Boiled food is more easily digested than fried or roasted (the frying pan should be anathema to a neuropath); lean meat than fat; fresh than salt; hot meat than cold; full-grown than young animals, though the latter are more tender; white flesh than red; while lean meat is made less, and fat meat more digestible, by salting or broiling. Oily dishes, hashes, stews, pastries and sweetmeats are hard to digest. Bread should be stale, and toasted crisply right through. The time, compared with the thoroughness of digestion, is of little importance, as it varies widely within physiologic bounds.

Most people fancy that the more they eat the stronger they become, whereas the digestion of all food beyond that actually needed to repair the waste due to physical and mental effort consumes priceless nerve energy, and weakens one. The greater part of excessive food has literally to be burnt away by the body, which causes great strain, mainly on the muscles. The question is not: "How much can I eat?" but: "How much do I need?"

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CHAPTER XII

INDIGESTION

"We know how dismal the world looks during a fit of indigestion, and what a host of evils disappear as the abused stomach regains its tone. Indigestion has lead to the loss of battles; it has caused many crimes, and inspired much sulphurous theology, gloomy poetry and bitter satire."—Hollander.

The nervous dyspeptic suffers no marked pain, but often feels a "sinking", has no appetite, and cannot enjoy life because his stomach, though sound, does not get enough nerve-force to run it properly.

A great deal of nerve-force is required for digestion, and if a man comes to the table exhausted, bolts his food, uses nerve-force scheming while he is bolting, and, immediately he has bolted a given amount, rushes off to work, digestion is imperfectly performed, nutriment is not assimilated, the nerve-force supply becomes deficient. He continues to overdraw his account in spite of the doctor's warning, and stomachic bankruptcy occurs, followed by a host of ills.

Nervous dyspepsia is a very obstinate complaint, but if tackled resolutely, it can to a great extent be mitigated; but let it be emphasized at once, that medicines, patent or otherwise, are useless. If dyspepsia be aggravated by other complaints, these should receive appropriate treatment, but the assertions so unblushingly made in patent-pill advertisements are unfounded. The very variety of the advertised remedies is proof of the uselessness of all.

Set aside certain periods three times a day for meals. Fifteen minutes before meal times, sit in a comfortable chair, relax all your muscles, close the eyes, and try to make the mind a blank. Rest!

Then eat the meal slowly and thoroughly. Conversation may lighten and lengthen a meal, but avoid politics, "shop" and topics of that type. What is wanted at table is wit, not wisdom.

Water may be drunk with meals, provided it is drunk between eating, and not while masticating, for it has decidedly beneficial effects upon the digestive functions. Water is usually forbidden with meals because if patients drink while eating, the water usurps the functions of saliva, and moistens the bolus, which is then swallowed with little or no mastication. If you cannot drink between mouthfuls, then drink only between meals. Never drink while food is in the mouth!

After the meal, lie down on the right side for half an hour, resting, and so directing all available nerve-energy to getting digestion well under way.

Indifferent appetites must be tempted by wholesome dishes made up in a variety of enticing ways. Fats are good, but must be taken in a tasty form. Eat fruit deluged with cream.

The crux of digestion is to

"Chew! CHEW!! and KEEP ON CHEWING!!!" for until food is thoroughly masticated there will be no relief. The only part of the whole digestive process placed under the control of consciousness is mastication, and, paradoxically, it is the only part that consciousness usually ignores.

A healthy man never knows he has a stomach; a dyspeptic never knows he has anything else, because he will not eat his food, but throws it into his stomach as the average bachelor throws his belongings into a trunk.

A varied, tasty diet, thoroughly chewed and salivated, with rest before and after meals, is the only means of curing dyspepsia, for no medicine can supply and properly distribute nerve-energy.

Digestive pills are all purgatives, with a bitter to increase appetite, and occasionally a stomachic, bound together with syrup or soap. Practically all contain aloes, and very rarely a minute quantity of a digestive ferment like pepsin. Taken occasionally as purges, most digestive pills would be useful, but none are suited to continuous use, and the price is, as a rule, out of all proportion to the primary cost, while one or two are, frankly, barefaced swindles.

The analyses of the British Medical Association give the following as the probable formulae for some well-known preparations:

Beecham's Pills.............................Aloes; ginger. Holloway's Pills............................Aloes; ginger. Page Woodcock's ............................Aloes; ginger; capsicum; cinnamon and oil of peppermint. Carter's Little Liver.......................Aloes; podophyllin; Pills liquorice. Burgess' Lion Pills.........................Aloes; ipecacuanha; rhubarb; jalap; peppermint. Cockle's Pills..............................Aloes; colocynth; jalap. Barclay's Pills.............................Aloes; colocynth; jalap. Whelpton's Pills............................Ginger; colocynth; gentian. Bile Beans..................................Cascara; rhubarb; liquorice; peppermint. Cicfa.......................................Cascara; capsicum; pepsin; diastase; maltose.

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CHAPTER XIII

DIETING

"Simple diet is best; many dishes bring many diseases," —Pliny.

"Alas! what things I dearly love— puddings and preserves— Are sure to rouse the vengeance of All pneumogastric nerves!" —Field.

The man who pores over a book to discover the exact number of calories (heat units) of carbohydrates, proteins and fats his body needs, means well, but is wasting time.

In theory it is excellent, for it should ensure maximum work-energy with minimum use of digestive-energy, but in practice it breaks down badly, a weakness to which theories are prone. One man divided four raw eggs, an ounce of olive oil, and a pound of rice into three meals a day. Theoretically, such a diet is ideal, and for a short time the experimenter gained weight, but malnutrition and dyspepsia set in, and he had to give up. The best diet-calculator is a normal appetite, and fancy aids digestion more than a pair of scales.

In spite of rabid veget- and other "arians", most foods are good (making allowances for personal idiosyncrasy) if thoroughly masticated. The oft-quoted analogy of the cow is incorrect, for herbivora are able to digest cellulose; but even cows masticate most laboriously.

Meat juices are the most digestion-compelling substances in existence, and a little meat soup, "Oxo" or "Bovril" is an excellent first course.

No one needs more than three meals per day, while millions thrive on one or two only, which should be ready at fixed hours; for the stomach when habituated becomes congested and secretes gastric juice at those hours without the impulse of the will, is ready to digest food, and gets that rest between-times which is essential to sound digestion. The man who has snacks between meals, and chocolates and biscuits between snacks can never hope to get well.

To eat the largest meal at midday, as is the custom of working-men, is best, provided one can take half an hour's rest afterwards.

Drink a pint of tepid water half an hour before every meal. If the stomach be very foul, add a teaspoonful of bicarbonate of soda to the water.

The question of alcohol is a vexed one, but Paul's "Take a little wine for thy stomach's sake," is undoubtedly sound advice, though had Paul been trained at a London hospital, he would have added "after meals". Unfortunately, moderation is usually beyond the ability of the neuropath, and consequently he should be forbidden to take alcohol at all. Spirits must be avoided.

Moderately strong, freshly made tea or coffee may be consumed in reasonable quantity.

Vegetable salads are excellent if compounded with liquids other than vinegar or salad oil, and of ingredients other than cucumbers, radishes, and the like.

Take little starchy food and sweetmeats. It may surprise those with "a sweet tooth" to learn that, to the end of the Middle Ages, sugar was used only as a medicine. Meat must be eaten—if at all—in the very strictest moderation, and never more than once a day. Eggs, fish and poultry—in moderation too—take its place.

Healthy children need very little meat, while it is a moot point if children of unstable, nervous build need any at all. The diet at homes for epileptics is usually vegetarian, and gives excellent results.

Never swallow skin, core, seeds or kernels of fruits, many of which, excellent otherwise, are forbidden because of the irritation caused to stomach and bowels by their seeds or skins.

Bromides are said to give better results if salt is not taken. A little may be used in cooking, if, as is usually the case, the patient has to eat at the common table, but condiments are unnecessary and often irritating to delicate stomachs.

The diet of nervous dyspeptics must be very simple, and though it is trying and monotonous to forgo harmful dainties in favour of wholesome dishes, it is but one of the many limitations Nature inflicts on neuropaths. Many an epileptic, after believing himself cured, has brought on a severe attack by an imprudent meal. La Rochefoucauld says: "Preserving the health by too strict a regimen is a wearisome malady", but it is open to all men to choose whether they will endure the remedy or the disease.

Most men eat six times the minimum and twice the optimum quantity of food per day. For every one who starves, hundreds gorge themselves to death. "Food kills more than famine", and the poor, who eat sparsely from necessity, suffer far less from gout, cancer, rheumatism and other food-aggravated diseases than the rich.

Most books give detailed lists of foods to be eaten and to be avoided, but this we believe is productive of little good.

Let the patient eat a mixed diet, well and suitably cooked, taking what he fancies in reason, masticating everything thoroughly, and gradually eliminating foods which experience teaches him are difficult for him to digest.

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CHAPTER XIV

CONSTIPATION

"Causing a symptom to disappear is seldom the cure of any ill; the true course is to prevent the symptom."

Rings of muscle cause wormlike movements of the bowels, and so propel forward food and waste. Weakening of these muscles or their nerve controls from any cause, results in a "condition of the bowels in which motions occur only when provoked by medicines or injections". In some cases though motions occur freely, food ingested is retained too long in the digestive tract.

The blood extracts what water it needs from the fluid waste in the large bowel, but when the weak muscles allow this to remain too long, an excess of moisture is removed, leaving hard, dry masses, painful to pass.

When the faeces reach the anus, they cause an uneasy feeling, which directs us to seek relief, but if we neglect this impulse the bowel may become so insensitive that it ceases to warn its owner of the need to evacuate. Meantime, the muscles which expel the faeces get weak, so that every motion needs a strong effort of will, and much harmful straining.

Much misery is caused by false modesty in the presence of others. It can never be immodest to attend to the calls of Nature, and such hypersensitiveness is dangerous, for rupture, piles, fissure, prolapse, fistula, are often due to straining.

Lack of exercise weakens the intestinal and abdominal muscles. Unsuitable or imprudent foods or drinks, indigestion, excessive worry, and anything that lowers the general health tend to produce constipation.

Bacteria flourish freely in faeces, and though it is doubtful whether the "Auto-intoxication" so freely ascribed to them, is supported by facts, it cannot be doubted that, whatever the precise mechanism by which the effects are produced, constipation does result in a lowering of the resistance to disease. More frequent fits, colic, foul breath, headache right across the forehead, lost appetite, drowsiness, skin eruptions, irritability, insomnia, melancholia and anaemia (especially the "green sickness" of women, usually connected with menstrual irregularities) are but a few of many ills partly or wholly due to or consequent upon constipation.

The symptoms of constipation of the small bowel are dry stools, usually light in colour.

To cure this type, more water should be drunk, so that the waste may pass to the large bowel in a fluid state. Drink freely between meals, especially in summer, when profuse perspiration often causes obstinate constipation.

The symptoms of constipation of the large bowel are furred tongue, foetid breath, sallow or jaundiced complexion, and mottled stools of round, hard balls, the first portion being very firm, and the remainder nearly liquid. There are occasional attacks of colic.

The first step towards cure is to form regular habits. At a suitable time, say shortly after breakfast, or after supper if you suffer from haemorrhoids, go to the lavatory, whether you feel uncomfortable or not. Wait patiently, do not try to hasten matters by violent straining, and if for some weeks there is little improvement, do not despair, for the habits of a lifetime are not overcome in five minutes, just because you have decided to amend your careless ways. A short, brisk walk beforehand often helps.

If necessary, use a chamber and "squat" as savages do. In this position, the thighs support the abdomen, and force is exerted without straining. Massaging the abdomen by firmly rubbing it round and round, clockwise, with the hand, often does good, as does pressure with a finger on the flesh between the end of the backbone and the anus. Try every method before taking purgatives, for with patience and determination these are rarely necessary.

Carefully cooked and "concentrated", easily digested and "pre-digested" foods contain little residue; every meal should contain some indigestible matter to stimulate the intestines. Brown bread, porridge, lettuce, cress, apples and coarse vegetables are all good for this purpose, but if taken too freely may cause heartburn and flatulence. Meat, milk, fish, eggs and most patent foods have not enough waste. Boiled milk is very constipating.

Purgatives, injections and medicines, alone, are useless, for the bowel becomes still more insensitive to natural calls under the artificial stimulation of drugs, on which it becomes so entirely dependent that without their aid it will not act.

It may be necessary to clean out the bowel by an enema.

Make a lather with clean warm water and plain soap, and fill the enema syringe (a half-pint size is useful). Smear the nozzle with vaseline, lean forward and insert into the anus, pointing a little to the left. Press the bulb, withdraw the nozzle, retain the liquid a few moments and a desire to go to stool will be felt.

A simpler plan is to buy glycerin suppositories. One is inserted into the anus and acts like an injection. It must be clearly understood that these are emergency measures.

If internal piles come down at stool, do not allow them to remain and get engorged with blood. See that your hands are scrupulously clean, and your nails closely cut and free from dirt; then moisten the middle finger with a little vaseline taken to the lavatory for the purpose, and gently return the haemorrhoids, sitting down for a few minutes to retain them.

A mild purge may be taken once a week with advantage. Glauber's Salts (Sodium Sulphate), Cascara Sagrada, and liquid paraffin are all good, while Castor Oil Globules are suited for children.

For flatulence, take a 10-minim capsule of Terebine after meals, or charcoal, either as French Rusks ("Biscols Fraudin") or a teaspoonful of powdered charcoal between meals. One drop of creosote on a lump of sugar, peppermint water, and sal volatile may also be used. Sufferers should toast bread, and use sugar sparingly.

Patent medicines almost invariably contain a brisk aperient.

* * * * *

CHAPTER XV

GENERAL HYGIENE

"Better to hunt in fields for health unbought, Than fee the doctor for a nauseous draught." —Dryden.

If men but realized what complicated machines they were, they would use themselves better. In the body are 240 bones and hundreds of muscles. The heart, no bigger than the clenched fist, beats 100,000 times a day; the aerating surface of the lungs is equal in area to the floors of a six-roomed house, and by means of its minute blood-vessels which would stretch across the Atlantic, 500 gallons of blood are brought into contact with over 3,000 gallons of air every day.

Seven million sweat-glands, 30 miles long, get rid of a pint of liquid and an ounce of solid waste each day while it takes a tube 30 feet long, with millions of glands, to deal with a sip of milk.

Man's finest steam engine turns one-eighth of the energy supplied into work; nature's engine, muscle, turns one-third into work. The body contains 9 gallons of water, enough carbon to make 9,000 lead pencils, phosphorus for 8,000 boxes of matches, iron for 5 tacks, and salt enough to fill half a dozen salt-cellars.

Over 40 food-ferments have been found in the liver; there are 5,000,000 red and 30,000 white blood corpuscles in a space as big as a pin's head, each one of which travels a mile a day and lives but a fortnight, millions of new ones being built up in the bone-marrow every second; a flash of light lasting only one eight-millionth of a second, will stimulate the eye, which can discriminate half a million tints. The ear can distinguish 11,000 tones, and is so sensitive that we hear waves of air less than one sixty-thousandth of an inch long; a mass of almost liquid jelly—for 81 per cent of the brain is water, and Aristotle thought it was a wet sponge to cool the hot heart—sends out impulses ordering our every thought and act, and stores up memory, we know not how or where.

There are 10,000,000,000 of cells in the brain cortex alone, and 560,000 fibres pass from the brain down the spinal cord.

A clear, watery cell, no larger than the dot on an "i" encloses factors causing genius or stupidity, honesty or roguery, pride or humility, patience or impulsiveness, coldness or ardour, tallness or shortness, form of head or hands, colour of eyes and hair, male or female sex, and the thousand details that make a man.

Yet man uses this marvellous mechanism but carelessly, and the widespread poverty, the worry and discord in the lives of the happiest, our ignorance, the evil habits we contract, and the vice, miseries, diseases and labours to which most expectant mothers are too often exposed, explain why one baby in every eight never walks; why but four of them live to manhood; why less than 40 years is now man's average span; and why this brief space is filled with suffering and misery, from which many escape by self-destruction.

Sound children do not come from unclean air, surroundings, habits, pursuits, passions and parents. Children conceived in unsuitable surroundings by unsuitable parents, die; must die; ought to die. They are not built for the stern battle of life.

* * * * *

"Where the sun does not enter, the doctor does!" —Italian proverb.

Plenty of fresh, clean air is essential to health.

In all rooms a block of wood nine inches high should be inserted beneath the whole length of the bottom sash of the window. This leaves a space between the top and bottom sashes through which fresh air passes freely, without draught, both night and day, for it should never be closed. A handy man will fit a simple device to prevent the windows being forced at night, but better let in a burglar than keep out air.

If it be cold or draughty in the bedroom, hang a sheet a foot from the window, put more blankets or an overcoat on the bed, or put layers of brown paper above the sheets, but never close the window.

You can take too much of many good things, but never too much pure air.

Cleanliness. Keep the body clean by taking at least one hot bath per week; per day if possible. Much filth is excreted by your sweat-pores; why let it cake on skin and underlinen, and silently silt up your thirty miles of skin canals, thus overworking the other excretory organs, and gradually poisoning yourself?

Neuropaths always suffer from sluggish circulation of the extremities, and to improve this, hot and cold baths, spinal douches and massage are excellent. A hot bath (98-110 deg. F.) ensures a thorough cleansing, but it brings the blood to the surface, where its heat is quickly lost, enervating one, and causing a bout of shivering which increases the production of heat by stimulating the heat-regulating centre in the brain. Baths above 110 deg. F. induce faintness. To prevent shivering, take a cold douche after the hot bath, and have a brisk rub down with a coarse towel, when a delightful, warm glow will result. Do not freeze yourself, or the reaction will not occur; what is wanted is a short, sharp shock, which sends the blood racing from the skin, to which it returns in tingling pulsations, which brace up the whole system. The douche is over in a few seconds, and may be enjoyed the year round, commencing in late Spring.

The cold bath must not be made a fetish. If the glow is not felt, give it up, and bathe in tepid (85-92 deg. F.) or warm (93-98 deg. F.) water. When started in the vigour of youth, the cold bath may often be continued through life, but it is unwise to commence in middle life. Parents should never force their children to take cold baths, to "harden them".

Other Hygienic Points. Tobacco is undesirable for neuropaths, save in moderation.

Clothes should be light, loose, and warm. Epileptics should wear low, stiff collars, half a size too large, with clip ties. Such a combination does not form a tight band round the neck, and can quickly be removed if necessary. Wear thick, woollen socks, and square-toed, low-heeled, double-soled boots. Hats should be large, light, and of soft material. Woollen underwear is best. Change as often as possible, and aim at health, not appearance.

Let all rooms be well lighted, well ventilated, moderately heated, and sparsely furnished with necessities. Shun draperies, have no window boxes, cut climbing plants ruthlessly away from the windows, and never obstruct chimneys.

Buy Muller's "My System", which gives a course of physical exercises without apparatus, which only take fifteen minutes a day. The patient must conscientiously perform the exercises each morning, not for a week, nor for a month, but for an indefinite period, or throughout life.

Finally, remember that so few die a natural death from senile decay because so few live a natural life.

* * * * *

CHAPTER XVI

SLEEPLESSNESS

"O magic sleep! O comfortable bird That broodest o'er the troubled sea of the mind Till it is hushed and smooth." —Keats.

Some men need only a few hours' sleep, but no one ever overslept himself in natural slumber. There are anecdotes of great men taking little sleep, but their power usually consisted in going without sleep for some days when necessary, and making up for it in one long, deep sleep. Neuropaths require from 10-13 hours to prepare the brain for the stress of the next day, but quality is more important than quantity.

Patients go to bed tired, but cannot sleep; fall asleep, and wake every other hour the night through; sleep till the small hours, and then wake, to get no more rest that night; only fall asleep when they should be rising; or have their slumber disturbed by nightmare, terrifying dreams, heart palpitation, and so on.

Noise often prevents sleep. A clock that chimes the quarters, or a watch that in the silence ticks with sledge-hammer beats, has invoked many a malediction. Traffic and other intermittent noises are very trying, as the victim waits for them to recur. Townsmen who seek rural quiet have got so used to town clatter, that barking dogs, rippling streams, lowing cows, rustling leaves, singing birds or chirruping insects keep them awake. Too much light, eating a heavy supper, all tend to banish repose, as do also violent emotions which produce toxins, torturing the brain and causing gruesome nightmares.

Grief and worry—especially business and domestic cares—constipation, indigestion, bad ventilation, stimulants, excitement and a hearty supper are a few of the many causes of insomnia.

In children sleeplessness is often due to the bad habit of picking a child up whenever it cries, usually from the pain of indigestion due to having been given unsuitable food. Feed children properly, and train them to regular retiring hours. School home-work may cause insomnia; if so, forbid it.

Man spends a third of his life in the bedroom, which should be furnished and used for no other purpose. Pictures, drapery above or below the bed, and wallpaper with weird designs in glaring colours are undesirable. The wall should be distempered a quiet green or blue tint, and the ceiling cream. A bedroom should never be made a storeroom for odds and ends, nor is the space beneath the bed suitable for trunks; least of all for a soiled-linen basket.

Some time before retiring, excitement and mental work should be avoided. The patient should take a quiet walk after supper, drink no fluid, empty bladder and bowels, and take a hot foot-bath.

Retire and rise punctually, for the brain, like most other organs, may be trained to definite habits with patience.

If sleeplessness be ascribed, rightly or wrongly, to an empty stomach, a glass of hot milk and two plain biscuits should be taken in bed; dyspeptics should take no food for three hours before retiring. If the patient wakes in the early morning he may find a glass of milk (warmed on a spirit-stove by the bedside) and a few plain biscuits of value.

A victim of insomnia should lie on his side on a firm bed with warm, light coverings, open the window, close the door, and endeavour to fix his attention on some monotonous idea; such as watching a flock of white sheep jump a hedge. Think of trifles to avoid thinking of troubles.

How often do we hear people complain that they suffer from insomnia, when in fact they get a reasonable amount of sleep, and indeed often keep others awake by their snoring.

When you wake, get up, for a second sleep does no good. When some one, on seeing the narrow camp-bed in which Wellington slept, said: "There is no room to turn about in it," the Iron Duke replied: "When a man begins to turn about in his bed it is time he turned out of it."

The only safe narcotic is a day's hard work. For severe insomnia consult a doctor; do not take drugs—that way lies ruin. By taking narcotics, or patent remedies containing powerful drugs, you will easily get sleep—for a time only—and then fall a slave to the drug. Such victims may be seen in dozens in any large asylum.

* * * * *

CHAPTER XVII

THE EFFECTS OF IMAGINATION

"The surest way to health, say what they will Is never to suppose we shall be ill; Most of the ailments we poor mortals know From doctors and imagination flow." —Churchill.

"Men may die of imagination, So depe may impression be take." —Chaucer.

"Suggestion is the introduction into the mind of a practical belief that works out its own fulfilment."—Guyau.

Man suffers from no purely imaginary ills, for mental ills are as real as physical ills, and though an individual be ailing simply because he persuades himself he is ailing, his mind so affects his body that he is actually unwell physically, though the cause of his trouble is purely mental.

The suffering of this world is out of all proportion to its actual disease, many people being tortured by fancied ills. Some dread a certain complaint because a relative has died of it.

Others are unwell, but while taking proper treatment they brood gloomily, and get worse instead of better as they should and could do.

Cheap medical and pseudo-medical works are not an unmixed blessing, for many a person who knows, and needs to know, nothing about disease, gets hold of one, and soon has most of the ills known to the faculty and some which are not.

If a patient be an optimist and persuades himself he is improving, he does improve. This is the explanation of "Faith moving mountains", for the curative power of prayer, Christian Science, laying-on of hands, suggestion treatment and patent medicine, depends on man's own faith, not on the supernatural.

A doctor in whom a patient has perfect confidence, will do him far more good with the same medicines, or even with no medicines at all, than one of riper experience in whose skill he has no faith.

Eloquent, though often inaccurate accounts of the benefits derived from patent medicines are persistently advertised until the mind is so influenced by the constant reiteration of miraculous cures, that, either because the healing forces of the body are thereby stimulated, or because the disease is curable by suggestion, the patient is benefited by such medicines.

Thinking of pain makes it worse and vice versa.

The curative effects of auto-suggestion were demonstrated at the Siege of Breda in 1625. The garrison was on the point of surrender when a learned doctor eluded the besiegers, and got in with some minute phials of an extraordinary Eastern Elixir, one drop of which taken after each meal cured all the ills flesh was heir to; two drops were fatal.

The "learned doctor" was a quick-witted soldier, and the elixir was coloured water sold by order of the commander. Its potency was due to the faith of all, who persuaded each other they were getting better, and an epidemic of infectious wellness followed ills due to depressed spirits.

One man after reading a list of symptoms said in great alarm: "Good Heavens. I have got that disease!" and, on turning the page, found it was... pregnancy.

As the great Scotch physiologist, Reid, said seventy years ago:

"Hope and joy promote the surface circulation of the body, and the elimination of waste matter and thus make the body capable of withstanding the causes which lead to disease, and of resisting it when formed. Grief, anguish and despair enfeeble the circulation, diminish or vitiate the secretions, favour the causes which induce disease, and impede the action of the mechanism by which the body may get rid of its maladies. An army when flushed with victory and elated with hope maintains a comparative immunity from disease under physical privations and sufferings which, under the opposite circumstances of defeat and despair, produce the most frightful ravages."

The classic description of the woeful effects of imagination is in Jerome's "Three Men in a Boat". Harris, having a little time on his hands, strolls into a public library, picks up a medical work, and discovers he has every affliction therein mentioned, save housemaid's knee. He consults a doctor friend and is given a prescription. After an argument with an irate chemist, he finds he has been ordered to take beefsteak and porter, and not meddle with matters he does not understand. A sounder prescription never was penned.

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CHAPTER XVIII

SUGGESTION TREATMENT

"To purge the veins Of melancholy, and clear the heart Of those black fumes that make it smart; And clear the brain of misty fogs Which dull our senses, our souls clog." —Burton.

Hypnosis and suggestion have suffered from those people who put back every reform many years—quacks and cranks—for while science, with open mind, was testing this new treatment, the quacks exploited it up hill and down dale.

Yet there is nothing supernatural in suggestion, for we employ it on ourselves and others every hour we live. Conscience consists only of the countless stored-up suggestions of our education, which by opposing any contrary suggestions, cause uneasiness.

Many of us conform through life to the suggestions of others, affection, awe, hero-worship and fear taking the place of reason.

The most resolute of men are influenced by tactful suggestions, which quietly "tip-toe" on to the margin of consciousness, awaken ideas which link up more and more associations, until an avalanche is started which forces itself on to the field of consciousness, the subject thinking the idea is his own.

Author and actor try by suggestion to make us think, laugh, or weep at their will, books are sold by suggestive titles, and many clothes are worn only to suggest wealth or respectability.

The best salesman is he who by artful suggestion sells us what we do not want; the best buyer he who by equally astute suggestion makes the seller part at a price which makes him regret the bargain the moment it is closed.

Suggestion treatment is of great use in curing nervous states and bad habits, and all neuropaths should practice self- or auto-suggestion. In severe cases a specialist must give the treatment.

The patient is taken by the neurologist to a cosy, restfully-furnished, half-lighted room, and placed in a huge easy chair facing a cheery fire. He sinks into the depths of the chair, relaxes every muscle, allows his thoughts to wander pleasantly, and soon his brain is at rest, and his mind, undisturbed by the fears which usually harass it, is ready to receive suggestions.

The doctor talks quietly, soothingly, but with the conviction born of knowledge to the patient about his trouble, assuring him that he can control his cravings; that he can put away the doubts or fears that have grown upon him. The true reason of his illness is pointed out, any little organic factors given due weight, and the idea that it is hereditary or due to Fate dispelled. Faults of character, reasoning and living are unsparingly exposed and appropriate remedies suggested, and he is shown how unmanly his self-torturing reproaches are, and how futile is remorse unless transmuted into reform.

The doctor's earnestness inspires confidence, and the patient unburdens his secret troubles, discusses means of remedying them, and turns from pain to promise, from remorse to resolve, from introspection to action, from dreading to doing.

Struck by the way the psycho-analyst reads his soul and lays bare petty meannesses, impressed by the patient thoroughness with which the doctor attends to each little symptom, confident that organic troubles—if there be any—will receive appropriate treatment, ready to carry out instructions, and disposed to believe the new treatment is of real value: under all these circumstances, the physician's suggestions carry very great weight with the patient.

The resolutions passed by the victim in this calm state sink deep into subconsciousness, and when next temptation, impulse or fear assails him, his own resolutions and the doctor's suggestions are so vividly recalled that he tries to control his thoughts, and, in due time he "wins out".

Anyone may induce the calm state, and repeat suitable suggestions. The patient should go to a quiet room, and, reclining on a comfortable couch before a cheery fire, close the eyes, relax the muscles, breathe deeply, and avoid all sense of strain.

The next step is to fix the imagination on some scene which suggests tranquility—smooth seas, autumnal landscapes, snow-clad heights, old-world gardens, deep, shady silent pools, childhood's lullabies, secluded backwaters, dim aisles of ancient churches.

After a few evenings' practice, you will be able gradually to exclude all other ideas, and focus on one, inducing a state which, somewhat similar outwardly, is free from the excitement of religious exaltation, and from the delusions of a medium's trance.

In this state, an appropriate suggestion must be made, sincerely, and with absolute faith in its power. Christ's miracles were the result of suggestive therapeutics, and He took care to inspire relatives with faith, to exclude scoffers, to surround himself by his believing Apostles, and, after treatment, said: "See thou tell no man!" well knowing that suggestion cannot withstand derision.

In this way, a patient of limited means can do for himself exactly what more fortunate ones pay large fees to specialists to do for them. The treatment is uncommon, but sound, for the medical profession is perhaps the most conservative on earth, and when specialists of repute use a method, you may be confident it is of value.

To cure sleeplessness, see that stomach and brain are at rest, bed comfortable, and feet warm; calm yourself, and focus on the idea of sleep, saying:

"I shall go to sleep in a few minutes, and wake at eight o'clock in the morning."

Repeat this a few times, persist for a few nights and you will quickly get drowsy, and fall asleep.

Phrases for other requirements will readily occur, as:

"I shall feel confident in open spaces!"

"I shall find no more pleasure in alcohol!" and so on.

Suggestion will not cure epilepsy, hysteria or neurasthenia, but it overcomes many of the symptoms which make the patient so wretched.

"Crutches are hung on the walls of miraculous grottos, but never a wooden leg."

Suggestion may move a paralysed arm, but the muscles only become healthy again in many days by slow repair; suggestion releases the catch, but the spring must be wound up by energy suitably applied.

* * * * *

CHAPTER XIX

MEDICINES

"Of simples in these groves that grow He'll learn the perfect skill; The nature of each herb, to know Which cures and which can kill." —Dryden.

So distressing a malady as epilepsy early attracted attention, and every treatment superstition could devise, or science could suggest, has been tried. Culpepper in his "Herbal" (300 years old), recommends bryony; lunar caustic (nitrate of silver) was extensively used, because silver was the colour of the moon, which caused madness.

The royal touch for scrofula (King's Evil) was also extended to epilepsy, the king blessing a ring, which was worn by the sufferer.

Another old remedy was to cut off a lock of the victim's hair while in a seizure and put it in his hand, which stopped (?) the attack. In Berkshire a piece of silver collected at the communion service and made into a ring was specific, but in Devon a ring made of three nails from an old coffin was preferred. Lupton says: "A piece of child's navel-string borne in a ring is good against falling sickness."

Nearly every drug in the Pharmacopoeia has been tried, the drugs now generally used being sodium, potassium and ammonium bromide.

Before bromides were introduced by Locock in 1857, very strict hygienic, dietic and personal disciplinary treatment combined with the use of drugs often effected improvement. Since the use of bromides, these personal habits have, unfortunately, been neglected, far too much reliance being placed on the "three times a day after meals" formula.

All bromides are quickly absorbed from the stomach and bowels, and enter the blood as sodium bromide, which lowers the activity of both motor and sensory centres, and renders the brain less sensitive to disturbing influences.

Unfortunately, the influence of bromides is variable, uncertain, and markedly good in only a small proportion of cases.

In about 25 per cent of cases, in which mild seizures occur at long periods, without mental impairment, the bromides arrest the seizures, either temporarily or permanently, after a short course. In another 25 per cent the bromides lessen the frequency and severity of the fits, this being the common temporary result of their use in all cases in the first stages.

In quite 50 per cent of cases, the effect of bromides diminishes as they are continued, and they finally exert no influence at all. Many cases are temporarily "cured", the drug is stopped, and the seizures recur. Bromides are valuable in recent and mild cases, but no medicine exerts much effect on severe cases of long standing, which usually end in an institution.

When these drugs are taken continuously, nausea, vomiting, sleepiness, confusion of thought and speech, lapses of memory, palpitation, furred tongue, unsteady walk, acne and other symptoms of "bromism" may arise, whereupon the patient must stop taking bromides and see a doctor, who will substitute other drugs for a time.

If heart palpitation be troublesome while using bromides, take a teaspoonful of sal volatile in water.

See a doctor if you can; until you see him, get from a chemist:

Potassii bromidi 10 grains. Sodii bromidi 10 grains. Boracis purificati 5 grains. Aquae 1 fluid ounce. Two tablespoonfuls in water three times a day after meals.

This prescription is for an adult. If the patient be under twenty-one, tell the chemist his age, and he will make it up proportionately.

Victims who have seizures with some regularity at a certain time, should take the three doses in one, two hours before the attack is expected. If there are long intervals between attacks, cease taking bromides after one fit and recommence three weeks before the next seizure is apprehended. When there is an interval of six months or more between attacks, take no drugs.

Bromides in solution are unpalatable, patients grow careless of regularity and dosage.

You must learn from your doctor and your own experience the prescription, time and dose best suited to your case, and then never miss a dose until you have been free from fits for two years, for the beneficial action of bromide depends on the tissues becoming and remaining "saturated" with the drug. Never give up bromides suddenly after long use, but gradually reduce the dose.

It is just when the disease has been brought under control, that patients consider further doctor's bills an unnecessary expense, with the result that a little later the fits recur, and a tedious treatment has to be commenced over again.

No value can be placed on any specific for epilepsy until it has been thoroughly tested for some years, and so proved that its effects are permanent, for almost any treatment is of value for a time, possibly through the agency of suggestion.

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CHAPTER XX

PATENT MEDICINES

"Men who prescribe purifications and spells and other illiberal practices of like kind."—Hippocrates.

"...Corrupted By spell and medicines bought of mountebanks." "Othello." Act I.

Carlyle said the world consisted of "so many million people, mostly fools"; and he was right, for to public credulity alone is due the immense growth of the patent-medicine trade.

It was formerly thought that for each disease, a specific drug could be found, but this idea is exploded. The doctor determines the exact condition of his patient, considers how he best may assist nature or prevent death, and selects suitable drugs. He carefully notes their action and modifies his treatment as required. The use of set prescriptions for set diseases is obsolete; the doctor of to-day treats the patient, not the disease.

A few patent medicines are of limited value; many are made up from prescriptions culled from medical works, and the rest are frauds, like potato starch. The evil lies in charging from three to four hundred times a just price, in ascribing to a medicine which may be good for a certain disorder, a "cure-all" virtue it does not possess, and in inducing ignorant people to take powerful drugs, reckless of results.

Ephemeral patent-medicine businesses, run by charlatans, whose aim is frankly to make money before they are exposed, spring up like mushrooms; and their cunningly worded advertisements meet the eye in the columns of every paper one opens for a few months; then they drop out, to reappear under another name, at another address. These rogues buy a few gross pills from a wholesale druggist, insert a small advertisement, and so lay the foundations of a profitable business.

The lure of the unknown is turned to account. "The discoverer went back to the Heart of Nature—and found many rare herbs used by Native Tribes." "The "Heart of Nature" was probably a single-room office tucked away down a Fleet Street alley, and analysis proves these medicines contain only common drugs, one "Herbal Remedy" being metallic phosphates.

A common procedure is to send a question form, and, after answering the query, "What are you suffering from?" with "Neurasthenia", the company "carefully study" this, and then inform you with a gravity that would grace the pages of "Punch", "You are the victim of a very intractable type of Neurasthenia", so intractable in fact that it will need "additional treatment"—at an "additional" fee.

The quack's advertisements are models of the skilful use of suggestion, and turn to rare account the half-knowledge of physiology most men pick up from periodicals. He frightens you with alarming and untrue statements, gains your confidence by a display of semi-true facts reinforced where weak by false assertions, and, having benefited himself far more than you, leaves you to do what you should have done at first, go to a doctor or a hospital.

Were it made compulsory for the recipe to be printed on all patent medicines, people would lose their childlike faith in coloured water and purges, and cease the foolish and dangerous practice of treating diseases of which they know little with drugs of which they know less.

The British Medical Association of 429, Strand, London, W.C., issue two 1s. books—"Secret Remedies: What they cost and what they contain", "More Secret Remedies"—giving the ingredients and cost price of most patent medicines. You are strongly urged to send for these books, which should be in every home.

The basis of every cure for epilepsy (not obviously fraudulent) is bromides. The usual method is to condemn vigorously the use of potassium bromide, and substitute ammonium or sodium bromide for it. Some advertisers condemn all the bromides, and prescribe a mixture of them; others condemn potassium bromide, and shamelessly forward a pure solution of this same salt in water as a "positive cure!"

In all cases the sale price is out of reasonable proportion to the cost, victims paying outrageous sums for very cheap drugs.

Most epileptics are poor, because their infirmity debars them from continuous or well-paid work, leaving them dependent on relatives, often in poor circumstances also. The picture of patients, already lacking many real necessities, still further denying themselves for weeks or months to purchase a worthless powder, is truly a pitiful one.

Bromides are unsatisfactory drugs in the treatment of epilepsy, but they are the best we have at present. Get them made up to the prescription of a doctor, and see him every month to report progress and be examined. In the end, this plan will be very much cheaper, and incomparably better, than buying crude bromides from quacks.

* * * * *

There is no drug treatment for either hysteria or neurasthenia, and when the doctor gives medicines for these complaints, it is to remedy organic troubles, or, more often because necessity forces him to pander to the irrational and pernicious habit into which the public have fallen of expecting a bottle of medicine whenever they visit a doctor. Osier, the famous Professor of Medicine at Oxford, truly observed that he was the best doctor who knew the uselessness of medicines. But when public opinion demands a bottle, and is unwilling either to accept or pay for advice alone, the doctor may be forced to give medicines which he feels are of little value, hoping that their suggestive power will be greater than is their therapeutic value.

Neuropaths invariably contract the habit of physicking themselves, and taking patent foods and drugs which are valueless.

So universal is this pernicious habit that we deem it desirable to criticize it here at some length.

One highly popular type consists of port wine, reinforced (?) by malt and meat extracts, and sold under a fanciful name. It has about the same value as a bottle of port, which costs considerably less. It is well to remember that many a confirmed drunkard has commenced with these "restoratives".

Malt extracts are also popular. They contain diastase, and therefore aid the digestion of starch, but the diastatic power of most commercial extracts is negligible.

Meat extracts of various makes contain no nourishment, but are valuable appetisers. Meat gravy is as effective and far cheaper.

Foods containing digestive ferments, which are widely advertised under various proprietary names are practically valueless, as are the ferments themselves sold commercially. Digestive disorders are very rarely due to deficiency of ferments, while pepsin is the only one among all the ferments that could act (and that only for a little while) in the digestive system.

Some of the disadvantages of predigested foods have been noted, and their prices are usually so exorbitant that eggs at 2s. 6d. each would be cheaper. The remarks of Sollmann the great pharmacologist are pertinent:

Limitations. The administration of food in the guise of medicine is sometimes advantageous; but medicinal foods are subject to the ordinary law of dietetics, and therefore cannot accomplish the wonders which are often claimed for them. The proprietary foods have been enormously overestimated, and have probably done more harm than good. The ultimate value of any food depends mainly on the amount of calories which it can yield, and on its supplying at least a minimum of proteins. In these respects, the medical foods are all inferior, for they cannot be administered practically in sufficient quantity to supply the needs of the body. They have a place as adjuvants to other foods, permitting the introduction of more food than the patient could otherwise be induced to take. Aside from the special diabetes foods and cod-liver oil, their value is largely psychic.

Predigested Foods. The value of these is doubtful, for digestive disturbances involve the motor functions and absorption more commonly than the chemical functions. Their continued use often produces irritation.

Liquid Predigested Foods. As sold, these are flavoured solutions containing small amounts (1/2-6 per cent) of predigested proteins, 1/2-15 per cent of sugars and other carbohydrates, with 12-19 per cent of alcohol, and often with large quantities (up to 30 per cent) of glycerin. Their protein content averages less than that of milk, and in energy value they are vastly inferior. Their daily dose yields but 55-300 calories including their alcohol; this is only one-thirtieth to one-fifth the minimum requirements of resting patients. To increase their dose to that required to maintain nutrition would mean the ingestion of an amount of alcohol equivalent to a pint of whisky per day.

Of recent years very expensive preparations of real or alleged organic iron compounds have had a large sale. Iron is a component of haemoglobin, a solid constituent (13 per cent by weight) of the blood, which combines with the oxygen in the lungs, and is carried (as oxyhaemoglobin) all over the body, giving the oxygen up to the tissues. Haemoglobin is an exceedingly complex substance, but it contains only one-third per cent by weight of iron in organic form.

The liver is the storehouse of iron, its reserve being depleted when there is an extraordinary demand for iron. The minute amounts of iron in ordinary food are amply sufficient for all our needs; any excess is simply stored, and, later excreted, and has no effect whatever on the circulating haemoglobin.

Iron is only of value in certain forms of anaemia, and the many patent medicines purporting to contain haemoglobin or organic iron are therefore useless to neuropaths. The Roman plan of drinking water in which swords had been rusted, is quite as valuable as drinking expensive proprietary compounds. When iron is indicated Blaud's Pills are perhaps the best preparation.

Huge quantities of patent medicines containing phosphates in the form of hypo-or glycerophosphates, and (or) lecithin are sold annually.

All phosphorus compounds are reduced to inorganic phosphates in the digestive tract, absorbed and eliminated, so that, as with iron, if phosphates are needed, the form in which they are taken is of no moment. Why, then, pay huge sums for organic-phosphorus compounds (synthesized from inorganic phosphates) when they are immediately reduced to the same constituents from which they were constructed, the only value in the reduction process being seen in the immense fortunes which patent-medicine proprietors accumulate?

Lecithin is isolated from animal brain, or egg-yolk, and commercial lecithin is impure. Not only does the ordinary daily diet contain ample lecithin (5 grammes), but two eggs will double this, while liver or sweetbread, both rich in phosphorous, may be eaten.

The much-vaunted glycerophosphates are decomposed to and excreted as phosphates. Sollmann's remarks apply to all similar proprietary articles:

"A proprietary compound of glycerophosphates and casein has been widely and extravagantly advertised as 'Sanatogen'. It is a very costly food, and in no sense superior to ordinary casein, such as cottage cheese."

Hypophosphites have been boomed by various people, chiefly for financial reasons. Five or six of them are usually prescribed, with the addition of cod liver oil, and perhaps quinine, and (or) iron and strychnine, the complexity of the prescription being expected, apparently, to compensate for the uselessness of its various ingredients.

To deduce rational remedies, it is first necessary to elucidate the causes of inefficiency; and to expect a brain which is out of order to function in an orderly manner simply because it is supplied with one of the substances necessary to its normal functioning (regardless of whether a deficiency of that substance is the cause of the disorder), is as rational as it would be to expect to restart an automobile engine, the magneto of which was broken, by filling up the half-empty petrol tank.

* * * * *

CHAPTER XXI

TRAINING THE NERVOUS CHILD

"When shall I begin to train my child?" said a young mother to an old doctor. "How old is the child, madam?" "Two years, sir!" "Then, madam, you have lost just two years," answered the old physician, gravely.

Neuropathic children are super-emotional, and from them come prodigies, geniuses, perverts and madmen. They are usually spare of build, with pale, sallow complexions, and dark rings under the eyes.

They can never sit still, but wriggle restlessly about on their seats, pick their nostrils, and bite their nails. They are always wanting to be doing something, but soon tire of it, and start something else, which is as quickly cast aside; their energy is feverish but fitful. They jump to conclusions, quickly grasp ideas; as quickly forget them. Having no capacity for calm, reasoned judgment, they are creatures of impulse, imperative but timid, suffer from strange ideas, and worry over trifles.

The affections are strong and vehement, likes and dislikes are taken without reason, while intense personal attachments—often unrequited—occur, but not seldom swing round to indifference, or even bitter enmity. The passions and emotions are all abnormal, for owing to deficiency in the higher inhibitory centres, the victim is blown about by every idle emotional wind that blows. The slightest irritation may provoke an outburst of maniacal rage, or a fit. Consequently, they require the most careful, but firm training, right from birth, to bring them up with a minimum of nerve-strain. Twitchings, night or day terrors, sleep walking, and incontinence of urine often trouble them. They should be examined by a doctor once a year.

These children have no balance, and are usually selfish, always garrulous, with a love of romancing, while a ready wit combined with fertile imagination often gains them a bubble reputation for learning they do not possess. Invention, poetry, music, artistic taste and originality are occasionally of a high order, and the memory is sometimes phenomenal; but desultory, half-finished work, and shiftlessness are the rule.

Their appetite is fitful and fanciful, they like unsuitable foods, and their digestive system is easily upset. At puberty, sexual perversity is common, and the animal appetite, is as a rule, very strong, though rarely, it may be absent. During adolescence, there is excessive shyness or bravado, always introspection, and exaggerated self-consciousness.

As they grow older, they readily contract hypochondria, neurasthenia, hysteria, alcoholism, insomnia and drug habits, and react unduly to the most trifling external causes, even to the weather, by which they are exhilarated or depressed.

Education. Send them to school only when the law compels you, and observe them closely while there, for health is far more important to them than education. "Infant prodigies" lack the mental staying power and physical robustness which real success demands, though they may do well for a time. Go to your old school: the successes of to-day were dunces twenty years ago; about those whose names are proudly emblazoned in fading gold on Rolls of Honour, a discreet silence is maintained.

Keep a keen lookout for symptoms of over-effort. Sleepiness, languor, a vacant expression, forehead wrinkled, eyebrows knit, eyes dull, sunken and surrounded by dark rings, twitchings, restlessness, or loss of appetite are all warnings that the pace is too strong for the child.

"These are the cases in which the School Board—who ordain that if children are well enough to play or run errands, they are well enough to attend school—should be defied."

This defiance must of course be reinforced by a doctor's certificate.

To the healthy, the strain of preparing for and enduring an examination is tremendous; to highly strung children it is dangerous. Home-work should be forbidden in spite of the authorities. Let the child join in the sports of the school as much as possible.

School misdemeanours form a thorny problem, for discipline must be maintained, and a stern but just discipline is very wholesome for this type, who are too apt to assume that because they are abnormal, they can be idle and refractory. On the other hand, parents should promptly and vigorously object to their children being punished for errors in lessons, or struck on the head.

Diet. Food, while being nourishing, and easily digested, must not be stimulating or "pappy". Meat, condiments, tea, coffee and alcohol are highly undesirable, a child's beverage being milk and water.

Meals should be ready at regular hours, and capricious appetites should freely be humoured among suitable foods, served in appetizing form to tempt the palate. Let them chatter, but see they do not get the time to talk by bolting their food.

Most children can chew properly soon after they are two, but they are never taught. Their food is "mushy", or is carefully cut, and gives them no incentive to masticate. So long as food is digestible, the harder it is the better, and plain biscuits, raw fruits, and foods like "Grape Nuts", are splendid. Mastication helps digestion; it also prevents nasal troubles.

The desire for food at odd moments causes trouble, which is aggravated if the meals are not ready at stated hours. Gently but firmly refuse the piece of bread-and-butter they crave, explain why you do so, and though they weep, or fly into a passion, do not lose your own temper, or beat, or give way to them. When accustomed to regular hours and firm refusals they will not crave for titbits between meals.

It is very hard for them to see other members of the family freely partaking of condiments, drinks and unsuitable foods, and be told they are the only ones who must refrain. A little personal self-sacrifice helps immensely, and if your child must refrain so might you.

All foods must be pure. Avoid tinned goods, and cheap jams, which contain mangels and glucose. Judged by the nutriment they contain—most cheap foods are very expensive.

Lightly boil, poach, or scramble eggs; steam fish and vegetables; cook rice and sago in the oven for three hours. See that milk puddings are chewed, for usually they are bolted more quickly than anything else. The stomach is expected to deal with unchewed rice pudding, because it is "nourishing". So are walnuts, but you do not swallow them whole.

Fruit must be fresh, ripe and raw, with skin and core removed. Brown bread, crisply toasted and buttered when cold, is best. Porridge is admirable, but many children dislike it. Try to induce a taste by giving plenty of milk, and sugar or syrup with it.

The starch-digesting ferments in the saliva and pancreas are not active until the age of 18 months, before which infants must not be given starchy foods like potatoes, cereals, puddings and bread.

All greenstuffs must be thoroughly washed, or worms may pass into the system. Foul breath, picking the nose, restlessness, fever and startings are often attributed to worms, when the real "worms" are mince pies, raisins, sour apples, and even beer.

Never force fat on children in a form they do not like, for there are plenty of palatable fats, as butter, dripping, lard and milk. Cream is as cheap, as good, and far nicer than cod-liver oil.

Decide on your children's diet, but do not discuss it with or before them. If a child does dislike a dish, never force it on him, but try to induce a liking by serving it in a more appetizing way. Never mix medicines with food.

Worms. Various symptoms are due to intestinal worms, and a sharp lookout should be kept for the appearance of any in the stools, and suitable treatment given when necessary.

Treatment for thread and round worms:

R. Santonini........................gr. ij. Hydrarg. chloridi mitis..........gr. ij. Pulv. aromatici..................gr. iv. Mix and divide into four.

Take one at bedtime every other night, followed by castor oil in the morning.

Tapeworms. These are rarer, being much more frequently talked or read about than seen. A doctor should be consulted.

Moral Training. The road to hell is broad and easy; so is that to heaven, for if bad habits are easily acquired, so are good ones.

Example is the best moral precept, and if the conduct of parents is good, little moral exhortation is needed. "What is the moral ideal set before children in most families? Not to be noisy, not to put the fingers in the nose or mouth, not to help themselves with their hands at table, not to walk in puddles when it rains, etc. To be 'good'!" To hedge in the child's little world, the most wonderful it will ever know, by hidebound rules enforced by severe punishments, is to repress a child, not to train it. While the commonest error is to spoil a child, it is just as harmful to crush it. Be firm, be kindly, and, above all, be fair.

Issue no command hastily, but only if necessary, and shun prohibitions based on petulance or pique. Give the child what it wants if easily obtainable and not harmful.

If the desire is harmful, explain why, but if a child asks for a toy, do not pettishly reply: "It's nearly bedtime!" when it is not, or even if it is.

Discipline is essential, but discipline does not consist in inconsistent nagging; harshly insisting on unquestioning obedience to some unreasonable command one moment, and weakly giving way—to avoid a scene—on some matter vitally affecting the child's welfare the next.

There must be no coddling, and no inducement to self-pity. Such children must be taught that they are capable of real success and real failure, and that upon personal obedience to the laws of health of body and of mind, this success or failure largely depends.

A child should be early accustomed to have confidence in himself. For this purpose all about him must encourage him and receive with kindliness whatever he does or says out of goodwill, only giving him gently to understand, if necessary, that he might have done better and been more successful if he had followed this or that other course. Nothing is more apt to deprive a child of confidence in himself than to tell him brutally that he does not understand, does not know how, cannot do this or that, or to laugh at his attempts. His educators must persuade him that he can understand, and that he can do this thing or that, and must be pleased with his slightest effort.

It seems a trifle to let a child have the run of cake plate or sweet-tray, or to stay up "just another five minutes, Mummy!" to avoid a howl, but these are the trifles that sow acts to reap habits, habits to reap character, and character to fulfil destiny. It is selfish of parents to avoid trouble by not teaching their children habits of obedience, self-restraint, order and unselfishness. Between five and ten is the age of greatest imitation, when habits are most readily contracted.

Come to no decision until hearing the child's wishes or statements, and thinking the matter out; having come to it, be inexorable despite the wiles, whines and wails of a subtle child. Reduce both promises and threats to a minimum, but rigidly fulfil them, for a threat which can be ignored, and a promise unfulfilled, are awful errors in training a child.

Persuade, rather than prohibit or prevent, a child from doing harmful actions. If it wants to touch a hot iron, say clearly it is hot, and will burn, but do not move it. Then, if the child persists, it will touch the iron tentatively, and the small discomfort will teach it that obedience would have been better. Let it learn as far as possible by the hard, but wholesome, road of experience.

Makeshift answers must never be given to a child. Awkward questions require truthful answers, even though these only suggest more "Whys?"

Sentimentality must be nipped promptly in the bud, and an imaginative and humorous view of things encouraged. The child must be taught to keep the passions under control, and to face pain (that great educator which neurotic natures feel with exaggerated keenness) with fortitude.

Fear must be excluded from a child's experience. "Bogies!" "Ghosts!" "Robbers!" and "Black-men!" if unintroduced, will not naturally be feared. The mental harm a highly strung child does by rearing most fearsome imaginings on small foundations is incalculable, and has led more than one to an asylum.

Try to train the child to go to sleep in the dark, but if it is frightened give it a nightlight. As Guthrie says, the comfort derived from the assurance that Unseen Powers are watching over it, is small compared to that given by a nightlight. He mentions a child who, when told she need not fear the dark because God would be with her, said: "I wish you'd take God away and leave the candle."

If the child wakes terrified, it is stupid and wicked to call upstairs: "Go to sleep!" A child cannot go to sleep in that state, and a wise mother will go up and softly soothe the frightened eyes to sleep.

Neuropathic children often have night terrors within an hour or two of going to bed. Piercing screams cause a hasty rush upstairs, where the child is found sitting up in bed, crouching in a corner, or trying to get out of door or window. His face is distorted with fear and he stares wildly at the part of the room in which he sees the terrifying apparition. He clings to his mother but does not know her. After some time he recovers, but is in a pitiful state and has to have his hand held while he dozes fitfully off. He often wets the bed or passes a large amount of colourless urine. Medical treatment is imperative.

Corporal punishment is unsuitable for neuropathic children, for the mere suggestion of its application usually causes such excessive dread, mental upset and terror as make it really dangerous. Such children are often said to be "naughty" when in reality they are unable to exercise self-control, owing to defective inhibitory power. Try patiently to inculcate obedience from the desire to do right, and make chastisement efficacious from its very exceptional character.

"The young child is too unconscious to have a deliberately perverse intention; to ascribe to him the fixed determination to do evil, is to judge him unjustly and often to develop in him an evil instinct. It is better in such a case to tell him he has made a mistake, that he did not foresee the consequences to which his action might lead, etc." Many parents fall into a habit of shaking, ear-boxing, and such-like harmful minor punishments for equally minor offences, which should be overlooked.

In all little troubles, keep quite calm. The child's nerve and association centres have not yet got "hooked up", and you cannot expect it to act reasonably instead of impulsively. This excuse does not apply to you. One excitable person is more than enough, for if both get angry, sensible measures will certainly not result.

The necessity for calmness cannot too strongly be urged. The treatment for a fit of temper, is to give the unfortunate child a warm bath, and put it to bed, with a few toys, when it will soon fall asleep, and awake refreshed and calm.

Proceed gently but with absolute firmness, start early, and remember that example is better than precept.

Religion. Offering advice on this subject is skating on very thin ice, and we do so but to give grave warning against neuropathic youth being allowed to contract religious "mania", "ecstasy", or "exaltation".

Neuropaths are given naturally to "see visions and dream dreams", and if this tendency be exaggerated an unbalanced moral type results. Jones says:

"The epileptic is apt to be greatly influenced by the mystical or awe-inspiring, and is disposed to morbid piety. He has an outer religiousness without corresponding strictness of morals; indeed the sentiment of religious exaltation may be in great contrast to his habitual conduct, which is a mixture of irritability, vice and perverted instincts."

Lay stress on the simple moral teaching of the New Testament, and avoid cranky creeds, cross references, or Higher Criticism. Teach them to practise the moral precepts, not to quote them by the page.

Without this practical bent, a "Revival" meeting is apt to result in a transient but harmful "conversion"; a form of religious sentiment which finds outlet, not so much in works as in morbid excitement. In these people, as in the insane, there is often a weird mixing-up of religious and sexual emotion.

Teach these children that the greatest good is not to sob over their fancied sins at "salvation" meetings, but to love the just and good, to hate the unjust and evil, and to do unto others as they would others should do unto them.

It is better for them to join one of the great churches, than become members of those small sects which maintain peculiar tenets.

A word of special warning must be given against Spiritualism. There may or may not be a foundation for this belief, but it is highly abnormal, and has led thousands into asylums.

The medium and the majority of her audience are highly neurotic, and a more unwholesome environment for an actual or potential neuropath could not be imagined.

The educated neuropath often peruses certain agnostic works, the result usually being deplorable, for this class are dependent on some stable base outside themselves, such as is found in a calm religion manifested in a steadfast attempt to overcome the weakness of the flesh, by ordering life in accordance with the teachings of the New Testament.

So long as abnormalities of character do not become too pronounced, friends must be content.

Such children must be trained to express themselves in a practical manner, not in weaving gorgeous phantasies in which they march to imaginary victory. Day dreams form one of those unlatched doors of the madhouse that swing open at a touch, the phantasy of to-day being written "emotional dementia" on a lunacy certificate to-morrow.

Finally, remember that above them hangs the curse:

"Unstable as water, thou shall not excel."

"Go thou softly with them, all their days!" and whether your tears fall on the ashes of a loved and loving, but weak and wilful one, or whether their tears bedew the grave of the only friend they ever knew, you will not have lacked a rich reward.

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CHAPTER XXII

DANGERS AT AND AFTER PUBERTY

"Th' expense of spirit in a waste of shame Is lust in action; and till action, Lust Is perjured, murderous, bloody, full of blame, Savage, extreme, rude, cruel, not to trust; Enjoyed no sooner but despised straight; Past reason hunted; and, no sooner had, Past reason hated, as a swallow'd bait On purpose laid to make the taker mad; Mad in pursuit, and in possession so; Had, having had, and in quest to have, extreme; A bliss in proof, and proved, a very woe; Before, a joy proposed; behind, a dream; All this the world well knows; yet none knows well, To shun the Heaven that leads men to this Hell!" —Shakespeare. Sonnet 129.

At puberty (from the age of 11-15) a boy becomes capable of paternity, a girl of maternity; during adolescence (from puberty to 25) the body in general, and the reproductive organs in particular, grow and mature.

In the boy, semen is secreted, the voice breaks, the genitals enlarge, hair grows on the pubes, face and armpits, and there is a rapid increase in height owing to growth of bone. In the girl menstruation commences, the pelvis is enlarged, bust and breasts develop, the complexion brightens, the hair becomes glossy, and the eyes bright and attractive.

In both, the sexual instinct awakens, and the mental, like the physical, changes are profound. There is great general instability, the child, at one time shy and reticent, is at another, boisterous and self-assertive.

Parents rarely realize the importance and trying nature of this period when "there awakes an appetite which in all ages has debased the weak, wrestled fiercely with the strong and overwhelmed too often even the noble". Adolescents suffer more from the lack of understanding, sympathy, appreciation and wise guidance shown by their blind parents, than they do from their own ignorance and perfervid imagination.

The transitions from radiant joy and confident expectation, reared on a flimsy basis of supposition, to dire despair consequent on a wrong reading of physical and mental changes, are rapid. Friends, lovers and heroes quickly succeed one another, play their parts, and give place to others.

The awakening of the sexual appetite is usually ignored, and children are left to gain knowledge of man's noblest power from companions, casual references in the Bible and other books, and unguarded references in conversation. Under such conditions not one in a thousand—and your child is not that one—escapes impurity and degraded sex ideas.

Wherever youth congregate, this subject crops up, and those who talk most freely to the others are just those with the most distorted and vicious ideas, whose discourse abounds in obscene detail and ribald jest. Your child must learn either from ignorant, unclean minds, or be taught in a clean, sacred way, which will rob sex of secrecy and obscenity; learn he will; if you will not teach your child, his pet rabbit will.

When children ask awkward questions, say quietly that such matters are not discussed with children, but promise to tell them all about it when they are ten years old; delay no longer, for most children learn self-abuse between ten and twelve.

Self-abuse is a bad habit, and no more a "sin" than is biting the nails. Unfortunately, people with no other qualification than a desire to do good, wrongly harp on the "sin" of it and draw lurid pictures of physical and mental wreck as the end of such "sinners", ignorant that if all masturbators went mad the world would be one huge asylum.

Exaggeration never pays in teaching youth. Tell the truth, which is bad enough without adding "white lies" with an eye to effect.

Coitus causes slight prostration, Nature's device to remind man to keep sexual intercourse within bounds, for while in moderation it is harmless, in excess it causes great prostration. Exactly the same applies to self-abuse, for, paradoxical as it seems, the real harm is done by the fear of the supposed harm.

The masturbator first suffers from the knowledge he is indulging in a pleasure he knows would be forbidden, and from fear of being found out; later he learns from friends, quack advertisements, or well-meaning books that self-abuse is a most deadly practice, and thereupon a tremendous struggle occurs between desire and fear, each act ending in an agony of remorse and dread of future consequences, which struggle does a thousand-fold more harm than the loss of a little semen.

The ill-effects of these mental struggles disappear after marriage, which means greater indulgence, but indulgence free from mental stress. In neuropaths, these mental struggles are the worst things that could occur, for they tend to make permanent the states we are trying to cure.

The most serious results of masturbation are moral not physical. Loss of will-power, self-reliance, presence of mind, reasoning power, memory, courage, idealism, and self-control; mental and physical debility, laziness, a diseased fondness for the opposite sex, and in later years, some degree of impotence or sterility, are its commoner results.

Teach your child, therefore, not from fear of physical harm, but because you wish him to be one of those fortunate few who live and die "gentlemen unafraid", because they had wise parents.

Let the mother instruct a girl, the father a boy, and not leave so vital a matter to an unsuitable pamphlet.

Buy one of the many "Knowledge for Boys or Girls" books and read it carefully.

Having made sure you can convey a simple account of the wonders of reproduction, and that you have rooted out the idea that sex is something to be apologized for, see the child and tell him it is time he learned of his private parts, as manhood draws near.

Then, speaking in a quiet, unembarrassed way, deliver your little homily, all the time insisting on the marvel, the romance, the poetry and the beauty of the sex. Let chivalry be your text, not fear, and repeat the Squire's sound parting advice to Tom Brown:

"Never listen to or say things you would not have your mother or sister hear."

Give a clear and complete description in simple words of the mechanism and marvel of reproduction, for half-knowledge generates a prurient curiosity about the other sex, thus defeating the very end you have so earnestly striven for.

Purity not impurity should be your text, and you should only refer to masturbation as a harmful habit, which should not be contracted.

Warn them to

"Keep the heart with all diligence, for out of it are the issues of life!"

by turning their thoughts instantly and determinedly away from sex ideas when they arise, as they will arise, time and again. It is useless to try not to think of them, the child must instantly turn its thoughts to to something else, for one who cannot stamp out a spark will not subdue a fiercely-raging conflagration.

Babies should not be carelessly caressed, and a fretful infant must never be soothed by playing with the genitals, as is done innocently by some mothers and nurses, and by others from motives more questionable. Freud showed that there are subconscious sexual desires in infants, which die out until reanimated at puberty in Nature's own way. If exaggerated by exuberant fondling, they gather force in the dark corners of the mind, and are later manifested in morbid sexual or mental perversity.

If you have good grounds for believing the habit has already been contracted, enlist medical advice. A great factor in the successful treatment of self-abuse is early recognition, and, after the unhygienic nature of the habit has carefully been pointed out, the child's sense of honour should be invoked.

Without further reference to the matter, try to become your child's confidant, for he will have to fight fires within and foes without. See that his time is filled with healthy sport and play, and ennoble his ideas with talk, books and plays which lay stress on chivalry and manliness. Give him plain food, tepid douches, and a firm bed with light, fairly warm clothing. Get him up reasonably early in the morning, and let him play until he is "dog-tired" at night.

Let children rub shoulders with others, keep them from highly exciting tales, let them read but little, and train them to be observant of external objects all the time.

Neuropaths develop very early sexually, and contract bad habits in the endeavour to still their unruly passions; with them, the future is darker than with the normal child, and the parent who neglects his duty may justly be held accountable for what happens to his child or his child's children.

Puberty is always a critical period in epilepsy, many cases commencing at this time, while in a number, fits commence in infancy, cease during childhood, and recommence at puberty, the baneful stimulus of masturbation being undoubtedly a factor in many of these cases.

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CHAPTER XXIII

WORK AND PLAY

Although most people would assume that epileptics are unable to follow a trade, there is hardly an occupation from medicine to mining, from agriculture to acting, that does not include epileptics among its votaries.

Outdoor occupations involving but little mental work or responsibility are best, but unfortunately just those which promise excitement and change are those which appeal to the neuropath.

A light, clean, manual trade should be chosen, and those that mean work in stuffy factories, amid whirring wheels and harmful fumes, using dangerous tools, or climbing ladders, must be avoided.

For the fairly robust, gardening or farming are good occupations, such workers getting pure air, continuous exercise, and little brain-work. Wood-working trades are good, if dangerous tools like circular saws are left to others.

For the frail neuropath with a fair education, drawing, modelling, book-keeping, and similar semi-sedentary work may do. Other patients might be suited as shoemakers, stonemasons, painters, plumbers or domestic servants, so long as they always work on the ground.

Some work is essential; better an unsuitable occupation than none at all, for the downward tendency of the complaint is sufficiently marked without the victim becoming an idler. Work gives stability.

Epilepsy limits patients to a humble sphere, and though this is hard to a man of talent, it is but one of many hard lessons, the hardest being to realize clearly his own limitations.

If seizures be frequent, the ignorant often refuse to work with a victim, who can only procure odd jobs, in which case he should strive to find home-work, at which he can work slowly and go to bed when he feels ill. A card in the window, a few handbills distributed in the district, judicious canvassing, and perhaps the patronage of the local doctor and clergy may procure enough work to pay expenses and leave a little over, for the essential thing is to occupy the mind and exercise the body, not to make money.

Very few trades can be plied at home and many swindlers obtain money under the pretence of finding such employment, charging an excessive price for an "outfit", and then refusing to buy the output, usually on the pretext that it is inferior. Envelope-addressing, postcard-painting and machine-knitting have all been abused to this end.

An auto-knitter seems to offer possibilities, but victims must investigate offers carefully.

Photography is easy. A cheap outfit will make excellent postcards, modern methods having got rid of the dark room and much of the mess, and postcard-size prints can be pasted on various attractive mounts.

If the work is done slowly, and in a good light, and the patient has an aptitude for it, ticket-writing is pleasant. Among small shopkeepers there is a constant demand for good, plainly printed tickets at a reasonable price.

On an allotment near home vegetables and poultry might be raised, an important contribution to the household, and one which removes the stigma of being a non-earner.

The mental discipline furnished by this home-work is invaluable, Neuropaths, especially if untrained, are unable to concentrate their attention on any matter for long, and do their work hastily to get it finished. When they find that to sell the work it must be done slowly and perfectly they have made a great advance towards training their minds to concentrate. Their weak inhibitory power is thus strengthened with happy results all round.

When the work and the weather permit, work should be done outdoors, and when done indoors windows should be opened, and, if possible, an empty or sparsely-furnished bedroom chosen for the work.

Recreations. These offer a freer choice, but those causing fatigue or excitement must be avoided, for patients who have no energy to waste need only fresh air and quiet exercise.

Manual are better than mental relaxations. Dancing is unsuitable, swimming dangerous, athletics too tiring and exciting. Bowls, croquet, golf, walking, quoits, billiards, parlour games and quiet gymnastics without apparatus are good, if played in moderation and much more gently than normal people play them. Play is recreation only so long as a pastime is not turned into a business. When a player is annoyed at losing, though he loses naught save his own temper, any game has ceased to be recreative.

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CHAPTER XXIV

HEREDITY

"Man is composed of characters derived from pre-existing germ-cells, over which he has no control. Be they good, bad, or indifferent, these factors are his from his ancestry; the possession of them is to him a matter of neither blame nor praise, but of necessity. They are inevitable."—Leighton.

The body is composed of myriads of cells of protoplasm, in each of which, is a nucleus which contains the factors of the hereditary nature of the cell. In growth, the nucleus splits in half, a wall grows between and each new cell has half the original factors,

Female ovum and male sperm (the cells concerned with reproduction) divide, thus losing half their factors, and when brought together by sexual intercourse form a germ-cell having an equal number of factors from mother and father.

How these factors are mingled—whether shuffled like two packs of cards, or mixed like two paints—we do not know. If two opposite factors are brought together, one must lie dormant. The offspring may be male or female, tall or short; it cannot be both, nor will there be a mixture. This rule only applies to clearly defined factors.

We are made by the germ-plasm handed down to us by our ancestors; in turn we pass it on to our children, unaltered, but mixed with our partner's plasm.

"The Dead dominate the Living" for our physical and mental inheritance is a mosaic made by our ancestors.

Variations which may or may not be inheritable do arise spontaneously, we know not how, and by variations all living things evolve.

A child resembles his parents more than strangers, not because they made cells "after their own image" but because both he and they got their factors from the same source.

Man's physical and mental, and the basis of his moral, qualities depend entirely on the types of ancestral plasm combined in marriage. Man may control his environment; his heritage is immutable. To suppress an undesirable trait the germ-cell must unite with one that has never shown it—one from a sound stock. An unsuitable mating in a later generation, however, may bring it out again (for factors are indestructible), and the individual showing it will have "reverted to ancestral type".

To give an instance: Does the son of a drunkard inherit a tendency to drink? No! The father is alcoholic because he lacks control, consequent upon the factors which make for control having been absent from his germ-plasm. He passes on this lack; if the mother does the same, the defect occurs—in a worse form—in the son. If the mother gives a control factor, the son may be unstable or apparently stable, this depending entirely on chance, but if the mother's plasm contains a strong control-factor, the defect will lie dormant in her son, who will have self-control, though if he marries the wrong woman he will have weak-willed children.

If the son becomes a toper, therefore, it is because he, like his father before him, was born with a defect—weak control—which might have made of him a drug-fiend, a tobacco-slave, a rake, or a criminal; in his home drink would naturally be the temptation nearest to hand, and he would show his lack of control in drunkenness.

The way a lily-seed is treated makes a vast difference to the plant which arises. If sown in poor soil, and neglected, a dwarf, sickly plant will result; if sown in rich soil, and given every care that enthusiasm, money and skill can suggest or procure, the result will be magnificent.

So with man. A well-nourished mother, free from care and disease, may have a finer child than a half-starved woman, crushed by worry and work, but neither starvation nor nourishment alter the inborn character of the child.

The body-cells are greatly changed by disease, poison, injury, and overwork, but these changes are not passed on, and despite the influence of disease from time immemorial, the germ-cell produces the same man as in ancient days. Without this fixity of character, this "continuity of the germ-plasm", "man" would cease to be, for the descendants of changeable cells would be of infinite variety, having fixity of neither form nor character.

Epilepsy, hysteria and neurasthenia are all outward signs of defect in the germ-plasm, and so they (or a predisposition to them) can be passed on, and inherited.

If a man shows a certain character, his plasm, had, and has, the causative factor. He may have received it from both his parents, when it will be strong, or from one only, when it will be normal. If he have it not, it is absent. The same applies to the plasm of the woman he mates, so there are six possible combinations, with results according to "Mendel's Law."

All the children will not inherit a taint unless both parents possess it, but, however strong one parent be, if the other is tainted, none of the children can be absolutely clean, but will show the taint, weak, strong, or dormant. This means that neuropathy will recur—and that it has previously occurred—in the same family, unless there be continual mating into sound stocks. If there is continual mating into bad stocks, it will recur frequently and in severe forms. All intermediate stages may occur, depending entirely on the qualities of the combining stocks.

From this we shall expect, in the same stock, signs of neuropathic taint other than the three diseases dealt with here, and these we get; for alcoholism, criminality, chorea, deformities, insanity and other brain diseases, are not infrequent among the relatives of a neuropath, showing that the family germ-plasm is unsound.

Epilepsy, one symptom of taint, is more or less interchangeable with other defects; the taint, as a whole, is an inheritable unit whose inheritance will appear as any one of many defects. This is shown by the fact that very few epileptics have an epileptic parent. Starr's analysis of 700 cases of epilepsy emphasizes this point.

Epilepsy in a parent 6 Epilepsy in a near relative 136 Alcoholism in a parent 120 Nervous Diseases in family 118 Rheumatism and Tuberculosis 184 Combinations of above diseases 142