"Therapeutics of Music"

Kai Tiaki : the journal of the nurses of New Zealand, Volume XV, Issue 4, 1 October 1922, Page 185

" Therapeutics of Music"

During the last fifty years the advances made m the art of healing have been many and various. Even within the recollections of most of us wonderful things have been done. What would our grandfathers have thought, for instance, of the electrocardiograph, and instrument by which each half of the heart can be observed separately, of a Bismuth meal, and all the wonders of diagnosis made possible by the discovery of X Kays ; of the deadly precision of the Bacteriological Laboratory, which is supposed to be like a photographic camera, " unable to lie." Is seems a long cry back to the old days of blood-letting, the seton, and the old wooden stethescope. Yes, what wonders our grandfathers worked, and what giants there were m the medical and surgical world m those days not so very long ago. One must bear this m mind, that they had none of the expert assistance that we can get now m the diagnosis and treatment of their cases. The art of diagnosis, as I learnt it is dying out. When I was a student we were taught on the Sherlock Holmes principle of intense observation, and had to depend largely on our own powers of observance and our own senses of hearing, seeing, feeling, and even smelling, for making a correct diagnosis. What happens now ? A patient comes m with some cardiac condition, let us say, surely a case of palpation and the stethescope ; not a bit of it. One gets him X Rayed instead of percussing out his cardiac dulness, and an electrocardiogram is taken to see if the fraction of a second between the auricular and the venticular beat is normal, and as a kind of after- thought someone suggests listening to his heart and feeling if the apex beat is displaced. Or again an abdominal tumour comes m for treatment, how differently is it set about. Remember that 30 or even 25 years ago opening the abdomen was a very different thing to now- a- days, and it was only after much examining by the staff of the Hospital, and on the opinion of the majority of them that the surgeon whose case it was, dared to open the abdomen. Look at appendicitis — a new disease —m my early days it was called perityprititis, and treated by fomentations and opium. So that you see great strides have

been made m the treatment of disease, for the most part entirely to the benefit of the patient ; but I cannot help feeling that what the patient gains the student loses, and the doctor newly qualified now is not so adept and observant as the one of 20 years ago. Fortunately with the improvement of transport, etc., no doctor need be far away from the Laboratories, and so it really does not matter so much, but it does matter a little. Take one case — you are called to a suspicious sore throat. In the old days, with nothing but your experience to help you, you began immediately to treat the patient for diphtheria. If it were not no harm was done ; how many doctors are inclined to wait till they get a report of the swab, and so may lose valuable time and perhaps even the patient's life. But this is a digression, what I intended to do was just to remind you of the wonderful things that have been done lately m medicine and surgery.

To take medicine alone. The physician has various means of treatment at his disposal : drugs, external application, vaccines, psycho- therapy, baths, dieting of various kinds, etc . , etc . , Some of these have advanced — some are very much where they were, and some have gone backwards. With regards to drugs — internal medicants — you will find that on the whole doctors prescribe less medicines for their patients than they used to. 1 am not considering the surgeons ; with the exception of castor oil they profess a profound ignorance of and contempt for drugs as a whole. It most be admitted that they have a little to say on their side. So many of the so-called specifics are of no scientific value and only, go to swell the profits of the wholesale druggists. No ; the old British Phamacopoeia is just about the same as it has been for the last fifty years. The art of healing has progressed on other lines than drugs. The war was responsible for a lot of new methods and chief among them, from the medical point of view is the " mind medicine " — suggestion, psycho-analysis, and the like. There is ho doubt that many wonderful, almost miraculous cures, have been brought about by some of these methods and my idea m choosing as a subject of these remarks ;

" The Therapeutics of Music," was that I think music has been neglected as an aid to healing, and of course it is just that class of case which would be influenced by suggestion that would benefit by a course of music. No one imagines that a broken leg or a cancer could be cured by hearing a hornpipe m one case, or a funeral march m the other ; but I am firmly convinced that if a musical person was dying of cancer, his end could be made easier by some kind of music given at regular intervals and m suitable doses.

Let us now look at the history of music, that is music as we understand it. Music by the great composers Bach , Handel , Chopin, Beethoven, etc. A great musician said once that there was no music before Handel and Bach, that is about 200 to 250 ago, and that before that time music was crude and incomplete. In the earlier days before Handel and Bach, music was chiefly m the hands of the Church, which is readily explained by the fact that churchmen were then almost the only people of education and culture. It is thus that St. Ambrose and St. Gregory have come to be named and honoured m musical history. Ambrose was Archbishop of Milan, from 374 to 379, and he took a keen interest m church music. Two hundred years later a reformer arose m the person of Pope Gregory. Most people have heard of Gregorian chants — a mediaeval way of chanting the Psalms used m high churches. The taste for Gregorian chants, like the taste for olives, has to be cultivated. Many share the feelings of the American, who, when he was told that David himself sang his Psalms to Gregorians, said he understood for the first time why Saul threw his javelin at him. As you all know m those early days religion and healing were closely associated. The Monks were the physicians of those times, and there is no doubt that their music had a very large place m the mental effect their other medicaments and simples had on their simple patients. Despite the cynical American, there is no doubt that David, playing on the harp, had a soothing effect on Saul's evil spirit, and if such a crude instrument as a harp of those days could cure a temporary fit of mania, there is no knowing what a Chopin's nocturne could do if applied m the proper manner, and rendered even by a good gramophone. The Saul

case is the only one I know of m the Bible, where music was used as a healing power ; the flute, harp, sackbut, psaltery, dulcimer, and all kinds of music were used apparently for other purposes, but were not these other purposes for the people's good, for we have already seen that it is only on the mental or nervous side that music can be of much therapeutic value. The mere fact of the ancient Biblical people hearing the music performed by those — to us— quaint instruments, no doubt had a great effect on them, though perhaps the good effect did not seem apparent as intimated by the fact that they put people into the burning fiery furnace when the music played. Instruments. — Let us now consider some individual instruments and what sentiments and emotional value we can put on some of them. The Piano is the commonest, and the- one most readily available for ordinary purposes. Yet I fear unless we get some player of more than ordinary ability, the performances of the average player have not much value as a therapeutic agent, except as a counter-irritant. Of course, if one could order a daily dose of a man like the Russian who was here lately, it would be a different thing. Good mechanical playing is by no means to be despised. Anyone who has seen much of sick " Tommies " during the war, knows what the gramophone meant to them. To simple men m quantity, soldiers and sailors, and the like, music has always had a great attraction, and I'm sure has affected them for good. Perhaps you can hardly imagine a concertina sounding nice ; but I have been at sea, becalmed m the tropics, a lovely moonlight night, and not a sound but an occasional splash or a ripple against the ship's side, and as one sat on the poop, moaning from away for'ard would come the strains of a wheezy old concertina, played by one of the crew. " Home Sweet Home," or " Silver Threads Among the Gold," some very ordinary tune, played m a very ordinary way, on a very ordinary instrument. Yet what thought's and memories it brought back to one, even sentimental, all to one's betterment I feel sure. Another scene : you are sitting working m lonely lodgings m London, late at night, half-a-dozen rough boys go by, one of them playing a mouthorgan, and all the rest marching along keeping time to it, all attracted by its far from

unmusical strains. Surely that mouth-organ may have been the means of leading them home and away from some low drinking place. Another instrument which has most wonderful powers for good and evil is the bacjpipe. The evil is only individual, and only exists, I suppose, outside Scotland — I refer to the dislike which many people have to that ancient instrument ; but what an amount of good has followed its wonderful and fearsome sounds, chiefly, of course, m warlike proceedings. In the old days one can imagine the clans m Scotland being worked up to a frenzy by the sound of their national pipes, and even up to the late war there are examples recorded where the Scotch regiments have rallied to the sound of their bagpipes. You remember one heroic piper on Dargai Heights, India, shot through both legs, and unable to continue the advance, yet he sat up and played with all his might, and the heights were taken. When I say " played with all his might," I imagine the pipes must be one of the hardest instruments to play that was ever invented. Not only does a piper always look as if he was trying hard to find who would burst first, himself or his bag, but just look at the tremendous amount of dignity and selfimportance noticeable m all performers on that 4 weird instrument. To my poor English mind that is one of its chief charms. While I was m England, lately, I had several opportunities of hearing and seeing the best bagpipe performers m London. At an "At Home," given at Stratford House, to " Distinguished Indian and Colonial Visitors," among whom we had the honour of being included, there were two forms of musical entertainment m the grounds, one was the band of the Grenadier Guards, and the other the pipers of the Scots Guards. The band, like any well-behaved band would do, retired into a far corner, put up its music stands and played delightful music, without any fuss. Then came the turn of the pipers. Did they retire into a corner ? Did they make no fuss ? Nothing of that kind. They came out boldly into the open, blew out their chests and strutted -up and down making those curious droning sounds which seem to bring out the worst m the uneducated ignorant Englishman, and the best m the Scotsman be he ever so ignorant or uneducated. Then these wonderful pipers paraded round the grounds, and how splendid

they looked as they swaggered past — marching with military precision, and playing as if that was the only thing on earth worth living for, and no doubt it was to them. I heard and saw them again on a very different occasion, the " Burial of the Unknown Warrior," the same proud men with the same proud 100k — the look that portrays the character of those wonderful Scottish Hegiments whose emblem is a thistle and whose motto can be translated into " Whoever interferes with me is m for trouble." There they were, marching slowly down m that wonderful procession, which included the highest soldiers and sailors m the land — all paying reverence to one poor unknown body being carried to its last resting-place on a gun-carriage, and music, music all the way, which brought a lump into ones throat and made the women cry; music of the massed Guards* Bands alternating with the sad drones of those wonderful pipers. There is nothing to my mind more affecting than a military funeral, even the authorities realise that the influence must have something to counteract it, for the bands are ordered to play the ligh test and gayest music they can on the return from the funeral. Tommy is a careless soul, so though he may regret his " pal " for a bit, a cheerful tune from the band soon puts his philosophical mind m its normal place again. I don't want to weary you by going through a long list of instruments, musical and otherwise, though I think one could pick out some good points m any one of them, so just m conclusion let us consider the organ, especially as played m places of worship. As I said earlier m the course of these remarks, music and religion have always been mixed up together — religion and healing — religion, music and emotional feeling, how much they are interwoven m the minds and morals of many people. I happened on another Armistice Day to be m Westminster Abbey for the eleven o'clock service and the two minutes' silence. Do you mean to tell me that any man or woman could have heard that wonderful service and come out and picked someone's pocket, or done a dirty trick on his neighbour ? No, there is no doubt all music and especially religious music has a wonderful effect on people. The buildings and associations, no doubt, help this effect. Wordsworth, writing a short poem on King's College Chapel, at Cambridge,

one of the most beautiful buildings of its kind m the world, with a unique example of fern- tracery roof, speaks of it as being a place : ' Where music dwells Lingering and wandering on as loth to die ; Like thoughts whose very sweetness yieldeth proof That they were born for immortality." You could not go out frovn a service at King's Chapel, and commit a murder. Nay rather the undergraduate walketh down the King's Parade m an orderly and thoughtful mood, and even forgets to smoke. Having mentioned a particular poet brings me to rather a curious anomaly m the matter of the healing power of music, and that is the INDIVIDUALITY OF THOSE MUSICIANS who have provided us with some of the most delightful and soothing and stirring music we could well require. I suppose we have all known musicial people. They are so often what is called " temperamental," our own town has seen evidence of this ; but if you read the lives of some of the great composers you come to the conclusion that they were most extraordinary people, and some of them not at all to be desired as neighbours. Handel remained a bachelor to the end of his life, though he had one or two narrow escapes.. " Perhaps it is as well that he remained unmated. He was an irascible person and he might have done as Beethoven did with his cook and thrown the soup m his wife's face when something went wrong with his temper." Yet this excitable person wrote the 4i Dead March m the oratoria " Saul." He was imperious to a degree, with at times a perfectly volcanic temper. His nerves were so irritable that he could not stand the sound of tuning, and so all the instruments were tuned before he arrived. One evening when the Prince of Wales was expected to be present, some '■ Wag " for a piece of fun, untuned them all. When the Prince arrived, Handel gave the signal to begin con spirito, but such was the horrible discord that the enraged conductor started up from his seat, and having overturned a double bass that stood m his way, seized a kettle-drum and threw it at the leader of the violins, with such force that he lost his wig m the effort. It was only when theJPrince himself requested him to go on, that he consented. Yet

Beethoven says of him that he was " the unapproachable master of all masters." Bach, the same writer tells us, was as a rule genial and kindly, but his temper would occasionally show itself. Thus at a rehearsal, when the organist had made a very bad blunder, he flew into a towering rage, tore his wig from his head and threw it at the offender, shouting that he had better have been a cobbler. Mozart was another curiosity. " All his adult life he suffered from abnormal restiveness. His barber has told what a trouble it was to shave him. No sooner was he seated, his neck encircled with a cloth, than he became lost m thought and oblivious to all around him. Then without a word he would jump up, move about the room, often into the adjoining one, while comb and razor m hand the barber would follow him." Poor Mozart, he was only 36 when he died, and his life was one long struggle with poverty, only on his death- bed, when he lay dying, was he offered a well-paid appointment as organist at St. Stephen's Cathedral. Beethoven was what we should call a freak now-a-days. He not only refrained from dressing his hair, but he hardly dressed himself, and was most careless m his apparel and behaviour. "It was dangerous for him to touch anything that was fragile, as he was sure to break it. More than once m a fit of passion he flung his inkstand among the wires of the piano." The stories of poor, mad Beethoven are numerous ; but I will not weary you with any more. I have simply given these examples of the peculiarities of musicians to show how extraordinary it is that nature has bestowed on so many of them a " kink " of some kind, and yet they have produced such wonders m the musical line that the whole world acknowledges their genius and is affected by their magnificent compositions. Coming to more modern days, look at Wagner's works, and how popular they have become to even the unmusical public. On Sunday afternoon, m London, you will find the Queen's Hall or the Palladium crammed with ordinary people who have come to hear a concert consisting entirely of Wagner's compositions. Surely that shows that their musical education is improving, and a musical mind cannot mean an evil one. Now music m some places and under some conditions is out of place and instead of having a good effect, has the

opposite on some people, like the bagpipes to which I referred before. No tea-shop m London is complete now without its orchestra ; personally I must admit I like them m moderation, but the unfortunate people who do not care for music with meals have rather a difficulty m finding a place without (" Punch"). It is more often the rule to get an encore, especially m places like the Trocadero, where they employ really good artists. There is no doubt that music is getting more and more popular, and that good music is becoming more appreciated than it was a few years ago. To my mind half the attraction of the Picture Show is the music : if you take that away I very much doubt if the movies would be the draw they are now. Learning to appreciate music must do good, and more good than any of the other arts — painting, sculpture, etc., — one can go to, and thoroughly enjoy a visit to the Royal Academy, but when you come out you leave it all behind — you can't bring it away with you as you can a good musical show. As Dr. Coward, the conductor of the Sheffield Choir, said the other day m the paper : ' ' Music engenders mirth, eliminating the bitter sting of life, and tends to stimulate or sooth the spirit, anything that makes for health and good spirits makes for good

business. Whistle, sing or play for your own amusement, let the family gramophone or automatic piano-player do its share m helping you. Supplement this by attention to music m church, concert, kinema, or opera. Music prevents man from becoming a mere petrified business machine." Those are exactly my own sentiments, and these remarks of Dr. Coward's would have made a splendid text for me, only I had got this paper pretty well finished when I came across them. I think it is perfectly right, music must help and cheer and smooth and strengthen us m our walk through life. k< The trivial round, the common task " m the life of the Nurse is more trivial and more common than any other profession I know, and anything that will help you, or the patient,is to be welcomed and encouraged. Surely music is one of these means to an end. In concluding these rambling remarks, which have been written, I'm afraid, without much method or cohesion, I may say that my only object has been to try and show how music — of all sorts — may and does influence us, and surely it can only influence us for good. Get music into your lives, and having got it there, let other people have the benefit of it, and if you can cheer up one lonely miserable soul, you have not lived m vain.