Why Worry? by George Lincoln Walton (interesting novels to read .TXT) 📖

The application of the term degeneration may be, and should be, it seems to me, limited to the signs, whether physical or mental, which indicate an obviously downward tendency. I have elsewhere suggested, and the suggestion has already found some acceptance, that when the variation is not definitely downward, deviation and deviate be substituted for the unnecessarily opprobrious and often inappropriate terms, degeneration and degenerate.

VII.

Il marche, dort, mange et boit comme tous les autres; mais cela n’empeche pas qu’il soit fort malade.

MOLIERE: Le Malade imaginaire.

The victim of hypochondria may present the picture of health, or may have some real ill regarding which he is unduly anxious. His consultation with a physician is likely to be preceded by letters explaining his exact condition, naming his various consultants and describing the various remedies he has taken. At the time of his visit notes are consulted, lest some detail be omitted. In his description anatomical terms abound; thus, he has pain in his lungs, heart, or kidney, not in his chest or back. Demonstration by the physician of the soundness of these organs is met by argument, at which the hypochondriac is generally adept.

The suggestion that the hypochondriac devotes undue attention to his own condition is met by him with indignant denial. Proposals that he should exercise, travel, engage in games, or otherwise occupy himself, fall on deaf ears, but he is always ready to try a new drug. If a medicine is found with whose ingredients the patient is not already familiar, its use is likely to produce a beneficial effect for a few days, after which the old complaint returns.

The case has come to my attention of a young man who, for fear of taking cold, remains in bed, with the windows of the room tightly closed and a fire constantly burning. He has allowed his hair to grow until it reaches his waist, he is covered with several blankets, wears underclothing under his nightshirt, and refuses to extend his wrist from under the bed-clothes to have his pulse taken.

Such faulty mental habits in minor degree are common. There are those who will not drink from a bottle without first inspecting its mouth for flakes of glass; some will not smoke a cigar which has been touched by another since leaving the factory; some will not shake hands if it can possibly be avoided; another pads his clothing lest he injure himself in falling. Many decline to share the occupations and pleasures of others through fear of possible wet feet, drafts of air, exhaustion, or other calamity. Such tendencies, though falling short of hypochondria, pave the way for it, and, in any event, gradually narrow the sphere of usefulness and pleasure.

No part of the body is exempt from the fears of the hypochondriac, but he is prone to centre his attention upon the obscure and inaccessible organs. The anecdote is told of a physician who had a patient of this type—a robust woman who was never without a long list of ailments. The last time she sent for the doctor, he lost patience with her. As she was telling him how she was suffering from rheumatism, sore throat, nervous indigestion, heart-burn, pains in the back of the head, and what not, he interrupted her:

“Ah,” he said in an admiring tone, “what splendid health you must have in order to be able to stand all these complaints!”

The phobias are so closely allied to hypochondria that it will not be out of place to discuss them here. A phobia is an insistent and engrossing fear, without adequate cause as judged by ordinary standards. Familiar instances are fear of open places (agoraphobia), fear of closed places (claustrophobia), and fear of contamination (mysophobia).

The sufferer from agoraphobia cannot bring himself to cross alone an open field or square. The sufferer from claustrophobia will invent any excuse to avoid an elevator or the theatre. When a certain lady was asked if she disliked to go to the theatre or church, she answered, “Not at all, but of course I like to have one foot in the aisle; I suppose everyone does that.”

The victim of mysophobia will wash the hands after touching any object, and will, so far as possible, avoid touching objects which he thinks may possibly convey infection. Some use tissue paper to turn the door-knob, some extract coins from the pocket-book with pincers. I have seen a lady in a public conveyance carefully open a piece of paper containing her fare, pour the money into the conductor’s hand, carefully fold up the paper so that she should not touch the inside, and afterwards drop it from the tips of her fingers into a rubbish barrel.

The case of a nurse who was dominated by fear of infection has come to my attention. If her handkerchief touched the table it was discarded. She became very adept at moving objects about with her elbows, was finally reduced to helplessness and had to be cared for by others.

Unreasoning fear of one or another mode of conveyance is not rare. It is said that Rossini found it impossible to travel by rail, and that the attempt of a friend to accustom him to it resulted in an attack of faintness (Lombroso).

The sufferer himself realizes, in such cases, that there is no reason in his fear—he knows he can undergo greater dangers with equanimity. Even doubting folly finds no answer to the question why should this danger be shunned and that accepted. The nearest approach to an answer is “I can’t,” which really means “I haven’t.”

The origin of the phobia is not always clear, but given the necessary susceptibility, circumstances doubtless dictate the direction the phobia shall take. A startling personal experience, or even reading or hearing of such an experience may start the fear which the insistent thought finally moulds into a fixed habit.

To the hypochondriac who concentrates his attention upon the digestive tract, this part of his body occupies the foreground of all his thoughts. He exaggerates its delicacy of structure and the serious consequences of disturbing it even by an attack of indigestion. A patient to whom a certain fruit was suggested said he could not eat it. Asked what the effect would be, he answered that he did not know, he had not eaten any for twenty years and dared not risk the experiment.

Extreme antipathies to various foods are fostered among this class. A lady told me that she perfectly abominated cereals, that she could not stand vegetables, that she could not bear anything in the shape of an apple, that she could not abide spinach, and that baked beans made her sick at the stomach.

The heart is perhaps the organ most often the object of solicitude on the part of the hypochondriac. When we realize that the pulse may vary in the healthy individual from 60 to over 100, according to circumstances, and that mere excitement may send it to the latter figure, we may appreciate the feelings of one who counts his pulse at frequent intervals and is alarmed if it varies from a given figure.

Inspection of the tongue is a common occupation of the hypochondriac, who is generally more familiar than his medical attendant with the anatomy of this organ.

Insistent desire regarding the temperature is common not only among hypochondriacs, but among others. I do not allude to the internal temperature (though I have been surprised to learn how many people carry a clinical thermometer and use it on themselves from time to time); I refer to the temperature of the room or of the outside air. The wish to feel a certain degree of warmth is so overpowering in some cases that neither work nor play can be carried on unless the thermometer registers the desired figure. A person with this tendency does not venture to mail a letter without donning hat and overcoat; the mere thought of a cold bath causes him to shudder.

Golf has cured many a victim of this obsession. It takes only a few games to teach the most delicately constructed that he can remain for hours in his shirt-sleeves on quite a cold day, and that the cold shower (preferably preceded by a warm one) invigorates instead of depresses him. Further experiment will convince him that he can wear thin underwear and low shoes all winter. Such experiences may encourage him to risk a cold plunge in the morning, followed by a brisk rub and a few simple exercises before dressing.

Morbid fears in themselves produce physical manifestations which add to the discomfort and alarm of the hypochondriac. I allude to the rush of blood to the head, the chill, the mental confusion, and the palpitation. These symptoms are perfectly harmless, and denote only normal circulatory changes. It is true that one cannot at will materially alter his circulation, but he can do so gradually by habit of thought. To convince ourselves of this fact, we need only remember to what a degree blushing becomes modified by change of mental attitude. Similarly, the person who has practiced mental and physical relaxation will find that the blood no longer rushes to his head upon hearing a criticism or remembering a possible source of worry.

The automatic processes of the body are in general performed best when the attention is directed elsewhere. After ordinary care is taken, too minute attention to the digestive apparatus, for example, may retard rather than aid it. Watching the digestion too closely is like pulling up seeds to see if they are growing.

The more attention is paid to the sensations, the more they demand. Nor can the degree of attention they deserve be measured by their own insistence. If one tries the experiment of thinking intently of the end of his thumb, and imagines it is going to sleep, the chances are ten to one that in five minutes it will have all the sensations of going to sleep. If this is true of the healthy-minded individual, how much more must it be so in the person who allows his thoughts to dwell with anxious attention on such parts of his body as may be the immediate seat of his fears. The next step is for various sensations (boring, burning, prickling, stabbing, and the like) to appear spontaneously, and, if attention is paid to them, rapidly to increase in intensity.

It is probable that the mere pressure of part upon part in the body, even the ordinary activity of its organs, would give rise to sensations if we encouraged them. Given an anomalous sensation, or even a pain, for which the physician finds no physical basis, and which, after a term of years, has produced no further appreciable effect than to make one nervous, it is always in place to ask one’s self whether the sensation or the pain may not be of this nature.

Medical instructors are continually consulted by students who fear that they have the diseases they are studying. The knowledge that pneumonia produces pain in a certain spot leads to a concentration of attention upon that region which causes any sensation there to give alarm. The mere knowledge of the location of the appendix transforms the most harmless sensations in that region into symptoms of serious menace. The sensible student learns to quiet these fears, but the victim of “hypos” returns again and again for examination, and perhaps finally reaches the point of imparting, instead of obtaining, information, like the patient in a recent anecdote from the Youth’s Companion:

It seems that a man who was constantly changing physicians at last called in a young doctor who was just beginning his practice.

“I lose my breath when I climb a hill or a steep flight of stairs,” said the patient. “If I