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Title: The modern malady
        or, Sufferers from "nerves"

Author: Cyril Bennett

Author of introduction, etc.: Herbert Tibbits

Release date: January 25, 2015 [eBook #48072]

Language: English

Credits: Produced by Chuck Greif and the Online Distributed
        Proofreading Team at http://www.pgdp.net (This file was
        produced from images available at The Internet Archive)


*** START OF THE PROJECT GUTENBERG EBOOK THE MODERN MALADY ***




Produced by Chuck Greif and the Online Distributed
Proofreading Team at http://www.pgdp.net (This file was
produced from images available at The Internet Archive)









                          THE MODERN MALADY.




                          THE MODERN MALADY;

                     Or, Sufferers from “Nerves.”

                                  BY

                            CYRIL BENNETT,

                  AUTHOR OF “THE MASSAGE CASE,” ETC.

                           _WITH A PREFACE_

                                  BY

                  HERBERT TIBBITS, M.D., F.R.C.P.E.,

     FOUNDER OF THE WEST END HOSPITAL FOR DISEASES OF THE NERVOUS
                             SYSTEM, ETC.

 “Absence of knowledge has for its inevitable fruit this result; that
the right exercise of our faculties leads, at first, not to true, but to false
   conclusions. The only means whereby our progress in knowledge can
be made harmonious is in frankly recognising and accepting this law of
                       our life.”--JAMES HINTON.

                                LONDON:
                            EDWARD ARNOLD.
                                 1890.

                       [_All rights reserved._]




PREFACE.

BY DR. TIBBITS.


I have been requested to write a Preface to the “Modern Malady,” and I
have pleasure in doing so, as it seems to me that the author, with whose
views I am in general agreement, has adequately and successfully carried
out a work, not over easy, but certainly wanted--_i.e._, an introduction
to public consideration, from a non-medical point of view, of a
condition of ill-health which is increasingly prevalent in all ranks of
society; which is as common in the slums of the East End as in the
mansions of the West; which incapacitates innumerable people (both men
and women) from the efficient discharge of the duties, and from the
proper enjoyment of the pleasures, of life; which undoubtedly often
owes its origin to injudicious medication; which is quite capable of
cure in certain ways which are not those generally adopted; and which is
still more capable of prevention.

The condition is technically called “Neurasthenia,” or “nerve-weakness.”
This is but a generic word, a convenient designation for a condition of
the nervous system, the symptoms of which vary widely; but beneath all
these symptoms, various as they may be, there is as their foundation a
condition of nerve-prostration and fatigue; and a permanent removal of
this condition is only brought about by keeping in mind a recollection
of its origin and directing treatment to the _fons et origo mali_; by
repairing, if only slightly damaged, by building up, if shattered, this
unfortunate nervous system. This state of ill-health used to be called
“Hysteria,” a name derived from an erroneous idea that there is a
special connection between the disease and a particular organ of the
body. It was even once thought that this organ moved about to various
parts of the body, and so caused the local symptoms; and various
nauseous drugs were given for centuries, on the theory that by their
offensive taste they would drive the wanderer back to its proper place.
It is also popularly supposed that “hysterical” people simulate their
symptoms and can control them if they wish. Both of these views are
quite wrong. The disease is a real disease, as truly a disease as is a
fever or an attack of bronchitis, and it is found in men as well as
women. In this connection I would ask, with Cyril Bennett, “Do the
majority of people know that they possess a nervous system at all? We
still hear educated persons talk of their nerves as if they were
something _spiritual_, as though nervous disorder were not a physical
disease.”

We should remember that the nervous system is one continuous structure,
and it is only the necessities of nomenclature and the ingenuity of
anatomists that have divided it into so many parts. It is as continuous
as is an oak tree with its various branches. The spinal cord and the
nerves are composed in varying proportions of the same materials as is
that part of the system which we call the brain: injury and disease
with them give rise to symptoms analogous to similar injury or disease
to the brain. Indeed, there are several brains,--some in the cord
itself, one in relation with the stomach and called the “abdominal
brain,”--but the intellect and perception reside only in that portion of
nervous material which is confined within the skull; injury there--in
addition to the symptoms common to injury in other parts--influencing
intellect, perception, and memory; and this is the only distinction.

Neurasthenia is especially prevalent, not only with members of certain
families (we all know people peculiarly liable to suffer from the
“nerves”), but certain races are more prone to it than others--the
French and American more than ourselves; and this fact must not be lost
sight of, nor the fact that the relatives of many of these
patients--probably afflicted themselves with a latent form of the same
condition--are frequently but ill-fitted to help the patient to
recovery, so that a temporary removal from their care is sometimes
advisable.

But prevention is better than cure, and this is best secured by healthy
hygienic, physical, mental, and moral surroundings,--by bestowing upon
the growing human plant a share of as intelligent a care as the gardener
bestows upon his grapes and his peaches; by no undue forcing, by no
undue straining, and by no undue school pressure; but by bodily
exercises in proportion to the strength of the body, and progressively
increased as the strength of the body increases, and by mental exercises
equally proportioned to the increasing mental strength, and not forced
beyond it; for the exercise of nerve-power is as fatiguing as that of
muscle-power, brings on the same feeling of exhaustion, and requires the
same recuperation by adequate food and rest.

So much for prevention: but when the nervous system _has_ broken
down--when the symptoms may vary from extreme mental and physical
exhaustion to that condition of what has been called “Death-trance,”
where the patient is apparently dead; that condition which has furnished
the theme for many a sensational story (but the most ghastly incidents
of fiction have been paralleled by authenticated facts)--then treatment
comes in. The less physic-drinking the better. As the late Sir William
Gull said, “Medicine was once given even for fractures. Disease is not
cured by drugs. It is the power of Nature that cures disease, and the
duty of the medical man is--not to give drugs--but to assist Nature.” So
spoke Sir William Gull; and Lord Coleridge, deciding a law case not long
since, said, “If you give a man drugs, you make him the arena of a
conflict of opposing poisons.”

The first thing to do, is to try to remove whatever defect in the
general health can be discovered. Then local treatment should be had
recourse to. One method of such treatment is that perfected by Weir
Mitchell of Philadelphia, and extensively carried out in this country
by Playfair, myself, and others. Stated generally, it consists, in
severe cases, in keeping the patient absolutely at rest in bed,
and obtaining the tonic influence of exercise by daily massage and
electricity,--_i.e._, skilled rubbing and kneading of the muscles, and
putting them in action by electricity. At the same time abundant food is
given in an easily digestible form. By this method the wearying effects
of fatigue are avoided and patients often recover rapidly. Skilled
massage and electrisation are essential. Without these, rest in bed will
probably convert the patient into a helpless invalid. This method has
been carried out extensively, and with marked success, for several years
past, at the West End School of Massage and Electricity, 67 Welbeck
Street, some of whose students have been sent to the Continent, India,
and the Colonies, there training other nurses, and becoming new centres
of usefulness.

But while upon this subject of massage, I would enter my earnest protest
against what is called “_isolation_,” and especially against any attempt
to “manage” a patient. As Cyril Bennett wrote in a former work, when a
doctor and a nurse think they are “managing” an invalid, nervous,
suffering woman, you may depend upon it that in nine cases out of ten
they are mis-managing her. The best physicians of the day are
remarkable, not more for their medical knowledge and skill, than for
their charm of manner, their human kindness, their warm sympathy with
suffering. The wise physician is the family friend, the trusted adviser,
the counsellor and comforter in many a trouble and anxiety: and so also
with the nurse. She should possess the _sensitive_ rather than the
_strong_ hand, and refinement, patience, tact, and sympathy.

In certain cases of nervous disease, great benefit is derived from the
use alone, and without massage, of the variety of electricity called
“Franklinism,” after the illustrious philosopher and statesman who so
carefully studied it. We have all heard the story of the thunder-cloud,
the kite, the key tied to the kite-string; Franklin’s disappointment
that he obtained no electricity; its coming on to rain, and by wetting
the string making it a conductor; and his delight at being able to draw
sparks--real miniature flashes of lightning--from the key with his
knuckles. This form of electricity has been little used until a short
time since, owing to certain inconveniences in its application; but
recent improvements in the manufacture of instruments have largely
removed these inconveniences, and placed at our service a remedy of
great promise, and in some cases of unequalled value.

The thanks of the medical profession are due to “Cyril Bennett” for a
sagacious, though not unkindly, criticism upon the more common methods
of treatment of that distressing affection, the “Modern Malady;” and in
indicating from a medical standpoint the opinions of a neurologist, I
venture to hope that the views of the author, who has so skilfully
sketched its salient features, may have received some support.

Finally, I would say that the day for the routine treatment of disease
has gone by, and progress of the most important character is being made
in the study of diet, exercise, sleep, rest, the application of water,
cold and hot, and many other agencies; and it has been well said that if
in the future, as in the past, nervous diseases are to be the measure of
our civilisation; if every increase in the illuminating power of the
mind is but an increase of surface to be eclipsed; if all new modes of
action of nerve-force are to be so many added pathways to sorrow; if
each fresh discovery or invention is to be matched by some new malady of
the nerves; we yet have this assurance, that science, with keen eyes and
steps that are not slow, is seeking and is finding means of prevention
and relief.

HERBERT TIBBITS.




AUTHOR’S PREFACE.


In the first part of this work I have dwelt on the errors in our mode of
treating Neurasthenia, consequent on the wide ignorance of the subject
which still prevails; in the second part, I have drawn attention to the
principal causes of the malady. The allegory forming the Introduction to
Part I. gives a brief history of nervous exhaustion and the modes of
treatment which have at various times been thought suitable to this most
painful and trying disease.

A friend, to whom I read the Introduction, criticised the quotation with
which I have concluded it. She objected that I thereby gave too high a
place to mere knowledge. I replied that I referred to the highest kind
of knowledge. This argument, however, fails to satisfy those who
persistently remind one of Eve’s transgression. In my humble opinion,
the point of that great and instructive history has always been missed.
Adam and Eve were cast out of Eden for eating of the tree of knowledge,
but if they had not been cast out of Eden, how could they have been
received into heaven? It was necessary to eat of the tree of knowledge
in order to desire to eat of the tree of life.

Again, before we can even desire to eat of the tree of knowledge, we
must be ignorant; and thus we see our ignorance itself to be a needed
stage in our upward evolution. We see in a glass darkly; we must become
fools that we may be wise. In our imperfect condition we do but catch
brief glimpses and fleeting shadows of the one mighty Truth. Just as our
nervous system must waste that it may be nourished, as the pendulum must
fall on the one side that it may rise on the other,[1] so must our
ignorance precede our half-knowledge, and our half-knowledge precede the
fuller revelation.

It is almost needless to add that I am oppressed with a sense of my own
incapacity for the task which I have here undertaken. But the most
ignorant may teach something to the most learned, if he go through life
by a different path. My only hope is that, in dealing with a subject
about which so little is known, even my observations--conscientious as
they are, however faulty--may be of some slight use to the community to
which I owe so much.

In preparing this work for the press, I have had the advantage of Mr.
Horace Hutchinson’s kind and generous assistance.

C. B.




CONTENTS.


_PART I._

Our Nerves and their Ill-Treatment.

CHAP.                                                   PAGE

I. INTRODUCTION                                           23

II. A THIEF IN THE NIGHT                                  37

III.   INEFFECTUAL TREATMENT                              47

IV.   ERRONEOUS NOTIONS                                   70

V.   OBSERVATION                                          85


_PART II._

The Causes of Neurasthenia.

VI. INTRODUCTION                                         101

VII. HEREDITY                                            104

VIII. IMPERFECTIONS OF OUR SOCIAL SYSTEM                 121

IX. AN IMPERFECT SYSTEM OF EDUCATION                     142

X. SECONDARY CAUSES OF NERVE-DETERIORATION               161




                               _PART I._

                  Our Nerves and their Ill-Treatment.

    “None shall rule but the humble.”--EMERSON.


Dedicated

TO THE

_MEDICAL MEN, NURSES, AND OTHERS_,

WHO, BY THEIR GENEROUS ASSISTANCE,

HAVE SO LARGELY CONDUCED TO THE SUCCESS OF THE AUTHOR’S
LABOURS

AMONGST OUR EPILEPTIC AND NEURASTHENIC POOR.




CHAPTER I.

_INTRODUCTORY._


Once there lived a race of men blest with very strong eyesight--so
strong that they were unconscious of possessing sight at all, but
accepted their marvellous endowment as a matter of course. These men
were hunters, who lived on the birds and beasts they shot with their
bows and arrows.

After a time our hunters learnt other arts besides that of the chase;
various implements were invented; industries such as spinning and
weaving were established; the primitive huts and sheds were discarded,
and commodious dwellings rose in their place. But their progress was not
unattended by serious disadvantages. For instance, the weavers, who
passed a great deal of their time indoors, began to lose the strength
and keenness of eyesight enjoyed by those who followed the chase.

At first little attention was paid to this calamity, but when some of
the weavers went blind and became a burden on the rest of the community,
a meeting was convened in the council-chamber called Public Opinion, the
most influential members of the tribe were consulted, and certain
conclusions were arrived at.

To be brief, it was decided that the malady in question was nothing more
nor less than a special manifestation of the Evil One, and that the
prompt execution of the sufferers was the only sure means of preventing
the spread of his power. It was therefore decreed that these uncanny and
mischievous weavers should at once be put to death. To ensure the
conviction of all suspected parties, a mode of trial was ordered which
had the advantage of being as efficacious as it was painful. So
everything seemed to be made quite safe and comfortable, and the spirits
of the tribe improved.

In spite of these excellent arrangements, however, some of the invalids
contrived to escape the doom thus thoughtfully prepared for them. It so
happened that certain of the community, who had not been invited to vote
at the meeting, held firmly to the belief that, so far from being
possessed by the Evil One, these dreaded weavers were divinely inspired.
Just because those whose sight was impaired could not see to do the work
which was close to their eyes, their advocates credited them with the
ability to discern things which were beyond the range of the most
powerful vision. They therefore protected the sufferers from trial and
honoured them with superstitious awe.

The disabled weavers had themselves done much to promote the conflicting
beliefs concerning them. When forced by growing blindness to abandon
their trade, they had been glad enough to make a livelihood by seemingly
exercising their supposed supernatural vision, and thus to escape from
reproach on the score of idleness; not anticipating that they would but
lay themselves open to suspicion of demon-fostering. In fact, they were
often self-deceived, for the disease exercised a peculiar effect on the
optic nerve, causing them, when they closed their eyes, to see before
them a variety of colours and forms which had no objective existence,
but which they frequently mistook for Divine revelation.

Time passed on. Notwithstanding the extreme measures taken to extirpate
the malady, it spread widely and increased in severity. Again the matter
was investigated, and again a meeting was convened.

This august assembly took a different view of the state of affairs from
that which had decreed the death of the sufferers. The former enactments
were repealed. Indeed, they were declared to be barbarous and unworthy
of the community which had so long tolerated them. With singular
unanimity it was agreed that the sufferers were really afflicted with
some incapacitating disease, the nature of which it was impossible to
discover, and for which it was vain to seek a cure. It was supposed to
originate in obscure injuries to the arms and legs, but on this point
there was difference of opinion. It never occurred to anybody that the
malady could have anything to do with impairment of the sight.

The ultimate decision of the court was to the effect that the suffering
weavers were to be relieved from the necessity of working for their
bread; that they should be permitted to remain a burden on the
community; that they should be kept within doors and tended as cripples,
and that surgeons should visit them and bandage their legs and arms.

These changes met with universal approval. The more humane members of
the tribe, who had shuddered at the former barbarities, were convinced
that the millennium had arrived, while the sufferers themselves accepted
their fate willingly enough. For though it was dull work to be kept
indoors with bandaged limbs, it was infinitely preferable to the hatred
and scorn of those around them, to say nothing of a violent and painful
death; and though many of them at first wished to use their limbs and
to take exercise in the open air on the days when there was no glare to
hurt their weak eyes, inactivity was less irksome than constant and
futile efforts to fulfil their tasks.

So, at first, every one was contented with the new decisions. True, all
the sufferers died sooner or later in a crippled condition, after a more
or less miserable and monotonous existence; but this unhappy result was
regarded as inevitable, and no further cure was sought for. Even the
invalids themselves came to attribute their bodily helplessness to their
original complaint, and not to the total disuse and tight bandaging
prescribed by the court.

Years went by, and brought no relief either to the disabled weavers or
to those who maintained them. On the contrary, the disease continued to
increase with frightful rapidity. All classes of the community--which
had, for the most part, abandoned its outdoor pursuits--were attacked in
turn. Further investigations were made as to the cause of the calamity;
a third meeting was convened, and definite conclusions were arrived at.

These, in some respects, showed more knowledge than the conclusions of
the second meeting. At the same time they showed less humanity. It
seemed as though the pendulum of human feeling had swung violently in
the direction of intolerance, then in the direction of tolerance,
returning once more, not quite to its former position, but to one far
beyond the mean of wisdom and moderation. Possibly the pendulum, in its
oscillations, would repeatedly pass and repass this mean point, till its
range should grow more and more limited, and it should at length find
repose.

The third meeting fully recognised many of the follies and absurdities
of its predecessors. Powerful speakers and keen investigators argued
with great force and clearness that the incapacity of the sufferers
arose entirely from disuse of the limbs, and not from disease. By some
of the speakers, this disuse was attributed--with a singular momentary
forgetfulness of past decrees--to the wicked deceit of the idle, and of
the friends who had solicited public charity in their behalf. The whole
community--so these excellent, well-meaning members insisted--had been
systematically gulled by the devices of impostors. There was nothing in
the world the matter with the disabled weavers and those whom they had
infected by their example. They must be forced to behave as if they were
well, and well they would become. No doubt their eyes were weak. Whose
eyes would not be weak after years of confinement within doors? Blazing
sunlight and constant use of eyes and limbs would soon cure their
fancies, and these infallible remedies must be prescribed for them at
once.

Such cogent common-sense arguments could not but meet with the approval
they deserved to meet with in the minds of the common-sense people who
heard them. The recommendations of the speakers were promptly adopted.

And now ensued a very singular state of affairs. By command of the
court, all invalids disabled by no visible and well-known disorder, were
forced to rise from their couches, to drag themselves about in the
blazing sunlight, and even to resume their former occupations. Some of
them, however, succeeded in simulating well-known disorders of the limbs
so cleverly, that they were considered, even by skilled investigators,
to be victims of chronic disease, and were mercifully left alone. Others
had already been partially cured by the complete rest from their labours
they had long enjoyed, and though the rough treatment they received, and
the trying effects of sudden exposure to light, caused them great
discomfort, they now learnt for the first time that they had recovered
the use of their eyes--long incarceration in dark rooms having prevented
their discovering the fact sooner. This result, however satisfactory to
themselves, was a source of infinite misery to their companions in
affliction, for it was hastily assumed that a mode of procedure which
had proved in the main efficacious with a few, must prove equally
efficacious with all.

True, some of the patients went altogether blind the moment they were
interfered with, and had to be conveyed to the blind asylum--in
accordance with the custom of the country--to be kept there for the rest
of their lives at the public expense. Some even developed real diseases
of the limbs, in consequence of their unaccustomed efforts to take
violent exercise. But these occasional failures by no means daunted the
resolution of philanthropic legislators. How could there be such a thing
as disease of the eyes while their own eyes were strong? With blindness
they were unhappily too well acquainted, even though they had never been
blind themselves; for when a man could not see at all, the fact could
readily be ascertained. But it was evident that so long as a man could
see, he was not blind, and therefore to treat him for loss of sight
would be absurd.

The larger number of those for whom work and sunlight were prescribed
neither lost their sight completely nor recovered it sufficiently to
perform their allotted tasks in even the most perfunctory manner. The
existence led by these unhappy people was miserable in the extreme.
Every effort to use the eyes was painful. The glare of the sunlight was
a torture baffling description. And their sufferings were not physical
only. Their fellow-men, including their nearest and dearest friends, did
their utmost to convince them of the illusory nature of their disease,
and continually implored them to exert their wills to overcome
temptations to imposture. By the more unfeeling, sneers and reproaches
were not spared. In sheer despair the less courageous of these
unfortunates died by their own hand.

Oddly enough, those who were the most uncompromising in their
discouragement of supposed impostors had themselves recently become
painfully conscious of impairment of vision. Fear of discovery made them
loud in denouncing others; ignorance of the nature of the malady gave
them hope that work and sunlight might conduce to their own cure. In
time, there were in that eccentric community an abundance of deceivers
of two different orders: the first pretending an illness other than that
which afflicted them; the second pretending to be well when they were
ill. It is said that the second class was larger than the first, and
that recruits were continually swelling its ranks.

Altogether, in spite of the well-intentioned efforts of the
investigators, the state of that tribe with regard to eye-disease was
very much worse than it had been while the regulations of the second
meeting were in force.

But, as the night is darkest immediately before the dawn, so, just as
things looked blackest, there came a change for the better. It chanced
that certain patients suffering from injuries to the limbs found their
eyesight much affected by the illness, and were rashly credited with
imposture. The injuries were declared to be wholly imaginary, and the
usual moral discipline was resorted to in order to cure the patients of
their delusion. Consequently, some of them were hopelessly crippled,
while others, who ultimately recovered the use of their limbs, were
blind for the rest of their days.

And now there was a panic in that hitherto contented community. Fears
were entertained that real disease (eye-weakness was not yet regarded
as actual illness) should frequently be overlooked in the midst of the
general craze for extirpating imposture. The continued increase in the
number of mysterious invalids occasioned anxious questioning on all
sides. The crippled patients seized the opportunity to complain loudly
of the usage they had received. Notwithstanding the remonstrances of the
more fortunate, they insisted on repeating, to all who would hear them,
the whole category of their woes. They never tired of declaring that
they had been cruelly and unjustly crippled, and that the eye-weakness
with which they had been temporarily afflicted was a terrible and
unmistakable malady, more painful even than injuries to the limbs, and
more urgently needing rational treatment.

So overwhelming was this evidence, so vehement were the witnesses, that
public attention was perforce called to their grievances. Further
investigations were made; further inquiries were diligently prosecuted;
and a fourth meeting was convened.

That meeting is still going on. Day after day the discussions are
resumed; day after day final judgment is deferred. The causes, nature,
and cure of the alarmingly prevalent eye-disease are all earnestly
debated. The ultimate decision of the court cannot be doubted. Sooner or
later it will be recognised that the great epidemic is a disease like
any other, to be treated with kindly consideration--to be cured, to be
prevented. Learned investigators, while admitting that their
examinations can discover no trace of disease in the eyes of the
sufferers, admit likewise that their failure is no argument whatever
against its existence. Pending the final judgment of the court, all
former cruel enactments have been repealed, and over the door of the
council-chamber have been inscribed these words, “Ignorance is the curse
of God. Knowledge is the wing on which we fly to heaven.”




CHAPTER II.

_A THIEF IN THE NIGHT._


Our life and progress may be aptly compared to the passage of
collections of particles through a fine sieve. The particles that will
not crumble are inevitably cast out, while those that succeed in passing
through it are rendered finer in the process. It would perhaps be apter
still to say, that we are passing continually through a series of
sieves, some coarse, some fine, and that the particles which survive the
ordeal, though refined in their passage, are perpetually losing
something they possessed before. Whether this be an advantage or a
disadvantage to them depends on the nature of that which is lost. Those
who survive the longest, in spite of constant paring and shaping,
fitting them for still finer passages, must have had their sieves
carefully graduated for them, each preceding sieve fitting them for the
next in order of progression.

Just as it is not the loudest things that have the most substance, so it
is not the largest things that contain the most power. We are told that
there is sufficient force holding together the particles composing a
single drop of water to make a whole flash of lightning. In the same
way, there may be more force concentrated in a small portion of the
nervous system than is diffused throughout all the rest of the body. And
our progress through the sieves may be a condensation of great forces
into our small compass. Leaving the matter of mere size of body out of
the question, one man of coarse organisation (A) may possess more
physical strength than a man of fine organisation (B). But B may rule
the world while A is a nonentity. B may, by means of his superior mental
capacity, subdue the powers of Nature to his will, and thus be master of
a force compared to which A’s physical strength is as a drop in the
ocean. B’s complex nervous system is the storehouse of a tremendous
energy.

Now, though we have been shaped in the past by sieves over which we have
had no control, we are nevertheless conscious of having acquired some
power of selecting and shaping the sieves of the future. Whether or no
our action in the matter is predetermined by the shape already given us,
the fact that we possess this power is indubitable.

In our age it would seem that we have arrived at a sieve that is either
exceptionally small or of an exceptional shape. Numbers of particles are
just now being rejected, not necessarily suddenly, but often subsequent
to unusually protracted, painful, and futile efforts at forcing a
passage through.

The question arises, Is this state of affairs inevitable? Have we not
power to graduate our sieves more effectually? And granting this power
of selection and modification, is it not possible that the sieve through
which we are endeavouring to force ourselves may be ill-shapen, and
calculated therefore to occasion needless destruction and deformity?

In some mode or other, we are all of us constantly considering this
problem. Pass through the sieves we must, if we would survive. The
process seems never-ending. We may be able to select or modify our
sieves, hurry our progress or retard it, but we can neither stand still
nor turn back. If we cannot or will not fit ourselves to the sieve, or
if mankind, by their combined action, cannot or will not fit the sieve
to us, then we must be cast out.

This casting out, if sudden, we term death; if slow, disease and death.
We have habituated ourselves to regard life and health as natural--death
and disease as unnatural if premature; but for our mode of thought in
the latter case there seems little justification. The process of
disintegration that we call disease is wholly natural. The result of two
opposing forces is the path of our planet in space; the result of two
opposing forces is our life. Let either force gain the ascendancy, and
our life goes, or begins to go.

Sooner or later, then, we must be rejected from a sieve. But our early
rejection and our late rejection are two very different matters. Our
sudden rejection or our slow rejection are two very different matters
also. Disintegration is always going on, but if we absorb sufficient
nutriment to repair the waste adequately, we are in health. If, owing to
disease of any part, the waste is more than we can repair, one of the
opposing forces has gained the ascendancy, and death has begun.

We justly regard this slow death in life as a most terrible fate: we
will do anything to avert it. To death itself we may be resigned; to
some it is an escape from suffering; by some it is regarded as the
entrance to a higher life. But all alike shrink from the prospect of
dragging out long years of pain and hopeless misery in the sick-room.
And just as we are becoming better acquainted with the causes and
prevention of disease in various forms, one form of it has recently
spread in our midst to an alarming extent, our ignorance of its nature
and origin rendering us powerless against its incursions.

Nervous prostration encounters us on all sides. It finds victims in all
classes of life. It has come amongst us like a thief in the night.

Disease, like any other adversary, finds out the most vulnerable part.
The most vulnerable part of our machinery is that about which we are
most ignorant. We are lamentably ignorant about our nervous systems; our
adversary, repulsed in other quarters, effects an entrance there. It is
far more difficult to expel him when once he has made his abode with us,
than to fortify the stronghold against him. Prevalent as this particular
form of disease is at the present moment, that is not the worst of the
evil. It is alarming and disheartening to be told that it is still on
the increase; but such is nevertheless the fact.

Professor Huxley very wisely says, that Nature gives us a blow and
leaves us to find out its meaning. More than that, she never stops
giving us blows until we have succeeded in doing so. It must be candidly
admitted that we are inexpressibly dull and require many very hard
knocks, and that when some one else is knocked and not ourselves, we are
apt to be extremely heartless.

It is only lately that the majority of non-medical people have become
conscious of possessing a nervous system at all. We still hear even
educated persons talk of their nerves as though they were something
spiritual--as though nervous disorder were not a physical disease. Such
inexcusable ignorance leads to shadowy, pernicious ideas about the
impossibility of curing the malady, or, supposing it to be regarded as
curable, to the adoption of cruel and fantastic methods of treatment. If
only we were forced to have all our remedies tried on ourselves before
trying them on others, patients would henceforth have a better time of
it. Unfortunately, many supposed remedies which are not unpleasant to
the healthy are torture to the diseased.

I regret to say, that I still come across people who regard nervous
prostration as sheer wickedness and obstinacy on the part of the
sufferer. Indeed, I have even heard the grace of God and a change of
heart talked about by excellent women as the only cure for cases that
had come under their notice. Far be it from me to underrate the power of
any good influence; but you have only to suggest that asthma shall be
treated by spiritual influence, and you will find that the good folks
regard you as a lunatic or as a profane person. Asthma being undoubtedly
a nervous disease, these distinctions are a little puzzling. I have even
heard of church-going being suggested as a remedy for nervous
excitability, regardless of the ventilation of the building, the length
of the sermon, and the tunefulness of the singing. Now, with all due
respect for church-going, I sometimes cannot help regretting that the
friends and advisers of the nervous do not believe in charms, like the
Neapolitans. If charms do no good, at all events they do no harm; and if
ignorant superstition must find vent, it is well if we can, at least,
render it innocuous.

The spiritual treatment of the diseased is nothing new; on the contrary,
it is hallowed by ancient custom. Anna of Saxony, the insane wife of
William the Silent, was shut up by her father in a miserable room, and
by his orders preached to daily, through a hole in the door, by a
minister of religion. But perhaps the poor lady suffered from insomnia!
Unfortunately the preaching proved ineffectual, for she died raving
mad.

An intelligent Italian gentleman, interested in the case of an English
friend suffering from nervous prostration, once endeavoured to console
him by saying that, in his opinion, it was only clever people who
suffered from nerves. Stupid people had the same things the matter with
them, he said, but they were too stupid to find it out. An original
notion, certainly. Unhappily, however true it may be that we lack the
wits to diagnose our ills, I know of many persons belonging to the
labouring classes who could scarcely be considered clever even by their
best friends, yet who are not only afflicted with the universal malady,
but are painfully conscious of the fact. Indeed, no rank or occupation
secures immunity from the visitations of our modern foe. In these days
of ready communication and rapid rise and fall of families, influences
affecting one part of the community quickly affect the whole. True,
certain conditions may be more fatal to fine organisations--to the
noblest and the best, to the most useful and the most intelligent--than
to the ill-developed; but of this more hereafter.

When I see people dropping out of the ranks one after another, each
probably having been confident that to him, at any rate, the disease
would never come, I am reminded of De Quincey’s “Klosterheim,” where
citizen after citizen was stolen away by the unseen foe. We understand
so little of the causes of these break-downs, that we will not be warned
in time; our partial but growing weakness is so gradual, that we become
accustomed to it, and think that nothing worse will befall us; and yet
the final collapse is often so sudden, that it at last comes upon us
unawares, and our total prostration is a surprise to ourselves. Perhaps
some shock or accident is blamed for the disaster, the long period of
weakness preceding it being ignored; or we fall a victim to some
well-known illness, and regard it as the judgment of Heaven, which we
were powerless to avoid, instead of telling ourselves that we might have
avoided it, and ought to have avoided it, by acting wisely in the first
instance, and fortifying ourselves against its inroads.




CHAPTER III.

_INEFFECTUAL TREATMENT._


We are most of us so far enlightened concerning our nervous systems as
to regard our nerves as a very useful means of communication between the
various parts of our machinery. The network of telegraph wires in this
country, with their chief offices, have frequently been compared to our
network of nerves with their chief offices, the brain and the spinal
centres. Yet this comparison gives a totally inadequate conception of
the functions of the nervous system. Many of us fail to realise that not
only do the nerves bear messages from one part of the machinery to
another, but that, without their co-operation, we can receive no
impressions from the outside world at all, and can perform no function
whatever. Without their aid, the eyes and ears are valueless, the
muscles refuse to do their work, the digestive and respiratory
processes cannot be carried on. If the nerve-centres are seriously
injured, we become paralysed or die. If they be impaired, the whole body
is enfeebled, and disease or incapacity of some particular organ may be
occasioned.

But, we may ask, how does it come about that, without external injury of
any kind, the nervous systems of good people, leading good lives and
given to good works, become impaired wholesale, and often remain
impaired in spite of all efforts to restore them?

Medical men tell us that, in such cases, the waste in the body exceeds
the nutritive supply; but this assertion may be made with equal truth in
regard to diseases of a different order, and, unfortunately, increase of
the nutritive supply does not necessarily cure nervous exhaustion; it is
the actual _nerve-waste_ that we have to put a stop to. Even where a
patient has purposely starved herself, mere feeding up does but bring
her back to the point at which she began to starve. And if we could know
the truth (if we would even try to know it), we should probably find
that loathing of the food, and incapability to assimilate it, were the
beginning of the seeming craze which, singularly enough, seems to afford
so much amusement to the average nurse. We therefore still have the
original disease to tackle. A long series of observations have convinced
me, that though this original disease is not often satisfactorily cured,
it can be cured, and ought to be cured. The reasons of so much failure
seem to me to be evident enough, and later on I hope to state them
fully.

Let me give some interesting and instructive instances of failure.

A few months ago I was told that a remarkable cure had been effected by
means of a well-known treatment, in which isolation, massage, and
electricity were the chief agents. I accepted an invitation to meet the
patient--a lady--at a friend’s house, and on asking for details of the
case, I was told that she had been for years prostrate on her couch, but
had been entirely restored to health and activity by the above
treatment.

At the time appointed, I went to my friend’s house and was introduced to
this “show-case.” What I saw was a lady manifestly suffering from severe
nervous exhaustion. The strained expression of her face was sufficient
evidence of mental fatigue; her attitude indicated bodily fatigue. Her
voice and manner betrayed a total lack of the energy and elasticity that
distinguish persons of her sanguine temperament when in good health, and
it was evident that continuous conversation was trying to her in the
extreme.

I talked with her for a few minutes, refraining from asking direct
questions. She readily informed me that she was undoubtedly cured by the
treatment she had recently undergone; that, though the massage was very
painful, she had greatly benefited by it; that she had been unable to
stir off her couch before undergoing it, but that she had now returned
to ordinary life, and was doing in all things as ordinary people did.
All I can say is, I am very sorry for ordinary people. She seemed
anxious to impress upon me the fact of her having had a real illness,
and not a fanciful illness; little knowing that at that moment I was
wondering at the strange fancies of those who could imagine such a
miserable invalid to be well. She ended by informing me triumphantly
that she was able to walk--how far do you think? Ten miles? Five miles?
No, not even one mile. This supposed convalescent--this “show-case”--was
able to drag herself _exactly half-a-mile_; that is to say, if she
rested on a seat half-way--and she was unmistakably done up at the end
of it.

And this was the result of paying from ten to twenty guineas a week for
a couple of months!

I ascertained afterwards, on closer inquiry, that the poor lady was
still weak and poorly in the opinion of unbiassed friends, but that her
doctor and nurse had treated her as if she were very fussy, and as if
the thing to be done was to cure her of her fancies. But there was
little need to tell me so: she was so evidently ashamed of ever having
been ill at all.

Why can it not be honestly recognised that a young woman who is too weak
to walk five miles, and chat with her friends afterwards without
over-fatigue, is in an unsatisfactory state of health; and that a young
lady who cannot walk half-a-mile without betraying, in spite of herself,
symptoms of nervous exhaustion, is in a most dangerous and alarming
state of health, and should at once be prevented from fatiguing herself
further, lest she should either die of nervous prostration (failure of
the heart’s action is, I believe, the polite name for this mode of
making our exit), or lest she should fall a prey to one or other of the
many forms of disease which are apt to attack weak women?

To a person of common-sense, the bodily fatigue of painful massage, and
the mental fatigue of being regarded as an imbecile, would hardly seem
conducive to cure in cases where repose of mind and body are urgently
needed; but in terror of that foe to our progress, the fixed idea, one
is careful to leave a corner for even the remotest of possibilities.

How this poor lady originally became a victim to the modern malady I do
not know. What happened after it had developed itself is easy enough to
comprehend. She had dragged herself about in misery till she could drag
herself about no more, and then she had taken to her couch. Want of
fresh air and exercise soon started a whole host of minor ills, which,
though painful and annoying, were less dangerous than continued
over-fatigue. These ailments were ineffectually doctored, one after
another, in a variety of ways. Then came a physician who carried her
bodily off to town, cured all the small ailments at once, and by means
of the strong moral influence brought to bear upon the patient,
persuaded her that lying in bed and having ailments was exceedingly
selfish and sinful, besides being inhuman to those about her. It was
then impressed upon her that she was cured, and she was warned against
falling into sin any more. The patient actually found some of her ills
cured, and persuaded herself that the remainder would yield in time.

It is a matter of fact that the intellectually weak are readily wrought
upon by those about them. In like manner, those who are suffering from
nervous prostration are often mere reflectors of their companions, and
their strength of character on recovery is a surprise to persons who
have only known them during illness. Our powers of will and judgment
depend not only on the number and correctness of the impressions
collected and combined in the storehouse of the nervous system, but on
the physical strength we have at command with which to put our machinery
in motion. Nervous weakness cannot but impair the needful connection
between its highly specialised parts.

So the patient is entered in the doctor’s book as cured, and goes home
to lead an ordinary life. The supposed success causes other ladies to be
treated in a similar manner. If the doctor refrains from telling them
how fanciful Miss So-and-so was, the nurse repairs the omission. In the
meantime Miss So-and-so, little suspecting that she is being held up as
a warning and an example,--perhaps even by name,--finds that her small
stock of strength has not been sufficiently increased to enable her to
bear the strain of an active existence. Perhaps she will break down
under some well-known disease, in which case her friends will say, “How
very unfortunate, just as Dr. ---- had cured her of her nervousness!”
Perhaps she will give in and take to her bed again, and then the nurses
will say to their patients, “She was all right as long as _we_ had her,
but after she went home she took to her messy ways again, and now you
see what she’s come to.”

If I have heard this sort of thing said once, I have heard it a hundred
times. In the days when I was even more ignorant than I am now, I used
to argue with these worthy, misguided folks; but I have since realised
the futility of trying to reason with people whose sieves have not pared
and shaped them into a capability for reasoning correctly.

Now you and I, and all cultured men and women in our community, have a
voice in the meetings at the council-chamber of Public Opinion, and have
power to modify the sieves through which these nurses pass. In fact, we
are always modifying them in one way or another, whether we recognise
the fact or not. And if we so far shirk our responsibilities as to allow
the sieves to be formed badly, then we are very selfish, and that is
infinitely worse than being ignorant and stupid. We shall not advance
matters a single stage by throwing mud at individuals who have
conscientiously done their best in very difficult circumstances.

Here is another case of failure which ought to commend itself to our
sense of humour.

I recently met a young lady who showed the ordinary symptoms of nervous
exhaustion. She had not collapsed entirely, but was forcing herself by
sheer strength of will to undergo the painful dragging-about process.
She informed me that she had just been consulting a physician who had
labelled her “hysteria.”[2] How delighted we all are when we get hold of
a label! I am, for one. Now this particular label is the concise and
technical mode of saying, “Disease unknown;” and in these days of hurry,
it is a great advantage to be concise.

But excellent as the label is in this respect, edifying as it is as an
example of candour, it is, unfortunately, peculiarly discouraging to the
patient, and therefore encouraging to the disease. So we are glad to
learn that it has at length been respectfully put to its long, last
sleep by our kind friend Dr. Tibbits; and, though we are willing to
admit that refuges for our half-knowledge are necessary landing-places
in our upward evolutionary climb, we must also regard this service
rendered by Dr. Tibbits as by no means the least with which he has
benefited humanity.

In “Massage and its Applications,” pp. 20-21, we read as follows:--

“I would ask you to allow me to enter my protest against that refuge of
destitute physicians and surgeons--the word ‘Hysteria!’ _What does it
mean? What do you understand by it?_ I have looked up many definitions
of it from all writers of repute, and I will not give you any one of
them. _The thing is non-existent._ The word is, as I have said, a refuge
for destitute medical practitioners, who, having to do with dreadfully
harassing cases of functional nervous disorder, take _‘Hysteria’_ as
their motto and their shield, and retire--or do not retire--from the
case under its shelter.”[3]

To go on with the story. The young lady was shut up and treated for
fussiness, though the wrong party would seem to have been under
treatment. And when the fuss was over, and the lady--with lightened
purse--was mercifully let loose again, she stoutly maintained that she
was no better than before. Her doctor, however, declared her to be
cured, and attributed her want of recognition of the fact to “hysteria.”
But then hysteria was the supposed disease for which the lady had been
treated!

So in this case the doctor had cured a disease which had no existence,
while the lady, in consequence of the disease which had no existence
and which had been cured, continued to consider herself as ill as
before.

Unfortunately, some cases of failure are less amusing than this one, and
have a more tragic ending. I have on record several instances in which
patients were treated as if a morbid craving for sympathy were the cause
of their illness, whereas it was in one case merely a symptom of the
disorder; in another, it was induced by the withholding on the part of
others the helpful sympathy with suffering which we all of us need, and
which we should all of us be ready to give; and in other cases there was
no proof at all of its existence. The results were extremely sad. One
lady, who had been treated to isolation and the interference of
incompetent nurses, became insane. A young man who had been forced to
exert himself became epileptic; another became partially paralysed.
These are solemn warnings. Those who have lain for a length of time in
bed are often more easy to cure than those who have long dragged
themselves about in pain and weakness. This is the interpretation, I
suspect, of the saying that it is the half-ill who are most difficult to
relieve. By the half-ill is meant those who are still dragging
themselves about, though they are often more ill than those who are
lying in bed.

Nervous exhaustion, as has been abundantly proved, is not usually
difficult to cure. Even epilepsy, if taken in time, yields
satisfactorily to rational treatment.[4] And if only nervous exhaustion
were better understood, the numbers of our insane and epileptic patients
would at once be marvellously reduced. Unhappily, the fantastic means
too often resorted to in order to cure supposed hysteria destroys the
patients’ faith in medical men, and renders them unwilling to submit to
further experiments. If only one could get hold of them in the early
stages of the disease, much suffering might be saved in the future. When
this is done, it sometimes happens that the patient does not realise how
much misery he has been spared, and is not proportionately grateful.

The other day a lady in a sadly overworked condition consulted a very
well-known medical man. He informed her that she was suffering from
“hysteria,” and recommended her to seek active employment. The lady, not
being a homœopath, objected to the proposed treatment. Since she was
suffering from fatigue, of what use could it be to prescribe fatigue as
a cure? The inexorable doctor took refuge in the imperative mood,--a
very favourite refuge when the patient has been labelled “disease
unknown,”--and she was overruled. With misplaced confidence and
reprehensible docility, she forced herself back to her work. Shortly
afterwards she had to be placed under care.

A worthy great-uncle of mine was one morning engaged in doctoring the
out-patients at the hospital he attended, when a poor woman addressed
him in pathetic tones, begging him to cure the malady in consequence of
which she endured unutterable things.

“Certainly, my good woman,” he said cheeringly. “What’s the matter?”

“I have a newt, sir,” was the unexpected response.

“A what?”

“A newt, sir, inside me.”

My uncle then recognised the case as being what he called “hysterical.”

People in those days were more sympathetic and less contemptuous in
their treatment of such unfortunates than most of us are now, so he said
in a kindly, soothing manner--

“Poor thing! Well, well, we’ll soon set that right. Now don’t you
distress yourself, my good woman. _I’ll_ soon settle the newt for you!”

Thereupon he gave her a bottle of coloured water and some bread-pills,
directing her to take them steadily for a few days and then return to
show herself to him. He fully expected, he added, that she would then be
quite restored to health.

Away went the sufferer.

At the time appointed she again visited the hospital.

“Well,” said my uncle cheerfully, “how are you? Newt’s quite done for, I
suppose?”

“Oh no, sir,” she replied piteously. “A terrible thing’s happened.”

“Indeed! Sorry for that. What is it?”

“_The newt’s had young ones!_”

My uncle gave that case up. I have no doubt he thenceforth regarded
“hysteria” as incurable in confirmed cases.

It is really surprising that so successful a practitioner should have
been short-sighted enough to treat a mere symptom instead of the disease
in which it originated. He appeared to think that his patient was
suffering from hallucination, from a morbid idea, and that if he could
remove the idea, she would be well. Had he realised that morbid ideas
argue a morbid condition of the nerves, and that the mere removal of one
hallucination after another would not suffice to repair actual
nerve-waste, he would certainly have refrained from expending his own
nerve-force in a vain endeavour. But I am glad to know that he at any
rate refrained from dissipating still further the poor woman’s small
capital of strength by frightening her and discouraging her. In this
respect his method compares favourably with that now in vogue at many
hospitals.

Here are three instances of more modern usage.

A woman of the labouring class presented herself at a country hospital
for treatment. She declared herself to be afflicted with severe pain in
one leg, rendering it almost helpless, and preventing her from
accomplishing her daily work. The medical gentlemen to whom she
addressed herself could find nothing wrong with the limb, and harshly
told her that her complaint was “hysteria.” One would have thought that
having discovered the disease and given it a name, they would have done
something to cure it. Not at all. The woman was sent away unrelieved, to
be a burden on her unhappy family or on the community, as the case might
be. Yet these gentlemen had probably heard of such things as nerves, and
knew them to be an even more essential part of the body than the legs.
Their refusal to treat the patient in question would have been excusable
had they systematically excluded all nervous cases, but this does not
appear to have been their practice. The poor woman went home and
struggled to do her work, but failed from weakness. In despair she
consulted a quack, who put her on an efficacious course of treatment and
cured her triumphantly. A member of the Hospital Committee, having these
facts brought under his notice, attended the next meeting, and moved
that that quack should at once be taken on to the staff to assist the
medical gentlemen with his valuable advice. The motion was lost.

Another woman, suffering from severe nervous exhaustion, applied for
relief at a large hospital in London, and received the same
answer--“Only hysteria.” One would really have thought that a disease so
widely recognised, and causing so much perplexity, would be a bad enough
thing to have without more being expected of one. However, the woman was
told that her complaint was all sham and nonsense, and she was sent
about her business. She went in despondency, for she was in a fearfully
exhausted condition. Soon afterwards a painful malady made its
appearance of the description usually considered “interesting,” and the
same hospital, which had closed its doors on the invalid, now opened
them wide, received her with kindness, and studied the disease
diligently. They failed to cure it, but that is a detail. Indeed, I
think they would have cured it if they could, but perhaps it was
incurable. This hospital admits itself to have been mistaken. It says it
was wrong in crediting the patient with “hysteria;” she was really
suffering, the doctors say, from the exhaustion preceding this
particular form of disease. In short, if they could have cured the
neurasthenia, which was the woman’s sole disease when she went to the
hospital in the first instance, she need never have contracted the
disease which was found so interesting. Lower the vitality of the whole
organism, and the part originally weakest breaks down; or the patient
may be exposed to some malign influence,--such as blood-poisoning, for
example,--which, in health, she would have been able to withstand, but
to which, in an enfeebled condition, she falls an easy prey. I had
watched this patient become ill. I had even tried to arrest her downward
progress; but my hands being tied, I could accomplish very little. She
was of neurasthenic inheritance, and was put in unfavourable conditions.
A hospital, taking entire possession of her at the right moment, might
have done a good deal.

At another hospital a young probationer began to break down from
overwork. She fell a victim to neurasthenia, and a very painful and
distressing malady she found it. She consulted one of the medical staff,
who rebuked her, told her she was suffering from “hysteria,” and ordered
her to go and work. Her health would have been destroyed, and she would
have been forced to abandon her career, had not a kindly, sensible
physician--such as, happily, abound in the much-tried medical
profession--come to the rescue, set her feet upon a rock, and ordered
her goings. She is still leading an active, useful life.

There have probably been many cases in which the patient has become
neurasthenic from monotony and want of occupation, and in which her cure
has seemingly been effected by her being forced to exertion. As a matter
of fact, the good results have been obtained chiefly by the patient
being placed in better conditions, and I have seen many such cases, who
have been entered in the doctor’s book as cured, relapse again on the
smallest provocation. Yet, as I have said before, neurasthenia can be
cured, and ought to be cured; and if we fail in our efforts, there must
be a screw loose in our mode of treatment.

One more instance of failure may be given here, out of a very large
number that might be recorded.

A young lady, rendered justly anxious by increasing nerve-weakness,
consulted a well-known physician. He asked what ailed her. She described
her symptoms, the most usual symptoms of neurasthenia. His comment on
her report was singular. He wondered that she should have come to him at
all, having no more than that the matter with her. One is again tempted
to ask what more one can be expected to have the matter? Surely,
continued languor, depression, neuralgia, and weakness are a
sufficiently heavy burden for anybody to bear, to say nothing of want of
comprehension on the part of others. Did the good gentleman wish the
lady to wait until she had developed something more “interesting”? Not
at all. We should wrong him by entertaining any such idea. He merely
believed neurasthenia to be three parts fuss and nonsense, and he
thought he was proving himself a kind friend to the young lady by
rousing her to a sense of her duty--the duty of dragging herself about
and saying nothing of her ailments. It is odd how very ready we all are
to preach duty--to somebody else. Nevertheless, let us honour the
conscientious physician for his honesty. Unfortunately, he failed to
cure the young lady, and for anything I know to the contrary, she may by
this time have developed something extremely interesting.




CHAPTER IV.

_ERRONEOUS NOTIONS._


It will be readily conceded that in order to treat nervous disease
successfully, we must have some special qualifications for our task. We
need not only learning, but experience and powers of ready observation.
Indeed, mere learning will avail us little in a still undiscovered
country, or in one where the observations of our predecessors have been
so frequently and unavoidably erroneous. But if it be true that all
disease is in a sense nervous disease--an affection of the nerves of
some particular part of the organism--the importance of the study of
neurasthenia cannot be overrated, provided that we study it from Nature,
and do not rely wholly on prevalent teaching concerning the mode of
treatment required.

Mr. Francis Galton, in his able work, “Natural Inheritance,” shows that
tendencies to certain maladies may lie latent in families tainted with
them in the past, and that, on the other hand, these may be increased in
severity by inheritance, and may even bring the family to an end. With
some complaints the rule would seem to be that they are either very
largely inherited by the offspring or not at all. Making some allowance
for difference in circumstance and mode of life of a given generation,
it will be found that where the nervous system has been strengthened,
the family malady has been successfully defied, and that where it has
been enfeebled, the enemy has made his appearance. As regards
consumption especially, it would be easy to give a large number of cases
in point. In the early stages of this terrible malady, when the enemy
had already effected an entrance and was clearly recognised by
physicians, I have known him to be summarily expelled, not by treating
the disease itself, not by sending the patient to warm climates, but by
adopting the very methods which are so effectual in neurasthenia.
Bracing air, frequent nourishment, cold water to the neck and spine,
mild tonics continued for a length of time, and freedom from worry--in
some cases massage and electricity also,--these are the true remedies so
long as remedies are of any use at all. I have known instances where
such a _régime_ has entirely banished the hereditary evil, and the
patient has resumed an ordinary existence.

Almost too much stress has recently been laid on the necessity for moral
treatment of the neurasthenic. Though it is impossible to lay too much
stress on the importance of good surroundings, the term “moral
treatment” has come to be employed in a wrong sense. Doctors and nurses
usually mean by it (not always) keeping the patient in 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 encouragement of the growth of the patient’s
will--not the enforcement of abject submission to the will of somebody
else,--total freedom from all noise, fatigue, and irritation, and the
constant presence of an improving influence and example. Special
attention must be called to this latter point. Jean Paul Richter 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
unlighted match.

Now, the notion that a woman less refined, less highly educated than the
patient, and originally of inferior mental and moral endowment, is to be
permitted to thwart and control her, is one that must, and does, work an
incalculable amount of harm. It is not by saying, “Be unselfish,” “Don’t
think of your ailments,” “Be self-controlled,” &c., that we can do any
good to a suffering invalid. If we have not built up our own
organisations--our characters--impression by impression, in the path of
right reason and true sanity, so that we can benefit others by our
unconscious influence, we had far better let the neurasthenic alone.

I have, moreover, come across neurasthenic patients who were far more
fitted to teach me endurance and sweet temper than I was to teach them.
Even in cases where we justly lament the absence of these virtues, we
should consider what strength of mind it must require to refrain from
irritability of temper, from yielding to constant pain and fatigue, and
from sinking into a state of complete inactivity. The efforts of
neurasthenics in this latter direction are often mistaken; Nature is
indicating the pressing need of rest; but we must nevertheless admire
the vigour of at least one portion of their nervous systems, though
realising that the health of the whole organism should not be sacrificed
to the demands of that one portion. Looking at the matter in this light,
we feel our self-righteousness to be misplaced, and our ready
interference to be an impertinence.

A patient suffering from neurasthenia was once lying ill at a small
nursing home, undergoing massage. A visitor at the house inquired of its
owner, a trained nurse, what ailed the lady.

“Oh, there’s nothing the matter with her,” replied the trained attendant
glibly. “She is only a little odd.”

What a vista of ignorance was opened up by this remark! How could a
patient who was ill enough to be subjected to the _Weir Mitchell_
treatment have nothing the matter with her, unless indeed she had simply
been condemned to imprisonment for the sake of the loaves and fishes she
would thereby be forced to dispense?

Two nurses at a hospital were once puzzling over the case of a
neurasthenic woman then under treatment there. They were perplexed, with
reason, because the woman appeared to be in pain, although the harsh
medical verdict was to the effect that she had no disease. They were
nice, kindly women, and were sorry for the patient. So they found a
middle course between the rival evidences by coming to the conclusion
that, though there was nothing the matter with her, her pains were “real
to her,” and they ought to treat her with gentleness. All I can say is,
if I ever get ill, may I be nursed by those two women. There is
something genuinely heroic about people who refuse to follow powerful
superiors to do evil.

Nevertheless, though their resolution was right and praiseworthy, their
conclusion was wrong. If we are unduly conscious of any part of our
bodies, that part is not in a healthy state. Wherever there is pain,
there is disintegration--disease, and because the medical advisers in
this instance could not find the disease, it by no means followed that
it was not there. “The fact is, we know very little about nerves,” said
a medical man the other day. His candour merits our respect. To say that
a patient can fancy pain is absurd. Pain is but a condition of the
nerves. If it is not there, we cannot feel it. It is objected that, if
we take a patient’s thoughts off her aches and pains, she ceases to feel
them, consequently the pain must be imaginary. But if we cut a finger
while in a state of excitement, we feel no pain. Not because the pain is
there and we are unconscious of it, but that while nervous energy is
diverted into another channel, there can be no pain. Read the account
of the burning of the martyrs of Valenciennes at the time of the Spanish
persecution in the Netherlands.[5] Those brave people were in a state of
ecstasy in which pain was impossible. If there is one thing certain in
past history, it is that they suffered absolutely nothing. The
contemporary evidence on the subject is overwhelming.

But, as far as the neurasthenic are concerned, the practice of taking
their attention off their pains has its dangers. The process is apt to
be fatiguing, so that the patients only have more pain as soon as the
distraction ceases. This fact is very exasperating to the more ignorant
of their attendants. “She was well enough as long as she was thinking of
something else,” the disappointed folks will tell you with an aggrieved
air. One woman, possessing many good qualities, informed me that what
such patients wanted was a “thrashing.” This nurse was a _masseuse_ in
the habit of “Weir Mitchelling” patients. Without supposing that her
views ever took a practical form, their existence could hardly conduce
to a kindly consideration for suffering invalids.

One very favourite notion about the nervous is, that they ought not to
be sympathised with. If any one will try this treatment for a little
while himself, even in health, he will find it necessary to fly pretty
quickly to people possessing natural human feeling, in order to avoid
drifting into permanent lunacy. In disease the danger is still greater.
I have always found that when I sympathised cordially with real causes
of distress, and simply disregarded unmistakably simulated ones, the
simulated ones died a natural death without more ado.

But which symptoms are real and which are simulated? Here the tough or
toughened organisation is usually hopelessly at sea. Here no information
will enlighten, no rules will guide. If we are by nature incapable of
making simple observations correctly, we had better give the whole thing
up and go into another line of business. Even the so-called simulated
symptoms are in a sense real symptoms of a morbid condition of brain;
so, however good observers we may be, if we have not the wisdom and the
patience to deal with these wisely and gently, we are still
disqualified. “But nervous patients are so trying!” Why, of course they
are. “Trying” is not the word. They are sometimes maddening. And nurses
who are overworked, which they ought not to be, will be saints if they
always contrive to keep their temper with them. We must remember,
however, that lunatics and delirious people are trying also, and why
should it be criminal to mismanage one kind of nervous disorder and not
another?

I was once travelling in a railway carriage in France. The stuffiness of
the place was poisonous, and I ventured to lower one of the windows a
few inches. Instantly a French gentleman, seated opposite to me, well
out of the draught, reared himself up and descended upon me with
indignation and with a positive sense of injury. He could not stand the
cold. Why had I opened the window? He must really be permitted to shut
it.

An English gentleman explained that we wished for air. The Frenchman was
amazed.

“It surely cannot hurt you,” he said, with violent gesticulation, “to
have the windows shut. But I, when they are open, I _suffer_.”

It would have been impossible to convince him of the fact that I
suffered when the window was shut as much as he did when it was open.

Some of our nurses are very like this French gentleman. Let the patient
have a cold, and they are quite pleased for her to put her feet in
mustard and water. Let her have a shattered nervous system, and nine out
of ten of them feel injured if they are told to stop their chatter. I
have known women who were in many respects capable nurses rendered
useless, as far as nervous patients were concerned, by the erroneous
notions with which they had been impregnated. One nurse told me
seriously that the proper way to manage a nervous invalid was to make
her afraid of you. She had had no personal experience in the matter, and
the little prattling monkey was hardly likely to inspire much terror;
but that was what she had been taught.

Doctors, too, sometimes indulge in whimsical ideas about these cases. A
nurse, who had recently “Weir Mitchelled” a neurasthenic patient, told
me that the lady, like many others suffering from disorder of the
medulla, had a difficulty in swallowing, and could not take the pills
that were ordered for her. I inquired what happened. She replied that
the doctor, evidently impressed with the belief that the difficulty was
all sham, insisted that she should get those pills down somehow. It was
done. But the nurse informed me that, in the effort, the poor lady
swallowed a whole bottle of water every day, and it was very bad for
her.

A gentleman once asked me if I knew what Beau Brummell was then employed
in doing in the other world. Much surprised at the question, I replied
that I could not imagine.

“Eating raw onions with a steel knife,” he said solemnly. “By and bye,
he will get to cabbage. For a long time he will be allowed no other
food.”

On this principle, what will happen to that doctor who made a sick
person swallow a whole bottle of water daily? But perhaps Beau Brummell
is not suffering merely for having spoken contemptuously of the
“creature” who ate cabbage, but for his indifference to the needs of
others throughout his life. As to the doctor, let us hope he will be
able to show a counterbalancing array of kind actions as a set-off
against his misdemeanour, and so escape penance.

After all, it requires little skill to find fault. The thing is to do
better. Unfortunately, it is just those medical men who have recognised
nervous exhaustion and done their best to treat it who, in the nature of
things, have made the most blunders and have been most blamed. This was
inevitable. It is by failure that we learn. There is all the more need
to draw attention to our failures and to point the moral. We have often
tried hard to treat the person and not the disease; we have even tried
to treat the disease and not the person. We must accustom ourselves to
attacking the enemy on all sides at once. We must realise that not only
the food that we eat and the air we breathe act upon the nervous system,
but every impression conveyed to it through our senses. We may think it
is of little consequence whether we say certain words to a patient or
not. We think they will soon be forgotten, or the damage done by them be
repaired. But no impression on anything in nature can be done away, not
even the impression of the faintest particle of light. The whole
universe throughout eternity is altered by our uttering one sentence or
leaving it unsaid.

Supposing we put a photographic plate into the camera and expose it,
then take it to the dark room and look at it. Can we see any change?
None whatever. But immerse it in the developing solution, and the change
it has undergone becomes apparent,--there is a picture on our plate. If
we take it out into the light without first fixing it, the picture fades
away. Is the plate therefore the same as it was before we took our
picture? No, it is entirely different, and nothing in the world can ever
restore the film on the plate precisely to its former condition.

In like manner outer impressions are every moment altering our nervous
structure, and life’s clock cannot be put back.




CHAPTER V.

_OBSERVATION._


We must bear in mind the fact that all observation is difficult, not
only because of our lack of perception, but because impressions already
received project themselves, so to speak, on to the objects to be
observed, and prevent our seeing these as they really are. Here lies the
true interpretation of the “fixed idea,” and the “subjective” order of
mind. The mind must not only be large enough and elastic enough to
receive new impressions, but must also combine them with the old, so as
to modify the former idea; for that which can only receive a new
impression at the cost of casting out former and equally truthful
impressions is deficient in retentiveness, and must always be wanting in
thoroughness. We see examples of this order of mind in persons who
eagerly take up one subject after another, but who permanently
assimilate nothing. Mental growth is manifestly of little advantage to
us if, while gaining on the one side, we are continually losing on the
other. Again, if we cut ourselves off from outer impressions we lose
mental power, for it is only by use of a part that nutriment can be
attracted to it; and if our impressions are too exclusively of one
particular order, our minds become ill-balanced.

Before we can be of special use as observers, therefore, education must
have meant for us “the harmonious development of all the faculties.” We
need to have our sense perceptions in good order that we may perceive
quickly and accurately; we need the retentive power to enable us to
store the impressions received; and we need the faculty of combining
these impressions in our minds--the lower manifestation of which process
we call imagination, and the higher, reasoning faculty.

Probably, in the cases where we generally attribute erroneous
observations to excess of imagination, the fault really lies in the
defective perceptive power. Either the nervous structure lacks
sufficient sensitiveness to respond readily to the stimulus, or it lacks
the strength to retain the impression. In these respects we commonly
note improvement with the amelioration of the general health. It is a
question, however, whether, if the stimulus were to make an adequate
impression, the impression would not be more effectually retained. Be
that as it may, we find persons who observe isolated facts readily
enough, and who remember them well, but who learn little thereby,
because they lack combining power. Isolated facts are facts to them and
nothing more. The notion of _law_ is a thing beyond them, and each fact
has to be observed separately.

These are just the persons who are unfit to have the charge of nervous
invalids, but for some mysterious reason they are just the persons into
whose hands nervous invalids most often fall. Perhaps the explanation
is, that ready combining power can exist only with a certain amount of
sensitiveness of nervous structure, and that the sieves through which
we pass our nurses may cast out those who would be of the greatest value
in nervous illness, besides tending to lessen the sensitiveness of those
that remain.[6] At all events, I have been disappointed to find that
women from whom I hoped great things as nurses--women of good
organisation, and certainly not of delicate constitution--have broken
down completely in the course of their hospital training; whilst women
whom I consider positively injurious to any kind of invalid have passed
through it triumphantly. The question arises, Are we not unwise so to
shape our sieves as to exclude the very people by whom we ourselves
would most prefer to be tended in sickness? Will any mere knowledge
atone for the loss of that keen intelligence which we recognise in
persons of so-called sympathetic disposition?

On inquiring the reason why so many highly desirable persons have been
cast out from the sieve of their hospital training, I have been told
that the fact causes no concern to the authorities, so numerous are the
women pressing in to take the place of the defeated strugglers for
existence. If this is no answer to the inquiries, it is at least as good
as most of the replies one gets when seeking for information on this
unsatisfactory subject. Supposing it to be true, we may well ask further
whether a too great narrowing of the spaces of the sieve in a particular
direction, combined probably with an extreme elongation in another
direction, does not tend to produce ill-shapen and one-sided nurses? I
say _tend_, because the present system is still new, and though it may
have immediate advantages, we should not blind ourselves to its possible
disadvantages in the future. We need always to remember that a process
of selection which ensures the survival of the toughest does not
necessarily ensure the survival of the fittest. There is such a thing as
evolving backwards, like the cave-fish who have lost their sight during
their long residence in the dark. The best things in life are not
machine-made.

But correct observation being such a complicated performance, we should
be very indulgent to people who make mistakes; especially so if we have
ever made a mistake ourselves. In our plentiful abuse of individuals, we
merely display our inability to recognise the limitations and
imperfections of “the thing called human nature.” We have reached a
certain landing-place in our upward climb by means of paying attention
to our sieves, but we have a long way still to go.

A few very simple experiments will suffice to show us how hard a thing
it is to see even what lies right under our very noses. We may then
perhaps realise how rash it is to form hasty opinions about the
complicated and invisible nervous systems of our suffering
fellow-creatures. Having got thus far, it may even dawn upon us that to
make our fanciful and erroneous theories (fanciful because founded on
insufficient knowledge, and erroneous because founded on the defective
observations of others) the excuse for ill-treating other people’s
nerves by showing a want of consideration for their sufferings, by
tormenting them with painful and fantastic tricks, and by indulging our
own tyranny and self-righteousness, is to manifest to the world an
extremely primeval species of childishness.

I once drew a character called “Dr. Broadley,” who, excellent man though
he was in some respects, put on a “stalk” when he came in contact with a
nervous patient. Now, three different people thought they recognised Dr.
Broadley, and informed me of the fact. They were all wrong. Not one of
their three supposed models had sat to me for his portrait. I am forced,
against my will, to the conclusion that there are in existence a
superfluous number of persons who make the proximity of an invalid the
excuse for displaying unnecessary airs. Surely it is not by such an
influence, such an example, that the morals of our patients are to be
improved.

I once put together two small prayer-books, so that the coloured edges
of the leaves were divided only by the edge of the thin cover of each
book. The leaves of one were of a bright golden colour; those of the
other had been tinted a dull red. The books were momentarily held up for
observation, with this interesting result. The leaves of the one book
were seen correctly, so far, at least, as their colour was concerned;
for they were unhesitatingly declared to be tinted with bright gold. The
leaves of the other, however, were with equal readiness declared to be
of a _golden_ red colour.

It is easy to understand how this mistake arose. The golden colour was
the first perceived, and the impression made by the dull red was not
strong enough in comparison to be correctly seen and retained in a brief
moment. The bright gold of the one book had so powerfully affected the
retina that the colour was cast, so to speak, on to the leaves of the
other book. These therefore appeared to be golden red in tint, instead
of the dull red they were in reality.

On another occasion a small smooth cake was placed in a dish together
with several large almond-cakes. When attention was attracted to it, it
was mistaken for a cocoanut cake.

Here a rapid inspection had sufficed to show that one cake was smaller
than the others. It had not sufficed to show the great difference in its
construction. The large cakes had been first perceived, and their
roughness was erroneously seen to be shared by the small cake.

Some people go through life with their minds so completely lined by a
series of crystallised impressions, that no aftercomers have the
smallest chance of even combining with them to produce a half-truth, to
say nothing of overcoming them to a sufficient extent to drive out the
errors and replace approximate truths by others still truer.

It may be objected that the above failures in perception of differences
(a much more difficult thing than perception of similarities[7]) was
occasioned solely by the speed with which the observations were made. I
entertained a contrary belief, and my belief was confirmed by the
following example of my own capacity for disgraceful blundering.

Shortly after the publication of “The Massage Case,” a friend asked me
how I could have made such a mistake as to attribute to Elfie during her
convalescence the strength to walk twenty miles in one day. I asked her
to show me the passage wherein I had erred. She did so; and I read that
Elfie really did walk twenty miles in the desert. I was amazed at my own
stupidity, for, considering the length of time required for complete
recovery from severe nervous exhaustion, it is evident that even the
charm of Dr. Risedale’s society could not be expected to inspire her
even temporarily with nerve-power for such a feat. I had looked steadily
at the passage for a few seconds before the idea occurred to me that I
might be seeing wrong. Then I scrutinised each word by the light of this
suspicion, and having hit upon a correct theory, I found out the truth.
It turned out that Elfie walked in the desert for twenty _minutes_, not
_miles_. An erroneous impression had been conveyed to my brain through
the ear; and by its disproportionate tenacity--disproportionate to my
perceptive power at the moment--had prevented my receiving a new and
truer impression through the eye.

I was overdone at the time, and took the warning; that is to say, I
rested. But many of our doctors and nurses, whose observations are of
the extremest importance, are supposed to do their work in a fatigued
condition, and are considered fit objects of abuse if they do it badly.
Why then do they overwork themselves? The answer to this question is
that they are underpaid. The butcher and the baker must always receive
the reward of their labours; the doctor and the nurse must often toil
for nothing, though we are aware that, in order to obtain efficiency in
any profession, it is essential that that profession should be well
paid. The community may object that it cannot afford to pay more than it
pays at present. Can it then afford to be kept ill or made ill by
ignorant interference or by erroneous notions? It would surely be
cheaper in the long-run to pay to get well or to learn how not to get
ill.

To be dogmatic about that which is least known would appear to be an
ineradicable characteristic of human nature in its present imperfect
state. “Fools rush in where angels fear to tread” is still a true
saying. In the treatment of nervous disease it is amply exemplified.
Where we are most ignorant, there we are most uncompromising in our
dealings. When we understood absolutely nothing of insanity, seeing
little connection between madness and disease, we resorted to the whip
and the chain. On waking to some conception of nervous disorder, we
perceive similarities more readily than differences, and proceed to lump
together all diseases of the nerves in the earlier stages under the name
of “hysteria.” Having already some vague foolish fixed idea in our heads
about “hysteria” being synonymous with idleness and general depravity,
we drag our patients about, beat them with wet towels, give them
frightful shocks, galvanic or otherwise, and then get rid of them as
quickly as possible, so as not to have the burden of remote
consequences.

But when more serious mischief is set up, what then? Why, then comes
tardily a perception of differences, and we divide nervous disorders
into hard and fast diseases, concluding that all had been different from
the very first. The later perception of underlying similarity has as yet
scarcely dawned. Some of these maladies are considered curable; others,
without rhyme or reason, are considered incurable.

With regard to the curability of nervous disease, let us consider what
happens when we travel by train from Eastbourne to London, and again
from Eastbourne to Brighton. In each case we pass through Willingdon and
Polegate, and stop at Lewes. We can get out at Lewes or at either of the
previous stations and return to Eastbourne, but if we proceed as far as
Lewes, our return journey will be longer than if we had got out at
Polegate. In the same way nervous disease is more quickly cured in the
early stages than in the later stages. Now, suppose that we are in a
train which does not stop between Lewes and London. It is evident in
this case that, if we have missed our chance of alighting at Lewes, we
must go on to the final goal; no return being possible. Thus, there is a
point in certain nervous diseases beyond which recovery is impossible.
On the other hand, in travelling from Eastbourne to Brighton, we have
several chances of retracing our steps even after leaving Lewes, where
the ways diverge; and so we find that, in some cases of nervous disease,
incurability is reached sooner than in others. And just as we must be
content to take longer to return from Lewes than from Polegate, so we
must be content with a slow cure in advanced nervous disorders, and
remember that, in administering nerve-tonics, the weaker the patient,
the weaker should be the dose; all attempts to hurry the cure being
fatal to success. Moreover, just as, in journeying from Eastbourne to
London, and from Eastbourne to Brighton, we travel along the same road
as far as Lewes, so all nervous diseases have a common origin in
nerve-deterioration which may be repaired.

Defective powers of observation bring with them this great evil,--we not
only fail to reduce a terrible malady to a minimum, but we mete out
unjust censure to those who seem to be responsible for the failure.
Whereas the really responsible party is the community at large--in
short, ourselves. We blame the doctor; but doctors are after all a small
minority, and the minority can only expand and take shape in the
direction in which the least pressure is put upon it by the majority.
The grotesque modes of treatment resorted to in past times evidently
gave satisfaction to all but the enlightened few, just as bad
Governments have been tolerated in the countries fitted only to be
governed badly.

But to be dissatisfied, to mete out blame, to expect a cure, are
healthier symptoms than a passive acceptance of the evil and a lazy
belief in incurability.

Medical science is unlimited. The law of our universe is progress.




                              _PART II._

                      The Causes of Neurasthenia.


    “Whoever degrades another degrades me,
     And whatever is done or said returns at last to me.”
       --WALT WHITMAN.




CHAPTER VI.

_INTRODUCTORY._


In individual cases of nerve-trouble, the illness is generally traced to
some cause, serious or trivial, real or imaginary, as the case may be.
Quite as much harm as good is wrought by the practice. If the patient
has suffered from some accident or malady leaving nerve-weakness as its
legacy, the large development of the supposed phrenological organ called
“Causality” on the part of the patient’s attendants will probably have
its uses. The invalid will not then be considered a criminal. If his
ailments cannot be cured, at all events he will meet with a certain
amount of consideration, and his sufferings will not be aggravated by
harshness. But if the cause of the mischief defy investigation, then a
false one will assuredly be invented to take its place; the natural love
of detraction, constantly recurring in consequence of the feeling of
superiority which indulgence in detraction gives us, will find an outlet
in action; and the sorrows of the patient, already great enough, will be
increased tenfold. Since all intelligent human beings like to know the
reason of the phenomena they observe, however imperfectly; since a
belief in non-existent causes brings with it disastrous results; it
behoves us to open our eyes to the true causes of nerve-deterioration in
our community, with a view to removing them as completely as lies in our
power.

In the first place, we must recognise the fact that we have contracted
the habit of transposing causes and symptoms. Evil practices, such as
drunkenness, for example, are blamed for the deterioration, instead of
being regarded as the outcome of nerve-instability; while, on the other
hand, nerve-instability itself is often regarded as criminality and the
outcome of an evil disposition, punishments and deterrents are resorted
to, time, money, and brains are wasted, criminal and lunatic classes are
perpetuated, jails and lunatic asylums are multiplied, simply because
we lack the knowledge to recognise that no amount of modification will
ever put right the nerve-structure which is radically wrong from the
birth. Excepting ignorance, the foundation of all woe, the first great
cause of neurasthenia which we must honestly face is HEREDITY.

We shall find, I think, that the second great cause is to be sought in
IMPERFECT SOCIAL CONDITIONS, and the third in AN IMPERFECT SYSTEM OF
EDUCATION.

Other minor causes we may easily enumerate, but they will all be more or
less secondary to these three, and dependent upon them. I propose,
therefore, to consider each of these in turn.




CHAPTER VII.

_HEREDITY._


All those to whose lot it has fallen to minister to the wants of
sufferers from nervous disease must have come across cases which they
were expected to benefit, but for whom, manifestly, very little could be
done. So great is human perversity, that though cases of epilepsy and
nervous exhaustion are every day regarded as incurable merely because
the most efficacious modes of treatment remain untried, these persons of
defective nervous system and perverted growth are often supposed capable
of development into ordinary people after a few weeks or months of
special attention on the part of those to whose care they are confided.

It seems useless to point out the wide difference between the two
classes. The non-medical mind cannot or will not understand it. Our
ignorance on such matters is boundless.

It has always appeared to me that these unfortunate defective people are
truly our sin-bearers, for they reap to the full the consequences of our
mistakes; they inherit the results of a pernicious order of affairs. The
parents have eaten sour grapes, and the children’s teeth are set on
edge. Cursed from their infancy with a fatal blight; expected to arrive
at a moral standard which is wholly beyond them; tormented in childhood
by vain attempts to force them to the level of other children; the small
stock of intelligence--which love, the great educator, might in some
instances have developed to a limited extent--dwarfed and dissipated by
impatient ignorance; objects too often of the heteropathy of which Miss
Cobbe speaks so feelingly in her exquisite work entitled “Duties of
Women;” these unhappy sufferers are surely spectacles fit to move the
pity of gods and men.

Yet, in cases where the nerves, by means of which alone the moral sense
can manifest itself, are altogether wanting, these are the very persons
who are glibly declared to be utterly bad. Just because they are
deficient, just because reformatory efforts can have no effect upon
them, it is thought excusable, and even laudable, to bestow upon them
hatred and scorn. And it frequently happens that those who so readily
mete out their hatred and scorn, believe that the Carpenter of Nazareth
ate with publicans and sinners, and consorted with those who were
possessed of devils; that the woman taken in adultery was not condemned;
that the dying thief on the cross was admitted to Paradise.

To care for the defective; to bestow on them the love that has been
withheld; to reverence them as the bearers of our common sins; to
mitigate their sufferings and shield them from injustice; this seems to
me the most Christlike work that can be undertaken by any philanthropist
in any age.

But some of these cases are not hopeless. If we have but knowledge and
patience enough to place them in the best conditions, much may be done
for the greater number of distorted beings. The longer we withhold our
aid, the less are our chances of success. Their original surroundings
are generally bad, owing to the same tendencies being inherited more or
less by other members of their families. And we must remember that, in
the treatment of nervous disease, we may show our wisdom quite as much
by what we refrain from doing as by what we do. We must not start with
the idea that we have to work a sudden reformation, but that we have to
allow the organism room to grow naturally and in the right direction. We
cannot create moral growth, or growth of any kind, but we can minister
to it and promote it by placing the organism in the conditions where it
shall absorb the largest amount of nutriment--of vitality,--and we can
then direct the pressure which determines its form.

We constantly see around us instances of persons, not naturally
defective, who have been subjected to lifelong distortion. In an
enlightened community this should be impossible. Place in a low
conservatory a plant that has a capacity for growing into a forest
tree; withhold from it the needed nutriment, and it will remain dwarfed;
deprive it altogether either of the food which it must assimilate in
order to maintain vitality, or of the light and air without which waste
cannot be promoted and function performed, and our plant must die. Give
it all these necessaries, but keep it in the low conservatory, and when
it reaches the roof of the building it will remain stunted or grow awry.
Perhaps the nutriment that ought to have enabled it to shoot upwards
will go into the lower branches, and the tree will become misshapen.

Does not this often happen to the human plant? Is not its lower nature
developed at the expense of the higher, because bounds are set to its
upward development?

The highest type of human being, then, is not merely that which has the
most vitality, but also that which can distribute it in due proportion
to its various parts, and that which has been permitted to expand
naturally in right directions. The extent to which we possess this
vitality,--the power we have of assimilating the force stored up in our
food, to repair waste and ensure growth,--is largely determined by
heredity.

True, this fact is in some quarters violently disputed; but not, I
think, in quarters deserving of much attention. Distorted people are
generally vehement, and resort to bare assertion and flat contradiction
when observation, analogy, and rational argument are all with their
opponent. It is well, perhaps, when the perverted force-current can
steam off so harmlessly instead of working mischief in other channels;
just as it is well when excitable political speeches and articles save
us from dangerous secret organisations.

A young lady once declined to entertain the idea of heredity for a
moment, on the ground that, supposing her to be the unfortunate
possessor of a grandmother who was a monster of wickedness, she would be
expected to prove herself a monster of wickedness likewise. It was in
vain for a gentleman present to point out that we usually have more than
one grandmother, and that if her other grandmother happened to be an
angel of light, she might with equal justice be expected to develop
angelic characteristics. She saw her side of the argument, but not his.
As a matter of fact, we know so little of the numbers of ancestors from
all of whom we may inherit, and we understand so little of the
conditions determining the inheritance of given characteristics, that we
are not yet in a position to entertain expectations at all. All we know
is, that we do not generally get so far as finding grapes on thorns and
figs on thistles. The interesting subject of heredity still offers a
wide field to the observer. So far, physiological revelation does but
prove the truth of the Biblical revelation--that nothing is of
ourselves, but that all is of God.

On the one hand too much has been made of heredity, and on the other
hand too little. Sometimes its warnings are wholly disregarded;
sometimes disease is regarded as inevitable if it has already existed in
a family, and if there are any symptoms of its recurrence, wise
precautions being consequently neglected. Good education would often
avert the evil. Unfortunately, it is in families displaying neurotic
tendencies that education is usually most hopelessly bad. It would be
easy to give numbers of instances in the upper classes where nervous
disease is, with the best intentions, literally being coined. Heredity
does not mean that certain hard and fast qualities are displayed by the
parents and inherited by the children, but that certain tendencies may
develop--pathologically or otherwise--in suitable surroundings. Insane
persons may have no insanity in their families, but may yet have
resulted from a combination of neurotic stocks, the conditions in which
the utmost might have been made of their defective structure having been
denied them. Indeed, the means resorted to in order to reform such
people would be ridiculous were not the whole affair so infinitely
pathetic. The smile of derision would be oftener on our lips but for the
tear of pity which follows close behind it.

Many persons rebel against the doctrine of heredity because they
consider it destructive of faith in God. Surely their own faith must
rest on very insecure foundations. Belief in an all-loving God can but
be strengthened by a knowledge of the means by which He develops and
guides His creations. Kinematics, mathematics, biology, all natural and
physical science--the means by which we study His great and continuous
“Act,” the universe--should serve to increase our faith, since in Him we
live and move and have our being. Even denying scientists do but reveal
Him. If it be true that when we would do good evil is present with us,
it is also true that when we do what seems evil we often bring about
good results. How can there be conflict between the laws of Nature and
the laws of Nature’s God?

Again, it is contended that it is possible for us to live an evil life,
and, by means of scientific knowledge, avert the suffering which, in a
God-fearing community is the reward of evil, the race being thereby
saved from destruction. A very little consideration will suffice to show
us that such contentions are without justification. The laws of God are
not to be evaded. We bring ourselves to nothing when we “kick against
the pricks.” We have seen that if any part be disused, nutriment can no
longer be attracted to it. Let that part of the organism by which the
moral sense manifests itself fall into disuse, and disintegration has
begun in that part--that is to say, a larger amount of waste than can be
repaired by nutrition. Supposing the defect to be counterbalanced by
excessive activity of another part of the organism, this is no true
compensation. No development of the lower part can atone for the loss of
the higher. We should, at best, have one-sided beings, who lack the
social instinct and must run counter to one another’s aims. Mutual
destruction would result from their downward progress, and regulations
previously agreed upon would be disregarded as the higher nature
deteriorated. Moreover, no excessively one-sided organism can remain
healthy. In such cases we commonly see the development of suicidal
tendencies.[8] Our degenerate tribe would thus be suicidal both
collectively and individually. In the most favourable circumstances
imaginable, their career would resemble that of “The-do-as-you-likes” in
Charles Kingsley’s “Water Babies;” but, as a matter of fact, no selfish
tribe could have such a good time of it as even these unfortunates had,
since roast pigs are not usually found running about in convenient
proximity to the lazy.

It cannot be too widely taught, then, that the moment we withdraw
ourselves from the paring and shaping action of life’s sieves, and
choose only what is pleasant, our deterioration begins. Physical disease
follows close at the heels of moral lethargy, just as physical disease
may impair the moral sense. And the degenerative process being begun,
our children and our children’s children, even unto the fourth
generation, may bear the burden of our shortcomings.

In our efforts to raise a healthy race, we are apt to make one very
serious blunder. We forget that the word _nervous_ has two meanings. In
its truer sense it implies strength, not weakness. Persons suffering
from nerve-trouble have come to be called nervous, and so the sensitive
organisation,--the finest, most highly developed organisation,--is quite
unjustly depreciated. The healthy sea-anemone is less sensitive than the
healthy human being. Would it therefore be preferable to be a
sea-anemone?

The confusion between the large and complex nervous organisation and a
diseased or defective condition has been aided by the fact that the
genius--the truly nervous man in the higher sense, the largest offshoot
from the great force-current--is invariably placed in hard conditions in
youth. He pays the penalty for being before his time. He belongs to a
higher standard than that into which he is forced. In the family nest he
is the ugly duckling; in the world he is persecuted. When his marvellous
insight and keen intelligence enable him to foresee the remote but
lasting pernicious effects of practices that are clung to by his fellows
for the sake of their immediate advantage, he falls by the hand of the
assassin or is universally credited with madness. Centuries after his
death, when his community has painfully toiled to his level, his
greatness is recognised, and he is deified or canonised.

It is perhaps well that the growth of such offshoots is limited in every
age by a mental atmosphere as real as the atmosphere surrounding our
globe and limiting our aerial flights. Apparently it is not decreed that
human progress shall be rapid. Nevertheless, a too wholesale destruction
of our most highly organised members must certainly ensure that
evolution backwards of which I spoke in another chapter.

The fact is, we find it hard to distinguish between genius and
eccentricity. The uncontrolled eccentricities of the matured do so much
harm, that it is found necessary to suppress them. But we should
remember that the genius is always eccentric in youth unless he is
allowed a very wide area for development--and this is the last service
his friends are willing to do him. He has, as it were, to develop into a
large circle. His great vitality and many-sidedness enable him to take
advantage of any chance diminution of pressure, and in each direction
where resistance is least he shoots out long points and angles. If any
of these angles be lopped or violently discouraged, he may be a
one-sided or distorted being. Let him alone, however, and in due course
he will fill in the spaces between his angles and grow into a finely
rounded being. But the magnificent virtue of letting one another alone
is still little cultivated by our community.

Now, persons who are merely eccentric do not shoot out their angles in a
variety of directions and fill in the spaces as soon as opportunity is
granted them. They have only one or two long angles, to which they
continue to add till they become such a nuisance that the peace and
safety of the community demand their control. Both genius and
eccentricity being hereditary, and the logical outcome of extreme
eccentricity in one generation being insanity in the next, we need to
exercise care in our dealings with these abnormal developments. To drive
men of genius into the ranks of the eccentrics is a very dangerous
policy. Let us honestly recognise the fact that we are all of us
potential madmen.

Curiously enough, those who have the least pretension to sound
organisation and rounded development are most often lauded as men of
genius. Talent in one special direction developed at the expense of more
essential parts of the organism, not an exceptional vitality, secures
them this distinction. We should be cautious as to the objects we choose
for admiration, since, by a natural law, that which we admire becomes
prevalent.

Some persons propose to reform the world by means of checking
reproduction from unfit types. But this measure would be useless so long
as our conditions continue to coin the thing we would destroy. And if we
could alter our conditions, the measure would be unnecessary, as the
unfit already existing would soon die a natural death or be suitably
modified. In some cases the wholesale change suggested would have very
bad results, for the children of misdirected geniuses may possibly
revert to the former standard and inherit the original genius of the
parent without his recent aberrations. Our measures would but serve
therefore to check the reproduction of these highly desirable types. In
the midst of our black ignorance on such matters, our wisest course is
to refrain from violent and irrevocable action. Instead of hurrying to
lop people’s angles, it would be well if we were first to try the effect
of removing pressure from the spaces between them.

The genius is proverbially known by his quick pulse, though the same
symptom may be observed in many defective people. Waste and repair alike
go on quickly. He is eminently adaptable; he takes any shape. But the
great test of the genuineness of the article is his sincerity. Above all
things must his higher moral sense remain intact.

History has given us one splendid example of the highest type of genius
in the great Dutch hero, William the Silent; the man who, to use the
words of his biographer, bore the burden of a nation’s sorrows on his
shoulders _with a smiling face_. A homeless wanderer with a price set
upon his head, poor, friendless and unsupported, this man opposed
himself to the trained legions of Spain, the wealth of Brazil, and the
tremendous machinery of the Inquisition.

The result was the independence of the United Provinces!

And the cause of it?

Here let us quote Father William’s own words.

“Before seeking to conclude a treaty with any earthly potentate,” he
writes to his brother Louis, “_I had entered into an alliance with the
King of Kings_.”

We are not surprised to learn that this man fell by the hand of an
assassin, with a prayer for others on his lips.




CHAPTER VIII.

_IMPERFECTIONS OF OUR SOCIAL SYSTEM._


To treat such a subject adequately in so small a space is obviously an
impossibility. It must suffice to point out some of the chief causes of
nerve-deterioration in present conditions, and the directions in which
some improvement may gradually be wrought. The notion that evils can be
remedied merely by passing laws is happily exploded. The law is now seen
to be evidence and ratification of public opinion, and also a means of
putting public opinion into action. Without this agreement on the part
of the majority, the law becomes a dead letter, or is enforced only at
the expense of dire catastrophe.

There is, however, one justification of the efforts of those who wish to
pass laws condemning certain abuses: they actually influence the public
mind by means of the agitation raised for the purpose of attaining
their ends; and so they create the opinion they would ratify. It also
frequently happens that the agitators arouse disgust at their bigotry
and fixity of idea, and so produce an opposite effect to that which they
intended. Indeed, though devotion to a Cause is generally supposed to be
an ennobling thing, it sometimes happens that it is a debasing and
demoralising thing. For, instead of Self being sunk in the Cause, the
Cause becomes with many a very excuse for selfishness. Persons
considered high-principled, who would on no account misrepresent or
defraud for their own confessed advantage, will nevertheless think
almost any expedient justifiable in what they are pleased to term the
public good.

In this loss of moral sense and judgment we find the secret of much of
the nerve-trouble of our day. The Self, having found a plausible excuse
for its assertion, loses no time in becoming as suicidal in its
tendencies as the uncontrolled Self usually is. Once committed to a
course of action, that course of action must be adhered to throughout
all opposition. Public support having in a weak moment been enlisted on
some false pretext, our utmost efforts must thenceforth be used to prove
this pretext true. Having gained a certain height, we dread to be cast
from our elevation. Then come harassing worries, overwork,
disappointment, and harmful excitement--all the sorrows, in fact, that
tend to lower vitality and injure the nervous system.

This new evil seems no less deadly in its effects than an exaggerated
personal ambition. Our complex social conditions render us in many
respects more dependent on one another than formerly. We have
associations and co-operations for everything. Increase of population
and means of communication bring us more into contact with our fellows.
Division of labour makes us indispensable to one another. We all govern
one another. We all have, in some form, a voice in public concerns.
Under the guise of advancing the common good, we have special
opportunities for advancing Self; and it is the element of
self-deception introduced into our striving after self-advancement, and
our consequent habit of deceiving others, which are specially injurious
to our moral sense. Marcus Aurelius tells us that that which is not for
the interest of the whole hive is not for the interest of a single bee.
He might with equal truth have said that that which is not for the
higher interests of a single bee cannot in the long-run benefit the
hive.

It may be questioned whether our exceeding unrest, our yearning for
notoriety, our eagerness to overwork ourselves, _i.e._, to draw on our
nerve-capital at the risk of breaking the bank, are not symptoms of
widespread nervous disease in the community rather than its causes; just
as, in the individual, the restless excitement regarded often as the
cause of the after-malady is in reality but a symptom of the
disintegration which has already begun. We may console ourselves with
the reflection that, neurasthenia in the individual being curable,
neurasthenia in the community is curable also; the community being but a
collection of individuals.

To go still deeper into the matter, we find that we are living in an age
of exceptionally rapid change, and all rapid changes have great dangers
because of the difficulty we find in adapting ourselves to altered
conditions. And the result of partial failure is seen not merely in
complete break-downs, but also in a general lowering of the vitality of
the nation. We are nearly all more or less nervous in the more usual
signification of the misused word. We have less of the calm confidence
that our fathers had; we indulge in alternate and spasmodic conceit and
cowardice; self-doubt one moment, self-assertion the next. The way in
which we skulk through life in terror of one another is truly
ridiculous. Our sensitiveness to the opinion of others is extreme. Can
we not realise that the opinion of others is of little moment? It
matters, indeed to themselves, though not to us; for the mode in which
people accustom themselves to think inevitably alters their nervous
structure. It is for them we should be concerned if they think wrongly;
not for ourselves. And while we spend our precious time in doubting and
fearing, in disputing as to whether men have wills or women have minds,
the great force-current flows tranquilly onwards, men and women alike
being but fleeting forms, capable of infinite development or of utter
degeneration.

One fertile source of danger to our stability has been the marvellous
speed at which human thought has advanced in this century. Owing to
recent scientific discoveries and mechanical inventions, the minds of
our younger generations have, in some respects, become more enlightened
than the less plastic minds of their elders. This inequality has
produced a great strain in many relations of life. Old theories have
been tested by the light of fresh information, and much misery and
nerve-deterioration have been occasioned in families by the rejection by
the younger members of tenets held sacred by their parents; real high
principle having, on both sides, prevented the sacrifice of belief,
which alone could effect a compromise. Each side seems to the other to
be cruel and unreasonable; yet both are right, even if both are wrong.
The elder, owing to their lack of faith, close their eyes to God’s
ever-progressive revelation; the younger, in their determination to
believe only what is demonstrable, lose sight of the value of much that
they deem worthy of rejection.

The position may be illustrated by the following allegory.

                     THE STORY OF THE AMPHIBIANS.

     _The streams of God flowed ever from the hills and watered the
     plain, and the waters of one of the streams gathered themselves
     together in a hollow place, and formed a lake where dwelt the great
     Amphibians. Now the Amphibians flourished in this lake and on its
     shores because its waters were brackish, and they believed it to be
     in this respect far superior to any other lakes of the plain._

     _But the time came when, owing to successive geological and
     atmospheric changes, the waters from the hills changed their
     course, and the streams which had flowed into the Amphibian abode
     dried up, so that the lake grew stagnant. And the sun’s heat
     falling upon it, caused the water to evaporate, while there was now
     no friendly stream to supply the waste. The waters therefore
     dwindled rapidly._

     _At first the Amphibians were unaware of any change in themselves
     consequent on the too brackish condition of the lake. But the fact
     was, that as the lake grew shallower and shallower, its inhabitants
     grew more and more torpid, and more and more inactive. Some of
     their children, however, who had inherited the former energetic
     disposition of their parents, and had not yet been reduced to a
     lethargic state by their surroundings, expressed great alarm at the
     stagnancy of the water, and consulted as to the means to be adopted
     to bring about a reform. They not only complained that the water
     was constantly evaporating, but that it was too salt._

     _They complained with reason. The brackish water had once been a
     source of health and energy to the Amphibians, but it was evident
     that the salt carried down into the lake by the stream had no means
     of escape, so that, as the water diminished by evaporation, the
     proportion of salt in the lake became far too great._

     _The children were convinced that the extreme saltness of the water
     was the chief cause of the torpidity of their parents and of the
     deterioration which they began to perceive in themselves, and this
     conviction caused them so much alarm, that they openly suggested
     emigration to one of the other lakes, which they believed to be
     fresh, as the only possible remedy for their ills. A few of them
     actually attempted the feat, but the distance to the nearest lake
     being great, and the Amphibians being unable to live long on land,
     some of them died by the way. Two or three of them gave up the
     toilsome journey in despair, and returned to the salt lake to
     report the unfortunate end of their friends. Their example was then
     held up as a warning to other aspiring spirits who had dreamed of
     fresh streams and waters new._

     _One or two of the emigrants, however, succeeded in reaching the
     nearest lake. How they fared there was not at first known to the
     conservative Amphibians, but during this period of uncertainty all
     who endeavoured to leave their old home were persecuted by their
     timorous companions, and those who succeeded in making their escape
     did so only after a prolonged and exhausting struggle. In spite of
     all opposition, the number of malcontents increased daily, and at
     last a new mode of remedying the unsatisfactory state of affairs
     was resorted to. The younger Amphibians in the old home seriously
     set to work to cut a canal from their own lake to that in which
     some of them believed their companions to be living happily._

     _The elder Amphibians, horrified at the work of destruction,
     continued their persecutions with renewed vigour. They refused to
     believe that the water of the lake was too salt; indeed, they even
     refused to believe that it was stagnant. They not only declared
     that a stream still flowed into it as of yore, but that no other
     stream flowed from the hills. Though ignorant of the fact that they
     themselves were degenerating, they were convinced that the
     restlessness and discontent of their children were due to a disease
     which should be discouraged. They urged that, even if they were to
     succeed in reaching the new lake, they would be unable to live in
     the fresh water, and that by cutting a canal between the two, they
     would flood the old lake, and thus diminish its saltness so
     considerably that the whole race would cease to thrive there._

     _Notwithstanding these arguments, the children persevered in their
     labours. The canal was finished sooner than they had anticipated,
     for those who had emigrated had been similarly employed, and the
     workers from the two lakes met in the middle of the strip of land
     which had formerly divided them. The results of the undertaking
     gave universal satisfaction. The old lake was rendered healthier by
     the influx of fresh water; the water of the new lake was improved
     by the saline flavour now imparted to it. The parents swam
     contentedly from one lake to the other, and saw with their own eyes
     the stream which flowed down from the hills and replenished the new
     lake._

Who could they have been, these timid, sceptical creatures, who accused
their children of the want of faith which was destroying themselves?

We have seen in the above story that some of those who valiantly
endeavoured to gain the new lake perished by the way, and so we find
that our recent scientific advances have been a cause of nerve-trouble,
apart from the persecutions they have entailed. The mental strife we
have gone through in our attempt to reconcile the ideas stored in our
minds, by no will of our own, with God’s ever-progressive revelation,
should teach us not to instil into the minds of our children as absolute
truth that which must necessarily be but approximate truth, changing
always with our own development. Seeming scientific facts themselves
assume a different complexion so soon as scientific discovery goes still
further. Even the axiom that two straight lines continued to infinity
cannot meet, ceases to be a fact to us, and is relegated to the region
of rational hypothesis, when we realise that we have never so much as
seen a straight line, all seeming straight lines being but parts of
curves; and that the mental picture we have been accustomed to form of a
straight line is but a picture of one of these curving lines. Almost the
hardest thing we have to learn is the impiety of putting cherished
beliefs in the place of the great God of the universe. Like Abraham, we
are called upon to sacrifice our Isaac. Like Abraham, we no sooner
freely consent to do so, than we find the ram ready for the sacrifice.
Directly we close our eyes to God’s progressive revelation and accustom
ourselves to inconsistency and to fallacious reasoning, we
unconsciously deteriorate.

Another outcome of recent rapid changes has been a great increase of
wealth, together with its unequal distribution. Whether this unequal
distribution might have been prevented, and whether it may or may not
now be remedied, cannot here be discussed. We have but to inquire
whether it has anything to do with the prevalent nerve-trouble; and I
think we must admit that excessive luxury on the one hand, and excessive
poverty on the other, are largely productive both of monotony and
overwork. At all events, it is principally amongst the well-to-do
classes that _ennui_ is complained of.

It cannot be doubted that monotony is a fertile source of nervous
disease. The fact is not always received, because the nature of the evil
is not understood. We fail to realise that monotony is an actual strain
upon the nerves, often an even greater strain than extreme fatigue; for
those who are overworked are supposed to require a holiday or change of
occupation, while those who are suffering from monotony often get no
relief until so much harm is done that mere change of scene or of
occupation is inadequate to repair the damage done to the ill-treated
nerves. In such cases the mischief wrought in the individual is similar
to the mischief now being wrought in the community--in each there is
excessive use of one part and disuse of another.

If we doubt that monotony is really a mode of overstrain, let us
consider the very meaning of the word. Why do we speak of a preacher’s
voice as monotonous, and why do we find the monotony of it tiring? Is it
not because a strain is thrown upon one part? If his preaching were more
varied, a number of smaller impressions would be made upon other parts.
If all the light which falls upon our eyes in the course of the day were
concentrated into one single flash, we should be blinded. And supposing
that all the impressions we receive throughout the day by means of
hearing, touching, tasting, and smelling, were to be concentrated into
stimulus of the brain passing through our eyes, we should probably
still be blinded, even though the process occupied the whole twelve
hours. But we fondly imagine that, though we have faculties to develop
and sympathies to enlarge by means of active life in the world and
contact with our fellows, we can shut ourselves off from the duties and
occupations which are as essential to our health as our daily food, and
yet escape the deterioration and suffering which must naturally follow
our over-use of one part and our disuse of another. We forget that we
can never cease to receive impressions unless we actually close our
senses, as when we shut our eyes and stop our ears. All we can do is to
determine what set of impressions we will receive. And if we are always
attracting nutriment to one particular part of our nervous system to the
exclusion of others, we are going the right way to become ill-balanced.
Not only are we rendering ourselves liable to mental disease by choosing
bad mental surroundings, but to physical disease also, since no bodily
function can be performed without the co-operation of the nervous
system. Highly organised persons suffer more from monotony than others,
because they have more faculties demanding healthy exercise, and also
because the greater the sensitiveness of our nerve-structure, the less
can we bear constant fatigue of one part.

The greatest sufferers from this species of folly and ignorance are, and
always have been, women. That curious form of neurasthenia which passes
under the singularly inappropriate name of “hysteria” is largely the
outcome of our modern ill-usage of the nervous system--the overstrain of
one part and the starvation of another. And owing to a marvellous
tendency of the human mind to add insult to injury, this very
affliction, which should most command our sympathy and aid because it
originates in cruel and idiotic injustice, is commonly regarded as fair
game for our sneers and reproaches. More than that, the female sex,
having been especially subjected to this kind of injustice, is often
reproached with inferiority because of the liability of women to fall
victims to the malady. It is as though we were to cut off a man’s arm,
and then laugh at him for having only one. Even women themselves, galled
by the contempt shown to their sex on account of its supposed
“hysterical” tendencies, display a lamentable want of feeling when
dealing with cases of nerve-trouble. They should bear in mind that if
their attempts at putting themselves on an equality with men seem to
destroy their womanly sympathies, they are not likely to attain their
end.

But we are now realising that the sons of “hysterical” women are apt to
suffer from neurasthenia, or even from epilepsy or insanity; so there is
hope that their sufferings may at last receive adequate attention and
consideration.

It is sometimes argued that in these enlightened days women are no
longer compelled to endure the miseries of monotony that have so
recently been their portion. This is, I think, a mistake. In large
towns, doubtless, outlet is usually found for their activities, but
numbers of women of the educated classes reside in the country and
undergo a sad process of deterioration, owing to the prejudices
entertained by those about them against their leaving home or seeking
congenial employment. The complaints I have to listen to from ladies who
have nothing to do are heart-rending. Tell them to cook their dinners,
and you find that some foolish convention stands in the way; urge their
entering some useful calling, and you are informed that their family
will cut them if they do anything of the sort. Possibly the only
occupation open to them is one for which training is necessary; and they
have not been trained. And then, because an evil naturally generates its
opposite, we find that when these women do succeed in finding
employment, they rush to a pernicious extreme and overdo themselves.

When mischief is once set up, and an unhappy sufferer falls into the
hands of unsympathetic doctors and nurses, her trials increase and
multiply. If she be suffering from seeming inactivity, she is reproved,
“roused,” and ordered to exert herself; the actual strain on the nerves
of monotony, and the need in many cases of absolute repose, being
wholly ignored. On the other hand, total inactivity is sometimes
prescribed as a remedy for overwork, when restlessness is so great that
enforced idleness maddens. The patience to gain the confidence of the
sufferer, and the sympathy to understand her ills and their causes, are
attributes of the higher order of mind that our sieves so often weed
out.

The evils of overwork are too well known to need much comment. Those who
have to earn their living cannot always avoid excessive fatigue, and
they are specially liable to suffer from it if cursed by congenitally
feeble organisations. But the strange thing is, that persons not obliged
to work hard, and not rendered restless by previous enforced inactivity,
should nevertheless deliberately make themselves ill. Nervous
exhaustion, however, is extremely insidious. We can draw on our capital
for a length of time without being made unpleasantly aware of growing
weakness; and though self-destructive tendencies do not usually
originate in a healthy, well-organised mind, people of good
constitution do sometimes break down in consequence of the physiological
ignorance in which they have been reared, or under the stress of a
combination of exceptionally untoward circumstances.

Sometimes the true cause of the evil is to be found in an exaggerated
personal ambition, showing none the less an ill-balanced mind; for, what
truly sane person would sacrifice health to such chimeras as wealth and
fame? All who have experienced wealth know perfectly well that it means
simply an accumulation of bothers and a sense of responsibility; that we
cannot, with our best endeavour, spend more than a certain amount upon
ourselves, and that the possession of great wealth really means our
acceptance of the arduous and thankless task of distributor to other
people. The only remaining reward possible to us is the answer of a
quiet conscience, and even that, we are aware, depends largely upon the
liver, which organ luxury is apt to upset. It is chiefly from the
wealthy that the ranks of the pessimists are recruited; and naturally
so. For just as perfect health cannot long exist without
self-forgetfulness, so all genuine happiness is to be found in working
for a worthy object. Happiness of this kind and health of the nervous
system go hand in hand;--at least, I have never found a prolonged
divorce between the two possible.

As to the other chimera, fame, those who trouble about it must surely
have a twist in their brains somewhere. The thing is a mere delusion of
our own. Let us consider how far our greatest English writer, William
Shakespeare, is known to the world. Of the vast populations of Africa,
Arabia, India, China, Japan, and Polynesia, to say nothing of the
inhabitants of Northern Asia, the native races of Australia and the
Americas, and the peasantry of the Continent, few have so much as heard
his name. And out of the small minority who have heard of it, how many
have read a line of him? Even to the mass of our own population he is
little known. Yet he lived but a couple of centuries ago and wrote as
few men have written.

The earliest historical record takes us back only four thousand years or
so--about a hundred generations--a mere flash of time compared to the
ages during which our planet must have endured; and of all who lived
before this brief period we know absolutely nothing.

For what, then, are we sacrificing our health, strength, and happiness?




CHAPTER IX.

_AN IMPERFECT SYSTEM OF EDUCATION._


We mould the clay while it is soft, that it may not be chipped or
pulverised when it is hard by contact with obstacles which it has not
been fitted to overcome. Is the process usually effectual? With how
little destruction to life, with how little injury to character, do we
graduate the sieves of our younger members? Do we succeed in moulding
them into sane, capable citizens, or are we so careful to impart special
kinds of instruction, to develop the part at the expense of the whole,
that our interference is positively detrimental to the individual, and
consequently to the community at large also?

I fear we can hardly be acquitted of this grave charge. The
physiological demands made by growth and development on the vitality of
the child are so great, that not only are abundant fresh air and
nutrition required for the work, but also a considerable supply of
surplus nervous energy. To use up this surplus energy for purposes other
than that for which it is intended, is to stunt growth, or to limit the
development of the mental faculties, or to diminish nerve-power; one of
the three inevitably. And the diminution of nerve-power must bring with
it physical, mental, or moral atrophy, according to the part on which
the greatest strain has been put and the conditions in which the victim
has been placed.

Moreover, children of large natural capabilities, whose complex nervous
systems require an exceptional amount of nutriment, and whose
sensitiveness and plasticity cause them to respond readily to
instruction, are just those who will first break down under prolonged
strain; and thus we may easily weed out the finer organisations, and
continue the race from the less highly developed types.

Observation of nervous patients shows us that their small stock of
available nerve-force may be attracted to one part to the detriment of
another. For this reason nervous disease is specially difficult to
understand. One patient told me he could get on fairly well if he used
his body and not his brain, or if he used his brain and not his body;
but if he tried to use both in the same day, he became ill. Of course,
he did in reality use both at the same time; what he meant was that, if
he exerted a fair amount of activity in the brain, he had only strength
to exert a very small amount of activity in the rest of the body, and
_vice versâ_. He was right in saying that his available store of energy
was so small that he could not expend even a moderate amount of it in
both physical and mental labour during the same day.

Others have told me that if they devoted themselves for a few days to
book-work and abstained from bodily labour, their studies became easy
and were performed without fatigue; but that if they began to take
exercise, they were compelled by exhaustion to abandon the book-work.
Moreover, the physical exertion caused great fatigue for a day or two,
until they grew accustomed to the altered mode of expending energy; and
when it had become easy to them, the same weariness was experienced for
a short time on their return to the book-work, even though the bodily
exercise was then totally discontinued. By no effort of will could the
two modes of activity be carried on together, unless only a very small
amount of power was expended in each, the rest of the day being given up
to repose. Total collapse followed the attempt, for the necessary
nerve-force was wanting.

We thus learn when we are weak a truth which is less apparent in health,
viz., that our available energy is a strictly limited quantity,
dependent on nutritive supply. How great, then, is the folly of those
who would urge to exertion persons in whom the nutritive supply is
defective! But how much greater is the folly of those who, during the
early years of the individual’s life, when the constitution is being
formed and future health in great measure determined, will persistently
compel him to expend his nerve-force in a particular direction, to the
detriment of other parts of the organism, or who put such a strain upon
the whole that the constitution is permanently injured! The partial
injury is perhaps the more dangerous because it is the less easily
observed. If a child begins to break down altogether under the stress of
his school course, we become aware of the fact, and by timely
interference sometimes--not always--put a stop to the work of
destruction. But many delicate boys and girls contrive to struggle
through their school course with little apparent harm, because the
greater amount of their spare nerve-force being attracted to the part on
which the strain is put, the allotted tasks can be performed. Whether
growth is thereby stunted; whether nerve-force in general be decreased;
whether perceptive power be dulled; whether the child have been
withdrawn from the active experience of life necessary to healthy
development; whether his various physiological needs have been fully
supplied--all these questions frequently remain unasked, provided that
the child have learnt a specified number of the more or less erroneous
notions of his ignorant fellow-creatures, and have put them down on
paper. And if he become neurasthenic, or succumb to some complaint to
which his lowered vitality makes him fall an easy prey, or if he grow up
with feeble powers of observation, or without the self-control dependent
on the firm will that can only be developed by means of the right
expenditure of a considerable amount of nerve-force, little connection
is traced between his defective education and his defective
nerve-structure. The children whose education has consisted chiefly of
instruction from books cannot properly be said to be educated at all. In
most cases their minds are warped by fixed ideas.

This is not saying that children should not be taught in the best sense
of the word; that they should not be disciplined and trained to
self-control, to habits of attention, and to ready observation; that
they should not have an intelligent interest awakened in them concerning
the universe in which they live. But mere book-learning will never do
this. It is, unhappily, possible to be a walking encyclopedia of
so-called knowledge, and yet to be an imperfect reflector of the life of
our time.

And of the wonders and glories of Nature that surround us every moment
from the cradle to the grave, how much are we taught? Yet these can be
studied at our leisure out in God’s blessed air and under God’s blessed
heaven. In the garden, at the river-bank, on the hill-side, by the
sea-shore, in the lonely desert, there we may find health and wisdom and
knowledge and happiness; and how many of us go to seek them there?

“A morning glory at my window satisfies me more than the metaphysics of
books,” says Walt Whitman. Few of us ever see this morning glory;
indeed, very few of us even take the trouble to look at an evening
glory. I have stood day after day on the parade at a small seaside
place, and have watched the sun sink below the watery horizon; sea,
sand, rocks and sky all being illumined with magnificent colouring.
Well-dressed people would pass and repass, some averting their eyes from
the splendid spectacle lavished on them by prodigal Nature, others
glancing at it vacantly with irresponsive countenances, others gazing on
the ground or at one another, and talking of the cut of their new
dresses or of the prices of stocks. Hardly any ever paused to look and
admire. Poor creatures! All this joy--joy showered abundantly on me--was
simply rejected by them. The essential God-like part of their natures
had been starved; they had been taught in stuffy schoolrooms by wearied
teachers and out of musty books; appreciation of the works of the good
God had not been included in the curriculum. Carlyle mourns the
extinction of the lamp of the soul. He is premature. In most of us it is
never so much as lighted.

Yet we have within us somewhere the capability for seeing--though as in
a glass darkly--a dim reflection of the Lord of Glory. We have but to
look--to be taught how to look aright--and to us the Lord shall be in
the earthquake and in the storm. We have but to listen--to be taught to
listen aright, and throughout the universe we shall hear the still,
small voice.

To Carlyle it was a tragedy that one man should die ignorant who had
capacity for knowledge. And are not the majority of us ignorant even of
the very things which lie most easily within our reach--of the air we
breathe, of the ground on which we tread, of the skies on which we gaze?
There is something known approximately about all of these which no man
hath taught to us. After all our years of nerve-deterioration in
stifling schoolrooms, few of us know anything of the very simplest facts
of life, of the composition of our own bodies, of the most ordinary
conditions of our own existence.

If any one doubts this assertion, let him ask two or three very
elementary questions in very elementary affairs of his neighbours and
acquaintance, and note the answers he obtains. The thing is easily
tested. Persons regarded as educated--persons who know all about the
doings of a certain aggressive warrior of past times, who from mere
greed of conquest cruelly attacked harmless savages, and then had the
hardihood to describe his own misdoings in writing--are hopelessly lost
and bewildered if you say to them, “What is your brain composed of?”
“What is a choanite?” “What makes the leaves grow on the trees?” “Where
does the soil in the garden come from?” “How does the dew find its way
on to the grass?” “Why does a ball bounce?”--or some such questions
which sound elementary and unscientific enough.

But perhaps the knowledge required to answer these questions correctly
belongs to departments of science which in most schools are regarded as
extra subjects, and only taught occasionally and perfunctorily. It is
certainly strange that information which ought surely to be imparted
early, and which may be imparted in a most interesting and enjoyable
way, should be put on one side for dry dates and grammar, a superfluity
of arbitrary arithmetical rules, and the record of immoral conduct on
the part of antique conquerors,--things which few wish to remember, and
which sensible persons mostly take pains to forget.

After all, we have only a limited space in which to store our knowledge.
As we grow up, we have to learn the things that are suited to our
several professions. We have no room for useless lumber, and must cast
it out. It never ought to have cumbered the ground. Let the dates be for
the historian, the grammar for the grammarian, the immoral records for
the classical scholar, and the endless arbitrary rules for the dull. By
the time we have specialised, we shall know what uninteresting details
we are forced to master, and what we may safely leave to the
encyclopædias. We shall not then have disquieted ourselves for nought.
Our early education should before all things mean for us “the harmonious
development of all the faculties.” For each of us and all of us should
be laid the foundation of the love of God and the knowledge of such of
His works as daily surround us. No other foundation can be secure.

As matters at present stand, we learn quite as much out of school as we
do in it. The training of the eye, and the hand, and the judgment in
games is not usually considered a necessary part of education, but it is
a very important part of it nevertheless. I am not sure that, up to a
certain age, it is not the most important part. We are apt to forget
that we go through life rapidly calculating weight, distance, and
balance, and that our success in many branches depends on our power of
ready attention, on our promptness of action, on our quick observation
of natural phenomena and the ways of our fellow-creatures, on our
delicacy of manipulation and on our perseverance and self-control, quite
as much as it does on the knowledge we have learnt from books.

Considering the imperfection of our present system of education;
considering how we dwarf, stunt, and starve the noblest and best part of
each individual, and the noblest and best individuals of the community,
the wonder is, not that there is so much nervous disease amongst us, but
that there is not more. Fortunately the tide has begun to turn, and we
are at last becoming alive to the fact that our method of instruction is
not all that could be wished. But we wake up slowly, and “cramming” is
still the order of the day. Indeed, competitive examinations seem to be
multiplying while we are cogitating. This is much to be regretted. If
ever the time arrives when all public posts and places of trust are
filled by persons who have gone through this extraordinary process of
mental stuffing, and who are about as fitted to understand the needs of
our race and the conditions of our right development as Strasburg geese
are fitted to set an example as athletes, then may God have mercy on us
all! In our complex social state, the nimble wit, the ready invention,
the adaptive disposition, are specially needed to find out for us the
best means by which the resources of Nature may more and more be used
for our service and to the support of our ever-increasing populations.
Persons who survive a process which destroys the most sensitive and
adaptive minds are but the intellectual lees and dregs of our community.
To perpetuate these at the expense of the more highly organised is
literally suicide. We are scarcely alive to our danger, because those
who have been trained on a different pattern still take the lead amongst
us, and the full results of the system of “cram” are not yet seen.

I was talking the other day to a lady who had recently been passing her
time in preparing lady candidates for examinations. She herself had
survived several of these ordeals; and, without falling into the error
of those who have eternally saddled on the innocent Tenderden steeple
the sole responsibility for the appearance of the Goodwin Sands, it may
be casually observed that she was in a frightfully nervous condition,
rendering her society a real trial to all but those skilled in the care
of nervous invalids. She answered candidly some questions which I had
the hardihood to put to her. I give both questions and answers almost
word for word:--

     _Q._ Which do you consider the cleverest of your pupils; those who
     pass, or those who fail?

     _A._ The clever ones fail quite as often as the stupid. Indeed,
     there are one or two clever ones at this moment whom I am very
     anxious about.

     _Q._ How do you explain that?

     _A._ In this way. When I find a pupil stupid, I just stuff the
     facts into her. She goes on grinding and grinding until she knows
     off what is necessary. This cramming is an art. If you know how to
     do it, you can shove the most stupid people through.

     _Q._ Then why do the clever ones sometimes fail?

     _A._ Well, they know most about the subject really, but, as far as
     I can make out, the examination does not test what you know, still
     less your general capabilities, but your power of keeping a certain
     amount of detail in your head for a time and putting it down on
     paper. People who don’t take it out of themselves with thinking,
     reasoning, and permanently assimilating, are best able to take in a
     number of facts after a fashion, and keep them near the surface
     ready for use. They are better at cramming the particular points
     that the crammer knows to be of use than the clever people are, and
     they are generally less sensitive. They are less affected by the
     weather, and the stuffiness of the place, and all those little
     things that make so much difference to some people at an
     examination.

Comment is needless.

I have had some opportunity of observing the cramming system in Germany,
and have been struck by the unsatisfactory nature of the results of
what goes by the name of education amongst girls of the well-to-do
classes. A German lady, who had had experience as a teacher in a large
public school, told me that she considered the present system of
teaching an entire mistake. “Look at the results,” she said. “How many
German women ever open any book but a novel? What do they care for
culture? The teacher has no time to _interest_ the girls in what they
learn. All there is time for is to cram them with the facts without
which they cannot pass the examination. As if true education could be
tested by an occasional examination! And the sacrifice of health amongst
these young girls is terrible!”

For my own part, I heartily sympathise with German ladies who read
nothing but novels. In my childhood I was taught French in England on
the most approved methods and at the cost of much hard toil. I
afterwards picked up German in Germany itself and in a pleasurable
manner. Ever since, the sight or sound of a French word has brought to
my mind the recollection of weariness, of being bored, of dry grammar
that has been of no earthly use to me, of a deplorable waste of sunshiny
hours. But the sight or sound of a German word recalls the soft thud of
my horse’s hoofs as I galloped along the natural Rotten Row of the
German pine forest; the ring of my skates as I glided swiftly over the
frozen meadows; the picturesque old houses standing out against a frosty
sky; the band in the Casino gardens; the voice of the soprano at the
opera; the magnificent chorus, “Heilig, heilig ist Gott der Herr,” sung
at the sacred concert in the old Marktkirche. And so it has come about
that while I am fairly well read in German literature, I am lamentably
ignorant of French literature. The study of the one is pleasure; the
study of the other is pain.

The mental impressions which delight are those that weave themselves
healthily into our structure and form a groundwork for future
impressions of a like order. Our happiness is composed, not only of the
joys of the present, but of the joys of the past. Learning, if it is to
be of the highest benefit to us, must before all things be made
pleasurable. In a few schools this principle is being recognised, but
owing to the low value still put by the community upon the best kind of
teaching, the reform is often carried out at the expense of throwing a
great strain upon an inadequate teaching staff. In the best of our high
schools for girls, the number of teachers is insufficient because the
funds are insufficient. We have not yet learnt to appreciate our
advantages and to pay a reasonable price for them.

We willingly spend our money on luxuries. Money represents so much
energy. And if the energy of the country be spent on that which
enervates, while that which improves and develops be left to languish,
how are we to avoid deterioration?

But before we spend our money on so called education, let us be sure
that it is worthy of the name. Cramming with detail is not beneficial
instruction; book-lore is not always wisdom; pedantry has nothing to do
with culture. It is a trite saying, but none the less true, that the
only positive knowledge we are capable of acquiring is a knowledge of
our own boundless ignorance. The first stepping-stone to a right
understanding is humility.




CHAPTER X.

_SECONDARY CAUSES OF NERVE-DETERIORATION._


Many minor causes of nervous exhaustion have been so often cited, and
such serious warnings have been uttered against them, that it is
scarcely worth while to draw attention to them here. It may suffice to
enumerate those which are more frequently ignored.

Of the infectiousness of nervous disease it seems almost useless at
present to speak, for few will listen. Probably the malady will, for
some time to come, continue to be spread abroad by those who suffer from
it, as certainly as leprosy is spread by the leper. The early symptoms
not being readily observed and recognised by the uninitiated, great
mischief can be wrought while all around remain unconscious of the
impending disaster. To young persons, and to those who inherit a
predisposition to nerve-weakness, the danger of infection is specially
great. Moreover, the predisposed often aid one another in the
development of the malady, a fact which is sufficiently proved by
observation of families exhibiting neurotic tendencies.

It has been fully recognised that imperfect recovery from some attack of
illness is a frequent cause of neurasthenia. It is not fully recognised
that the cause is usually a preventible one. A very common blunder is
generally at the root of the mischief. It is thought necessary to hurry
on the convalescent lest she should “drift into chronic invalidism,” as
the saying goes. The result is that the patient recovers to a certain
extent, only to fall a victim later to chronic nervous weakness.
Patients who are making a natural and healthy recovery are over-eager to
exert themselves, and require to be kept back. Should this eagerness not
be manifested, it is a mistake to say that the patient must be roused in
order to preserve her from neurasthenia. Neurasthenia is already there,
and unless the building up of the nervous system go hand in hand with
the patient’s exertions, those exertions will assuredly be productive of
harm. Unfortunately the patient is frequently removed from the watchful
care of the doctor and the nurse just as watchful care is most urgently
needed.

It does not occur to many of us, but it is nevertheless true, that
whenever we foster wrong theories of life, we render ourselves liable to
nerve-trouble. If we make mistakes in our drawing of the chart by the
guidance of which we mean to steer our bark,--if we omit to note down
the most dangerous rocks, and imagine obstacles in a course which we
might follow with safety,--small wonder that we suffer shipwreck. Mr.
Laurence Oliphant has pointed out how foolishly we encourage erroneous
notions in the children in our schools; how persistently we teach them
that the road to happiness is to be found in selfishness, and award
honour and approbation to those who have succeeded in getting the better
of their fellows. In the wider school of the world the same principle is
adhered to. The man who amasses a fortune, however selfishly, is the
man to whom the peerage is offered, and for whom we manifest admiration.
Nemesis follows. Those who are plunged into conditions for which they
have not been gradually fitted necessarily suffer in the change.
Unaccustomed luxury brings its own deterioration, while the excessively
unequal distribution of wealth thus encouraged brings inevitable misery
on the whole community. To the Shakespeare and the Newton no peerage is
offered and scant admiration is accorded, though by their individual
genius the whole race be raised. Consequently, the Shakespeare and the
Newton are rare birds; not because it matters to themselves whether they
are rewarded or no; not because the heaven-sent genius requires any
earthly inducement to do his heavenly work; but because we create, for
that which we admire and reward, an atmosphere in which it can arise and
flourish.

There is one very serious result of our refusal to honour those to whom
honour is due. The task of raising and training healthy and capable
people to the work of the world and the service of God, and--as the
orthodox believe--in the very likeness of God, is surely not the least
noble task to which human beings can devote themselves. And this, though
in a degree men’s work, is, in a greater degree and in a more special
manner, the work of women. What honour is awarded to women who guard
their health, develop their faculties and enlarge and enrich their
minds, that they may be fitted to perform the community’s highest work?
Absolutely none. True, it is not their only work; it does not fall to
the lot of all to perform it; but every good and well educated woman,
knowing herself to be a potential mother, tries conscientiously to fit
herself for the part she may be called upon to play, and in so doing
becomes aware of her own value. That so few women thus prove themselves
to be good and well educated is scarcely the fault of women in
particular. It is the fault of the whole community. Just as a
Shakespeare and a Newton may rise superior to inadequate appreciation,
so do some great women. But these women are, and must be, exceptions.
The majority of women, no less than men, depend in large measure on the
sympathy, approbation, and esteem of others.

Perhaps women need these incentives even more than men need them,
because for centuries their love of approbation has been developed
abnormally by their dependence on men, and by the need they have
experienced of securing their approval. Natural feelings, denied egress
by the front door, find their way out at the back door. By reprehensible
means, and greatly to the detriment of both sexes, women have
continually forced themselves into notice, while fulsome flattery and
exemption from work demanding the healthy employment of their faculties,
have taken the place of legitimate and inspiring honour.

A fresh result of the determined withholding from women of the
distinction and approbation which has been honestly earned, is
manifesting itself in a curious manner in these modern times. Women too
noble by nature to indulge in ignoble ways the faculties within them
that cried out for exercise, stung by taunts of inferiority, chafed by
the deprivation of means for obtaining the rational education and the
experience of the world which were to them as the very breath of life,
conscious of talents no whit inferior to those of the men about them,
have flung themselves into the whirl of public affairs, and, with truly
admirable perseverance and indomitable pluck, have won for themselves
the only honours open to them.

Some good has thereby been wrought. Employments suited to women, and
hitherto closed to them, have now been thrown open; book-learning--too
often a miserable system of cram, but perhaps better than nothing at
all--has been placed within their reach. Public attention has been
attracted to long-standing injustice; and considering the immense
importance to the whole race of the full development of all the
faculties of women, it was, and still is, to the interest of the public
to give the fullest attention to the subject which it can manage to
spare.

Unfortunately the affair has another aspect which here closely concerns
us. The over-eagerness with which some women have thrown themselves into
the struggle for existence has in some quarters earned for the sex as a
whole the reputation of possessing more self-feeling, less
disinterestedness, and more sordidness of aim than men. It has been
rashly assumed that because the pioneers of a movement have acted
foolishly, because they have been injured in fighting a battle harder
than any that will have to be fought by those for whom they prepare the
way, all women are necessarily unfit for active life in the world. Alarm
on the one side generates deleterious irritation on the other side.
Faculties which might be devoted to the creditable performance of
valuable work are dissipated in fighting for the privilege of doing the
work at all. It should be remembered that those who have been starved
always devour food with injurious avidity when it is at last brought
within their reach, unless they are mercifully restrained by wise
well-wishers.

It cannot be doubted, however, that women who conscientiously perform
their own special work in the world must have less strength at their
disposal for other work than the majority of men. So far from this
being to their discredit, the extreme importance of their own special
functions ought to be more generally recognised. At the present time,
the women who neglect their duties are apparently held in as much esteem
as the women who render the State the highest possible service.

Another point is worthy of careful consideration. Certain professions
were once held to be unlawful for women on the ground that their
intellectual faculties were of too inferior an order to enable them to
follow masculine callings successfully. Women thereupon attained
eminence in these very professions, thereby proving that their
intellects, at all events, were equal to the occasion. An intimate
acquaintance with some of the women who have thus proved their mental
capacity has convinced me that they are not, on that account, very
highly organised people. So far from having enlarged their whole circle,
they seem to have shot out a long angle on one side of their natures at
the expense of drawing to a corresponding extent on the other side. The
emotional part of them appears to be defective, and the defect
manifests itself chiefly in a lamentable want of sympathy, and in an
annoying, though often amusing, deficiency of humour. It may be that the
sieves of these professions are of a particularly distorting order, and
that the sensitive organisations of women are more easily injured by
them than are the tougher organisations of men. Distortion is apt to
produce nerve-deterioration in both sexes, but especially in the highly
strung nervous systems of women.

Unfortunately, the Modern Malady is at present so little understood,
that the very people who are betraying the most serious symptoms of
nervous weakness are often declared by those about them to be in
excellent health, a mistake which the sufferers themselves, eager to
avoid the imputation of nervousness, are careful to foster. On one
occasion I remarked to friends on the enfeebled state of nerve to which
a clever and energetic woman had been reduced, owing in part to her
labours in an arduous profession. Although the symptoms were
unmistakable, my words were received with derision.

“Mrs. T---- nervous!” exclaimed my friends. “What an idea! As if such a
thing could be possible!”

The notion that nervous weakness was a species of illness to which any
one might fall a victim if placed in conditions calculated to produce
it, was entirely beyond the mental range of these good people. And
following the natural law, in proportion to their ignorance was their
conviction of profound wisdom. Mrs. T---- had more and more earned for
herself a wide reputation for “strong-mindedness.” She was popularly
supposed to be “hard,” and judging from my own experience of her
character, I should say that the popular judgment was in that instance
more correct than usual; though why so noble a quality as mental
strength should be associated with defectiveness, with the terrible
process of loss of feeling--a continual lopping of the sensitive
tendrils by means of which the human plant keeps itself in touch with
its environment and draws from it its mental nutriment--I am unable to
imagine. Now, my friends were convinced that the defect of emotional
nature commonly called hardness, and a condition in which emotional
symptoms are often manifested, were things incompatible. They therefore
bestowed ridicule upon me, and considered that they had “fixed that
matter up.” My belief is that the dear ladies would have “fixed up” with
equal alacrity any matter in the whole of this wide universe.

But Dame Nature, always stern in carrying out her threats, slowly but
surely brought Mrs. T----’s downward career to its logical conclusion.
She was compelled to give up work and seek seclusion for a season. Her
friends and acquaintance were surprised, but the tragedy was by no means
astonishing. Ambition, and consequent overwork, began the mischief; the
hardness which was supposed to be her safeguard completed it. Once out
of sympathy with her fellow-creatures, her sorrows were endless. Loving
herself more than them, she tried to act in her own interests in
opposition to theirs. Her fellow-creatures took their revenge. The
perception that is born of sympathy now being blunted, she estimated
their characters wrongly; she confided in the untrustworthy and was
suspicious of the trustworthy. Her blunders were productive of suffering
not only to herself but to others. Blame, friction, and harassing cares
followed, in the midst of which her brain gave way.

There are those who, cursed by the taint of insanity in their families,
pray daily to God to preserve them from this frightful evil, and who,
even while they are praying, turn their backs upon the road that leads
to sanity. That road is the enlarging of the sympathies.

It is sometimes urged that much sympathy is a bad thing, not only for
its possessor, but for those with whom he comes in contact. Persons who
give indiscriminately to beggars, who make a great show of superficial
pity and affection, or who shed tears on the smallest provocation--all,
in short, who, from nervous disorder or congenital weakness, are wanting
in judgment and self-control, are almost invariably classed with highly
developed people of large emotional natures.

As a matter of fact, the two classes have nothing in common. Any poor
lunatic, whose injured nerve-centres are incapable of disposing
healthily of the full amount of energy generated, can manifest an excess
of superficial emotion. It is noteworthy that the very people who save
themselves trouble by giving to beggars without careful inquiry into the
merits of the case will save themselves trouble in other respects at the
expense of their fellow-creatures, and that those who harrow others by a
needless and self-indulgent emotional display are precisely those who
will abundantly prove their selfishness and shallowness of feeling so
soon as any sacrifice is demanded of them.

On the other hand, we sometimes find that the most truly sympathetic
people earn for themselves a quite undeserved reputation for hardness,
for it is not always either wise or kind to show all the sympathy we
feel. Only the largest natures can rise superior to their innate love of
approbation; only those who are really actuated by a desire to benefit
humanity can resist the temptation to flatter weakness when there is
anything to be gained by so doing. The most successful in this respect
run the greatest risk of misconception. Self-control is regarded as want
of feeling; unselfishness may appear like indifference. In dealing with
the nervous, virtue must often be satisfied with its own reward. After
all, the reward is a large one. It is nothing less than the cure of our
patient.

Continued unselfish action is the only sufficient test of deep feeling.
The tree is known by its fruit. The world is full of mimetic people who
can speak so well and write so well as to deceive the very elect, should
these be so simple as to judge them by their professions. Unhappily the
elect too often forget the injunction to acquire the wisdom of the
serpent.

Amongst the most serious secondary causes of nerve-deterioration in
modern times we find one to which attention has recently been drawn by
many writers of distinction. It is not merely overwork, hurry, and
excitement that are injurious to our organisms, but a lack of the
solitude and calm in which impressions are combined and ideas created.
Many of us live in the midst of such a whirl of rapidly succeeding
sights, sounds, and sensations, that only a confused recollection of
them is left in our minds. It is as though we were to eat incessantly,
leaving no leisure for digestion; as though we were so eager to know,
that we should refuse to wait to learn. We forget that the sure test of
knowledge and progress is the power to reproduce the impressions we have
assimilated; not the very elementary capability of putting down on paper
the undiluted and undigested detail which has been stuffed into the
outer chamber of our minds for that purpose. We must create; we must
see, and show to others, “the light that never was on sea or land.”

How is this to be accomplished? In attempting to answer the question,
let us consider what we do when we wish to obtain the photograph of a
face that does not exist. We photograph a number of faces one over the
other on the same plate. Is that enough? Does it suffice us to obtain a
series of impressions on our plate? No; we now need the dark room, the
developing and fixing solutions, and the presiding genius of a higher
intelligence, before we can obtain the negative of a face that never yet
was seen.

And if in this age we expose ourselves to an abundance of impressions,
but ignore or underrate the solitude of the dark room, the imaginative
faculty which combines and develops, to say nothing of the presiding
genius of a higher intelligence, what is to become of our creative
power? What, indeed, is to become of our sanity? Moreover, we must
remember that there is one great difference between ourselves and the
photographic plate. The plate is sensitised once for all; it receives
its picture and its work is done. But we are, or may be, always
absorbing into ourselves that which sensitises us more and more highly,
and of receiving more and more perfect pictures. In addition to which
great privilege, we may not only communicate to others, but eventually
hand down to others, the faculty thus obtained.

How much reason is there in the creed that we should believe only in the
existence of that which is borne witness to by our five senses? In that
case we must consider ourselves as perfectly developed as it is
possible for creatures to be. All evolution has been a course of
rendering ourselves, and being rendered, more and more capable of
discerning that which is; and, considering how feeble an atom is man in
the midst of so mighty a universe, it is unlikely that the process can
yet be finished. Perhaps the deaf bee believes itself to be perfectly
constituted, yet a whole world of sound is cut off from it. Just because
it has so tremendous a defect, it is unable to comprehend its own loss.
From how much in the universe are we also cut off? How far do we injure
ourselves by ignoring the existence of that which it is important to us
to learn? It is argued, however, that reliable evidence should correct
the evidence of each man’s individual senses.[9] When we inquire more
closely what is meant by this, we find merely that the experience of the
majority of mankind in the past is the source of light which is to
illumine individual darkness. A strange source truly! Supposing that
the most highly developed of the bees--and the most highly developed are
necessarily a small minority--were to obtain some inkling of the nature
of sound, and were to attempt to impart it to their companions, would
they not be told that the universal experience of bee-kind was against
their theories? Would not the deaf creatures be angered by the
insinuation of their deafness and consequent inferiority?

And so we may in time discover that, though the honest agnostic may be,
and often is, far superior to the dogmatic religionist, it is only
persons of a certain degree of development (of all classes) who are
capable of belief in the unseen, and that this development has little to
do with the faculty of passing examinations. It is possible that the
higher faculties are not best developed as we imagine; that what we most
usually call brain-work is often rather a means of using up our store of
intellectual power than of developing it. The fact that our greatest men
of genius have come from the lower ranks of life rather than from the
higher should lead us to ask whether the nobler part of mind grows
better in the school of the pedagogue or in the school of Nature.[10]

There are cases on record of animals who have been taken by a circuitous
route to a distant land, which they had never before visited, and who,
on being released, have returned home as straight as the crow flies. In
like manner, people have been known to find their way direct to their
destination through portions of crowded cities to which they were
strangers. Others walk confidently in the dark without hurting
themselves. They _feel_ when they are near an obstacle or a precipice.
Others approach the most savage beasts and receive no hurt.

If these instances are rejected as fables, we must in consistency reject
many supposed scientific facts which we have accepted on no better
evidence. Yet what sense or faculty possessed by the majority can
account for them?

The man whose measure of the universe is largest, whose development is
the widest and most symmetrical, is the man who, having once reached
maturity, is the least liable to fall a victim to neurasthenia; not only
because his knowledge of quicksands is greatest, but because he has
proved his adaptability. The success or failure of the large nature to
reach maturity depends quite as much upon circumstance as upon the rate
and method of his development. One great poet may survive detraction,
but a Chatterton destroys himself. If the detraction be equal in both
cases, other circumstances are very different. Coleridge survived a
mistaken and injurious mode of education, but he survived it--an
opium-eater.

Observation and experience teach us that human beings may be divided
into two classes. (1.) Those who act; (2.) Those who are acted upon.[11]
The first class, whether so regarded by the world or not, are
essentially sane. The second, whether so regarded by the world or not,
are essentially insane. The first have a will; the second have none--to
speak of. The first are responsible; the second are irresponsible. The
first, through self-sacrifice, develop and progress; the second, through
self-seeking, fail and deteriorate. Accidental illness may cause members
of the first to drop to the second; helpful influence may enable members
of the second to climb to the first.

The second class may be subdivided into those who drift helplessly
before circumstance, and those who break themselves in pieces before the
circumstances that are too strong for them. These latter cannot be
persuaded to leave off trying to accommodate the whole universe in their
own little measure. Strange to say, they are often credited with
possessing strength of will, whereas they merely possess its hostile
counterfeit, self-will.

Conquest where conquest is possible, and submission without exhausting
struggle where conquest is impossible, are doubtless true wisdom. But
wisdom implies knowledge; and knowledge, right education; and
education, the divinely imparted faculty for receiving instruction.

To gain the victory over self on the one hand, and to yield submission
to God’s eternal laws on the other hand, this is liberty--the glorious
liberty of the children of God.

It is surely our capacity for development, our power to rise, even at
the cost of much suffering, to a knowledge of God, to the likeness of
God, that constitutes the great hope of the universe. The idea is
admirably expressed in an exquisite chant, entitled “Song of the
Universal,” by the well-known American poet-philosopher, Walt Whitman:--

    “Over the mountain-growths, disease and sorrow,
     An uncaught bird is ever hovering, hovering,
     High in the purer, happier air.

    “From imperfection’s murkiest cloud
     Darts always forth one ray of perfect light,
     One flash of heaven’s glory.

        *       *       *       *       *

    “All, all for immortality,
     Love like the light silently wrapping all,
     Nature’s amelioration blessing all,
     The blossoms, fruits of ages, orchards divine and certain,
     Forms, objects, growths, humanities, to spiritual images ripening.

    “Give me, O God, to sing that thought,
     Give me, give him or her I love, this quenchless faith,

        *       *       *       *       *

     Belief in plan of Thee enclosed in time and space,
     Health, peace, salvation universal.

    “Is it a dream?
     Nay, but the lack of it the dream,
     And failing it life’s lore and wealth a dream,
     And all the world a dream.”


                               THE END.

                 PRINTED BY BALLANTYNE, HANSON AND CO.
                         EDINBURGH AND LONDON

       *       *       *       *       *

                           THE MASSAGE CASE.

                         _BY THE SAME AUTHOR._

                      (2 VOLS. T. FISHER UNWIN.)

                             THE HOSPITAL.

“The author of this decidedly clever novel seems to have written ‘The
Massage Case’ as a reminiscence of a very unpleasant personal
experience.... From this point of view it is noteworthy for its studious
moderation of tone. Not only have we the contrast between the two
doctors and nurses, the good and the bad, but the good qualities of Dr.
Broadley and the woman employed by him are honestly stated. There is no
attempt to depict either as an impostor, and the doctor’s energy and
force of character are spoken of with frank admiration, although these
are the main instruments in bringing the patient to the verge of
madness.... Such a character is perfectly real, perfectly possible; and
while the mischief that results from his somewhat pachydermatous honesty
and lack of fine perception is plainly stated--while we are shown that
the very force and strength of character which had won him his place in
the front of the profession tend to overawe his patient, and make her
submit in silence to wrong judgment of her symptoms--there is no attempt
to vilify Dr. Broadley himself, nor the profession to which he
belongs.... If this book, which, under the guise of a story, points out
clearly, but with a not unfriendly hand, the errors into which both
branches of the medical profession are apt to fall, and makes doctors
and nurses more careful and kind, we, at least, will bid it welcome.”

       *       *       *       *       *

                   _REVIEWS OF “THE MASSAGE CASE.”_

                           BY CYRIL BENNETT.

               THE BOSTON MEDICAL AND SURGICAL JOURNAL.

“This is the first novel that has come to our notice in which massage
takes a prominent part. It is a very good story, told with the
simplicity and earnestness of truth, and probably part, if not all of
it, is founded on fact.... We need not go from home to find nursing
homes and private hospitals of this kind. There are some keen
delineations of character in the book. The eminently successful
practitioner, who overwhelms people with his powerful individuality, and
compels them into saying and doing what he means them to say and do, is
well described. So also is the highly appreciated old-fashioned nurse,
who has become a little too knowing.... But what became of the patient?
That is just how our readers can while away a few hours very pleasantly
in finding out for themselves.”


THE SPECTATOR.

“The best part of the story is the description of the nursing home. Here
we are sometimes reminded of Charles Reade.”


THE ZOOPHILIST.

“This is a pleasantly readable novel of a very praiseworthy type,
chiefly remarkable, from our point of view, for the pen and ink
portraits of two very dissimilar medical men, and an exposure of the
evils which may ensue to a nervous patient from falling into
unsympathetic hands.... We presume the moral is that massage, like
certain doctors, does not suit everybody.”

THE GUARDIAN.

“The author apparently desires to show that an eminent physician ... may
easily become the tool of a determined woman who has made up her mind
that the course of true love shall not run, smoothly or otherwise, to a
conclusion that she deems undesirable; that ‘nursing homes’ may be so
manipulated as to serve temporarily as places of confinement for persons
whose relations find it inconvenient that they should be at liberty; and
that the ‘Weir Mitchell System,’ whatever excellences it may possess, is
not a panacea for every disorder to which humanity is subject.”


THE STANDARD.

“These volumes are apparently written to warn the public that nefarious
persons find very easily, in massage ‘homes,’ all the conveniences for
getting their uncongenial relations put out of the way and tortured,
which used to be the speciality of private lunatic asylums. If so, we
hope that Cyril Bennett may be the Charles Reade to rouse the world to
open the doors of these new and hitherto unsuspected Bastilles.”


ILLUSTRATED LONDON NEWS.

“Picturesque and animated scenes of Eastern life.”


WHITEHALL REVIEW.

“His two volumes are amusing and interesting, and written in a style
which promises much in the future.... There are truth, life, and colour
throughout the book.”




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FOOTNOTES:

[1] See Hinton’s “Life in Nature.”

[2] The form of neurasthenia which most frequently receives this label
is cerebrasthenia with emotional symptoms. It often exists without
myelasthenia or any kind of bodily exhaustion.

[3] I have known the term “hysteria” applied to cases of well-marked
brain disease, to cases of brain exhaustion from internal disease or
disorder, to states of bodily weakness without disorder of the brain, to
mere habitual eccentricity,--in fact, to anything and everything.

[4] See Tyrrell’s “Tonic Treatment of Epilepsy.”

[5] Motley’s “Rise of the Dutch Republic.”

[6] The more highly developed the organism, the greater its
sensitiveness.

[7] By this I do not mean that higher perception of the similarity
underlying all differences, which comes much later in life, when
differences have been fully appreciated.

[8] Not merely tendencies to actual suicide, but an inability to
recognise true advantage.

[9] We reason only from sensation. Knowledge is but “registered
feeling.”

[10] Professor Weismann draws attention to the fact, that the
development of a faculty by the parent, on the most generally approved
method, by no means ensures its transmission to the offspring.

[11] See Dr. Maudsley’s “Essay on Hamlet.”









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