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diff --git a/13197-0.txt b/13197-0.txt new file mode 100644 index 0000000..c9dbf2f --- /dev/null +++ b/13197-0.txt @@ -0,0 +1,1402 @@ +*** START OF THE PROJECT GUTENBERG EBOOK 13197 *** + +WEAR AND TEAR, + +OR + +HINTS FOR THE OVERWORKED. + +BY +S. WEIR MITCHELL, M.D., LL.D. HARV., + +MEMBER OF THE NATIONAL ACADEMY OF SCIENCES, PRESIDENT OF THE COLLEGE OF +PHYSICIANS OF PHILADELPHIA, ETC. + +_FIFTH EDITION_, +THOROUGHLY REVISED. + +PHILADELPHIA: +J.B. LIPPINCOTT COMPANY. +LONDON: 10 HENRIETTA STREET, COVENT GARDEN. + +Entered according to Act of Congress, in the year 1871, by +J.B. LIPPINCOTT & CO., +In the Office of the Librarian of Congress at Washington. + + +PRINTED BY J.B. LIPPINCOTT COMPANY, PHILADELPHIA. + + + +PREFACE. + +The rate of change in this country in education, in dress, and in diet +and habits of daily life surprises even the most watchful American +observer. It is now but fifteen years since this little book was written +as a warning to a restless nation possessed of an energy tempted to its +largest uses by unsurpassed opportunities. There is still need to repeat +and reinforce my former remonstrance, but I am glad to add that since I +first wrote on these subjects they have not only grown into importance +as questions of public hygiene, but vast changes for the better have +come about in many of our ways of living, and everywhere common sense is +beginning to rule in matters of dress, diet, and education. + +The American of the Eastern States and of the comfortable classes[1] is +becoming notably more ruddy and more stout. The alteration in women as +to these conditions is most striking, and, if I am not mistaken, in +England there is a lessening tendency towards that excess of adipose +matter which is still a surprise to the American visiting England for +the first time. + +I should scarcely venture to assert so positively that Americans had +obviously taken on flesh within a generation if what I see had not been +observed by many others. It would, I think, be interesting to enter at +length upon a study of these remarkable changes, but that were scarcely +within the scope of this little book. + +[Footnote 1: Happily, a large class with us.] + + + + + + +WEAR AND TEAR. + +OR + +HINTS FOR THE OVERWORKED. + + +Many years ago[1] I found occasion to set before the readers of +_Lippincott's Magazine_ certain thoughts concerning work in America, and +its results. Somewhat to my surprise, the article attracted more notice +than usually falls to the share of such papers, and since then, from +numerous sources, I have had the pleasure to learn that my words of +warning have been of good service to many thoughtless sinners against +the laws of labor and of rest. I have found, also, that the views then +set forth as to the peculiar difficulties of mental and physical work +in this country are in strict accordance with the personal experience of +foreign scholars who have cast their lots among us; while some of our +best teachers have thanked me for stating, from a doctor's stand-point, +the evils which their own experience had taught them to see in our +present mode of tasking the brains of the younger girls. + +[Footnote 1: In 1871.] + +I hope, therefore, that I am justified in the belief that in its new and +larger form my little tract may again claim attention from such as need +its lessons. Since it was meant only for these, I need not excuse myself +to physicians for its simplicity; while I trust that certain of my +brethren may find in it enough of original thought to justify its +reappearance, as its statistics were taken from manuscript notes and +have been printed in no scientific journal. + +I have called these Hints WEAR and TEAR, because this title clearly and +briefly points out my meaning. _Wear_ is a natural and legitimate result +of lawful use, and is what we all have to put up with as the result of +years of activity of brain and body. _Tear_ is another matter: it comes +of hard or evil usage of body or engine, of putting things to wrong +purposes, using a chisel for a screw-driver, a penknife for a gimlet. +Long strain, or the sudden demand of strength from weakness, causes +tear. Wear comes of use; tear, of abuse. + +The sermon of which these words are the text has been preached many +times in many ways to congregations for whom the Dollar Devil had always +a more winning eloquence. Like many another man who has talked wearily +to his fellows with an honest sense of what they truly need, I feel how +vain it is to hope for many earnest listeners. Yet here and there may be +men and women, ignorantly sinning against the laws by which they should +live or should guide the lives of others, who will perhaps be willing to +heed what one unbiased thinker has to say in regard to the dangers of +the way they are treading with so little knowledge as to where it is +leading. + +The man who lives an out-door life--who sleeps with the stars visible +above him--who wins his bodily subsistence at first hand from the earth +and waters--is a being who defies rain and sun, has a strange sense of +elastic strength, may drink if he likes, and may smoke all day long, and +feel none the worse for it. Some such return to the earth for the means +of life is what gives vigor and developing power to the colonist of an +older race cast on a land like ours. A few generations of men living in +such fashion store up a capital of vitality which accounts largely for +the prodigal activity displayed by their descendants, and made possible +only by the sturdy contest with Nature which their ancestors have waged. +That such a life is still led by multitudes of our countrymen is what +alone serves to keep up our pristine force and energy. Are we not merely +using the interest on these accumulations of power, but also wastefully +spending the capital? From a few we have grown to millions, and already +in many ways the people of the Atlantic coast present the peculiarities +of an old nation. Have we lived too fast? The settlers here, as +elsewhere, had ample room, and lived sturdily by their own hands, little +troubled for the most part with those intense competitions which make it +hard to live nowadays and embitter the daily bread of life. Neither had +they the thousand intricate problems to solve which perplex those who +struggle to-day in our teeming city hives. Above all, educational wants +were limited in kind and in degree, and the physical man and woman were +what the growing state most needed. + +How much and what kind of good came of the gradual change in all these +matters we well enough know. That in one and another way the cruel +competition for the dollar, the new and exacting habits of business, the +racing speed which the telegraph and railway have introduced into +commercial life, the new value which great fortunes have come to possess +as means towards social advancement, and the overeducation and +overstraining of our young people, have brought about some great and +growing evils, is what is now beginning to be distinctly felt. I should +like, therefore, at the risk of being tedious, to re-examine this +question--to see if it be true that the nervous system of certain +classes of Americans is being sorely overtaxed--and to ascertain how +much our habits, our modes of work, and, haply, climatic peculiarities, +may have to do with this state of things. But before venturing anew +upon a subject which may possibly excite controversy and indignant +comment, let me premise that I am talking chiefly of the crowded +portions of our country, of our great towns, and especially of their +upper classes, and am dealing with those higher questions of mental +hygiene of which in general we hear but too little. If the strictures I +have to make applied as fully throughout the land--to Oregon as to New +England, to the farmer as to the business man, to the women of the +artisan class as to those socially above them--then indeed I should cry, +God help us and those that are to come after us! Owing to causes which +are obvious enough, the physical worker is being better and better paid +and less and less hardly tasked, while just the reverse obtains in +increasing ratios for those who live by the lower form of brain-work; so +that the bribe to use the hand is growing daily, and pure mechanical +labor, as opposed to that of the clerk, is being "levelled upward" with +fortunate celerity. + +Before attempting to indicate certain ways in which we as a people are +overtaxing and misusing the organs of thought, I should be glad to have +the privilege of explaining the terms which it is necessary to use, and +of pointing out some of the conditions under which mental labor is +performed. + +The human body carries on several kinds of manufacture, two of +which--the evolution of muscular force or motion, and intellection with +all moral activities--alone concern us here. We are somewhat apt to +antagonize these two sets of functions, and to look upon the latter, or +brain-labor, as alone involving the use or abuse of the nervous system. +But every blow on the anvil is as distinctly an act of the nerve centres +as are the highest mental processes. If this be so, how or why is it +that excessive muscular exertion--I mean such as is violent and +continued--does not cause the same appalling effects as may be +occasioned by a like abuse of the nerve-organs in mental actions of +various kinds? This is not an invariable rule, for, as I may point out +in the way of illustration hereafter, the centres which originate or +evolve muscular power do sometimes suffer from undue taxation; but it is +certainly true that when this happens, the evil result is rarely as +severe or as lasting as when it is the organs of mental power that have +suffered. + +In either form of work, physical or mental, the will acts to start the +needed processes, and afterwards is chiefly regulative. In the case of +bodily labor, the spinal nerve-centres are most largely called into +action. Where mental or moral processes are involved, the active organs +lie within the cranium. As I said just now, when we talk of an overtaxed +nervous system it is usually the brain we refer to, and not the spine; +and the question therefore arises, Why is it that an excess of physical +labor is better borne than a like excess of mental labor? The simple +answer is, that mental overwork is harder, because as a rule it is +closet or counting-room or at least in-door work--sedentary, in a word. +The man who is intensely using his brain is not collaterally employing +any other organs, and the more intense his application the less +locomotive does he become. On the other hand, however a man abuses his +powers of motion in the way of work, he is at all events encouraging +that collateral functional activity which mental labor discourages: he +is quickening the heart, driving the blood through unused channels, +hastening the breathing and increasing the secretions of the skin--all +excellent results, and, even if excessive, better than a too incomplete +use of these functions. + +But there is more than this in the question. We do not know as yet what +is the cost in expended material of mental acts as compared with motor +manifestations, and here, therefore, are at fault; because, although it +seems so much slighter a thing to think a little than to hit out with +the power of an athlete, it may prove that the expenditure of nerve +material is in the former case greater than in the latter. + +When a man uses his muscles, after a time comes the feeling called +fatigue--a sensation always referred to the muscles, and due most +probably to the deposit in the tissues of certain substances formed +during motor activity. Warned by this weariness, the man takes rest--may +indeed be forced to do so; but, unless I am mistaken, he who is +intensely using the brain does not feel in the common use of it any +sensation referable to the organ itself which warns him that he has +taxed it enough. It is apt, like a well-bred creature, to get into a +sort of exalted state under the stimulus of need, so that its owner +feels amazed at the ease of its processes and at the sense of +_wide-awakefulness_ and power that accompanies them. It is only after +very long misuse that the brain begins to have means of saying, "I have +done enough;" and at this stage the warning comes too often in the shape +of some one of the many symptoms which indicate that the organ is +already talking with the tongue of disease. + +I do not know how these views will be generally received, but I am sure +that the personal experience of many scholars will decide them to be +correct; and they serve to make clear why it is that men may not know +they are abusing the organ of thought until it is already suffering +deeply, and also wherefore the mind may not be as ruthlessly overworked +as the legs or arms. + +Whenever I have closely questioned patients or men of studious habits as +to this matter, I have found that most of them, when in health, +recognized no such thing as fatigue in mental action, or else I learned +that what they took for this was merely that physical sense of being +tired, which arises from prolonged writing or constrained positions. The +more, I fancy, any healthy student reflects on this matter the more +clearly will he recognize this fact, that very often when his brain is +at its clearest, he pauses only because his back is weary, his eyes +aching, or his fingers tired. + +This most important question, as to how a man shall know when he has +sufficiently tasked his brain, demands a longer answer than I can give +it here; and, unfortunately, there is no popular book since Ray's clever +and useful "Mental Hygiene," and Feuchtersleben's "Dietetics of the +Soul," both out of print, which deals in a readable fashion with this or +kindred topics.[1] Many men are warned by some sense of want of +clearness or ease in their intellectual processes. Others are checked by +a feeling of surfeit or disgust, which they obey or not as they are +wise or unwise. Here, for example, is in substance the evidence of a +very attentive student of his own mental mechanism, whom we have to +thank for many charming products of his brain. Like most scholars, he +can scarcely say that he ever has a sense of "brain-tire," because cold +hands and feet and a certain restlessness of the muscular system drive +him to take exercise. Especially when working at night, he gets after a +time a sense of disgust at the work he is doing. "But sometimes," he +adds, "my brain gets going, and is to be stopped by none of the common +plans of counting, repeating French verbs, or the like." A well-known +poet describes to me the curious condition of excitement into which his +brain is cast by the act of composing verse, and thinks that the happy +accomplishment of his task is followed by a feeling of relief, which +shows that there has been high tension. + +[Footnote 1: See, now, "Brain-Work and Overwork," by H.C. Wood, M.D.; +also, "Mental Overwork and Premature Disease among Public and +Professional Men," by Ch. K. Mills, M.D.; also, "Overwork and Sanitation +in Public Schools, with Remarks on the Production of Nervous Disease and +Insanity," by Ch. K. Mills, M.D.,--_Annals of Hygiene_, September, +1886.] + +One of our ablest medical scholars reports himself to me as having never +been aware of any sensation in the head, by which he could tell that he +had worked enough, up to a late period of his college career, when, +having overtaxed his brain, he was restricted by his advisers to two or +three hours of daily study. He thus learned to study hard, and ever +since has been accustomed to execute all mental tasks at high pressure +under intense strain and among the cares of a great practice. All his +mind-work is, however, forced labor, and it always results in a distinct +sense of cerebral fatigue,--a feeling of pressure, which is eased by +clasping his hands over his head; and also there is desire to lie down +and rest. + +"I am not aware," writes a physician of distinction, "that, until a few +years ago, I ever felt any sense of fatigue from brain-work which I +could refer to the organ employed. The longer I worked the clearer and +easier my mental processes seemed to be, until, during a time of great +sorrow and anxiety, I pushed my thinking organs rather too hard. As a +result, I began to have headache after every period of intellectual +exertion. Then I lost power to sleep. Although I have partially +recovered, I am now always warned when I have done enough, by lessening +ease in my work, and by a sense of fulness and tension in the head." +The indications of brain-tire, therefore, differ in different people, +and are more and more apt to be referred to the thinking organ as it +departs more and more from a condition of health. Surely a fuller record +of the conditions under which men of note are using their mental +machinery would be everyway worthy of attention. + +Another reason why too prolonged use of the brain is so mischievous is +seen in a peculiarity, which is of itself a proof of the auto-activity +of the vital acts of the various organs concerned in intellection. We +sternly concentrate attention on our task, whatever it be; we do this +too long, or under circumstances which make labor difficult, such as +during digestion or when weighted by anxiety. At last we stop and +propose to find rest in bed. Not so, says the ill-used brain, now +morbidly wide awake; and whether we will or not, the mind keeps turning +over and over the work of the day, the business or legal problem, or +mumbling, so to speak, some wearisome question in a fashion made useless +by the denial of full attention. Or else the imagination soars away +with the unrestful energy of a demon, conjuring up an endless procession +of broken images and disconnected thoughts, so that sleep is utterly +banished. + +I have chosen here as examples men whose brains are engaged constantly +in the higher forms of mental labor; but the difficulty of arresting at +will the overtasked brain belongs more or less to every man who overuses +this organ, and is the well-known initial symptom of numerous morbid +states. I have instanced scholars and men of science chiefly, because +they, more than others, are apt to study the conditions under which +their thinking organs prosper or falter in their work, and because from +them have we had the clearest accounts of this embarrassing condition of +automatic activity of the cerebral organs. Few thinkers have failed, I +fancy, to suffer in this way at some time, and with many the annoyance +is only too common. I do not think the subject has received the +attention it deserves, even from such thorough believers in unconscious +cerebration as Maudsley. As this state of brain is fatal to sleep, and +therefore to needful repose of brain, every sufferer has a remedy which +he finds more or less available. This usually consists in some form of +effort to throw the thoughts off the track upon which they are moving. +Almost every literary biography has some instance of this difficulty, +and some hint as to the sufferer's method of freeing his brain from the +despotism of a ruling idea or a chain of thought. + +Many years ago I heard Mr. Thackeray say that he was sometimes haunted, +when his work was over, by the creatures he himself had summoned into +being, and that it was a good corrective to turn over the pages of a +dictionary. Sir Walter Scott is said to have been troubled in a similar +way. A great lawyer, whom I questioned lately as to this matter, told me +that his cure was a chapter or two of a novel, with a cold bath before +going to bed; for, said he, quaintly, "You never take out of a cold bath +the thoughts you take into it." It would be easy to multiply such +examples. + +Looking broadly at the question of the influence of excessive and +prolonged use of the brain upon the health of the nervous system, we +learn, first, that cases of cerebral exhaustion in people who live +wisely are rare. Eat regularly and exercise freely, and there is scarce +a limit to the work you may get out of the thinking organs. But if into +the life of a man whose powers are fully taxed we bring the elements of +great anxiety or worry, or excessive haste, the whole machinery begins +at once to work, as it were, with a dangerous amount of friction. Add to +this such constant fatigue of body as some forms of business bring +about, and you have all the means needed to ruin the man's power of +useful labor. + +I have been careful here to state that combined overwork of mind and +body is doubly mischievous, because nothing is now more sure in hygienic +science than that a proper alternation of physical and mental labor is +best fitted to insure a lifetime of wholesome and vigorous intellectual +exertion. This is probably due to several causes, but principally to the +fact that during active exertion of the body the brain cannot be +employed intensely, and therefore has secured to it a state of repose +which even sleep is not always competent to supply. There is a Turkish +proverb which occurs to me here, like most proverbs, more or less true: +"Dreaming goes afoot, but who can think on horseback?" Perhaps, too, +there is concerned a physiological law, which, though somewhat +mysterious, I may again have to summon to my aid in the way of +explanation. It is known as the law of Treviranus, its discoverer, and +may thus be briefly stated: Each organ is to every other as an excreting +organ. In other words, to insure perfect health, every tissue, bone, +nerve, tendon, or muscle should take from the blood certain materials +and return to it certain others. To do this every organ must or ought to +have its period of activity and of rest, so as to keep the vital fluid +in a proper state to nourish every other part. This process in perfect +health is a system of mutual assurance, and is probably essential to a +condition of entire vigor of both mind and body. + +It has long been believed that maladies of the nervous system are +increasing rapidly in the more crowded portions of the United States; +but I am not aware that any one has studied the death-records to make +sure of the accuracy of this opinion. There can be no doubt, I think, +that the palsy of children becomes more frequent in cities just in +proportion to their growth in population. I mention it here because, as +it is a disease which does not kill but only cripples, it has no place +in the mortuary tables. Neuralgia is another malady which has no record +there, but is, I suspect, increasing at a rapid rate wherever our people +are crowded together in towns. Perhaps no other form of sickness is so +sure an indication of the development of the nervous temperament, or +that condition in which there are both feebleness and irritability of +the nervous system. But the most unquestionable proof of the increase of +nervous disease is to be looked for in the death statistics of cities. + +There, if anywhere, we shall find evidence of the fact, because there we +find in exaggerated shapes all the evils I have been defining. The best +mode of testing the matter is to take the statistics of some large city +which has grown from a country town to a vast business hive within a +very few years. Chicago fulfils these conditions precisely. In 1852 it +numbered 49,407 souls. At the close of 1868 it had reached to 252,054. +Within these years it has become the keenest and most wide-awake +business centre in America. I owe to the kindness of Dr. J.H. Rauch, +Sanitary Superintendent of Chicago, manuscript records, hitherto +unpublished, of its deaths from nervous disease, as well as the +statement of each year's total mortality; so that I have it in my power +to show the increase of deaths from nerve disorders relatively to the +annual loss of life from all causes. I possess similar details as to +Philadelphia, which seem to admit of the same conclusions as those drawn +from the figures I have used. But here the evil has increased more +slowly. Let us see what story these figures will tell us for the Western +city. Unluckily, they are rather dry tale-tellers. + +The honest use of the mortuary statistics of a large town is no easy +matter, and I must therefore ask that I may be supposed to have taken +every possible precaution in order not to exaggerate the reality of a +great evil. Certain diseases, such as apoplexy, palsy, epilepsy, St. +Vitus's dance, and lockjaw or tetanus, we all agree to consider as +nervous maladies; convulsions, and the vast number of cases known in +the death-lists as dropsy of the brain, effusion on the brain, etc., are +to be looked upon with more doubt. The former, as every doctor knows, +are, in a vast proportion of instances, due to direct disease of the +nerve-centres; or, if not to this, then to such a condition of +irritability of these parts as makes them too ready to originate spasms +in response to causes which disturb the extremities of the nerves, such +as teething and the like. This tendency seems to be fostered by the air +and habits of great towns, and by all the agencies which in these places +depress the health of a community. The other class of diseases, as +dropsy of the brain or effusion, probably includes a number of maladies, +due some of them to scrofula, and to the predisposing causes of that +disease; others, to the kind of influences which seem to favor +convulsive disorders. Less surely than the former class can these be +looked upon as true nervous diseases; so that in speaking of them I am +careful to make separate mention of their increase, while thinking it +right on the whole to include in the general summary of this growth of +nerve disorders this partially doubtful class. + +Taking the years 1852 to 1868, inclusive, it will be found that the +population of Chicago has increased 5.1 times and the deaths from all +causes 3.7 times; while the nerve deaths, including the doubtful class +labelled in the reports as dropsy of the brain and convulsions, have +risen to 20.4 times what they were in 1852. Thus in 1852, '53, and '55, +leaving out the cholera year '54, the deaths from nerve disorders were +respectively to the whole population as 1 in 1149, 1 in 953, and 1 in +941; whilst in 1866, '67, and '68, they were 1 in 505, 1 in 415.7, and 1 +in 287.8. Still omitting 1854, the average proportion of neural deaths +to the total mortality was, in the five years beginning with 1852, 1 in +26.1. In the five latter years studied--that is, from 1864 to 1868, +inclusive--the proportion was 1 nerve death to every 9.9 of all deaths. + +I have alluded above to a class of deaths included in my tables, but +containing, no doubt, instances of mortality due to other causes than +disease of the nerve-organs. Thus many which are stated to have been +owing to convulsions ought to be placed to the credit of tubercular +disease of the brain or to heart maladies; but even in the practice of +medicine the distinction as to cause cannot always be made; and as a +large proportion of this loss of life is really owing to brain +affections, I have thought best to include the whole class in my +statement. + +A glance at the individual diseases which are indubitably nervous is +more instructive and less perplexing. For example, taking the extreme +years, the recent increase in apoplexy is remarkable, even when we +remember that it is a malady of middle and later life, and that Chicago, +a new city, is therefore entitled to a yearly increasing quantity of +this form of death. In 1868 the number was 8.6 times greater than in +1852. Convulsions as a death cause had in 1868 risen to 22 times as many +as in the year 1852. Epilepsy, one of the most marked of all nervous +maladies, is more free from the difficulties which belong to the +last-mentioned class. In 1852 and '53 there were but two deaths from +this disease; in the next four years there were none. From 1858 to '64, +inclusive, there were in all 6 epileptic deaths: then we have in the +following years, 5, 3, 11; and in 1868 the number had increased to 17. +Passing over palsy, which, like apoplexy, increases in 1868,--8.6 times +as compared with 1852; and 26 times as compared with the four years +following 1852,--we come to lockjaw, an unmistakable nerve malady. Six +years out of the first eleven give us no death from this painful +disease; the others, up to 1864, offer each one only, and the +last-mentioned year has but two. Then the number rises to 3 each year, +to 5 in 1867, and to 12 in 1868. At first sight, this record of +mortality from lockjaw would seem to be conclusive, yet it is perhaps, +of all the maladies mentioned, the most deceptive as a means of +determining the growth of neural diseases. To make this clear to the +general reader, he need only be told that tetanus is nearly always +caused by mechanical injuries, and that the natural increase of these in +a place like Chicago may account for a large part of the increase. Yet, +taking the record as a whole, and viewing it only with a calm desire to +get at the truth, it is not possible to avoid seeing that the growth of +nerve maladies has been inordinate. + +The industry and energy which have built this great city on a morass, +and made it a vast centre of insatiate commerce, are now at work to +undermine the nervous systems of its restless and eager people,[1] with +what result I have here tried to point out, chiefly because it is an +illustration in the most concentrated form of causes which are at work +elsewhere throughout the land. + +[Footnote 1: I asked two citizens of this uneasy town--on the same +day--what was their business. Both replied tranquilly that they were +speculators!] + +The facts I have given establish the disproportionate increase in one +great city of those diseases which are largely produced by the strain on +the nervous system resulting from the toils and competitions of a +community growing rapidly and stimulated to its utmost capacity. +Probably the same rule would be found to apply to other large towns, but +I have not had time to study the statistics of any of them fully; and, +for reasons already given, Chicago may be taken as a typical +illustration. + +It were interesting to-day to question the later statistics of this +great business-centre; to see if the answers would weaken or reinforce +the conclusions drawn in 1871. I have seen it anew of late with its +population of 700,000 souls. It is a place to-day to excite wonder, and +pity, and fear. All the tides of its life move with bustling swiftness. +Nowhere else are the streets more full, and nowhere else are the faces +so expressive of preoccupation, of anxiety, of excitement. It is making +money fast and accumulating a physiological debt of which that bitter +creditor, the future, will one day demand payment. + +If I have made myself understood, we are now prepared to apply some of +our knowledge to the solution of certain awkward questions which force +themselves daily upon the attention of every thoughtful and observant +physician, and have thus opened a way to the discussion of the causes +which, as I believe, are deeply affecting the mental and physical health +of working Americans. Some of these are due to the climatic conditions +under which all work must be done in this country, some are out-growths +of our modes of labor, and some go back to social habitudes and +defective methods of early educational training. + +In studying this subject, it will not answer to look only at the causes +of sickness and weakness which affect the male sex. If the mothers of a +people are sickly and weak, the sad inheritance falls upon their +offspring, and this is why I must deal first, however briefly, with the +health of our girls, because it is here, as the doctor well knows, that +the trouble begins. Ask any physician of your acquaintance to sum up +thoughtfully the young girls he knows, and to tell you how many in each +score are fit to be healthy wives and mothers, or in fact to be wives +and mothers at all. I have been asked this question myself very often, +and I have heard it asked of others. The answers I am not going to give, +chiefly because I should not be believed--a disagreeable position, in +which I shall not deliberately place myself. Perhaps I ought to add that +the replies I have heard given by others were appalling. + +Next, I ask you to note carefully the expression and figures of the +young girls whom you may chance to meet in your walks, or whom you may +observe at a concert or in the ball-room. You will see many very +charming faces, the like of which the world cannot match--figures +somewhat too spare of flesh, and, especially south of Rhode Island, a +marvellous littleness of hand and foot. But look further, and +especially among New England young girls: you will be struck with a +certain hardness of line in form and feature which should not be seen +between thirteen and eighteen, at least; and if you have an eye which +rejoices in the tints of health, you will too often miss them on the +cheeks we are now so daringly criticising. I do not want to do more than +is needed of this ungracious talk: suffice it to say that multitudes of +our young girls are merely pretty to look at, or not that; that their +destiny is the shawl and the sofa, neuralgia, weak backs, and the varied +forms of hysteria,--that domestic demon which has produced untold +discomfort in many a household, and, I am almost ready to say, as much +unhappiness as the husband's dram. My phrase may seem outrageously +strong, but only the doctor knows what one of these self-made invalids +can do to make a household wretched. Mrs. Gradgrind is, in fiction, the +only successful portrait of this type of misery, of the woman who wears +out and destroys generations of nursing relatives, and who, as Wendell +Holmes has said, is like a vampire, sucking slowly the blood of every +healthy, helpful creature within reach of her demands. + +If any reader doubts my statement as to the physical failure of our +city-bred women to fulfil all the natural functions of mothers, let him +contrast the power of the recently imported Irish or Germans to nurse +their babies a full term or longer, with that of the native women even +of our mechanic classes. It is difficult to get at full statistics as to +those a higher social degree, but I suspect that not over one-half are +competent to nurse their children a full year without themselves +suffering gravely. I ought to add that our women, unlike ladies abroad, +are usually anxious to nurse their own children, and merely cannot. The +numerous artificial infant foods now for sale singularly prove the truth +of this latter statement. Many physicians, with whom I have talked of +this matter, believe that I do not overstate the evil; others think that +two-thirds may be found reliable as nurses; while the rural doctors, who +have replied to my queries, state that only from one-tenth to +three-tenths of farmers' wives are unequal to this natural demand. There +is indeed little doubt that the mass of our women possess that peculiar +nervous organization which is associated with great excitability, and, +unfortunately, with less physical vigor than is to be found, for +example, in the sturdy English dames at whom Hawthorne sneered so +bitterly. And what are the causes to which these peculiarities are to be +laid? There are many who will say that late hours, styles of dress, +prolonged dancing, etc., are to blame; while really, with rare +exceptions, the newer fashions have been more healthy than those they +superseded, people are better clad and better warmed than ever, and, +save in rare cases, late hours and overexertion in the dance are utterly +incapable of alone explaining the mischief. I am far more inclined to +believe that climatic peculiarities have formed the groundwork of the +evil, and enabled every injurious agency to produce an effect which +would not in some other countries be so severe. I am quite persuaded, +indeed, that the development of a nervous temperament is one of the many +race-changes which are also giving us facial, vocal, and other +peculiarities derived from none of our ancestral stocks. If, as I +believe, this change of temperament in a people coming largely from the +phlegmatic races is to be seen most remarkably in the more nervous sex, +it will not surprise us that it should be fostered by many causes which +are fully within our own control. Given such a tendency, disease will +find in it a ready prey, want of exercise will fatally increase it, and +all the follies of fashion will aid in the work of ruin. + +While a part of the mischief lies with climatic conditions which are +utterly mysterious, the obstacles to physical exercise, arising from +extremes of temperature, constitute at least one obvious cause of ill +health among women in our country. The great heat of summer, and the +slush and ice of winter, interfere with women who wish to take exercise, +but whose arrangements to go out-of-doors involve wonderful changes of +dress and an amount of preparation appalling to the masculine creature. + +The time taken for the more serious instruction of girls extends to the +age of nineteen, and rarely over this. During some of these years they +are undergoing such organic development as renders them remarkably +sensitive. At seventeen I presume that healthy girls are as well able +to study, _with proper precautions_, as men; but before this time +overuse, or even a very steady use, of the brain is in many dangerous to +health and to every probability of future womanly usefulness. + +In most of our schools the hours are too many, for both girls and boys. +From nine until two is, with us, the common school-time in private +seminaries. The usual recess is twenty minutes or half an hour, and it +is not as a rule filled by enforced exercise. In certain schools--would +it were common!--ten minutes' recess is given after every hour; and in +the Blind Asylum of Philadelphia this time is taken up by light +gymnastics, which are obligatory. To these hours we must add the time +spent in study out of school. This, for some reason, nearly always +exceeds the time stated by teachers to be necessary; and most girls of +our common schools and normal schools between the ages of thirteen and +seventeen thus expend two or three hours. Does any physician believe +that it is good for a growing girl to be so occupied seven or eight +hours a day? or that it is right for her to use her brains as long a +time as the mechanic employs his muscles? But this is only a part of +the evil. The multiplicity of studies, the number of teachers,--each +eager to get the most he can out of his pupil, the severer drill of our +day, and the greater intensity of application demanded, produce effects +on the growing brain which, in a vast number of cases, can be only +disastrous. + +My remarks apply of course chiefly to public school life. I am glad to +say that of late in all of our best school States more thought is now +being given to this subject, but we have much to do before an evil which +is partly a school difficulty and partly a home difficulty shall have +been fully provided against. + +Careful reading of our Pennsylvania reports and of those of +Massachusetts convinces me that while in the country schools overwork is +rare, in those of the cities it is more common, and that the system of +pushing,--of competitive examinations,--of ranking, etc., is in a +measure responsible for that worry which adds a dangerous element to +work. + +The following remarks as to the influence of home life in Massachusetts +are not out of place here, and will be reinforced by what is to be said +farther on by a competent authority as to Philadelphia: + +"The danger of overwork, I believe, exists mainly, if not wholly, in +graded schools, where large numbers are taught together, where there is +greater competition than in ungraded schools, and where the work of each +pupil cannot be so easily adjusted to his capacity and needs. And what +are the facts in these schools? I am prepared to agree with a recent +London School Board Report so far as to say that in some of our graded +schools there are pupils who are overworked. The number in any school +is, I believe, small who are stimulated beyond their strength, and the +schools are few in which such extreme stimulation is encouraged. When, +with a large class of children whose minds are naturally quick and +active, the teacher resorts to the daily marking of recitations, to the +giving of extra credits for extra work done, to ranking, and to holding +up the danger of non-promotion before the pupils; and when, added to +those extra inducements to work, there are given by committees and +superintendents examinations for promotion at regular intervals, it +would be very strange if there were not some pupils so weak and so +susceptible as to be encouraged to work beyond their strength. There is +another occasion of overwork which I have found in a few schools, and +that is the spending of nearly all of the school time in recitation and +putting off study to extra time at home. When, in a school of forty or +more, pupils belong to the same class, and are not separated into +divisions for recitation and study, there is a temptation to spend the +greater part of the time in recitation which few teachers can resist; +and if tasks are given, they have to be learned out of school or not at +all. Pupils of grammar schools are known to feel obliged to study two or +three hours daily from this cause at a time when they should be +sleeping, or exercising in the open air. Frequently, however, it is not +so much overwork as overworry that most affects the health of the +child,--that worry which may not always be traced to any fault of system +or teacher, but which, it must be admitted, is too often induced by +encouraging wrong motives to study. + +"In making up the verdict we must not forget that others besides the +teacher may be responsible for overwork and overworry. The parents and +pupils themselves are quite as often to blame as are the teachers. An +unwillingness on the part of pupils to review work imperfectly done, and +a desire on the part of parents to have their children get into a higher +class, or to graduate, frequently cause pupils to cram for examinations +and to work unduly at a time when the body is least able to bear the +extra strain. Again, children are frequently required to take extra +lessons in music or some other study at home, thus depriving them of +needed exercise and recreation, or exhausting nervous energy which is +needed for their regular school work. + +"It will be observed that in this charge against parents I do not speak +of those causes of ill health which really have nothing to do with +overwork, but which are oftentimes forgotten when a school-boy or girl +breaks down. I allude to the eating of improper and unwholesome food, to +irregularity of eating and sleeping, to attendance upon parties and +other places of amusement late at night, to smoking, and to the +indulgence of other habits which tend to unduly excite the nervous +system. For very obvious reasons these causes of disease are not +brought prominently forward by the attending physician, who doubtless +thinks it safer and more flattering to his patrons to say that the child +has broken down from hard study, rather than from excesses which are +somewhat discreditable. While parents are clearly to blame for +endangering health in the ways indicated, it may be a question whether +the work required to be done in school should not be regulated +accordingly; whether, in designating the studies to be taken, and in +assigning lessons, there should not be taken into consideration all the +circumstances of the pupil's life which can be conveniently ascertained, +even though those circumstances are most unfavorable to school work and +are brought about mainly through the ignorance or folly of parents. Of +course there is a limit to such an adjustment of work in school, but +with proper caution and a good understanding with the parents there need +be little danger of advantage being taken by an indolent child; nor need +the school be affected when it is understood to be a sign of weakness +rather than of favor to any particular pupil to lessen his work. Not +unfrequently there are found other causes of ill health than those which +I have mentioned; such, for instance, as poor ventilation, overheating +of the school-room, draughts of cold air, and the like; not to speak of +the annual public exhibition, with the possible nervous excitement +attending it. All of these things are mentioned, not because they belong +directly to the question of overwork, but because it is well, in +considering the question, to keep in mind all possible causes of ill +health, that no one cause may be unduly emphasized."[1] + +[Footnote 1: Forty-ninth Annual Report of the Massachusetts Board of +Education, p. 204 (John T. Prince).] + +In private schools the same kind of thing goes on, with the addition of +foreign languages, and under the dull spur of discipline, without the +aid of any such necessities as stimulate the pupils of what we are +pleased to call a normal (!) school. + +In private schools for girls of what I may call the leisure class of +society overwork is of course much more rare than in our normal schools +for girls, but the precocious claims of social life and the indifference +of parents as to hours and systematic living needlessly add to the +ever-present difficulties of the school-teacher, whose control ceases +when the pupil passes out of her house. + +As to the school in which both sexes are educated together a word may be +said. Surely no system can be worse than that which complicates a +difficult problem by taking two sets of beings of different gifts, and +of unlike physiological needs and construction, and forcing them into +the same educational mould. + +It is a wrong for both sexes. Not much unlike the boy in childhood, +there comes a time when in the rapid evolution of puberty the girl +becomes for a while more than the equal of the lad, and, owing to her +conscientiousness, his moral superior, but at this era of her life she +is weighted by periodical disabilities which become needlessly hard to +consider in a school meant to be both home and school for both sexes. +Finally, there comes a time when the matured man certainly surpasses the +woman in persistent energy and capacity for unbroken brain-work. If then +she matches herself against him, it will be, with some exceptions, at +bitter cost. + +It is sad to think that the demands of civilized life are making this +contest almost unavoidable. Even if we admit equality of intellect, the +struggle with man is cruelly unequal and is to be avoided whenever it is +possible. + +The colleges for women, such as Vassar, are nowadays more careful than +they were. Indeed, their machinery for guarding health while education +of a high class goes on is admirable. What they still lack is a correct +public feeling. The standard for health and endurance is too much that +which would be normal for young men, and the sentiment of these groups +of women is silently opposed to admitting that the feminine life has +necessities which do not cumber that of man. Thus the unwritten code +remains in a measure hostile to the accepted laws which are supposed to +rule. + +As concerns our colleges for young men I have little to say. The cases I +see of breakdown among women between sixteen and nineteen who belong to +normal schools or female colleges are out of all proportion larger than +the number of like failures among young men of the same ages, and yet, +as I have hinted, the arrangements for watching the health of these +groups of women are usually better than such as the colleges for young +men provide. The system of professional guardianship at Johns Hopkins is +an admirable exception, and at some other institutions the physical +examination on matriculation becomes of the utmost value, when followed +up as it is in certain of these schools by compulsory physical training +and occasional re-examinations of the state of health. + +I do not see why the whole matter could not in all colleges be +systematically made part of the examinations on entry upon studies. It +would at least point out to the thoughtful student his weak points, and +enable him to do his work and take his exercise with some regard to +consequences. I have over and over seen young men with weak hearts or +unsuspected valvular troubles who had suffered from having been allowed +to play foot-ball. Cases of cerebral trouble in students, due to the use +of defective eyes, are common, and I have known many valuable lives +among male and female students crippled hopelessly owing to the fact +that no college pre-examination of their state had taught them their +true condition, and that no one had pointed out to them the necessity +of such correction by glasses as would have enabled them as workers to +compete on even terms with their fellows. + +In a somewhat discursive fashion I have dwelt upon the mischief which is +pressing to-day upon our girls of every class in life. The doctor knows +how often and how earnestly he is called upon to remonstrate against +this growing evil. He is, of course, well enough aware that many sturdy +girls stand the strain, but he knows also that very many do not, and +that the brain, sick with multiplied studies and unwholesome home life, +plods on, doing poor work, until somebody wonders what is the matter +with that girl; or she is left to scramble through, or break down with +weak eyes, headaches, neuralgias, or what not. I am perfectly confident +that I shall be told here that girls ought to be able to study hard +between fourteen and eighteen years without injury, if boys can do it. +Practically, however, the boys of to-day are getting their toughest +education later and later in life, while girls leave school at the same +age as they did thirty years ago. It used to be common for boys to +enter college at fourteen: at present, eighteen is a usual age of +admission at Harvard or Yale. Now, let any one compare the scale of +studies for both sexes employed half a century ago with that of to-day. +He will find that its demands are vastly more exacting than they +were,--a difference fraught with no evil for men, who attack the graver +studies later in life, but most perilous for girls, who are still +expected to leave school at eighteen or earlier.[1] + +[Footnote 1: Witness Richardson's heroine, who was "perfect mistress of +the four rules of arithmetic"!] + +I firmly believe--and I am not alone in this opinion--that as concerns +the physical future of women they would do far better if the brain were +very lightly tasked and the school hours but three or four a day until +they reach the age of seventeen at least. Anything, indeed, were better +than loss of health; and if it be in any case a question of doubt, the +school should be unhesitatingly abandoned or its hours lessened, as at +least in part the source of very many of the nervous maladies with which +our women are troubled. I am almost ashamed to defend a position which +is held by many competent physicians, but an intelligent friend, who has +read this page, still asks me why it is that overwork of brain should be +so serious an evil to women at the age of womanly development. My best +reply would be the experience and opinions of those of us who are called +upon to see how many school-girls are suffering in health from +confinement, want of exercise at the time of day when they most incline +to it, bad ventilation,[1] and too steady occupation of mind. At no +other time of life is the nervous system so sensitive,--so irritable, I +might say,--and at no other are abundant fresh air and exercise so +important. To show more precisely how the growing girl is injured by the +causes just mentioned would lead me to speak of subjects unfit for full +discussion in these pages, but no thoughtful reader can be much at a +loss as to my meaning. + +[Footnote 1: In the city where this is written there is, so far as I +know, not one private girls' school in a building planned for a +school-house. As a consequence, we hear endless complaints from young +ladies of overheated or chilly rooms. If the teacher be old, the room is +kept too warm; if she be young, and much afoot about her school, the +apartment is apt to be cold.] + +The following remarks I owe to the experience of a friend,[1] a woman, +who kindly permits me to use them in full. They complete what +I have space to add as to the matter of education, and deserve to be +read with care by every parent and by every one concerned in our public +schools. + +[Footnote 1: Miss Pendleton.] + +"There can be no question that the health of growing girls is overtaxed; +but, in my opinion, this is a vice of the age, and not primarily of the +schools. I have found teachers more alive to it than parents or the +general public. Upon interrogating a class of forty girls, of ages +varying from twelve to fourteen, I found that more than half the number +were conscious of loss of sleep and nervous apprehension before +examinations; but I discovered, upon further inquiry, that nearly +one-half of this class received instruction in one or two branches +outside of the school curriculum, with the intention of qualifying to +become teachers. I could get no information as to appetite or diet; all +of the class, as the teacher informed me, being ashamed to give +information on questions of the table. In the opinion of this teacher, +nervousness and sleeplessness are somewhat due to studies and in-door +social amusements in addition to regular school work; but chiefly to +ignorance in the home as to the simplest rules of healthy living. Nearly +all the girls in this class drink a cup of tea before leaving home, eat +a sweet biscuit as they walk, hurried and late, to school, and nothing +else until they go home to their dinners at two o'clock. All their +brain-work in the school-room is done before eating any nourishing food. +The teacher realized the injurious effects of the present forcing +system, and suggested withdrawing the girls from school for one year +between the grammar- and high-school grades. When I asked whether a +better result would not be obtained by keeping the girls in school +during this additional year, but relieving the pressure of purely mental +work by the introduction throughout all the grades of branches in +household economy, she said this seemed to her ideal, but, she feared, +impracticable, not from the nature of schools, but from the nature of +boards. + +"A Latin graduating class of seven girls, aged seventeen and eighteen +years, stated that they do their work without nervousness, restlessness, +or apprehension. + +"This, with other statistics, would seem to bear out your theory that +after seventeen girls may study with much less risk to health. + +"So far as I have observed, the strain or tear is chiefly in the case of +girls studying to become teachers. These girls often press forward too +rapidly for the purpose of becoming self-supporting at the age of +eighteen. The bait of a salary, and a good salary for one entering upon +a profession, lures them on; and a false sympathy in members of boards +and committees lends itself to this injurious cramming. + +"Our own normal school,[1] which is doing a great, an indispensable, +work in preparing a trained body of faithful, intelligent teachers, has +succumbed to this injurious tendency. We have here the high and normal +grades merged into one, the period of adolescence stricken out of the +girl's school life, and many hundreds of girls hurried annually forward +beyond their physical or mental capacity, in advance of their physical +growth, for the sake of those who cannot afford to remain in school one +or two years longer. I say this notwithstanding the fact that this +school is, in my opinion, one of the most potent agencies for good in +the community." + +[Footnote 1: Philadelphia.] + +"Overpressure in school appears to me to be a disease of the body +politic from which this member suffers; but it also seems to me that +this vast school system is the most powerful agency for the correction +of the evil. In the case of girls, the first principle to be recognized +is that the education of women is a problem by itself; that, in all its +lower grades at all events, it is not to be laid down exactly upon the +lines of education for boys. + +"The school system may be made a forceful agency for building up the +family, and the integrity of the home is without doubt the vital +question of the age. + +"Edward Everett Hale, with his far spiritual sight, has discerned the +necessity for restoring home training, and advocates, to this end, short +school terms of a few weeks annually. It is probable that in the future +many school departments will be relegated to the home, but the homes are +not now prepared to assume these duties. + +"When it was discovered that citizens must be prepared for their +political duties the schools were opened; but the means so far became +an end that even women were educated only in the directions which bear +upon public and not upon household economy. The words of Stein, that +'what we put into the schools will come out in the manhood of the nation +afterward,' cannot be too often quoted. Let branches in household +economy be connected with all the general as distinguished from +normal-school grades, and we not only relieve the girl immediately of +the strain of working with insufficient food, and of acquiring skill in +household duties in addition to the school curriculum, we not only +simplify and harmonize her work, but we send out in every case a woman +prepared to carry this new influence into all her future life, even if a +large number of these women should eventually pursue special or higher +technical branches; for we are women before we are teachers, lawyers, +physicians, etc., and if we are to add anything of distinctive value to +the world by entering upon the fields of work hitherto pre-empted by +men, it will be by the essential quality of this new feminine element. + +"The strain in all work comes chiefly from lack of qualification by +training or nature for the work in hand,--tear in place of wear. The +schools can restore the ideal of quiet work. They have an immense +advantage in regularity, discipline, time. This vast system gives an +opportunity, such as no private schools offer, for ascertaining the +average work which is healthful for growing girls. It is quite possible +to ascertain, whether by women medical officers appointed to this end, +or by the teachers themselves, the physical capacity of each girl, and +to place her where this will not be exceeded. Girls trained in school +under such wise supervision would go out into life qualified to guard +the children of the future. The chief cause of overwork of children at +present is the ignorance of parents as to the injurious effects of +overwork, and of the signs of its influence. + +"The first step toward the relief of over-pressure and false stimulus is +to discard the pernicious idea that it is the function of the normal +school to offer to every girl in the community the opportunity for +becoming a teacher. This unwholesome feature is the one distinctive +strain which must be removed from the system. It can be done provided +public and political sentiment approve. The normal school should be only +a device for securing the best possible body of teachers. It should be +technical. + +"Every teacher knows that the average girl of seventeen has not reached +the physical, mental, or moral development necessary to enter upon this +severe and high professional course of studies, and that one year is +insufficient for such a course. + +"Lengthen the time given to normal instruction,--make it two years; give +in this school instruction purely in the science of education; relegate +all general instruction to a good high school covering a term of four +years. In this as in all other progressive formative periods the way out +is ahead. + +"It will be time enough to talk of doing away with a portion of the +girls' school year when the schools have fulfilled their high mission, +when they have sent out a large body of American women prepared, not for +a single profession, even the high feminine vocation of pedagogy, but +equipped for her highest, most general and congenial functions as the +source and centre of the home." + +I am unwilling to leave this subject without a few words as to our +remedy, especially as concerns our public schools and normal schools for +girls. What seems to me to be needed most is what the woman would bring +into our school boards. Surely it is also possible for female teachers +to talk frankly to that class of girls who learn little of the demands +of health from uneducated or busy or careless mothers, and it would be +as easy, if school boards were what they should be, to insist on such +instruction, and to make sure that the claims of maturing womanhood are +considered and attended to. Should I be told that this is impracticable, +I reply that as high an authority as Samuel Eliot, of Massachusetts, has +shown in large schools that it is both possible and valuable. As +concerns the home life, it is also easy to get at the parents by annual +circulars enforcing good counsel as to some of the simplest hygienic +needs in the way of sleep, hours of study, light, and meals. + +It were better not to educate girls at all between the ages of fourteen +and eighteen, unless it can be done with careful reference to their +bodily health. To-day, the American woman is, to speak plainly, too +often physically unfit for her duties as woman, and is perhaps of all +civilized females the least qualified to undertake those weightier tasks +which tax so heavily the nervous system of man. She is not fairly up to +what nature asks from her as wife and mother. How will she sustain +herself under the pressure of those yet more exacting duties which +nowadays she is eager to share with the man? + +While making these stringent criticisms, I am anxious not to be +misunderstood. The point which above all others I wish to make is this, +that owing chiefly to peculiarities of climate, our growing girls are +endowed with organizations so highly sensitive and impressionable that +we expose them to needless dangers when we attempt to overtax them +mentally. In any country the effects of such a course must be evil, but +in America I believe it to be most disastrous. + +As I have spoken of climate in the broad sense as accountable for some +peculiarities of the health of our women, so also would I admit it as +one of the chief reasons why work among men results so frequently in +tear as well as wear. I believe that something in our country makes +intellectual work of all kinds harder to do than it is in Europe; and +since we do it with a terrible energy, the result shows in wear very +soon, and almost always in the way of tear also. Perhaps few persons who +look for evidence of this fact at our national career alone will be +willing to admit my proposition, but among the higher intellectual +workers, such as astronomers, physicists, and naturalists, I have +frequently heard this belief expressed, and by none so positively as +those who have lived on both continents. Since this paper was first +written I have been at some pains to learn directly from Europeans who +have come to reside in America how this question has been answered by +their experience. For obvious reasons, I do not name my witnesses, who +are numerous; but, although they vary somewhat in the proportion of the +effects which they ascribe to climate and to such domestic peculiarities +as the overheating of our houses, they are at one as regards the simple +fact that, for some reason, mental work is more exhausting here than in +Europe; while, as a rule, such Americans as have worked abroad are well +aware that in France and in England intellectual labor is less trying +than it is with us. A great physiologist, well known among us, long ago +expressed to me the same opinion; and one of the greatest of living +naturalists, who is honored alike on both continents, is positive that +brain-work is harder and more hurtful here than abroad, an opinion which +is shared by Oliver Wendell Holmes and other competent observers. +Certain it is that our thinkers of the classes named are apt to break +down with what the doctor knows as cerebral exhaustion,--a condition in +which the mental organs become more or less completely incapacitated for +labor,--and that this state of things is very much less common among the +savans of Europe. A share in the production of this evil may perhaps be +due to certain general habits of life which fall with equal weight of +mischief upon many classes of busy men, as I shall presently point out. +Still, these will not altogether account for the fact, nor is it to my +mind explained by any of the more obvious faults in our climate, nor yet +by our habits of life, such as furnace-warmed houses, hasty meals, bad +cooking, or neglect of exercise. Let a man live as he may, I believe he +will still discover that mental labor is with us more exhausting than we +could wish it to be. Why this is I cannot say, but it is not more +mysterious than the fact that agents which, as sedatives or excitants, +affect the great nerve-centres, do this very differently in different +climates. There is some evidence to show that this is also the case with +narcotics; and perhaps a partial explanation may be found in the manner +in which the excretions are controlled by external temperatures, as well +as by the fact which Dr. Brown-Séquard discovered, and which I have +frequently corroborated, that many poisons are retarded in their action +by placing the animal affected in a warm atmosphere. + +It is possible to drink with safety in England quantities of wine which +here would be disagreeable in their first effect and perilous in their +ultimate results. The Cuban who takes coffee enormously at home, and +smokes endlessly, can do here neither the one nor the other to the same +degree. And so also the amount of excitation from work which the brain +will bear varies exceedingly with variations of climatic influences. + +We are all of us familiar with the fact that physical work is more or +less exhausting in different climates, and as I am dealing, or about to +deal, with the work of business men, which involves a certain share of +corporal exertion, as well as with that of mere scholars, I must ask +leave to digress, in order to show that in this part of the country at +least the work of the body probably occasions more strain than in +Europe, and is followed by greater sense of fatigue. + +The question is certainly a large one, and should include a +consideration of matters connected with food and stimulants, on which I +can but touch. I have carefully questioned a number of master-mechanics +who employ both foreigners and native Americans, and I am assured that +the British workman finds labor more trying here than at home; while +perhaps the eight-hour movement may be looked upon as an instinctive +expression of the main fact as regards our working class in general. + +A distinguished English scholar informs me that since he has resided +among us the same complaints, as to the depressing effects of physical +labor in America, have come to him from skilled English mechanics. What +share change of diet and the like may have in the matter I have not +space to discuss.[1] + +[Footnote 1: The new emigrant suffers in a high degree from the same +evils as to cookery which affect only less severely the mass of our +people, and this, no doubt, helps to enfeeble him. The frying-pan has, I +fear, a better right to be called our national emblem than the eagle, +and I grieve to say it reigns supreme west of the Alleghanies. I well +remember that a party of friends about to camp out were unable to buy a +gridiron in two Western towns, each numbering over four thousand eaters +of fried meats.] + +Although, from what I have seen, I should judge that overtasked men of +science are especially liable to the trouble which I have called +cerebral exhaustion, all classes of men who use the brain severely, and +who have also--and this is important--seasons of excessive anxiety or of +grave responsibility, are subject to the same form of disease; and this +I presume is why we meet with numerous instances of nervous exhaustion +among merchants and manufacturers. The lawyer and clergyman offer +examples, but I do not remember to have seen many bad cases among +physicians. Dismissing the easy jest which the latter statement will +surely suggest, the reason for this we may presently encounter. + +My note-books seem to show that manufacturers and certain classes of +railway officials are the most liable to suffer from neural exhaustion. +Next to these come merchants in general, brokers, etc.; then less +frequently clergymen; still less often lawyers; and more rarely doctors; +while distressing cases are apt to occur among the overschooled young of +both sexes. + +The worst instances to be met with are among young men suddenly cast +into business positions involving weighty responsibility. I can recall +several cases of men under or just over twenty-one who have lost health +while attempting to carry the responsibilities of great manufactories. +Excited and stimulated by the pride of such a charge, they have worked +with a certain exaltation of brain, and, achieving success, have been +stricken down in the moment of triumph. This too frequent practice of +immature men going into business, especially with borrowed capital, is a +serious evil. The same person, gradually trained to naturally and +slowly increasing burdens, would have been sure of healthy success. In +individual cases I have found it so often vain to remonstrate or to +point out the various habits which collectively act for mischief on our +business class that I may well despair of doing good by a mere general +statement. As I have noted them, connected with cases of overwork, they +are these: late hours of work, irregular meals bolted in haste away from +home, the want of holidays and of pursuits outside of business, and the +consequent practice of carrying home, as the only subject of talk, the +cares and successes of the counting-house and the stock-board. Most of +these evil habits require no comment. What, indeed, can be said? The man +who has worked hard all day, and lunched or dined hastily, comes home or +goes to the club to converse--save the mark!--about goods and stocks. +Holidays, except in summer, he knows not, and it is then thought time +enough taken from work if the man sleeps in the country and comes into a +hot city daily, or at the best has a week or two at the sea-shore. This +incessant monotony tells in the end. Men have confessed to me that for +twenty years they had worked every day, often travelling at night or on +Sundays to save time, and that in all this period they had not taken one +day for play. These are extreme instances, but they are also in a +measure representative of a frightfully general social evil. + +Is it any wonder if asylums for the insane gape for such men? There +comes to them at last a season of business embarrassment; or, when they +get to be fifty or thereabouts, the brain begins to feel the strain, and +just as they are thinking, "Now we will stop and enjoy ourselves," the +brain, which, slave-like, never murmurs until it breaks out into open +insurrection, suddenly refuses to work, and the mischief is done. There +are therefore two periods of existence especially prone to those +troubles,--one when the mind is maturing; another at the turning-point +of life, when the brain has attained its fullest power, and has left +behind it accomplished the larger part of its best enterprise and most +active labor. + +I am disposed to think that the variety of work done by lawyers, their +long summer holiday, their more general cultivation, their usual tastes +for literary or other objects out of their business walks, may, to some +extent, save them, as well as the fact that they can rarely be subject +to the sudden and fearful responsibilities of business men. Moreover, +like the doctor, the lawyer gets his weight upon him slowly, and is +thirty at least before it can be heavy enough to task him severely. The +business man's only limitation is need of money, and few young +mercantile men will hesitate to enter trade on their own account if they +can command capital. With the doctor, as with the lawyer, a long +intellectual education, a slowly-increasing strain, and responsibilities +of gradual growth tend, with his out-door life, to save him from the +form of disease I have been alluding to. This element of open-air life, +I suspect, has a share in protecting men who in many respects lead a +most unhealthy existence. The doctor, who is supposed to get a large +share of exercise, in reality gets very little after he grows too busy +to walk, and has then only the incidental exposure to out-of-door air. +When this is associated with a fair share of physical exertion, it is an +immense safeguard against the ills of anxiety and too much brain-work. +For these reasons I do not doubt that the effects of our great civil +war were far more severely felt by the Secretary of War and President +Lincoln than by Grant or Sherman. + +The wearing, incessant cares of overwork, of business anxiety, and the +like, produce directly diseases of the nervous system, and are also the +fertile parents of dyspepsia, consumption, and maladies of the heart. +How often we can trace all the forms of the first-named protean disease +to such causes is only too well known to every physician, and their +connection with cardiac troubles is also well understood. Happily, +functional troubles of heart or stomach are far from unfrequent +precursors of the graver mischief which finally falls upon the +nerve-centres if the lighter warnings have been neglected; and for this +reason no man who has to use his brain energetically and for long +periods can afford to disregard the hints which he gets from attacks of +palpitation of heart or from a disordered stomach. In many instances +these are the only expressions of the fact that he is abusing the +machinery of mind or body; and the sufferer may think himself fortunate +that this is the case, since even the least serious degrees of direct +exhaustion of the centres with which he feels and thinks are more grave +and are less open to ready relief. + +When affections of the outlying organs are neglected, and even in many +cases where these have not suffered at all, we are apt to witness, as a +result of too prolonged anxiety combined with business cares, or even of +mere overwork alone, with want of proper physical habits as to exercise, +amusement, and diet, that form of disorder of which I have already +spoken as cerebral exhaustion; and before closing this paper I am +tempted to describe briefly the symptoms which warn of its approach or +tell of its complete possession of the unhappy victim. Why it should be +so difficult of relief is hard to comprehend, until we remember that the +brain is apt to go on doing its weary work automatically and despite the +will of the unlucky owner; so that it gets no thorough rest, and is in +the hapless position of a broken limb which is expected to knit while +still in use. Where physical overwork has worn out the spinal or motor +centres, it is, on the other hand, easy to enforce repose, and so to +place them in the best condition for repair. This was often and happily +illustrated during the late war. Severe marches, bad food, and other +causes which make war exhausting, were constantly in action, until +certain men were doing their work with too small a margin of +reserve-power. Then came such a crisis as the last days of McClellan's +retreat to the James River, or the forced march of the Sixth Army Corps +to Gettysburg, and at once these men succumbed with palsy of the legs. A +few months of absolute rest, good diet, ale, fresh beef and vegetables +restored them to perfect health. + +In all probability incessant use of a part flushes with blood the +nerve-centres which furnish it with motor energy, so that excessive work +may bring about a state of congestion, owing to which the nerve-centre +becomes badly nourished, and at last strikes work. In civil life we +sometimes meet with such cases among certain classes of artisans: +paralysis of the legs as a result of using the treadle of the +sewing-machine ten hours a day is a good example, and, I am sorry to +add, not a very rare one, among the overtasked women who slave at such +labor. + +Now let us see what happens when the intellectual organs are put +over-long on the stretch, and when moral causes, such as heavy +responsibilities and over-anxiety, are at work. + +When in active use, the thinking organs become full of blood, and, as +has been shown, rise in temperature, while the feet and hands become +cold. Nature meant that, for their work, they should be, in the first +place, supplied with food; next, that they should have certain intervals +of rest to rid themselves of the excess of blood accumulated during +their periods of activity, and this is to be done by sleep, and also by +bringing into play the physical machinery of the body, such as the +muscles,--that is to say, by exercise which flushes the parts engaged in +it and so depletes the brain. She meant, also, that the various +brain-organs should aid in the relief, by being used in other directions +than mere thought; and lastly, she desired that, during digestion, all +the surplus blood of the body should go to the stomach, intestines, and +liver, and that neither blood nor nerve-power should be then misdirected +upon the brain: in other words, she did not mean that we should try to +carry on, with equal energy, two kinds of important functional business +at once. + +If, then, the brain-user wishes to be healthy, he must limit his hours +of work according to rules which will come of experience, and which no +man can lay down for him. Above all, let him eat regularly and not at +too long intervals. I well remember the amazement of a distinguished +naturalist when told that his sleeplessness and irregular pulse were due +to his fasting from nine until six. A biscuit and a glass of porter, at +one o'clock, effected a ready and pleasant cure. As to exercise in the +fresh air, I need say little, except that if the exercise can be made to +have a distinct object, not in the way of business, so much the better. +Nor should I need to add that we may relieve the thinking and worrying +mechanisms by light reading and other amusements, or enforce the lesson +that no hard work should be attempted during digestion. The wise doctor +may haply smile at the commonplace of such directions, but woe be to the +man who neglects them! + +When an overworked and worried victim has sufficiently sinned against +these simple laws, if he does not luckily suffer from disturbances of +heart or stomach, he begins to have certain signs of nervous +exhaustion. + +As a rule, one of two symptoms appears first, though sometimes both come +together. Work gets to be a little less facile; this astonishes the +subject, especially if he has been under high pressure and doing his +tasks with that ease which comes of excitement. With this, or a little +later, he discovers that he sleeps badly, and that the thoughts of the +day infest his dreams, or so possess him as to make slumber difficult. +Unrefreshed, he rises and plunges anew into the labor for which he is no +longer competent. Let him stop here; he has had his warning. Day after +day the work grows more trying, but the varied stimulants to exertion +come into play, the mind, aroused, forgets in the cares of the day the +weariness of the night season, and so, with lessening power and growing +burden, he pursues his purpose. At last come certain new symptoms, such +as giddiness, dimness of sight, neuralgia of the face or scalp, with +entire nights of insomnia and growing difficulty in the use of the +mental powers; so that to attempt a calculation, or any form of +intellectual labor, is to insure a sense of distress in the head, or +such absolute pain as proves how deeply the organs concerned have +suffered. Even to read is sometimes almost impossible; and there still +remains the perilous fact that under enough of moral stimulus the man +may be able, for a few hours, to plunge into business cares, without +such pain as completely to incapacitate him for immediate activity. +Night, however, never fails to bring the punishment; and at last the +slightest prolonged exertion of mind becomes impossible. In the worst +cases the scalp itself grows sore, and a sudden jar hurts the brain, or +seems to do so, while the mere act of stepping from a curb-stone +produces positive pain. + +Strange as it may seem, much of all this may happen to a man, and he may +still struggle onward, ignorant of the terrible demands he is making +upon an exhausted brain. Usually, by this time he has sought advice, +and, if his doctor be worthy of the title, has learned that while there +are certain aids for his symptoms in the shape of drugs, there is only +one real remedy. Happy he if not too late in discovering that complete +and prolonged cessation from work is the one thing needful. Not a week +of holiday, or a month, but probably a year or more of utter idleness +may be absolutely essential. Only this will answer in cases so extreme +as that which I have tried to depict, and even this will not always +insure a return to a state of active working health. + +I am very far from conceding that the vehement energy with which we do +our work is due altogether to greed. We probably idle less and play less +than any other race, and the absence of national habits of sport, +especially in the West, leaves the man of business with no inducement to +abandon that unceasing labor in which at last he finds his sole +pleasure. He does not ride, or shoot, or fish, or play any game but +euchre. Business absorbs him utterly, and at last he finds neither time +nor desire for books. The newspaper is his sole literature; he has never +had time to acquire a taste for any reading save his ledger. Honest +friendship for books comes with youth or, as a rule, not at all. At last +his hour of peril arrives. Then you may separate him from business, but +you will find that to divorce his thoughts from it is impossible. The +fiend of work he raised no man can lay. As to foreign travel, it +wearies him. He has not the culture which makes it available or +pleasant. Notwithstanding the plasticity of the American, he is now +without resources. What then to advise I have asked myself countless +times. Let him at least look to it that his boys go not the same evil +road. The best business men are apt to think that their own successful +careers represent the lives their children ought to follow, and that the +four years of college spoil a lad for business. In reality these years, +be they idle or well filled with work, give young men the custom of +play, and surround them with an atmosphere of culture which leaves them +with bountiful resources for hours of leisure, while they insure to them +in these years of growth wholesome, unworried freedom from such business +pressure as the successful parent is so apt to put on too youthful +shoulders. + +Somewhat distracted by the desire to be brief, and yet to tell the whole +story, I have sought, in what I fear is a very loose and disconnected +way, to put in a new light some of the evils which are hurting the +mothers of our race, and those which every day's experience teaches the +doctor are gravely affecting the working capacity of numberless men. I +trust I have succeeded in satisfying my readers that we dwell in a +climate where work of all kinds demands greater precautions as to health +than is the case abroad. We cannot improve our climate, but it is quite +possible that we have not sufficiently learned to modify the conditions +of labor in accordance with those of the sky under which we live. + +No student of the nervous maladies of American men and women will think +I have overdrawn any part of the foregoing sketch. It would have been as +easy, had such a course been proper, to tell the individual stories of +youth, vigorous, eager, making haste to be rich, wrecked and made +unproductive and dependent for years or forever; and of middle age, +unable or unwilling to pause in the career of dollar-getting, crushed to +earth in the hour of fruition, or made powerless to labor longer at any +cost for those who were dearest. + +THE END. + + + + + + + +End of the Project Gutenberg EBook of Wear and Tear, by Silas Weir Mitchell + +*** END OF THE PROJECT GUTENBERG EBOOK 13197 *** |