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mentally. The new objects that he sees not only take off his attention from his diseased sensations, but the new excitement that he feels, as he sees them one after another, dif. fuses a refreshing and invigorating influence throughout his system. And imagination lends her aid in producing this effect. It seems to him that every thing is better than it was where he was so lately shut up with the feeling almost of a prisoner—that the air is more pure, the grass more green, the foliage of the trees more dense and rich, and even the sun more cheerfully bright. Something, it is true, is to be attributed to change of air under such circumstances, but much less commonly than to the influence of change of scene upon the mind. The sick room, as every physician has frequent occasion to witness, acquires after a time a monotony that is dreary and painful to the confined invalid. Day after day he sees the same furniture and same walls, every irregularity of whose surface he becomes acquainted with, and he is forced to seek for some variety even in the most trivial circumstances. “There, Doctor,” said an invalid playfully, “I have made a little change to-day. I have had the rocking chair put the other side of the fire-place, and the bureau moved to that corner, and those phials on the shelf, you see, have changed their places. My friends, Cologne and Camphor, have gone to the other side of that vase, and those drops (which, by the way, Doctor, I think that I have taken so long that some change would be well) have their station now quite at the other end of the shelf. And my good grandmother, you see, looks down upon me from the other side of the room. Variety is pleasing, Doctor, even within a few yards square, when one can not get any farther.” Even when the invalid is not confined to the sick chamber, but has Vol. III. 64
his rides and his walks, the monotony of every day's routine becomes a weariness. And no wonder that an escape from this is so often so manifestly beneficial to him. But it is not merely the diversion of mind, attendant upon change of scene, that benefits the invalid, but his release from those mental associations, that have so tenaciously connected themselves with his sickness, has an important influence. The place where he has spent wearisome days and nights of pain and restlessness and languor, must necessarily have unpleasant associations connected with it. These hinder, and in some cases even prevent convalescence; and when he casts them off, he feels that he has rid himself of a great burden, and as he goes on in his course with a light heart, a fresh impulse is given to the vital powers of his body, making him to feel, as he says that he does, like a new man. The mind of the sick man sometimes gets into a fixed, unvaried state, with one settled cast to its ideas. The tendency of this is to make the diseased condition of body to remain fixed also. It is important, therefore, to alter this mental state—to break up this unvarying train of thought and feeling. There are different ways of doing this in the different cases that present, and the physician must judge as to the most proper mode of effecting the object in each case. I will give but two examples as illustrations. A patient who had been very sick, but who had recovered from the severity of her attack, and who was in a fair way for getting well, remained precisely in the same condition for some time. Her mind was in a fixed state of gloom, marked by a perfectly unvaried expression of countenance. Her friends had tried in every way to make her cheerful, but it "was in vain, for the simple reason that all their attempts to do so were obvious. I knew that she had naturally a lively sense of the ludicrous, and therefore, after getting her somewhat off her guard by some incidental conversation, I then with an air of perfect carelessness, uttered something which I thought would be very apt to hit her mirthfulness, as the phrenologists term it. It did so, and a smile kindled up at once upon her sad countenance. The spell was now fairly broken. She speedily regained her wonted cheerfulness, and the load being cast off, she went straight on in the bright road of convalescence. In this case it was but a small thing, after all, that turned the current of thought and feeling, and the means which had been used, most persons would suppose, were much better calculated to do it. All direct and palpable efforts to make the gloomy invalid cheerful, are almost always unsuccessful; and yet it is such efforts that are most commonly made use of by the friends of the sick. The course which was pursued in the other case which I will mention, was quite a different one. The patient was a clergyman, who had the impression strongly fastened upon his mind that he should certainly die, and could not be made to admit by the force of any reasoning, the possibility even of his recovery. It was not an opinion founded upon evidence, but it was a fixed state of mind, which was the product of the disease. It was important to remove, if possible, this all-absorbing thought, for it was reacting unfavorably upon the disease itself. It could not be done by argument, nor by speaking to him the words of hope; for it was not a conviction of truth arrived at by any reasoning, but an impression unaccountable, but strong and vivid. He did not think that he should die, but he felt that he knew it. Some remedy, then, different from either of these, was necessary. As he
was a man of stern, decided religious principle, I determined to make a bold onset in that quarter. I told him that God alone knew whether he would die or recover, and that he was doing wrong—absolutely committing high-handed sin, as setting himself up as knowing what God only knows. This was the substance of what I said to him, and it produced the desired effect. The impression was dislodged from his mind, and though he occasionally talked discouragingly of the result of his sickness, he never said after that, that he knew that he should die. In chronic cases especially, the patient is often prevented from recovering by the influence of unpleasant circumstances in their situation, or in their relation to others around them. The friends of the sick often get out of patience with them in the tediousness of a long confinement. Sometimes there is unkindness, and this to the weakened mind and depressed spirits of the invalid, is often a burden that can not be borne. Some secret grief often neutralizes the influence of medicine. There is often great want of tact in managing the whims and caprices of the sick. Many expect them to be as reasonable in their notions and desires and feelings as if they were well. It is unwarrantable and unjust to demand this of a weakened and beclouded mind, and agitated nerves. Trifles light as air affect the sick strongly. The very grasshopper is a burden to them. It is with the mind of a sick man as it is with his senses. Noise troubles him—even the motion of a rocking chair, perhaps, or the swinging of a foot, disturbs his sight, and through that sense disturbs his mind. The darling child, whom he delights, when he is well, to see him running about playing his little pranks, must be taken out of the room, because he makes his father's head to whirl and to ache. Thus easily is he disturbed through the senses. Just
so is it with his mind—it is as easily disturbed, and circumstances, which would scarcely excite a passing thought in health, now agitate and depress him. Disappointments, that ordinarily would be felt but for a moment and slightly, he can hardly brook now. Every mother has often seen how easily her child is grieved by little things, when mind as well as body is prostrated by sickness. And she does not commonly get out of patience with it for its seemingly unseasonable griefs, but soothes and quiets them. It would be well if all the attendants and friends of the sick had more of that patience and forbearance, which are prompted by a mother's tenderness. The sick often contract strong feelings of dislike towards some things, and sometimes towards individuals. They may regret it, and see that it is unfounded and foolish, and yet not be able to get rid of it. Some make the sick dislike them by their very kindness, because it is so officious and pains-taking. There is a tact in the good and judicious nurse which dictates just what to do and how much, and many of the attendants on the sick are sadly deficient in this. The fretfulness and impatience of contradiction, which are so often the product of the nervousness of disease, are generally not to be combatted, but to be borne with. The considerations which I have already presented clearly show the propriety of this maxim ; and yet it is a maxim which is very commonly neglected. Many a dispute about the most trivial things is held between the patient and the attendant or friend, when a little tact might have diverted the weakened mind from the subject, without yielding in the least any thing, which pride of opinion or firmness would prompt to hold fast to. I once heard a mother, a woman of intelligence too, dispute with her sick daughter about the number of crack
ers she had eaten during the day, each maintaining her side of the question with as much zeal and pertinacity, as if it were a matter of vital importance. The result was that the patient was injuriously agitated by this rencontre about nothing, and ended it by bursting into tears, and the mother triumphed, as was her wont to do, by having the last word. And this was a fair specimen of the moral management of that patient during a long sickness. It added vastly to her nervousness, and clouded a mind filled with lofty and refined and tender sentiment, and made that chamber a scene of painful exhibition of thought and feeling, when a different management might have soothed her agitated nerves, and left the sensitive chords of her soul to respond clearly and harmoniously to the gentle touch of friendship and love. The patient often feels, and takes comfort in feeling, that his temporary outbursts of fretfulness and impatience are understood by his friends, as having no consonance with the real feelings of his heart. A much respected patient, of whose sickness I have many pleasant recollectons, was one day speaking to me of his sister in the highest terms of eulogy. “Yet,” said he, “I scold at her, but I have no business to do it. However, she understands it. She knows that I am nervous, and that I am sometimes hardly myself, and she forgives it all.” Let me not be understood to mean that all the notions and caprices of the sick are to be yielded to as a matter of course. I only object to an useless and injudicious warfare with them. There should always be firmness exercised in the management of the sick, but there should be no struggle with them from mere pride of opinion, or a desire for authority, or from want of a proper charity for their mental weakness. They should never be directly opposed, except it be distinctly and manifestly for their good. One very common mistake in the mental management of some chronic cases remains to be noticed. I refer to those cases in which the nervous system is so deranged, as to produce a variety of sensations of a deceptive character. Such patients are generally laughed at as hypochondriacs, and they are told by their friends, and sometimes even by physicians, that these sensations are wholly imaginary. This is not so. Some of their notions about them are mere imaginations, it is true ; but the sensations themselves are to some extent, at least, real. Imagination may magnify them, but it does not ordinarily create them. The wrong ground which is so often taken in regard to such patients, sometimes essentially retards their recovery. They feel that they are trifled with, and they have but little confidence in the judgment of those who deny that their sensations are real, and therefore have but little if any in the remedies which they administer to them. Besides, the mind of the patient is disturbed continually by the disputes and consequent ill feeling which such differences of opinion necessarily engender, and this of course has a tendency to aggravate the diseased condition. As an illustration of these remarks, I will mention a single case. The patient, who had long been an invalid, had, among a great variety of sensations, a burning, twinging, sometimes a pulling sensation, in the region of the stomach. Her notion about it was that there was
a cancer there, that really pulled and burned and twinged. She had been assured again and again that there was no cancer there, but so little credit had been given to her account of her sensations by those who had told her so, that she had on her part given little credit to their knowledge of her case. I immediately told her that I had no doubt that the nerves in that part of the body were the seat of the sensations she described, but that she was wrong in the disease which she fancied to be the cause of those sensations. By taking this plain and obviously proper ground with her as to the nature of her case, making the true distinction between what was real and what was imagined, she was induced to give up the imaginary notion that was weighing down her spirits. This view of her case, so consonant with the faithful report of her own sensations from day to day, commended itself to her common sense, and by inspiring confidence and hope, did quite as much for her recovery as any other remedial means that were used. Among the great variety of topics which have suggested themselves in connection with the subject of this article, I have selected those, the discussion and illustration of which would most interest and profit the general reader. There are two topics, however, of this character that I have omitted, simply because the proper and full elucidation of them would make this article altogether too long. I refer to the influence of hope in curing disease, and the influence of diversion of mind in the treatment of insanity.
RELIGION is no unmeaning thing. In whatever form embraced, whether as true or false, it takes strong hold of the human mind—excites a controlling influence in directing the conduct, and in shaping the characters of men. No other interest is the subject of so much instruction, and none impresses itself more deeply on all the forming elements of thought and feeling. Its place is in the inner sanctuary of the heart, where law and conscience meet— the secret chamber of the soul, where God speaks and man responds, and where therefore, the whole frame-work of character is formed. If men are known by the company they keep, or by the books they read, equally true is it that they are known by the religion they profess. This stamps its own image on all the conceptions of the mind— forms and fashions all our ideas of right and wrong—makes a man what he is. For, while the stream may not rise as high as its source, there is a certainty that it will never rise higher. Men may not indeed be as good as their religion would make them ; but they are never better than their principles. Every one bears a likeness to his creed. The Turk, for example, is ignorant, sensual, vindictive—the natural product of his religion—what Islamism will make any man, whose mind is subjected to its debasing influence. The faith of the Jew makes a Jew— keeps him, like the fabled waters of Arethusa, from mingling into one with the wide ocean of being around him.
Like every other system of religion, Christianity exerts an influence peculiar to itself. It brings out, in the conduct of those who embrace it, a result more or less in sympathy with the great principles, which
it inculcates. The same may be said of the various forms in which it is held by men. Each one makes impressions peculiar to itself. For, the form is to him that embraces it, the whole of Christianity. Those therefore, whose minds are constantly under its teaching, will think, feel, and act more or less in accordance with its principles. The result, in their actions, will correspond with its character. The Romanist and the Protestant, both profess to embrace true Christianity. But the teaching of the two systems, is very different. Romanism commands “submission to authority without examination.” Protestantism bids men “submit themselves only to conviction.” The former enjoins a blind belief. The latter teaches, with the Apostle, to prove all things and to hold fast that which is good. The one therefore, dispenses with reason in men; the other rejects whatever is put in its place. On the one hand then, we have, “believe,” and on the other, “examine,” as the basis of moral culture. The result, in the working of these opposite principles, must, in the nature of things, be very dissimilar. The genuine Romanist is like his creed. He moves in the lines of its direction. He thinks, feels, and acts, in conformity with its teaching. It moulds all the elements of the man; makes him just what he is, the slave of his fears, the creature of delusion and superstition, the willing subject of a crushing, terrible despotism. In him we see no life, no stirring activity, no onward movement. The man is paralyzed by his faith. The Protestant also is like his creed. He conforms to its teaching. He thinks and acts freely—is in bondage to no one—searches for the truth, holds it fast, aad rejoices in its light