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Religion And Health Part 12

"This is my experience after much thought, much knowledge of human nature, and not a little study of all the difficulties you relate to me."

But it must not be thought that these dreads cause only the trivial instances of nervous breakdown in which people never very capable give way before the strenuous call of commercial life in the large cities of our time. Nor must it be thought that education is dispelling them.

Some idea of the important role that dreads may play in the production of human ills that seem to be very serious and that often prove quite incapacitating for mental and physical work, even in men of fine abilities and proven powers, may be gathered from what happened during the recent Great War. The Allied nations had to maintain some fifty thousand beds behind the lines for the accommodation of patients suffering from functional nervous affections really founded on dreads.

At the beginning these cases were misunderstood, and they were unfortunately called "shell shock" because they seemed so serious that it was thought that they were {240} due to some concussion of the nervous system, that is, some shaking up of its elements that made it impossible for it to function normally, even though there were no external signs of injury. After a time, however, it came to be appreciated that the great majority of these patients were suffering from major hysteria due to loss of control over the nervous system as a consequence of the almost inevitable dreads which developed in the awful conditions of warfare in the trenches, with its terrifying sights and sounds, and with the intense strain put upon the nervous system because of the demands made upon physical energy almost to the point of exhaustion.

After loss of sleep and irregular eating, wet feet for days at a time, exposure to the inclemencies of the weather and then having to withstand an enemy attack, often at dawn after a fearsome barrage had been laid down on them for hours, it is no wonder that in many cases men's nervous control did give way. They were not cowards, they were not malingerers; on the contrary they were often brave men who had volunteered for the service, giving up important positions at home to take up the defense of their country; and yet after a time their dreads dominated them and they suffered from all sorts of symptoms.

Some of them could not see, a number could not hear; some could not use their legs, and some could not employ their arms properly; some walked with a limp, some had tremor that made their usefulness as soldiers absolutely at an end. Nearly all of them had a series of complaints which they wanted to detail in all their minuteness to every physician who came near. Their stories of what had happened were mainly untrue or utter exaggerations of the actual events, and yet these men were not liars and they were not the doddering idiots that they sometimes {241} seemed to be; they were just fellow mortals who meant to do their best, and who had been affected in this way because they were asked to stand what was beyond their strength of soul to withstand.

The educated suffered more than the uneducated. There were four times as many "shell shock" cases among the officers of the British army in proportion to their number as there were among the privates. Neither ambition nor nobility nor any artificial distinction of any kind seemed to make any difference, for all classes and conditions of men came down with it. Its frequence can be very well judged from the fact that one third of all the dismissions from the British army, not counting the wounded, was for "shell shock", which of course should be called by its proper name of major hysteria. One seventh of all the dismissions, if the wounded were included, was for this reason. It had been the custom to think before the war that only a comparatively few men, mostly those of a certain feministic appearance and delicacy of constitution, were likely to suffer from hysteria. It was found, however, that college graduates who stood at the head of their classes, athletes who held records, broad-shouldered, healthy men who had been considered to be the very acme of common sense, men who were supposed to be without a nerve in their make-up, all these proved to have "nerves"; and when the war "got on their nerves", they suffered from the complaints which we have mentioned and many others, including pains and discomforts of all kinds, and inabilities and incapacities, motor and sensory as well as of the memory, of the mind or the will.

This recent significant experience will give some idea of how potent dreads may be in the production of {242} symptoms which seem surely to be due to physical rather than merely mental conditions. Most people would probably be inclined to think that in so far as dreads produced diseases by the exaggeration of minor symptoms, at most scarcely more than mental conditions of discomfort would result from them. What are called the psychoneuroses, that is, the neurotic affections dependent on the state of mind, may simulate almost any of the organic conditions and may seem to be serious diseases. Through the creation of unfortunate habits, they may give rise to a great many rather severe physical symptoms. The war neuroses emphasized this for us.

Inability to use limbs, either legs or arms, is quite common in connection with them; disturbances of sensation, such as defective hearing and eyesight, or even what seems to be complete blindness and deafness, may develop. Tremors are quite common, and pains and aches in connection with the disabilities of the limbs are extremely frequent.

A very usual experience is to find that a patient has as a preliminary suffered some injury. This may not be very severe, but it is enough to cause the sufferer to spare the limb that is affected; and unfortunately physicians sometimes put a limb with a minor affection in plaster of Paris or in a splint for a time. The patient's own solicitude with regard to the hurt may cause almost as effective splinting of it as a plaster cast or wooden slat and a bandage.

Whenever this happens, the unused muscles lose some of their nutrition. This is due partly to the fact that the circulation is interfered with because the active contraction of muscles, especially of the legs, is depended on by nature to help the venous or return circulation by bringing about compression of the veins. The valves in the veins are so arranged that when the {243} veins are compressed and the blood thus pressed out of them, it cannot move away from the heart but is impelled onward toward the heart. Besides, the sending down of nervous impulses for the active use of muscles increases the size of the arteries to the part by direct action on their walls, and whenever there is failure to send impulses down, the arteries do not carry as much blood as usual, and the nutrition of the part suffers as a result.

If this inactive state of the muscles continues for a few days, they will become somewhat flaccid, and after a week or more will actually begin to decrease in size. As a consequence of this, they cannot be used to as good advantage as before, and use of them sets up an achy condition as soon as the limb is set free for use, whether it has been splinted by the physician or by the patient's mind. If the patient is still solicitous, he notices this condition of pain and concludes that it means that the muscles are not yet in the condition of health where they should be used, and he puts on the splints, metaphorical or literal, once more. The muscles grow more flaccid and eventually atrophic as a consequence, until sometimes there will be a difference of more than an inch in the girth of two limbs at the same point, and this atrophy may proceed much farther. It seems almost impossible to believe that men and women could thus make a limb useless, but this is actually what happens rather frequently. The effects of the original injury will pass off in a few days, but the effects of the disuse of the limb may remain for months or even years because of the disturbance of circulation and of nerve impulse. It is probable that the nerves themselves have a trophic or nutritional--that is, vitalizing--influence upon muscles. Some physiologists actually talk of there being {244} trophic fibers in the nerves, though it would seem more reasonable to think that the nerve trophic effect comes from the modification of the circulation to the part.

Whenever muscles have to be increased in size or won back from an atrophic condition, the individual to whom they belong must go through a period of soreness and tenderness in those muscles which often is very hard to bear. The young fellow who, after a rather relaxed summer, begins training for the football team in the fall, knows how sore and tender his muscles have become. After the first day or two of training, each time he wakes up at night he turns over in bed with the feeling that every bit of him is full of tenderness. Any number of people under similar circumstances are inclined to think that they must have caught cold. They usually reason thus: "I got into a perspiration and sat down for a while and then took cold, and that is the reason for all this painful condition that has developed."

That word "cold" is as unfortunate as "shell shock." There is no such thing as taking cold. We catch infections, but much more frequently in fall and spring than in winter. The young man who is in training usually pays no attention to such unfavorable suggestions or dreads, since he knows that he must take his medicine of further hard exercise until he has hardened and developed his muscles and then, instead of their causing discomfort, nothing in the world gives him so much satisfaction as their active exercise.

Older people, however, and especially those who have what may be called a "dready" disposition, do not call their muscle discomfort soreness and tenderness; they speak of pains and aches. The very words carry a suggestion of evil with them, and above all they carry with {245} them an inhibitory suggestion which keeps muscles from being used normally. If, then, certain older people get an injury, even though it may not be very serious, so long as it causes them to give up the use of a limb for a while, or sets them to using the muscles of it a little differently from before, a psychoneurosis on the basis of a dread, but with the physical basis of somewhat atrophied muscles to keep it up, may develop and persist for weeks and months and even years. As a consequence of this state--much more of the mind than the body--men may walk lame or be very awkward in the use of one arm, or they may have a little stoop, or they may dread very much the using of some group of muscles. Such conditions occasionally occur in the neck or in various parts of the back, and especially in the lumbar region, with strikingly visible effects.

It might seem impossible that such conditions should develop and persist for any length of time in sensible and above all intelligent people, and yet I suppose that every physician's case book contains a number of examples. After he has been in practice for ten years or more this will surely be true, if he has had much to do with nervous patients. One of the most distinguished scientists that we had in this country, possessed of one of the finest intellects of our generation, thoroughly sensible and noted for his executive ability, suffered from a slight attack of sciatica, to which he had been predisposed by some unusual work in connection with a heavy fall of snow when he had to go out and do the shoveling himself, since labor was not available. He never quite got over it. For some time he carried two crutches because he had so little confidence in putting down the foot on that side, after having spared it for a {246} while. Then for several years he carried a single crutch. In the meantime he was examined by half a dozen of the best physicians in the country, who could find nothing the matter with him except that disuse had rendered the muscles of that leg slightly atrophic, and he would have to push through a period of soreness and tenderness while exercising them. He carried a cane ever afterwards, walked a little lame and favored that leg.

Persistent sciaticas of this kind and lumbagoes are much more common than they are thought. It was a case of this kind, undoubtedly, that brought about Bernheim's interest in hypnotism at Nancy and initiated that wave of attention to hypnotism at the end of the nineteenth century which did so much harm. A patient who had suffered from sciatica for some years and walked a little lame as a consequence came under Bernheim's care, and he tried without success every therapeutic resource at his command to make him better. Finally his patient gave up calling on him, completely discouraged. He had gone to a great many physicians before Bernheim, and all of them had failed to do him any effectual good. They could relieve his discomfort for a while, but when he stopped taking drugs, that returned and his limb could be used no better than before.

Some months after Bernheim missed the patient from his clinic he met him on the street one day, walking perfectly straight without his cane and evidently entirely well. He was so much interested that he stopped to ask what had cured him. The patient told him he had gone around to Liebault, who, almost alone in Europe, was still practicing hypnotism, for the practice had been greatly discredited by certain exposures in England shortly after the middle of the century. Bernheim, who had ignored {247} Liebault's work before, now took an interest in it and found of course that hypnotism--or indeed, though Bernheim did not know that, anything else that would give these patients the confidence to push through a period of tenderness and soreness in regaining the use of their muscles--would cure them. The incident began that period of reawakened interest in hypnotism which now constitutes such a ludicrous series of events in the medicine of the end of the nineteenth century.

Such cases are by no means so uncommon as they might be thought. I have known the teacher of a high school to slip while coming out of school, fall on his knee, bruise it rather badly, and then have this bruised condition heal very well, only to develop in the course of a few weeks a distinct inability to use the muscles of that leg properly, until he had to walk with a marked limp. The circumference of the limb above the knee reduced distinctly in size, it suffered more from cold than did the other one; it perspired more freely; it was distinctly more sensitive to the touch, and it would seem as though there must be some serious underlying nervous condition. He passed through the hands of several specialists, including one who wanted to remove a cartilage in the knee joint which he said had been dislocated, and another who insisted that he was suffering from a neuritis of a branch of the sciatic nerve, and who wanted to inject water within the sheath of it or at least lay it bare and stretch it.

Fortunately we persuaded him to join an athletic club and take more exercise than usual and above all exercise that limb. He had had massage and passive movements for it, but these are of very little service in these cases, because the nervous impulses must come down from above. It would almost seem as though the {248} will sent down some of its own creative energy through the nerves which lead to the part. He is now entirely well, though he suffered for several years, and absolutely nothing was done for him except to make him eat better and make him push through a period of soreness and tenderness--he used to call them pains and aches before we explained the condition to him--until he had properly recovered the use of his limb.

On the other hand, I have known a good clergyman with a rather similar condition to this, who had bumped his shin bone not far below the knee and after recovery from that had developed a marked psychoneurosis in the muscles above the knee, refuse to be cured by any such simple procedure as merely exercising himself back to health. He could not bring himself to think that it was only his own lack of will power that had caused the condition to develop. Above all he needed something external to cure him. He finally went to a bone-setter, one of these old fellows who claim to be the seventh son of a seventh son, or something of that kind, possessed of marvelous hereditary power and instinctive intuition in the matter of setting bones right, and who cure nearly everything under the sun and a few other things besides by their supposed bone-setting processes. My clerical friend was sure that he had been cured by the bone-setter, but any physician would have told him that what had happened was that his faith in his healer had released his inhibition of his muscles and given him the confidence to go on and use them as they should be used,--that is, of course, as far as he possibly could at first. Then they were gradually restored to their former condition of health and strength. That is what happened, and he has had no recurrence. He is quite {249} sure, however, that the trouble was a subluxation of his hip joint, which the bone-setter set right, thus allowing nervous impulses and the blood to flow properly through the part once more. His own will was the only obstacle and it was that alone that had to be overcome and used as a therapeutic agent.

These patients are the stock in trade of all sorts of irregular practitioners. Whenever they think anything is the matter with them they must be "cured"; they never get better of themselves. They need something or somebody to which to pin their faith. It is the hardest thing in the world to find out what is the matter with a man who has nothing the matter with him except a state of mind and its consequences in his physical condition. He must have his state of mind changed first of all, and usually he requires some rather strong suggestion for that purpose. What is likely to affect him most favorably is some novel or unusual method of treatment, or some new discovery in science recently applied to medicine, or some new method of healing, or some supposedly new invention or discovery in therapeutics. These patients are a veritable nuisance in medicine. It is the cures of them, made by all sorts of new-fangled remedies, which make it so difficult for physicians to judge whether a new remedy has a positive favorable physical effect or only a mental influence.

Very probably the best appreciation of the place of dreads in life and how much of good is accomplished by their neutralization can be obtained from the number of sufferers of all kinds who are cured by all sorts of new remedies which prove after a time to have no physical effect at all. We have discussed this subject of the {250} remedies that have come and gone in medicine in the volume "Psychotherapy." It has been very well said that the most important chapter in the history of medicine is that of the cures that have failed. It illustrates very thoroughly how much influence the mind has over the body, and particularly how much dreads have meant for the production of symptoms which have been relieved whenever the patient had his dreads lifted, no matter what might be the agent to accomplish this purpose. Instead of decreasing, dreads have increased just in proportion as popular education has spread and more people have been able to read and receive unfavorable suggestions of all kinds. This has been particularly true with the diminution of the influence of religion over people's minds.

All sorts of religious substitutes which would give people enough confidence in themselves to enable them to throw off their dreads have gained vogue and have come to be very popular institutions in recent years. Dowie, who claimed he was Elijah returned to earth, and Schlatter, who said that he was divinely inspired to cure people, were as successful in the twentieth century as Greatrakes "the stroker,"

who said that the Holy Ghost appeared to him in a dream and told him to heal people, in the seventeenth. Metaphysical healing of all kinds has been successful, and spiritualistic healing and new thought and magnetic healing, with as little magnetism about it as Mesmer's famous battery which had no electricity,--all these have cured people. All sorts of healers are successful just because they lift the dreads and make people forget the inhibitions that they have been exercising over their functions. Indeed this state of fear thought is one of the most prolific sources of {251} symptoms, or rather let us say of complaints, that medicine has to do with at all times, hence the importance of the chapter of the cures that have failed. Almost any religious feeling will be helpful in the matter, but an abiding sense of rational religion will save many people from being imposed on by all sorts of upstart theories and religious systems which base their claim to recognition on these cures of human beings.

These patients furnish a great many of the cures made at shrines. That is why at every shrine there are so many crutches and canes and braces and belts and splints and supports of various kinds to be seen. They have been left there by grateful patients who were able to drop them as the result of the change of mind that came over them during their devotions. Many cures besides these occur at shrines, and I have taken a good deal of pains to assure myself that most of the affections that are healed at them are quite different from these psychoneuroses. Over sixty per cent of the cures made at Lourdes, for instance, are of tuberculosis processes. Many of these are of external visible lesions.

Some of them, after years of progress in spite of all sorts of treatment, heal over in the course of twenty-four hours. I have seen this happen to a lupus, at Lourdes, during my stay there, and I do not know how to explain that incident by any natural process. To me it seemed surely supernatural. I know that there are some physicians who suggest that we do not know all the possibilities of the therapeutic effect of the mind on the body, and somehow there may be included in the psychotherapeutic armamentarium the power to heal tissues rapidly, even when they have been the subject of a chronic granulomatous process for years, but I cannot but think that is {252} merely an effort to retain what seems to me plainly miraculous within the domain of the natural.

I know too that Doctor Boissarie's experience, so carefully noted and written out in his clinic at Lourdes, shows that there are cases of real joint trouble which have been cured with similar rapidity, but these are very rare. Most of the halt and crippled who are cured at shrines have simply been the victims of an attitude of mind which has affected their muscles and their use of certain joints unfavorably, so that they had to carry crutches or canes or wear braces. The deep influence of religion will cure them very often, but it is not a miracle in any supernatural sense of the word, though it is a wonderful event, and that is all that miracle means by etymology.

Indeed, professors of neurology have occasionally foretold that certain of these patients would perhaps be cured at shrines, and their prophecies in specific instances have been fulfilled. The cures are examples of what faith can do in lifting a dread, but that faith may be exercised with regard to much less worthy objects than are presented at shrines and yet work successfully. When George Cohan, in the "Miracle Man", had the cure that attracted attention to the "new prophet" occur with regard to a lame boy, he was eminently wise in the selection of just the type of case that could very readily be cured that way, and yet the fact that the boy had been lame for years and now walked perfectly made the healer seem a veritable wonder worker.

Dreads have always been with mankind, and their effects upon human bodies have been the stock in trade of the medicine man in primitive tribes and among savages and of his successors in suggestive medicine among educated and even cultivated people down to our own {253} time.

They can be conjured away by almost any impression that is deep enough to produce a favorable suggestion. Religion of all kinds has been appealed to successfully to neutralize them. The one rational cure for them is a deep sense of confidence in the Almighty and in an overruling Providence which serves to dissipate the phobic state of mind with its inevitable inhibitions on bodily functions. It may be necessary for its successful working that the correction of many minor physical ills should be secured, but the all-important basis of successful treatment for the psychoneurosis and the many ailments of mankind which are complicated by psychic states is a thoroughgoing belief that God is in His heaven and all is well with the world, even though there may be difficulties to be overcome, hardships to be borne, and many things that are far from easy to understand.

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CHAPTER XIV

SUFFERING

The problem of the meaning of suffering and evil in the world is the greatest natural mystery that man has to face. It has raised the question as to whether life is worth living or not in some minds. It causes a great many people to be disturbed about the meaning of life and has led some sensitive people to conclude that there cannot be an overseeing, all-wise Providence since otherwise He would surely prevent all the needless suffering there is in the world. Biologists, owing to their occupation with the thought of the struggle for existence in current theories of evolution, have been particularly inclined to say that they could not think that there was a Providence because there was so much of carnage in nature, so much ruthless destruction of life amid suffering for which it would be hard to find any satisfactory reason. There has been no little exaggeration in this view, for a calm review of conditions as they obtain in nature shows not so much of active contest as a healthy competition for the means of existence, in the midst of which death comes to the weakling without anything like the suffering so much emphasized.

It must not be forgotten that the supersensitiveness of the sedentary student must be taken into account in the appreciation of the significance of such a declaration, {255} for the recluse scientist often shrinks from trials that the active outdoors man finds only a stimulus to action, which serve to develop powers and give satisfaction rather than any real suffering. The incentive to have life and to have it more abundantly which this affords to heartier natures makes the poet's expression, _forsan et haec olim meminisse juvabit_, "perhaps we shall be glad to recall these hardships in the time to come", easy to appreciate. Life without suffering would lack that contrast which saves it from the dull monotony that might tempt to waste of energy in dissipation.

Perhaps the best illustration of the actual benefit to man which accrues from suffering is to be found in the fact that one of the surprising results of the presence of the mystery of suffering in the world is that meditation over it has given rise to the five greatest dramatic poems that were ever written. Men contemplating it have been led to the expression of the deepest thoughts that have ever stirred minds. These great poems have come at longer and shorter intervals during four thousand years, from Job, the essential ideas for which probably date from about 1800 B.C., though its literary form is much later, through AEschylus' "Prometheus", Shakespeare's "Hamlet", Calderon's "The Wonder-working Magician", down to Goethe's "Faust." Of these five dramatizations of the mystery of human suffering, recurring poetic impersonations of Hamlet's

"The time is out of joint: O cursed spite, That ever I was born to set it right!"

the greatest, as conceded by all the critics, is not--as might be expected from the very prevalent impression that man makes wonderful progress down the ages--the {256} last one, Goethe's "Faust", but is the first one, Job. No one has ever expressed so well the only reasonable attitude of mind that man must take in the presence of evil and suffering as this "man of the land of Hus whose name was Job and who was simple and upright and fearing God and avoiding evil", yet who had to bear some of the severest trials that man has ever been called upon to undergo.

Mr. H. G. Wells has recently, in one of his thought-stimulating novels, shown us that verisimilitude of the most modern type could be woven into a story which followed the outlines of the book of Job very closely, so that far from being dead, even the novelty-seeking fiction readers of our generation have brought home to them the fact that Job is still a very living piece of literature. Job's answer to the mystery of evil is that man must confess his inability to understand it, but he can trust the God who "thunders wonderfully with His voice"

and "doth great and unsearchable things", "who commandeth the snow to go down on the earth and the winter rain", "who knoweth what ways the light spreads and heat divideth on the earth", "who joins together the shining stars, the pleiads, and can stop the turning about of Arcturus" and "who created behemoth and leviathan and can bind the rhinoceros and has fashioned the ostrich." All that Job can say is, "I know that Thou canst do everything and that no thought can be withholden from Thee", therefore for any impatience that he may have displayed over his suffering he reprehends himself and promises to do penance in dust and ashes,--"and after this Job lived one hundred and forty years and saw his sons and his sons' sons, even four generations. So Job died, being old and full of days."

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In any consideration of suffering, above all in connection with the related subjects of health and religion, we must not forget that suffering has always been a badge of the race, the common lot of men, so that this very community of it greatly reduces human reaction toward it, since the sufferer cannot help but note that every one else must submit to it as well as himself. At times among those who fail to think deeply enough this may be doubted. The poor may even envy the rich because they suppose that they must by their riches escape suffering, but most physicians soon learn to appreciate very well that the mental discomforts of the wealthy, their disappointed social ambitions, their thwarted aspirations after greater wealth, their envy of their more successful neighbors, but above all their frequent disappointment in their children, though it is almost invariably their very wealth that has spoiled the children and brought their greatest griefs on them, are really the source of much more genuine suffering than the poor have to bear. The worries of life increase with possessions, not decrease, as is fondly hoped, and as the author of the "Romance of the Rose" said some seven centuries ago:

"And he who what he holds esteems Enough, is rich beyond the dreams Of many a dreary usurer.

And lives his life-days happier far; For nought it signifies what gains The wretched usurer makes, the pains Of poverty afflict him yet Who having, struggleth still to get."

Suffering must ever remain a mystery, especially when we take into account the fact that all of us are profoundly possessed by the desire for happiness. We can never {258} probe to the bottom of the mystery and know all its meaning, but at least we can readily understand that in the vast majority of cases, instead of being an evil, it is a good.

Nothing so deepens and develops character as suffering. Take the case of our young men who went to the war--so many of them scarcely more than boys, feeling but little of the responsibilities of life--and see how they have come back to us matured by the hardships and sufferings through which they had to go. Thucydides said nearly twenty-five hundred years ago, "There is very little difference among men, only a few of them rise above the great mass because they have gone through hard things when they were young."

It would seem as though we had changed all that, for we are deeply intent on making things just as easy as possible for the young, but a generation ago Gladstone repeated Thucydides' expression with heartiest approval, and twenty years ago John Morley, writing the life of Gladstone, agreed with both of them. I wonder if there are two men in our time who have known men better than Gladstone and Morley.

In that sense suffering is no mystery, and it is easy to see how it is quite literally true that "Whom the Lord loves He chastises." It is the chastisement of suffering that brings out the powers of men. Any one who has not had to suffer in life is nearly always a self-centered egoist without sympathy, but above all without that fellow feeling that comes only from having gone through similar experience. He who has not suffered has not really lived below the surface of his being at all, and he does not know himself. To "know thyself" is the most important thing in the world and the only way to know others. The men who have done great thinking for us {259} have nearly always been men who had to suffer much. It was a blind Milton who wrote "Paradise Lost." When Camoens wrote what German and French critics think--and when Germans and French agree about anything there is probably a deep underlying truth in it--the greatest epic in modern time, he was starving in a garret, and his old Indian servant was begging for him on the streets to secure enough to keep body and soul together until the great work was finished. Cervantes wrote what Lord Macaulay called "incomparably the greatest novel ever written" in a debtor's prison, out of which it seemed he might never be able to secure his release.

Dante wrote what many think the greatest poem ever written during a long exile in which he learned "how bitter it is to eat the bread of other's tables." _Poeta laudatur et alget,_ "the poet is praised and starves", is as true in our time as when Horace said it three thousand years ago.

Goldwin Smith has brought out very clearly the fact that suffering and evil are really a necessity in the world if this is to be a place of trial, as every one believes, for of course such a belief represents the only satisfactory explanation of life as we have it. Man must have something to strive for and against if there are to be stepping stones of our dead selves to higher things, and so it is not surprising that Doctor Goldwin Smith should have said:

"At the same time, so far as we can discern, character can be formed only by an effort which implies something against which to strive; so that without evil or what appears to us evil, character could not be formed. The existence of evil in fact, so far as we can see, is the necessary condition of active life."

Suffering has been with us from the beginning and it will always be with us; instead of an evil it is one of God's {260} great gifts to man, and yet it sometimes makes little souls bitter and swamps the efforts of those who cannot rise above its trials. Religion is the one element that is supremely helpful in this. Above all in the terminal sufferings of mankind, when there is no longer any question of pain that has to be borne in developing character for this life, the only consolation is that to be derived from religion and a firm belief in a hereafter and an acknowledgment of the fact that somehow God knows best and all is for the best. Without this the awful suffering from cancer which is increasing rather than diminishing, and which seems to be so rooted in human nature that we shall probably never solve its mystery or at least be able to secure human nature against it, as well as ever so many other chronic sources of pain that will never cease entirely until the end of life comes, become hideous specters for humanity, and suffering has very little meaning.

No matter what our attitude of mind may be with regard to suffering, there is no question but that we have to stand it under present conditions in this little world of ours. During the next twelve months scarcely less than one hundred thousand persons will die of cancer in this country and a million and a half victims of the disease will breathe their last throughout the world. When we add up all the accidents in industry and transportation, all the wounds in war and civil life, and then add the affections which in one way or another cause mechanical stoppages of processes in the body, for these are the exquisitely painful conditions, it is easy to understand that we need consolation for suffering. An old medical axiom is that "the doctor can seldom cure but he can often relieve and can always console."

There are a good many physicians, however, who feel their ability to console sadly {261} hampered by the fact that so many men and women in our time do not believe in a hereafter for which their sufferings in this world can be a preparation, and that therefore the terminal suffering of existence, of which there is and manifestly always will be such an amount, can mean nothing for them except just so much pain that has to be borne without any good reason that they can see, except that somehow or other things were so arranged in this world that there is ever so much more of pain and suffering than of joy in it.

Two thousand years ago Cicero said in his own oratorical way that it was better for all of us to believe in immortality, for if there was no immortality we should never live after death to know it--which comes very near being an Irish bull by anticipation--while if there was, and we had not believed in it, there would come a very rude awakening to the truth of things. Something of the same problem has been put in much more flippant and yet very expressive way in modern slang. "If there is no other world than this, then some one handed us an awful lemon when we were sent into existence." That is, I suppose, one answer to the mystery of suffering so sure to come to all men in some way or other, and it is one that counsels us to seek the only real consolation for suffering,--that which is to be found in the religious feeling that somehow or other, somewhere, there is some one who knows and understands, and suffering has its meaning. "God's in His heaven and all's well with the world" in spite of the fact that "nature red in tooth and claw" works such sad havoc with her creatures.

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