ome mental trouble, which reacted upon his
bodily condition and tended to retard his complete recovery of
health. However, a doctor cannot force the confidence of a patient
even in that patient's own interest, and I was, therefore, compelled
to work in the dark, and to work without satisfaction to myself and
lasting benefit to Sir Graham. You now let in a strange light upon
the case, and I have little doubt what course would be the best to
pursue in regard to the future. Sir Graham's nervous system has
broken down so completely that, as often happens in nervous cases,
his very nature seems to have changed. The energy, the remarkable
self-confidence, the hopefulness and power of looking forward, and
of working for the future, which have placed him where he is--these
have vanished. He is possessed by a fixed idea, and imagines that it
is this fixed idea which has preyed upon him and broken him down.
But my knowledge of nerve-complaints teaches me that the fixed idea
follows on the weakening of the nervous system, and seldom or never
precedes it. I find it is an effect and not a cause. But it is a
fact that the fixed idea which possesses a man under such
circumstances is often connected, and closely, with the actual cause
of his illness. Sir Graham Hamilton is suffering from long and
habitual overwork in connection with the sea; overwork of the
imagination, of the perceptive faculty, and in the mere mechanical
labour of putting on canvas what he imagines and what he perceives.
In consequence of this overstrain and subsequent breakdown, he has
become possessed by a fixed sea-idea, and traces all his
wretchedness to this episode of the boy and the picture. You will
say I did not succeed in curing him because I did not discover what
this fixed idea was. How can that be, if the idea comes from the
illness and not the illness from the idea. In reply I must inform
you that a tragic idea, once it is fixed in the mind of a man, can,
and often does, become in itself at last a more remote, but
effective, cause of the prolonged continuance of the ill-health
already started by some other agent. It keeps the wound, which it
has not made, open. It is most important, therefore, that it should,
if possible, be banished, in the case of Sir Graham as in other
cases. Your amiable deception has quite possib