296 PSYCHOTHERAPY : SCIENTIFIC AND RELIGIOUS chap.
repeating. This asthmatic, who was on a holiday journey, was awakened in his hotel by a violent paroxysm of his disease. ' Greatly distressed for breath, he got out of bed and hunted for the matches. He had a craving for fresh air but could not find the window. " Confound these third-rate hotels where one gropes vainly in the dark ! " He is suffocating and he clamours for air. Feeling about, he at length finds a pane of glass. " Damn it all, where's the window bolt ? . . . Never mind, this will do ! " and he breaks the pane. The fragments fall to the floor. Now he can breathe ; again and again he fills his chest with the fresh air ; the throbbing at his temples passes, and he goes back to bed. " Saved ! " . . . Next morning, one of the items in his hotel bill was " Broken clock-case,
fr. 4-35 " ' H (p. 92).
O' Donovan states that he ' has no doubt that in some cases the patient's mind operates through the endocrine system, and in others through the vasomotor system. More, often the writer thinks, a patient's complaint is maintained by a disordered function of the receptive parts of the brain, rather than by a disorder of the sensory motor endings. Minds, sensibility and emotional tones vary; but he hopes to show that dermatological practice must be extremely difficult if the various factors that play upon the patient's mind be disregarded. . . . The skin is a complex vital organ, not a hide ; and such psychological factors as permeate the practice of general medicine must have their full recognition in cutaneous medicine ' l6s (pp. 7-8).
That there is often nervousness among rheumatic children is a common clinical observation, as also that a psychological situation may precipitate an attack of chorea (St. Vitus's dance). Still217 holds the view that chorea is particularly apt to develop in nervous children.