| "That the will is infinite and the execution confined." |
| Troilus and Cressida |
The symptom of disease that humanity dreads the most is pain. Fortunately, it is also the symptom which is most under the control of the will, and which can be greatly relieved by being bravely faced and, to as great an extent as possible, ignored. It requires courage and usually persistent training to succeed in the relief of severe pain in this way, but men have done it, and women too, and men and women can do it, if they really want to, though unfortunately all of the trend of modern life has been in the opposite direction, of avoiding pain at whatever cost instead of bravely facing it. The American Indian, trained from his youth to stand severe pain, scoffed at even the almost ingeniously diabolical tortures of his enemy captors. After they had pushed slivers beneath his nails or [{113}] slowly crushed the end of a finger, or put salt in long, superficial wounds that had bared a whole series of sensitive cutaneous nerves, he has been known to laugh at them, and ask them proudly, without giving a sign of the pain that he was enduring, whether that was all that they could do. It was just a question of the human will overcoming even the worst sensations that the body could send up to the brain and deliberately refusing to permit any reactions that would reveal the reflex torment that was actually taking place.
The war has done much to bring back the recognition of that diminution—to a great extent at least—or even almost entire suppression of pain which may occur, indeed almost constantly does occur, as a consequence of a man facing it bravely. We have been accustomed to think of the early martyrs as probably divinely helped in their power to withstand pain. Whatever of celestial aid they had, we know that martyrs for all sorts of causes, some of them certainly not divine, have exhibited some degree of this same steadfastness. Their behavior makes it reasonably clear that as the result of making up their minds to stand the pain involved, they have actually suffered so little that it was not [{114}] difficult to suppress external manifestations of their sufferings. It is not merely a suppression of the reflexes that has occurred but a minimizing to a very striking degree of the actual sensations felt. We have many stories of the older time before the modern use of anaesthetics, which tell how bravely men endured pain and at the same time retained their power to do things. Indeed, some of them accomplished purposes in the midst of what would seem like supreme agony which made it very clear that pain alone has nothing like the prostrating effect that it is often supposed to have.
For we have well authenticated tales of physicians performing amputations on themselves at times when no other assistance was available, and accomplishing the task so well that they recovered without complications. A blacksmith in the distant West, whose leg had been crushed by the fall of a huge beam, actually had himself carried into his shop and amputated his own limb above the knee, searing the blood vessels with hot irons as he proceeded. Such a manifestation of will power is, of course, exceptional to a degree, and yet it illustrates what men can do in the face of conditions that are usually supposed [{115}] to be overwhelming. Many a man in lumber camps or in distant island fisheries or on board fishing vessels, far beyond the hope of reaching a physician in time for him to be of service, has done things of this kind. We can be quite sure that the will to accomplish for himself what seemed necessary to save his life lessened his pain, made it ever so much more bearable and generally proved the power of the human will over even these physical manifestations in the body that are commonly supposed to be quite beyond any interference from the psychical part of nature. The spirit can still dominate the flesh, even in matters of pain, and dictate how much it shall be affected. It is a hard lesson to learn, but it is one that can be learned by proper persistence.
In the early part of the war particularly many a young man had to face even serious operations without an anaesthetic. The awful carnage of the first six weeks of the war had not been anticipated and therefore there were not sufficient stores of anaesthetics available to permit of their use in every case. Besides, many operations had to be performed so close to the front and under such circumstances that there could not be anaesthetics for all of them; and it was a never-ending source of [{116}] surprise to those who witnessed the details to see how bravely and uncomplainingly the young men took their enforced suffering. Many a one, when his turn came to be operated on, quietly asked for a cigarette and then bore unflinchingly painful manipulations that the surgeon was extremely sorry to have to inflict. Over and over again, when there was question of the regular succession of patients, young soldiers in severe pain suggested that some one else who seemed in worse condition than they, or who perhaps was not quite so well able to stand pain and control himself, should be attended to before they were. There is no doubt at all that this very power of self-control lessened their pain and made it ever so much easier to bear and less of a torment than it would have been otherwise.
Any great diversion of mind that turns the attention completely to something else will lessen even severe pain so much as to make it quite negligible for the moment. Headaches disappear promptly when there is an alarm of fire, and toothaches have been known to vanish, for the time at least, as the result of a burglar scare. Much less than this is needed, however, and there are many familiar examples [{117}] which illustrate the fact that the turning of the attention to something else will greatly diminish or even abolish pain.
The well known story of the French surgeon about to set a dislocation is a typical demonstration. His patient was a woman of the nobility, her dislocation was of the shoulder and it was necessary for him to inflict very severe pain in order to replace it. Besides, as the result of the reflex of that pain, he was certain to meet with great resistance from spasm in the surrounding muscles. It was before the days of anaesthetics, which relieve all of these inconveniences, and above all, relax the muscles. The surgeon got ready to do the ultimate manipulation that would replace the joint in its proper relation, and necessarily inflicted no little pain in his preparations. The lady complained very much, so he turned on her angrily, told her that she must stand it, slapped her in the face, and before she had recovered from the shock, the dislocation had been restored to the normal condition. It was rather heroic treatment, and it is to be hoped that she understood it, but it is easy to understand how much the procedure lessened her physical pain.
When the mind is very much preoccupied [{118}] and the will intent on accomplishing some immediate purpose, even severe pain will not be felt at all. Instances of this are not rare, and men who are advancing in a charge on a battlefield will often be wounded rather severely, and yet continue to advance without knowing anything about their wounds until a friend calls attention to their bleeding, or they themselves notice it; or perhaps even loss of blood may make them faint. The late President Roosevelt furnished a magnificent illustration of this principle when he was wounded some years ago in the midst of a political campaign. A crank shot at him, in one of the Western cities, and though the bullet penetrated four inches of muscle on his chest wall, and then flattened itself against a rib, he did not know that he was wounded. The flattening of the bullet must have represented at least as much force as would be exerted by a heavy blow on the chest, and yet the Colonel never felt it. His friends congratulated him on his escape from injury until it was noted that blood was oozing through a hole that had been made in his coat. The intense will activity of the President simply kept him from noticing either the shock or the pain.
Not long before the war a striking example was given of how a man may stand suffering in spite of long years of the refining influences of a sedentary scholarly life, most of it spent indoors. The second last General of the Jesuits developed a sarcoma on his upper arm and was advised to submit to an amputation of the arm at the shoulder joint. He was a man well on in the sixties and the operation presented an extremely serious problem. The surgeons suggested that he should be ready for the anaesthetic at a given hour the next morning and then they would proceed to operate. He replied that he would be ready for the operation at the time suggested, but that he would not take an anaesthetic. They argued with him that it would be quite impossible for him to stand unanaesthetized the extensive cutting and dissection necessary to complete an operation of this kind in an extremely important part of the body, where large nerves and arteries would have to be cut through and where the slightest disturbance on the part of the patient might easily lead to serious or even fatal results. Above all, he could not hope to stand it in tissues that had been rendered more sensitive than before by the enlarged circulation to the part, due to [{120}] the growth of the tumor, and the consequent hyperaemic condition of most of the tissues through which the cutting would have to be done and which were thus hypersensitized.