A DEPARTMENT OF GOOD MEDICINE AND GOOD CHEER FOR THE WAYFARING DOCTOR Conducted by GEORGE F. BUTLER, A. M., M. D. L Society and Solitude ET me venture to offer for the reader's consideration a few suggestions upon society and solitude, in the form of notes by the way, hazarding the promise that in proportion to our interest in life itself will the study of the theme engage our best thoughts and reflections. What is society? Wherein lies the subtle charm that binds us to our fellow creatures in the world at large, permeates with its vitality and hope the body politic of our republic, links us indissolubly with the remotest nations of the earth, and, blended with the divine instinct of human affection, renders forever sacred the associations and memories embalmed in the idea of home? Shall we degrade its name and import, limiting its sphere to the private theatricals of a drawingroom; to a multitude of dainty nothings, uttered only, to tickle the ear and leave us poorer than ever? To a brooch, a glove, the latest genteel gossip, the conversation at an afternoon bridge-whist party-the dryrot of social intercourse? Of such inanity, one is reminded in its first interview, as created by George Elliot, between Grandcourt and Gwendolen, and the author's caustic remark, "Then commenced what is called conversation." No, to a nobler category of thoughts and feelings, to a higher plane ot action, must we assign, in its finest sense, society. In its purity, society is the embodiment of that inward longing of the heart which calls us from our lonely hearthstones to seek communion with the outer world; to test our theories of life and, through the medium of brave sympathies and the advantage of a deeper acquaintance with the excellence and the follies of mankind, see revealed to ourselves our own virtues and shortcomings. Upon the very threshold of society, we should assume a modest confidence, accepting as final the lessons of experience, however closely they may be brought home to us. Doubtless there are few occasions more mortifying than the sudden discovery in the presence of superior intellect and force that we have overestimated our worth. Everyone guards within a retired niche of his heart's chapel the pleasing assurance that he is not wholly unimportant as a factor of mankind, and the revelation that our pet theories and deductions, drawn from what we fancied had been a careful study of our fellowmen, are, after all, erroneous, is little calculated to awaken in an ordinary mind better feelings than those of disappointment and regret. at The chagrin arises mainly from the fact that we have been worshipping false idols in attaching undue importance to private doctrines. It is this morbid self-consciousness, this want of humility in our desires consequent thereupon that obtrudes every step our own selfish personality, that gives to society, in most circles, the aspect, not of a generous conflict between inspired men and women, but, of a paltry skirmish wherein each individual hides behind a shield of triple defense the foibles that must not, on any account, be disclosed to the enemy. Yet, the instincts of human nature are keener than our strategy, and, in the long run, every man finds the level to which his faculties elevate or degrade him. Let us, however, but stand bravely in the presence of others, with the beam of sincerity in our eyes and the message of truth upon our lips, seeking only to know and to be known, filled with the genial warmth of love and charity, and instantly society acquires a new character and more stately proportions. We no longer are conscious actors in a petty drama, a conventional farce: the faces and actions of those around us become ennobled and the air we breathe is transfused with kindliness and grace. Persons whom in our exclusiveness or haste we have wrongly classified, according to our narrow standard of human excellence, develop richer forms and qualities and we are confounded with our own stupidity. A distinguished American writer tells us of an English visitor who complained to him that in his rural village at home there was really nothing of interest, no one remarkable for intellect or power, and he adds thoughtfully that the very man he had sought with such ardor was, probably, living next door to him. In an unpretending country town, I have often watched the face of a certain railway official and marked in his conduct the strange want of delicacy, the ignorance of manners-alas, not infrequent in American characters! I once was indignant with him, seeing a grayhaired man publicly shamed, by his rudeness, for a pardonable oversight in the purchase of his ticket, thinking to myself: "Well, this man is honest and perhaps, uncouth as he appears, he serves his part in the economy of his race, though of such can not be the "kingdom of heaven." A few days afterward, I saw from the morning train bound for a distant city a handkerchief fluttering and, in answer to its greeting, an aged mother watching intently the receding figure of her son, and I found upon examination that each day this act of parting veneration was renewed. In a moment, the boor became a hero. Here were poetry, feeling, filial affection, that should lighten during an anxious day the yearning solicitude of that mother's thought. And, from another window, I have often seen a hand grimy in the exercise of a terrible profession waving a bunch of engine waste to the wife and child who stood awaiting the godspeed. Are not such examples a rebuke to us? And, are we not led by them to this conviction, to me the crowning lesson of society, that we are oftener deceived in our evil than in our good opinions of others? Again, I might tell you of a certain man, now bowed with years, who at the age of twenty wrestled with one of the most frightful forms of mortal temptation, and for upward of half a century this poor shoemaker has heard the voices of ministering angels proclaiming his triumph, till his gray hairs seem like aureole about his venerable head. And all of us have witnessed these instances of dignity and merit in those whose outward appearance and circumstances offered an little interest to a careless observer of men and manners. They teach us that virtue resides in humble places as well as in the minds of the exalted, appealing to us to forego our shallow judgments of mankind, to look deeper into the heart of society, and gather strength, and confidence in each other, from the undying gleams of truth and honor that illumine the obscurest paths. Nay, more, we are led by the contemplation of society, in its amplest sense and import, to recognize that it is synonymous with humanity: for, it is not in the conversation, however admirable; it is not in the wit, the elegance, the taste, the witchery of the dance, the wooing whispers of music and art: not in these lie the charm, the secret fascination which draw a contemplative spirit to seek comfort in the company of others. It is in the universal instinct of humanity, the uplifting consciousness of mortal brotherhood, like that which inspires the verse of Terrence: "I am a man from nothing that is human alienate." So firmly rooted in our nature lies this beneficent principle of mutual dependence, that hermitage seems impossible to a healthy, vigorous intellect. Notwithstanding a hundred disenchantments, we return, like prodigals, from the wastes of bitterness and isolation to the old faces, the familiar haunts that have before shed lethe upon our troubled lives. Even the venom we have nurtured, when betrayal darkened for us the lovely vistas of the soul's hope and faith, is changed to healing balsam by the renewal of a friendly smile or the touchstone of confiding assurance. We are shocked that we could have regarded with indifference the wealth of goodness, of purity, of love that encompassed our little measure of life, and we turn with firmer vows of fidelity to the warm sympathies that only await our behest to be called into generous activity. Yet, the forces which pervade the living world about us come to us often unbidden and, through secret avenues amid whose green arches dwell silence and forgiveness, become our protecting nemesis. Let a man be never so broken on the wheel of fortune; let the anguish of the heart's bereavement sweep over and subdue him and the sunlight wound and the carols of birds awaken in his imagination only that deathlike sense of unreality that is the soul's most poignant pain-the touch of a child's soft palm laid joyously and confidingly in his own, the notes of a cherished song falling upon the stillness of his wo like an unearthly greeting, or the innocent laughter of one whose days should know no sorrow will quicken in his being the springs of gentler feeling and elevate his weary consciousness into a serener, nobler atmosphere. So long has he toiled to gather his poor bundle of faggots, and, lo! at the fireside of mankind, he may sit and partake of the most bountiful of human cheer. Unhappy is he to whom such tokens of divine compassion bring no peace, who can not joyfully respond to the unseen visitants of earth or own the blessed thrill that wakens with the pressure of a friendly hand! To such a one, indeed, all is mockery and ruin, society "stale and unprofitable", and the grandest energies of mortals only the fever of pitiless unrest. Perhaps no benefit to be derived from social intercourse, considered in its amplitude as I have indicated it, is comparable to the abiding trust in human nature developed by an intelligent survey of the motives and passions that sway mankind. As our insight becomes deepened by experience and wise interpretation, we learn to comprehend more justly the finer play of feeling of which all classes of men and women are capable, should the magic sesame ever fling wide the doors of higher emotion in them. As an instance of this latent virtue (too stilled), here is an episode in a conventional drama I witnessed played some time ago. I refer to the play "Fairfax," in which the heroine is doomed to suffer what Mr. Mill, in his "Subjection of Women," calls "the sad irony of life," being wedded to a brutal husband whose passions, long since estranged from their natural object, have plunged him into an abyss of degradation and shame. Even the thought of his dying child can not rouse him from the torpor of his moral obliquity, and in a moment of fiendish wrath he attempts to wrest from his pleading wife by force the means of her support and of the child's salvation which chance has brought to her. In the struggle which ensues, the weapon which he directs against her is, through the benignant resources of modern melodrama, accidentally turned against himself, and its discharge terminates his besotted life. Filled A ас with dismay, the wife flees southward, appearing, in the following act, under an assumed name, as governess in a wealthy family residing on an impossible estate situated on the banks of the St. John's River of Florida. Here, the heir apparent falls madly in love with her and she is sorely pressed to conceal her identity, which poverty and still more a genuine affection for her suitor persuade her to attempt. stranger appears, who, being well quainted with her previous history, including the fatal encounter with her husband, hastens to warn her of the duplicity of her position toward his friend her lover; and finally a still further disclosure reveals the secret she struggled to hide-less from motives of policy than from the overmastering passion which has assumed control of her womanly nature. Then follow the bitter reproaches of her betrothed and the misery of finding herself discarded by the friends of yesterday, who lose no occasion to augment the intensity of her grief by the most heartless contumely and scorn. Distracted by conflicting emotions, the poor woman sinks under a weight of private agony. Finally, having recovered her selfpossession, she determines to address a letter to her lover, containing a full confession of the catastrophe which has blighted her fondest hope. The whole scene, by the way, has been admirably treated, the situations being highly dramatic and replete with unaffected power and simplicity. And now comes the moment to which these necessary details have conducted us. With averted face, the woman offers him the declaration which is to free her character from the stain that fate has cast upon it, while the circumstances therein related, she well knows, may only serve to confirm the suspicion of her crime. Taking the paper from her hand, the man simply asks in a voice of mingled sternness and affection whether it includes any record of guilt, and this her consciousness of innocence prompts her to deny unequivocally. As he turns from her, all his doubts are merged in manly magnanimity and trust, and the climax of his faith is reached when he silently holds the unread confession in the flame of a taper and calmly watches the burning of the confession that has so humiliated her. Instantly a tempest of applause burst from the house. One almost could feel the pulse of the delighted audience as it responded to that irresistible transport. But, most interesting to me and that which bears more directly upon our subject was the fact that the first outburst of approval came from the gallery: not from the jeweled palms of luxury and pride, but, from the stenographers, the clerks, the shopgirls, the servants, the newsboys, and the sad company of those to whom life has much of tragedy and shame. That single noble impulse in them bespoke the universality of the affections, the instinctive recognition of honor and truth that will never fade while human hearts endure. It was the one touch of nature that makes the whole world kin, which, to him who cherishes true reverence for mankind, is more eloquent than the drama itself and makes society possible even among the humblest and poorest of us all. From these instances, we deduce the reflection that our opinions of others are only relative, being subject, always, to the degree of insight which education and knowledge of the world confer. It is never safe to predicate of fellow men what they are or may be; at most, we may utter the impressions we receive from their language and address, assuming that there is yet a possibility of something greater than we recognize in them, to which they would rise should occasion call for its display. The heroes of all ages, the inspiration of all transcendent epochs in the world's history and the uncomplaining martyrdom of daily life that commands our admiration wherever we turn to examine the elements of society attest this supreme fact. Το weigh humanity with the justice of a Portia, to put yourself in his or her place, to consider no man or woman too mean for sympathy and care, these are the dictates of wisdom in dealing with the world. I remember well the pleasing surprise I felt one night in a "cow-camp" in old Indian Territory, listening to a cowboy chanting this sweet song: Think of all the affectionate fidelity with which Livingstone's savage Makololos clung to him in those African wilds, when from commiseration for their condition he would go forward alone! Alfred Wallace, in "Natural Selection," relates of the Santals of upper Tartary, that they traveled three hundred miles on foot to pay a debt of honor to the British rajahs, though the obligation could never have been enforced; and we learn of a race inhabiting Ceylon among whom falsehood is absolutely unknown. These examples might easily be multiplied, as the best books of travel evince. They are but illustrations of a central truth, namely, that conversance with society in its relations to humanity is to be regarded an inestimable privilege in its tendency to inculcate faith in our fellow men. I think we should look with delight upon the glad faces of children, mindful of the soul's promise in them; the vicissitudes of maturity are but the reflection of our own griefs and pleasure; and he who reverences not age from instructive veneration for experience has learned little of the solemnity and grandeur of life. Limiting the scope of our subject to its more immediate significance, it is to be regretted that so frequent an obstacle to the simple relations upon which all healthful society is based is found in our hopeless longing to be understood. This jostling with agreeable company, those multitudinous acts of conventional courtesy, the talent and imagination, the coquetry and grace, which are, as it were, the peace-offerings, the milk and honey with which social enjoyment entices us, are, yet, unsavory compared with the priceless boon of being taken at our best, be it only by one kindred heart among mortals. Philosophy whispers to us the comforting assurance that to be great is to be misunderstood, that all the wisest and noblest in all times have been falsely estimated by their own age. But, bringing the maxim down to our own quiet circle, we are distressed by the discovery that the converse of it is very far from true and that to be misunderstood seldom means to be great. The foundation of this familiar disappointment doubtless would upon analysis, be seen to rest upon human vanity. It is the ghost of that hydra-headed self-consciousness, that morbid, decrepit introspection which afflicts the thought the manners and literature of our century. (To be continued) JACOBY: "UNSOUND MIND AND LAW" The Unsound Mind and the Law, a Presentation of Forensic Psychiatry. By George W. Jacoby, M. D. New York: Funk & Wagnalls Company. 1918. Price $3.00. At variance with the custom of centuries, dealing with insane persons should be primarily not a legal but a medical problem. This is so because the insane are not normal people to whom the law can apply without suitable adaptation. It is true that legal restraint is necessary in the case of insane persons since these are prone to commit acts usually involuntarily or, at any rate, without deliberate premeditation, that endanger the wellbeing and even the life of their fellow-beings. However, legal restraint in such case is neither curative nor preventive. It is merely an ancillary means for the application of remedies undertaken either for the restoration of mental health or for the purpose of preventing the incurably insane from injuring themselves or others. This should be recognized by those in charge of the mentally unsound. The author of the book before us calls attention to the disproportion between the more recent advances in psychiatric medicine and the conservatism or stagnation that exist in English and American laws in the same field. The author claims justly that the science of medicine must constitute a logical basis for every treatise on juristic psychiatry, for, the medical facts alone are stable, even if their scientific recognition may be uncertain and may vary with the lapse of time. Legislation, however, always is subject, necessarily, to relatively arbitrary and, often, illogical changes. In the nature of things, it should adapt itself to the science of medicine, a contrary procedure being ill-advised and productive of serious results. "That psychoses do not differ from other diseases, that they are usually conjoined with states of bodily disorder, and, conse quently, that insane-asylums are nothing other than hospitals adapted to the special requirements of patients suffering from diseases of the brain and nervous system, constitute fundamental truths which must become part of every person's knowledge. Not until these truths are generally recognized will the final prejudice disappear against those who are mentally disturbed and against the asylums for the insane; and only then will the relationship between jurisprudence and psychiatry be of a more intimate and harmonius nature." (From the Preface.) For these reasons, neurologists and psychiatrists and, indeed, all medical men, owe it to themselves and to humanity to correct and counteract the erroneous conceptions still existing concerning mental disorders and to bring about a just understanding of these affections as the only means by which a proper estimation of the medicolegal problems affecting the insane may be arrived at. This, the author declares, was his chief incentive in writing his treatise. In the first main division of the book, the general relation is dealt with that jurisprudence bears to psychiatry, considering more especially (in addition to simulation and dissimulation and the self-accusations of the insane) the various degrees of responsibility and the significance they bear to civil and criminal procedures. The second main division is devoted to psychiatric expertism and describes the manifestations by means of which the most important psychoses and neuro-psychoses may be recognized. The third part is devoted to a consideration of hypnosis and anomalies of sexual sense, while the fourth and last part indicates the manner in which written or verbal expert opinions are to be formed or rendered. It was manifestly impossible for the author to write a book on these subjects that might be easy to read; indeed, it requires careful and detailed study since the problems involved are difficult to say the least. The outstanding claim of the author which |