Respiratory Training.—Shortness of breath is often a bothersome symptom, especially for stout people, and prevents them from taking necessary exercise. When it cannot be traced directly to some affection of the heart or of the circulatory apparatus, it is usually due to lack of exercise. Much can be done for it by deliberate training. In the modern time, with elevators so common, people seldom have to walk up-stairs, and consequently one of the modes of exercise that was particularly likely to furnish some training in deep breathing is absent. Any one who has seen the shallow breathing of many of the patients who come to Nauheim and how much it has improved by the gradually increased walks up the hills around the valley, will appreciate how much training in deep breathing means. This exercise of the diaphragm will often give benefit besides in making the bowels more regular, and in getting rid of the accumulation of fat in the abdomen, which is one of the mechanical causes of the interference with the diaphragm and consequent shortness of breath.
Training the Appetite.—Just as training may be used for the sensory and motor systems that are external, so it may also be used for many internal functions analogous to these. There are a great many people who eat too little. They are the nervous, irritable persons with no fund of reserve energy to draw on when anything happens, and who are in their years before middle life likely to be the victims of infectious disease. They suffer much from lack of proper covering in the winter time and from a certain protection that is afforded to the nervous system generally by being up to weight. Often their under-weight is a life-story, and occasionally it is a family matter. When [{217}] they suffer from neurotic symptoms a gain in weight nearly always does them good. They complain that when they increase their diet they have uncomfortable feelings. This is only what is to be expected, since the muscularis of their stomach—much more important than its secretory function—has not been accustomed to as much exercise as is now being demanded of it.
On the other hand, for those who are over-weight, training in eating less is the one important therapeutic factor. If their diet is cut down suddenly, they soon become discouraged. If there is a gradual reduction of food quantities, variety being allowed, so that they may eat practically everything they have been eating before, the system gradually accommodates itself to less and less food. This is the only sensible way of bringing about reduction in weight. It requires constant attention over a long period, but it can be done with excellent success.
In the same way the bowels may be trained to perform their work regularly. Habit means probably more with them than any other factor. Our digestive tract, however, is largely dependent on habit. We get hungry three times a day or twice a day, according to the custom that we have established. Countries differ radically in the matter, and nearly always, when a man goes from one country to another in early years, he changes to the habits of the new country, though if he comes after middle age he usually clings to those that he is used to.
Training to Stand Pain.—There are many painful conditions, especially involving the muscles in the neighborhood of joints, that are worse on rainy days and are spoken of as rheumatism, that can be very much improved by training in the use of muscles. As men grow older and gain in weight, the lack of exercise in their sedentary lives incapacitates their muscles for activities of many kinds. The consequence is that where most strain is put upon them, in the neighborhood of joints, they readily become tender and painful. It is this class of cases particularly that is benefited by irregular practitioners of all kinds. Mental healing, osteopathy, Eddyism, the many liniments, rubbings and manipulations prove beneficial. What is needed is training in the use of muscles so as to enable them to do the work that is required of them without discomforting reaction. This is particularly true for the leg and foot muscles. Exercises that strengthen the muscles of the calf and of the thigh, and particularly such as require free movement of the foot, are almost sure to relieve these patients of many annoying symptoms. Pains around the ankles and in the knee and hip, worse in rainy weather, disappear as a consequence of such gradually increased use of these muscles as gives them increased nutrition and power. This subject is discussed more fully under [Foot Troubles] and [Painful Conditions of the Knee.]
There may be a training in bearing discomfort which is of great value to over-sensitive patients. Some nervous patients seem to suffer merely from their ordinary physiological functions. These are the patients who abuse the drugs that are supposed to bring relief. There is just one mode of treatment that is successful with them: they must be told to bear their discomfort for a while without seeking drug relief, but always securing freedom from discomfort by means of attention to other things, until gradually they have succeeded in diverting their minds from the concentration of attention on their functions which is causing their disturbance. The whole programme [{218}] need not be outlined to them or they will perhaps have a revulsion of feeling against it that will make its accomplishment impossible. They can, however, be made to stand their discomforts for a time with the promise that it is for the best, since there will be eventually an improvement.
Intellectual Faculties.—Nearly every one of our faculties can be trained to do much better work than we have any idea of if we only are willing to take the trouble and give the attention. I have often shown people who came complaining of loss of memory that if they wanted to train themselves to remember they could do so. The memory probably cannot be bettered any more than can the sense of touch in the blind man, but by attention to minute details, in the concentration of the mind on certain subjects, it can accomplish results that seemed quite impossible before. All systems of improving the memory are founded on this method of concentrating attention on what one wishes to remember and connecting it with other things that we know by experience are readily remembered.
CHAPTER V
OCCUPATION OF MIND
Two classes of patients frequently apply to physicians for relief from various discomforts. They are, first, people who have no regular occupation and who often are in what is supposed to be the happy position of being able to do just what they please. The second class consists of those who take their occupations too seriously, so that they never get away from them and, as a consequence, disturb their physical functions. The feelings that these two classes complain of—for, when analyzed, their symptoms prove really to be uncomfortable feelings—can usually be "bothered" away and, if not entirely forgotten, made to disappear when the patients become deeply interested in something other than their usual occupation. The first class of patients needs occupation of mind; the second needs diversion of mind, and that subject will be taken up in another chapter.
Uncomfortable Sensations, Their Location and Causes.—These pains and aches, as patients call them, though it is well to remember that they are only discomforts, senses of unequal pressure, of constriction, or perhaps only unusual feelings, or consciousness of sensation, may occur in every part of the body. Perhaps they are most commonly complained of in the head. Many of the so-called headaches that are more or less continuous consist of these senses of pressure or of constriction over a particular part of the skull. Sometimes there may be a sense of pressure at the back of the eyes. Very often there is a feeling of heaviness at the back of the head that makes the patient feel as if relief would come if the head were allowed to drop forward and if sleep could be thus obtained. Every other portion of the head, however, even within the cavities, may have some of these uncomfortable sensations. In some persons, there is a tightness in the throat. In others, there is a feeling of fullness of one cheek and the dread that they may not be able to use it properly in talking. Sometimes the uncomfortable feeling is within the nose. Not infrequently the discomfort is in the ear.