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Page 9
Another form of evil to be encountered in these cases is less easy to
deal with. Such an invalid has by unhappy chance to live with some near
relative whose temperament is also nervous and who is impatient or
irritable. Two such people produce endless mischief for each other.
Occasionally there is a strange incompatibility which it is difficult to
define. The two people who, owing to their relationship, depend the one
on the other, are, for no good reason, made unhappy by their several
peculiarities. Lifelong annoyance results, and for them there is no
divorce possible.
In a smaller number of cases, which have less tendency to emotional
disturbances, the phenomena are more simple. You have to deal with a
woman who has lost flesh and grown colorless, but has no hysterical
tendencies. She is merely a person hopelessly below the standard of
health and subject to a host of aches and pains, without notable organic
disease. Why such people should sometimes be so hard to cure I cannot
say. But the sad fact remains. Iron, acids, travel, water-cures, have
for a certain proportion of them no value, or little value, and they
remain for years feeble and forever tired. For them, as for the whole
class, the pleasures of life are limited by this perpetual weariness and
by the asthenopia which they rarely escape, and which, by preventing
them from reading, leaves them free to study day after day their
accumulating aches and distresses.
Medical opinion must, of course, vary as to the causes which give rise
to the familiar disorders I have so briefly sketched, but I imagine that
few physicians placed face to face with such cases would not feel sure
that if they could insure to these patients a liberal gain in fat and in
blood they would be certain to need very little else, and that the
troubles of stomach, bowels, and uterus would speedily vanish.
I need hardly say that I do not mean by this that the mere addition of
blood and normal flesh is what we want, but that their gradual increase
will be a visible result of the multitudinous changes in digestive,
assimilative, and secretive power in which the whole economy inevitably
shares, and of which my relation of cases will be a better statement
than any more general one I could make here.
Such has certainly been the result of my own very ample experience. If I
succeed in first altering the moral atmosphere which has been to the
patient like the very breathing of evil, and if I can add largely to the
weight and fill the vessels with red blood, I am usually sure of giving
general relief to a host of aches, pains, and varied disabilities. If I
fail, it is because I fail in these very points, or else because I have
overlooked or undervalued some serious organic tissue-change. It must be
said that now and then one is beaten by a patient who has an
unconquerable taste for invalidism, or one to whom the change of moral
atmosphere is not bracing, or by sheer laziness, as in the case of a
lady who said to me, as a final argument, "Why should I walk when I can
have a negro boy to push me in a chair?"
It will have been seen that I am careful in the selection of cases for
this treatment. Conducted under the best circumstances for success, it
involves a good deal that is costly. Neither does it answer as well, and
for obvious reasons, in hospital wards; and this is most true in regard
to persons who are demonstratively hysterical. As a rule, the worse the
case, the more emaciated, the more easy is it to manage, to control, and
to cure. It is, as Playfair remarks, the half-ill who constitute the
difficult cases.
I am also very careful as to being sure of the absence of certain forms
of organic disease before flattering myself with the probability of
success. But not all organic troubles forbid the use of this treatment.
Advanced Bright's disease does, though the early stages of contracted
kidney are decidedly benefited by it, if proper diet be prescribed; but
intestinal troubles which are not tubercular or malignant do not; nor do
moderate signs of chronic pulmonary deposits, or bronchitis.[13]
Some special consideration needs to be given to the subject of
heart-disease. Especially in cases of broken compensation, by lessening
the work required of the heart so that it needs to beat both less often
and with less force, the simple maintenance of the recumbent position is
a great aid to recovery, and massage properly used will still further
relieve the heart. Disturbed compensation is usually accompanied by
failure of nutrition, often by distinct an�mia, and these and the
anxiety which naturally enough affects the mind of a person with cardiac
disorder are all best handled, at first at least, by quiet and rest.
Later, the methods of Schott, baths and resistance movements, may carry
the improvement further. Even in old and established cases of valvular
disease much may be done if the patient have confidence and the
physician courage enough to insist upon a sufficient length of rest. The
palpitation and dyspnoea of exophthalmic goitre are promptly helped by
rest and massage, and with other suitable measures added, cures may be
effected even in this intractable ailment.
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