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
1891
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 rapidity of change in this country in education, dress, 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 energy tempted to its largest uses by
unsurpassed opportunities. There is still a 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 are most striking, and, if I am not mistaken, in England there
is a lessening tendency towards that excess of adipose matter [fat] 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 was scarcely within the scope of
this little book.
[1]Happily, a large class with us.
WEAR AND TEAR,
OR
HINTS FOR THE OVERWORKED.
Many years ago[2]
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.
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 the 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 screwdriver, a penknife for a gimlet. Long strain, or the sudden
the demand of strength from weakness causes tears. 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, and 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 colonists 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. 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 is true that the nervous system of certain classes of
Americans are 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
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 businessman, 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; so that the bribe to use the hand is growing daily, and pure
mechanical labor, as opposed to that of the clerk, is being leveled up; 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 centers that originate or evolve muscular power do
sometimes suffer from undue taxation. Still, 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 afterward 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 he becomes.
On the other hand, however, a man abuses his powers of motion in the way of work,
he is at all events encouraging 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 one of the many symptoms which
indicate that the organ is already talking with the tongue of the 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.[3]
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.
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,[4]
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.
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."[5]
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.[6]
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,[7]
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.
The following remarks I owe to the experience of a friend,[8]
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.
"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,[9] 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."
"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.[10]
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.
[2]In 1871.
[3]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.
[4]I asked two citizens of this uneasy town--on
the same day--what was their business. Both replied tranquilly that they were
speculators!
[5]Forty-ninth Annual Report of the
Massachusetts Board of Education, p. 204 (John T. Prince).
[6]Witness Richardson's heroine, who was
"perfect mistress of the four rules of arithmetic"!
[7]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.
[8]Miss Pendleton.
[9]Philadelphia.
[10]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.
THE END.
