Certain it is that our thinkers of the cla.s.ses 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 cla.s.ses 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-Sequard discovered, and which I have frequently corroborated, that many poisons are r.e.t.a.r.ded in their action by placing the animal affected in a warm atmosphere.

It is possible to drink with safety in England quant.i.ties 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 a.s.sured 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 cla.s.s 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 s.p.a.ce to discuss.[1]

[Footnote 1: The new emigrant suffers in a high degree from the same evils as to cookery which affect only less severely the ma.s.s of our people, and this, no doubt, helps to enfeeble him. The frying-pan has, I fear, a better right to be called our national emblem than the eagle, and I grieve to say it reigns supreme west of the Alleghanies. I well remember that a party of friends about to camp out were unable to buy a gridiron in two Western towns, each numbering over four thousand eaters of fried meats.]

Although, from what I have seen, I should judge that overtasked men of science are especially liable to the trouble which I have called cerebral exhaustion, all cla.s.ses 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 cla.s.ses 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 s.e.xes.

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 cla.s.s 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-sh.o.r.e. 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 embarra.s.sment; 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 p.r.o.ne 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 a.s.sociated 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, amus.e.m.e.nt, 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 ill.u.s.trated 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 succ.u.mbed 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 cla.s.ses 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 acc.u.mulated 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 gla.s.s 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 amus.e.m.e.nts, 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 t.i.tle, has learned that while there are certain aids for his symptoms in the shape of drugs, there is only one real remedy. Happy he if not too late in discovering that complete and prolonged cessation from work is the one thing needful. Not a week of holiday, or a month, but probably a year or more of utter idleness may be absolutely essential. Only this will answer in cases so extreme as that which I have tried to depict, and even this will not always insure a return to a state of active working health.

I am very far from conceding that the vehement energy with which we do our work is due altogether to greed. We probably idle less and play less than any other race, and the absence of national habits of sport, especially in the West, leaves the man of business with no inducement to abandon that unceasing labor in which at last he finds his sole pleasure. He does not ride, or shoot, or fish, or play any game but euchre. Business absorbs him utterly, and at last he finds neither time nor desire for books. The newspaper is his sole literature; he has never had time to acquire a taste for any reading save his ledger. Honest friendship for books comes with youth or, as a rule, not at all. At last his hour of peril arrives. Then you may separate him from business, but you will find that to divorce his thoughts from it is impossible. The fiend of work he raised no man can lay. As to foreign travel, it wearies him. He has not the culture which makes it available or pleasant. Notwithstanding the plasticity of the American, he is now without resources. What then to advise I have asked myself countless times. Let him at least look to it that his boys go not the same evil road. The best business men are apt to think that their own successful careers represent the lives their children ought to follow, and that the four years of college spoil a lad for business. In reality these years, be they idle or well filled with work, give young men the custom of play, and surround them with an atmosphere of culture which leaves them with bountiful resources for hours of leisure, while they insure to them in these years of growth wholesome, unworried freedom from such business pressure as the successful parent is so apt to put on too youthful shoulders.

Somewhat distracted by the desire to be brief, and yet to tell the whole story, I have sought, in what I fear is a very loose and disconnected way, to put in a new light some of the evils which are hurting the mothers of our race, and those which every day's experience teaches the doctor are gravely affecting the working capacity of numberless men. I trust I have succeeded in satisfying my readers that we dwell in a climate where work of all kinds demands greater precautions as to health than is the case abroad. We cannot improve our climate, but it is quite possible that we have not sufficiently learned to modify the conditions of labor in accordance with those of the sky under which we live.

No student of the nervous maladies of American men and women will think I have overdrawn any part of the foregoing sketch. It would have been as easy, had such a course been proper, to tell the individual stories of youth, vigorous, eager, making haste to be rich, wrecked and made unproductive and dependent for years or forever; and of middle age, unable or unwilling to pause in the career of dollar-getting, crushed to earth in the hour of fruition, or made powerless to labor longer at any cost for those who were dearest.

THE END.