Chapter V: Introduction: II (2)

It is a great pity that the work of the cleric and the work of the doctor should ever clash; for they are ordained (the Prayer-book again) for the mutual society, help, and comfort that the one ought to have of the other. Only, if they are to be friends in ministering to the sick and the dying, they must be friends always. If, in social life, they do not get on well together, they will not work together well in the sick-room. If the doctor makes stupid jokes against religion, and the cleric doses his parishioners with quack medicines; if the doctor is dull to the wonders of faith, and the cleric is dull to the wonders of science: if neither has the grace to recognise and honour and openly praise the good works of the other--how shall they adjust themselves, in the presence of impending death, who thus waste the opportunities of daily life?

THE RELATION OF PRIEST AND DOCTOR TO PATIENT

BY

JANE WALKER, M.D.

PHYSICIAN, NEW HOSPITAL FOR WOMEN

THE RELATION OF PRIEST AND DOCTOR TO PATIENT

BY JANE WALKER, M.D.

In considering the subject of Religion and Medicine, we shall be helped by looking back to the beginnings of things, when people first realised that illnesses existed, and that certain of them were curable. They knew nothing of internal anatomy or physiology, nothing of the origin and treatment of disease, nothing of its infectious, communicable character. The treatment, or, at any rate, the healing of disease, must have been by means of what seemed to be mental influences in those early ages. Why, our very word ‘Influenza,’ revived within comparatively recent years, shows how vaguely and imperfectly was understood a disease which now we recognise as having a definite train of symptoms, but of which we still know so little that we speak of it merely as an _influence_.

The idea of mental influence in disease was first scientifically formulated about twenty-five years ago, and was provided with one of those queer names which we now use more or less glibly, with a sort of comforting feeling that we understand the subject, when we have successfully mastered the spelling and pronunciation--the scientific name _psychotherapeutics_, or, in plain English, _mind cure_. These investigations were undertaken in France, to start with, at Nancy University, by Liébault, who published, in 1866, ‘Treatment by Suggestion,’ and by Bernheim, and simultaneously in Paris by Charcot, and they were primarily to observe sundry methods of treatment used at that time in an unscientific manner, such as animal magnetism, mesmerism, hypnotism, &c. Liébault’s book, which was taken little notice of at the time, gave a full description of the methods he pursued, which more or less coincide with those followed by doctors who practise Treatment by Suggestion and Hypnotism at the present day. He lived a retired life, and practised entirely amongst the poor, who were devoted to him, but, at the same time, regarded him as an amiable enthusiast. Liébault finally retired on a very small competency, not acquired from his practice, which was altogether unremunerative.

As a result of this gathering up of all these so-called occult methods of treatment into the more or less exact science of Psychotherapeutics, have come into prominence many cults--or sects, shall we call them?--such as Mental Healing, Faith Cures, Peculiar People, Metaphysical Healing, Christian Science, each of which is overlaid with doctrines of a more or less dubious kind. The growth of these various bodies of late years has been extraordinarily rapid: to mention two of them only, Christian Science and New Thought are now enthusiastically practised and believed in by many thousands of people, both here and in America, and hundreds of churches have been provided and erected in their names.

It must not be lost sight of that Christian Science, as well as New Thought, which has been described by Mr. Dresser, one of its chief exponents, as being ‘a common-sense, rational phase of the Mental Healing Doctrine,’ ‘are dealing with genuine _facts_ in the sphere of Mental Therapeutics’; but these facts are entirely independent of the theories by which either school attempts to explain them.

The spread of Christian Science was viewed with considerable alarm by many influential members and dignitaries of our own Church, and this feeling was brought to a head at the Pan-Anglican Congress in 1908, when a large meeting on the subject was held at the Albert Hall, which is fully reported in the handbook of the Pan-Anglican Congress.

Following on the Pan-Anglican Congress meeting came the Pronouncement of the Bishops assembled in Conference at Lambeth, in July 1908. The report of this Conference is published by the S.P.C.K. as a pamphlet. On November 16, 1908, an important conference on Spiritual Healing was held at Sion College, which was presided over by Prebendary Pennefather, who said that the Church had too long neglected that part of her teaching and ministry. Mr. Hickson gave an account of the Society of Emmanuel, and stated that they desired to revive in the Church the use of the gift of healing committed to her by our Lord.

The Rev. Francis Boyd explained the objects and work of the Guild of Health. They held that bodily healing was not of primary importance, that sanctification might indeed be gained through sickness, but that a fuller sanctification might be gained by those who sought to be made whole by a more real and vital union with our Lord. The Guild of Health, Mr. Boyd proceeded to say, recognised three systems of healing--physical, mental, and spiritual--though there was not necessarily any opposition between them. They felt, however, that Spiritual Healing was the only system which concerned the Church. They were quite alive to the dangers of over-estimating the value of bodily health, and only desired to further it so far as it ministered to the perfection of the whole nature of man. After some further discussion, a resolution was passed that, ‘In the opinion of this Conference, the time has come to form a Central Church Council in the diocese of London, for the consideration of questions connected with Healing by Spiritual means.’

At the outset, we must take exception to Mr. Boyd’s three systems. I very much question whether there is more than _one_ system, and I am convinced that physical and mental are one and the same. And I would go so far as to say, that the disastrous mistakes that have been made in the past, and which are still in operation to-day in the treatment of one large section of sick people, viz. the insane, largely owe their origin to this arbitrary division. And, by a curious irony, the branch of medical science where there is the most marked predominance of materialism is this very department of mental diseases. This is all the more curious when we reflect, what occult influences have been, in all ages, supposed to work upon the insane. The obnoxious word ‘lunatic’ is a proof of this. The moon was by some supposed to have a deleterious effect on the intellect; insane persons were spoken of as ‘moonstruck’; the periodicity of the mental attacks was also supposed to have some relation to the lunar interval. Indeed, the whole subject of insanity bristles with occult and mysterious theories. The really hopeful treatment of insanity began when it--a mental disease--was treated, not by mental, but by physical methods, and the more mental and physical are taken together as one and the same, the more rational and productive of good, in the best sense, is our treatment likely to be. Indeed, the whole indivisibility of the three systems is nowhere so well shown as in the arbitrary division of Religious Insanity. Surely if we try to turn the minds of the sufferers from any considerations of religion, by removing their Bibles, by preventing them from any religious discussion, or from taking part in any religious ceremonies, we are helping to keep up the evil. People, as we put it, become insane on religious matters, not only because they have been dwelling on the subject unduly, but because it is naturally of the greatest importance, and absorbs more attention than probably anything else in the world. Now, as the more purely physical, as distinguished from the more or less occult methods of regarding the insane, has become the more enlightened and modern view of the subject, so has the spiritual method of dealing with it come into prominence. Spiritual ministrations to the insane may be thought to be useless, or, at any rate, to be fraught with little practical utility. Comparatively recently a man who had charge of a country parish was appointed chaplain to Broadmoor, which is the asylum for insane criminals. A friend, on being told of the appointment, said to him, ‘Why, whatever will you say to them? You can only talk to them of their sins.’ ‘Talk to them of their sins!’ he said; ‘I shall never mention them.[10] I shall talk to them of Hope.’

[10] ‘The Society of the Crown of Our Lord’ was formed for the
purpose of supplying spiritual ministrations to the insane.

I have thought it advisable to dwell rather at length on the question of the insane, because it really rather fairly represents my point of view on this subject. Whether you agree with me or not, it is better that I should state quite fairly and straightly my position, which has only been reached by honestly striving after truth, and by looking fully into the subject for the purposes of this paper. In talking about Spiritual Healing, we are hampered at the start, because we have only actual knowledge of physical things, i.e. of things as they appear to us here. We have to define spiritual things in physical terms, because they are the only things we know and understand. Time and space do not exist in the spiritual domain. Take just one word in illustration of my meaning, the word _Rest_. Our present state of being here has certain peculiarities. Labour involves rest from labour, and if the limits of rest and labour are exceeded, the result is ruin to man’s moral and physical being. Disease is sure to follow the inactive mind or body, and then comes a time when ‘we cannot do the things we would.’ But these things do not exist in spiritual language. ‘They rest not day and night, but cry “Holy, Holy, Holy.”’ When we pray ‘Eternal rest grant them, O Lord,’ we have no thought of a period of rest as we understand it, but rest in and with God.

We are far too apt to think that suffering is an evil--it is not necessarily so; on the contrary it may be a blessing, because it is often a direct means of advance towards perfection. Far too much attention is paid at the present day to temporal benefits. ‘Get rid of poverty, of suffering, and the world will be virtuous and happy,’ but this is not so. The people who starve and brutally ill-use their children are not the very poorest; they are usually well-to-do in the world. There is a great deal too much of considering poverty as a _real_ cause of suffering. Christ’s mission of redemption was not primarily a mission for the relief of suffering. If He bids us to take up our cross, He also bids us, as a quite essential corollary, to follow Him. Indeed, taking up our cross is useless, if we do not follow Him. Pain, far from being shunned, should be welcomed and embraced, because it brings us nearer to the sufferings of our Blessed Lord. It is not, of course, mere pain in itself that lifts and cleanses: it is pain rightly and courageously borne, from whatever motive. If this be true, the modern revolt against all suffering--and here I quote from the late Miss Caroline Stephens’s article on ‘Pain,’ published in the _Hibbert Journal_ for October 1908--‘is obviously suicidal. To extinguish all suffering, were that possible, would be to deprive the world of a leverage as all-pervading and effectual towards spiritual elevation and purification, as is gravitation towards stability.’

Pain and evil are not interchangeable terms, but are quite different. Evil cannot be innocent, though pain can be, and often is. When the disciples said, ‘What hath this man or his parents done that he should be born blind?’ they formulated the usually accepted idea at that time, and an idea, moreover, that dies very hard. The whole treatment of disease in the Middle Ages was based on it.

If we quite briefly consider our Lord’s miracles, they were _signs_ of His Divine mission, not proofs, and in performing them, He felt limitations; for we are definitely told that in Capernaum ‘He did no more mighty works, because of their unbelief.’ These signs were sudden manifestations of His power, and as such they are preferably called Divine Healing. They showed the very highest degree of spiritual power, but there was nothing really new. Christ was the perfect manifestation of eternal things, and eternal things are obviously never new. Perhaps the fact that our Lord thought it worth while to show his power in bodily healing was intended to teach us that to keep our bodies in health is an important religious duty, and more than that, that all hygienic social work undertaken is an important part of the duties of religion. Both nursing and doctoring bring us very near to part of the work of Christ, for He went about doing good to the sick, and He symbolised this, not only by His healing words, but by the simple medicines and nursing of the Good Samaritan. But just as illness is by no means caused by evil or ill-doing, so it is equally clear that goodness does not of necessity bring health. The question of bodily health has no connexion with spiritual conceptions at all. If it were so, the persons who are the strongest physically would be the most spiritual; but we know, of course, that this is not so. Take St. Catherine of Siena, one of the greatest of saints, statesmen, and scholars that the world has ever known. She healed others, but she died herself of a lingering, painful disease, at the early age of thirty-three. Also St. Paul, who prayed the Lord thrice that the thorn in the flesh which tormented him might be removed. And the Lord’s reply has been a help and comfort, and a lesson to countless thousands ever since. ‘My grace is sufficient for thee, for My power is made perfect through weakness.’ And what we so very often see now, persons bereft of all that makes life dear, in suffering of mind or body maybe, yet rise above their weakness, and carry through such reforms and such noble acts as they never could have done had they been allowed to remain in bodily health and comfortable and happy surroundings. Indeed, St. Paul’s affliction was the means of his converting the Galatians, for his illness compelled him to stop with them for a time, and in writing to the Corinthians from them, he could truly say, ‘Most gladly, therefore, will I rather glory in my weaknesses that the strength of Christ may cover me.’ To repeat, it is our duty, as far as can be, to keep our bodies in health, though we can most of us conceive of circumstances when to lose our life may be indeed to save it.

In a sermon preached for the ‘Guild of Poor Brave Things,’ the present Bishop of London, who is the president of the Guild, said: ‘What made more impression on me as an undergraduate at Oxford than all the sermons I ever heard in chapel was a young don, insisting, at the risk of his life, on ministering to an undergraduate dying of a most infectious disease.’

After all, St. Paul’s life, as narrated by himself, can hardly have been considered as hygienic. ‘Of the Jews five times received I forty stripes save one. Thrice was I beaten with rods, once was I stoned, thrice I suffered shipwreck, a night and a day have I been in the deep; in journeyings often, in perils of rivers, in perils of robbers, in perils of my own countrymen, in perils from the Gentiles, in perils in the city, in perils in the wilderness, in perils in the sea, in perils amongst false brethren; in labour and travail, in watchings often, in hunger and thirst, in fastings often, in cold and nakedness. Besides those things that are without, there is that which presseth upon me daily, anxiety for all the churches.’ In comparison with this, the ‘Don’t-worry Gospel’ of the Christian Scientists seems utterly beside the mark. Health is undoubtedly good, but it must sometimes be cast away in the service of others.

Of course there is a philosophical difficulty in the whole position of the relation of religion to medicine. In a manner they are, as it were, at loggerheads from the outset. The Church is bound to teach that it matters not how long or how short a man’s life is, if it is rightly spent, whereas the doctor’s point of view must be to keep the man alive at any price. And although we may feel that, under certain circumstances, the medical attitude might be modified, it is the only safe one in the present state of our knowledge. Euthanasia seems, on the surface, a most humane and comforting suggestion, but it is allowing us finite beings to take into our own hands things which are beyond our comprehension. We all know of instances where it must have been thought that death would be preferable to life; but apart from the presumptuous thought of mere human beings, look how often the maimed bodily frame ‘rises on stepping stones of its dead self to higher things.’ A man struck with blindness, for example, may be living a full and perfect and whole life, in spite of his maimed condition, because he puts out all his powers and lives at the top of his bent. Such a man is in the highest state a healthy being. The unwhole man is one who is always in terror of his life, and who does not accept with faith and cheerfulness, and in a life of prayer, the ills that are laid upon him by a wise and Divine Providence. It is true that there are more things wrought by prayer than this world dreams of. Yes, but even our prayers have necessary limitations arising from our imperfect knowledge, and when St. James declared that the prayer of faith shall save the sick, he spoke at a time when scientific investigation was non-existent, and when people must have been sorely distressed by their total inability to overcome the diseases from which those around them were suffering. But for us, whose physical knowledge is so much more exact, to refuse to accept the remedies which hard and patient toil has discovered, under God’s help and guidance (there whether we recognise it or not), is both presumptuous and foolish. Spiritual Healing--i.e. a quasi-miraculous process--_must_ die a natural death, even if the agony is prolonged. It is simply pandering to charlatanism, and by its exaltation of the Health of the Body, is almost pagan in its effects. It is, moreover, an emphatic expression of individualism at a time when co-operation in every direction is the natural and right trend of affairs; for truly never did we feel so strongly as now, that no man liveth to himself, and no man dieth to himself--as true of nations as of individuals. It is, therefore, in the highest sense, reactionary, and a sentimental attempt to put the clock back, which is doomed to failure. Take one item, which is wrapped up in this idea of Spiritual Healing, and that is Demoniac Possession. This was an ancient belief, as is shown by some of the miracles narrated in the Gospels, and there is an attempt to revive it in the present day, and with that, a practice of Exorcism as a cure for it. ‘But,’ and here I quote from ‘Religion and Medicine,’ ‘it is a significant fact that as education spreads, belief in demoniac possession dies out, and the greatest strongholds of the belief to-day are in non-Christian countries.’ A possible explanation of this is, that in Christian countries, spiritual forces have been actively at work for many generations, and that this spiritual activity has weakened the power of the forces of evil. There is, too, no blinking the question that the behaviour of insane people, or even of people supposed to be insane, might be explained on the theory of demoniac possession. For example, how often one sees people generally good and kind, and even truly religious, go suddenly into a fury of temper or violence of some kind; or in delirium we know that quite sweet, innocent people say dreadful things which one would think they could not even _know_. No doubt to some people the temporary possession by some evil spirit is a more comfortable theory than that it is a revelation of the natural man in us, when discipline and training are in some way relaxed, and that such is our _real_ nature let loose.

The dangers of a belief in, and of practising _consciously_, Spiritual Healing are great, as far as doctors are concerned. It simply puts a premium on ignorance and laziness, and is disastrous to exact knowledge and scientific investigation. Spiritual healers assert that to dwell on the abnormal and pathological prevents their work on the normal. But who is to say what is the normal, till abnormalities have been weighed and considered? No, to people like myself who practise medicine, it is a dangerous and uncertain weapon to employ. Far be it from me to say that the spiritual side of medicine should be ignored altogether. We know that our prayers, rightly offered, are a help to our patients--we _know_ that the ordained Sacraments of the Church are a help to them. Moreover, we know very well that there is no royal road to the treatment of disease. We know well how many cases there are in our various hospitals and infirmaries, that have baffled all the skill of diagnosis and treatment that has been vouched to the world up to the present time. Is it rational to believe that such cases will be healed by a glance, or a touch, or a word of any merely human person, however holy, who is manifestly ignorant of any ordinary scientific knowledge? No, Spiritual Healing as a cult, as a part of the sacramental life of the Church, will cease to exist, but all that has come out of it will be quickened and strengthened. We shall feel greater need of prayer and intercession, and we shall feel more and more the real value of meditation.

That the medical profession is fully alive to the importance of the question, in spite of its difficulties, may be inferred from the following extract from the _British Medical Journal_, November 6, 1909:

‘We welcome the discussion at the Harveian Society, as a sign that the profession is more fully realising the value of certain potentialities of healing and relief, which an ingrained materialism passes by on one side. All around us spiritual or mental healing is going on. It is our duty, as it is our interest, to study the process scientifically, to define its limitations both in regard to the conditions to which it is applicable and to the persons who can successfully apply it, and to recognise perhaps more fully than before that man is a compound of body and spirit, both of which have to be taken into account by those who undertake the treatment of disease. The first step to be taken, if the profession is not to surrender a large part of its sphere of usefulness, is that medical practitioners should be trained in psychology as well as in physiology. In saying this we do not wish to be understood as pinning our faith entirely to experimental psychology. A careful study of the works of the great masters of the human heart is at least as important as the estimate of time reactions and the accuracy of visual impressions.’ ‘A careful study of the works of the great masters of the human heart’--this rings true, and makes one hopeful, in spite of the confusion in terms that exist in regard to Psychic Healing and Spiritual Healing.

Spiritual Healing may be defined as a change in a person’s point of view. It may be a question of building up character, or of development of spiritual attributes. In both cases, it is essentially a matter of instruction. And the teaching will be effective in proportion as the teacher is possessed of sincerity and sympathy. I am anxious to be most emphatic in saying this, because so much misunderstanding has arisen of late on all sides, owing to misconceptions on this point. Spiritual Healing can only, in quite a secondary way, be a physical process. Again, take the case of a man who becomes blind in a way that prohibits any idea of his ever recovering his sight; he may develop into a miserable, discontented being on account of his affliction. He comes under the influence of some teaching, of some person, or of some sudden religious inspiration. He is healed. Can he see again? No, but he has risen superior to his blindness. He is a _whole_ man once more. This is all that he and his lay friends know. He _may_ even enjoy better physical health than he did while his blindness oppressed him. Or, again, there may be morbid physical conditions directly or indirectly attributable to a morbid temperament, sleeplessness due to wrongdoing, or chronic dyspepsia due to worry. In such cases as these, the doctor may do little or nothing. The malady is only incidentally a physical one. Here ‘Spiritual Healing’ in the true sense is the only remedy, and every liberal-minded medical practitioner would desire it for the patient.

Practically, as I have repeatedly found from experience, priest and doctor can combine to the great advantage of the patient. Medical practitioners need have no fear that, with wise and experienced priests, they will find their special province interfered with; on the contrary, their hands will be strengthened, the patients calmed, and their fortitude increased. It has been my lot many times to find the irritable patient resentful of her illness, and of God’s dealing with her, brought to a calm, hopeful, restful frame of mind, and that by the ministrations and prayers of a wise and tactful priest.

Perhaps St. Catherine of Siena expresses what is meant by all this in speaking of praying for others. ‘It is toil for him ... to hold him in the presence of God.’ And it is here that the priest can so greatly assist us in our labours on behalf of those weak or sick ones who have been entrusted to our care.

FAITH AND MENTAL INSTABILITY

BY

THEO. B. HYSLOP, M.D.,

SUPERINTENDENT OF BETHLEM HOSPITAL

FAITH AND MENTAL INSTABILITY

BY THEO. B. HYSLOP, M.D.

_The Tendency for Insanity to increase on Account of the Stress of Life._

That there is a tendency for insanity to increase on account of the stress of competition and all the complexities of modern civilisation few will deny. The burden of taxation upon the nerve tissues and the drain upon their stores of energy must necessarily go on increasing as the uses for the physical mechanism of the body and limbs diminish and become replaced by the more complex nervous activities essential to brain and mental avocations. The influences of rural and urban life, trades and occupations, &c., as favouring the occurrence of insanity, have been dealt with in an exhaustive manner in various reports, treatises, and innumerable papers, and the result has been to apprise us of the fact that the percentage of individuals who are incapable by reason of mental perversion or defect from taking active and useful parts as citizens far exceeds our previous conceptions as to the extent of the degeneration in our midst.

It is well-nigh impossible to obtain a complete census of the physical and mental states of the people. Statistics furnish us with so many fallacies that for present purposes I prefer to omit them, and deal only with broad issues which seem to have direct bearings upon the mental health of the community.

It is now an accepted fact that civilisation, with its tendencies towards the aggregation of individuals into dense communities, favours the occurrence in those communities of overcrowding, pauperism, crime, and degeneration. For those designed by habit and heredity to rural life, migration to cities where the struggle for life is continued under totally different circumstances is disastrous, and for them the step from country to town is but one of the commonest of all the steps towards mental and physical deterioration, the accidents of civilisation finding in them merely the readiest victims.

The necessity of this migration, as determined by the state of agriculture, makes it none the less an evil, and it is a symptom in the evolution of an essentially agricultural race which is fraught with extreme danger to the maintenance of its nervous and mental stability.

The problem, however, has a different aspect for those who by habit and heredity are trained for city life, and certain it is that increased facilities for travelling are tending to decentralise our cities and thereby render the city dwellers healthier and more fit to cope with the drain upon their nervous energies. As a physician, it would appear to the writer that the problem of Sunday observances in town and country have different bearings on the health and physical fitness of the people. There is no doubt that periodic decentralisation of town dwellers is essential to the maintenance of bodily health, and it is also true that physical exercise and change from mental to physical functioning and _vice versa_ is essential to all--i.e. if the balance between the mental and physical powers is to be adequately maintained. It is, of course, to be understood that to a physician the preservation of this balance is his first care, and to him is entrusted the function of aiding in the proper observance of all that is in agreement with biological and, therefore, natural laws. To him there is a great difference between ‘observance’ and ‘belief’; and he sees in them either mutually co-operative or mutually destructive factors for good or ill respectively.

If religious observances, under determined conditions, are found to be useful and essential for the sane in mind and body, they are also likely to be so, under conditions otherwise determined and arranged, for the insane. Many insane patients are totally incapable of attending any religious function. Some must be prohibited; others may be encouraged. As an asylum physician the writer may state that a generic case of religious excitement or enthusiasm may most advisedly even be restrained from religious functions until at least the acute symptoms have subsided. There can be little doubt that no religious officer would be likely to succeed in accomplishing much for patients without an accurate knowledge of insanity and the mental experiences of those whom he seeks to influence. The fact that mental aberration forms a special study and phase of life increases his difficulties and limits his possibilities. Where there is apparent failure both inside asylums and without, such failures may very possibly be attributed to the deficiencies of the doctrine, the discipline of the religion itself, the organisations peculiar to it, or the functionaries associated with it in our day. If the Christian religion is a true philosophy, it is the duty of all who profess Christianity to assist in the practical application of its precepts, where such can be judiciously and safely applied, taking religious things perforce as they find them, and utilising their own special knowledge to the best possible advantage, according to the conditions they find.

Is a person with deep religious conviction better equipped to face the stress of life than an unbeliever? An answer to this question was given by the writer in a paper read at the annual meeting of the British Medical Association held at Leicester in 1905. In stating that ‘a true and philosophical religion raises the mind above a mere incidental emotionalism’ he used the word ‘religion’ in its literal sense, as derived from _re_ and _lego_, to gather and consider, as opposed to _negligens_. He in no way extended its connotation so as to include demonstrations of incidental emotionalism, superstition, or fanaticism. Religion and moral obligation he considered to be almost convertible terms, both equally compatible with intuitionalism, utilitarianism, or any other ‘ism’ derived from the study of the laws of life and mind. Moral laws are generally principles of thought and action, which an intelligent being must apply for himself in the guidance of his conduct, and the translation of such general principles (expressed either in general abstract form or in the form of a command) into particular actions. Conformity with such precepts of morality may with reason be regarded as a safeguard against the ‘lusts of the flesh.’

Religious enthusiasm in itself cannot justly be termed an evil. Rather does it embody the most healthy and preservative development of our social forces. Like many other tendencies of the mind, it is subject to exaggeration, misapplication, and a predominance of the emotions over the intellect. The typical cases of religious insanity directly developable from sectarian and even undenominational religious enthusiasm, from religious meditations, exercises, devotions, or superstitions, are by no means so common as they are supposed to be by the uninitiated observer. The true point lies in this, that very many mental cases bear a strongly marked religious or at least moral aspect. The psychology of the subject will show, for example, that acute depression--a predominant phase of abnormal emotional life--leads almost necessarily to a religious interpretation. And this is even more the case with many actual sense perversions. Such, I mean, as have ever been associated with the ideas of the supernatural.

These are not necessarily caused by religious over-excitement or enthusiasm. They may assume the appearance of it, because, being the deepest and most real feelings, desires, and convictions of the perverted organic life or of the moral reaction which accompanies it, they cannot well be expressed or described except in strong moral terms. Over and over again does this appear, and often among those least likely to be suspected of any religious predisposition. That these feelings should be clothed according to the prevailing ideas and creed of the patient is an essential reproduction of the mind. But, after all, this only relates to the form of their appearance, and there are many things which lie deeper.

Religious excitement is not infrequently assigned as a cause of insanity. The writer has stated elsewhere his belief that the philosophy of the infinite, far from being a source of aberrations of thought which may be deemed insane, is the ultimate point of our mental evolution, and that a true and philosophical religion raises the mind above a mere incidental emotionalism and gives stability. With no religion and no moral obligation the organism is apt to become a prey to the lusts of the flesh and their consequences. Gasquet observes that religion may either produce or tend to hinder unsoundness of mind; that it may cause certain symptoms of insanity or modify them; and, lastly, that it may be employed as a means of moral prevention and treatment. He believes that every form of religion, however widely it may differ from our standard of the truth, if it enforces the precepts of morality, is a source of strength to the sound mind that sincerely accepts it.

Clouston has justly observed that far more depends upon the brain that goes to church than upon what it may obtain in the church. That is to say, there must be the predisposition to break down, the religious influence being often merely an accident. It must also be remembered that religious over-enthusiasm may be merely a symptom and not a cause.

Much misconception through misquotation has arisen in connexion with the writer’s views as to the therapeutic value of prayer. Reference to the context of his views expressed before the Society for the Study of Childhood will show that reference was made to the _habit_ of prayer in childhood, and its therapeutic value was there urged more as a preventive than as a curative agent. It was urged that the mental hygiene of childhood was not to be determined by any special denominational method.

Such limited methods may result in the fixity of an idea or belief quite compatible with usefulness in any sphere of activity, but they do not deal with the broader and deeper question of the preservation of the mental health of the individual. The exaggerated importance of the denominational question, which has engendered passive resistance, ought to give way to the question of mental health and engender a strong and active resistance to all that tends to narrow or circumscribe the mental life of the infant. It ought to be our object as teachers and physicians to fight against all those influences which tend to produce either religious indifference or intemperance, and to subscribe as best we may to that form of religious belief, so far as we can find it practically embodied or effective, which believes in ‘the larger hope,’ though it condemns unreservedly the demonstrable superstition and sentimentality which impede its progress and power. As an alienist, and as one whose whole life has been concerned with the sufferings of the human mind, the writer believes that of all the hygienic measures to counteract disturbed sleep, depression of spirits, and all the miserable sequelæ of a distrait mind, he would undoubtedly give the first place to the simple _habit_ of prayer. Let the child be taught to believe in an anthropomorphic God the Father, or in an all-pervading medium of guidance and control, or in the integrity of a cosmic whole, with its transmutations, evolutions, and indestructibilities. It matters little, for they all lead in the same direction. Let there but be a habit of nightly communion, not as a mendicant or repeater of words more adapted to the tongue of a sage, but as a humble individual who submerges or asserts his individuality as an integral part of a greater whole. Such a habit does more to clean the spirit and strengthen the soul to overcome mere incidental emotionalism than any other therapeutic agent known to him. Our schools are as gardens for the cultivating, judicious pruning and sustaining young life by gardeners who have, or who ought to have, full knowledge of the tender plants under their care. Our churches are to the moral welfare of the community as our schools are to the intellectual. The church has been aptly termed ‘God’s Garden,’ where the art of living good lives and the making of character is helped by specially appointed gardeners. It is needless to say, however, that the light of reason or sanity, as bestowed upon us by Nature, is the light to which all other considerations must give way lest we in our turn too soon pass the borderland of knowing things as they are.

MEDICAL ASPECTS OF MENTAL HEALING

BY

H. G. G. MACKENZIE, M.A., M.B.

MEDICAL ASPECTS OF MENTAL HEALING

BY H. G. G. MACKENZIE, M.A., M.B.

I. _Spiritual Healing in the Light of Modern Medical Science_

I have been asked in this chapter to put together some recent expressions of opinion by members of my own profession on the subject of ‘mental’ and ‘spiritual’ healing. No attempt whatever is made to give an exhaustive summary. It will be sufficient for my purpose if I can make clear to the non-medical reader--

(1) That there is nothing new in the elaborate and confident pretensions now being thrust forward by a variety of ‘healers.’

(2) That, so far from scientific medicine ‘standing helpless in the presence of a new phenomenon,’ she is in possession of a very large amount of clinical material on which quite definite conclusions have been formed; and, as always, she is perfectly ready to consider and investigate any new evidence which might tend to mitigate the force of such conclusions.

Now, there are obviously two main lines of investigation. We may consider (1) the _à priori_ reasonableness of the claim that certain bodily diseases can be cured by ‘mental’ or spiritual processes, or we may proceed to (2) an _à posteriori_ investigation of cases of alleged cures. A third method of investigation, that which is, of course, adopted in _all_ cases of scientific treatment of disease by new methods, viz. the tabulation of all cases treated, with the diagnosis, extent of disease, immediate and permanent results, negative as well as positive, noted in each case, is not usually possible, since no psychic or spiritual healer whom I have ever met seems to consider such tabulation at all necessary or even desirable.

In the first place, I submit a somewhat long quotation from an admirable paper[11] by one of the greatest medical authorities in the English-speaking world, Professor W. Osler.

[11] _The Treatment of Disease_, by W. Osler, M.D., F.R.S. London:
Henry Frowde. 1909.

‘An influenza-like outbreak of faith-healing seems to have the public of the American continent in its grip. It is an old story, the oldest indeed in our history, and one in which we have a strong hereditary interest, since scientific medicine took its origin in a system of faith-healing beside which all our modern attempts are feeble imitations.... Once or twice in each century the serpent entwining the staff of Æsculapius gets restless, contorts, and in his gambols swallows his tail, and all at once in full circle back upon us come old thoughts and old practices which for a time dominate alike doctors and laity. As a profession we took origin in the cult of Æsculapius ... whose temples were at once magnificent shrines and hospitals.... Amid lovely surroundings, chosen for their salubrity, and connected with famous springs, they were the sanatoriums of the ancient world. The ritual of the cure is well known, and has been beautifully described by Pater in Marius the Epicurean.... The popular shrines of the Catholic Church to-day are in some ways the direct descendants of this Æsculapian cult, and the cures and votive offerings at Lourdes and Ste. Anne are in every way analogous to those of Epidaurus.’

Osler goes on to speak with much tenderness of the apparently ineradicable nature of the credulity evinced not merely by the multitude but by persons educated widely, if not well, in the matter of the healing of disease. It is indeed a portentous fact. The slightest acquaintance with the history of therapeutics, the most casual examination of the evidence of alleged cures, the faintest stirring of the reasoning faculty, as the votary asks himself whether the foremost pathologists who work continuously with the best available material in an institution devoted to the scientific study of cancer will not be more likely to arrive at a correct estimate of the probability of cure, by means other than extirpation, than a quite uninstructed _masseur_ who has taken to ‘spiritual healing,’ these, one would suppose, would be sufficient to check the growth of credulity which we see in such evidence around us. Yet the reader will probably feel that Osler is not going beyond the warrant of easily ascertainable fact when he says:

‘We must acknowledge its potency to-day as effective among the most civilised people, the people with whom education is the most widely spread, yet who absorb with wholesale credulity delusions as childish as any that have enslaved the mind of man.’

Professor Osler’s conclusion is worth quoting:

‘Having recently had to look over a large literature on the subject of mental healing, ancient and modern, I have tried to put the matter as succinctly as possible. In all ages and in all climes the prayer of faith has saved a certain number of the sick. The essentials are, first, a strong and hopeful belief in a dominant personality, which has varied naturally in different countries and in different ages: Buddha in India and in Japan, where there are cults to match every recent vagary; Æsculapius in ancient Greece and Rome; our Saviour and a host of Saints in Christian communities; and, lastly, an ordinary doctor has served the purpose of common necessity very well. Faith is the most precious asset in our stock-in-trade. Once lost, how long does a doctor keep his clientele? Secondly, certain accessories--a shrine, a grotto, a church, a temple, a hospital, a sanatorium [Osler might have added the admirably devised entourage in such places as ‘Physical Culture’ Institutes and ‘light cure’ establishments], surroundings that will impress favourably the imagination of the patient. Thirdly, suggestion in one of its varied forms--whether the negation of disease and pain [as among the ‘Eddyites’], the simple trust in Christ of the Peculiar People, or the sweet reasonableness of the psychotherapeutist. But there must be the will-to-believe attitude of mind, the mental receptiveness--in a word, the faith which has made bread-pills famous in the history of medicine.’ We must, however, recognise the limitations of ‘mental healing.’ ‘Potent as is the influence of the mind on the body, and many as are the miracle-like cures which may be worked, all are in functional disorders, and we know only too well that nowadays the prayer of faith neither sets a broken thigh nor checks an epidemic of typhoid fever.’

The following extract is from an article in the _British Medical Journal_ of March 13, 1909. The article begins by quoting from a paper by Dr. Allan Hamilton (U.S.A.) to the following effect:

‘In all this agitation, it would almost seem as if the intelligent physician had never made use of psychotherapy, but that he was a mechanical giver of drugs and took little or no interest in his patients. If the new critics of the medical profession, who have been so active of late, would take the trouble to investigate, they would often find, among the great and successful men of all times and of to-day, that the human side is very strongly developed, and that their patients are studied from every point of view, and treated accordingly.’

‘We would add,’ says the writer of the article in the _British Medical Journal_, ‘that the intelligent application of the physician’s knowledge of the influence of the body on the mind is the one condition of success in the difficult art of dealing with patients and reinforcing the curative power of Nature or, what comes to the same thing, enabling sufferers to work out their own deliverance from the thraldom of functional disease. All really great physicians have used this force, sometimes, it may be, unconsciously, but often with deliberate intent. It is the power of influencing the mind of the patient or, in other words, of exciting confidence in his gift of healing, that makes what is called “personal magnetism.”’

At this point I may be permitted to offer one or two observations.

(1) To speak quite strictly, it is not a question of _‘à priori’ possibility or impossibility_. As Huxley pointed out, twenty years ago, few things can be said to be _impossible_ except mathematical misstatements or manifest contradictions. Thus 2 + 2 cannot possibly yield any result but 4. A square circle, a raised depression, are, in the strictest sense of the term, _impossibilities_. But, with regard to an enormous number of alleged phenomena popularly styled _impossible_, what is really meant is either that they are not impossible at all, but only in some high degree improbable, or that we have not sufficient knowledge to enable us to say whether or not they are impossible. In any case, before accepting them, we are bound as honest men to demand evidence which may be thoroughly sifted. The sort of stuff which we usually get, when we ask for such evidence, will be instanced at a later stage.

(2) Again, to speak quite strictly, I do not know that anyone would care to draw a hard-and-fast line between what is ‘functional’ and what is ‘organic.’ These terms are extremely convenient, but we must remember that they are only terms. There is an oft-recurring danger, against which we all require to be continually on our guard, of falling into the old error of the realists. ‘Animate and inanimate’ (assuming that the recent claim to have demonstrated in metals a process of reproduction analogous to those observed in protoplasm is endorsed, as seems probable), ‘genus and species,’ ‘animal and vegetable,’ these and many others are eminently useful classifications, and the border line between each and its opposite varies from comparative precision to extreme vagueness. But in no case are they absolutely precise in the sense in which the distinction between an integer and a vulgar fraction is precise. And in the matter of the terms ‘functional’ and ‘organic’ we must walk very warily indeed. Is epilepsy a functional neurosis or an organic disease? Analogy suggests organic changes. No such changes have been constantly demonstrated by _post mortem_ evidence; partly, of course, because _post mortem_ examinations of cases of death in the epileptic or epileptiform condition have been extremely rare, and are not very common in cases where there is a well-authenticated history of attacks; but partly because our investigations into the minute anatomy of many morbid conditions are at present barred by the limitations of microscopic vision. We have no right whatever to assert dogmatically that there is no organic change in a tissue because we cannot see it under a magnification of 1000 diameters--though for a variety of reasons, which all pathologists will recognise, it is not altogether _probable_ that a magnification of 10,000 diameters would in such cases demonstrate a constant change. In any case, if we are told by a spiritual or psychic healer that he cures cases of, let us say, old-standing chronic nephritis or cirrhosis of the liver by his own peculiar methods, our reply must be, not that this is impossible because we are dealing with organic disease, but rather that--

(1) If he claims to act mentally or spiritually on the higher centres of the brain and so to reach the diseased tissues, a cure is in the highest degree unlikely, for a reason which will be given at a later stage;

(2) If his method is avowedly quite empirical, and he only professes to exercise a power which he does not even dimly understand, we must respectfully ask for evidence, which can be examined and tested to the satisfaction of a competent and impartial mind.

Now, as to the influence of ‘suggestion,’ whether or not accompanied by other methods, e.g. hypnotism, magnetism, electricity, &c., on (so-called) functional conditions, modern medical science speaks with no uncertain voice.

At a meeting of the Harveian Society held last October, much interesting information was produced.

A paper of great and permanent value was read by Dr. Claye Shaw on the ‘Influence of Mind as a therapeutic agent.’ It is impossible in the space at my disposal to quote more than two brief extracts from his paper. He thus defines ‘suggestion’:

‘Suggestion is the insinuation of a belief or impulse into the mind of a subject by any means, or by words or questions, usually by emphatic declaration; also the impulse of trust and submission which leads to the effectiveness of such incitement.’

On the effects of treatment by suggestion, Dr. Claye Shaw writes:

‘It is with such conditions as chronic inebriety, opium, or the drug habit, that suggestion is most powerful; with acute insanity I have not seen it successful, and, though it has been fairly tested in asylum practice, it has not obtained general recognition as a therapeutic agent.’

A considerable number of medical men, alienists and others, took part in the discussion which followed the reading of the paper.