I was feeling particularly pleased with the arrangements, when, after a neat little speech on his part, commendatory of me, and when we supposed him to be about to begin his lecture, he suddenly turned to me and said, bluntly: "You will be so good as to take the class to-day. Young gentlemen, I bid you good morning," and abruptly took up his hat and left. I sat facing an expectant and surprised class of shrewd young fellows, and I was quite unprepared to proceed.
I had intended my first lecture to be a great success. It was ready for the following day; but my notes were at home, and my position can, therefore, be better imagined than described.
I was thinking over this and the strange behavior of my generally punctilious predecessor, when he entered my office, unannounced, and, after the ordinary salutations and apologies for having placed me in so undesirable a position in the morning, he told me the following episode from his history. I will give it in his own words, omitting, as far as possible, all comment made by me at the time, thus endeavoring to leave you alone with him and his story, as I was that night. This will better enable me to impart the effect to you as it was conveyed to me at the time. It greatly interested me then, but the more I think it over, the less am I able to decide, in my own mind, all of the psychological questions which it aroused then and which it has since called up. This is the story.
I.
I am, as you know, not a young man, and in the practice of my profession, which has extended over a period of nearly thirty years, I have learned to diagnose the cases that come under my care very slowly and by degrees. Every year has taught me, what you will undoubtedly learn—for I have great hopes for your future career—that physical symptoms are often the results of mental ailments, and that, while cordials and powders are sometimes very useful aids, the first and all-important thing is to understand fully the true history of my patient.
I have laid stress upon the word true, simply because while a history is easy enough to get, about the most difficult matter in this world to secure is the history of one who comes to a physician ailing in body or in mind. It is easy enough to treat a broken leg, a gunshot wound, or even that ghastliest of physical foes, diphtheria, if it is one of these and nothing more.
But if it is a broken leg as to outward sign, and a broken heart as an inward fact, then the case is quite another matter, and the treatment involves skill of a different kind.
If the bullet that tore its way through the body was poisoned with the bitterness of disappointment, anxiety, terror, or remorse, something more is needed than bandages and beef-tea.
If diphtheria was contracted solely from a defective sewage-pipe, it will, no doubt, yield to remedies and pure air. But if long years of nervous and mental prostration have made ready its reception, the work to be done is of a much more serious nature.