Treatment by occupation is also of great economical importance to many patients, as it enables them to be trained once more for professional work. To practice a profession has a very salutary effect on a human being's health. Unfortunately, medicine has usually underrated the importance of this question of following a profession, and even when this has not been the case the matter has been judged on false premises. Physically weak people with a tendency to tuberculosis have before now been recommended to betake themselves to gardening or agriculture, regardless of the fact that these occupations make such severe calls on a person's physical strength as to nullify the advantages derived from working in the open air. Nevertheless, it must be admitted that the advisability of being engaged in some calling has for some time past obtained at least casual recognition from the standpoint of somato-therapeutics, whereas the psycho-therapeutic importance of occupation has been almost totally ignored. Forel has pointed out that numbers of people pine away because they are not allowed to choose a calling suited to their talents and inclinations. I have frequently noticed the quarrels that have arisen in this way. A doctor must always endeavour to overcome the prejudices of parents and relatives.

This is often observable in the case of daughters. Many young girls desire serious occupation, but their parents, who were brought up with old-fashioned ideas and who are disinclined to adapt themselves to the ideas of the day, refuse their consent for fear of damaging the reputation and social position of the family. The result is that a girl who is thus thwarted in her desire to engage in an occupation congenial to her mental disposition falls ill, becoming more especially hysterical and nervous, or when either of these two morbid states already exists their cure is impeded. In nearly every case the healthiest course is that of allowing a woman to occupy herself in whatever manner best imparts fulness to her life. This, of course, is not intended to run counter to the view that a happy marriage generally fulfils the object of a woman's life. But when financial, social, or other reasons prevent such a marriage taking place, or even when a married woman fails to find that marriage entirely fills her life, we have to think of some form of activity to make good the deficiency.

Naturally, these considerations in the choice of a calling do not only apply to the female sex but to the male as well, though prejudice plays a greater part in coming to a decision in the former case. Of course when a doctor has to take part in such a dispute he must make a most careful study of the individuality of the person in question. Forel, who warmly recommends professional occupation as a therapeutic measure, utters a word of warning against considering every one an unappreciated genius whose parents do not at once let him have his own way. Psychopathic persons, and especially the weak-minded and the very hysterical, are just the people who so very frequently misjudge and overrate their powers. Such people always want to imitate any person who has made a public success. One wants to be a singer, a girl to become an actress, and a third, who has perhaps been a passable business man, suddenly thinks he has a call to reform electro-technics or the policy of the country. The psycho-therapeutist must carefully distinguish between the moods of such insignificant persons and tendencies that have to be taken seriously. Individuals of the former type only look to results; they object to devoting years of arduous study to attain the end.

It is different with people who are really in earnest. It is not so much the desire to pose as leaders of thought that actuates them, but rather the instinctive impulse to engage in some occupation for which they feel themselves to be naturally fitted. It often falls to the lot of a doctor to smooth their way and overcome any opposition their relatives may offer. Of course, he will not invariably be in a position to decide which of the two cases he is dealing with in any particular instance. Knowledge of human nature, earnest study of the individual in question, consultation with other specialists, and often a lucky shot, will lead to a correct decision, the importance of which can hardly be overrated.

We have seen that in many cases the patient himself asks for some professional occupation, and the doctor's assistance is then only necessary to overcome the opposition of his family and thereby render the way smooth. But in other cases the very thing the doctor has to do is to combat the patient's opposition to work by explaining to him that he can only maintain or regain his health by taking on some serious occupation. These considerations also apply to elderly persons whose tendency to hypochrondia and brooding can often only be overcome by their being engaged in some form of regular work. The impulse to work which this brings rejuvenates them and has a salutary effect on their disposition and health. Even the occasional cares and excitement attached to business are often far less injurious to the nervous system than doing nothing and the absence of any impulse to work. I must here refer to what I said concerning traumatic neuroses on page 349, where I pointed out that the certain prospect of a permanent income and the absence of any compulsion from without have proved injurious to many people.

Of other psycho-therapeutic measures I may mention treatment in an institute, to which reference has already been occasionally made. Hospital treatment was recommended for many affections long ago, but its field of activity has been greatly widened in recent times. It is often advisable that a patient should be admitted into an institute because many therapeutic measures can only be properly carried out there - a complicated hydro-therapeutic treatment, diet cures, operations, etc. Treatment in an institution is also often necessary on psycho-therapeutic grounds. The patient has to be removed from his former surroundings and relieved of his business and domestic cares. He requires relief from the injurious influence of over-anxious friends, and from everything tending to counteract the doctor's advice or upset his plans; or it may even be that it is advisable to place the patient under the doctor's continuous influence. Anything of this sort can rarely be accomplished at home, though it may-very well be in a good institute. There are many other influences to be considered in this connection, and Wiedeburg has called attention to them in a pamphlet Sometimes a patient is benefited when he hears that he is to visit an establishment of which he has heard good accounts.