Volitional therapeutics and diversion of the attention have already given us an opportunity of mentioning treatment by occupation. Although we occasionally find mention made of it earlier, it is only in quite recent times that it has come to be seriously recognized as an accessory therapeutic agent that should be used methodically. Occupation not merely provides the patient with a temporary diversion from his troubles, but very frequently proves a true, indeed, the only remedy. Health in the case of most people presupposes well-regulated and active habits. Even in cases of incurable disease it is often of the greatest importance, since it provides the quickest means of suppressing the feeling of being ill. It is of far greater benefit to a sufferer from locomotor ataxy to keep him suitably employed than to leave him to his fate. " Even in cases of real sickness we must carefully distinguish between the illness and the feeling of being ill. For the most part the latter greatly exceeds the former" (C. W. Hufeland). It is just the very feeling of being ill that is soonest lessened by regular work.

Of course, we must individualize as much as possible in choosing the occupation. Many kinds of work are precluded by the nature of the disease. But apart from this, the capabilities, interests, degree of education, social position, pecuniary circumstances, age, sex, nationality of the patient, besides the tendencies of the times and many other matters, may any one of them determine what particular occupation is to be recommended. In that satirical but very instructive book entitled Stolpertus, the Young Doctor at the Bedside, that appeared more than a hundred years ago, the author expresses the opinion that many a fine lady would be better off with a besom in her hand than a fan. However right this may be, and however justified we may be in not laying too great a stress on the patient's social position when choosing him an occupation, each of the factors mentioned above has to be taken into earnest consideration. We cannot employ an educated person merely with cleaning rooms, and on the other hand we should hardly recommend to a simple, uneducated woman the study of the history of Italian art as an occupation. A doctor must also avoid basing the advice he gives on his own personal tastes.

Because he is himself an enthusiastic Wagnerite, he must not therefore recommend a patient who has no ear for music to attend Wagner's operas or sit out symphony concerts. Even though an interest in works of art is often only aroused by being brought into contact with them, the question of natural disposition yet plays an important part in the selection of the work. The colour-blind can never see things as the normal do, and there is an analogous distinction between persons of different mental constitution. A doctor should also never allow himself to be influenced by the patient's relatives; and he should therefore pay no attention to those mothers and husbands who still believe they have a right to deprive young girls and married women of every book dealing with the woman-question or similar problems. Times have changed, and any one who wishes to be convinced of this fact need only listen to the conversation that goes on between young men and young women nowadays. At all events, we have no business to withhold such books from women of a properly earnest disposition or to deny them a suitable sphere of activity.

In certain cases the doctor will lay the chief value on the mental, in others on the bodily activity caused by the occupation. It is often necessary to prescribe visits to the theatre, concerts, museums, a particular course of reading, to the importance of which B. Laquer, Loewenfeld, Oppenheim and others have drawn attention. The further education of adults has also to be attended to by giving instruction either in languages or in other subjects. It sometimes has a very good effect if the doctor superintends the patient's work; recommends him, for instance, to read some book and then makes him repeat what he has read, or else gives him a written exercise - a translation, for example - and himself supervises the performance of the task. About the only thing a doctor had to do formerly was to write prescriptions, but his duties nowadays are very diversified.

B. Laquer has attempted to classify the books that should prove useful to patients according to Dunin's three chief types of the molimina presented by the sick. He has consequently made the selection of a book depend upon whether diversion, soothing, or encouragement is indicated. But I hardly think that a patient's reading can be arranged in this way according to types of disease. This method of differentiation will not, as a rule, hold good in practice, the other aforesaid factors playing too great a part Similarly, it is very often futile to attempt to improve the frame of mind of a patient suffering from very low spirits by giving him humorous or farcical books to read. And I think the old rule that a malade imaginaire should never be allowed to obtain possession of a book of the kind called humorous still holds good in many cases of hypochondriasis.

Although we may consider the reading of suitable books a remedial measure, we must remember, on the other hand, that unsuitable books are injurious. Every practitioner knows the amount of misery that popular works on the "terrible" consequences of masturbation have caused. The discussion of mental diseases plays an important part in modern literature, and Ibsen's works in particular must be considered inimical to the public good. Of course we must admit that forbidden fruit tastes sweetest, and it is therefore often better to give direct advice as to what should be read - i.e., the patient should not be forbidden to read dangerous books, but rather recommended useful ones. It is often prohibition that first leads a patient astray.

Moreover, the dangers connected with the nature of the book read were pointed out many years ago. In 1839 there appeared a work by Bird, entitled Mesmerism and Belies Lettres, in which the author made a special attack on Justinus Kerner for trenching on the domain of psychiatrics in a poem and a novel. Kerner's productions were compared with Shakespeare's; and Bird made out that Kerner, in contradistinction to Shakespeare, had done harm because his descriptions were wrong.