Surely my act of kindness should not become an
obligation for the future, nor should the fact that I
conferred a benefit of my own free will constitute a
reason that I should be ordered to do it against my
will; neither should it become customary that once a
"man has cured anybody, he must for ever treat all
those whom his former patient wishes him to treat.
Under those conditions we should have elected our

 

patients to be our masters, paying them, too, by
playing slave to them and executing all their orders.
What could be more inequitable than this? Because
I restored you to health in this way when you had
fallen severely ill, do you think that you are therefore
empowered to abuse my skill?
 
That is what I might have said if what he enjoined
upon me were possible, and I were refusing to obey
him in absolutely everything, and under compulsion.
But as things are, consider now what his commands
are like. “Since you have cured me,” says he,
“from insanity, since my wife too is insane and has
the same symptoms” (for so he thinks), “and has
been given up by others in the same way, and since
you can do everything, as you have shown, cure her
too and free her forthwith from the disorder.”” That,
to hear it so simply put, might seem very reasonable,
particularly to a layman, inexperienced in matters
of medicine. But if you will listen to my plea on
behalf of my profession, you will discover that all
things are not possible to us, that the natures of
ailments are not alike, that the cure is not the same
or the same medicines effective in all cases; and
then it will be clear that there is a great difference
between not wishing to do a thing and not being
able. Suffer me to indulge in scientific discourse
about these matters, and do not consider my discussion of them tactless, beside the point, or alien
and unseasonable.
 
In the first place, the natures and temperaments of
human bodies are not the same, although they are


 

admittedly composed of the same elements, but
some contain more, or perhaps less, of this, others
of that. And I say further that even the bodies of
males are not all equal or alike either in temperament or in constitution. So it is inevitable that the
diseases which arise in them should be different both
in intensity and in kind, and that some bodies should
be easy to cure and amenable to treatment, while
others are completely hopeless, being easily affected
and quickly overcome. Therefore, to think that all
fevers or consumptions or inflammations of the lungs
or madnesses, if of one and the same kind, are alike
in all bodies is not what one expects of sound-minded,
sensible men who have investigated such matters.
No, the same ailment is easy to cure in this person
but not in that. Just so, I take it, with wheat;
if you cast the same seed into different plots of ground,
it will grow in one way in the ground that is level,
deep-soiled, well watered, blessed with sunshine
and breezes, and thoroughly tilled, yielding a full,
rich, abundant harvest, no doubt, but otherwise in a
stony farm on a mountain, or in ground with little
sun, or in the foothills; to put it generally, in
different ways according to the various soils. So too
diseases become prolific and luxuriant or less so
through the soils which receive them. Omitting
this point and leaving it entirely uninvestigated, my
father expects all attacks of insanity in all bodies to
be alike and their treatment the same.
 
In addition to these important distinctions, it is
easy to grasp the fact that the bodies of women differ
very widely from those of men, both in respect to


 

the dissimilarity of their diseases and in respect to
one’s hopefulness or despair of a cure. For the
bodies of men are well-knit and sinewy, since they
have been trained by toils and exercises, and by an
open-air life; but those of women are weak and
soft from being reared indoors, and white for lack of
blood, deficiency of heat, and an excessive supply
of the moist humour. They are therefore more
susceptible than those of men, prone to diseases,
intolerant of medical treatment, and above all, more
liable to attacks of insanity ; for since women have
much bad temper, frivolity, and instability, but little
physical strength, they easily fall into this affection.
 
It is not right, then, to ask of the physicians the
same treatment for both, when we know that there
is a great gulf between them, dissociated as they have
been from the very first in their entire mode of life,
and in all their activities and all their pursuits. So
when you say “It is a case of insanity,” add, “insanity in a woman,” and do not confuse all these
variations by subsuming them under the title of
insanity, which seems always one and the same
thing, but distinguish them, as is right, in their
nature and see what can be done in each case. That
is what we do, for, as I remember telling you in the
beginning of my speech, the first thing that we consider is the constitution and temperament of the
patient’s body, what quality predominates in it,
whether it is inclined to be hot or cold, whether it is


 

vigorous or senile, tall or short, fat or lean, and
everything of that sort. In short, if a man examines
into these matters to begin with, he will be very
trustworthy when he expresses any doubt or makes
any promise.