retty
sure that they are not seriously ill; but when they assure us dreamily
that they "feel first-rate," forget to ask us how they are getting
along, or become drowsily indifferent to the outlook for the future,
then we redouble our vigilance, for we fear that we recognize the
gradual approach of the Great Restbringer, the merciful drowsiness which
in nine cases out of ten precedes and heralds the coming of the Long
Sleep.

Lastly, the cases in which the sufferings of the patient are due chiefly
to a morbid action of his or her imagination, are a small percentage of
the total of the ills which come before us for relief. But, even of this
small percentage, _only a very few are in perfect or even reasonably
good physical health_. A large majority of even these neurasthenics,
psychasthenics, imaginary invalids, and bodily or mental neurotics, have
some physical disturbance, organic or functional, which is the chief
cause of their troubles. And the important point is that our success in
relieving these sufferers will depend upon our skill in ferreting out
this physical basis, and the extent to which we can succeed in
correcting or relieving it. We no longer ridicule or laugh at these
unfortunates. On the contrary we pity them from the bottom of our
hearts, because we know that their sufferings, however polarly remote
they may be from endangering their lives in any way, and however
imaginary in a purely material sense, are _to them_ real. Their
happiness is destroyed and their efficiency is crippled just as
genuinely and effectively as if they had a broken limb or a diseased
heart.

We are now more and more firmly convinced that these patients, however
ludicrously absurd their forebodings, are _really sick_, either bodily
or mentally, and probably both. A perfectly healthy individual seldom
imagines himself or herself to be ill. And as the list of so-called
functional diseases--that is to say, those diseases in which no
definite, objective mark of degeneration or decay in any tissue or organ
can be discovered--are steadily and swiftly diminishing under the
scrutiny of the microscope and the methods of the laboratory, so these
purely imaginary diseases, these "depressed mental states," these
"essential morbid tendencies," are also rapidly diminishing in number,
as cases are more conscientiously and personally studied and worked out.

Even hysteria is no longer looked upon as sheer perversity on the part
of the patient, b