Psychotherapy Part 80

Sensations and Memory.--Just as soon as people compare their memories with others, as they do when they worry and begin to grow introspectively self-conscious, they find noteworthy differences and because of differences they will be p.r.o.ne to think that their memory is pathologically defective when it is only different, or, still more, that because they are not able to remember some things, as others do, their memory must be failing. It is well known that some people have a good memory for things seen, others for things heard, and still others only for things in which they have taken actual part. These are spoken of as visual, auditory and action memories. Memories for things seen are divided into special cla.s.ses. Some people remember forms very well, while others remember colors. It is evident that our memories are somehow dependent on the special mode in which sensation affects us and that our acutest sensations are the sources of our longest and best memories. Color vision defectives are not affected much by colors and easily forget them. The tone-deaf have no memory for tunes. Every sense defect affects the memory. Sense defects are often unconscious.

Their effect on memory may {683} only be noted when introspection begins to bring out the special sensation and memory qualities of the individual. Nature, not disease, may be the basis of some memory troubles thus brought to recognition. All these curious phenomena with regard to memory need to be recalled whenever there is question of a supposed deterioration of it, for it is not easy to decide such a question.

Limits of Normal Forgetfulness.--Curious instances of forgetfulness may occur in the experience of men with excellent memories, which, when they happen to persons morbidly inclined to test their every act, are interpreted to signify something much more serious than they really mean. Nearly everyone has had more than once the experience of telling a story to a particular group of people and then forgetting all about having told it and coming back a few days later to tell it over again. Occasionally a teacher hears the same lesson a week apart and yet does not remember that he went over it before, though the cla.s.s is almost sure to do so. A man may repeat a lecture that he has given before to the same audience without realizing it. The story has been told more than once of a clergyman delivering the same sermon on two Sundays in succession and, though such lapses are very rare, they do not necessarily indicate a failing memory, but may only mean a lack of concentration of attention on the part of the human mind. Prof.

Ribot in his "Diseases of Memory" tells the story of one such case in which the subject was quite alarmed lest it should indicate that he was beginning to suffer from some serious memory disturbance due to brain disease, though there was no ground for his fears:

A dissenting minister, apparently in good health, went through the entire pulpit service one Sunday morning with perfect consistency--his choice of hymns and lessons and extempore prayer being all related to the subject of the sermon. On the Sunday following he went through the service in precisely the same manner, selecting the same hymns and lessons, offering the same prayer, giving out the same text, and preaching the same sermon. On descending from the pulpit he had not the slightest remembrance of having gone through precisely the same service on the preceding Sunday. He was much alarmed and feared an attack of brain disease, but nothing of the kind supervened.

Attention not Memory.--When patients come with complaints of the loss of memory, the most important thing is to a.n.a.lyze their symptoms carefully. This will usually enable us to give patients ample rea.s.surance. I have known men who were convinced that they were losing their memories because of their failure to recall important details in their business affairs in the midst of much hurry and bustle in the winter time, find that when they were living a simpler life in the course of travel or life in the country during the summer time under conditions different from the ordinary, their memory could be absolutely depended on for trains and travel details and all important matters to which they were now devoting attention.

Cultivating Looseness of Memory.--Many people complain of loss of memory in the sense that they do not now remember when things took place as well as they used to. For instance, I have had men of fifty tell me that they were sure that their memories were growing weaker than they used to be because a number of times within a year they had found that events which they thought had taken place only a year or two ago really dated four or {684} five or even more years in the past. Some are considerably disturbed by this. As a matter of fact it is only another instance of lack of attention. Most of what we read in newspapers attracts so little of our serious attention that it is no wonder that we do not recall with exactness when events took place.

Events crowd each other out of memory. Newspaper reading is, indeed, the best possible cultivation of looseness of memory that we could have. We do not expect to remember what we read. We would probably grow distracted if we did. At the end of the day if you ask a man what he read in the morning paper he will have no idea at all, unless something especially startling or particularly interesting to him has turned up. After a week we could no more separate Monday's from Tuesday's news of the week before than we could recall a random list of events, having heard it but once. We cultivate looseness of memory with great a.s.siduity. Let us not be surprised if, to some extent, we succeed.

Memories Individual.--People are often much worried over children's memories and may communicate this worry and anxiety to the children themselves, making them solicitous. It is probable that our memories are like our stature. They are what they are. By thinking we cannot add a cubit to the one nor facility to the other. The training of the memory is a very small element compared to the natural faculty. It must not be forgotten, however, that many distinguished men have been noted for rather bad memories when they were young and yet these faculties have developed quite enough to enable them to accomplish good work afterwards. The memory is, after all, a comparatively unimportant faculty in itself and other intellectual faculties surpa.s.s it in significance. It is the faculty that first develops, however, and so a child is often thought to be intellectually slow when it has not so bright a memory as its companions, though a little later its other faculties may develop so as to put it on a plane above its fellows. Memories, too, are very individual and may not retain any of the ordinary subjects, while they may be very attentive for certain special lines of thought. This form of the faculty is better, for the encyclopedic memory is usually of little use and, except in high degrees, encourages superficiality rather than real knowledge.

As a matter of fact, few of our greatest thinkers have had what would be called brilliant memories and it would almost seem as though the diversion of mental energy to this faculty rather disturbed the development of the others. Many a distinguished man has been rather notorious as a child for bad memory, so that in the early days when memory was the only faculty called upon at school he was set down as a dunce. Perhaps the most striking example of this was Sir Isaac Newton, who was actually called a dunce, and yet the world would welcome a few other such dunces. Thomas of Aquin, the great medieval writer on philosophy and theology, who still influences philosophy so much, was so slow as a young man that he was called by his fellow pupils "the dumb ox." His great teacher, Albertus Magnus, recognized the depth of mind that his fellow students could not see and declared that the bellowings of that "ox" would be heard throughout the world. Sir Walter Scott was spoken of as a very backward child. This is all the more surprising to those who know and appreciate the wealth of information that he put into his Waverley Novels. Goldsmith, than whom we have no more brilliant writer in English, seemed not only a dunce as a child, but all his {685} life, so far as outward appearance went, was a numbsknll. This was due to a lack of readiness rather than any lack of wit.

Tricks of Memory.--Some tricks of memory may be very disturbing to those who are over-occupied with themselves and with the possibility of losing their memory. For their consolation it is well for the physician who hears their complaints to have at hand some stories that ill.u.s.trate certain of these curious tricks of memory. I had been trying to persuade a literary woman for some time that it was not her memory that was playing her false, but merely her habit of attention and lack of concentration of mind on things because she is occupied with a great many interests, when one day she came to me with what she thought was absolutely convincing proof that her memory was going. She had read a pa.s.sage in a newspaper the day before which she liked very much, but after reflection it sounded strangely like some of the things that she had thought along these lines herself. It was a quotation, but there was no indication to tell whence it came. A little inquiry, however, showed that the quotation was from an article of her own written only two years before. Here was definite proof of a failure of memory. Strange as it may seem, however, this experience is quite common. I feel sure that there is not a single writer for periodical literature who has not had similar experiences. Anyone who writes much editorially, where the articles are unsigned, finds it rather difficult two or three years later, as a rule, to be absolutely sure which editorials are his. Occasionally it happens that even by the time the proof comes back for monthly periodicals, say six weeks or two months, some at least of what was written may seem quite unfamiliar. This will be particularly true if phases of the same subjects have been treated in successive articles and thus repet.i.tions are caused.

There is plenty of good warrant for such occurrences in the lives of distinguished writers. Scott once heard a song in a drawing-room that he did not care for very much and he said rather contemptuously, "Oh!

that's some of Byron's stuff." His attention was called to the fact that he was the author of the stuff himself. Carlyle confessed to Froude when Froude went over some of the pa.s.sages of Carlyle's own autobiography with him, that he had quite forgotten some of the things written down there. Manzoni, the distinguished Italian writer, whose "I Promessi Sposi" has probably been more read throughout Europe than any novel written during the nineteenth century, except possibly some of Scott's, tells some stories of his own lapses of memory and, above all, of having once quoted a sentence of his own to confirm something that he was saying, though he confessed that he did not know by whom the quotation had been written.

Memory and Low Grade Intelligence.--There are many people who complain of their memory and of their inability to recall many things which others recall without difficulty. They are p.r.o.ne to think that this is some defect in them and not infrequently, as a consequence of comparisons, they persuade themselves that their memory was better and that it has lost some of its qualities. Until they became familiar with some of the feats of memory possible of performance by others, they were quite satisfied, but now they find in every instance of forgetting a new symptom of an increasingly deficient memory. I have found in these cases, that setting before such people some of the curiosities of memory, and especially the fact that memory is by no {686} means necessarily connected with profound intelligence, so that, indeed, its presence is quite compatible with a low grade of intelligence or even with what is practically idiocy, will do much to rob these gloomy forebodings of their terrors with regard to their own supposed deterioration of intellect. Ribot, in his "Diseases of Memory" [Footnote 52] has an excellent pa.s.sage in which he sums up a number of these peculiarities of memory that are likely to be especially consolatory to people of ordinary memory who are worrying about themselves.

[Footnote 52: International Scientific Series, D. Appleton & Co., New York.]

It has long been observed that in many idiots and imbeciles the senses are very unequally developed; thus, the hearing may be of extreme delicacy and precision, while the other senses are blunted.

The arrest of development is not uniform in all respects. It is not surprising, then, that general weakness of memory should co-exist in the same subject with evolution and even hypertrophy of a particular memory. Thus certain idiots, insensible to all other impressions, have an extraordinary taste for music, and are able to retain an air which they have once heard. In rare instances there is a memory for forms and colors, and an apt.i.tude for drawing. Cases of memory of figures, dates, proper names, and words in general, are more common.

An idiot "could remember the day when every person in the parish had been buried for thirty-five years, and could repeat with unvarying accuracy the name and age of the deceased, and the mourners at the funeral. Out of the line of burials he had not one idea, could not give an intelligible reply to a single question, nor be trusted even to feed himself." Certain idiots, unable to make the most elementary arithmetical calculations, repeat the whole of the multiplication table without an error. Others recite, word for word, pa.s.sages that have been read to them, and cannot learn the letters of the alphabet. Drobisch reports the following case of which he was an observer: A boy of fourteen, almost an idiot, experienced great trouble in learning to read. He had, nevertheless, a marvelous facility for remembering the order in which words and letters succeeded one another. When allowed two or three minutes in which to glance over the page of a book printed in a language which he did not know, or treating of subjects of which he was ignorant, he could, in the brief time mentioned, repeat every word from memory exactly as if the book remained open before him. The existence of this partial memory is so common that it has been utilized in the education of idiots and imbeciles. It is worth noting that idiots attacked by mania or some other acute disease frequently display a temporary memory. Thus, an idiot in a fit of anger told of a complicated incident of which he had been a witness long before, and which at the time seemed to have made no impression upon him.

Training Memory.--In recent years in many departments of therapeutics training has been found to be of value. This is especially true with regard to nervous defects. Probably one of the greatest surprises that nervous specialists have had in the last twenty-five years in the domain of therapeutics came from the introduction of Frenkel's methods of retraining the muscles in locomotor ataxia. This idea of retraining has been found useful in such distinct departments as the use of the eye muscles, the co-ordination of the muscles of speech, so as to get rid of stuttering and stammering, and the muscles of the hand for writing. We are only just beginning to realize that retraining can be of great value in psychic affections also. Patients may be disciplined against their dreads and tremulousness due to over-apprehension and against even certain defective uses of their intellect. Urbantschitsch of Vienna showed that by training defective hearing it might in many cases be very much improved. What he accomplished, however, was not {687} any better use of the external auditory apparatus, but a more intense attention of mind which enabled the patient to catch and understand sounds which had hitherto been so vague that their significance was lost.

In a number of cases of complaint of loss of memory I have deliberately set patients to retrain their memories and have at least relieved their apprehensions if I have not always succeeded in increasing their actual memory power. It has even seemed, however, that in old people some actual improvement of the memory faculties was thus brought about. Under the head of Occupation of Mind I have referred to the exercise of memory in younger people as representing an excellent form of mental diversion. When the idea first suggested itself it seemed as though patients would not take to it at all, and yet I have found that with a little persuasion they become much interested and find a great deal of pleasure in their gradually increasing power to recall the great thoughts of great authors in the literal original words. A reference to that chapter will tell more of my experience. This made me more confident of the possibilities there were of making people understand that if they were losing their memories they could bring them back by proper exercise. In this way many of the modern evils of lack of attention and of failure of concentration of mind can be corrected.

My rule now is to tell patients who come complaining of loss of memory that if there is any real loss of memory it is due to their improper use of the faculty, or perhaps to their failure to exercise it sufficiently, for the proper performance of function depends on adequate exercise. They are then instructed to take certain simple cla.s.sical bits of literature and commit them to memory. At the beginning such short poems with frequently repeated rhymes of the modern poets as are comparatively easy to learn are set as memory exercises. Later Goldsmith's "Traveler" and "Deserted Village" are suggested. Then pa.s.sages from Shakeaspeare are given. Just as soon as the patient finds that he can commit to memory as he used to, if he only gives himself to the task, a change comes over his ideas with regard to the loss of memory. For many of these people the occupation of mind is an excellent therapeutic measure. Besides selections can be made in such a way as to keep before their minds the thoughts they most need in the shape of memory lessons. It is a discipline of memory that revives it and also a constant exercise in favorable suggestion.

Gregor in the _Monattschrift fur Psychiatrie und Neurologie_, Band XXI, has detailed some of his experiences with the retraining of the memory of patients suffering from Korsakoff's Psychosis--alcoholic neuritis with psychic disturbances, especially of memory. The patient was required to learn words and then after a certain length of time was tested to see if he could learn a similar series with fewer repet.i.tions than at first. The memory increased in capacity with the exercises and there was evidently a definite gain in the faculty. In this disease patients have also lost the power to some degree at least of recognizing objects. After exercises in recognition they are much more capable in this matter, however, and it is evident that in every way the memory can be improved. This experience, with a serious form of disease that gravely impairs the memory, shows how much can be accomplished in circ.u.mstances far more unfavorable than are those which usually bring patients to the physician complaining of deficiencies of memory.

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CHAPTER XI

PSYCHIC CONTAGION

The term psychic contagion is often thought of as merely figurative.

It is, however, quite literal. Many minds are influenced by what they see happening round them and induced to imitate the activities of others. The term psychic contagion is so thoroughly descriptive of what happens that it deserves the place that it has secured.

Everywhere and at all times we find historical traces of psychic contagion compelling people to perform in crowds or groups the most curious and inexplicable and sometimes the most horrible things. Even in the old myths before the times of the Trojan War, we have the story of hysteria spreading among the daughters of King Proteus, so that the famous old physician, Pelampus, had to administer white h.e.l.lebore in goat's milk in order to relieve them. It is probable that this rather heroic remedy with its definite effect upon the bowels produced such a revulsion of feeling as to cure the hysteria. Anyone who has read the awful tragedy that Euripides has written in the _Bacchae_ will have had brought home to him a typical example of psychic contagion. The queen mother in the midst of one of the Bacchic orgies kills her own son in the frenzy that has come from the religious excitement exaggerated by the a.s.sociation of a number of women in the religious rites of the G.o.d Bacchus. It is well understood that this was not a case of drunkenness, but of psychic intoxication.

Phrygian Bacchantes are described as overcome from time to time by paroxysms of curious uncontrollable automatic movements with or without disturbance of consciousness. This represents the earliest form of what came to be known afterwards as St. Vitus Dance when it spread among a number of people. Such manifestations were not at all uncommon in the East in the earlier days and they have continued during all history. In Hindustan epidemics of automatic movements, evidently ch.o.r.eic in character, have been known for many centuries under the name of _lapax_. Outbreaks of this kind were common in the Middle Ages and Paracelsus has described them as happening early in the sixteenth century. At any time the occurrence of an hysterical seizure in a crowded hall, and especially in a schoolroom, will lead to other hysterical manifestations. A case of ch.o.r.ea will induce imitative movements in susceptible bystanders that may be quite uncontrollable. Tics of various kinds are readily picked up by children and special care must be exercised to prevent their spread.

In general the state of mind is extremely important in all these conditions and they can be influenced favorably only through the mind.

Contagions Trifles.--Perhaps the extent to which psychic contagion influences us can be seen better in little things than anywhere else.

Everyone knows how contagious yawning is. Again and again observations have been made while actors were yawning upon the stage. Nearly everyone in the theater begins to yawn in a few minutes and, in spite of the most determined {689} efforts, every now and then even the most serious-minded elderly gentleman in the audience finds himself unconsciously joining in. It seems foolish and to an onlooker appears almost prearranged. It is only necessary, however, to yawn a few times in a street car, especially at night, to have many imitators. Nearly the same thing is true of all respiratory phenomena. Sighing, for instance, is quite contagious. Coughing is often as much the result of imitation as anything else. At certain pauses in church services a preliminary cough is heard and then some scattering coughs here and there, like the musketry of scouts, and then a whole battery of coughs is let off, especially if it is in the winter time, because nearly everybody within hearing is tempted to cough. To talk about yawning or coughing or sighing before some people is almost sure to produce a tendency to these manifestations. These apparently trivial happenings help to explain many phenomena of human imitation in more serious things.

Most of the phenomena a.s.sociated with expression are liable to be initiated as the result of imitation. Laughing, for instance, is particularly contagious among young folks and is especially likely to be insuppressible when they wish to be particularly solemn. At religious services it takes but little to make people laugh and giggle, no matter how much they may wish to be dignified and reverential. A few giggling girls will sometimes disturb a serious service. Extremes are particularly p.r.o.ne to meet in this matter and the sublime easily becomes the ridiculous. A t.i.tter will set off even the best intentioned of young folks in spite of resolutions to the contrary. Crying has something of the same contagious nature, though it is not quite so strong, but among women tears are particularly likely to evoke tears. The epidemic of curious manifestations of expression, usually of an hysterical nature, that we know by tradition to have spread in communities in the Middle Ages and much later, are only typical examples of this tendency for modes of expression to be contagious to an exaggerated degree.

Expectoration is largely dependent on imitation, sometimes conscious, of course, but often quite unconscious. In the recent crusade organized to prevent the spread of tuberculosis the question of expectoration as a diffusing agent of the bacilli has given a new importance to observations on this subject. It is recognized that we have "a spitting s.e.x" and that men spit from force of habit, boys imitate them, while women and girls almost never spit. There is no reason in the world why when men and women are engaged in the same occupations there should be any difference in this regard between them, yet employers know how hard it is to keep corners and by-places in the rooms where men work free from expectoration, while no such difficulty is found where women work. We have a spitting s.e.x because of psychic contagion, and in spite of the fact that there are serious dangers connected with the habit. What is true of spitting may also be true of other habits relating to the respiratory pa.s.sages. Hawking and blowing the nose more frequently than is needed are spread by psychic contagion and certain habits in these matters that are injurious to the respiratory apparatus often require considerable effort to break.

Fads and Health.--Enlightened as we think ourselves, we have many more examples of psychic contagion in the present than we would perhaps care to admit, unless the facts were called to our special attention.

{690} At a particular period in the modern time it becomes the fad to do things in a special way. We write alike, we build our houses after a common type. We take our recreation in a particular fas.h.i.+on.

Bicycling comes in and goes out; roller skating attacks nearly every one of the young folks and then is abandoned. There are fas.h.i.+ons in everything and fas.h.i.+ons, after all, are recurring instances of psychic contagion. The mental influence spreads from one to another. It may be that a particular fas.h.i.+on, as in houses or in clothes, is especially ugly. That makes no difference. After a time taste revolts against it, but in the meantime the psychic contagion is enough to overturn the canons of taste. There are fas.h.i.+ons in literature, or at least what is called literature. The nature novel comes and goes, then the novel of adventure has its place, then the detective novel, after a time the little-country prince or princess and their romance comes into fas.h.i.+on. After a time we realize that these are pa.s.sing fancies, but in the meantime they have influenced many people.

Some of these fas.h.i.+ons bring conditions that are deleterious to health. The moving-picture show in places that almost never have a stime of sunlight in them and are, in their way, quite as bad, especially for respiratory troubles, as the dust-laden atmosphere of the roller-skating rink, become the fad of the moment in spite of knowledge or ignorance of hygiene. Just now we are in the midst of a fad for fresh air, that, unfortunately, goes and comes with the centuries and we have no guarantee that people will not learn again to live in closely sealed houses. High heels come and go, as do corsets of various kinds, more or less injurious, in spite of the admonition of the physician. In fact, one of the most interesting studies in psychic contagion is the history of the fas.h.i.+ons. A particular fas.h.i.+on, especially in its exaggerated forms, will probably look well on about one-fifth of the women at a given time. About four-fifths of them, however, adopt it in spite of the fact that on three-fifths it emphasizes certain qualities that it would be well to keep in the background. It is woman's princ.i.p.al desire to please, yet this is completely perverted by the psychic epidemic of fas.h.i.+on which causes people to follow after others quite as much as did the medieval people in various fads that attracted attention and have come down to us.

Our enlightenment, at least in as far as that word means general diffusion of the ability to read, has rather added to the power of psychic contagion. People accept ideas from others almost as unconsciously as they catch disease from those suffering from it. The psychology of advertising shows how easy it is to make people accept things just by insisting on them and by frequent repet.i.tions of statements. The psychology of the proprietary medicine business in modern times is about as typical an example of psychic contagion induced deliberately as one could well imagine. Those who stop to reason do not fall victims. Most people, however, do not stop to reason. They have not the mental resistive vitality to render them immune to the influence of certain irrationalities and so literally hundreds of millions of dollars have been spent on perfectly useless, oftentimes harmful drugs, which people had become persuaded through the psychic contagium of printer's ink were sure to do them good. The psychology of the mob has been studied somewhat in recent years and it shows how clear it is that men follow after one another in doing foolish things even more than in doing wise ones. Psychic contagion is a prominent factor in life, it always has been, is now, and evidently always {691} will be, and must be reckoned with by anyone who wishes to recognize the principles that underlie psychotherapy.

Suicide Contagions.--It is with regard to much more serious things than fas.h.i.+ons, however, that psychic contagion is most manifest. For instance, there is no doubt that suicide is frequently the result of such psychic influence. Seldom does it happen that a very queer suicide is reported without there being certain imitations of it more or less complete in various parts of the country afterwards. There is no doubt that the reporting of suicides has a serious effect in this matter. Perhaps the most striking example of this that we have ever had in America was the well-known suicidal epidemic at Emporia, Kansas, which reached its height just about the middle of June, 1901.

Two or three well-known people in town committed suicide at the end of May and the beginning of June. A veritable epidemic of suicide broke out as a consequence. Nothing seemed to stop it and the authorities were much disturbed. Finally it was agreed that the most potent influence in bringing about the imitation of the epidemic was the publication of the details of the suicides in the papers. The Mayor of the city, after consulting with the Board of Health, decided to issue the following proclamation:

I have consulted the Board of Health, and if the Emporia papers do not comply with my request I shall have a right to stop, and I will stop summarily, the publication of these suicide details, under the law providing for the suppression of epidemics. There is clearly an epidemic in this city, and although it is mental, it is none the less deadly. Its contagion may be clearly shown to come from what is known in medicine as the psychic suggestion found in the publication of the details of suicides. If the paper on which the local Journals are printed had been kept in a place infected with smallpox, I could demand that the Journals stop using that paper, or stop publication.

If they spread another contagion--the contagious suggestion of suicide--I believe the liberty of the press is not to be considered before the public welfare, and that the courts would sustain me in using force to prevent the publication of newspapers containing matter clearly deleterious to the public health.

Murder.--In almost the same way murders prove contagious. Especially is this true of murder and suicide together. These occur notably in groups. A man who is downhearted and for whom the future looks blank, will, out of a sense of pity for those who are dependent on him, murder them and himself; then the brutal story is reported and another tottering intellect gives way and a similar story has to be told within a few days. A mother who is melancholic about her health and includes her children in her gloomy outlook makes away with them and herself. Within a few days a similar story is reported because of the influence of psychic contagion. Very often there are distinct imitations of the methods employed in the first case. Often, however, it is only the idea itself that has proved contagious. There is no doubt that this suggestion brings about subsequent cases when otherwise such an awful thought might not occur. The connection is too clear for us to doubt the reality of it or to think that it is mere coincidence. As in Emporia, doubtless the suppression of the description of such events would have a beneficial effect. There are many disequilibrated minds, apparently just tottering on the verge of an insane act of this kind, that are pushed over by the suggestion furnished by the details of another story.

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Place of Psychic Contagion.--The physician who would treat nervous patients successfully and use psychotherapeutics to advantage must recognize the place that psychic contagion has in influencing the generality of mankind. We know that direct suggestions are profoundly influential. It must be constantly kept in mind, however, that indirect suggestion, suggestion that does not come by any formal method, but that is represented by the examples of those around, also has great weight.

Favorable Influence.--Fortunately it is not alone for evil that psychic contagion is manifest. People in a crowd stand fatigue better than when alone. Soldiers marching in step do not notice their tiredness to such a degree and even forget their sore feet. People suffering from hunger, so long as there is a good spirit among them, will help each other to bear it. The accidents in coal mines in recent years in which men have been imprisoned for considerable periods have shown that in groups they stand the hards.h.i.+ps of confinement and of lack of food and water better than they do when alone, men live longer, they do not suffer so much or at least their suffering is not so insistent, and they bear up better.

This has been particularly noticed in the cures at various watering places. The very air of the place takes on a favorable suggestion that is helpful to patients. The routine, the hopefulness of those who are completing the cure, the stories of improvement, the evident betterment, all these things combine to give a psychic contagion of health. Health is, in this sense, quite as contagious as disease. This must be taken advantage of just as far as possible for the advantage of patients. On the other hand, ideas are contagious for ill and patients may derive from their environment notions that prove auto-suggestive and against which it is extremely difficult to work.

Ideas derived from the general feelings of those around, without any direct suggestion, may become obsessions. The physician, therefore, must be ready to secure prophylaxis against psychic contagion and then by counter-suggestion relieve the patient, who has become afflicted by it, of the resulting disturbance of mind. It must not be forgotten that, instead of being less susceptible as education and civilization progress, people really become more susceptible.