As a rule neurasthenic individuals become, as is well known, worse as far as the mental condition is concerned when they are asked to assume new responsibilities. This physical side of the choice of Superiors, and of those to be elected by members of the community, should always receive due attention, though sometimes it is entirely lost sight of. Not a few communities, however, have suffered in their usefulness and in the fulfilment of the design of their institute by the selection of Superiors whose neurotic conditions sometimes seemed to proclaim a high degree of piety, which was, however, rather emotional than practical. The physician's view of some of these cases would add materially to the knowledge of the character of such individuals.
It should in general be very clear that the development of any serious nervous disease, which is not likely to be cured by ordinary remedies or which requires freedom from responsibility as the first requisite for improvement, should be the signal for consideration as to a change of Superiors. Physicians see much more of the evil that may be worked in this way, and realise the true significance of what is often a sad state of affairs, much better than those who have not the secret of the cause of the unfortunate condition. It is almost needless to say that the question of obedience to some one whose responsibility is not complete, but is influenced by neurotic disturbance, becomes an extremely difficult problem for the subject, and one in which there is apt to be the feeling that it was not the original intention of his obligation of obedience to bind him under such circumstances.
With regard to women especially, it must be remembered that there is for them a period between the ages of forty { 250} and fifty, during which for several years they are extremely unsuited for the responsibilities and exacting duties of a Superior. These years prove even to mothers of families, surrounded only by their own children and the ordinary circumstances of home life, a time of worry and irritation that plays sad havoc even with the best of dispositions. Mothers constantly complain to their physicians of an irritability of temper which they can scarcely account for, and which makes them do and say things which they are extremely sorry for afterwards. It is easy to understand, then, that a Superior with still more insistent duties when brought in contact with a number of persons, some of whom are almost sure not to be entirely sympathetic, is likely to suffer from irritation that is not a sign of absence of a fitting religious disposition, but only a physical manifestation of the physical strain through which she has to pass at this time of life. The years of the menopause, to be very plain, should not be allowed to make a Superior's life miserable and to add to the difficulties that a religious community always has to face in its relations to its Superior and to one another. Charcot, the distinguished French neurologist, used to say that women should never be asked to assume special responsibilities during the days of their monthly period, for their judgments are often warped by their physical condition. It is doubtful whether, in the majority of normal women, this is quite true, though the expression deserves to be remembered. There is no doubt, however, that the years of the change of life do bring on very serious modifications of the character of the individual, and occasionally these changes are lasting.