The Modern Malady

I HAVE been requested to write a Preface to the “Modern Malady,” and I have pleasure in doing so, as it seems to me that the author, with whose views I am in general agreement, has adequately and successfully carried out a work, not over easy, but certainly wanted—i.e., an introduction to public consideration, from a non-medical point of view, of a condition of ill-health which is increasingly prevalent in all ranks of society; which is as common in the slums of the East End as in the mansions of the West; which incapacitates innumerable people (both men and women) from the efficient discharge of the duties, and from the proper enjoyment of the pleasures, of life; which undoubtedly often owes its origin to injudicious medication; which is quite capable of cure in certain ways which are not those generally adopted; and which is still more capable of prevention.

The condition is technically called “Neurasthenia,” or “nerve-weakness.” This is but a generic word, a convenient designation for a condition of the nervous system, the symptoms of which vary widely; but beneath all these symptoms, various as they may be, there is as their foundation a condition of nerve-prostration and fatigue; and a permanent removal of this condition is only brought about by keeping in mind a recollection of its origin and directing treatment to the fons et origo mali; by repairing, if only slightly damaged, by building up, if shattered, this unfortunate nervous system. This state of ill-health used to be called “Hysteria,” a name derived from an erroneous idea that there is a special connection between the disease and a particular organ of the body. It was even once thought that this organ moved about to various parts of the body, and so caused the local symptoms; and various nauseous drugs were given for centuries, on the theory that by their offensive taste they would drive the wanderer back to its proper place. It is also popularly supposed that “hysterical” people simulate their symptoms and can control them if they wish. Both of these views are quite wrong. The disease is a real disease, as truly a disease as is a fever or an attack of bronchitis, and it is found in men as well as women. In this connection I would ask, with Cyril Bennett, “Do the majority of people know that they possess a nervous system at all? We still hear educated persons talk of their nerves as if they were something spiritual, as though nervous disorder were not a physical disease.”

We should remember that the nervous system is one continuous structure, and it is only the necessities of nomenclature and the ingenuity of anatomists that have divided it into so many parts. It is as continuous as is an oak tree with its various branches. The spinal cord and the nerves are composed in varying proportions of the same materials as is that part of the system which we call the brain: injury and disease with them give rise to symptoms analogous to similar injury or disease to the brain. Indeed, there are several brains,—some in the cord itself, one in relation with the stomach and called the “abdominal brain,”—but the intellect and perception reside only in that portion of nervous material which is confined within the skull; injury there—in addition to the symptoms common to injury in other parts—influencing intellect, perception, and memory; and this is the only distinction.

Neurasthenia is especially prevalent, not only with members of certain families (we all know people peculiarly liable to suffer from the “nerves”), but certain races are more prone to it than others—the French and American more than ourselves; and this fact must not be lost sight of, nor the fact that the relatives of many of these patients—probably afflicted themselves with a latent form of the same condition—are frequently but ill-fitted to help the patient to recovery, so that a temporary removal from their care is sometimes advisable.

But prevention is better than cure, and this is best secured by healthy hygienic, physical, mental, and moral surroundings,—by bestowing upon the growing human plant a share of as intelligent a care as the gardener bestows upon his grapes and his peaches; by no undue forcing, by no undue straining, and by no undue school pressure; but by bodily exercises in proportion to the strength of the body, and progressively increased as the strength of the body increases, and by mental exercises equally proportioned to the increasing mental strength, and not forced beyond it; for the exercise of nerve-power is as fatiguing as that of muscle-power, brings on the same feeling of exhaustion, and requires the same recuperation by adequate food and rest.

So much for prevention: but when the nervous system has broken down—when the symptoms may vary from extreme mental and physical exhaustion to that condition of what has been called “Death-trance,” where the patient is apparently dead; that condition which has furnished the theme for many a sensational story (but the most ghastly incidents of fiction have been paralleled by authenticated facts)—then treatment comes in. The less physic-drinking the better. As the late Sir William Gull said, “Medicine was once given even for fractures. Disease is not cured by drugs. It is the power of Nature that cures disease, and the duty of the medical man is—not to give drugs—but to assist Nature.” So spoke Sir William Gull; and Lord Coleridge, deciding a law case not long since, said, “If you give a man drugs, you make him the arena of a conflict of opposing poisons.”

The first thing to do, is to try to remove whatever defect in the general health can be discovered. Then local treatment should be had recourse to. One method of such treatment is that perfected by Weir Mitchell of Philadelphia, and extensively carried out in this country by Playfair, myself, and others. Stated generally, it consists, in severe cases, in keeping the patient absolutely at rest in bed, and obtaining the tonic influence of exercise by daily massage and electricity,—i.e., skilled rubbing and kneading of the muscles, and putting them in action by electricity. At the same time abundant food is given in an easily digestible form. By this method the wearying effects of fatigue are avoided and patients often recover rapidly. Skilled massage and electrisation are essential. Without these, rest in bed will probably convert the patient into a helpless invalid. This method has been carried out extensively, and with marked success, for several years past, at the West End School of Massage and Electricity, 67 Welbeck Street, some of whose students have been sent to the Continent, India, and the Colonies, there training other nurses, and becoming new centres of usefulness.

But while upon this subject of massage, I would enter my earnest protest against what is called “isolation,” and especially against any attempt to “manage” a patient. As Cyril Bennett wrote in a former work, when a doctor and a nurse think they are “managing” an invalid, nervous, suffering woman, you may depend upon it that in nine cases out of ten they are mis-managing her. The best physicians of the day are remarkable, not more for their medical knowledge and skill, than for their charm of manner, their human kindness, their warm sympathy with suffering. The wise physician is the family friend, the trusted adviser, the counsellor and comforter in many a trouble and anxiety: and so also with the nurse. She should possess the sensitive rather than the strong hand, and refinement, patience, tact, and sympathy.

In certain cases of nervous disease, great benefit is derived from the use alone, and without massage, of the variety of electricity called “Franklinism,” after the illustrious philosopher and statesman who so carefully studied it. We have all heard the story of the thunder-cloud, the kite, the key tied to the kite-string; Franklin’s disappointment that he obtained no electricity; its coming on to rain, and by wetting the string making it a conductor; and his delight at being able to draw sparks—real miniature flashes of lightning—from the key with his knuckles. This form of electricity has been little used until a short time since, owing to certain inconveniences in its application; but recent improvements in the manufacture of instruments have largely removed these inconveniences, and placed at our service a remedy of great promise, and in some cases of unequalled value.

The thanks of the medical profession are due to “Cyril Bennett” for a sagacious, though not unkindly, criticism upon the more common methods of treatment of that distressing affection, the “Modern Malady;” and in indicating from a medical standpoint the opinions of a neurologist, I venture to hope that the views of the author, who has so skilfully sketched its salient features, may have received some support.

Finally, I would say that the day for the routine treatment of disease has gone by, and progress of the most important character is being made in the study of diet, exercise, sleep, rest, the application of water, cold and hot, and many other agencies; and it has been well said that if in the future, as in the past, nervous diseases are to be the measure of our civilisation; if every increase in the illuminating power of the mind is but an increase of surface to be eclipsed; if all new modes of action of nerve-force are to be so many added pathways to sorrow; if each fresh discovery or invention is to be matched by some new malady of the nerves; we yet have this assurance, that science, with keen eyes and steps that are not slow, is seeking and is finding means of prevention and relief.

HERBERT TIBBITS.

IN the first part of this work I have dwelt on the errors in our mode of treating Neurasthenia, consequent on the wide ignorance of the subject which still prevails; in the second part, I have drawn attention to the principal causes of the malady. The allegory forming the Introduction to Part I. gives a brief history of nervous exhaustion and the modes of treatment which have at various times been thought suitable to this most painful and trying disease.

A friend, to whom I read the Introduction, criticised the quotation with which I have concluded it. She objected that I thereby gave too high a place to mere knowledge. I replied that I referred to the highest kind of knowledge. This argument, however, fails to satisfy those who persistently remind one of Eve’s transgression. In my humble opinion, the point of that great and instructive history has always been missed. Adam and Eve were cast out of Eden for eating of the tree of knowledge, but if they had not been cast out of Eden, how could they have been received into heaven? It was necessary to eat of the tree of knowledge in order to desire to eat of the tree of life.

Again, before we can even desire to eat of the tree of knowledge, we must be ignorant; and thus we see our ignorance itself to be a needed stage in our upward evolution. We see in a glass darkly; we must become fools that we may be wise. In our imperfect condition we do but catch brief glimpses and fleeting shadows of the one mighty Truth. Just as our nervous system must waste that it may be nourished, as the pendulum must fall on the one side that it may rise on the other,[1] so must our ignorance precede our half-knowledge, and our half-knowledge precede the fuller revelation.

It is almost needless to add that I am oppressed with a sense of my own incapacity for the task which I have here undertaken. But the most ignorant may teach something to the most learned, if he go through life by a different path. My only hope is that, in dealing with a subject about which so little is known, even my observations—conscientious as they are, however faulty—may be of some slight use to the community to which I owe so much.

In preparing this work for the press, I have had the advantage of Mr. Horace Hutchinson’s kind and generous assistance.

C. B.

	———
PART I. Our Nerves and their Ill-Treatment.
CHAP.		PAGE
I.	INTRODUCTION	23
II.	A THIEF IN THE NIGHT	37
III.	INEFFECTUAL TREATMENT	47
IV.	ERRONEOUS NOTIONS	70
V.	OBSERVATION	85
	———
PART II. The Causes of Neurasthenia.
VI.	INTRODUCTION	101
VII.	HEREDITY	104
VIII.	IMPERFECTIONS OF OUR SOCIAL SYSTEM	121
IX.	AN IMPERFECT SYSTEM OF EDUCATION	142
X.	SECONDARY CAUSES OF NERVE-DETERIORATION	161

 

 

 

Dedicated

TO THE

MEDICAL MEN, NURSES, AND OTHERS,

WHO, BY THEIR GENEROUS ASSISTANCE,

HAVE SO LARGELY CONDUCED TO THE SUCCESS OF THE AUTHOR’S

LABOURS

AMONGST OUR EPILEPTIC AND NEURASTHENIC POOR.

ONCE there lived a race of men blest with very strong eyesight—so strong that they were unconscious of possessing sight at all, but accepted their marvellous endowment as a matter of course. These men were hunters, who lived on the birds and beasts they shot with their bows and arrows.

After a time our hunters learnt other arts besides that of the chase; various implements were invented; industries such as spinning and weaving were established; the primitive huts and sheds were discarded, and commodious dwellings rose in their place. But their progress was not unattended by serious disadvantages. For instance, the weavers, who passed a great deal of their time indoors, began to lose the strength and keenness of eyesight enjoyed by those who followed the chase.

At first little attention was paid to this calamity, but when some of the weavers went blind and became a burden on the rest of the community, a meeting was convened in the council-chamber called Public Opinion, the most influential members of the tribe were consulted, and certain conclusions were arrived at.

To be brief, it was decided that the malady in question was nothing more nor less than a special manifestation of the Evil One, and that the prompt execution of the sufferers was the only sure means of preventing the spread of his power. It was therefore decreed that these uncanny and mischievous weavers should at once be put to death. To ensure the conviction of all suspected parties, a mode of trial was ordered which had the advantage of being as efficacious as it was painful. So everything seemed to be made quite safe and comfortable, and the spirits of the tribe improved.

In spite of these excellent arrangements, however, some of the invalids contrived to escape the doom thus thoughtfully prepared for them. It so happened that certain of the community, who had not been invited to vote at the meeting, held firmly to the belief that, so far from being possessed by the Evil One, these dreaded weavers were divinely inspired. Just because those whose sight was impaired could not see to do the work which was close to their eyes, their advocates credited them with the ability to discern things which were beyond the range of the most powerful vision. They therefore protected the sufferers from trial and honoured them with superstitious awe.

The disabled weavers had themselves done much to promote the conflicting beliefs concerning them. When forced by growing blindness to abandon their trade, they had been glad enough to make a livelihood by seemingly exercising their supposed supernatural vision, and thus to escape from reproach on the score of idleness; not anticipating that they would but lay themselves open to suspicion of demon-fostering. In fact, they were often self-deceived, for the disease exercised a peculiar effect on the optic nerve, causing them, when they closed their eyes, to see before them a variety of colours and forms which had no objective existence, but which they frequently mistook for Divine revelation.

Time passed on. Notwithstanding the extreme measures taken to extirpate the malady, it spread widely and increased in severity. Again the matter was investigated, and again a meeting was convened.

This august assembly took a different view of the state of affairs from that which had decreed the death of the sufferers. The former enactments were repealed. Indeed, they were declared to be barbarous and unworthy of the community which had so long tolerated them. With singular unanimity it was agreed that the sufferers were really afflicted with some incapacitating disease, the nature of which it was impossible to discover, and for which it was vain to seek a cure. It was supposed to originate in obscure injuries to the arms and legs, but on this point there was difference of opinion. It never occurred to anybody that the malady could have anything to do with impairment of the sight.

The ultimate decision of the court was to the effect that the suffering weavers were to be relieved from the necessity of working for their bread; that they should be permitted to remain a burden on the community; that they should be kept within doors and tended as cripples, and that surgeons should visit them and bandage their legs and arms.

These changes met with universal approval. The more humane members of the tribe, who had shuddered at the former barbarities, were convinced that the millennium had arrived, while the sufferers themselves accepted their fate willingly enough. For though it was dull work to be kept indoors with bandaged limbs, it was infinitely preferable to the hatred and scorn of those around them, to say nothing of a violent and painful death; and though many of them at first wished to use their limbs and to take exercise in the open air on the days when there was no glare to hurt their weak eyes, inactivity was less irksome than constant and futile efforts to fulfil their tasks.

So, at first, every one was contented with the new decisions. True, all the sufferers died sooner or later in a crippled condition, after a more or less miserable and monotonous existence; but this unhappy result was regarded as inevitable, and no further cure was sought for. Even the invalids themselves came to attribute their bodily helplessness to their original complaint, and not to the total disuse and tight bandaging prescribed by the court.

Years went by, and brought no relief either to the disabled weavers or to those who maintained them. On the contrary, the disease continued to increase with frightful rapidity. All classes of the community—which had, for the most part, abandoned its outdoor pursuits—were attacked in turn. Further investigations were made as to the cause of the calamity; a third meeting was convened, and definite conclusions were arrived at.

These, in some respects, showed more knowledge than the conclusions of the second meeting. At the same time they showed less humanity. It seemed as though the pendulum of human feeling had swung violently in the direction of intolerance, then in the direction of tolerance, returning once more, not quite to its former position, but to one far beyond the mean of wisdom and moderation. Possibly the pendulum, in its oscillations, would repeatedly pass and repass this mean point, till its range should grow more and more limited, and it should at length find repose.

The third meeting fully recognised many of the follies and absurdities of its predecessors. Powerful speakers and keen investigators argued with great force and clearness that the incapacity of the sufferers arose entirely from disuse of the limbs, and not from disease. By some of the speakers, this disuse was attributed—with a singular momentary forgetfulness of past decrees—to the wicked deceit of the idle, and of the friends who had solicited public charity in their behalf. The whole community—so these excellent, well-meaning members insisted—had been systematically gulled by the devices of impostors. There was nothing in the world the matter with the disabled weavers and those whom they had infected by their example. They must be forced to behave as if they were well, and well they would become. No doubt their eyes were weak. Whose eyes would not be weak after years of confinement within doors? Blazing sunlight and constant use of eyes and limbs would soon cure their fancies, and these infallible remedies must be prescribed for them at once.

Such cogent common-sense arguments could not but meet with the approval they deserved to meet with in the minds of the common-sense people who heard them. The recommendations of the speakers were promptly adopted.

And now ensued a very singular state of affairs. By command of the court, all invalids disabled by no visible and well-known disorder, were forced to rise from their couches, to drag themselves about in the blazing sunlight, and even to resume their former occupations. Some of them, however, succeeded in simulating well-known disorders of the limbs so cleverly, that they were considered, even by skilled investigators, to be victims of chronic disease, and were mercifully left alone. Others had already been partially cured by the complete rest from their labours they had long enjoyed, and though the rough treatment they received, and the trying effects of sudden exposure to light, caused them great discomfort, they now learnt for the first time that they had recovered the use of their eyes—long incarceration in dark rooms having prevented their discovering the fact sooner. This result, however satisfactory to themselves, was a source of infinite misery to their companions in affliction, for it was hastily assumed that a mode of procedure which had proved in the main efficacious with a few, must prove equally efficacious with all.

True, some of the patients went altogether blind the moment they were interfered with, and had to be conveyed to the blind asylum—in accordance with the custom of the country—to be kept there for the rest of their lives at the public expense. Some even developed real diseases of the limbs, in consequence of their unaccustomed efforts to take violent exercise. But these occasional failures by no means daunted the resolution of philanthropic legislators. How could there be such a thing as disease of the eyes while their own eyes were strong? With blindness they were unhappily too well acquainted, even though they had never been blind themselves; for when a man could not see at all, the fact could readily be ascertained. But it was evident that so long as a man could see, he was not blind, and therefore to treat him for loss of sight would be absurd.

The larger number of those for whom work and sunlight were prescribed neither lost their sight completely nor recovered it sufficiently to perform their allotted tasks in even the most perfunctory manner. The existence led by these unhappy people was miserable in the extreme. Every effort to use the eyes was painful. The glare of the sunlight was a torture baffling description. And their sufferings were not physical only. Their fellow-men, including their nearest and dearest friends, did their utmost to convince them of the illusory nature of their disease, and continually implored them to exert their wills to overcome temptations to imposture. By the more unfeeling, sneers and reproaches were not spared. In sheer despair the less courageous of these unfortunates died by their own hand.

Oddly enough, those who were the most uncompromising in their discouragement of supposed impostors had themselves recently become painfully conscious of impairment of vision. Fear of discovery made them loud in denouncing others; ignorance of the nature of the malady gave them hope that work and sunlight might conduce to their own cure. In time, there were in that eccentric community an abundance of deceivers of two different orders: the first pretending an illness other than that which afflicted them; the second pretending to be well when they were ill. It is said that the second class was larger than the first, and that recruits were continually swelling its ranks.

Altogether, in spite of the well-intentioned efforts of the investigators, the state of that tribe with regard to eye-disease was very much worse than it had been while the regulations of the second meeting were in force.

But, as the night is darkest immediately before the dawn, so, just as things looked blackest, there came a change for the better. It chanced that certain patients suffering from injuries to the limbs found their eyesight much affected by the illness, and were rashly credited with imposture. The injuries were declared to be wholly imaginary, and the usual moral discipline was resorted to in order to cure the patients of their delusion. Consequently, some of them were hopelessly crippled, while others, who ultimately recovered the use of their limbs, were blind for the rest of their days.

And now there was a panic in that hitherto contented community. Fears were entertained that real disease (eye-weakness was not yet regarded as actual illness) should frequently be overlooked in the midst of the general craze for extirpating imposture. The continued increase in the number of mysterious invalids occasioned anxious questioning on all sides. The crippled patients seized the opportunity to complain loudly of the usage they had received. Notwithstanding the remonstrances of the more fortunate, they insisted on repeating, to all who would hear them, the whole category of their woes. They never tired of declaring that they had been cruelly and unjustly crippled, and that the eye-weakness with which they had been temporarily afflicted was a terrible and unmistakable malady, more painful even than injuries to the limbs, and more urgently needing rational treatment.

So overwhelming was this evidence, so vehement were the witnesses, that public attention was perforce called to their grievances. Further investigations were made; further inquiries were diligently prosecuted; and a fourth meeting was convened.

That meeting is still going on. Day after day the discussions are resumed; day after day final judgment is deferred. The causes, nature, and cure of the alarmingly prevalent eye-disease are all earnestly debated. The ultimate decision of the court cannot be doubted. Sooner or later it will be recognised that the great epidemic is a disease like any other, to be treated with kindly consideration—to be cured, to be prevented. Learned investigators, while admitting that their examinations can discover no trace of disease in the eyes of the sufferers, admit likewise that their failure is no argument whatever against its existence. Pending the final judgment of the court, all former cruel enactments have been repealed, and over the door of the council-chamber have been inscribed these words, “Ignorance is the curse of God. Knowledge is the wing on which we fly to heaven.”

OUR life and progress may be aptly compared to the passage of collections of particles through a fine sieve. The particles that will not crumble are inevitably cast out, while those that succeed in passing through it are rendered finer in the process. It would perhaps be apter still to say, that we are passing continually through a series of sieves, some coarse, some fine, and that the particles which survive the ordeal, though refined in their passage, are perpetually losing something they possessed before. Whether this be an advantage or a disadvantage to them depends on the nature of that which is lost. Those who survive the longest, in spite of constant paring and shaping, fitting them for still finer passages, must have had their sieves carefully graduated for them, each preceding sieve fitting them for the next in order of progression.

Just as it is not the loudest things that have the most substance, so it is not the largest things that contain the most power. We are told that there is sufficient force holding together the particles composing a single drop of water to make a whole flash of lightning. In the same way, there may be more force concentrated in a small portion of the nervous system than is diffused throughout all the rest of the body. And our progress through the sieves may be a condensation of great forces into our small compass. Leaving the matter of mere size of body out of the question, one man of coarse organisation (A) may possess more physical strength than a man of fine organisation (B). But B may rule the world while A is a nonentity. B may, by means of his superior mental capacity, subdue the powers of Nature to his will, and thus be master of a force compared to which A’s physical strength is as a drop in the ocean. B’s complex nervous system is the storehouse of a tremendous energy.

Now, though we have been shaped in the past by sieves over which we have had no control, we are nevertheless conscious of having acquired some power of selecting and shaping the sieves of the future. Whether or no our action in the matter is predetermined by the shape already given us, the fact that we possess this power is indubitable.

In our age it would seem that we have arrived at a sieve that is either exceptionally small or of an exceptional shape. Numbers of particles are just now being rejected, not necessarily suddenly, but often subsequent to unusually protracted, painful, and futile efforts at forcing a passage through.

The question arises, Is this state of affairs inevitable? Have we not power to graduate our sieves more effectually? And granting this power of selection and modification, is it not possible that the sieve through which we are endeavouring to force ourselves may be ill-shapen, and calculated therefore to occasion needless destruction and deformity?

In some mode or other, we are all of us constantly considering this problem. Pass through the sieves we must, if we would survive. The process seems never-ending. We may be able to select or modify our sieves, hurry our progress or retard it, but we can neither stand still nor turn back. If we cannot or will not fit ourselves to the sieve, or if mankind, by their combined action, cannot or will not fit the sieve to us, then we must be cast out.

This casting out, if sudden, we term death; if slow, disease and death. We have habituated ourselves to regard life and health as natural—death and disease as unnatural if premature; but for our mode of thought in the latter case there seems little justification. The process of disintegration that we call disease is wholly natural. The result of two opposing forces is the path of our planet in space; the result of two opposing forces is our life. Let either force gain the ascendancy, and our life goes, or begins to go.

Sooner or later, then, we must be rejected from a sieve. But our early rejection and our late rejection are two very different matters. Our sudden rejection or our slow rejection are two very different matters also. Disintegration is always going on, but if we absorb sufficient nutriment to repair the waste adequately, we are in health. If, owing to disease of any part, the waste is more than we can repair, one of the opposing forces has gained the ascendancy, and death has begun.

We justly regard this slow death in life as a most terrible fate: we will do anything to avert it. To death itself we may be resigned; to some it is an escape from suffering; by some it is regarded as the entrance to a higher life. But all alike shrink from the prospect of dragging out long years of pain and hopeless misery in the sick-room. And just as we are becoming better acquainted with the causes and prevention of disease in various forms, one form of it has recently spread in our midst to an alarming extent, our ignorance of its nature and origin rendering us powerless against its incursions.

Nervous prostration encounters us on all sides. It finds victims in all classes of life. It has come amongst us like a thief in the night.

Disease, like any other adversary, finds out the most vulnerable part. The most vulnerable part of our machinery is that about which we are most ignorant. We are lamentably ignorant about our nervous systems; our adversary, repulsed in other quarters, effects an entrance there. It is far more difficult to expel him when once he has made his abode with us, than to fortify the stronghold against him. Prevalent as this particular form of disease is at the present moment, that is not the worst of the evil. It is alarming and disheartening to be told that it is still on the increase; but such is nevertheless the fact.

Professor Huxley very wisely says, that Nature gives us a blow and leaves us to find out its meaning. More than that, she never stops giving us blows until we have succeeded in doing so. It must be candidly admitted that we are inexpressibly dull and require many very hard knocks, and that when some one else is knocked and not ourselves, we are apt to be extremely heartless.

It is only lately that the majority of non-medical people have become conscious of possessing a nervous system at all. We still hear even educated persons talk of their nerves as though they were something spiritual—as though nervous disorder were not a physical disease. Such inexcusable ignorance leads to shadowy, pernicious ideas about the impossibility of curing the malady, or, supposing it to be regarded as curable, to the adoption of cruel and fantastic methods of treatment. If only we were forced to have all our remedies tried on ourselves before trying them on others, patients would henceforth have a better time of it. Unfortunately, many supposed remedies which are not unpleasant to the healthy are torture to the diseased.

I regret to say, that I still come across people who regard nervous prostration as sheer wickedness and obstinacy on the part of the sufferer. Indeed, I have even heard the grace of God and a change of heart talked about by excellent women as the only cure for cases that had come under their notice. Far be it from me to underrate the power of any good influence; but you have only to suggest that asthma shall be treated by spiritual influence, and you will find that the good folks regard you as a lunatic or as a profane person. Asthma being undoubtedly a nervous disease, these distinctions are a little puzzling. I have even heard of church-going being suggested as a remedy for nervous excitability, regardless of the ventilation of the building, the length of the sermon, and the tunefulness of the singing. Now, with all due respect for church-going, I sometimes cannot help regretting that the friends and advisers of the nervous do not believe in charms, like the Neapolitans. If charms do no good, at all events they do no harm; and if ignorant superstition must find vent, it is well if we can, at least, render it innocuous.

The spiritual treatment of the diseased is nothing new; on the contrary, it is hallowed by ancient custom. Anna of Saxony, the insane wife of William the Silent, was shut up by her father in a miserable room, and by his orders preached to daily, through a hole in the door, by a minister of religion. But perhaps the poor lady suffered from insomnia! Unfortunately the preaching proved ineffectual, for she died raving mad.

An intelligent Italian gentleman, interested in the case of an English friend suffering from nervous prostration, once endeavoured to console him by saying that, in his opinion, it was only clever people who suffered from nerves. Stupid people had the same things the matter with them, he said, but they were too stupid to find it out. An original notion, certainly. Unhappily, however true it may be that we lack the wits to diagnose our ills, I know of many persons belonging to the labouring classes who could scarcely be considered clever even by their best friends, yet who are not only afflicted with the universal malady, but are painfully conscious of the fact. Indeed, no rank or occupation secures immunity from the visitations of our modern foe. In these days of ready communication and rapid rise and fall of families, influences affecting one part of the community quickly affect the whole. True, certain conditions may be more fatal to fine organisations—to the noblest and the best, to the most useful and the most intelligent—than to the ill-developed; but of this more hereafter.

When I see people dropping out of the ranks one after another, each probably having been confident that to him, at any rate, the disease would never come, I am reminded of De Quincey’s “Klosterheim,” where citizen after citizen was stolen away by the unseen foe. We understand so little of the causes of these break-downs, that we will not be warned in time; our partial but growing weakness is so gradual, that we become accustomed to it, and think that nothing worse will befall us; and yet the final collapse is often so sudden, that it at last comes upon us unawares, and our total prostration is a surprise to ourselves. Perhaps some shock or accident is blamed for the disaster, the long period of weakness preceding it being ignored; or we fall a victim to some well-known illness, and regard it as the judgment of Heaven, which we were powerless to avoid, instead of telling ourselves that we might have avoided it, and ought to have avoided it, by acting wisely in the first instance, and fortifying ourselves against its inroads.

WE are most of us so far enlightened concerning our nervous systems as to regard our nerves as a very useful means of communication between the various parts of our machinery. The network of telegraph wires in this country, with their chief offices, have frequently been compared to our network of nerves with their chief offices, the brain and the spinal centres. Yet this comparison gives a totally inadequate conception of the functions of the nervous system. Many of us fail to realise that not only do the nerves bear messages from one part of the machinery to another, but that, without their co-operation, we can receive no impressions from the outside world at all, and can perform no function whatever. Without their aid, the eyes and ears are valueless, the muscles refuse to do their work, the digestive and respiratory processes cannot be carried on. If the nerve-centres are seriously injured, we become paralysed or die. If they be impaired, the whole body is enfeebled, and disease or incapacity of some particular organ may be occasioned.

But, we may ask, how does it come about that, without external injury of any kind, the nervous systems of good people, leading good lives and given to good works, become impaired wholesale, and often remain impaired in spite of all efforts to restore them?

Medical men tell us that, in such cases, the waste in the body exceeds the nutritive supply; but this assertion may be made with equal truth in regard to diseases of a different order, and, unfortunately, increase of the nutritive supply does not necessarily cure nervous exhaustion; it is the actual nerve-waste that we have to put a stop to. Even where a patient has purposely starved herself, mere feeding up does but bring her back to the point at which she began to starve. And if we could know the truth (if we would even try to know it), we should probably find that loathing of the food, and incapability to assimilate it, were the beginning of the seeming craze which, singularly enough, seems to afford so much amusement to the average nurse. We therefore still have the original disease to tackle. A long series of observations have convinced me, that though this original disease is not often satisfactorily cured, it can be cured, and ought to be cured. The reasons of so much failure seem to me to be evident enough, and later on I hope to state them fully.

Let me give some interesting and instructive instances of failure.

A few months ago I was told that a remarkable cure had been effected by means of a well-known treatment, in which isolation, massage, and electricity were the chief agents. I accepted an invitation to meet the patient—a lady—at a friend’s house, and on asking for details of the case, I was told that she had been for years prostrate on her couch, but had been entirely restored to health and activity by the above treatment.

At the time appointed, I went to my friend’s house and was introduced to this “show-case.” What I saw was a lady manifestly suffering from severe nervous exhaustion. The strained expression of her face was sufficient evidence of mental fatigue; her attitude indicated bodily fatigue. Her voice and manner betrayed a total lack of the energy and elasticity that distinguish persons of her sanguine temperament when in good health, and it was evident that continuous conversation was trying to her in the extreme.

I talked with her for a few minutes, refraining from asking direct questions. She readily informed me that she was undoubtedly cured by the treatment she had recently undergone; that, though the massage was very painful, she had greatly benefited by it; that she had been unable to stir off her couch before undergoing it, but that she had now returned to ordinary life, and was doing in all things as ordinary people did. All I can say is, I am very sorry for ordinary people. She seemed anxious to impress upon me the fact of her having had a real illness, and not a fanciful illness; little knowing that at that moment I was wondering at the strange fancies of those who could imagine such a miserable invalid to be well. She ended by informing me triumphantly that she was able to walk—how far do you think? Ten miles? Five miles? No, not even one mile. This supposed convalescent—this “show-case”—was able to drag herself exactly half-a-mile; that is to say, if she rested on a seat half-way—and she was unmistakably done up at the end of it.

And this was the result of paying from ten to twenty guineas a week for a couple of months!

I ascertained afterwards, on closer inquiry, that the poor lady was still weak and poorly in the opinion of unbiassed friends, but that her doctor and nurse had treated her as if she were very fussy, and as if the thing to be done was to cure her of her fancies. But there was little need to tell me so: she was so evidently ashamed of ever having been ill at all.

Why can it not be honestly recognised that a young woman who is too weak to walk five miles, and chat with her friends afterwards without over-fatigue, is in an unsatisfactory state of health; and that a young lady who cannot walk half-a-mile without betraying, in spite of herself, symptoms of nervous exhaustion, is in a most dangerous and alarming state of health, and should at once be prevented from fatiguing herself further, lest she should either die of nervous prostration (failure of the heart’s action is, I believe, the polite name for this mode of making our exit), or lest she should fall a prey to one or other of the many forms of disease which are apt to attack weak women?

To a person of common-sense, the bodily fatigue of painful massage, and the mental fatigue of being regarded as an imbecile, would hardly seem conducive to cure in cases where repose of mind and body are urgently needed; but in terror of that foe to our progress, the fixed idea, one is careful to leave a corner for even the remotest of possibilities.

How this poor lady originally became a victim to the modern malady I do not know. What happened after it had developed itself is easy enough to comprehend. She had dragged herself about in misery till she could drag herself about no more, and then she had taken to her couch. Want of fresh air and exercise soon started a whole host of minor ills, which, though painful and annoying, were less dangerous than continued over-fatigue. These ailments were ineffectually doctored, one after another, in a variety of ways. Then came a physician who carried her bodily off to town, cured all the small ailments at once, and by means of the strong moral influence brought to bear upon the patient, persuaded her that lying in bed and having ailments was exceedingly selfish and sinful, besides being inhuman to those about her. It was then impressed upon her that she was cured, and she was warned against falling into sin any more. The patient actually found some of her ills cured, and persuaded herself that the remainder would yield in time.

It is a matter of fact that the intellectually weak are readily wrought upon by those about them. In like manner, those who are suffering from nervous prostration are often mere reflectors of their companions, and their strength of character on recovery is a surprise to persons who have only known them during illness. Our powers of will and judgment depend not only on the number and correctness of the impressions collected and combined in the storehouse of the nervous system, but on the physical strength we have at command with which to put our machinery in motion. Nervous weakness cannot but impair the needful connection between its highly specialised parts.

So the patient is entered in the doctor’s book as cured, and goes home to lead an ordinary life. The supposed success causes other ladies to be treated in a similar manner. If the doctor refrains from telling them how fanciful Miss So-and-so was, the nurse repairs the omission. In the meantime Miss So-and-so, little suspecting that she is being held up as a warning and an example,—perhaps even by name,—finds that her small stock of strength has not been sufficiently increased to enable her to bear the strain of an active existence. Perhaps she will break down under some well-known disease, in which case her friends will say, “How very unfortunate, just as Dr. —— had cured her of her nervousness!” Perhaps she will give in and take to her bed again, and then the nurses will say to their patients, “She was all right as long as we had her, but after she went home she took to her messy ways again, and now you see what she’s come to.”

If I have heard this sort of thing said once, I have heard it a hundred times. In the days when I was even more ignorant than I am now, I used to argue with these worthy, misguided folks; but I have since realised the futility of trying to reason with people whose sieves have not pared and shaped them into a capability for reasoning correctly.

Now you and I, and all cultured men and women in our community, have a voice in the meetings at the council-chamber of Public Opinion, and have power to modify the sieves through which these nurses pass. In fact, we are always modifying them in one way or another, whether we recognise the fact or not. And if we so far shirk our responsibilities as to allow the sieves to be formed badly, then we are very selfish, and that is infinitely worse than being ignorant and stupid. We shall not advance matters a single stage by throwing mud at individuals who have conscientiously done their best in very difficult circumstances.

Here is another case of failure which ought to commend itself to our sense of humour.

I recently met a young lady who showed the ordinary symptoms of nervous exhaustion. She had not collapsed entirely, but was forcing herself by sheer strength of will to undergo the painful dragging-about process. She informed me that she had just been consulting a physician who had labelled her “hysteria.”[2] How delighted we all are when we get hold of a label! I am, for one. Now this particular label is the concise and technical mode of saying, “Disease unknown;” and in these days of hurry, it is a great advantage to be concise.

But excellent as the label is in this respect, edifying as it is as an example of candour, it is, unfortunately, peculiarly discouraging to the patient, and therefore encouraging to the disease. So we are glad to learn that it has at length been respectfully put to its long, last sleep by our kind friend Dr. Tibbits; and, though we are willing to admit that refuges for our half-knowledge are necessary landing-places in our upward evolutionary climb, we must also regard this service rendered by Dr. Tibbits as by no means the least with which he has benefited humanity.

In “Massage and its Applications,” pp. 20-21, we read as follows:—

“I would ask you to allow me to enter my protest against that refuge of destitute physicians and surgeons—the word ‘Hysteria!’ What does it mean? What do you understand by it? I have looked up many definitions of it from all writers of repute, and I will not give you any one of them. The thing is non-existent. The word is, as I have said, a refuge for destitute medical practitioners, who, having to do with dreadfully harassing cases of functional nervous disorder, take ‘Hysteria’ as their motto and their shield, and retire—or do not retire—from the case under its shelter.”[3]

To go on with the story. The young lady was shut up and treated for fussiness, though the wrong party would seem to have been under treatment. And when the fuss was over, and the lady—with lightened purse—was mercifully let loose again, she stoutly maintained that she was no better than before. Her doctor, however, declared her to be cured, and attributed her want of recognition of the fact to “hysteria.” But then hysteria was the supposed disease for which the lady had been treated!

So in this case the doctor had cured a disease which had no existence, while the lady, in consequence of the disease which had no existence and which had been cured, continued to consider herself as ill as before.

Unfortunately, some cases of failure are less amusing than this one, and have a more tragic ending. I have on record several instances in which patients were treated as if a morbid craving for sympathy were the cause of their illness, whereas it was in one case merely a symptom of the disorder; in another, it was induced by the withholding on the part of others the helpful sympathy with suffering which we all of us need, and which we should all of us be ready to give; and in other cases there was no proof at all of its existence. The results were extremely sad. One lady, who had been treated to isolation and the interference of incompetent nurses, became insane. A young man who had been forced to exert himself became epileptic; another became partially paralysed. These are solemn warnings. Those who have lain for a length of time in bed are often more easy to cure than those who have long dragged themselves about in pain and weakness. This is the interpretation, I suspect, of the saying that it is the half-ill who are most difficult to relieve. By the half-ill is meant those who are still dragging themselves about, though they are often more ill than those who are lying in bed.

Nervous exhaustion, as has been abundantly proved, is not usually difficult to cure. Even epilepsy, if taken in time, yields satisfactorily to rational treatment.[4] And if only nervous exhaustion were better understood, the numbers of our insane and epileptic patients would at once be marvellously reduced. Unhappily, the fantastic means too often resorted to in order to cure supposed hysteria destroys the patients’ faith in medical men, and renders them unwilling to submit to further experiments. If only one could get hold of them in the early stages of the disease, much suffering might be saved in the future. When this is done, it sometimes happens that the patient does not realise how much misery he has been spared, and is not proportionately grateful.

The other day a lady in a sadly overworked condition consulted a very well-known medical man. He informed her that she was suffering from “hysteria,” and recommended her to seek active employment. The lady, not being a homœopath, objected to the proposed treatment. Since she was suffering from fatigue, of what use could it be to prescribe fatigue as a cure? The inexorable doctor took refuge in the imperative mood,—a very favourite refuge when the patient has been labelled “disease unknown,”—and she was overruled. With misplaced confidence and reprehensible docility, she forced herself back to her work. Shortly afterwards she had to be placed under care.

A worthy great-uncle of mine was one morning engaged in doctoring the out-patients at the hospital he attended, when a poor woman addressed him in pathetic tones, begging him to cure the malady in consequence of which she endured unutterable things.

“Certainly, my good woman,” he said cheeringly. “What’s the matter?”

“I have a newt, sir,” was the unexpected response.

“A what?”

“A newt, sir, inside me.”

My uncle then recognised the case as being what he called “hysterical.”

People in those days were more sympathetic and less contemptuous in their treatment of such unfortunates than most of us are now, so he said in a kindly, soothing manner—

“Poor thing! Well, well, we’ll soon set that right. Now don’t you distress yourself, my good woman. I’ll soon settle the newt for you!”

Thereupon he gave her a bottle of coloured water and some bread-pills, directing her to take them steadily for a few days and then return to show herself to him. He fully expected, he added, that she would then be quite restored to health.

Away went the sufferer.

At the time appointed she again visited the hospital.

“Well,” said my uncle cheerfully, “how are you? Newt’s quite done for, I suppose?”

“Oh no, sir,” she replied piteously. “A terrible thing’s happened.”

“Indeed! Sorry for that. What is it?”

“The newt’s had young ones!”

My uncle gave that case up. I have no doubt he thenceforth regarded “hysteria” as incurable in confirmed cases.

It is really surprising that so successful a practitioner should have been short-sighted enough to treat a mere symptom instead of the disease in which it originated. He appeared to think that his patient was suffering from hallucination, from a morbid idea, and that if he could remove the idea, she would be well. Had he realised that morbid ideas argue a morbid condition of the nerves, and that the mere removal of one hallucination after another would not suffice to repair actual nerve-waste, he would certainly have refrained from expending his own nerve-force in a vain endeavour. But I am glad to know that he at any rate refrained from dissipating still further the poor woman’s small capital of strength by frightening her and discouraging her. In this respect his method compares favourably with that now in vogue at many hospitals.

Here are three instances of more modern usage.

A woman of the labouring class presented herself at a country hospital for treatment. She declared herself to be afflicted with severe pain in one leg, rendering it almost helpless, and preventing her from accomplishing her daily work. The medical gentlemen to whom she addressed herself could find nothing wrong with the limb, and harshly told her that her complaint was “hysteria.” One would have thought that having discovered the disease and given it a name, they would have done something to cure it. Not at all. The woman was sent away unrelieved, to be a burden on her unhappy family or on the community, as the case might be. Yet these gentlemen had probably heard of such things as nerves, and knew them to be an even more essential part of the body than the legs. Their refusal to treat the patient in question would have been excusable had they systematically excluded all nervous cases, but this does not appear to have been their practice. The poor woman went home and struggled to do her work, but failed from weakness. In despair she consulted a quack, who put her on an efficacious course of treatment and cured her triumphantly. A member of the Hospital Committee, having these facts brought under his notice, attended the next meeting, and moved that that quack should at once be taken on to the staff to assist the medical gentlemen with his valuable advice. The motion was lost.

Another woman, suffering from severe nervous exhaustion, applied for relief at a large hospital in London, and received the same answer—“Only hysteria.” One would really have thought that a disease so widely recognised, and causing so much perplexity, would be a bad enough thing to have without more being expected of one. However, the woman was told that her complaint was all sham and nonsense, and she was sent about her business. She went in despondency, for she was in a fearfully exhausted condition. Soon afterwards a painful malady made its appearance of the description usually considered “interesting,” and the same hospital, which had closed its doors on the invalid, now opened them wide, received her with kindness, and studied the disease diligently. They failed to cure it, but that is a detail. Indeed, I think they would have cured it if they could, but perhaps it was incurable. This hospital admits itself to have been mistaken. It says it was wrong in crediting the patient with “hysteria;” she was really suffering, the doctors say, from the exhaustion preceding this particular form of disease. In short, if they could have cured the neurasthenia, which was the woman’s sole disease when she went to the hospital in the first instance, she need never have contracted the disease which was found so interesting. Lower the vitality of the whole organism, and the part originally weakest breaks down; or the patient may be exposed to some malign influence,—such as blood-poisoning, for example,—which, in health, she would have been able to withstand, but to which, in an enfeebled condition, she falls an easy prey. I had watched this patient become ill. I had even tried to arrest her downward progress; but my hands being tied, I could accomplish very little. She was of neurasthenic inheritance, and was put in unfavourable conditions. A hospital, taking entire possession of her at the right moment, might have done a good deal.

At another hospital a young probationer began to break down from overwork. She fell a victim to neurasthenia, and a very painful and distressing malady she found it. She consulted one of the medical staff, who rebuked her, told her she was suffering from “hysteria,” and ordered her to go and work. Her health would have been destroyed, and she would have been forced to abandon her career, had not a kindly, sensible physician—such as, happily, abound in the much-tried medical profession—come to the rescue, set her feet upon a rock, and ordered her goings. She is still leading an active, useful life.

There have probably been many cases in which the patient has become neurasthenic from monotony and want of occupation, and in which her cure has seemingly been effected by her being forced to exertion. As a matter of fact, the good results have been obtained chiefly by the patient being placed in better conditions, and I have seen many such cases, who have been entered in the doctor’s book as cured, relapse again on the smallest provocation. Yet, as I have said before, neurasthenia can be cured, and ought to be cured; and if we fail in our efforts, there must be a screw loose in our mode of treatment.

One more instance of failure may be given here, out of a very large number that might be recorded.

A young lady, rendered justly anxious by increasing nerve-weakness, consulted a well-known physician. He asked what ailed her. She described her symptoms, the most usual symptoms of neurasthenia. His comment on her report was singular. He wondered that she should have come to him at all, having no more than that the matter with her. One is again tempted to ask what more one can be expected to have the matter? Surely, continued languor, depression, neuralgia, and weakness are a sufficiently heavy burden for anybody to bear, to say nothing of want of comprehension on the part of others. Did the good gentleman wish the lady to wait until she had developed something more “interesting”? Not at all. We should wrong him by entertaining any such idea. He merely believed neurasthenia to be three parts fuss and nonsense, and he thought he was proving himself a kind friend to the young lady by rousing her to a sense of her duty—the duty of dragging herself about and saying nothing of her ailments. It is odd how very ready we all are to preach duty—to somebody else. Nevertheless, let us honour the conscientious physician for his honesty. Unfortunately, he failed to cure the young lady, and for anything I know to the contrary, she may by this time have developed something extremely interesting.

IT will be readily conceded that in order to treat nervous disease successfully, we must have some special qualifications for our task. We need not only learning, but experience and powers of ready observation. Indeed, mere learning will avail us little in a still undiscovered country, or in one where the observations of our predecessors have been so frequently and unavoidably erroneous. But if it be true that all disease is in a sense nervous disease—an affection of the nerves of some particular part of the organism—the importance of the study of neurasthenia cannot be overrated, provided that we study it from Nature, and do not rely wholly on prevalent teaching concerning the mode of treatment required.

Mr. Francis Galton, in his able work, “Natural Inheritance,” shows that tendencies to certain maladies may lie latent in families tainted with them in the past, and that, on the other hand, these may be increased in severity by inheritance, and may even bring the family to an end. With some complaints the rule would seem to be that they are either very largely inherited by the offspring or not at all. Making some allowance for difference in circumstance and mode of life of a given generation, it will be found that where the nervous system has been strengthened, the family malady has been successfully defied, and that where it has been enfeebled, the enemy has made his appearance. As regards consumption especially, it would be easy to give a large number of cases in point. In the early stages of this terrible malady, when the enemy had already effected an entrance and was clearly recognised by physicians, I have known him to be summarily expelled, not by treating the disease itself, not by sending the patient to warm climates, but by adopting the very methods which are so effectual in neurasthenia. Bracing air, frequent nourishment, cold water to the neck and spine, mild tonics continued for a length of time, and freedom from worry—in some cases massage and electricity also,—these are the true remedies so long as remedies are of any use at all. I have known instances where such a régime has entirely banished the hereditary evil, and the patient has resumed an ordinary existence.

Almost too much stress has recently been laid on the necessity for moral treatment of the neurasthenic. Though it is impossible to lay too much stress on the importance of good surroundings, the term “moral treatment” has come to be employed in a wrong sense. Doctors and nurses usually mean by it (not always) keeping the patient in order, making her forget herself, rousing her, and—too often—irritating her; whereas good moral treatment should before all things mean gentleness, cheerfulness, patience, the encouragement of the growth of the patient’s will—not the enforcement of abject submission to the will of somebody else,—total freedom from all noise, fatigue, and irritation, and the constant presence of an improving influence and example. Special attention must be called to this latter point. Jean Paul Richter tells us:—

“The first rule to be observed by any one who will give something is, that he must himself have it.”

In other words, it is useless to attempt to light the fire with an unlighted match.

Now, the notion that a woman less refined, less highly educated than the patient, and originally of inferior mental and moral endowment, is to be permitted to thwart and control her, is one that must, and does, work an incalculable amount of harm. It is not by saying, “Be unselfish,” “Don’t think of your ailments,” “Be self-controlled,” &c., that we can do any good to a suffering invalid. If we have not built up our own organisations—our characters—impression by impression, in the path of right reason and true sanity, so that we can benefit others by our unconscious influence, we had far better let the neurasthenic alone.

I have, moreover, come across neurasthenic patients who were far more fitted to teach me endurance and sweet temper than I was to teach them. Even in cases where we justly lament the absence of these virtues, we should consider what strength of mind it must require to refrain from irritability of temper, from yielding to constant pain and fatigue, and from sinking into a state of complete inactivity. The efforts of neurasthenics in this latter direction are often mistaken; Nature is indicating the pressing need of rest; but we must nevertheless admire the vigour of at least one portion of their nervous systems, though realising that the health of the whole organism should not be sacrificed to the demands of that one portion. Looking at the matter in this light, we feel our self-righteousness to be misplaced, and our ready interference to be an impertinence.

A patient suffering from neurasthenia was once lying ill at a small nursing home, undergoing massage. A visitor at the house inquired of its owner, a trained nurse, what ailed the lady.

“Oh, there’s nothing the matter with her,” replied the trained attendant glibly. “She is only a little odd.”

What a vista of ignorance was opened up by this remark! How could a patient who was ill enough to be subjected to the Weir Mitchell treatment have nothing the matter with her, unless indeed she had simply been condemned to imprisonment for the sake of the loaves and fishes she would thereby be forced to dispense?

Two nurses at a hospital were once puzzling over the case of a neurasthenic woman then under treatment there. They were perplexed, with reason, because the woman appeared to be in pain, although the harsh medical verdict was to the effect that she had no disease. They were nice, kindly women, and were sorry for the patient. So they found a middle course between the rival evidences by coming to the conclusion that, though there was nothing the matter with her, her pains were “real to her,” and they ought to treat her with gentleness. All I can say is, if I ever get ill, may I be nursed by those two women. There is something genuinely heroic about people who refuse to follow powerful superiors to do evil.

Nevertheless, though their resolution was right and praiseworthy, their conclusion was wrong. If we are unduly conscious of any part of our bodies, that part is not in a healthy state. Wherever there is pain, there is disintegration—disease, and because the medical advisers in this instance could not find the disease, it by no means followed that it was not there. “The fact is, we know very little about nerves,” said a medical man the other day. His candour merits our respect. To say that a patient can fancy pain is absurd. Pain is but a condition of the nerves. If it is not there, we cannot feel it. It is objected that, if we take a patient’s thoughts off her aches and pains, she ceases to feel them, consequently the pain must be imaginary. But if we cut a finger while in a state of excitement, we feel no pain. Not because the pain is there and we are unconscious of it, but that while nervous energy is diverted into another channel, there can be no pain. Read the account of the burning of the martyrs of Valenciennes at the time of the Spanish persecution in the Netherlands.[5] Those brave people were in a state of ecstasy in which pain was impossible. If there is one thing certain in past history, it is that they suffered absolutely nothing. The contemporary evidence on the subject is overwhelming.

But, as far as the neurasthenic are concerned, the practice of taking their attention off their pains has its dangers. The process is apt to be fatiguing, so that the patients only have more pain as soon as the distraction ceases. This fact is very exasperating to the more ignorant of their attendants. “She was well enough as long as she was thinking of something else,” the disappointed folks will tell you with an aggrieved air. One woman, possessing many good qualities, informed me that what such patients wanted was a “thrashing.” This nurse was a masseuse in the habit of “Weir Mitchelling” patients. Without supposing that her views ever took a practical form, their existence could hardly conduce to a kindly consideration for suffering invalids.

One very favourite notion about the nervous is, that they ought not to be sympathised with. If any one will try this treatment for a little while himself, even in health, he will find it necessary to fly pretty quickly to people possessing natural human feeling, in order to avoid drifting into permanent lunacy. In disease the danger is still greater. I have always found that when I sympathised cordially with real causes of distress, and simply disregarded unmistakably simulated ones, the simulated ones died a natural death without more ado.

But which symptoms are real and which are simulated? Here the tough or toughened organisation is usually hopelessly at sea. Here no information will enlighten, no rules will guide. If we are by nature incapable of making simple observations correctly, we had better give the whole thing up and go into another line of business. Even the so-called simulated symptoms are in a sense real symptoms of a morbid condition of brain; so, however good observers we may be, if we have not the wisdom and the patience to deal with these wisely and gently, we are still disqualified. “But nervous patients are so trying!” Why, of course they are. “Trying” is not the word. They are sometimes maddening. And nurses who are overworked, which they ought not to be, will be saints if they always contrive to keep their temper with them. We must remember, however, that lunatics and delirious people are trying also, and why should it be criminal to mismanage one kind of nervous disorder and not another?

I was once travelling in a railway carriage in France. The stuffiness of the place was poisonous, and I ventured to lower one of the windows a few inches. Instantly a French gentleman, seated opposite to me, well out of the draught, reared himself up and descended upon me with indignation and with a positive sense of injury. He could not stand the cold. Why had I opened the window? He must really be permitted to shut it.

An English gentleman explained that we wished for air. The Frenchman was amazed.

“It surely cannot hurt you,” he said, with violent gesticulation, “to have the windows shut. But I, when they are open, I suffer.”

It would have been impossible to convince him of the fact that I suffered when the window was shut as much as he did when it was open.

Some of our nurses are very like this French gentleman. Let the patient have a cold, and they are quite pleased for her to put her feet in mustard and water. Let her have a shattered nervous system, and nine out of ten of them feel injured if they are told to stop their chatter. I have known women who were in many respects capable nurses rendered useless, as far as nervous patients were concerned, by the erroneous notions with which they had been impregnated. One nurse told me seriously that the proper way to manage a nervous invalid was to make her afraid of you. She had had no personal experience in the matter, and the little prattling monkey was hardly likely to inspire much terror; but that was what she had been taught.

Doctors, too, sometimes indulge in whimsical ideas about these cases. A nurse, who had recently “Weir Mitchelled” a neurasthenic patient, told me that the lady, like many others suffering from disorder of the medulla, had a difficulty in swallowing, and could not take the pills that were ordered for her. I inquired what happened. She replied that the doctor, evidently impressed with the belief that the difficulty was all sham, insisted that she should get those pills down somehow. It was done. But the nurse informed me that, in the effort, the poor lady swallowed a whole bottle of water every day, and it was very bad for her.

A gentleman once asked me if I knew what Beau Brummell was then employed in doing in the other world. Much surprised at the question, I replied that I could not imagine.

“Eating raw onions with a steel knife,” he said solemnly. “By and bye, he will get to cabbage. For a long time he will be allowed no other food.”

On this principle, what will happen to that doctor who made a sick person swallow a whole bottle of water daily? But perhaps Beau Brummell is not suffering merely for having spoken contemptuously of the “creature” who ate cabbage, but for his indifference to the needs of others throughout his life. As to the doctor, let us hope he will be able to show a counterbalancing array of kind actions as a set-off against his misdemeanour, and so escape penance.

After all, it requires little skill to find fault. The thing is to do better. Unfortunately, it is just those medical men who have recognised nervous exhaustion and done their best to treat it who, in the nature of things, have made the most blunders and have been most blamed. This was inevitable. It is by failure that we learn. There is all the more need to draw attention to our failures and to point the moral. We have often tried hard to treat the person and not the disease; we have even tried to treat the disease and not the person. We must accustom ourselves to attacking the enemy on all sides at once. We must realise that not only the food that we eat and the air we breathe act upon the nervous system, but every impression conveyed to it through our senses. We may think it is of little consequence whether we say certain words to a patient or not. We think they will soon be forgotten, or the damage done by them be repaired. But no impression on anything in nature can be done away, not even the impression of the faintest particle of light. The whole universe throughout eternity is altered by our uttering one sentence or leaving it unsaid.

Supposing we put a photographic plate into the camera and expose it, then take it to the dark room and look at it. Can we see any change? None whatever. But immerse it in the developing solution, and the change it has undergone becomes apparent,—there is a picture on our plate. If we take it out into the light without first fixing it, the picture fades away. Is the plate therefore the same as it was before we took our picture? No, it is entirely different, and nothing in the world can ever restore the film on the plate precisely to its former condition.

In like manner outer impressions are every moment altering our nervous structure, and life’s clock cannot be put back.

WE must bear in mind the fact that all observation is difficult, not only because of our lack of perception, but because impressions already received project themselves, so to speak, on to the objects to be observed, and prevent our seeing these as they really are. Here lies the true interpretation of the “fixed idea,” and the “subjective” order of mind. The mind must not only be large enough and elastic enough to receive new impressions, but must also combine them with the old, so as to modify the former idea; for that which can only receive a new impression at the cost of casting out former and equally truthful impressions is deficient in retentiveness, and must always be wanting in thoroughness. We see examples of this order of mind in persons who eagerly take up one subject after another, but who permanently assimilate nothing. Mental growth is manifestly of little advantage to us if, while gaining on the one side, we are continually losing on the other. Again, if we cut ourselves off from outer impressions we lose mental power, for it is only by use of a part that nutriment can be attracted to it; and if our impressions are too exclusively of one particular order, our minds become ill-balanced.

Before we can be of special use as observers, therefore, education must have meant for us “the harmonious development of all the faculties.” We need to have our sense perceptions in good order that we may perceive quickly and accurately; we need the retentive power to enable us to store the impressions received; and we need the faculty of combining these impressions in our minds—the lower manifestation of which process we call imagination, and the higher, reasoning faculty.

Probably, in the cases where we generally attribute erroneous observations to excess of imagination, the fault really lies in the defective perceptive power. Either the nervous structure lacks sufficient sensitiveness to respond readily to the stimulus, or it lacks the strength to retain the impression. In these respects we commonly note improvement with the amelioration of the general health. It is a question, however, whether, if the stimulus were to make an adequate impression, the impression would not be more effectually retained. Be that as it may, we find persons who observe isolated facts readily enough, and who remember them well, but who learn little thereby, because they lack combining power. Isolated facts are facts to them and nothing more. The notion of law is a thing beyond them, and each fact has to be observed separately.

These are just the persons who are unfit to have the charge of nervous invalids, but for some mysterious reason they are just the persons into whose hands nervous invalids most often fall. Perhaps the explanation is, that ready combining power can exist only with a certain amount of sensitiveness of nervous structure, and that the sieves through which we pass our nurses may cast out those who would be of the greatest value in nervous illness, besides tending to lessen the sensitiveness of those that remain.[6] At all events, I have been disappointed to find that women from whom I hoped great things as nurses—women of good organisation, and certainly not of delicate constitution—have broken down completely in the course of their hospital training; whilst women whom I consider positively injurious to any kind of invalid have passed through it triumphantly. The question arises, Are we not unwise so to shape our sieves as to exclude the very people by whom we ourselves would most prefer to be tended in sickness? Will any mere knowledge atone for the loss of that keen intelligence which we recognise in persons of so-called sympathetic disposition?

On inquiring the reason why so many highly desirable persons have been cast out from the sieve of their hospital training, I have been told that the fact causes no concern to the authorities, so numerous are the women pressing in to take the place of the defeated strugglers for existence. If this is no answer to the inquiries, it is at least as good as most of the replies one gets when seeking for information on this unsatisfactory subject. Supposing it to be true, we may well ask further whether a too great narrowing of the spaces of the sieve in a particular direction, combined probably with an extreme elongation in another direction, does not tend to produce ill-shapen and one-sided nurses? I say tend, because the present system is still new, and though it may have immediate advantages, we should not blind ourselves to its possible disadvantages in the future. We need always to remember that a process of selection which ensures the survival of the toughest does not necessarily ensure the survival of the fittest. There is such a thing as evolving backwards, like the cave-fish who have lost their sight during their long residence in the dark. The best things in life are not machine-made.

But correct observation being such a complicated performance, we should be very indulgent to people who make mistakes; especially so if we have ever made a mistake ourselves. In our plentiful abuse of individuals, we merely display our inability to recognise the limitations and imperfections of “the thing called human nature.” We have reached a certain landing-place in our upward climb by means of paying attention to our sieves, but we have a long way still to go.

A few very simple experiments will suffice to show us how hard a thing it is to see even what lies right under our very noses. We may then perhaps realise how rash it is to form hasty opinions about the complicated and invisible nervous systems of our suffering fellow-creatures. Having got thus far, it may even dawn upon us that to make our fanciful and erroneous theories (fanciful because founded on insufficient knowledge, and erroneous because founded on the defective observations of others) the excuse for ill-treating other people’s nerves by showing a want of consideration for their sufferings, by tormenting them with painful and fantastic tricks, and by indulging our own tyranny and self-righteousness, is to manifest to the world an extremely primeval species of childishness.

I once drew a character called “Dr. Broadley,” who, excellent man though he was in some respects, put on a “stalk” when he came in contact with a nervous patient. Now, three different people thought they recognised Dr. Broadley, and informed me of the fact. They were all wrong. Not one of their three supposed models had sat to me for his portrait. I am forced, against my will, to the conclusion that there are in existence a superfluous number of persons who make the proximity of an invalid the excuse for displaying unnecessary airs. Surely it is not by such an influence, such an example, that the morals of our patients are to be improved.

I once put together two small prayer-books, so that the coloured edges of the leaves were divided only by the edge of the thin cover of each book. The leaves of one were of a bright golden colour; those of the other had been tinted a dull red. The books were momentarily held up for observation, with this interesting result. The leaves of the one book were seen correctly, so far, at least, as their colour was concerned; for they were unhesitatingly declared to be tinted with bright gold. The leaves of the other, however, were with equal readiness declared to be of a golden red colour.

It is easy to understand how this mistake arose. The golden colour was the first perceived, and the impression made by the dull red was not strong enough in comparison to be correctly seen and retained in a brief moment. The bright gold of the one book had so powerfully affected the retina that the colour was cast, so to speak, on to the leaves of the other book. These therefore appeared to be golden red in tint, instead of the dull red they were in reality.

On another occasion a small smooth cake was placed in a dish together with several large almond-cakes. When attention was attracted to it, it was mistaken for a cocoanut cake.

Here a rapid inspection had sufficed to show that one cake was smaller than the others. It had not sufficed to show the great difference in its construction. The large cakes had been first perceived, and their roughness was erroneously seen to be shared by the small cake.

Some people go through life with their minds so completely lined by a series of crystallised impressions, that no aftercomers have the smallest chance of even combining with them to produce a half-truth, to say nothing of overcoming them to a sufficient extent to drive out the errors and replace approximate truths by others still truer.

It may be objected that the above failures in perception of differences (a much more difficult thing than perception of similarities[7]) was occasioned solely by the speed with which the observations were made. I entertained a contrary belief, and my belief was confirmed by the following example of my own capacity for disgraceful blundering.

Shortly after the publication of “The Massage Case,” a friend asked me how I could have made such a mistake as to attribute to Elfie during her convalescence the strength to walk twenty miles in one day. I asked her to show me the passage wherein I had erred. She did so; and I read that Elfie really did walk twenty miles in the desert. I was amazed at my own stupidity, for, considering the length of time required for complete recovery from severe nervous exhaustion, it is evident that even the charm of Dr. Risedale’s society could not be expected to inspire her even temporarily with nerve-power for such a feat. I had looked steadily at the passage for a few seconds before the idea occurred to me that I might be seeing wrong. Then I scrutinised each word by the light of this suspicion, and having hit upon a correct theory, I found out the truth. It turned out that Elfie walked in the desert for twenty minutes, not miles. An erroneous impression had been conveyed to my brain through the ear; and by its disproportionate tenacity—disproportionate to my perceptive power at the moment—had prevented my receiving a new and truer impression through the eye.

I was overdone at the time, and took the warning; that is to say, I rested. But many of our doctors and nurses, whose observations are of the extremest importance, are supposed to do their work in a fatigued condition, and are considered fit objects of abuse if they do it badly. Why then do they overwork themselves? The answer to this question is that they are underpaid. The butcher and the baker must always receive the reward of their labours; the doctor and the nurse must often toil for nothing, though we are aware that, in order to obtain efficiency in any profession, it is essential that that profession should be well paid. The community may object that it cannot afford to pay more than it pays at present. Can it then afford to be kept ill or made ill by ignorant interference or by erroneous notions? It would surely be cheaper in the long-run to pay to get well or to learn how not to get ill.

To be dogmatic about that which is least known would appear to be an ineradicable characteristic of human nature in its present imperfect state. “Fools rush in where angels fear to tread” is still a true saying. In the treatment of nervous disease it is amply exemplified. Where we are most ignorant, there we are most uncompromising in our dealings. When we understood absolutely nothing of insanity, seeing little connection between madness and disease, we resorted to the whip and the chain. On waking to some conception of nervous disorder, we perceive similarities more readily than differences, and proceed to lump together all diseases of the nerves in the earlier stages under the name of “hysteria.” Having already some vague foolish fixed idea in our heads about “hysteria” being synonymous with idleness and general depravity, we drag our patients about, beat them with wet towels, give them frightful shocks, galvanic or otherwise, and then get rid of them as quickly as possible, so as not to have the burden of remote consequences.

But when more serious mischief is set up, what then? Why, then comes tardily a perception of differences, and we divide nervous disorders into hard and fast diseases, concluding that all had been different from the very first. The later perception of underlying similarity has as yet scarcely dawned. Some of these maladies are considered curable; others, without rhyme or reason, are considered incurable.

With regard to the curability of nervous disease, let us consider what happens when we travel by train from Eastbourne to London, and again from Eastbourne to Brighton. In each case we pass through Willingdon and Polegate, and stop at Lewes. We can get out at Lewes or at either of the previous stations and return to Eastbourne, but if we proceed as far as Lewes, our return journey will be longer than if we had got out at Polegate. In the same way nervous disease is more quickly cured in the early stages than in the later stages. Now, suppose that we are in a train which does not stop between Lewes and London. It is evident in this case that, if we have missed our chance of alighting at Lewes, we must go on to the final goal; no return being possible. Thus, there is a point in certain nervous diseases beyond which recovery is impossible. On the other hand, in travelling from Eastbourne to Brighton, we have several chances of retracing our steps even after leaving Lewes, where the ways diverge; and so we find that, in some cases of nervous disease, incurability is reached sooner than in others. And just as we must be content to take longer to return from Lewes than from Polegate, so we must be content with a slow cure in advanced nervous disorders, and remember that, in administering nerve-tonics, the weaker the patient, the weaker should be the dose; all attempts to hurry the cure being fatal to success. Moreover, just as, in journeying from Eastbourne to London, and from Eastbourne to Brighton, we travel along the same road as far as Lewes, so all nervous diseases have a common origin in nerve-deterioration which may be repaired.

Defective powers of observation bring with them this great evil,—we not only fail to reduce a terrible malady to a minimum, but we mete out unjust censure to those who seem to be responsible for the failure. Whereas the really responsible party is the community at large—in short, ourselves. We blame the doctor; but doctors are after all a small minority, and the minority can only expand and take shape in the direction in which the least pressure is put upon it by the majority. The grotesque modes of treatment resorted to in past times evidently gave satisfaction to all but the enlightened few, just as bad Governments have been tolerated in the countries fitted only to be governed badly.

But to be dissatisfied, to mete out blame, to expect a cure, are healthier symptoms than a passive acceptance of the evil and a lazy belief in incurability.

Medical science is unlimited. The law of our universe is progress.

IN individual cases of nerve-trouble, the illness is generally traced to some cause, serious or trivial, real or imaginary, as the case may be. Quite as much harm as good is wrought by the practice. If the patient has suffered from some accident or malady leaving nerve-weakness as its legacy, the large development of the supposed phrenological organ called “Causality” on the part of the patient’s attendants will probably have its uses. The invalid will not then be considered a criminal. If his ailments cannot be cured, at all events he will meet with a certain amount of consideration, and his sufferings will not be aggravated by harshness. But if the cause of the mischief defy investigation, then a false one will assuredly be invented to take its place; the natural love of detraction, constantly recurring in consequence of the feeling of superiority which indulgence in detraction gives us, will find an outlet in action; and the sorrows of the patient, already great enough, will be increased tenfold. Since all intelligent human beings like to know the reason of the phenomena they observe, however imperfectly; since a belief in non-existent causes brings with it disastrous results; it behoves us to open our eyes to the true causes of nerve-deterioration in our community, with a view to removing them as completely as lies in our power.

In the first place, we must recognise the fact that we have contracted the habit of transposing causes and symptoms. Evil practices, such as drunkenness, for example, are blamed for the deterioration, instead of being regarded as the outcome of nerve-instability; while, on the other hand, nerve-instability itself is often regarded as criminality and the outcome of an evil disposition, punishments and deterrents are resorted to, time, money, and brains are wasted, criminal and lunatic classes are perpetuated, jails and lunatic asylums are multiplied, simply because we lack the knowledge to recognise that no amount of modification will ever put right the nerve-structure which is radically wrong from the birth. Excepting ignorance, the foundation of all woe, the first great cause of neurasthenia which we must honestly face is HEREDITY.

We shall find, I think, that the second great cause is to be sought in IMPERFECT SOCIAL CONDITIONS, and the third in AN IMPERFECT SYSTEM OF EDUCATION.

Other minor causes we may easily enumerate, but they will all be more or less secondary to these three, and dependent upon them. I propose, therefore, to consider each of these in turn.

ALL those to whose lot it has fallen to minister to the wants of sufferers from nervous disease must have come across cases which they were expected to benefit, but for whom, manifestly, very little could be done. So great is human perversity, that though cases of epilepsy and nervous exhaustion are every day regarded as incurable merely because the most efficacious modes of treatment remain untried, these persons of defective nervous system and perverted growth are often supposed capable of development into ordinary people after a few weeks or months of special attention on the part of those to whose care they are confided.

It seems useless to point out the wide difference between the two classes. The non-medical mind cannot or will not understand it. Our ignorance on such matters is boundless.

It has always appeared to me that these unfortunate defective people are truly our sin-bearers, for they reap to the full the consequences of our mistakes; they inherit the results of a pernicious order of affairs. The parents have eaten sour grapes, and the children’s teeth are set on edge. Cursed from their infancy with a fatal blight; expected to arrive at a moral standard which is wholly beyond them; tormented in childhood by vain attempts to force them to the level of other children; the small stock of intelligence—which love, the great educator, might in some instances have developed to a limited extent—dwarfed and dissipated by impatient ignorance; objects too often of the heteropathy of which Miss Cobbe speaks so feelingly in her exquisite work entitled “Duties of Women;” these unhappy sufferers are surely spectacles fit to move the pity of gods and men.

Yet, in cases where the nerves, by means of which alone the moral sense can manifest itself, are altogether wanting, these are the very persons who are glibly declared to be utterly bad. Just because they are deficient, just because reformatory efforts can have no effect upon them, it is thought excusable, and even laudable, to bestow upon them hatred and scorn. And it frequently happens that those who so readily mete out their hatred and scorn, believe that the Carpenter of Nazareth ate with publicans and sinners, and consorted with those who were possessed of devils; that the woman taken in adultery was not condemned; that the dying thief on the cross was admitted to Paradise.

To care for the defective; to bestow on them the love that has been withheld; to reverence them as the bearers of our common sins; to mitigate their sufferings and shield them from injustice; this seems to me the most Christlike work that can be undertaken by any philanthropist in any age.

But some of these cases are not hopeless. If we have but knowledge and patience enough to place them in the best conditions, much may be done for the greater number of distorted beings. The longer we withhold our aid, the less are our chances of success. Their original surroundings are generally bad, owing to the same tendencies being inherited more or less by other members of their families. And we must remember that, in the treatment of nervous disease, we may show our wisdom quite as much by what we refrain from doing as by what we do. We must not start with the idea that we have to work a sudden reformation, but that we have to allow the organism room to grow naturally and in the right direction. We cannot create moral growth, or growth of any kind, but we can minister to it and promote it by placing the organism in the conditions where it shall absorb the largest amount of nutriment—of vitality,—and we can then direct the pressure which determines its form.

We constantly see around us instances of persons, not naturally defective, who have been subjected to lifelong distortion. In an enlightened community this should be impossible. Place in a low conservatory a plant that has a capacity for growing into a forest tree; withhold from it the needed nutriment, and it will remain dwarfed; deprive it altogether either of the food which it must assimilate in order to maintain vitality, or of the light and air without which waste cannot be promoted and function performed, and our plant must die. Give it all these necessaries, but keep it in the low conservatory, and when it reaches the roof of the building it will remain stunted or grow awry. Perhaps the nutriment that ought to have enabled it to shoot upwards will go into the lower branches, and the tree will become misshapen.

Does not this often happen to the human plant? Is not its lower nature developed at the expense of the higher, because bounds are set to its upward development?

The highest type of human being, then, is not merely that which has the most vitality, but also that which can distribute it in due proportion to its various parts, and that which has been permitted to expand naturally in right directions. The extent to which we possess this vitality,—the power we have of assimilating the force stored up in our food, to repair waste and ensure growth,—is largely determined by heredity.

True, this fact is in some quarters violently disputed; but not, I think, in quarters deserving of much attention. Distorted people are generally vehement, and resort to bare assertion and flat contradiction when observation, analogy, and rational argument are all with their opponent. It is well, perhaps, when the perverted force-current can steam off so harmlessly instead of working mischief in other channels; just as it is well when excitable political speeches and articles save us from dangerous secret organisations.

A young lady once declined to entertain the idea of heredity for a moment, on the ground that, supposing her to be the unfortunate possessor of a grandmother who was a monster of wickedness, she would be expected to prove herself a monster of wickedness likewise. It was in vain for a gentleman present to point out that we usually have more than one grandmother, and that if her other grandmother happened to be an angel of light, she might with equal justice be expected to develop angelic characteristics. She saw her side of the argument, but not his. As a matter of fact, we know so little of the numbers of ancestors from all of whom we may inherit, and we understand so little of the conditions determining the inheritance of given characteristics, that we are not yet in a position to entertain expectations at all. All we know is, that we do not generally get so far as finding grapes on thorns and figs on thistles. The interesting subject of heredity still offers a wide field to the observer. So far, physiological revelation does but prove the truth of the Biblical revelation—that nothing is of ourselves, but that all is of God.

On the one hand too much has been made of heredity, and on the other hand too little. Sometimes its warnings are wholly disregarded; sometimes disease is regarded as inevitable if it has already existed in a family, and if there are any symptoms of its recurrence, wise precautions being consequently neglected. Good education would often avert the evil. Unfortunately, it is in families displaying neurotic tendencies that education is usually most hopelessly bad. It would be easy to give numbers of instances in the upper classes where nervous disease is, with the best intentions, literally being coined. Heredity does not mean that certain hard and fast qualities are displayed by the parents and inherited by the children, but that certain tendencies may develop—pathologically or otherwise—in suitable surroundings. Insane persons may have no insanity in their families, but may yet have resulted from a combination of neurotic stocks, the conditions in which the utmost might have been made of their defective structure having been denied them. Indeed, the means resorted to in order to reform such people would be ridiculous were not the whole affair so infinitely pathetic. The smile of derision would be oftener on our lips but for the tear of pity which follows close behind it.

Many persons rebel against the doctrine of heredity because they consider it destructive of faith in God. Surely their own faith must rest on very insecure foundations. Belief in an all-loving God can but be strengthened by a knowledge of the means by which He develops and guides His creations. Kinematics, mathematics, biology, all natural and physical science—the means by which we study His great and continuous “Act,” the universe—should serve to increase our faith, since in Him we live and move and have our being. Even denying scientists do but reveal Him. If it be true that when we would do good evil is present with us, it is also true that when we do what seems evil we often bring about good results. How can there be conflict between the laws of Nature and the laws of Nature’s God?

Again, it is contended that it is possible for us to live an evil life, and, by means of scientific knowledge, avert the suffering which, in a God-fearing community is the reward of evil, the race being thereby saved from destruction. A very little consideration will suffice to show us that such contentions are without justification. The laws of God are not to be evaded. We bring ourselves to nothing when we “kick against the pricks.” We have seen that if any part be disused, nutriment can no longer be attracted to it. Let that part of the organism by which the moral sense manifests itself fall into disuse, and disintegration has begun in that part—that is to say, a larger amount of waste than can be repaired by nutrition. Supposing the defect to be counterbalanced by excessive activity of another part of the organism, this is no true compensation. No development of the lower part can atone for the loss of the higher. We should, at best, have one-sided beings, who lack the social instinct and must run counter to one another’s aims. Mutual destruction would result from their downward progress, and regulations previously agreed upon would be disregarded as the higher nature deteriorated. Moreover, no excessively one-sided organism can remain healthy. In such cases we commonly see the development of suicidal tendencies.[8] Our degenerate tribe would thus be suicidal both collectively and individually. In the most favourable circumstances imaginable, their career would resemble that of “The-do-as-you-likes” in Charles Kingsley’s “Water Babies;” but, as a matter of fact, no selfish tribe could have such a good time of it as even these unfortunates had, since roast pigs are not usually found running about in convenient proximity to the lazy.

It cannot be too widely taught, then, that the moment we withdraw ourselves from the paring and shaping action of life’s sieves, and choose only what is pleasant, our deterioration begins. Physical disease follows close at the heels of moral lethargy, just as physical disease may impair the moral sense. And the degenerative process being begun, our children and our children’s children, even unto the fourth generation, may bear the burden of our shortcomings.

In our efforts to raise a healthy race, we are apt to make one very serious blunder. We forget that the word nervous has two meanings. In its truer sense it implies strength, not weakness. Persons suffering from nerve-trouble have come to be called nervous, and so the sensitive organisation,—the finest, most highly developed organisation,—is quite unjustly depreciated. The healthy sea-anemone is less sensitive than the healthy human being. Would it therefore be preferable to be a sea-anemone?

The confusion between the large and complex nervous organisation and a diseased or defective condition has been aided by the fact that the genius—the truly nervous man in the higher sense, the largest offshoot from the great force-current—is invariably placed in hard conditions in youth. He pays the penalty for being before his time. He belongs to a higher standard than that into which he is forced. In the family nest he is the ugly duckling; in the world he is persecuted. When his marvellous insight and keen intelligence enable him to foresee the remote but lasting pernicious effects of practices that are clung to by his fellows for the sake of their immediate advantage, he falls by the hand of the assassin or is universally credited with madness. Centuries after his death, when his community has painfully toiled to his level, his greatness is recognised, and he is deified or canonised.

It is perhaps well that the growth of such offshoots is limited in every age by a mental atmosphere as real as the atmosphere surrounding our globe and limiting our aerial flights. Apparently it is not decreed that human progress shall be rapid. Nevertheless, a too wholesale destruction of our most highly organised members must certainly ensure that evolution backwards of which I spoke in another chapter.

The fact is, we find it hard to distinguish between genius and eccentricity. The uncontrolled eccentricities of the matured do so much harm, that it is found necessary to suppress them. But we should remember that the genius is always eccentric in youth unless he is allowed a very wide area for development—and this is the last service his friends are willing to do him. He has, as it were, to develop into a large circle. His great vitality and many-sidedness enable him to take advantage of any chance diminution of pressure, and in each direction where resistance is least he shoots out long points and angles. If any of these angles be lopped or violently discouraged, he may be a one-sided or distorted being. Let him alone, however, and in due course he will fill in the spaces between his angles and grow into a finely rounded being. But the magnificent virtue of letting one another alone is still little cultivated by our community.

Now, persons who are merely eccentric do not shoot out their angles in a variety of directions and fill in the spaces as soon as opportunity is granted them. They have only one or two long angles, to which they continue to add till they become such a nuisance that the peace and safety of the community demand their control. Both genius and eccentricity being hereditary, and the logical outcome of extreme eccentricity in one generation being insanity in the next, we need to exercise care in our dealings with these abnormal developments. To drive men of genius into the ranks of the eccentrics is a very dangerous policy. Let us honestly recognise the fact that we are all of us potential madmen.

Curiously enough, those who have the least pretension to sound organisation and rounded development are most often lauded as men of genius. Talent in one special direction developed at the expense of more essential parts of the organism, not an exceptional vitality, secures them this distinction. We should be cautious as to the objects we choose for admiration, since, by a natural law, that which we admire becomes prevalent.

Some persons propose to reform the world by means of checking reproduction from unfit types. But this measure would be useless so long as our conditions continue to coin the thing we would destroy. And if we could alter our conditions, the measure would be unnecessary, as the unfit already existing would soon die a natural death or be suitably modified. In some cases the wholesale change suggested would have very bad results, for the children of misdirected geniuses may possibly revert to the former standard and inherit the original genius of the parent without his recent aberrations. Our measures would but serve therefore to check the reproduction of these highly desirable types. In the midst of our black ignorance on such matters, our wisest course is to refrain from violent and irrevocable action. Instead of hurrying to lop people’s angles, it would be well if we were first to try the effect of removing pressure from the spaces between them.

The genius is proverbially known by his quick pulse, though the same symptom may be observed in many defective people. Waste and repair alike go on quickly. He is eminently adaptable; he takes any shape. But the great test of the genuineness of the article is his sincerity. Above all things must his higher moral sense remain intact.

History has given us one splendid example of the highest type of genius in the great Dutch hero, William the Silent; the man who, to use the words of his biographer, bore the burden of a nation’s sorrows on his shoulders with a smiling face. A homeless wanderer with a price set upon his head, poor, friendless and unsupported, this man opposed himself to the trained legions of Spain, the wealth of Brazil, and the tremendous machinery of the Inquisition.

The result was the independence of the United Provinces!

And the cause of it?

Here let us quote Father William’s own words.

“Before seeking to conclude a treaty with any earthly potentate,” he writes to his brother Louis, “I had entered into an alliance with the King of Kings.”

We are not surprised to learn that this man fell by the hand of an assassin, with a prayer for others on his lips.

TO treat such a subject adequately in so small a space is obviously an impossibility. It must suffice to point out some of the chief causes of nerve-deterioration in present conditions, and the directions in which some improvement may gradually be wrought. The notion that evils can be remedied merely by passing laws is happily exploded. The law is now seen to be evidence and ratification of public opinion, and also a means of putting public opinion into action. Without this agreement on the part of the majority, the law becomes a dead letter, or is enforced only at the expense of dire catastrophe.

There is, however, one justification of the efforts of those who wish to pass laws condemning certain abuses: they actually influence the public mind by means of the agitation raised for the purpose of attaining their ends; and so they create the opinion they would ratify. It also frequently happens that the agitators arouse disgust at their bigotry and fixity of idea, and so produce an opposite effect to that which they intended. Indeed, though devotion to a Cause is generally supposed to be an ennobling thing, it sometimes happens that it is a debasing and demoralising thing. For, instead of Self being sunk in the Cause, the Cause becomes with many a very excuse for selfishness. Persons considered high-principled, who would on no account misrepresent or defraud for their own confessed advantage, will nevertheless think almost any expedient justifiable in what they are pleased to term the public good.

In this loss of moral sense and judgment we find the secret of much of the nerve-trouble of our day. The Self, having found a plausible excuse for its assertion, loses no time in becoming as suicidal in its tendencies as the uncontrolled Self usually is. Once committed to a course of action, that course of action must be adhered to throughout all opposition. Public support having in a weak moment been enlisted on some false pretext, our utmost efforts must thenceforth be used to prove this pretext true. Having gained a certain height, we dread to be cast from our elevation. Then come harassing worries, overwork, disappointment, and harmful excitement—all the sorrows, in fact, that tend to lower vitality and injure the nervous system.

This new evil seems no less deadly in its effects than an exaggerated personal ambition. Our complex social conditions render us in many respects more dependent on one another than formerly. We have associations and co-operations for everything. Increase of population and means of communication bring us more into contact with our fellows. Division of labour makes us indispensable to one another. We all govern one another. We all have, in some form, a voice in public concerns. Under the guise of advancing the common good, we have special opportunities for advancing Self; and it is the element of self-deception introduced into our striving after self-advancement, and our consequent habit of deceiving others, which are specially injurious to our moral sense. Marcus Aurelius tells us that that which is not for the interest of the whole hive is not for the interest of a single bee. He might with equal truth have said that that which is not for the higher interests of a single bee cannot in the long-run benefit the hive.

It may be questioned whether our exceeding unrest, our yearning for notoriety, our eagerness to overwork ourselves, i.e., to draw on our nerve-capital at the risk of breaking the bank, are not symptoms of widespread nervous disease in the community rather than its causes; just as, in the individual, the restless excitement regarded often as the cause of the after-malady is in reality but a symptom of the disintegration which has already begun. We may console ourselves with the reflection that, neurasthenia in the individual being curable, neurasthenia in the community is curable also; the community being but a collection of individuals.

To go still deeper into the matter, we find that we are living in an age of exceptionally rapid change, and all rapid changes have great dangers because of the difficulty we find in adapting ourselves to altered conditions. And the result of partial failure is seen not merely in complete break-downs, but also in a general lowering of the vitality of the nation. We are nearly all more or less nervous in the more usual signification of the misused word. We have less of the calm confidence that our fathers had; we indulge in alternate and spasmodic conceit and cowardice; self-doubt one moment, self-assertion the next. The way in which we skulk through life in terror of one another is truly ridiculous. Our sensitiveness to the opinion of others is extreme. Can we not realise that the opinion of others is of little moment? It matters, indeed to themselves, though not to us; for the mode in which people accustom themselves to think inevitably alters their nervous structure. It is for them we should be concerned if they think wrongly; not for ourselves. And while we spend our precious time in doubting and fearing, in disputing as to whether men have wills or women have minds, the great force-current flows tranquilly onwards, men and women alike being but fleeting forms, capable of infinite development or of utter degeneration.

One fertile source of danger to our stability has been the marvellous speed at which human thought has advanced in this century. Owing to recent scientific discoveries and mechanical inventions, the minds of our younger generations have, in some respects, become more enlightened than the less plastic minds of their elders. This inequality has produced a great strain in many relations of life. Old theories have been tested by the light of fresh information, and much misery and nerve-deterioration have been occasioned in families by the rejection by the younger members of tenets held sacred by their parents; real high principle having, on both sides, prevented the sacrifice of belief, which alone could effect a compromise. Each side seems to the other to be cruel and unreasonable; yet both are right, even if both are wrong. The elder, owing to their lack of faith, close their eyes to God’s ever-progressive revelation; the younger, in their determination to believe only what is demonstrable, lose sight of the value of much that they deem worthy of rejection.

The position may be illustrated by the following allegory.

Who could they have been, these timid, sceptical creatures, who accused their children of the want of faith which was destroying themselves?

We have seen in the above story that some of those who valiantly endeavoured to gain the new lake perished by the way, and so we find that our recent scientific advances have been a cause of nerve-trouble, apart from the persecutions they have entailed. The mental strife we have gone through in our attempt to reconcile the ideas stored in our minds, by no will of our own, with God’s ever-progressive revelation, should teach us not to instil into the minds of our children as absolute truth that which must necessarily be but approximate truth, changing always with our own development. Seeming scientific facts themselves assume a different complexion so soon as scientific discovery goes still further. Even the axiom that two straight lines continued to infinity cannot meet, ceases to be a fact to us, and is relegated to the region of rational hypothesis, when we realise that we have never so much as seen a straight line, all seeming straight lines being but parts of curves; and that the mental picture we have been accustomed to form of a straight line is but a picture of one of these curving lines. Almost the hardest thing we have to learn is the impiety of putting cherished beliefs in the place of the great God of the universe. Like Abraham, we are called upon to sacrifice our Isaac. Like Abraham, we no sooner freely consent to do so, than we find the ram ready for the sacrifice. Directly we close our eyes to God’s progressive revelation and accustom ourselves to inconsistency and to fallacious reasoning, we unconsciously deteriorate.

Another outcome of recent rapid changes has been a great increase of wealth, together with its unequal distribution. Whether this unequal distribution might have been prevented, and whether it may or may not now be remedied, cannot here be discussed. We have but to inquire whether it has anything to do with the prevalent nerve-trouble; and I think we must admit that excessive luxury on the one hand, and excessive poverty on the other, are largely productive both of monotony and overwork. At all events, it is principally amongst the well-to-do classes that ennui is complained of.

It cannot be doubted that monotony is a fertile source of nervous disease. The fact is not always received, because the nature of the evil is not understood. We fail to realise that monotony is an actual strain upon the nerves, often an even greater strain than extreme fatigue; for those who are overworked are supposed to require a holiday or change of occupation, while those who are suffering from monotony often get no relief until so much harm is done that mere change of scene or of occupation is inadequate to repair the damage done to the ill-treated nerves. In such cases the mischief wrought in the individual is similar to the mischief now being wrought in the community—in each there is excessive use of one part and disuse of another.

If we doubt that monotony is really a mode of overstrain, let us consider the very meaning of the word. Why do we speak of a preacher’s voice as monotonous, and why do we find the monotony of it tiring? Is it not because a strain is thrown upon one part? If his preaching were more varied, a number of smaller impressions would be made upon other parts. If all the light which falls upon our eyes in the course of the day were concentrated into one single flash, we should be blinded. And supposing that all the impressions we receive throughout the day by means of hearing, touching, tasting, and smelling, were to be concentrated into stimulus of the brain passing through our eyes, we should probably still be blinded, even though the process occupied the whole twelve hours. But we fondly imagine that, though we have faculties to develop and sympathies to enlarge by means of active life in the world and contact with our fellows, we can shut ourselves off from the duties and occupations which are as essential to our health as our daily food, and yet escape the deterioration and suffering which must naturally follow our over-use of one part and our disuse of another. We forget that we can never cease to receive impressions unless we actually close our senses, as when we shut our eyes and stop our ears. All we can do is to determine what set of impressions we will receive. And if we are always attracting nutriment to one particular part of our nervous system to the exclusion of others, we are going the right way to become ill-balanced. Not only are we rendering ourselves liable to mental disease by choosing bad mental surroundings, but to physical disease also, since no bodily function can be performed without the co-operation of the nervous system. Highly organised persons suffer more from monotony than others, because they have more faculties demanding healthy exercise, and also because the greater the sensitiveness of our nerve-structure, the less can we bear constant fatigue of one part.

The greatest sufferers from this species of folly and ignorance are, and always have been, women. That curious form of neurasthenia which passes under the singularly inappropriate name of “hysteria” is largely the outcome of our modern ill-usage of the nervous system—the overstrain of one part and the starvation of another. And owing to a marvellous tendency of the human mind to add insult to injury, this very affliction, which should most command our sympathy and aid because it originates in cruel and idiotic injustice, is commonly regarded as fair game for our sneers and reproaches. More than that, the female sex, having been especially subjected to this kind of injustice, is often reproached with inferiority because of the liability of women to fall victims to the malady. It is as though we were to cut off a man’s arm, and then laugh at him for having only one. Even women themselves, galled by the contempt shown to their sex on account of its supposed “hysterical” tendencies, display a lamentable want of feeling when dealing with cases of nerve-trouble. They should bear in mind that if their attempts at putting themselves on an equality with men seem to destroy their womanly sympathies, they are not likely to attain their end.

But we are now realising that the sons of “hysterical” women are apt to suffer from neurasthenia, or even from epilepsy or insanity; so there is hope that their sufferings may at last receive adequate attention and consideration.

It is sometimes argued that in these enlightened days women are no longer compelled to endure the miseries of monotony that have so recently been their portion. This is, I think, a mistake. In large towns, doubtless, outlet is usually found for their activities, but numbers of women of the educated classes reside in the country and undergo a sad process of deterioration, owing to the prejudices entertained by those about them against their leaving home or seeking congenial employment. The complaints I have to listen to from ladies who have nothing to do are heart-rending. Tell them to cook their dinners, and you find that some foolish convention stands in the way; urge their entering some useful calling, and you are informed that their family will cut them if they do anything of the sort. Possibly the only occupation open to them is one for which training is necessary; and they have not been trained. And then, because an evil naturally generates its opposite, we find that when these women do succeed in finding employment, they rush to a pernicious extreme and overdo themselves.

When mischief is once set up, and an unhappy sufferer falls into the hands of unsympathetic doctors and nurses, her trials increase and multiply. If she be suffering from seeming inactivity, she is reproved, “roused,” and ordered to exert herself; the actual strain on the nerves of monotony, and the need in many cases of absolute repose, being wholly ignored. On the other hand, total inactivity is sometimes prescribed as a remedy for overwork, when restlessness is so great that enforced idleness maddens. The patience to gain the confidence of the sufferer, and the sympathy to understand her ills and their causes, are attributes of the higher order of mind that our sieves so often weed out.

The evils of overwork are too well known to need much comment. Those who have to earn their living cannot always avoid excessive fatigue, and they are specially liable to suffer from it if cursed by congenitally feeble organisations. But the strange thing is, that persons not obliged to work hard, and not rendered restless by previous enforced inactivity, should nevertheless deliberately make themselves ill. Nervous exhaustion, however, is extremely insidious. We can draw on our capital for a length of time without being made unpleasantly aware of growing weakness; and though self-destructive tendencies do not usually originate in a healthy, well-organised mind, people of good constitution do sometimes break down in consequence of the physiological ignorance in which they have been reared, or under the stress of a combination of exceptionally untoward circumstances.

Sometimes the true cause of the evil is to be found in an exaggerated personal ambition, showing none the less an ill-balanced mind; for, what truly sane person would sacrifice health to such chimeras as wealth and fame? All who have experienced wealth know perfectly well that it means simply an accumulation of bothers and a sense of responsibility; that we cannot, with our best endeavour, spend more than a certain amount upon ourselves, and that the possession of great wealth really means our acceptance of the arduous and thankless task of distributor to other people. The only remaining reward possible to us is the answer of a quiet conscience, and even that, we are aware, depends largely upon the liver, which organ luxury is apt to upset. It is chiefly from the wealthy that the ranks of the pessimists are recruited; and naturally so. For just as perfect health cannot long exist without self-forgetfulness, so all genuine happiness is to be found in working for a worthy object. Happiness of this kind and health of the nervous system go hand in hand;—at least, I have never found a prolonged divorce between the two possible.

As to the other chimera, fame, those who trouble about it must surely have a twist in their brains somewhere. The thing is a mere delusion of our own. Let us consider how far our greatest English writer, William Shakespeare, is known to the world. Of the vast populations of Africa, Arabia, India, China, Japan, and Polynesia, to say nothing of the inhabitants of Northern Asia, the native races of Australia and the Americas, and the peasantry of the Continent, few have so much as heard his name. And out of the small minority who have heard of it, how many have read a line of him? Even to the mass of our own population he is little known. Yet he lived but a couple of centuries ago and wrote as few men have written.

The earliest historical record takes us back only four thousand years or so—about a hundred generations—a mere flash of time compared to the ages during which our planet must have endured; and of all who lived before this brief period we know absolutely nothing.

For what, then, are we sacrificing our health, strength, and happiness?

WE mould the clay while it is soft, that it may not be chipped or pulverised when it is hard by contact with obstacles which it has not been fitted to overcome. Is the process usually effectual? With how little destruction to life, with how little injury to character, do we graduate the sieves of our younger members? Do we succeed in moulding them into sane, capable citizens, or are we so careful to impart special kinds of instruction, to develop the part at the expense of the whole, that our interference is positively detrimental to the individual, and consequently to the community at large also?

I fear we can hardly be acquitted of this grave charge. The physiological demands made by growth and development on the vitality of the child are so great, that not only are abundant fresh air and nutrition required for the work, but also a considerable supply of surplus nervous energy. To use up this surplus energy for purposes other than that for which it is intended, is to stunt growth, or to limit the development of the mental faculties, or to diminish nerve-power; one of the three inevitably. And the diminution of nerve-power must bring with it physical, mental, or moral atrophy, according to the part on which the greatest strain has been put and the conditions in which the victim has been placed.

Moreover, children of large natural capabilities, whose complex nervous systems require an exceptional amount of nutriment, and whose sensitiveness and plasticity cause them to respond readily to instruction, are just those who will first break down under prolonged strain; and thus we may easily weed out the finer organisations, and continue the race from the less highly developed types.

Observation of nervous patients shows us that their small stock of available nerve-force may be attracted to one part to the detriment of another. For this reason nervous disease is specially difficult to understand. One patient told me he could get on fairly well if he used his body and not his brain, or if he used his brain and not his body; but if he tried to use both in the same day, he became ill. Of course, he did in reality use both at the same time; what he meant was that, if he exerted a fair amount of activity in the brain, he had only strength to exert a very small amount of activity in the rest of the body, and vice versâ. He was right in saying that his available store of energy was so small that he could not expend even a moderate amount of it in both physical and mental labour during the same day.

Others have told me that if they devoted themselves for a few days to book-work and abstained from bodily labour, their studies became easy and were performed without fatigue; but that if they began to take exercise, they were compelled by exhaustion to abandon the book-work. Moreover, the physical exertion caused great fatigue for a day or two, until they grew accustomed to the altered mode of expending energy; and when it had become easy to them, the same weariness was experienced for a short time on their return to the book-work, even though the bodily exercise was then totally discontinued. By no effort of will could the two modes of activity be carried on together, unless only a very small amount of power was expended in each, the rest of the day being given up to repose. Total collapse followed the attempt, for the necessary nerve-force was wanting.

We thus learn when we are weak a truth which is less apparent in health, viz., that our available energy is a strictly limited quantity, dependent on nutritive supply. How great, then, is the folly of those who would urge to exertion persons in whom the nutritive supply is defective! But how much greater is the folly of those who, during the early years of the individual’s life, when the constitution is being formed and future health in great measure determined, will persistently compel him to expend his nerve-force in a particular direction, to the detriment of other parts of the organism, or who put such a strain upon the whole that the constitution is permanently injured! The partial injury is perhaps the more dangerous because it is the less easily observed. If a child begins to break down altogether under the stress of his school course, we become aware of the fact, and by timely interference sometimes—not always—put a stop to the work of destruction. But many delicate boys and girls contrive to struggle through their school course with little apparent harm, because the greater amount of their spare nerve-force being attracted to the part on which the strain is put, the allotted tasks can be performed. Whether growth is thereby stunted; whether nerve-force in general be decreased; whether perceptive power be dulled; whether the child have been withdrawn from the active experience of life necessary to healthy development; whether his various physiological needs have been fully supplied—all these questions frequently remain unasked, provided that the child have learnt a specified number of the more or less erroneous notions of his ignorant fellow-creatures, and have put them down on paper. And if he become neurasthenic, or succumb to some complaint to which his lowered vitality makes him fall an easy prey, or if he grow up with feeble powers of observation, or without the self-control dependent on the firm will that can only be developed by means of the right expenditure of a considerable amount of nerve-force, little connection is traced between his defective education and his defective nerve-structure. The children whose education has consisted chiefly of instruction from books cannot properly be said to be educated at all. In most cases their minds are warped by fixed ideas.

This is not saying that children should not be taught in the best sense of the word; that they should not be disciplined and trained to self-control, to habits of attention, and to ready observation; that they should not have an intelligent interest awakened in them concerning the universe in which they live. But mere book-learning will never do this. It is, unhappily, possible to be a walking encyclopedia of so-called knowledge, and yet to be an imperfect reflector of the life of our time.

And of the wonders and glories of Nature that surround us every moment from the cradle to the grave, how much are we taught? Yet these can be studied at our leisure out in God’s blessed air and under God’s blessed heaven. In the garden, at the river-bank, on the hill-side, by the sea-shore, in the lonely desert, there we may find health and wisdom and knowledge and happiness; and how many of us go to seek them there?

“A morning glory at my window satisfies me more than the metaphysics of books,” says Walt Whitman. Few of us ever see this morning glory; indeed, very few of us even take the trouble to look at an evening glory. I have stood day after day on the parade at a small seaside place, and have watched the sun sink below the watery horizon; sea, sand, rocks and sky all being illumined with magnificent colouring. Well-dressed people would pass and repass, some averting their eyes from the splendid spectacle lavished on them by prodigal Nature, others glancing at it vacantly with irresponsive countenances, others gazing on the ground or at one another, and talking of the cut of their new dresses or of the prices of stocks. Hardly any ever paused to look and admire. Poor creatures! All this joy—joy showered abundantly on me—was simply rejected by them. The essential God-like part of their natures had been starved; they had been taught in stuffy schoolrooms by wearied teachers and out of musty books; appreciation of the works of the good God had not been included in the curriculum. Carlyle mourns the extinction of the lamp of the soul. He is premature. In most of us it is never so much as lighted.

Yet we have within us somewhere the capability for seeing—though as in a glass darkly—a dim reflection of the Lord of Glory. We have but to look—to be taught how to look aright—and to us the Lord shall be in the earthquake and in the storm. We have but to listen—to be taught to listen aright, and throughout the universe we shall hear the still, small voice.

To Carlyle it was a tragedy that one man should die ignorant who had capacity for knowledge. And are not the majority of us ignorant even of the very things which lie most easily within our reach—of the air we breathe, of the ground on which we tread, of the skies on which we gaze? There is something known approximately about all of these which no man hath taught to us. After all our years of nerve-deterioration in stifling schoolrooms, few of us know anything of the very simplest facts of life, of the composition of our own bodies, of the most ordinary conditions of our own existence.

If any one doubts this assertion, let him ask two or three very elementary questions in very elementary affairs of his neighbours and acquaintance, and note the answers he obtains. The thing is easily tested. Persons regarded as educated—persons who know all about the doings of a certain aggressive warrior of past times, who from mere greed of conquest cruelly attacked harmless savages, and then had the hardihood to describe his own misdoings in writing—are hopelessly lost and bewildered if you say to them, “What is your brain composed of?” “What is a choanite?” “What makes the leaves grow on the trees?” “Where does the soil in the garden come from?” “How does the dew find its way on to the grass?” “Why does a ball bounce?”—or some such questions which sound elementary and unscientific enough.

But perhaps the knowledge required to answer these questions correctly belongs to departments of science which in most schools are regarded as extra subjects, and only taught occasionally and perfunctorily. It is certainly strange that information which ought surely to be imparted early, and which may be imparted in a most interesting and enjoyable way, should be put on one side for dry dates and grammar, a superfluity of arbitrary arithmetical rules, and the record of immoral conduct on the part of antique conquerors,—things which few wish to remember, and which sensible persons mostly take pains to forget.

After all, we have only a limited space in which to store our knowledge. As we grow up, we have to learn the things that are suited to our several professions. We have no room for useless lumber, and must cast it out. It never ought to have cumbered the ground. Let the dates be for the historian, the grammar for the grammarian, the immoral records for the classical scholar, and the endless arbitrary rules for the dull. By the time we have specialised, we shall know what uninteresting details we are forced to master, and what we may safely leave to the encyclopædias. We shall not then have disquieted ourselves for nought. Our early education should before all things mean for us “the harmonious development of all the faculties.” For each of us and all of us should be laid the foundation of the love of God and the knowledge of such of His works as daily surround us. No other foundation can be secure.

As matters at present stand, we learn quite as much out of school as we do in it. The training of the eye, and the hand, and the judgment in games is not usually considered a necessary part of education, but it is a very important part of it nevertheless. I am not sure that, up to a certain age, it is not the most important part. We are apt to forget that we go through life rapidly calculating weight, distance, and balance, and that our success in many branches depends on our power of ready attention, on our promptness of action, on our quick observation of natural phenomena and the ways of our fellow-creatures, on our delicacy of manipulation and on our perseverance and self-control, quite as much as it does on the knowledge we have learnt from books.

Considering the imperfection of our present system of education; considering how we dwarf, stunt, and starve the noblest and best part of each individual, and the noblest and best individuals of the community, the wonder is, not that there is so much nervous disease amongst us, but that there is not more. Fortunately the tide has begun to turn, and we are at last becoming alive to the fact that our method of instruction is not all that could be wished. But we wake up slowly, and “cramming” is still the order of the day. Indeed, competitive examinations seem to be multiplying while we are cogitating. This is much to be regretted. If ever the time arrives when all public posts and places of trust are filled by persons who have gone through this extraordinary process of mental stuffing, and who are about as fitted to understand the needs of our race and the conditions of our right development as Strasburg geese are fitted to set an example as athletes, then may God have mercy on us all! In our complex social state, the nimble wit, the ready invention, the adaptive disposition, are specially needed to find out for us the best means by which the resources of Nature may more and more be used for our service and to the support of our ever-increasing populations. Persons who survive a process which destroys the most sensitive and adaptive minds are but the intellectual lees and dregs of our community. To perpetuate these at the expense of the more highly organised is literally suicide. We are scarcely alive to our danger, because those who have been trained on a different pattern still take the lead amongst us, and the full results of the system of “cram” are not yet seen.

I was talking the other day to a lady who had recently been passing her time in preparing lady candidates for examinations. She herself had survived several of these ordeals; and, without falling into the error of those who have eternally saddled on the innocent Tenderden steeple the sole responsibility for the appearance of the Goodwin Sands, it may be casually observed that she was in a frightfully nervous condition, rendering her society a real trial to all but those skilled in the care of nervous invalids. She answered candidly some questions which I had the hardihood to put to her. I give both questions and answers almost word for word:—

Comment is needless.

I have had some opportunity of observing the cramming system in Germany, and have been struck by the unsatisfactory nature of the results of what goes by the name of education amongst girls of the well-to-do classes. A German lady, who had had experience as a teacher in a large public school, told me that she considered the present system of teaching an entire mistake. “Look at the results,” she said. “How many German women ever open any book but a novel? What do they care for culture? The teacher has no time to interest the girls in what they learn. All there is time for is to cram them with the facts without which they cannot pass the examination. As if true education could be tested by an occasional examination! And the sacrifice of health amongst these young girls is terrible!”

For my own part, I heartily sympathise with German ladies who read nothing but novels. In my childhood I was taught French in England on the most approved methods and at the cost of much hard toil. I afterwards picked up German in Germany itself and in a pleasurable manner. Ever since, the sight or sound of a French word has brought to my mind the recollection of weariness, of being bored, of dry grammar that has been of no earthly use to me, of a deplorable waste of sunshiny hours. But the sight or sound of a German word recalls the soft thud of my horse’s hoofs as I galloped along the natural Rotten Row of the German pine forest; the ring of my skates as I glided swiftly over the frozen meadows; the picturesque old houses standing out against a frosty sky; the band in the Casino gardens; the voice of the soprano at the opera; the magnificent chorus, “Heilig, heilig ist Gott der Herr,” sung at the sacred concert in the old Marktkirche. And so it has come about that while I am fairly well read in German literature, I am lamentably ignorant of French literature. The study of the one is pleasure; the study of the other is pain.

The mental impressions which delight are those that weave themselves healthily into our structure and form a groundwork for future impressions of a like order. Our happiness is composed, not only of the joys of the present, but of the joys of the past. Learning, if it is to be of the highest benefit to us, must before all things be made pleasurable. In a few schools this principle is being recognised, but owing to the low value still put by the community upon the best kind of teaching, the reform is often carried out at the expense of throwing a great strain upon an inadequate teaching staff. In the best of our high schools for girls, the number of teachers is insufficient because the funds are insufficient. We have not yet learnt to appreciate our advantages and to pay a reasonable price for them.

We willingly spend our money on luxuries. Money represents so much energy. And if the energy of the country be spent on that which enervates, while that which improves and develops be left to languish, how are we to avoid deterioration?

But before we spend our money on so called education, let us be sure that it is worthy of the name. Cramming with detail is not beneficial instruction; book-lore is not always wisdom; pedantry has nothing to do with culture. It is a trite saying, but none the less true, that the only positive knowledge we are capable of acquiring is a knowledge of our own boundless ignorance. The first stepping-stone to a right understanding is humility.

MANY minor causes of nervous exhaustion have been so often cited, and such serious warnings have been uttered against them, that it is scarcely worth while to draw attention to them here. It may suffice to enumerate those which are more frequently ignored.

Of the infectiousness of nervous disease it seems almost useless at present to speak, for few will listen. Probably the malady will, for some time to come, continue to be spread abroad by those who suffer from it, as certainly as leprosy is spread by the leper. The early symptoms not being readily observed and recognised by the uninitiated, great mischief can be wrought while all around remain unconscious of the impending disaster. To young persons, and to those who inherit a predisposition to nerve-weakness, the danger of infection is specially great. Moreover, the predisposed often aid one another in the development of the malady, a fact which is sufficiently proved by observation of families exhibiting neurotic tendencies.

It has been fully recognised that imperfect recovery from some attack of illness is a frequent cause of neurasthenia. It is not fully recognised that the cause is usually a preventible one. A very common blunder is generally at the root of the mischief. It is thought necessary to hurry on the convalescent lest she should “drift into chronic invalidism,” as the saying goes. The result is that the patient recovers to a certain extent, only to fall a victim later to chronic nervous weakness. Patients who are making a natural and healthy recovery are over-eager to exert themselves, and require to be kept back. Should this eagerness not be manifested, it is a mistake to say that the patient must be roused in order to preserve her from neurasthenia. Neurasthenia is already there, and unless the building up of the nervous system go hand in hand with the patient’s exertions, those exertions will assuredly be productive of harm. Unfortunately the patient is frequently removed from the watchful care of the doctor and the nurse just as watchful care is most urgently needed.

It does not occur to many of us, but it is nevertheless true, that whenever we foster wrong theories of life, we render ourselves liable to nerve-trouble. If we make mistakes in our drawing of the chart by the guidance of which we mean to steer our bark,—if we omit to note down the most dangerous rocks, and imagine obstacles in a course which we might follow with safety,—small wonder that we suffer shipwreck. Mr. Laurence Oliphant has pointed out how foolishly we encourage erroneous notions in the children in our schools; how persistently we teach them that the road to happiness is to be found in selfishness, and award honour and approbation to those who have succeeded in getting the better of their fellows. In the wider school of the world the same principle is adhered to. The man who amasses a fortune, however selfishly, is the man to whom the peerage is offered, and for whom we manifest admiration. Nemesis follows. Those who are plunged into conditions for which they have not been gradually fitted necessarily suffer in the change. Unaccustomed luxury brings its own deterioration, while the excessively unequal distribution of wealth thus encouraged brings inevitable misery on the whole community. To the Shakespeare and the Newton no peerage is offered and scant admiration is accorded, though by their individual genius the whole race be raised. Consequently, the Shakespeare and the Newton are rare birds; not because it matters to themselves whether they are rewarded or no; not because the heaven-sent genius requires any earthly inducement to do his heavenly work; but because we create, for that which we admire and reward, an atmosphere in which it can arise and flourish.

There is one very serious result of our refusal to honour those to whom honour is due. The task of raising and training healthy and capable people to the work of the world and the service of God, and—as the orthodox believe—in the very likeness of God, is surely not the least noble task to which human beings can devote themselves. And this, though in a degree men’s work, is, in a greater degree and in a more special manner, the work of women. What honour is awarded to women who guard their health, develop their faculties and enlarge and enrich their minds, that they may be fitted to perform the community’s highest work? Absolutely none. True, it is not their only work; it does not fall to the lot of all to perform it; but every good and well educated woman, knowing herself to be a potential mother, tries conscientiously to fit herself for the part she may be called upon to play, and in so doing becomes aware of her own value. That so few women thus prove themselves to be good and well educated is scarcely the fault of women in particular. It is the fault of the whole community. Just as a Shakespeare and a Newton may rise superior to inadequate appreciation, so do some great women. But these women are, and must be, exceptions. The majority of women, no less than men, depend in large measure on the sympathy, approbation, and esteem of others.

Perhaps women need these incentives even more than men need them, because for centuries their love of approbation has been developed abnormally by their dependence on men, and by the need they have experienced of securing their approval. Natural feelings, denied egress by the front door, find their way out at the back door. By reprehensible means, and greatly to the detriment of both sexes, women have continually forced themselves into notice, while fulsome flattery and exemption from work demanding the healthy employment of their faculties, have taken the place of legitimate and inspiring honour.

A fresh result of the determined withholding from women of the distinction and approbation which has been honestly earned, is manifesting itself in a curious manner in these modern times. Women too noble by nature to indulge in ignoble ways the faculties within them that cried out for exercise, stung by taunts of inferiority, chafed by the deprivation of means for obtaining the rational education and the experience of the world which were to them as the very breath of life, conscious of talents no whit inferior to those of the men about them, have flung themselves into the whirl of public affairs, and, with truly admirable perseverance and indomitable pluck, have won for themselves the only honours open to them.

Some good has thereby been wrought. Employments suited to women, and hitherto closed to them, have now been thrown open; book-learning—too often a miserable system of cram, but perhaps better than nothing at all—has been placed within their reach. Public attention has been attracted to long-standing injustice; and considering the immense importance to the whole race of the full development of all the faculties of women, it was, and still is, to the interest of the public to give the fullest attention to the subject which it can manage to spare.

Unfortunately the affair has another aspect which here closely concerns us. The over-eagerness with which some women have thrown themselves into the struggle for existence has in some quarters earned for the sex as a whole the reputation of possessing more self-feeling, less disinterestedness, and more sordidness of aim than men. It has been rashly assumed that because the pioneers of a movement have acted foolishly, because they have been injured in fighting a battle harder than any that will have to be fought by those for whom they prepare the way, all women are necessarily unfit for active life in the world. Alarm on the one side generates deleterious irritation on the other side. Faculties which might be devoted to the creditable performance of valuable work are dissipated in fighting for the privilege of doing the work at all. It should be remembered that those who have been starved always devour food with injurious avidity when it is at last brought within their reach, unless they are mercifully restrained by wise well-wishers.

It cannot be doubted, however, that women who conscientiously perform their own special work in the world must have less strength at their disposal for other work than the majority of men. So far from this being to their discredit, the extreme importance of their own special functions ought to be more generally recognised. At the present time, the women who neglect their duties are apparently held in as much esteem as the women who render the State the highest possible service.

Another point is worthy of careful consideration. Certain professions were once held to be unlawful for women on the ground that their intellectual faculties were of too inferior an order to enable them to follow masculine callings successfully. Women thereupon attained eminence in these very professions, thereby proving that their intellects, at all events, were equal to the occasion. An intimate acquaintance with some of the women who have thus proved their mental capacity has convinced me that they are not, on that account, very highly organised people. So far from having enlarged their whole circle, they seem to have shot out a long angle on one side of their natures at the expense of drawing to a corresponding extent on the other side. The emotional part of them appears to be defective, and the defect manifests itself chiefly in a lamentable want of sympathy, and in an annoying, though often amusing, deficiency of humour. It may be that the sieves of these professions are of a particularly distorting order, and that the sensitive organisations of women are more easily injured by them than are the tougher organisations of men. Distortion is apt to produce nerve-deterioration in both sexes, but especially in the highly strung nervous systems of women.

Unfortunately, the Modern Malady is at present so little understood, that the very people who are betraying the most serious symptoms of nervous weakness are often declared by those about them to be in excellent health, a mistake which the sufferers themselves, eager to avoid the imputation of nervousness, are careful to foster. On one occasion I remarked to friends on the enfeebled state of nerve to which a clever and energetic woman had been reduced, owing in part to her labours in an arduous profession. Although the symptoms were unmistakable, my words were received with derision.

“Mrs. T—— nervous!” exclaimed my friends. “What an idea! As if such a thing could be possible!”

The notion that nervous weakness was a species of illness to which any one might fall a victim if placed in conditions calculated to produce it, was entirely beyond the mental range of these good people. And following the natural law, in proportion to their ignorance was their conviction of profound wisdom. Mrs. T—— had more and more earned for herself a wide reputation for “strong-mindedness.” She was popularly supposed to be “hard,” and judging from my own experience of her character, I should say that the popular judgment was in that instance more correct than usual; though why so noble a quality as mental strength should be associated with defectiveness, with the terrible process of loss of feeling—a continual lopping of the sensitive tendrils by means of which the human plant keeps itself in touch with its environment and draws from it its mental nutriment—I am unable to imagine. Now, my friends were convinced that the defect of emotional nature commonly called hardness, and a condition in which emotional symptoms are often manifested, were things incompatible. They therefore bestowed ridicule upon me, and considered that they had “fixed that matter up.” My belief is that the dear ladies would have “fixed up” with equal alacrity any matter in the whole of this wide universe.

But Dame Nature, always stern in carrying out her threats, slowly but surely brought Mrs. T——’s downward career to its logical conclusion. She was compelled to give up work and seek seclusion for a season. Her friends and acquaintance were surprised, but the tragedy was by no means astonishing. Ambition, and consequent overwork, began the mischief; the hardness which was supposed to be her safeguard completed it. Once out of sympathy with her fellow-creatures, her sorrows were endless. Loving herself more than them, she tried to act in her own interests in opposition to theirs. Her fellow-creatures took their revenge. The perception that is born of sympathy now being blunted, she estimated their characters wrongly; she confided in the untrustworthy and was suspicious of the trustworthy. Her blunders were productive of suffering not only to herself but to others. Blame, friction, and harassing cares followed, in the midst of which her brain gave way.

There are those who, cursed by the taint of insanity in their families, pray daily to God to preserve them from this frightful evil, and who, even while they are praying, turn their backs upon the road that leads to sanity. That road is the enlarging of the sympathies.

It is sometimes urged that much sympathy is a bad thing, not only for its possessor, but for those with whom he comes in contact. Persons who give indiscriminately to beggars, who make a great show of superficial pity and affection, or who shed tears on the smallest provocation—all, in short, who, from nervous disorder or congenital weakness, are wanting in judgment and self-control, are almost invariably classed with highly developed people of large emotional natures.

As a matter of fact, the two classes have nothing in common. Any poor lunatic, whose injured nerve-centres are incapable of disposing healthily of the full amount of energy generated, can manifest an excess of superficial emotion. It is noteworthy that the very people who save themselves trouble by giving to beggars without careful inquiry into the merits of the case will save themselves trouble in other respects at the expense of their fellow-creatures, and that those who harrow others by a needless and self-indulgent emotional display are precisely those who will abundantly prove their selfishness and shallowness of feeling so soon as any sacrifice is demanded of them.

On the other hand, we sometimes find that the most truly sympathetic people earn for themselves a quite undeserved reputation for hardness, for it is not always either wise or kind to show all the sympathy we feel. Only the largest natures can rise superior to their innate love of approbation; only those who are really actuated by a desire to benefit humanity can resist the temptation to flatter weakness when there is anything to be gained by so doing. The most successful in this respect run the greatest risk of misconception. Self-control is regarded as want of feeling; unselfishness may appear like indifference. In dealing with the nervous, virtue must often be satisfied with its own reward. After all, the reward is a large one. It is nothing less than the cure of our patient.

Continued unselfish action is the only sufficient test of deep feeling. The tree is known by its fruit. The world is full of mimetic people who can speak so well and write so well as to deceive the very elect, should these be so simple as to judge them by their professions. Unhappily the elect too often forget the injunction to acquire the wisdom of the serpent.

Amongst the most serious secondary causes of nerve-deterioration in modern times we find one to which attention has recently been drawn by many writers of distinction. It is not merely overwork, hurry, and excitement that are injurious to our organisms, but a lack of the solitude and calm in which impressions are combined and ideas created. Many of us live in the midst of such a whirl of rapidly succeeding sights, sounds, and sensations, that only a confused recollection of them is left in our minds. It is as though we were to eat incessantly, leaving no leisure for digestion; as though we were so eager to know, that we should refuse to wait to learn. We forget that the sure test of knowledge and progress is the power to reproduce the impressions we have assimilated; not the very elementary capability of putting down on paper the undiluted and undigested detail which has been stuffed into the outer chamber of our minds for that purpose. We must create; we must see, and show to others, “the light that never was on sea or land.”

How is this to be accomplished? In attempting to answer the question, let us consider what we do when we wish to obtain the photograph of a face that does not exist. We photograph a number of faces one over the other on the same plate. Is that enough? Does it suffice us to obtain a series of impressions on our plate? No; we now need the dark room, the developing and fixing solutions, and the presiding genius of a higher intelligence, before we can obtain the negative of a face that never yet was seen.

And if in this age we expose ourselves to an abundance of impressions, but ignore or underrate the solitude of the dark room, the imaginative faculty which combines and develops, to say nothing of the presiding genius of a higher intelligence, what is to become of our creative power? What, indeed, is to become of our sanity? Moreover, we must remember that there is one great difference between ourselves and the photographic plate. The plate is sensitised once for all; it receives its picture and its work is done. But we are, or may be, always absorbing into ourselves that which sensitises us more and more highly, and of receiving more and more perfect pictures. In addition to which great privilege, we may not only communicate to others, but eventually hand down to others, the faculty thus obtained.

How much reason is there in the creed that we should believe only in the existence of that which is borne witness to by our five senses? In that case we must consider ourselves as perfectly developed as it is possible for creatures to be. All evolution has been a course of rendering ourselves, and being rendered, more and more capable of discerning that which is; and, considering how feeble an atom is man in the midst of so mighty a universe, it is unlikely that the process can yet be finished. Perhaps the deaf bee believes itself to be perfectly constituted, yet a whole world of sound is cut off from it. Just because it has so tremendous a defect, it is unable to comprehend its own loss. From how much in the universe are we also cut off? How far do we injure ourselves by ignoring the existence of that which it is important to us to learn? It is argued, however, that reliable evidence should correct the evidence of each man’s individual senses.[9] When we inquire more closely what is meant by this, we find merely that the experience of the majority of mankind in the past is the source of light which is to illumine individual darkness. A strange source truly! Supposing that the most highly developed of the bees—and the most highly developed are necessarily a small minority—were to obtain some inkling of the nature of sound, and were to attempt to impart it to their companions, would they not be told that the universal experience of bee-kind was against their theories? Would not the deaf creatures be angered by the insinuation of their deafness and consequent inferiority?

And so we may in time discover that, though the honest agnostic may be, and often is, far superior to the dogmatic religionist, it is only persons of a certain degree of development (of all classes) who are capable of belief in the unseen, and that this development has little to do with the faculty of passing examinations. It is possible that the higher faculties are not best developed as we imagine; that what we most usually call brain-work is often rather a means of using up our store of intellectual power than of developing it. The fact that our greatest men of genius have come from the lower ranks of life rather than from the higher should lead us to ask whether the nobler part of mind grows better in the school of the pedagogue or in the school of Nature.[10]

There are cases on record of animals who have been taken by a circuitous route to a distant land, which they had never before visited, and who, on being released, have returned home as straight as the crow flies. In like manner, people have been known to find their way direct to their destination through portions of crowded cities to which they were strangers. Others walk confidently in the dark without hurting themselves. They feel when they are near an obstacle or a precipice. Others approach the most savage beasts and receive no hurt.

If these instances are rejected as fables, we must in consistency reject many supposed scientific facts which we have accepted on no better evidence. Yet what sense or faculty possessed by the majority can account for them?

The man whose measure of the universe is largest, whose development is the widest and most symmetrical, is the man who, having once reached maturity, is the least liable to fall a victim to neurasthenia; not only because his knowledge of quicksands is greatest, but because he has proved his adaptability. The success or failure of the large nature to reach maturity depends quite as much upon circumstance as upon the rate and method of his development. One great poet may survive detraction, but a Chatterton destroys himself. If the detraction be equal in both cases, other circumstances are very different. Coleridge survived a mistaken and injurious mode of education, but he survived it—an opium-eater.

Observation and experience teach us that human beings may be divided into two classes. (1.) Those who act; (2.) Those who are acted upon.[11] The first class, whether so regarded by the world or not, are essentially sane. The second, whether so regarded by the world or not, are essentially insane. The first have a will; the second have none—to speak of. The first are responsible; the second are irresponsible. The first, through self-sacrifice, develop and progress; the second, through self-seeking, fail and deteriorate. Accidental illness may cause members of the first to drop to the second; helpful influence may enable members of the second to climb to the first.

The second class may be subdivided into those who drift helplessly before circumstance, and those who break themselves in pieces before the circumstances that are too strong for them. These latter cannot be persuaded to leave off trying to accommodate the whole universe in their own little measure. Strange to say, they are often credited with possessing strength of will, whereas they merely possess its hostile counterfeit, self-will.

Conquest where conquest is possible, and submission without exhausting struggle where conquest is impossible, are doubtless true wisdom. But wisdom implies knowledge; and knowledge, right education; and education, the divinely imparted faculty for receiving instruction.

To gain the victory over self on the one hand, and to yield submission to God’s eternal laws on the other hand, this is liberty—the glorious liberty of the children of God.

It is surely our capacity for development, our power to rise, even at the cost of much suffering, to a knowledge of God, to the likeness of God, that constitutes the great hope of the universe. The idea is admirably expressed in an exquisite chant, entitled “Song of the Universal,” by the well-known American poet-philosopher, Walt Whitman:—

 
THE END.

PRINTED BY BALLANTYNE, HANSON AND CO.
EDINBURGH AND LONDON

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THE MASSAGE CASE.
BY THE SAME AUTHOR.
(2 Vols. T. Fisher Unwin.)

THE HOSPITAL.

“The author of this decidedly clever novel seems to have written ‘The Massage Case’ as a reminiscence of a very unpleasant personal experience.... From this point of view it is noteworthy for its studious moderation of tone. Not only have we the contrast between the two doctors and nurses, the good and the bad, but the good qualities of Dr. Broadley and the woman employed by him are honestly stated. There is no attempt to depict either as an impostor, and the doctor’s energy and force of character are spoken of with frank admiration, although these are the main instruments in bringing the patient to the verge of madness.... Such a character is perfectly real, perfectly possible; and while the mischief that results from his somewhat pachydermatous honesty and lack of fine perception is plainly stated—while we are shown that the very force and strength of character which had won him his place in the front of the profession tend to overawe his patient, and make her submit in silence to wrong judgment of her symptoms—there is no attempt to vilify Dr. Broadley himself, nor the profession to which he belongs.... If this book, which, under the guise of a story, points out clearly, but with a not unfriendly hand, the errors into which both branches of the medical profession are apt to fall, and makes doctors and nurses more careful and kind, we, at least, will bid it welcome.”

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REVIEWS OF “THE MASSAGE CASE.”
By CYRIL BENNETT.

THE BOSTON MEDICAL AND SURGICAL JOURNAL.

“This is the first novel that has come to our notice in which massage takes a prominent part. It is a very good story, told with the simplicity and earnestness of truth, and probably part, if not all of it, is founded on fact.... We need not go from home to find nursing homes and private hospitals of this kind. There are some keen delineations of character in the book. The eminently successful practitioner, who overwhelms people with his powerful individuality, and compels them into saying and doing what he means them to say and do, is well described. So also is the highly appreciated old-fashioned nurse, who has become a little too knowing.... But what became of the patient? That is just how our readers can while away a few hours very pleasantly in finding out for themselves.”

THE SPECTATOR.

“The best part of the story is the description of the nursing home. Here we are sometimes reminded of Charles Reade.”

THE ZOOPHILIST.

“This is a pleasantly readable novel of a very praiseworthy type, chiefly remarkable, from our point of view, for the pen and ink portraits of two very dissimilar medical men, and an exposure of the evils which may ensue to a nervous patient from falling into unsympathetic hands.... We presume the moral is that massage, like certain doctors, does not suit everybody.”

THE GUARDIAN.

“The author apparently desires to show that an eminent physician ... may easily become the tool of a determined woman who has made up her mind that the course of true love shall not run, smoothly or otherwise, to a conclusion that she deems undesirable; that ‘nursing homes’ may be so manipulated as to serve temporarily as places of confinement for persons whose relations find it inconvenient that they should be at liberty; and that the ‘Weir Mitchell System,’ whatever excellences it may possess, is not a panacea for every disorder to which humanity is subject.”

THE STANDARD.

“These volumes are apparently written to warn the public that nefarious persons find very easily, in massage ‘homes,’ all the conveniences for getting their uncongenial relations put out of the way and tortured, which used to be the speciality of private lunatic asylums. If so, we hope that Cyril Bennett may be the Charles Reade to rouse the world to open the doors of these new and hitherto unsuspected Bastilles.”

ILLUSTRATED LONDON NEWS.

“Picturesque and animated scenes of Eastern life.”

WHITEHALL REVIEW.

“His two volumes are amusing and interesting, and written in a style which promises much in the future.... There are truth, life, and colour throughout the book.”

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ARNOLD’S ENGLISH LITERATURE SERIES.

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