our part is sometimes con- 
 pose as a . TP ... 
 
 scientific tagious, and often actively mspiring in seemingly 
 
 man. 
 
 hopeless cases presenting this infirmity. This 
 leads me to say that it is not our duty to pose 
 at the bedside as scientific men. The physi- 
 cian is an artist whose skill is derived through 
 various sciences from careful and accurate ob- 
 servation. 
 
 Do not lose This skiU is sometimes shown in managing, as 
 
 your hold 
 
 on the Sir Dyce Duckworth points out, ^ a wilful patient 
 
 patient. 
 
 by falling m with his views, so far as is not incon- 
 sistent with the best interests of his case. Such a 
 man will occasionally submit at once to treatment 
 on lines which commend themselves to him and on 
 no others. If the proceeding be in no way detri- 
 mental and not distinctly contra-indicated, we may 
 now and then thus temporise, and lose no hold on 
 the patient, whatever be the issue. He will pro- 
 bably, in the case of failure, submit more readily 
 afterwards to orthodox treatment. 
 A wide ^ A wide knowledge of our common humanity in 
 
 knowledge 
 
 of our all its aspects and workings is of much assistance 
 
 patients 
 
 necessary, in managing different classes of patients. It is 
 necessary to know how our several patients live ; 
 
IN PEAOTICE 
 
 169 
 
 to know how they spend their days; how they 
 eat, drink, work, and amuse themselves. I have 
 known strange difficulties to arise from ignorance 
 or misapprehension of some of these matters. It 
 may lead to very undesirable prescriptions, both of 
 food and physic, or of health resorts.' 
 
 Again : * Confidence may be gained, and is Avoid aii 
 
 uncer- 
 
 always strengthened, by a close and careful atten- tainty 
 tion to the minutest details of the case before us. 
 All hesitation and appearance of uncertainty is to 
 be strenuously avoided. A medical man who can- 
 not keenly regard his patient, eye to eye, with 
 firmness and directness, is hardly likely to succeed. 
 And no less must he similarly regard every one — 
 relations, friends, or nurses — who are dependent 
 on, and should be trustful of, him. With this 
 must be associated gentleness, promptness of 
 decision, a power of command, and a perfectly dis- 
 ciplined temper. All these qualities are requisite 
 in those who have to guide and lead others — naval 
 or military qualities we may call them — but always 
 without any of the overbearing conduct of the without 
 
 becoming a 
 
 martinet. Brightness and cheerfulness, without martinet, 
 levity, are always of value in enlisting the sym- 
 pathy of the sick, and the inlet of a little wit or 
 humour on appropriate occasions does more good 
 
170 UNCONSCIOUS THEEAPBUTICS 
 
 than some remedies. Many men of excellent 
 ability and professional skill fail to impress their 
 patients favourably, because they lack all sense 
 of humour, and have no power of command or of 
 methodical adaptation of means towards the end 
 in view. Their bedside manner is bad. They 
 make their diagnosis and prescribe, but the patient 
 and the attendants are left in uncertainty both as 
 to the exact opinion formed and the precise methods 
 enjoined by the practitioner. Casual directions, 
 with permission to do this or that, or to take this 
 or that, fail to impress anybody, and the result is 
 unsatisfactory. Dogmatism, founded on sound 
 principles, is as good for patients and their friends 
 as it is for students in the lecture-room. We must 
 be definite, and we must be lucid.' 
 
 As our knowledge of human nature grows, and 
 as we gain insight into the varying environments, 
 and try to realise the temptations of patients in 
 the several social strata, we should become in- 
 creasingly prudent and sympathetic, and thus see 
 more clearly the line of tactical conduct requisite 
 in each case. 
 
 All a phy. Everything, indeed, a physician says and does 
 oxToeT^^ in the sick-room is to be regarded as a medicine, 
 medidn^^ and producing as real, if not as manifest, effects 
 
IN PEAOTICE 
 
 171 
 
 upon the state of the patient as any of the drugs 
 he administers. 
 
 'The self-respecting physician,' says Dr. Dr. Coiiins 
 
 on the self- 
 Collins,^ * must, however, distinguish the mental respectmg 
 
 physician. 
 
 factor from the physical agency in the means to 
 which he has recourse. He must develop suffi- 
 cient ability and knowledge to distinguish between 
 the remedy through suggested value of drugs and 
 other physical measures, and the hopeless credulity 
 induced in such proceedings as mind cure through 
 thought transference or the "telepathic action" of 
 drugs.' 
 
 It is, indeed, these grotesque exaggerations that 
 in our subject obscure so much of its truth. 
 
 One of the main objects in successful manage- Let your 
 
 manner 
 
 ment of the sick is, as we have seen, to secure the inspire 
 
 faith. 
 
 patient's confidence. The psychical influence of 
 the mental attitude thus established is one of 
 enormous, though little understood, value in all 
 therapeutic efforts. It is the attitude which best 
 promotes recovery, and we gladly co-operate with 
 it. But all people have not faith in us or in our 
 arts. The power of keeping hope and confidence 
 alive in the bosom of the patient and of his friends 
 
 ^ Dr. J. Collins, Treatment of Diseases of the Nervous System^ 
 p. 14a. 
 
172 UNCONSCIOUS THEEAPEUTICS 
 
 is a great one, and the look with which you meet 
 them has much to do with this ; a bright, fresh, 
 thoughtful countenance, and an easy, cheerful, 
 soothing manner infuse repose into your patient's 
 mind, and carry him with you towards recovery. 
 Value of A cheery word sometimes rekindles the lamp 
 
 even a 
 
 word^^ of hope, and does the timorous and desponding as 
 much good as a prescription ; and it is your duty 
 to gain and retain the confidence of your patient 
 and his friends by all honourable means. 
 
 But much more can be done therapeutically by a 
 skilled physician than giving mere temporary cheer. 
 
 Dr. Fieury Maurico de Fleury enlarges on the value of an 
 
 on 
 
 implanted implanted idea : ^ * Let us learn and remember that 
 
 ideas. 
 
 in the practice of life it is frequently possible to 
 substitute a fixed idea for an absurd obsession, 
 and excellent habits for the most deplorable whims. 
 In this precisely the psychological treatment of 
 indolence consists — this the patient task that the 
 physician of strayed minds ought to undertake. 
 You, who desire to learn the marvellous art of 
 capturing minds, help your patient to choose an 
 employment really in conformity with his vocation. 
 Embellish the idea with every gem of hope that 
 can be hung upon it; contentment with oneself, 
 
 » Dr. de Fleury, Medicine and the Mind, p. 243. 
 
IN PEACTICE 
 
 173 
 
 worldly importance of fame and fortune to be won. 
 Talk of it constantly ; make it come back and back, 
 like a motif of Wagner's ; press it upon attention by 
 reiteration. Soon you will see the brain will allow 
 itself to be caught ; it will not be able to do without 
 that dear besetting idea. Lastly, when the idea 
 has become clear, it will result in action. 
 
 * Make it to be understood that the idea is for How to 
 everybody; that it is in the air, and may be thcnr^* 
 snapped up by somebody else, if your patient does 
 not make it his own at once. Thus it is that real 
 advantage may be taken of our worst faults, vanity 
 and jealousy, and that the fixed idea which is the 
 malady of the mind may be changed into an ele- 
 ment of creative energy. What a resource for the 
 indolent and the weak ! ' 
 
 This long exordium gives us, I think, in a sirw. w. 
 practical way, the best means by which Sir Wm. advice. 
 Gull's advice may be carried out. He says : ' The 
 first duty of the physician is to encourage the 
 hypochondriac to forget his woes ; but nothing is 
 so difficult in practice : and that, for the best of 
 all reasons. The sufferings are most vividly real, 
 and it is almost impossible he should forget them 
 till they cease.' ^ 
 
 > Sir W. W. Gull, Collected Writings, p. 301. 
 
174 UNCONSCIOUS THEEAPEUTICS 
 
 Dr. Moore Eloquence, indeed, is not needed to describe the 
 
 on hope as , 
 
 the elixir mightmess 01 the therapeutic power of the bright 
 
 vitce. 
 
 rays of hope, from whatever dewdrop of an idea 
 they may be reflected. Dr. Moore says : ^ ' She 
 speaks for herself to every mortal, and supplies 
 gratis to every sufferer a real catholicon and uni- 
 versal elixir vitce. Like an angel, she can con- 
 centrate her healing virtue in a homeopathic 
 globule, or diffuse it through all the living waters 
 of the world. The multitudinous baths, douches, 
 wet bandages, and cold draughts of hydropathic 
 establishments are mesmerised by her touch.' 
 Never sow But if hope is thus powerful, and is often 
 despair. g^^.Q^g^^j [j^ ^ patient from a word or look from the 
 doctor, on the other hand despair and the idea 
 of disease are introduced often with even greater 
 ease into the patient's mind, and are often sown by 
 the doctor entirely from his ignorance of the power 
 of a look or word, coupled, perhaps, with a mistaken 
 conscientiousness. 
 Evil * I have heard a patient say,' says Dr. Tuckey,^ 
 
 S^by ' that she now had the headache the doctor 
 doctors, ^Q-^Q^ ]2er about last week, but which was then 
 absent,' 
 
 ^ Moore, Poiuer of the Soul on the Body, p. 367. 
 
 - Dr. C. L. Tuckey, PsychotheraiyeiUics, 4th edit. pp. 12, 13. 
 
IN PEACTICE 
 
 Dr. Goodhart ^ mentions the case of an hysteri- 
 cal woman who consulted a doctor about her health. 
 He examined her chest and thought he detected 
 signs of phthisis, and expressed great surprise that 
 she had no cough. Though up to that time she 
 was free from any symptom of the kind, the 
 suggestion was sufficient to excite a most trouble- 
 some and obstinate cough, which it was very 
 difficult to cure. Dr. Goodhart cites this case as 
 a warning to the practitioner against being too 
 persistent in asking leading questions. 
 
 Professor A. Ford says : ^ * During the summer Professor 
 
 A. Ford's 
 
 of 1891, I met an attendant, K., from Wiirtemberg, remark- 
 able case. 
 
 while I was lecturing at Zurich, who had constant 
 headaches for two years after a severe pneumonia. 
 The physician there told him these headaches 
 would never leave him, as they were an inheritance 
 from his father, and he had never lost them, 
 always feeling a dull pressure on the head. This 
 showed the two years' headache was nothing else 
 than the result of an unconscious suggestion of 
 the physician. The man had only had the most 
 temporary headaches before. I then told him 
 definitely that headaches were not an inheritance, 
 
 ^ Dr. Goodhart, Ilarveian Lectures ; Common NeiLwses^ 1891. 
 Prof. A. Ford, American Journal of Psychology, vol. iv. p. 4. 
 
176 UNCONSCIOUS THERAPEUTICS 
 
 He com- 
 mits the 
 fault 
 himself. 
 
 How to 
 sow hope 
 truthfully. 
 
 and could easily be cured. Since then (four months) 
 the chronic headache had disappeared. This case,' 
 he continues, ' seems to be very instructive, because 
 it shows how easily physicians, without knowing it, 
 can produce sickness by pessimistic prophecies, by 
 anxious looks or words. Thus are actual diseases 
 suggested (unconsciously) by the physician. I 
 myself,' he says, ' have committed the same fault. 
 A female attendant suffered with pains in the 
 stomach. I diagnosed and treated her anxiously 
 for gastric ulcer. For months she kept her 
 bed, and gradually recovered, with the stomach 
 very sensitive for years. I have not now the 
 slightest doubt that her long sickness was pro- 
 duced by over-anxious investigation and strict 
 regimen.' 
 
 No doubt many who read this will feel rather 
 uncomfortable as they recall how often they have 
 said, ' Ah, yes ; the heart is a little dilated ; it 
 may never be strong again.' Or, if they have not 
 said this (a favourite utterance of a rather well- 
 known physician), they have said something equally 
 fatal to their patients. 
 
 What, then, are we to do ? and how are we to 
 sow hope in the minds of patients suffering from 
 grave disease without sacrificing the truth ? or, on 
 
IN PEACTICE 
 
 177 
 
 the other hand, how are we to avoid doing them 
 a positive and possibly lasting injury by our 
 candour ? 
 
 First seize upon and make a feature of every Do not say 
 
 a case is 
 
 hopeful point. If you feel cure is impossible, hopeless, 
 neither promise it nor say it is hopeless ; but 
 dwell rather on the great alleviation and improve- 
 ment that is possible. Our knowledge, after all, is 
 not so certain and so positive that we are often 
 justified in extinguishing all hope. 
 
 We must neyer promise more than we can Do not pro- 
 mise more 
 
 perform ; but we may often leave the final issue than you 
 
 can 
 
 vague, even where only one end is likely, and let perform, 
 events themselves foreshadow and prepare the 
 patient for the final verdict. However, no amount 
 of instructions and hints will meet the varied 
 circumstances. The best service we can render is 
 to point out the danger and injury of unconsidered 
 and depressing speech, on the one hand, and, on 
 the other, the value of the unconscious therapeutics 
 of hope. 
 
 Dr. Carpenter goes so far as to say that * the Dr. 
 
 Carpenter 
 
 confident expectation of a cure is the most potent on value of 
 
 expecta- 
 
 means of bringing it about, doing that which no tion. 
 medical treatment can accomplish,' and this may be 
 affirmed as a generalised result of experiences of 
 
 N 
 
178 UNCONSCIOUS THEEAPEUTICS 
 
 the most varied kind extending through a long 
 series of ages. 
 
 Physical The physical examination of the patient consti- 
 
 examma- 
 
 tion as a tutes another variety of therapeutics which may be 
 
 therapeutic n n , . i > 
 
 agent Called to a great extent unconscious. Only this very 
 day it was my lot to have a patient sent to me from 
 the north of England, and I found her confidence 
 had been sapped and her malady confirmed wholly 
 by the cursory and partial nature of the physical 
 examinations previously made by medical men. 
 
 Lest this be taken as an instance of superior 
 skill, let me hasten to add that the doctors were 
 neither hasty nor careless. The neglect is often 
 due to the extent and accuracy of the medical 
 knowledge of the doctor, combined, however, with 
 ignorance of unconscious therapeutics, 
 is little A physician would no doubt say that he makes 
 
 by doctors, all physical examinations to satisfy himself as to 
 the presence or absence of disease. He little 
 thinks that a great point about them is to satisfy 
 the patient, and that the examination has not only 
 a diagnostic value for the physician, but a thera- 
 peutic value to the patient. His tactus eruditus, 
 his trained eye and ear may satisfy him in a 
 
 Examine 
 for the 
 patient's 
 
 eaiie. ^^^^ patient, and this is a point it is well to 
 
 patients ^^^^ another ; but it will not satisfy 
 
IN PEACTIOE 179 
 
 remember. For more than one doctor has got 
 credit for too little skill when he really had too 
 much — but not of the right sort.^ 
 
 It is very fooHsh in these matters to put on the 
 heavy scientific air and decline to play to the 
 gallery or to descend to the level of the man in the 
 street, when neither the one nor the other is 
 demanded. All that is asked is that the science of Do not 
 
 despise any 
 
 unconscious therapeutics, which has such a power- means that 
 
 helps your 
 
 ful influence on your patient's health, be at least patient. 
 
 gravely and patiently considered. 
 
 And now, a word as to suggestions. These, sugges- 
 tions 
 
 like nitrogen, can seldom be assimilated in a ^^ii^ct and 
 
 indirect. 
 
 raw state, but are readily taken in combination. 
 Hypnotism, however, is of doubtful benefit in most 
 neurotic cases. Some patients of low mental 
 calibre are benefited by the direct suggestion that 
 they are rapidly getting well ; more, however, 
 
 * It is very curious, in this connection, to notice how gratefully 
 and patiently the often perfunctory pommelling of patients by 
 relays of students in the out-patient departments or wards of a 
 hospital is not only borne but enjoyed by the sufferers. They 
 feel not only a deep satisfaction at the attention their case is 
 receiving, but the confidence it inspires gives an unconscious 
 therapeutic power to any remedy prescribed that is of immense 
 value. Compared with this display of force, the value of the 
 skill of the trained physician, to whom a glance or a touch is 
 enough, is at a heavy discount amongst the poor ; and though 
 he give the same prescription it may not have the same effect. 
 
 N 2 
 
180 UNCONSCIOUS THEEAPEUTICS 
 
 benefit by the use of means directed to combat the 
 symptoms complained of, such as electricity, 
 massage, drugs, exercises, &c., which, besides 
 doing a certain amount of good directly, do still 
 more by the suggestions they convey to the 
 patient's mind, and also afford a rational prelude 
 to an intelligible cure. They appeal to the patient's 
 reason — or at any rate to that which passes under 
 that name — and afford satisfactory food to the mind 
 which finds a gratification in the use of extensive 
 and elaborate means. 
 Every good There are two methods of suggestion open : a 
 
 physician 
 
 uses sug. more active and talkative way, which turns the 
 
 gestions. 
 
 subject's attention to the desired point by direct 
 suggestions ; and a more passive and silent way, 
 which attempts a general quieting of the mind, in 
 which a new balance of impulses may be inaugu- 
 rated, and the desire for normal functions may 
 work itself up to increased influence. Every good 
 physician makes use of these two means to increase 
 the effectiveness of his remedies. At the right 
 time, they are almost a substitute for all other aid, 
 and in the mystical therapy of all periods through 
 four thousand years they have here and there 
 developed a high technique. 
 
 Much of the success of both methods depends, 
 
IN PEACTICE 
 
 181 
 
 of course, upon the ability of the transmitter to Success 
 
 depends on 
 
 make the suggestions effective. His personal how they 
 
 ^ ^ arc made. 
 
 appearance and way of talking, his voice and 
 temperament, must be persuasive, and his reputa- 
 tion and authority must reinforce the expectancy 
 which prepares the inhibitions. Teachers and 
 lawyers and ministers strengthen their influence 
 by these silent servants of a dominant mind.^ 
 
 As I have already said, suggestions in the 
 patient's ordinary state are greatly strengthened 
 by adjuvants in the form of impressive means, 
 more or less elaborate. In the hypnotic condition 
 these are not needed, as the patient's unconscious 
 mind is then entirely accessible. 
 
 Touch is often a material aid in the convey- vaiueof 
 ance of thoughts, as wires aid telegraphy. In 
 some cases a decided manner, with a hand laid 
 firmly on the patient's arm, will enable him to 
 assimilate suggestions otherwise inoperative. 
 
 Sometimes, indeed, the beam of the scale of sugges- 
 life and death is so evenly balanced that it will save life.^ 
 turn this way or that, according to the skill, or the 
 want of it, that is displayed ; and this not in the 
 cases merely of nervous diseases. ' Patients suffer- 
 ing from organic disease often show marked im- 
 
 * See Psychology and Life, by Hugo Miinsterberg, pp. 246, 247. 
 
182 UNCONSCIOUS THEEAPEUTICS 
 
 provement as the result of advice which can have 
 no direct physical influence on the malady itself. 
 It is ever for the physician to infuse hope into his 
 patient, and call his attention to signs of improve- 
 ment he may fail to see.^ 
 Tiie « Showing an earnest, anxious, gentle interest 
 
 patient ^ ' *^ 
 
 broUier Welfare of patients, as present in mind as 
 
 well as in body, is another very strong faith - 
 inspiring quality ; — to assure a sufferer, in sin- 
 cerity and kindness, that you will take the same 
 care of him as though he were your own brother.' ^ 
 A good hint is, when remedies are used that 
 are intended to act partly through the mind, to 
 take care to look the patient earnestly and steadily 
 in the face, and give precise instructions as to the 
 time and mode of using them, and so greatly 
 enhance their therapeutic power. 
 
 Dr. Rush's Dr. Eush never prescribed remedies of doubtful 
 
 prescrip- 
 tions, physical efficacy in the various stages of acute 
 
 disease till he had worked up his patients into a 
 
 confidence bordering on certainty of their probable 
 
 good effects. The success of this measure much 
 
 oftener exceeded than disappointed his expectation. 
 
 * Dr, J. Collins, Treatment of Diseases of the Nervous System^ 
 p. 141. 
 
 The Physician himself, p. 46. 
 
IN PEAOTICE 
 
 183 
 
 Closely connected with this confidence in the Cause of 
 
 immunity 
 
 treatment of patients, and affording a personal ^^^^^.^^^ 
 illustration of its value, is the immunity from 
 infection enjoyed by physicians and nurses ; which 
 is far more due to the preoccupation of their 
 minds, leaving no room for selfish terrors, than to 
 any precautions they may adopt. It is also partly 
 due to the confidence begotten by long familiarity 
 with, and exposure to, danger. 
 
 Dr. Weir Mitchell's hints in the management Dr. s. w. 
 
 ^ Mitchell 
 
 of a female patient are of value here. He says : ^ on manage- 
 ment of 
 
 ' It then becomes the business of her physician to ^^^J ^ 
 
 patients. 
 
 tell her what is real, what is unreal, what must be 
 respected, what must be overcome and fought. 
 She has acquired within herself a host of enemies. 
 Some are strong, some are feeble. The hour for 
 absolute trust has arrived, and she must now 
 believe in her adviser ; or, if she cannot, she 
 must acquire one in whom her belief will be entire 
 and unquestioning. She must believe you can 
 succeed. This is a form of faith-cure which has 
 other illustrations. You tell her that she must dis- 
 regard her own feelings. She credits you with know- 
 ledge, and so wins her fight ' (by obeying you). 
 Of course no strong or certain course can be 
 ^ Dr. S. Weir Mitchell, Doctor and Patient, pp. 131, 132. 
 
184 UNCONSCIOUS THEEAPEUTICS 
 
 A doctor taken by any physician in mental therapeutics 
 
 must know 
 
 his. , until he has got a grasp of the mental condition 
 
 patient s ox 
 
 mind. of his patient. ' One must take into considera- 
 tion the patient's temperament, his manner 
 of life, his social scale, his personal and family 
 history, his special beliefs, his likes and dislikes. 
 Each physician will have to judge for himself how 
 far he is willing to come down to the beliefs and 
 principles of his patients.' ^ 
 On mental Then, with regard to the state of the patient's 
 grounds, mind, there is the question of mental backgrounds. 
 
 The mental background is the unconscious stand- 
 point that your patient occupies, and with which, 
 as far as possible, your remarks and attitude 
 should harmonise until you are able by degrees to 
 change it. The permanence of the cure of a nerve 
 patient often depends upon the extent to which 
 you are able to change his outlook in life. And 
 to do this you must first know it, and the figures 
 and the language and arguments you use must fit 
 Varieties in to somo Gxtont with the scenery of his thoughts — 
 grounds, with the psychical plane on which he moves. 
 
 A mobile background to thought is a sign of 
 mental health, and consists of mental scenery that 
 
 * Dr. J. Collins, Treatment of Diseases of the Nervous System, 
 p. 140. 
 
IN PEACTICE 
 
 185 
 
 can be readily shifted at will to suit the figures 
 that have to move on the stage before it : as, for 
 example, a religious background to the mind in 
 church ; a political one in the House ; a medical 
 one at a bedside. Without these appropriate set- 
 tings the actions and words that are seen and heard 
 seem uncongenial and bizarre. This we can all un- 
 derstand with regard to ourselves ; but it is also so 
 with regard to our patients. To regale with some Mistakes 
 
 from 
 
 music-hall story a religious enthusiast, to bore ignorance 
 
 as to this. 
 
 with small medical details a patient whose whole 
 soul is wrapped up in music, to quote Browning or 
 Ruskin to a fox-hunter, or talk horses to a city 
 curate, may be illustrations of introducing ideas 
 before incongruous backgrounds. 
 
 I have said that a mobile background speaks Fixed 
 of health ; in the same way unstable backgrounds, grounds 
 
 . . mean 
 
 that are ever shiftmg without the patient's will, insanity, 
 tell of nerve weakness, and fixed backgrounds 
 that never alter go with insanity. The mental 
 background is simply the condition of the uncon- 
 scious mind ; and this knowledge of it is a great 
 help to cure. Indeed, I find personally that it 
 sometimes takes days to discover in a patient the 
 background of his thoughts, but it is so important 
 that one never feels one has begun to touch the 
 
186 UNCONSCIOUS THEEAPEUTICS 
 
 Doctor at 
 cross pur- 
 poses till 
 he under- 
 stands 
 patient's 
 mind. 
 
 A good 
 subject for 
 study. 
 
 Propor- 
 tions of 
 spiritual 
 and 
 
 animal. 
 
 case mentally until it is ascertained ; and when it 
 is, a mutual confidence and understanding is esta- 
 blished that is a great help. 
 
 I do not know that I have succeeded in making 
 my idea clear, but I am convinced of its importance ; 
 and that until what I have called the mental back- 
 ground of the patient is manifest, the doctor talks 
 to him mostly at cross purposes ; and however 
 good what he says may be in itself, it fails of its 
 purpose because it is out of harmony with the 
 patient's attitude of mind. 
 
 This subject, amongst many others, appears to 
 me to be one of those points connected with Un- 
 conscious Therapeutics of such interest and great 
 value medically that it might with advantage be 
 taught to the medical student. I feel sure that 
 before long some definite move must be made to 
 give to this science a recognised place in our 
 curriculum ; and we see in consultation every day, 
 and hear from our patients, what an amount of 
 suffering and mistakes occur from the ignorance 
 that is allowed to prevail on the whole matter. 
 
 The proportions of the qualities of mind and 
 body in people appear to be very different. Some 
 seem two-thirds spiritual and one-third animal; 
 and others seem to be but one-third spiritual and 
 
IN PEACTICE 
 
 187 
 
 two-thirds animal, between which are all inter- 
 mediate grades. If you attempt to treat all these 
 alike you will certainly fail. 
 
 It is in the different treatments required Trouble 
 
 with 
 
 with regard to this point that one often finds so patient's 
 
 ^ friends. 
 
 much trouble with the patient's friends, particu- 
 larly if they are intelligent and have a smattering 
 of medical lore. Accustomed only to medical 
 routine, and utterly unaware of the delicacy of 
 unconscious therapeutics, they find much fault if 
 they see you apparently going with the patient's 
 views, and seemingly fostering her peculiarities that 
 you may firmly gain her confidence and work from 
 and in harmony with her mental background until 
 you gradually change it to yours, and with it the 
 habits. They * understood you always made the 
 patient do what you wished,' whereas you appear 
 to be letting the patient do what she wishes. Now, 
 even to a medical man, this course may appear 
 weak, simply because the whole matter is one he 
 has never studied. 
 
 But, on consideration, it is clear that merely to change a 
 change the patient's habits in harmony with your ground for 
 background of thought is of no permanent value, curc?^^^^^^^ 
 The point is, to change the patient's background or 
 line of thought, and then the habits can easily be 
 
188 UNCONSCIOUS THEEAPEUTICS 
 
 altered, and altered permanently. But as long as 
 the patient thinks her way is right she will relapse 
 when she leaves you. 
 
 The training of the patient's mind is, there- 
 fore, a work of great value and interest, and well 
 worthy of study, as on it often depends the 
 permanency of the cure effected. 
 De Fieury Dr. Maurice de Pleury says : ^ ^ The human mind 
 hig^bhe^^^ may he modified. If the stimulations of which I 
 have spoken are methodical and of moderate in- 
 stead of excessive intensity, you may attune the 
 mind to gladness in life and love of work. Thus 
 the task of the doctor moralist defines itself : it is 
 to bring the brain up to the standard of moderate 
 energy, and induce it to form the habit of remain- 
 ing at that point. It is therapeutics dealing with 
 the temporary weakness or more serious paralysis 
 of our will, the great regulator of the human 
 machine ; disorder in love, disorder in work, in- 
 sensate anger or vain sadness — these are the sins of 
 enfeebled wills. If the hygiene which we desire 
 succeeds in teaching men to live worthily and to 
 work well, then it is in truth a sound morality ; for, 
 except loving and working, what is there of serious 
 import here below ? ' 
 
 ' Dr. de Fieury, Mind and Medicine, pp. 343, 356. 
 
IN PEACTICE 
 
 189 
 
 Speaking of indirect suggestion, one finds, Casual 
 
 remarks 
 
 curiously enough, that, given casually, it is often often most 
 
 effectual. 
 
 more effective than if earnestly made. A remark 
 to a nurse or friend is often better than an exhor- 
 tation to the patient. 
 
 One of the most important forms of more direct Moral sug- 
 
 gestions 
 
 suggestion, that can only be administered by a ^^^^^^^^^^ 
 physician who is in the fullest confidence of his trusted 
 
 *^ physician. 
 
 patient, is that which points out the evil, and the 
 weakness, and the folly of that character of mind 
 that feeds upon itself ; and that draws out the 
 mind to altruistic and worthy objects, and thereby 
 alters the flow of the unconscious current of 
 thought, which has been feeding the disease all 
 through ; and thus makes the subconscious mind 
 itself undo the mischief it has done, and changes 
 the mental background. 
 
 Some can do more, and can cure directly by 
 bold assurance. A doctor who has the patient's 
 full confidence may cure a patient by telling him 
 he is cured. Such cases, however, are rare. Dr. 
 Paul Edwards, of Paris, cures or cured his patients 
 thus. The therapeutic force was in himself. But 
 these are exceptional methods, and my desire is 
 rather to write for the medical man generally. sceptical 
 
 The hardest patients to influence are those who hardest to 
 
190 UNCONSCIOUS THEEAPEUTICS 
 
 Conceit a havG lost all faith, and are without confidence 
 
 great evil 
 
 in patients, in any one person or agent ; and another very 
 difficult class are those whose conceit and self- 
 sufficiency are such that they know well that at all 
 points their own judgment is better than yours ; 
 and that, though at times they may submit to 
 your arbitrary and mistaken orders under protest, 
 time will show you to be wrong and themselves 
 to be right, which they take care it does. 
 
 A great deal of a patient's mental state is 
 shown in his manner. When a patient speaks 
 of his dreadful sufferings in a quiet, firm voice, 
 and with no change of expression, it will be easy to 
 form a judgment about him, and suspect incipient 
 neuromimesis, or disease of the unconscious mind. 
 
 Sudden 
 
 Dr. Weir Mitchell writes : ^ ' Now and then you 
 dke^ct^ meet with cases in which, from sudden shock or 
 accident, a woman is led to manufacture a whole 
 train of disabling symptoms ; and if in these 
 instances you can convince her that she is well, 
 and can walk, eat, &c., like others, you make one 
 of those singular cures which at times fall to the 
 lot of mind or faith curers when the patient has 
 not had the happy fortune to meet with a physician 
 who is intelligent, sagacious as to character, and has 
 
 » Dr. S. W, Mitchell, Doctor and Patient, pp. 134, 138. 
 
 suggestion. 
 
IN PEACTICE 
 
 191 
 
 the courage of his opinions. I could relate many 
 such cases, if this were the place to do so ; but all 
 I desire here is to win the well woman and the 
 nervously sick woman to the side of the physician. 
 
 ' When you sit beside a woman you have thus 
 saved from mournful years of feebleness, and 
 set afoot to taste anew the joy of wholesome life, 
 nothing seems easier than, with hope at your Quite easy 
 
 in some 
 
 side and a chorus of gratitude in the woman's cases, 
 soul, to show her how she has failed, and to make 
 clear to her how she is to regain and preserve 
 domination over her emotions ; nor is it then less 
 easy to point out how the moral failures, which 
 were the outcome of sickness, may be atoned for 
 in the future, now that she has been taught to see 
 their meaning, their evils for herself, and their 
 sad influence on the lives of others.' 
 
 I have spoken, in a previous chapter, of the Thews 
 
 medicairix 
 
 vis medicairix naturce, and shown clearly how nauirce 
 
 can be 
 
 highly we regard it ; but it can and must be aided, 
 aided frequently, and it is here the physician 
 occupies his true place. Every physician should 
 make an accurate study of the point where Nature 
 ends, and where art must begin in the cure of the 
 disease. We must learn to distinguish cases in 
 which we can safely depend on Nature, from those 
 
192 UNCONSCIOUS THERAPEUTICS 
 
 which Nature cannot successfully combat, and treat 
 each accordingly ; for, as has been well said, when 
 we have learned to distinguish those that need an 
 Propor- ounce of medicine and a grain of wisdom from 
 
 tions of 
 
 wisdom those that need an ounce of wisdom and a grain 
 
 and 
 
 medicine, of medicino, WO may be said to have entered upon 
 the path of professional success. 
 
 On the other hand it is puzzling to observe 
 how many men are doing fairly well who know 
 nothing of all this. Our solution, of course, is, 
 not that ' they do not know it,' but that * they do 
 not know that they know it.' 
 
 It is important in connection with this to 
 remember that generalities and averages are but 
 devices to help our idleness of thought, and that 
 we never meet an average patient to whom book 
 rules wholly apply — each of our patients, at any 
 rate, is, curiously enough, a particular case. 
 Dr. Collins ' The physician himself,' says Dr. Collins,^ 
 ment^of" ^ is of the first importance in the treatment of 
 asthenia, nourasthonia — ^.e. his personality. He should 
 continually strive to lift his patient from the 
 quagmire of despair and desperation into which 
 he has been hurled by this dreadful malady. A 
 
 1 Dr. J. Collins, Treatment of Diseases of the Nervous System, 
 p. 420. 
 
IN PRACTICE 
 
 193 
 
 patient with neurasthenia should be examined and 
 treated with the same attention to details as one 
 with typhoid fever or endocarditis.' 
 
 Details are of perhaps greater importance in sirH. 
 nervous than even in other diseases. Sir H. i mportance 
 
 of details. 
 
 Holland says : ^ ' The physician who leaves the 
 bedroom of his patients, especially in cases of 
 acute disorder, without attending to more than the 
 prescription of medicine and diet, but very imper- 
 fectly fulfils his office. He is bound, further, to 
 look to temperature, to ventilation, the state of the 
 patient's bed, his posture, the needful change of 
 clothing, the proper use of water, and the main- 
 tenance of quiet. These things are often passed 
 over, and yet will do more towards the relief 
 of suffering than a page covered with the best 
 medical latinity.' 
 
 The formation of good habits in the patient Pormafcion 
 is of great value in nervous cases, and especially habits in 
 the regulation of the bowels, by an action without 
 aperients, at the same hour each morning. In 
 my experience, apart from organic disease, this 
 can always be obtained by the patient formation 
 of the habit— a process taking from two to six 
 weeks. 
 
 ^ Sir H. Holland, Medical Notes, p. 389. 
 
 0 
 
194 UNCONSCIOUS THEEAPEUTICS 
 
 In all cases it is most important to mould the 
 treatment to suit the individual case, and not to 
 expect the patient to be moulded to the treatment. 
 But even with the greatest care the practitioner is 
 repeatedly defeated by nervous influences, which he 
 at first failed to appreciate ; and gradually dis- 
 covers that he succeeds by employing measures 
 which act solely on his patient's mind. 
 Doctors to "Weir Mitchell points out ^ that ^ the doctor who 
 
 be avoided. ^ ^ 
 
 gives much medicine, and many medicines, who is 
 continually changing them, and who does not insist 
 with care on knowing all about the patient's habits 
 as to diet, meal times, sleep, modes of work, and 
 hours of recreation, is, on the whole, one to avoid.' 
 De Fieury De Flourv adds : ' In neglecting the systematic 
 
 on doctors' 
 
 weapons, and Scientific employment of mental influence in 
 the course of disease, medical practitioners throw 
 aside a weapon for combating it, more power- 
 ful than all the drugs in the Pharmacopoeia. 
 It must be acknowledged, however, that the 
 higher hygiene which I propose can only be 
 exercised efiicaciously by a tete-a-tete in the con- 
 sulting-room of a specialist, and that it actually 
 s lay confession without prestige and without 
 poetry.' 
 
 - Dr. S. Weir Mitchell, Doctor and Patient, p. 28. 
 
IN PEACTICE 
 
 195 
 
 But, as a rule, by treatment doctors and nurses Conven- 
 tional 
 
 usually mean, in nerve cases, keeping the patient in nerve 
 
 ^ ' ' 1 o 1 ^ treatment. 
 
 strict order, making her forget herself, rousing 
 her, and too often irritating her; whereas good 
 moral treatment should before all things mean 
 gentleness, cheerfulness, patience, the encourage- 
 ment of the growth of the patient's will in a 
 right direction, with enforcement of abject submis- 
 sion to the will of some one else, total freedom 
 from all noise, fatigue, and irritation, and the 
 constant presence of an improving influence and 
 example. 
 
 On the other hand, fear is in itself a great The thera- 
 peutics of 
 
 therapeutic agent ; but is, like the salts of copper fear, 
 and other poisonous drugs, too dangerous for 
 general use by medical men. Still, in some cases, 
 fear in very small doses acts as a sort of mental 
 digitalis. One golden rule of mental therapeutics 
 may be here recalled, that the cure of the sick 
 body or exhausted nerves must precede the cure 
 of the sick mind ; in fact, the physical must go 
 before the psychical. 
 
 With regard to professional visits to patients. The value 
 
 , of a visit 
 
 we have already pomted out that, in special cases, itself, 
 visits may be paid mainly for the sake of the 
 moral influence that the doctor exerts upon the 
 
 q2 
 
196 UNCONSCIOUS THEEAPEUTICS 
 
 Olla 
 
 podrida a 
 good dish. 
 
 Thera- 
 peutics of 
 the clock. 
 
 In vomit- 
 ing, consti- 
 pation, 
 delivery, 
 &c. 
 
 patient. The mere sight of the doctor is to many 
 patients an agreeable and stimulating treat (of 
 course it depends on the doctor), and has a dis- 
 tinct therapeutic value in the monotony of the 
 sick room. A doctor who undervalues the worth 
 of such visits forgets the therapeutic value of his 
 personality; that, in some cases, outweighs any 
 derived from his skill. 
 
 Finally, in concluding this chapter of * Olla 
 podrida ' (which, after all, is a good dish, though, 
 like haggis, *fine confused feeding'), I may say 
 a little more about the value of a new unconscious 
 curative agent from my own experience. I refer 
 to the therapeutic value of a striking mantel-piece 
 clock (I say clock, in preference to watch, because 
 it has a greater value ; and I say mantel-piece 
 instead of hall clock for the same reason ; and I 
 add striking as being of still greater efficacy). Sir 
 Dyce Duckworth, without dwelling on the value 
 of mental therapeutics, has pointed out its use 
 by means of the clock in showing the great effect 
 in cases of persistent vomiting in giving the liquid 
 food in teaspoonfuls every five minutes by the 
 clock. If the patient is told that the food thus 
 given with strict punctuality will be retained, and 
 if he can see the clock clearly from the bed, it 
 
IN PEACTICE 197 
 
 will probably be successful, for at the exact time 
 the subconscious mind enables the stomach, pro- 
 bably by some inhibitory power over the vomiting 
 centre in the medulla, to retain food. I have 
 found the greatest help from the clock in the feed- 
 ing of infants, in the curing of constipation, and 
 in the regulation of the pains in delivery, of which 
 I have given some details elsewhere. 
 
 I 
 
 I 
 
198 UNCONSCIOUS THEEAPEUTICS 
 
 CHAPTEE VIII 
 
 THE SECRET OF SUCCESS IN PRACTICE 
 
 I HAVE hitherto been ccnsidering and illus- 
 trating the theory and practice of Unconscious 
 Therapeutics, both natural and medical, from many 
 points of view. I have also glanced at the 
 value of the doctor's personality, apart from his 
 drugs, and considered from the professional and 
 lay standpoints the value of his manner and 
 environment. 
 
 So far, indeed, I may say that what I have 
 written has been mainly in the interests of the 
 patient, what I now write is more directly in the 
 
 Written interests of the doctor, for in this chapter I con- 
 in the 
 
 doctor's sider a little, with the aid of some of our great 
 
 interest. . i . i 
 
 leaders in the profession, the qualities which spell 
 success in the medical world. 
 Success in The proportion of men that attain success in 
 
 medicine. i i i • t 
 
 medicine must be measured by the meaning I 
 
SECEET OP SUCCESS IN PEACTICE 199 
 
 attach to the word. If by success we mean earning 
 a living, I may at once answer that a little more 
 than one out of every two, almost three out of five, 
 do this from our London schools. But if by success 
 we mean distinction and cleverness, the proportion 
 is hardly one in twelve of those who study for the 
 profession, and about one in seven of those who 
 enter the profession. 
 
 From this calculation it is obvious that six- 
 sevenths of the profession, if not, indeed, too old, 
 must still feel some interest in the question of real 
 success in medicine, and may, I will hope, be 
 ready to consider any practical suggestions that 
 may help thereto. 
 
 The following proportions of the various classes sir Jamea 
 
 Paget's 
 
 of professional success among the students at propor- 
 tions. 
 
 Bart.'s were, I believe, worked out by Sir James 
 Paget. 
 
 Out of 100 medical students at Bart.'s, it was 
 found, in after years, that 2| per cent, had become 
 distinguished men ; 5 per cent, were accounted 
 clever men ; 50 per cent, were earning a livelihood, 
 but were not distinguished ; 10 per cent, were 
 struggling, but failed to earn a competence ; 15 
 per cent, were absolute failures from various 
 causes, and the rest had died or could not be 
 
200 UNCONSCIOUS THERAPEUTICS 
 
 traced. He says,' after studying the careers of 
 200 of his students : 
 Sir James * Nothing appears more certain than that the 
 
 Paget on ^ 
 
 medical personal character, the very nature, the will 
 
 success. *^ 
 
 of each student had far greater force in deter- 
 mining his career than any help or hindrance 
 whatever.' 
 
 And it is the same now — for the times and the 
 places and the work to be done, and its responsi- 
 Personai bilities, may change; but the value of personal 
 
 character 
 
 determines character wiU ever remain the same, whatever 
 
 success. 
 
 may be the advances in scientific knowledge. 
 
 It is indeed impossible to attach too much 
 weight to such an important and authoritative 
 utterance founded on such data. Such a remark 
 alone is sufficient to justify the stress I lay in 
 this book on the value of personality and upon 
 unconscious therapeutics ; and to endorse the im- 
 portance of any and every effort to bring, to the 
 knowledge of the physician — his own value. Only, 
 here Sir James considers this personality, not as 
 I have hitherto spoken of it in its importance to 
 the patient, but in its value to the doctor himself, 
 as bearing on and determining the man's success 
 in life. In the conclusion he arrives at we see 
 
 ^ Sir James Paget, Selected Essays, p. 32. 
 
SECEET OF SUCCESS IN PEACTICE 201 
 
 that he does not give the palm to scientific skill, The value 
 
 ^ ^ of person- 
 
 nor to profound knowledge, but to personal cha- ^jj^y^^^^ 
 racter as the great factor in success. Once more, taught, 
 then, 1 ask, is it extravagant to believe that some 
 benefit to students would accrue if the subject of 
 this book were included as a part of their profes- 
 sional education; and if, without sacrificing the 
 scientific side, some slight allusion were authori- 
 tatively made to the moral, mental, and social 
 qualifications of the practitioner ? 
 
 We must remember that such teaching is not Quacks 
 
 abound for 
 
 unneeded. Quacks, or rather humbugs, of which want of 
 
 such 
 
 I have spoken in Chapter II., are found in the teaching, 
 profession as well as out of it. 'The quackery,' 
 says Dr. Hooker, ' which is practised among medical j^gf^^^ ^J!^^ 
 men, is a much greater evil than that which is v^ofe^mon 
 abroad among the community. I attack it, there- 
 fore, with an unsparing hand. In doing so I 
 expose many of the tricks and manoeuvres which 
 are employed by those physicians who, pursuing 
 medicine as a trade instead of a profession, study 
 the science of patient-getting to the neglect of the 
 science of patient-curing.' * A mercenary doctor," 
 says Sir William Sanders, * is indeed a creature is abhorred 
 
 of God and 
 
 abhorred of God and man ; ' but still, we may man. 
 venture to observe, is not infrequently in favour 
 
202 UNCONSCIOUS THEEAPEUTICS 
 
 with women ; nor, obviously, is he unknown in the 
 profession. 
 
 With all this we cordially agree, but we must 
 remember that there are amongst us would-be 
 purists, who, instead of merely hunting down such 
 medical quacks on ethical grounds, pursue many 
 of their colleagues vindictively, solely because 
 they run counter to ancient professional lines of 
 demarcation of crusted theories and of pharma- 
 Medicai ceutical therapeutics. There are many high (and 
 are not dry) medical circles in which, even if nothing is 
 quacks. ^^.^^ ^ ^.^^ deprecatory air prevails when natural 
 
 remedies are spoken of and lauded; while im- 
 patience, if not contempt, is hardly restrained if 
 mental therapeutics be even alluded to. 
 
 The combined voice of the schools and their 
 teachers, and that of some of the higher luminaries 
 of the Physicians' College in favour of a merely scien- 
 tific training, have, and rightly so, great weight in 
 the profession ; and a large majority of medical men 
 feel somewhat uneasy at dabbling in any lore that 
 Eminent does not bear their imprimatu7\ It is thus that 
 
 men as . , , i • t 
 
 hindrances, emment men may become hmdrances, m pro- 
 portion to their position, if they do not possess 
 that true greatness which can readily recognise as 
 truth something which they may have never taught 
 
SECEET OP SUCCESS IN PEACTICE 203 
 
 or been taught themselves. It is thus, also, that 
 centres of education may retard knowledge in 
 certain branches of very real professional value, 
 but which are as yet not officially recognised by 
 them. 
 
 Such professional * drags ' as we have de- 
 scribed abound, and are often much en evidence at 
 the meetings of our learned societies. Their influ- 
 ence is often of use ; it is of its abuse that we speak. 
 
 De Styrap well remarks in * The Young Prac- 'The 
 
 , , Young 
 
 titioner : ' ' * The skilful use of medicine is but Practi- 
 tioner * 
 
 one of the many elements that constitute pro- again, 
 fessional skill. You must study mankind as well 
 as medicine, and also bear in mind, when acting 
 upon diseased bodies, that they are possessed with 
 hearts and minds that have strong passions, warm 
 sentiments, and vivid imaginations, which sway 
 them powerfully both in health and disease. To 
 be successful you should fathom each patient's 
 mind, discover its peculiarities, and comport your- 
 self in harmony with all its conditions. Let hope, 
 expectation, faith, contentment, fear, resolution, 
 will, and other psychological aids be your constant 
 levers, for each may at times exercise legitimate 
 power.' 
 
 ^ De Styrap, The Young Practitioner, p. 1, 
 
204 UNCONSCIOUS THEEAPEUTICS 
 
 There can be no doubt that the success or 
 failure of a practitioner depends often just as much 
 on his experience as a medical psychologist as on 
 his skill in drugs. 
 The And is not this the real clue to much that 
 
 perplexing perplexos US with regard to the success of our 
 successes ^^^y^^^,^,^^ 9 often soo, with surprise not un- 
 mingled with envy, some fellow-physician soaring 
 above his friends, and we are greatly puzzled ; for 
 we well know that his professional knowledge of 
 medicine is, perhaps, not so broad nor profound 
 as our own, and yet his waiting-rooms are crowded, 
 while ours are mostly empty. 
 
 Probably, with a professional charity that, 
 alas ! often thinks evil, we solve the difficulty by 
 putting down his success to his cheek, or push, or 
 advertising methods, all of which, of course, we 
 scorn ; or to some lucky fluke that has brought 
 him into repute ; in short, to anything and every- 
 thing rather than to some power in himself, some 
 is the use quality or skill we do not possess. And yet the 
 scious^^" truth may be that his success is really due to the 
 peutics. value of the unconscious therapeutics used by him 
 in benefiting his patients' bodies through influenc- 
 ing their minds in various ways. 
 
 Of course, the man himself may not know the 
 
SBCEET OP SUCCESS IN PEACTICE 205 
 
 cause of his own success, for we are convinced Many 
 
 do not 
 
 there are to-day distinguished ornaments of our knowtho 
 
 secret of 
 
 profession who are quite unconscious of the real their own 
 
 success. 
 
 agent that has placed them in their exalted 
 position ; just as there are, on the other hand, 
 clever men who are equally unconscious of the real 
 cause that has kept them in obscurity ; and yet, 
 surely, truths that have such far-reaching effects 
 in our practice, and are such factors in our success, 
 form an essential part of our medical knowledge. 
 
 Some may object that what we refer to are 
 purely natural gifts, which a man either has or 
 has not, and that it is useless to call attention to 
 matters over which we have no control. But it is not 
 true that we can acquire nothing during life besides 
 what we possess from birth. On the contrary, not ^^cmi 
 
 ^ ^ make up 
 
 only can we, by use and wise direction, greatly in- ^^^j^^f^^j^^^"^^ 
 crease what we have, but we can by practice make 
 up for natural deficiencies in a marvellous way. 
 
 Some undoubtedly have the faculty, as we say, Some have 
 
 these 
 
 instinctively (w^hich simply means by the action of qualities 
 
 instinc- 
 
 the unconscious mind) of adapting themselves, in tiveiy. 
 voice, manner, and expression, to the needs of the 
 patient before them, so that these shall produce 
 their highest therapeutic effects. And there can 
 be no doubt that what is thus instinctive is at 
 
206 UNCONSCIOUS THEEAPEUTICS 
 
 Sir C. 
 Wyndham 
 on the 
 medical 
 man. 
 
 Louis XI. 
 and his 
 doctor. 
 
 once more natural and more effective than what 
 is consciously assumed. It is undoubtedly this 
 natural gift that is the great secret of success. 
 But the man who has not got this may do much 
 to acquire it, once he grasps the value of his 
 personality and of unconscious therapeutics. 
 
 Several of our wisest teachers have laid down, 
 in connection with this, what they believe essential 
 to success in medicine ; and I will quote one or 
 two. On October 1 last year Sir Charles Wyndham, 
 himself a medical man, said : 
 
 ' The medical art is the minister and interpreter 
 of man. Its influence over the lives, thoughts, 
 pursuits, and desires thus laid before you will be 
 enormous. You will be conversant with the simple 
 annals of the poor and the inner lives of the great. 
 You will be welcomed as a friend in the cottage, 
 and you may stand on the steps of a throne — 
 blessed by the lowly ; desired, even sometimes 
 feared, by the mighty. More to Louis XI. than 
 all the remonstrances of his counsellors, the de- 
 nunciation of his confessor, the relics of the saints, 
 or the leaden images of the Virgin above his brow, 
 was the uplifted finger of his physician. And the 
 interaction of body and mind is such that no one 
 can treat the one without treating the other too. 
 
SEOEET OF SUCCESS IN PEACTICE 207 
 
 * There have been some extremists who have 
 held that all bodily states are pm-e creations of the 
 mind ; others that all mental states are merely 
 products of the physical organism ; or, as Condorcet 
 tersely puts it, Virtue is a gas and poetry a 
 secretion." Each of these extreme theories has 
 long since been discarded, and it is now recognised 
 that by processes, mysterious in origin but dis- 
 cernible in action, mind and body determinate and Mind and 
 mould one another ; whilst the empire of medicine mould 
 
 1 • IIP! • n -I T ^^^^^ other. 
 
 dommates both for the preservation of the lives 
 and happiness of its subjects. In exact proportion, 
 therefore, to the vastness and stringency of this 
 empire is the responsibility of its administrators 
 and the need for those essential qualities of watch- 
 fulness, tact, sympathy, and discretion. 
 
 ^ But do not let this seduce you into even the 
 faintest suspicion of misusing the dominion which 
 you will necessarily possess over the lives and in- 
 terests of those committed to your charge — whose 
 habits, modes of thought, and human weaknesses 
 will be an open book to you. It is because this 
 danger is so insidious that the law in its wisdom 
 has placed the relation of doctor and patient in the Kelation of 
 same category as those existing between the priest patient, 
 and penitent, the solicitor and client ; not because 
 
208 UNCONSCIOUS THEEAPEUTICS 
 
 doctors, solicitors, and priests are dishonourable 
 men or undeserving of grateful recognition, but 
 because the mere existence and intimacy of the 
 relation raises of itself the presumption of supre- 
 macy on the one side, subjection on the other. . . . 
 requisites moral roquisites of your calling are summed 
 
 fession^^'^ up in the embracing virtue of loyalty — to your 
 profession, to your patients, and to yourselves. 
 No less exacting, however, are the demands made 
 by your vocation upon the intellectual side of your 
 nature. Never was there a time in the history of the 
 healing art when greater alertness and versatility 
 of mind were required by its practitioners to cope 
 with the ever-increasing rapidity of development.' 
 Dr. Wm. Dr. William Osier, at Toronto, on the same 
 
 Osier on 
 
 medicine, day, spoke in somewhat similar language to that 
 of Sir C. Wyndham : 
 
 * Professional work of any sort tends to narrow 
 the mind, to limit the point of view, and to put a 
 hall-mark on a man of a most unmistakable kind. 
 On the one hand are the intense, ardent natures, 
 absorbed in their studies, and quickly losing inte- 
 rest in everything but their profession, while other 
 faculties and interests rust in them unused. On 
 the other hand are the bovine brethren, who think 
 of nothing but the treadmill and the corn. From 
 
SECEET OP SUCCESS IN PEACTICE 209 
 
 very different causes— the one from concentration, 
 the other from apathy — both are apt to neglect those 
 outside studies that widen the sympathies and 
 help a man to get the best there is out of life. 
 
 *Like art, medicine is an exacting mistress, 
 and in the pursuit of one of the scientific branches 
 — sometimes, too, in practice — not a portion of a 
 man's spirit may be left free for other distractions ; 
 but this does not often happen. On account of 
 the intimate personal nature of his work, the 
 doctor, perhaps more than any other man, needs 
 that higher education of which Plato speaks — 
 that education in virtue from youth upwards 
 which enables a man eagerly to pursue the ideal per- 
 fection," It is not for all, nor can all attain to it ; 
 but there is comfort and help in the pursuit, even 
 though the end is never reached. For a large ma- 
 jority the daily round and the common task furnish 
 more than enough to satisfy their heart's desire, 
 and there seems no room left for anything else.' 
 
 Dr, Weir Mitchell writes,^ as to natural remedies : Dr. 
 
 Mitchell on 
 
 * It would, I think, be found that the best men of success in 
 
 medicine. 
 
 every time were most apt to consider with care the 
 general habits of their patients as to exercise and 
 diet, and to rely less than others on the mere use 
 
 ' Dr. S. Weir Mitchell, Doctor and Patient^ pp. 16, 38, 44. 
 
 P 
 
210 UNCONSCIOUS THEEAPEUTICS 
 
 No trifles 
 to a suc- 
 cessful 
 man. 
 
 Imagina- 
 tive insight 
 a factor in 
 success. 
 
 of drugs.' With regard to personal qualities that 
 lead to success he says : 
 
 * There is a potent combination of alertness in 
 observation with a never satisfied desire to know 
 even the trifles of a case, which, with sagacity, 
 gives a medical mental character as rare as it is 
 valuable. For such men there are no trifles, and, 
 on entering a sick-room, they seem to absorb at a 
 glance matters which escape others, and yet to the 
 end are still so quietly observant and searching 
 that they never seem to be quite content with what 
 they have learned. Not to know surely is to them 
 a form of unhappiness. 
 
 ' I know men who have never suffered gravely 
 in mind or body, who yet have some dramatic 
 power to enter into the griefs of others, and to 
 comprehend, as if by intuition, just what others 
 feel, and hence how best to say and do the things 
 which heal or help. I know others, seemingly 
 as tender, who, with sad experience to aid them, 
 appear to lack the imaginative insight needed to 
 make their education in sorrow of use to their 
 fellows. There are times when all that men can 
 give of sympathetic tenderness is of use. There are 
 others when what you crave is but the outcome of 
 morbid desires for some form of interested attention. 
 
SECEET OP SUCCESS IN PRACTICE 211 
 
 * You may ask too much, and every doctor 
 knows how curiously this persistent claim for what 
 you call sympathy does, as the nurses say, take 
 it out of a doctor.'' ' 
 
 Dr. John Brown says of Sydenham : ^ 
 
 *As an instrument for discovering diseases I 
 have never seen his perspicacity equalled ; his 
 mental eye is achromatic, and admits into the 
 judging mind a pure white light, and records an 
 undisturbed, uncoloured image, undiminished and 
 unenlarged in its passage ; and he has the moral 
 power, courage, and conscience to use and devote 
 such an inestimable instrument to its right end. 
 It appears that physic is one of those departments 
 in which there is frequent necessity for the exercise 
 of an incommunicable faculty of judgment and a 
 sagacity which may be called transcendental, as 
 extending beyond the simple combination of all 
 that can be taught by precept.' 
 
 I close my extracts on this subject with sirj. r. 
 the words of Sir J. Russell Reynolds, which are wTtUe toe 
 
 physician. 
 
 SO helpful, so loftily conceived, and expressed 
 with such felicity, that I quote them at some 
 length, convinced that none can read them without 
 
 * Dr. John Brown, Horce Sicbsecivce, 1st Series, art. * Locke 
 and Sydenham,' 
 
 P 2 
 
212 UNCONSCIOUS THEEAPEUTICS 
 
 feeling their highest impulses quickened and 
 strengthened.^ 
 
 ' You must take far other views than these, and 
 see that, in each sufferer who may come before you, 
 there is an individual history, as interesting as, 
 perhaps more so than, your own; you must see 
 Disease that disease is something far more important and 
 
 never 
 
 wholly far deeper than an aching head, a hurried breath- 
 
 physical. 
 
 ing, or a fluttering pulse ; that disease is something 
 much more serious than the mere interference 
 with the mechanism of physical life ; that the 
 measure of its evil is, not the increased rapidity of 
 pulse, not the daily wasting of the body, nor its 
 numerical frequency in the bills of mortality, but 
 the degree to which it so tells upon the mind, 
 heart, will, and power of man, that it prevents him 
 from doing that work in this world which it has 
 been given him to do. 
 You must < If, then, you would so learn of life as to 
 
 treat the 
 
 man. alleviate its woes, you must not regard your 
 patients as merely interesting clinical phenomena ; 
 you must not look on them as cleverly acting 
 physiological machines, upon which you may 
 experiment for your own diversion ; you must not 
 
 ' Sir J. Eussell Eeynolds, Essays and Addresses, pp. liv, 
 22, 43, 75, 241, 284, 306. 
 
SECEET OF SUCCESS IN PEACTICE 213 
 
 imagine that cases " are brought before you for 
 the purpose of illustrating books, or of proving 
 so-called statistical laws ; that diseases are existing 
 for the sake of teaching you the long names which 
 men have given them, or for the sake of establish- 
 ing this or the other pathological opinion ; that 
 limbs have been created and broken that you may 
 feel the crepitus of fractured bones; or blighted, 
 that the surgeon may display his skill in their 
 amputation. 
 
 * These principles you must learn by means Be human 
 
 ^ ^ ^ ^ ^ ^ and not 
 
 besides those of chemical experiment and dissec- mechanic 
 tion ; you must learn them in the hearts and lives 
 of your fellow-men. You must come to know the 
 meaning of the infant's look, to understand the 
 tone and teaching of its cry. You must appreciate 
 the patience and long-suffering of woman, and the 
 hardihood and rough exterior of man. You must 
 look and see beneath these, if you would measure 
 the true degree of their affliction. You must learn 
 to feel with and understand the feebleness of age, 
 and gain all that is required for your ministration 
 to its wants, from those hints that come to you 
 through the failing powers and closing avenues of 
 a soul that has for a long while battled with a 
 world too rough. 
 
214 UNCONSCIOUS THERAPEUTICS 
 
 Value of < True sympathy will reveal much to you that 
 sympathy. sciencG cannot see ; wherever there is life, there is 
 your field of study ; wherever there is suffering, 
 there is your field of work ; and truly to relieve its 
 burden your spirit must be that of Him whose life 
 was the perfect life — whose presence and word 
 brought peace and health, and into whose work in 
 this world it is our highest aim and highest dignity 
 to enter. 
 
 feH m his ^ knowledge and sympathy that the 
 
 place. jj^ip ig given. Like good actors, you must so 
 throw yourselves into the mental and moral con- 
 dition of those with whom you have to deal, that 
 you think their thoughts and feel their feelings, 
 and so understand their wants and try to fill them. 
 
 * Again, third, your knowledge and your skill 
 must be always ready, not lying in dust-covered 
 books upon your shelves, but always at your 
 fingers' ends. 
 
 Physicians ' Success wiU mainly depend upon yourselves. 
 
 are born . , , 
 
 not made. If it IS true that the poet is born, not made, that 
 dogma is quite as true with regard to the physician. 
 You must be men that your patients and their 
 friends can trust, and do so without knowing it. 
 You must be calm, without indifference ; judicial, 
 without dogmatism ; clear and ready, without 
 
SECEET OP SUCCESS IN PEACTICE 215 
 
 rashness; kind, but with both tenderness and 
 firmness. 
 
 * You will gain your patient's confidence, I be- g^^^^'^y^^^' 
 lieve, by showing that you are more than a physician 
 or a surgeon, and that will be by making him feel 
 you are a man. This is not to be done by yielding 
 to his fancies, nor by the assumption of either 
 superhuman knowledge or any quite exceptional 
 ability ; but by simply showing that you know 
 what he wants, that you can understand his 
 sorrows, and will bring for their relief all that the 
 knowledge of the time has placed within your 
 reach. No one can help you much to do these 
 things — you must learn the art yourselves ; and I 
 am sure that the most direct road to such learning 
 is, first, to forget yourself ; try and throw yourself Forget 
 
 yourself. 
 
 into your patient's condition — for you can if you 
 will — try to understand him and his surroundings, 
 and ask yourself : What would be the thing said to 
 you that would be the most helpful to you if you 
 were in his place ? And then, with the strength of 
 your knowledge, gained by reading and experience, 
 tell him that, and bid him God-speed. 
 
 ' I am sure that, in giving the help we hope and 
 ought to give to suffering and sorrowing man, we 
 shall do nothing worthy of the name unless we 
 
216 UNCONSCIOUS THEEAPEUTICS 
 
 The 
 
 essential 
 factor. 
 
 Sir F. 
 
 Treves on 
 the value 
 of tact. 
 
 realise, and that to the full, the importance of this 
 factor (of religious faith) in our lives and theirs ; 
 and so guide its operation as to help it to hasten, 
 subdue, control, and comfort those to whom it is 
 the minister that they feel to be sent from God to 
 help them in their passage through this region of 
 passing shadows to that of realities which are 
 abiding things.' 
 
 There is one special ingredient of success of 
 which I have spoken elsewhere, but to which I 
 may again briefly advert. I refer to tact. 
 
 Sir Frederick Treves says : * A man may pos- 
 sess all the learning that a well-equipped library 
 may contain, and all the erudition attentive obser- 
 vation in the wards may bestow, and yet be short 
 of complete success as a practitioner of his art. 
 Absolute efficiency cannot be gauged by academic 
 distinction, nor can it be discovered by the touch- 
 stone of the examination table. In the accomplish- 
 ments of the most learned physician there may be 
 one thing lacking, the need of which may stand 
 between him and the fullest equipment for success, 
 and that one thing is a tactful and a sympathetic 
 knowledge of his fellow man. It is possible that a 
 doctor may be acquainted with all that is to be 
 known of the diseases of man, and yet know too 
 
SECRET OP SUCCESS IN PEACTIOE 217 
 
 little of the man himself. Indeed, it is not too 
 much to say that the highest qualifications of the 
 practitioner of medicine are not to be represented 
 by any university degree nor discovered by any 
 system of inquisition.' 
 
 This tact, this knowledge of human nature, 
 combined with wisdom, patience, and skill in deal- 
 ing with disease, require far higher qualities than 
 mere scientific attainments. There are, indeed. Tactless 
 
 men 
 
 men of the highest scientific eminence who are should not 
 
 practise. 
 
 rightly relegated to research and academic lives, 
 for so utterly devoid of tact are they that to let 
 them loose to practise upon their fellow-creatures 
 would be little short of a crime. Tact by no means 
 necessarily goes with the most powerful brain or 
 the most extensive knowledge ; it is, however, a 
 first essential to success. Sir W. W. Gull may be Tact of 
 
 ^ Sir W. 
 
 named as one who was a past master in the art, w. Guii. 
 and many other names will come to the minds of 
 those who have been fortunate to mix with the 
 leaders in our profession. 
 
 Insight in discerning the keynote of the cha- Value of 
 
 ^ e> J insight. 
 
 racters we have to deal with is of the greatest value 
 in practice ; but, on the whole, for those who may 
 not possess this, it is comforting to reflect that, 
 after all, sound judgment and common sense are 
 
218 UNCONSCIOUS THEEAPEUTICS 
 
 the most pre-eminent qualities for a really reliable 
 medical man. 
 
 Minor qualities may be added. Sir William 
 Dalby says ^ that you will be a failure if you do 
 not care for children, and there is much in this. 
 Command Command over the expression of the face is one 
 expression, of these minor helps that may be named. When a 
 patient makes an assertion which seems improbable, 
 or even untrue, no sign of doubting his veracity 
 should be given ; one must be specially careful not 
 even to seem to smile when obliged to hear the 
 most grotesque comparisons made by the patient 
 between his own sensations or pains and those 
 which never have been, nor ever could be, experi- 
 enced by any human being. The most grotesque 
 assertions or statements, such as ' My liver stopped 
 at half-past four this morning,' or complaints con- 
 cerning ' haricot veins,' must be encountered with 
 gravity and fortitude, and a kindly interest given 
 to the most wearisome and pointless, and even 
 nauseous narrations. 
 Do not Such is the role of the successful physician ; 
 
 worship 
 
 the golden but he wlio endures it all merely for the sake of 
 success will soon weary of it, unless he be an in- 
 curable worshipper at the shrine of the golden 
 * Sir W. Dalby, Medicine as a Career, p. 19. 
 
 calf. 
 
SECEET OP SUCCESS IN PEACTICE 219 
 
 calf; while he who sees that in all this he is 
 subserving the highest interests of his patient, and, 
 by winning his confidence and regard, is establish- 
 ing a fulcrum from which he can work his lever 
 of professional skill to lift the sufferer out of the 
 slough of disease, will find nothing common or 
 unclean, but will simply fulfil his duty with its 
 high goal before him. 
 
 All successful doctors are not replicas. The Successful 
 
 men are 
 
 very strength of their personalities which have J^^^j^^^^!^^ 
 raised them to the first rank have at the same practice, 
 time individualised them ; for there are certain 
 mental qualities essential to be a skilful physician. 
 These qualities stamp their impress upon the 
 practice of his profession, and give it its character. 
 I have spoken already of the value of hopeful- 
 ness to the patient. I may quote, in closing, 
 some wise words of Sir Dyce Duckworth on the 
 subject : ^ 
 
 * I speak next of hopefulness in the conduct of sir Dyce 
 
 ^ ^ Duckworth 
 
 diseases as a necessary equipment of all who 
 practise our art. We have — and always have had 
 — optimists and pessimists in medicine. I com- 
 mend neither mood, for it is certain that each may 
 be the outcome of ignorance or inexperience. While 
 
 * Sir D. Duckworth, British Medical Journal, October 3, 190B. 
 
220 UNCONSCIOUS THEEAPEUTICS 
 
 nothing is more damaging to a man's reputation 
 than an unfulfilled evil prognosis, it fares badly 
 with him who, not having recognised indications 
 of danger, has consequently raised false hopes ; 
 yet there is a measure of hopefulness which is 
 always becoming in our duties, which is potent 
 to inspire action and to secure the highest efforts 
 of all engaged in the service of the sick. 
 
 ' Those whose studies lie mainly in morbid ana- 
 tomy and pathological processes may naturally be 
 disposed to pessimism in medicine. We, who study 
 disease in our fellow-creatures, are more inclined 
 to hopefulness, for we, happily, can often recognise 
 a residuum of recuperative power in the body and 
 its organs which, though gravely disturbed, are 
 yet capable of restoration to normal or, at least 
 adequate, functions. 
 
 * Such hopefulness should be carried to the bed- 
 side of the patient, and its power is not small both 
 in reinforcing remedial agents and in promoting 
 recovery. With it lies much of the personal 
 influence exerted by those who succeed well in 
 practice, and the absence of it sometimes explains 
 the failure of others, often able and accomplished, 
 to impress or inspire their patients. Do not 
 imagine for a moment that in thus urging a rational 
 
SECEET OP SUCCESS IN PRACTICE 221 
 
 and wholesome degree of hopefulness in our pro- Hopeful- 
 ness is not 
 
 fessional conduct I am approaching the subject of faith- 
 
 healing. 
 
 that pestilent nonsense called "faith-healing," which 
 in these days of widely spread religious indifference 
 is captivating many silly people. I am much 
 mistaken if Lancashire wits and common sense 
 pay any heed to this American importation. It is 
 truly deplorable to find that the sacred name of 
 Christian is claimed for this method by persons 
 whose education ought to be a safeguard against 
 such preposterous folly. Perhaps the explanation 
 may be found in the sage remark of John Hunter 
 that " everything new carries a greater weight, and 
 makes a deeper impression on a weak mind." We 
 shall do better to take to heart the words of Peter 
 Mere Latham : Medicine, as it begins to touch 
 upon higher interests, even the interests of life 
 and death, should feel itself in alliance with higher 
 motives than any which can be thought to help 
 and quicken its pursuit as a mere science. Medicine 
 claims a sort of moral respect in the handling ; it 
 calls upon the conscience as well as the intellect 
 for more caution to avoid error and more tearful- 
 ness of overstepping the truth." ' 
 
 There is no doubt this message of hope goes 
 like a herald through all the lower regions of the 
 
222 UNCONSCIOUS THERAPEUTICS 
 
 unconscious mind, and through it quickens the 
 action, and probably the metabolism, of every cell. 
 It has been well said that confidence gives rest, 
 hope gives energy. 
 British The ' British Medical Journal,' in an editorial 
 
 Medical ' 
 
 Joimiai comment on Sir F. Treves' Liverpool address, 
 
 on strength ■'■ ' 
 
 in medi- g^yS : 
 cine. ^ 
 
 * Fortiter, fideliter, feliciter — -these three great 
 words make a fine motto at the end of a finely 
 conceived and finely written address. Of the 
 three, we care least for the first. For there is a 
 false strength that does more harm than good — the 
 vanity and self-assurance of the man who loves 
 to manage the case by himself," who dislikes 
 consultation, who watches " cases that ought 
 to have been subjected to a definite line of treat- 
 ment days or weeks before. It is all very well to 
 be masterful and positive ; but the best sort 
 of strength is in the man who often asks for 
 help, and, in the fight against disease, stoops to 
 conquer.' 
 
 To become a typical clinical investigator, such 
 as Sydenham and others, not only intellectual 
 gifts but great moral qualities are necessary. 
 Sydenham more than any other physician made 
 his profession a part of his religion. Dr. Stephen, 
 
SECRET OF SUCCESS IN PRACTICE 223 
 
 President of the College of Physicians of New 
 York, beautifully expresses this idea ; and with 
 his words I may fitly close this chapter : ' The iteiigio 
 
 medicL 
 
 vocation of the practising physician is the spirit of 
 Christianity in action.' 
 
224 UNCONSCIOUS THEEAPEUTICS 
 
 CHAPTER IX 
 
 THE ACTION OF UNCONSCIOUS THERAPEUTICS 
 
 Before giving in this chapter a few instances of 
 the action of unconscious therapeutics generally, 
 Dr. I should like to extract from the Harveian Oration, 
 
 FcrriGr's 
 
 Harveian by Dr. Ferrier, in 1902, an important record of the 
 
 Oration. 
 
 action of mind and thought on the blood vessels 
 and heart : 
 
 ' The most manifest organic expressions of 
 emotion are those in the domain of the circulation 
 with which, for the present, we are more imme- 
 diately concerned. The observations of Binet and 
 Courtier ^ show that every feeling, whether agree- 
 able or painful, acts primarily as an excitant. The 
 passage from the state of repose into the state of 
 activity, intellectual or emotional, causes vaso-con- 
 striction. The stronger the stimulus, the greater 
 the effect, and for this reason perhaps the more 
 painful feelings and emotions, which can be more 
 
 » ' La Vie Emotionnelle/ L'Ann^e Psychologique, 1897. 
 
IN ACTION 
 
 225 
 
 readily experimentally induced, cause more marked 
 vaso-constriction than those that are more agree- 
 able. The heart is accelerated, the respiratory Onthc 
 rhythm is altered, becoming more rapid and more emotion on 
 
 1 • 1 1 T • • cii'cu- 
 
 profound, with obliteration of the respiratory pause, lation. 
 and at the same time there is a general rise of 
 blood pressure.' If the volume of the brain is 
 simultaneously registered by the plethysmograph, 
 as Mosso has described, and Brodie and I have 
 verified, one observes almost constantly an in- 
 crease. This seems to indicate that there is a 
 relation of antagonism between the volume of the 
 brain and that of the extremities. But this is not 
 an absolute rule, for Mosso has observed that the 
 oscillations in the brain volume do not in all re- 
 spects run parallel to those of the extremities, 
 probably owing to local variations in the cerebral 
 blood vessels themselves. 
 
 * Whether the quality of the sensation or emo- 
 tion, as such — that is, whether it be agreeable or 
 disagreeable, pleasurable or painful — is always 
 associated with characteristic and uniform changes 
 in the circulation, is still the subject of considerable 
 difierence of opinion. 
 
 ' It is probable that the discrepancies are largely 
 
 * Binet et Vaschide, L\innee Psycliologi(iuc, 1897. 
 
 Q 
 
226 UNCONSCIOUS THEEAPEUTICS 
 
 Complex conditioned by the fact that the characters of feel- 
 nature of 
 
 pleasure ing are, as maintained by Wundt, much more 
 
 and pain. " *^ 
 
 complex than can be expressed in simple terms of 
 pleasure or pain. For, besides being pleasurable 
 or the reverse (Lust — ^77^^^65^), feelings are exciting 
 or soothing {Erregiing — Berithigung), straining 
 or relaxing {Spa7inu7ig — Lostmg), and vary in 
 intensity. And Brahm maintains ^ that each of 
 these conditions has its specific influence on the 
 circulation. Hence the results may so vary in 
 different individuals that absolute uniformity pro- 
 bably does not exist. 
 Pleasure ' Apart from the suddenness of the change from 
 
 causes 
 
 dilatation, a stato of repose to a state of activity — whether 
 this be indifferent, such as mere surprise, or of a 
 painful or pleasurable character — the balance of 
 evidence is in favour of the view that pleasurable 
 sensations and emotions are accompanied by vas- 
 cular dilatation and low tension, while the contrary 
 are associated with vascular constriction and high 
 tension pulse. This is borne out not only by 
 experiments on normal individuals,^ but by obser- 
 
 * ' Experimentelle Beitrage zur Gefiihlsleliren,' Philosoplii- 
 sche Studien, Bd. xviii. Hft. 1. 1901. 
 
 " Lehmann, Kojjjerliclun Aeusserungen i)sycliischer Zustande, 
 1899. 
 
IN ACTION 
 
 227 
 
 vations on the morbid states of joy and sadness in 
 the typical forms of insanity.^ 
 
 ' The vascular dilatation of pleasurable states of 
 mind is associated with a more active circulation 
 and exaltation of all the vital processes — dynamic 
 and metabolic ; while the opposite condition obtains 
 in states of mental pain. Conversely also, given 
 the vascular and corporeal state, arising spon- 
 taneously or induced artificially, usually associated 
 with any particular mood, trains of thought and 
 states of feeling corresponding therewith are apt 
 to arise in consciousness. This, in all probability, 
 as Lange indicates, is the origin of the use of 
 stimulants and nervines of various kinds, which 
 all nations, and at all times, have discovered for 
 themselves. That wine maketh merry the heart 
 of man " is only a more picturesque statement of 
 the truth I am endeavouring to convey in more 
 didactic style. 
 
 ' Pleasurable and painful emotions are thus not 
 merely subjective states of consciousness, but at 
 the same time objective corporeal conditions of 
 exalted or depressed vital energy respectively, 
 
 ^ Dumas, La Tristesseet la Joie, 1900; Broadbent, TJie Pulse, 
 1890 ; Maurice Craig, ' Blood-pressure Supply in Mental Plea- 
 sure and Pain ' (Dublin Journal of Mental Science^ February 
 1900), 
 
 q2 
 
228 UNCONSCIOUS THERAPEUTICS 
 
 which manifest themselves not only in outward 
 attitude and gestures, but in the relative power of 
 the organism to withstand debilitating agencies of 
 all kinds. . . . 
 
 Emotions < As all the emotions, however complex, are 
 
 have more 
 
 effect than founded Ultimately on the effective tone accompany- 
 oniy. ing the exercise of the organs of sensation in all 
 their relations, visceral and somatic, the emotional 
 and sensory substrata are one and the same. And 
 it is not improbable that each organ has its own 
 affective tone, its own centre, and contributes its 
 own share to the general emotional result. Whether 
 the feelings are conditioned from within or with- 
 out, by presentation or representation, the effect 
 on the circulation is the same. That which seems 
 to constitute the chief difference between simple 
 feelings and emotions is the relatively greater 
 influence of the latter as compared with the former. 
 Emotions are unitary composites of simple feelings, 
 and the resulting aggregate is much more power- 
 ful than any one of its individual elements. Fear, 
 which is mental pain, causes greater acceleration 
 of the heart, greater vascular constriction, and 
 greater pallor than can be induced by mere physical 
 pain. Not only is the circulation profoundly 
 affected, but there is a tendency to irradiation 
 
IN ACTION 
 
 229 
 
 beyond the cardiac and vasomotor into all the 
 splanchnic functions; so that we observe, inter 
 aliay profuse perspiration, horripilation, and move- 
 ments of the abdominal and pelvic viscera, which 
 can rarely, if ever, be reflexly induced by any 
 degree of peripheral stimulation. In its more Fear may 
 intense forms it may for ever arrest the heart- 
 beat, or so break down all the protective mechanism 
 of the organism that flight, defence, or other means 
 of adaptation are rendered impossible, and the 
 animal falls an easy victim to the danger assail- 
 ing it. 
 
 *When we inquire by what mechanism the 
 centres of thought and feeling influence the heart 
 and blood vessels -whether there are cortical, 
 cardiac, and vasomotor centres, properly so called, 
 or whether the cerebral hemispheres act only 
 indirectly upon the cardiac and vasomotor centres 
 of the medulla oblongata— we come upon a subject 
 on which, in the present state of our knowledge, 
 it is necessary to speak with caution, avoiding too 
 confident or dogmatic assertion. Several observers Mode of 
 (Schiff, Bochefontaine, Danilewsky, and others) unknown, 
 have described variations in the rate of the heart 
 and tone of the blood vessels as resulting from 
 irritation of various portions of the cerebral hemi- 
 
230 UNCONSCIOUS THERAPEUTICS 
 
 spheres, particularly the motor area, or adjoining 
 region.' 
 
 This research, exhaustive as it is, stops at the 
 question of detailed psychophysical action, and 
 certainly falls far short of explaining, on psycho- 
 physiological grounds, the phenomena I shall 
 
 "We mast 
 
 record. There can indeed be no doubt that until 
 more i^ght. we have a far clearer understanding of the modiis 
 operandi of the unconscious mind in health, the 
 method of interaction of mind and body, and the 
 way in which the body as a whole lives, we cannot 
 expect to understand the manner in which the 
 stimulation of the mind in various ways can be 
 made to arrest or undo morbid processes, and even 
 to repair organic lesions. The use of unconscious 
 therapeutics is, and must be in the present state of 
 our knowledge, almost entirely empirical, being in 
 this only on a par with a large variety of drugs 
 and other therapeutical agencies. 
 Dr. A. T. Speaking of the power of unconscious thera- 
 
 Myers on . . -r^ * m n «■ . x • • 
 
 uncon- peutics. Dr. A. T. Myers says : * In exammmg a 
 thera- patient in a modern hospital, we rely on observable 
 peutics. measurable facts, less on the patient's own 
 
 statement of what he feels, least of all on his 
 theories how he came to feel it. In doctoring him 
 we rely much on definite operations, and on those 
 
IN ACTION 
 
 231 
 
 few drugs whose action on the body we can prove ; 
 little on the patient's prayers for recovery, least of 
 all, perhaps, on the encouraging words we throw in. 
 Yet cures have always been effected by other than 
 physical means. Either these can be referred to 
 physiological means which have escaped detection, 
 or they cannot, and have a psychical basis.' 
 
 The effect on the patient's mind varies, of Temi^era- 
 course, much with the patient's temperament, as, SSs 
 
 . mental 
 
 mdeed, all know. Moreover, those acquamted thera- 
 peutics. 
 
 with the natural history of disease know well 
 that a particular malady in a patient of sanguine 
 temperament may be looked on more favourably 
 (for psychical reasons) than in one of a phlegmatic 
 constitution. In the former case we can rely on a 
 resiliency which will fail us at the critical moment 
 in the other. 
 
 Still, in all there is some response to psychic 
 measures ; and yet, as Myers says, the physician, 
 even if he uses these, generally despises them. 
 ^ The Young Practitioner ' observes : ' New or novel 
 remedies often aid the cure through mental 
 influences. Many sound practitioners of the legi- Many 
 
 sound 
 
 timate orthodox school prescribe valuable true practition- 
 ers con- 
 remedies, but give them just as they would ciemned. 
 
 administer them to an animal ; as if their only 
 
232 UNCONSCIOUS THBEAPEUTICS 
 
 duty consisted in telling the sick what drugs to 
 swallow ; and they seem to despise the aid of 
 faith, hope, and mystic expectation.' 
 Examples But to tum to examples of the force of un- 
 
 of uncon- 
 
 sciouB conscious therapeutics. Some of the followinsj 
 
 thera- ^ ^ 
 
 peutics. instances have been recorded before, but doubtless 
 are new to most of my readers, and they could, of 
 course, be multiplied many times from the experi- 
 ence of others. Indeed, we may say that there is 
 not a single medical man who reads these pages, 
 w^ho has been in practice for any length of time, 
 but can, if he will, adduce from his own experience 
 decisive examples of the beneficent action of 
 unconscious therapeutics. 
 A case of The followin^' is a very interesting case. Sir 
 Grainger Thomas Grainger Stewart says : ' In heart disease 
 
 Stewart'Ss 
 
 the most important element is rest. Second in 
 importance is, perhaps, the element of hope. If a 
 patient becomes persuaded that he may recover, 
 that good compensation may be established, he 
 becomes more hopeful about himself, and his heart 
 benefits correspondingly. If a patient is gloomy 
 and despondent, this damages the organ in a way 
 we cannot at present fully explain.' 
 Lady cured A lady Suffered from organic heart disease, and 
 her re'a^son. rapidly developed dropsy, from distress at the 
 
IN ACTION 
 
 233 
 
 misconduct of her husband, and was m imminent 
 peril of death. At this crisis she lost her reason. 
 The disturbing mental factor (distress of mind) 
 being eliminated, the balance of the labouring 
 circulation quickly righted itself.' This is a very 
 remarkable and rare illustration of unconscious 
 therapeutics. 
 
 Emotions generally both cause and cure diseases. Effects of 
 
 joy and 
 
 Joy causes and increases palpitation of the heart fear, 
 by intensified * vital ' action ; terror does the same 
 in another way, both being what Wundt calls 
 * exciting ' feelings. 
 
 As an illustration of what terror can do in Death 
 
 from fear. 
 
 inhibiting the action of the heart we may quote 
 the case of the artillery recruit who died at Douai 
 last year from a bath. He was in good health, 
 but always declared a bath would kill him. Some 
 comrades thereupon stripped him, and put him 
 into the water. When he was lifted out he was 
 dead, and ^ post-mortejyi revealed no organic cause 
 of death. 
 
 As a general principle, as we saw in the 
 Harveian Oration, pleasurable emotions increase 
 the vital functions, and painful ones depress 
 them. 
 
 The action of the heart is greatly affected by 
 
234 UNCONSCIOUS THEEAPEUTICS 
 
 Heart's 
 
 action 
 
 altered. 
 
 Anaesthe- 
 sia and 
 hyper- 
 testhesia. 
 
 Pain 
 inhibited 
 by mind. 
 
 emotions through the sympathetic system ; it is 
 quickened or slowed, or even stopped, by mental 
 shock, through the tenth nerve. 
 
 The movements of the heart are altered, and 
 peculiarities of the beat are exaggerated, when 
 attention is closely fixed upon it. There is little 
 evidence, however, that mind can produce more 
 than functional disturbance of the heart. 
 
 Some instances of feelings stopped or altered 
 by mental action, mainly unconscious, may now 
 be given. 
 
 Anaesthesia is common with melancholies ; 
 hypersesthesia with neurotics. Both insensibility 
 and pain are common in mental diseases. 
 
 Soldiers in victory remain practically insensible 
 to cold and other painful feelings. Hunger and 
 thirst are modified by the condition of the mind. 
 Thirst is often removed by the attention being 
 diverted. On the other hand, it is very common 
 among soldiers at the beginning of a battle. 
 Troops on active service seldom feel any pain in 
 their wounds until the fight is over. 
 
 Carpenter says (and the writer can bear most 
 emphatic testimony to the same fact) that he has 
 often found in speaking, when suffering from severe 
 rheumatic pain, that it has entirely ceased to be 
 
IN ACTION 
 
 235 
 
 perceived until he sat down, when it returned in 
 full force. 
 
 Pains, it is well known, go when the doctor 
 comes, and toothache ceases in the dentist's room. 
 Dr. Carpenter discusses the question in such Dr. 
 
 . Carpenter 
 
 mstances as to whether the pam has been con- discusses 
 
 the modus 
 
 sciously felt, though not remembered. He rightly ojperandi. 
 considers this as a mere assumption ; for, although 
 changes may occur in the sensorium, they cannot 
 be said to be felt without consciousness. 
 
 During the O'Connell agitation in Ireland, Lord Lord 
 
 Anglesey's 
 
 Anglesey, who had suffered for years continuously neuralgia, 
 from tic-douloureux, was quite free from pain. 
 
 A woman was brought on a couch into the 
 London Hospital by two ladies, who said she had 
 been suffering from incurable paralysis of the spine 
 for two years ; and, having exhausted all their 
 means in nursing her, they now sought to get her 
 admitted, pending her removal to a home for 
 incurables. In two hours she was relieved by Cure of 
 
 1-1 Till - • hysterical 
 
 agencies which owed all their virtue to their in- paralysis, 
 fluence on the mind, and I walked with the woman 
 briskly up and down the waiting-room ; and she 
 then returned home in an omnibus, being com- 
 pletely cured of her paralysis. 
 
 An amusing case is that of a paralysed girl, 
 
236 UNCONSCIOUS THEEAPEUTICS 
 
 Also by a who, OH learning that she had secured the 
 
 curate. 
 
 affections of the curate who used to visit her, 
 got out of bed and walked — cured ; and afterwards 
 made an excellent pastor's wife. 
 
 A remarkable instance of this sort of cure is 
 that of a child afflicted with paralysis, who was 
 brought up from the country to Paris to the Hotel- 
 Dieu. The child, who had heard a great deal of 
 the wonderful metropolis, its magnificent hospitals, 
 its omnipotent doctors, and their wonderful cures, 
 Also by was awe-struck, and so vividly impressed with the 
 
 doctor's 
 
 presence, idea that such surroundings must have a curative 
 influence that the day after her arrival she sat up 
 in bed much better. The good doctor just passed 
 round, but had no time to treat her till the third 
 day, by which time, when he came round, she was 
 out of bed, walking about the room, quite restored 
 by the glimpses she had got of his majestic 
 presence. How easily instances of the thera- 
 peutic value of the professional presence alone 
 could be multiplied ! 
 
 I have already alluded to the following case, 
 which I now give more fully : 
 
 Cure of A patient, about seventy years of age, came to 
 
 obstinate 
 
 constipa- ^le in deep distress about her obstinate constipa- 
 tion ^ 
 
 tion from paresis of the rectum, which was so 
 
IN ACTION 
 
 237 
 
 severe that every enema and pill had failed, and 
 mechanical evacuation was the last resource. This 
 condition had continued for some years, a trained 
 nurse living in the house. 
 
 The patient was of exceptionally powerful mind 
 and will, and remarkable intellect. Seeing this, 
 I relied upon the clock as an efficacious aperient. 
 I explained the power of an exact habit over the 
 bowels, and told her she would be cured if at 9.30 
 exactly by the clock on the mantel -piece she sought 
 relief each morning. She was at first aided artifi- by the 
 
 clock. 
 
 cially at the exact hour ; but after a few mornings, 
 when 9.30 arrived and she was taken out of bed, 
 a natural action was obtained ; only she sometimes 
 wanted to relieve the bowels before the hour. This 
 was never allowed ; she was told that to be too 
 soon would prevent the cure as much as being too 
 late. At the end of six weeks the bowels were 
 daily relieved without medicine, at half-past nine 
 exactly, by the power of the unconscious mind; 
 and at the end of six months she had never missed 
 a day. She has now no further trouble. This is 
 a remarkable instance of the action of unconscious 
 therapeutics in the decline of life. 
 
 A young lady tottered into an out-patients' Hysterical 
 
 dysphagia. 
 
 department of one of our large London hospitals, 
 
238 UNCONSCIOUS THEEAPEUTICS 
 
 not long since, followed by her mother in an agony 
 of mind, having an open tin of ' Brand's ' in one 
 hand and a spoon in the other. She had brought 
 this because her daughter was dying from a con- 
 traction of the gullet, and she wished to show us 
 that not even a little jelly could be swallowed. 
 
 The girl was reduced to a skeleton, and would 
 certainly have died from neuromimesis if not 
 relieved ; for there can be no doubt that people 
 die solely from hysterical affections, though some 
 may question it. After using appropriate means 
 to affect the mind indirectly, in about half an hour 
 Cured on the patient was sitting in one of the wards eating 
 
 the spot, 
 
 a large plateful of boiled mutton, potatoes, and 
 turnips, with ^ hospital pudding ' to follow. 
 
 It is cases like these, when seen by men 
 wholly ignorant of the powers, and perhaps of the 
 existence, of the unconscious mind, that are 
 necessarily considered fraudulent and the patients 
 ' malingerers.' 
 
 The ' Lancet ' records a case of Dr. Barkas's, of 
 a woman (58) with supposed disease of every 
 organ, with pains everywhere, who had tried every 
 Cure of method of cure, but was at last experimentally 
 eases by cured by mental therapeutics, pure and simple. 
 
 purewbiter 
 
 Assured that death would result from her state. 
 
IN ACTION 
 
 239 
 
 and that a certain medicine would infallibly cure 
 her, providing it was administered by an expe- 
 rienced nurse, one tablespoonful of pure distilled 
 water was given her at 7, 12, 5, and 10, to the 
 second, with scrupulous care ; and in less than 
 three weeks all pain ceased, all diseases were 
 cured, and remained so. This is a valuable 
 experiment, as excluding every material remedy without 
 
 any 
 
 whatever, and proving that the mental factor material 
 
 remody. 
 
 alone can cure as well as when it is associated 
 with material remedies. This incidentally gives 
 also another illustration of the therapeutic power 
 of the clock. 
 
 Kant was able to forget the pain of gout by Kant could 
 
 forget 
 
 voluntary effort of thought ; but it always caused a gout, 
 dangerous rush of blood to the head. 
 
 Braid's able experiments in hypnotism prove 
 that every variety of feeling may be excited by the 
 mind, *such as heat or cold, pricking, creeping, 
 tingling, spasmodic twitching of muscles, catalepsy, 
 a feeling of attractive or repulsive sights of every 
 form and hue, odours, tastes, and sounds in endless 
 variety, and so on, according as accident or inten- 
 tion may have suggested them.' 
 
 Bouchet tells us • that the physicians of Mont- 
 * Moore, The Power of the Soul over the Body, p. 369. 
 
240 UNCONSCIOUS THEEAPEUTICS 
 
 Cruel pellier had two criminals delivered to them every 
 
 death of a 
 
 criminal year, after the horrible Eoman fashion, for vivi- 
 
 from fright. 
 
 section. On one occasion they tried what effect 
 would follow from mere expectation of death in a 
 perfectly healthy person. They told the subject 
 of their experiment that they would take the 
 easiest method of destroying his life by opening 
 his veins in warm water. They therefore blind- 
 folded him, set his feet in water, pricked instead of 
 lancing them, and then continued to speak to each 
 other as if they saw the life and blood ebbing 
 together. The man sat still ; when they un- 
 covered his face, he was dead. 
 
 I have given some similar cases in the ' Uncon- 
 scious Mind.' 
 
 Powers of By hypnotic suggestion blisters on the forehead 
 scious have been produced by stamp paper. 
 
 mind in . i t 
 
 hypnotism. Agam, two blisters, one upon one arm and 
 another on the corresponding part of the other 
 arm in the same individual, have in this manner 
 been produced, but with the suggestion that 
 one would rapidly heal without pain, while 
 the other would become inflamed and painful ; 
 and the suggestions have been perfectly carried 
 out. 
 
 In arresting slight hemorrhage mental shock is 
 
IN ACTION 
 
 241 
 
 undoubtedly efficacious, and a living toad or a cold 
 
 doorkey is successful in stopping it. 
 
 Will power, consciously exercised, often fails to Unconsci- 
 ous mind 
 
 act, but cures if unconsciously exerted. For stops 
 
 cough. 
 
 example, I had a young niece with a most 
 obstinate hacking cough. One day, when I took 
 her to the Crystal Palace, I found that no effort of 
 hers, even assisted by vigorous scoldings, served 
 to stop her constant coughing. Coming home, 
 however, the novel plan of offering one penny for 
 each station she reached without coughing was 
 entirely successful all the way. 
 
 Dr. Buckley records the following case. A Eheuma- 
 doctor was called to see a lady with severe rheu- by uncon- 
 
 scious 
 
 matism, and tried to extemporise a vapour bath in tiiera- 
 bed with an old tin pipe and a tea-kettle ; and ^^^^^^^* 
 only succeeded in scalding the patient with 
 the boiling water proceeding from the over-full 
 kettle through the pipe. The patient screamed, 
 * Doctor, you have scalded me ! ' and leaped out 
 of bed. But her rheumatism was cured, and did 
 not return. 
 
 Speaking of cures of rheumatism and heart Psychic 
 
 , cures at 
 
 disease at Nauheim, Dr. Leith, in his lectures at Nauheim. 
 Edinburgh, in 1896, on pathology, was ' inclined to 
 doubt whether all the benefits of this spa were not, 
 
 R 
 
242 UNCONSCIOUS THEEAPEUTICS 
 
 after all, to be explained largely, if not entirely, by 
 the influence of the mental factor,' a suggestion, 
 however, which, with all my bias, I cannot alto- 
 gether accept. 
 
 Unconsci- At the annual meeting of the British Medical 
 
 ous thera- 
 peutics ill Association in 1902, the following suggestive table 
 
 surgery. ^ 
 
 of the action of unconscious therapeutics in sup- 
 posed uterine disease, was given (published in the 
 Journal on October 11, 1902) : 
 
 1. Abdominal section ; no disease found ; patient 
 informed ; nothing removed ; patient apparently cured. 
 
 2. Abdominal section ; tuberculous condition ; 
 nothing removed ; patient apparently cured. 
 
 3. Abdominal section ; fibroid condition (uterus, 
 ovaries, or other organ) ; nothing removed ; patient 
 apparently cured. 
 
 4. Abdominal section ; no disease found ; nothing 
 removed ; patient not informed ; patient apparently 
 cured. 
 
 5. Abdominal section ; no disease found ; patient 
 and friends informed ; patient apparently not bene- 
 fited. 
 
 6. Patient under anaesthetic ; no section done ; 
 patient apparently cured. 
 
 7. Abdominal section ; appendages removed ; patient 
 apparently cured. 
 
 8. Abdominal section ; uterus removed ; patient 
 apparently cured. 
 
 9. Abdominal section ; appendages removed ; patient 
 sent to asylum. 
 
IN ACTION 
 
 10. Abdominal section ; uterus removed ; patient 
 sent to asylum. 
 
 11. Abdominal section; tuberculous condition; 
 nothing removed ; patient not cured. 
 
 It will be seen in cases 1-4 the patient was 
 apparently cured by the mental effect of the 
 abdominal section. In case 6 by the mere 
 anaesthetic and the idea of abdominal section. In 
 7 and 8 something was done ; but it is open, of 
 course, to question, in the light of 1-4, whether 
 the patient would not have been ' cured ' without. 
 
 I have put * cured ' in inverted commas, what does 
 because here, and throughout, the word is used to mean ? 
 mean the cessation of all symptoms, not necessarily 
 the complete restoration of the organic condition. 
 After all, this is a cure ; for an organic change 
 that produces no symptoms is, to the patient, 
 non-existent. Many doctors, as I have shown, 
 set up * diseases ' or symptoms by calling attention 
 to some organic defect that hitherto has produced 
 no inconvenience. 
 
244 UNCONSCIOUS THERAPEUTICS 
 
 CHAPTEE X 
 
 ON THE STUDY OF UNCONSCIOUS THERAPEUTICS 
 
 I SHALL in this chapter in the first place look a 
 little at the vast amount of exaggeration, and in 
 some cases fraud, which is so mixed up with the 
 science of Mental Therapeutics, and constitutes, 
 undoubtedly with many, a drawback to its study. 
 I am persuaded this is due, to a large extent, to 
 the fact that this science is nowhere systematically 
 taught, and so cause and effect form a vicious 
 Tho circle. The vicious circle is a familiar phenomenon 
 circle.^ in hysteria. In this case an important subject is 
 not taught because surrounded by fraud, and it is 
 surrounded by fraud because it is not taught. It 
 is discouraging that this state of things should be 
 possible in this twentieth century; the difficulty 
 should but serve as an incentive for study if rightly 
 study of considered ; for neglect of study because of fraud is 
 
 mind 
 
 is the a very poor excuse, and fraud because of ignorance 
 is the natural sequence. There can be no doubt that 
 
ITS STUDY 
 
 245 
 
 in the radiance of the true light false lamps pale 
 and vanish. Quackery will and must continue 
 to flourish as long as the profession ignores and 
 refuses to teach this great branch of the healing 
 art. On the other hand, in proportion as it is Scicnco 
 
 will 
 
 intelligently taught, and its laws and their limits displace 
 
 super- 
 ascertained, the fictions and frauds which have so stition. 
 
 largely obscured the subject will disappear, or at 
 any rate lose much of the power they have at pre- 
 sent with intelligent people. 
 
 I shall subsequently speak further of the needs 
 of study and teaching on the subject, and of 
 methods by which unconscious therapeutics may 
 be learned. 
 
 The following expose will give some idea of the a general 
 
 , , expose of 
 
 amount and variety of the quackery with which our quack 
 
 methods. 
 
 subject is at present encumbered, and is of especial 
 interest, as all through the reader cannot fail to 
 observe that the truth is continually appearing 
 through clouds of folly and exaggeration. 
 
 Speaking ironically of some extravagances of 
 mental and spiritual science (so called), a well- 
 known writer says : ^ 
 
 * One group proceeds as follows : First, the First 
 
 group. 
 
 human mind must somehow be able to perceive 
 
 * Hugo Miinsterberg, Psychology and Life, pp. 232, &q. 
 
246 UNCONSCIOUS THEEAPEUTICS 
 
 in an incomprehensible way the ideas and thoughts 
 of others. By gradual approaches this telepathic 
 talent seems also connected with the power to have 
 knowledge of distant physical occurrences ; and if 
 our concessions have reached this point we ought 
 not to strain at the little addendum, the vision of 
 the future. 
 
 Second * A second group of mystical powers may be 
 
 group. 
 
 formed by the corresponding active influences. 
 In an inconceivable way, it is assumed, the human 
 mind can control the thoughts and actions of 
 others ; and here, again, small steps lead soon to 
 greater and greater mysteries. 
 
 * With another group the mental influence may 
 reach not only the soul, but also the body of the 
 other person, and may restore his disturbed 
 health ; even a child may produce such meta- 
 physical healing of consumption and heart disease, 
 cancer and broken legs. The mind which by 
 " love " brings together the fragments of a neigh- 
 bour's broken bones ought surely to have no serious 
 difficulties with the movements of inorganic bodies ; 
 at the bidding of such a mind tables fly to the 
 ceiling, and a little stick in the hands of a weak 
 woman cannot be moved by the strongest man. 
 JrouD group refers to the functions of a 
 
ITS STUDY 247 
 
 deeper self, which is usually hidden under our 
 regular personality. In the most different trance 
 states, in crystal vision and automatic writing, 
 this mysterious self appears and remembers all 
 that we have forgotten, knows many things that 
 we never knew, writes and acts without our con- 
 trol, and shows connections which go far beyond 
 our powers, and mostly even beyond our tastes. 
 Nearly related to these facts is a fourth circle of 
 mystical doctrines, which deal with the psychical 
 deeds of human spirit after the earthly death. 
 
 * We must carefully consider where the mystery 
 begins. The attitude of common sense, however, 
 must not be allowed to dictate this line of demar- 
 cation ; otherwise the psychologist woulu be bound 
 to denounce all facts which are rare and surprising 
 to the native consciousness, or incapable of expla- 
 nation to the dilettante. 
 
 * . . . We may pass on to another main group of Fourth 
 
 group. 
 
 personal influences, the therapeutical ones. The 
 man of common sense is more suspicious of fraud 
 in this field than anywhere else, and yet the 
 psychologist must here concede if possible a greater 
 part of the claimed facts than in the other domains 
 of mysticism. He will reject a good deal, it is 
 true, and in acknowledging the rest of the facts he 
 
248 UNCONSCIOUS THERAPEUTICS 
 
 will not think of committing himself to the theories ; 
 yet he must feel sorry that truth demands from 
 him the acknowledgment of anything, not because 
 he thinks himself bound to advertise the regular 
 practising pliysician, but because he knows how 
 these facts carry with them a flock of contagious 
 confusing ideas, 
 methods of ' To-day the passive method of indirect sug- 
 suggestioi^. gestion is the vehicle of the Christian Scientists 
 ! and metaphysical healers ; the active way of more 
 "" "^^ ..^^^ direct suggestion belongs to the mind curers and 
 mental healers. 
 ^ * To murmur the Greek alphabet with the touch- 
 ing intonation and gesture of supplication is as 
 strengthening for the health as many of their in- 
 vocations for the man who believes in the meta- 
 physical cure ; it may be quite unimportant whether 
 the love-curer at his bedside thinks of the psychical 
 Absolute, or of the spring hat she will buy with the 
 fee for her metaphysical healing. From the psy- 
 chological point of view, the direct method and 
 healing by love are thus almost identical ; both 
 are confined to the narrow limits within which the 
 nervous system influences the pathological pro- 
 cesses. 
 
 ' If the glaring light of criticism is thrown on 
 
ITS STUDY 249 
 
 the twilight literature of mental healers, the effect Light on 
 
 quack 
 
 is often surprising. Some of the facts " prove literature, 
 to be simply untrue, having grown up through 
 gossip and desire for excitement, through fear and 
 curiosity, through misunderstandings and imagina- 
 tions. Another set of the facts " turns out to be 
 ' true, but not mysterious ; being merely a checkered 
 field of abnormal mental phenomena, such as 
 belong to hypnotism, somnambulism, hysteria, 
 insanity, hyperaesthesia, automatic action, and so 
 forth. 
 
 * Another large group is based on conscious and 
 unconscious fraud, from the mildest form down, 
 through a long scale, to the boldest spiritualistic 
 forgery, such as described in Eobert Browning's 
 Sludge the Medium." If we take away these 
 three large groups, there is a remainder which 
 may deserve discussion as to its interpretation. 
 
 ' Consider how, again and again, the honoured 
 leaders of mystical movements have been un- 
 masked as cheap impostors, and their admired 
 wonders recognised as vulgar tricks ; how tele- 
 pathic performances have been reduced to a simple 
 signalling by breathing or noises ; and how seldom 
 disbelievers have interrupted a materialisation 
 seance without putting their hands on a provision 
 
250 UNCONSCIOUS THEEAPEUTICS 
 
 of beards and draperies. Think of all this, and 
 the supposed facts dwindle more and more. 
 Quacks < These claims to mystic powers have been dif- 
 
 quarrel 
 
 among ferent at different periods and in different nations, 
 
 them- ' 
 
 selves. Q^Yid are still so divergent that no scientist can 
 contend more sharply with the mystical creeds 
 than they contend with one another in the different 
 sets to-day. The telepathists annihilate the theo- 
 sophists, and the spiritualists belittle the tele- 
 pathists ; and when the Christian Scientists and 
 metaphysical healers on the one side, the mind 
 curers and the faith curers on the other side, have 
 spoken of each other, there remain few abusive 
 words at the disposal of us outsiders.' 
 
 Aresi- There is no doubt, as the writer says, that 
 
 duum of 
 
 truth there is a residuum of truth in all this fraud, and 
 
 beneath 
 
 it all. truth is ever precious ; and gold is not the less 
 gold, however it be mixed with dross. I have 
 already endeavoured to give the facts which show 
 the power of unconscious therapeutics in medicine, 
 and they are few and simple. 
 
 But the fancies and fictions that surround and 
 distort them are innumerable. Amongst these we 
 may include a very large batch from America. 
 One would suppose superstitions and credulity 
 would flourish rather amongst the old and effete 
 
ITS STUDY 
 
 251 
 
 nations of Europe than amongst the young and Quackery 
 
 nourishes 
 
 vigorous sons of freedom in America. But it is in America, 
 not so ; for proHfic and novel forms of faith heal- 
 ing, mind healing, higher health and higher 
 thought healing. Christian and mental science 
 healing, spiritualistic and hypnotic healing, coupled 
 too often with the grossest exaggerations and 
 absurdities, we have to go to the United States 
 of America. We have a few indigenous growths, 
 but they are sickly and respectable compared 
 with these outrageous Transatlantic products that 
 flourish like the green-bay tree. 
 
 Quack remedies, as a whole, are, naturally, Quackery 
 divided into two classes, the older and more re- kinds, 
 spectable in some ways being represented by patent 
 medicines, any psychic element being kept in the 
 background ; the newer is profoundly psychic, and 
 includes all sorts of (American) science schools. 
 
 With regard to the former. Dr. Hutchison Dr. iiut- 
 
 . . , - chison on 
 
 made some interestmg remarks at the London patent 
 
 . , medicines. 
 
 Hospital, from which we make a brief extract : ^ 
 
 * He advocated a Committee of the British Futile 
 
 TVT T 1 * • • • • • remedies. 
 
 Medical Association to inquire into the composition 
 of these so-called remedies, and to expose them. 
 
 * In the meantime, however, they must all do 
 
 * See British Medical Joitrnal, December 26, 1903. 
 
252 UNCONSCIOUS THBEAPEUTICS 
 
 what they could in their private capacities to fight 
 the evil. The public looked to the medical pro- 
 fession for guidance in these matters, as in every- 
 thing relating to health. If necessary, the public 
 must be educated in the elements of physiology, 
 and the process must be begun in the higher ranks 
 of life, for quackery was not confined to any par- 
 ticular section of the community ; it was certainly 
 as rife in Belgravia as in Bethnal Green. The 
 upper classes, the so-called cultured classes, be- 
 lieved in patent medicines and quackery to an 
 extent which was almost incredible. Dr. Hutchison 
 concluded his lecture by pointing out that it ought 
 never to be possible for a patent medicine vendor 
 to say with truth that he had succeeded in curing 
 a case where a doctor had failed. That meant that 
 practitioners must give more attention to the treat- 
 ment of disease, and particularly to the treatment 
 of minor ills, than they did at the present time.' 
 
 Composi- The following particulars were given by Dr. 
 
 quack Hutchison as representing the approximate in- 
 
 remedies. . . 
 
 gredients of various patent and proprietary pre- 
 parations : 
 
 Beecham's Pills : Aloes, ginger, and soap. 
 Bile Beans : Cascara, rhubarb, liquorice, and ol. 
 menth. pip., coated with gelatine. 
 
ITS STUDY 
 
 253 
 
 Cockle's Pills : 
 Barclay's Pills 
 
 Aloes, colocynth, and rhubarb. 
 
 Carter's Little Liver Pills : Podophyllin (gr. ^) and 
 aloes soc. (gr. ^) in each pill. 
 
 HoUoway's Pills : Aloes, rhubarb, saffron, Glauber's 
 salts, and pepper. 
 
 Page Woodcock's Wind Pills : Aloes, ol. carui, and 
 soap. 
 
 Eno's Fruit Salt : Sodium bicarbonate, tartaric and 
 citric acids. 
 
 Lamplough's Pyretic Saline : Citric acid, with 
 potassium and sodium bicarbonates. 
 
 Keating's Cough Lozenges : Ipecacuanha, lactu- 
 caria, squill, liquorice, tragacanth, and sugar. 
 
 Owbridge's Lung Tonic : Balsam of tolu, oil of 
 aniseed, and oil of cloves. 
 
 Trilene Tablets : Sugar and a vegetable constituent 
 of unknown nature. 
 
 Mrs. Allen's Hair Eestorer : Lead acetate, milk of 
 sulphur, scented with oil of cinnamon. 
 
 Tatcho : Purified oil of paraffin and essential oil of 
 lemon. 
 
 Koko : Borax, glycerine, and rose water. 
 
 Cuticura : Vaseline and oil of bergamot. 
 
 Homocea : Camphor, oil of cajuput, and lard. 
 
 St. Jacob's Oil : Oil of turpentine, ol. succini, soft 
 soap, and capsicum. 
 
 Lineel Liniment : Zinc and magnesium chlorides, 
 with glycerine. 
 
 The means Dr. Hutchison suggests for lessen- 
 ing this old-fashioned quackery are, it will be 
 
254 UNCONSCIOUS THEEAPEUTICS 
 
 Physiology Seen, two in number, and both equally futile. The 
 
 and care- 
 ful treat- One IS the better education of the public in phy- 
 
 ment pro- 
 posed siology ; the other that the doctors should pay 
 
 remedies. 
 
 more attention to treatment, especially of the 
 minor ills. 
 
 Is this, then, all that medical science can sug- 
 gest as a prevention of quackery ? Mrs. Partington 
 with her broom for the Atlantic was as efficient. 
 
 Why, the public know quite enough (some 
 think too much) about physiology as it is, and 
 they who know most are often the quack's best 
 customers ; and as for the profession, surely they 
 do not relish Dr. Hutchison's suggestion that they 
 do not pay enough attention to the treatment of 
 minor ills, or echo his belief that, if they did, 
 fewer quack pills would be sold. 
 
 Dr. Hutchison rightly enough lays down the 
 law that no quack should be able to say he had 
 succeeded in curing a case when a doctor had 
 failed ; but they do, and will, as Sir James Paget 
 well pointed out, until some remedy less trivial 
 than those here adduced be suggested. 
 No aiiu- Dr. Hutchison makes no allusion whatever to 
 
 sion to the i , i . • j t j ^ 
 
 real force the force that alone gives vitality to quackery. 
 
 that cures. , • i j 
 
 Let me ask him three questions on certain patent 
 medicines he has analysed. 
 
ITS STUDY 
 
 255 
 
 In the cases of Beecham's Pills and Lineel Questions 
 
 to Dr. 
 
 (1) That all the testimonials to their remark- 
 able virtues are fraudulent ; 
 
 (2) That those cures that are genuine are pure 
 coincidences, and not ' cures ; ' 
 
 (3) That aloes, ginger, and soap, or zinc and 
 magnesium chloride, prescribed by himself, would 
 produce the same effects ? 
 
 These are the only three possible alternatives 
 to the man who rejects the psychic ; and a negative 
 is the only answer to all three. 
 
 The chief power in patent medicines is the effect 
 on the unconscious mind (through consciousness) 
 of the advertising and repute of these remedies, 
 and the cure of quackery lies in the scientific 
 education of medical men in these powers, and the 
 use of them for cure in a legitimate way. The 
 longer they ignore them, the better for quackery. 
 
 With regard to the second class of various The second 
 
 schools of healing science (American), a recent 
 writer in the ^ British Medical Journal ' reviews ^^-msh 
 
 * We live in an age in which there is not only t^^®"^- 
 a survival of superstition and a belief in the occult 
 and in quackery of all descriptions, but in an age 
 
 Liniment does he believe— 
 
 Hutchison. 
 
 them as follows : — 
 
 Medical 
 Joimial 
 describes 
 
256 UNCONSCIOUS THEEAPEUTICS 
 
 in which there has been a positive revival of an 
 hysterical form of occultism, a jumble of pseudo- 
 science and irreligion. Faith-healing, of which 
 so-called Christian Science is the type, is a money- 
 making concern, and a diploma from a college of 
 psychic healing can be obtained after a course of 
 study not extending beyond three weeks ; in some 
 circumstances in three days. 
 
 * Medicine and religion in remote times grew 
 up side by side, and their exposition was in the 
 hands of the same individual — the priest-doctor. 
 A belief in the occult was therefore a factor in 
 each. Even Hippocrates, who was the first to 
 attempt to put medicine on an improved basis, 
 jumbled fact and fiction and fable in the humoral 
 system of pathology. Every physician claimed to 
 be a miracle-worker in a small way, on the strength 
 of cures effected through the influence of the mind 
 on the body — that was, by suggestion and expectant 
 attention. . . . 
 
 Historical < The morbid influence of occultism, v/hich to 
 
 retrospect. 
 
 some extent declined in the time of Galen, began 
 to luxuriate again in the Dark Ages in association 
 with alchemy, astrology, necromancy, and religious 
 superstition. Faith-healing, touching for king's 
 evil, mesmerism, homoeopathy, and clairvoyance 
 
ITS STUDY 257 
 
 kept occultism going from the time of the Stuarts 
 to the end of the eighteenth century, and the 
 nineteenth century was remarkable for the revival 
 of the belief in spiritualism, mental telepathy, and 
 " divine healing." 
 
 ' Quackery, as represented by fraudulent insti- Reasons 
 
 given for 
 
 tutes for the deaf, the sale of ear-drums, and of success of 
 
 quackery 
 
 panaceas for every ailment under heaven, appeared 
 to prosper as of yore, and would continue to do so 
 whilst the majority of mankind were unthinking 
 in medical matters, and unable to throw off the 
 occultism of the nursery. 
 
 * Unfortunately, the supporters of quackery, 
 Christian Science, occultism, and all forms of 
 medical heterodoxy were found as often in the 
 castle as in the cottage.' 
 
 I consider in this last paragraph but one, the 
 writer in the ' British Medical Journal ' has com- 
 pletely missed the real cause of the continuance are not 
 
 the real 
 
 of quackery. It is not due to the fact that * the causes, 
 majority of mankind are unthinking in medical 
 matters, and unable to throw off the occultism of 
 the nursery,' at all, but to quite a different reason. 
 
 Quackery, as I have pointed out in a previous Quacks 
 
 would soon 
 
 work, would soon come to an end and fade awav ^"^isappear 
 
 if they 
 
 before the spread of knowledge, and the decay of ^^^^^ 
 
 s 
 
258 UNCONSCIOUS THEEAPEUTICS 
 
 superstition, under the fostering care of the School 
 Board and our higher educational system, but for 
 one thing. It can show real cures, both un- 
 deniable and numerous, in spite of the vast number 
 that may not bear scrutiny. 
 
 This the physician cannot, alas ! deny, though 
 he may deplore it. After allowing full discount for 
 forged and false testimonials (which are not so 
 numerous as supposed), for purely imaginary 
 diseases and the credulity of mankind, and even 
 for the lesser functional disorders, there remains 
 behind a large residuum that cannot by any in- 
 genuity be explained aw^ay. 
 Case of At any rate, the public believes it has suffered 
 
 rheuma- " ^ 
 
 tibm cured, ixom somo diseaso, say, rheumatism, for which, in 
 the ordinary course and the absence of the quack, 
 it would have gone to the nearest doctor ; with the 
 result of a possible more or less tardy cure, and the 
 certainty of a considerable bill. 
 
 Whereas now, the purchase for 7AcZ. or Is. l^d. 
 of a small bottle of something in a wrapper, black 
 with testimonials, has already given relief, maybe 
 even before it has been taken, on the mere reading 
 of the wonderful cures effected. Now it is quite 
 
 Surprise of possible that no one is more surprised as well as 
 pleased at the cures than the quack vendor of the 
 
ITS STUDY 
 
 259 
 
 same ; but it is not for him to deny what he cannot 
 account for, as the doctor is often tempted to do, 
 because his interest is to magnify cures, which he 
 promptly does. It is, therefore, doubtless true 
 that, in spite of all our science, quackery flourishes ; Reason 
 
 wliy 
 
 and the reason of it is by no means that all men quackery 
 are fools, but that it undoubtedly effects nume- 
 rous cures, and some — if it be not heresy to 
 breathe it — that have been attempted in vain by 
 eminent scientific men, the sufferers having only 
 tried quackery when all else has failed. 
 
 It is also true that these cures, as we have 
 said, astonish, perhaps, equally the quack and the 
 doctor. 
 
 But let us look more closely at the pseudo- Pseudo- 
 
 religious 
 
 religious systems of heahng that make a gain of systems, 
 the credulity and folly of mankind without recourse 
 to patent pills or Is, l^d. medicines. These are 
 found everywhere, but abound most, like the * 
 ordinary quack, not, as might be supposed, in 
 Eussia, or in Turkey, or Armenia, or South 
 America, or other darkish corners of the civilised 
 world, but in the very focus of intellectual and 
 rational light and life—the United States of 
 America. 
 
 The greatest of these latter-day mystics is 
 
 a 2 
 
260 UNCONSCIOUS THEEAPEUTICS 
 
 Mrs. Mary 
 
 Baker 
 
 Eddy. 
 
 Extent of 
 Christian 
 Science. 
 
 British 
 Medical 
 Journal on 
 Christian 
 Science. 
 
 undoubtedly at present the Eev. Mary Baker Eddy, 
 whose voluminous work on Christian Science, in two 
 volumes, is the text-book of the entire sect, number- 
 ing certainly half a million or more, here and in 
 America, of educated followers, far above the 
 average in wealth and culture — many, alas ! 
 formerly having been among the most lucrative of 
 the physician's patients. The text-book is ap- 
 pointed to be read by Mrs. Eddy in all her churches, 
 side by side with the Bible ; and in one of her 
 handsome buildings in New York, that cost over 
 20,000?., as well as in her first English church, 
 this work is read every Sunday morning to a 
 crowded and attentive congregation of upper-class 
 educated people. 
 
 With their dogmas we need not interfere ; cures 
 are detailed and vouched for, and are undoubtedly 
 effected, as I believe, by the power of Uncon- 
 scious Therapeutics. 
 
 But to the sober-minded Christian physician, 
 some of the means used to accomplish this end 
 appear most blasphemous as well as most offensive 
 to his common sense. That this is not an exaggera- 
 tion, I think this extract from the ^ British Medical 
 Journal ' will prove : 
 
 * This is intended for a case of cancer of the 
 stomach, but would doubtless be equally appro- 
 
ITS STUDY 
 
 261 
 
 priate mutatis mutandis for the treatment of any 
 other affection. The healer sits by the bedside of 
 the sufferer and repeats the following : ^ 
 
 ' Holy Eeality ! We believe in Thee that Thou art 
 everywhere present. We really believe it. Blessed 
 Eeality, we do not pretend to believe, think we believe, 
 believe that we believe. We believe. Believing that 
 Thou art everywhere present, we believe that Thou art 
 in this patient's stomach, in every fibre, in every cell, 
 in every atom, that Thou art the sole, only Eeality of 
 the stomach. Heavenly, Holy Eeality, we will not try 
 to be such hypocrites and infidels as every day of our 
 lives to affirm our faith in Thee and then immediately 
 begin to tell how sick we are, forgetting that Thou art 
 everything and that Thou art not sick, and therefore 
 that nothing in this universe was ever sick, is now sick, 
 or can be sick. 
 
 ^ We know. Father and Mother of us all, that there 
 is no such thing as a really diseased stomach ; that the 
 disease is the Carnal Mortal Mind given over to the 
 world, the Flesh, and the Devil; that the mortal 
 mind is a twist, a distortion, a false attitude, the 
 Harmatia of Thought. Shining and Glorious Verity, 
 we recognise the great and splendid Fact that the 
 moment we really believe the Truth, Disease ceases to 
 trouble us ; that the Truth is that there is no disease 
 in either real Body or Mind; that in the Mind what 
 seems to be a disease is False Belief, a Parasite, a hateful 
 
 ^ Just as this edition is going to press this extract from the 
 British Medical Journal is repudiated by a representative Chris- 
 tian Scientist. There is no time to verify the words, but even 
 if much distorted they represent the underlying thoughts of 
 this school. 
 
262 UNCONSCIOUS THEEAPEUTICS 
 
 Excrescence, and that what happens in the Body is the 
 shadow of the Lie in the Soul. 
 
 ' Lord, help us to believe that All Evil is Utterly 
 Unreal ; that it is silly to be sick, absurd to be ailing, 
 wicked to be wailing, atheism and denial of God to say, 
 " I'm sick." Help us to stoutly affirm with our hand in 
 your Hand, with our eyes fixed upon Thee, that we 
 have no Dyspepsia, that we never had Dyspepsia, that 
 we never will have Dyspepsia, that there is no such 
 thing, that there never was any such thing, there never 
 will be any such thing. Amen. 
 
 *And this blasphemous drivel is the kind of 
 thing by which the minds of persons, who in other 
 directions have given proof of high intelligence, 
 are led captive. How can we boast of the progress 
 of knowledge when this silliest of superstitions is 
 found in the very homes of sweetness and light " ? ' 
 
 All this is indeed most humiliating, and were it 
 not that I believe in a true therapeutic force 
 which has no connection with such incantations 
 and methods, and yet which everywhere underlies 
 them, I should make no reference to this cult, as, 
 personally, I have the highest regard for many of 
 its members. 
 
 But there is another point with regard to these 
 Faith- systems. 
 
 afford a These extraordinary tenets have a certain 
 
 of mind.* value, I think, not so much from their truth as 
 
ITS STUDY 
 
 263 
 
 from their selective power— that is to say, they 
 form an admirable test of mental condition ; and 
 there can be little doubt that those whose constitu- 
 tion of mind enables them to accept them, form, 
 ipso facto, favourable media for the display of 
 faith-healing powers. 
 
 The difficulty, not perhaps with such a cult as 
 Christian Science — which, in a certain way, is 
 calculated to catch the spirit of the age — but with 
 the simpler forms of quackery, is why they, at any 
 rate, continue to flourish in the twentieth century ; 
 for one would think they hardly appealed to many 
 minds to-day. 
 
 But they do, and to so many of the so-called Educated 
 
 classes not 
 
 educated classes ; and the reason, no doubt, is that educated, 
 a large number of the * educated ' classes are not 
 educated. For it is, no doubt, a fact, though with 
 many exceptions, that the less the cultivation and 
 education of the conscious mind, the more readily 
 are cures effected by unconscious therapeutics. 
 Mental therapeutics used consciously are better 
 adapted for truly educated people. 
 
 Perhaps the real reason of success may be 
 twofold. Skey gives one when he says, speaking skey on 
 
 hysteria. 
 
 of hysteria : ^ ' It may be asserted with truth that 
 every part of the body may become, under provoca- 
 ' Skey, Lectures on Hysteria, pp. 44, 77. 
 
264 UNCONSCIOUS THEEAPEUTICS 
 
 tion, the seat of an apparent disease that in reality 
 does not exist ; that it may, and often does, assume 
 all the attributes of reality with an exactness of 
 imitation which nothing short of careful and 
 accurate diagnosis can distinguish from the real 
 disease. Nevertheless, I unhesitatingly assert that 
 real disease is not found in a greater proportion 
 than one case in twenty ; and even this is a liberal 
 allotment.' 
 
 That is to say, that the vast majority of nervous 
 diseases are not organic, but, being purely mental 
 in their origin {i.e. not * real ' diseases), are cured 
 most easily by mental remedies. 
 Quackery The second is, that these quack medicines, 
 
 cures 
 
 believers, extravagant doctrines, and varied fetishes afford 
 one and all real and true mental remedies to those 
 classes of minds that can receive them and believe 
 in them. 
 
 Mind Now, although all sick persons do not run after 
 
 all cures, quacks (for which we may be thankful), yet it is 
 true that all sick persons may be benefited by 
 mental medicine in some form or other. 
 
 ^11 should be known,' says Osgood Mason,^ 
 * far and wide, in the profession and out of it, that 
 y\ there is a subjective, a psychic, element in the 
 ' Osgood Mason, Hypiotism and Suggestion, p. 46. 
 
ITS STUDY 
 
 265 
 
 practice of the healing art, and it is in that 
 direction, rather than in the multiplication of 
 drugs, that the therapeutics of the future is to be 
 enriched.' 
 
 Well, if this be so, and if our enemies the Be not too 
 
 ' ' proud to 
 
 quacks have long shown us by unwelcome demon- 
 strations, in curing some of our incurables, that a 
 real power lies somewhere behind all their jargon 
 and their exaggerations, we must not be too 
 proud or haughty to learn what it is, in the first 
 place, and to teach it in the second. 
 
 England has lately given a conspicuous example 
 in her army of how well she can do this if she 
 wishes. In the late African War it was painfully War Office 
 
 and the 
 
 brought home to our military pride that our Boers, 
 enemies — a handful of despised farmers — accom- 
 plished feats and displayed tactics of a nature 
 superior to what our highly equipped and expensive 
 soldiery could attempt ; and, bitter though the 
 lesson has been, and high though the price was, 
 the War Office, with all its conservatism, has 
 endeavoured earnestly to profit by it. It surely 
 cannot be that the College of Physicians is more college of 
 crusted with prejudice than the War Office itself, rnd^wlr^" 
 
 Office. 
 
 and I cannot but believe that slowly and silently 
 a different and more enlightened spirit is finding 
 
266 UNCONSCIOUS THBEAPEUTICS 
 
 its way into its counsels ; and the more particu- 
 larly when I have been able to quote so largely 
 in support of unconscious therapeutics from the 
 writings of some of its more prominent officials. 
 
 Of course, in one way the times, in their 
 idolatry of science, are not propitious. 
 Science Scienco has displaced from her proper place 
 
 displaces ^ i i l 
 
 sopiiy ^^^^ throne a comprehensive philosophy. 
 
 There is, perhaps, some excuse for humanity 
 and medicine that they have partly forgotten 
 philosophy. The discoveries of science have been 
 so brilliant that man's mental vision has been 
 dazzled by them. Moreover, the use made by 
 science of * force,' ' law,' &c., has drawn away 
 from the general to the particular. 
 
 i^aba- ' In medicine this has taken the form of an 
 
 gliati on 
 
 science. inducHo per enumerationejn simplicem ; and so 
 we have often failed to see the wood for the trees. 
 The trees have been so numerous as to hide 
 the wood. If we had stood at a distance on some 
 elevation, we should have had a much better 
 prospect of seeing the lie and disposition of the 
 wood. No doubt in time all this will come. In 
 good time the unnatural division at present in 
 existence will be undone.' ^ 
 
 * Eabagliati, A]phcy}isms, p. 224. 
 
ITS STUDY 
 
 267 
 
 The result is, all subjects not strictly scientific 
 are much neglected in medical schools, or kept 
 absolutely in the background. 
 
 Speaking of these subjects, Sir Dyce Duckworth Sir Dyce 
 
 ^ ^ J ? J Duckworth 
 
 says : ^ * For such an education I prefer the old on ' hu- 
 manities.* 
 
 term of '^the humanities;" and in my belief our 
 profession suffers at the present time from no 
 greater deprivation than the loss of thorough 
 training on those lines which should be compulsory 
 to all who aspire to enter it. We hear much about 
 medical ethics in these days, and the need of some 
 authoritative body to appeal to and regulate such 
 matters. I do not know,' he says, speaking of 
 the effect of manner on the patient, * that any 
 specific teaching is anywhere given on this matter.' 
 
 ' The Young Practitioner ' wisely observes : 
 ^ The mental management of the sick is often far 
 more difficult than the physical. A close, thought- 
 ful study of the mental forces and of mental 
 therapeutics is one of the necessities that the 
 legitimate profession is still very deficient in.' 
 
 The result of the neglect of this study has 
 naturally been profound ignorance, and nowhere 
 has this had more disastrous practical effect in 
 preventing cures, aggravating disease, and dis- 
 
 ' Sir Dyce Duckworth, Lancet, October 17, 189G. 
 
268 UNCONSCIOUS THEEAPEUTICS 
 
 gusting patients with legitimate medicine than in 
 functional nerve disease. 
 
 ' To my notion,' says Dr. Inman,^ * there is not 
 in all medical history a more melancholy chapter 
 than that which treats of hysteria ; and there are 
 still extant in many books examples of reasoning 
 that are simply contemptible. Who, for example, 
 that knows the natm^e and character of our women, 
 could believe that all of them, from the highest to 
 the lowest, had, without any conspiracy amongst 
 themselves, invented a set of symptoms whose 
 chief characteristics were pain in the individual 
 and mystery for the doctor, and yet which at the 
 same time should be actualities and nonentities — 
 non-existent, yet aggravated by sympathy — and all 
 dependent more or less upon a desire to be 
 married ? I can hardly write calmly when I think 
 of the obloquies heaped upon our females in certain 
 medical works ; indignities, indeed, unsupported 
 by a tittle of valid evidence. With these ideas 
 was associated in the doctor's mind a belief that 
 hysterical sufferings were feigned, with a view of 
 eliciting sympathy, and deserved to be treated in a 
 rough manner, and by disagreeable medicaments. 
 Upon many a sufferer hard usage was inflicted, 
 
 ' Dr. Inman, On the Restoration of Healthy pp. 500, 502. 
 
ITS STUDY 
 
 269 
 
 where gentle nursing was needed, and a horrible 
 compound of atrocious drugs was ordered as medi- 
 cine, when all that was really required was such 
 nutritious materials as milk and rum. Well do I 
 recall the unction with which a hospital physician 
 boasted to me of the efficacy of his Mistura Diabolica, 
 or Satanic physic, in obstinate cases of hysteria.' 
 
 Dr. Wade says : ^ 'In dwelling upon the short- 
 comings of our younger brethren, let me say at 
 once that I am very far from laying the blame 
 altogether upon their shoulders ; for, after all, we 
 can only expect from an individual what he has 
 been taught, and if no one from the commencement 
 of his career has pointed out to him the higher and 
 nobler characteristics of his profession, he may 
 perhaps be held excusable for growing to regard 
 it in the light of a business and nothing more. 
 Kather I would blame the system by which he is 
 begotten. To my mind there is no doubt that a 
 great amount of good would result from adding a 
 course of teaching in ethics to the usual curri- 
 culum. If that were done, in addition to the 
 suggestion of requiring a period of probation after 
 qualifying, we should have a fair substitute for 
 apprenticeship. But, after all, a thing that is a 
 ^ Dr. Wade, British Medical Journal, September 27, 1902. 
 
270 UNCONSCIOUS THEEAPEUTICS 
 
 substitute can never be quite so good as the thing 
 itself.' 
 
 Of course, here he only speaks of ethics ; but 
 the principle is true of all non-scientific subjects. 
 
 Dr. E. T. Tibbits, of Bradford, says : ^ A know- 
 ledge of moral philosophy, including ethology, the 
 science of character, should be cultivated by all 
 those engaged in the practice of medicine.' 
 
 Sir J. Eussell Eeynolds writes : ^ ^ It would 
 seem that some very scientific persons attach more 
 importance to the fact that some cell was y^^^ of 
 a line in diameter, than that the individual from 
 whom the cell may have been obtained suffered 
 pain, distress, or some other adversity ! No one 
 admires more than I do minute and accurate 
 observation ; but what I protest against is the 
 selection of facts (when j^ou have to deal with an 
 individual) in such a way as to record some most 
 carefully, which you are able to w^eigh or measure, 
 and entirely to ignore others which it may be 
 difficult to express and impossible to measure.' 
 
 This severe indictment of the ultra-scientific 
 spirit is even more deserved to-day than when Dr. 
 Eeynolds wrote it. 
 
 But we have indeed had evidence enough, and 
 ^ Sir J. Eussell Eeynolds, Essays and Addresses, p. 184. 
 
ITS STUDY 
 
 271 
 
 in the mouths of many witnesses, to establish the 
 charge against professional training which is ad- 
 vanced in this book, and I would now proceed, in 
 words which I have used in a previous appeal, to 
 ask in all earnestness and all seriousness : Is it 
 right, is it scientific, is it fair, that a medical 
 man should have gone laboriously through college 
 and hospital, sick ward, and lecture theatre, and 
 learned all that the medical science of the latter 
 half of the nineteenth century could teach him, 
 and yet be left in such utter ignorance of psycho- 
 therapy, of the effect of unconscious therapeutics ? 
 Instances of the disastrous effects of this ignorance 
 could be multiplied, alas ! indefinitely ; but the 
 full list of victims of this systematised neglect will 
 never be made out, and the evil, all unconsciously 
 done, never be known. 
 
 It is quite futile to urge that men have their 
 idiosyncrasies, and can never be all alike. This is, 
 of com'se, true, but is beside the mark ; and is no 
 reason whatever for keeping from them the know- 
 ledge of 'the therapeutic value of agencies that 
 affect the patient's mind, while teaching all about 
 the drugs that affect his body. One might as well 
 refuse to teach physical diagnosis because all men 
 are not equally good observers, or surgery because 
 
272 UNCONSCIOUS THEEAPEUTICS 
 
 manual skill varies greatly, as to leave in neglect 
 the science of mental therapeutics because all 
 cannot use it with the same effect. 
 
 The argument refutes itself, for if all naturally 
 practised mental therapeutics unconsciously, there 
 would be less need for teaching it ; and it is just 
 because all men are not alike, that scientific in- 
 struction should be given in the power for good or 
 evil that resides in the doctor himself, alike in 
 causing, aggravating, and curing disease. It is 
 not that their practice or prescriptions have to be 
 radically altered ; it is not that their text-books 
 are to be cast aside ; but it is that, everywhere, 
 and at all times, they shall have constantly before 
 them the two questions : ' What part does mind 
 play in causing this disease ? ' and ^ How far can 
 it be made to assist in its cure ? ' 
 
 With this, of course, goes a knowledge and 
 sense of the value of their own personality, and 
 how to use it for good, and not for evil. 
 
 The point to be decided is whether the force of 
 mind in disease is a real and important subject for 
 study— whether it is one of practical value to 
 medical men.'^ 
 
 * In connection with this I think I may repeat here what I 
 have said in other words in Chapter II., that drugs come, in a 
 
ITS STUDY 
 
 273 
 
 I think I have now said enough, and quoted 
 enough, to show that the opinion of a large num- 
 ber in the profession, who are worthy of our highest 
 respect, agrees that it is. It is a subject alluded to 
 everywhere, and taught nowhere ; and no single 
 day passes in a medical man's life but he and his 
 patients must suffer consciously or unconsciously 
 from his ignorance of it. Is it, then, a subject that 
 could be taught with advantage in our schools? 
 Emphatically, yes ; and one, too, which, if properly 
 taught, would be found of absorbing interest. 
 
 In the causation of disease, if not the greatest, 
 it is at any rate the most universal, factor. Clini- 
 cally, how interesting to observe in the wards how 
 much of each disease is due to the mental factor ! 
 
 sense, under the head of unconscious therapeutics ; for we judge 
 that, on the whole, a large percentage of their power is due to 
 their effect unconsciously on the mind of the patient, and thence 
 on the body, and not at all, as is generally thought, entirely due 
 to their chemical contents and their purely physical properties. 
 This has long been thought to be the case with regard to a large 
 number of homceopathic remedies consisting of inappreciable 
 doses of a drug ; but I am convinced it is also true of B.P. drugs 
 in B.P. doses. This in itself is a large and interesting subject, 
 of which little is known ; but enough comes to light incidentally 
 from time to time fully to justify this statement. Indeed, as we 
 know, so strong is the mental percentage, as sometimes entirely 
 to neutralise the strong physical qualities of the drug, as when 
 opium pills, believed to be aperient, produce diarrhoea, &c. If 
 the above be true, the psychic use of drugs will form an important 
 part of the subject for study. 
 
 T 
 
274 UNCONSCIOUS THEEAPEUTICS 
 
 The part the mind plays in sickness in different 
 classes, in the two sexes at different ages, in dif- 
 ferent occupations, and in the different groups of 
 disease, might all be worked out ; for the whole 
 subject is practically virgin soil, and those who 
 pursue this study are really explorers in an un- 
 trodden country. 
 
 Lectures might be given as facts are accumu- 
 lated. Text-books would appear of a novel type, 
 giving scientifically a whole body of facts bearing 
 on disease, not to be found in any of our standard 
 works at present ; and psychological medicine 
 would no longer be confined to questions of lunacy, 
 but would embrace the interesting study of the 
 relations of the sound mind to the diseased 
 body. Three days are given up to Papers on Psy- 
 chology at the Annual Medical Congress. So far 
 they have been occupied exclusively with the study 
 of the insane mind and allied questions. 
 
 It would be a great advance if one of these 
 three days could be given up to the study of the 
 sane mind in relation to the cause and cure of 
 disease and to mental therapeutics generally. 
 
 If we turn from cause to cure, the subject 
 widens, and the interest is intensified. 
 
 When once the matter is fairly studied clinically 
 
ITS STUDY 
 
 275 
 
 and scientifically, the first point that is pressed 
 home upon the consciousness is the magnitude of 
 the subject and the great interest attaching to it. 
 Its study, too, differs so completely in character 
 from that of scientific medical subjects that it 
 comes as a relief and a relaxation, rather than an 
 additional burden. 
 
 Amongst others, the curriculum might very 
 well embrace the following subjects : 
 
 1. The general facts connected with the unity 
 of man, and the interdependence of the psychic 
 and physical in all parts of the body, and in all 
 the different organs. First of all in health, thus 
 taking up the great question as to how, as a whole, 
 the body lives. Then the special interactions in 
 all varieties of disease, and the general enumera- 
 tion and consideration of the various mental 
 agencies that act consciously or unconsciously as 
 causes of disease predisposing or exciting ; and 
 another list of those that act therapeutically, con- 
 sciously or unconsciously. 
 
 2. Another distinct subject of study might be 
 that of temperaments, mental conditions compatible 
 with sanity, nervous states and phases, and mental 
 backgrounds, or habits of thought, fixed, mobile, or 
 erratic. 
 
 T 2 
 
276 UNCONSCIOUS THEEAPEUTICS 
 
 8. Again, different characters might be studied, 
 and the way in which education, reasoning, or 
 emotional powers or instincts aided or retarded 
 the action of unconscious therapeutics. 
 
 4. Many other subjects of a general nature will 
 suggest themselves ; but we might proceed to con- 
 sider a little-known subject, and that is, drugs as 
 a variety of unconscious therapeutics ; or, in other 
 words, a study of their psychic as distinguished 
 from their physical action. Medical men will be 
 surprised, when this subject is studied, to find 
 how the popularity, the advertising, the mode of 
 administering, and the personality of the doctor 
 who orders it, or of the nurse who gives it, alters 
 the clinical effects of the same drug ; and how, 
 therefore, psychic and physical effects are com- 
 bined in differing ratios, and thus a great deal 
 that is obscure in their action is explained, and 
 the inertia of one and the activity of another 
 sample is not always explained by their relative 
 impurity or purity, but by other reasons little 
 thought of. 
 
 These psychic effects can, of course, be studied 
 throughout the whole range of conscious thera- 
 peutics of a natural and non-pharmaceutical order, 
 such as baths, manipulations, health resorts, &c.. 
 
ITS STUDY 
 
 277 
 
 the psychic action of which is still more marked 
 than in the case of drugs ; which is one reason, 
 doubtless, why they are becoming increasingly 
 popular. 
 
 5. Then we may consider the grand natural 
 therapeutics of the vis medicatrix natures that in 
 power transcends all our efforts ; and we may study 
 closely all the various means by which this 
 marvellous operation of the unconscious mind may 
 be stimulated or retarded in various ways. 
 
 6. All forms of suggestion, direct and indirect, 
 plain or wrapped up in various treatments, would 
 form a large and fruitful subject of study, and 
 might include various forms of auto-suggestion and 
 hypnotism, &c. 
 
 7. Lastly, I would mention a careful con- 
 sideration of the personality of the physician, 
 taking as my text this saying of Sir James Paget, 
 as the outcome of a consideration of the careers 
 of two hundred of his students, which we have 
 already quoted in Chapter VIII. 
 
 * Nothing appears more certain than that the 
 personal character, the very nature, the will of 
 each student, had far greater force in determining 
 the career than any help or hindrance whatever.' 
 
 Ethics, morals, professional conduct, and eti- 
 
278 UNCONSCIOUS THEEAPEUTICS 
 
 quette, tact, and even dress and manners and 
 general surroundings, would be far better to be 
 taught at the commencement of a professional 
 career, when there would be some opportunity of 
 carrying the teaching into effect, than ignorance 
 in these matters pointed out at the close of a 
 professional career as a cause of its failure. 
 
 I have, of course, not nearly covered the 
 range of therapeutics at present practically un- 
 touched ; but have, I think, said enough to show 
 there is sufficient cause for writing this book. 
 
 Some of the subjects I have mentioned are so 
 novel that they may afford fair objects for ridicule 
 or cynicism ; but when the humorist and cynic 
 have had their say, the thoughtful man will see 
 there is still enough left to form the basis of a new 
 and profitable branch of medical study. 
 
LIST OF SOME WRITEES AND THEIR 
 WORKS REFERRED TO IN THIS BOOK. 
 
 AcLAND, Sir H. Memoirs of Sir W. W, Gull. 
 American Journal of Psychology, 
 Annee PsycJiologiquCy L\ 1897. 
 Aphorisms, Eabagliati. 
 
 BiNET ET Courtier. La Vie Emotionnelle. 
 BiNET ET Vaschide. U A.nnee Psychologique, 1897. 
 Blood-pressure Supply in Mental Pleasure and Pain, 
 
 Maurice Craig. 
 British Medical Journal, 1894, 1902, 1903. 
 Broadbent, Sir W. The Pulse. 
 Brown, Dr. J. Horce Suhsecivce, 1st Series. 
 Bruce, Dr. J. Mitchell. Practice of Therapeutics. 
 
 Career, Medicine as a. Sir W. Dalby. 
 Oathell, Dr. D. W. The Physician himself. 
 Collected Writings. Sir W. W. Gull. 
 Collins, Dr. J. Treatment of Diseases of the Nervous 
 System, 
 
 Courtier et Binet. La Vie Emotionnelle, 
 
 Craig, Maurice. Blood-pressure Supply in Mental Plea- 
 sure and Pain, {Dublin Journal of Medical Science, 
 1900.) 
 
280 UNCONSCIOUS THEEAPEUTICS 
 
 Dalby, Sir W. Medicine as a Career, 
 
 De Morhis Vulgarihus. Hippocrates. 
 
 Dictionary of Medicine, Sir R. Quain. 
 
 Diseases of Women, Dr. Herman. 
 
 Disorder, Nerves in. Dr. Schofield. 
 
 Doctor and Patient, Dr. S. Weir Mitchell. 
 
 Doctor of the Old School, A. Ian Maclarbn. 
 
 Doctors and Doctors. Graham Everett. 
 
 Doctors, Hints to, R. Gersany. 
 
 Duckworth. Sir D. Lancet, 1896. 
 
 Duckworth, Sir D. British Medical Journal, 1903. 
 
 Dumas. La Tristesse et la Joie, 1900. 
 
 Dynamics, Mental, Dr. J. H. Green. 
 
 Essays and Addresses, Sir J. R. Reynolds. 
 Essays, Scientific, Sir James Paget. 
 Essays, Selected. Sir James Paget. 
 Everett, Graham. Doctors and Doctors, 
 
 Ferrier, Dr. D. Harveian Oration, 1902. 
 
 Fleury, Dr. de. Medicine and the Mind. 
 
 Force of Mind, The. Dr. Schofield. 
 
 Ford, Prof. A. American Journal of Psychology, Vol. 4. 
 
 Fothergill, Dr. M. The Will Power, 
 
 Gairdner, Sir W. The Physician a Naturalist, 
 Galen. Opera, 
 
 Gersany, Dr. R. Hints to Doctors, 
 GooDHART, Dr. G. Harveian Lectures, 1891. 
 Green, Dr. J. H. Mental Dynamics. 
 Gull, Sir W. W. Collected Writings, 
 Gull, Memoirs of Sir W, W, Sir H. Acland. 
 
 Harveian Oration, 1902, 1891. 
 
 Health, Restoration of, On the. Dr. Inman. 
 
WEITEES AND WOEKS ON THE SUBJECT 281 
 
 Herman, Dr. Diseases of Women. 
 Hints to Doctors, E. Gersany. 
 Hippocrates. De Morbis Vulgaribus, 
 Holland, Sir H. Medical Notes, 
 Hooker, Dr. J. Physician and Patient, 
 Horce Suhsecivce, Dr. J. Brown. 
 Hutchison, Dr. British Medical Journal^ 1903. 
 Hyjpnotism and Suggestion, Osgood Mason. 
 Hypnotism and Suggestion, Dr. Lloyd Tuckey. 
 Hysteria, Lectures on, Skey. 
 
 Inman, Dr. On the Bestoration of Health, 
 
 KiRKES. Physiology, 10th Edit. 
 
 Lancet, 1896. 
 
 Lectures on Hysteria, Skey. 
 Lectures on Pathology, Lancet, 1896. Dr. Leith. 
 Leith, Dr. Lectures on Pathology. {Lancet, 1896.) 
 Life, Psychology and. Hugo Munsterberg. 
 
 Maclaren, Dr. Ian. A Doctor of the Old School, 
 Mason, Osgood. Hypnotism and Suggestion, 
 Masters in Medicine. Sir James Simpson. 
 Medical Notes, Sir H. Holland. 
 Medicine and the Mind, Dr. de Fleury. 
 Medicine as a Career. Sir W. Dalby. 
 Medicine, Dictionary of. Sir E. Quain. 
 Meynoirs of Sir J, Paget. Paget. 
 Memoirs of Sir W, W, Gull, Sir H. Acland. 
 Mental Dy nannies. Dr. J. H. Green. 
 
 Mental Pleasure and Pain, Blood Pressure Sujjply in, 
 
 Maurice Craig. 
 Mind, Force of Dr. Schofibld. 
 Mitchell, Dr. S. Weir. Doctor and Patient, 
 Moore, Dr. Potoer of the Soul on the Body, 
 Munsterberg, Hugo. Psychology and Life, 
 
282 UNCONSCIOUS THEEAPEUTICS 
 
 Naturalist^ Physician a. Sir W. Gairdnbr. 
 Nerves in Disorder* Dr. Schofield. 
 
 Old School, Doctor of the. Ian Maclaren. 
 On the Restoration of Health, Dr. Inman. 
 Oj^era. Galen. 
 
 Paget, Sir J. Scientific Essays, 
 Paget. Memoirs of Sir James Paget, 
 Paget, Sir J. Selected Essays, 
 Pathology, Lectures on. Dr. Leith. 
 Patient, Doctor and. Dr. Weir Mitchell. 
 Physician and Patient, Dr. J. Hooker. 
 Physician a Naturalist, Sir W. Gairdner. 
 Physician hhnself, The, Dr. D. W. Cathell. 
 Physiology, Kirkes. 
 
 Poiuer of the Soul on the Body, Dr. Moore. 
 Poiver, The Will, Dr. M. Fothergill. 
 Practice of Therapeutics. Dr. J. Mitchell Bruce. 
 Practitioner, The Young. Dr. de Styrap. 
 Psychology and Life. Hugo Munsterberg. 
 Pulse, The, Sir William Broadbent. 
 
 Quain. Dictionary of Medicine, 1894. 
 
 Eabagliati, Dr. Ajphorisms. 
 
 Bestoration of Health, On the. Dr. Inman. 
 
 Eeynolds, Sir J. R. Essays and Addresses, 
 
 Schofield, Dr. A. T. Unconscious Mind, 
 Schofield, Dr. A. T. Force of Mmd, 
 Schofield, Dr. A. T. Nerves in Disorder, 
 Scientific Essa^ys, Sir James Paget. 
 Selected Essays, Sir James Paget. 
 Simpson, Sir James. Masters in Medicine, 
 
WEITEES AND WOEKS ON THE SUBJECT 283 
 
 Skey, Dr. Lectures on Hysteria. 
 Soul, Power of the, on the Body. Dr. Moore. 
 Styrap, Dr. de. The Young Practitioner. 
 Suggestion, Hypnotisrn and. Osgood Mason. 
 Suggestion, Hypnotism and. Dr. Lloyd Tuckey. 
 
 Therapeutics, Practice of. Dr. M. Bruce. 
 Treatment of Diseases of the Nervous System. Dr. J. 
 Collins. 
 
 Treves, Sir F. British Medical Journal, 1902. 
 Tristesse, La, et la Joie. Dumas. 
 Tuckey, Dr. C. Lloyd. Hypnotism and Suggestion. 
 Tuckey, Dr. C. Lloyd. Psychotherapy. 
 
 Unconscious Mind, The. Dr. Schofield. 
 
 Vie Emotionnelle, La. Binet et Courtier, 
 
 Wade, Dr. British Medical Journal, 1902. 
 
 Wardle, Dr. M. British Medical Journal, 1902. 
 
 West, Dr. C. Medical Times and Gazette, 1882. 
 
 White, Prof. Mind, Vol. 6. 
 
 Will Power, The. Dr. M. Fothergill. 
 
 Writijigs, Collected. Sir W. W. Gull. 
 
 WuNDT. Beitrdge zur Theorie der Sinnes Vermehrung. 
 
 Wyndham, Sir C. British Medical Journal, 1903. 
 
 Young Practitioner, The. Dr. de Styrap. 
 
INDEX OF SUBJECTS 
 
 M.T. (or T.M.) = mental therapeutics 
 U.M. = unconscious mind 
 U.T. (or T.U.) = unconscious therapeutics 
 V.M.N. = vis medicatrix naturcB 
 
 Abdominal section and mind 
 
 cure, 242 
 Accurate and broad, doctors 
 
 should be, 160 
 Achromatic mental eye, 211 
 Acquired and natural reflexes, 15 
 Act Uke medicine, doctors, 170 
 Action of brain, Bernheim on 
 double, 30 
 of drugs disturbed by mind, 43 
 of hypnotism, 32 
 of muscle in peritonitis, 70 
 psychophysical, obscure, 230 
 safety valve. Dr. J. Mitchell 
 
 Bruce on, 67 
 of skin in peritonitis, 70 
 of U.M. and V.M.N., 57 
 unconscious, of mental thera- 
 peutics, 32 
 of V.M.N., 55 
 of V.M.N., details of, 66 
 Actions of unconscious therapeu- 
 tics, 224 
 
 of mental therapeutics, rea- 
 sonable, 32 
 two, of mental therapeutics, 
 31 
 
 Active and passive suggestion, 
 180 
 
 Actors in medical profession, 164 
 like doctors, 214 
 
 I Acute disease, will and, 45 
 disease, V.M.N, in, 74 
 Adaptation, Bizzozero on, 62 
 i value of the power of, 205 
 i Address on manners, Sir D. Duck- 
 worth's, 163 
 Advance in mental medicine, 
 probable, 22 
 of psychology, 17 
 Advantage of single eye, 5 
 
 unconsciousness as an, 153 
 i5!tiology of neuromimesis, 9 
 Agency in mental cures, 47 
 Agent, time is a therapeutic, 
 119 
 
 Agents, mental effects of psychical, 
 127 
 
 Agreeable surroundings beneficial, 
 I 120 
 Aid for V.M.N., 191 
 AHenists in Egypt, 79 
 Allen's, Mrs., Hair Restorer, com- 
 position of, 253 
 Alteration of heart's action by 
 
 emotion, 234 
 Alteratives for mind, 21 
 Amateur nurses, value of, 50 
 America and superstition, 250 
 overrun with quackery, 1 
 position of psychotherapeu- 
 tics in, 1 
 
286 UNCONSCIOUS THERAPEUTICS 
 
 Amusements, value of, 110 
 Anaemia and suggestions, 35 
 Anaesthesia and hypersesthesia, 
 234 
 
 Anaesthetics without gas, 35 
 Analysis of London medical 
 
 schools, 199 
 Aneurysm cured by clot, 73 
 natural therapeutics in, 73 
 rational treatment of, 73 
 Angel, hope as an, 174 
 
 inflammation as an, 68 
 unawares, V.M.N, as an, 63 
 Angels and devils in medicine, 85 
 Anglesey, Lord, and neuralgia, 235 
 Animal and spiritual proportions, 
 186 
 
 Animals, men treated as, 231 
 Anorexia, natural therapeutics of, 
 67 
 
 Antiquity of medicine, 79 
 Antitoxin and V.M.N., 74 
 ' Apologia pro libro meo,* 8 
 Appeal, earnest, to reader, 271 
 Appearance of doctors, Hippo- 
 crates on, 90 
 Appendicitis and V.M.N. , 69 
 Appointments, suggestion for, 139 
 
 value of making, 133 
 Apprenticeship, value of, 51 
 Aptitude, natural, for profession, 
 165 
 
 Arguments of ' British Medical 
 
 Journal' irrelevant, 63 
 Aristotelian Society on mind, 11 
 Aristotle on nature, 81 
 Armies, phagocyte, have a head, 
 
 67 
 
 Art and science of medicine, 25 
 Sir C. Wyndham in medical, 
 206 
 
 Artificial bedside manners, 164 
 Artificiahty, evil of, 106 
 Artist, physician is an, 168 
 Artists and gifts of heahng, 114 
 Asclepiades on t^Uo, citOf et 
 jucunde, 58 
 opposes Hippocrates, 58 
 
 Assertion, cured by, 187 
 Assurance office, story of, 124 
 Athenians on Mars hill, 37 
 Attractions of medical men, 2 
 Augustine, St., on Nature, 57 
 Avarice of surgeons, 80 
 Average patient non existent, 192 
 Avoidance of artificiality, 105 
 
 of exaggeration, 171 
 
 of rash promises, 177 
 
 Background, change of mental, 
 187 
 
 insanity and fixed, 185 
 keep hobbies in, 91 
 Backgrounds, mental, 184 
 
 mistakes from ignorance of, 
 
 185 
 mobile, 184 
 Bacon on Nature, 60, 65 
 Bad doctors. Dr. S. Weir Mitchell 
 on, 194 
 habits, breaking of, 121 
 manners, evil of, 155 
 i manners in doctor, 145 
 
 prognoses dangerous, 220 
 i Balance, doctors weighed in, 113 
 I Barbers' Company and surgeons, 
 I 79 
 
 ! Barclay's Pills, composition of, 
 
 I 253 
 
 i Barkas, Dr., on mind cure by 
 
 water, 238 
 Barker, Dr., on V.M.N., 74 
 BaiTington, Sir K., on gifts of 
 
 healing, 113 
 Bartholomew's, St., proportion of 
 
 successful students, 199 
 Barton, Dr. W., on Dr. Begbie, 107 
 Bath, soldier killed by, 233 
 Baths as ' suggestion ' remedies, 42 
 psychic action of electric, 128 
 Battle, mind of soldier in, 234 
 Beale,. Dr., on life, 9 
 ' Bear,' story of a, 144 
 ' Bears,' successful, 93 
 Bed as a doctor, 26 
 
INDEX OP SUBJECTS 
 
 287 
 
 Bedside, doctor at, 120 
 
 hopefulness at, 220 
 
 manners, 163, 170 
 Beecham's Pills, composition of, 
 252 
 
 Begbie, Dr., Sir D. Duckworth on, 
 107 
 
 Behevers, quackery cures, 269 
 Beneficial symptoms of perito- 
 nitis, 69 
 
 Benefit from single interview, 114 
 
 of cheerful manner, 101 
 Bennett, Dr., and inert drugs, 46 
 Bernheim on double brain action, 
 
 30 
 
 Bile Beans, composition of, 253 
 Binet on feelings as excitants, 224 
 Bizzozero on adaptation, 62 
 
 on phagocytosis, 64 
 Blisters produced by mind, 290 
 Blood vessels and mind. Dr. Fer- 
 
 rier on, 224 
 Body action, mind action as 
 
 genuine as, 40 
 Body and mind, doctors and drugs 
 for, 113 
 and mind mould each other, 
 207 
 
 and mind. Sir J. Paget on, 7 
 and soul move together, 19 
 and will, 15 
 
 changes and emotions, 224- 
 230 
 
 cured before nerves, 195 
 influenced by thoughts, 3 
 mind casts a shadow like, 103 
 mysterious tenant of, 28 
 nutrition of, altered by mind, 
 35 
 
 states as produced by mind, 
 207 
 
 Boerhaave and Nature, 58 
 Boers and War Office, 265 
 Boldness, value of, 109 
 Bones, broken, healed by love, 246 
 Book on U.M., 81 
 
 on mental therapeutics 
 needed, 4 
 
 1 Book, reason for writing, 116 
 I tendency of this, 153 
 Boucliet on death from fright, 
 
 ! 239 
 
 I Bovine doctors, 208 
 I Brahm on feelings. 226 
 i Braid's experiments on feeling, 
 I 239 
 Brain, idea paths in, 42 
 Braine, Mr. W., on narcosis with- 
 out ether, 35 
 Brevity, evil of, 106 
 Brilliant dictum of Sir James 
 
 Paget, 97 
 ' British Medical Journal,' 63 
 and faith healing, 255 
 ignores cause of quackery, 257 
 i on Cln-istian Science, 260 
 
 on mind cure in uterine dis- 
 ease, 242 
 on power of mind over mind, 
 48 
 
 on strength in medicine, 222 
 1 Broad and accurate, doctor should 
 i be, 160 
 
 i Brother, patient as, 182 
 Broussais, Dr., on the real physi- 
 cian, 110 
 Brown, Dr. J., on ideal physician, 
 110 
 
 Dr. J., on medicine, 25 
 Dr, J., on Sydenham, 211 
 Dr. J., on two eyes, 6 
 Sir T., Sir F. Treves on, 63 
 Bruce, Dr. J. Mitchell, follows 
 Sydenham, 60 
 on ideal physician, 85 
 on kidney diseases, 67 
 on Nature, 60 
 on Nature's methods, 64 
 
 I on patient's environment, 124 
 on safety-valve action, 67 
 on value of V.M.N., 65, 67 
 on women, 52 
 Buckley, Dr., on mind cure of 
 
 j rheumatism, 241 
 
 ' Buzzard, Dr., on psychic remedias, 
 
 j 36 
 
288 UNCONSCIOUS 
 
 THEEAPEUTICS 
 
 Calf, the worship of the golden, 
 218 
 
 Calm, doctor should be, 90 
 Calomel, doctor equal to, 2 
 Cancer of stomach, treatment of , 
 
 by Christian Science, 251 
 Candour, value of, 106 
 Capacity for taking pains, 161 
 Capture minds, how to, 172 
 Cardan, Dr., and the clock, 45 
 
 Morley's life of, 45 
 Cardiac dilatation and V.M.N. , 67 
 dilatation, natural therapeu- 
 tics of, 67 
 Care in details, 160 
 Carefulness, value of, 106 
 Carelessness, evil of, 106 
 Carlyle and dress, 89 
 Carpenter, Dr., on mode of mind 
 action, 235 
 on rheumatism and mind, 234 
 on value of expectation, 177 
 Carter's little Liver Pills, compo- 
 sition of, 253 
 Castle and cottage, quackery in, 
 257 
 
 Casual directions unsatisfactory, 
 170 
 
 Casual remarks often most effec- 
 tive, 189 
 Cathell, Dr., on cheerfulness, 110 
 on doctors' fees, 94 
 on manners, 93 
 Causation of disease, the universal 
 
 factor in, 273 
 Cause, mental therapeutics treat 
 the, 21 
 
 of hysteria not conscious 
 
 mind, 9 
 of immunity from infection, 
 
 183 
 
 of perplexing success, 204 
 of quackery ignored by * Bri- 
 tish Medical Journal,' 257 
 of scepticism, 167 
 of success, Sir J. Paget on, 200 
 of success in suggestion, 181 
 Certainty, value of, 106, 169 
 
 Change of background essential, 
 187 
 
 value of, 119 
 Chapter written by patient, 123 
 Character determined by success, 
 200 
 
 personal, of Sydenham, 59 
 study of, 275 
 Charrin, Dr. A., on details of 
 
 V.M.N., 61 
 Cheerful manner, benefit of, 101 
 
 waiting-room, 137 
 Cheerfulness, value of, 106, 111, 
 172 
 
 Chemical therapeutics, 3 
 Childhood and V.M.N., 13 
 Children and doctor. Sir W. Dalby 
 
 on, 218 
 Choice of a nurse, 149 
 
 shown by V.M.N., 67 
 Christ, spirit of, 214 
 Christian Science and ' British 
 Medical Journal,' 256, 260 
 Science, extent of, 260 
 Science, treatment of cases 
 
 by, 261 
 Scientists, 52 
 
 Scientists and suggestion, 248 
 Christianity, doctor's vocation is 
 
 the spirit of, 223 
 Church, Sir W. S., on Nature, 61 
 Church, the, as hygienist, 22 
 Circle, the vicious, in hysteria, 244 
 Circulation, effects of emotion on, 
 
 225 
 
 Classes, educated, are not edu- 
 cated, 263 
 Cleanliness and doctor, 87 
 CHmates as ' suggestion ' remedies, 
 42 
 
 CHnical medicine. Sir W. W. Gull 
 on, 157 
 
 Clock, constipation cured by 
 means of, 236 
 of fate, the, 135 
 Sir D. Duckworth on value of, 
 196 
 
 therapeutic value of, 196 
 
INDEX OP SUBJECTS 
 
 289 
 
 Cockle's Pills, composition of, 
 253 
 
 Coleridge on hope in doctors, 113 
 College of Physicians and War 
 
 Office, 265 
 Collins, Dr. J., on psychotherapy, 1 
 
 on hysteria, 14 
 
 on neurasthenia, 192 
 
 on pain, 17 
 
 on patient's temperament, 
 184 
 
 on physical measures, 127 
 on self-respecting physician, 
 71 
 
 on suggestion, 182 
 Colour blindness and scepticism, 
 167 
 
 Command of facial expression, 218 
 
 value of, 169 
 Common sense and true judgment, 
 value of, 217 
 therapeutics symptomatic, 21 
 Complex nature of pleasure and 
 
 pain, 226 
 Compounds of feelings, emotions 
 
 as, 228 
 Conceit can kill or cure, 45 
 doctors should avoid, 78 
 in patients, 190 
 Concept of mind widened, 8 
 Conduct and U.M., 13 
 Confidence, Dr. Leahy on value 
 of, 51 
 gives immunity, 183 
 how to gain patient's, 215 
 Conscious action of mental thera- 
 peutics, 32 
 and unconscious fraud, 249 
 mind can aid V.M.N., 75 
 mind, no direct cure by, 56 
 mind cannot produce hysteria, 
 10 
 
 cannot affect body, 7 
 little power of, 56 
 suggestion, two sides of, 31 
 suggestion useful, 34 
 Consciousness deepened in hypno- 
 tism, 34 
 
 Consciousness, hmitation of mind 
 to, 6 
 
 not limit of mind, 12 
 threshold of, 11 
 Conservative action of V.M.N., 55 
 Constipation cured by the clock, 
 196 
 
 Consultant and family doctor, 112 
 Consultants, faults of, 166 
 
 value of personality of, 112 
 Consultation, suggestion as to, 142 
 
 when advisable, 165 
 Convalescence, value of, 119 
 Conventional nerve treatment, 194 
 Cortical excitation and hysteria, 14 
 Cough by suggestion, 175 
 
 lozenges, Keating' s, composi- 
 tion of, 253 
 
 natural therapeutics of, 72 
 
 stopped by U.M., 241 
 Courage, value of, 106 
 Courtier on emotion, 224 
 Criminal's cruel death from fright, 
 239 
 
 Criticism, destructive, easy, 138 
 
 of quack literature, 249 
 Crumbs, imitation, for the sick, 97 
 CuJlen, Dr., on V.M.N., 57 
 Curate and paralysed girl, 236 
 Curative faith, 112 
 
 power of patient's mind, 49 
 Cure by assertion, 189 
 
 by clot in aneurysm, 73 
 by direct suggestion, 190 
 by dogmatism, 51 
 by expectation, 43 
 by quackery, example of-, 258 
 doctors do not, 61 
 meaning of the word, 243 
 mode of, by Dr. Edwards, 189 
 of hysterical dysphagia, 237 
 of hysterical paralysis, 235 
 of lady by losing reason, 232 
 of obstinate constipation, 236 
 of patients by quacks, 23 
 of sceptical patients is hard, 
 189 
 
 of suggested paralysis, 36 
 
290 UNCONSCIOUS THEEAPEUTICS 
 
 Cure, pseudo-religious systems of, 
 259 
 
 pursuit of science before, 157 
 surprise of quack at, 258 
 Cures at spas, 46 
 
 by consultants, 47 
 by manner and method, 52 
 importance of permanent, 150 
 mental. Dr. S. Weir Mitchell 
 
 on, 45 
 mind helps in all, 264 
 moral. Dr. de Fleury on, 49 
 personality of physician in 
 all, 49 
 
 psychic, at Nauheim, 241 
 quack, how to lessen, 52 
 Curing and killing by will, 45 
 Cuticura, composition of, 253 
 
 Dalby, Sir William, on doctors 
 and children, 218 
 on faith, 112 
 
 Danger of ignorance of mental 
 therapeutics, 19 
 of leading questions, 175 
 of snapshot diagnosis, 109 
 of the therapeutics of fear, 195 
 
 Dead hand in medicine, 26 
 
 Death from fear, 233 
 
 from fright, Boucher on, 239 
 is failure of V.M.N., 66 
 suggestion of, 119 
 
 Decision, value of, 106, 169 
 
 Defective medical school training, 
 24 
 
 Defence of mental therapeutics, 38 
 Dejficiency, natural, can be made 
 
 good, 205 
 Definition of quacks and humbugs, 
 45 
 
 of U.T., 153 
 Delicacy of U.T., 187 
 Dehvery, pains of, regulated by 
 
 clock, 197 
 Dentists in Egypt, 79 
 Depressing doctor, story of, 10 
 
 manner, evil of, 99 
 
 Depression, Dr. B. Carter on, 21 
 
 evil of, 106 
 
 hinders V.M.N., 75 
 
 of waiting, 139 
 
 of waiting-room, 135 
 Description of patient, 131 
 
 of Sir F. Simpson, 108 
 
 of visit to doctor, 131 
 
 of woman, 144 
 Despair, never sow, 174 
 Despotism in medicine. Sir W. 
 
 Gairdner on, 25 
 Destructive criticism easy, 138 
 Details, evil of exaggeration in, 146 
 
 great minds fail in, 160 
 
 of action in peritonitis, 71 
 
 of action of V.M.N., 66 
 
 of V.M.N., Dr. A. Charrin on, 
 61 
 
 Sir H. Holland on importance 
 of, 193 
 
 Deterioration of the profession, 
 155, 156 
 
 Devils and angels in medicine, 85 
 Diagnosis by snapshot, 109 
 evil of hurried, 146 
 hypnotism good for, 33 
 importance of correct, 148 
 Diagnostic and therapeutic value 
 
 of physical examination, 178 
 Dietary as ' suggestive ' remedy, 
 42 
 
 Different meaning of U.T., 28 
 Difficulties of treatment, 149 
 Difficulty of truthfulness, 96 
 Digestion and will, 122 
 Dignity, value of, 106 
 Dilatation of heart and V.M.N., 67 
 
 pleasure causes, 226 
 Dilemma of profession, 9 
 Direct and indirect suggestions, 
 179 
 
 mental therapeutics, 32 
 suggestion and mental thera- 
 peutics, 30 
 suggestion, cure by, 190 
 Directions as to details, 160 
 casual, unsatisfactory, 170 
 
INDEX OF 
 
 Discipline of the face, 94 
 of temper, value of, 169 
 
 Disease, acute, V.M.N, in, 74 
 
 force of mind in, should be 
 
 taught, 273 
 nature of mind seen in, 28 
 never wholly physical, 212 
 not cured by drugs, 60 
 of heart. Sir T. G. Stewart on, 
 232 
 
 real importance of, 212 
 symptoms, therapeutics of, 72 
 Diseases, acute, will in, 45 
 
 are produced by suggestion, 
 34 
 
 healed by Nature, 37 
 mental, mental remedies for, 
 36 
 
 mind cures mental, 20 
 none cured without V*M.N., 
 55 
 
 not created for doctors, 213 
 suggested list of, 34 
 Display of intelligence by phago- 
 cytes, 67 
 Distraction, therapeutics of, 64 
 Diuresis, natural, therapeutics of, 
 67 
 
 Division between science and 
 philosophy, 266 
 
 Doctor and drugs for mind and 
 body, 113 
 and his personality, 102 
 and introspection, 102 
 and new patients, 134 
 and patient, relation of, 207 
 and prayer, 142 
 and therapeutics, 2 
 as unconscious medicine, 77 
 at bedside, 120 
 bed as a, 26 
 
 better than prescription, 48 
 chosen by women, 92 
 equal to calomel, 2 
 faith in, a necessity, 82 
 helped by patient, 53 
 hurry injures, 14 
 ignores his mental force, 27 
 
 SUBJECTS 291 
 
 Doctor, interest of the, 198 
 is he a gentleman ? 155 
 knowledge essential for, 213 
 Louis XI. and his, 206 J 
 Maclaren's Highland, 89 
 minor qualities of, 218 
 moral requisites of, 208 
 moralist, task of, 188 
 more than his prescription, 
 100 
 
 must be a man, 215 
 
 must know patient's mind, 
 
 184, 186 
 not a martinet, 169 
 of B.C. 4600, 154 
 powerless before quack, 23 
 qualities of, 110 
 recreation for, 150 
 rudeness of, 145 
 self-taught, in mental thera- 
 peutics, 18 
 story of cheerful, 100 
 successful, trifles important 
 
 to, 210 
 sympathy exhausts, 211 
 therapeutic value of, 195 
 trustworthiness of, 82 
 what he is, has, and does, 117 
 who did no harm, 154 
 Doctor's actions and conscious 
 therapeutics, 117 
 bad manners, 145 
 dogmatism cures, 60 
 environment, value of, 126 
 face, value of, 5, 98 
 hobbies, Gersany on, 91 
 house, Young Practitioner on, 
 126 
 
 kindness and sympathy, 83 
 life not always happy, 148 
 manner and hypochondria, 
 100 
 
 manner described by patient, 
 144 
 
 manners, 92 
 
 manners affect patient, 115 
 mind shown by conduct, 104 
 oily smile, 145 
 
 u 2 
 
292 UNCONSCIOUS THEEAPBUTICS 
 
 Doctor's personality and October i 
 addresses, 102 
 
 personality, U.T., 117 
 presence cures paralysis, 236 
 smile, Dr. O. W. Holmes on, 
 98 
 
 tombstone, 104 
 true place, 67 
 value, de Fleury on, 49 
 vocation. Dr. Stephen on, 223 
 visits and U.M,, 161 
 word, importance of, 51 
 words as medicine, 170 
 work. Sir W- W. Gull on, 65 
 Doctors and cleanliness, 87 
 and dress, 87 
 and healthy looks, 90 
 and mental philosophy, 157 
 and morality, 90 
 and prayer, 152 
 and women, 52 
 as artists, 168 
 as 'bears,' 93 
 as gods, 85 
 as patients, 111 
 as tonics, 111 
 assist V.M.N., 65 
 be natural, 145 
 can aid V.M.N., 74 
 can improve home, 147 
 Coleridge on hope in, 113 
 dislike hypnotism, 34 
 dis.ike mental therapeutics, 41 
 dislike psychotherapeutics, 2 
 do not cure, 61 
 evil suggestions by, 174 
 imposed on in homes, 149 
 in support of V.M.N., 61 
 leading, use psychotherapeu- 
 tics, 50 
 like action, 214 
 Lord Hervey on, 80 
 matter of fact, 78 
 mercenary, abhorred of God 
 
 and man, 201 
 must be definite, 170 
 not scientists, 168 
 personally affect patients, 104 
 
 Doctors, self-conscious, 77 
 
 should ali be taught psycho- 
 therapeutics, 272 
 should avoid conceit, 78 
 should be broad and accurate, 
 160 
 
 should be calm, 90 
 should be candid, 140 
 should maintain dignity, 166 
 should sow hope, 176 
 successful, not at all alike, 219 
 tactless, should not practise, 
 217 
 
 to be avoided, 194 
 ' vril ' in, 141 
 weighed in balance, 113 
 Doctors' ignorance of secret of 
 success, 205 
 ignorance of their power, 53 
 manners, Gersany on, 90 
 weapons. Dr. de Fleury on, 
 194 
 
 Dogmatism, value of, 170 
 Door-bell, effect of, 132 
 Door-key and haemorrhage, 241 
 Double brain action, Bernheim on, 
 30 
 
 Dramatic power, value of, to 
 
 doctor, 210 
 Dress as ' suggestion ' remedy, 42 
 Carlyle on, 89 
 Dr. de Styrap on, 87 
 in the old time, 88 
 of Highland doctor, 89 
 personality more than, 88 
 Drudges, medical, do not succeed, 
 167 
 
 Drug, sympathy as, 100 
 Drugs and ideas, 46 
 
 and natural mediums, 2 
 and unconscious therapeutics, 
 272 
 
 as psychic medicine, study of, 
 
 275 • 
 
 as quasi-mental remedies, 39 
 as suggestion remedies, 42, 
 
 180 
 
 I cannot cure mind disease, 20 
 
INDEX OP 
 
 Drugs, difficulty of testing, 43 
 inert, Dr. Bennett on, 46 
 inert through mind, 44 
 mental influence more than, 
 194 
 
 professional, 203 
 psychic action of, 42 
 psychic value of, Sir S. Wilks 
 on, 42 
 
 stronger than mind force, 44 
 
 twofold value of, 42 
 
 useless without V.M.N., 66 
 Dualists and monists, 18 
 Duckworth, Sir D., and Dr. Beg- 
 bie, 107 
 
 and ideal physician, 107 
 
 on hopelessness, 219 
 
 on humanities, 267 
 
 on management of the sick, 163 
 
 on mental therapeutics, 267 
 
 on value of clock, 196 
 Duties of physician, Dr. Hooker 
 on, 157 
 
 Dying people, Sir B. W. Richard- 
 son on, 45 
 Dysphagia, hysterical, 237 
 
 Earliest physician, Dr. Whitting- 
 
 ton on, 154 
 Early medical training, 8 
 Earnest appeal to readers, 271 
 Ease of sudden cure, 191 
 Eddy, Mrs. Mary Baker, 260 
 Educated classes not educated, 263 
 Education of organs, 121 
 Plato on higher, 209 
 retarded by medical schools, 
 203 
 
 U.T. and, 263 
 
 and quackery, 253 
 Edwards, Dr., mode of ciu-e, 189 
 Effect of temperament on re- 
 covery, 231 
 Effects of door-bell, 132^ 
 
 of emotion on the circulation, 
 225 
 
 of fear, 228 
 
 of hypnotism, 56 
 
 SUBJECTS 293 
 
 Effects of joy and fear, 233 
 Egypt, medical science in, 79 
 Electric light baths and Kiag, 128 
 light baths, psychic action of, 
 128 
 
 Electricity a psychic remedy, 36 
 as suggestion, 180 
 Moebius on psvchic force of, 
 128 
 
 Elixir vitcd, hope as, 174 
 Elizabeth, Queen, surgeons in days 
 of, 79 
 
 Eminent men as hindrances, 202 
 Emotions and body changes, 224, 
 230 
 
 and weight of brain, 225 
 Binet and Courtier on, 224 
 effect of, on vaso-motors, 224 
 mode of body actions un- 
 known, 229 ' 
 more powerful than feelings, 
 228 
 
 of pleasure and pain, 233 
 Empirical medicines legitimate, 39 
 
 use of drugs increasing, 74 
 
 use of U.T., 230 
 Encouragement, value of, 120 
 Enemies, learning from, 265 
 England, prejudice strong in, 2 
 Englishman's modesty, 2 
 Eno's Fruit Salt, composition of, 
 
 253 
 
 Environment and U.M., 148 
 as mental therapeutics, 29 
 as ' suggestion ' remedy, 42 
 as therapeutic agent, 125 
 value of doctor's, 126 
 value of new, 148 
 value of patient's, 124 
 
 Essential factor in practice, 216 
 Imowledge for doctor, 213 
 
 Ether, narcosis without, Mr. W. 
 Braine on, 35 
 
 Ethics and U.M., 13 
 in medicine, 269 
 medical, 41, 267 
 medical. Sir J. Fife on, 156 
 of placebos, 38 
 
294 UNCONSCIOUS THEEAPEUTICS 
 
 Ethics of suggestion, 37 
 of the profession, 155 
 
 Etiquette, medical, 83 
 
 Everett, Graham, on doctors, 80 
 
 Evil consequences of waiting, 136 
 of arti6cial manners, 105 
 of bad manners, 155 
 of bad suggestion, 155 
 of conceit in patients, 190 
 of depressing manner, 99 
 of exaggeration, 146 
 of fear, 106 
 
 of hurried diagnosis, 147 
 of marking time, 147 
 of morning visits, 131 
 of old treatment of hvsteria, 
 268 
 
 of suggestion of death, 119 
 of transplanting, 125 
 of uncertainty, 16& 
 of unpunctuality, 140 
 of waiting, 135 
 
 professional charity often 
 
 thinks, 204 
 suggestions by doctors, 174 
 suggestions, Dr. A. Ford on, 
 
 175 
 
 suggestions, Dr. Goodhart on, 
 175 
 
 Exaggeration and mental thera- 
 peutics, 232 
 
 to be avoided, 171 
 
 Examinations, physical, therapeu- 
 tic value of, 178 
 
 Example of quack cure, 258 
 
 Examples of U.T., 232 
 
 Exercise as ' suggestion ' remedy, 
 180 
 
 Expectation cures, 43 
 
 Dr. Carpenter on value of, 177 
 
 value of, 43 
 Experiment on feeling, Braid's, 
 239 
 
 Experts not well balanced, 104 
 Expos4 of quack methods, 245 
 Expression of face, command of, 
 218 
 
 Extension of medical study, 186 
 
 Extent of Christian Science, 260 
 of U.M., 14-16 
 
 Eye, a single, 6 
 
 mental, achromatic, 211 
 single, of Sydenham, 69 
 single, open to-day, 59 
 
 Eyes, two, in medicine, 25 
 value of two, 6 
 
 Face, description of, 94 
 
 of doctor, value of, 60, 98 
 the medical, 60 
 Facial expression, command of, 
 218 
 
 Failure of V M.N. is death, 66 
 Failures, medical proportion of, 
 199 
 
 Faith and trust, value of, 183 
 cures, 52 
 
 cures as test of mind, 262 
 
 in doctor a necessity, 82 
 
 Sir W. Dalby on, 112 
 
 that cures, 112 
 Faith-healing and 'British Medical 
 Journal,' 255 
 
 historical retrospect of, 256 
 Faith, hopefulness is not, 220 
 
 manner should inspire, 171 
 False imitation of mind and con- 
 sciousness, 6 
 
 strength, harm of, 222 
 Family doctor and consultant, 112 
 
 physician's opportunities, 161 
 Fancies and fictions in quackery, 
 
 250 ^ 
 Fashions in medicines, 44 
 Fate, the clock of, 135 
 Faults of consultants, 166 
 Fear and joy, effects of, 233 
 
 death from, 233 
 
 evil of, 106 
 
 may paralyse, 229 
 
 therapeutics of, 195 
 Fee, psycho- therapeutics of, 50 
 
 therapeutical value of, 78 
 Feeling, Brahm on, 226 
 
 Braid's experiments on, 239 
 
 physical process with every, 17 
 
INDEX OF SUBJECTS 
 
 295 
 
 Feeling, varieties of, 226 
 
 Wundt on, 226 
 Feelings as excitants. Dr. Binet 
 on, 224 
 
 emotions more powerful than, 
 228 
 
 Ferrier, Dr., on mind and heart, 
 224 
 
 Fife, Sir John, on medical profes- 
 sion, 156 
 Finger ends, knowledge at, 214 
 Firmness, value of, 98, 106 
 Fixed backgrounds, 185 
 Fleury, Dr. de, on doctors and 
 doctors' weapons, 194 
 on doctor's value, 49 
 on implanted ideas, 172 
 on mental therapeutics, 21 
 on mind culture, 158 
 on mind modifying, 188 
 on value of big words, 50 
 Food in waiting-room, 138 
 Force in quackery, the real, 255 
 of mind in disease should be 
 taught, 273 
 Forces affecting patients, 118 
 Ford, Dr, A., on evil suggestions, 
 175 
 
 Forget yourself, 215 
 Forgetfulness, evil of, 106 
 Formation of good habits in 
 
 patients, 193 
 Foriiter, fiddlier, feliciter, 222 
 Fothergill, Dr. M., on the will, 
 
 44 
 
 Four classes of therapeutics, 3 
 
 sorts of mental therapy, 29 
 Fraud, conscious and unconscious, 
 249 
 
 hysteria is not, 244 
 Friends of patients and doctors. 
 148 
 
 of patients, trouble with, 187 
 patients as, 151 
 patients seen before, 142 
 value of, 119 
 Fright, Bouchet on death from, 
 239 
 
 Frock-coat in medicine, 89 
 Futile remedies for quackery, 254 
 
 Gairdnkr, Sir W., on despotism 
 
 and medicine, 25 
 Galen on hysteria, 14 
 on Nature, 57 
 on V.M.N., 65 
 Gas, angesthetics without, 35 
 
 virtue as a, 207 
 Gastric catarrh and V.M.N., 67 
 
 ulcer by suggestions, 176 
 Geniuses as * bears,' 93 
 Gentleman, is a doctor a, 155 
 i physician, a, 84 
 I Gentleness, value of, 106, 169 
 Gentlewomen as nurses, 150 
 Genuineness of mind action, 40 
 Gersany on doctors' hobbies, 91 
 on doctor's manners, 90 
 i Getting on, value of, 121 
 i Gifts of healing, 113 ^ 
 j of healing and laity, 114 
 
 of healing. Sir K. Barrington 
 on, 114 
 Gloomy waiting-rooms, 135 
 Golden calf, worship of, 218 
 Good bedside manners, 164 
 
 manners, students should 
 learn, 165 
 1 of peritonitis, 70 
 
 physicians use suggestions, 
 180 
 
 temper, value of, 106 
 two powers for, 116 
 V.M.N. active for, 75 
 Goodhart, Dr., on evil sugges- 
 tions, 175 
 Gout and mind, Kant on, 239 
 Great minds fail in detail, 160 
 
 men, inspiration of, 109 
 Greater powers of electric light 
 
 baths, 129 
 Greek alphabet, therapeutics of, 
 248 
 
 Green, Dr., on ideal physician, 84 
 on manners, 93 
 
296 UNCONSCIOUS THEEAPEUTICS 
 
 Gregory, Dr. John, on ideal physi- 
 cian, 84 
 
 Grotesque statements by patients, 
 218 
 
 Growth of use of natural remedies, 
 43 
 
 Gull, Sir W. W., on chemical medi- 
 cine, 157 
 
 on doctors' work, 65 
 
 on hypochondriacs, 17S 
 
 on Nature, 60 
 
 on Nature's remedies, 26 
 
 on psychic force, 4 
 
 on psychic prescription, 43 
 
 tact of, 217 
 Gymnastics as * suggestion * re- 
 medy, 42 
 
 Habits, breaking of bad, 121 
 
 formation of good, in patient, 
 193 
 
 time to form, 193 
 value of, 119 
 Hair Restorer, Mrs. Allen's, com- 
 position of, 253 
 Haphazard use of mind cures, 153 
 Harm of false strength, 222 
 Head of phagocyte armies, 67 
 Headache by suggestion, 174, 175 
 Healing, gifts of, 113 
 
 metaphysical, Miinsterberg 
 
 on, 246 
 power increased by use, 115 
 Health, not strength, pursuit of, 
 122 
 
 Healthy looks and doctors, 90 
 mind diffuses health, 161 
 
 Heart action and fear, 229 
 
 and mind, Dr. Ferrier on, 
 224 
 
 disease and loss of mind, 232 
 disease, Sir J. G. Stewart on, 
 232 
 
 Heart's action altered, 234 
 Hemorrhage stopped by toads, 
 241 
 
 Hercules and lole, 51 
 
 Herman, Dr., on psychic remedies, 
 36 
 
 Hernia, treatment of, in 1737, 80 
 Hervey, Lord, on doctors, 80 
 Hesitancy, evil of, 105 
 i Higher education, Plato on, 209 
 Highland doctor, Maclaren on, 89 
 High-minded purists and mind 
 
 cures, 40 
 Hindrances, eminent men as, 202 
 Hippocrates, Dr. S. Weir Mitchell 
 on, 58 
 
 on doctor's appearance, 90 
 on Nature, 57 
 opposed by Asclepiades, 58 
 I Hobbies injure practice, 91 
 
 to be kept in background, 91 
 Holland, Sir H., on importance of 
 details, 193 
 on manners. 111 
 Holloway's Pills, composition of, 
 253 
 
 Holmes, Dr. 0. W., on doctors' 
 
 smiles, 98 
 Home as it is, 147 
 
 as it should be, 148 
 bad for neurasthenia, 148 
 I doctors can improve, 147 
 j patient better seen in, 126 
 j patients should be seen at, 130 
 value of seeing patient in, 137 
 : Homes, doctors imposed on in, 149 
 Homocea, composition of, 253 
 Homoeopathy and hope, 174 
 Hooker, Dr., on physician's duties, 
 1 157 
 
 on the judicious physician, 
 158 
 
 , Hope, always inspire, 177 
 
 1 helps V.M.N., 75 
 
 I Dr. Moore on value of, 174 
 
 ! doctors should sow, 176 
 
 ; in doctors, Coleridge on, 113 
 
 in heart disease, 232 
 
 U.M. on, 232 
 
 value of, 119, 219, 106 
 Hopefulness, Sir D. Duckworth on, 
 219 
 
INDEX OP 
 
 Hopefulness not faith-healing, 
 221 
 
 Hospital, treatment of patient in, 
 230 
 
 House, value of doctor's, 126 
 How to cure patients, 151 
 
 to gain patients' confidence, 
 215 
 
 to make permanent cure, 151 
 Human life, not mechanical, 213 
 
 Sir J. R. Reynolds on, 27 
 Humanities, Sir D. Duckworth 
 
 on the, 267 
 Humanity, knowledge of, neces- 
 sary, 168 
 Humble origin of medical men, 
 81 
 
 Humbugs and mental therapeu- 
 tics, 41 
 
 and quacks, diiference be- 
 tween, 41 
 Humour, value of, 170 
 Hunter, John, on great men, 53 
 
 on impressions, 221 
 Hurried diagnosis, evil of, 140 
 Hurry, evil of, 106 
 
 injures doctor, 141 
 Hutchison, Dr., on patent medi- 
 cines, 251 
 
 questions to, 255 
 
 remedy for quackery, 252 
 Hygiene, personal experience in, 91 
 
 the higher, 194 
 Hygienic value of the Church, 22 
 HyperaBsthesia and anaesthesia, 238 
 Hypertrophy and V.M.N., 74 
 Hypnotism, action of, 32 
 
 deepens consciousness, 34 
 
 disliked by doctors, 34 
 
 effects of, 56 
 
 is good for diagnosis, 33 
 
 powers of U.V.M. in, 240 
 
 sensation increased in, 133 
 
 value of, 179 
 Hypochondria and doctor's 
 
 manners, 100 
 Hypochondriacs, Sir W. W. Gull 
 on, 173 
 
 SUBJECTS 297 
 
 Hysteria and cortical excitation, 
 14 
 
 and malingering not synony- 
 mous, 10 
 
 and marriage, 268 
 
 and real disease, proportion 
 of, 264 
 
 and the vicious circle, 244 
 
 danger of, 238 
 
 Dr. Inraan on, 268 
 
 Dr. J. Collins on, 14 
 
 evil of old treatment of, 268 
 
 Galen on, 14 
 
 melancholy chapter in thera- 
 peutics, 268 
 mistura diaholica in, 269 
 not consciously caused, 9 
 not fraud, 244 
 not produced by will, 10 
 problem of, 9 
 
 requires study of mind, 244 
 Skey on, 263 
 Sydenham on, 14 
 symptoms of unconscious, 9 
 Hysterical dysphagia, 237 
 paralysis, 235 
 
 Ideal physician, the, 81 
 
 Dr. T. BroTvn on, 81 
 
 Dr. Bruce on, 85 
 
 Sir D. Duckworth on, 107 
 
 Dr. Green on, 84 
 
 Dr. Gregory on, 84 
 
 Sir J. Simpson on, 108 
 
 Dr. Stirling on, 83 
 
 Sir T. Watson on, 107 
 Idea paths in brain a ' sugges- 
 tion,' remedy, 42 
 Ideas and drugs, 46 
 
 three for patient, 159 
 Ignorance about patients, mis- 
 takes from, 169 
 
 evil done through, 107 
 
 of cause of success, 205 
 
 of mental backgroimd, mis- 
 takes from, 185 
 
 of mental therapeutics, 37 
 
298 UNCONSCIOUS 
 
 THEEAPEUTICS 
 
 Ignorance of mental therapeutics 
 dangerous, 19 
 
 of mind action indefensible, 
 40 
 
 quackery flourishes on, 245 
 Ignoring of unconscious mind, 48 
 Ill-temper, evil of, 106 
 Illustrations of natural treatment, 
 72 
 
 Imaginary, pain is never, 17 
 Imaginative insight, value of, 210 
 Imitation crumbs for the sick, 97 
 of natural processes by treat- 
 ment, 72 
 of V.M.N. bv nitrite of amyl, 
 67 
 
 Immunity and the V.M.N., 65 
 
 from infection, cause of. 183 
 Impatience, evil of, 106 
 Implanted ideas. Dr. Fleurv on, 
 172 
 
 Implanting of an idea, 173 
 Importance of correct diagnosis, 
 147 
 
 of details, Sir H. Holland on, 
 19 
 
 of doctor's words, 51, 113 
 of patient's manner, 190 
 of permanent cures, 150 
 of trifles to success, 210 
 Imposition and mysticism, 249 
 Impressions are all permanent, 52 
 Dr. Hunter on, 221 
 narcosis from past, 35 
 Impressive means and suggestions, 
 181 
 
 Impulse and suggestive therapeu- 
 tics, 31 
 
 Increase of empirical use of drugs, 
 44 
 
 Indictment of ultra-scientific spirit, 
 270 
 
 Indirect and direct suggestions, 
 178 
 
 mental therapeutics, 32 
 Indivisibility of mind, 3 
 Indolence, psychological treat- 
 ment of, 172 
 
 f Inert drugs. Dr. Bennett on, 41, 46 
 Inflammation as an angel, 68 
 
 natural therapeutics of, 68 
 Influence, magnetic, 141 
 
 of physician on patient, I 
 of thoughts on body, 3 
 Influences on nervous system, 118 
 mental, more than drugs, 
 194 
 
 mental, value of, 159 
 of environment, therapeutic, 
 123 
 
 of others, therapeutical, 117, 
 129 
 
 social, as 'suggestion' re- 
 medy, 42 
 Inhibition of pain by mind, 234 
 Injury to patients by bad manners, 
 106 
 
 Inman, Dr., on history of hysteria, 
 
 268 
 
 Inner life of Sir J. Paget, 108 
 Insanity and fixed backgrounds, 
 185 
 
 Inscription on vase, 109 
 Insight, value of, 217 
 Inspiration of great men, 109 
 Inspire hope always, 177 
 Inspired idiots, 106 
 Intelligence displayed by phago- 
 cytes, 67 
 Interaction of mind and body un- 
 known, 230 
 Interest of malingering, 57 
 of the doctor, 198 
 value of, 106 
 Interval between patients, 141 
 
 how to employ, 142 
 Interview, benefit from single, 114 
 
 with patient first, 146 
 Introspection and doctor, 102 
 Intuitive qualities best, 205 
 lole and Hercules, 51 
 Irrelevancy of ' British Medical 
 
 Journal' 63 
 Isolation as a 'suggestion' re- 
 medy, 42 
 natural therapeutics of, 71 
 
INDEX OF SUBJECTS 
 
 299 
 
 Joy and fear, effects of, 233 
 Judicious physician, Dr. Hooker 
 on, 158 
 
 Kant on mind and gout, 239 
 Keating's Cough Lozenges, compo- 
 sition of, 253 
 Kidney diseases, Dr. ]\Iitchell 
 
 Bruce on, 67 
 Killing and curing by will, 45 
 Kindness and sympathy of doctor, 
 83 
 
 King and electric baths, 128 
 Knowledge at fingers' ends, 214 
 essential for doctor, 214 
 manner versus, 167, 169 
 of humanity necessary, 168 
 unconscious, 192 
 Koko, composition of, 253 
 
 Lady cured by losing her reason, 
 282 
 
 doctors, value of, 132, 142 
 patients, how to manage, 183 
 Laity and mind in medicine, 25 
 gifts of healing, 114 
 value doctor's personality, 
 104 
 
 Lamplough's Pyretic Saline, com- 
 position of, 253 
 * Lancet' on cure by pure water, 
 238 
 
 on psychic remedies, 52 
 Lange on use of stimulants, 226 
 Last resource, travel as, 162 
 Last words of Dr. Sutton, 51 
 Latham, Dr., on medicine, 221 
 Latinity, medical, details better 
 
 than, 193 
 Leading questions, danger of, 175 
 Leahy^ Dr., on value of confidence, 
 
 57 
 
 Learning from our enemies, 265 
 Lectures and text-books on M.T., 
 274 
 
 Legitimacy of mind action, 40 
 
 ! Legitimate emi)irical medicine, 39 
 i Lehmann on pulse and feelings, 
 
 I 226 
 
 Leith, Dr., on cure at Nauheim, 
 241 
 
 Levity, evil of, 106 
 Lihro meo, apologia pro, 8 
 Life, inner, of Sir J. Paget, 107 
 I of doctor not always happv, 
 I 148 ^ ^ 
 
 I saved by peritonitis, 71 
 i saved by suggestions, 181 
 I Light on quack literature, 249 
 j Limitations of mind to conscious- 
 j nesg, 6 
 
 i Lineel liniment, composition of, 
 253 
 
 List of partly psychical remedies, 
 42 
 
 of ' suggestion ' diseases, 34 
 of * suggestion ' remedies, 42 
 Little power of conscious mind 
 
 over body, 56 
 Liver Pills, Carter's Little, com- 
 position of, 253 
 Liverpool, address by Sir F. 
 
 Treves, 222 
 Locum tenens, story of, 91 
 Looking at patient, value of, 182 
 Loss from neglect of mental 
 therapeutics, 24 
 of mind and heart disease, 232 
 of sense of proportion, 105 
 Louis XL and his doctor, 206 
 
 Maclaren's highland doctor, 89 
 Magnetic influence, 141 
 Maids better than men servants, 
 132 
 
 Make cures permanent, 151 
 Mahngering and hysteria not 
 synonymous, 10 
 
 interest of, 57 
 
 what constitutes, 10 
 Man a unity, 19 
 
 doctor must be a, 215 
 
 how to see, 5 
 
300 UNCONSCIOUS THEEAPEUTICS 
 
 Management of patients, 163 
 
 of sick, Sir D. Duckworth on, 
 163 
 
 of wilful patients, 168 
 psychic, more difficult than 
 
 physical, 267 
 Manner and method as cure, 52 
 Sir D. Duckworth on, 163 
 must have variety, 95 
 of doctor described by patient, 
 
 144 
 
 of doctor, Gersany on, 90 
 of doctor and hypochondria, 
 100 
 
 psychic influence of, 171 
 should inspire faith, 171 
 therapeutics of, 163 
 Manners, bad, in doctor, 145 
 bedside, 163 
 benefit of cheerful, 100 
 Dr. Cathell on, 93 
 evil of artificial, 105 
 evil of bad, 155 
 evil of depressing, 99 
 Dr. Green on, 93 
 Sir H. Holland on, 111 
 natural value of, 151 
 never to be assumed, 87 
 of doctor, 92 
 
 of doctor affect patient, 115 
 students should have good, 
 165 
 
 versus knowledge, 167 
 Marking time, evil of, 147 
 Marriage and hysteria, 268 
 Mars' hill, Athenians on, 37 
 Martinet, doctor not a, 169 
 Mason Osgood on psychic thera- 
 peutics, 264 
 Massage a psychic remedy, 36 
 
 as a suggestion, 42 
 
 as a remedy, 180 
 Matter-of-fact doctors, 78 
 
 purpose no property of, 67 
 Meaning of single eye, 5 
 
 of the word ' cure,' 243 
 Means aid suggestion, 181 
 Mechanical, Be human, not, 213 
 
 Mechanical therapeutics, 4 
 Meddlesome purists, 202 
 Medical art. Sir C. Wyndham on, 
 206 
 
 backgrounds, 185 
 Medical drudges do not succeed, 
 167 
 
 education, 269 
 ethics, 41, 267 
 
 ethics, Dr. M. Wardle on, 155 
 etiquette, 83 
 face, the, 50 
 
 failm:es, proportion of, 199 
 frock coat, 89 
 
 ignorance, quacks flourish 
 
 from, 24 
 latinitv, details better than, 
 
 193" 
 
 leaders use placebos, 38 
 man, attraction of, 2 
 man, earliest known, 1 54 
 man a pharmacopoeia, 2 
 men, humble origin of, 81 
 men, Sir F. Treves on, 82 
 obloquies on women, 268 
 pioneers are not quacks, 202 
 profession, actors in, 164 
 profession. Sir John Fife on, 
 156 
 
 psychology, value of, 204 
 schools retard education, 203 
 school training, defects of, 24 
 science in Egypt, 79 
 science in 1737, 80 
 study, new branch of, 278 
 study, subject for, 93, 186 
 study of suggestion, 31 
 success. Sir James Paget on, 
 277 
 
 teaching at present unfair, 271 
 trade-unionism, 41 
 training, early, 8 
 vices, 106 
 Medicine an exacting mistress^ 209 
 angels and devils in, 85 
 antiquity of, 79 
 ' British Medical Journal ' on 
 strength in, 222 
 
INDEX OF SUBJECTS 
 
 301 
 
 Medicine and character, 270 
 chest, physician as a, 77 
 clinical value of, 157 
 doctor's words as, 170 
 dead hand in, 26 
 empire of, 207 
 empirical, legitimate, 39 
 ethics of, 269 
 fashions in, 44 
 how to succeed in, 203 
 Dr. Hutchison on patent, 251 
 Dr. W. Osier on, 208 
 Sir J. Paget on success in, 
 199 
 
 and philosophy, 266 
 and religion, 256 
 a science and art, 25 
 stereoscope in, 5 
 Dr. Styrap on success of, 159, 
 203 
 
 success in, 108 
 two eyes in, 25 
 value of details in, 146 
 and wisdom, 25, 192 
 wise teacher on success in, 
 206-221 
 
 Melancholy and anassthesia, 234 
 Men as physiological machines, 212 
 nerves abhorrent to, 132 
 treated as animals, 231 
 Mental alteratives as ' suggestion ' 
 remedy, 42 
 backgrounds, 184 
 cures, agency in, 47 
 cures as consultants, 47 
 cures, tuto, cito, etjucunde, 41 
 cures, U.M. agent in, 47 
 effects of electricity, 127 
 effect of physical agents, 127 
 environment of patient, 126 
 eye, achromatic, 211 
 factor in pathology, 66 
 influence more than drugs, 194 
 influences and phagocytosis, 
 64 
 
 influences, value of, 159 
 medicine, probable advance 
 in, 22 
 
 Mental personality of the physi- 
 cian, 33 
 philosophy, doctors and, 157 
 potassium, 21 
 
 remedies for mental diseases, 
 36 
 
 remedies as quasi-drugs, 39 
 states as produced by body, 
 207 
 
 therapeutics, 4 
 M.T. act by U.M., 37 
 
 affects temperament, 231 
 and direct suggestion, 30 
 and exaggeration, 244 
 and force of mind, 20 
 and indirect suggestion, 30 
 and modern physicians, 17 
 and physical means, 32 
 and quacks, 41 
 are unconscious therapeutics, 
 32 
 
 book on, needed, 4 
 
 danger of ignorance of, 19 
 
 defence of, 38 
 
 direct and indirect, 32 
 
 environments aid, 79 
 
 essential in good practice, 40 
 
 four sorts of, 29 
 
 ignorance of, 37 
 
 integral part of medicine, 37 
 
 lectures and text-book on, 274 
 
 loss from neglect of, 24 
 
 more legitimate than drugs, 37 
 
 mostly unconscious, 29 
 
 no small action of, 32 
 
 not taught in schools, 4, 18 
 
 points for study in, 274 
 
 practised unwittingly, 37 
 
 Sir D. Duckworth on, 267 
 
 treat cause, 21 
 
 two actions of, 31 
 
 unconscious action of, 32 
 
 value of, 20, 54 
 
 V.M.N. in, 29 
 
 Mental touch is tact, 162 
 yet not unconscious, 9 
 
 Mercenary doctors, Sir W. Sanders 
 on, 201 
 
302 UNCONSCIOUS 
 
 THEEAPEUTICS 
 
 Mercury, use of, in 1733, 46 
 Mercy, true sister of, 150 
 Mesopotamia, that blessed word, 
 50 
 
 Metabolism and hope, 222 
 Metaphysical healers and sugges- 
 tion, 248 
 Metchnikoff on purpose, 64 
 Methods of love cure, 248 
 
 of quackery exposed, 245 
 Mind action as genuine as body 
 action, 40 
 action natural, 40 
 alteratives for, 21 
 alters nutrition of body, 35 
 and body, connection of, 3 
 and body, doctors and drugs 
 
 for, 113 
 and body, interaction of, not 
 
 known, 230 
 and body mould each other, 
 207 
 
 and body, reaction of, 3 
 and body, Sir J. Paget on, 7 
 and gout, Kant on, 239 
 and heart, Dr. Ferrier on, 
 224 
 
 and hunger and thirst, 234 
 and rheumatism, 234 
 and sensory motor reflexes, 15 
 Aristotelian Society on, 11 
 casts shadows Uke body, 103 
 conception of, must be 
 
 widened, 7 
 conscious, cannot affect body, 
 
 7 
 
 conscious, can aid V.M.N., 75 
 culture. Dr. Fleury on, 158 
 cure and paralysed child, 236 
 cure by water, 238 
 cure, ignorance of, indefen- 
 sible, 40 
 cure more than prescription, 
 160 
 
 cure of rheumatism. Dr. 
 
 Buckley on, 241 
 cures and abdominal section, 
 
 242 
 
 Mind ciu'es and high-minded pur- 
 suits, 40 
 cures and haphazard use of, 
 153 
 
 cures mental diseases, 20 
 disturbs action of drugs, 43 
 drugs inert through, 44 
 faith comes as test of, 262 
 force, drugs stronger than, 44 
 helps all cures, 264 
 in medicine and laity, 25 
 in therapeutics, 1-19 
 is indivisible, 13 
 limited to consciousness, 6-12 
 modifying. Dr. de Fleury on, 
 188 
 
 Dr. Moore on power of, 3 
 narrowed by professional 
 
 work, 208 
 not two, 12 
 
 of doctor shown in conduct, 
 104 
 
 of patient, doctor must know, 
 184 
 
 of physician, value of, 48 
 over mind, power of, from 
 
 ' British Medical Journal,' 
 
 48 
 
 pain inhibited on, 234 
 produces bhsters, 240 
 recognised by its products, 7 
 shown in surroundings, 104 
 subconscious, 7 
 to consciousness, false limita- 
 tion of, 6 
 training of patient, 188 
 unconscious, and physiology, 
 12 
 
 unconscious, book on, 8 
 imconscious, not a contradic- 
 tion, 12 
 Minds, how to capture, 172 
 Mineral waters as suggestive 
 
 remedy, 42 
 Minor operation as suggestive 
 remedy, 42 
 
 qualities of doctor, 208 
 therapeutics as influences, 123 
 
INDEX OP SUBJECTS 303 
 
 Mistakes from ignorance about 
 patients, 169 
 from ignorance of back- 
 ground, 185 
 Mistura diabolica in hysteria, 269 
 Misuse of psychotherapy in Ame- 
 rica, 1 
 
 Mitchell, Dr. W., on bad doctors, 
 194 
 
 on cure by suggestion, 190 
 on doctor's manners, 92 
 on Hippocrates, 58 
 on management of women, 
 183 
 
 on mental cures, 45 
 on success in medicine, 209 
 on sympathy, 96 
 on value of patient to doctor, 
 54 
 
 Mobile backgrounds, 184 
 Mode of body actions unknown, 
 229 
 
 of mind action, 235 
 
 Modern methods of suggestion, 248 
 physician and mental thera- 
 peutics, 17 
 
 Modesty of our countrymen, 2 
 
 Moebius on psychic force of 
 electricity, 128 
 
 Money-making concern, Christian 
 Science, 256 
 
 Monist and dualist, 18 
 
 Moore, Dr., on power of mind, 3 
 on value of hope, 174 
 
 Moral cures. Dr. de Fleury on, 49 
 management of sick, 158 
 requisite's of physician, 208 
 suggestion, value of, 189 
 value of medicine, 221 
 
 Morality of doctors, 90 
 of suggestion, 36 
 
 Morbid processes stopped slowly 
 by V.M.N., 66 
 
 Morley's Life of Dr. Cardan, of 
 Milan, 45 
 
 Morning visits, evil of, 131 
 
 Mosso on the plethysmograph, 225 
 
 Motor-car, patient as, 27 
 
 Miinsterberg on quack methods, 
 245 
 
 on suggestion, 181 
 Muscles, action of, in peritonitis, 
 70 
 
 mind training of, 158 
 Must treat the man, not disease, 
 212 
 
 Myers, Dr. A., on U.T., 230 
 
 Mysterious tenant of body, 28 
 Mystical powers, Miinsterberg on, 
 246 
 
 Mysticism and imposition, 249 
 
 Napoleon on Nature, 64 
 Narcosis without ether, W. Braine 
 on, 35 
 
 Natural and acquired reflexes, 15 
 aptitude for profession, 1 65 
 deficiencies can be made good, 
 205 
 
 manners, value of, 151 
 medicines and drugs, 26 
 mental therapeutics, 55 
 processes, treatment should 
 
 imitate, 72 
 remedies, growing use of, 43 
 remedies. Sir W. W. Gull on, 
 
 26 
 
 remedies. Dr. W. Mitchell on, 
 209 
 
 smile must be, 99 
 therapeutics in appendicitis, 
 69 
 
 therapeutics of anorexia, 67 
 therapeutics of cardiac dila- 
 tation, 67 
 therapeutics of cough, 72 
 therapeutics of diuresis, 67 
 therapeutics of inflammation, 
 68 
 
 therapeutics of isolation, 71 
 therapeutics of nausea, 69 
 therapeutics of peritonitis, 69 
 therapeutics of rest, 70 
 Naturalist, physician not a, 110 
 Naturalness, value of, 106 
 
304 UNCONSCIOUS THEEAPEUTICS 
 
 Nature and therapeutics in aneu- 
 rism, 73 
 St. Augustine on, 57 
 Bacon on, 60, 65 
 Boerhaave on, 58 
 Dr. Mitchell Bruce on, 60 
 Sir W. S. Church on, 61 
 cures disease, 61 
 despised by Asclepiades, 59 
 Galen and Aristotle on, 58, 65 
 Sir W. W. Gull on, 60 
 heals diseases, 57 
 Hippocrates on, 57 
 imitated by wise doctor, 74 
 is U.M., 8, 62 
 is V.M.N., 56 
 
 of mind seen in disease, 28 
 Sydenham on, 58, 59 
 Nature's methods profound. Dr. 
 
 W. Bruce on, 64 
 Nauheim, psychic cures at, 241 
 Necessity for recreation, 150 
 
 of change of background, 187 
 of knowledge of humanity, 
 168 
 
 of true sympathy, 96 
 Need of teaching U.T., 245 
 Negative suggestions, 31 
 Neglect in medical teaching, 4 
 of mental therapeutics, 4 
 of psychic therapeutics, reason 
 of, 6 
 
 Nerve action, Herbert Spencer on, 
 30 
 
 cases, hypnotism in, 179 
 cases, nurse for, 149 
 patient described, 131 
 patient on lady doctors, 143 
 patients require time, 53 
 patients, sympathy essential 
 
 for, 162 
 patients, treatment of, 130- 
 
 152 
 
 sufferers are outcasts, 162 
 tonics and stimulants, 227 
 treatment, conventional, 194 
 Nerves abhorrent to men, 132 
 body cured before, 195 
 
 Nervous patients and home, 147 
 
 system, influences on, 118 
 Neurasthenia, Dr. J. Collins on, 
 192 
 
 home bad for, 148 
 
 Neuromimesis, aetiology of, 9 
 
 Neurotics, hypnotism of, 239 
 
 Never sow despair, 174 
 
 New branch of medical study, 278 
 drugs, difficulty of testing, 43 
 patients and doctor, 134 
 remedies most effectual, 43 
 remedies. Dr. Styrap on, 231 
 
 Nitrite of amyl in imitation of 
 V.M.N., 67 
 
 Not two minds, 12 
 
 Novel sub -title, 2 
 
 Novelty of Chapter VL, 123 
 
 Nurse, choice of a, 149 
 personality of, 149 
 
 Nurses, cause of immunity, 183 
 gentlewomen as, 150 
 value of amateur, 150 
 
 Nutrition of body altered by mind, 
 35 
 
 Obloquies on women in medical 
 
 works, 268 
 Obscurity of cause of successes, 
 205 
 
 of psycho-physical action, 230 
 Observation, value of, 106 
 Obstinate constipation, 236 
 October addresses and doctor's 
 
 personality, 102 
 OcuHsts in Egypt, 79 
 Oil, St. Jacob's, composition of, 
 
 253 
 
 Oily smile of doctor, 145 
 Old time, medical dress in, 88 
 Old treatment of hysteria, evils of, 
 268 
 
 One thing lacking, 216 
 Opportunities of family physician, 
 161 
 
 Opposition of U.M., 48 
 Optimists and pessimists, 219 
 
INDEX OP SUBJECTS 
 
 305 
 
 Order of seeing patients, 134 
 Organic processes influenced by 
 
 psychic action, 56 
 Organs, education of, 121 
 
 good servants and bad mas- 
 ters, 121 
 
 Origin of medical men, humble, 81 
 Osier, Dr. W., on medicine, 208 
 Osteopaths, 52 
 
 Outcasts, nerve sufferers as, 1G2 
 Out-patients and U.T., 179 
 Owbridffe's Lung Tonic, composi- 
 tion of, 253 
 
 Paget, Sir J., brilliant dictum of, 
 97 
 
 inner life of, 108 
 
 on cause of success, 200, 277 
 
 on J. Hunter's ignorance, 53 
 
 on mind and body, 7 
 
 on personal characteristics, 32 
 
 on quacks, 23 
 
 on success in medicine, 199 
 Page Woodcock's Wind Pills, 
 
 composition of, 253 
 Pain, Dr. J, Collins on, 17 
 
 inhibited by mind, 234 
 
 is never imaginary, 17 
 Pains, capacity for taking, 161 
 Paralysed child and mind cure, 
 
 " 236 
 
 girl and curate, 236 
 Paralysis cured by doctor's pre- 
 sence, 236 
 fear of future, 229 
 suggested cure of, 36 
 Paraplegia, hysteric. Dr. Buzzard 
 on, 36 
 
 Pare, Ambroise, on V.M.N., 59 
 Passive and active suggestion, 180 
 Past impressions, narcosis from, 
 35 
 
 impressions, suggestions from, 
 35 
 
 Patent medicines and quackery, 
 251 
 
 medicines, composition of, 251 
 
 i Patent medicines, cure by, 258 
 
 medicines. Dr. Hutchison on, 
 251 
 
 \ Pathology, mental factor in, 66 
 
 : Patience, value of, 106, 162 
 
 I Patient affected by doctor's man- 
 
 i ners, 115 
 
 I as a brother, 182 
 
 as a motor-car, 27 
 \ average, non-existent, 192 
 • better seen at home, 126 
 
 chapter written by, 123 
 
 cured by quacks, 23 
 ; described, 131 
 i describes doctor's manners, 
 144 
 
 ; describes rude doctor, 145 
 ' describes waiting-room, 135 
 
 first interview with, 146 
 i formation of good habits in, 
 ' 193 
 
 : injured by ignorance, 101 
 j knows value of doctor, 48 
 I may help doctor, 53 
 i mental environment of, 126 
 I relation of doctor and, 207 
 
 solid view of, 5 
 \ Patient's confidence, how to gain, 
 215 
 
 friends, trouble with, 187 
 
 I grotesque statements, 218 
 
 mind, doctor must know, 184, 
 
 ' 186 
 
 temperament. Dr. J. Collins 
 on, 184 
 
 \ visit, story of, 133 
 Patients as friends, 151 
 
 \ conceit in, 190 
 doctors as. 111 
 
 I environments. Dr. J. Mitchell 
 Bruce on, 125 
 forces affecting, 118 
 how to cure, 151 
 how to manage lady, 183 
 interests of, come first, 96 
 interval between, 142 
 management of, 163 
 management of wilful, 168 
 X 
 
306 UNCONSCIOUS THBEAPEUTICS 
 
 Patients, manners important, 190 
 mind, curative power of, 49 
 mistakes through ignorance 
 
 about, 169 
 nervous at home, 147 
 order of seeing, 134 
 point of view, 130-132 
 qualities that benefit, 106 
 qualities that injure, 106 
 seen before friends, 142 
 should be seen at home, 130 
 temporising with, 168 
 three ideas for, 159 
 treatment must suit, 194 
 unreasonableness of rich, 166 
 value of environment, 124 
 Patronage by the wealthy, 166 
 Peace of mind, value of, 121 
 Peculiarities to be conquered, 123 
 
 value of, 86 
 Peritonitis, action of muscles on, 
 70 
 
 and natural therapeutics, 69 
 as surgeon's friend, 72 
 life saved by, 71 
 Permanent cures, importance of, 
 151 
 
 Perplexing cause of success, 204 
 Personal character determines suc- 
 cess, 200 
 character of Sydenham, 59 
 experience in hygiene, 91 
 power not taught, 115 
 qualities. Dr. J. Mitchell Bruce 
 on, 210 
 
 Personality, doctor and his, 102 
 mental, of the physician, 33 
 more than dress, 88 
 of doctors affects patients, 104 
 of doctor and October ad- 
 dresses, 103 
 of the nurse, 149 
 of physician, 2, 77-116 
 of physician as seen by 
 
 patient, 130 
 of physician in every cure, 49 
 of physician, study ofj 177 
 of Sir J. Simpson, 108 
 
 Personality, therapeutic power of, 
 105 
 value of, 51 
 
 value of consultant's, 112 
 value of, should be taught, 
 200^ 
 
 Pessimism in medicine, evil of, 220 
 Pessimists and optimists, 219 
 Phagocyte displays intelligence, 67 
 
 armies have a head, 67 
 Phagocytosis and mental influ- 
 ences, 64 
 proves purpose, 64 
 Pharmacopoeia, medical man as, 2 
 Philosophy and medicine, 266 
 displaced by science, 266 
 Physical action more certain than 
 psychic, 44 
 and psychic repair, 27 
 before psychical, 195 
 disease never wholly, 212 
 examination as therapeutic 
 
 agent, 178 
 means and mental therapeu- 
 tics, 32 
 
 measures act psychically, 127 
 process with every feeling, 17 
 therapeutics, 3 
 Physician a gentleman, 84 
 as a quack, 79 
 as pharmacopoeia, 77 
 earliest, Dr. Whittington on, 
 153 
 
 Dr. J. Bro^n on ideal, 81 
 Dr. J. Mitchell Bruce on ideal, 
 
 85 
 
 Sir D. Duckworth on ideal, 
 107 
 
 Dr. Green on ideal, 84 
 Dr. J. Gregory on ideal, 84 
 Dr. Hooker on judicious, 158 
 influence on mind of patients, 
 1 
 
 is an artist, 168 
 moral requisites of, 208 
 not naturalist, 110 
 opportunities of family, 161 
 personality of, 77-116 
 
INDEX OF SUBJECTS 
 
 307 
 
 Physician should know his power, 
 33 
 
 Sir J. R. Reynolds on, 211 
 Dr. Stirling on ideal, 83 
 the ideal, 81 
 
 Sir T. Watson on ideal, 107 
 Physician's dress in olden times, 
 88 
 
 mind, value of, 48 
 Physicians born, not made, 214 
 cause of immunity of, 183 
 College of, and War Office, 265 
 good, use suggestions, 180 
 Dr. Hooker on duties of, 157 
 superior to surgeons, 79, 80 
 truthfulness of, 95 
 Physiological machines, men as, 2 
 Physiology and unconscious mind, 
 12 
 
 as remedy for quackery, 254 
 is unconscious mind, 8 
 Picture, pathetic, by Sir J. Paget, 
 23 
 
 Pills, quack, composition of, 253 
 Pioneers, medical, are not quacks, 
 202 
 
 Placebos used by medical leaders, 
 38 
 
 value of, 38 
 Plague, Sydenham and great, 60 
 Platitudes for the young physi- 
 cian, 159 
 Dr. Styrap on, 86 
 Plato on higher education, 209 
 Pleasure and pain, complex nature 
 of, 226 
 and pain, emotion of, 233 
 causes dilatation, 226 
 Piethvsmograph, Mosso on the, 
 226^ 
 
 Points for study in mental thera- 
 peutics, 274 
 
 Political background, 185 
 
 Permanency of all impressions, 61 
 
 Pomposity, evil of, 106 
 
 Popularity, therapeutic value of, 
 124 
 
 Potassium, mental, 21 
 
 Power of adaptation, value of, 205 
 of conscious mind is small, 56 
 of doctor's face on patient, 99 
 of healing increased by use, 
 115 
 
 of mind over mind, 48 
 
 of mind over mind, * British 
 
 Medical Journal ' on, 48 
 of personal presence, 51 
 of the mind. Dr. Moore on, 3 
 of unconscious mind in hyp- 
 notism, 240 
 Powers for good, two, 116 
 Practice, essential factor in, 216 
 injured by hobbies, 91 
 mental therapeutics essential 
 
 in good, 40 
 of unconscious therapeutics, 
 153 
 
 secret of success in, 198-223 
 and theory, 6 
 Practise, tactless men should not, 
 216 
 
 Prayer, doctor and, 142 
 
 for patients, 152 
 Prejudice strong in England, 2 
 Prescription, doctor better than, 
 48 
 
 mind cure more than, 160 
 Prescriptions, doctor more than 
 his, 100 
 Dr. Rush's mode of, 182 
 Proba.ble advance in mental medi- 
 cine, 22 
 Problem of hysteria, 9 
 Problems, religious, solved, 13 
 Processes, morbid, stopped by 
 V.M.N., 66 
 organic, influenced by psychic 
 action, 56 
 Products, mind reorganised by its, 
 7 
 
 Profession, delusion of, 201 
 deterioration of, 155, 156 
 dignity of, 166 
 mercenary doctors in, 201 
 natural aptitude for, 165 
 quacks inside of, 201 
 X 2 
 
308 UNCONSCIOUS THEEAPEUTICS 
 
 Profession, single eye in, 5 
 Professional charity often thinks 
 evil, 204 
 visits, unprofessional, 161 
 visits, value of, 195 
 work narrows mind, 208 
 Profundity' of Nature's methods, 
 26 
 
 Proportion, loss of sense of, 105 
 of successful students, 199 
 of wisdom and medicine, 192 
 that attain success, 198 
 Proportions of real disease and 
 hysteria, 264 
 of spiritual and animal, 186 
 Pseudo-religious systems of cure, 
 259 
 
 Psychic action of electric light 
 baths, 128 
 and physical remedies, 38 
 cures at Nauheim, 241 
 effects of natural therapeu- 
 tics, study of, 276 
 force of electricity, 127 
 force, Sir W. W. Gull on, 4 
 influence of manners, 171 
 management more difficult 
 
 than physical, 267 
 prescription of Sir W. W. 
 
 Gull, 43 
 quackery, 251 
 quality unconscious, 114 
 remedies. Dr. Buzzard on, 36 
 remedies. Dr. Herman on, 36 
 remedies, ' Lancet ' on, 36 
 remedies take time and skill, 
 53 
 
 value of drugs, Sir S. Wilks 
 
 on, 42 
 value of electricity, 36 
 value of massage, 36 
 Psychical processes unconscious, 
 
 11 
 
 remedies partly, 42 
 remedies seldom purely, 38 
 
 Psychological links not frauds, 40 
 treatment of indolence, 172 
 
 Psychology, advance of, 17 
 
 1 Psycho-physical action obscure, 
 230 
 
 Psycho-therapeutics, doctors' dis- 
 like of, 2 
 doctors should be taught, 272 
 of fee, 50 
 
 Osgood Mason on, 264 
 position in America, 1 
 reason of neglect of, 6 
 J used by all leaders, 50 
 
 Psychotherapy, 1 
 
 Dr. J. Colhns on, 1 
 misused in America, 1 
 should it be taught ? 271 
 
 Pulse and feelings, Lehmann on, 
 226 
 
 Purists, meddlesome, 202 
 
 high-minded^ and mind cures, 
 40 
 
 Purpose no property of matter, 67 
 Purposive action of V.M.N., 55 
 Pursuit of health, not strength, 122 
 
 of science before cure, 157 
 Put yourself in his place, 97, 131, 
 241 
 
 Pyretic Saline, Lamplough's, com- 
 ! position ot 253 
 
 I Quack cures, how to lessen, 52 
 I cure of rheumatism, 258 
 j literature, light on, 249 
 j pills, composition of, 253 
 I Quackery, America overrun with, 1 
 and psycho- therapeutics, 2 
 and the twentieth century, 
 263 
 
 cures believers, 264 
 exposed, 245 
 
 flourishes in America, 250 
 I flourishes on ignorance, 245 
 ! flourishes, reason why, 259 
 ' futile remedies for, 254 
 i Dr. Hutchison's remedy for, 
 j 252 
 1 real power, 265 
 I reasons for success in, 257 
 I the real force, 255 
 
INDEX OF 
 
 Quacks and humbugs, difference 
 between, 41 
 
 and mental therapeutics, 41 
 
 and real cures, 258 
 
 cure patients, 23 
 
 doctors powerless before, 23 
 
 flourish from medical ignor- 
 ance, 34 
 
 formed by ignorance, 201 
 
 how to fight them, 252 
 
 inside the profession, 201 
 
 medical pioneers are not, 202 
 
 Sir J. Paget on, 23 
 
 physicians as, 79 
 
 quarrels of, 250 
 
 thrive because they cure, 257 
 Qualities of doctor, 110 
 
 personal. Dr. W. Mitchell on, 
 210 
 
 that benefit patients, 106 
 ■ that injure patients, 106 
 
 Quality of single eye, 5 
 
 Quasi-mental remedies, drugs as, 
 39 
 
 Questions to Dr. Hutchison, 255 
 two, doctors should ask, 272 
 Quickness, value of, 106 
 
 Rabagliati, Dr., on science, 266 
 Rare variety of M.T., 233 
 Rash promises, avoid, 177 
 Rational treatment of aneurysm, 73 
 Reaction of mind and body, 3 
 Real cures by quacks, 258 
 
 disease and hysteria, propor- 
 tions of, 264 
 force in quackery, 255 
 importance of disease, 212 
 physician, Dr. Broussais on, 
 110 
 
 power in quackery, 265 
 Reasonable action of mental thera- 
 peutics, 32 
 Reason for neglect of psychothera- 
 peutics, 6 
 for writing book, 116 
 lady cured by losing, 232 
 
 SUBJECTS 309 
 
 Reason why quackery flourishes, 
 
 259 
 
 Reasons for success in quackery, 
 257 
 
 Recofirnised recuperative power. 
 220 
 
 Recovery, how effected, 231 
 Recreation for doctors, 150 
 Reflexes, natural and acquired, 15 
 Reformed waiting-room, 137 
 Relation of doctor and patient, 
 207 
 
 Religion and medicine, 256 
 Religious backgrounds, 185 
 
 influence as ' suggestion ' re- 
 medy, 42 
 problems solved, 13 
 systems of cure, 259 
 Remarks, casual, most effective, 
 189 
 
 Remedies by suggestion, 180 
 by suggestion, list of, 42 
 mental, for mental diseases, 36 
 most powerful when new, 43 
 natural, Sir W. W. Gull on, 26 
 partly psychical, 42 
 psychic. Dr. Herman on, 36 
 rarely wholly inert, 38 
 seldom purely psychical, 38 
 
 Remedy for quackery, Dr. Hutchi- 
 son's, 252 
 
 Repair, physical and psychic, 27 
 
 Residuum of real quack cures, 258 
 of truth in quackery, 250 
 
 ResponsibiUty of doctor, 82 
 
 ' Rest, and be still,' doctor's 
 motto, 65 
 natural therapeutics of, 70 
 
 Reynolds, Sir J. R., on human life, 
 27 
 
 on the true physician, 211 
 on too scientific treatment, 
 270 
 
 Rheumatism and mind. Dr. Car- 
 penter on, 234 
 cured by U.M., 241 
 Richardson, Sir B. W., on dying 
 people, 45 
 
310 UNCONSCIOUS 
 
 THEEAPBUTICS 
 
 Rich patients, unreasonableness 
 of, 166 
 
 Richter, J. Paul, on reality, 110 
 Rudeness of doctor, 145 
 Rush, Dr., mode of prescription, 
 182 
 
 Safety-valve action, Dr. J. 
 
 Mitchell Bruce on, 67 
 Saint Jacob's Oil, composition of, 
 
 253 
 
 Saunders, Sir W., on mercenary- 
 doctors, 201 
 Sceptical patients hard to cure, 189 
 Scepticism and colour blindness, 
 167 
 cause of, 167 
 Schools, education retarded in 
 
 medical, 203 
 Science and art of medicine, 25 
 and philosophy, unnatural 
 
 division between, 266 
 displaces philosophy, 256 
 of character. Dr. E. Tibbits 
 
 on, 270 
 of U.T., 153 
 
 pursuit of, before cure, 157 
 Rabagliati on, 266 
 will displace superstition, 245 
 Scientists, doctors not, 168 
 Scotchman and weak doctor, 
 
 story of, 124 
 Screens in waiting-room, 138 
 Secondary consideration, dress a, 
 88 
 
 Self-conscious doctors, 77 
 Self-reliance and success, 95 
 Self-respecting physician. Dr. Col- 
 lins on, 171 
 Self, subliminal, 7 
 Semon, Sir F., on ethics of place- 
 bos, 38 
 
 Sensation increased in hypnotism, 
 33 
 
 Sense of proportion lost, 105 
 Sensori -motor reflexes in mind, 15 
 Sermon on mind shadow, 104 
 
 Seven subjects for study in mental 
 
 therapeutics, 275 
 Sexual influences as * suggestion ' 
 
 remedy, 42 
 Shadow cast by mind like body, 
 
 104 
 
 Shocks as suggestion remedy, 42 
 Sick helped by healthy mind, 161 
 ' imitation crumbs ' for the, 
 97 
 
 moral management of, 158 
 
 Sir D. Duckworth on manage- 
 ment of, 163 
 Simplicity not shallowness, 26 
 Simpson, Sir J., description of, 108 
 
 as ideal physician, 108 
 Single eye, advantage of, 5 
 
 eye. meaning of, 5 
 
 eye of Sydenham, 59 
 
 eye, quality of, 5 
 
 interview, benefit from, 114 
 Sisters of mercy, true, 150 
 Sketch of waiting-room, 135 
 Skey on hysteria, 263 
 Skill required for psychical reme- 
 dies, 53 
 
 Skin, action of, in peritonitis, 70 
 Smile must be natural, 99 
 
 of doctor, Dr. 0. W. Holmes 
 
 on, 98 
 oily, of doctor, 145 
 Smoking, value of, 119 
 Snapshot diagnosis, 109 
 Social knowledge of patients neces- 
 sary, 168 
 Sokhit-ni-onkh, testimony of, 154 
 Soldier's death from fear, 232 
 Soldiers, mind of, in battle, 234 
 Solemnity, evil of, 106 
 Solid view of patient, 5 
 Soul and body move together, 19 
 Sound judgment and common 
 
 sense, 217 
 Spas, cures at, 46 
 Special feeding as suggestion 
 remedy, 42 
 
 occupation as suggestion cure, 
 42 
 
INDEX OF 
 
 Specialists in Egypt, 79 
 Spectrum, U.M. and, 15 
 Spencer, Herbert, on nerve action, 
 30 
 
 Spinal curvature and V.M.N., 74 
 paralysis, cure of hysterical, 
 235 
 
 Spirit of Christ, 214 
 Spiritual and animal, proportions 
 of, 186 
 
 Stamp paper produces blisters, 240 
 Stephens on doctor's vocation, 223 
 Stereoscope in medicine, 5 
 Stereoscopic thinking, 5 
 vision, 5 
 
 Sterling, Dr., on ideal physician, 83 
 Stewart, Sir T. G., on heart disease, 
 232 
 
 Stimulants and nerve tonics, 226 
 
 Stimulation of V.M.N., 57 
 
 Story of assurance office, 124 
 of a ' bear,' 144 
 of cheerful doctor, 101 
 of depressing doctor, 100 
 of locum tenens, 91 
 of patient's visits, 133 
 
 Strength in medicine, ' British 
 Medical Journal ' on, 222 
 may do more harm than good, 
 222 
 
 Students should learn good man- 
 ners, 165 
 Study of mind required in hys- 
 teria, 244 
 of unity of man, 19, 275 
 of U.T., 179, 244 
 Styrap, Dr., on angels and devils, 
 83 
 
 on doctor's house, 126 
 on dress, 87 
 on new remedies, 231 
 on science of medicine, 159, 
 203 
 
 platitudes on doctors, 86 
 Sub-conscious mind, 7 
 Subject for medical study, 93 
 
 for mental study, 186 
 Sub-title, a novel one, 2 
 
 SUBJECTS 311 
 
 Success determined by personal 
 character, 200 
 in medicine, 198 
 in medicine. Dr. W. Mitchell 
 
 on doctor's, 209 
 in medicine, wise teachers on, 
 
 206-221 
 in practice, secret of, 198-223 
 in quackery, reasons for, 257 
 in suggestion, 181 
 Successes, cause of perplexing, 204 
 Successful ' bears,' 93 
 
 men not all alike, 218 
 practice and unity of man, 19 
 Sudden cure by direct suggestion, 
 190 
 
 Suggested paralysis, cure of, 36 
 Suggestion, active and passive, 
 180 
 
 and anaemia, 35 
 and hypnotism, 32 
 and telepathy, 171 
 Dr. J. ColHns on, 182 
 conscious, two sides of, 31 
 cough by, 171 
 cures through U.M., 30 
 direct and indirect, 179 
 diseases, list of, 34 
 evil of, 155 
 
 from past impressions, 35 
 gastric ulcer by, 176 
 headache by, i74, 175 
 indirect, and mental thera- 
 peutics, 30 
 is it moral ? 36 
 may save life, 181 
 medical study of, 131 
 modern methods of, 248 
 Miinsterberg on, 181 
 negative and positive, 31 
 of death, 119 
 produces diseases, 34 
 remedies, 180 
 remedies, drugs as, 42 
 remedies, list of, 42 
 study of, 227 
 Dr. L. Tuckey on, 34 
 vahie of moral, 189 
 
312 UNCONSCIOUS THEEAPEUTICS 
 
 Suggestions as to consultations, 
 142 
 
 conscious, useful, 34 
 evil, by doctors, 174 
 for appointments, 139 
 for waiting-room, 137 
 Suggestive therapeutics and im- 
 pulse, 31 
 Superstition and America, 250 
 Suppuration, natural therapeutics 
 of, 68 
 
 Surgeon in days of Queen Eliza- 
 beth, 79 
 
 Surgeon's friend, peritonitis as, 
 72 
 
 Surgeons, avarice of, 80 
 Surgeons in Barbers' Company, 79 
 
 physicians superior to, 79, 80 
 Surgery, U.T. in, 242 
 Surprise of quack at cure, 250 
 Surroundings as therapeutics, 120 
 
 mind shown in, 104 
 Sutton, Dr., teaching at London 
 Hospital, 8 
 
 last words, 51 
 Sydenham and great plague, 60 
 
 and his profession, 222 
 
 Dr. J. Brown on, 211 
 
 followed by Dr. J. Mitchell 
 Bruce, 60 
 
 on hysteria, 14 
 
 on Nature, 58, 59 
 
 weakness of, 59 
 Sydenham's personal character, 59 
 Sympathy and kindness of doctor, 
 83 
 
 as a drug, 100 
 
 essential for nerve doctor, 162 
 exhausts doctor, 211 
 Dr. W. Mitchell on, 96 
 real, value of, 97 
 true, essential, 96 
 true, value of, 214 
 value of, 106 
 Symptoms of disease, therapeutics 
 of, 72 
 
 of hysteria not conscious, 9 
 of peritonitis beneficial, 69 
 
 Systems of cure, pseudo-religious, 
 289 
 
 Tact is mental touch, 162 
 of Sir W. W. Gull, 217 
 Sir F. Treves on value of, 216 
 value of, 94, 162 
 
 Tactless men should not practise, 
 216 
 
 Task of doctor moralist, 188 
 Tatcho, composition of, 253 
 Teachers, wise, on success in 
 
 medicine, 206-221 
 Teaching, neglect in medical, 4 
 
 of manner, 165 
 
 of manners, 267 
 
 of mental backgrounds, 186 
 
 of psychotherapy, 271 
 
 of U.T., 153 
 
 of V.M.N. in schools, 76 
 Telepathy and suggestion, 171 
 
 Miinsterborg on, 246 
 Temperament, Dr. Cathell on, 110 
 
 Dr. J. Colhns on patient's, 184 
 
 affects M.T., 230 
 Temperaments, study of, 275 
 Temporising with patients, 168 
 Tendency of this book, 153 
 Test of mind, faith cures as, 262 
 Testimony of Sokhit-ni-onkh, 154 
 Testing new drugs, 43 
 Therapeutic agent, environment 
 as, 125 
 
 power of distraction, 64 
 
 power of personality, 105 
 
 power of clock, 237-239 
 
 symptoms of disease as, 72 
 
 value of clock, 196 
 
 value of doctor, 2, 195 
 
 value of fee, 78 
 
 value of physical examina- 
 tion, 178 
 
 value of popularity, 129 
 Therapeutics, book on, needed, 4 
 
 chemical, 3 
 
 commonly symptomatic, 21 
 delicacy of unconscious, 187 
 
INDEX OF 
 
 Therapeutics, four classes of, 3 
 influence others, 117 
 influences of others, 117-129 
 influences, minor, 123 
 of manner, 163 
 mechanical, 8 
 mental, 4 
 
 mental, not taught, 4 
 T.M. act by V.M.N., 37 
 
 and direct suggestion, 230 
 
 and environment, 29 
 
 and force of mind, 20 
 
 and physical means, 32 
 
 and quacks, 41 
 
 and V.M.N., 29 
 
 danger of ignorance about, 19 
 
 defence of, 38 
 
 direct, 32 
 
 doctor's dislike of, 41 
 essential in good practice, 40 
 Dr. Fleury on, 21 
 ignorance of, 37 
 indirect, 32 
 
 integral part of medicine, 37 
 more legitimate than drugs, 37 
 mostly unconscious, 29 
 not taught in schools, 18 
 practised unwittingly, 27 
 unconscious action of, 32 
 
 Therapeutics, natural, of cardiac 
 dilatation, 67 
 natural, and peritonitis, 67 
 natural, in aneurysm, 73 
 natural, in appendicitis, 69 
 natural, of anorexia, 67 
 natural, of cough, 72 
 natural, of diuresis, 67 
 natural, of inflammation, 68 
 natural, of isolation, 71 
 natural, of nausea, 69 
 natural, of rest, 70 
 of fear, 195 
 
 Therapeutics, the mind in, 1-19 
 unconscious, 3 
 unconscious action of, 224 
 unconscious, cause of per- 
 plexing successes, 204 
 
 T.U. in natural therapeutics, 38 
 
 SUBJECTS 313 
 
 T.U., different meanings of, 28 
 is never taught, 271 
 power in Christian science, 260 
 practice of, 153 
 Therapy, mental, four sorts of, 29 
 Thermometer and unconscious 
 
 mind, 15 
 Thinking, stereoscopic, theory and 
 
 practice of, 5, 6 
 Thirst, hunger, and the mind, 
 234 
 
 Thought, trains of, 42 
 Thoughts influence body, 3 
 Three ideas for patient, 159 
 Threshold of consciousness, 11 
 Tibbits, Dr. E. T., on science of 
 
 character, 270 
 Time as therapeutic agent, 119 
 required by nerve patients, 53 
 to form habits in, 193 
 Toads, haemorrhage stopped by, 
 
 240 
 
 Tombstone of doctor, 104 
 Tonics, doctors as. 111 
 Touch, value of, 181 
 Trade-unionism, medical, 41 
 Training, medical school defective, 
 24 
 
 of muscles and mind, 158 
 
 patient's mind, 188 
 Transplanting, evil of, 125 
 Travel as last resource. 162 
 
 as ' suggestion ' remedy, 42 
 Treat the man, not disease, 212 
 Treatment, difficulties of, 149 
 
 must suit patient, 194 
 
 of cancer by Christian Science, 
 261 
 
 of hernia in 1734, 80 
 
 of neurasthenia. Dr. T. Collins 
 on, 192 
 
 of patient in hospital, 230 
 
 psychological, of women, 172 
 
 Sir J. Russell Reynolds on 
 too scientific, 270 
 
 should imitate natural pro- 
 cesses, 72 
 
 useless without V.M.N., 66 
 
314 UNCONSCIOUS THEEAPBUTICS 
 
 Treves, Sir F., Liverpool address, 
 222 
 
 on Sir T. Browne, 63 
 
 on medical men, 82 
 
 on peritonitis, 70 
 
 on value of tact, 216 
 
 on V.M.N., 65-68 
 Trials of nerve patients, 130-152 
 Trifles important to successful 
 
 men, 210 
 Trilene Tablets, composition of, 
 253 
 
 Trouble with patient's friends, 187 
 True place of doctor, 65 
 
 remedy for quackery, 255 
 sisters of mercy, 150 
 sympathy essential, 96 
 Trust and faith, value of, 183 
 Trustworthiness of doctor, 82 
 Truth, residuum of, in quackery, 
 250 
 
 Truthfulness, difficulty of, 96 
 
 of physician, 95 
 Tuckey, Dr. L., on evil suggestion, 
 34, 174 
 
 Tuto, cito, et jucundef and Ascle- 
 
 piades, 58 
 and mental cures, 41 
 Twentieth century and quackery, 
 
 263 
 
 Two eyes, value of, 59 
 eyes in medicine, 25 
 kinds of quackery, 257 
 powers for good, 116 
 questions doctors should ask, 
 272 
 
 Ultea-scientiftc spirit, indict- 
 ment of, 270 
 Uncertainty, evil of, 169 
 Unconscious action of mental 
 therapeutics, 32 
 action of vis medicatrix na- 
 
 turce, 55 
 and conscious fraud, 249 
 gift of healing, 113 
 knowledge, 192 
 
 Unconscious medicine, doctor as, 
 77 
 
 U.M. agent in all mental cures, 47 
 and antitoxin, 74 
 and backgrounds, 185 
 and childhood, 13 
 and conduct, 13 
 and doctor's visits, 161 
 and environment, 148 
 and ethics, 13 
 and hope, 222 
 and Nature, 8 
 and religious problems, 13 
 and physiology, 8, 12 
 and quackery, 255 
 and spectrum, 15 
 and thermometer, 15 
 and Wundt, 16 
 book on, 8 
 
 cough stopped by, 241 
 extent of, 14, 16 
 ignored, 48 
 is anathema, 16 
 mental therapeutics act by, 37 
 Nature is, 62 
 not a contradiction, 12 
 opposition to, 15 
 Unconsciousness is an advantage, 
 153 
 
 Dr. Myers on, 230 
 Unconscious psychical processes, 
 11 
 
 psychic quality of healing, 114 
 U.T., 3, 2.30 
 
 action of, 224 
 and education, 263 
 and doctor's personality, 117 
 and drugs, 272 
 and out-patients, 179 
 are mental therapeutics, 38 
 cause of perplexing successes, 
 204 
 
 delicacy of, 187 
 
 different meanings of, 28 
 
 examples of, 232 
 
 fancy and fiction in, 250 
 
 must be taught, 271 
 
 of physical examinations, 178 
 
INDEX OF SUBJECTS 
 
 315 
 
 U.T., science of, 153 
 
 should be studied, 179 
 should be taught, 153 
 and surgery, 242 
 value of, 20 
 Tvhat are they ? 153 
 Unfairness of present medical 
 
 training, 271 
 Unity, man is a, 19 
 
 of man must be studied, 19 
 of man, study of, 275 
 Universal factor in causation of 
 
 disease, the, 273 
 Universality of mind action, 40 
 Unnatural division between science 
 
 and philosophy, 266 
 Unprofessional professional visits, 
 161 
 
 Unpunctuality, evils of, 140 
 Unreasonableness of sick patients, 
 166 
 
 Unsatisfactorv, casual directions, 
 170 
 
 Unstable mental backgrounds, 185 
 Unsuitable manner in doctor, 145 
 Unzer on expectation, 43 
 Usefulness of conscious sugges- 
 tions, 34 
 Use increases healing power, 115 
 of drugs becoming more em- 
 pirical, 44 
 of mercury in 1733, 46 
 of natiu-al remedies growing, 
 43 
 
 of stimulants, Lange on, 227 
 of suggestion by good physi- 
 cians, 180 
 Uterine disease, mind cure in, 242 
 
 Value of amateur nurses, 150 
 of apprenticeship, 51 
 of a smile, 98 
 
 of big words, De Fleury on, 50 
 
 of boldness, 109 
 
 of casual remarks, 189 
 
 of certainty, 169 
 
 of cheerfulness, 111-171 
 
 Value of confidence, Dr. Leahy on, 
 51 
 
 of directions as to details, 160 
 of doctor at bedside, 120 
 of doctor, De Fleury on, 49 
 of doctor's environment, 126 
 of doctor's face, 50-98 
 of dogmatism, 170 
 of dress, 87 
 
 of encouragement, 120 
 
 of expectation, 42 
 
 of expectation, Dr. Carpenter 
 
 on, 177 
 of faith and trust, 183 
 of firmness, 98 
 of friends, 119 
 of getting on, 121 
 of hope, 119 
 
 of hope. Dr. Moore on, 174 
 
 of hopefulness, 219 
 
 of imaginative insight, 210 
 
 of implanted ideas, 172 
 
 of insight, 217 
 
 of lady doctors, 143 
 
 of looking at patient, 182 
 
 of making appointments, 133 
 
 of manner, 95 
 
 of medical psychology, 204 
 
 of medium in detail, 146 
 
 of mental influences, 159 
 
 of mental therapeutics, 20-54 
 
 of moral suggestion, 189 
 
 of natural manners, 145, 151 
 
 of new environment, 148 
 
 of patience, 1 62 
 
 of patient's environment, 124 
 
 of patient to doctor, Dr. W. 
 
 Mitchell on, 54 
 of peace of mind, 121 
 of peculiarities, 86 
 of peritonitis, 70 
 of personality, 57 
 of personality should be 
 
 taught, 200 
 of physical examination to 
 
 patient, 178 
 of phj^sician's mind, 48 
 of placebos, 38 
 
316 UNCONSCIOUS THEEAPEUTICS 
 
 Value of powers of adaptation, 205 
 of real sympathy, 97, 214 
 of seeing patients at home, 
 
 130-137 
 of tact, 94-162 
 of tact. Sir F. Treves on, 216 
 of touch, 181 
 of two eyes, 6, 59 
 of visits, 195 
 of waiting-room, 36 
 psychic, of electricity, 36 
 psychic, of massage, 36 
 to patient of doctor's face, 99 
 twofold, of drugs, 42 
 Vanity, evil of, 106 
 Varieties of feeling, Wundt on, 226 
 
 of mental backgrounds, 184 
 Vase, inscription on, 109 
 Vaso- motors, emotions as, 224 
 Verbosity, evil of, 106 
 Vices of medical men, 106 
 Vicious circle in hysteria, 244 
 
 trains of thought, 42 
 Victorian, early, waiting-room, 
 135 
 
 View, patient's point of, 130-152 
 Virtue as a gas, 207 
 Virtues can be acquired, 205 
 Visit in morning, evils of, 131 
 
 patient's story of, 133 
 
 to doctor described, 131 
 Visits, unprofessional and profes- 
 sional, 161 
 V.M.N., 55-76 
 
 action is action of U.M., 57 
 
 active for good, 75 
 
 acts unceasingly, 55 
 
 and Ambroise Pare, 59 
 
 and antitoxin, 74 
 
 and appendicitis, 69 
 
 and cardiac dilatation, 67 
 
 and Dr. Cullen, 57 
 
 and gastric catarrh, 67 
 
 and hypertrophy, 74 
 
 and immunity, 65 
 
 and spinal curvature, 74 
 
 and U.T., 55 
 
 and wounds, 68 
 
 V.M.N, as angel unawares, 63 
 
 ' British Medical Journal ' on, 
 63 
 
 can be aided, 191 
 details of action of, 66 
 Dr. Barker on, 74 
 Dr. John BroTO on, 81 
 Dr. J. Mitchell Bruce on, 65, 
 67 
 
 Dr. A. Charrin on details of, 
 61 
 
 doctors can aid, 74 
 doctors in support of, 61 
 drugs useless without, 66 
 essential to all cures, 55 
 failure of, in death, 66 
 Galen on, 65 
 helped by hope, 75 
 in acute disease, 74 
 in hysteria, 75 
 in mental therapy, 29 
 in Nature, 56 
 
 morbid processes stopped 
 
 slowly by, 66 
 nitrite of amyl imitates, 67 
 power of adaptation, 62 
 processes should be taught, 76 
 purpose shown by, 66 
 rearranges vessels, 74 
 shows purpose and choice, 67 
 stimulation of, 57 
 study of, 276 
 
 treatment useless without, 66 
 Sir F. Treves on, 63, 68 
 Vocation of doctor. Dr. Stephen 
 on, 223 
 
 Vomiting cured by clock, 196 
 ' Vril ' in doctors, 142 
 
 Wade, Dr., on medical education, 
 269 
 
 Waiting, evil consequences of, 136 
 
 injures patient, 143 
 
 is depressing, 139 
 Waiting-room as it is, 135 
 
 as it should be, 137 
 
 described by patient, 136 
 
INDEX OF SUBJECTS 
 
 317 
 
 Waiting-room, food in, 138 
 
 screens in, 138 
 
 value of, 130 
 Wardie, Dr. M., on medical ethics, 
 155 
 
 War Office and Boers, 265 
 Water, ' Lancet ' on cure by, 238 
 Watson, Sir T., on ideal physician, 
 107 
 
 Weak doctor and Scotchman, 124 
 Weakness of Sydenham, 59 
 Wealthy, patronage by the, 166 
 Weapons, Dr. do Flenry on doc- 
 tor's, 194 
 Weight of brain, emotions and, 225 
 What constitutes malingering, 10 
 White, Professor T., on mind, 11 
 Whittington, Dr., on earliest 
 
 physicians, 154 
 Widened conceptions of mind, 7 
 Wilful patients, management of, 
 168 
 
 Wilks, Sir S., on psychic value of 
 
 drugs, 42 
 Will and digestion, 122 
 
 cannot produce hysteria, 10 
 curing and killing by, 45 
 Dr. Fothergill on the, 44 
 in acute diseases, 45 
 Wind Pills, Page Woodcock's, 
 composition of, 253 
 
 Wisdom and medicine, 192 
 
 in medicine, 25 
 Wise doctors imitate Nature, 74 
 teachers on success in medi- 
 cine, 206-221 
 Woman, description of, 144 
 Women and doctors, 52 
 choose the doctor, 92 
 I Dr. J. Mitchell Bruce on, 52 
 j Dr. Weir IVIitchell on manage- 
 ment of, 183 
 Word ' cure,' meaning of the, 243 
 Words, Dr. de Fleury on value of 
 big, 50 
 
 importance of doctor's, 51, 
 113 
 
 value of cheerful, 171 
 Work, doctor's true, 65 
 
 professional, narrows mind, 
 208 
 
 Worship of the golden calf, 218 
 Wounds and V.M.N., 68 
 Wundt and V.M.N., 16 
 
 on feeling, 226 
 W^yndham, Sir C, on medical art, 
 206 
 
 Young Practitioner's platitudes, 
 159 
 
 Yourself, forget, 215 
 
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