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,