Social Work; Essays on the Meeting Ground of Doctor and Social Worker — John Shaqi
Social Work; Essays on the Meeting Ground of Doctor and Social WorkerCabot, Richard C. (Richard Clarke)
Science
Social Work; Essays on the Meeting Ground of Doctor and Social Worker
Cabot, Richard C. (Richard Clarke)
Charities, Medical; Friendly visiting; Medical social work -- United States; Social service
I refer not merely to the so-called nervous diseases, the neuroses and
psychoses, the myriad forms of nervousness without recognizable basis in
organic disease, but also to the mental complications and results of
serious organic diseases such as tuberculosis, arteriosclerosis, and
surgical injuries. The classical studies of Charcot, Pierre Janet, and
others have made clear to the whole world the existence of a body of
diseases in which the mental functions are obviously deranged while
still the patient is not insane in any legal sense, and does not show on
physical examination any evidence of gross organic disease.
Neurasthenia, psychasthenia, hysteria, are among the more common types
marked out by the studies of great psychologists and clinicians. Little
or nothing has been added by the studies of German, American, and
English physicians to our knowledge of these diseases. But throughout
the history and development of France's leadership in the study of these
diseases, one cannot help noticing that interest is concentrated largely
upon diagnosis; comparatively little attention is paid to treatment. The
great leaders have not been extensively followed. Their suggestions have
not been carried out on a large scale nor followed sufficiently into the
field of practical therapeutics.
Especially is this true in the field of _visceral neuroses_ or nervous
symptoms referred by the patient to one or another organ--the stomach,
the pelvic organs, the bowels--in which nevertheless no evidence of
disease can be found. In these diseases English, French, and American
physicians alike persist for the most part in humoring and soothing the
patient by the administration of remedies known to have no real
influence upon disease and designed chiefly to make the patient feel
that something is being done for him. This is superficial treatment. It
makes no attempt to attack the determining causes of the disease.
Whether or not there are any psychogenic diseases, whether or not purely
psychical events can be proved to produce the group of symptoms known as
neurasthenia, psychasthenia, or hysteria, or whether there are physical
causes contributing to produce the symptoms, this at any rate may be
said with confidence: that if we are to root out the patient's trouble,
if we are to bring about anything approaching a radical cure, we must
attack the mental symptoms directly and upon their own grounds, that is,
by mental means, chiefly by reëducation. _The mental element in these
diseases is at any rate the most vulnerable point of attack._ It is here
that we can most profitably exert therapeutic pressure.
Public-domain text, read in full here on John Shaqi.
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