a patient to have pluck, and a sufficient supply of doggedness to be capable of making a continued effort; to make up his mind in his saner moments not to yield to the sinking feelings that will come over him, to fight against his illness as against an attacking enemy, to feel that he is determined to pull through, if only to please his friends, to spite his rivals, to foil his foes, or to accomplish some non-completed task. I remember to have had somewhat similar ideas in my own maladies, and I feel sure they were of much assistance to my recovery.
Such impulses as these from the organs of thought and will must of necessity have a distinct effect upon the rest of the nervous system, and thus over the heart and other organs, if only through the emotions, and that a beneficial and stimulating effect; these impulses may therefore make all the difference in tiding over a crisis, and during early convalescence. But of course the influence of the mental state upon disease is unquestioned. The absence in these races of this important factor, and the presence of the stagnating fatalism above mentioned, are, I feel sure, the causes of many a death.
One of my first cases, and it taught me a great lesson, was that of a stalwart East African who complained of feeling ill; on examination nothing could be found amiss but slight febrile symptoms and a small patch of pleuritic friction. To my surprise, the poor negro began by saying he was going to die; he went to his bunk, and next day I found him much the same, except that the heart's action was rather enfeebled, though no physical signs of cardiac disease could be detected. He was, however, utterly uninterested in his condition, and only took food under compulsion. In the evening he suddenly expired, more as it seemed for I was unfortunately unable to make a post-mortem investigation—from what I might call inertia than from his actual disease. Later experience told me that had I bullied the man, and given him brandy with my own hand, and stirred him out of his apathy, I might have saved his life. But it was often noticed among us that if, on becoming ill, these men predict that they are sick unto death, they will, if left to themselves, simply go and lie down and quietly die, refusing all assistance.
Confirmation of this view is found in the following words of Hume Nisbet, when speaking of similar races:
When hope ceases to glow in their breasts, or a superstitious omen tells them that they are to die—it may be the word of the magician, or the bone pointed at them, as among the Queenslanders, or the lizard running over them, as with the Maori, or the utter weariness of life taking possession, as with the Sidi-boys—they can lie down and give up life as easily and methodically as they fall asleep.
