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ON PHYSICAL DISEASE FROM MENTAL
In an address I had the honour to deliver before the St. Andrew's Medical Graduates Association in December, 1868, I took the opportunity briefly to direct the attention of those practitioners of medicine who are not specially engaged in the treatment of the insane, to the great importance of recognizing the influence of mental action on physical disease. I ventured to press the fact that the most scientific physicians have fallen into the error of studying, with too exclusive a care, the observable conditions of the body, healthy or diseased, and those agents or agencies for curing diseases which produce the most obvious effects—such as knives and other instruments, anesthetic vapours, active drugs, heat and cold, electrical shocks, and the like. I admitted that as the pure physical existence is the groundwork and the primary necessity of the highest form of living thinking thing, it is by nature the first duty of the healer to make that corporeal frame pure and whole, but I insisted that it is equally his duty to study what shall enter by the senses or windows of the mind, and though invisibly entering, be potent forces for . evil or for good. Because an agency is not visible, not tangible, is it, I asked, less real? If a man lose his mind by the loss of his blood, that, it is said, is plain to understand, for
it is physical; but if some horror come upon the man through his mind, so that, like poor Horatio, he is be-chilled
“ Almost to jelly by the act of fear,
Stands dumb, and speaks not," is not that, too, physical - an action direct of mind on matter, reversing the physics of the body, and creating disease? It must be so; and in the study of this action, from the universe into the man, lies a world almost unknown.
I argued further that charlatans of all kinds have, with strange acuteness, touched, without understanding it, this unknown world. They have played, it is said, on the credulity of man; they have done more; they have, in ignorance of what they were doing, reached the animal motion through the direct entrances by which the universal spirit enters also. I urged that the need for new contemplation in this direction increases with the intellectual development of the race; that the animal body, in order to maintain equality of power, and be the equal of the soul within it, must, in the course of the suns, be replaced by an organism more finely moulded, more accessible to the external beauty and harmony, more sensitive of pain, more sensible of weakness, less susceptible of maladies evidenced through matter, more susceptible of maladies evidenced through mind, and more impressionable to cure or to injury through the mind than through the baser body. And, lastly, I submitted that to study these changes of existence and action, to open this unknown world of natural truth, not to trade upon the knowledge of its existence, but to comprehend it with wisdom, are tasks to which the man of physic must either devote himself or retire with humiliation from one of the strongest holds in philosophy.
The subject thus glanced at in the address to which I have referred is the key note of the present effort. desirous to bring before those who are most conversant with the mental side of disease, the question I have opened, from its physical point of view, and to illustrate how in many and
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 themselves, classes distinguished by the character of work in which they 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.
I divide these classes into six.
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, howerer, 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