o this matter cautious handling, because, for some reason, the ennui
of rest and seclusion is far better borne by women than by the other
sex.

Even in cases whose moral aspects do not at once suggest an imperative
need for seclusion it is well to remember, as regards neurasthenic
people, that the treatment involves for a time daily visits of some
length from the masseur, the doctor, and possibly an electrician, and
that to add to these even a single friendly visitor is often too much
to be readily borne; but I am now speaking chiefly of the large and
troublesome class of thin-blooded emotional women, for whom a state of
weak health has become a long and, almost I might say, a cherished
habit. For them there is often no success possible until we have broken
up the whole daily drama of the sick-room, with its little selfishness
and its craving for sympathy and indulgence. Nor should we hesitate to
insist upon this change, for not only shall we then act in the true
interests of the patient, but we shall also confer on those near to her
an inestimable benefit. An hysterical girl is, as Wendell Holmes has
said in his decisive phrase, a vampire who sucks the blood of the
healthy people about her; and I may add that pretty surely where there
is one hysterical girl there will be soon or late two sick women. If
circumstances oblige us to treat such a person in her own home, let us
at least change her room, and also have it well understood how far we
are to control her surroundings and to govern as to visitors and the
company of her own family. Do as we may, we shall always lessen thus our
chances of success, but we shall certainly not altogether destroy them.

I should add here a few words of caution as to the time of year best
fitted for treatment. In the summer seclusion is often undesirable when
the patient is well enough to gain help by change of air; moreover, at
this season massage is less agreeable than in winter, and, as a rule, I
find it harder to feed and to fatten persons at rest during our summer
heats. That this rule is not without exception has been shown by Drs.
Goodell and Sinkler, both of whom have attained some remarkable
successes in midsummer.

One of the questions of most importance in the carrying out of this
treatment is the choice of a nurse. Just as it is desirable to change
the home of the patient, her diet, her atmosphere, so also is it well,
for the mere alterative value of such change, to surround