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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