The modern malady

by Cyril Bennett

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.