James Walsh - Psychotherapy

There are certain popular medical practices that are related to these old traditions of deterrent therapeutics. In many manufacturing establishments, in spite of progress with regard to sepsis and antisepsis and the diffusion of information as to first aid to the injured, it is still the custom to put spittle on wounds. I am sure that every doctor has seen quids of tobacco used in this way. Even native-born Americans, who are not illiterate, are sometimes found using some deterrent material. I have known such a man use his own urine as an eye-wash for sore eyes, and the use of children's urine for such purposes is much commoner than might be thought. After all, it is only a generation since physicians used to taste urine in order to determine whether it contained sugar or not, and I have seen a country doctor even take between his finger and his thumb a little of the excrement of a child and apply his tongue to it, pretending of course that he obtained very valuable information this way.

Excretions and Secretions .—All the human excretions have formed the basis of vaunted remedies. Tears, on the principle that like cures like, were used for melancholia; nasal secretion to lessen respiratory difficulty through the nose; sputum for various mouth affections, but also as an application to external abrasions, and to the eyes, the ears, and the like. Undoubtedly patients were helped by many of these, not because of any physical effect, but because they felt easier as a consequence of the satisfaction of having something done for them, and the consequent freedom from solicitude which allowed nature to produce her curative reaction without interference. The greater the effort he has to make, apparently the more efficiently does he control this disturbing state of mind. This is the secret of many cures now as well as in the olden time.

Whatever good effect is produced in such cases comes, of course, from the persuasion that these substances will do good, and there must be a strong suggestion to that effect before the repugnance can be overcome. While we are prone to think the older peoples who used such materials commonly are to be condemned for ignorance and superstition, it is well to recall that human nature has not changed, and is still ready to be influenced in the same way. Brown Sequard's extract of testicular substance came in this category. We had a wave of organotherapy a few years ago, and we know now that whatever benefits patients derived from taking heart substance for heart troubles, and brain substance for brain troubles, and kidney for renal diseases, was entirely due to mental influence. The cannibal who eats the heart of his enemy, thinking that the vigor and courage of the other will pass into him, undoubtedly has for a time a power of accomplishment greater than before. Nothing acts so powerfully as suggestion of this kind to give renewed vigor and to enable us to tap sources of energy that we were not aware of in ourselves, and that enable us to accomplish what before seemed quite impossible, and even to bring about curative reactions.

Diseases Benefited.—Observe the classes of disease that were particularly relieved by deterrent therapeutics. Headache was one of these. All sorts of things were cures for headaches—the touch of the hangman's rope, or of an executed criminal, or some herb gathered in the graveyard in the dark of the moon, or pills made of the excrement of various animals. The forms of headache thus relieved would be those in which over-attention to self, rather than real headache, produced queer feelings in the head, though concentration of attention might exaggerate this into an ache. Foot troubles were cured by deterrent therapeutics. To wear the shoes of a dead person, especially of a murderer who had been hanged, would cure them. Colic was cured by pills of excrementitious materials, and by all sorts of other deterrent remedies. For instance, one well-known remedy was to wash the feet and drink the wash-water. The wash-water of little babies was a favorite remedy for the vague abdominal pains of old maids, and for the symptoms due to the menopause.

Deterrent Pain.—A striking illustration of a strong mental influence helping out a slight amount of therapeutic efficiency is found in the use of the actual cautery for medical affections. At a number of times in history most of the chronic pains and aches, the arthritises, the so-called gouty tendencies when localized, the rheumatic affections and especially the chronic rheumatisms, have been treated by means of the cautery. All of the neuralgias, many of the neuroses, all of the neuritises and a certain number of so-called palsies and paralyses, were treated successfully by this means. It is a very suggestive remedy producing a deep impression that now relief must be in sight. It became popular over and over again, though after a time it always lost its influence, and ceased to have the beneficial effects that it had at the beginning of its reintroduction.

During the second half of the eighteenth and the beginning of the nineteenth century the cautery became very popular. It was applied particularly in the form of the moxa. A cylinder of cotton was employed for this purpose, being set on fire and allowed to burn on the skin of the patient, producing a deep wound. The mental effect of this can be readily understood. Baron Larrey, one of the most eminent surgeons of the time, thought the moxa one of the best aids that he had in the treatment of many affections where the knife was not indicated. There were large groups of diseases in which it was almost a specific. Larrey employed it in affections of vision, of smell, of taste, of hearing and of speech. In many paralytic affections of the muscular system, in all chronic affections of the head, among which he enumerates non-traumatic affections, hydrocephalus, chronic headaches and many other affections supposed to be seated in the cranium. In asthma he was particularly successful with the moxa. Old catarrhal affections yielded to it. Consumption was frequently benefited by it. Most of the chronic affections of the uterus were benefited, as were also similar affections of the stomach. He considered that the moxa must be admitted, without contradiction, to be the remedy par excellence against rachitis. In Pott's disease, which he called dorsal consumption, it worked wonders. In sacrocoxalgia, in cocygodynia and femero-coxalgia he had excellent results with the moxa.

A glance at this list shows exactly the class of cases in which suggestion has always played a large role, and for which there has been, at various times, a series of specific remedies, medicinal, manipulative and surgical. Others extended the value of the moxa beyond these affections. Ponto found it valuable in gout, and in the various chronic affections which are sometimes grouped under the name chronic rheumatism. He insisted that the moxa could be placed on almost any part of the body, though the contra indications he suggests show how far the men of his time went with its use. Only these portions named might not have a moxa applied to them. It must not be used on the skull, on the eyelids, on the ears, on the mamme, on the larynx and on the genitals, though it might be applied to the perineum or the perineal body.

Deterrent Taste and Smell.—The disturbing effects produced by other senses besides those of sight have been used in the same way for the production of definite therapeutic suggestive effects. A number of the ill-tasting, almost nauseating drugs of the olden time prove to have very little real therapeutic efficiency in the light of modern clinical careful observation. This is particularly true of the herbs and simples. Many a disgusting preparation apparently owed all of its' good effects on the patient to the effort that was required to swallow it, producing such a favorable influence upon the mind, by contrecoup as it were, that the patient got better. A little girl said that cough medicines were nasty things they gave you in order to keep you from catching cold again. The sense of smell has been used in the same way. Valerian is probably an efficient drug in certain respects, but undoubtedly its efficiency is materially increased by its intensely repulsive odor. For many of the psycho-neuroses and neurotic conditions generally the ammonium valerianate is likely to be much more efficient than the strychnin valerianate, though probably the latter should be considered as more physically efficacious in its tonic properties. Asafetida, musk and some preparations of the genital organs of animals that used to be in the pharmacopeia, owed most, if not all, of their power, whatever it was, to the mental effect of their odor and the feeling of deterrence that had to be overcome before they were taken.