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.