Religion and Health — Chapter 13 Part 2 DREADS

A very usual experience is to find that a patient has as a preliminary suffered some injury.

This may not be very severe, but it is enough to cause the sufferer to spare the limb that is affected; and unfortunately physicians sometimes put a limb with a minor affection in plaster of Paris or in a splint for a time.

The patient's own solicitude with regard to the hurt may cause almost as effective splinting of it as a plaster cast or wooden slat and a bandage.

Whenever this happens, the unused muscles lose some of their nutrition.

This is due partly to the fact that the circulation is interfered with because the active contraction of muscles, especially of the legs, is depended on by nature to help the venous or return circulation by bringing about compression of the veins.

The valves in the veins are so arranged that when the {243} veins are compressed and the blood thus pressed out of them, it cannot move away from the heart but is impelled onward toward the heart.

Besides, the sending down of nervous impulses for the active use of muscles increases the size of the arteries to the part by direct action on their walls, and whenever there is failure to send impulses down, the arteries do not carry as much blood as usual, and the nutrition of the part suffers as a result.

If this inactive state of the muscles continues for a few days, they will become somewhat flaccid, and after a week or more will actually begin to decrease in size.

As a consequence of this, they cannot be used to as good advantage as before, and use of them sets up an achy condition as soon as the limb is set free for use, whether it has been splinted by the physician or by the patient's mind.

If the patient is still solicitous, he notices this condition of pain and concludes that it means that the muscles are not yet in the condition of health where they should be used, and he puts on the splints, metaphorical or literal, once more.

The muscles grow more flaccid and eventually atrophic as a consequence, until sometimes there will be a difference of more than an inch in the girth of two limbs at the same point, and this atrophy may proceed much farther.

It seems almost impossible to believe that men and women could thus make a limb useless, but this is actually what happens rather frequently.

The effects of the original injury will pass off in a few days, but the effects of the disuse of the limb may remain for months or even years because of the disturbance of circulation and of nerve impulse.

It is probable that the nerves themselves have a trophic or nutritional--that is, vitalizing--influence upon muscles.

Some physiologists actually talk of there being {244} trophic fibers in the nerves, though it would seem more reasonable to think that the nerve trophic effect comes from the modification of the circulation to the part.

Whenever muscles have to be increased in size or won back from an atrophic condition, the individual to whom they belong must go through a period of soreness and tenderness in those muscles which often is very hard to bear.

The young fellow who, after a rather relaxed summer, begins training for the football team in the fall, knows how sore and tender his muscles have become.

After the first day or two of training, each time he wakes up at night he turns over in bed with the feeling that every bit of him is full of tenderness.

Any number of people under similar circumstances are inclined to think that they must have caught cold.

They usually reason thus: "I got into a perspiration and sat down for a while and then took cold, and that is the reason for all this painful condition that has developed."

That word "cold" is as unfortunate as "shell shock."

There is no such thing as taking cold.

We catch infections, but much more frequently in fall and spring than in winter.

The young man who is in training usually pays no attention to such unfavorable suggestions or dreads, since he knows that he must take his medicine of further hard exercise until he has hardened and developed his muscles and then, instead of their causing discomfort, nothing in the world gives him so much satisfaction as their active exercise.

Older people, however, and especially those who have what may be called a "dready" disposition, do not call their muscle discomfort soreness and tenderness; they speak of pains and aches.

The very words carry a suggestion of evil with them, and above all they carry with {245} them an inhibitory suggestion which keeps muscles from being used normally.

If, then, certain older people get an injury, even though it may not be very serious, so long as it causes them to give up the use of a limb for a while, or sets them to using the muscles of it a little differently from before, a psychoneurosis on the basis of a dread, but with the physical basis of somewhat atrophied muscles to keep it up, may develop and persist for weeks and months and even years.

As a consequence of this state--much more of the mind than the body--men may walk lame or be very awkward in the use of one arm, or they may have a little stoop, or they may dread very much the using of some group of muscles.

Such conditions occasionally occur in the neck or in various parts of the back, and especially in the lumbar region, with strikingly visible effects.

It might seem impossible that such conditions should develop and persist for any length of time in sensible and above all intelligent people, and yet I suppose that every physician's case book contains a number of examples.

After he has been in practice for ten years or more this will surely be true, if he has had much to do with nervous patients.

One of the most distinguished scientists that we had in this country, possessed of one of the finest intellects of our generation, thoroughly sensible and noted for his executive ability, suffered from a slight attack of sciatica, to which he had been predisposed by some unusual work in connection with a heavy fall of snow when he had to go out and do the shoveling himself, since labor was not available.

He never quite got over it.

For some time he carried two crutches because he had so little confidence in putting down the foot on that side, after having spared it for a {246} while.

Then for several years he carried a single crutch.

In the meantime he was examined by half a dozen of the best physicians in the country, who could find nothing the matter with him except that disuse had rendered the muscles of that leg slightly atrophic, and he would have to push through a period of soreness and tenderness while exercising them.

He carried a cane ever afterwards, walked a little lame and favored that leg.

Persistent sciaticas of this kind and lumbagoes are much more common than they are thought.

It was a case of this kind, undoubtedly, that brought about Bernheim's interest in hypnotism at Nancy and initiated that wave of attention to hypnotism at the end of the nineteenth century which did so much harm.

A patient who had suffered from sciatica for some years and walked a little lame as a consequence came under Bernheim's care, and he tried without success every therapeutic resource at his command to make him better.

Finally his patient gave up calling on him, completely discouraged.

He had gone to a great many physicians before Bernheim, and all of them had failed to do him any effectual good.

They could relieve his discomfort for a while, but when he stopped taking drugs, that returned and his limb could be used no better than before.

Some months after Bernheim missed the patient from his clinic he met him on the street one day, walking perfectly straight without his cane and evidently entirely well.

He was so much interested that he stopped to ask what had cured him.

The patient told him he had gone around to Liebault, who, almost alone in Europe, was still practicing hypnotism, for the practice had been greatly discredited by certain exposures in England shortly after the middle of the century.

Bernheim, who had ignored {247} Liebault's work before, now took an interest in it and found of course that hypnotism--or indeed, though Bernheim did not know that, anything else that would give these patients the confidence to push through a period of tenderness and soreness in regaining the use of their muscles--would cure them.

The incident began that period of reawakened interest in hypnotism which now constitutes such a ludicrous series of events in the medicine of the end of the nineteenth century.

Such cases are by no means so uncommon as they might be thought.

I

have known the teacher of a high school to slip while coming out of school, fall on his knee, bruise it rather badly, and then have this bruised condition heal very well, only to develop in the course of a few weeks a distinct inability to use the muscles of that leg properly, until he had to walk with a marked limp.

The circumference of the limb above the knee reduced distinctly in size, it suffered more from cold than did the other one; it perspired more freely; it was distinctly more sensitive to the touch, and it would seem as though there must be some serious underlying nervous condition.

He passed through the hands of several specialists, including one who wanted to remove a cartilage in the knee joint which he said had been dislocated, and another who insisted that he was suffering from a neuritis of a branch of the sciatic nerve, and who wanted to inject water within the sheath of it or at least lay it bare and stretch it.

Fortunately we persuaded him to join an athletic club and take more exercise than usual and above all exercise that limb.

He had had massage and passive movements for it, but these are of very little service in these cases, because the nervous impulses must come down from above.

It would almost seem as though the {248} will sent down some of its own creative energy through the nerves which lead to the part.

He is now entirely well, though he suffered for several years, and absolutely nothing was done for him except to make him eat better and make him push through a period of soreness and tenderness--he used to call them pains and aches before we explained the condition to him--until he had properly recovered the use of his limb.

On the other hand, I have known a good clergyman with a rather similar condition to this, who had bumped his shin bone not far below the knee and after recovery from that had developed a marked psychoneurosis in the muscles above the knee, refuse to be cured by any such simple procedure as merely exercising himself back to health.

He could not bring himself to think that it was only his own lack of will power that had caused the condition to develop.

Above all he needed something external to cure him.

He finally went to a bone-setter, one of these old fellows who claim to be the seventh son of a seventh son, or something of that kind, possessed of marvelous hereditary power and instinctive intuition in the matter of setting bones right, and who cure nearly everything under the sun and a few other things besides by their supposed bone-setting processes.

My clerical friend was sure that he had been cured by the bone-setter, but any physician would have told him that what had happened was that his faith in his healer had released his inhibition of his muscles and given him the confidence to go on and use them as they should be used,--that is, of course, as far as he possibly could at first.

Then they were gradually restored to their former condition of health and strength.

That is what happened, and he has had no recurrence.

He is quite {249} sure, however, that the trouble was a subluxation of his hip joint, which the bone-setter set right, thus allowing nervous impulses and the blood to flow properly through the part once more.

His own will was the only obstacle and it was that alone that had to be overcome and used as a therapeutic agent.

These patients are the stock in trade of all sorts of irregular practitioners.

Whenever they think anything is the matter with them they must be "cured"; they never get better of themselves.

They need something or somebody to which to pin their faith.

It is the hardest thing in the world to find out what is the matter with a man who has nothing the matter with him except a state of mind and its consequences in his physical condition.

He must have his state of mind changed first of all, and usually he requires some rather strong suggestion for that purpose.

What is likely to affect him most favorably is some novel or unusual method of treatment, or some new discovery in science recently applied to medicine, or some new method of healing, or some supposedly new invention or discovery in therapeutics.

These patients are a veritable nuisance in medicine.

It is the cures of them, made by all sorts of new-fangled remedies, which make it so difficult for physicians to judge whether a new remedy has a positive favorable physical effect or only a mental influence.

Very probably the best appreciation of the place of dreads in life and how much of good is accomplished by their neutralization can be obtained from the number of sufferers of all kinds who are cured by all sorts of new remedies which prove after a time to have no physical effect at all.

We have discussed this subject of the {250} remedies that have come and gone in medicine in the volume "Psychotherapy."

It has been very well said that the most important chapter in the history of medicine is that of the cures that have failed.

It illustrates very thoroughly how much influence the mind has over the body, and particularly how much dreads have meant for the production of symptoms which have been relieved whenever the patient had his dreads lifted, no matter what might be the agent to accomplish this purpose.

Instead of decreasing, dreads have increased just in proportion as popular education has spread and more people have been able to read and receive unfavorable suggestions of all kinds.

This has been particularly true with the diminution of the influence of religion over people's minds.

All sorts of religious substitutes which would give people enough confidence in themselves to enable them to throw off their dreads have gained vogue and have come to be very popular institutions in recent years.

Dowie, who claimed he was Elijah returned to earth, and Schlatter, who said that he was divinely inspired to cure people, were as successful in the twentieth century as Greatrakes "the stroker," who said that the Holy Ghost appeared to him in a dream and told him to heal people, in the seventeenth.

Metaphysical healing of all kinds has been successful, and spiritualistic healing and new thought and magnetic healing, with as little magnetism about it as Mesmer's famous battery which had no electricity,--all these have cured people.

All sorts of healers are successful just because they lift the dreads and make people forget the inhibitions that they have been exercising over their functions.

Indeed this state of fear thought is one of the most prolific sources of {251} symptoms, or rather let us say of complaints, that medicine has to do with at all times, hence the importance of the chapter of the cures that have failed.

Almost any religious feeling will be helpful in the matter, but an abiding sense of rational religion will save many people from being imposed on by all sorts of upstart theories and religious systems which base their claim to recognition on these cures of human beings.

These patients furnish a great many of the cures made at shrines.

That is why at every shrine there are so many crutches and canes and braces and belts and splints and supports of various kinds to be seen.

They have been left there by grateful patients who were able to drop them as the result of the change of mind that came over them during their devotions.

Many cures besides these occur at shrines, and I have taken a good deal of pains to assure myself that most of the affections that are healed at them are quite different from these psychoneuroses.

Over sixty per cent of the cures made at Lourdes, for instance, are of tuberculosis processes.

Many of these are of external visible lesions.

Some of them, after years of progress in spite of all sorts of treatment, heal over in the course of twenty-four hours.

I have seen this happen to a lupus, at Lourdes, during my stay there, and I do not know how to explain that incident by any natural process.

To me it seemed surely supernatural.

I know that there are some physicians who suggest that we do not know all the possibilities of the therapeutic effect of the mind on the body, and somehow there may be included in the psychotherapeutic armamentarium the power to heal tissues rapidly, even when they have been the subject of a chronic granulomatous process for years, but I cannot but think that is {252} merely an effort to retain what seems to me plainly miraculous within the domain of the natural.

I know too that Doctor Boissarie's experience, so carefully noted and written out in his clinic at Lourdes, shows that there are cases of real joint trouble which have been cured with similar rapidity, but these are very rare.

Most of the halt and crippled who are cured at shrines have simply been the victims of an attitude of mind which has affected their muscles and their use of certain joints unfavorably, so that they had to carry crutches or canes or wear braces.

The deep influence of religion will cure them very often, but it is not a miracle in any supernatural sense of the word, though it is a wonderful event, and that is all that miracle means by etymology.

Indeed, professors of neurology have occasionally foretold that certain of these patients would perhaps be cured at shrines, and their prophecies in specific instances have been fulfilled.

The cures are examples of what faith can do in lifting a dread, but that faith may be exercised with regard to much less worthy objects than are presented at shrines and yet work successfully.

When George Cohan, in the "Miracle Man", had the cure that attracted attention to the "new prophet" occur with regard to a lame boy, he was eminently wise in the selection of just the type of case that could very readily be cured that way, and yet the fact that the boy had been lame for years and now walked perfectly made the healer seem a veritable wonder worker.

Dreads have always been with mankind, and their effects upon human bodies have been the stock in trade of the medicine man in primitive tribes and among savages and of his successors in suggestive medicine among educated and even cultivated people down to our own {253} time.

They can be conjured away by almost any impression that is deep enough to produce a favorable suggestion.

Religion of all kinds has been appealed to successfully to neutralize them.

The one rational cure for them is a deep sense of confidence in the Almighty and in an overruling Providence which serves to dissipate the phobic state of mind with its inevitable inhibitions on bodily functions.

It may be necessary for its successful working that the correction of many minor physical ills should be secured, but the all-important basis of successful treatment for the psychoneurosis and the many ailments of mankind which are complicated by psychic states is a thoroughgoing belief that God is in His heaven and all is well with the world, even though there may be difficulties to be overcome, hardships to be borne, and many things that are far from easy to understand.

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