S. Weir Mitchell

“ Given a nervous, hysterical, feeble woman, shut out from the world, and if she does not in time become irritable, exacting, hungry for sympathy and petty power, she is one of nature's noblest. A mother or sister gives herself up to caring for her. She is in the grip of an octopus. Every fine quality of her nature helps to hurt her, and at last she breaks down utterly and can do no more. She, too, is become nervous, unhappy, and feeble. Then every one wonders that nobody had the sense to see what was going on. I can count many examples of nervousness which have arisen in this fashion. ”

“ Through all ages we have insisted that he shall feel himself bound by a code of moral law, to which, on the whole, he has held without question, while creeds of more serious nature were shifting and changing. What the Greek fathers of medicine asked of him we still ask of him to-day. He must guard the secrets wrung from you on the rack of disease. He is more often than he likes a confessor, and while the priest hears, as I have once said, the sins and foibles of to-day, he is as like as not to have to hear the story of a life. ”

“ It is so easy and pleasant to yield to the caprices of those we love, when they are in pain or helpless from illness,—so doubly hard at such times to say no. Yet, if in the case of a long convalescence, such as follows, perhaps, a typhoid or scarlet fever, we balance for the little one the too-easily yielded joy of to-day against the inevitable stringency of discipline, which, with recovered health, must teach the then doubly difficult lesson of self-restraint, we shall see, I think, that, on the whole, we do not add to the sum of happiness to which the child is entitled. ”

“ I wish that every woman could attain to the best that men have. I wish for her whatever in the loftiest training helps to make her as mother more capable, as wife more helpful; but I would on no account let the healthiest woman thus task her brain until she is at least nineteen. If she is to marry, and this puts it off until twenty-three, I consider that a gain not counted by the advocates of the higher education. I leave to others to survey the broad question of whether or not it will be well for the community that the mass of women should have a collegiate training. ”

“ It would be as impossible as to make him morally and physically, by any educational or other training, what the woman now is, his true superior in much that is as high, and as valuable as any mental capacities he may possess; nor does my creed involve for woman any refusal of the loftiest educational attainments. I would only insist on selection and certain limitations as to age of training and methods of work, concerning which I shall by and by have something more to say. Neither would I forbid to her any profession or mode of livelihood. This is a human right. ”

“ In health, when not nervous, a woman well knows that there are seasons when she must predetermine not to be nervous; and when ill-health has made her emotional, she must learn to be still, more constantly on guard. Above all, it is the small beginnings of nervousness which she has to fear.
Tears are, for the nervous woman, the seed of trouble. Let her resolutely shun this commencement of disaster. The presence of others is apt to insure failure of self-control. ”

“ When one has watched a woman from whom opium has been taken away, even with skilful tenderness, roll in agony on the floor, rend her garments, tear out her hair, or pass into a state of hysterical mania, the physician is made to feel that no suffering for which she took the drug can have been as bad as the results to which it leads. The capacity to suffer, which comes on as we remove the poison, is almost inconceivable. It lasts long, and is the true difficulty in the way of forming anew habits of wholesome endurance. ”

“ Old tastes return and mild delights become luxuries, as if the new tissues in nerve and brain were not sated, like those of the older body in which they are taking their places.
When you are acutely ill, the doctor is business-like and gravely kind; you want him in a way, are even anxious to see him for the relief he may bring, or the reassurance. But when you begin to feel as if you were a creature reborn, when you are safe and keenly enjoying the return of health, then it is that the morning visit is so delightful. ”

“ In times of more serious peril and suffering, be assured that the best sympathy is that which calmly translates itself into the desire to be of practical use, and that the extreme of capacity to feel your woes would be in a measure enfeebling to energetic utility. This it is which makes a man unfit to attend those who are dear to him, or, to emphasize the illustration, to medically treat himself. He goes to extremes, loses judgment, and does too much; fears to hurt, and does too little. I once saw a very young physician burst into tears at sight of a burnt child, a charming little girl. ”

“ The mother at the sick-bed of her young child is, however, a being quite often as difficult to manage as her child. All her instinctive maternity is up in arms. Deep in the heart of many mothers there is an unconfessed and half-smothered sense of wrath at the attack which sickness has made on her dear one. Then nothing is too much to give; no sacrifice of herself or others too great to grant or demand. The irritability and feebleness of convalescence makes claims upon her love of self-sacrifice, and her prodigality of tenderness as positive and yet more baneful. ”

“ The spring came early, and once out of doors the swiftly-flitting hours of sensory acuteness brought to me on every breeze nameless odors which have no being to the common sense,—a sweet, faint confusion of scents, some slight, some too intense,—a gamut of odors. Usually I have an imperfect capacity to apprehend smells, unless they are very positive, and it was a curious lesson to learn how intense for the time a not perfect function may become. ”

“ All his days he has walked amidst misery, anguish, bodily and mental suffering. Be careful when you come to test him by his ability to feel what you call sympathy. In its loftiest meaning this is the capacity to enter into, to realize, and hence to feel with and for you. There is a mystery about this matter. I know men who have never suffered gravely in mind or body, who yet have some dramatic power to enter into the griefs of others, and to comprehend, as if by intuition, just what others feel, and hence how best to say and do the things which heal or help. ”

“ As a profession, it is my sincere conviction that in our adherence to a high code of moral law, and in the general honesty with which we do our work, no other profession can be compared with ours. Our temptations, small and large, negative and positive, are many and constant, and yet I am quite sure that no like group of men affords as few illustrations of grave moral weaknesses. It is commonplace to say that our lives are one long training in charity, self-abandonment, all forms of self-restraint. The doctor will smile at my thinking it needful to even state the fact. He begins among the poor ”

“ Some lonely hospital patient has just reasons for knowing early or late in his disease the truth as the doctor sees it. I have never been able to feel certain that in any case of acute or hopeless illness to know surely what lay before a sick man did distinctly shorten his life. I have seen many people in apparent health made ill by the shock of emotion,—by fear, grief, anger, jealousy. Diseased persons feel less, or show less in a physical way, the results we might expect to see from even the most rudely conveyed intelligence as to their probable future. ”

“ When you sit beside a woman you have saved from mournful years of feebleness, and set afoot to taste anew the joy of wholesome life, nothing seems easier than with hope at your side, and a chorus of gratitude in the woman's soul, to show her how she has failed, and to make clear to her how she is to regain and preserve domination over her emotions ”

“ The oversensitiveness to pain persists for months, and is a constant temptation. The moral and mental habits formed under opium—the irresolution, the recklessness, the want of shame, in a word, the general failure of all that is womanly—need something more than time to cure. But I am not preaching to the woman just set free from this bondage to sin, and speak of her only to emphasize the horror with which I would wish to inspire the well, who yet may come some day to be the suffering. ”

“ In my own wood-life or canoe journeys I used to wonder how little I read or cared to read. One has nowadays many resources. If you sketch, no matter how badly, it teaches and even exacts that close observation of nature which brings in its train much that is to be desired. Photography is a means of record, now so cheaply available as to be at the disposal of all, and there is a great charm of a winter evening in turning over sketch or photograph to recall anew the pleasant summer days. Beyond all this, there is botany. ”

“ She does not see that her very affection unfits her for the calm control of the sick-room, and that her inevitable anxiety is incompatible with tranquil judgment. If you tell her that nursing is a profession, and that the amateur can never truly fill the place of the regular, she smiles proudly, and thinks that affection is capable of all things, and that what may be lost in skill will be made up in thoroughness and compensated by watchfulness, such as she believes fondly only love can command. It is hard to convince such a woman. ”

“ Hitherto I have dealt most with the intellectual outfit needed for the best practice of medicine, but the criticism I have just made brings me on more delicate ground. The man who feels himself so competent that his self-esteem forbids him to seek advice when he knows and must know he has come to the end of his reasonable resources, lacks the humility which belongs to larger natures, and he, too, is a man to avoid.
Be sure that the physician cannot he a mere intellectual machine. None know that better than we. ”

“ Indulgence becomes inevitable, or seems to become so, and the mother is rare who does not insist that they shall have what they desire, and that her other children shall yield to them in all things. Her answer to herself and others is, "They have so little; let them at least have what they can." As rare as the reasonable mother is the sick child who can stand this treatment and survive with those traits of character which it above all others requires to make its crippled life happy, not to say useful. ”

“ Our own Sims's book about himself is worth reading, but is too realistic for the library table, yet what a strangely valuable story it is of the struggle of genius up to eminent success. But these are the heroes of a not unheroic profession, and I had almost forgotten to set among them, as a study of character, the life of the tranquil, high-minded Jenner, the country doctor who swept the scars of smallpox from the faces of the world of men, and beside him John Hunter, his friend, impulsive, quick of temper, enthusiastic, an intensely practical man of science. ”

“ Very irritable in youth, her clear brain and strong sense of duty overcame it in proportion to the growth of what in others creates it. All opiates she disliked, and could rarely be induced to take them. "If my mind gets weaker, I shall go to pieces——;" and, laughing always, "the bits would be worthless as the scattered bricks of a sound house." Surely such a life is a fruitful lesson in the uses of endurance, for be sure that both she and all around her were the better and happier, yes, and she the less a sufferer, for her mode of dealing with a life of pain. ”

“ Few men in early life can do much more than is needed to learn our art and its sister sciences; but, as time goes on, there are many who can add to it other pursuits which greatly benefit them in a wide sense, and enlarge and strengthen their mental powers, or pleasantly contribute to the joys of life, and so even to the growth of a man's moral nature. The wise physician, who is fond of etching or botany, the brush, or the chisel or the pen, or who is given to science, does well to keep these things a little in the background until he is securely seated in the saddle of professional success. ”

“ The books on mind-cure are calculated to make much and serious evil. I have read them with care, and have always risen from them with the sense of confusion which one would have if desired to study a pattern from the back of a piece of embroidery. There is, however, a class of minds which delight in the fogs of mystery, and, when a book puzzles them, accept this as evidence of depth of thought. ”

“ The man who lives out of doors awhile acquires better sense of moral proportions, and thinks patiently and not under stress, making tranquil companions of his worthy thoughts. This is a great thing, not to be hurried. There seems to me always more time out of doors than in houses, and if you have intellectual problems to settle, the cool quiet of the woods or the lounging comfort of the canoe, or to be out under "the huge and thoughtful night," has many times seemed to me helpful. One gets near realities out of doors. Thought is more sober; one becomes a better friend to one's self. ”

“ The history of precision in medicine is worth the telling, if only to teach the lay reader something of that vast struggle to know the truths of disease, which is little understood beyond the ranks of the most scholarly of my profession. The first step was due to Galileo. In 1585 he used his pendulum to record the pulse, in a fashion at which we smile to-day, and yet what he tried to do was the birth of precision in medicine. ”

“ It is a sad drawback in the face of the duties of life, that a very little emotional disturbance will suffice to overcome the woman as it does not do the man, and that the same disease which makes him irritable makes her nervous. Says Romanes, in an admirable and impartial article on the mental differences of men and women, "She is pre-eminent for affection, sympathy, devotion, self-denial, modesty, long-suffering or patience under pain, disappointment, and adversity, for reverence, veneration, religious feeling, and general morality." ”

“ Last of all, and here she must be simple and natural, what mood of mind does it all bring to her, for every landscape has its capacity to leave you with some general sense of its awe, its beauty, its sadness, or its joyfulness. ”

“ In each case there are years of troublesome treatment, all sorts of unpleasant limitations, pain it may be, and certainly, at the best, a variety of discomforts. The joy and little pleasures of youth are gone. It makes one sorrowful to think of such cases, even when all that competent means can do to help them is at their disposal, and still more to reflect on those who have to battle for health with no more resource than is left to the needy. What shall we not do for them! The woman's whole tendency is to give them all of herself and all else that she can control. ”

“ Too much is taken for granted, and inefficient opinions are the outcome of carelessness. Every new case in a household should be dealt with as if it were a stranger's, and outside familiarity should not be allowed to breed contempt of caution in study or lead to half measures. Every consultant will agree with me that this kind of social nearness of the doctor to his patient is a common cause of inert advice, and nowhere more distinctly so than when unwise physicians attempt to practise in their own households on those they love. ”

“ As I remember these patients, and I have seen them by the score, far on in their evil ways, such women are most often those who lack the power, even in health, to endure pain. Some defect of training or of nature has made pain, or even distress or insomnia, ills to be relieved at once regardless of cost. Let them but feel that relief for the time is possible, and self-restraint is over. They will have the thing they crave. You cure them of the vile opium habit at awful cost of suffering, and they relapse on the first new trial of endurance, and men of their type more surely than women. ”

“ To sum up, we credit these little ones with a simplicity of moral organization which forbids us to believe that the causes which are active for mischief in their elders are not as potent for evil in them. The popular and reasonable creed of moral education, which teaches us to ask from a well child self-control, self-restraint, truth of statement, reasonable endurance of the unavoidable, good temper, is not too lightly or too entirely to be laid aside when sickness softens the rule of health and all our hearts go out in pity to the little sufferer. ”

“ Another, more resolute, submits with patience, does not give way, as we put it, tries to distract her attention, knowing that even as distinct suffering as toothache may be less felt in the presence of something which interests the mind and secures the attention. Nothing, indeed, is more instructive than to watch how women bear pain,—the tremendous calamity it is to one, the far slighter thing in life it is to another. ”