II
The young physician, just beginning to practise, is astonished at the remarkable things which his patients tell him with the utmost confidence and in all good faith. Nearly all relate the story of their illness, beginning with that circumstance which, in their opinion, originated it. It is an innate tendency which spurs the human mind to find an explanation for everything; and the reason of phenomena, which is the foundation of science, is yet the cause of prejudices and the most abundant source of error. If I were to mention the names of all the maladies which are thought to be produced by fear, I should be obliged to copy nearly the whole index of a pathological text-book, and with small advantage to the reader, for the authors, after exhausting their scientific matter, state empirically everything their patients tell them, provided their affirmations bear an appearance of truth. I shall only mention facts beyond doubt, or those least controversial, supporting them by examples taken from the most reputed authors.
Chomel relates that a physician, after having performed the autopsy of a man who had died from hydrophobia, was so overcome by the fear of having infected himself, that he lost both appetite and sleep, felt a horror of all liquids and a choking sensation in the throat when he forced himself to drink. For three days he wandered through the streets like one desperate. His colleagues and friends, believing it to be the effect of imagination, made every effort to convince him of the fact, and by keeping him with them, they succeeded in ridding him of the ill-omened thought, and he recovered.
It is an incomprehensible phenomenon, but yet admitted by all medical writers, that fear may of itself give rise to phenomena exactly resembling those of hydrophobic infection. A celebrated physician, Bosquillon, believed that fear alone was the cause of hydrophobia and not the bite or the saliva of the dog.
Dubois tells of two brothers who were bitten by a mad dog. One had to leave at once for America, and thought no more about it. When he returned twenty years afterwards, he heard through some thoughtless person that his brother had died of hydrophobia, and was so agitated by the news that he fell ill and died, showing all the symptoms of rabies. Medical works are full of instances of persons bitten by dogs, who only developed hydrophobic symptoms after being incautiously told that the dog was mad. It is often impossible even for the physician to distinguish hypochondriac hydrophobia from true rabies; even the manner of death is no guide, for tetanic contractions of the respiratory organs appear also in hypochondriac hydrophobia.
The physician can often save these patients, if he knows how to exert authority and to make use of means to convince the sufferer that he has nothing to fear.
The story is told of a physician who was called to a female patient infected with actual rabies, after his colleagues had declared that she was incurable. He examined her attentively, then kissed her on the mouth to prove to her that she was not hydrophobic. The patient recovered.
More especially during epidemics does fear play havoc. From the most remote antiquity physicians have observed that the timid die more easily. Giorgio Baglivi, in his celebrated book 'Praxis Medica,’[34] describing the effects of an earthquake which took place in Rome in 1703, says that although not a single person was killed, several died of fever through fear, many women miscarried, and all bedridden invalids grew worse. Larrey had already noticed that on the fields of battle and in the lazarets soldiers belonging to the conquered army succumbed more easily to their wounds, while the victors more speedily recovered. This was confirmed in the war of 1870.
Fear alone may develop all the symptoms of a pestilential malady, even when the epidemic causes are totally wanting. Just recently, in one of his works on hysteria and hypochondria, Jolly relates the case of a patient of his, a lady in Strasburg, who received the news of the death of a relative from cholera in a distant country. She was very much frightened, and imagined that she herself was attacked by it. She lost her appetite and suffered for eight days from violent attacks of diarrhœa, and only after convincing her that there was not a single case of cholera in Strasburg, and that she was a prey to her own imagination, was it possible to allay the serious intestinal disturbances produced by fear. As soon as a report of cholera spreads through a town, all hypochondriacs feel worse.
Physicians who have described the dreadful spectacle of the lazarets during epidemics, mention the great number who die victims to fear, in many of whom the symptoms of the plague had not even appeared. Some have died suddenly from the fear of being taken to the lazaret, others have committed suicide, as we are told the cowardly have been seen to do in battle, who, terrified at the sight of death, or weary of suffering, have placed their chin on the muzzle of their gun and blown out their brains.
What horror we should feel could we read year by year the story of those who have succumbed to nostalgia, grief, humiliation; in misery, winter-cold, or want of food! Of men who have died hopelessly in the snow or lost in the sands of the desert, of others who have been shipwrecked and thrown upon the rocks, and whom a little courage might have saved; of men who have languished in gloomy prisons, in lonely monasteries or in exile, and who have died rather of mental than of bodily suffering.