_ CHAPTER XVII. THE WILL IN SO-CALLED CHRONIC RHEUMATISM
"I should do it
With much more ease; for my good will is to it."
The Tempest.
In popular estimation, rheumatism is one of the commonest of affections. When a physician asks a patient, especially if the patient is over forty years of age, "Have you ever suffered from rheumatism?" the almost invariable response is, "Yes", though but little further inquiry is needed to show that what the patient means is that he has suffered from some painful conditions in the neighborhood of his joints, or that his muscles have been sore or inclined to ache in rainy weather, or that he has undergone some other vague discomforts connected with dampness. Chronic rheumatism is a term that includes a great many of the most varied conditions. True rheumatism, that is, acute articular rheumatism, is now recognized as an infectious disease which runs a definite course, usually with fever, for some ten days to ten weeks, and requires confinement to bed usually for a month or more. Very rarely will any connection be found between this affection, which presents always Galen's four classic symptoms of inflammation, swelling, redness, heat and pain (
tumor, rubor, color, et dolor), and the usual conditions which are broadly characterized as rheumatism. Just as soon as patients are asked if their rheumatism included these symptoms there is denial, yet the idea of their having had rheumatism remains.
As a matter of fact, there are a number of sore and painful conditions in connection with muscles and particularly in and around joints that have, without any scientific justification at least, been called chronic rheumatism. Any painful condition that is worse in rainy weather is sure to be so named. As old dislocations, sprains and wrenches of joints, broken bones, as well as muscular conditions of all kinds, including flat foot and other yielding of joints, all produce this effect, it is easy to understand that there is an immense jumble of all sorts of painful conditions included under the term "chronic rheumatism." Some of them, particularly in older people, produce lameness or at least inability to walk distances without showing the disability; a great many of them produce distinct painful conditions during the night following the use of muscles and often disturb patients very much, because they arouse the dread that they are going to be crippled as they grow older.
Indeed, one of the most serious effects of these recurring painful conditions is the dread produced lest they should cause such progressive affections in and around joints as would eventually make the patients bed-ridden. There are a certain number of cases of so-called rheumatoid arthritis which produce very serious changes in joints with inevitable crippling and quite beyond all possibility of repair. These cases are often spoken of as chronic rheumatism and it is the solicitude produced by the dread of them that makes the worst part of the discomfort in many a so-called chronic rheumatic case. If their affection is to be progressive, then the patients foresee a prolonged confinement to bed in the midst of severe pain, hopeless of ultimate cure. It may be said at once that these cases of rheumatoid arthritis have nothing to do with rheumatism, represent a special acute infection, are never a sequela of any of the rheumatic conditions and are fortunately very rare. This assurance of itself is quite sufficient to make ever so much better a great many patients who feel that they suffer from rheumatism.
The painful conditions that are described under the term chronic rheumatism would seem to be quite beyond any power of the will to affect. They are at least supposed to represent very definite changes in the tissues, usually of chronic character and therefore not amenable to any remedies except those of physical influence. Besides, they are so frequent that surely if there were any question of the will being able to control them or bring relief for them, most sufferers would discover this fact for themselves and apply the remedy from within. It is not to be expected that a very great many people would suffer pains and aches that are worse in rainy weather if all that was needed was the exertion of their will power either to throw off the affection or to perform such exercises and activities as would gradually make their conditions better. In general it is felt that painful conditions of this kind cannot be affected by the will and that distinctly material and not psychic therapeutics must be looked to for their relief.
Now it so happens that the best illustration of the power of the will to "cure" people, that is, to relieve them completely of their affections and start them afresh in life with the feeling that they are no longer handicapped by disease, is to be found exactly in the group of cases that have almost from time immemorial been called chronic rheumatisms. We have had more "cures" of various kinds announced for these--chemical, electrical, physical, hydriatic, movement therapy and so forth--than for almost any other group of diseases. More irregular practitioners of medicine all down the ages have made a reputation by curing these affections than have won renown by treating any other set of ills to which humanity is heir. Like the poor, these ills are still with us, in spite of all the "cures" and probably nowhere is the expression of the old French physician that "the therapeutics of any generation is always absurd to the second succeeding generation" better illustrated than in regard to them. These cases serve to emphasize very clearly, however, the fact that the pains and aches of mankind are largely under the control of the will.
The more one studies these cases of so-called chronic rheumatism the easier it is to understand how they become the signal "cures" which attract attention to the quacks and charlatans who promise much, but do nothing in particular, though they may give medicines or treatment of some kind or another. They only arouse the patient's will to be better and the determination to use his will with confidence, now that the much praised treatment is doing something which will surely make him better. Cases of this kind have constituted a goodly part of the clientele of the great historic impostors who succeeded in making large sums of money out of curing people by methods that in themselves had no curative power. A review of some of the chapters of that very interesting department of human history, the history of quackery, is extremely suggestive in that regard. The only way to get a good idea of the basic significance of these cases is to realize by what they were cured and by whom they were cured.
One of the most interesting illustrations of that phase of human credulity is the story of Greatrakes, the Irish adventurer who had been a soldier in Flanders, and who when his campaigns were over set up to be a healer of mankind. He chose his opportunity during the time while Cromwell, as Lord Protector of Great Britain, had refused to continue the practice of touching the ailing which the Kings of England had pursued for hundreds of years since the Confessor's time. Cromwell did not impugn the efficacy of the Royal Touch but he refused to have anything to do with it himself. Greatrakes found it an opportune moment to announce that for three nights in succession he had been told in a dream by the Holy Spirit that in the absence of the King he was to touch people and cure them.
One might possibly think that with no better credentials than this and no testimony except his own claim in the matter Greatrakes would receive but scant attention. Any one who thinks so, however, does not understand human nature. It was not long before some of the people who had been sufferers for longer or shorter periods went to Greatrakes and allowed him to try his hand at healing them. They argued that at least if it did them no good it could do them no harm, and it was not long before some of them declared that they had been benefited by his ministrations. Very soon then he was able to furnish what seemed to be abundant evidence of Divine Mission in the cures that were worked by his more than magic touch. Above all, people who had been sufferers for prolonged periods, who had gone the rounds of physicians, who had tried all sorts of popular remedies, and some of whom had been declared incurable were healed of their ills after a series of visits to Greatrakes. No wonder then that patients came more and more frequently, until his name went abroad in all the country and in spite of the difficulties of travel people came from long distances just to be treated by him.
All that he did was to ask the patient to expose the affected part and then Greatrakes would stroke it with his hand, assure the patient that a wonderful new vitality would go into them because of his Mission from on High and promise them that they would surely get better, explaining of course that betterment would be progressive and that it would start from this very moment. The stroking was the important part of the cure and so he is known in history as "Greatrakes the Stroker." It may be said in passing that while those who were touched by the English kings in the exercise of the prerogative of the Royal Touch were usually presented with a gold coin which had been particularly coined for that purpose as a memorial, a corresponding gold piece, a sovereign as a rule, in Greatrakes' method of treatment passed from the patient to the healer. It was a case of metallotherapy with extraction of the precious metal from the patient, as is always the case under such circumstances.
Here in America we had a similar experience, though ours had science as the basis of the superstition in the case instead of religion. The interest aroused by Galvani's experience with the twitching of frogs' legs when exposed nerve and muscle were touched by different metals led Doctor Elisha Perkins to invent a pair of tractors which would presumedly apply Galvani's discovery to therapeutics. These were just plain pieces of metal four or five inches long, shaped more or less like a lead pencil and tapering to a blunt point. With these, as Thatcher, one of our earlier historians of medicine, tells us, Perkins succeeded in curing all sorts of ailments, but particularly many different kinds of painful conditions. He was most successful in the treatment of "pains in the head, face, teeth, breast, side, stomach, back, rheumatism and so forth." In a word, he cured the neuralgias and the rheumatic pains and the chronic rheumatisms which are the source of so much trouble--and especially complaint--for the old, and which so often physicians, in any time of the world's history, have been unable to cure.
For a time his success was supposed to be due to some curious electrical power that he was using. Learned pamphlets were issued to show that animal magnetism or animal electricity or Galvanism was at work. Professors at no less than three universities in America gave attestations in favor of its efficacy. Time has of course shown that there was absolutely no physical influence of any kind at work. The only appeal was to the mind. Elisha Perkins was a Yale man of education and impressive personality, "possessing by nature uncommon endowments both bodily and mental ", and he succeeded in impressing on his patients the idea that they would surely be cured; he thus overcame the dreads, released the will power, gave new hope and a tonic stimulus to appetite, created a desire for exercise, and then the will kept this up and before long the patient was cured.
When animal magnetism, as it was called about the middle of the nineteenth century, was practised without apparatus, one of its most important claims to the consideration of physicians was founded on its power to heal chronic painful affections which had previously resisted all therapeutic efforts. The power of neuro-hypnotism, as it came to be designated, to accomplish this, will be best appreciated from the fact that this state was being used as a mode of anaesthesia for surgical operations. When the news of the use of ether to produce narcosis for surgical purposes at the Massachusetts General Hospital first came to England, it did not attract so much attention as would otherwise have been the case, because English physicians and surgeons were just then preoccupied with the discussion of neuro-hypnotic anaesthesia, and those who believed in it thought that ether would not be necessary, while those who refused to believe thought the report with regard to ether just another of these curious self-delusions to which physicians seemed to be so liable.
Perkins' declarations of the curative value of his tractors were, after all, only a succeeding phase of what Mesmer had called to the attention of the medical profession and the public in Paris not quite a generation before. Mesmer seated his patients around a tub containing bottles filled with metallic materials out of which wires were conducted and placed in the hands of patients seated in a circle around it. Mesmer called this apparatus a
baquet or battery and it was thought to have some wonderful electric properties. A great many people who received the treatment were cured of chronic pains and aches that had sometimes lasted for years. So many prominent people were involved that the Government finally ordered an investigation to be made by French scientists with whom, because he was the Minister from the colonies at the time, our own Benjamin Franklin was associated. They declared that there was not a trace of electricity or any other physical force in Mesmer's apparatus. He was forbidden to continue the treatment and there was a great scandal about the affair, because a large number of people felt that he was doing a great deal of good.
When hypnotism came in vogue again at the end of the nineteenth century, it was a case of chronic rheumatism that gave it its first impetus in scientific circles. Professor Bernheim of Nancy had tried in vain all of his remedies in the treatment of a patient suffering from lumbago. The patient disappeared for a time and when Bernheim next saw him, he was cured. Bernheim had treated him futilely for months and was curious to know how he had been cured. The patient told him that he had been cured by hypnotism as practised by Liebault. This brought Bernheim to investigate Liebault's method of hypnotism and made him a convert to its practice. It was the interest of the school of Nancy in the subject that finally aroused Charcot's attention and gave us the phase of interest in hypnotism which attracted so much public attention some thirty years ago. Many other cases of those very refractory affections--lumbago and sciatica--have been cured by hypnotism when they have resisted the best directed treatment of other kinds over very long periods.
It is these chronic rheumatisms, so called, the chronic pains and aches in muscles in the neighborhood of joints, that were cured by the Viennese astronomer, Father Maximilian Höll, in the eighteenth century. He simply applied the magnet and saw the result, and felt sure that there must be some physical effect, though there was none. His work was taken up by Pfarrer Gassner of Elwangen who, after using the magnets for a time, found that there was no need of their application, provided the patients could by prayer and other religious means be brought into a state of mind where they were sure that they were going to get better. They then proceeded to use their muscles properly in spite of the pain that might result for a time, and as a result it was not long before they were cured of their affections. The Church forbade his further practise because of his expressed idea that pain came from the power of evil and dropped from men when they turned to God, which was the eighteenth-century anticipation of Eddyism. Dowie's cures were largely of similar affections, and patients sometimes dropped their crutches and walked straight who could not walk before.
A great many of the so-called chronic rheumatisms are really the result of dreads to use muscles in the proper way because for the moment something has happened to make their use painful. A direct injury, a wrench, or some incident causes a joint for a time to be painful when used. In sparing it, the muscles around it are used differently than before and as a consequence become sensitive and painful. It is quite easy, then, for people to form bad habits which they cannot break because they have not the strength of will to endure the sore and tender condition which develops when they try to use muscles properly once more. The young athlete who wants to get his muscles in good condition knows that he must pass through a period of soreness and tenderness, sometimes of almost excruciatingly painful character. He does so, however, and does not speak of his condition as involving pains and aches but only soreness and tenderness.
Older people, however, who have to get their muscles back into good condition after a period of disuse following an injury or some inflammatory disturbance, find this period of discomfort very difficult to bear and so keep on using their muscles somewhat abnormally and at mechanical disadvantage. As a consequence, these muscles remain tender, are likely to ache in rainy weather and often give a good deal of discomfort. Until the sufferers can be brought to use their wills properly, so as to win back their muscles to normal use, they will not get well. An application of magnets or a Leyden jar or Mesmer's battery of the eighteenth century, or Perkins' tractors, or neuro-hypnotism, or animal magnetism, or later hypnotism, or Dowie's declaration of their cure, enables them to use their will in this regard and then they proceed to recover. It is surprising how many presumedly intelligent people--at least they have received considerable education--have been cured of conditions that they have endured for years by some remedy or mode of treatment that actually had no physical effect.
St. John Long, the English charlatan who has been mentioned in the chapter on tuberculosis, also succeeded in making a name for himself in connection with the chronic rheumatisms and the so-called rheumatic pains and aches of older people. Between consumption and these conditions, he caught both the young and the old, and thus rounded out his clientele. For consumption he provided an inhalant; for rheumatic conditions, a liniment. This liniment became very famous in that generation for its power to relieve the pains and aches, both acute and chronic, of mankind. So many people were cured by it and above all, so many of them were people of distinction--lords and ladies and the relatives of the nobility--that Parliament was finally petitioned in the interests of suffering humanity to buy the secret of the liniment from its inventor and publish it for the benefit of the world. I believe that a substantial sum, representing many, many thousands of dollars in our time, was actually voted to St. John Long and the recipe for his liniment was published in the British pharmacopeia. In composition, it was, I believe, only a commonplace turpentine liniment made up with yolks of eggs instead of oil, as had been the custom before. Just as soon as this fact became known, the wonderful cures which had occurred in connection with its use ceased to a great extent, for distinguished members of the nobility and their relatives would not be cured by so common-place a medium as an ordinary turpentine liniment. St. John Long was even accused of not having sold his real secret to the Government, but there was no reason at all to think that. He had been producing his cures not by his liniment but by the strong effect of his prestige and reputation as a healer upon the minds of his patients and the consequent release of will power which enabled them to do things which they thought they could not do before. We have had many wonderful curative oils of various kinds since then, with all sorts of names from Alpha to Omega and very often called after a saint,--though St. John Long was as far as possible from being a saint in the ordinary acceptance of that word. These modern curative oils and liniments have been merely counter-irritants, but at times, owing to a special reputation acquired, they have been counter-irritants for the mind and stimulants for the will which have enabled old people to persist through the periods of soreness and tiredness until they reacquired the proper use of their muscles. _