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JAMA 100 Years Ago
September 11, 2002


Author Affiliations

JenniferReiling, Assistant Editor

JAMA. 2002;288(10):1298. doi:10.1001/jama.288.10.1298-JJY20027-2-1

The address in medicine was delivered by DR. HUGH T. PATRICK, Chicago, who stated that the initiative of all therapeutics should be prophylaxis. To be able to present a specific illustration of the force of inheritance in the genesis of functional nervous affection, he had tabulated from his office records 100 consecutive cases which might be included under the general term nervousness, and he found that in 70 per cent. of them a neurotic heredity had been in evidence. While a bad heredity was the most frequent and most potent factor in the production of nervousness, knowledge of this fact should not lead the profession into apathetic resignation, but rather make it face the difficulty with wise determination. Next to inheritance came the never-ceasing formative power of environment. Reaction to extraneous influences began at birth, and ceased only with the extinction of life, but childhood and youth were the plastic stages. For preventing nervousness in the child or removing that already present, Patrick thought that there was nothing so effective as the toughening of the body and mind. A child who was made to have tough muscles, strong lungs and a vigorous digestion; who could stand changes of temperature and endure pain, was already a long way from nervousness. More important still was toughness of psychic fiber. The child who could support disappointment, who could be crossed without a tantrum, and who habitually obeyed, was building a bulwark against nerves, and the one who was not easily frightened, had self-control and a budding courage had nipped half a dozen neuroses in the bud. But to procure this toughness a certain exposure to bodily discomfort and mental hardship was necessary.

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