The application of the term degeneration may be, and should be, it seems to me, limited to the signs, whether physical or mental, which indicate an obviously downward tendency. I have elsewhere suggested, and the suggestion has already found some acceptance, that when the variation is not definitely downward, deviation and deviate be substituted for the unnecessarily opprobrious and often inappropriate terms, degeneration and degenerate.
VII. HYPOCHONDRIA
Il marche, dort, mange et boit comme tous les autres; mais cela n'empeche pas qu'il soit fort malade.
MOLIERE: Le Malade imaginaire.
The victim of hypochondria may present the picture of health, or may have some real ill regarding which he is unduly anxious. His consultation with a physician is likely to be preceded by letters explaining his exact condition, naming his various consultants and describing the various remedies he has taken. At the time of his visit notes are consulted, lest some detail be omitted. In his description anatomical terms abound; thus, he has pain in his lungs, heart, or kidney, not in his chest or back. Demonstration by the physician of the soundness of these organs is met by argument, at which the hypochondriac is generally adept.
The suggestion that the hypochondriac devotes undue attention to his own condition is met by him with indignant denial. Proposals that he should exercise, travel, engage in games, or otherwise occupy himself, fall on deaf ears, but he is always ready to try a new drug. If a medicine is found with whose ingredients the patient is not already familiar, its use is likely to produce a beneficial effect for a few days, after which the old complaint returns.
The case has come to my attention of a young man who, for fear of taking cold, remains in bed, with the windows of the room tightly closed and a fire constantly burning. He has allowed his hair to grow until it reaches his waist, he is covered with several blankets, wears underclothing under his nightshirt, and refuses to extend his wrist from under the bed-clothes to have his pulse taken.
Such faulty mental habits in minor degree are common. There are those who will not drink from a bottle without first inspecting its mouth for flakes of glass; some will not smoke a cigar which has been touched by another since leaving the factory; some will not shake hands if it can possibly be avoided; another pads his clothing lest he injure himself in falling. Many decline to share the occupations and pleasures of others through fear of possible wet feet, drafts of air, exhaustion, or other calamity. Such tendencies, though falling short of hypochondria, pave the way for it, and, in any event, gradually narrow the sphere of usefulness and pleasure.