with or without distinct lesions of the stomach, womb, or other organs.

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