Part 1

WEAR AND TEAR,

HINTS FOR THE OVERWORKED.

BY S. WEIR MITCHELL, M.D., LL.D. HARV.,

MEMBER OF THE NATIONAL ACADEMY OF SCIENCES, PRESIDENT OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA, ETC.

FIFTH EDITION, THOROUGHLY REVISED.

PHILADELPHIA: J.B. LIPPINCOTT COMPANY. LONDON: 10 HENRIETTA STREET, COVENT GARDEN.

Entered according to Act of Congress, in the year 1871, by J.B. LIPPINCOTT & CO., In the Office of the Librarian of Congress at Washington.

PRINTED BY J.B. LIPPINCOTT COMPANY, PHILADELPHIA.

PREFACE.

The rate of change in this country in education, in dress, and in diet and habits of daily life surprises even the most watchful American observer. It is now but fifteen years since this little book was written as a warning to a restless nation possessed of an energy tempted to its largest uses by unsurpassed opportunities. There is still need to repeat and reinforce my former remonstrance, but I am glad to add that since I first wrote on these subjects they have not only grown into importance as questions of public hygiene, but vast changes for the better have come about in many of our ways of living, and everywhere common sense is beginning to rule in matters of dress, diet, and education.

The American of the Eastern States and of the comfortable classes is becoming notably more ruddy and more stout. The alteration in women as to these conditions is most striking, and, if I am not mistaken, in England there is a lessening tendency towards that excess of adipose matter which is still a surprise to the American visiting England for the first time.

I should scarcely venture to assert so positively that Americans had obviously taken on flesh within a generation if what I see had not been observed by many others. It would, I think, be interesting to enter at length upon a study of these remarkable changes, but that were scarcely within the scope of this little book.

WEAR AND TEAR.

HINTS FOR THE OVERWORKED.

Many years ago 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 brain and body. Tear is another matter: it comes of hard or evil usage of body or engine, of putting things to wrong purposes, using a chisel for a screw-driver, a penknife for a gimlet. Long strain, or the sudden demand of strength from weakness, causes tear. Wear comes of use; tear, of abuse.

The sermon of which these words are the text has been preached many times in many ways to congregations for whom the Dollar Devil had always a more winning eloquence. Like many another man who has talked wearily to his fellows with an honest sense of what they truly need, I feel how vain it is to hope for many earnest listeners. Yet here and there may be men and women, ignorantly sinning against the laws by which they should live or should guide the lives of others, who will perhaps be willing to heed what one unbiased thinker has to say in regard to the dangers of the way they are treading with so little knowledge as to where it is leading.

The man who lives an out-door life--who sleeps with the stars visible above him--who wins his bodily subsistence at first hand from the earth and waters--is a being who defies rain and sun, has a strange sense of elastic strength, may drink if he likes, and may smoke all day long, and feel none the worse for it. Some such return to the earth for the means of life is what gives vigor and developing power to the colonist of an older race cast on a land like ours. A few generations of men living in such fashion store up a capital of vitality which accounts largely for the prodigal activity displayed by their descendants, and made possible only by the sturdy contest with Nature which their ancestors have waged. That such a life is still led by multitudes of our countrymen is what alone serves to keep up our pristine force and energy. Are we not merely using the interest on these accumulations of power, but also wastefully spending the capital? From a few we have grown to millions, and already in many ways the people of the Atlantic coast present the peculiarities of an old nation. Have we lived too fast? The settlers here, as elsewhere, had ample room, and lived sturdily by their own hands, little troubled for the most part with those intense competitions which make it hard to live nowadays and embitter the daily bread of life. Neither had they the thousand intricate problems to solve which perplex those who struggle to-day in our teeming city hives. Above all, educational wants were limited in kind and in degree, and the physical man and woman were what the growing state most needed.

How much and what kind of good came of the gradual change in all these matters we well enough know. That in one and another way the cruel competition for the dollar, the new and exacting habits of business, the racing speed which the telegraph and railway have introduced into commercial life, the new value which great fortunes have come to possess as means towards social advancement, and the overeducation and overstraining of our young people, have brought about some great and growing evils, is what is now beginning to be distinctly felt. I should like, therefore, at the risk of being tedious, to re-examine this question--to see if it be true that the nervous system of certain classes of Americans is being sorely overtaxed--and to ascertain how much our habits, our modes of work, and, haply, climatic peculiarities, may have to do with this state of things. But before venturing anew upon a subject which may possibly excite controversy and indignant comment, let me premise that I am talking chiefly of the crowded portions of our country, of our great towns, and especially of their upper classes, and am dealing with those higher questions of mental hygiene of which in general we hear but too little. If the strictures I have to make applied as fully throughout the land--to Oregon as to New England, to the farmer as to the business man, to the women of the artisan class as to those socially above them--then indeed I should cry, God help us and those that are to come after us! Owing to causes which are obvious enough, the physical worker is being better and better paid and less and less hardly tasked, while just the reverse obtains in increasing ratios for those who live by the lower form of brain-work; so that the bribe to use the hand is growing daily, and pure mechanical labor, as opposed to that of the clerk, is being "levelled upward" with fortunate celerity.

Before attempting to indicate certain ways in which we as a people are overtaxing and misusing the organs of thought, I should be glad to have the privilege of explaining the terms which it is necessary to use, and of pointing out some of the conditions under which mental labor is performed.

The human body carries on several kinds of manufacture, two of which--the evolution of muscular force or motion, and intellection with all moral activities--alone concern us here. We are somewhat apt to antagonize these two sets of functions, and to look upon the latter, or brain-labor, as alone involving the use or abuse of the nervous system. But every blow on the anvil is as distinctly an act of the nerve centres as are the highest mental processes. If this be so, how or why is it that excessive muscular exertion--I mean such as is violent and continued--does not cause the same appalling effects as may be occasioned by a like abuse of the nerve-organs in mental actions of various kinds? This is not an invariable rule, for, as I may point out in the way of illustration hereafter, the centres which originate or evolve muscular power do sometimes suffer from undue taxation; but it is certainly true that when this happens, the evil result is rarely as severe or as lasting as when it is the organs of mental power that have suffered.

In either form of work, physical or mental, the will acts to start the needed processes, and afterwards is chiefly regulative. In the case of bodily labor, the spinal nerve-centres are most largely called into action. Where mental or moral processes are involved, the active organs lie within the cranium. As I said just now, when we talk of an overtaxed nervous system it is usually the brain we refer to, and not the spine; and the question therefore arises, Why is it that an excess of physical labor is better borne than a like excess of mental labor? The simple answer is, that mental overwork is harder, because as a rule it is closet or counting-room or at least in-door work--sedentary, in a word. The man who is intensely using his brain is not collaterally employing any other organs, and the more intense his application the less locomotive does he become. On the other hand, however a man abuses his powers of motion in the way of work, he is at all events encouraging that collateral functional activity which mental labor discourages: he is quickening the heart, driving the blood through unused channels, hastening the breathing and increasing the secretions of the skin--all excellent results, and, even if excessive, better than a too incomplete use of these functions.

But there is more than this in the question. We do not know as yet what is the cost in expended material of mental acts as compared with motor manifestations, and here, therefore, are at fault; because, although it seems so much slighter a thing to think a little than to hit out with the power of an athlete, it may prove that the expenditure of nerve material is in the former case greater than in the latter.

When a man uses his muscles, after a time comes the feeling called fatigue--a sensation always referred to the muscles, and due most probably to the deposit in the tissues of certain substances formed during motor activity. Warned by this weariness, the man takes rest--may indeed be forced to do so; but, unless I am mistaken, he who is intensely using the brain does not feel in the common use of it any sensation referable to the organ itself which warns him that he has taxed it enough. It is apt, like a well-bred creature, to get into a sort of exalted state under the stimulus of need, so that its owner feels amazed at the ease of its processes and at the sense of wide-awakefulness and power that accompanies them. It is only after very long misuse that the brain begins to have means of saying, "I have done enough;" and at this stage the warning comes too often in the shape of some one of the many symptoms which indicate that the organ is already talking with the tongue of disease.

I do not know how these views will be generally received, but I am sure that the personal experience of many scholars will decide them to be correct; and they serve to make clear why it is that men may not know they are abusing the organ of thought until it is already suffering deeply, and also wherefore the mind may not be as ruthlessly overworked as the legs or arms.

Whenever I have closely questioned patients or men of studious habits as to this matter, I have found that most of them, when in health, recognized no such thing as fatigue in mental action, or else I learned that what they took for this was merely that physical sense of being tired, which arises from prolonged writing or constrained positions. The more, I fancy, any healthy student reflects on this matter the more clearly will he recognize this fact, that very often when his brain is at its clearest, he pauses only because his back is weary, his eyes aching, or his fingers tired.

This most important question, as to how a man shall know when he has sufficiently tasked his brain, demands a longer answer than I can give it here; and, unfortunately, there is no popular book since Ray's clever and useful "Mental Hygiene," and Feuchtersleben's "Dietetics of the Soul," both out of print, which deals in a readable fashion with this or kindred topics. 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.