Psychotherapy Part 6

CHAPTER VI

QUACKERY AND MIND CURES

Not less interesting than the therapeutic results obtained by men who in good faith were using inert remedies that they thought effective, are the cures obtained by men who had good reason to know that the therapeutic methods they were using were quite inefficient. Their good results, often loudly proclaimed by healed patients, are obtained entirely through the patients' minds. Usually these men are supposed to possess some wonderful therapeutic secret, which they have obtained by a fortunate discovery, or by long years of study, though usually their discovery is a myth and their long years of study a fable. So long as people can be brought to believe in their powers many cures are sure to follow their ministrations. The real secret is their knowledge of human nature. They induce people to tap new sources of vital energy in themselves, and somehow they succeed in bringing to their aid this law of reserve energy. Besides, in many cases the real reasons why patients continue to have certain symptoms once they have been initiated, is that their worry about themselves inhibits their natural curative power. This inhibition is prevented or obliterated by the change of mind produced by the quack, and then the _vis medicatrix naturae_ brings about a cure.

Probably the oldest story that we have of a quack in our modern sense of the word is found in the Arabian Nights, some of the stories of which were old even in the time of Herodotus. One day Galen, famous for his work at Rome in the second century after Christ, found a wandering healer pursuing his avocation in his front yard. He found also that this man succeeded in relieving certain patients for whom he had been unable to do anything. He {47} found that the medicines prescribed were likely to do harm rather than good, yet many of the patients were benefited.

Galen succeeded in winning the man's confidence, who told him his story. He had been a weaver, but his wife thought he was not making money enough to support her properly, so she had advised him to become a leech. After taking lessons from a wandering quack, he set up for himself. When Galen inquired as to his method of making a diagnosis, he found that he did it entirely by his knowledge of human nature. He was even able to tell what was the matter with patients at a distance when friends came to demand medicine for them.

We think that such ready deception was possible only in earlier times, when education was not widely diffused and when belief in superst.i.tions was fostered. Any such idea completely ignores the modern status of the quack and the success that he meets among even the more intelligent members of the community. Indeed, with the diffusion of information in modern times the quack has secured a wider audience. Superficial ideas of science are disseminated by the newspapers and by the magazines, people think that they understand all about it, and then these ideas are turned to their own advantage by the irregular pract.i.tioners of medicine. We have quacks by the score in all the centers of population, making a livelihood by exploiting the ailing, and serving to no small extent to create a feeling of popular discontent towards the physician, because that serves the purpose of quackery. Indeed, it is during the past century or a little more that some of the most striking examples of quackery have occurred.

Cagliostro.--Cagliostro, whose story is told in Dumas' "Memoirs of a Physician," and an excellent account of whose life may be found in Carlyle's "Miscellanies," is one of the great quacks and humbugs of history. He began his supposed medical work at Strasburg by the modest claim that during his travels in the East he had found a series of remedies which made old people young. In proof of his power to do this he exhibited his wife. She was a handsome young woman of very shady reputation whom he had married on his travels. She professed to be sixty years of age, though she was really under thirty and looked it, but she claimed that she had a son who had served for many years in the Dutch army. This imposition was so effective that in Strasburg, and subsequently in Paris, the charming pair collected large sums from wealthy old persons, especially from women on whom the marks of time had begun to show, and who expected, as the result of the treatment, to be shortly as young and as handsome-looking as Madame Cagliostro herself.

We might think that it is quite impossible for any such a deception as this supposed renewal of youth to be practiced in our more enlightened day when popular education is so widely diffused. We must not forget, however, that the newspapers bring us evidence every month of some old person who is quite sure that something that was being done for him was, if not renewing his youth, at least giving him back much of his pristine vigor, healing his aches and pains, and enabling him to take up his work once more. In treating the ravages of old age, which would seem to be altogether beyond any influence of psychotherapy, some of the most striking results are obtained. New therapeutic methods for the old come into vogue every year. As they grow older, {48} people become discouraged and so do not exert even the natural energy that they have for the maintenance of health and the keeping up of strength. Their discouragement keeps them from exercising enough, and this decreases appet.i.te and sleep, and as a consequence there are many disturbances of function. All of this disappears as soon as they feel encouraged. Brown Sequard and his extract of testicular tissues is a typical example of how strong suggestion may influence the old and make them think that they are renewing their vigor and strength, and even their youth.

Perkins, Prince of Quacks.--Shortly after Cagliostro an American succeeded in using a very simple idea to gain world fame and at the same time to make an immense amount of money. He was a Connecticut Yankee with the typical name, Elisha Perkins. Dr. Perkins must have been born under a lucky star; at least he lived in fortunate circ.u.mstances for his purposes. Galvani's discovery of the twitchings that occur in the frog's legs when a nerve-muscle preparation or its equivalent was touched by metals in contact, had aroused world-wide discussion as to the place of electricity and magnetism in biology.

Volta's brilliant experiments, which led to the invention of the Voltaic Pile, still further increased men's interest in this subject.

It was then that Dr. Perkins came to exploit these electrical and magnetic ideas in medicine by means of a very simple invention. It was indeed the simplicity of his apparatus that made its appeal even more wide than would otherwise have been the case, and, be it said, left a larger measure of profit for the inventor.

Oliver Wendell Holmes in his "Medical Essays" [Footnote 4] has told the story of what may be called the rise and fall of tractoration. Any physician who wants to appreciate the real significance of cured cases should read Holmes' essay. We quote:

[Footnote 4: Houghton, Mifflin Co., Boston.]

Dr. Elisha Perkins was born at Norwich, Connecticut, in the year 1740. He had practiced his profession with a good local reputation for many years, when he fell upon a course of experiments, as it is related, which led to his great discovery. He conceived the idea that metallic substances might have the effect of removing diseases, if applied in a certain manner; a notion probably suggested by the then recent experiments of Galvani, in which muscular contractions were found to be produced by the contact of two metals with the living fiber. It was in 1796 that Perkins' discovery was promulgated in the shape of the Metallic Tractors, two pieces of metal, one apparently iron and the other bra.s.s, about three inches long, blunt at one end and pointed at the other. These instruments were applied for the cure of different complaints, such as rheumatism, local pains, inflammations, and even tumors, by drawing them over the affected parts very lightly for about twenty minutes. Dr. Perkins took out a patent for his discovery, and traveled about the country to diffuse the new practice.

[Footnote 5: (Transcriber: This footnote is not numbered in the text but appears to refer to the preceding paragraph.): In one of Plautus' plays there is a curiously interesting expression that is recalled by this subject. The dramatist described one of his characters, Sosia, as thrown into a sleep by the manipulations of Mercury. These manipulations are described as _tractim tangere_--that is, to touch strokingly. It would remind one very much of Perkins' Tractors, and in this regard the fact that Mercury was to the Romans, besides being the messenger of the G.o.ds, the divinity of thieves, seems not without interest.]

Just what the tractors were composed of may be found in the description of them filed with an application for a patent in the Rolls Chapel Office in London. They were not simply two different metals, but a combination of many metals, with even a little of the precious metals in them, partly because {49} of the appeal that this would make to the mult.i.tude, as chloride of gold did to our own generation, but doubtless mainly because the claim of precious metals entering into the composition enabled the inventor to sell his tractors at a better price.

Dr. Holmes continues:

Perkins soon found numerous advocates of his discovery, many of them of high standing and influence. In 1798 the tractors had crossed the Atlantic, and were publicly employed in the Royal Hospital at Copenhagen. About the same time the son of the inventor, Mr.

Benjamin Dougla.s.s Perkins, carried them to London where they soon attracted attention. The Danish physicians published an account of their cases in a respectable octavo volume, containing numerous instances of alleged success. In 1804 an establishment, honored with the name of the Perkinean Inst.i.tution, was founded in London. The transactions of this inst.i.tution were published in pamphlets, the Perkinean Society had public dinners at the Crown and Anchor, and a poet celebrated their medical triumphs. [Footnote 6]

[Footnote 6: "See pointed metals, blest with power t' appease The ruthless rage of merciless disease, O'er the frail part a subtle fluid pour, Drenched with the invisible galvanic shower, Till the arthritic staff and crutch forego And leap exulting like the bounding roe!"]

Miss Watterson [Footnote 7] tells how he attracted attention. Like all successful quacks, he had an inborn genius for advertising.

[Footnote 7: "Mesmer and Perkins's Tractors,"

_International Clinics_, Vol. III, Series 19. 1909.]

He lived in the house once occupied by John Hunter [how characteristic this is--the first quack we mentioned in this chapter, took up his work in Galen's front yard], and in 1804 the Perkinean Inst.i.tute was opened, but by the end of 1802, 5,000 cases had already been treated. Lord Rivers was president. Sir William Barker, Vice-President [Prominent legislators, lawyers, bankers always lend their names.] Twenty-one physicians, nineteen surgeons, and the leading veterinaries succ.u.mbed to the influence of the magic tractors. One "eminent physician" who had had 30 guineas from a country patient and had done him no good was very angry when the sick man took to Perkinism.

"Why, I could have cured you in the same way with my old brick-bat or tobacco pipe, or even my fingers."

"Then why, sir," answered the patient in a stern voice (Perkins quotes this), "did you dishonorably pick my pocket when you had the means of restoring me to health?"

In some 176 pages young Perkins gives us the pick of 2,000 cases who had, of course, been foolish enough at first to put faith in the ordinary physician and his drugs.

In Bath, particularly, where aristocratic London went, as they do to-day, to repair the damage wrought by a season in town, the Tractor Cure was the talk of the place. But an enemy dwelt there, a Dr. Haygarth, an unbeliever. He, with a certain Dr. Falconer, fabricated a pair of false tractors. Five cases of gout and rheumatism were operated on by the conspirators, who discussed in a light tone the wonders of magnetism as they described circles, squares and triangles with the sham tractors. "We were almost afraid to look each other in the face lest an involuntary smile should remove the mask from our faces," says Haygarth, but the two a.s.sistant doctors, unaware of what was being done, were almost converted to Perkinism when they saw the five patients slowly mending under the treatment. One man experienced such burning pain that he begged to wait till the next day. [Footnote 8]

[Footnote 8: Compare the first effects of the Leyden Jar, related in the chapter on Pseudo-Science.]

So rapid, and so many were the hospital cures wrought by these two doctors, that patients crowded to them and they could hardly spare five minutes to eat. They amused themselves inventing other instruments made of common nails and sealing wax, and effected with them cures, while they sent a pair of false tractors {50} to Sir William Watson in London and Dr. Moncriffe in Bristol, who operated with them with wonderful results.

It must not, however, be thought that the uneducated, or the unskilled, or even merely unoccupied, were the only ones taken in by the supposed power of Perkins' Tractors. As we have seen, many physicians did not hesitate to avow themselves publicly as believers in this new and marvelous application of magnetism to human healing.

It is true that the only thing we know about the men who became advocates of this new instrumental therapeusis, is their connection with it. The attention of the scientific world was rather cleverly managed. Dr. Perkins presented a pair of his tractors and the book that he had written about their use to the Royal Society. The custom of that learned body was to accept such presentations by a formal letter of thanks and place the objects and books on their shelves. No formal investigation of the claims to scientific consideration of such presentations was made. All possible advantage was taken of the fact that the Royal Society had accepted the new invention and had publicly thanked the discoverer for it.

How characteristically recent this old story is; it is renewed on every possible occasion and wears all the familiar aspect of modern devices for securing recognition and obtaining the apparent approbation or recommendation of some scientific society or inst.i.tution. We had an example of it a few years ago when a nostrum exploiter signed the register of an International Congress immediately after a great medical investigator and then used a photograph of the names for advertising purposes.

How did the tractors secure the vogue they enjoyed? Those who believed in them did so not because of the scientific theory that animal magnetism or magnetic influence was behind them, nor because of the plausible ways of the Connecticut Yankee, but because of the unquestioned and unquestionable facts of actual healing that they saw in connection with the use of the tractors. Every one of these applications of science to medicine that has proved to be pseudo-scientific after enthusiasm subsides has made its appeal through the cures effected by it. Cures are what Eddyism advances to support its claims, cured patients are presented as their most effective argument by the osteopaths, cured symptoms are the proofs for Hahnemannism, but none of these systems of treatment ever cured as many cases in a corresponding time as did Perkins' tractors. They cured all sorts of physical ills, but their only effect was exerted through the mind.

Holmes wrote:

Let us now look at the general tenor of the arguments addressed by believers to sceptics and opponents. Foremost of all, blazoned at the head of every column, loudest shouted by every triumphant disputant, held up as paramount to all other considerations, stretched like an impenetrable s.h.i.+eld to protect the weakest advocate of the great cause against the weapons of the adversary, was that omnipotent monosyllable which has been the patrimony of cheats and the currency of dupes from time Immemorial--Facts! Facts! FACTS!

First came the published cases of the American clergymen, brigadier-generals, almshouse governors, representatives, attorneys and esquires. Then came the published cases of the surgeons of Copenhagen. Then followed reports of about one hundred and fifty cases, published in England, "demonstrating the efficacy of the metallic practice" in a variety of complaints, both upon the human body and on horses, etc. But the progress of facts in Great Britain did not stop here. Let those who rely upon the numbers {51} of their testimonials, as being alone sufficient to prove the soundness and stability of a medical novelty digest the following from the report of the Perkinistic Committee. "The cases published (in Great Britain) amounted, in March last, the date of Mr. Perkins'

last publication, to about five thousand. Supposing that not more than one cure in three hundred, which the tractors have performed, has been published, and the proportion is probably much greater, it will be seen that the number, to March last, will have exceeded one million five hundred thousand!"

It is not surprising that with such "facts" behind them the tractors attracted deep and wide attention. A contemporary tells of it and the fate of the inventor:

A gentleman in Virginia sold a plantation and took the pay for it in tractors. Nothing was more common than to sell horses and carriages to buy them. But the worst (or the best) of it was, yellow fever was raging in New York, and Perkins thought he could cure the fever with the tractors and fell a victim to the fever himself.

Success of Quackery.--Always in the history of quackery and, indeed, in the history of all therapeutics, the appeal is to the cures that have been effected. This is the only evidence, of course, that can be adduced for the development of therapeutics, and yet the history of medicine makes it clear how carefully supposed cures must be a.n.a.lyzed if they are really to mean anything. Mesmer could adduce thousands of cured cases. Perkins could do the same. Every quack in history, from Galen's weaver, who became a leech, down to the last street corner nostrum vendor, does the same thing. When on the strength of supposed cures, then, a new system of therapeutics is introduced, it is much more likely than not that there is no foundation for the claims made.

We have had ever so many more experiences of disappointment after the introduction of remedies which cured at the beginning of their history, than we have had of remedies that maintain themselves after prolonged experience. It is the att.i.tude of scepticism and suspended judgment until after a remedy or method of treatment has been tried on many different kinds of cases in varying circ.u.mstances that const.i.tutes the only efficient safeguard against repeating the unfortunate errors of old times in the matter of drugs and remedial measures. If the public could be made to realize this, they would be much less easily taken in.

What the quacks cure are not always imaginary ills, but often ills that are very real, at least to the patients, and the symptoms of which are relieved by the confidence aroused in the new remedy and the representations of the supposed discoverer, who, in spite of the exaggerated claims which he makes, somehow succeeds in catching the trust of patients. Very often this process initiated by the quack is really only the beginning of the cure.

In most people a vicious circle of pathological subsidiary causes is formed when anything becomes the matter. Patients are persuaded that a serious illness is ahead of them. This keeps them from exercising as much as before. Becoming overcareful of their diet, they reduce it below the normal limit for healthy activity. This causes them to have less energy for work and disturbs their sleep. Then a host of minor symptoms, supposed to be due to the disease, whatever it is or they think it is, but really consequent upon the unhealthy habits that have formed, begin to develop. Just as soon as confidence in their power to regain health is restored to these people, a virtuous circle, {52} to use the Latin word virtue in its etymological sense, of strength and courage, is formed. Everything conspires to stimulate the patients; they live more naturally, the subsidiary symptoms consequent upon their bad habits disappear and the disappearance of each one of them means for the patients a new a.s.surance of triumph over disease. They attribute every improvement to the remedy they happen to be taking, though most of them are due to the changes in their habits, their diversion of mind, and the new energy released by their sense of encouragement.

An excellent example of how some of these mental persuasions in quackery act, and of how the cure is often really due to the physician who previously treated the case, though it is credited to the quack, may be found in the story that Hilton tells in his "Rest and Pain":

When this patient was first seen by a surgeon, he was thought to be laboring under some disease of the bladder and kidneys, for he had severe lumbago, pain over the bladder, and offensive urine. There had been no suspicion of anything wrong as regards the spine. He was a master painter and a house decorator, and was monstrously conceited, thinking himself right and everybody else wrong. When I explained to him, after careful examination, that the spine was the cause of the symptoms, he was not satisfied with my opinion and without my knowledge consulted Sir Benjamin Brodie, who also a.s.sured him that his spine was diseased and told him that he must rest it by lying down. To this he then a.s.sented. As he could not be controlled in his own house, I persuaded him to go to Guy's Hospital, where he had got nearly well; but he was very impatient, and would not remain long enough under my care to be quite cured. He returned home, gradually improved, and was getting quite well when some pseudo friend advised hydropathy and homeopathy--it did not matter which of the two--as "the thing" to cure him. After a few months he was perfectly restored, not by either hydropathy or homeopathy, but, no doubt, by nature. The man, however, feels convinced that hydropathy and homeopathy cured him. It so happens, gentlemen, that sometimes we do not get the degree of credit which perhaps belongs to us.

To Mr. Hilton's reflections one is tempted to add that many of these patients, after having been seriously ill, cannot bring themselves to think that they will gradually get well by the forces of nature. Even after they have improved very much they are still inclined to think that that improvement is illusory or will relapse because they have not been "cured," that is, actively treated, in some way so that a "cure" should result. When they are nearly well, because of properly directed rest and nursing, someone recommends some irregular form of treatment. They take it up and this gives them confidence that they are being cured. This state of mind makes the ultimate steps of their recovery more rapid than it otherwise would be. As a consequence, the irregular gets the credit. Immediately after this case Mr. Hilton tells the story of another case in which a "rubber" got all the credit for the cure. It is evident that the modern osteopath has only somewhat systematized what had been in existence generations ago.

All this tendency of human nature to respond to anything that is done for it, provided the promise of cure goes with it, is taken advantage of by the quack, sometimes unconsciously, for his own purposes.

Results, as a rule, are secured, in spite of the remedies that he suggests, which in most cases do harm rather than good. Of the thousands of remedies that have been introduced by quacks, not one now remains, though every one of them produced {53} wonderful cures on a great many patients at some time or other. It is the duty of the physician to secure just as good results honestly. He must influence the patient's mind favorably so as to bring about a modification of habits and a hopeful outlook on life, in spite of whatever ailment there may be. If he can do so he will have in his hands the best therapeutic measure that has been employed in all the history of medicine. It is the most universally applicable. It will cure, that is help, all forms of disease. It will relieve many of the symptoms of even incurable diseases. It will occasionally arouse the resistive vitality of the patient to such an extent that even apparently incurable diseases will be overcome. This is the lesson that the modern student of medicine must draw from the history of quackery.

CHAPTER VII

NOSTRUMS AND THE HEALING POWER OF SUGGESTION