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Popular Science Monthly/Volume 84/March 1914/Psychotherapy in Folk-Medicine

PSYCHOTHERAPY IN FOLK-MEDICINE
By Dr. ABRAM LIPSKY

NEW YORK CITY

PSYCHOTHERAPY may look like a discovery of the twentieth century, but the truly remarkable thing about it is the extent to which it has been practised without being scientifically understood. It has been in the world since the remotest antiquity, nor has it ever left the precincts of civilization. A scholar spelling out an Assyrian inscription discovers a cure for rheumatism as follows: "Surround the patient with a circle of leavened meal, place his foot upon a reed-bearing dough, then put away the refuse-food. Take him seven time across the surrounding circle, saying 'Ea hath loosed, free the evil, Ea hath created, still the wrath, undo the knots of evil, for Ea is with thee! Physician of the World! Ninnissin! Thou art the gracious mother of the world, the leader of the underworld, the mistress of E-dubbo,'" etc. What is this but psychotherapy? A New England cure for rheumatism is to take a cat along to bed. That too is psychotherapy and rests on essentially the same principle.

The scientific person will say that these are interesting examples of heathen superstition, but that no one was ever cured by such means. That is just the question. In the light of our present knowledge, the probability is that both the Assyrian and the New England methods have worked—at least sometimes. Both are illustrations of the influence of thought upon the body. In the one case, faith of a religious nature dispels the physical symptoms; in the other, fear of the cat is probably the therapeutic distraction—or, as the psychologists call it, the "dissociation."

Popular psychotherapy has long known what science is only now finding out. The best known example of mind-cure is probably that of the toothache that ceases when the dental office is approached. If a man may cure his toothache by walking in the direction of a dentist's office, why may he not cure it by spitting into a frog's mouth, or scratching his gum with a nail and driving the nail into an oak tree, or pulling out with his own teeth the teeth of a dead man's skull, or solemnly repeating the lines:

Christ passed by his brother's door,
Saw his brother lying upon the floor,
What aileth thee, brother?
Pain in the teeth?
Thy teeth shall pain thee no more.
In the name of the Father, Son and the
Holy Ghost!

Why should it be more difficult to believe that toothaches have been cured by each and every one of these methods as promptly as by the sight of a dentist's forceps? The therapeutic agent in each case is the same. It is psychical, and we call it "suggestion."

But if a toothache can be cured by psychotherapy, why not the ague? That too has often been done. Can modern psychotherapy produce a prettier illustration of the method of auto-suggestion than this—described in an old Saxon medical book? We are told that the sick man wrote the words "Febra Fuge" (fly away, fever) on a piece of paper and, beginning with the last letter, cut off a letter each day. The fever abated day by day and when the letter "F" finally fell, the ague disappeared. Fifty others, besides the narrator, were cured the same year by this method!

As the virtue of a dose of medicine does not depend upon the kind of spoon in which it is conveyed to the patient's lips so, a different way of administering suggestion for the ague proves in New England to-day of equal potency with that described by the early English.writer. The patient goes out with a friend and looks on while the friend cuts down willow rods corresponding in number to the hour of the day. Each rod must then be burnt singly and as the last one turns to ashes the distressing symptoms disappear.

Among the country people of modern England a variety of devices for circumventing the ague are known. If you peg a lock of your hair into an oak and give a sudden jerk with your head, your ague will be transferred to the oak. Or, to mention only one other, you may take nine or eleven snails, string them on a thread, saying with each slimy bead, "Here I leave my ague." Frizzle them over a fire and as the snails disappear, so will your ague.

Observe how the last method accords with modern scientific psychotherapy. The practitioners of the Emmanuel movement tell us, in "Religion and Medicine," that when giving one's self a verbal autosuggestion, it is well to accompany the words with some action, however trifling and absurd—the absurdity of the action, in fact, being rather something in its favor. For example, when you say to yourself: "I put away all worry," you might put an old shoe out of sight and think of your worry as staying with the shoe. The snail cure for ague obviously anticipates these directions. It takes advantage, moreover, in a very cunning way of another psychological discovery—the hypnotic influence of bright light when stared at fixedly. Most people now-a-days are familiar with this phenomenon from their experience in staring at strongly illuminated stereopticon screens. They know how difficult it is to keep awake—unless the lecture is unusually exciting. Now, suggestion is most effective on persons who are in a somnolent or hypnotic condition, and your credulous rustic, staring into the fire as the snails sizzle and repeating to himself, "Here I leave my ague," is performing a very pretty psychological experiment on strictly scientific lines.

Scientific psychotherapy has undoubtedly taken this hint of reinforcing verbal suggestion with a trivial action from popular practise. The device is perhaps best known in popular medicine as applied to the cure of warts. You strike the wart downwards three times with the knot of a reed as you make your auto-suggestion, or, you rub it seven times with the third finger of the left hand in the direction in which the sun moves; or, you wet your forefinger with saliva and stroke the wart in the direction of a passing funeral; or, you touch each wart with a pebble, place the pebbles in a bag and lose them—the finder getting the warts; or, you tie as many knots in a hair as you have warts and throw the hair away; or, you steal a piece of bacon, rub the wart and slip the bacon under the bark of an ash tree, thus causing the warts to disappear from your hand and appear on the bark; or, you get another, by hook or by crook, to count your warts, when they will pass over to him.

Let it not be supposed that the foregoing remedies are merely prescriptions, but not cures. Innumerable experiments have been made with them by persons who sincerely believed in their efficacy, and the evidence of their success is as abundant as that of the success of more academic methods. The great variety of methods—and those enumerated do not begin to exhaust the list—shows that the particular differences between them 'are of no consequence, but that any device based upon the faith of the patient may be employed to utilize the control which the mind, under certain circumstances, may exercise over the so-called vegetative processes of the human system. That the most powerful suggestion may fail of its object is, of course, perfectly well-known. A case is reported of a German peasant, unpleasantly endowed with too many warts, who stood on his head in a newly made grave. To a superstitious yokel this was an extremely powerful suggestion, but the warts remained.

Any one who is of the opinion that these remedies for warts can not be effective because they are so little countenanced by scientific medical authority, will see the matter in a new light if he will take the trouble to look up the remedies that are recommended by the medical authorities themselves. A standard medical work (Foster's "Reference Handbook of the Medical Sciences") names a few of them and dismisses the rest with the remark that they are too numerous to mention, as every physician has his favorite remedy. The diversity among these remedies being as great as among the popular cures, the inference seems justified that there is nothing inherently curative in the one class any more than in the other, but that they all depend upon that principle which is common to them all—the principle of suggestion.

The strange, the mysterious and the weird have great suggestive potency, and hence drugs culled at unearthly hours, during unusual conjunctions of the moon and planets, on St. John's or St. Agnes' Eve, have unusual curative properties. The rare stone bezoar, or bezar—a concretion found in the intestines of certain animals like goats—was believed in colonial New England to have magical powers. Any mysterious rite may be efficacious if linked with a vague but strong superstitious belief. In 1884, two children in Suffolk, England, between Needham and Barking, were reported cured of infantile hernia by means of the cleft-ash rite. The procedure was as follows: A sapling was split upward, beginning a few feet from the ground and tied at the top to prevent the cleft from extending all the way up. The cleft was held open and the child passed through three times, head downward, each time by a different person. The sapling was then bound up securely at short intervals. It grew together again—which was supposed to be the reason why the children recovered.

Miracles are sometimes due to the reinforcement of suggestion by the fascinatingly horrible, and hence the curative property of things associated with corpses, skulls, gallows, graveyards and so on. One of the many remedies for ague in England is to wear chips from a gallows around one's neck; for a wen one should go alone at night to the spot where a fresh corpse lies—preferably that of an executed criminal—and pass its hand over the wen. A poor woman living in the neighborhool of Hartlepool, England, some years ago was induced by a "wise woman" to go alone at night to an outhouse where a suicide lay awaiting the coroner's inquest and to hold the hand of the corpse on her wen all night. She died shortly after from mental shock. Another woman at Cuddesden, Oxfordshire, asked for the hand of a corpse in order to cure a goiter. Her father, she said, had been cured by the same means, the swelling having diminished as the hand mouldered away. In 1850, it was common for numbers of invalids in certain parts of England to congregate round the gallows in order to receive the "death stroke"—the touch of an executed criminal's hand. The practise declined because of the high fees the hangmen came to charge for applying the remedy.

There was a time when powdered mummy was a highly valued medicine throughout Europe. Carbonized and powdered animals are still used in China and Japan, as crushed bones once were in England. The celebrated chemist, Eobert Boyle, relates, in his essay on "The Porousness of Animal Bodies," how, "having been one summer frequently subject to bleed at the nose and reduced to employ several remedies to check the distemper, that which I found the most effectual to staunch the blood was some moss off a dead man's skull (sent for a present from Ireland where it is far less rare than in most other countries) though it did but touch my skin till the herb was a little warmed." Mere contact with the gruesome object was sufficient.

Will it be objected that Boyle was deceived and that his nose-bleed could not have been stopped as he says it was? Let it be remembered that the possibility of controlling hemorrhages by suggestion has been demonstrated repeatedly by experiment on subjects under hypnotism. The Emmanuel practitioners have done it by their methods. The Bible reports a case, and the popular devices for stopping nose-bleed are about as numerous as for curing warts—one of the most favorite being to slip a cold key between the skin and the clothes. Boyle tells of another case, that of a young man, whose nose-bleed was stopped by the external application of an agate, and in his collection of household remedies he mentions, among other instances of suggestive therapeutics, the holding of a certain herb in the hand as another excellent measure against nose-bleed.

The horrible was relied upon by the Romans to give them the requisite psychic shock. They drank the blood of gladiators for epilepsy, and to-day in Denmark, China and Switzerland, curative suggestion for epilepsy, hydrophobia and consumption is obtained from the blood of decapitated criminals. The Egyptian kings took baths of blood to cure elephantiasis, and the Vikings drank from the skulls of their conquered foemen at solemn festivals. Next to the horrible, the loathsome and nauseating have been utilized. The bitter medicines that used to be prescribed by the old-fashioned doctors, and the vile compounds made from the excreta of goats, cats, dogs, mice and other animals owed their curative properties to the same principles. Nor have the worst of these medicines passed away from civilized lands, as a little inquiry among some of the latest arrivals from rural Europe has demonstrated.

Belief in the curative power of the means employed is the most important element in its success. We know now that it does not so much matter upon what the belief is based so long as the belief is strongly present. Faith, in former ages, was almost entirely at the command of religious ideas. To-day, faith in scientific conceptions and scientific authority has largely taken the place of religious faith. Let a man feel that a certain mode of procedure rests upon scientific principles, and the method, whether right or wrong, will have therapeutic value. Cures recommended by popular tradition are contemptuously dismissed as mere relics of ancient superstition, but any remedy administered with a show of scientific reasoning and authority is sure to produce results. A slight examination of the scientific remedies for whooping-cough will show how true are these observations.

The number of approved remedies for whooping-cough is about as large as for warts. Only a few will be mentioned here. Schlief used a bath of compressed air and reported eighty-five per cent, cured in fifteen seances. Gay, supposing that "the sublingual ulcer was the initial specific of whooping-cough, cauterized it with nitrate of silver and reports several cases cured in a short time!" Mohn has reported cases of whooping-cough "cured as if by enchantment" by the use of sulphur fumigators. The child is dressed in clean clothes and sent from the room, which is closed and fumigated with burning sulphur for five hours in the morning. After the room is aired the child sleeps there at night. One trial is generally sufficient for a cure! These observations have been enthusiastically confirmed by Manly.[1] Another physician cured 101 cases out of 169 by letting them inhale illuminating gas. Still another cured 219 out of 341 by the same method. Powdered benzoin cured 75 per cent, of one physician's cases. Seventeen patients were cured by another with boric acid and roasted coffee, and so on ad infinitum.[2]

There is, of course, no intention here of disputing the correctness of these statistics. They have been quoted only to show the similarity between the curative principle underlying them and that relied upon by a woman, probably of German descent, who was seen on the bank of the Schuylkill River, holding a live fish head foremost in the mouth of her child in order to relieve the child of the whooping-cough. The principle is plainly brought out again in the injunction to one seeking a remedy for his disease "to follow the directions given by a man riding on a piebald horse."

Religious emotion has undoubtedly been the most powerful agency known for energizing curative suggestion. We usually call it impotent superstition when it appears among lowly or primitive peoples. The Malay is patently and grossly superstitious when he recites: "Not mine are the materials, they are the materials of Kemah-ul-hakim. Not to me belongs this neutralizing charm. It is not I who apply it. It is Malim Karinim who applies it." But if he believes in Kemah-ul-hakim and Malim Karinim and is tremendously impressed by the formula he recites, we need not hesitate to believe that—sometimes—he is cured thereby.

The Englishman of Elizabeth's day was no doubt immensely superior in mental power to the poor Malay who has just been quoted. His religion was more logical and more efficacious than that of the Malay and perhaps his charms worked oftener. To the cold and unfeeling eye of science, however, the therapeutic principle in the charm, spoken by the Malay and that spoken by the Englishman is the same. This was the Elizabethan Englishman's charm for ague:

When Christ saw the cross, He trembled and shaked and they said to Him, Hast thou the ague? And He said unto them, I have neither ague nor fever; and whosoever bears these words, either in writing or in mind, shall never be troubled with ague or fever. So help thy servants, O Lord, who put their trust in thee.

The same Englishman recited, in order to stop a hemorrhage:

So may it please the Son of God. So His mother Mary. In the name of the Father, stop, O blood! In the name of the Holy Ghost, stop, blood! In the name of the Holy Trinity.

It is no longer possible, as was only recently the tendency, to deny all the miraculous cures ascribed to sarcred relics and to the touch of saintly persons. Science formerly had no explanation to offer and dismissed all such claims with contempt. They must now be admitted to be at least of possible occurrence. Authentic cures by healers not of the most exalted character have taken place in our own day almost before our very eyes. Faith in the power of a supposedly sacred personality has made them possible. In the hey-dey of royalty the divinity that was believed to hedge a king produced the undisputed cure of many a wretched invalid. Between three and four hundrd persons were said to have been cured by Queen Elizabeth annually of scrofula or the King's Evil. James the Second is reported to have cured three hundred and fifty at one time amid great pomp and ceremony—a circumstance that doubtless contributed materially to the success of the operation.

Religion after having been expelled by science from the field of therapeutics is now being invited back again. Science is obliged to admit that it was mistaken in its wholesale condemnation of appealing to religion in illness. And this change of attitude on the part of science has been brought about by the rise of two or three new concepts—suggestion, subconsciousness, multiple personality. That which formerly seemed absurd, now seems perfectly reasonable. It seems as reasonable that healers of the sick should make use of the immense suggestive reinforcement of religion as of the aid lent by the newer authority of science.

Unenlightened members of the medical profession in their desire to discount the achievements of psychotherapy declare that all that is of value in the new methods has long been known and used by regular practitioners. A large part of this claim is perfectly true. We all know that the success of many a prosperous physician is not due to his superior scientific equipment—in which he often is notoriously lacking—but to the faith inspired by his "personality." In some instances, gentle, soothing tones, in others, brusqueness and peremptoriness of manner, convey the very useful suggestion of great ability justified in its assumption of authority. The particular remedy prescribed after that is of no consequence.

But we must go a step farther. We must admit not only that regular medical practitioners have been making use of the principles of suggestion, but that the people at large, the common people, the ignorant and the superstitious, have had an intuition into their nature and have been practising psychotherapeutics, with more or less of success, from the dawn of history down to our own day. The practise of medicine is, even to-day, an art largely based upon empirical rules learned from the experience of the common people. Scientific medicine has in the past adopted into its pharmacopoeia a great many of the "simples" cherished by the people, but has discarded their innumerable hints as to the value of psychotherapy. It is now beginning to turn to this neglected wisdom, to make use of the spiritual "simples," to learn what curative powers reside in the soul.

  1. Mohn in the Revue Internationale des Science Med., November, 1886, and The Practitioner, August, 1888.
  2. Quoted in Foster's "Handbook."