Why Worry?, George Lincoln Walton [bts books to read .TXT] 📗

hurry, I often get a sharp pain in my side. Those are the symptoms of a serious heart trouble.”

“Not necessarily, sir,” began the physician, but he was interrupted.

“I beg your pardon!” said the patient irritably. “It isn’t for a young physician like you to disagree with an old and experienced invalid like me, sir!”

 

*

 

There is no absolute standard for the proper degree of solicitude regarding one’s health, but if the habitual invalid possess a physique which would not preclude the average normal individual from being out and about, even at the expense of a pain, a stomach ache, or a cold, there is probably a hypochondriacal element in the case. It is a question of adjustment of effect to cause.

The term “imaginary” is too loosely applied to the sensations of the hypochondriac. This designation is unjustified, and only irritates the sufferer, rouses his antagonism, and undermines his confidence in the judgment of his adviser. He knows that the sensations are there. To call them imaginary is like telling one who inspects an insect through a microscope that the claws do not look enormous; they do look enormous—through the microscope—but this does not make them so. The worrier must learn to realize that he is looking at his sensations, as he does everything else, through a microscope.

If a person living near a waterfall ignores the sound, he soon ceases to notice it, but if he listens for it, it increases, and becomes finally unbearable. Common sense teaches him to concentrate his attention elsewhere; similarly, it demands that the victim of “hypos” disregard his various sensations and devote his attention to outside affairs, unless the sensations are accompanied by obvious physical signs. Instead of running to the doctor, let him do something—ride horseback, play golf, anything requiring exercise out of doors. Let him devote his entire energy to the exercise, and thus substitute the healthy sensations of fatigue and hunger for the exaggerated pains and the anomalous sensations which are fostered by self-study. Let him remember moreover, that nature will stand an enormous amount of outside abuse, but resents being kept under close surveillance.

In practicing the neglect of the sensations, one should not allow his mind to dwell on the possibility that he is overlooking something serious, but rather on the danger of his becoming “hipped,” a prey to his own doubts and fears, and unable to accomplish anything in life beyond catering to his own morbid fancies.

 

*

 

Turning now to the bibliographic study of hypochondria, an interesting and characteristic contrast is offered between Huxley, who called himself a hypochondriac, but apparently was not, and Carlyle, who resented the imputation, though it apparently had some justification in fact.

With regard to Huxley,—the only basis for the diagnosis hypochondria in a given case, is undoubted evidence, by letter or conversation, that the question of health is given undue prominence. I have looked carefully through the volume of Huxley’s letters (published by his son), without definitely establishing this diagnosis. The state of his health and the question of his personal comfort received comparatively little attention. Whatever suffering Huxley endured he seems to have accepted in a philosophical and happy spirit, thus:

“It is a bore to be converted into a troublesome invalid even for a few weeks, but I comfort myself with my usual reflection on the chances of life, ‘Lucky it is no worse.’ Any impatience would have been checked by what I heard about … this morning … that he has sunk into hopeless idiocy. A man in the prime of life!”

With regard to Carlyle,—it is true, as claimed by Gould (_Biographic Clinics_, 1903) that he showed every evidence of eyestrain with resulting symptoms, particularly headache. This does not, however, preclude his having had hypochondria also, and in view of the violent and reiterated complaints running through his letters it seems quite credible that Froude’s estimate of his condition was not far wrong. Surely, unless Carlyle was merely trying his pen without intending to be taken seriously, he devoted to the question of health a degree of attention which may be fairly adjudged undue.

The first letter I quote (from those cited by Gould in fortifying his position) is of special interest as presenting in rather lurid terms Carlyle’s ideal of health. After reading this letter one cannot help suspecting that the discomforts so vividly described in his other letters were compared by him with this ideal rather than with those of the average individual.

“In the midst of your zeal and ardor,… remember the care of health…. It would have been a very great thing for me if I had been able to consider that health is a thing to be attended to continually, that you are to regard that as the very highest of all temporal things for you. There is no kind of achievement you could make in the world that is equal to perfect health. What to it are nuggets and millions’? The French financier said ‘Why is there no sleep to be sold!’ Sleep was not in the market at any quotation…. I find that you could not get any better definition of what ‘holy’ really is than ‘healthy.’ Completely healthy; mens sana in corpore sano. A man all lucid, and in equilibrium. His intellect a clear mirror geometrically plane, brilliantly sensitive to all objects and impressions made on it and imaging all things in their correct proportions; not twisted up into convex or concave, and distorting everything so that he cannot see the truth of the matter, without endless groping and manipulation: healthy, clear, and free and discerning truly all around him.”

The following extracts illustrate his attitude toward his physical shortcomings, whatever they may have been.

… “A prey to nameless struggles and miseries, which have yet a kind of horror in them to my thoughts, three weeks without any kind of sleep, from impossibility to be free from noise.”

“I sleep irregularly here, and feel a little, very little, more than my usual share of torture every day. What the cause is would puzzle me to explain. I take exercise sufficient daily; I attend with rigorous minuteness to the quality of my food; I take all the precautions that I can, yet still the disease abates not.”

“Ill-health, the most terrific of all miseries.”

“Grown sicker and sicker…. I want health, health, health! On this subject I am becoming quite furious…. If I do not soon recover, I am miserable forever and ever. They talk of the benefit of health from a moral point of view. I declare solemnly, without exaggeration, that I impute nine-tenths of my present wretchedness, and rather more than nine-tenths of all my faults, to this infernal disorder in the stomach.”

“Bilious, too, in these smothering windless days.”

“Broke down in the park; konnte nichts mehr, being sick and weak beyond measure.”

“Many days of suffering, of darkness, of despondency…. Ill-health has much to do with it.”

“Occasionally sharp pain (something cutting hard, grasping me around the heart)…. Something from time to time tying me tight as it were, all around the region of the heart, and strange dreams haunting me.”

“There is a shivering precipitancy in me, which makes emotion of any kind a thing to be shunned. It is my nerves, my nerves…. Such a nervous system as I have…. Thomas feeling in his breast for comfort and finding bilious fever…. All palpitating, fluttered with sleeplessness and drug-taking, etc…. Weary and worn with dull blockheadism, chagrin (next to no sleep the night before).”

“A head full of air; you know that wretched physical feeling; I had been concerned with drugs, had awakened at five, etc. It is absolute martyrdom.”

“A huge nightmare of indigestion, insomnia, and fits of black impatience with myself and others,—self chiefly…. I am heartily sick of my dyspeptic bewilderment and imprisonment.”

“Alas! Alas! I ought to be wrapped in cotton wool, and laid in a locked drawer at present. I can stand nothing. I am really ashamed of the figure I cut.”

Froude’s statements regarding Carlyle’s condition are as follows:

“… The simple natural life, the ‘wholesome air, the daily rides or drives, the poor food,… had restored completely the functions of a stomach never so far wrong as he had imagined…. Afterwards he was always impatient, moody, irritable, violent. These humours were in his nature, and he could no more be separated from them than his body could leap off its shadow…. He looked back to it as the happiest and wholesomest home that he had ever known. He could do fully twice as much work there, he said, as he could ever do afterwards in London.”

“… If his liver occasionally troubled him, livers trouble most of us as we advance in life, and his actual constitution was a great deal stronger than that of ordinary men…. Why could not Carlyle, with fame and honor and troops of friends, and the gates of a great career flung open before him, and a great intellect and a conscience untroubled by a single act which he need regret, bear and forget too? Why indeed! The only answer is that Carlyle was Carlyle.”

These observations carry weight as representing the impartial and judicial estimate of a careful observer desiring only accurately to picture Carlyle as he was. The only logical conclusion, it seems to me, was that Carlyle, in addition to ocular defect with its legitimate consequences, was weighed down by worry over the failure to realize his own exaggerated ideal of health, that he devoted an undue degree of attention to this subject and was unduly anxious about it—in other words, that he had decided hypochondriacal tendencies.

 

VIII.

NEURASTHENIA

It was a common saying of Myson that men ought not to investigate things from words, but words from things; for that things are not made for the sake of words, but words for things.

Diogenes Laertius.

 

This term (properly, though not commonly, accented upon the penult), was introduced by Beard to designate the large class of overworked and worried who crowded his consulting room. The word is derived from the Greek neuron nerve, and astheneia weakness.

Among the symptoms of this disorder have been included disorders of digestion and circulation, muscular weakness, pains, flushes and chills, and anomalous sensations of every variety. It has been especially applied to cases showing such mental peculiarities as morbid self-study, fear of insanity and the various other phobias, scruples, and doubts with which we have become familiar.

The “American Disease” has been adopted abroad, and volumes have been devoted to it. Neurasthenia has been divided into cerebral, spinal, and otherwise, according as the fears and sensations of the patient are referred to one or another part of his body. While the term neurasthenia is becoming daily more familiar to the general public, it is being, on the whole, used, except as a convenient handle, rather less among neurologists. [Footnote: In substantiation of this statement I need only cite the recent contribution of my friend, Dr. Dana, on the “Partial Passing of Neurasthenia.”] The question has arisen whether the symptoms of neurasthenia are always due to simple exhaustion. Advice regarding method, as well as amount, of work, is coming into vogue. Peterson, in a letter published in Collier’s Weekly (November 9, 1907) thus arraigns a patient who has told him he is a practical business man, and that his mind has been so occupied with serious matters that he has been unable to attend to his health.

“You, practical! you, a business man! Why, you never had a serious thought in your life until now—at least not since you were a lad in the country…. Since boyhood you have never given a serious thought to health, home, wife,