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Deterrent Therapeutics





In the history of therapy a peculiar phase was the use of all sorts of
materials, intensely repugnant to human nature and deterrent to all
the finer feelings, but which, nevertheless, proved curative of many
ills. We know now that there was absolutely nothing remedial in these
substances or methods of treatment, but only the effect produced upon
the patient's mind. If the patient makes sufficient effort to overcome
the intense repugnance, that enables him to release hitherto latent
vital energies, or to correct hampering inhibitions which have
prevented curative reactions. The more the patient had to conquer
himself, or herself, the more surely did the remedy produce a good
effect. It was effective, however, not only among the poor and the
uneducated, but often also among the better informed, provided the
patients became persuaded of its efficiency. Persuasion in these
matters is usually best secured by the reports of cured cases. It is
easy to obtain "cures" from almost anything. They are set up as
confident proofs of the remedial virtue of methods of treatment. They
have been, in the history of medicine, more often the indexes of
action upon mind than upon body. Real remedies help patients to get
better. Supposed remedies, that afterwards prove quite inert, cure.


Portions of Corpses.--One of the ingredients of the famous Unguentum
Armarium (see chapter on Nostrums) was, as has been said, moss scraped
from the skull of a man who had been hanged. It was declared to be
particularly efficacious against so-called dead members, such as the
blanched fingers of Raynaud's disease, or the hysterical palsies, and
other functional paralytic conditions of the limbs. The real
therapeutic factor was not the gruesome material itself, but the
potent suggestions awakened by it. It is probable that the quacks and
witch doctors who gave out the formula of their remedies as containing
such material often did not take the trouble to collect them, and that
their salves and ointments were really quite inoffensive preparations.

Touch of the Hanged.--Some of the traditions which gather round the
effect of contact with the body of a hanged person are curiously
interesting from the standpoint of psychotherapy. This form of
execution seems to have had a much more potent influence in producing
therapeutic elements in the bodies of the victims than any other. We
do not hear much of the touch of a beheaded person's body nor of any
place in medicine for portions of the victims of execution by
shooting, though Van Helmont claims curative properties for these in
lesser degree. All sorts of ailments were, however, supposed to be
cured by the touch of a hanged person. Thomas Hardy in his "Wessex
Tales" tells of a young woman in his time suffering from a paralyzed
arm, apparently a form of paralysis due to a functional nervous
condition, who was recommended by an old "conjure" doctor to touch her
bared arm, as soon after the execution as possible, to the purple mark
of the rope around the neck of a man who had been hanged. The doctor
assured her this was the only means by which she could be cured. We
would not be surprised to hear of her cure under such circumstances.

Hardy has carefully collected his material regarding the traditions of
the southern part of England, and he makes the hangman say, when the
woman applies to him for permission to touch the body of the victim,
that such a request had not been made for some years, but that there
used to be many applicants when he was a younger man. He adds,
moreover, that it was the custom to apply to the governor of the
prison and that usually this application was made by the physician of
the patient who accompanied him or her on the visit to the corpse.
There is no doubt that physicians did, in many cases, have recourse to
such methods, and that the reasons for their belief in the efficacy of
the touch of the dead was that they had seen the cure in this way of
many puzzling diseased conditions, which their skill in wortcraft and
herbal medicines had not enabled them to relieve. The touch of the
corpse was supposed to bring about a "turning of the blood," and this
produced the good effects. Occasionally the patients fainted from
terror, yet afterwards were found to be able to use limbs that had
been quite beyond their control before. The story is typical of what
happened in country districts all over Europe for centuries.


Mummies.--How little distant we are from the use of such material for
therapeutic purposes will be appreciated from the fact that mummy was
used in medicine down nearly to the end of the eighteenth century. The
first edition of the "Encyclopedia Brittanica" (1768) said:

We have two different substances preserved for medicinal use under
the name of mummy, though both in some degree of the same origin.
The one is the dried and preserved flesh of human bodies, embalmed
with myrrh and spices; the other is the liquor running from such
mummies, when newly prepared, or when affected by great heat or
damps. The latter is sometimes in a liquid, sometimes of a solid
form, as it is preserved in vials well stopped, or suffered to dry
and harden in the air. The first kind of mummy is brought to us in
large pieces, of a lax and friable texture, light and spongy, of a
blackish brown color, and often damp and clammy on the surface: it
is of a strong but disagreeable smell. The second kind of mummy, in
its liquid state, is a thick, opaque, and viscous fluid, of a
blackish color, but not disagreeable smell. In its indurated state,
it is a dry solid substance, of a fine shining black color, and
close texture, easily broken, and of a good smell; very inflammable,
and yielding a scent of myrrh and aromatic ingredients while
burning. This, if we cannot be content without medicines from our own
bodies, ought

to be the mummy used in the shops; but it is very scarce and dear;
while the other is so cheap, that it will always be most in use.

All these kinds of mummy are brought from Egypt. But we are not to
imagine, that anybody breaks up the real Egyptian mummies, to sell
them in pieces to the druggists, as they may make a much better
market of them in Europe whole, when they can contrive to get them.
What our druggists are supplied with, is the flesh of executed
criminals, or of any other bodies the Jews can get, who fill them
with the common bitumen so plentiful in that part of the world; and
adding a little aloes, and two or three other cheap ingredients,
send them to be baked in an oven, till the juices are exhaled, and
the embalming matter has penetrated so thoroughly that the flesh
will keep and bear transportation into Europe. Mummy has been
esteemed resolvent and balsamic: but whatever virtues have been
attributed to it, seem to be such as depend more upon the
ingredients used in preparing the flesh, than in the flesh itself;
and it would surely be better to give those ingredients without so
shocking an addition.


Serpents in Therapeutics.--Snakes and portions of snakes have been
prominent features of deterrent therapeutics at all times. Headaches
were cured by wrapping a dead snake around the head, or by the touch
of a snake's skin, and sore throat by wearing a snake's skin around
the throat at night. This seems one degree better than the custom,
still common, of wrapping the stocking, that has been worn during the
day, around the neck. In the chapter on Graves Disease, the use of the
touch of a snake, or of a snake's skin worn around the neck, is
mentioned. Girdles made of snake's skin or snakes themselves, were
supposed to be good for colic and for various internal troubles, and
were sometimes, among barbarous peoples, a sovereign remedy for the
ills of pregnancy and assured the woman a safe delivery and an easy
labor. Undoubtedly they lessened dreads by suggestion and the effort
necessary to overcome repugnance. Some of the symptoms of the
menopause have been cured in the same way. Rattlesnake oil has had a
special reputation among mountainous people, where the snakes
abounded, for the pains and aches of the old, and the vague joint
discomfort, sometimes spoken of as rheumatic, but really due to
various individual conditions. It is probable that in most cases the
oil thus employed was not extracted from the rattlesnake, but was some
ordinary oil palmed off under that name, and having its special
effectiveness because of the thought associated with it.

Various portions of serpents are still in use, sometimes in the hands
of physicians, though usually in popular medicine. I knew a physician
in a small inland city who had a great local reputation for curing
external eye troubles, and who owed not a little of it to the fact
that the people in his neighborhood thought that he used rattlesnake
oil as one of the ingredients for his strongest prescriptions. He was
supposed to be able to dissolve even cataract by his remedies, and
there is no doubt that in many cases of chronic indolent ulcer of the
eye he was able to bring about a cure sooner, and have it last longer,
than those of the regular profession who had not the advantage of this
popular faith. He was careful to buy rattlesnakes from certain of the
mountain people, who killed and brought them to him and who advertised
the fact that they had such commissions from him. The stories were
made all the more interesting by the fact that the doctor would not
purchase dead rattlesnakes. They must be brought to him alive, since
the therapeutic virtues can only be extracted immediately after death.
A mountaineer with a couple of live rattlesnakes with him is always an
interesting object and a fine advertisement. One would like to
know what the doctor did with the snakes--that is, how he disposed of
them without suspicion. Homeopathic physicians still have
lachesis-viper venom in their pharmacopeia. Their remedies, however,
if they really follow the dilution principle of their founder, can
have an effect only on the mind, so that the use of lachesis is not
surprising.


Repugnant Remedial Measures.--Quite in keeping with the use of
deterrent remedies of various kinds are the recommendations to do
certain things that involve great self-control, and the overcoming of
repugnance, or fright, or the like. A favorite mode of preparing
remedies in the Middle Ages was to gather the particular herbs for the
prescription in a graveyard in the dark of the moon. The patient
himself was supposed to gather them and to be alone when doing so, if
they were to be effective. How much occupation of mind and diversion
of thought would be afforded for timid people by the effort to
overcome themselves to this extent! The occupation of mind alone and
the concentration of thought necessary for the ordeal would be quite
sufficient to divert many people from the centralization of attention
on themselves, which is responsible for so many of their symptoms, or
for that exaggeration of symptoms that aggravates the ailment.


Ordures as Remedies.--Among all primitive peoples we have the story
of the use, as remedies, of ordures of various kinds, of repugnant
portions of animals, of ground insects, of animal excrement and urine,
and even of human excretions, of the blood of serpents, or eels, or
carrion feeding birds, and the like. Ground lice and insects of
various kinds are very common as prescriptions in the history of
primitive medicine. They turn up here and there through the Middle
Ages, and they are said to be still used in China. The more one knows
about side-tracks in medicine, the more does one find of far-fetched
repugnant materials vaunted as wonderful cures. Some of the substances
employed are so disgusting that one does not care to mention, much
less discuss, them. I have had a man tell me that, in a severe
epidemic of diphtheria, he saved his children's lives when they were
attacked by the disease, and the children of others were dying all
around him, by blowing the dried excrement of dog down their throats.

There are certain popular medical practices that are related to these
old traditions of deterrent therapeutics. In many manufacturing
establishments, in spite of progress with regard to sepsis and
antisepsis and the diffusion of information as to first aid to the
injured, it is still the custom to put spittle on wounds. I am sure
that every doctor has seen quids of tobacco used in this way. Even
native-born Americans, who are not illiterate, are sometimes found
using some deterrent material. I have known such a man use his own
urine as an eye-wash for sore eyes, and the use of children's urine
for such purposes is much commoner than might be thought. After all,
it is only a generation since physicians used to taste urine in order
to determine whether it contained sugar or not, and I have seen a
country doctor even take between his finger and his thumb a little of
the excrement of a child and apply his tongue to it, pretending of
course that he obtained very valuable information this way.


Excretions and Secretions.--All the human excretions have formed the
basis of vaunted remedies. Tears, on the principle that like cures
like, were used for melancholia; nasal secretion to lessen respiratory
difficulty through the nose; sputum for various mouth affections,
but also as an application to external abrasions, and to the eyes, the
ears, and the like. Undoubtedly patients were helped by many of these,
not because of any physical effect, but because they felt easier as a
consequence of the satisfaction of having something done for them, and
the consequent freedom from solicitude which allowed nature to produce
her curative reaction without interference. The greater the effort he
has to make, apparently the more efficiently does he control this
disturbing state of mind. This is the secret of many cures now as well
as in the olden time.

Whatever good effect is produced in such cases comes, of course, from
the persuasion that these substances will do good, and there must be a
strong suggestion to that effect before the repugnance can be
overcome. While we are prone to think the older peoples who used such
materials commonly are to be condemned for ignorance and superstition,
it is well to recall that human nature has not changed, and is still
ready to be influenced in the same way. Brown Sequard's extract of
testicular substance came in this category. We had a wave of
organotherapy a few years ago, and we know now that whatever benefits
patients derived from taking heart substance for heart troubles, and
brain substance for brain troubles, and kidney for renal diseases, was
entirely due to mental influence. The cannibal who eats the heart of
his enemy, thinking that the vigor and courage of the other will pass
into him, undoubtedly has for a time a power of accomplishment greater
than before. Nothing acts so powerfully as suggestion of this kind to
give renewed vigor and to enable us to tap sources of energy that we
were not aware of in ourselves, and that enable us to accomplish what
before seemed quite impossible, and even to bring about curative
reactions.


Diseases Benefited.--Observe the classes of disease that were
particularly relieved by deterrent therapeutics. Headache was one of
these. All sorts of things were cures for headaches--the touch of the
hangman's rope, or of an executed criminal, or some herb gathered in
the graveyard in the dark of the moon, or pills made of the excrement
of various animals. The forms of headache thus relieved would be those
in which over-attention to self, rather than real headache, produced
queer feelings in the head, though concentration of attention might
exaggerate this into an ache. Foot troubles were cured by deterrent
therapeutics. To wear the shoes of a dead person, especially of a
murderer who had been hanged, would cure them. Colic was cured by
pills of excrementitious materials, and by all sorts of other
deterrent remedies. For instance, one well-known remedy was to wash
the feet and drink the wash-water. The wash-water of little babies was
a favorite remedy for the vague abdominal pains of old maids, and for
the symptoms due to the menopause.


Deterrent Pain.--A striking illustration of a strong mental influence
helping out a slight amount of therapeutic efficiency is found in the
use of the actual cautery for medical affections. At a number of times
in history most of the chronic pains and aches, the arthritises, the
so-called gouty tendencies when localized, the rheumatic affections
and especially the chronic rheumatisms, have been treated by means of
the cautery. All of the neuralgias, many of the neuroses, all of the
neuritises and a certain number of so-called palsies and paralyses,
were treated successfully by this means. It is a very suggestive
remedy producing a deep impression that now relief must be in sight.
It became popular over and over again, though after a time it
always lost its influence, and ceased to have the beneficial effects
that it had at the beginning of its reintroduction.

During the second half of the eighteenth and the beginning of the
nineteenth century the cautery became very popular. It was applied
particularly in the form of the moxa. A cylinder of cotton was
employed for this purpose, being set on fire and allowed to burn on
the skin of the patient, producing a deep wound. The mental effect of
this can be readily understood. Baron Larrey, one of the most eminent
surgeons of the time, thought the moxa one of the best aids that he
had in the treatment of many affections where the knife was not
indicated. There were large groups of diseases in which it was almost
a specific. Larrey employed it in affections of vision, of smell, of
taste, of hearing and of speech. In many paralytic affections of the
muscular system, in all chronic affections of the head, among which he
enumerates non-traumatic affections, hydrocephalus, chronic headaches
and many other affections supposed to be seated in the cranium. In
asthma he was particularly successful with the moxa. Old catarrhal
affections yielded to it. Consumption was frequently benefited by it.
Most of the chronic affections of the uterus were benefited, as were
also similar affections of the stomach. He considered that the moxa
must be admitted, without contradiction, to be the remedy par
excellence against rachitis. In Pott's disease, which he called
dorsal consumption, it worked wonders. In sacrocoxalgia, in
cocygodynia and femero-coxalgia he had excellent results with the
moxa.

A glance at this list shows exactly the class of cases in which
suggestion has always played a large role, and for which there has
been, at various times, a series of specific remedies, medicinal,
manipulative and surgical. Others extended the value of the moxa
beyond these affections. Ponto found it valuable in gout, and in the
various chronic affections which are sometimes grouped under the name
chronic rheumatism. He insisted that the moxa could be placed on
almost any part of the body, though the contra indications he suggests
show how far the men of his time went with its use. Only these
portions named might not have a moxa applied to them. It must not be
used on the skull, on the eyelids, on the ears, on the mamme, on the
larynx and on the genitals, though it might be applied to the perineum
or the perineal body.


Deterrent Taste and Smell.--The disturbing effects produced by other
senses besides those of sight have been used in the same way for the
production of definite therapeutic suggestive effects. A number of the
ill-tasting, almost nauseating drugs of the olden time prove to have
very little real therapeutic efficiency in the light of modern
clinical careful observation. This is particularly true of the herbs
and simples. Many a disgusting preparation apparently owed all of its'
good effects on the patient to the effort that was required to swallow
it, producing such a favorable influence upon the mind, by
contrecoup as it were, that the patient got better. A little girl
said that cough medicines were nasty things they gave you in order to
keep you from catching cold again. The sense of smell has been used in
the same way. Valerian is probably an efficient drug in certain
respects, but undoubtedly its efficiency is materially increased by
its intensely repulsive odor. For many of the psycho-neuroses and
neurotic conditions generally the ammonium valerianate is likely to be
much more efficient than the strychnin valerianate, though probably
the latter should be considered as more physically efficacious in
its tonic properties. Asafetida, musk and some preparations of the
genital organs of animals that used to be in the pharmacopeia, owed
most, if not all, of their power, whatever it was, to the mental
effect of their odor and the feeling of deterrence that had to be
overcome before they were taken.

There is a precious therapeutic secret in this use of deterrent,
repugnant, frightful materials which patients use to advantage under
certain circumstances. It illustrates the influence of the mind over
the body, and emphasizes the fact that such influence can be exerted
in the full only when a deep impression is produced upon the patient.
Whether this can be imitated without deceit, and without the use of
undignified methods, must depend on the physician himself and his
personality. There can be no doubt that there is a wonderful power
here to be employed. It must be the physician's business to find out
in each individual case, according to his own personal equation, just
how he may be able to use at least some of it. It is well worth
studying and striving for, because nothing is more potent for
psychoneurotic conditions, and for neuroses on the borderland of the
physical, than which no ailments are more obstinate to treatment.





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