-GE.PraiefcffSl' A TREATISE ON MEDICAL PSYCHOLOGY; OK, THE INFLUENCE OF THE MIND OVER THE HEALTH OF THE BODY, AND SKETCH OF PRACTICE. DESIGNED BOTH FOR m USE OF PRACTITIONERS OF MEDICINE AND THE PEOPLE. BY john w. Wright, a. m., m. d. FIRST KDiriON. MOTTO: " FvtoOi Ji'cccuroj/" PUBLISHED FOR THE AUTHOR. LOUISVILLE: lS'.'f., V/v\ Wf5lt Entered according to Act of Congress, by JOHN W. WRIGHT, A. M., M. D., In the Clerk's Office of the District Court of Kentucky. TO PROF. T. S. BELL, ,\l. D., Professor of Theory and Practice of Medicine in the Medical University of Louisville. As an exponent of my high regard for his attainments in Scientific Medicine, and for his personal and professional friendship, to him this work is inscribed by the AUTHOR. PREFACE. Submitting this work to the medical profes- sion and common people, I feel safe in saying that both alike appreciate the influence of the mind over the health of the body. This being a new science, the author cannot more than ap- proximate to completion. Scientifically consid- ered, Psychology is the science of all sciences, for without mind there is no science. Any in- fluence operating so powerfully on the health of the body as does the mind must at once be- come a proper object of study. The extreme practical tendency of the minds of men has caused them to overlook this important subject. The subject has been regarded as abstract, mysterious and impracticable; the truth is quite to the contrary. No science is moro practical or more important. This volume is submitted in the hope that thousands of our people by it may learn to ob- serve the laws and phenomena of mind and body in both health and disease, so that both the mind and body may befit the subject for the highest duties in the busy arena of life. Want of this kind of knowledge has ruined 6 PREFACE. many sparkling gems of intellect; many ro- bust bodies have become the blighted victims of disease. There is a false, very false notion in the minds of many in regard to the possi- bility of studying the mode of action of mind on body. There is no more trouble to see how the mind affects the body than to see how the body affects the mind. We know that the mind is reached through the bodily organism in etherization and intoxication, and by many other drugs. We know that the mind affects the bodily organism in blushing, turning pale from fright, &c. Medical Psychology, support- ed by common-sense philosophy is new, origin- al, beautiful, and of the highest importance. High Grove, October, 1866. CONTENTS. An Essay on the present Status of Medicine in this Country, page 9—Introduction, 31. CHAPTER I.—Psychology in relation to other Sci- ences, 39—Psychology—What? 39—Medical Psy- chology—What? 41—Its relation to Education, 43. CHAPTER II.—Psychology—Its relation to Practi- cal Medicine, 48. CHAPTER III.—The Cerebral Hemispheres the seat of the Intellect, 55. CHAPTER IV.—The Temperaments, 67—The San- guine Temperament, C7—The Lymphatic Temper- ament, G8—The Nervous Temperament, 09—The Billious Temperament, 70—General Remarks, 71. CHAPTER V.—Sense-perception, or the Five Senses, 75 —Touch, 78—Sight, 80—Hearing, 84—Taste, 89—Smell, 90. CHAPTER VI.—The Mind affected by the different states of the Nervous System, 95 —Sleep, 9G — Dreams, 101—Somnambulism, 101—Somniloquism, 105—Mesmerism, 105—Spirit-Rapping, 110—Ar- tificial Delirium, 114—Delirium of Disease, 115— Mania, 11G—Insanity, 117. CHAPTER VII.—Psychological Out-croppings, 119 —The Florid Cheek, 121—The Pallid Cheek, 124— Mental and Muscular Activity agree, 12G. Vlii CONTENTS. CHAPTER VIII.—Thought and Action, 131. CHAPTER IX.—Life a Magic Ring, 144—Infancy, 144—Youth, 152—Maturity, 163—Ago, 166. CHAPTER X.—The Human Will, 169. CHAPTER XI.—The Circulation, 130. CHAPTER XI[.—Respiration, 194. CHAPTER XIII. —The Skin, 205. CHAPTER XIV.—Digestion, 211. CHAPTER XV.—Secret"on, 2?1. CHAPTER XVI—Excretion, 228. CHAPTER XVII.—Sketch of Practice, 233—In- termittent Fever, 210—Typhoid Fever, 247—Re- mittent and Typho-malarial Fever, 251—Yellow Fever, 252—Measles, 253—Scarlet Fever, 254 — Cholera Asphyxia, 255-Cholera Morbus, 262 — Flux or Dysentery, 263—Small-Pox, 265—Rheu- matism, 266—Gout, 267—Colic, 268—Diphtheria, 269—Thrush or Apfchae, 270—Croup, 271—Cat- arrh or Bad Cold, 272 — Hooping-Cough, 273 — Asthma, 274—Dyspepsia, 276—Consumption, 279 Mumps, or Parotiditis, 280—Bronchitis, 281__Pneu- monia, 282—Pleurisy, 284—Spotted Fever, 285— Hysteria, 287 —Worms, 292 —Headache, 292— Toothache, 293—Neuralgia, 293—Best Modes of Preserving Health, 294—Conclusion, 299. A3ST ESSA.Y ON THE PRESENT STATUS OF MEDICINE IN THIS COUNTRY. The profession of medicine is a deep, learned Bcience. Not only is it a profound science, but a sublime art, considered either in respect to any of its parts, or as a symmetrical whole. He who boasts of his proficiency, his large, liberal attainments in medicine, as the result of one, two or three years' study, but boasts of his own ignorance. I regret to see the great in- difference shown by so many who practice medicine. They give little or no time to the real erudition of their profession. Of course qualification can not be estimated in years. One would learn more in one year than others would ever learn. It is the amount of knowl- edge acquired for which we contend. It is surprising to see what a large business some men can do, in the practice of medicine, on so small a capital. I think the status of the pro- fession is much too low in this country. It ought to be nearer what it is in England and Scotland. In this country there ought to be a 9 10 MEDICAL psychology. statute law in every State, defining the qualm- cations of a Doctor—the status which he must attain before entering upon the responsible duties of his profession. It ought to be that he commences practice because he knows something about it—not that he commences practice that he may by tampering with or de- stroying human life, learn something about medicine. I think we as a people might improve by the discretion of the government, shown in the selection of Surgeons during the late civil war. A Surgeon was not received except by due ex- amination. This examination was conducted by a board of learned Surgeons. The candi- date was not received because he was the stu- dent of some good doctor, or an Alumnus of some Medical College; but received when he proved himself worthy of the position which he sought. It can not be that human life is less precious out of the army than it is in the army. Why then shall not the guardians of public health look to the importance of this subject. I do not think such a course would at all im- pinge on the liberty of this country. I do not mean that any one who has a nostrum, may not have the right to sell it, if they can find a buyer. If an old woman has found an article good for a cold, let her sell it if she can find a present status of medicine. 11 buyer. But do not dignify her with the title of doctor in medicine. No one who has not received the degree of doctor of medicine is a doctor according to medical ethics. The vast amount of competition in the medi- cal profession in this country will tend to drop out quack-nosters. They can then retire to other pursuits for which they are far better qualified. It would be better for them, per- haps, and certainly much better for the com- munity. The great confidence people have in specific remedies is one cause why quacks flourish. Many persons have the idea that there is a specific, certain remedy for every variety and complication of disease. They suppose one has this specific while another is destitute of it. They apply to one, and he does not seem to help them immediately. They thence conclude that he has not the specific remedy for their particular affection. They then try another and another indefinitely. They thus make themselves the victims of the most arrant quacks. They ought to apply to a physician of tried and known judgment, and confide themselves entirely to him for treatment. There are few who confide sufficiently in this class of doctors. Specific remedies are very few in number; hence the folly of such con- 12 MEDICAL PSYCHOLOGY. fidenco on the part of the people generally. Take a physician of judgment who can treat the specific disease you have, and take care of your general health at the same time. I think a higher standing in the profession might be easily and harmoniously adopted. I do not speak with any reference to those who are now practising. Of course I mean no ex post facto law, but one which looks forward in its bearing. -The system I would suggest is to make the Medical Colleges and Universities more the ob- jects of public care. The Legislature of each State might appoint a board of learned doc- tors, fix their number, define their duty, and let the State pay the members of the board a salary, &c, &c. This board should examine each Esculapian disciple after he has gradu- ated in a chartered Medical College or Univer- sity. The effect of this on Medical Colleges would be to make them more strict and thorough in their course of instruction. Some Colleges or doctor manufactories run through, in due time, all the materials that enter. Num- bers bring in the money much faster than the quality. If their work had to be inspected by an impartial board before it was forced on the credulous public, they would reject at least one candidate every seven years. Numbers arc present status of medicine. 13 turned out every year that would not spoil from over maturity if held over until the next year. The effect on each student of medicine would be to give him a higher aim; use greater assi- duity in obtaining a higher degree of excel- lence. No student who is pursuing his studies in the spirit of sincerity and truth should feel these qualifications a curb to his efforts. Con- trary-wise, they should be a goad to his genius. I am often surprised, that young men entering the medical profession aim so low; do so little to advance their knowledge and bless suffering humanity as it groans beneath the burden of so many diseases; which burdens medicine is des- tined to lighten or remove. Many seem only to desire the amassment of money and not the gold of medical wisdom. This is indispensably necessary, that one pro- vide a comfortable living. Men of fine literary sense often seem to have no financial capacity at all. Financial sense is needed to keep one from embarrassment; at the same time afford the means of living while he can pursue hia studies. Nothing can be more certain than that expenses will keep up. Gains are always uncertain ; but expenses are certain. The fol- lowing is certainly an opportune sentiment: 14 MEDICAL PSYCHOLOGY. "For age and want, save while you may, No morning sun lasts all the day." While this sentiment expressed in linear measure is very true, there is no mental excel- lence without labor is just as true. There is wisdom in Mr. Webster's statement that there are always plenty of vacant rooms up stairs in every profession. This need only to be repeated to be believed. The upper rooms are never crowded, while the lower ones are always crowded. Applicants keep guard continually around the house to get in the the lower rooms. It is worthy of recollection that candidates for upper rooms must enter the lower ones first. They must receive the first degree before they can be raised to the higher degrees. I think many young men starting in profes- sional life most signally fail because they take higher positions than they can fill with either honor or profit to themselves. They have to abandon them with disgrace. The public con- fidence is thus destroyed. When they see that people have lost confidence in them, they then lose confidence in themselves. While if they would seek a position they could maintain, they might rise to a higher, after filling one lower. Stepping stones are of the greatest importance to those aspiring to PRESENT STATUS OF MEDICINE. 15 position in life. The scale of position is a graduated scale. Young men would do well to mark its gradations. They should study well the measure of their own ability to fill them. It is much more reputable to stand first in a common place, than be last in a high place. It is my purpose to say something in regard to the learned professions of this country. They are Theology, Medicine, and Law. If a man study the subtleties of Divinity, the study is as illimitable as the universe, and as vast as eternity, consequently I dont think it compara- ble to either Law or Medicine. I proceed to notice the comparative learning of Law and Medicine. In what I have to say of the legal profession, I do not ignore the profession of law. I am happy to say they have attained so much nearer the maximum of what they ought to be in our own country than has the medical profession. I regret most of all, that our profession, which should stand first in learning, estimation and guardianship of our countrymen, is now trailing. I think many fathers have a very in- correct idea as to the amount of capacity re- quired to make a good doctor. Of the boy who early manifests an aptness to learn, the father thinks he is a boy of fine promise, not because 16 MEDICAL PSYCHOLOGY. he is his boy merely, but because he has real mental ability. The father will say of that boy, I want to educate him for the law—I want to make a lawyer of him. That is very well: if he is determined to force the profession of law on his son, he will certainly need the ben- efit of an education. Of another boy much more stupid he will say, I want to make a doctor of him. Now let us look without.prejudice at the facts which underlie this mode of procedure. In the first place, the father assumes a false premise. It is that law is a more learned pro- fession than medicine. That this is a false premise I think I will satisfactorily show. The father, with his false premise assumed, sets apart his son of most natural ability for the law. The father, from his experience rea- sons thus: I have known men of small ability, little scientific and no classical learning, to suc- ceed in medicine. I know in reason they could not have succeeded half so well at law. But I do not think his success in medicine is because it is a less learned profession. It cannot be that the inferior boy succeeds because of his real intellectual ability. In the start it is admitted that he has not real ability. This fact is presented as a reason why he had best study medicine. Is it his eminent skill that gives him success ? No, for it is in the mouth PRESENT STATUS OF MEDICINE. 17 of every body that he is very unlucky; but some how or other people like him, and he is doing well—yes, much better for himself than his patients. Now father, I think he succeeds because the profession honors him much more than he honors the profession. Again, he suc- ceeds in medicine when he could not at law; because in law he would be placed on his real merit, there to stand or fall. We all think he would certainly fall. In medicine it is far differ- ent. He does not stand upon real, native, in- tellectual ability; but success crowns the altar of his labors, because he takes advantage of the ignorance and prejudice of the people. Most of all I think he succeeds in gaining repu- tation by the " Vis Medicatrix Natura," or the obvious tendency in disease to cure itself. Nearly all diseases are curative in their nature, except hydrophobia and epilepsy, &c. Hence the trite old saying, "we only assist nature" by the use of medicine. The ignorance on the part of many who practice medicine, as to what is health, and what is disease, is almost incredible. These are cardinal points in medi- cine, health, disease, pathology. It is of the utmost importance to know the conditions of the various organs in health and disease. The way in which medicine is now practiced in this country, I leave for others to say 18 MEDICAL PSYCHOLOGY. whether the injury done by blundering em- pirics is not as great as the good done by the scientific practice of intelligent physicians. I believe that a scientific doctor can give medi- cine and produce a given effect with as much certainty as the painter can mix paints to pro- duce a given color. This remark, of course, is applicable only where the physician under- stands the true pathology, hence, I argue the necessity of a higher status in the medical pro- fession. I now proceed to state my reasons for believing medicine (not its abuse) to be a more learned profession than the profession of law. 1st. Because medicine is related, either directly or remotely, to all scientific investiga- tions and discoveries. 2d. Because medicine is progressive, while law is fixed from the time of its enactment. 3d. Because the physician must often be a law maker, while the lawyer never is. He only expounds law already made by persons more august than himself. Readers, we now ask your unbiased contem- plation of these propositions, supporting the position that medicine is a more learned profes- sion than that of law. I think when you re- flect on the truth of them, that you must agree with me. In this investigation, truth is the PRESENT STATUS OF MEDICINE. 19 lone idol of my reverence, to fix reason and regale the intellect. 1st. Because it is related either directly or remotely to all scientific investigations and dis- coveries. Behold, how overthronged every chamber of your mind is by the phenomena derived from the simple kite experiment of Benjamin Frank- lin in June, 1752, who now stands a mental pyramid to the intellectual world. Every part of medicine being shaped in some degree by his investigations and discoveries, he has had a wonderful influence in giving shape and direction to much of medical research. All inquiring medical minds have attempted to grapple with the laws of that subtle fluid, electricity, discovered by him. I do not mean that the kite experiment gave Franklin the first idea he had of the existence of electricity. He then gained a more tangible idea of its behavior, of its plus and minus, or positive and negative conditions; the utility of the me- tallic point was then demonstrated. The knowledge of this has saved the life and prop- erty of millions. The protective power of the lightning-rod is easily demonstrated to the un- learned. A miniature house fastened together by springs furnishes a beautiful exemplification of the prophylactic influence of the steel point. 20 MEDICAL PSYCHOLOGY. If a stream of electricity is caused to pass upon it when there is no rod erected, it is imme- diately thrown in pieces; but if a rod is erected, the destructive agent is harmlessly led away. The house stands symmetrical in all its parts. Not a spring is unfastened. This simple experiment once seen, is satisfactory to the feeblest intellect of the utility of the light- ning-rod. I feel,, kind reader, you will pardon my digression to amplify, as this little work is not expected to be confined exclusively to the members of our profession. In 1785, Cavendish, aided by the electrical spark, first analyzed atmospheric air. By this analytical process, he resolved air into its porteine elements. See with wondering admiration what an im- mense influence this scientific investigation and discovery has had on medical science. All our knowledge of oxydation in the process of respiration is traceable to this analysis as its fountain source—how oxygen is given to the various tissues of the body and carbonic acid exhaled. That this is true, one can easily prove by blowing his breath in lime water. In a short time the transparency of the water is changed by the appearance of carbonate of lime (common chalk.) The milky appear- ance of the water proves the existence of car- PRESENT STATUS OF MEDICINE. 21 bonic acid. The converse of what we see in animals is true of plants. They appropriate carbonic acid to their cells by which they grow and exhale oxygen, as if nature would thus show us an example of economy. She gives to animals what plants manufacture and give off She gives to plants what animals manufacture and part with. Nature in this seems to econo- mise and keep the elementary constituents of air in equilibrio. In corresponding ratio the analysis of water has had its influence on the science of medicine. No intelligent per- son can say, in truth, that these discoveries have not had a mighty influence in giving shape to both the science and art of medicine. These facts noticed are only units of the thou- sands of others which might be cited to show that medicine is related, either directly or remotely, to all scientific investigations and dis- coveries. In law, there is no such a relation existing. It is unaffected and unchanged by the proud march of science, or the sublime triumph of scientific investigation and dis- covery. The practitioners of law have no cycles of science with which to keep pace. Tn medicine he must keep up with the multifari- ous conquests of science, or forever play be- hind the curtains in the corner of ignorance. 22 MEDICAL PSYCHOLOGY. They cannot come upon the stage to play in the great theatre of intelligent professional life. II. Because medicine is progressive, while law is fixed from the time of its enactment. Medicine is continuously progressive. Each profound cycle of science stamps its impress on medicine, while law is fixed, or at least written. For common or unwritten law is only a logical deduction from written law. Each successive step in the endless march of medicine; each successive link in the golden chain of knowl- edge makes us feel— " What's now discovered only serves to show, That's nothing to what is yet to know." See what a shining revolution in medicine the use of the microscope has made. So mighty and so accurate are its infinitessimal and molecular wonders, that the issues of hu- man life and death have been suspended on the knowledge gained by its use. The fate of criminals in courts of justice have been made to culminate in the truth of microscopic revela- tion. Not only so, but the safety and rescue of thousands from the immediate ravages of disease is due to the use of the microscope. All these facts show the progressive tendency of medicine. Eeasoning a posteriori, or from effect back to cause, wc arc enabled to account PRESENT STATUS OF MEDICINE. 23 for myriads of phenomena which would other- wise be as dark to the mind as Egyptian night. The microscope has bathed diagnosis, progno- sis, and intelligent pathology, in floods of re- splendent light. What a correct idea of the pathology of pectoral diseases is obtained when the sputum is placed under the range of the microscope. It reveals with such unerring cer- tainty, that Dr. Bennett easily detected a feigned hemorrhage in a case of bronchitis. The patient, when told by Dr. Bennett that the blood corpuscles were those of a bird, the blood of which she had mixed with her own expecto. ration, she became alarmed and said she had done it for the purpose of deceiving him. This case is instanced to show the truth of micro- scopic examination. It was Dr. Bennett's knowledge of the shape of the blood corpuscle which enabled him to detect the deception. This knowledge he had, in the first place, gained by the use of the microscope. A truly great instrument it must be to give the shape, appearance and dimensions of a body so small as a blood corpuscle, when its diameter is only one four-thousandths of an inch. To deter- mine its bi-concavity, its comparative size, its bright rim and its opalescent centre; all this is done by the microscope, an instrument, the name of-which indicates its use. Its name 24 MEDICAL PSYCHOLOGY, is from /juxyor, small, and a-oxzco, to view. About the real idea is a magnifying glaes to view small objects at a short distance. The stethoscope gives us a more accurate knowl- edge of the normal sounds of the thoracic or- gans. This is what "its name implies; but I think its name is rather a misnomer. Its de- rivation means this: oredor, the breast, and axorrsat, to examine; but its use means a sound conductor, not only from the breast, but from the abdomen or elsewhere. This instrument increases the force of sounds. Sounds other- wise inaudible, are by the stethoscope rendered audible. If we know the normal sounds of organs in health, we can readily detect the ab- normal sounds in disease. The thermometer also lends its progressive aid to the science of medicine. The thermometer is an instru- ment for measuring heat from ■d-sp/mr, warm and fitrpov measure. Heat is divided into latent and free. It is the free heat which we measure with the thermometer. It gives no knowledge of the latent heat which the bodies contain. The Hygrometer, like the other instruments noticed, lends its impetus to increase the velocity of medical progression. Hygrometer an instrument for measuring the degrees of PRESENT STATUS OF MEDICINE. 25 moisture of the atmosphere. If farmers had one, it would assist them very much when they have such an intense desire to know the pros- pects of rain in a drouth. We have then the microscope, stethoscope, thermometer, hygrom- eter, all acting as so many inlets, which pour their contents into the ever-swelling and ever- flowing stream of medical progression. Pro- gression is stamped upon them all in golden capitals, standing out in bold relief to every inquiring mind. These are only a few means by which medicine progresses. Besides these are the thousands of chemical apparatuses, chemical agents, and re-agents, chemical actions, and reac- tions, with the almost innumerable chemical tests. All these bespeak the proud achievements of science. They teach us that by their aid the progress of medicine is ever onward—the goal of original research still soliciting with its lustre of beauty and unrivaled grandeur. These few hints arc sufficient to establish the proposition that medicine is progressive —that no such progression exists in law, con- sequently the greater degree of learning is necessary to master medicine. Law is a fix- ture from its enactment. Medicine is ever subject to change from every new ray of light emitted from the ever-glowing sun of science. III. Because the physician must often be a 3 26 MEDICAL PSYCHOLOGY. lawmaker, while the lawyer expounds the law already made by persons more august than him- self. If it is argued that medicine is writ- ten as well as law, true, much in medicine is written. Alas, it is too true that much is falsely written. It requires the soundest learning, and the best judgment, to know what is false and what is true. Judgment and reason must be combined with close observa- tion to make a good practitioner of medicine. It may not be improper here to discriminate between judgment and reason. Judgment is synthetic, and reason analytic. Judgment places together the component parts, and draws therefrom an opinion. Reason separates the component parts for examination or analysis. After the separation for examination, and each part consecutively examined, then the opinion is made up of the whole from the examination of all its parts. When the parts are united and an opinion is made up of the whole, this is the office of judgment. In medicine, laws are varied to suit the case. He is a miserable, blundering, blind empiric, who treats every case alike. All must, in the very nature of things, turn upon the pinion of his judgment and common sense. By common sense, I mean a knowledge of men and things. A physician who uses remedies without understanding the PRESENT STATUS OF MEDICINE. 27 true pathology, and without knowing the true philosophy of their action, is about as often a speedy messenger of death, as a minister of health. He must, of necessity, practice in this way if he confines himself to books strictly, and has not judgment or ability to vary the laws of medicine to suit a given case. No such order is necessary in law—the strict letter and meaning of the law is the guide. The proper construction of the language of the law is what is mainly necessary. This properly done, its judicious application to a given case only remains. A law in medicine is the same as a law elsewhere; it is only a rule of action. No man in the practice of medicine can have a fixed rule of action. He must hear the evi- dence in the case and make his rule of action from this data. Symptoms vary, constitutions are unlike; therefore, a man's judgment must vary each treatment. All judicious, skillful practice of medicine must be founded on this principle. Every thing must turn upon the pinion of his judgment. No practitioner can administer opium to infants with the same impunity that adults bear it. For, indeed, no one can be too cautious about giving to infants any prepara- tion of opium even in the smallest quantity, while on the contrary they bear mercury much bet- 28 MEDICAL PSYCHOLOGY. ter when the dose is proportioned to the age of the recipient. A safe, cautious practitioner, would not use aloic purgation in the case of a parturient female. The danger would be, too great peristaltic action of the bowels. This might cause uterine contraction, and uterine contraction produce abortion. It may be said that this conclusion is derived by sorites, or chain argument, nevertheless it is certainly true. Under other auspices than the above named, aloic purgations might be safe and proper. It is needless, I think, longer to pur- sue this point. I have heard the remark from eminent jurists that medicine was a more learned profession than law. Among them I mention the name of Judge C. W. Logan, of Louisville, who has now fallen asleep ; but that he possessed a fine legal mind, no one will have the hardihood to deny. Truth and fidelity to his client is the lawyer's business. To construct a new law is not the business of a practitioner at the bar. That is the business of a states- man. In short, a correct statement of the dif- ference between a lawyer and a doctor, in re- gard to the point we are considering is this: the lawyer expounds fixed or written law that bears on a given case. The physician con- structs a law to suit a given case. The lawyer has the law and case both given. The phy- PRESENT STATUS OF MEDICINE. 29 sieian has a case given, and he has to make a law for the government of it. Again the con- clusion recurs from each and all the three combined propositions, that medicine (not the abuse of medicine) is a more learned profes- sion than law. I do not think my remarks derogatory to the legal profession. I congrat- ulate them, that their profession, as a body in this country, is so much nearer what it ought to be than is our own time-honored profession. INTRODUCTION. Every practitioner of medicine is aware of the mighty influence which mental emotions exert over the different states of bodily health. Why, then, shall we not study the mysterious "modus operandi " and learn the true philoso- phy of their action? It is very easy for men to descant loudly about what a work on psy- chology in its relation to medicine ought to be. In this way they can remove difficulties viva voce, as if the difficulties possessed only the levity of a feather; but when they would begin to compose and make it what it ought to be, they move difficulties as if they possessed more gravity than lead, or rather more often they would not remove them at all. It is the weak- minded, the superficial and the ignorant who are readiest to try to bring plain science into ridi- cule, leaving out of view the fact that " true learning is always simple." It is only the su- perficial and the galvanized kind of learning that is so very ostensive. Real science, as it approximates to truth and completion, is always more simple. Adam 31 32 MEDICAL PSYCHOLOGY. Smith very justly remarked that machinery was always more complex when first invented. True science only can render it more simple. The greatest of labor is requisite to say great things in few plain words. Often when this great labor is bestowed, the great truth told, it seems only a very plain proposition. This sim- plicity the master minds most appreciate, while the weak-minded feel that there is but little spoken of importance because it is not covered in the profusion of language. Ho who makes the attempt only can know the difficulties ris- ing in lengthened lines at every step before him who investigates the mysterious and mazy lab- yrinths found in the kingdom of mind. For four dark and bloody years the fortunes of war has held every thing at such an uncertain tenure that I have been depressed, dispirited and hindered from an undertaking at once so towering aud sublime. To tell the precise ac- tion of mind on matter I cannot, you cannot. Perhaps we are destitute of a faculty that would enable us to do so. One thing we do know, that there is a nexus, or connecting link between mind and matter which we cannot ex- plain. No theme can be more profoundly mysterious than the hygienic relation of mind over the health of the body. The radiant gleam of hope which we now have, shows that INTRODUCTION. 33 the retarding influence of war may soon be re- moved, and our political sky be calm, serene, and beautiful. No desire of novelty moves me as I write, it is only a sincere and unabating desire to seek and to communicate the gold of knowledge. If I shall only plant the germin- ating seeds of original research in a field so fer- / tile with the sparkling gems of thought, that will J realize my most consummate wish. The high- i est object of my life culminates in obtaining ■ and disseminating knowledge. It must be that in future years more attention will be given to this subject so pregnant with importance to every human being. It may be that I shall only hint at principles which minds \ more profoundly mature, will to the world un- fold. The scintillating spark of this volume may ignite matter, the blaze of which shall shine to the world with as much effulgence and bsauty as the light-house offers at night-fall to the anxious mariner on the uncertain ocean. Here, in the course of my general remarks, I do not think it improper to notice the term mind and soul. I think the obvious difference between the two terms is, that soul is more comprehensive than mind. There are certain things predicable of the soul which cannot be affirmed of the mind. When the term soul is used, it carries with it the idea of a moral na- 34 medical psychology. ture, something which makes us intuitively feel approbation in view of a right course of conduct and disapprobation in view of a wrong course of conduct. This moral nature, or moral faculty, we attribute to conscience, a power given us by our creator. Now to illus- trate the difference between mind and soul: beasts have minds which manifest themselves in various ways. We know they have memo- ry and will, with as much certainty as we know the sun is bright or the earth is round. Hence we often observe that a brute once bad- ly frightened, ever afterwards remembers it. I was riding one day in my uncovered buggy, and hoisted my umbrella, which frightened my horse very badly, and he seems never to have forgotten it. If we are harmed by a brute, we may intimidate it with blows to prevent the repetition of that harm. It would be most foolish in us to administer blows, if we did not think that the brute would remember the cor- rection. We must rationally conclude, also, that the muscles of their bodies move in obedi- ence to their wills. When a blow is applied to any part of their bodies, the sensation of pain is given by the nervous centres, for pain is the cry of agony, coming from the affected part. In regard to the actions of human beings, we cherish quite a different class of feeling. INTRODUCTION. 35 All human courts of justice are founded on this principle: that all its subjects possess knowledge of a higher grade than the brute. However much the actions of a brute, and those of a man may agree in many respects, there are others in which they very widely differ. We should feel quite differently towards a par- ent who would destroy its child, and a brute that should destroy its young, We should have a moral loathing and disgust toward the parent, which we never feel towards a brute. The foundation for human responsibility is laid in the moral constitution of the mind. It is this which makes man a responsible, moral agent— a fit subject of moral government. We thence predicate of man, that he possesses a soul, because he has this moral nature. We have no evidence of its existence in brutes, therefore, we predicate of brutes, mind only. Men have minds, brutes have minds also. Men have souls, but brutes have no souls. This is the true-de- duction. The difference between mind and soul is, that soul is more comprehensive than mind in its application. Mind comprehends intelli- gence, will, memory, &c, but soul comprehends all that mind does, and a moral nature besides. Unless this is the proper discrimination between the terms mind and soul, brutes possess a soul. We have no evidence that brutes possess a 36 medical psychology. moral nature, therefore they have no soul. We have evidence that they have minds, therefore we say they have minds, but no soul. Man gives evidence of what we call mind in brutes, and he gives evidence of a much higher grade of powers, which we call a moral nature. We therefore affirm of man, that he has all that is meant by mind or soul, while brutes cannot have more than mind, at least we have no evidence that they possess a moral nature. The question has been asked, " What more hath man than instinct, what less hath the brute than reason?" Every judicial pro- ceeding must be governed by the evidence given. We have just as good evidence that man has a moral nature in addition to instinct, as we have that the vegetable world is clothed in green. We have no evidence that brutes reason from known facts to derive unknown conclusions. The a priori process is never shown in their actions. This is the part of human reason, to trace a cause to its legitimate effect, or conversely, to reason a posteriori, or from effect back to its cause. In the absence of all such evidence on the part of beasts, we conclude that human reason is much above the highest exhibition of reason manifested by brutes. In answer to the question, what more hath man than instinct ? In the first place, he INTRODUCTION. 37 has reason which is of a much higher grade than instinct. Secondly, he has a moral nature which elevates him far above the instinct of brutes. The beast has a great deal less than human reason, because human reason takes known facts to arrive at unknown conclusions* The most exalted stretch of brute reason gives no evidence of this high grade of reason which we choose to denominate human reason. I have been diffuse in my general remarks about mind in a general sense, that we might the better understand the restricted sense in which I shall use it in this book. I shall of course use it to mean the human mind. In this restricted sense, I shall not use the term mind in contra- distinction to the term soul. Psychology more naturally suggests the word soul, but I shall use mind as its equivalent. When thus used, mind is restricted to the human mind. Thus used, it is the synonym of the word soul. No one can object to this use of the terms, if they themselves choose greater precision. For it is 'allowable in discussion, that a person make their own definitions and use them accordingly. CHAPTER I. PSYCHOLOGY, IN RELATION TO OTHER SCIENCES. Psychology, what ? A discourse or descrip- tion of the human soul—the sublime science of mind. The word psychology, is so much more definite than mental philosophy, that I select it in preference to to that term—Psychology, from f)suken, soul, and logos, discourse. It has for its object, the investigation of the facts and laws of mental operations. This is the great emporium of science, for there is naught of sci- ence at all without a mind to conceive it. It is within the awe-inspiring precincts of the mind, that so many streams of knowledge well up. Such a stream is the science of number, the science of quantity, and the science of astrono- my, &c. Our ideas of time and space are pure- ly productions of the human intellect. The human body, curious and wonderful as it is in its formation, wide, extending as are the laws by which it is governed, is nevertheless infinite- ly inferior in worth and dignity to the lordly 39 40 MEDICAL PSYCHOLOGY, spirit that dwells within this fair castle, presid- ing over its beautiful domain. Anatomy is deeply wonderful, but psychology is superla- tively more wonderful. It is this which places us upon the summit of intelligence, and gives us the mastery and lordship over this lower world. As all the numberless converging paths at the mountain's base, point to and culminate upon its summit, so all the sciences point to, and culminate in the science of mind. Psy- chology is the golden nucleus around which all the other sciences arrange themselves, as so many sparkling points in the galaxy most superb. Men carry their investigations and inquiries to the home of the stars. Why not study and classify the operations of their own minds, as well as arrange the stars in classes and constellations? When the astronomer places his eye to the telescope to behold the wonders of far off worlds which inhabit their starry homes, why not turn his meditations within, and say, what is my mind? for it is this alone which enables me to be cognizant of any of the revelations of science. Shall it be neglected because it is mysterious ? Is not its importance as great as its mysteriousness? Lover of learning, do not neglect this important theme because it has no cabinet of splendor filled with royal paintings and relics of distant IN RELATION TO OTHER SCIENCES. 41 countries. The mind is like the strata which underlies the mountain, giving it shape and contour, as it pierces the bending opalescent cloud. The silvery mountain of science rest3 upon the strata of mind. Medical Psychology, what? It investigates the science of mind as related to the science of life. That the operations of the human mind effects very much the conditions of health, no person of intelligence can deny. The phy- sician soon observes the mind to be the secret spring of human action. With this observa- tion, he makes the mind an important part of his study, although he may not understand how the mind effects the living tissues of the body. He must be aware that it exercises a great in- fluence over them. A well-timed word often does more good than a medicine. It is the great placebo which often quiets muscular, nervous, and arterial excite- ment. In order to understand the true pathol- ogy of a disease, it is necessary to know the effect caused by the exertion of each of the mental faculties. One great truth, we must bear in mind in considering this subject, is that the mind is a unit—one and indivisible— not capable of separation into parts like the body under the dissector's blade, although the mind is one immaterial, indestructible spiritual. 4 42 MEDICAL PSYCHOLOGY, substance. Yet for the sake of description we give its faculties appropriate names. This nomenclature becomes necessary from its func- tions. By a faculty of mind is meant its power of action, or of performing some op- oration. These faculties or powers of mind have as many different names as the mind is capable of performing different operations, such as thinking, feeling, acting, remembering, imagining, judging, perceiving, reasoning, lov- ing, fearing, hating, desiring, choosing, reject- ing, &c, &c. When we speak of the mind per- forming those actions, they are not to be con- sidered as parts of a whole, for the mind is not separable into parts. It is one spiritual substance manifesting itself in all these various ways. It is conceded that the pleasures of fan- cy are more conducive to health than those of the understanding. Those of the understand- ing are wrought out by the dint of thinking— they require mental exertion. Each mental effort must reasonably induce some degree of bodily depression. If this is not true, why is it that the student feels so prostrated after a day of hard study? Why is rest and relaxation so sweet to him? Why does his bodily powers demand recuperation? It is because his mind has been at work, and this mental effort tends tQ oppress and depress the vital powers. The IN RELATION TO OTHER SCIENCES. 43 expenditure of nervous force causes 'exhaustion. Medical psychology seeks to know the true phi- losophy of the phenomena—to trace the men- tal cause to its legitimate physical effect. We often hear of the different states of health be- ing materially affected by the violence of men- tal emotions. This, no doubt, is often the real cause—mysterious and ill-understood as it is, it must doubtless often be true. Its Relation to Education. This science must be of the greatest importance to the teacher who understands it, and judiciously ap- plies it in his instructions to the youth. In this way, he may learn them the wisdom of the motto I vcoOc 1'saurov. For to know" thyself is the par excellence of all wisdom. This is what med- ical psychology assumes to make known. We never can learn to make close discriminations until we know something definite about the science of mind—we see the manifestations of mind through matter. The immaterial mind displays itself through the material organism of the body. Then, as all our ideas of mind are obtained while that mind is united to a liv- ing body, how important must this science be to a teacher who has to train the young mind in such a way as to strengthen its powers, and increase the bodily vigor to maintain its mental strength. We see a want of this knowledge 44 MEDICAL PSYCHOLOGY, often, when we enter the school-room, and see | the pale, enemic child, who is dwindling away for want of proper attention to the vigor of ] mind and body. These must be kept as near ' in equilibrio as possible. When the mind of a child is much stronger, in proportion, than the body, the body is apt to languish; defective nutrition and secretion are apt to supervene, thus the dire seeds of disease are well planted in its constitution. Give that child plenty of free air, a good nutritious diet at proper inter- vals. If the season is winter, warm clothing. Encourage the pleasures of taste and fancy. The child cannot always live in the regions of intellect. Too much labor of mind weakens the body, and bodily weakness weakens the mind ultimately. Both then, enter the vortex of ruin together. The dearest, brightest hopes of the fond parents are forever lost. On the contrary, if the child is plethoric, and fond of the pleasures of sense, encourage him to study, stimulate him by every possible motive. Kindness and sincere interest in the pupil's welfare, secure the best possible control over the child. Brute force, to govern the child and make it virtuous, has deservedly gone out of fashion. This practice has perished with its using; but virtue is indispensable to the well-being of each child, as well as to the IN RELATION TO OTHER SCIENCES. 45 school or civil government. I think if more time in schools was spent in inculcating the principles of virtue and morality in general, instead of indoctrinating the young mind with the dogmas of some particular church, the world would be much better. He is not a competent teacher who knows only the knowl- edge he wishes to impart, and does not know the nature of the mind to which he is seeking to impart that knowledge. The mind is a harp of many strings. The teacher must not only know the music he wishes to play, but must understand how to use the instrument on which he is to play. The mind is the instrument, the teacher's knowledge the music. The body is the man who keeps the instrument in order, and gives it tone. The teacher must be pro- ficient in all these, if he is efficient in teaching. Medical psychology must, of necessity, be very intimately related to education, and to our own personal interest and < happiness. We study the heavenly bodies which move on in si- lent majesty, regardless of man or his des- tiny. The cycles of mathematical science, age after age, has marked their swift but silent mo- tion, as they move on in the calmness of their own eternity. They moved, age after age be- fore we came on the stage of existence, and will probably move age after age, when we 46 MEDICAL PSYCHOLOGY, have left life's stage forever. If we extend our inquiries to science, so remotely connected to us, shall we not study one so directly bearing on our own interest and happiness as the one we are now considering. Medical psychology, unlike these inquires, assumes a practical nature. It is not inquiring after worlds afar off, beautiful and unknown. It is a question practical in importance. What am I ? What is this body, so fearfully and wonderfully made? What is this mysterious soul, which animates my body, and is the pre- siding divinity over all my actions? What is that mysterions change which comes over me, called sleep ? What is that final change which must come over me, of which sleep is the image, that change you call death? What is that principle you call conscience, which, when I do wrong, it fills my soul with misery, and my very existence overruns with remorse? What is this will that moves my body in obedience to its volitions ? Does divine provi- dence pre-determine this will, or am I free to enter the malestrom of ruin, or pursue the pathway of virtue which leads to happiness. These are questions which we should study, not as abstractions, for they have an extremely practical bearing on our personal interest and happiness. This study tends, in an unpar- IN RELATION T« > OTHER SCIENCES. 47 alleled degree, to sharpen and to quicken all the powers of the mind. It trains the mind to discriminate closely and correctly, to place things in their proper relation to each other, to make original research after the cause where the effect is known. Personal interest and happiness must be greatly dependent on a research of so much importance as that of medical psychology, which seeks to investigate the laws which govern both mind and body. CHAPTER II. PSYCHOLOGY—ITS RELATION TO PRACTICAL MEDICINE. Psychology, and its application to practical medicine, is supported by facts just as conclu- sive as the facts which support any of the sciences. All physical science rests for support on the laws, facts, and phenomena attending its ex- istence. All we know of matter, is the phe- nomena it presents to our senses. When our physical organs come in contact with an exter- nal object, our first sensation is that we met with resistance, otherwise we should not have known that a door, a chair, or a table had impeded our advance. This is only the report of the tactile senses to the mind. They commu- nicate the sensation through the nervous fila- ments to the brain. The brain is the whisper- ing gallery of the soul, profoundly more won- derful than the whispering gallery of Paris, France. The machinery of mind works noise- lessly, yet with none the less power. Volcanic 48 ITS RELATION To PRACTICAL MEDICIFE. 49 influence may be generated in silence, but that does not destroy its terrific power. We know what it is only from its phenomena. The same is true of mind, we know it presents us with various phenomena, and that certain laws gov- ern its existence; but what matter is in itself, or why is it so, we cannot know. Neither can we know what mind is in itself, or why it is so. This is the sum total of what is meant by incomprehensibility. We know the fact, but how it is so, or why it is so, we do not, cannot know. Facts alone must furnish the data which must control the human reason, whether it is considering the kingdoms of matter ex- ternal to itself or its own mysterious kingdom. The mind is an imperium in imperio. A ques- tion may be instituted, how can the mind know the mind? Can the eye see itself? No, the eye cannot see itself. But it presents us with phenomena by which we know its existence. While this may seem to be an objection to psychology as a science, it is a real advantage in its study. The mind does not have to take its flight to far off star-lit worlds for facts. Its facts are at its own command, and self- possessed. The astronomer may turn ps}*chol- ogist by taking his eye from the telescope, and turning it within and make "mankind the great study of man," inquiring what is this 5 50 MEDICAL PSYCHOLOGY, lordly influence of mind making all the mem- bers of my body its obedient servants; con- troling muscular activity at the option of my will. This principle is indestructible, therefore immortal—whence, then, is my destination— amid the destruction of the. material world, and the fearful wreck of the created universe. What is this, mysterious state called death, of which sleep is the image? What is this dread-inspiring separation between soul and body; when the body returns again by decom- position to the mother dust. You need, not arouse from the dream visited stupor of ignor- ance to study psychology as an ideal delusion, (for it is the diamond corner stone of all science; the life-breath of all knowledge. Psychology is the starting point of all science. There would be no science without mind to- conceive it. Science is purely a construction of the mind. Psychology is the people's instructor and the physician's treasure. Do you tell me that all intelligent actions are governed by the mind? I do, unhesitatingly says the mental philosopher. Does the mind give an impulse through the nervous system, which causes the muscles to contract, and motion is the result. Yes, says the Anatomist and Psychologist sim- ultaneously. Psychology and medicine are full partners in the play of life, both in health and ITS RELATION T