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various ways the practice of medicine becomes a single and simple art and science in the hands of physicians who treat the disorders exhibited either through the phenomena of the mind or the body. This is my primary object, but there is another, hardly secondary. I am anxious also to put before the world at large the existence of certain physical social evils which are under perfect control, but which, developing with an increasing intelligence, are degrading the physical powers of our most powerful living men, and are interfering with the progressive development of powerful generations of men who should, or rather might, belong to the future.
Let me at once guard myself from any suspicion of a desire to exaggerate the evils of mental strain, by the remark that I have no idea of any evil from mental work when that is carried on with evenness and order and generalization. I take the brain to be the most enduring of organs—the organ that admits of most change, the organ that requires most change, the organ that is the most perfect repository of animal force and the most ready dispenser of it; the organ that can rest in parts when jaded, and work in parts that are not jaded at one and the same time. I look on mental work, and even on hard mental work, as conducive to health of life and length of days. I speak only of evils resulting from extreme strain or shock effecting mainly the grey matter of the cerebral structures; strain induced either by persistent and prolonged struggle, or by sudden and vehement shock conveyed by the senses and translated too urgentlyinto conscious manifestation.
Subjects of Mental Strain. Those who become subject to unfair mental influences from intense or prolonged strain belong to particular and easily defined classes of society. They are all mental workers, but as mental workers they constitute classes of themselvesclasses distinguished by the character of work in which they
I divide these classes into six.
First, there is the mere copyist, the man who sits all day at his desk, and transfers copies of writing, or of a speech, to a piece of paper. The clerk, the compositor, the reporter, and the second and third rate author are of this class.
Secondly, there is the thinker and writer, who copies also, but not directly from other writings, nor from thoughts expressed by other minds, but who goes to the great manuscripts of the Supreme Author-to the hills, and plains, and oceans, to the living kingdoms of all animals, and of all times, and translates the histories of these in written words, bringing the vastness of the universe, as seen by his superior sense, into moderate compass and legible form, so that lesser minds may read through him the truths he sees and unfolds.
Thirdly, there is the speculative man, usually very selfish and locked up in himself; who from day to day, and night to night, and hour to hour, schemes; who walks with his head down, his eyes on the earth, and thinks; thinks how he shall meet this obstacle, waylay that plan, shrewdly anticipate such and such event: a truly business man in the world's common acceptation.
Fourthly, there is the man who carries on his shoulders other people's anxieties, who thinks for others rather than for himself, and must never be tired by the effort: the professional man is here represented; the politician, the minister of religion, the physician and surgeon, the lawyer and the accountant.
Fifthly, there is the artist, who labours towards perfection in producing some given form-ideal or real-who, absorbed in his work, forgets the noisy crowd around him, and day after day toils on, living with his own creations, one in the world, but not of the world.
Lastly, there is the learner, the student; the child or youth whose will is hardly his own, who works when he is bidden, and plays when he is permitted ; who is fed too often with flattery or blows, and between, or by one and the other, is at length turned out in life prepared, as it is thought, by education and training, to fight the great and unceasing battle of life.
Amongst these classes we meet with those who suffer mainly from the consequences of mental strain ; but the injury is very unequally distributed. The copyist, who merely records the impressions he has received, and enters them direct on paper, is subject to little waste of force beyond that which is expended in muscular action, and his disorders are therefore confined chiefly to dyspepsia resulting from confinement at the desk, or from insufficient repose.
The second class of men, those who think as they write, suffer more determinately. With regard their work, however, I believe it need never be made injurious to the health of the body, and when it is varied and not compressed, it is one of the healthiest of occupations. The dangers to which men of letters are exposed, according to my observation, are two only: one the danger of rapid and intense thought with an impulse to chronicle instantly, and at any time, by night as by day what are called “happy conceptions ; » the other the danger of writing against time, and of sustaining a readiness, at any moment, to write at any length, on any conceivable topic.
The third class of men, the speculators, are a more extreme class, and suffer exceptionally from mental strain. The man who during life has simply to beat down enemies as they appear, to take one up and another down, has hard work ; but the speculator meets obstacles on all sides, and while he is winning in front, must often find himself held back by a strong hand in the rear. His life is to waylay, to calculate how he shall make up a book that shall win, come what will
The absorption of this man's thoughts in his own plans and devices removes from him generally the idea of illness and of
death. He differs from the man of ordinary business, in fact, in his insusceptibility to the necessities of his own physical existence. His life is surrounded with a kind of vulgar romance, and his own over-weening self-confidence, his consciousness that he either can or ought to devise schemes and calculations, which must or should carry the day, bear with them an enthusiasm which might well be devoted to a better
But by-and-by, in spite of himself, and in spite of the absorption, he begins to fail, and then the usual course is to resort to stimulants, by way of support. At last he suddenly breaks down; but buoyed up by constant hope of better days, he believes to the end that he shall recover, and retains his propensities with unflinching determination.
The ailments of the speculator are usually compound in character; for he is, in most cases, a man of active life, and the whole of his organism, muscular and nervous, is equally taxed. If he be a betting man, the race-course or some other out-door pursuit calls him into the open air. If he be a gambler, he is subjected to considerable muscular fatigue. Hence it follows that he is exposed to a variety of exhausting influences. His first symptoms usually commence with irregular action of the heart, and this is followed by results pertaining to a failure of that organ. In the majority of cases he succumbs, after exposure, to some sub-acute inflammatory disorder. He takes cold, suffers from congestion of the lungs or kidneys, and, unable to bear the shock, sinks rapidly under it, his mind becoming intensely irritable, or even losing its balance. Often he does some foolish thing, trips in his calculation, and is pronounced “insane."
The professional class of men stand amongst those who suffer most severely and decisively from what may be called simple exhaustion of the nervous system, resulting from active over-work. These differ from the other classes in most points. They differ from the original thinker in that they
are neither closeted in the study nor intense in working out original designs. Learned in certain matters of fact and principles which the world at large does not comprehend, they are constantly putting their knowledge into practice on behalf of others, and seeing the faults, failings, and miseries of humanity, they become in time inured and ready for every surprise. They differ from the speculator in that they have, after a time, but little enthusiasm. They learn of the Preacher that “all things are alike to all;" they incline further with the same authority, that all things come alike to all; that “as it happeneth to the wise, even so to them; and they praise the dead which are already dead more than the living which are yet alive.” Notwithstanding this, their philosophy fails them as their physical life advances. They suffer greatly from little annoyances connected with other men's concerns, and in the very fulness of their self-sacrifice —for of all men they least consider their own private con
they become morbidly' sensitive to slights of every kind and more dissatisfied. Success, which in early time was the object of their life, brings with it terrible cares that are not unfrequently harder to bear than the worst failures. When they have made a position, they must maintain it at all risks; and having attained their rank, must sustain it despite time and labour. Add to these things this responsibility, that the labour done is for others and is open to the criticism of circles of people who knowing nothing of the difficulties, are consistent in the belief, thatif they had had the management they could have done so much better,—and the picture is complete.
In the members of the professional class the brain is constantly being exercised without enthusiasm, and the body is daily being exercised without any sufficient rest. The result is that the excitement of brain which leads to insanity is exceedingly rare, and that those physical ailments which follow as secondary to the overworked brain become developed.