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Psychotherapy And Modern Medicine

Paracelsus.--Paracelsus, the great physician of the first half of the
sixteenth century, who may well be considered the father of modern
pharmaceutics, had no illusions with regard to the exclusive power of
drugs over disease. He recognized that mental influence was extremely
important, and often lent a power not otherwise possessed to many
remedies. He said:

Imagination and faith can cause and remove diseases. Confidence in
the virtue of amulets is the whole secret of their efficacy. It is
from faith that imagination draws its power. Anyone who believes in
the secret resources of Nature receives from Nature according to his
own faith; let the object of your faith be real or imaginary, you
will in an equal degree obtain the same results.

Personal magnetism, in the sense in which we now use it, a
transference of the idea from the science of magnetics as related to
the phenomena of the magnet, seems to have originated with Paracelsus.
He was sure that the influence exerted over certain patients by
certain physicians was due to a force very like that exerted by the
magnet over iron. He was even inclined to think that magnets
themselves might exert a strong potency over diseased conditions, and
he found them to be useful in epilepsy. Doubtless in many cases of
supposed epilepsy successfully treated the ailment was really of an
hysterical nature. In these cases the strong suggestion which the use
of the magnets gave for many centuries acted favorably.

Agrippa.--The writings of Cornelius Agrippa, a contemporary of
Paracelsus, and, like him, a student of alchemy and of the secrets of
nature, contain corresponding passages which serve to show how much of
interest there was in mental influence during the Renaissance. All of
these men were, of course, a little outside of the ordinary medical
tradition, intent on getting to realities, not being satisfied either
with words or assumptions, refusing to accept many thing that the
physicians of their time completely credited. Agrippa in a
characteristic passage said:

Our mind doth effect divers things by faith (which is a firm
adhesion, a fixed intention, and a vehement application of the
worker or receiver) in him that cooperates in anything, and gives
power to the work which we intend to do. So that there is made in
us, as it were, the image of the virtue to be received, and the
thing to be done in us, or by us. We must, therefore, in every work
and application of things, affect vehemently, imagine, hope and
believe strongly, for that will be a great help.

Van Helmont.--At the end of the sixteenth century Van Helmont, who
carried on the work in pharmaceutics begun by Paracelsus, and to whom
we owe the discovery of a number of substances commonly used, as well
as the invention of the word "gas," was a thorough believer in the
influence of mind over body and, indeed, in the existence in human
beings of storehouses of latent energy ordinarily unemployed, but
that might under special circumstances be tapped to produce wonderful
effects. Indeed, some passages remind us of Prof. James' expressions
in his discussion of the law of human energy. Van Helmont said:

All magical power lies dormant in man, and requires to be excited.
(Compare Prof. James's "Law of Mental Energy" in the chapter on
Mental Influence). This (need for excitation) is particularly the
case if the subject upon whom we wish to operate is not in the
most favorable disposition; if his internal imagination does not
abandon itself entirely to the impression we wish to make upon him;
or if he towards whom the action is directed possesses more energy
than he who operates. But when the patient is well disposed or
weak, he readily yields to the magnetic influence of him who
operates upon him through the medium of his imagination. In order to
operate powerfully, it is necessary to employ some medium; but this
medium is nothing unless accompanied by internal action.

Sydenham.--In the more modern period the deliberate use of the
influence of the mind on the body is quite as clear. Undoubtedly the
greatest of modern physicians, who well deserves the name of the
English Hippocrates, is Sydenham. How much Sydenham realized that many
of his patients' ailments could only be cured by occupying their minds
with other things is seen in his writings. There is a characteristic
story told by Dr. Paris in his "Pharmacologia" which illustrates this
well and is a striking anticipation of what we are prone to think of
as very modern views in these matters:

This great physician, Sydenham, having long attended a gentleman of
fortune with little or no advantage, frankly avowed his inability to
render him any further service, at the same time adding, that there
was a physician of the name of Robertson, at Inverness, who had
distinguished himself by the performance of many remarkable cures of
the same complaint as that under which his patient labored, and
expressing a conviction that, if he applied to him, he would come
back cured. This was too encouraging a proposal to be rejected; the
gentleman received from Sydenham a statement of his case, with the
necessary letter of introduction, and proceeded without delay to the
place in question. On arriving at Inverness, and anxiously inquiring
for the residence of Dr. Robertson, he found, to his utter dismay
and disappointment, that there was no physician of that name, nor
ever had been in the memory of any person there. The gentleman
returned, vowing eternal hostility to the peace of Sydenham, and on
his arrival, at home indignantly expressed his indignation at having
been sent on a journey of so many hundred miles for no purpose.
"Well," replied Sydenham, "are you better in health?" "Yes, I am now
quite well; but no thanks to you." "No," says Sydenham, "but you may
thank Dr. Robertson for curing you. I wished to send you on a
journey with some object of interest in view; I knew it would be of
service to you: in going, you had Dr. Robertson and his wonderful
cures in contemplation; and in returning, you were equally engaged
in thinking of scolding me."

Morgagni.--In the century following Sydenham we have a number of
examples cited by Morgagni, the father of pathology, in which his
recognition of the value of the mind as a curative agent and of the
harm that may be done by over-occupation of the mind is set forth at
its proper value. Benjamin Ward Richardson in his "Disciples of
AEsculapius" [Footnote 2] tells of two incidents in which this phase
of Morgagni's very practical application of knowledge to medical
practice is exemplified:

[Footnote 2: London, 1901]
In other examples, where the symptoms are due to mental oppression,
he pursued a course of treatment that was of soothing nature. A
distinguished professor of physic at Bologna happened to discover
that his pulse was intermittent, and being extremely anxious about
it was incessantly feeling his pulse, to discover that the evil was
daily increasing. Morgagni's advice to his patient was to take his
finger off his wrist and not to inquire too anxiously about his
condition. The advice was followed, and the result was a complete
removal of the disturbance.

It is a very singular truth that in describing the action of the
nervous system on the circulation Morgagni shows that he was
cognizant of the fact that the circulation may be disturbed by two
sets of nervous irritations, one inflicted through the
pneumogastrics, the other "through those nerves which are
subservient to the arteries"--the vaso-motor system which is readily
disturbed by the mind. In one patient he observed great
perturbations of the pulse in both wrists as the result of mental
anxiety. But a day or two later the pulse derangement was confined
to the left side altogether. The pulse of the right arm was quite
regular, while that of the left arm still showed the inequality.
When the mental distress was relieved, this pulse also became equal.

Morgagni cites Sydenham's contemporary, Lancisi, the great Italian
physician, as recognizing the influence of the emotions on the heart.
Examples of similar convictions as to mental influence in medicine are
also found in the works of Morgagni's great contemporaries, Boerhaave
and Van Swieten, and the great physicians of the seventeenth and
eighteenth centuries were closely imitated in their recognition of the
value of the influence of mind over body in medicine by their
successors in the profession.

John Hunter.--Wise old John Hunter recognized the influence of the
mind on the body very clearly. He said, for instance, "There is not a
natural action in the body, whether voluntary or involuntary, that may
not be influenced by the peculiar state of mind at the time." He lays
it down as a law that "every part of the body sympathizes with the
mind, for whatever affects the mind, the body is affected in
proportion." He said further, "as a state of the mind is capable of
producing a disease, another state of it may affect a cure." He called
attention to the fact that the touch of a corpse produced wonderful
effects upon the minds of patients. He said, "Even tumors have yielded
to the stroke of a dead man's hand." He observes that "while we should
naturally expect that diseases connected with the nerves--and those in
which their alteration is in the action of parts not in their
structure--would be most affected by the imagination, we find that
there are other diseases in which they appear to have little
connection that are much affected by the state of mind."

German Mind Healing.--In his monograph on "Psychotherapy in Its
Scientific Aspects" [Footnote 3] Dr. Berthold Kern calls attention to
a forgotten book of the German physician Scheidemantel, published in
1787. Its title was "The Emotions as Remedies." It seems to be very
rare since even our Surgeon General's Library has no copy of it. The
author treated psychotherapy systematically. He insisted that man was
a unit in which body and soul mutually influenced each other.
Scheidemantel blamed the moralists for considering the soul
exclusively and the physicians for thinking only of the body. He
thought that this was a serious mistake for both sides and he seems to
have anticipated much of our recent discussion on the influence of the
body and of things physical generally in what is called crime and
various divagations from law. On the other hand, he thought that the
influence of the mind on the body was one of the most important
elements in therapeutics.

[Footnote 3: "Die Psychische Krankenbehandlung im Ihren
Wissenschaftlichen Grundlagen." Berlin 1910.]

Reil, after whom the Island of Reil is named, and who taught us much
with regard to brain anatomy, was also interested in the influence of
mind on body. He was the professor of anatomy at Berlin in the early
part of the nineteenth century and had great influence over the
medical science of the time. He insisted on the recognition and
development of psychotherapy and hoped to give it a place beside the
medical and surgical treatment of human ills. He did much to create a
current of thought in German medicine which culminated in Johann
Mueller's very definite expressions with regard to the power of the
mind over the body.

Very probably the most striking expression of the influence of mind
upon body is in that wonderful old book, Johann Mueller's text-book of
physiology, issued in an English edition (London, 1842) under the
title "Elements of Physiology." The subject, a favorite study, is set
forth very clearly, and evidently from personal knowledge. He
recognized that the mind might influence every organ and function of
the body. The influence of expectancy he emphasized particularly:

The influence of ideas upon the body gives rise to a very great
variety of phenomena which border on the marvelous. It may be stated
as a general fact that any state of the body, which is conceived to
be approaching and which is expected with perfect confidence and
certainty of its occurrence, will be very prone to ensue as the mere
result of that idea, if it do not lie without the bounds of
possibility. The case mentioned by Pictet, in his observations on
nitrous oxide, may be adduced as an illustration of such phenomena.
A young lady, Miss B., wished to inspire this intoxicating gas; but
in order to test the power of the imagination, common atmospheric
air was given to her, instead of the nitrous oxide. She had scarcely
taken two or three inspirations of it, when she fell into a state of
syncope, which she had never suffered previously; she soon
recovered. The influence of the ideas, when they are combined with a
state of emotion, generally extends in all directions, affecting the
senses, motions and secretions. But even simple ideas, unattended
with a disturbed state of the passions, produce most marked organic
effects in the body.

With regard to the influence of the mind over the body in the matter
of fatigue Mueller is especially emphatic. He states just as clearly
two generations ago the Law of Reserve Energy as James stated it in
recent years. Of course, Mueller was far beyond his time in everything,
but then men who really think always are, and even Mueller's accurate
expression only represents what had been in the minds of thinking men
in many previous generations. He says:

The idea of our own strength gives added strength to our movements.
A person who is confident of effecting anything by muscular efforts,
will do it more easily than one not so confident in his own power.
The idea that a change is certainly about to take place in the
actions of the nervous system, may produce such a change in the
nervous energy, that exertions hitherto impossible become possible.
This is still more likely to be the case, if the individual is at
the time in a state of mental emotion.

Even this necessarily fragmentary and rather disjointed sketch of the
main features of psychotherapeutics, as we see them recognized by the
great physicians of the past, serve to show that mental influence
has always been appreciated as an important element in the care of the
individual patient.

The times when special attention has been paid to psychotherapy have
certain special characteristics. Usually the periods have come just
after a signal advance in medicine made through devotion to physical
science. Great attention is given to the advances and for a time the
individual patient is forgotten in the hope that at last physical
science is going to solve the problems of the physical man. With the
disappointment that always follows there is a reversion of feeling and
men realize once more how important is the mental state of the
patient, even in physical diseases. Then there comes an emphatic
expression of the value of psychotherapy. We are at present in the
midst of one of these periods, hence the widespread interest in the

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