Whether we shall ask a patient to walk or to take rest is a question which turns up for answer almost every day in practice.  Most often we incline to insist on exercise, and are led to do so from a belief that many people walk too little, and that to move about a good deal every day is well for everybody.  I think we are as often wrong as right.  A good brisk daily walk is for well folks a tonic, breaks down old tissues, and creates a wholesome demand for food.  The same is true for some sick people.  The habit of horse-exercise or a long walk every day is needed to cure or to aid in the cure of disordered stomach and costive bowels, but if all exertion gives rise only to increase of trouble, to extreme sense of fatigue, to nausea, to headache, what shall we do?  And suppose that tonics do not help to make exertion easy, and that the great tonic of change of air fails us, shall we still persist?  And here lies the trouble:  there are women who mimic fatigue, who indulge themselves in rest on the least pretence, who have no symptoms so truly honest that we need care to regard them.  These are they who spoil their own nervous systems as they spoil their children, when they have them, by yielding to the least desire and teaching them to dwell on little pains.  For such people there is no help but to insist on self-control and on daily use of the limbs.  They must be told to exert themselves, and made to do so if that can be.  If they are young, this is easy enough.  If they have grown to middle life, and created habits of self-indulgence, the struggle is often useless.  But few, however, among these women are free from some defect of blood or tissue, either original or acquired as a result of years of indolence and attention to aches and ailments which should never have had given to them more than a passing thought, and which certainly should not have been made an excuse for the sofa or the bed.

Sometimes the question is easy to settle.  If you find a woman who is in good condition as to color and flesh, and who is always able to do what it pleases her to do, and who is tired by what does not please her, that is a woman to order out of bed and to control with a firm and steady will.  That is a woman who is to be made to walk, with no regard to her complaints, and to be made to persist until exertion ceases to give rise to the mimicry of fatigue.  In such cases the man who can insure belief in his opinions and obedience to his decrees secures very often most brilliant and sometimes easy success; and it is in such cases that women who are in all other ways capable doctors fail, because they do not obtain the needed control over those of their own sex.  I have been struck with this a number of times, but I have also seen that to be too long and too habitually in the hands of one physician, even the wisest, is for some cases of hysteria the main difficulty in the way of a cure,—­it is so easy to disobey the familiar friendly attendant, so hard to do this where the physician