A great many of the operations that have been performed on women during the past generation have been quite unnecessary, but have been performed because women felt themselves so miserable that they kept insisting that something must be done to relieve them, until finally it was felt that an operation might do them some good. It would surely do them no harm or at least make them no worse, and there was always the possibility that the rest in the hospital, the firm persuasion that the operation was to do them good, the inculcation of proper habits of eating during convalescence might produce such an effect on their minds as would give them a fresh start in life. Undoubtedly a great many women who were distinctly improved after operations owed their improvement much more to the quiet seclusion of their hospital life, their own strong expectancy {274} and the care bestowed upon them under the hospital discipline without exaggerated sympathy which brought about the formation of good habits of life, than to their operation. Many a woman gained weight after an operation simply because her eating was properly directed, and this was the main part of the improvement which took place. Operations are sometimes needed and when they are the patient will probably not get well without one; but as a distinguished neurologist, Doctor Dercum of Philadelphia, said in a paper read before the American Medical Association last year, the neurologist is constantly finding patients on whom one or several operations have been performed, some of them rather serious abdominal operations, the source of whose complaints is a neurosis and not any morbid condition of the female or other organs. Occasionally one sees something like this in men, and I shall never forget seeing at Professor Koenig's clinic in Berlin a sufferer from an abdominal neurotic condition on whom no less than three operations for the removal of his appendix had been performed, until finally Professor Koenig felt that he would be justified in tattooing over the right iliac region the words "No Appendix {275} Here." The condition developed in a young soldier as the result of a fall from a horse and his affection resembled very much some of the neuroses that came to be called, unfortunately, "shell shock" during the present war.