Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and HysteriaMitchell, S. Weir (Silas Weir)
Science
Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria
Mitchell, S. Weir (Silas Weir)
Hysteria; Neurasthenia; Rest
All the moral uses of rest and isolation and change of habits are not
obtained by merely insisting on the physical conditions needed to effect
these ends. If the physician has the force of character required to
secure the confidence and respect of his patients, he has also much more
in his power, and should have the tact to seize the proper occasions to
direct the thoughts of his patients to the lapse from duties to others,
and to the selfishness which a life of invalidism is apt to bring
about. Such moral medication belongs to the higher sphere of the
doctor's duties, and, if he means to cure his patient permanently, he
cannot afford to neglect them. Above all, let him be careful that the
masseuse and the nurse do not talk of the patient's ills, and let him by
degrees teach the sick person how very essential it is to speak of her
aches and pains to no one but himself.
I have often asked myself why rest is of value in the cases of which I
am now speaking, and I have already alluded briefly to some of the modes
in which it is of use.
Let us take first the simpler cases. We meet now and then with feeble
people who are dyspeptic, and who find that exercise after a meal, or
indeed much exercise on any day, is sure to cause loss of power or
lessened power to digest food. The same thing is seen in an extreme
degree in the well-known experiment of causing a dog to run violently
after eating, in which case digestion is entirely suspended. Whether
these results be due to the calling off of blood from the gastric organs
to the muscles, or whether the nervous system is, for some reason,
unable to evolve at the same time the force needed for a double
purpose, is not quite clear, but the fact is undoubted, and finds added
illustrations in many of the class of exhausted women. It is plain that
this trouble exists in some of them. It is likely that it is present in
a larger number. The use of rest in these people admits of no question.
If we are to give them the means in blood and flesh of carrying on the
work of life, it must be done with the aid of the stomach, and we must
humor that organ until it is able to act in a more healthy manner under
ordinary conditions. It may be wise to add that occasional cases of
nervousness or of nervous disturbance of digestion are seen in which the
patient assimilates food better if permitted to move about directly
after a meal; and I recall one instance of very persistent gastric
catarrh where the uncomfortable symptoms following meals only began to
disappear when as an experiment the patient was ordered to take a quiet
half-hour's stroll after each meal, instead of the rest usually ordered.
Public-domain text, read in full here on John Shaqi.
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