,transcriber's ,note3 ,italics have been rendered using underscores and bold using equals signs4 ,a number of printer's errors have been corrected1 and are listed at the end4 99 99 99 99 99 ---------------------------------------- ------------------ ,applied ,psychology for ,nurses ,by ,mary ,f4 ,porter1 ,a4 ,b4 ,graduate ,nurse2 ,teacher of ,applied ,psychology1 ,highland ,hospital1 ,asheville1 ,n4 ,c4 ,philadelphia and ,london ,w4 ,b4 ,saunders ,company #aiba ---------------------------------------- ------------------ ,copyright1 #aiba1 by ,w4 ,b4 ,saunders ,company ,,printed ,,in ,,america ,,press ,,of ,w4 ,b4 ,,saunders ,,company ,,philadelphia ,,to ,,the ,,memory ,,of ,,my ,,father ,,foreword ,this little book is the outgrowth of a conviction1 strengthened by some years of experience with hundreds of supposedly normal young people in schools and colleges1 confirmed by my years of training in a neurological hospital and months of work in a big city general hospital1 that it is of little value to help some people back to physical health if they are to carry with them through a prolonged life the miseries of a sick attitude4 ,as nurses ,i believe it is our privilege and our duty to work for health of body and health of mind as inseparable4 ,experience has proved that too often the physically ill patient 7hitherto nervously well7 returns from hospital care addicted to the illness-accepting attitude for which the nurse must be held responsible4 ,i conceive of it as possible that every well trained nurse in our country shall consider it an essential to her professional success to leave her patient imbued with the will to health and better equipped to attain it because the sick attitude has been averted1 or if already present1 has been treated as really and intelligently as the sick body4 ,to this end ,i have dealt with the simple principles of psychology only as the nurse can immediately apply them4 ,the writer wishes to acknowledge her indebtedness for criticism of this work and for several definitions better than her own1 in the chapters ,the ,normal ,mind and ,variations ,from ,normal ,mental ,processes1 to ,dr4 ,robert ,s4 ,carroll1 who through the years of hospital training helped her to translate her collegiate psychology from fascinating abstract principles into the sustaining bread of daily life4 ,,mary ,f4 ,,porter4 ,,asheville1 ,n4 ,c41 ,august1 #aiba4 ,,contents ,,page ,,chapter ,i ,,what ,,is ,,psychology8 #aa ,,chapter ,,ii ,,consciousness #bj ,the ,unconscious #bc ,consciousness is ,complex #bi ,consciousness in ,sleep #ca ,consciousness in ,delirium #cb ,,chapter ,,iii ,,organs ,,of ,,consciousness #cd ,the ,central and ,peripheral ,nervous ,systems in ,action #ce ,the ,sympathetic ,nervous ,system #cg ,,chapter ,,iv ,,relation ,,of ,,mind ,,and ,,body #dj ,the ,cerebrum or ,forebrain #dc ,,chapter ,v ,,the ,,normal ,,mind #dg ,,chapter ,,vi ,,the ,,normal ,,mind 7,continued7 #ei ,instinct #ei ,memory #fb ,the ,place of ,emotion #fg ,the ,beginning of ,reason #fi ,development of ,reason and ,will #ga ,judgment #gb ,reaction ,proportioned to ,stimuli #ge ,normal ,emotional ,reactions #gg ,the ,normal ,mind #gg ,,chapter ,,vii ,,psychology ,,and ,,health #gi ,necessity of ,adaptability #hj ,the ,power of ,suggestion #hd ,one ,thought ,can ,be ,replaced by ,another #hi ,habit is a ,conserver of ,effort #ij ,the ,saving ,power of ,will #ic ,,chapter ,,viii ,,variations ,,from ,,normal ,,mental ,,processes #ie ,disorders and ,perversions #ie ,,chapter ,,ix ,,variations ,,from ,,normal ,,mental ,,processes 7,continued7 #aja ,factors ,causing ,variations from ,normal ,mental ,processes #ajh ,heredity #ajh ,environment #aji ,personal ,reactions #aaj ,,chapter ,x ,,attention ,,the ,,root ,,of ,,disease ,,or ,,health ,,attitude #aab ,the ,attention of ,interest #aab ,the ,attention of ,reason and ,will #aah ,,chapter ,,xi ,,getting ,,the ,,patient',s ,,point ,,of ,,view #abd ,what ,determines the ,point of ,view #abd ,getting the ,other ,man's ,point of ,view #abf ,the ,deluded ,patient #acc ,nursing the ,deluded ,patient #ace ,the ,obsessed ,patient #acf ,the ,mind a ,prey to ,false ,associations #acg ,,chapter ,,xii ,,the ,,psychology ,,of ,,the ,,nurse #aci ,accuracy of ,perception #ada ,training ,perception #adb ,association of ,ideas #adc ,concentration #adf ,self-training in ,memory #aej ,,chapter ,,xiii ,,the ,,psychology ,,of ,,the ,,nurse 7,continued7 #aeb ,emotional ,equilibrium #aeb ,self-correction #afj ,training the ,will #afa ,,chapter ,,xiv ,,the ,,nurse ,,of ,,the ,,future #afd 99 99 99 99 99 ,,index #afi ,applied ,psychology for ,nurses ,,chapter ,i ,,what ,,is ,,psychology8 ,wise men study the sciences which deal with the origins and development of animal life1 with the structure of the cells1 with the effect of various diseases upon the tissues and fluids of the body2 they study the causes of the reactions of the body cells to disease germs1 and search for the origin and means of extermination of these enemies to health4 ,they study the laws of physical well-being4 ,they seek for the chemical principles governing the reactions of digestive fluids to the foods they must transform into heat and energy4 ,so the doctor learns to combat disease with science1 and at the same time to apply scientific laws of health that he may fortify the human body against the invasion of harmful germs4 ,thus1 eventually1 he makes medicine itself less necessary4 ,but another science must walk hand in hand today with that of medicine2 for doctors and nurses are realizing as never before the power of mind over body1 and the hopelessness of trying to cure the one without considering the other4 ,hence psychology has come into her own as a recognized science of the mind1 just as biology1 histology1 chemistry1 pathology1 and medicine are recognized sciences governing the body4 ,as these are concerned with the how and why of life1 and of the body reactions1 so psychology is concerned with the how and why of conduct and of thinking4 ,for as truly as every infectious disease is caused by a definite germ1 just as truly has every action of man its adequate explanation1 and every thought its definite origin4 ,as we would know the laws of the sciences governing man's physical well-being that we might have body health1 so we would know the laws of the mind and of its response to its world in order to attain and hold fast to mind health4 ,experience with patients soon proves to us nurses that the weal and woe of the one vitally affects the other4 ,psychology is the science of mental life1 both of its phenomena and their conditions4 ,so ,william ,james took up the burden of proof some thirty years ago1 and assured a doubting world of men and women that there were laws in the realm of mind as certain and dependable as those applying to the world of matter--men and women who were not at all sure they had any right to get near enough the center of things to see the wheels go round4 ,but today thousands of people are trying to find out something of the way the mind is conceived1 and to understand its workings4 ,and many of us have in our impatient1 hasty investigation1 self-analytically taken our mental machines all to pieces and are trying effortfully to put them together again4 ,some of us have made a pretty bad mess of it1 for we tore out the screws and pulled apart the adjustments so hastily and carelessly that we cannot now find how they fit4 ,and millions of other machines are working wrong because the engineers do not know how to keep them in order1 put them in repair1 or even what levers operate them4 ,so books must be written--books of directions4 ,if you can glibly recite the definition above1 know and explain the meaning of mental life1 describe its phenomena and their conditions1 illustrating from real life2 if you can do this1 and prove that psychology is a science1 i4 e41 an organized system of knowledge on the workings of the mind--not mere speculation or plausible theory--then you are a psychologist1 and can make your own definitions4 ,indeed1 the test of the value of a course such as this should be your ability1 at its end1 to tell clearly1 in a few words of your own1 what psychology is4 ,the word science comes from a ,latin root1 scir1 the infinitive form1 scire1 meaning to know4 ,so a science is simply the accumulated1 tested knowledge1 the proved group of facts about a subject1 all that is known of that subject to date4 ,hence1 if psychology is a science1 it is no longer a thing of guesses or theories1 but is a grouping of confirmed facts about the mind1 facts proved in the psychology laboratory even as chemical facts are demonstrated in the chemical laboratory4 ,wherein psychology departs from facts which can be proved by actual experience or by accurate tests1 it becomes metaphysics1 and is beyond the realm of science2 for metaphysics deals with the realities of the supermind1 or the soul1 and its relations to life1 and death1 and ,god4 ,physics1 chemistry1 biology have all in their day been merely speculative4 ,they were bodies of theory which might prove true or might not4 ,when they worked1 by actually being tried out1 they became bodies of accepted facts1 and are today called sciences4 ,in the same way the laws of the working of the mind have been tested1 and a body of assured facts about it has taken its place with other sciences4 ,it must be admitted that no psychologist is willing to stop with the known and proved1 but1 when he has presented that1 dips into the fascinations of the yet unknown1 and works with promising theory1 which tomorrow may prove to be science also4 ,but we will first find what they have verified1 and make that the safe foundation for our own understanding of ourselves and others4 ,what do we mean by mental life8--or1 we might say1 the science of the life of the mind4 ,and what is mind8 ,but let us start our quest by asking first what reasons we have for being sure mind exists4 ,we find the proof of it in consciousness1 although we shall learn later that the activities of the mind may at times be unconscious4 ,so where consciousness is1 we know there is mind2 but where consciousness is not1 we must find whether it has been1 and is only temporarily withdrawn1 before we say ,mind is not here4 ,and consciousness we might call awareness1 or our personal recognition of being--awareness of me1 and thee1 and it4 ,so we recognize mind by its evidences of awareness1 i4 e41 by the body's reaction to stimuli2 and we find mind at the very dawn of animal life4 ,consciousness is evidenced in the protozooen1 the simplest form in which animal life is known to exist1 by what we call its response to stimuli4 ,the protozooen has a limited power of self-movement1 and will accept or reject certain environments4 ,but while we see that mind expresses itself in consciousness as vague1 as dubious as that of the protozooen1 we find it also as clear1 as definite1 as far reaching as that of the statesman1 the chemist1 the philosopher4 ,hence1 the phenomena of mental life embrace the entire realms of feeling1 knowing1 willing--not of man alone1 but of all creatures4 ,in our study1 however1 we shall limit ourselves to the psychology of the human mind1 since that concerns us vitally as nurses4 ,animal psychology1 race psychology1 comparative psychology are not within the realm of our practical needs in hospital life4 ,we would know the workings of man's mind in disease and health4 ,what are the instinctive responses to fear1 as shown by babies and children and primitive races8 ,what are the normal expressions of joy1 of anger1 or desire8 ,what external conditions call forth these evidences8 ,what are the acquired responses to the things which originally caused fear1 or joy1 or anger8 ,how do grown-ups differ in their reactions to the same stimuli8 ,why do they differ8 ,why does one man walk firmly1 with stern1 set face1 to meet danger8 ,why does another quake and run8 ,why does a third man approach it with a swagger1 face it with a confident1 reckless smile of defiance8 ,all these are legitimate questions for the psychologist4 ,he will approach the study of man's mind by finding how his body acts--that is1 by watching the phenomena of mental life--under various conditions2 then he will seek for the why of the action4 ,for we can only conclude what is in the mind of another by interpreting his expression of his thinking and feeling4 ,we cannot see within his mind4 ,but experience with ourselves and others has taught us that certain attitudes of body1 certain shades of countenance1 certain gestures1 tones of voice1 spontaneous or willed actions1 represent anger or joy1 impatience or irritability1 stern control or poise of mind4 ,we realize that the average man has learned to conceal his mental reactions from the casual observer at will4 ,but if we see him at an unguarded moment1 we can very often get a fair idea of his mental attitude4 ,through these outward expressions we are able to judge to some extent of the phenomena of his mental life4 ,but let us list them from our own minds as they occur to us this work-a-day moment1 then1 later on1 find what elements go to make up the present consciousness4 ,as ,i turn my thoughts inward at this instant ,i am aware of these mental impressions passing in review3 ,you nurses for whom ,i am writing4 ,the hospitals you represent4 ,what you already know or do not know along these lines4 ,a child calling on the street some distance away4 ,a brilliant sunshine bringing out the sheen of the green grass4 ,the unmelodious call of a flicker in the pine-tree1 and a towhee singing in the distance4 ,a whistling wind bending the pines4 ,a desire to throw work aside and go for a long tramp4 ,a patient moving about overhead 7she is supposed to be out for her walk1 and ,i'm wondering why she is not74 ,the face and voice of an old friend whom ,i was just now called from my work to see4 ,the plan and details of my writing4 ,the face and gestures of my old psychology professor and the assembled class engaged in a tangling metaphysic discussion4 ,a cramped position4 ,some loose hair about my face distracting me4 ,an engagement at #g4cj4 ,a sharp resolve to stop wool-gathering and finish this chapter4 ,and yet1 until ,i stopped to examine my consciousness1 ,i was keenly aware only of the thoughts on psychology ,i was trying to put on paper4 ,but how shall we classify these various contents8 ,some are emotion1 i4 e41 feelings2 others are intellect1 i4 e41 thoughts2 still others represent determination1 i4 e41 volition or will4 ,there is nothing in this varied consciousness that will not be included in one or another of these headings4 ,let us group the contents for ourselves4 ,the nurses for whom ,i am writing3 ,a result of memory and of imagination 7both intellect74 ,a sense of kinship and interest in them 7emotion74 ,a determination that they must have my best 7will1 volition74 ,and so of the hospitals3 ,my memory of hospitals ,i have known1 and my mental picture of yours made up from piecing together the memories of various ones1 the recollection of the feelings ,i had in them1 etc4 7intellect74 ,what you already know4 ,speculation 7intellect71 the speculation based on my knowledge of other schools 7memory which is intellect74 ,a desire 7emotion7 that all nurses should know psychology4 ,child calling on street4 ,recognition of sound 7intellect7 and pleasant perception of his voice 7emotion74 ,desire to throw work aside and go for a tramp on this gorgeous day4 ,emotion1 restrained by stronger emotion of interest in work at hand1 and intellect1 which tells me that this is a work hour--and will1 which orders me to pay attention to duties at hand4 ,so all the phenomena of mental life are included in feelings1 thoughts1 and volitions which accompany every minute of my waking life1 and probably invade secretly every second of my sleeping life4 ,the conditions of mental life--what are they8 #a4 ,in man and the higher animals the central nervous system1 which1 anatomy teaches us1 consists of the brain and spinal cord4 7,in the lowest forms of animal life1 a diffused nervous system located throughout the protoplasm47 #b4 ,an external world4 #c4 ,a peripheral nervous system connecting the central nervous system with the outside world4 #d4 ,the sympathetic nervous system1 provided to assure automatic workings of the vital functions of the body4 ,these organs of the mind will be discussed in a later chapter4 ,,chapter ,,ii ,,consciousness ,we took a glimpse at random into the mental life of an adult consciousness1 and found it very complicated1 constantly changing4 ,we found it packed with shifting material1 which1 on the surface1 seemed to bear very little relation4 ,we found reason1 feeling1 and will all interacting4 ,we found nothing to indicate that a consciousness as simple as mere awareness might exist4 ,we believe there might be such in the newborn babe1 perhaps even in the baby a month old2 but can we prove it8 ,let us look within again and see if there are not times of mere1 bare consciousness in our own experience that give us the proof we need4 ,i have slept deeply all night4 ,it is my usual waking time4 ,something from within or from without forces an impression upon my mind1 and ,i stir1 and slowly open my eyes4 ,as yet ,i have really not seen anything4 ,with my eyes open my mind still sleeps--but in a few seconds comes a possessing sense of well-being4 ,obeying some stimulus1 not recognized by the senses as yet1 ,i begin to stretch and yawn1 then close my eyes and settle down into my pillows as for another nap4 ,i am not aware that ,i am ,i1 that ,i am awake1 that ,i have yawned and stretched4 ,i have a pleasant1 half-dreamy feeling1 but could not give it a name4 ,for those few seconds this is all my world--a pleasant drowsiness1 a being possessed by comfort4 ,my consciousness is mere awareness--a pleasant awareness of uncomplicated existence4 ,in another moment or two it is a consciousness of a day's work or pleasure ahead1 the necessity of rising1 dressing1 planning the day1 the alert reaction of pleasure or displeasure to what it is to bring1 the effort to recall the dreams of sleep--the complicated consciousness of the mature man or woman4 ,but ,i started the day with a mental condition close to pure sensation1 a vague feeling of something different than what was just before4 ,or this bare consciousness may come in the moment of acute shock1 when the sense of suffering1 quite disconnected from its cause1 pervades my entire being2 or at the second when ,i am first coming back after a faint1 or at the first stepping out from an anesthetic4 ,in these experiences most of us can recall a very simple mental content1 and can prove to our own satisfaction that there is such a thing as mere awareness1 a consciousness probably close akin to that of the lower levels of animal life1 or to that of the newborn babe when he first opens his eyes to life4 ,consciousness1 then1 in its elements1 is the simplest mental reaction to what the senses bring4 ,how shall we determine when consciousness exists8 ,what are its tests8 ,the response of the mind to stimuli1 made evident by the body's reaction1 gives the proof of consciousness in man or lower animal4 ,but what do we mean by a stimulus8 ,light stimulates me to close my eyes when first entering its glare from a dark room1 or to open them when it plays upon my eyelids as ,i sleep and the morning sun reaches me4 ,it is a stimulus from without4 ,the fear-thought1 which makes my body tremble1 my pupils grow wide1 and whitens my cheeks1 is a stimulus from within4 ,an unexpected shot in the woods near-by1 which changes the whole trend of my thinking and startles me into investigating its cause1 is a stimulus from without causing a change within4 ,a stimulus1 then1 is anything within or without the body that arouses awareness2 and this is usually evidenced by some physical change1 however slight--perhaps only by dilated pupils or an expression of relief4 ,when we see the reaction of the body to the stimulus we know there is consciousness4 ,on the other hand1 we cannot say that consciousness is always absent when the usual response does not occur2 for there may be injury to organs accounting for the lack of visible reaction1 while the mind itself may respond4 ,but with due care1 in even such cases1 some external symptoms of response can usually be found if consciousness exists4 ,we have already realized how complex1 intricate1 and changing is fully developed consciousness4 ,,the ,,unconscious ,but the mind of man knows two distinct conditions of activity--the conscious and the unconscious4 ,mind is not always wide awake4 ,we recognize what we call the conscious mind as the ruling force in our lives4 ,but how many things ,i do without conscious attention2 how often ,i find myself deep in an unexplainable mood2 how the fragrance of a flower will sometimes turn the tide of a day for me and make me square my shoulders and go at my task with renewed vigor2 or a casual glimpse of a face in the street turn my attention away from my errand and settle my mind into a brown study4 ,usually ,i am alert enough to control these errant reactions1 but ,i am keenly aware of their demands upon my mind1 and frequently it is only with conscious effort that ,i am kept upon my way unswerved by them1 though not unmoved4 ,when we realize that nothing that has ever happened in our experience is forgotten2 that nothing once in consciousness altogether drops out1 but is stored away waiting to be used some day--waiting for a voice from the conscious world to recall it from oblivion--then we grasp the fact that the quality of present thought or reaction is largely determined by the sum of all past thinking and acting4 ,just as my body is the result of the heritage of many ancestors plus the food ,i give it and the use to which ,i subject it1 so my mind's capacity is determined by my inheritance plus the mental food ,i give it1 plus everything to which ,i have subjected it since the day ,i was born4 ,for it forgets absolutely nothing4 ,that is not true1 you say1 for ,i have tried desperately to remember certain incidents1 certain lessons learned--and they are gone4 ,moreover1 ,i cannot remember what happened back there in my babyhood4 ,ah1 but you are mistaken1 my friend4 ,for you react to your task today differently because of the thing which you learned and have forgotten4 ,your mind works differently because of what you disregarded then4 ,you have forgotten it1 but your brain-cells1 your nerve-cells have not2 and you are not quite the same person you would be without that forgotten experience1 or that pressing stimulus1 which you never consciously recognized1 but allowed your subconsciousness to accept4 ,some night you have a strange1 incomprehensible dream4 ,you cannot find its source1 but it is merely the re-enacting of some past sensation or experience of your own1 fantastically arrayed4 ,some day you stop short in your hurried walk with a feeling of compulsion which you cannot resist4 ,you know no reason for it1 but some association with this particular spot1 or some vague resemblance1 haunts you4 ,you cannot place it4 ,one day you hit the tennis-ball at a little different angle than you planned because a queer thought came unbidden and directed your attention aside4 ,again1 under terrific stress1 with sick body and aching nerves1 you go on and do your stint almost mechanically4 ,you do not know where the strength or the skill is derived4 ,but your unconscious or subconscious--as you will--has asserted itself1 has usurped the place of the sick conscious1 and enabled you automatically to go on4 ,for we react to the storehouse of the unconscious even as we do to the conscious4 ,remember that the unconscious is simply the latent conscious--what once was conscious and may be again1 but is now buried out of sight4 ,the mind may be likened to a great sea upon which there are visible a few islands4 ,the islands represent the conscious thoughts--that consciousness we use to calculate1 to map out our plans1 to form our judgments4 ,this is the mind that for centuries was accepted as all the mind4 ,but we know that the islands are merely the tops of huge mountain-ranges formed by the floor of the sea in mighty1 permanent upheaval2 that as this sea-floor rises high above its customary level and thrusts its bulk above the waters into the atmosphere1 is the island possible4 ,just so there can be no consciousness except as that which is already in the mind--the vast subconscious material of all experience--rises into view and relates itself through the senses to an outside world4 ,we speak very glibly of motion1 of force1 of power4 ,we say ,the car is moving now4 ,but how do we know8 ,away back there in our babyhood there were some things that always remained in the same place1 while others changed position4 ,the changing gave our baby minds a queer sensation2 it made a definite impression2 and sometimes we heard people say move1 when that impression came4 ,finally1 we call the feeling of that change move1 or movement1 or motion4 ,the word thereafter always brings to our minds a picture of a change from one place to another4 ,the process--the slow comprehending of the baby mind--was buried in forgetfulness even at the time4 ,but had not the subconscious been imprinted with the incident and all its succeeding associations1 that particular phenomenon we could not name today4 ,it would be an entirely unique experience4 ,so our recognition of the impression is merely the rising into consciousness of the subconscious material in response to a stimulus from the outside world which appeals through the sense of sight4 ,we can get no response whatever except as the stimulus asking our attention is related by like or not like something already experienced2 that is1 it must bear some relation to the known--and perhaps forgotten--just as the island cannot be1 except as1 from far down below1 the sea-floor leaves its bed and raises itself through the deeps4 ,the visible island is but a symbol of the submarine mountain4 ,the present mental impression is but proof of a great bulk of past experiences4 ,and so we might carry on the figure and compare the birth of consciousness to the instant of appearance of the mountain top above the water's surface4 ,it is not a new bit of land4 ,it is only emerging into a new world4 ,but1 you ask1 do you mean to assert that the baby's mind is a finished product at birth2 that coming into life is simply the last stage of its growth8 ,how unconvincing your theory is4 ,no1 we only now have the soil for consciousness4 ,the island and the submarine mountain are different things4 ,the sea-floor is transformed when it enters into the new element4 ,an entirely different vegetation takes place on this visible island than took place on the floor of the sea before it emerged4 ,but the only new elements added to the hitherto submerged land come from the new atmosphere1 and the sea-floor immediately begins to become a very different thing4 ,nevertheless1 what it is as an island is now1 and forever will be due1 primarily1 to its structure as a submarine mountain4 ,in the new atmosphere the soil is changed1 new chemical elements enter in1 seeds are brought to it by the four winds--and it is changed4 ,but it is still the sea-floor transformed4 ,just so the baby brain1 complete in parts and mechanism at birth1 is a different brain with every day of growth in its new environment1 with every contact with the external world4 ,but it is1 primarily and in its elements1 the brain evolved through thousands of centuries of pushing up to man's level through the sea of animal life1 and hundreds of centuries more of the development of man's brain to its present complete mechanism through experience with constantly changing environment4 ,hence1 when the baby sees light and responds by tightly shutting his eyes1 then later by opening them to investigate1 his sensation is what it is because through the aeons of the past man has established a certain relation to light through experiencing it4 ,to go further than this1 and to find the very beginning1 how the first created life came to respond to environment at all1 is to go beyond the realm of the actually known4 ,but that he did once first experience his environment1 and establish a reaction that is now racial1 we know4 ,so our baby soon shows certain instinctive reactions4 ,he reaches out to grasp4 ,he sucks1 he cries1 he looks at light and bright objects in preference to dark1 he is carrying out the history of his race1 but is making it personal4 ,he has evolved a new life1 but all his ancestors make its foundation4 ,the personal element1 added to his heritage1 has made him different from any and all of his forebears4 ,but he can have no consciousness except as a bit from the vast inherited accumulation of the past of his ancestors1 of all the race1 steps forth to meet a new environment4 ,and again you ask1 ,how came the first consciousness8 ,and again ,i answer1 ,it is as far back as the first created or evolved organism which could respond in any way to a material world2 and only metaphysics and the ,god behind metaphysics can say4 ,we only know that careful laboratory work in psychology--experiments on the unconscious--today prove that our conscious life is what it is1 because of3 first1 what is stored away in the unconscious 7i4 e41 what all our past life and the past life of the race has put there72 second1 because of what we have accepted from our environment2 and this comprises our material1 intellectual1 social1 and spiritual environment4 ,,consciousness ,,is ,,complex ,the one fact we want at this stage of our inquiry is simply this3 that consciousness1 awaking at birth1 very soon becomes complex4 ,however single and simple in content immediate consciousness may be1 it is so intimately linked with all preceding experience that a pure sensation is probably never known after the first second of life4 ,as the sensation is registered it becomes a basis for comparison4 ,that first sensation1 perhaps1 was just a feeling of something4 ,the next is a feeling of something that is the same1 or is not the same1 as the first4 ,so immediately perception is established4 ,the baby consciousness recognizes that the vague feeling is1 or is not1 that same thing4 ,and from perception to a complex consciousness of perceptions1 of ideas1 of memories and relations1 and judgments1 is so short a step that we cannot use our measuring rods to span it4 ,thus through the various stages of life1 from infancy to maturity1 the conscious is passing into the unconscious1 only to help form later a new conscious thought4 ,hence the conscious thought is determined by the great mass of the unconscious1 plus the external world4 ,but every thought1 relegated to the unconscious1 through its association there--for it is plastic by nature--comes back to consciousness never quite the same1 and meets never quite the same stimulus4 ,and as a result a repeated mental experience is never twice exactly the same4 ,so the conscious becomes the unconscious and the unconscious the conscious1 and neither can be without the other4 ,our problem is to understand the workings of the mind as it exists today1 and to try to find some of its most constructive uses2 and on that we shall focus attention4 ,to that end we must first examine the various ways in which consciousness expresses itself4 ,we have recognized two distinct mental states--the conscious and the unconscious--and have found them constantly pressing each on the other's domain4 ,our study of consciousness reveals the normal in the aspects of sleeping and waking1 also various abnormal states4 ,consciousness may become excited1 depressed1 confused1 delirious1 or insane4 ,we shall consider later some of the mental workings that account for these abnormal expressions4 ,at present let us examine the mind's activities in sleep and in delirium4 ,,consciousness ,,in ,,sleep ,sleep seldom1 if ever1 is a condition of utter unconsciousness4 ,we so frequently have at least a vague recollection1 when we wake1 of dreaming--whether or not we remember the dream material--that we are inclined to accept sleep as always a state of some kind of mental activity1 though waking so often wipes the slate clean4 ,a new word which serves our purpose well has come into common use these last years1 and we describe sleep as a state of rest of the conscious mind made possible as weariness overpowers the censor1 and this guard at the gate naps4 ,the censor is merely that mental activity which forces the mind to keen1 alert1 constructive attention during our waking hours1 a guard who censors whatever enters the conscious mind and compares it with reality1 forcing back all that is not of immediate use1 or that is undesirable1 or that contradicts established modes of life or thought4 ,in sleep we might say that the censor1 wearied by long vigilance1 presses all the material--constantly surging from the unconscious into consciousness1 there to meet and establish relations with matter--back into the unconscious realms1 and locks the door1 and lies and slumbers4 ,then the half-thoughts1 the disregarded material1 the unfit1 the unexpressed longings or fears1 the forbidden thoughts2 in fact1 the whole accumulation of the disregarded or forgotten1 good1 bad1 and indifferent--for the unconscious has no moral sense--seize their opportunity4 ,the guard has refused to let them pass4 ,he is now asleep4 ,and the more insistent of them pick the lock and slip by1 masquerading in false characters1 and flit about the realms of the sleeping consciousness as ghosts in the shelter of darkness4 ,if the guard half-wakes he sleepily sees only legitimate forms2 for the dreams are well disguised4 ,his waking makes them scurry back1 sometimes leaving no trace of their lawless wanderings4 ,so the unconscious thoughts of the day have become sleep-consciousness by play acting4 ,,consciousness ,,in ,,delirium ,at this time of our study it will suffice to say that in delirium and in insanity1 which we might very broadly call a prolonged delirium1 the toxic brain becomes a house in disorder4 ,the censor is sick1 and sequence and coherence are lost as the thronging thoughts of the unconscious mind press beyond the portals into consciousness1 disordered and confused4 ,we shall later find1 however1 that this very disorder falls into a sort of order of its own1 and a dominant emotion of pain or ecstasy1 of depression or fear1 of exaltation or depreciation calls steadily upon the stored away incidents and remembered1 related feelings of the past and interprets them as present reality4 ,the censor of the sick brain is stupefied by toxins1 shock1 or exhaustion1 and the citadel he is supposed to guard is thronged with besiegers from every side4 ,the strongest--i4 e41 those equipped with most associations pertinent to the emotional status at the time--win out1 occupy the brain by force1 and demand recognition and expression from all the senses1 deluding them by their guise of the reality of external matter4 ,we find consciousness1 then1 determined by all past experience1 by an external world1 and by its organ of expression--the brain4 ,consequently1 our psychology leads us into anatomy and physiology1 which1 probably1 we have already fairly mastered4 ,in rapid review1 only1 in the following chapter we shall consider the organs of man's consciousness1 the brain1 spinal cord1 and the senses1 and try to establish some relation between the material body and its mighty propelling force--the mind4 ,,chapter ,,iii ,,organs ,,of ,,consciousness ,nothing is known to us until it has been transmitted to the mind by the senses4 ,the nerves of special sense1 of sight1 hearing1 smell1 taste1 touch1 the temperature sense 7hot or cold sense71 the muscular sense 7sense of weight and position71 these1 and the nerves controlling voluntary motion1 form the peripheral1 or surface1 nervous system4 ,this acts as a connecting medium between the outside world and the central nervous system1 which is composed of the brain and spinal cord4 ,we might liken the nerves1 singly1 to wires1 and all of them together to a system of wires4 ,the things of the external world tap at the switchboard by using the organs of special sense2 the nerves1 acting as wires1 transmit their messages2 at the switchboard is the operator--consciousness--accepting and interpreting the jangle of calls4 ,the recognition by the brain of the appeals coming by way of the transmitting sense1 and its interpretation of these appeals1 is the mind's function of consciousness1 whether expressed by thinking1 feeling1 or willing4 ,,the ,,central ,,and ,,peripheral ,,nervous ,,systems ,,in ,,action ,i am passing the open door of a bake-shop1 and a pervading odor fills the air4 ,i think hot rolls1 because my organ of smell--the nose--has received a stimulus which it transmits along my olfactory nerves to the brain2 and there the odor is given a name--hot rolls4 ,the recognition of the stimulus as an odor and of that odor as hot rolls is consciousness in the form of thinking4 ,but the odor arouses desire to eat--hunger2 and this is consciousness in the form of feeling4 ,the something which makes me walk into the shop and buy the rolls is consciousness in the form of willing4 ,the sensory appeal from the outside world gained admission through the sense of smell2 this transmitted the message1 and consciousness recognized the stimulus1 which immediately appealed to my hunger and incited action to satisfy that hunger4 ,the ear of the operator in the telegraph office1 again1 might illustrate consciousness4 ,it must be able to interpret mere clickings into terms of sense4 ,to the operator the sounds say words1 and the words are the expression of the object at the other end of the wire4 ,the brain is the receiving operator for all the senses1 which bring their messages in code1 and which it interprets first as sound1 vision1 taste1 touch1 feel1 smell1 temperature2 then more accurately as words1 trees1 sweet1 soft1 round1 acrid1 hot4 ,the mind can know nothing except as the stimulus is transmitted by sense-channels over the nerves of sense1 and received by a conscious brain4 ,a baby born without sight1 hearing1 taste1 smell1 or touch would remain a mere bit of clay4 ,he could have no awareness4 ,but so long as any one sense channel remains open the mind may acquire some knowledge4 ,suppose ,i am paralyzed1 blind1 and deaf1 and you put a tennis-ball into my hand4 ,i cannot tell you what it is1 not even what it is like4 ,it means nothing whatever to me1 for the sense channels of touch1 sight1 and hearing1 through which alone it could be impressed upon my brain1 are gone4 ,suppose ,i am blind and deaf1 but have my sense of touch intact2 that ,i never saw or touched or heard of a tennis-ball before1 but ,i know apple and orange4 ,i can judge that the object is round1 that it is about the size of a small orange or apple4 ,it is very light1 and has a feel of cloth4 ,i know it to be something new in my experience4 ,you tell me in the language of touch that it is tennis-ball2 and thereafter ,i recognize it by its combination of size1 feel1 and weight1 and can soon name it as quickly as you1 who see it4 ,suppose ,i am blind and my hands are paralyzed1 but ,i have my hearing4 ,you tell me this is a tennis-ball1 and if ,i have known tennis-ball in the past1 ,i can describe it to you4 ,it has been impressed upon my brain through my sense of hearing2 and memory immediately supplies the qualities that go with tennis-ball4 ,but if none of the senses has ever developed1 my brain can receive no impression whatever2 it cannot have even the stimulus of memory4 ,hence conscious mind cannot be1 except as some sense-channel or channels have been opened to carry thought material to the brain4 ,so far as we know today1 in this world1 mind is absolutely dependent upon the sense organs and the brain--upon matter--for existence4 ,,the ,,sympathetic ,,nervous ,,system ,associated with the central nervous system by connecting nerves--but located outside of it in various parts of the body--are groups of nerve-cells 7gray matter7 and their fibers1 forming what we call the sympathetic nervous system--the direct connecting link between mind and body4 ,the central nervous system is the director of all conscious action of the body2 the sympathetic orders all unconscious action4 ,the beating of the heart1 the contraction of the blood-vessels1 hence the flowing of the blood1 the processes of digestion1 the functioning of the glands1 are all directed by the sympathetic4 ,in other words1 the central nervous system normally controls the movements of the voluntary muscles2 the sympathetic controls those of the involuntary muscles4 ,the quick blush1 the sudden paling of the cheeks1 the start of fear1 the dilated pupils of fright are the direct result of the action of involuntary muscles under control of the sympathetic system4 ,the stimulus is received by the central nervous system2 the fibers connecting the central and the sympathetic systems carry the message quickly to the latter1 which immediately respond by ordering contraction or expansion of involuntary muscles4 ,so tears flow1 we breathe freely again or we quake and tremble1 our pupils widen or contract1 the heart beats suffocatingly1 or seems almost to stop4 ,the sympathetic system1 as the name implies1 is influenced by suggestions from the emotions rather than from the intellect4 ,we might say that it is controlled by the feeling mind rather than the thinking mind1 for intellect cannot influence it in the least4 ,the wise nurse1 who knows something of the laws of the mind1 soon realizes that the sympathetic nervous system1 rather than physical disability1 causes many indigestions1 headaches1 diarrheas1 dry mouths1 chills2 is responsible for much nausea1 much exhaustion1 etc4 ,when she has had wider experience she finds that almost any known physical disorder can be unconsciously imitated by the suggestible patient1 whose sympathetic nervous system causes physical reactions to respond to the feelings of a sick mind4 ,let the nurse remember1 however1 that is it not for her to decide whether the disorders from which her patient suffers are of physical or nervous origin4 ,it is for her1 on the other hand1 to study her patient's mentality and reactions1 and to become expert in reporting symptoms of nervous as well as of physical significance4 ,,chapter ,,iv ,,relation ,,of ,,mind ,,and ,,body ,we have found that mind is entirely dependent upon the bodily organs for its existence4 ,is the body in the same way dependent upon the mind8 ,can the mind die and the body go on8 ,given a perfect body with unblocked sense channels1 and put the mind to sleep1 paralyze the central nervous system with alcohol in sufficient quantity so that the undamaged peripheral nervous system--the senses--can obtain no response or recognition from it1 and that perfect body is as useless for the time as if dead4 ,but here comes proof of the remarkable hold of the body on life4 ,the unconscious mind takes up the burden of directing the sympathetic nerves to stimulate the muscles of breathing4 ,the unconscious sees to the beating of the heart4 ,it directs the contraction of the blood-carrying vessels4 ,it maintains certain vital processes of secretion4 ,thus automatically life goes on2 the body still reacts to a limited field of stimuli1 and consciousness recognizes it not4 ,but when the unconscious mind ceases to function1 then1 indeed1 does the body die4 ,yet the conscious mind may die and the body live on1 so long as the unconscious continues its activity4 ,it is possible for the human body to live for years1 utterly paralyzed1 with many of the senses gone1 with no consciousness of being--if cared for by other persons--a merely vegetable existence4 ,the current of power is broken2 but the spark is still glowing1 though utterly useless because connected with nothing4 ,and it may continue to glow for some time while properly stimulated from outside sources4 ,we might liken the mind to the boiler in which steam is generated1 and the body to the engine which the steam runs4 ,if the boiler bursts1 the engine stops2 but it may not be otherwise damaged4 ,it simply cannot carry out its main function of motion any longer4 ,the fires under the boiler are still burning and can be kept burning so long as fuel is provided1 but the connection is broken and the great bulk of iron is a useless thing in that it can no longer fulfil its purpose4 ,in just such a way may the mind be paralyzed2 but the spark of life1 which has through all the years kindled the now lost mind to action1 may still remain--a useless thing1 which would die away if not tended from without by other bodies whose minds are still intact4 ,but in the demented mind consciousness still remains1 the awareness of the young child or baby stage of life4 ,the connection between the upper or conscious brain centers and the body has been tampered with2 it no longer is direct1 but breaks off into switch-lines4 ,but the contact still holds between the lower or unconscious mind and the body2 so the automatic body functions go on1 directed as they were in babyhood before the independent mind assumed control4 ,hence1 when all acute consciousness is finally gone1 the unconscious mind1 a perfect automaton1 may still carry out the simplest vegetative activities of existence4 ,when body is dead1 mind1 so far as its reactions to the world we know are concerned1 ceases to act4 ,but when the conscious mind is dead the body may yet live as a vegetable lives1 with all its distinctively human functions lost4 ,motionless1 save for the beating of the heart and the reaction of the lungs to air1 the body may still be alive1 though the mind long since has ceased all earthly activity4 ,so we discover that an organ of mind is an essential1 here1 to life of mind1 and that mind only can induce this organ to any action above the vegetative stage4 ,but1 on the other hand1 we find that life can exist without conscious mind1 even if untended by others1 for a limited time4 ,if the direct nerve connections between the brain and the hand1 the brain and the foot1 or the brain and the trunk are cut off1 the mind henceforth realizes nothing of that part except as the sense of sight reports upon it2 for the optic nerves relate the hand and mind1 through this sense1 as truly as the motor nerves which carry the mind's message for motion to the hand1 and the sensory nerves which carry back to the mind the hand's pain4 ,but let the optic nerve be inert1 the sensory and motor connections broken between brain and hand1 or foot and trunk1 or brain and trunk1 and the hand or foot may be amputated and the mind never sense the fact2 the trunk may be severely injured and the mind be serenely unconscious4 ,so the brain in man is the one immediate bodily condition of the mental operations4 ,take away all the brain and man's body is a useless mass of protoplasm4 ,the brain's varied and intricate nerve connections with all parts of the body1 through nerves branching from the main trunks in the spinal cord1 we shall not discuss1 for you know them through your study of anatomy4 ,for the purpose of our psychology we need consider only two of the main divisions of the brain--the cerebrum1 which includes what we call the right and left hemispheres1 and the cerebellum4 ,,the ,,cerebrum ,,or ,,forebrain ,for convenience the various lobes of the cerebrum are known as frontal1 temporal1 parietal1 and occipital1 according to the parts of the brain referred to3 as forehead1 temples1 crown1 or occiput4 ,the cerebellum1 or hind brain1 is also divided into two hemispheres1 and is situated behind and below the hemispheres of the cerebrum4 ,a system of localization has been roughly mapped out1 the result of careful laboratory work on animals and of studying the loss of various functions in human beings as related to the location of brain injuries4 ,from these experiments it seems proved that consciousness belongs only to the cortex or surface of the upper brain1 and that the vast realm of the unconscious belongs to the lower brain centers4 ,hence the cortex is the organ of consciousness1 and the lower centers are the repository of the unconscious until it again becomes conscious4 ,the motor zone of the cortex we now know to be situated in the convolutions bordering the fissure of ,rolando4 ,vision is evidently excited from the occipital lobes1 though not yet conclusively proved4 ,smell1 presumably1 is located in the temporal lobes4 ,considered action is directed from the upper hemispheres only4 ,it is significant that the hemispheres of the cerebrum are also accepted as the seat of memory for man--that intellectual quality which makes him capable of acting from absent stimuli1 stimuli only present to memory2 which makes it possible for him to reason the present from the experiences of the past4 ,but in all animal life1 except the higher forms1 the control of action is from the lower brain centers1 centers which respond only to present objects4 ,with them memory1 as man knows it1 is lacking2 but the reactions of the past are indelibly imprinted upon motor nerves and muscles1 so that when the present object presses the button1 as it were1 calling forth the experience of the race1 the animal instinctively reacts4 ,but of what use to man1 then1 are the lower brain centers8 ,in man1 as in lower animals1 they care for the vegetative functions of life1 so that our blood continues to circulate1 the air enters and leaves our lungs1 digestion is carried on1 with no assistance from the upper centers1 the hemispheres of the cerebrum being thus left free for concentration on the external world of matter1 which it can transform into a world of thought4 ,it is the lower or vegetative brain that may still exist and keep life intact when the functions of the cerebrum are destroyed4 ,we can say1 then1 of the brain as a whole that it is the organ of the mind1 the sine qua non of the mind1 the apparatus for the registration of sense impressions4 ,the senses themselves are the rudiments of mind1 are the means by which stimuli alighting on sense organs enter consciousness2 for the nerves of special sense immediately carry the impetus to the brain1 where it is recognized as the not me1 the something definitely affecting the me1 and demanding reaction from the me4 ,the functions of the cerebrum we find grouping themselves in three classes3 intellect1 emotion1 and volition1 more simply1 thinking1 feeling1 and willing2 and we find no mental activity of the normal or abnormal mind which will not fall into one of these groupings4 ,this does not mean that one part of the brain thinks1 another part wills1 another part feels2 for in the performance of any one of these functions the mind acts as a whole4 ,our thinking or our willing may be permeated with feeling1 but the entire mind is simply reacting simultaneously upon various stimuli4 ,,chapter ,v ,,the ,,normal ,,mind ,mind1 we found1 is born in the form of consciousness when the outside world impresses itself upon the brain-cells by way of the senses4 ,this consciousness1 observation and experiment prove1 is first a feeling one1 later a feeling-thinking-willing one4 ,the mind1 then1 is really the activity of the brain as it feels1 as it thinks1 as it wills4 ,we express this in descriptive terms when we speak of mind as the flow of consciousness1 the sum of all mental associations1 conscious and unconscious4 ,for mind is never a final thing4 ,looking within at our own mental processes we find that always our thought is just becoming something else4 ,we reach a conclusion1 but it is not a resting place1 only a starting place for another4 ,my thought was that a moment ago1 but while it was that it was becoming this1 and even now it is becoming something else4 ,thinking is mind4 ,feeling is mind4 ,willing is mind4 ,but for the sake of clearness we speak of feeling1 thinking1 and willing as being functions of mind4 ,mind acts by using these powers4 ,but to what end does it act8 ,what purpose does it serve8 ,for these functions are not the reasons of being for the mind1 even as motion--while the immediate purpose of the locomotive--is not its chief end4 ,the steam engine may stand in the same spot while its wheels revolve madly2 it may move along the tracks alone1 and accomplish nothing2 or it may transport a great train of loaded cars4 ,unless it moves to some definite point and carries merchandise or people there1 it is a useless1 indeed1 a dangerous invention4 ,we find1 in fact1 that it functions to the very definite end of taking man and his chattels to specified places4 ,and so it is with the mind4 ,if it is thinking and feeling and willing only for the sake of exercising these mental powers1 it might better not be4 ,but what end do we actually find these functions serving8 ,mind1 with its powers of thinking1 feeling1 and willing1 gives an external world of matter2 an internal world of thought1 and so relates them to each other as to make them serve man's purposes4 ,thus these functions exist for accomplishment4 ,in the solving of a problem1 for instance1 the mind thinks1 primarily2 in the enjoyment of music it feels1 primarily1 though its feeling may be determined by the intellectual verdict on the music2 in forcing its owner to sit at the piano and practice in the face of strong desire to attend the theater1 it wills1 primarily4 ,now one of its functions predominates2 now another4 ,but the whole mind1 not a feeling section1 or a thinking section1 or a willing section1 operates together to produce action4 ,when ,i play the piano it calls on all my mind4 ,i think the music4 ,i feel it4 ,i make my fingers play it4 ,but the thinking1 the feeling1 and the willing act together to result in the fingers playing4 ,the mind1 then1 is an instrument of achievement4 ,it fulfils its purpose when it makes matter serve useful ends4 ,emotion or feeling is the function of the mind which associates a sense of pleasure or pain with every thought or act4 ,feeling is the affective state of mind4 ,by this we mean that it has the power to move us4 ,and this emotion primarily does2 for our feeling of pleasure or pain moves us to action1 as well as precedes and accompanies and follows action4 ,the word emotion is usually employed to denote an acute feeling state1 while the word mood denotes a prolonged feeling condition1 i4 e41 a less acute emotional state4 ,the word feeling1 however1 is used to cover both2 for in each case the sensational element manifests itself in a definite physical affect1 pleasurable or painful in some degree4 ,thinking is a conscious mental activity exercised to evolve ideas from perceptions1 and to combine and compare these ideas to form judgments4 ,intellection1 or thinking1 might be explained as the mental process which converts sensation into percepts1 groups percepts to form concepts or ideas1 stores away ideas and sensations for future use1 and recalls them when needed--the recalling being memory--and by reason combines1 compares1 and associates ideas to form judgments1 then compares judgments to form new judgments4 ,the process of intellect we name by terms denoting activity1 such as intellection1 thinking1 the stream of thought1 and the latter describes it most truly4 ,volition or will is the function of the mind which compels the expression of thought or feeling in action4 ,for clarity we might indicate the mind and its functions in the following diagram3 _/ ,emotion ,pleasure ,pain _/ ,eye ,ear _/ ,sensation _/ ,nose 7impression ,mouth on mind from ,skin some organs7 ,muscles ,viscera ,general sensation ,perception 7recognition of of object _/ cause of sensation7 of quality ,mind ,intellect1 or _/ ,mind the ,stream ,self _/ of ,thought ,organic ,memory ,inorganic ,percept ,concept ,abstract ,ideation ,concrete ,imaginative ,fanciful ,constructive ,reason ,judgment ,will _/ ,the following terms are ones constantly used in psychology1 and are briefly defined that there may be no haziness in their application4 ,sensation is the uninterpreted response of the mind to stimuli brought by sense organs4 hot4 ,examples3 ,feeling of cold4 pain4 ,sensation may arouse instinct and cause reflex action1 or start a feeling state1 or a train of thought4 ,perception is the conscious recognition of the cause of a given sensation4 fluid--water4 ,example3 cold--snow4 pain--cut4 ,percept is a word often used to denote the mind's immediate image of the thing perceived4 ,percepts are of two kinds3 object and quality4 ,example3 object1 as water4 quality1 as fluid4 ,memory is the mind's faculty of retaining1 recognizing1 and reproducing sensations1 percepts1 and concepts4 ,organic memory is the mind's reproduction of past bodily sensations4 ,example3 ,i recall the physical sensations of a chill1 and live it over in my mind1 so that ,i can accurately describe how a chill feels to me1 though ,i can but surmise how one feels to you4 ,inorganic memory is the mind's reproduction of its own reactions in the past4 ,example3 ,myself having a chill1 how ,i acted2 what ,i thought and my emotions during that chill4 ,ideation is the mind's grouping of percepts by the aid of memory1 to form concepts4 ,example3 ,i perceive color1 form1 mouth1 eyes1 nose1 chin1 etc4 ,these percepts ,i combine as a result of past experience 7memory7 to form my concept1 face2 and the process of combining is ideation4 ,concepts are mental representations of things or qualities1 i4 e41 of object or quality percepts4 ,we might say that the percept is the mind's immediate image of a thing or quality1 and the concept is the result of the storing up and grouping and recombining of percepts4 ,thus a lasting mental picture is secured2 and my idea of horse1 for instance1 is so clear and definite a thing in my mind that if ,i should never again see a particular horse1 ,i should yet always be able to think accurately of a horse4 ,concepts are of two kinds--concrete and abstract4 ,a concrete concept1 or concrete idea 7for concept and idea are interchangeably used71 is an idea of a particular object or quality4 ,examples3 ,this wine-sap apple 7object concept74 ,this sweet orange 7quality concept74 ,an abstract concept1 or abstract idea1 is a mental reproduction of a quality or an object dissociated from any particular setting or particular experience4 ,abstract ideas are of two kinds4 ,we speak of them as abstract object concepts and as abstract quality concepts4 ,an abstract object concept we might call a generalized idea1 an idea comprehending all objects having certain things in common4 ,example3 ,my idea of animal includes many scores of very different individual animals1 but they all have bodies and heads and extremities4 ,they all have some kind of digestive apparatus2 they breathe1 and can move4 ,an abstract quality concept is easier to think than to explain4 ,it is as though the mind in considering a multitude of different objects found a certain quality common to many of them1 and it abstracted1 i4 e41 drew this particular quality1 and only this1 from them all1 and then imagined it as a something in itself which it calls redness1 or whiteness1 or goodness4 ,thereafter1 whenever it finds something like it anywhere else again it says1 ,that is like my redness4 ,so ,i call it red4 ,in other words1 consciousness thereafter can determine in a newly discovered object something it knows well merely because that something corresponds to a representation which experience and memory have already formed4 ,these comprehensive concepts1 or universals1 as some psychologists term them1 the mind1 having pieced together from experience and memory1 holds as independent realities1 not primarily belonging to this or that1 but lending themselves to this or that4 ,for example3 ,my mind says white1 and sees white in some object4 ,but ,i see the white only because my mind has a quality concept1 whiteness4 ,this outside object corresponds to my concept4 ,i recognize the likeness and call it white4 ,i speak of goodness1 or purity1 of benevolence2 or of fulness1 emptiness1 scantiness4 ,there is no object or quality in the outside world ,i can say is goodness1 or fulness4 ,but ,i do see things in the external world through my ideas of goodness or fulness that correspond to these ideas4 ,they have some of the qualities the ideas embrace2 and so ,i point them out and say1 ,this represents purity2 that1 impurity2 or1 ,this is full1 that is empty4 ,one satisfies my concept of purity1 while the other does not4 ,one fulfils my concept of fulness2 the other does not4 ,and because we can never point out any one quality in the outside world and say ,this is purity1 and all of purity2 this is goodness2 or this good plus this good plus this makes all of goodness2 because of this impossibility we speak of these concepts as having reality somewhere4 ,they are absolutes1 universals1 abstract quality concepts--the unfound all of which the things we call pure and good are but the part4 ,apperception is the process of comparing the new with all that is in the mind1 and of classifying it by its likeness to something already there4 ,with an abstract idea of an object in mind we very deftly1 through the use of memory and constructive imagination1 deduce the whole from the part recognized as familiar4 ,example3 ,in walking through the field1 along the bank of the brook1 ,i glimpse under the low-hanging branches of the weeping willow a restlessly moving hoof4 ,i see a certain kind of hoof and only that4 ,or ,i hear a lowing sound4 ,and ,i say cow4 ,i have not seen a cow1 but only a part which tells me a cow is there2 for all the cows ,i ever saw had hoofs of that general description1 and so it fits into my concept cow1 and into no others4 ,or ,i have heard cows1 only1 give that lowing sound before4 ,from my perception1 then1 of hoof or sound ,i apperceive cow4 ,memory relates that hoof or that lowing sound to a certain kind of animal known in the past2 and constructive imagination draws in all the rest of the picture that belongs with it4 ,again1 we may apperceive an object or quality from our recognition of something which in our experience has been associated1 under those particular circumstances1 with only that object or quality4 ,i see smoke on the ocean's far horizon1 and ,i decide instantly1 a steamer4 ,i have not perceived any steamer1 but only something that goes with it1 as it were4 ,i see the ship with my mind1 not with my eyes2 for ,i know that a cloud of smoke out there always has1 in my past experience1 represented just that4 ,i compare the newly appearing stimulus--smoke in that particular location--with all that is associated with it in my mind1 and classify it with the known4 ,i apperceive steamer4 ,in apperception1 then1 we construct from the known actually perceived by the senses1 the unknown4 ,how does the child realize that the moving speck on the distant hillside is his father8 ,there is nothing to indicate it except that it is black and moves in this direction4 ,but experience tells ,johnny that father comes home that way just about this time4 ,moreover1 it says that father looks so when at that distance4 ,when ,johnny is as sure it is his father as if he could see his face close beside him he has apperceived him4 ,the speck on the hill is the newly arriving stimulus4 ,johnny compares it with what corresponds to it in his mind's experience and proclaims1 as a fact1 that he sees his father4 ,reason is the mind's comparison and grouping of concepts to form judgments1 and its association of judgments to form new judgments4 ,example3 ,my concept man includes the eventual certainty of his death4 ,my concept mortal means subject to death4 ,therefore my judgment is1 ,man is mortal4 ,reason has compared the concepts and found that the second includes the first4 ,judgment is the mind's decision arrived at through comparing concepts or other judgments4 ,example3 ,man is mortal is my decision after comparing the concepts man and mortal and finding that the latter really includes the former4 ,judgment at the same time says that ,mortals are men1 is not a true conclusion4 ,for in this case the first concept is not all included in the second4 ,mortals are all life that is subject to death4 ,we may assume personal consciousness even as we recognize an individual body4 ,psychology does not deal with any awareness separated from a person4 ,it knows no central mind of which you partake or ,i partake1 and which is the same for us both4 ,a universal consciousness would simply mean one which is the sum of yours and mine and everybody's who lives today1 or who has ever lived4 ,so by personal consciousness the psychologist means his consciousness1 or yours1 or mine4 ,but they can never be the same2 for mine is determined by my entire past and by how things and facts and qualities affect me2 and yours1 by your past1 and by things and facts and qualities1 and by how they affect you4 ,personal consciousness is the mind's recognition of self2 and as the self changes with every added experience1 so personal consciousness is modified4 ,stream of thought is a term ,james has brought into common usage to illustrate the fact1 already stressed1 that thinking1 as we know it1 is never static1 is never one thing1 one percept1 one concept1 one judgment2 but is a lot of these all together1 just beginning to be or just beginning to change into something else4 ,we never know a concept1 for instance1 except as it is a part of our entire consciousness1 related to all the rest2 just as we do not know the drop of water in the brook as it flows with the stream4 ,we can take up one on our finger-tips1 however1 and separate it from all the rest4 ,but analyzed in the laboratory1 this drop will contain all the elements that a pint or gallon or a barrel of the same water contains4 ,the drop is what it is because the stream has a certain composition4 ,we only have a brook as drops of rain combine to make it1 but we also have only the drops as we separate them from the steam4 ,imagination is the combining by the mind1 in a new way1 things already known4 ,this may be either into fantastic groupings divorced from reality1 or into new1 possible1 rational groupings not yet experienced4 ,so imagination is of two kinds1 the fantastic and the constructive4 ,fantastic imagination1 or fantasy1 gives us gnomes1 fairies1 giants1 and flying horses1 and all the delights of fairy tales4 ,constructive imagination is the basis for invention1 for literature1 and the arts and sciences4 ,the word thinking1 defined early in this chapter1 is broadly used to denote the sum of all the intellectual faculties4 ,thinking is really the stream of thought4 ,,chapter ,,vi ,,the ,,normal ,,mind 7,continued7 ,,instinct ,we have found that the mind's chief end is action1 of itself1 or of its body4 ,but what are its incentives to action8 ,we see the very young baby giving evidences of an emotional life1 living in an affective1 or feeling environment1 leading a pleasure-pain existence1 from the first4 ,he acts as desire indicates4 ,but from the very moment of his birth he performs actions with which he cannot as yet have a sense-memory connection1 because he is doing them for the first time4 ,how can he know how to respond to stimuli from the very beginning8 ,no other possible explanation offers itself than that he is born with certain tendencies to definite action4 ,these we call instincts--man's provision to keep him going1 as it were1 till reason develops4 ,instincts are handed down from all the past4 ,definite tendencies1 they are1 to certain specific reflex actions in response to certain sensations4 ,these responses1 from the very beginning of animal life1 have been toward avoiding pain1 and toward receiving pleasure4 ,it is as though the stimulus presses the trigger--instinct--and the muscle responds instantly with reflex action4 ,this mechanism is the means of protection and advancement1 and takes largely the place of intelligence in all animal life4 ,it is what makes the baby suck and cry1 clutch and pull1 until a sense memory is established4 ,so instinct is really race memory4 ,we call instinctive those immediate1 unthought reactions which are the same with all mankind4 ,the pugnacious instinct--the desire to fight--is the natural reaction of every human being of sane mind to attack4 ,the inner necessity of avenging is so strong in the child or man of untrained mind or soul that he acts before he thinks4 ,he strikes back1 or shoots1 or plots against his enemies4 ,only rare development of spirit or the cautious warning of reason which foresees ill consequences1 or a will trained to force control1 can later make the instinct inactive4 ,where instinct ends and sense memory1 imitation1 and desire step in is difficult to determine4 ,later in life probably most of what we consider instinctive action is simply so-called reflex action1 depending on sense memory1 action learned so young that it is difficult to distinguish it from the true reflex action1 which is due only to race memory4 ,james1 in his ,talk to ,teachers1 gives us a partial list of the instincts4 ,thus3 ,fear ,ownership ,shyness ,love ,constructiveness ,secretiveness ,curiosity ,love of approbation ,the ambitious impulses3 ,imitation1 ,emulation1 ,pride1 ,ambition1 ,pugnacity ,to this partial list we would add self-preservation1 reproduction1 etc4 ,but instincts conflict with each other1 and man carries about with him in babyhood many of them which may have been very useful to his prehistoric ancestors1 but which only complicate things for him4 ,fear and curiosity urge opposite lines of conduct4 ,love of approbation and shyness are opposed4 ,love and pugnacity are apt to be at odds4 ,so1 gradually1 as intelligence increases1 the child refuses to allow such impulses to lead him to action4 ,when fear-instinct and love-instinct are at war1 reason is provided to come to the rescue4 ,instincts are racial tendencies of sensational or emotional states to determine action4 ,instincts are the germs of habit1 and when instinct would give rise to a reaction no longer useful1 reason1 abetted by new habit formation1 in the normal mind1 weakens instinct's force2 and the habit is discarded and the instinct gradually declines4 ,in prehistoric times when food was scarce1 and man had not learned the art of tilling the soil1 hunger forced him to fight for what he got to eat4 ,as there was often not enough to go around1 he maimed or killed his fellow-man that he might have all he wanted1 obeying the instinct to survive4 ,so1 now1 the baby instinctively clutches for all that appeals to him4 ,but an abundance of food for all1 or the intelligent realization that co-operation brings more to the individual than does fighting1 and a developed sense of responsibility toward others2 or merely the fear of the scorn of fellow beings1 or the desire to be protected by the love of his kind2 perhaps a genuine love of people1 acquired by spiritual development1 puts the primitive habit of food-grabbing into the discard4 ,finally1 the very instinct of self-preservation may be transformed into desire to serve others4 ,no better illustration of this can ever be offered than the sacrifices of the ,world ,war4 ,,memory ,no mind retains consciously everything that has ever impressed it4 ,it is necessary that it put aside what ceases to be of importance or value and make way for new impressions4 ,we found early in our study that the subconscious never forgets1 but harbors the apparently forgotten throughout the years1 allowing it to modify our thinking1 our reactions4 ,but the conscious mind cannot be cluttered with the things of little importance when the more essential is clamoring4 ,so there is a forgetting that is very normal4 ,we forget numberless incidents of our childhood and youth2 we may forget the details of much that we have learned to do automatically2 but the subconscious mind is attending to them for us4 ,do you know how to skate8 and if so1 do you remember just how you did it the first time8 ,probably all you recall is that you fell again and again because your feet would slip away from where you meant them to be4 ,when you glide over the ice now it is as natural as walking1 and as easy4 ,you cannot remember in detail at all how you first struck out1 nor the position of your feet and arms and legs1 which you felt forced to assume4 ,at the time there was very real difficulty with every stroke--each one was an accomplishment to be attempted circumspectly1 in a certain definite way4 ,all you remember now is1 vaguely1 a tumble or two1 soreness1 and lots of fun4 ,we forget details we have intrusted to others as not a part of our responsibility4 ,we forget the things which in no way concern us1 in which we have no interest and about which we have no curiosity4 ,and it is well that we do so4 ,if it were not for the ability to forget1 our minds would be like a room in which we have lived a lifetime1 where we have left everything that has been brought into it since our birth4 ,it would be piled ceiling high1 with no room for us1 and with difficulty only could we find what we want4 ,as we grow from babyhood to childhood1 from childhood to youth1 from youth to maturity the room changes with us4 ,we put off childish things4 ,they are stored away somewhere1 in an attic or basement1 or destroyed4 ,and day after day something new is added1 displacing something else4 ,in the case of the mind all these things are stored and cataloged in the subconscious1 and forgotten1 until some need causes us to look into our catalog-index and see the experience again1 or some association calls it back1 relating it to something new4 ,so our discussion of the subconscious involved also a discussion of memory4 ,but what of the things we must use frequently and cannot find in our minds8 ,what of absent-mindedness and faulty memory8 ,in such cases our minds might be compared to a cluttered room full of things we need and want to use every day1 but in confusion4 ,we know where many of them are1 the ones we care most about2 but we have to rummage wildly to find the rest4 ,we have no proper system of arrangement of our belongings4 ,you laid down that book somewhere1 absent-mindedly1 and now you cannot tell where4 ,you were thinking of something else at the time1 and inattention proves a most common cause of poor memory4 ,perhaps you simply have more books than the room can hold in an orderly way1 and so you crowded that one in some corner1 and now have no recollection of where you put it4 ,poor memory is the result of lack of attention1 or divided attention at the time the particular attention-stimulus knocked4 ,you asked me to buy a ribbon of a certain shade and a certain width when ,i went to town4 ,i was thinking of my dentist appointment4 ,however1 ,i heard your request1 answered it graciously1 took the money you offered1 still wondering if the dentist would have to draw that tooth4 ,and the chances are that ,i forgot your ribbon4 ,i was giving you only a passive and divided attention4 ,or ,i have more to do than ,i can possibly accomplish in the next six hours4 ,you ask me to buy the ribbon4 ,i attend accurately for the moment1 think distractedly1 ,how can ,i do it all8--but ,i will--and crowd the intention into an already overburdened corner of my mind1 fail to associate it with the other thoughts already there1 and return six hours later without the ribbon4 ,my sense of hurry1 of stress1 of the more important thing to be done1 or a reaction of impatience at the request1 forced back the ribbon thought and allowed it to be hidden by others4 ,i was really giving you only partial attention1 or an emotion interfered with attention2 and ,i forgot4 ,hence we find that a faulty memory may exist in an otherwise normal mind when poor attention1 or divided attention due to emotional stress or to an overcrowded mind1 which makes it impossible to properly assort its material1 interferes4 ,again1 we forget many things because they are unpleasant to remember4 ,we have no desire1 no emotional stimulus to make us remember2 or because some of the associations with the forgotten incident are undesirable4 ,we forget many things because if we remembered them we would feel called upon to do some unpleasant duty4 ,you forgot your tennis engagement with ,b1 perhaps1 because you were so engrossed in a pleasure at hand1 or in your work1 that anything which interrupted was1 under the circumstances1 undesirable4 ,you may have wanted very much to play with him1 but some more pressing desire--to care well for your patient1 or to continue the present amusement--was stronger4 ,or you forgot because you did not want to play with him and had no excuse to offer at the time4 ,you wished to forget4 ,perhaps he does not play a good game1 or you do not like him1 or at least you like some one else much more1 and he happened along2 so you forgot ,b4 ,the unconscious mind saw to it that something else was kept so prominently before your attention that it could not return to the less desired4 ,thus a forgetting may be purely the result of an emotional interference which makes it1 all in all1 more pleasant to forget than to remember4 ,if we would help ourselves or our patients whose memories are faulty1 and who make them worse by their continual fretting over their disability1 we must train ourselves to be willing to forget all that does not in the least concern our interests or those of the people about us1 and does not add anything desirable to our knowledge4 ,thus we may avoid overcrowding the mind4 ,but when we would remember let us give our whole active attention at the moment of presentation of the new stimulus1 and immediately tie it up with something in past experience2 let us recognize what it is that we should remember1 and call the reinforcement of will1 which demands that we remember whether we want to or not4 ,sincere desire to remember will inspire early and frequent recalling1 with various associations1 or hooks1 until the impression becomes permanent4 ,the average patient's poor memory is made worse by his agitation and attention to it1 and his conviction that he cannot remember4 ,the fear of forgetting often wastes mental energy which might otherwise provide keenness of memory4 ,if the nurse ties up some pleasant association with the things she wants the sick man to remember1 and disregards his painful effort to recall other things1 then--unless the mind is disordered--he will often find normal memory reasserting itself4 ,we shall consider this question of memory in more detail in a later chapter of practical suggestions for the nurse4 ,,the ,,place ,,of ,,emotion ,feeling ,cannot ,be ,separated from ,thinking4--,emotion we found the constant accompaniment of every other mental activity4 ,it is first on the stage of consciousness and1 in the normal mind1 last to withdraw4 ,when ,i am working at a problem in doses or solutions1 trying to learn my materia medica1 or wrestling with the causes of disease in my medical nursing1 or thinking how ,i can eke out my last ten dollars till ,i get some more1 ,i am pursued with some vague or well-defined feeling of annoyance or satisfaction1 of displeasure or pleasure4 ,if all goes well1 the latter2 if not1 the former4 ,feeling ,cannot ,be ,separated from ,will4--,i cannot will without a feeling accompaniment1 pleasant or unpleasant4 ,i may be using my will only in carrying out what intellect advises4 ,but we found that intellect's operations are always affective1 i4 e41 have some feeling of pleasure or pain4 ,and the very act of will itself is a pleasant one and much easier if it is making me do what ,i want to do2 it is a vaguely or actively unpleasant one if it is making me act against desire4 ,in the end1 however1 if ,i act against desire in pursuance of reason or a sense of duty1 the feeling of pleasure in the victory of my better self is asserted4 ,and feeling cannot be separated from will4 ,feeling ,cannot ,be ,separated from ,action4--,i cannot do anything without a feeling of comfort or discomfort1 happiness or unhappiness4 ,try it for yourself when you are feeding a patient1 making a bed1 giving a bath or massage1 preparing a hypodermic4 ,other things being normal1 if you are performing the task perfectly1 the feeling of satisfaction1 of pleasure1 of the very ability to work effectively1 with speed and accuracy and nicety1 comes with the doing4 ,if you are bungling1 there is a pervading sense of dissatisfaction1 of unpleasantness4 ,in the automatic or semi-automatic action a great economy of nature has conservatively put feeling at the absolute minimum2 but it has not eradicated it4 ,as you walk across the ward1 though your predominating thought and feeling may be elsewhere1 there is a sense of pleasure or displeasure in the very movement4 ,if your body is fresh and you are of an energetic type and in happy frame of mind1 a pervasive feeling of satisfaction is experienced4 ,if tired or discouraged or sore from unaccustomed exercise1 every step registers protest4 ,thus we find by experiment that there is no thought we have1 no single conscious movement or action1 nor any expression of the will1 but is accompanied with what the psychologist broadly terms pleasure or pain4 ,so emotion1 the first expression of mentality1 is never absent from any mental or physical act4 ,it permeates all we do1 as well as all we think and will1 with the partial exception of automatic action1 above indicated4 ,,the ,,beginning ,,of ,,reason ,we found feeling by far the strongest factor in producing action in babyhood and childhood4 ,our instinctive doing1 we learned1 is the result of a race impulse4 ,will acts chiefly at emotion's bidding4 ,but very early the baby's experience operates as a partial check to feeling's exclusive sway4 ,it keeps him from touching the fire1 no matter how its brightness attracts4 ,it may be merely the sense memory of hurt when fingers and that bright thing came together2 and one such impression will probably prevent him from ever again touching it4 ,or it may be the brain-cell's retention of the painful feeling of slapped hands when the fingers reaching out to the flame had not yet quite touched4 ,these punishment experiences are only effective in many children after more or less repetition has set up an automatic prohibition from brain to motor nerves2 but right here intellect begins to assert itself in the form of sense memory4 ,the baby does not reason about the matter4 ,his nerve-cells simply remember pain1 and that particular brightness and glow1 and finger touch--or that reaching out to the glow--and slapped hands1 as occurring together4 ,in the same way he early connects pleasure with the taste of certain forbidden things4 ,he does not know they are sweet4 ,he only knows ,i want4 ,even here his desire to taste may be checked in action by a vivid memory of what happened when he tasted that other time1 and was spanked or put in his little room all alone with only milk and bread to eat for a long time4 ,later on the child may think1 from cause to effect1 thus3 ,sweet1 good1 want1 taste1 spank1 hurt 7or no dinner1 all by self1 lonely71 spank hurt more than sweets good4 ,not taste4 ,but long before he can work this out1 consciously1 two distinct memories1 one of pleasure and one of pain1 are aroused by the sight of the sweet4 ,and what he will do with it depends upon which memory is stronger4 ,in other words1 his action is governed altogether by his feeling1 though memory1 which is an intellectual factor1 supplies the material for feeling4 ,,development ,,of ,,reason ,,and ,,will ,later still1 when the child is older1 we may have somewhat the following mechanism3 ,sweets1 good1 want1 taste2 spank1 hurt2 don't care1 spank not hurt much1 maybe never found put1 sweets very good4 ,now the child is reasoning and choosing between two courses of action1 don't and do4 ,his decision will depend upon whether immediate satisfaction of desire is stronger than the deferred satisfaction of being good1 and the fear of punishment4 ,he probably prefers to take a chance1 and even if the worst comes1 weighs it with the other worst1 not having the sweet--and takes the bird in the hand4 ,he has reasoned1 and has chosen between two emotions the one which his judgment says is the more desirable2 and his will carries out the decision of his reasoning4 ,his chief end in life is still to get the most immediate pleasure4 ,still later in child-life1 much later1 perhaps1 his decision about the jam is based on neither love of it nor fear of punishment1 but--despite his still sweet tooth--on a reasoned conclusion that if he eats jam now he may be sick1 or he may spoil his appetite for dinner2 or on a consideration that sweets between meals are not best on dietetic principles2 and will very readily backs up the result of his reasoning4 ,though his determination is largely based upon feeling1 reason has chosen between feelings1 between immediate desire to have1 and desire to avoid future discomfort4 ,reason is triumphant over present desire4 ,,judgment ,the conclusion or decision that reason has reached we call a judgment4 ,the youth who decides against the sweet between meals1 we say1 has good judgment4 ,and we base our commendation on the proved fact that sweets are real fuel1 giving abundantly of heat and energy1 and are not to be eaten as mere pastime when the body is already fully supplied with high calorie food not yet burned up2 that if sweets are eaten at irregular intervals and at the call of appetite1 and not earned by an adequate output of physical work1 the digestive apparatus may become clogged1 and an overacid condition of the entire intestinal tract threaten4 ,we call judgment good1 then1 when it is the result of reasoning with correct or logical premises which correspond with the facts of life4 ,we call it bad when it is the conclusion of incorrect or partial or illogic premises4 ,a premise is a proposition laid down1 proved1 supposed1 or assumed1 that serves as a ground for argument or for a conclusion2 a judgment leading to another judgment as a conclusion 7,standard ,dictionary74 ,let us illustrate good and bad judgment by following out two lines of reasoning1 each quite accurate as such4 ,i want sweets4 ,sweets are good for people4 ,they give heat and energy1 and ,i need that1 for ,i am chilly and tired4 ,people say ,don't eat sweets between meals4 ,but why8 ,they contain just what ,i need and the sooner ,i get them the better4 ,so ,i have sweets when ,i want them4 ,the judgment to take the sweets as desire indicates is entirely logical if we accept all the premises as correct4 ,and they are1 so far as they go2 but they are partial2 and so cannot altogether correspond with the facts of life4 ,sweets are good for people who expend much physical energy4 ,they prove injurious in more than limited amounts to the bed-ridden1 the inactive1 or the sluggish4 ,hence this premise is partial and so far incorrect4 ,sweets do give heat and energy1 true4 ,i am chilly and tired1 also true4 ,but why8 ,because ,i am already toxic from the sweets and meats ,i have had throughout my sedentary years4 ,the question is1 ,do ,i need any more energy-producing food when ,i am not burning up what ,i have8 ,so again the premise is partial4 ,i do need heat and energy1 but ,i already have the material for it1 and my mode of life has disorganized my system's capacity to utilize these foods normally4 ,so now sweets have become a detriment to my well-being4 ,the judgment which determines me to the habit of eating sweets between meals is the result of logic1 but of logic spent on tying up premises which do not fit the facts of the case4 ,one of the most prevalent defects of judgment is illustrated in this common disability to select premises which fit the facts4 ,ignorance1 emotional reasoning1 and a defective critical sense probably explain most poor judgments4 ,the other judgment illustrates the logic of correct1 provable premises4 ,no1 ,i shall wait until dinner-time4 ,i have no need of so rich a food1 for ,i had an adequate meal at the usual time and have not worked hard enough to justify adding this burden to my digestive apparatus2 besides only hard workers with their muscles can afford to eat many sweets4 ,they cause an overacid condition when taken in excess2 and any except at mealtimes would be excess for me1 with my moderate physical exercise4 ,this judgment we call good4 ,its premises correspond to scientific facts4 ,but much reasoning must always be done with probable premises1 ones which seem to correspond to the facts1 but which have yet to be proved4 ,and our judgment from such suppositions cannot be final until we see if it works4 ,some few centuries ago supposedly wise men called ,christopher ,columbus a fool4 ,of course the world was flat4 ,if it were round man would fall off4 ,it was all spread out and the oceans were its limits4 ,if it should be round1 like a ball1 as that mad man claimed1 then the waters must reach from ,europe 'round the sphere and touch ,asia2 or there might be land out there beyond the ocean's curve4 ,but it wasn't round1 and the idea of finding a new way to ,asia by sailing in the opposite direction was a fool's delusion4 ,their logic was perfect4 ,if the earth was flat1 and ,asia lay east of ,europe1 it was madness to sail west to reach it4 ,but they argued from a wrong premise1 so their judgment was imperfect--for they did not yet know the facts4 ,the result of all reasoning is judgment4 ,and judgment is good as the materials of the reasoning process correspond to facts1 or are in line with the most probable of the yet unknown4 ,it is poor as the reasoning material fails to meet the facts1 or is out of harmony with the most probable of the yet unproved4 ,it is of no avail1 then1 to attempt to improve our final judgments as such4 ,we must examine the materials we reason with1 then learn to group and compare them logically4 ,and in the very separating of true premises from false1 we use and train the judgment we would improve4 ,and this the normal mind can do4 ,,reaction ,,proportioned ,,to ,,stimuli ,in the normal mind the emotional or feeling accompaniment of thought and action is proportionate and adequate to the circumstances1 i4 e41 there is a certain feeling1 of a certain strength1 natural to every thought and act2 and when only that strength1 not more or less1 accompanies the thought or the act1 we say1 ,that man is emotionally stable4 ,his mind is normally balanced4 ,joy naturally follows some stimuli2 sorrow others4 ,disappointment or loss1 shock1 failure1 death of loved ones1 illness in ourselves or others1 do not normally bring joy4 ,a keen sense of suffering1 temporarily1 perhaps1 of numbness2 the inability to grasp the calamity2 or flowing tears1 an aching heart1 or the stress of willed endurance1 are natural1 and normal reactions to such stimuli4 ,a developed will may refuse indulgence in the outward expression of the normal feeling of shock1 grief1 and loss2 and this may be normal4 ,but normal volition does not force us to laugh and dance and be wildly merry in the face of grief and loss and pain4 ,it only suggests the adequate1 reasonable acceptance of the facts that cannot be changed--the acceptance of love1 faith1 and hope that sees in present suffering a means of consecration to service2 it does not convert the emotion of sorrow and loss into a pleasurable one4 ,normal reason does not suggest that will force the reactions to loss and suffering that belong by nature to attainment and success4 ,nor does reason suggest the long face1 the bitter tears1 a storm of anger1 in response to comedy and farce1 in the face of a good joke1 or to meet success2 and normal will puts reason's counsel into effect4 ,,normal ,,emotional ,,reactions ,some emotions1 that seem exaggerated at first thought1 may be normal under the circumstances4 ,for no one can know the whole background for emotional response in the life of another4 ,after being long shut up in a darkened room1 with bandaged eyes and aching head and sick body1 the first visit to the bit of woods back of the house--when all the pains have gone--may bring almost delirious joy4 ,the green of the foliage1 the blue of the sky1 the arousing tang of the air1 the birds1 the sense of freedom--all go to the head like new wine4 ,the abandon of joy is a normal response under the circumstances1 now4 ,it would hardly be normal to one whose habit it is to visit this same bit of woods every day1 to one who loved it1 but for whom it had lost the force of newness4 ,to the child1 who has never in all his little life had a wish not gratified1 the denial of a desired stick of candy is as great a calamity as is the loss of a fortune to the grown man4 ,and the child reacts to feeling equally intense4 ,these are normal reactions to stimuli--normal1 under the circumstances4 ,,the ,,normal ,,mind ,the normal mind reasons clearly with the best data at hand to results that will stand the test of conformity to reality2 the normal mind uses reason and feeling1 guided by reasonable attitude2 in the normal mind reason advises action and will brings it about2 in the normal mind feeling proportionate to the circumstances accompanies every thought and every action4 ,and in the well-balanced man or woman every function of the mind leads to action as its final end4 ,but man only approximates the normal4 ,the perfectly balanced man or woman is so rare as to be a marked person4 ,the average intelligent individual only in general approximates this standard4 ,he goes beyond it in spurts of untrammeled genius1 to wrench lightning from the heavens1 and to send his trains through the air2 or he allows his feelings to dictate to his reason1 and much of the time so exaggerates or depreciates the simple facts of life that the results of his reasoning no longer conform sufficiently to reality as to be thoroughly dependable4 ,,chapter ,,vii ,,psychology ,,and ,,health ,in the use of its functions the mind manifests certain powers and certain modes of expression which can act as powerful allies or as damaging enemies of health4 ,we speak of man as adaptable1 but also as a being of habits4 ,we speak of him as feeling when we wish to express the fact that his emotions influence his body4 ,we expect of the average man a certain amount of suggestibility4 ,we say that he is tremendously affected by his environment1 which simply means that his attention1 naturally centered chiefly on the things at hand1 largely determines what he is4 ,but we recognize that a man of trained mind can choose and will to substitute for his present surroundings thoughts upon more constructive things from past experience1 or from future possibilities1 or from within the mind's own storehouse4 ,his ability to largely modify his life by his will1 we recognize as man's greatest power4 ,adaptability1 emotional response1 suggestibility1 attention1 thought-substitution1 habit-formation1 and will can minister vitally to health1 or can prove damaging avenues of disease4 ,,necessity ,,of ,,adaptability ,adaptability is as essential to life of mind as to life of body2 and health of mind as well as health of body is determined by the individual ability to adjust himself to environment4 ,there are dreamers who have lived in their ideal world so long that they cannot meet the stern realities of life when they come4 ,the shock is too great for the mind that has accepted only the fantastic1 the real as the dreamer would have it2 and he lets go altogether his hold on the actual1 accepting the would-be world as present fact4 ,and we call him insane4 ,other visionaries wakened rudely to life as it is1 accept it as unchangeable fate1 lose all their true ideals and become cynical1 or victims of utter depression for whom life holds nothing that matters4 ,still others go on through the years self-satisfied and serene because they simply refuse to believe unpleasant truths2 they pretend that their wishes are realities1 and acknowledge as facts only the pleasant things of existence4 ,the first two groups have failed to adapt self to life as it is1 and the mind is lost or so damaged as to no longer serve its body properly4 ,the pretenders have adjusted themselves1 and so long as they can remain happily self-deceived all goes well for them1 though they complicate living for others4 ,however1 they have made an adaptation1 a defective one1 it is true1 but one through which the mind may survive4 ,some of this class1 however1 finally build up a more and more elaborate system of self-deception until they1 too1 are insane4 ,the practically adaptable man can dream dreams1 but always recognizes them as dreams1 and can stop at will2 can vision a beautiful ideal1 but comprehends that it is not yet reality1 though it may some time become so if he learns and fulfils the laws leading to its realization4 ,the adaptable man or woman recognizes the real as fact1 desirable or otherwise1 the fantastic as unreal and only to be indulged in as a pastime1 and the ideal as the possible1 a thing for which to work and sacrifice4 ,so perfect adaptability would mean perfect mental poise4 ,it is for the nurse to realize that the greater number of her patients do not belong to any of these classes absolutely1 but that some of them have tendencies leading in these various directions4 ,and it is her privilege to recognize the trend of her sick patient's mental workings1 and to so deftly and unobtrusively encourage the recognition of facts as things which are to be used--not as stumbling-blocks--that her mental nursing1 as her physical1 shall be directed toward health4 ,she can help her patient to accept illness and suffering as realities to be faced1 and treatment as a means1 whether pleasant or not1 of making it possible for health to replace them4 ,the understanding nurse can actively help her charge one step at a time toward adaptation to the new environment1 remembering that many of the sick1 particularly the depressed1 cannot be encouraged or incited to effort by having future health held out to them4 ,they are capable only of living in the present and doubting all the future4 ,there ,can ,be ,no ,neurosis ,without a ,psychosis4--,if the brain is the organ of the mind1 then what affects the brain must perforce be at least registered by mind4 ,so every physical shock1 accident1 toxic condition1 infection--even the ordinary cold--rouses the mind at least to awareness1 usually to discomfort4 ,for the nerve-cells and fibers--those inseparable parts of the body mechanism--speedily report the fact that they are being tampered with4 ,in the toxicity of the infections these very delicate tissues are nourished by toxic fluids2 in accidents they carry all the messages from the injured part4 ,then the brain--that center of all man's reactions and the organ of all his consciousness--receives the report of the disturbance and translates it into terms of more or less disability4 ,the neurosis has become a psychosis4 ,the physical condition has become a mental discomfort4 ,normally this ensuing mind state should be in accordance with the extent of the injury to the nerve-cells and fibers4 ,but under long-continued discipline1 or influenced by emotion1 the conscious mind may not recognize the neurosis2 whereas1 in the hypersuggestible1 consciousness will translate it into entirely disproportionate suffering4 ,a great problem of nervous education is what the mind will do with discomfort or pain4 ,will it put all its attention there and respond with nervousness1 irritability1 demand for sympathy2 or will it relegate all the minor pains to their own little places1 accepted as facts but to be disregarded except in so far as actual treatment is needed8 ,will it turn to attend to the host of other more desirable objects8 ,or in case of acute suffering1 will it take it as a challenge to endurance8 ,will it use it as a means to strengthen volition1 as a stepping-stone to self-mastery8 ,realizing the force of the law--no neurosis without a psychosis--the nurse will try to eliminate unnecessary irritations to physical comfort1 while she helps the patient to adjust himself to the ones which are inevitable4 ,it is the doctor's problem rather than hers1 except as she carefully fulfils orders1 to eliminate the toxic causes of psychosis4 ,it is hers to help the patient to meet adequately the effects of the infections or toxins1 and to prevent as far as possible the surrender to uncontrolled nervousness4 ,her object is to have him face the psychosis as one of the simple facts of science1 then turn the sick mind's attention to more important things2 she would encourage will to force endurance2 she would stimulate the feeling life to the forward look of confidence and faith1 or to acceptance of life's suffering as a challenge4 ,the nurse knows that pains beyond the power of endurance the doctor will lighten4 ,and the patient's reaction to discomfort and suffering1 the understanding nurse1 without any preaching1 can very largely influence4 ,,the ,,power ,,of ,,suggestion ,one almost universal condition found in illness is hypersuggestability4 ,here is the nurse's despair and her hope4 ,suggestion may come from without or from within4 ,when from within1 we call it autosuggestion4 ,many of the sick are temporarily resting their reasoning faculties and their judgment4 ,the sick body is causing a feeling of jangling nerves1 and the mind1 too1 is strongly tempted to be sick4 ,so every harsh sound1 every jolt1 almost every sentence spoken in their hearing suggests immediate nervous reactions4 ,the mind does not wait to weigh them4 ,the nervous system reacts to them the second the impression is registered4 ,the whole self is oversensitive1 and the very inflection of a voice has enormous significance4 ,let the nurse remember that her way of giving a treatment1 her expression1 or her very presence becomes a potent stimulus on the second1 one to which the patient's mind responds like a flash-light when the button is pressed4 ,the nurse must comprehend the principle of the nervous effect on the patient of all that is done and said1 and realize her tremendous privilege in making those stimuli wholesome4 ,the nurse who has a sympathetic insight1 with unswerving loyalty to orders1 can carry them out with the average patient1 unpleasant though they may be to him1 in such a way that his wholesome emotional response will be called forth1 a response of co-operation1 or of faith or of good breeding1 or of downing the impulse to indulgence2 or a response directed toward holding the nurse's interest and attention1 and so keeping her in the room2 such a response as will gain some privilege1 etc4 ,but there are some patients in whose cases ordinary persuasion1 suggestion or requests fail4 ,they are too nervously or mentally sick to be moved by logic1 or to respond with customary grace to a request which their reason is not awake to answer4 ,all usual suggestions may fail of effect4 ,and for these few1 in order that health may be at all assured1 even the discipline of force may be necessary4 ,but the nurse must use this only as a last resort1 of course1 and in accordance with the doctor's orders1 and then solely as treatment leading toward the ways of health4 ,before turning to this final method she should clearly1 firmly1 and kindly explain the principle of the discipline if the patient's mind is at all capable of grasping it4 ,in any case1 force should be used only as the surgeon uses his knife4 ,it hurts1 but only to help and to save2 and it is not called upon when other methods can secure the needed results4 ,but force1 thus limited in its application1 may prove the only suggestion which will bring about the action necessary to health on the part of the patient4 ,force unwisely and unkindly used proves a damaging suggestion1 causing reactions of fear or anger2 or it may lead to delusions of persecution and to strengthened resistance4 ,many suggestions come to the patient from within4 ,discomfort in the right side may suggest appendicitis4 ,a slight indigestion1 often purely nervous1 may be interpreted as inability to care for certain diet1 etc4 ,the wise nurse will displace as many of these as she can by casual suggestions on her own part4 ,she will demand of herself that her very presence be quieting1 calming1 happy2 that her conversation with her patient shall vibrate with a certain something that gives him courage and strengthens the desire and the will to health2 that her care of him shall prove confidence-breeding4 ,the patient's attitude1 when he is at all suggestible1 is largely in the nurse's hands1 and she can make his illness a calamity by dishonest1 fear-breeding1 or suspicion-forming suggestion4 ,after all1 the whole question here is one of the normality of the nurse's own outlook on life and people4 ,the happier1 truer1 and more wholesome it is1 the more really can she help her patient to both bodily and mental health4 ,of one thing let the overzealous nurse beware4 ,do not irritate your patient by a patent1 blatant1 hollow cheerfulness that any one of any sense knows is assumed for his benefit4 ,personally ,i know of no more aggravating stimulus4 ,what ,we ,attend ,to ,determines ,what ,we ,are4--,this is one of the first laws of education4 ,if the child's attention from birth could be controlled1 his future would be absolutely assured4 ,but attention is a thing of free will and cannot be forced by others4 ,it can be won through interest or self-directed by will4 ,the child's attention is entirely determined by interest1 interest in the morbid and painful as truly as in the bright and happy4 ,punishment interests him tremendously because it affects him1 it interferes with his plan of life1 it holds his entire immediate attention to his injured self4 ,but something more impelling quickly makes him forget his hurt feelings and he is happy again4 ,the average sick person is emotionally very much like the child4 ,his will at the time1 as we noted before1 is tempted to take a rest1 and his interest is ready to follow bodily feeling unless something more impelling is offered4 ,the nurse who can direct attention to other people1 to analyzing the sounds of the street1 to understanding something of the new life of a hospital or sick room1 to planning a house1 or choosing its furniture or equipping a library1 or supplying a store2 to intelligent references to books or current events2 or to redecorating the room--all in his mind2 to an appetizing tray1 a dainty flower1 a bit of sunshine1 a picture1 etc41 is fixing the patient's attention on something constructive1 helping him to get well by forgetting to think of himself4 ,thus the nurse1 knowing the laws of attention1 can keep herself alert to divert and direct her patient's thought to wholesome interests4 ,knowing the possibility of thought substitution1 she can open up new channels of thinking4 ,knowing the power of the will to assist in health bringing and health keeping1 she can sometimes stimulate long-dormant determination4 ,let her beware1 however1 of making the convalescent too dependent upon help from without1 but prick his pride to gradually increasing doing for himself4 ,arouse his reasonable ambition1 but let him realize that life must be taken up again a step at a time2 and that he can do it4 ,if limitations must be accepted1 try to inspire the feeling of pride in accomplishing the utmost possible within a limitation1 and an acceptance of the inevitable without bitterness4 ,attending to the unhappy1 the painful1 the boring without looking beyond makes life unhappy1 painful1 and a bore4 ,not that the nurse should ignore these realities1 but she can accept them whole-souledly herself as not the final things1 as merely the rocks that can be used to stand upon and get a view of the something better for everybody4 ,when they are thus used by the wholesome mind1 facts1 the very barest and meanest of them1 can be made useful as stepping-stones to the happier facts beyond them4 ,if the nurse can direct or tactfully lead the patient's attention away from himself and his illness1 she has found a big reinforcement to his treatment4 ,this question is so vital in the care of patients that it will be discussed at greater length later on4 ,,one ,,thought ,,can ,,be ,,replaced ,,by ,,another ,if we control attention we control thought1 and with the suggestible patient this principle depends upon the one just now considered4 ,hope and courage-breeding thoughts can replace despairing and fearful ones1 but it will be only when attention is directed through interest or by will to new material4 ,there is no blank in waking consciousness4 ,the last thought or feeling or perception1 through association of ideas1 brings up a related one1 and so on indefinitely4 ,we may start with a pebble on the road and go on logically1 smoothly1 until in five minutes we are thinking of the coronation of ,king ,george1 with no sense of anything at all unusual in the succession4 ,it may be a very roundabout process1 from pebble through rough way1 ways that hurt1 dangerous ways1 brigands1 uncertainties of life4 ,uncertain lies the head that wears a crown1 ,king ,george and his crown1 coronation4 ,but this constant stream of thought can be broken into at any point by a spoken word1 a passing vehicle1 which diverts the mind's trend4 ,so the nurse can take advantage of the mind's very suggestibility1 and substitute for the unhappy and sickness breeding by turning attention to anything else of a happier color1 and may divert the entire stream of thought in that direction4 ,she who knows these simple laws of the mind1 and who at all knows people1 is a therapeutic agent of unlimited value4 ,,habit ,,is ,a ,,conserver ,,of ,,effort ,it is always easier to follow a beaten path than to break one's way through untrodden forests4 ,it is easier to walk after we learn how1 and learning how is simply doing it over and over until the legs and feet have acquired habits of motion and accommodation to distances and to what is underfoot4 ,it is easy to do anything after we have done it again and again1 so that it has become second-nature1 and second-nature is habit4 ,the wise man early forms certain habits of personal care1 of eating1 sleeping1 exercising2 of study1 of meeting the usual occurrences of life4 ,the first day he spent at anything new was a hard one4 ,nothing was done naturally4 ,active attention had to be keenly held to each detail4 ,he had to learn where things belonged1 how to do this and that for the first time1 how to work with his associates4 ,do you remember the first hospital bed you ever made1 the first bed-bath you gave1 the first massage8 ,you had to be taught bit by bit1 detail by detail4 ,you did not look upon the finished whole1 but gave almost painful attention to each step that led to the made bed1 the completed bath1 or the given massage4 ,your fingers were probably all thumbs unless you had experience in such things before you came to the hospital4 ,your mind was tired from the strain of trying to remember each suggestion of your instructor4 ,the second time1 or certainly the third or fourth time1 it went better4 ,after a week of daily experience you gave the bath or massage or made the bed with much less effort4 ,a month later the work was practically automatic and accomplished in a fraction of the time you spent on it that first day4 ,now you can do it quickly and well with little conscious thought2 and at the same time carry on a brisk conversation with your patient or think out your work for the day4 ,your mind is free for other thoughts while you perform the task easily and perfectly4 ,your method of doing the work has finally become a habit which saves the effort of conscious attention4 ,the details of your routine work are directed by the subconscious4 ,the habit will be energy and time saving in proportion to the accuracy of your first conscious efforts spent on the new undertaking4 ,thus1 useful habit is the result of active effort4 ,we can acquire habits of thinking and habits of feeling as well as habits of doing4 ,but the other habits1 the bad ones1 are not acquired with effort4 ,we fall into them4 ,hazy thinking is easier than clear thinking4 ,suppose you are by nature rather oversanguine or overdespondent1 and you make no genuine attempt to evolve that nature into poise4 ,directing will to do what desire opposes is too difficult1 and you go the way of least resistance4 ,so easily are the bad habits formed2 but only with tremendous effort of will and persistence in refusing their insistent demands can they be broken or replaced by helpful ones4 ,but habits can be learned2 and bad habits can be broken when an overpowering emotion is aroused against them1 possesses the mind1 and controls the will2 or when reason weighs them in the balance and judgment finds them wanting1 and volition directs the mind to displace them by others4 ,the nurse meets in her patients numberless habits which retard recovery of body and make for an unwholesome mental attitude4 ,some patients have the complaint habit1 some the irritation habit1 some the self-protection habit1 some the habit of impatience1 some of reckless expression of despair1 some of loss of control1 some of incessant self-attention4 ,the nurse who can arouse an incentive to habits of cheer expression when the least cause of cheer appears1 who can by reason1 or if that is not possible1 by suggestion2 by holding out incentives1 or by making some privilege depend upon control--this nurse can help her patient to displace habits of an illness-accepting mind by habits of a health-accepting one4 ,above all1 let her beware of opening the way to habits of invalidism4 ,some people acquire the hospital habit because it is easier to give way to ill-feeling1 however slight1 and to be cared for with comfort1 than to encourage themselves to build up endurance by giving little attention to minor ailments4 ,,the ,,saving ,,power ,,of ,,will ,it is not uncommon to hear a doctor say1 ,nothing but his will pulled him through that time4 ,it does not mean quite what it says1 for the patient's will would have been helpless to cure him without the medicine and the treatment4 ,but it does mean that in some cases when life is hovering on the brink1 even the most skilful treatment cannot hold it back if the will to live is gone4 ,the chances may be half and half4 ,lack of desire to live may drop the balance on the death side4 ,determination and hope and confidence may overweigh the life side4 ,for the influence of will in refusing to surrender to depression may throw the needed hair's weight in favor of more normal circulation4 ,depression and emotion may so effect the sympathetic nervous system as to cause a lowered circulatory activity4 ,determination1 based on volition1 may stimulate a response from the sympathetic system which will increase heart activity4 ,and certainly1 when it is not a matter of life and death1 but a prolonged recovery1 will is a saving grace4 ,the patient who sets all his sick energies to the task of winning health reaches his goal quicker than the hopeless and depressed4 ,perhaps his will merely brings utter relaxation for the time1 forces acceptance of present helplessness only for the sake of giving the body a better chance to recuperate2 but the very fact that it is acting to hopefully carry out orders lightens by half the nurse's task of getting him well2 and she can encourage this will to co-operate with the doctor's efforts by suggestion1 by her directness and honesty1 by the quiet assurance that at least a reasonable degree of health is won by effort4 ,we have touched upon only a few of the laws of the mind4 ,the nurse can help develop saving mental habits and wholesome attitudes while she helps to strengthen sick bodies2 she can make a cure a little more certainly lasting who will remember that3 #a4 ,adaptability is essential to life and health4 #b4 ,there is no neurosis without a psychosis4 #c4 ,suggestion may be a powerful factor for health4 #d4 ,what we attend to determines what we are4 #e4 ,thought substitution is possible4 #f4 ,habit is a conserver of effort4 #g4 ,will is a saving power4 ,,chapter ,,viii ,,variations ,,from ,,normal ,,mental ,,processes ,,disorders ,,and ,,perversions ,life would be a very simple proposition if the mental machinery always worked right4 ,but this is peculiarly subject to damage both from without and from within4 ,from without it may be damaged by the toxins of food1 as in the acute toxic psychoses2 by the poison of drink1 as in the alcohol-produced psychoses1 such as acute alcoholic hallucinosis2 by lack of muscular exercise1 resulting in a deficient supply of oxygen to burn up the accumulated toxins from energy-producing foods2 by the infections1 which may result in the infection-exhaustion psychoses2 by wrong methods of education1 and by surroundings which demand too severe a mental strain in the struggle toward adjustment4 ,these damages from without we class roughly as environmental4 ,from within the mental workings may be injured by emotional dominance2 by bad habits of thinking and feeling and doing--often the result of wrong methods of education2 by defective heredity2 by undeveloped will2 by the insanities4 ,these danger sources from within we might classify as self-produced and hereditary4 ,there may be disorders of any or every function of the intellect1 disorders of feeling1 and perversions of will4 ,some of the most commonly met we list below4 ,disorders of the ,functions of ,intellect4 _/ ,hyperesthesia 7exaggeration of sensation7 as found in neurasthenia1 or in mania4 ,anesthesia 7absence of sensation7 as in the numbness of hysteria2 in sensory paralysis4 ,disorders _/ ,retardation of as in dementia and melancholia4 ,sensation ,clouding or dulness as in simple depression4 ,perversion as in dementia and melancholia4 ,sweet may taste sour2 fresh food may smell decayed4 _/ ,hyperesthesia 7exaggeration7 as in neurasthenia or mania4 ,anesthesia ,disorders as in hysteria or paralysis4 of ,retardation ,perception as in dementia and melancholia4 _/ ,clouding or dulness 7being as in simple depression4 dependent ,illusion on sensation found in normal mind--easily corrected2 is always found in many insanities4 disturbed ,hallucinations with it74 frequently met in the infection-exhaustion psychoses1 in dementia1 in paranoia1 in acute hallucinosis of alcoholism4 _/ ,hypochondriasis found in many of the hypersuggestible1 frequent in the mild depressions and in all victims of self-attention4 ,retardation found in most depressions4 ,deficiency as in idiocy--the inability to form new concepts4 ,acceleration as in hypo-mania4 ,poverty as in the abnormally self-centered2 as in melancholia4 ,rambling ideas as in chronic insanity4 ,flight of ideas as in manias1 hysterias1 and acute deliriums4 ,disorders _/ ,fixed ideas of as in paranoia4 ,ideation ,perversions 7concepts change their meaning altogether7 as in dementia4 ,ideogenous pains as in hysteria4 ,compulsive ideas common in borderland states2 in psychasthenia1 or hysteria4 ,disorientation thing1 7wrong idea of place1 or person72 found in confused conditions2 in delirium from infections2 in insanities4 ,confusion as in the infection-exhaustion psychoses2 in insanities4 _/ ,absent-mindedness4 ,amnesia 7morbid forgetfulness74 temporary1 ,disorders _/ ,aphasia prolonged1 of permanent 7see later explanation74 ,memory ,perversion as fabrications1 due to memory-confusion or inaccuracy2 also due to excessive ideation and defective judgment4 _/ _/ ,somatic as in hypochondriasis4 ,persecutory as in paranoia4 ,unworthiness as in simple depression or melancholia4 ,delusions ,grandeur ,systematized _/ as in mania or paranoia4 ,disorders _/ ,transient ,nihilistic of ,fixed often found in melancholia4 ,reason ,reference as in paranoia4 ,altered personality as in hysteria4 ,perverted personality 7patient may believe he is a dog72 as in dementia4 ,emotional thinking4 ,shut-in personality as seen in the deficient social capacity of potential dementia praecox4 _/ ,defective judgment in all insanities2 in hysteria4 ,ex43 ,patient who accepts mental suggestion of disability as reality4 ,perverted judgment ,disorders _/ in severe dementias--as influenced by unreasonable of fear1 hatred1 etc42 ,judgment in all acute insanities--as manifested in inability of patient to rid himself of his delusions4 ,absence of judgment in all acute insanities2 in later dementias4 ,limitations in many so-called normal and in all the abnormal4 _/ ,suggestibility in hysteria4 ,excitement in mania4 ,depression in melancholia4 ,disorders _/ ,phobias of as found in psychasthenia4 ,emotion ,deficiency as in the apathy of depression4 ,perversion in mania1 in depression1 in catatonia4 ,deterioration in dementia4 ,sense of unreality found in all borderland cases4 _/ ,wilfulness in many normal4 ,very common in hypomania4 ,willessness 7aboulia or paralysis of will7 often found in psychasthenia2 and in depressive states4 ,morbid inhibition as in depressive states4 ,indecision as in psychasthenia2 as in simple depression4 ,obsessions found pre-eminently in psychasthenia4 ,tics ,disorders _/ in many borderland cases2 of in the hypersensitive as often the only expression ,will of any neuropathic tendency4 ,distractibility as in hypomania and frequently in hysteria4 ,negativism as in catatonia4 ,mutism as in catatonia4 ,compulsive acts as in psychasthenia1 hysteria1 etc4 ,psychomotor overactivity 7volition unable to check7 as in mania4 ,psychomotor retardation 7volition unable to energize7 as in depression4 ,from this limited survey of the mind's disorders we realize that every departure from the normal mental attitude tends to associate itself with one of the following five states of mental disability4 ,depression1 ,exaltation1 ,perversion1 ,enfeeblement1 ,deficiency4 ,,chapter ,,ix ,,variations ,,from ,,normal ,,mental ,,processes 7,continued7 ,hyperesthesia is abnormal sensitiveness to stimulation4 ,anesthesia is loss1 either temporary or permanent1 of any of the senses4 ,perversion is morbid alteration of function which may occur in emotional1 intellectual1 or volitional fields4 ,example3 ,the odor of a rose causing an acute sense of physical pain4 ,an illusion is a false interpretation of a perception4 ,the normal mind is quite subject to illusions1 either due to a faulty sense organ1 or to a preconceived state of mind which so strongly expects or presages something else than reality as to misinterpret what the senses bring4 ,examples3 ,the crooked stick as a snake4 ,a ghost created from shadow4 ,an ordinary ringing in the ears as sleigh-bells4 ,milk tasting like blood4 ,an hallucination is a perception without an object4 ,the hallucinated individual projects1 as it were1 the things of his mind's creation into the outer world1 and accepts them as reality4 ,he sees snakes where there is nothing to suggest them2 sees a ghost where there is no shadow2 believes that the taste of blood is constantly in his mouth4 ,there are possible hallucinations of every sense4 ,nonexistent objects are seen1 touched1 tasted1 heard1 or smelled4 ,hypochondriasis is a state characterized by persistent ideas of non-existent physical disabilities4 ,the hypochondriac has every known symptom of indigestion1 or of heart disease1 or is threatened with tuberculosis--all in his mind2 and whatever the disorder he seizes upon1 his attention hovers there1 while the ideas of that particular disability persist and strengthen4 ,a flight of ideas is an abnormal rapidity of the stream of thought4 ,every perception so immediately is linked with some association of experience that expression is swift and often incoherent4 ,one word will follow another with amazing rapidity1 words suggested by sound association1 usually1 rather than by that of meaning4 ,example3 ,made a rhyme1 had a dime1 did a crime1 got the time1 bring some lime4 ,this association by rhyme is quite common4 ,but the associations of meaning are not uncommon4 ,example3 ,made a rhyme4 ,mary was a poet4 ,mary had a little lamb4 ,where's ,mary8--,mary6--,no ,jim--,jim1 all my children--calling1 calling1 calling1 etc4 ,a fixed idea is one which morbidly stays in the mind and cannot be changed by reason4 ,example3 ,in hypochondriasis1 as given above4 ,ideogenous pains are either pains born of an erroneous idea1 or mental reproductions of pains now having no physical cause4 ,a suggestible person1 learning that his grandfather died of an organic heart1 conceives the idea that he has inherited the trouble1 and begins to suffer cardiac pains2 and as long as the idea persists the pain is felt4 ,compulsive ideas are ideas which intrude1 recur1 and persist despite reason and will4 ,example3 ,the compulsive idea of contamination may lead its victim to wash and rewash his hands at every contact with matter1 until finally1 though they are raw and sore1 he is incapable of resisting the act4 ,disorientation is a state of mental confusion as to time1 place1 or identity4 ,amnesia is pathologic forgetfulness4 ,example3 ,as sometimes found in the infection-exhaustion psychoses1 when the entire past of the patient may be wiped out for the time4 ,cases of permanent amnesia are known4 ,aphasia is a defect in the interpretation or production of language4 ,there may be motor aphasia1 auditory aphasia1 vocal aphasia1 sight aphasia2 and with disability to produce words1 they may yet be recognized when seen2 or when they can be spoken they may not be recognized when heard2 or with inability to speak them1 they are accurately sensed by hearing2 or though understood when heard1 they are incomprehensible when read4 ,a delusion is a false belief which cannot be corrected by reason4 ,a somatic delusion is one centering upon alterations in the organs or their functions4 ,example3 ,absence of a stomach1 inability to swallow4 ,a nihilistic delusion is one which denies existence in whole or part4 ,example3 ,mother denies the existence of her child4 ,a delusion of reference is one in which the deluded individual believes himself an object of written1 spoken1 or implied comment4 ,example3 ,the actors on the stage are directing their remarks directly against the victim in the box4 ,a shut-in personality is one that habitually responds inadequately to normal social appeal4 ,sense of unreality is one of the commonest psychic alterations through which customary sensation states are displaced by unnatural and usually distressing ones4 ,examples3 ,the breakfast table appears undefinably altered4 ,laughter is accompanied by strange1 rather than by normal1 sensations4 ,morbid inhibition is an abnormal1 negative activity of the will4 ,sometimes a patient will try pitifully to express some thought or feeling2 the desire to explain is there1 but will is blocked in action4 ,or the patient attempts to dress1 makes repeated new beginnings1 but cannot succeed4 ,we say1 ,he is inhibited4 ,an obsession is an idea which morbidly dominates the mind1 constantly suggesting irrational action4 ,obsessed patients may consistently step in such a way as to avoid the juncture of the flagstones on the pavement2 may insist on removing their shoes in church2 may hail each person met on the street and tap him on the arm2 may refuse to ever leave the house without an open umbrella2 or may try to attack every man they see1 not because they want to hurt or kill1 but because they are obsessed to the performance of the action4 ,a tic is a useless1 habitual spasm of a muscle imitating a once purposeful action4 ,motor tics1 such as habitual jerking of the arms1 shrugging the shoulder1 contorting the face1 shaking or nodding the head1 snapping the fingers1 etc41 are very common among nervous children1 and even in many otherwise normal grown-ups4 ,distractibility is an abnormal variation of attention4 ,the common inability of the hypomanic patient to hold his attention to any subject when another is open1 is very like the distractibility of the child who turns to every new interest as it is presented4 ,negativism is a state of persistent compulsion to contrary response to suggestion4 ,it is with these patients as though not only initiative were lost but also the power to follow another's lead4 ,but their independence asserts itself in opposing every suggestion and in acting so far as possible contrary to it4 ,mutism1 as used in psychiatry1 is an abnormal inhibition to speech4 ,patients sometimes speak no word in many months4 ,to all appearance they are true mutes4 ,then suddenly something may remove the mental blockade and they talk4 ,compulsive acts are acts contrary to reason1 which the will cannot prevent4 ,a seemingly quite normal patient will sometimes grab a vase from a stand in passing1 and dash it to the floor4 ,something urged him to do it1 and he could not resist4 ,others will tear their clothes to shreds1 not in anger1 but because they could not help it4 ,psychomotor overactivity is abnormal activity of both mind and body1 contrary to reason and uncontrolled by will4 ,psychomotor retardation is an underactivity of both mind and body in which consciousness is dulled and the body sluggish4 ,a neurosis is a disorder of the nerves1 which may be functional or organic4 ,nervousness is properly termed a psychoneurosis--for we have learned that there can be no neurosis without an accompanying psychosis4 ,psychosis is the technical synonym for insanity4 ,borderland disorders constitute a group in which mental perversions do not yet so dominate reactions as to make them irrational4 ,twilight is neither night nor day2 the feelings of the hysteric are not insane1 but the actions may be4 ,insanity is a prolonged departure from the individual's normal standard of thinking1 feeling1 and acting4 ,mania is insane excitement4 ,melancholia is the inability of the mind to react to any stimulus with other than gloom and depression4 ,melancholia may be of the intellectual type or of the emotional type4 ,the patient who tells you constantly that he has murdered all his children1 that he is a criminal beyond the power of ,god to redeem1 who seems chained to his delusions1 yet shows no adequate feeling reaction1 no genuine sorrow1 we call a case of the intellectual type of melancholia4 ,another patient misinterprets every normal reason for happiness until it becomes a cause of settled foreboding4 ,the mother1 whose son fought safely through the war and is now returning to her1 feels that his coming forecasts calamity for him4 ,he had better have died in ,france4 ,she is of the emotional type of melancholia4 ,hysteria is a nervous disorder based upon suggestibility1 and capable of imitating most known diseases4 ,insane impulses are morbid demands for reckless action beyond the control of the will4 ,example3 ,the impulse to kill1 quite regardless of who may be the victim4 ,psychopathic personality is a term much used today to designate an hereditary tendency on the part of the individual to mental disorder4 ,the neuropath is the individual with an inborn tendency to the neurosis4 ,neurotic is a term broadly employed for the nervous in whom emotions predominate over reason4 ,neurasthenia is a nervous disorder characterized by undue fatiguability4 ,psychasthenia is a nervous disorder characterized by a sense of unreality1 weakness of will1 self-accusation1 and usually by phobias and obsessions1 all subject to temporary correction by reason or influence from without4 ,hypochondriasis is a disorder characterized by morbid attention to bodily sensations1 and insistent ideas of bodily disorder4 ,phobia is a morbid fear or dread4 ,,factors ,,causing ,,variations ,,from ,,normal ,,mental ,,processes ,,heredity ,when we consider the accumulated possibilities for disorder which the family tree of almost any one of us can show1 the wonder is not that there are so many nervous or insane1 but rather that any come within hailing distance of the normal4 ,for multitudes are born of parents whose bodies were food poisoned or alcohol or drug poisoned1 and whose nervous systems were tense and irritable1 oversensitive1 and suffering from the effect of these same toxins on the brain4 ,others are of manic-depressive parentage2 some are possibly even of paranoic or dementia praecox lineage2 while many of our finest and best had psychopathic or neuropathic heredity4 ,syphilis1 itself1 and the underpower bodies of tuberculosis are heritages of many4 ,when we realize1 too1 that we are born with certain inherent tendencies of temperament1 which are too often of the melancholic or overcholeric type1 our wonder grows that we are not doomed to defeat at birth4 ,were it not for the possibilities in the germ-plasm of choosing the much of good also in our heredity1 often enough to overbalance the bad1 and for the proved power of environment and training to modify or even altogether overcome the harmful parts of our birthright1 there would be little hope for many4 ,,environment ,while environment may prove the saving grace from poor heredity1 it may itself add heavily to the debit side4 ,with the very best of health backgrounds1 environment may damage body and mind beyond repair4 ,under environment we include everything that touches life from without--people1 things1 work1 play1 home1 school1 social life1 business life1 college-life1 etc4 ,among factors of environment damaging to mental health are overemotional family life1 overstrict home discipline or the lack of needed discipline2 overfeeding1 underfeeding1 wrong diet1 lack of proper exercise1 stimulants1 drugs1 overstimulation1 overprotection1 too much hardship and privation1 loneliness1 poor educational methods1 immorality1 etc4 ,,personal ,,reactions ,what will decide whether a human being can resist1 successfully1 bad tendencies in heredity1 or in environment1 or in both1 and keep a reasonably balanced mind8 ,it demands insight1 ambition1 will2 and if these remain the body can be forced to saving ways of health1 and body and mind can largely make their own environment4 ,but with heavy handicaps of heredity or environment1 or both1 and poor insight1 or lack of desire1 or weak will1 nothing can save the mind from neurotic taint or worse--nothing but obedience to some one strong enough to control the habits of that life1 until self-control is born4 ,and there is a hope that it can be born in the most neurotic or neurasthenic1 so long as the mind is sane4 ,but after all1 a large number of people whose mental processes are not normal1 have only themselves1 their poor emotions1 their lazy wills1 their hazy thinking to blame4 ,we except what are called the heredity insanities--dementia praecox and the other dementias and the manic-depressive groups and paranoia and psychasthenia--for in these cases1 possibly with the exception of the manic depressives1 even the most perfect environment could probably not prevent the disorder from asserting itself4 ,many neurotics1 neurasthenics1 and hysterics are curable if they will seriously undertake to fulfil the laws of physical and mental health--simple laws1 but ones which demand a strengthened will to carry out4 ,,chapter ,x ,,attention ,,the ,,root ,,of ,,disease ,,or ,,health ,,attitude ,,the ,,attention ,,of ,,interest ,attention naturally follows interest4 ,it can1 however1 be held by will to the unappealing1 with the usual result of transforming it into a thing of interest4 ,one of the laws of the mind we have already stressed is that what we attend to largely determines what we are1 or shall be4 ,the interests which secure our consideration may be the passive result of emotional life1 the things which naturally appeal1 which give us sensations that the mind normally heeds2 or they may be the active result of our will which has forced application upon the things which reason advised as worth acquiring4 ,we found that the beginning of health of mind consists in the directing of thought toward the health-bringing attitude4 ,we have seen how quickly the normal mind can be diverted from the undesirable by a new or stronger emotional stimulus4 ,we found that the sole appeal to attention in the baby-life is through the emotions1 and that it is natural throughout life for the mind to heed and follow the interesting2 which is only another way of saying that thinking follows where emotion leads1 unless volition steps in to prevent4 ,the supreme test of the will's power is its ability to hold the train of thought in the line that reason directs1 when feeling would draw it elsewhere4 ,this ability marks the man who does big things2 while the inability to ever turn attention away from the interests proposed by feeling assures weakness4 ,some of the most charming people we shall ever know are those temperamental children of happiness whose interests are naturally wholesome and externalized1 whose natures are spontaneous and joyous1 and who live as they feel1 seemingly never knowing the stress of forced concentration4 ,with them attention follows feeling1 feeling is sweet and true1 and volition simply carries out what feeling dictates4 ,and life may not be complicated4 ,but there is another class whose attention also follows in the ways of least resistance2 and life for them is a wallowing in the morbid and unwholesome4 ,in them feeling is perverted1 they seem to see life habitually through dark glasses2 they passively attend to the sad1 the distressing1 sometimes the gruesome and the horrible with a sort of pallid joy in their own discolored images4 ,the first group puts joy in all they see1 because they are brimming full of joy themselves4 ,these others find only the unwholesome in life because their minds are storehouses of it4 ,we say that each type has projected himself1 that is1 has thrust himself out into the external world1 and is standing back1 looking at his own nature and calling that the universe4 ,but neither of these two groups can long withstand the stress of a world they only feel and have never attempted to comprehend4 ,the irresponsibly happy ones are too often crushed and broken when life proves to bring loss and failure and disappointment2 the morbid probably will cease some day to enjoy their melancholic moods1 and be unable to find their way out of them4 ,if both had learned to control attention1 they might have been saved4 ,the happy1 care-free child of the light is at desperate loss when the sun he loves is obscured1 if he has not learned to look upon the far side of the clouds to find that there they glow golden with the rays temporarily shut from him4 ,because clouds were not interesting to him he never attended to them--and now he cannot4 ,if the pessimistic1 morbid one had looked away from the shadow to the sun it hid he1 too1 in the end might have seen with sane eyes and lived so wholesomely as to find all the good there was in life4 ,willed attention1 rather than spineless feeling distractibility1 might have saved him4 ,when thinking can be forced to follow where trained reason directs1 and can be kept in that direction1 the greatest problem of physical and nervous well being is solved4 ,to the nurse there is no other principle of psychology so important4 ,but no child ever had his attention diverted by reasoning alone4 ,the object at which you wish him to look must be made more impelling than the one he already sees1 or he must want much to please you1 else he only with his eyes will follow your command while his mind returns to his real interest2 and the second you cease to command that eye service1 he looks back to the thing that was holding him before4 ,the beginning of all education is in arousing a want to know2 in turning desire in the direction of knowledge4 ,i am an undisciplined child and ,i want only candy for my lunch4 ,it is not good for me4 ,milk is what ,i should have4 ,i don't want it4 ,you may deprive me of the candy and force me to drink the milk1 and ,i can do nothing but submit4 ,but ,i rebel within1 and ,i am only more convinced that ,i hate it and want candy1 and that you are my natural enemy because you force the one upon me and deprive me of the other4 ,if ,i were insane and so1 of course1 could not be reasoned with1 this might be inevitable4 ,but it would be unfortunate4 ,in that case1 if possible1 do not let me see the candy2 let only the food it is best for me to have be put before me1 and perhaps eventually ,i shall come to want the more wholesome thing--for it is better than the hunger4 ,but as it happens ,i am a perfectly normal person1 only ,i am sick4 ,i am tired of bed1 and want to sit up--and it does seem that ,i should have my desire4 ,the nurse1 wise in her knowledge of sick grown-ups1 who are1 after all1 very like children1 will find a way to divert my mind from the immediate ,i want to something which ,i also can be led to want4 ,i may agree that ,i want more the better feeling an hour from now4 ,perhaps her humorous picture of the effects of too early freedom on my condition1 or of my body's urgent demand for rest1 regardless of my mind's wish2 perhaps only a joke which diverts me2 perchance the take-for-granted you want to help us out air2 mayhap the story to be read or told2 or simply the poise and quiet assurance of the nurse who never questions my reasonableness and acquiescence2 perhaps her confidence that this will serve as a means to the end ,i covet--will result in my gladly taking her advice1 and my perfect willingness to wait for new orders1 while ,i indulge in beautiful plans ,i shall carry out when they finally arrive4 ,in other words1 with the sick as with children1 attention naturally follows interest4 ,and the good nurse realizes that it is not wise to force co-operation when she can secure it by diverting her patient's thoughts to another interest than the one now holding him4 ,very often1 merely by chatting quietly about something she has learned has an appeal1 she can make the patient forget his weariness and boredom1 or his resistance to details of treatment4 ,the very milk he is refusing to drink may be down before he realizes it4 ,but right here lies a hidden reef which may cause wreckage in the future4 ,it is good therapy to divert attention by appealing to another interest when the patient is too sick or too stubborn or not clear enough mentally to be reasoned with4 ,but if this becomes a principle1 and his reason and active co-operation are never secured to make him choose the way of health for himself1 the hour he is out of the nurse's hands he reverts to the things that now happen to appeal to him4 ,then unless some wise friend is near to continue her method of making the reasonable interesting1 the advice of reason can go to smash4 ,there has been a very constant illustration throughout the past of the unwisdom of relying upon diverted attention alone as an effective therapeutic agent4 ,we hope this will not illustrate our point so clearly in the future4 ,the drunkard1 who is just recovering from a big spree1 and feels sick and disgusted with himself1 and sore and ashamed1 is appealed to in glowing terms of the wellness and strength and buoyancy of the man who never drinks4 ,he has no mornings after4 ,the ,lord is just waiting to save this dejected victim of alcohol from his hateful enemy who has made him what he is at this hour1 and will forgive all his sottishness1 his sins4 ,he will be respected2 he can command the love of his family again4 ,he will no longer be a slave1 but a free man4 ,right now1 respect of the world and love of family and friends1 and cleanness1 and the forgiveness of a good ,god are infinitely more interesting than this splitting headache1 this horrible sick feeling4 ,and attention may be very readily diverted4 ,this promised new life is more attractive than the present4 ,it is easy to keep attention there4 ,and he reforms4 ,he swears off for keeps4 ,he is a happy man1 a free man4 ,for a few days or weeks1 perhaps even longer1 he glories in his new self-respect4 ,it is a strange and enticing sensation4 ,then one day something goes wrong4 ,he loses some money1 or he is awfully tired1 or the wife and children bore him1 and all of a sudden the one greatest interest in the world is a drink4 ,and because his thinking can always be led by his feeling2 because he has never learned to force it to go elsewhere1 he has his drink4 ,appealing to his emotions did not and cannot save him unless that appeal is followed at the right moment by awakened reason1 which will look at the whole proposition when the mind is at its normal best1 and choose to follow where rational feeling directs4 ,nor will reason save unless volition comes to its support and strongly backs it up and enforces what it advises4 ,,the ,,attention ,,of ,,reason ,,and ,,will ,so the good nurse will not consider her work done when she has diverted mental processes into channels of co-operation4 ,when the patient1 who is capable of reasoning1 knows the why of his treatment1 and realizes that he can only keep well as he himself takes over the job and puts his mind on things outside of his feelings1 and carries out the doctor's instructions for the sake of securing a certain end--then he has been under a good nurse4 ,this wise helper never preaches1 but makes the healthy goal very desirable1 stirs up an ambition to attain it1 and prods the will to keep on after it despite anything feeling may say4 ,this attitude on the part of the nurse presupposes that her own attention1 while with her patient1 is upon him and upon securing his health1 and not upon her tiredness1 or boredom1 or headache1 or the party tonight1 or the man who has asked her to go to the theater with him tomorrow4 ,she1 surely1 must learn to direct her thoughts where reason suggests1 and to gain new interests through willed attention1 or as a nurse she is less than second rate4 ,nor can she get the best results until she can turn with a single mind to the patient at hand as the immediate problem to be solved4 ,and probably neither nurse nor doctor does any better service1 except in saving life itself1 than in keeping the patient from thinking constantly of himself and his ills4 ,for it seems of little use to have made some people physically well1 if they are to carry through prolonged years the curse of constant self-attention1 self-centeredness1 an ingrowing ego4 ,there are a few simple laws of the mind hinging upon attention which are today being impressed upon teachers in every department1 in kindergarten1 public school1 college1 and university4 ,and they are as necessary to the nurse as to the teacher4 ,three of them we have already discussed3 #a4 ,attention naturally follows interest4 #b4 ,attention may be held by will where reason directs4 #c4 ,new interests grow out of willed attention4 ,a fourth we shall stress before considering the use the nurse can make of them3 #d4 ,the thing to which our chief attention is given becomes the most important thing4 ,do not contradict this too quickly4 ,don't say that nursing gets your chief consideration because it is1 of necessity1 your profession2 but that you love your music infinitely more1 and look forward to that through all your hours on duty4 ,if this merely proves that music is distracting your attention1 you are doing your nursing as a means1 and not as an end2 you give it probably all the attention necessary for good work1 but your real desire is music4 ,your chief attention is directed toward that goal4 ,hence music is to you the most important thing4 ,if your will is sufficiently trained to keep you from consciously thinking of it1 still you are dreaming of it and working for it4 ,you may make a very good nurse1 but you will never be as excellent a one as the woman from whom nursing demands first and chief attention4 ,we sometimes speak of one woman as a born nurse1 and say of another1 ,she's a good nurse1 thoroughly conscientious1 but not a natural one like ,miss ,x4 ,it only means that ,miss ,x's main purpose in life has always been caring for the sick1 while ,miss ,y's secondary concern is that4 ,there is a third1 however1 who may be sidetracked into nursing1 but whose chiefest interest and attention in life has not been so much a certain profession or accomplishment1 but a passion for people1 with an ability to enter into their lives understandingly4 ,she may not care for nursing in itself4 ,it is only accidental that her thoughts were turned to it4 ,but her liking for people makes it easier for her to concentrate attention on the details of nursing1 as thereby she is fulfilling her life's ambition in studying and serving human beings4 ,she may be a real success if she can only convince herself that this is her forte4 ,if not1 and she dreams of other fields of service1 her concentration on the thing at hand is not perfect enough for her to compete successfully with the born nurse4 ,whatever it is1 the thing that gets our chief attention is the most important to us4 ,it may be lack of appetite1 or pain in the side1 indigestion1 general disability1 discomfort1 the mistreatment we once received1 the mistake we once made1 or the sin we committed--whatever it is that holds our attention1 it is the most absorbing and interesting thing in the universe1 though it may be an utterly morbid interest1 an unhappy attention4 ,but it blots out for the time the rest of the world4 ,a big hint for the nurse exists therein4 ,let her try in every lawful way to divert her patient's attention from the disease-breeding stimuli toward the happy and wholesome ones4 ,for the nurse herself in the care of patients let us draw some conclusions from these laws of the mind's working3 #a4 ,have a goal in view for the patient's health of both body and mind4 #b4 ,work toward instilling in your patient a health ambition--a pride in health4 #c4 ,remember that overcrowding the mind defeats your purpose of making one clear impression4 #d4 ,win interest by any legitimate means to the next step toward the goal1 and only the next4 #e4 ,work for attention to hopeful1 courageous1 and happy things4 ,let us as nurses remember always that it is for the patient's sake and not for our own that certain results must be obtained4 ,our work is usually in helping the doctor to get the best possibilities out of the material at hand1 and we cannot hope to change the fabric4 ,but we can help to repair it2 we can sometimes influence the color and suggest some details of the pattern1 or assist in the making over process2 and when the fabric is substantial and beautiful we may assist in preventing its marring4 ,so we may help to evolve a body-health and mind-health attitude from what seemed the wreckage of a disease-accepting mind2 or we may have the great privilege of warding off the disease-accepting attitude4 ,but always1 in all our care of patients1 let us not neglect or fail to use wisely this central fact of psychology2 that anything that gains attention1 even for a moment1 leaves its impress on the mind2 that the direction of attention determines our general reaction to life4 ,,chapter ,,xi ,,getting ,,the ,,patient',s ,,point ,,of ,,view ,,what ,,determines ,,the ,,point ,,of ,,view ,the point of view of any individual depends upon temperament1 present conditions--mental and physical--and the aim of the life4 ,that is1 it depends upon his inherited tendencies plus a unique personal something1 plus all the facts of his environment and experience1 plus what he lives for4 ,richard and ,jim both live in ,philadelphia1 ,richard on ,walnut ,street and ,jim on ,sansom ,street4 ,richard's father is of the best ,quaker stock1 with hundreds of years of gentle and aristocratic ancestry behind him4 ,he followed his father and his grandfather into the profession of medicine1 and is a well-known specialist1 alert1 keen1 expert1 and deservedly honored4 ,he is at home in ,greek and ,latin1 ,french1 and the sciences4 ,he selects at a glance only the conservative best in art and music and literature4 ,his world is a gentleman's world1 a scholar's world1 and the world of a scientist and a humanitarian4 ,and ,richard1 his son1 is true to type4 ,jim's father is the ash man4 ,his world is in the alleys and basements4 ,his pastime1 cheap movies1 and the park on ,sundays4 ,when he is not working he is too dead tired for anything heavier than the ,sunday ,supplement or perhaps the socialist club-rooms1 where he talks about the down-trodden working man and learns to hate the idle rich4 ,he spends his money on food and cheap shows and showy clothes4 ,he talks loudly1 eats ravenously1 works hard1 is honest1 and wants something better for his children than he and the old woman have had4 ,his music is the street-organ1 the movie piano1 and the band--some of it excellent too--but none of your dreamy stuff--good and lively4 ,and his son1 ,jim1 is true to type4 ,after the ,armistice ,jim and ,richard1 who have fought for months side by side1 go to ,paris together4 ,richard may have a fling at ,jim's amusements for the sake of playing the game and seeing how the other half lives and all that--but before long we shall find him in the high-class theaters and restaurants1 visiting the wonderful art collections and libraries1 riding in luxurious automobiles1 and staying in the best hotels he can find4 ,and even though ,jim may have saved ,richard's life and ,richard is eternally grateful1 and loves ,jim as a dandy good scout1 their ways will inevitably drift apart when the one big common interest of fighting together for a free world is over4 ,they will always remember each other4 ,jim will decide that a highbrow can be a real man1 and ,richard will ever after have a fellow-feeling for the other half and think of them now as folks4 ,but ,jim is not at home in ,richard's neighborhood and circle2 and ,richard is a fish out of water in ,jim's4 ,the point of view of each has been largely determined by his heredity and his environment4 ,but suppose ,jim isn't true to type4 ,from the time he was a mere youngster the ash-man life did not appeal to him4 ,in school he liked the highbrow crowd2 he took to ,latin and literature4 ,he has a feeling of vague disgust when he sees a vulgar picture1 a shudder when the street-organ grinds4 ,there is something in ,jim different4 ,he isn't in tune with either his immediate heredity or his environment4 ,the contribution from some remote ancestor has overbalanced the rest1 and ,jim becomes a professional man4 ,or perhaps ,richard breaks his father's heart4 ,instead of following the trail already made1 he cuts loose1 frequents vulgar resorts1 hates his school work1 becomes a loafer and a bum--and1 finally1 a second-rate day laborer4 ,again1 what he is himself1 his vital spark has been stronger than immediate heredity and environment1 and has broken through4 ,,getting ,,the ,,other ,,man',s ,,point ,,of ,,view ,our points of view are very frequently merely hereditary or acquired prejudices1 hence altogether emotional rather than rational4 ,we only with great difficulty see things through another man's eyes4 ,it necessitates comprehending his background fully1 and standing exactly where he stands1 so mind and eyes can both look out from the same conditions that confront him4 ,and this is only possible for the man or woman possessed of a vicarious imagination4 ,such an imagination1 however1 can be cultivated4 ,you hate my father4 ,he injured yours--unjustly1 to your mind1 of course1 for yours can do no wrong4 ,from my point of view this father of mine is a great1 good man4 ,from your point of view he is wicked and cruel4 ,we are both honest in our emotion-directed opinions4 ,until you can know my father as ,i know him1 and ,i can know yours as you know him1 we shall never agree about them4 ,but ,i can learn to understand why you feel as you do1 and you can learn to understand why ,i feel as ,i do4 ,i can put myself1 in imagination1 in your place1 and see that other man as my father1 and pretty well grasp your point of view1 and you can likewise get mine4 ,after all1 the law is very simple4 ,each man is the result of the things he puts his attention chiefly upon2 and he puts it naturally upon the things which his forebears and his surroundings have held before him4 ,the rare person and the trained person can assert the vital spark of his own personality and tear attention away from the easy direction and force1 and hold it somewhere else4 ,so he can change his points of view by learning that there are other vantage grounds which direct to better results4 ,with some one else to lead the way and give a bit of help1 or with the urge of desire to understand the new viewpoint1 or by the drive of his will1 he can change his own4 ,let us not forget that what we see depends on whether or not our eyes are normal1 on where we look1 or on what kind of spectacles we wear4 ,two things we can change--where we look1 and the spectacles4 ,if our eyes were made wrong we probably cannot change that1 but we can often correct poor vision by right artificial lenses4 ,there are people doomed to live in most unattractive1 crowded surroundings who make a flower-garden of charm and sweetness there1 or1 without grounds1 keep a window-box of fragrance4 ,the normal person can pretty largely either make the most impossible environment serve his ends or get into a better one4 ,so we can usually look to something constructive1 helpful1 attractive1 or beautiful2 and we can refuse to wear blue spectacles4 ,we nurses soon realize that there are just about as many points of view as there are people1 and that if we would help cure attitudes as well as bodies1 and so lessen the tendency to sickness1 it behooves us to learn to see what the other man sees through his eyes or by the use of his glasses1 from where he stands4 ,let us try just a few experiments4 ,hold your pain and suffering from your appendix operation1 and disappointment because you can't be bridesmaid at your chum's wedding1 up close to your eyes1 and you cannot see anything else4 ,they crowd the whole field of vision4 ,look at the world from the eyes of a spoiled woman of wealth who for twenty years has had husband1 friends1 and servants obedient to her every whim4 ,she has grown selfish and demanding4 ,what she has asked for1 hitherto1 has been immediately forthcoming4 ,now she is ill1 and she naturally considers the doctors and nurses mere agents to secure her relief from discomfort4 ,she is willing to pay any price for that--and still she is allowed to suffer4 ,from her point of view it is utterly unreasonable1 inexcusable4 ,what are hospitals and nurses for1 anyway8 ,and she is carping1 critical1 and disagreeable4 ,her attitude is as sick as her body4 ,how could it be otherwise8 ,look about you from an aching mind and body1 after days of suffering and sleeplessness1 and unless you are a rare person and have a soul that sees the sunshine back of everything--you will find the world a place of torture4 ,look out from despair and loss of the ones you love best1 or from failure of will to meet disaster1 and everybody may be involved in bringing about your suffering1 or in effecting your disgrace4 ,look out on the world from the eyes of the immigrant who has lost all his illusions of the land where dollars grow on the street and where everyone has an equal chance to be president1 and if you do not cringe in abject humility1 you are not unlikely to be insufferably self-asserting1 considering that the world has robbed you and that now it is your turn to get all that is coming to you4 ,so you make loud demands in a rude1 ordering voice4 ,the nurse is there to wait upon you--and finally you will have your innings4 ,look out from the resentful eyes and smarting mind of the negro who is just beginning in a northern city to realize that his boasted equality is a farce1 and you will try to prove to the white nurse that you are as good as anybody4 ,you are impossible2 but back of all your bravado and swagger and rudeness and complaint of neglect because of your color1 you realize that you cannot measure up4 ,you know you belong to a different race1 most of whose members are daily giving evidences of inferiority2 and you are sure that the nurse is thinking that4 ,look from the eyes of the new rich1 or the very economical1 and you are going to get your money's worth out of your nurses4 ,the nurse who can get back of her patient's forehead and put her mind there and let it work from the patient's point of view1 will learn a saving sense of humor1 will be strict without antagonizing1 will clear away a lot of mental clouds and help to make permanent the cure the treatment brings4 ,one can often judge very truly a patient's real character by his reaction to his sickness4 ,on the other hand1 frequently it only indicates that he has not yet properly adapted himself to a new experience and a trying one4 ,we hear so often1 ,why1 she's a different person these days1 since she's feeling better4 ,it's a joy to do things for her4 ,she was the same person a while back1 but had not learned to accept discomfort4 ,any of the following list of adjectives we hear applied to our patient again and again by the nurses3 unreasonable stubborn lazy deluded cranky resistive unco-operative will-less hipped obsessed hypocritical of mean disposition excitable fearful exacting dissatisfied undecided wilful self-centered morbid doubtful demanding retarded abusive depressed spineless self-satisfied ,unpleasant terms they are1 and condemning ones if accepted as final4 ,when the nurse realizes that under the same conditions she would probably merit them herself1 she becomes more anxious to remove the conditions1 and less bent upon blame4 ,we must admit that the highest type person1 when sick of any physical illness1 does not deserve such descriptive terms as these4 ,but they are the rare folks1 few and far between2 while the great mass of us have not acquired more than enough self-control and thoughtfulness for the ordinary routine of life4 ,we are weakly upset by the unexpected4 ,if it is a pleasant unexpected1 we are plus in our enthusiasm1 and people applaud2 if the unpleasant unexpected1 we fall short1 and people deplore our weakness4 ,if we learn our lesson of self-control and adaptability1 and gain in beauty of character through experience1 it has served a purpose4 ,but the nurse deals with the average of human nature1 and she finds their reaction faulty4 ,very often1 if she is observant1 she will discover that a patient responds in a very different way to some other nurse1 who somehow finds that trying sick woman charming or thoughtful1 likable or sweet4 ,of course1 it may be because the other nurse weakens discipline and caters to the patient's whims2 but it is just as likely to be because she has tempered her care and her strictness with understanding4 ,she has grasped the patient's point of view2 and with that start1 the chances are #ej per cent4 more in favor of the patient grasping and acceding to the wise nurse's point of view4 ,shall we not remember that our trying1 cranky1 stubborn patient is a sick person1 and learn to treat that stubbornness or crankiness as a symptom indicating her need1 just as we would a rising temperature8 ,when we can meet her attitude with comprehension1 and1 if necessary1 with quietly firm disregard1 then we are beginning to be good nurses4 ,some of the most common of these sick reactions with which the nurse must deal are enhanced suggestibility1 repression1 oversensitiveness1 stubbornness1 fear1 depression1 and irritability4 ,and each one demands a different method of approach if real help is to be given4 ,old ,isaac ,walton wrote a book many1 many years ago called ,the ,complete ,angler4 ,he was a famous amateur fisherman1 and he says there are only three rules to be observed and they will bring sure success3 #a4 ,study your fish4 #b4 ,study your fish4 #c4 ,study your fish4 ,if the angler follows these directions1 he is not apt to offer the wrong bait4 ,when he knows all their little peculiarities1 he will know how to catch his fish4 ,the complete angler has an unlimited patience and an infinite sense of repose and calm4 ,he never hurries the fish1 lest they become suspicious of his bait4 ,and he proves that these three rules work4 ,the nurse who accepts every patient as like every other1 and treats him accordingly1 will never be a great success4 ,the nurse who studies her fish and learns their psychology1 will be a therapeutic force4 ,she will know the why of the way that patient acts4 ,,the ,,deluded ,,patient ,if the patient's mind is temporarily clouded through infection or suffering1 he may be reacting to a delusion1 an obsession1 a fixed idea of disability1 a terrifying fear4 ,sometimes he persistently refuses food1 and gives no reason for it4 ,the unthinking nurse is tried1 puzzled1 and irritated4 ,in other ways1 perhaps1 the patient seems quite normal4 ,but1 after all1 the explanation is very simple4 ,he probably is as confident that the food is poisoned as you are that it is as it should be4 ,no arguing would convince him1 for1 to his mind1 the nurse is either a complete dupe or an agent of the people whom he knows are plotting his death4 ,and urging him only strengthens his conviction4 ,the writer recalls one such case of a patient who had to be tube fed through many months1 though a tray was set before her three times a day--and as regularly refused4 ,then one day she was seen slipping food from off another patient's tray and eating it greedily1 not knowing she was observed4 ,when questioned1 though she had never before given a reason for refusing food served to her1 she said that they had nothing against ,mrs4 ,b41 so wouldn't try to poison her4 ,her reasoning was excellent when one accepted her premises4 ,she had bitter enemies4 ,they were not enemies of ,mrs4 ,b4 and would not harm ,mrs4 ,b4 ,therefore she dare not touch her own food1 but could eat ,mrs4 ,b4's if no one knew4 ,these deluded patients live in a world we often do not sense1 a world whose reality we do not appreciate4 ,the nurse1 after much experience1 finds that there is a key to every resistance1 to every lack of co-operation1 to abnormal attitudes and actions4 ,she realizes that a powerful emotion of desire or fear1 of love or hate1 of ambition or self-depreciation1 of hope or despair1 of faith or distrust1 unchecked by reason or judgment through the years1 has provided a soil upon which emotional thinking alone can grow4 ,the patient is a mere puppet of the suggestions of emotions which may not be at all pertinent to the facts4 ,,nursing ,,the ,,deluded ,,patient ,the nurse soon realizes the uselessness of attempting to argue a patient out of his delusions1 of trying to convince him that the things he sees and hears and perhaps tastes and feels1 are but hallucinations4 ,her very insistence only fastens his attention more firmly upon the false conclusion or makes him more convinced that his mind is giving him a true report from the senses of sight and hearing and taste and feeling4 ,but often a quiet disregard of the delusions while the nurse goes on her way and holds her patient to his routine1 consistently and confidently1 as she would in case they were not true1 will eventually cause him to question their reality just because no calamity results4 ,the nurse acts as if these delusions and hallucinations were non-existent in reality1 and when the occasion arises1 through the patient's questioning1 she urges him to exert his will to act also as if they were not true2 to try it and see what happens4 ,arguing1 also1 she finds1 usually antagonizes or makes the patient stubborn4 ,he cannot prove by her logic his point1 but he knows from inner experience that he sees what he sees1 hears what he hears1 and knows what he knows4 ,the fact that the nurse does not is merely annoying evidence that she is blind1 deaf1 or stupid to these things of his reality4 ,he knows he is lost and damned1 or tainted2 that he is ,king ,george1 ,caesar1 or the ,lord1 as the case may be2 or that his internal organs are all wrong4 ,he feels it and the nurse can't--therefore1 he alone has true knowledge of it4 ,in the end1 the wise nurse who never disputes with him1 but leads him on to action which utterly disregards these things1 may bring about a gradual conviction in the patient's mind that a man couldn't do what he does if all these things were true2 and the delusion slowly may lose its force or the hallucination fade away4 ,many patients drop them from their lives entirely4 ,many others in whom dementia is not indicated1 or in whose cases it is indefinitely delayed1 can come to an intellectual realization that all these things are fantasies1 and do not represent reality2 that despite their continued1 frequent1 or occasional demands upon feeling life1 they can be consistently ignored4 ,these psychopathic individuals may act as they would if the delusions never came henceforth to their consciousness1 and so be enabled to live a comparatively normal life4 ,,the ,,obsessed ,,patient ,a patient who is suffering from obsessions must carry out certain abnormal actions1 or be wretched4 ,she cannot do otherwise4 ,it is as though she were forced by some outside agent1 though the forcing is actually from within4 ,when the nurse realizes this1 and the more essential fact--that many patients1 who have not true obsessions1 yet have a tendency toward obsessed ways of thinking and doing--when she comprehends it almost as she would if she were the victim1 then she is ready to help the patient by gently making the action impossible1 and at the same time diverting attention4 ,,the ,,mind ,a ,,prey ,,to ,,false ,,associations ,sometimes a nurse reminds a patient of some one in the past who has complicated her life in an unhappy way1 so she distrusts or dreads her or is made constantly uncomfortable in her presence4 ,in such a case1 if the nurse reports her patient as resistive1 or fearful or cringing1 or distrustful1 she is really misrepresenting her2 for under another's care that patient may show an entirely opposite reaction4 ,the nurse can only sense the strength of the influence of heredity and environment and habit of thought1 which would give the explanation of many things in her patient's attitude4 ,nor can she realize just what shade of meaning certain phrases and words have for her charge4 ,to the nervously overwrought person the most innocent reference--father1 sister1 wife1 home--may bring concepts that are unbearable4 ,the association of the word may make for deep unhappiness1 of which the nurse knows nothing4 ,but she can learn that all these things do influence attitude1 can appreciate the difficulty of her patient's effort at adjustment1 and do all in her power to make that adjustment possible4 ,if the patient is reasonable she can appeal to her reason4 ,if she is too sick for that1 the nurse can use happy suggestions4 ,if the mind is deluded and obsessed she can use firm kindness4 ,she can learn what loss of privileges will affect the rude and unco-operative patient1 and may be allowed to try that4 ,she can sometimes help the patient to self-control by making her realize that after each outburst she will be constructively ignored4 ,but the point we wish to make is this3 ,there are some sick reactions which the nurse1 if she recognizes as such1 can help the patient to transform into wholesome ones4 ,at the very least the wise nurse can learn to simplify her own difficulties by accepting the unpleasant patient as possibly the result of her illness1 and refusing to allow her trying attitude to get on her nerves4 ,the patient may be reacting normally to the stimulus her untrained and toxic brain received4 ,and when the nurse can see into the other's mental workings1 get her point of view1 she is ready to give fundamental help4 ,,chapter ,,xii ,,the ,,psychology ,,of ,,the ,,nurse ,the mind can be as definitely developed and strengthened as the body4 ,the man who has suffered for years an organic disease will never have the same force as he who has never been seriously ill2 but his constitution can be built up and made as efficient as possible within its limitations4 ,many a man or woman who has an organic heart disorder1 through treatment and the proper exercises gradually increased1 can very often approximate through many years the output of a normally strong person4 ,the individual weakened by a tuberculous infection can frequently1 by following a prescribed regimen for a time1 by wise1 scientific diet and rest treatment and the help of the out-of-doors1 then by carefully increased physical activity1 finally live the useful1 average life4 ,but it takes scientific care to evolve the weak body into a strong one2 and in some cases1 at best1 it can never stand the same strain that the uninjured one carries with ease4 ,however1 even damaged bodies can be made very productive within their limited spheres4 ,also the naturally perfect physique can quickly become unfit through neglect or infections or misuse4 ,in the same way1 and just as definitely1 can the mind be developed and strengthened4 ,some are by nature keen1 alert1 brilliant4 ,they may develop into masterfulness2 or they1 too1 may degenerate1 through abuse1 or from the effect of body infections1 into uselessness4 ,the germ-plasm has foreordained some individuals to psychic disorders2 but training and mode of life can modify many of these defects4 ,and the average mind1 like the average physical organs1 can be made more efficient through partaking of the proper mental food1 through careful training and wise use4 ,no more urgent necessity faces the professional woman than this of training her mind to its highest productiveness4 ,argument is not needed to convince intelligent people today that the accomplishment of life depends upon mentality4 ,let us look into the very ,a1 ,b1 ,c's of mind development1 and as nurses undertake to equip ourselves to master our profession from the ground up4 ,the first essential is ability to think clearly4 ,steps to ,clear ,thinking3 #a4 ,accurate perception1 with attention to the thing that reason chooses4 #b4 ,association of ideas4 #c4 ,concentration1 acquired by the help of emotion and will4 #d4 ,emotional equilibrium1 which refuses to allow feeling to obscure judgment by leading reason astray4 #e4 ,self-correction4 #f4 ,automatic habits1 which free the mind of all unnecessary crowding4 ,,accuracy ,,of ,,perception ,the beginning of learning is perception4 ,keen1 accurate perception at the time of first introduction of a new fact or thought1 and the linking up of that new material with something already in consciousness1 insures in the normal mind the ability to remember and use that fact or thought again4 ,the things casually perceived and not definitely tied up with something else are soon forgotten by the conscious mind4 ,you pass a florist shop where a score of different flowers and plants are displayed4 ,if your thoughts are intently on your errand you may glance in1 see flowers1 color1 perhaps a riot of colors only--and beauty2 and you feel a glow of pleasure from the sight4 ,but a moment later you cannot name the blooms in the window4 ,perhaps roses come to mind because you have very special feeling for them2 or carnations1 or sweet peas4 ,but the window as a whole you perceive only as flowers1 and color1 and beauty4 ,you cannot describe it in detail1 for you gave it only passive attention4 ,but if you went to that window to know its contents2 to find out what the florist had in his shop1 because you are very interested in all flowers and plants1 then you can tell minutely what is there4 ,you had a purpose in perceiving the window2 your will held attention upon each object in turn2 and your love of flowers 7an emotion7 eased the effort of volition when it might have tired4 ,perception1 then1 is of three kinds3 passive1 incited by interest1 and directed by will4 ,and the perception which is the basis of accurate knowledge is one of keen interest1 or of will1 or of interest plus will4 ,,training ,,perception ,the nurse who demands of herself that she perceive accurately paves the way for accurate1 deft service in her profession4 ,there are constant means at hand for training in the art4 ,suppose you try to get so definite a picture of each ward or room you enter1 in a swift but attentive examination of its furnishings and their locations1 and of the patients1 that you can reproduce it to yourself or a friend some days later4 ,you come into a large ward1 with a row of beds on either side of the door1 and a wide central space between4 ,how many beds in each row8 ,there is a table at the far end of the room1 opposite the door1 and a nurse in white is writing there4 ,why does she wear white8 ,what is her name8 ,to your right is a closet-like room opening from the ward4 ,that is a medicine-room1 you are told4 ,how many windows has the ward8 ,you glance from bed to bed with a rapid passing in review of the patients4 ,which ones seem to you very ill8 ,there is a large white screen about one4 ,you are told that when treatments are given the screen is put there1 or that when a patient is dying the bed is screened4 ,you look for the ventilators1 and see how many are open and how they work4 ,you see a room-thermometer1 and ask at what temperature it is kept4 ,the nurse explains that a certain degree is ordered1 and that1 so far as possible1 the ventilators are operated to insure that4 ,if your attention has followed all these details with careful1 accurate perception2 if you have grasped them clearly1 one by one1 at the time1 you will be able to answer quickly next day when some one asks how many patients the wards accommodate1 and how many beds are vacant4 ,you can describe the lighting and ventilation1 the room temperature1 etc4 ,and later on you will quickly see to it that a screen is properly placed when you know treatments are to be given4 ,,association ,,of ,,ideas ,after the first few years of life practically nothing enters consciousness that cannot by some likeness or contrast or kinship be connected with something already there4 ,were it not for this saving economy memory would be helpless4 ,so the nurse who is in earnest and eager to master her new work will not only perceive carefully each detail of arrangement1 but in two or three days at most will know each patient there2 she will have worked out a system of associations1 remembering not a meaningless name1 but an individual with certain characteristics which she ties up with her name1 and so gives it a definite personality4 ,she thereafter recalls not merely a patient1 but a very special patient2 and as she comes to mind she brings a title with her1 which is her symbol4 ,likewise when her name is spoken or thought1 she herself comes into the nurse's immediate consciousness4 ,a bed in a certain part of the room will be no longer merely a bed1 but ,mrs4 ,brown's bed4 ,remembering can be made easy by using some such method as this3 ,the first bed to the right as you enter is ,mrs4 ,meade's4 ,she is the woman with the broken hip4 ,the next is ,mrs4 ,blake's1 that blonde1 big woman who wants more attention than any one else4 ,the third is ,mrs4 ,bunting's4 ,she has wonderful1 curling black hair1 and a nice response to everything done for her4 ,the next beyond is ,mrs4 ,o',neil's4 ,she looks as ,irish as her name sounds1 and you will remember her by that4 ,so each bed comes to mean a certain patient1 and each patient comes to suggest the ones on either side of her--her neighbors4 ,blondeness and bigness together call ,mrs4 ,blake to mind4 ,broken hip means ,mrs4 ,meade1 etc4 ,each individual on that side of the ward becomes associated with a name which stands for definite characteristics4 ,then you begin at the left bed nearest the door and follow the occupants back on that side4 ,you may remember better by jotting them down in order of the beds1 with names and a brief comment on each patient4 ,keep that list on a small card in your pocket for reference for a day or two1 then depend on memory entirely4 ,i have personally found this an excellent method4 ,you are expected to be able to turn quickly to any medicines needed in emergency1 and you soon learn to remember them and where they are placed by the arrangement into classes or kinds1 which most hospitals require4 ,cathartics are together1 hypnotics together1 etc4 ,so when you want cascara you associate it with cathartic and turn to that shelf4 ,you learn very soon that poison medicines are kept apart from the others1 and quickly associate the poison label with danger to patients1 necessity of locking safely away and hiding the key from any but those responsible for the care of the sick4 ,learning to look closely at the patient's face1 instead of casually glancing at her when you care for her1 makes it possible for you to note changes of expression1 heightened color1 dilated pupils1 a trace of strain1 etc4 ,then try to find the exact word that will express what you see4 ,such experiments in perception and attention1 association and memory1 repeatedly demanded of yourself--i4 e41 the being able to recall and describe in detail the room- or ward-arrangements and to place the patients accurately1 as we have just described--will prove invaluable practice1 helping you to attend to every change in your patient's demeanor and expression1 which may prove significant symptoms4 ,and remember that while the mind can only contain so many isolated facts1 yet there is no limit to its possibilities when the power of association of ideas is employed4 ,your first step to clear thinking is accuracy of perception1 with attention to the thing reason chooses2 your second is association of the things perceived1 a grouping of them to fit in with each other1 and with what is already in the mind4 ,and both imply the third--concentration1 aided by emotion and will4 ,for passive attention and haphazard associations assure the opposite of clear thinking4 ,,concentration ,how to ,study4--,you learn sooner or later from experience that the quickest and best way to learn anything new is to give it your undivided attention at the moment2 to perceive one thing at a time and to perceive it as something that is definite1 or as some quality that is unblurred4 ,one of you will spend three hours on an anatomy lesson1 another two hours1 while a third nurse may give it a half-hour of concentrated study and know it better than either of you1 if you have been day-dreaming1 or talking1 or rebelling at the luck which keeps you indoors learning about bones1 when the tennis-court is so inviting4 ,true1 some minds have better natural equipment and some have better previous training than others4 ,but the average mind could learn a lesson well in much less time than is spent upon learning it poorly4 ,few people hold their attention strictly to the task at hand if something more interesting beckons1 or if they feel tired1 or blue4 ,but you can learn to do it4 ,put aside a certain amount of time today for study2 hold your undivided attention on your lesson1 regardless of how many pleasanter things appeal4 ,when your eyes or your thoughts wander from your note-book1 bring them back forcibly1 if need be4 ,your first task is to keep your eyes there1 instead of letting them follow your roommate's movements1 or resting them by watching the street below4 ,but it is easier to do this than to make your mind grasp the meaning of the things you see4 ,you may read two or three pages1 and not receive one idea1 not even be able to recall any words from the context4 ,your eyes are obeying your will and seeing the words1 but your mind is wool-gathering4 ,now take yourself in hand firmly4 ,if you are really a bit fagged1 try some deep-breathing exercises before the open window1 bathe your face in cold water4 ,then read a paragraph1 close your book1 and write1 if you are not alone1 or repeat to yourself aloud1 if your roommate is out1 what that paragraph says--its meaning4 ,if you cannot do it1 read it again with that end in view4 ,repeat the process1 and hold yourself to it day after day1 if necessary1 until finally will has won the battle1 or1 better still1 your will to learn has been reinforced by an interest in the very competition with yourself1 if not yet in the contest4 ,then1 as you learn some facts from your notes1 use your imagination to apply them in real life4 ,the triceps muscle4 ,what is it for8 ,your notes inform you1 and then it is really interesting to see how it performs its function4 ,what origins and attachments must the triceps have to make it extend the arm8 ,your notes say that a muscle tends to draw the part to which it is attached toward its origin4 ,this triceps muscle straightens the arm4 ,in that case it must oppose the flexion at the elbow4 ,how is that likely to be done8 ,the triceps must start somewhere above the elbow1 and quite far above1 too1 to be able to make a straight angle of an acute one2 it must start toward the back in order to draw back the forearm2 and be attached to the back of the bone below4 ,also it must be quite a long muscle4 ,so much reason tells you4 ,now let me see how it is done1 in fact4 ,and you find that the triceps has three origins high above its one attachment as a tendon1 to give it a good strong pull4 ,these are in the outside of the humerus and in the scapula4 ,that is logical1 and you will remember it4 ,now how does the arm bend8 ,what pulls against the triceps8 ,and you are interested before you know it4 ,there is nothing1 good1 bad1 or indifferent1 but has some points of interest if the mind turns its entire attention to it4 ,but our tendency is to grow tired of calling back our wandering thoughts again and again to the thing that is hard1 dry1 or stupid4 ,and we need more incentive than just the doing of the duty because it is to be done4 ,we need a compelling interest in the goal to encourage our wills to concentration on the less interesting4 ,let us first think out the why of knowing anatomy if we are to be nurses4 ,and if the profession of nursing is the goal1 let anatomy become just the next stretch of the road that leads to it4 ,concentration can be acquired4 ,it may require three hours at first to learn your lesson2 but later on you will do it in two1 then in one1 and perhaps in less4 ,and when you can sit down with your notes and learn them with voices about you--perhaps2 with some one else in the room2 with a party an hour ahead2 when you can disregard all but the work at hand1 then you can concentrate1 and the big battle of your life as a student is won4 ,study is no longer drudgery4 ,lessons occupy much less of your time and leave you more free hours4 ,because you give them your whole mind you learn them in a fraction of the hours hitherto wasted upon them1 when you studied with divided attention4 ,when you are doing clear thinking on the thing at hand1 satisfactory results are assured4 ,,self-,,training ,,in ,,memory ,hand in hand with clear thinking goes reliable memory4 ,but so many of us have it not1 and feel its need so strongly that we shall consider for a moment some means of training it4 ,william ,james holds that brain-paths cannot be deepened2 that memory is not strengthened in that way4 ,there is a natural retentiveness with which some of us are born--the men of colossal intellect--and they remember and are able to use infinitely more things acquired in the past1 because they have a brain substance of greater tenacity in holding impressions than others possess4 ,james compares some brains to wax in which the mark left by the seal is permanent2 and others he compares to jelly which vibrates at every touch1 but retains no dent made in it4 ,from our study of the subconscious we know that the dent did leave an impression on the brain2 but it was in the subconscious4 ,so we beg to change the figure and liken1 in all mankind1 that part of the brain that handles the subconscious to wax1 while granting that in some rare cases parts handling the conscious material also hold impressions1 as does the wax4 ,consequently1 according to this theory1 we do not strengthen our memories by repetition of facts1 lines1 or phrases4 ,we cannot grave any deeper the memory paths which nature has provided at birth4 ,but the attention to the thing to be remembered1 which repetition has required1 has made a larger number of connections of the words with each other1 of thought with thought1 and of the new with the old4 ,so we have tied the new together with the old by that many more strings1 as it were2 and any bit of the new tugs at other bits2 and the old to which it is tied brings the new with it when it comes to the fore4 ,in other words1 careful attention1 at the time1 to the new stimulus1 and its association with the already known1 together with repetition1 will form a whole system of relations in the mind1 and the newly entered material soon become so well-known that it will be difficult to disregard it4 ,when1 in spite of determined effort to remember1 the thing is forgotten1 especially in the nurse's case1 it is usually because the emotional reaction to weariness or to some like obstacle has interfered with proper attention4 ,james advises us if we would improve memory1 to improve our thinking processes2 to pay more and keener attention1 so that we will link things closely together4 ,this in itself will help to arouse interest in the thing to be remembered2 and keen interest alone1 or careful attention at the time of introduction of the new1 and repetition of the thing to be retained1 with a will which holds the attention fast1 will assure a good1 workable memory in any normal mind4 ,,chapter ,,xiii ,,the ,,psychology ,,of ,,the ,,nurse 7,continued7 ,,emotional ,,equilibrium ,suppose that when you first enter the ward you are wishing with all your heart you had never decided to become a probationer4 ,perhaps the white screen and its possible meaning has so frightened you that your thoughts refuse to go beyond it4 ,suppose the very sight of so much sickness has agitated you instead of strengthening your determination to help nurse it4 ,that is1 suppose your emotions1 your feelings1 so fill your mind that perception is necessarily inaccurate and blurred4 ,then tomorrow your account of the ward will be hazy1 and your desire will probably be against returning to a place where so many unpleasant feelings were aroused4 ,the emotional balance which refuses to allow feelings to obscure judgment by leading reason astray is a necessary safeguard for the work of the nurse4 ,there is little place in the profession for the woman who is all sentiment1 but perhaps there is less for the one without sentiment4 ,feeling1 we found1 is the first expression of mind--feeling which in the early months is entirely selfish4 ,the happiest baby you know is not sweet and winning to please you1 but because he feels comfortable and happy and cannot keep from expressing it4 ,his universe is his own little self and you exist only in your relation to him4 ,if you give him pleasure he likes you2 if pain1 he does not want you4 ,his mother often fails to please him1 but satisfies him so much more frequently than anybody else that he loves her best4 ,then comes nurse or father--if he proves the satisfactory kind of father1 or she a nurse he can love4 ,to the baby whatever he happens to want is good4 ,what is not desirable is bad4 ,and such emotional responses are altogether normal in early months1 yes1 even until the child is old enough to use reason to choose between two desires the one that will in the end prove more satisfying4 ,but they are defects in adult life4 ,the nurse who would always act as her first feeling dictates would not be in training many days4 ,unpleasant sights and sounds1 the fear of making a mistake which might harm a patient1 the undesirability of long hours of hard work in caring for patients who frequently only find fault with her best efforts1 would early decide her in favor of another life-work4 ,comparatively few so-called grown-ups are guided only by feeling2 and most of those are in institutions that are well safeguarded4 ,but a great many mature men and women allow feeling to unduly influence their thinking4 ,the sentimental nurse1 for instance1 may find it very difficult to give an ordered hypodermic4 ,the patient dreads the pain and the nurse fears hurting her4 ,suppose she were to fail to give it on such grounds4 ,this is an almost unthinkable case4 ,but the very nurse who agrees that such an emotional weakling should not be allowed to train1 will help her patient1 even when recuperating nicely1 to grow inexcusably self-centered1 by sympathizing with every complaint1 warning her at every turn1 by allowing her and even encouraging her1 perhaps1 to discuss her illness and suffering in the minutest detail4 ,this nurse is more damaging than the sentimentalist who fails to give the hypodermic2 for that slip is easily discovered1 and the transgressor must immediately reform and obey orders1 or be dismissed4 ,but the second nurse may take perfect care of the sick body1 and the doctor never realize that she is developing the sickness idea in her patient's mind4 ,in both of these instances reason has followed the leadings of feeling4 ,it is unpleasant to hurt the patient1 and she is disagreeable1 too1 when you insist on carrying out the orders4 ,it is easier to agree with her ideas and sympathize with her troubles1 much easier than to find some other avenue for her thinking1 or to search for feeling substitutes4 ,it is pleasanter right now to allow her mind to slip unmolested into sick reactions than to lead her1 unwilling as she is1 into the ways of health4 ,reason follows feeling's logic1 which suggests that it is much better for the patient to talk of her ills than to keep them pent up inside2 and judgment is sadly obscured4 ,the emotionally balanced nurse hears the story once1 that she may have the material for helping the need4 ,feeling1 perhaps deep and genuine sympathy with a real trouble1 is aroused1 and rightly4 ,but this brings a keen desire to help the situation4 ,reason insists that talking of sufferings1 real or fancied1 only makes them more insistently felt2 that there must be some better way to meet them4 ,it suggests various methods to divert the patient's attention1 to change the train of thought until she is able herself to direct it into healthful channels2 judgment weighs the propositions and decides upon the one which will lead toward establishing a health attitude4 ,the nurse is continually meeting the necessity of acting contrary to fear and discouragement and weariness of spirit4 ,how can she secure emotional equilibrium for herself8 ,keep in mind the fact that most sick people are very suggestible2 that you have a definite responsibility to make your suggestions to your patient wholesome2 and that your mood is a constant suggestion to him4 ,remember that he needs your best4 ,then1 if your own trouble seems too great to bear1 determine that1 so long as you remain on duty1 you will not let it show4 ,try an experiment4 ,see if you can go through the day carrying your load of sorrow1 or disappointment or chagrin1 with so serene a face that the sick for whom you are caring will not suspect that you have a burden at all4 ,that is a triumph worth the striving4 ,then--if you can let it make you a little more comprehending of others' pain1 a little more gentle with the sickest ones1 a bit more patient with the trying ones1 more kindly firm with the unco-operative1 realizing that each one of them all has his burden too--you have not choked feeling1 but you have fulfilled reason's counsel3 that sick people are not the ones to help you in your stress2 that a good nurse should rise above personal trouble to the duty at hand4 ,your judgment has compared your reasons1 and decided that you should act before your patients as you would if all were well4 ,and will holds you to emotional equilibrium4 ,such a thing can be done in a very large measure2 and no better opportunity for emotional control will ever be offered than the necessity of being calm and serene before your patients1 no matter how you feel4 ,but1 while reason and judgment teach us to control the expression of certain feelings1 they urge that this control be exercised in transforming those feelings into helpful ones and giving them an adequate outlet4 ,such a substitution has been suggested above4 ,let us not forget that nothing in existence is of personal value until it gives some one an emotion2 that feeling is the beauty of life2 that living1 without the happy1 wholesome affective glow1 would not be worth the effort2 that beauty and strength and sweetness of feeling make for a worthy self4 ,remember1 too1 that feeling is the curse of life4 ,it is feeling that would make us give up the whole struggle2 and ugliness and weakness and bitterness of feeling make for a despicable self4 ,hope lies for us all in the realization that we can choose our feelings1 our responses4 ,we can be utterly discouraged1 and bitter and depressed at failure2 or we can recognize it as a sign-board telling us that the other way than the one we just followed leads to the goal4 ,and we can follow its pointing finger with faith in a new attempt because1 now1 we know at least how not to go4 ,we can learn despair from all the bitter and the hateful and the mean2 or we can learn that they never could be called so if there were not the sweet1 the lovable1 and the generous with which to compare them4 ,you can learn to search as with a microscope for all the undesirable traits of your patients1 or you can calmly accept all that assert themselves as undeniable facts1 but use your microscope to find their desirable characteristics which offer possibilities of being brought to the foreground4 ,you cannot constructively help yourself or your patient by denying the existence of the less worthy traits2 but you can resolve to call out the something better4 ,and if you do not find it1 as may rarely be the case1 you can refuse to let it make you skeptical of finding it in others4 ,let us remember always that1 ,it is not things or conditions or people that harm us2 it is only the way we respond to them that can hurt4 ,this one great truth1 if really believed and made a part of all our thinking1 would save scores of people from nervous wreckage4 ,it is a favorite saying of a wise man who has helped a great many people to endure and take new courage when life seemed too hard to meet4 ,that big1 broken-arm case on the ward cursed you yesterday because you would not loosen his splints4 ,and you rushed from the room angry and humiliated1 wishing you could quit nursing forever1 and asked to be moved because you had been insulted4 ,but that man cannot harm you4 ,he has never known a real lady in his life before4 ,his training from childhood has been to regard women as chattels to do man's bidding2 his experience in life is that they usually do what he asks--women of his kind4 ,moreover1 he has never had a serious pain before1 and it is not to be endured4 ,of course1 the man must be dealt with and made to realize the distinction between his new surroundings and the old4 ,probably the intern or the doctor is the one to do it4 ,also he must be brought to apologize1 or leave the hospital1 perhaps4 ,but he did not hurt you4 ,your own reaction did that4 ,for outside things or people cannot damage what we are in ourselves4 ,the way we respond to them does the harm4 ,when you can control your expression of anger and humiliation1 and substitute for your intense feeling a desire that such a patient may learn that pain is often the gateway to healing2 that some respect for women may be kindled in him1 so that eventually such an outburst in the ward may be impossible for him or for anyone who heard it2 then you are choosing between emotions the one of helpfulness1 for the one of justified indignation2 and feeling has followed reason1 rather than leading reason astray4 ,the judgment which decides you to try methods which will shame or inspire some manliness into the patient was one influenced by a well-balanced emotional life4 ,if we would really acquire emotional poise1 there are a few practical1 proved methods we might adopt for ourselves4 ,when we can hold back the expression of the almost overpowering impulse or passion of anger and resentment and hurt2 absolutely shut tight our lips until we can think2 then wait until we can think without the strain of intense feeling1 we will not only keep ourselves out of trouble1 but will be able to calmly state our position1 right the wrong done us if wrong there was1 or recognize that we ourselves were wrong4 ,for we seldom analyze the situation properly under the influence of strong feeling4 ,if we want to accomplish anything with our words1 let us wait until we can speak them without having to choke down our sobs or cram back our hot anger1 or forcibly restrain ourselves from tearing things or slamming doors4 ,after all that wild fire of emotion is gone1 judgment will lead us to wisely reasoned action4 ,,self-,,correction ,accuracy in work1 a primary essential to the nurse1 can become automatic if she will demand of herself accuracy of perception1 and concentrate on learning and doing until details almost take care of themselves2 if she will correct her own work by the standards taught her1 and recognize just why and wherein she falls short4 ,not that she can always do things with the nicety in which they were taught4 ,she cannot give eighteen ward patients in eight hours the same detailed care her private patients would receive if she had only two of them for the same length of time4 ,in such a case she must often sacrifice refinements of detail in service2 but there is no excuse for sacrificing accuracy in the necessary treatments of her charges4 ,the nurse merely chooses between the multitude of things which can be done for her ward1 the important ones which must be done4 ,because she is rushed is no excuse for giving a poor hypodermic injection or a careless bed-bath4 ,accuracy in doing the essential things should be so automatic that it takes not a whit more time than inaccurate doing2 and such accuracy is chiefly dependent on constant self-correction when the task is still new1 and on never letting up in practice until the details of the doing become practically automatic4 ,,training ,,the ,,will ,there is no better opportunity for will-training than the hospital affords the nurse4 ,the constant necessity of acting against desire1 of doing tasks which in themselves cannot be agreeable1 calls for a developed will1 while it gives it constant exercise4 ,moods of discouragement and depression cannot be indulged4 ,the nurse must do her work no matter how tired or blue or frazzled she feels1 if she is not too sick to be on duty2 for all time lost1 she knows1 is to be made up to the hospital before training is completed4 ,can this will to do1 despite strong desire to the contrary1 this mood control and the ability to disregard physical discomfort1 be acquired2 and if so1 how8 ,it is a law of the mind and of the body that any task becomes easier by repetition4 ,we found that automatic habit eases much of the strain of action4 ,what seemed repulsive service to the probationer on her first day in the hospital1 she forced herself to do because she wanted to be a nurse4 ,she may go on through her three years unreconciled to these particular duties1 yet holding herself to them because she likes other features of her work1 or because she must earn her living and this seems the best avenue open to her1 or because her will to become a nurse is strong enough to make her act continually against desire4 ,and finally1 for almost every nurse1 the interest in the end to be attained overshadows the unpleasant incidents in its way4 ,the tasks are actually easier by their constant repetition1 and her feeling of repugnance becomes only a mild dislike4 ,she has strengthened her will by continuing to act against desire4 ,but there is a better way to the same goal4 ,the woman who has thought out the reasons for and against taking training2 who has considered it carefully as a profession1 and has chosen to put up with any obstacles in the way of becoming a graduate nurse1 can find a happy adjustment to the disagreeable incidents it involves4 ,realizing that the paths of learning are seldom thoroughly smooth1 she can resolve to use their very roughness for firmer footholds1 as a means to self-control1 as a fitting for the sterner hardships of self-support1 of nursing the dangerously ill1 alone1 of meeting suffering and death in her patients with quiet courage and faith4 ,in other words1 she can meet the thousand and one personal services which in themselves might be disagreeable and prove pure drudgery1 not merely with the stern will to do them because they are a necessary part of obtaining a desired end1 but also for the sake of adding to the comfort and well-being of each patient in her care4 ,the emotion of interest and kindly desire will ease the strain which will undergoes in demanding that she not shirk the disagreeable4 ,for there is little stress in doing what we wish to do4 ,it is psychologically possible to find genuine pleasure in the meanest tasks if the doing is backed up by a strong desire to make life count as much for others as possible4 ,the nurse who comes to realize the waste involved in carrying out against desire what reason proposes and volition dictates1 will try to secure the co-operation of desire1 and save will-force for more worthy accomplishment4 ,a constant opportunity for will-strengthening comes to many a nurse during the early weeks and months of training in the necessity of going on despite the sheer tiredness1 the weary backs and swollen1 tender1 aching feet4 ,the one who means to see it through disregards them as far as possible on duty1 gets all the out-of-doors her time permits1 takes special exercises to strengthen weak spots1 and relaxes her body while she reads or studies or visits in her off-duty time4 ,in the end1 not only does her body adjust itself to the new work1 but her will has become a better ally for the next demands upon it2 her endurance is remarkably increased4 ,when she can accept hardship1 drudgery1 weariness of mind and body and perhaps of soul1 the nagging of unco-operative patients1 and the demands on her sympathies of the suffering2 when she can meet these as challenges to develop a strong will--a will not only to endure1 but to find happiness and give service through it all--then the nurse has learned the art of making every circumstance a stepping-stone to mastery and achievement4 ,,chapter ,,xiv ,,the ,,nurse ,,of ,,the ,,future ,the student of life and of the sciences which deal with the origin and development of the human race1 and with the relations of man to man and nation to nation--such sciences as biology and anthropology1 sociology and ethics and history--comes to the conclusion that life exists for the development of mind4 ,and mind is not merely intellect1 but the only gateway we know to character1 to soul4 ,the deepest students of human science see no reason for life except as it evolves a perfect mind--man's goal1 his ideal4 ,and this visioned perfect mind is one which adjusts itself without friction to the body1 making it fulfil the laws of health that it may help and not hinder mind's progress2 one which adjusts itself to people and things1 co-operating with other minds to develop manners and customs and laws of the most satisfactory community living2 one which forces things to be servants of its will2 one which makes harmony of life by fulfilling the laws of the soul as well as of the intellect and of the body4 ,if we believe that life exists for the development of mind into a force of intellect and character and soul1 then we need not ask why a nurse should know something of the laws of mind4 ,she does not ask why she should know anatomy or pathology4 ,her work is dependent upon such knowledge4 ,but if the center of life1 the thing which makes the body a living1 moving1 acting agent instead of a clod1 is mind2 if the one thing which makes a difference between animal life and mineral and vegetable life is consciousness1 i4 e41 mind2 and if everything that affects that body1 its organ1 affects mind also--then surely no nurse can afford to learn only the rules of repair or of keeping in order the instrument of consciousness1 without knowing what effect her efforts have on the mind itself4 ,it is as though an ignorant maid accepted a piano as merely a piece of furniture to be kept clean and shining1 and in her zeal to that end scrubbed the keyboard with soap and water which1 dripping down into the body of the instrument1 swells and damages its felts1 rusts and corrodes its keys1 and ruins its notes4 ,when she knows that she may thus make impossible the beautiful sounds she has heard it give1 and that the more carefully the keyboard is handled the more sure is the beauty resulting1 her care is to keep it as free as possible of dust1 to see that the top is down and the keyboard covered when she sweeps--and to clean it hereafter in such a way as to never injure its tone4 ,the nurse has a much greater function than merely to help in saving the body and keeping its machinery in order4 ,if the aim of life is the strengthening and perfecting of the mind--that urge of life1 then surely the nurse's big aim will be to help establish such health of body as leads toward health of mind4 ,in the average man or woman this vital urge becomes temporarily blocked by the very weakness of the body it urges4 ,the body must give the life-flame some fuel1 or it dies out2 but with very little fuel it flickers on1 waiting1 hoping for the more that it may burn strongly again4 ,in the cases the nurse handles very often the vital spark has been poorly fed by the disabled body1 and so discouragement or depression1 or loss of grip results1 or the flame continues to shine brightly with whatever little sustenance it receives1 and so encourages the body to greater effort for it2 or sinks into embers1 glowing steadily though dully2 or it burns wildly1 recklessly--it becomes what we call wild fire1 that has no direction and no purpose save to burn up everything it can find4 ,in other words1 the nurse deals with those in whom the urge is weakened--the depressed and discouraged2 with those whose spirits never flag in their steady shining--those brave souls we could almost worship2 and those others who hold grimly on with quiet grit and courage1 but with no cheer2 and with the unstable ones of neuropathic or psychopathic tendency who become hysteric or maniacal4 ,what will the nurse do for them all8 ,will not an understanding of how to recall the ambition to live1 the will to get well1 and the grit to see the thing through1 be an incalculable asset4 ,,the ,,nurse ,,of ,,the ,,future ,the nurse of the future will not be merely a handmaiden to care for the sick body by deftly carrying out the doctor's orders4 ,she will do this almost automatically as a matter of course1 and skilfully2 but it will be the merest beginning of her mission4 ,that mission itself will be to eliminate the causes of disease2 to teach the ways of health1 to supervise the sanitary conditions of city1 town1 and country4 ,practical ways and the wise means to this end will be taught in her hospital1 which will become a community center with clinics1 teaching through its doctors and nurses the way to health1 instead of merely treating and advising the cases as they come4 ,but the greatest contribution of the nurse of the future will be a wide-spread desire for health and will to health1 rather than a desire and will to avoid discomfort and pain and danger of death4 ,this will to health will doom in the sane mind the disease-accepting attitude4 ,it will do all that common sense and applied medical science can do to strengthen the body2 then it will take what life brings in the way of unavoidable disease and weakness and inability1 with an uncringing mind4 ,it will hold the mind's attitude to serenity and poise and accomplishment within the necessary limits of its disordered body4 ,it will be master of its dwelling and make the most of the little the body can give1 and force all bearable weakness and pain to be stepping-stones to endurance and will-strength and cheer4 ,it will not accept physical limitations as final things4 ,if life must be lived in a prison-house it will be its own jailer1 and fill the rooms with flowers1 music1 friends1 and happiness4 ,no nurse is competent to help her patient to overcome any curable physical weakness1 and keep the mind serene in the face of the incurable1 until she herself has learned that the will to health is capable of transforming disease of body1 from disaster1 into health of mind and soul4 ,the nurse of the future will know the laws of mind as she knows the course of disease2 she will be dedicated to such wise care of existing disease as will lead to prevention of future disease2 and she will be a sworn1 trained ally of the health-accepting mind4 ,,index ,absent-mindedness1 #fd ,absolutes1 #ed ,abstract concept1 #eb object concepts1 #ec quality concepts1 #ec ,accuracy of perception1 #ada ,action cannot be separated from feeling1 #fh ,acts1 compulsive1 #ajf ,adaptability1 #gi necessity of1 #hj ,amnesia1 #ajc ,anesthesia1 #aja ,aphasia1 #ajc ,apperception1 #ed ,association of ideas1 #adc ,attention1 #gi of interest1 #aab of reason and will1 #aah root of disease or health attitude1 #aab ,autosuggestion1 #hd ,awareness1 #ae ,bad habits1 #ia ,beginning of reason1 #fi ,body and mind1 relation of1 #dj ,borderland disorders1 #ajg ,brain1 #cc hind1 #dc ,censor1 #ca ,central and peripheral nervous systems in action1 #ce ,cerebellum1 #dc ,cerebrum1 #dc functions of1 #de ,clear thinking1 steps to1 #adj ,compulsive acts1 #ajf ideas1 #ajc ,concentration1 #adf ,concepts1 #eb abstract1 #eb object1 #ec quality1 #ec concrete1 #eb ,concrete concepts1 #eb ,consciousness1 #ae1 #bj1 #ba definition1 #ae flow of1 #dg in delirium1 #cb in sleep1 #ca is complex1 #bi organs of1 #cd personal1 #eg ,delirium1 consciousness in1 #cb ,deluded patient1 #acc nursing of1 #ace ,delusion1 #ajd nihilistic1 #ajd of reference1 #ajd somatic1 #ajd ,determination1 #ah ,development of reason and will1 #ga ,disease attitude1 attention1 root of1 #aab ,disorders1 #ie borderland1 #ajg of emotion1 #ii of functions of intellect1 #if of ideation1 #ig of judgment1 #ii of memory1 #ih of perception1 #if of reason1 #ih of sensation1 #if of will1 #ii ,disorientation1 #ajc ,distractibility1 #aje ,effort1 habit a conserver of1 #ij ,emotion1 #ah1 #de1 #di disorders of1 #ii the place of1 #fg ,emotional equilibrium1 #aeb reaction1 normal1 #gg ,environment as cause of variation from normal mental processes1 #aji ,equilibrium1 emotional1 #aeb ,false associations1 mind a prey to1 #acg ,feeling1 #di cannot be separated from action1 #fh from thinking1 #fg from will1 #fh ,fixed idea1 #ajc ,flight of ideas1 #ajb ,forebrain1 #dc ,future1 the nurse of the1 #afd ,getting other man's point of view1 #abf patient's point of view1 #abd ,habit a conserver of effort1 #ij bad1 #ia hospital1 #ib ,habit-formation1 #gi ,hallucination1 #aja ,health and psychology1 #gi attitude1 attention1 root of1 #aab ,heredity as course of variation from normal mental processes1 #ajh ,hind brain1 #dc ,hospital habit1 #ib ,how to study1 #adf ,hurt1 #gj ,hyperesthesia1 #aja ,hypersuggestability1 #hd ,hypochondriasis1 #ajb1 #ajh ,hysteria1 #ajg ,idea1 compulsive1 #ajc fixed1 #ajc ,ideas1 association of1 #adc flight of1 #ajb ,ideation1 #eb disorders of1 #ig ,ideogenous pains1 #ajc ,illusion1 #aja ,imagination1 #eh ,impulses1 insane1 #ajh ,inhibition1 morbid1 #ajd ,inorganic memory1 #eb ,insane impulses1 #ajh ,insanity1 #ajg ,instinct1 #ei ,instincts1 list of1 #fa ,intellect1 #ah1 #de functions of1 disorders of1 #if ,interest1 attention of1 #aab ,judgment1 #ef1 #gb disorders of1 #ii ,life1 mental1 #ad conditions of1 #ai phenomena of1 #ae ,mania1 #ajg ,melancholia1 #ajg ,memory1 #ea1 #fb disorders of1 #ih inorganic1 #eb organic1 #ea self-training in1 #aej ,mental disability1 states of1 #ajj life1 #ad conditions of1 #ai phenomena of1 #ae processes1 normal1 variations from1 #ie1 #aja factors causing1 #ajh ,mind1 #ad1 #cc a prey to false associations1 #acg and body1 relation of1 #dj functions of1 #ej normal1 #dg1 #gg ,mood1 #di ,morbid inhibition1 #ajd ,motion1 #bf ,movement1 #bf ,mutism1 #ajf ,necessity of adaptability1 #hj ,negativism1 #ajf ,nervous systems1 central and peripheral1 in action1 #ce sympathetic1 #cg ,nervousness1 #ajf ,neurasthenia1 #ajh ,neuropath1 #ajh ,neurosis1 #ajf from psychosis1 #hb ,neurotic1 #ajh ,nihilistic delusion1 #ajd ,normal emotional reactions1 #gg ,normal mental processes1 variations from1 #ie1 #aja factors causing1 #ajh mind1 #dg1 #gg ,nurse of the future1 #afd psychology of1 #aci ,nursing deluded patient1 #ace ,obsessed patient1 #acf ,obsession1 #aje ,one thought replaced by another1 #hi ,organic memory1 #ea ,organs of consciousness1 #cd ,overactivity1 psychomotor1 #ajf ,pain1 #fi ideogenous1 #ajc ,patient1 deluded1 #acc nursing of1 #ace obsessed1 #acf ,patient's point of view1 getting1 #abd what determines it1 #abd ,percept1 #ea1 #eb ,perception1 #ea accuracy of1 #ada disorders of1 #if training of1 #adb ,peripheral and central nervous systems in action1 #ce ,personal consciousness1 #eg reactions as cause of variation from normal mental processes1 #aaj ,personality1 psychopathic1 #ajh shut-in1 #ajd ,perversions1 #ie1 #aja ,phenomena of mental life1 #ae ,phobia1 #ajh ,place of emotion1 #fg ,pleasure1 #fi ,point of view1 getting other man's1 #abf patient's1 getting1 #abd what determines it1 #abd ,poor memory1 #fd ,power of suggestion1 #hd ,premise1 #gb ,protozooen1 consciousness in1 #ae ,psychasthenia1 #ajh ,psychology and health1 #gi definition1 #ab of the nurse1 #aci ,psychomotor overactivity1 #ajf retardation1 #ajf ,psychoneurosis1 #ajf ,psychopathic personality1 #ajh ,psychosis1 #ajg neurosis from1 #hb ,pugnacious instinct1 #fj ,reactions1 normal emotional1 #gg proportioned to stimuli1 #ge ,reason1 #ef and will1 attention of1 #aah development of1 #ga beginning of1 #fi disorders of1 #ih ,reference1 delusion of1 #ajd ,relation of mind and body1 #dj ,retardation1 psychomotor1 #ajf ,saving power of will1 #ic ,science1 #ac ,second-nature1 #ij ,self-correction1 #afj ,self-training in memory1 #aej ,sensation1 #ea disorders of1 #if ,sense of unreality1 #ajd ,shut-in personality1 #ajd ,sleep1 consciousness in1 #ca ,somatic delusion1 #ajd ,steps to clear thinking1 #adj ,stimuli1 reaction proportioned to1 #ge ,stimulus1 definition1 #bb ,stream of thought1 #ej1 #eg ,study1 how to1 #adf ,suggestibility1 #gi ,suggestion1 power of1 #hd ,sympathetic nervous system1 #cg ,the unconscious1 #bc ,thinking1 #di1 #eh cannot be separated from feeling1 #fg clear1 steps to1 #adj ,thought1 stream of1 #ej1 #eg ,thought-substitution1 #gi ,tic1 #aje ,training perception1 #adb the will1 #afa ,unconscious1 the1 #bc ,universals1 #ec ,unreality1 sense of1 #ajd ,variations from normal mental processes1 #ie1 #aja factors causing1 #ajh ,volition1 #de1 #ej ,what determines patient's point of view1 #abd we attend to determines what we are1 #hf ,will1 #ej1 #gi and reason1 attention of1 #aah development of1 #ga cannot be separated from feeling1 #fh disorders of1 #ajj saving power of1 #ic training of1 #afa ,a ,short ,history of ,nursing ,from the ,earliest ,times to the ,present ,day ,by ,lavinia ,l4 ,dock1 ,r4,n4 ,secretary1 ,international ,council of ,nurses ,in ,collaboration with ,isabel ,maitland ,stewart1 ,a4,m41 ,r4,n4 ,assistant ,professor1 ,department of ,nursing and ,health1 ,teachers ,college1 ,columbia ,university1 ,new ,york #abo4 ,price1 #c4jj ,this ,new ,volume ,has ,been ,prepared ,especially for the ,use of ,student ,nurses ,it is1 in effect1 a condensation of the four volumes of the larger ,history of ,nursing1 prepared by ,miss ,dock in collaboration with ,miss ,nutting1 a work which has been considered standard on the subject1 but which1 by its very nature1 was too elaborate for class use4 ,this condition has now been overcome by condensation into this single1 comprehensive1 inexpensive volume of all the salient facts of the larger work4 ,it is generally believed that the best place in the nursing curriculum for the ,history of ,nursing is in the early part of the first year1 when the student is just beginning to form her conception of nursing1 and is being initiated into its traditions4 ,the ,many ,excellent ,features of this ,short ,history of ,nursing will inevitably bring it into use in a very great number of ,hospital ,training ,schools2 it should1 of course1 be in the library of every ,hospital which does not maintain a ,training ,school4 ,it is believed that it will be found to be ,the ,best ,volume on ,this ,important ,subject 7,over7 ,some of the ,putnam ,nursing ,books ,maxwell and ,pope's ,practical ,nursing ,price #b4ej4 ,cadmus' ,manual of ,obstetrical ,nursing ,approximate price #a4ej4 ,dock's ,materia ,medica for ,nurses ,price #b4be4 ,higgins' ,psychology of ,nursing ,price #b4ej4 ,pope's ,manual of ,nursing ,procedure ,price #b4dj4 ,pope's ,essentials of ,anatomy and ,physiology for ,nurses #fjj pages4 ,price #b4ij4 ,pope's ,quiz ,book for ,nurses #dhe pages4 ,price #b4ej4 ,dock and ,nutting's ,history of ,nursing ,in four volumes4 ,illustrated volumes #a and #b1 price #g4ej4 ,volumes #c and #d1 price #g4ej4 ,dock and ,stewart's ,short ,history of ,nursing ,one volume1 #djj pages4 ,price #c4jj4 ,pope's ,physics and ,chemistry for ,nurses #dej pages4 ,price #b4ej4 ,arthur ,w4 ,isca ,medical and ,nurse ,books ,besse ,building ,minneapolis1 ,minnesota 99 99 99 99 99 ,transcriber's ,note3 ,here is a list of corrected errors4 ,line numbers count from the start of the book itself not including the ,transcriber's ,note4 ,alternatively1 use the ,,html version1 in which the errors are marked4 l#ghj3 ecstacy changed to ecstasy l#abeh3 ,missing full-stop in i4 e4 l#affe3 or changed to of l#agff3 pasttime changed to pastime l#ahfg3 strees changed to stress l#ahhc3 council changed to counsel l#aiid3 1 changed to 4 l#bcbd3 em-dash changed to hyphen l#behh3 hypochondrasis changed to hypochondriasis l#bhag3 successfuly changed to successfully l#cccd3 stubborness changed to stubbornness l#dabj3 in changed to is l#daih3 weakenss changed to weakness ,the inconsistent hyphenation of hypo-mania is as in the original4