Physician and patient

by Worthington Hooker

CHAPTER XIV.
THE MUTUAL INFLUENCE OF MIND AND BODY IN DISEASE.[38]

Many seem to think that when the body is sick, it is simply a sickness of the body alone, and the mind has nothing to do with it. They do indeed allow that when actual mental derangement occurs in connection with any disease the mind is affected with the body; but they are prone to lose sight of the fact in all ordinary cases of disease, and yet it exists in these as really, though not to the same degree. The influence of disease upon the mind is obvious to the most careless and superficial observer, when he sees the delirium produced by inflammation of the brain; but such cases seem to him to stand out as glaring exceptions to what he considers the great general fact—that the mind is independent of the ailments of the body. Physicians themselves too often overlook the influence of mind in their treatment of disease, and the community generally have very inadequate views of its extent and universality. There can not be any sickness of the body, however slight, that does not produce some effect upon the mind, and which is not influenced either for good or for ill through mental impressions.

It is important in the management of the sick, not only that this fact should be kept clearly and steadily in view by the physician; but that it should be understood by the community, so that the efforts of the physician may not be thwarted, as they often are, by the attendants and friends of the sick, when he aims to act upon bodily disease by impressions made on the mind. And I refer not in this remark merely to impressions of this kind where the attempt to produce them is so palpable that the most careless observer would perceive it, but to all those influences which the physician is exerting upon the minds of the sick, in his daily intercourse with them. In truth, everything that he says and does in the sick room, is to be regarded as really a medicine, and producing as real if not as manifest effects upon the state of the patient, as any of the drugs that he administers.

It will be profitable, then, to the general reader, as well as to the medical man, to examine the influences which the mind and the body exert upon each other in sickness, the use which can be made of such influences in the cure of disease, and the abuse to which they are liable from the mismanagement of those who have the care of the sick.

Before doing this, however, it may be both interesting and profitable to look at the connection which exists between the body and the mind. There are various figures used to illustrate this connection. The most common one is that in which the mind is spoken of as dwelling in the body as a habitation. In a certain sense this is true. This tabernacle of flesh, as the Bible aptly terms it, is, in its present state a habitation, which the mind is to leave in a short time, to return to it, however, at length, rebuilt and refitted in a more glorious, an incorruptible form, to dwell in it then forever. But this illustration of the mysterious connection of the mind with the body is but a partial one—it does not express the extent nor the intimacy of that connection. The mind is not a mere dweller put into this habitation. Its union with it is not thus loose and easily severed. It is bound to its every nerve and fibre, so that the least touch of the body at any point affects the mind. Instead of being put into the body, it has, being thus interlaced, as we may say, fibre with fibre, grown with its growth, and strengthened with its strength. In the feebleness of infancy the mind is just as feeble as the body, and they both grow together up to the vigor and firmness of manhood, and both decline together in old age. So close is their union through all the stages of life, and so equally is each affected by the joys and sufferings of the other, that we might justly conclude that at death, when the tabernacle crumbles into dust, the mind falls with it never to rise again, had not a divine revelation told us that, indissoluble as this connection appears during life, almighty power will dissever it and release the soul from the thousand ties that bind it to its habitation at the very moment of its destruction. Were it not for this assurance of our immortality, we could look forward in the uncertain future to nothing but blank, drear annihilation, as awaiting our minds, just as it does the minds of the brutes that perish.

In our carefulness to avoid materialism, we are too apt to look upon the mind and the body as two separate and independent things. At death they do indeed become so, but who of us knows that they would, were it not for the fiat of the Almighty? Who knows that there is not a necessity for the putting forth of his power in each individual case at the time of death, to prevent the mind of man from dying with his body, just as the mind of the brute does with his? The very prevalent notion that the mind is essentially indestructible, and that it is put into the body as a separate thing, having the power of itself to leave the body whenever it dies, rests on no substantial proof. That it is destined thus to leave the body is quite another thing.

Materialists, of whom we are pained to say there are many among believers in phrenology, though they flatly deny it,[39] seem to think that the brain produces thought pretty much as the liver makes bile or the stomach gastric juice. This doctrine would be gratuitous, a mere supposition, even if there were no Christian revelation to contradict it. But while we discard all such anti-Christian and absurd fantasies, we must not run to the other extreme, as some good men have done. It must be admitted, that in this life all the manifestations of mind are not only connected with, but are dependent upon, a material organization. The nature of this connection and dependence is of course a mystery, but of its existence there is no doubt. So far as injury is done to the brain and nervous system, just so far are the manifestations or actions of the mind impaired. And, on the other hand, moral causes, acting directly upon the mind, affect through it the organization. And when insanity results from moral causes thus acting, it is not a direct effect, but an indirect one—the organization affected by the mind is thrown into a diseased state, and reacts upon the mind, influencing its manifestations. If the mind thus acted upon were a spirit, separated from the body, the result would be merely the feelings, which the motives applied would naturally produce, and not the unnatural feelings of insanity. It is not strictly proper then to speak of a ‘mind diseased.’

Let me not be understood to mean that mental derangement in every case is to be attributed to disease that leaves such palpable traces that the dissecting knife would reveal it if death were to take place. There are diseased operations in the body, that are hidden from our view—so hidden, that they not only leave no traces, but often develop no characteristic bodily symptoms.

Although the principles above stated are often overlooked, and sometimes doubted, or even denied, there are some cases in which they stand out so plainly, that everybody acknowledges for the time their truth. For example, if a man, by a blow on his head, has a piece of his skull pressed inward upon his brain, he becomes senseless, and, if he arouse at all from his stupor, his mind is obviously in an unnatural state. The surgeon raises the depressed bone, and thus taking off the pressure from the brain, restores the mind of the man to activity and sanity. In this case it is plain to every one, that the mental manifestations were suspended by a cause acting directly upon the material organization, and that they were revived again by the removal of this cause.

Take another example. A man of strong and clear mind becomes deranged, and at length arrives at perfect idiocy. He goes down to the grave in this condition. No one supposes that in such a case the mind is affected independently of the body, but the mental state is of course attributed to bodily disease; and affection fondly, and we may say rationally, cherishes the expectation, that when the mind shall be freed from this tabernacle of flesh, it will emerge from its long night of darkness, and possess again its faculties in full, just as the man who lies senseless from pressure upon the brain, is restored to mental activity when that pressure is taken off by the trephine and elevator of the surgeon.