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Unfavorable Mental Influence

Much as may be accomplished by psychotherapeutics through favorable
mental influence--the modifying of the mental attitude towards
disease, diversions of mind from aches and pains, concentration of
attention on subjects apart from ailments--much more may be done by
removing any unfavorable mental influence. This of itself produces
symptoms either by interfering with normal processes through
surveillance of them, or by so exaggerating, through attention to
them, slight symptoms that may be present that patients are made quite
miserable, though there is no adequate physical cause for their
condition. Perhaps the most striking example that we have of
unfavorable mental influence as productive of the persuasion that
disease is present, is familiar to every physician who is close to
medical students when they are first introduced to the symptoms of
disease. It is almost a rule that certain members of the class
immediately conclude that they are suffering from one or more of the
symptoms which they are studying, and that, therefore, they must have
the diseases with which the symptoms are associated. If at this time
they walk on the shady side of a street on an autumn day and have a
little shivery feeling, or when they get into the sun they feel a
glow, these two very normal feelings are exaggerated into chilliness
and fever, and the student has to go to his professor to have his
mental malaria or typhoid treated. To the student, his symptoms are
for the moment very real, and unless someone in whom he has confidence
reassures him, his discomfort will probably continue for some time.

Pathological Suggestion.--In a word, suggestions of disease are much
easier to take than is usually imagined, and if people read or hear
much about diseases they are likely to jump to the conclusion that
they are sufferers. Under present conditions there are many more such
sinister suggestions put before people than used to be the case. The
newspapers are constantly reporting curious cases and rare diseases,
and usually those of absolutely unfavorable prognosis and inevitably
fatal termination are particularly dilated on. Pathology has become a
source of many sensations, until the community generally has come
to eke out the thrills of the day's news by reading about fatal
diseases and fatal injuries, whenever murder and suicide sensations
fail. As a consequence, many become persuaded that they are suffering
from forms of disease of which they have not a symptom, and, not
infrequently, the wonderful cures that are reported in the newspapers
consist of nothing more than recoveries from these imaginary ills into
which people have suggested themselves as the result of reading about
morbid states.

A typical illustration of the power of the mind to influence the body
unfavorably is recognized in many of the comic stories that have had a
vogue in recent years. Their underlying thought is that if a man is
only told often enough, and by a number of different people, that he
does not look well, or if he is even asked a little solicitously as to
whether he feels well or not, he will almost invariably begin to
persuade himself that there must be something the matter with him.
After a time, under the influence of this unfavorable suggestion, he
begins to feel tired and is likely to think that he cannot go on with
his work. When meal time comes his appetite fails him. A victim has
been even known to go home and send for the doctor, persuaded that
there is something the matter, simply because a series of friends, for
a joke, or sometimes through a mistake, have insisted on asking him
questions that called attention to his state of health. Few men are
strong enough to stand the influence of unfavorable suggestion of this
kind, if it is frequently repeated. More direct forms of suggestion of
disease have, of course, even greater effects. Many a man goes to a
quack only feeling a little out of sorts and wanting to reassure
himself, but easily becomes persuaded that there is something serious
the matter with him.

Unfavorable Suggestion in Ancient Times.--This unfavorable influence
of the mind on the body, even to the extent of the production of
disease by means of suggestion, was recognized by the ancients. They
knew and wrote of hypochondriasis and, indeed, they invented the term.
In many of these cases the seat of auto-suggestion is supposed to be
the digestive organs and the localization of the discomfort is in the
hypochondria, that is, in the upper abdominal region. The Grecian
writers seemed to recognize clearly that the symptoms were the result
of thinking over much about self and concentration of attention upon
unfavorable suggestions.

Plato, in the "Republic," says:

In former days the guild of Asclepius did not practice our present
system of medicine, which may be said, he declares, to educate
diseases. He cites the example of Herodicus who, "being a trainer
(of gymnasts) and himself of a sickly constitution, by a happy
combination of training and doctoring, came to the invention of
lingering death; for he had a mortal disease, which he perpetually
tended, and, as recovery was out of question, he passed his entire
life as a valetudinarian." Plato, finishing the description, makes
us recognize the hypochondriac when he says: "He could do nothing
but attend upon himself, and he was in constant torment whenever he
departed in anything from his usual regimen, and so dying hard, by
the help of science he struggled on to old age."

The picture of the neurasthenic, or hypochondriac, who has educated
himself, as Plato says, into disease, is an interesting parallel to
modern conditions in this matter.

Nowhere more than in this matter of knowledge of disease, can weight
be attached to Pope's dictum that a little knowledge is a
dangerous thing, and that one must drink deep or touch not the Pierian
Spring of medical information. The teaching of pathology under the
guise of physiology, now so common in our schools, is likely to do
more harm than good. Various pathological conditions, such as those
produced by alcohol and tobacco, have been emphasized to such an
extent as to produce unfavorable suggestions in the pupils' minds with
regard to the untoward events that may happen in their insides, and
the serious lasting pathological changes that may occur, though all
unconsciously, to the sufferer as the result of indiscretions. The
study of the morbid changes produced in the mucous membranes of the
digestive tract by the use of stimulants, impresses ideas on the mind
that are readily transferred to other abuses in eating or drinking.
The rather vivid pictures and descriptions of the pathological
conditions that may develop, become a portion of the acquired
consciousness as to internal conditions, and this consciousness acts
as an unfavorable suggestive factor whenever there are any digestive

Bacteriphobia.--The development of bacteriology has had a similar
effect, especially because periodicals and newspapers like to take up
only the sensational side of biological discoveries. Most physicians
who have had anything to do with nervous diseases have seen cases of
misophobia, the fear of dirt, which in our day has taken on the
special character of fear of microbes. Those who are sensitive to the
possibility of contamination learn of the almost sacrificial
precautions that surgeons take to avoid wound infection, and conclude
that practically everything they handle must fairly reek with
microbes. They hesitate about touching the door knob or latch, and
invent all sorts of excuses to wait for a moment outside the door in
order to have someone else open it. Especially are they timorous about
touching the door knobs of a physician's residence, or the chairs in
his waiting room, or even to shake hands with him. Hospital walls and
doors become an abomination to them. These cases emphasize how much of
unfavorable suggestion there has been in the present spread of popular
knowledge with regard to microbes.

A writer on popular science once said that every time we spread a
piece of bread of the size of the hand with butter, we scatter over
its surface as many microbes as there are inhabitants in the United
States. The expression has gone the rounds, producing its effect on
sensitive people, occasionally causing even a disgust for so important
an article of diet as butter, more often giving rise to an extreme
sensitiveness with regard to any special savor that butter may have,
and it may have many according to the prevailing food of the cow.
There has been much emphasis laid on the potentialities for harm of
the microbes, and very little on the important part which they play in
the production of many forms of food materials. Most people know and
dread the fact that microbes produce disease. Very few seem to realize
that while we know many thousands of different kinds of microbes,
scarcely more than a score of them are known to be seriously
pathogenic, while all the others are either indifferent or, as we know
of very many, are actually benefactors of mankind.

People have heard much of the flora of the digestive tract, until they
have come to think with anxiety of the almost infinite number and
multitudinous variety of the minute plant life that finds a habitat in
the human intestine. Most people think that all of these are, in
tendency at least, harmful, and are only kept from being
positively dangerous by the overwhelming vital activity of the mucous
membrane and the secretions which keep them from exerting their malign
activity. Very few appreciate the fact that the intestinal flora, far
from being a disturbing factor, are often an aid to digestion, and
that the equilibrium established among them favors many biological and
chemical processes which help in the preparation of food and in the
breaking up of waste products that might be dangerous if reabsorbed
during their stay in the intestinal tract. Microbes we have always
with us and always will have, and men have lived to round old age, not
only in spite of them, but very probably partially because of them.
They are part of that beneficent mystery of nature of which as yet, in
spite of scientific progress, we know comparatively little.

Opposing Favorable Suggestion,--A recent striking change of
sentiment with regard to one form of food material furnishes a good
example of how little we know about the real effect of bacterial life
within the digestive tract. There was a time, not so long since, when
sour milk was supposed to be especially harmful, or at least only
likely to do good to those of particularly strong digestive vitality.
Metchnikoff's work on the influence of sour milk on the digestive
tract, however, has brought a complete reversal of opinion in this
matter. Now most physicians are convinced that the bacillus of sour
milk, acts in the intestinal tract to inhibit the reproduction and
growth of other, and possibly more disturbing, bacterial agents. Sour
milk is looked upon as one of the things that, by neutralizing certain
unfortunate bacterial processes in the digestive tract, lead to
longevity. There seems no doubt at all, that those who consume a great
deal of it, live longer lives than the average, and many old men have
taken to its use with a consequent amelioration of digestive

The popularization of bacteriology, then, has been one of those
moments of unfavorable suggestion that have affected a large number of
people. Such influences do not mean much for people of phlegmatic
temperament. For others, however, they have a weighty significance and
make every symptom, or more properly every sensation, that is at all
unusual in the digestive tract, seem of ominous import. Certain
sensations inevitably accompany digestion. The peristaltic movements
are usually said to be unfelt, but even a slight exaggeration brings
them into the sphere of sensation. Where attention is given to the
abdominal region and its contents, feelings that ordinarily are not
noticed at all come to be perceived. With the unfavorable suggestion
derived from the unfortunate diffusion of a superficial knowledge of
pathology and of bacteriology instead of hygiene and the science of
beneficent microbiology, these feelings produce a bad effect upon the

Familiar Examples of Unfavorable Suggestion.--There are many familiar
examples of the discomfort that may be produced by the mental
persuasion that something will disagree with us, or that certain
feelings have a significance quite beyond that which ought to be
attributed to them. Everyone knows how qualmy may be the feeling
produced by being told that something eaten with a relish contained
some unusual material, or was cooked under unclean conditions. Food
that agrees quite well with people, so long as they do not know too
much about it, often fails to be beneficial after they see how it has
been prepared. It is often said that people would not relish the food
placed before them if they were aware how lacking in cleanliness
was the place of its preparation, and how negligent those who had
charge of it. Occasionally a peep at the kitchen of a boarding house
effectually takes away appetite, or disturbs the equanimity with which
food must be taken, if there is to be that undisturbed digestion which
makes for healthy nutrition.

It is, indeed, with regard to digestion that the influence of the mind
on the body, favorable as well as unfavorable is, perhaps, most
effectively exercised. Unfortunately the unfavorable influence is even
more pronounced than its opposite. Some people are much more sensitive
than others in this respect, and even the thought of certain defects
in the preparation of their food seriously disturbs them. Everyone has
had the experience of seeing sensitive persons leave the table because
some one insisted on telling a nauseating tale. Anyone who has seen
the effect of talking of blood sausage or fried brains with black
butter sauce at a table on shipboard, when some practical joker was
exercising his supposed wit, knows how much the imagination can
disturb, not only appetite but digestion. The attitude of mind means
much, and especially are such unfavorable suggestions likely to
produce serious effects in inhibiting digestion.

Suggestion and Seasickness.--Seasickness illustrates the place of
unfavorable suggestion in digestion. The nausea, consequent upon the
movement of a vessel at sea, is due to a disturbance of the
circulation within the skull, and particularly of the circulation in
the semi-circular canals. The organ of direction of the body is
disturbed by the over-function demanded of it, consequent upon the
continuous movement of the vessel. This is, however, only a
predisposing element. A strong additional factor is the firm
persuasion many people have that they will suffer from nausea and
seasickness, and the unfavorable expectancy thus aroused. Most people
have to give their dole to Neptune. Those who for weeks before have
been expecting and dreading it usually pay a heavy tribute. Probably
the best remedy for seasickness is the suggestion that there is no
necessity for losing more than a meal or two, if even that much,
provided there is simplicity of diet and proper predisposition of body
by gentle opening of the bowels, and lack of the over-feeding that
sometimes comes from dinners given before departure. I have known many
people who, after suffering severely not in one but in many voyages,
have, by means as simple as this, been saved from days of seasickness
even in rough weather.

Most of the cures for seasickness that have been suggested have
depended principally on the suggestive element. For instance, there is
no doubt that many people are relieved by wearing dark glasses, and
this remedy does good for train sickness and other afflictions of a
similar kind. There is, however, no good physical reason why wearing
dark glasses should help except through their constant physical
suggestion. A simple remedy that has helped many through seasickness
is the wearing of a sheet of glazed paper, usually some heavy
writing-paper, immediately over the skin of the abdominal region. This
of itself has no physical effect, but the sensation of its presence
constantly obtrudes itself, and by making people feel that they must
be better because a great many other people have declared that they
were bettered by this remedy, they actually suffer less from nausea
and vomiting. Many of the internal remedies employed for seasickness
are directed to the stomach and intestines. As the seat of the
difficulty is not here but within the skull, the reputation which
these remedies have acquired has been due largely to the suggestive
effect of taking them rather than to any physical qualities they
possessed, though of course they have served to set at rest stomachs
disturbed by unfavorable expectancy.

Disease Groups and Suggestion.--Labeling groups of ailments with a
single term gives rise to many unfortunate conclusions and dreads with
regard to what a particular condition really is. The word
"indigestion" is commonly used for any stomach discomfort or
disturbance, especially that occurring after eating, from the slight
distress because too much has been eaten, or the uncomfortable feeling
of fullness because too much liquid has been taken, or the discomfort
due to an unsuitable mixture of food materials, to such serious
conditions as develop when there is motor insufficiency of the
stomach, followed by dilatation, with delay of the food for long
periods and with consequent fermentation, distress and bad breath.
Whenever the word "indigestion" is mentioned, the patient may think of
the worst cases that he has seen or heard of with this label, and
concludes that while his ailment may not be very serious just now, it
is only a question of time until it becomes so, and that unless he can
get rid of his uncomfortable feeling he is destined to have one of the
forms of "indigestion" that are productive of such serious discomfort,
with probably ever increasing torment, until some fatal complication
develops. The initial symptoms of gastric ulcer and cancer have been
labeled indigestion, and people, often recalling the serious
consequences that followed in such cases, fear for themselves.

Fearing the Worst.--This looseness of terms is noted with regard to
many other forms of disease. Rheumatism calls up the picture of
advanced arthritis deformans, with the awful deformed joints and
bed-riddenness, which should not bear the term rheumatism at all, but
which the patient has heard called so. Catarrh is the simplest of
inflammatory processes, meaning merely an increase of secretion,
functional in character and without any serious disturbance of an
organic character beneath it, but many people have heard the
foul-smelling ozena called catarrh, at least popularly, and so the
mental picture of such a repulsive progressive process as beginning in
them is suggested. It is important, therefore, when using words that
have such wide connotation as these, to explain exactly what is meant,
and perhaps, better still, not to use the words, but to employ some
more specific term that does not carry a cloud of dreads with it.
Indigestion can be a very simple passing set of symptoms, but once
certain people get the notion that they are troubled with indigestion,
their minds dwell on it to such an extent that they are likely to
limit their eating more than they should, and to disturb digestive
processes by thinking about them and using up in worry nervous energy
that should be allowed to flow down to actuate digestion.

So-called Incurability.--Patients are likely to hear entirely too much
of the incurability of disease. To the doctor and patient this word,
incurability, often has an entirely different meaning. The doctor
means only that the diseased tissues cannot be restored to their
previous condition by any of our known remedies, and that the effects
of the deterioration are likely to be felt to some degree for the rest
of the patient's life. To the patient it means, as a rule, not only
that the doctor can do nothing for him, which is usually quite
untrue, for much can be done for his symptoms even though the
underlying disease may be intractable, but also that the symptoms are
to grow constantly worse. This is often quite without foundation, for
nature's compensatory powers are very wonderful and seldom fail to
afford relief. In a great many cases fatal termination comes, not from
the original affection, but through intercurrent disease. Above all,
incurable means to many patients that finally the victim is to become
more and more subject to the pains and ills of his "incurable" ailment
until he becomes perhaps a pitiable object. Incurability, when we
recall that patients are so likely to mistranslate this term in the
way indicated, must be a word little used. Etymologically it is never
true, for cura means care, and we can always care for and relieve
the patient. In every chronic case there is room for hope of much
relief through accustomedness, various remedies, nature's compensatory
methods, and, above all, the modification of the state of mind.

There is probably no incurable disease that is ever quite as serious
as it is pictured by its victim when he first hears this word
pronounced. When we recall the chances of life, and that in any given
case, almost as a rule, the patient will live to hear of the deaths of
men and women who were in perfect good health when his ailment was
pronounced incurable, there is much of consolation to be derived from
conditions as they are. It seldom happens that a physician sees a
sufferer from tuberculosis, whose affection is running a somewhat
chronic course, without being able to find out that since the first
symptoms of the disease manifested itself, one or more of the
patient's near relatives have died because of exposure incident to
their abounding health. Pneumonia, appendicitis, typhoid fever,
accidents of various kinds, take off the healthy relatives, while the
tuberculous patient, constantly obliged to care for his health, lives
on, and often is able to accomplish a good deal of work. It is
important to impress facts of this kind upon these "incurable" cases,
for they represent the light in the desert, or the shout, or the
whistle at sea, that give renewed energy when nature seems about to
give up the struggle.

Thinking Health.--Hudson in "The Law of Mental Medicine" [Footnote 14]
suggests that we should think health and talk health on all suitable
occasions, remembering that under the law of suggestion health, as
well as disease, may be made contagious. This expression probably
represents an important element for the prophylaxis of disease under
all conditions. Under present conditions people talk entirely too much
about disease and have too many suggestions of pathological
possibilities constantly thrown around them by our newspapers, our
magazines and by popular lecturers as well as by our free public
libraries. People have learned to think and talk disease rather than
health. This predisposes them to exaggerate the significance of their
feelings, if it does not actually, on occasion, lower their resistive
vitality because of solicitude. The medical student torments himself
with the thought that he is suffering from the diseases that he
studies, and we cannot expect that the general public will be even as
sensible as he is in this matter. On the contrary, people generally
are much more liable to exaggerate the significance of their feelings,
hence the necessity for healthy suggestions rather than innuendoes of

[Footnote 14: McClurg, Chicago, 1903.]

In recent years, to paraphrase Plato's expression, people are much
more inclined to educate themselves in disease than in health.
The result has been a storehouse of unfavorable suggestion, from which
ideas are constantly being taken to make whatever symptoms that may be
present seem unduly important. Consequently people look for the worst,
and suggest themselves into conditions where not only are they
exaggerating their symptoms, but they are absolutely preventing the
flowing down of such nervous impulses as will enable them to overcome
affections that are present. Whenever anything turns up that lessens
their tendency to unfavorable auto-suggestion, their health improves.
Hence the taking, with confidence, of any quack medicine, no matter
what its constituents, cures them; hence the success of the numerous
and very varied forms of mental treatment. New Thought, Eddyism,
osteopathy, and the like, attain most of their successes because of
the removal of unfavorable suggestions, and the setting up in their
stead of favorable suggestion. In psychotherapy the first duty of the
physician is to undo all the unfavorable suggestion at work, and, if
successful in that, great therapeutic triumphs are possible.

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