PUBLIC^ LIBRARY UC-NRLF JkB n? M7b THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA PRESENTED BY PROF. CHARLES A. KOFOID AND MRS. PRUDENCE W. KOFOID Digitized by the Internet Archive • in 2007 with funding from Microsoft Corporation http://www.archive.org/details/brawiwoxkoverworOOwoodrich AMERICAN HEALTH PRIMERS. EDITED BY W. W. KEEN, M.D., Fellow of the College of Physicians of Philadelphia, and Surgeon to St. Mary's Hospital. AMERICAN HEALTH PRIMERS. Brain-Work Overwork. ^dr. h: c. wood, Clinical Professor of Nervous Diseases in the University of Pennsyl- vania , Member of the National Academy of Science t etc., etc. v>*Ko PHILADELPHIA: P. BLAKISTON, SON & CO., No. IOI2 WALNUT STREET. 188 2. Copyright PRESLEY BLAKISTON. j/^^hU^Jtu JbiJU K-RA we^ - fuiu Vk*($ ITS. ' CONTEN CHAPTER I. INTR OD UCTION PAGE Are Nervous Diseases Increasing? — General Inten- tion of the Book . IO CHAPTER II. GENERAL CAUSES OF NERVOUS TROUBLE. Exposure — Sexual Excesses — Alcohol — Tea and Coffee — Gluttony 18 CHAPTER III. WORK. Effects of Emotional and Intellectual Work — In- struments of Brain — Unnecessary Work — Proper Age for Labor — Difference in Labor-Power of Sexes — Woman's Work. . * . * • 43 CHAPTER IV. REST IN LABOR. Law of Habitual Action — Proper Time of Work — Variety of Work 76 M363797 Vlll CONTENTS, CHAPTER V. REST IN RECREATION PAGE Laws of Recreation — Sabbath Question — Sunday- School — Games — Exercise — Vacation ; Length, Method, and Place of Spending — Camping Out. 85 CHAPTER VI. REST IN SLEEP. Varieties of Sleep — How Sleep Rests — Theories of Sleep — Going to Sleep — Time and Amount of Sleep . . . no CHAPTER VII. CONCLUSION Paroxysmal Labor — Stimulants during Labor — Signs of Nervous Breakdown 122 BRAIN-WORK AND OVERWORK. CHAPTER I. INTRODUCTION. THERE exists, both within and without the ranks of the Medical Profession, a wide-spread belief that the exigencies of modern life are producing an ever-increasing amount of nervous diseases. At first sight it seems easy to decide whether this belief be or be not well founded. In reality, however, it is at present not possible to come to a positive conclusion as to how much nervous diseases are upon the increase. Reliable statistics, for America at least, are wanting; and even the figures furnished by the Registrar- General of England are open to grave criticism. As, however, they are the best at command, the fol- lowing table, taken from Dr. Althaus's work upon "Diseases of the Nervous System/' is appended. This table appears to prove that the importance of the role played by nervous disorders does not 9 IO BRAIN- WORK AND O VER WORK. V • bo ^ o *0 a> oi CO o *P *p y-t IO C5 CO o fa 4> ^_, 00 rH rH CO rH rH rH rH CO rH ^ . Tt" lO O t^ N ^h £> "^ ^ 00 Tf !>. O N On u o^ O On ^t ^J vo fa w Oh <D t/5 t/3 co" to CS vcT t^ dv w £S <«■ to *^ M IO t^ p M CM M to to to ^ Oh G <L> o o "^ O ^ CO CO CO u Is rH 62 00 rH CM 6* CM CM rH rH r~i rH r~i rH rH l/J ry) CO „ M !>. IO o 3 <u C* co W ON !>. o fa s fa o el O W3 > cS 0> V3 Os 6s CO ON co" On M to Ov oo" w »s o to IO CM Os O to I bo GO o O CD rH CO rJ4 < O *o rH CNl »o rH CD < c/) H W fa fa 4> 4J 5 o © CM CD rH rH rH rH rH H o far C/j 00 M IO M Th as S Q s & <o IO t^ CO ^J- w «5 •si vo^ to in M d CO to to to to to to in to fa 9 Is i bo ^ CO »o O CO CM o o ; CO CO 00 CO ^» OD *g © CM CM rH CM rH CO CM CQ CM CM o yj co tt M to IO t^ fa •J3 <u m 4-J to to vo HI 00 ffi O rt M a to (M CO o^ ^ o * H r^ (j co" rf M d cT ho . as rt to > On VO VO IO S3 i CM CO rH CO rH CO rH <L) »H o I T 1 1 CO I CO 3> 1 Si ** 1° in co CO !> CM 1> CM !>. CO 00 00 rH 00 rH GO rH »0 GO rH CO 00 rH CO CO rH INTR OD UCTION. 1 1 increase. Another very curious result, seemingly proven by the figures of the Registrar-General in the hands of Dr. Althaus, is that the deaths from affec- tions of the class under consideration are proportion- ately more numerous in rural districts than in cities. Thus, in a period of twenty-five years, the percentage of deaths from nervous diseases was in London, io'66 ; in the south-western counties of England, 11*20 ; in Wales, 15*38. In view of these figures, it would appear that the popular belief in the increase of nervous affections rests only upon the superiority of modern diagnosis ; or, in other words, that nervous diseases seem more frequent only because we recognize them more clearly than did our fathers. It seems to me, however, that to most minds they will appear to prove too much. I think most professional men will agree in believing that there is some fallacy underneath them, and will refuse to surrender their belief that the increasing wear and tear of modern life is showing itself in a corresponding increase of nervous troubles. Of course, in the limits of the Health Primer, it is not possible to discuss this question at length; but it may help, in preparing the ground for what is to follow, to point out some of the more obvious, although often forgotten, fallacies. In the first place, it is very clear that the figures of the Registrar-General fail to cover the whole case. 12 BRAIN-WORK AND OVERWORK. Death is but one act in the Drama of Life. It is notorious that very many of the most troubleful nervous disorders produce not death, but life-long misery, the victim perishing at last of some disease not known as nervous. The record books of the government office take no count of such cases. Thus thirty years of confinement from spinal irritation may end in a consumption, and as such appear in the rec- ord. The history of epilepsy is but too often that of a slow but irresistibly progressive failure of mental power, until it may be the boy or girl disappears in the gloom of the idiot asylum, finally to die of a pneu- monia or a fever. Insanity rages or mopes in the wards of the hospital, in after years to be noted by the Registrar as a fatal dysentery. Often again, and these are the saddest of cases, the mental warp is not sufficient for the asylum, but is enough to render miserable the life of the individual, and to blast the happiness of the home circle. Death is the common lot ; than which the living death, the perpetual tor- tures of a nervous disorder, is far worse. How often is suicide the index of a nervous breakdown ; yet who registers suicide as a nervous disease ? A very large number of the most fatal of nervous diseases occur especially in early childhood. These are, in many instances, the direct products of pri- vations or of gross violations of the laws of health. As the science of hygiene is being more and more INTR OD UCTION. 1 3 widely studied, and more effort put forth to obey some of the most obvious hygienic laws, the nerv- ous diseases of early childhood are becoming less frequent. As a notable instance may be cited the cretenism of Switzerland ; formerly, in certain dis- tricts, the pathetically disgusting children and adults met one at every turn. Now, under the improved conditions of life, a creten is everywhere a sufficient rarity to attract attention*. The diminution of fatal infantile nervous diseases is probably sufficient to affect the figures of the Registrar. Again, it must be remembered that many of the registered nervous dis- eases are really not diseases of the nervous system, but of some other organ. A man dies of convulsions due to excrementitious poison, retained in the system because the kidneys are diseased and unable to separate from the blood the noxious matters which are continually being formed in the body. Another man dies of an apoplexy, because the diseased kidneys have produced simultaneously both a disease of the arteries, whereby their coats have lost their toughness and elasticity, and become brittle, and also an increase in the size and power of the heart, which causes it to drive the blood with excessive force. Usually, the elastic artery dilates, r. <?., gives a little when the on-coming blood-wave abuts against it ; now the elasticity of the artery being gone, no yielding is possible. In the place of toughness is 14 BRAIN- WORK AND O VER WORK. brittleness, and when the abnormally powerful blood stream strikes the diseased artery wall, no wonder the latter often gives way and the current breaks through into the brain tissue. The vital fluid, out of its bounds, is a foreign body to the brain ; it tears, lacer ates, destroys, and a death from apoplexy results. In both these cases — in the convulsion, in the apoplexy — a death from nervous disease may be registered. Work, worry, the special exigencies of modern life may have had nothing to do with the fatal result. The disease, in fact, has not been of the nervous system, but of the kidneys, the heart, and the arteries. Modern science is revealing more and more clearly, on the one hand, that many of the so-called nerv- ous diseases are really affections of other organs; and, on the other hand, that many affections of other organs are in part or solely dependent upon disordered nervous action. Cut a muscle off from its connec- tion with the nerve centres, in forty-eight hours the microscope will show that its structure is altering. I have seen the buttocks slough from a man in a few days, as the result of an affection of the spinal cord. How far pneumonia, and other acute and chronic dis- orders, have their origin in nervous exhaustion, we do not yet know ; but the more we do know the more close does the connection seem. A very notable illustration of such a breakdown oc- INTR OD UCTION. 1 5 curred last spring in the case of Supervising Surgeon- General Woodworth, of the Marine Hospital Corps. The winter had been spent in the severest labor, under aggravated excitement and amidst great anxiety. It ended in disappointment. Immediately erysipelas and pneumonia appeared, and rapidly proved fatal. Not a death from nervous disorder, but a death undoubt- edly in great measure, if not entirely, due to a giving out of the nervous system : a death from nervous strain, from the rush and worry of life. One very suggestive point, already noted, in the figures of the Registrar-General is the greater pro- portion of the deaths from the so-called nervous dis- eases in the rural districts than in the cities. The habitual disregard of hygienic laws in the town is mostly of such a character as to breed fevers, con- sumptions, and similar affections. In the country, especially in the English country, from which our statistics are drawn, the lack of crowding, the abund-. ance of fresh air, the outdoor life, all have a dispo- sition to diminish fevers, consumptions, and allied ills; whilst, on the other hand, the long hours of hard physical labor, the exposure to all sorts of weather, the continuous hardships, have a tendency to cause slow rheumatisms, degenerations of the organs of the circulation and of the kidneys, and finally death from diseases which seem to be, though they are not in their essence, affections of the great nervous centre — 1 6 BRAIN- WORK AND O VER WORK. ' the brain. It is really the blood-vessels or the kid- neys which are at fault. The facts enumerated lead us to accept with great reserve any deduction from the figures of the Regis- trar-General as to the lessening in modern times of nervous diseases. The figures do not belittle the importance of work and worry, they increase that of other causes. For our present purposes, it is com- paratively unimportant whether nervous diseases are or are not on the increase. They certainly are suf- ficiently numerous and serious to warrant the most careful consideration. The exact degree, and even the exact character, of the influences of modern life upon the human nervous system for evil may not be fully known ; but certain- ly we do know enough to warrant the statement of the following summary or proposition : Modern life has a twofold action in regard to nervous affections ; it protects from many degenerations which are the results of physical hardships and exposure, but it tends to produce nervous exhaustion, which may end in brain-softening or some other marked nervous dis- ease, or may find its outcome in a pneumonia or a fever. It is evident that a Primer like the present should give clear ideas how to meet and avoid not only those causes of nervous disease which are peculiar to our civilization, but also those which have long been INTRODUCTION. 17 operative, and which are more gross in their charac- ter. To these shall be devoted the second chapter of this book, whilst subsequently work and worry will Claim attention, and the final lesson be wrought out of rest — the consoler of every tired and weary worker. As, however, rest is a most important sub- ject, and one of which the fullest discussion is neces- sary, several chapters shall be given to its study. 2* B CHAPTER II. GENERAL CAUSES OF NERVOUS TROUBLE. IN the present chapter it is proposed to consider those causes of nervous disease which are in no ways especially incident to modern life. So far from becoming more influential, many of these causes are growing less and less potent, under that gradual bet- terment of life conditions which is steadily taking place throughout the civilized globe. It is very plain that all bad hygienic conditions and surroundings tend to cause brain deterioration — bad food, bad water, habitual filth, living in badly ventilated, damp, or dark houses — these and many similar circum- stances are sufficiently potent. A brain that only gets just enough nourishment to keep it alive will not produce much, and will not develop its powers; a brain that never has its proper bath of oxygen feels the want of its kindly stimulus, and moves most sluggishly in growth, as well as in thought-produc- ing. This aspect of the subject in hand is, however, so closely related to general bodily hygiene, that it shall 18 CAUSES OF NERVOUS TROUBLE. 1 9 not be discussed here in detail. But it does seem right to repeat the oft-told but oft-forgotten platitude, that all these ill conditions act with twofold power upon the developing nervous system of the child : that precisely as a force which does not sensibly affect the mature tree twists the sapling, so do the swaddling-clothes of bad hygienic conditions influ- ence the growing, plastic mass of the child's brain. Many a child's brain is as truly prevented from de- veloping, or as distinctly forced into unnatural dis- tortion by bad hygienic surroundings, as is the Chi- nese lady's foot by its bands and wrappings. The harvest depends not only on the natural soil, but also largely upon the conditions of the early sowing. With these preliminary remarks, I shall pass at once to the consideration of those great causes of nervous affection to whose discussion this chapter has been assigned. These may be well studied under two headings, Exposure and Dissipation. Allusion has already been made to the effects of physical exposure and hardship in the production of nerve troubles, but the subject will bear a little more elaboration. In the higher walks of life, as well as in the lower, not rarely acute nervous disorders come from sudden exposures. Not long since I saw a gen- tleman who stretched himself upon the cold, damp ground when heated, and the same evening suffered from paralysis, produced by congestion of his spinal 20 BRAIN- WORK AND VER WORK. cord. Every practitioner of medicine must have seen instances of paralysis of the face due to sudden exposure of the heated countenance to a draught of cold air, or of thinly-slippered feet to the cold earth. Such cases of acute nervous disease due to sudden exposure are, however, very rare, when compared with those in which the nervous trouble has been second- arily caused by diseases of the circulation or of the kidneys, which have been the immediate result of the exposure. Pneumonias, rheumatisms, etc., fol- lowing a "cold," are patent to everyone; but the damage wrought by the exposure is often far less apparent, though none the less real and destructive. It is to these insidious results that attention most needs to be directed, because they are most often overlooked. Not long since a physician of one of our inland cities brought to my office a patient who was believed to be suffering from chronic brain disease, on ac- count of an intense headache, which dated back to a few days' service in the militia, during the disturb- ances in the mining districts of our State. This headache was soon discovered to be due to Bright' s disease of the kidneys, which, in turn, was undoubt- edly the result of the exposure on the mountains. The case is here mentioned, especially because it illustrates so well the dangers which beset not only sudden sol- diering, but also the " camp cure." Habitual physical hardships are certainly more fre- CAUSES OF NERVOUS TROUBLE. 21 quently productive of nervous affections in the lower than in the higher ranks of life ; but it is by no means certain that this is true of what may be called acute physical hardships and acute nervous trouble. Hab- ituated from childhood to extremes of temperature, to damps, and excessive exertion, the backwoodsman or the sailor is a very different being from the man he guides across the trackless waste of land or water. Some years since, a very promising young physician of this city died of Bright' s disease, for which no other cause could even be imagined but that, in some of his numerous camping excursions, the disease pro- cess had been commenced. The person who is hab- itually protected runs a risk from even an hour's ex- posure. It cannot be too strongly impressed that exposure is a relative term. One morning, as the mists rolled off the summit of Mount Tahawus, I crawled out from under a pile of blankets, and, almost benumbed with the cold, shiveringly gathered together the em- bers of the dying camp-fire. A guide some yards off rose from the damp ground, where he had spent the night entirely unprotected, except by the cotton shirt and pantaloons which hid his nakedness, and looking at his coat hanging up in the tree overhead, said, "I'll be goll darned if it war n't cold enough last night to put one's coat on." Whenever a person accustomed to the luxuries of 22 BRAIN-WORK AND OVERWORK. city life goes gypsying, there is always danger from exposure and hardships. "Camp cure," properly carried out, has in it the promise of renewed life and vigor — yea, even of* renewed youth ; but it has also the seeds of death for those who, through ignorance, carelessness, or recklessness, neglect the dictates of that sound reason commonly called common sense. In a later chapter, " camping out ** will be fully con- sidered. For the present, it suffices to call attention to exposure during camp life as a possible cause of nerve troubles, and to the importance of guarding against it. In my own experience, exposure plays a very sec- ondary role in the production of apoplexies, brain- softenings, and the like, when compared with dissi- pation. I verily believe that both in the higher and lower ranks of life, whilst work and worry count their victims by hundreds, dissipation counts its by thousands. Many of my readers may be tempted to skip the rest of this chapter, which is to be devoted to this subject. Very well. Only this shall be said, Let. him who will, in his virtuous indignation or compla- cency, pass these paragraphs by, search with me the huge quarto of old Webster. In it we read, Dissi- pation, " the act of scattering." The connection with the word of the idea of vice seems to be mod- ern — a natural outgrowth of the terrible scattering CAUSES OF NERVOUS TROUBLE. 2 1 ©f power which vice produces. My reader may not be vicious, but how many of us can look over our lives and say there has been no dissipation ? Every injudicious effort, every unwise putting forth of power, every indulgence in softening luxury, is a dissipation. It is not, however, of such forms of dissipation that it is intended here to speak. The word is employed to introduce discussion of the excessive indulgence in pleasures, which may be classified as gastronomic, sexual, alcoholic — the groups being enumerated in the reverse order of their fatality. Alcohol, and its effects upon the system, would form an appropriate topic for one entire Health Primer ; at such length can it not, however, here be considered. If there be one subject about which it is more nec- essary than another to write guardedly, and to beg for an unbiassed hearing, it is alcohol. It has been stated that no American judge, however honest, has been known, in a political case, to decide against his party. Precisely parallel is the case of alcohol. Par- tisanship, pro and con, very often swallows up so completely the reason of the author or speaker, as to make his asserted facts as exposed as are his be- liefs to the witticism of old Dr. Rush, who said : "The French lie, and Dr. relies on them." The average temperance lecturer is just as ready with his misstatements as the lover of whiskey is with his. 24 BRAIN-WORK AND OVERWORK. The results of a very thorough examination of the action of alcohol upon the system, may be summed up in a few words. In small amount, it is an arterial and cerebral stimulant, increasing tli£ activity both of the circulation and of the workings of the brain ; in large quantities, it paralyzes both brain and heart. It is in one sense a food, in that it is capable of being burnt up in the system, and yield- ing force. It does not seem to be, on the other hand, a food in the narrower sense of the term, i. e., it is not a substance capable of being formed into tissue. When in sufficient amount, it seems to have the power of checking tissue change, i. <?., of retard- ing the chemical actions of the body. Taken with food in proper quantity, it aids digestion by stimu- lating the gastric glands to secrete. Taken without food, and in a concentrated form, its irritant proper- ties come into view, and acute or chronic inflamma- tions of the stomach are produced. Picked up by the veins of the stomach, the alco- hol is carried directly to the liver, which, when taken undiluted upon an empty stomach, r it reaches almost as concentrated as when imbibed, and by its irritant action chronic inflammation of the liver may be produced. Carried through the blood-vessels, the poison is constantly in contact with their walls, and hence, in habitual hard drinkers, chronic inflamma- tions of the coats of the vessels, with aneurisms and CAUSES OF NERVOUS TROUBLE. 2$ apoplexies in their train, are frequent. Escaping from the body through the kidneys, if in excess, alcohol irritates those organs continually by its pres- ence in their most secret structure, and Bright's dis- ease or chronic inflammations of the kidneys result. For the brain, alcohol has an especial fondness. In the hollow places in the cerebrum, known as ventri- cles, it has often been found in almost concentrated solution. The deaths directly and indirectly produced by alcohol are so innumerable, that to speak of them is to tell a wearily-known tale. A few figures, how- ever, may be cited, to show the enormous percentage of nervous affections produced by this agent. In 1844, it was reported to the English Parliament that in the ninety-eight visited insane asylums of England, containing in the aggregate 12,007 insane persons, 1,799, or fifteen per cent, of the cases, were due to excessive indulgence in alcohol, and four per cent, to dissipation, of which drunkenness formed one feat- ure. Dr. Hutchinson reported in the Glasgow asy- lum (1840 to 1846), one out of four cases as alco- holic. More recently (1872), it has been officially stated that in the Wakefield asylum sixteen per cent, of all classes, and the Edinburgh asylum sixteen per cent, of the men and seven per cent, of the women, surfer from the abuse of spirituous liquors. The collated reports of the insane pauper establishments 3 26 BRAIN- WORK AND O VER WORK. of Engird seem to show that, in eleven per cent, of all their inmates, mental ruin is referable to alcohol, and that those who may be termed alcoholic insane paupers yearly cost the state between $400,000 and $500,000 for maintenance. Figures can be multi- plied, all pointing in the same direction ; but only a few more shall be quoted, gleaned from the dis- ease and death records of Northern Europe. Hess found in a Swedish asylum that half the insane men had been drunkards. Evidence, more frightful even than this, of the ravages wrought by alcohol is furnished by the effects of the removal of the heavy tax on alcoholic drinks in Norway. In eleven years, (1825-36,) the percentage of increase for the whole population was, in mania, forty-one per cent. ; melancholy, sixty-nine per cent., and dementia, twenty-five per cent. Worse even than this was the effect upon the rising generation, for idiocy increased one hundred and fifty per cent. That this increase was due to the augmented consumption of alcohol was •shown by the inquiry made by Dahl, who found that out of one hundred and fifteen idiots sixty per cent, were the children of drunken fathers and mothers. Drunkenness in the parent is the cause not only of idiocy in the offspring, but of various other outputs of nervous degeneration and nervous weaknesses. Facts such as those just stated barb the arrows of the total abstainer. To combat or to insist upon the CAUSES OF NERVOUS TROUBLE. 2J argument that the abuse of alcohol by certain per- sons renders its proper use by others unjustifiable, does not belong to the province of this Primer. The present duty seems to be to point out clearly the exact physical relations of alcoholic potations to nerves and their centres. From what has been said, it is plain that the habitual use of large quantities of alcohol is a deadly sin against the brain and its de- pendencies. The results of an occasional debauch are far less serious to the man or woman than are those of habitual slight intoxication or " befuddling.' * Whether there be or be not moral danger or turpi- tude in the occasional drinking of a toddy or a social glass, certainly, if the process be not repeated too often, no physical ill results to the man himself. It is the habitual, every-day use that is dangerous. Even when the daily tipple never reaches the point of slight intoxication, it is fraught with evil. Espe- cially is this so if a strong liquor be used in an undi- luted form and upon an empty stomach. A dram taken in the middle of the morning, amounting to two or three ounces of whiskey, is far from service- able. The man who requires a couple of ounces of whiskey or brandy before breakfast upon rising, has travelled some distance on the road towards alcoholic ruin. The effect of an occasional excess may be worse for the offspring than for the parent. A child begot- 28 BRAIN-WORK AND OVERWORK. ten during a spree would be very apt to be idiotic or epileptic, although the father had been sober for many years previously. It is by no means clear that any evil results are produced by the habitual employment of small quan- tities of well diluted alcohol, as beer or wine. Only a few general truths can be affirmed with certainty. It may be assumed as demonstrated, that in the young and vigorous man, not over-worked, and sup- plied with plenty of good food, alcohol is not in any sense a necessity; and if in the least excess does harm. It tends to provoke appetite, and promote digestion when too much is already eaten and digested. It tends to limit tissue waste, whereas in health tissue changes rarely, if ever, proceed too fast. It is plain that to the sedentary person, whose unused muscles require little food and waste too slowly, alcohol is doubly dangerous. The use of wine is more apt to be injurious to the clerk than to the peasant, to the dweller in the city than to the roamer on the mountains. The old English squire was able to get drunk every night through a long life, because every morning he gal- loped madly twenty or thirty miles across the country after the hounds. The violent exercises renewed his tissues, used up the surplus food, flushed the glands which are the sewers of the system, and washed out CAUSES OF NERVOUS TROUBLE. 29 through sweating skin the excess of alcohol and the impurities produced by it, and thereby finally prevented his sensuality from having a worse effect than an occasional attack of the gout. To those whom hard fate deprives of a supply of proper food, I believe alcohol, in the form of beer or a light " Land-Wein, M is a great boon. It renders the bit of bread and cheese almost a sumptuous meal ; it aids the digestion of coarse food which might otherwise be a load to the stomach, and, like tobacco, takes off some of the edge of physical hardship. In Europe the food of the masses is very restricted in variety, and often scanty and unwholesome. With- out wine or beer, life would, seemingly, be harder than at present. In America every one who works has an abundance of good food, and alcoholic bever- ages are unnecessary to the young and vigorous. On the other hand, as the years draw on apace and the forces of life fail, wine becomes a valuable aid and comfort. The weariness of age, with its mani- fold annoyances, craves a slight stimulant narcotic ; the feeble digestion needs strengthening; the general failure of force is well met by a substance whose destruction in the system shall yield without effort much of power. In the mentally overworked, wine in moderation is perhaps also beneficial. In all cases it must be borne in mind that there is great danger, not only from 3* 30 BRAIN-WORK AND OVERWORK. excess of a weak alcoholic drug, but also from un- diluted, strong spirits, even when taken in small quantities. v To lay down a fixed amount of alcohol as the cor- rect daily supply of an aged or overworked person is evidently not possible. Individual idiosyncrasies and habits vary too greatly and are too powerful. It is as much as can be said, that without directions from a physician, a half-pint of light claret in the twenty-four hours should never be habitually ex- ceeded. Whatever the individual opinion may be on the tem- perance question, it is certain that nowadays there is to every one an abundance of warning as to the effects of alcoholic excess. The value of temperance in the other pleasure of the table is, however, not so often lauded or appreciated. Not long since, in a company of so-called temperance people, I joined a group of men who were discussing with much warmth of feeling the amount of money wasted in the United States on alcoholic drinks. Jolly, well-fed reformers were they, with rotund and placid outlines which bespoke ha- bitual good cheer and good digestion. Each, during the day, had had his usual overplus of food, yet each soon swept from the table a most bounteous quantity of the expensive luxuries furnished by the generous host. One, two, three, perhaps four hundred dol- lars* worth of provision gone to weigh down stomachs CAUSES OF NERVOUS TROUBLE. 3 1 already overcrowded, to enrich blood already too richly fed, to still further choke emunctories already clogged up with the surplus of food daily furnished beyond the wants of the system. Injury to the sys- tem from alcohol is great, injury from gluttony only less. The yearly waste of money in alcohol in this country is frightful, that of superfluous food only less. Almost every one eats more food than is re- quired ; indeed, the system is so constructed as to provide for a habitual oversupply of food. The meat that is not needed is soon broken up in the blood into substances which are incapable of forming tissue. These substances are really poisonous, and, if allowed to remain, produce grave injury ; but in the skin, in the intestines, in the kidneys, they meet with thousands of glands whose duty it is to remove them from the blood. These glands are the so-called emunctories. The power of these excreting glands is limited ; they are only capable of so much labor. When a great excess of food is habitually taken, they are habitually overworked. The blood, under these cir- cumstances, becomes loaded with improper materials ; and it may be that the gouty habit is created, which in turn is prone, sooner or later, to produce degen- eration of the walls of the blood-vessels, resulting in apoplexies. The man who gets an occasional jolly hour from 3 2 BRAIN- WORK AND O VER WORK. a moderate potation is, perhaps, morally no more of a sinner than he who gets an occasional heavy night from over-indulgence at the table, and appears, also, to suffer no more of permanent physical ill. It is the habitual over-eating or the habitual drinking which plays havoc with vitality. Almost every well- to-do person eats more than is necessary for the re- quirements of the system. As above stated, Nature has, however, provided for the removal of this excess ; but overwork brings enfeeblement, and an excess of noxious matters in the blood is a constant irritation to the emunctories \ enfeebled and irritated, no won- der these long-tried but faithful servants often finally become fatally diseased. The food principles, which are composed largely of nitrogen, are chiefly taken out of the body by the kidneys. Hence it is an overplus of food containing much of the nitrogenous principles, i. e. , meats, which is especially liable to overwork and irritate the kidneys. I believe myself that many seem- ingly inscrutable cases of chronic disease of the kid- neys depend upon excessive flesh-eating. Very few, if any, of those who read this book will ever suffer from an insufficient supply of food, but among the so-called working-classes cases of nervous exhaus- tion, hysteria, etc., are frequent, in which the lack of proper nourishment has greatly aided in the produc- tion of the disease. There are multitudes of seam- stresses who chiefly subsist upon bread and tea. Under CAUSES OF NERVOUS TROUBLE. 33 these circumstances, the impoverished blood fails to nourish the nerve-centres, and headache, hysterical symptoms; and other manifestations of lowered nerve- tone soon manifest themselves. The substitution of beer for tea would be a decided gain in the dietary of such persons. As either extreme in food-taking is capable of doing injury, what should be the food of the brain- worker, and is there any especial diet to which he should adhere? The answer to the second part of this double question is : There is no food especially adapted to nourish the organ of thought ; no pe- culiar diet for the brain-worker. He or she should eat such food as other rational beings eat, avoiding excess, but always eating sufficient : bearing in mind the fact, that while Nature provides for getting rid of an excess of food from the system, she has no means of making up a deficiency : remembering, also, that a mixed diet, with plenty of vegetables and fruit — meat usually not more than twice a day — is the best. Closely connected with this food subject is that of the use of certain narcotic stimulants — tobacco, cof- fee, tea, and their congeners. It may be thought absurd to consider these substances under the head of dissipation, — certainly the amount of injury wrought by them is not comparable to that produced by alcohol, — nevertheless, they are potent for evil, C 34 BRAIN- WORK AND O VER WORK. and their influence is very perceptible in the nervous disorders of modern life. In a class by itself stands tobacco, a substance wMch acts upon the human organism as a most deadly poison, but which is the daily solace of mill- ions of human beings. In persons unaccustomed to its use, even small quantities of it produce a horrible nausea and vomiting, attended with giddiness and a feeling of intense wretchedness and weakness. When larger quantities are taken, the results are still more pronounced — burning pain in the stomach, purging, giddiness passing into a low delirium, a rapid, feeble, and finally imperceptible pulse, cramps in the limbs, absolute loss of muscular strength, and at last com- plete collapse, deepening into death. That a substance possessed of such powers should, in spite of them, be so largely used by man, seems to prove that there is in it some peculiar virtue fitting the needs of the race. What, however, is the differ- ence between the man and the woman, that one should and the other should not crave or need this drug ? A female cynic would say that the distinction rests in the superior selfishness of the lord of crea- tion, who is unwilling that his lady's boudoir, much less her person, shall reek of that odor which he him- self bears about with him. But I believe that, although selfishness is operative, there is a deeper cause for the prevailing difference. There is much CAUSES OF NERVOUS TROUBLE. 35 reason for believing that tobacco lessens the waste of nervous tissue, enabling it to perform its labor with less friction, so to speak, than would otherwise be the case. Be this or be this not true, it is probable that the tobacco habit is, in great measure, psychical, and it is plain how that this psychical cause is more pow- erful in the man than in the woman. In the busy mart of the city, in the fatigues and excitement of a military campaign, in the exposures of a hunter's or a sailor's life, — wherever men strive and endure, — the nervous system craves something that, after the day's worry and battle, shall soothe it into quiet. The life of the average woman is much more tranquil and uni- form than that of the man, and her work is never so active and intermittent as is his; her day's strife is not so fierce, though it may be never finished. These may seem useless speculations, but they really serve to indicate what seems to me the proper use of tobacco by the brain-worker, namely, that its employment should be restricted to the hours of rest and calm ; that it should be used to soothe the nerv- ous system, and help it to settle into the state of quiet in which it recuperates its powers. The more sedentary, and the freer from emotional or other ex- citement, is the life of the brain-worker, the less ex- cuse is there for the use of the narcotic. Moderation in the use of tobacco is almost as necessary to the brain-worker as is moderation in the use of alcohol. 36 BRAIN-WORK AND OVERWORK. I am sure that very frequently nervous breakdown is hurried and assisted in its development by the con- stant employment of the drug. The manifestations of the excessive use of tobacco are not always uniform, but in the great majority of cases they consist of evidences of excessive nervous irritability, especially affecting the heart. Minor ills, such as chronic sore throat, dyspepsia, etc., are not rare, but the serious symptoms which demand atten- tion are usually connected with the heart. Cardiac distress and palpitations, irregular, intermittent pulse — these, in minor and major degrees, are nearly always present when tobacco has played an impor- tant part in the production of a nervous breakdown. It should never be forgotten, that the sedentary brain-worker bears tobacco much worse than does he who leads an active outdoor life ; and also that the same individual, during his periods of active outdoor exertion, resists the deleterious effects of tobacco much more strongly than he does when a desk-stu- dent. More than this, not only do habits of life, but also individual and race peculiarities, affect the tolerance of tobacco. Idiosyncrasies, i. e., individ- ual peculiarities, must be studied in the individual ; but peculiarities of classes or races of people, i. e., temperaments, may be studied as general princi- ples. It may, therefore^ be laid down as a law, that nervous temperaments badly withstand the deleteri- CAUSES OF NERVOUS TROUBLE. 37 ons effects of large amounts of tobacco. The phleg- matic Teutonic student lives in an atmosphere of tobacco -smoke which would be irresistible to his nervous American confrere. It is evident that, as with alcohol, so with tobacco, no fixed rule can be properly enunciated as to the daily amount to be used. I have seen a large num- ber of cases in which tobacco had evidently been very potent for evil ; and my experience seems to warrant me in stating that very frequently, if not usually, in the nervous American, who works hard with his brain and takes but little exercise, more than two mild cigars a day is injurious; and that it is best to take the "smoke" after dinner, during the hours of rest. Theiri, the active principle of tea, and other iden- tical or closely allied alkaloids, are found in various plants, widely separated in their geographical distri- bution, as well as in their botanical relations. When- ever such a principle exists in a plant, that plant is used by the inhabitants of the country as a drink. Our North American Indian had his "Yaupon," or black drink, made out of a species of ilex or holly. Ilex Paraguayensis, Paraguay holly, or Paraguay Tea, furnishes the beverage of a continent; the coffee- bean, the coca-leaf, the chocolate-nut, the true tea- leaf, burden the cbmmerce of the world. Though, like tobacco, these various principles apparently 4 3 8 BRAIN- WORK AND O VER WORK. lessen the waste of tissue, I conceive the great reason of their universal use is psychical" — men take them because their effects are pleasant. Although these substances are similar in their action, they are by no means identical. Of coca and Paraguay tea I have had no experience, and few, if any, of my readers will ever use them. I shall, therefore, say no more about them. Of the drinks habitually employed in this country chocolate stands by itself in that it contains compara- tively little of active principle. It is used almost solely on account of its pleasant taste, and I have never seen any ill effects from its use, saving only sometimes a little gastric disturbance, produced, apparently, by the fatty matter it contains. Those with whom chocolate disagrees soon find it out, and it is not necessary to say more about the subject. Tea and coffee in their crude state contain the same active substance. Experience teaches, however, that their action upon the system is by no means identical. The reason of this is not far to seek. In the cup of tea the thein exists unchanged. But the coffee-berry is roasted before using, and, whilst part of this same alkaloid probably escapes change, there is formed in the roasted bean, and conse- quently to be found in the cup of coffee, a new sub- stance — the so-called empyreumatic or tarry oil of coffee. This is far from being devoid of activity. CAUSES OF NERVOUS TROUBLE. 39 Dr. Lehman, the great physiological chemist, has found that it is even more powerful than caffeine itself, especially in producing sleeplessness. Daily experience shows, also, that coffee is inju- rious to more persons than is tea, producing in very many headache. This is, probably, in some cases at least, due to its disagreeing with the stomach. It often seems to irritate the mucous membrane. It is notorious that in persons suffering from diarrhoea coffee is apt to act as a purgative. In armies, coffee is mostly used as the beverage to lighten the fatigues of the campaign ; but I have been surprised to find tea so greatly preferred in districts of the Northern Wilderness, that the guides would use nothing else. It is probable, therefore, that the two beverages are similar in their general powers. The symptoms most frequently produced by them are headache and general nervousness — often, in coffee- drinkers, dyspepsia being added to these ills, and sometimes also palpitation or other disturbances of the heart. Wherever apparently causeless headaches exist, the possibility of their being produced by the undue use of tea or coffee should always be thought of. Not long since I was called in consultation in a case in which a severe, habitual headache had resisted treat- ment for a year or more. Inquiry revealed that tea was very largely taken three times a day, and stopping 40 BRAIN-WORK AND OVERWORK. the habit cured the headache. The worst of these cases are seen in poor women, who substitute tea for meat, and live almost exclusively on bread and tea. Under these circumstances, thin or poor blood, with its train of nervousness, neuralgias, hysterias, etc., are sure to be produced, partly by the action of the tea, partly by the lack of proper food, partly by the strain of overwork and anxiety. It should never be forgotten, that amongst the well-fed and comfortable there are persons who are unable to withstand the deleterious effects of even small quantities of tea and coffee, and that the amount taken by an individual is not an absolute measure of the mischief possible to be wrought. The general law is, that in the sedentary and in those of nervous temperament, the free use of the cup that cheers, but does not inebriate, is most prone to do harm. In Germany, one may watch a yearling baby drink- ing beer with its parents in the Volksgarten, and in our farmhouses, or at the table of the laborer in this country, the toddling child may often be seen with its cup of tea or coffee. Elaborate argument is scarcely necessary to prove that this is altogether wrong ; the sensitive nervous organization of the child is es- pecially susceptible to the action of narcotics. Every physician knows that it is not safe to give a dose of opium to the child proportionate to that administered CAUSES OF NERVOUS TROUBLE. 4 1 to the adult. In the open-air life of the farm, the tea and coffee may have no perceptible influence on the child ; but in the city, where everything tends to increase the nervous temperament, so often inherited, the effect is decided. To allow even a boy or girl in their teens to study under the influence of one of these stimulants, is an abomination. It would seem natural here to speak of the employ- ment of tea and coffee by the adult as a means of as- sisting the brain to labor; but this will be better dis- cussed in the next chapter. It is now necessary to approach a subject whose importance forbids silence, but whose nature is such as almost to forbid utterance in a popular work like the present. Yet how is the lesson to be learned, if no one teaches it ? It is scarcely necessary or right here to say much about the dangers of a sexually impure life. Only this should be remembered, that across the life of the man who yields once to temp- tation, lies the shadow of a possible fate to himself, and, if he marries, to those most dear to him, amongst the most horrible on earth ; that no precaution, that no supposed character on the part of his partner in guilt, is any guarantee of escape from a disease which, once induced, is ineradicable from the system. Also, that apparent escape from evil consequences is by no means always a real escape. A large proportion of severe brain affections are the 4* 42 BRAIN- WORK AND O VER WORK. result of contracted disease; and it has been my fate to see many persons who were astounded when told the true nature of their disorder — they having never suspected that they had suffered, although they freely confessed to having, in their youth, exposed them- selves to the contagion. They thought they had escaped, but the early sowing yielded in after years its harvest of suffering and death. A paragraph seems here to be required, also, con- cerning the practice of secret vice by the young. This notice is not only necessitated by the natural impor- tance of the subject, but also by the widespread adver- tisements of lying quacks both in and out of the secu- lar, and even the religious, press. The effects of the practice are not nearly so bad as the statements in the advertisements indicate. Indeed, in my own experi- ence, there have been at least two cases in which all the suffering was mental and imaginative, to one where there was a distinct physical basis of complaint. The extent of the quackery shows the richness of the har- vest — if patients were not forthcoming, money to pay for the advertising would soon fail. By any moth who may be tempted to be singed at the candle of this class of quacks, the following considerations ought to be well weighed : The advertising doctor has no knowledge which is not possessed by the regular physician, whilst, in the majority of cases, he is an ignorant man. By advertising, he becomes a profes- CAUSES OF NERVOUS TROUBLE. 43 sional outlaw, and a man who is an outlaw among his fellows may be safely set down as unprincipled. He who has a reputation to lose will not risk it for a trifle, much less throw it away. Usually, an advertis- ing doctor is unprincipled as well as ignorant, and will, by lying, by extortion, by keeping ill, etc., filch all that he can from his victim. The only sensible course in this, as in other cases of real or imagined illness, is carefully to select a well-educated doctor, and, if any doubt be still felt, to request a consultation with a second physician. Secret vice, although its results have been greatly exaggerated, is capable of producing, and does pro- duce, much serious disease. Its practice is by no means confined to males, and is very often persisted in rather through ignorance than through want of virtue. There comes, therefore, in the life of the youth of both sexes, a time when it is the duty of the appropriate parent to explain fully and modestly the relations of the sexes. In regard to girls, Nature points out the appropriate age, and the explanation should immediately follow the first evidences of sex- ual development. In regard to boys, individual needs and circumstances differ, but about the twelfth or fourteenth year would seem proper. Always the par- ent should remember that innocence is not virtue, but ignorance ; and that it is a very poor foundation 44 BRAIN- WORK AND O VER WORK. upon which to rest in the temptation that comes, especially in our large cities, to every one. In a considerable proportion of the cases of nervous breakdown which have come under my notice, the disorder has had its origin in matrimonial excesses. Intemperance in this regard rests as often in igno- rance as in lack of self-control. Whether indulged in through want of knowledge or want of virtue, ex- cess always brings the penalty in the shape of weari- ness, lassitude, loss of power to do mental work, and gradual impairment of nerve-force, which may pro- gress until the man or woman is reduced to a con- dition of hysterical exhaustion. Sometimes excess seems for a long time to bear no evil fruits, until suddenly a serious organic nervous affection is de- veloped. The danger from this source is especially real to brain-workers, as the robust man, who leads a life of activity in the open air, is far more able to resist. The important point as to where the line is to be drawn between proper and improper indulgence must be settled by each individual for himself, with or without the aid of his physician. To phlegmatic persons, whose occupation is active, and whose work is largely muscular, greater latitude is allowable ; but for the nervous student, great caution is necessary. CHAPTER III. WORK. BY the sweat of thy brow shalt thou earn thy bread, is the old curse pronounced for trans- gression. Labor of the lower kinds, — hard, muscular work, — unskilled putting forth of brute strength in mere toil, is a penalty, a sorrow, in spite of all that may be written about the dignity of labor. A skilled occupation is, however, far otherwise. Brain-work, if it be not too severe, brings its reward with it in a continual renewal of interest in life. Possibly the man most to be pitied is he who has no object in liv- ing — no work which gives zest to existence. Never- theless, scarcely lower down in the ranks of misery is he who has too much to do ; whose toil is beyond his strength. If the testimony of the people themselves is to be received, the number of overworked members of this community is something frightful in the aggregate; but the catalogue of lazy men, who are forever talking about the multitude of their labors, is not a short one. Those who complain most of being excessively busy 45 46 BRAIN-WORK AND OVERWORK. and jaded are usually the farthest from exhaustion. The very busy man rarely finds time to think or speak about himself. Perhaps in this is the real peril — the danger of breakdown to the valuable life is enhanced by the forgetfulness of self. In the eager pursuit of wealth, fame, or other ob- ject, the maxims of wisdom are apt to be forgotten, and the warnings of the physician neglected ; in- deed, too often are the warnings of Nature herself overlooked, and the slight symptoms that presage the storm unnoticed. The really busy man is the one who most needs to read books of the character of the present. To save the life of the man who is always afraid of being overworked, it is hardly worth while to write a Health Primer. The human organism is able to endure an enor- mous amount of continuous toil without detriment, provided the labor be performed with as little friction as possible. But .not rarely achievement bears no proportion to effort ; too often* is it the waste, not the legitimate outflow of force, which drains the supply of energy^ The thorough-going materialist, who follows his be- lief to its extreme logical conclusion, teaches that pas- sion and thought are the direct results of the action of the brain ; that precisely as spittle is the secretion of the salivary and buccal glands, so are ideas the secre- tion of the brain. The writer and probably the great work. 47 majority of the readers of this Primer do not sub- scribe to this doctrine. But the most enthusiastic and orthodox of theologians, whilst asserting that there is something endowed with perpetual life be- hind the physical mass of the cerebrum, acknowl- edge that for correct thinking a healthy brain is necessary; and that the brain is an instrument — a machine, one of the results of whose working is the putting forth of thought. Every machine performs its work in obedience to certain laws, and every skilled mechanic ought to understand at least the general principles of construction of the machine he works with. Before a fair discussion of the effect of work upon the brain can be carried on between author and reader, some slight account of the nature and structure of the organ must be premised, for the sake of those who are ignorant of this class of facts. The conflict between the various grades of so-called scientific and orthodox thinkers has waged so noisily about the colorless, structureless material which is the basis of all known life, — and in which indeed all known life resides, — that every one to-day is familiar with the word protoplas?n. Do not be startled, O reader. Neither in or out of the paths of orthodoxy are we to wander together in the study of the so-called higher problems of life. I merely want to direct attention to the fact, that the brain is only a mass of protoplasm, 48 BRAIN-WORK AND OVERWORK. in the highest degree peculiar, and, as the scientist says, specialized, i. e., set apart for a peculiar func- tion or office. Now all protoplasm dies continually in its own action. It is a sort of sphinx, intensely active, ever dying, but ever renewing itself until the time comes when, from some inscrutable law of its own being, or from the failure of its supply of food, it loses its power of recruiting itself, and in verity dies forever. All bodies are either simple or com- pound. Science has discovered that the ultimate particle of an elementary or simple body has a defi- nite weight, and probably also form. To this ulti- mate indivisible particle the name of atom has been given. A compound body also has its ultimate par- ticle, which cannot be divided without destroying the constitution of the compound body, or decomposing it, as the chemist says. This ultimate compound par- ticle is made up of a definite number of atoms, and consequently has its fixed size, weight, and probably form : it has been graced with the title of molecule. Protoplasm is a mass of molecules, and when one of these molecules has performed its life act, be that act the making of a drop of saliva or the deduction of the law of gravity, the molecule dies. The proto- plasmic mass dies not, with its molecules, because other molecules have not exercised themselves, and are perfect. The protoplasmic mass does not waste, because the remaining molecules immediately set work. 49 to work to take away the dead matter, and to form a new living particle in the mould left by this removal. Although the work of the brain proto- plasm is so peculiar, its method of work and re- quirements are precisely those of other protoplasm; it must have oxygen and the other foods which are carried through the body in the blood. This ne- cessity requires that blood-vessels should everywhere run through the brain. Again, the extreme speciali- zation of the protoplasm of the nerve-centre causes it to be extremely delicate, whilst many of its actions are so essential to life, that protection from injury, and even from any disturbance by external circum- stances, is eminently demanded. This protection is obtained by so placing the brain in a bony case — the skull — that those portions of the brain which preside over the breathing and circulation, i. e. y the vital functions, are placed at the bottom, and are covered by the whole mass of the brain itself, as well as guarded on all sides by this skull. The unyielding nature of the skull, and the softness of the brain tissue, expose the cerebrum to remarkable variations of pressure. If more blood goes into the brain than usual, there must be within the skull an unnatural pressure ; whilst if less blood than normal goes to the organ, the pressure will fall. It is prob- able that the variations in the amount of liquid in the brain cavities compensate in a measure for these 5 D 50 BRAIN-WORK AND OVERWORK. changes of the pressure, but every surgeon has seen an abundance of cases of the so-called compression of the brain, when consciousness was lost because of the pressure upon the contents of the skull. This very sketchy outline of the primary princi- ples of construction and action which govern brain- work is probably sufficient for the necessities of our case. It is plain how mental labor affects the brain. A thought is the index-hand that marks the death of a protoplasmic molecule, or rather of protoplasmic molecules, for the production of a thought is usually a complex process involving many molecules. Nor- mally, this molecule or these molecules are removed and replaced by the processes of nutrition as fast as destroyed. If, however, thought follows thought with such instant rapidity that no time is allowed for the reproduction of protoplasmic molecules, by and by so many molecules or working units will have been used up as to produce a constantly growing scarcity of those normal particles which are capable of building up the new working units that shall replace those that have been wasted by the continuous mental efforts. Long before such a condition is reached, a profound sense of weariness usually gives an abundant warning that labor must be desisted from, and that the brain imperatively needs rest in which to rejuvenate itself. If during the day's labor not too much work has WORK, 5 1 been performed — if the process of destruction has not gone too far, the brain, during the night's sleep, is able to reconstruct all that was injured, and, when the light summons to active life, to start as fresh and perfect as it was the previous morning. If, however, the work has been a little too severe or the period of recuperation a little too short, the brain does not quite recoup itself for its expenditures, and starts in the morning a little less capable of effort. The loss may be so slight as not to be perceptible, but it is the many mickles which make the muckle. Let us sup- pose, for illustration, that instead of there being in the brain on the second day 30 million million of molecules, there were only 29 million 999 thousand 900 million of perfect working units. The account would be short; but so little short, that all would seem perfect, the deficiency not being perceptible. Let the process^go on week after week, month after month, year after year — a constant growing poverty, no more irresistibly perceived than many a slowly growing pe- cuniary bankruptcy, — until at last not enough of mole- cules are left for labor, and nervous breakdown ensues, with perhaps scarcely enough of molecules remaining to rebuild at all the mental machine. It is not hard to understand, in this light, why so long time is required for the recovery of a case of nervous exhaustion. The brain merely tired may have the power of re- forming a million of atoms in a night. The brain 5 2 BRAIN- WORK AND O VER WORK. which has been using its substance can perhaps build only fifty atoms in the specified time, and months are required to replace the wasted tissue. Worse than this, it would seem that the exhausted brain produces molecules not only small in quantity, but also poor in quality. It develops new molecules very slowly and also very imperfectly. Hence it happens so often that the brain, once thoroughly used up, never re- covers its pristine powers. It is a well-known fact, that the worst breakdowns are those which have been very slowly brought about. This may be because the brain becomes, as it were, able to produce work and to destroy atoms without the long-neglected sense of weariness being felt ; a sort of benumbment coming over the organ, which renders it insensible to its own needs, until it comes to its last working units without having perceived its oncoming poverty. It is like a spendthrift who will not look at the wasting of his principal, but calls everything he can get his hands on income until the whole is gone. It is indisputable, that the way in which mental work is done influences greatly the destruction of cerebral protoplasms, i. e., the wear of the brain. It is therefore a matter of the greatest importance to understand the best ways of working. In this, as in so many other things which we are studying, indi- vidual peculiarities are of importance. Of still work. 5 3 greater importance, however, are the wider principles of uniform application to all classes of persons. These shall be now considered ; idiosyncrasies seem- ing to arrange themselves for consideration better with the topics of the next chapter. In the first place, it is plain that, if from any cause, the brain fails to perceive the weariness which is its safeguard, it may continue to go on in some supreme effort of continuous work until its substance has been so wasted that there is not enough left for speedy recuperation. Usually, the most intense effort only demands a proportionately complete and prolonged rest. But there would seem to have been cases, or so at least it is asserted, in which the continuous putting forth of energy has been so severe and so protracted as actually to use up the brain, and not leave enough of power to carry on the vital action, and immediate death has ensued. Such results as these plainly can not occur under any humdrum circumstances. It needs the excitement of battle to prevent the warrior from feeling a severe wound, and to such excitement must that be comparable which benumbs the brain so completely to all sense of tire and causes it to destroy itself. The man who is set to ditching very rarely injures his muscles or his nervous system by his day's work, whilst he who is half- crazed by the excitement of the boat-race may readily give himself life-long in- 5* 54 BRAIN-WORK AND OVERWORK. jury. What is true of muscular labor is also true of brain-work. Labor without excitement is far less dangerous than work with excitement. The banker who struggles in the hoarse, surging crowd of a Black Friday does not do the intellectual work of a scholar's day; but it may be months before his nervous system recovers from the strain of that one day, in which anxiety and excitement have had the supremest mastery. Under these circumstances, health and fortune are but too often wrecked to- gether. Nervous exhaustion is very frequent amongst brokers and stock speculators, but not more so than among those whose speculative operations are based upon grain, gold, or any other form of property. Stocks are more easily handled and transferred than most other valuables, and offer accordingly more temptation to the gambling spirit. It is, however, speculation, and not what it deals in, which marks the transaction. Speculators are often said to have broken down from overwork. In most cases, how- ever, the man has really performed but little mental, and absolutely no physical, labor. He has been crushed, not by work, but by emotional excitement. Here we come upon a most important factor in the nervous destruction of modern life, which has not before been noted in this Primer. Intellectual work without excitement rarely kills, and only after years of almost continuous labor. Even when work. 55 there is a moderate degree of habitual excitement, death from overwork is a very lingering one. The acute danger is confined almost exclusively to exces- sive emotion. Why excitement renders work dan- gerous, it is not difficult to see. As already stated, excitement benumbs feelings In other words, the at- tention of the patient is so riveted by the object which causes the excitement, that minor attractions are un- noted. The excitement prevents the brain from per- ceiving the sense of weariness which warns that the limit of safe labor is reached, and that the time has come for rest. Then, again, in intellectual as in all other forms of work, speed is attained only by the exercise of great power — the difference of effort on the part of the racer during the contest, and of a cart-horse drawing the sulky which was used in the race slowly round the track, is patent. A moderate amount of excitement probably does no greater in- jury than by increasing the speed and time of work. In intense emotional excitement, the case is far otherwise. It is inconceivable that any momentary intellectual effort should permanently injure a man ; it certainly is conceivable that a sudden emotion should kill a man, and for it to seriously injure a per- son is not of rare occurrence. Did any man, by think- ing, ever change the color of his hair in a night? Fright has undoubtedly effected such a change. Every physic iar in large nervous practice must have seen 56 BRAIN- WORK AND O VER WORK. hysteria, St. Vitus's dance, or other severe nervous disease, developed by fright. Some little time since, a child was brought to me by her parents with this statement : The girl, apparently in perfect health, went on a summer afternoon to walk in the country. Overtaken by a sudden thunder-gust, she took refuge under a tree. A violent stroke of lightning felled a tree in her immediate vicinity, and in* a few hours she was suffering from a violent chorea (St. Vitus's dance), which required months of careful treatment for its cure. The method in which emotion acts upon the ner- vous system is probably complex. In the first place, it seems to me clear that in some way, not, per- haps, at present to be understood, the molecules of the protoplasm are directly affected. The stoppage of the heart by fright or sudden fury, and tTie rush of its movements in anger, are familiar proofs that emotion paralyzes nervous action, or provokes intense dis- charge of nervous force. The depressing effect of long-continued, severe grief can hardly rest upon other foundation than a slow change wrought in the structure of the nervous system by the influence of the emotion. With an instrument to measure the force with which the blood moves in the arteries, it is easy to demonstrate that physical pain produces an immediate discharge of nervous energy. But the result of excessive emotional excitement work. 57 does not solely depend upon the causes alluded to. The excitement which strong emotion produces may- be so intense as to be, in itself, a direct source of peril and injury. In this excitement the speed of the nervous action tells. Then, again, in many cases, there is an alternation of conflicting emotions. This is notably the case of the broker or stock speculator. Indeed, in almost all cases of persistent, strong emo- tional excitement, joy and fear, hope and anxiety, continually alternate. These sudden transitions make the brain comparable to an engine which is being run not only at its utmost speed, but with continual rever- sals, which strain its every part. Under the influence of strong hope, the heart's ac- tion is intensified, and the force of the circulation increased ; whilst by fear the heart is paralyzed. Consequently, there is a continual varying of the pressure of the blood in the closed cavity of the skull, so that the brain suffers upon a Black Friday not only from its own intense molecular oscillations, but also from a continual varying of the blood pressure upon it. The mechanical influence of the sudden alterations of pressure upon the brain, under the play of conflicting emotions, is evidently one source of peril, and is, perhaps, not sufficiently recognized. Some time since, in my experience, a gentleman who had failed in business, and whose sensitive nature had suffered intensely because he was dependent for 5 8 BRAIN- WORK AND O VER WORK. the necessaries of life upon his friends, unexpectedly received, whilst at the table of an intimate associate, a valuable government appointment. He ceased eat- ing, and a few minutes later went to his boarding- house, and up-stairs to his room. A short time after- wards he threw open the window and yelled murder into the night. Attracted by his cries, some persons entered the house, rushed up-stairs, and found him lying upon the floor. He had just sufficient con- sciousness to state that some one had hit him upon the side of the head ; in a few moments he became unconscious, and soon died. The circumstances were such as to render it certain that no one had en- tered his room before the alarm which he had raised. He had, consequently, not been struck. There was no external bruise, but at the post-mortem examina- tion a vessel was found to have been torn upon the side of the head on which he had said the blow had been received. Unquestionably, the sensation of a blow was produced by the sudden outpouring of the blood into the brain. In this case the walls of the blood-vessels were certainly weakened by dis- ease, and it is possible that this disease was in part due to the long-continued despondency. Certainly, the sudden passage from this condition of low spirits to one of great exhilaration increased the force of the circulation. The weakened arterial walls being una- WORK. 59 ble to resist this, gave way, and the blood escaped into the brain. In worry, not work ; in excitement, not calm in- tellectual labor, lies the greatest peril. Nevertheless, the calmest intellectual labor may become excessive toil, and most men have to perform their brain-work under more or less excitement. It is therefore essen- tial to study how the greatest amount of labor can be performed with the least possible strain or injury to the nervous system. Of course, the rule to reduce the excitement to as low a point as is possible must never be forgotten. Again, if excessive excitement be endured, prolonged rest must follow it. The rest is not solely required for the recuperation of the ner- vous protoplasms. The excitement, of course, causes an afflux of blood to the part ; the blood-vessels are dilated to their utmost. So soon as the excitement subsides, they contract more or less completely to their normal calibre. If the distention of these ves- sels be too severe or too prolonged ; or if, what is a more real danger, the dilatation be too frequently repeated at short intervals, damage is wrought by the coats of the blood-vessels being weakened. This weakness prevents them from recovering their normal condition or tone. Thus gradually is set up a state of habitual excess of blood or congestion in the brain. For it must be remembered that the force qf the blood current tends everywhere to stretch weak 60 BRAIN- WORK, AND O VER WORK. vessels, to form, as it were, pools and bayous in every place where the channels are opened out to them. The more closely this subject is investigated, the more evident becomes the need of a rest after labor, proportionate in extent not only to the labor itself, but to the excitAnent under which it is per- formed. The nature of the rest thus required will be fully discussed later ; at present, we must examine the laws in obedience to which the brain shall be en- abled to perform excessive work with the least possi- ble injury to its structure. If any machine is being run to its utmost speed, great care is exercised to diminish resistance and friction to as great an extent as possible. The good mechanic keeps the cutting-bar of his planing-machine as sharp as possible ; a well-drilled sawyer neglects not the teeth that chew their way through the log. The thinking machine — the brain — works with cer- tain tools. It is clear that, if these tools or instru- ments be dull or out of order, an enormous loss of power must occur in using them. The most im- portant of these tools of the brain are the special senses. It is of the first importance to have the organs of the special senses in good order. The machinist who neglects his tools is usually consid- ered a "poor tool." Yet there are hundreds of brain-workers who never think that they are using tools at all, much less what those tools are and in WORK. 6 1 what condition they may be. Perhaps most of those who have ever overworked their nervous system until a^ state of general nervous irritability was reached, have noticed how irritating it is under these circum- stances to listen to a person who speaks indistinctly. Many have no doubt suffered, from the effort to see or hear that which is indistinct, an almost unendura- ble increase of nervousness, without knowing why the effort was so irritating. The reason is not, however, far to seek. The history of the recognition of a spoken word may be briefly summarized. An impression is made by the moving air upon the drum of the ear. The membrane vibrates, and its movements or vibrations are propagated along the auditory nerve in the inner apparatus of hearing until they are registered upon certain nervous ganglia, or collection of nervous mat- ter, at the base of the brain. If this registration be distinct, sharp, clear, the higher perceptive organs of the brain read it without difficulty, and the list- ener becomes conscious of the word without an effort. If, however, the intonation be indistinct, the percep- tive organs are only able, by a decided effort, to de- cipher the blurred image recorded in the lower brain. This effort normally may not be painful ; but if the brain be exhausted, then the increased nervous irri- tability is the indication of the effect of the strain. The increased mental effort necessary in imperfect 6 62 BRAIN- WORK AND VER WORK. hearing is very perceptible to most persons who are listening to a foreign language which they know well by the eye, but to whose sounds the ear has not been well accustomed. To the partially deaf, a similar effort is necessary in following an ordinary conversa- tion. Hence partial deafness adds materially to the brain strain in an intellectual worker. In the case of a lawyer of some note in this State, wax in the ear exerted a perceptible influence in the causation of a general nervous irritability and weakness, which was fast impairing professional usefulness. A syringe for the ear and a pair of spectacles for the eyes made a happy man, and added some thousands a year to the family income. The most important of the perceptive instruments of the brain, that which is most used and most apt to get out of order, is the eye. This organ is won- derful in its constructive adaptation to its duties. But, as it exists in civilized man, whilst theoretically all that can be desired, practically it is often very imperfect. There are, in fact, as few perfect eyes as perfect sets of teeth. An image falling upon the front of the eye is brought to a focus upon a certain nervous expanse called the retina, at the back of the organ. The impression made upon the retina is transmitted to the nervous ganglia at the base of the brain and there registered, to be taken note of by the higher centres WORK. 63 which preside over conscious visual perception. If the rays of light be accurately focused upon the ret- ina, a sharp image is there formed ; the retinal im- pression being clear and distinct, that at the base of the brain is correspondingly so. Under these cir- cumstances, the perceptive organs read without labor what is passing in the outer world. It is plain, that if there be optical defects in the eye, the retinal image will be indistinct, and only by an effort will the upper brain be able to recognize the blurred record made upon the lower brain. Moreover, there are certain muscular structures within the eye whose function it is to alter the position of the ocular lenses so as to accommodate the eye to seeing ob- jects at various distances. When there is any physi- cal defect in the eye, these muscles are continually straining in the endeavor to make up for the optical deficiencies. The muscles become wearied out by the incessant overwork and act irregularly ; possibly they fail from paralytic feebleness to change the focusing of the eye to suit the ever-varying needs of ordinary seeing, or more often the movements are rendered irregular and restricted by cramps. As the result of the muscular disorder, the image on the retina is further blurred, and the brain suffers more and more. It is also very probable that the imperfectly focused image acts upon the retina itself as an irritant, in the course of 64 BRAIN- WORK AND O VER WORK. time affecting its structure and impairing its power of transmitting the image to the brain. In the be- ginning, the eye trouble is only an easily remedied mechanical defect ; uncorrected, in the end, it may become a serious implication of the whole eye. This process of eye-strain and brain-strain may go on unrecognized for years, until at last the individual is arrested by the giving out of the brain, or by the retinal irritations becoming so severe that vision is no longer endurable. In the great majority of cases, however, Nature does not play this trick upon the per- son who is insulting the law of his being, but gives an abundance of warning in the form of headaches, etc. Eye headaches are usually referred to the brow itself, but sometimes to other portions of the head. Pain in the brow or in the eyeball, inability to read at night without discomfort, the fact that an evening spent in the dazzling glare of a theatre is followed by a morning of headache, a slight indistinctness of vision, or sense of weariness or effort in seeing, any of these warnings ought to be sufficient to send the brain-worker post haste to the oculist. To dwell upon the propriety of avoiding unneces- sary work seems to be giving utterance to platitudes. Not five days since, however, I saw a grain merchant of large connections, who boastingly said, " Doctor, I go on ' Change, buy and sell thousands of dollars worth of wheat, flour, etc., and never take note of a WORK. 65 transaction until my return to the counting-house, when I dictate to the clerk, who writes it out. In twenty years I have not made a mistake." This no doubt showed the possession of a very good memory, but it certainly revealed the existence of a very poor judgment, or the absence of proper thought. The mem- orizing was really an added strain which was unneces- sary, and none the less real from being unfelt. It wa*s a most foolish addition to a sum of labor which, in its final footing up, proved too much for the brain of which it was required, and rendered mental bank- ruptcy inevitable. A very common form of unnecessary labor on the part of authors is the unnecessary use of the pen. There is a physical fatigue of the arm which reacts most powerfully upon the cerebral territory which directs that arm. Most of my readers know some- thing of the so-called writer's palsy or writer's cramp, in which the muscles of the forearm strangely lose the power of guiding and driving along the pen, although capable of wielding the blacksmith's hammer. This affection is largely a local one, and is usually looked upon purely as such ; but I am sure, at least in some cases, it is connected with more deep-seated exhaus- tion of nerve power. I have seen it in the clerk, who showed no signs of brain failure, and I have seen it in the hard -worked scientist, as the first symptom of a progressive general failure of a nervous energy.* This 6* E 66 BRAIN- WORK AND O VER WORK. would indicate what experience teaches to be true, that the mere physical act of writing aids in using up the vital powers of the hard-worked author. Any one who has ever employed an amanuensis long enough to become accustomed to the habit of dicta- tion will, I think, confirm the much greater ease of composition in this way than with the pen. If the amanuensis be a short-hand writer, speed as well as ease is gained. As excessive emotion is so much more injurious to the brain than excessive work, it is of primary im- portance to the brain-worker to control the feelings. This is true both of sudden paroxysms of passion and of long-continued states of feeling. No less a physiologist than John Hunter is said to have lost his life by allowing himself to get angry, although he well knew that the strain of passion was very dan- gerous to his diseased heart. The danger from over-ambition and anxiety are much greater in this country than in Europe, pre- cisely as life is more unsettled and its possibilities for work and advancement much greater here than in the older lands. Few things strike the American more forcibly, when travelling in Germany and other con- tinental countries, than the patient and even happy contentment of the people with a hard lot as com- pared with the feverish discontent to which he is at home accustomed. WORK. 67 Many of my readers may say at this point, this is very true, but we cannot control our mental states. Here it is, however, where men overlook the influence which they have over themselves and their destiny. If a man believe in the Christian religion, he has no logical excuse for discontent and over-anxiety. It is taught that there is a good Father, who watches over each person who tries to do right, and so takes care that all shall in the end work for his good. Any one who really believes this with a tithe of the force that the religious melancholic believes that he is doomed to eternal woe, is, by his belief, not only rendered calm in danger, but happy and contented in adversity. All over-ambition and anxiety must be rooted in want of resignation to suffer in the present for future good, or in want of absolute trust in the truth of Christian- ity. Since the few people, who are not willing to labor in the present for future competence and hap- piness, are mostly those whose physical natures shelter them against over-anxiety ; in the vast majority of cases, lack of real belief in a Divine Providence is the true cause of the discontent which, in so many cases, helps to wear out the mental powers. On the other hand, if a man can gain no comfort from a Christian faith, he yet can do much to lessen the emotional strain upon himself. Many persons obtain some solace from other philosophies than that of Christ. Fatalism really does at least benumb the 68 BRAIN-WORK AND OVERWORK. sensitiveness of thousands of the race. The futil- ity of striving against the inevitable has, to some minds, an effect comparable to that upon conscious- ness of the first violent blow the maniac deals his head as he rushes against the wall. It is not, how- ever, to such points as these, but to the more indirect methods in which a man may mitigate the effects of emotional strain, that I want especially to direct attention. There are but very few men who cannot, by a direct act of the will, control their anxiety and am- bition, at least in some measure. The man who does not exert his will to influence his temper, is not much respected by his fellows. We teach our children from childhood the necessity of such control, and exercise them in it. If a sudden emotion can be to- tally suppressed, a more continuous one can be kept under. This truth should be taught everywhere. Men need to learn that by an effort they can inhibit anxiety as well as anger. One rule, into whose observance most men can train themselves, is to avoid business cares out of business hours. The man who carries his load eight hours a day, will carry it longer than he who bears it eighteen hours out of the twenty-four. There are various helps at hand towards this relief — the collect- ing of postage -stamps, the game af whist, the follow- ing of some natural history study, the opera, a work. 6g thousand methods of diverting the attention and causing the mind to forget its strain, will suggest themselves. In these methods there is, of course, diversity of value. This shall be discussed in the next chapter. At present, attention is only called to the fact, often lost sight of, that by direct and indirect means cares can be laid aside, and that the proper doing of this makes an enormous difference in the working power of a man. This very day I was consulted by a gentleman, who said : " Doctor, I swore to sift a certain matter to the bottom, and kept thinking and thinking about it, until here I am," It is exactly such action as this against which I want here to protest most strongly. The saddle that is never off soon galls. Systematic, purposive, wilful laying aside of care and work is a necessity to him who would accomplish his utmost. Before passing to the subject of brain-rest, it is right to speak of a fruitful cause of brain-failure and of general shipwreck in life, namely, severe work at too early an age. During all the early years of life, the cerebral mass is, for several reasons, excessively liable to evil results from overwork. When the child is born, the brain is only so far developed as to be the seat of an im- pulse to reach for the breast and extract nourishment therefrom. By and by into the sodden countenance comes an expression of consciousness. The child JO BRAIN- WORK AND O VER WORK. begins to feel, to hear, to see. From that time forth development of the brain goes on rapidly. This de- velopment, it must be remembered, is not a mere growth, but a constant unfolding of latent powers — a continual progress into a higher and higher life. It is not necessary to show how, under these cir- cumstances, overwork is especially dangerous. The terrible possibility of diverting energy which should be spent in development to the needs of labor, and thereby dwarfing the brain itself, is never to be lost sight of. No real work should ever be required of the child under six years of age. Many children can learn without work. Play that teaches, as in that mod- ern improvement for very young children, the Kinder- garten, does no harm. As the child progresses, short hours, and strict attention during them, should con- stantly be the aim. The average age of the American college-student is much less than that of his English brother ; con- sequently, it is foolish to expect of him as large an amount of work as is concentrated into the Cam- bridge life of an English scholar. The pressure that is put upon an ambitious boy at most of our higher institutions of learning is very great ; some of the young men break down at once — not, perhaps, suf- fering from any nervous disorder, but dying of con- sumption, or other disease of the constitution. Other ' men pass brilliantly through their college career, and WORK. 7 1 afterwards disappear; whilst late in life to the front come men whose lives at college have been not dis- tinguished at all, or more distinguished for "larking" than for study. This is, in part, no doubt due to the fact that those qualities of mind or character which give pre-eminence in the school-room, are often not those which yield the richest fruit in later life. The power of acquiring knowledge is the faculty which puts the schoolboy at the head of his class. Very often it is not associated with the power of using knowledge to advantage, or with the judgment and foresight which are so effective in the world's battles. Again, in many cases, the young man does not stand forward in the college course because the motive power is wanting. The praises of the teach- ers and older friends are no stimulant to him ; the plaudits, the petty honors, are to him very little, com- pared with the joyous life of the playground. When, however, the struggle for existence comes, and the pressure of real life is upon him, the motive is fur- nished, — the latent, perhaps unsuspected, abilities are aroused, the energy of play becomes the power of work. Though these and similar reasons will ac- count for many of the cases of failure of youthful, brilliant promise, it can hardly be doubted that, in many instances, there has been an arrest of brain development, produced by too severe use in early life. J 2 BRAIN-WORK AND OVERWORK. The injury thus wrought in the young brain by ex- cessive study may not be apparent at the moment, though, for this, it is none the less real. There have been numerous cases in which the brain of the stu- dious child has developed rapidly for awhile, and then suddenly ceased to expand. It is perfectly conceiv- able that a too rapid growth shall give an imperfect result. Very 'rapid increase in other portions of the body than the cerebrum often results in imperfection, and it would seem as though, in the class of cases just spoken of, the brain has developed so rapidly that its tissue is not perfect ; or, perhaps it has exhausted all its developmental force, so that, instead of increasing in functional ability during the fifteen years succeed- ing college life, it barely maintains its hastily-acquired development. There has been of late years a vast deal of atten- tion paid to female education, and the co-education of the sexes is the fashionable reform. The muscles of the average man weigh just so much more than do the muscles of the average woman, and the brain of the average man just so much more than does the brain of the average woman. When woman can compete with man in muscular contest, she will probably be able to compete with him in intellectual rivalry. Every physician in large city practice must have seen the sad results from the endeavor to put a man's work upon a woman. Among the saddest wrecks of WORK. 73 our modern civilization are the faded, heartless, help- less, and hopeless women who have been driven to ruin by the stern necessity of daily bread ; but, per- haps, sadder than these wrecks, because more unnec- essary, are the sacrifices to the Moloch of excessive culture made of their daughters by men of wealth and position. That co-education of the sexes does not work more injury than, it does, is largely due to the fact that woman ripens earlier than does man — that the girl of eighteen is, in physical maturity, fully equivalent to the youth of twenty-one. As a result of this, at the ages of college life, the female brain is more ma- ture, and proportionately tougher, than is the male brain. The girl is nearer the work-level of the boy than is the woman that of the man. This is not the place to discuss woman's work in the world ; but, because I have just said what seems to me both important and true, though to many it may be unpalatable, I may be allowed to express my sympathy with every effort to extend the opportunity of women to make a comfortable livelihood — a sym- pathy which does not prevent surprise at the direction of much of the modern movements. The legal and the medical professions, among the most wearing of all callings, are everywhere invaded \ but pharmacy is left entirely to men, and clerical labor almost as much so. The duties of a druggist are exactly such 7 74 DRAIN-WORK AND OVERWORK. as trained women would meet men in as their equals, or even as their superiors. The power of pleasing, combined with deftness and accuracy of manipula- tion, and with the ability to be physically content with a sedentary life, are the qualities required by^ the drug-clerk. Surely, these qualities abound more in the weaker than in the stronger sex. The total neglect of such a field, and the preference for the tumult of the forum or the toil and exposure of med- ical practice, seem remarkable. If this subject were not so foreign to the object of this Primer, I would like to discuss it in detail. Al- most daily my walks lead me into a large publishing- house, with, perhaps, twenty clerks, and but one woman anfong them. In most of the large mercan- tile establishments in this country a similar state of affairs prevails. Why the so-called mercantile col- leges should not include both sexes among their scholars, is not at all clear to the average profes- sional mind. The learning of the lesson of not over-taxing the brain before its full maturity is as important for early manhood as for childhood. Before thirty years of age, great business care, anxiety, or excitement is doubly dangerous, because the brain is not yet tough- ened for its work. Yet every American lad of twenty- one believes himself capable of bestriding the Pegasus at hand, be it in politics, in business, or in profes- sional life. work. 75 The aged face toddling about with some diminutive newsboy, into whose half a dozen years want has compressed the misery of a lifetime, is pitiful enough. But more peculiarly painful is it to watch, as it has been my fate to do, the face of early manhood deep- ening its lines to those of age, under the shadow of a great toil and responsibility. The largest proportion of persons who really break down under the pressure of work, are furnished from the ranks of young men. The veteran of many a conflict, toughened and be- numbed by his years of labor and anxiety, carries easily a load of care and responsibility that at thirty would have crushed him. This long chapter is at last ended. What in a few words are the lessons which I have striven in it to teach my fellow brain-workers ? i. To avoid excitement and emotional disturbance as far as possible. 2. To take proper rest, one proportionate to the labor. 3. To keep in order the instruments with which the brain works. 4. To avoid unnecessary labor and worry. 5. To avoid over-taxing the unmatured brain. Very simple common sense rules, of which most persons will say "I know all that," but of which most persons, and possibly among them the writer of this Primer, are, to a greater or lesser extent, habitually disre^ardful. CHAPTER IV. REST IN LABOR. THAT labor necessitates rest is evidently as true of the brain of man as of the muscular system. But as brain-work is more complicated than muscular work ; or, in other words, as the cerebral organization is more complex than that which presides over locomo- tion, so does it become more difficult to determine exactly the nature of its proper rest. What I have to say upon the subject seems to me best arranged under these headings: Rest in Labor, Rest in Recre- ation, Rest in Sleep. Rest in Labor. — If it were possible really to obtain for the brain true rest in labor, then would it be pos- sible to work on uninterruptedly without fear of ex- haustion. Plainly to do so is impossible ; in labor complete rest is not to be found, but the phrase is allowable ; because there is this much of truth in its wording, namely, that there is work which is much more laborious than it should be; and because the heading serves well to open the discussion as to the method in which the brain can be induced to produce 76 REST IN LABOR. J J the largest fruit with the least wear of its tissue. In a measure, the ground of this discussion has already been covered, but care will be exercised not to repeat unduly. There are certain laws which govern all nervous centres, and under which the thinking part of the brain acts as closely as do portions of less exalted power. One of these laws is that of habitual action, which may very well be expressed as follows : When a certain series of nervous acts have once taken place, there is a tendency to their repetition, the tendency growing stronger and stronger as the ?iumber of repe- titions is increased. If it were not for this law, edu- cation would be of little value. The child learns with pain and difficulty : as the habit of fixing the attention is formed, and the memory strengthened, in familiar speech, by use, learning becomes easier. The musician at first plays the piece with slowness and fatigue, but soon his fingers run over the strings almost automatically. This gain is, for the musician, not only in favor of the individual piece of music, but also of musical methods, and of the general facil- ity of playing. By repetition, not only is the habit formed of playing easily the single piece, but also to a less extent of playing a certain style of music, and to a still less degree all music. This law of habitual action is so imperative, that it governs not only the correct movements of the cere- 7* yS BRAIN-WORK AND OVERWORK. brum, but also its disease processes. Epilepsy is a familiar and most striking instance of this. Usually, this affection is dependent upon a cause which cannot be reached ; but it may originate in an injury to the head, a splinter in the flesh, a worm in the intestine, or other tangible something. If a patient suffer from epilepsy due to a removable cause, and this cause be taken away, very rarely do the fits cease at once. The paroxysms recur, although the original point of irrita- tion is no longer present, because the nervous system has formed the habit at certain intervals of exploding, as it were, a mine of energy; or, in simpler language, the fit recurs because it has occurred so frequently ; and the longer the series of fits before the removal of the irritant, the less the chance of breaking up the acquired habit. A plausible explanation of these facts is not hard to find. Mental action, as has been insisted upon, is always accompanied by molecular changes in proto- plasm. Memory consists probably in a permanent setting of some of these changes. Learning a piece of music, or learning anything, is probably a casting of some of the protoplasmic molecules into a particu- lar form. In complicated acts, like piano-playing, there is further a use of a certain number or portion of the infinite multitude of nerve fibres which join the nerve centres together Every time these nerve fibres are traversed, they become more permeable to the REST IN LABOR. 79 nervous impulse; the road is at once opened up; crooked places. made straight, roughness and obsta- cles smoothed out. Thus a certain succession of musical "impulses" strike the ear time and again until the tune is learned, i. e., until these impulses have not only so affected the brain cells as to be recognized by the consciousness as familiar, but also to make an impression so deep that it is a permanent photograph on the brain cell. In the musician, the brain cells, or protoplasm, in playing the piece of music, give origin to a com- plicated series of impulse, which travel out to the fingers and their guiding muscles. In learning to play a given piece by memory, the music, by the repetition, has been permanently registered on the brain protoplasm, and the various pathways of ner- vous discharge have been travelled so often that these registered impulses once set in motion again flow down the well accustomed roads without any direc- tion from consciousness. It is perfectly possible for a man to play as automatically as does the music-box. Whatever may be our theory as to the mechanism involved, the fact is indisputable, that the brain works with most ease in the manner in which it has been accustomed to work. This is especially true of the organ as it grows older. The proverbial difficulty in getting new ideas, or rather new methods of thought, into old men, is evidently due to the physical structure of the organ having become too set and rigid to allow 80 BRAIN -WORK AND OVERWORK. of new channels of communication being formed, or, in other words, of new ways of thinking ; for it must be remembered that every new way of thinking is associated with a new way of movement in connect- ing fibres and the protoplasm of some brain cells. The reason it is so difficult for an old brain to re- member new things is doubtless similar. There must be an end to the physical possibilities of photograph- ing one impression upon another, even in an organ offering so many millions of sheets as does the brain. More than this, with age comes stiffness and rigidity, and not easily does a new impression leave its mark upon a mass of protoplasm which has been hammered into hardness by the incalculable imprints of seventy years of active life. The law of habitual action is especially to be borne in mind in regard to training. The finest effects of training in most persons are to be gained only before thirty years of age, and even after twenty-four in many people comparatively little is to be accomplished. This, of course, applies especially to methods of brain acting such as ways of thinking. He who has never been a student until he is twenty-four years old, will rarely become one. To a less extent it applies also to mere physical skill. A German manufacturer said not long ago-to the writer, " Our workmen are losing their skill because, in the new generations, their time from eighteen to twenty-one is given up entirely to the military service ; and from twenty-one REST IN LABOR. 8 1 to twenty-four one-half of each year is similarly used. When they do get free, they are too old to learn." It is also owing to the law of habitual action that new work is so difficult to the middle-aged or old. Whenever a man past forty years of age is tempted to enter into new fields of intellectual activity, he should remember not only that the danger from brain strain is far greater than if new methods of work were not put upon his cerebrum, but also that the chances of success are not nearly so great as if he had started younger. It is very common to see old- ish men, who have retired from business with a for- tune, becoming restless from want of occupation, engage in enterprises of a character to which they are not accustomed, and fail. The reason of the failure in such cases is not lack of ability, but the fact that old brains, accustomed to one line of work, have been unable successfully to compete in another line with intellects more youthful or more appropriately trained. The law of habitual action holds to some extent in regard to times of work. Theoretically, at least, it is better to have stated periods for labor, for rest, for recreation. Even in the case of methods, some brains remain flexible much longer than do others ; and in regard to the regular alternation of work and rest individual differences are very great. Some F 82 BRAIN-WORK AND OVERWORK. minds are systematic from birth ; in others, system is impossible ; in others, it is acquired. Whether the peculiarities of the brain are* inherent or acquired, they are to be consulted ; and so long as they do not contravene any important law the brain works most easily in obedience with them. One man studies most fruitfully at night; another finds that he can write most easily in the early morn- ing; the former is prone to assert that the night is the best time for intellectual labor, whilst the latter waxes eloquent concerning the advantages of early rising ; and if he be a doctor, like enough what suits him must suit his patients. The truth is that there is no inherent indisputable superiority for brain labor of one time of the twenty- four hours over another. English laws are all made during the night watches, although the day is seem- ingly the natural period of labor. In the far north, men exist and prosper working and sleeping alike during months of uninterrupted daylight. The human organism needs exposure to light ; provided it gets sufficient of that, it makes no difference per se whether its work is accomplished at one period of the twenty-four hours or another. It is therefore not so much the time of work as the regularity of it, which is to be thought of. Systematic arrangement of the time, regularity of work, is to some minds very important. It is, however, largely dominated by what we may term REST JN LABOR. 83 mental individuality. There is no doubt that most brains of power have individual characteristics in their manner of working as well as in the character of their work. Whether these have been the result of circumstances, or are inherent to the peculiar or- ganization of the brain, does not matter so far as the present question is concerned. These acquired or congenital peculiarities are, as already stated, of great importance. Much can often be done by effort to alter them, but sometimes they are unconquerable. Indeed, it has seemed to me that the more powerful and more original a brain is, the more apt it is to be a law to itself. The minor laws of mental methods are especially domi- nated by these peculiarities. Habits of systematic work, so important to some, seem impossible to others. There are people in whom the cerebrum will only produce in its own times and seasons. The rule of conduct for each brain-worker is to study carefully the instrument he uses, and, if it be possible, to bring it into a systematic method of work, or into some method best suited to his peculiar circum- stances. It may be allowable to cite the author's own profession as one in which it is necessary to train the brain away from methodical study and work. The literary or scientific physician, busy in practice, must acquire the habit of writing, or read- ing, or thinking, at odd moments; before dinner, or in the carriage jogging about the streets, or in the 84 BRAIN-WORK AND OVERWORK. office between the visits of patients. The power of great accomplishment under the circumstances of a medical life is almost always based upon the power of taking up a subject at once, pushing it along and dropping it in a moment. According to the nature of his brain and the needs of his position in life, so must the brain-worker use his judgment to con- trol and train the wonderful instrument which has been given him to work with. Rest in labor is to be obtained to some extent by proper variety in work. There is an old saying that when an Indian gets tired of walking, he runs ; and when a horse shows distress in a race, to break him up for a few minutes, i. e. 9 to change the pace from trotting to running. How far it is practicable for any individual to carry out the indication of which I am now speaking, must be left to the decision of his own judgment. I am, however, well convinced that the clerk who strains over long columns of figures every day, for hour after hour, is really wearing himself much more than is he who interrupts his labor with tasks of a different character. It is not difficult to invent a theory that shall explain the beneficial re- sults of variety. Precisely as in the horse, different muscular movements are called into play by varying the pace, so in the case of brain-work, different cells and fibres are in all probability employed in different sorts of mental action. CHAPTER V. REST IN RECREATION. STERN Miles Standish, at the head of his Puritan bands, roaming the wild woods in search of the wilder savage, no doubt would have smiled grimly had any one suggested that recreation of some sort is a necessity for the highest development of man. Mayhap, however, sturdy Miles himself tingled with a profane joy as he smote right vigorously those ene- mies of the Lord — the red Indians. Certainly, the fathers who nursed our good old English tongue in the perilous days of its infancy, before it had girded itself with strength for the conquest of the world, better knew the value of joyful forgetfulness of care. Well did they call it a re-creation. Much that passes for enjoyment in this world, so far from being a re-creation, is, in verity, a dissipation — not a gathering, but a scattering, of force. Some years since, a young lady giving an account of a steamboat trip amidst the grandeurs of Lake Superior, said, enthusiastically, "we had a magnificent time. We danced every night until near daybreak, and 8 Sk 86 BRAIN-WORK AND OVERWORK. never came out of our state-rooms until four o'clock in the afternoon. ' ' Evidently, even re-creating would be of no avail in such a case. There are, however, numbers of sensible people who are not aware of the principles which ought to underlie all pleasure- seeking that is intended to aid in gathering force. To those who have not any special object of thought or life, pleasure-seeking is only a means of "killing time," of getting rid of the monotony of existence; but to the brain-worker, the hours of pleasure must be made to yield as much of profit as is possible. Life being an earnest effort, enjoyment must be earnest, and act in unison with labor to a common end. The first principle to be borne in mind is that joy, pleasure, all similar emotions, are really mental stim- ulants, aiding — it may be by increasing the flow of blood to the brain, or, perhaps, by a direct stimulant influence upon the cerebral protoplasm — in the build- ing up, restoring, and general repairing of the waste which has been wrought by excessive work. Hence is deduced the first obvious law governing the seek- ing of recreation — pleasure must be given by the pur- suit. This obvious truism is by no means always remembered. What school-girl does not recall some dreary hours of stupid "constitutional walks"? What exile for health some banishment to places where existence itself became a burden ? Whereas, REST IN RECREATION. 87 a little effort on the part of the teacher might have filled the walk with interest ; and a little care exer- cised by the doctor in selecting the place of exile might have made the time of banishment bright in after-life with pleasant memories. There is no way of deciding beforehand as to what will give most pleasure to an individual. The per- sonal equation is here supreme. One man finds his highest enjoyment in the prayer-meeting, another at the card-table; one finds his choicest hours in the calm languor of an ocean voyage, whilst to another, the excitement of the chase is almost the ultimate joy of existence. It is here perfectly safe to allow the individual taste the fullest scope consistent with virtue, and with certain physical and mental laws to be spoken of directly. The more important of the principles other than that already mentioned, which should be borne in mind in selecting our habitual recreations, are in- cluded in the following sketch. Recreation should not involve mental labor, espe- cially labor of a kind similar to that of the working- hours. There is one especial breaking of this law, which is so frequent and so often injurious, that I must direct especial attention to it; although the con- demnation of the abuse expose me to misinterpreta- tion and unfriendly criticism. I refer to the turning, by religious persons, of a day which should be a Sab- 88 BRAIN-WORK AND OVERV/ORK. bath of rest and recreation into one of great labor — the hardest, it may be, of the seven. There are, in this city, plenty of school-teachers who toil in the secular school-room all the week, and in the church and Sab- bath-school-room all the Sunday. To the business man, who ciphers through the week, measures tape, or studies how he can sell for two dollars John Jones's labor, that he has only paid one for ; to the misses who, during the week, suffer from no greater toil than that of attending to a few household duties and mak- ing calls, Sabbath-school teaching may be a means of doing good to themselves, as well as to others. On the other hand, to the overstrained school-teacher it is a grievous injury. Teaching is teaching, whatever the subject may be that is taught ; the mental methods are very similar, though the matter changes. The labor of teaching out of the Bible on Sunday is, for the teacher, a mere continuation of the labor of teaching out of the grammar or the geography on the week-days. Such a Sabbath-school teacher attempts to wring out of her organism, weak and nervous though it be, seven days' toil a week, in the very teeth of the commandment "Six days shalt thou labor, and do all thy work." She is wronging her- self, and also those parents who tacitly agree to pay her for the best she can give their children on a week- day. There is spread out for her the fields and the woods, REST IN RECREATION. 89 with their sunlight and shadow, with their pure air and physical joys. In them may be found a real Sabbath afternoon of calm recreation. Better for her, and for those committed to her charge during the week, that she gather there the refreshment and strength that shall enable her to carry the Sabbath- school lessons into her life, and scatter everywhere through the week what the woods and fields have given her on the Sunday. The whole Sabbath question looms up here as a subject of discussion ; but it is one not easily dealt with, and I dismiss it with the suggestion for thought that there is no rest out of sleep unconnected with recreation, though, when one is tired, mere sitting in a chair in quiet may be recreation. Games have always been, and probably always will be, a source of recreation with large classes of people. They naturally divide themselves into out-door or active and in-door or sedentary games. When prac- ticable, those pastimes which involve much muscular exertion are preferable for the sedentary student, be- cause they yield the excellent fruits of exercise ; bu-t of such games I shall speak more in detail in the next section. It is hardly necessary to say of sedentary games that they should suit the individual taste ; but it is very necessary to point out that they should not con- travene the rule laid down a few pages back in re- 8* 90 BRAIN-WORK AND OVERWORK. gard to the laboriousness of recreations. All games requiring severe thinking ought to be looked at with suspicion by the man of active mental habits, and the more closely allied the mental action required by a game is to the habitual mental work of the indi- vidual, the more decidedly should the pastime be put in the background, even if there be a passion for it. Of all games with which I am acquainted, chess is the one most enticing and requiring most of mental labor. It is absolutely to be condemned as a recrea- tion to those whose life-work requires long-continued hard thinking. With the man whose chief strain is emotional, as is the case with many men in business, the thinking of chess-playing may do no harm, or even be beneficial. The game requires an entirely different sort of cerebral action from that which is habitual to such a business man. In regard to sci- entists, the case is different. I was once quite fond of the game, but found that the strain of its playing was fully equal to that of severe composition or of hard study of an abstruse science. After the work was done, it was only chess-playing, and experience soon led to a complete abandonment of the game. It seems, nay, it is, foolish to waste so much of mental energy on a pastime Such useless labor is only excusable in those whose life-work is enjoy- ment, whose strain is emotional, or whose day's work is a round of monotonous labor not involving REST IN RECREATION. 9 1 the higher mental faculties. A practical test of the value of a recreation, which may be applied to chess- playing as to any other pastime, is: "Do I feel brighter and more able for work after indulging in it?" In the far extreme from chess are certain games which may produce an emotional strain by producing an excitement passing beyond proper recreation. The old gambler has become so habituated to irrita- tion that nothing but the most severe prodding will even titillate his feelings. But to any but the hard- ened all betting upon games is a strain, which be- comes more and more intense as the stakes become more and more valuable. Evidently, such a pastime in no way refreshes or strengthens for the next day's work. There are various games which produce a decided excitement without passing the limit of possible good. In choosing from among these, it should be remem- bered that the rule heading this section here applies thoroughly ; that he who has labored upon dry intel- lectual subjects is better in the evening for an emo- tional stirring up; whilst he who has spent his hours in the turmoil and excitement of the stock or grain exchange needs rather some calm intellectual pastime which shall restore his mental equilibrium. Recreation should be made conducive to bodily im- provement. This rule or proposition evidently con- 9 2 DRAIN- WORK AND O VER WORK. nects itself closely with the subject of exercise. There is perhaps no other one hygienic theme which in the last twenty years has received so much atten- tion as has exercise, and concerning which so much twaddle has been written. In it some, who speak as those having authority, see the grand panacea for all individual ills as well as the hope of the perfection of the race. It does not seem to occur to these fanatics that farmers and laborers not only die as well as other people, but even appear to suffer nearly or quite as much during their earthly pilgrimage. In order to understand how much or how little of good is to be expected from exercise, it is necessary to comprehend what takes place in muscular move- ments, and in what way they are beneficial. Volun- tary motion of a hand and arm is the result of a complicated series of acts. Successive discharges of nerve-force occur, commencing in the upper brain and passing downwards along the spinal cord and outward along the nerves until the muscles are reached, and are called by the nervous impulse or force into action. It is a lesson not to be forgotten, that in exercise, not merely the muscle, but almost the whole nervous system, labors ; and that muscular movements are just as truly a putting forth of nervous power or energy as are mental efforts. It is next proper to get a clear idea of how exer- cise can do good ; a knowledge of what is and is not REST IN RECREATION. 93 possible often serving a most salutary purpose in cor- recting extravagant beliefs and expectations. Re- searches made in the laboratories of Germany seem to show that the animal heat is chiefly, if not exclu- sively, generated in the muscular system. Animal heat, like the heat of the fire, is the result of com- bustion ; not of a rapid, however, but of a slow com- bustion, or, as the chemist would say, oxidation. In combustion or burning, substances are destroyed, that is, turned into gases, etc., and returned to the air and earth. Now the blood has entering it from all parts of the body partially effete or used-up mate- rials. If the recent theories be correct, one of the beneficial effects of exercise is in the destruction of these effete substances. The aid here is twofold; during exercise, the oxidation goes on most strongly in the muscles, and hence during the exertion there is an increased combustion of material which other- wise would clog up the system ; further, the muscles are themselves kept in health by the exercise, so that the beneficial influence of the exercise is maintained during the period of rest. Exercise also, without doubt, does good by restor- ing or maintaining the balance of the circulation. When an organ is in active work, the blood flows to it. A brain which is habitually worked to its full powers is flushed with blood many hours out of the twenty-four, so that there is always some danger that, 94 BR % AIN- WORK AND O VER WORK. during the periods of quiet, the brain shall not be able to free itself from the excess of blood. In ex- ercise, the muscles are in action, the blood is drawn to them, and thus the brain is relieved. Again, during many hours of every day of life, digestion is in full progress and the abdominal organs are full of blood. If there be no outside force to aid these abdominal organs, they in turn may not be able, dur- ing their period of rest, to get rid of their excess of the vital fluid. If brain-work and stomach-work be forced and the muscles remain quiescent, it is very likely that most of the blood of the body will be concentrated in the head and abdomen, and the in- dividual suffer accordingly. That exercise is capable of doing good to the man in other ways than those noted, we have no knowl- edge. Its beneficial powers would seem to be lim- ited to its aiding in purifying the blood and in equal- izing the proportionate amounts of the fluid in the different portions of the body. On the other hand, it cannot too strongly be in- sisted upon that exercise is potent for evil as well as for good, and that when excessive it is certainly in- jurious. The famous athlete, Winship, when in his best condition, often fainted in a warm room ; and it is notorious that a large proportion of professional athletes die early of lung and heart diseases. The reason of this is not far to seek. The heart and lungs REST IN RECREATION, 95 are naturally proportioned in power to the wants of the body. When, as was the case with Dr. Winship, the muscular system is preternaturally developed, a preternatural amount of work is required of the heart and lungs. Increase of the bulk of a man's muscle means also increase of the bulk of his blood, as well as increase of the territory to be travelled by that blood. Such increase of blood and territory de- mands an augmentation of power to drive the vital fluid through the system, and also to get rid of the gases of the blood. Only to a certain extent can the heart accommodate itself by enlargement to this, whilst there is no reason to believe that the lungs can largely augment the surface which they have for purposes of aeration. The probable explanation of Dr. Winship's fainting in a hot, close room, is that his heart and lungs, under the most favorable circumstances, had as much as they could do to meet the needs of the system, so that when the air became impure, they were unable to fulfil the requirements. At least, one of the reasons that men whose muscular systems have been preternaturally developed so often die of lung and heart diseases is to be found in the fact that these organs are, in such people, habitually overworked. It is very important for all who are training chil- dren for brain-work to remember that an over-devel- opment of the muscles is possible. Artificial sys- g6 BRAIN- WORK AND O VER WORK. terns, like that of Dr. Winship's, in which the mus- clec are so cultivated as to be especially able for great sudden efforts, are peculiarly bad. Great mo- mentary muscular strength and great endurance under continued exertion are by no means synonymous. They may be united in the same person, but it is possible to possess one without the other. To a peaceably disposed person, who is neither a butcher nor a belligerent, to be able to lift an ox is not ex- tremely valuable ; while to be able to stand a hard march of twenty hours' duration is almost invaluable, because such a march requires that endurance which enables a man to perform severe continuous labor of almost any sort. Violent sudden efforts, habitually repeated, are especially prone to develop the faculty of excessive momentary strength. Weight-lifting, health-lifts, and all similar forms of exercise are, at least for the child, an abomination, the practice of which cannot be too strongly condemned. What is wanted is protracted muscular work or play of a light character, to bring the habit of endurance. Boat- ing, cricketing, out-door plays of all sorts, such as a normal boy of himself naturally is fond of, are prob- ably in most cases the best means at command for training the embryo man. Only some little system should be given, even to play. The use of gymnas- tics for boys is, in some measure, open to objection, as the open air is the right place for play; but in our REST IN RECREATION. g? climate during much of the year out-doors is not so attractive as it might be. Nevertheless, open air sports are certainly preferable when the weather is at all favorable. When gymnastics are practised, great care should always be taken to see that the exercise be not too severe to be persisted in for some time. I would here especially commend to those who can afford the expense such forest schools as that of Prof. Rothrock as uniting in the highest degree opportuni- ties for the proper physical and mental development of boys. What has been said of violent exercise for young people is also applicable to adults. Health-lifts and all forms of short, violent exercise should only be employed when time cannot be had for out-door ex- ercise. They are, however, not so injurious as in the case of boys, because in the man the muscles are more set and less easily influenced in their develop- ment as to sudden or persistent strength. Still, horseback-riding, boating, hunting, and other forms of more gentle out-door exercise are, even for the adult, far preferable to these modern devices for cheat- ing Nature by attempting to get the good effects of exercise at a less sacrifice of time than was intended. The only excuse that can justify the use of these methods or instruments is an impossibility of getting something better, and there are very few men whose 9 G 98 BRAIN- WORK AND O VER WORK. circumstances of life really force them to such make- shifts. There are persons who hold that there is an antag- onism between brain and muscle. The position is partially correct in that an extreme development of one is at the expense of the other. A Winship can- not be expected to have much brain power ; and it is probably possible to develop a child which shall be as much a brain-monster as some athletes are muscle- monsters. Beyond this, so far as training children is in discussion, the truth does not go. The best man for doing a life of brain-work is he who has been in childhood symmetrically developed, and who has acquired all the endurance his constitution will permit of. There is certainly in the adult some antagonism be- tween hard physical and mental labor. Muscular work rests upon a putting forth of nervous energy, and the man who has exhausted his stock of nervous energy in violent exercise, cannot expect to perform a prodigy of brain labor. Did any one, in the even- ing of a day spent in following the hounds or tramp- ing after a pair of pointers, ever compose a poem or write a sermon ? The cup of tea or toddy, the easy chair, the cheery story, finish far better the day's work and prepare for the early bed. The converse of this I believe also to be true. In my own experi- ence, I am sure that when engagements are such as REST IN RECREATION. 99 really to work the brain to its highest capability of production, exercise must be lessened or entirely done away with ; only it must be remembered that, at this high-pressure rate, the system cannot hold out permanently, and that after long spells of such work- ing, periods of rest and recuperation must make up for the excessive consumption. Again, there are persons who are possessed of very active and power- ful brains, although their muscles are feeble. In some of these cases it is a grievous mistake to incul- cate the habit of exercise. There is a very well- known brain-worker in this city, who was advised by his physician to live in West Philadelphia, and every day to walk backward and forward to his place of business, a distance in all of not more than five miles. The result of this was continued and pro- gressive failure in the brain-power of production, with no improvement of the general health. Not until after some months of depression was the idea suggested that mayhap the exercise was not beneficial. When it was given up, not merely did the power of work return, but the health began to recover. In persons of middle age, whose muscular system has almost wasted away from lack of use, any sudden resumption of active habits is not desirable. By attention to diet, by graduated exercise, the attempt should be made slowly and permanently to recover lost vigor. IOO BRAIN-WORK AND OVERWORK. How much exercise, then, should the brain-worker take to himself? From the propositions laid down a few pages back, it would seem a correct deduction that the proper amount of exercise is that which will keep the muscles in good health and which will ena- ble them to meet the physical requirements of the rest of the body, /. e., to remove from the blood all impurities and to draw from the internal organs % the excess of blood in them. As with a good many other general principles, the application of this to the in- dividual case is not always easy. But usually a man will be able to judge for himself by studying the condition of his muscles ; if these are becoming more and more attenuated or fatty, less voluminous and more flabby ; if the elasticity of step and carriage is growing less, more exercise is usually required. In dyspeptic cases, exercise is also often very beneficial in the relief of the stomachic distress. Closely connected with the subject of exercise is that of the summer vacation. In the first place, it is proper here to insist upon the value of a periodical complete annual rest, a rest which should be propor- tionate to the severity of the winter's strain. Two weeks is the accustomed vacation in mercantile circles, but certainly is not long enough for ordinary purposes. A hard-working man will, in the long run, produce more for taking at least three weeks' holiday, and very often a month or six weeks' rest is a saving of time. REST IN RECREATION. IOI In the summer vacation, the end is twofold ; first, to rest the wearied brain ; second, to restore as far as possible the health of the muscles, of the digestive organs, and of any other part of the body which may have suffered damage during the winter's work. It is usually the emotional as much as, or sometimes even more than, the intellectual wear of the brain which is destructive during the long year of labor, and con- sequently, during recreation, freedom from anxiety and other depressing emotions is of prime import- ance. When a man is so situated that he cannot take care, he is very apt to cease from care. The ocean voyager is completely cut off from the receipt of any news, and in this complete isolation lies one of the chief sources of the great usefulness of sea- travel. Home cares and home worries are left be- hind; but as the shore is approached, and with it the possibility of hearing of the progress of business and other interests, with remarkable alacrity the mind rises out of its apathy to take up the old burdens. The isolation of the man who buries himself in the wilderness is not less complete than that of the voy- ager, and few of those who have spent their vacation in the wilds will not recognize the same freedom from anxiety that is felt upon the sea, as well as a reawakening of the faculties, when the settlements are approached, similar to that which occurs in the voyager nearing shore. 102 BRAIN-WORK AND OVERWORK. Along with, rest from anxiety and care during a vacation, it is well to get the active assistance of cheerful emotions. A jolly time is not merely an enjoyment ; it is a benefit. A dull vacation is, in a great part, a wasted vacation. What affords one man pleasure is to another very tiresome ; and it is the pleasure of the individual, not pleasure in an abstract sense, which is to be sought after. There is a peculiar variety of pleasurable sensation produced by travelling, which aids very favorably in unbending most minds. But in this country the va- cations are usually of necessity taken in the hot months, and car-riding in a torrid atmosphere laden with dust is refreshing neither to the mind nor body. I have seen many persons come back from their sum- mer trips more jaded and exhausted than before they started ; simply used up, mind and body, by the fatigues of travel. This is, of course, worse than a waste of time, opportunity, and money. What is true of travel is no less true of the life at many of our summer watering-places. Perpetual camp-meetings, such as are seen at some of our mod- ern religious sea-side resorts, and perpetual fashion- able life, such as occurs at other sea-side resorts, are about equally bad in their physical tendencies. They both minister to a taste for excessive excite- ment that is very exhausting, and they both yield an annual harvest of nervous, hysterical women. For- REST IN RECREATION. IO3 tunately, the temptation to either mode of spending a vacation is felt only by a very limited class of brain- workers. Passing these matters by without further discussion, it is necessary to say a few words more about the subject immediately in hand. The mental constitu- tions of people vary so much that, as with habitual recreation, so also with the annual vacation, no posi- tive law of choice is possible. Under certain restric- tions of physical and moral force, both in selecting the habitual recreation and also in choosing a vaca- tion, the man must be a law unto himself, and, with a due regard to his physical and mental needs, decide upon that which best suits his natural or acquired tastes. Experience would seem to show that conditions of the atmosphere not appreciable to the physicist, have a most marked influence over the human organ- ism. Sea air, mountain air, etc., really do appear to influence a man physically for better or worse, and in the choice of a spot for the summer vacation, their power must not be lost sight of. Here again individual peculiarities are inscrutable and tri- umphant. As a rule, no physician can tell with cer- tainty beforehand as to whether salt or mountain air, a low or a high altitude, will suit a patient. Only by trial can the idiosyncrasies be made out. Most per- sons are able, from their own experience, to settle for themselves what suits them best, and should be 104 BRAIN- WORK AND O VER WORK guided by their own knowledge. It is worth noting, however, that in a very large number of cases, the best results are obtained by alternating the sea-shore and the mountains — going first for two weeks to the former, and afterwards for two to four weeks to the latter. The choice of the place in which a vacation is to be spent involves »ery closely the method or way in which the time is to be passed. In making the selection, it is important that the choice be guided, not solely by the direct needs of the brain, but also by the wants of the muscular, digestive, and other parts of the organism. The delicate man who so places himself that for three or four weeks he will be forced to live on sour bread and salt mackerel, will be very apt to reap the reward of his folly. He who goes to the sea- shore, to Saratoga, or to other resorts, and spends his days in bed and his nights in the ball-, bar-, or bil- liard-room, cannot expect to bring back muscles and other organs in improved health. He may himself enjoy such dissipation more than anything else, but his muscles and digestive organs do not find the same aid and comfort therein. The only things, leaving out of sight spring waters and other medicinal agents, that can modify the condition of the muscu- lar system and relieve the digestive organs of an habitual excess of blood are abstinence, air, sunlight, exercise. The pleasures of abstinence are not best REST IN RECREATION. 105 enjoyed during a summer vacation, and nothing more need be said about them here. The popular appreciation of the value of fresh air is very far from being as thorough as it might be. During the rebellion, it was no uncommon sight to see sick men, who had been languishing in the ward of a hospital, suddenly improve when placed in exposed tents. The windows of the wards had been habit- ually kept open, but this was by no means as efficient as the perpetual air-bath of a porous tent. The more pure air the better, and by night as well as by day. There is this much of truth in the popular prejudice against night air — in malarious districts the air after dusk does contain more of the peculiar poi- son than does the atmosphere in the sunlight. But in high, healthful districts, night air is very good air. Of the value of sunlight, it is not necessary to say much. Sufficient also has already been said concern- ing exercise, and the method in which it does good. It is right, however, here to caution against a not un- common abuse of exercise in the summer vacation. A man whose muscles are soft and flabby from ten months of disuse, cannot expect them all at once to equal the thews of a woodman or athlete. It is not uncommon for an ambitious young man to injure himself, or at least to fail of getting the good he ought, by working too hard, especially in the begin- ning of his trip. 1 06 BRAIN- WORK AND O VER WORK. Some years since, I was consulted by a prominent scientist, who said, " Doctor, when you are sick, who attends you? " I replied, " Dr. . Why do you ask?" " Oh, I want to find out whom the doctors select to attend them; that man shall be my doctor." If this line of reasoning be correct, camping out may be considered as well recommended, for, whether in Canada or the Adirondacks, the parties will be found to contain an extraordinary proportion of medical men. I believe myself that, under suitable circum- stances, camping out is by far the best way of pro- curing a healthful summer rest. It requires, how- ever, a certain amount of natural aptitude, and of robustness. To some persons the long hours in the wilderness are very irksome ; and when there is no zest for their pleasures, or appreciation of their end- less natural charms, the woods become simply a place for discomfort, hardships, and tedium. The great value of " camp-cure " is to be found in the freedom from care and anxiety which its isolation produces ; in the constant pleasant excitement main- tained by the continually shifting multitude of novel objects and experiences ; in the continual exposure to fresh air, and in the abundant exercise. Some of these very sources of enjoyment and strength may, however, readily become sources of danger. It is wonderful, considering the extraordinary change in the habits of life, how seldom persons "take cold" dur- REST IN RECREATION. 107 ing these trips. Nevertheless, it is very easy to lay the foundations of a serious, if not fatal, illness by undue exposure. What was said very early in this Primer concerning the relativeness of exposure should be borne in mind. The man who sleeps on a bed beneath a roof all the rest of the year is a very different animal from his guide who is in the woods ten months of each year. Heavy woollen under-clothing should always be pro- vided, when a camping expedition in any of our ordi- nary northern regions is intended. Then care should always be taken to have a sufficiency of covering for the night. In most expeditions, it is essential not to be loaded down with baggage ; but, after considerable experience, I would most strongly advise every travel- ler of this sort to provide himself with one strong outer woollen suit, two complete sets of woollen un- der-clothing, one heavy and one light, and a heavy blanket, or, much better, a buffalo robe. I have found the robe much warmer at night than is a heavy double blanket, and not very much more burdensome in the day. It is also necessary to take some rubber clothing, either in the form of a coat, or else of an ordinary army blanket. A wide, long coat has seemed to me the preferable form. If the party consist of two, and the nature of the route be such as to require loads to be lightened, the night-clothing is best ar- IOS BRAIN-WORK AND OVERWORK. ranged by one person taking the robe, the other a blanket, and the twain sharing a common bed. The light under-clothing should be worn in the day, when the sun is warm and exercise abundant. On cool nights all the under-clothing, as well as the outer suit of clothes, may be worn. I am very sure that more protection can be obtained out of a given weight of wool by putting it in under-clothing than in any other way. Were the nature of the trip of such a character as to make it imperative to reduce the impedimenta, I would greatly prefer to go without the blanket, trusting to two suits of heavy under-cloth- ing, than to skimp the under-clothing for the sake of the blanket. The right plan, especially for the inexperienced, is to avoid all trips in which it is not possible to take a proper supply of clothing. By means of horses in the Rocky Mountain region, and of canoes in the lake or river districts, of both East and West, the so- journer is enabled to carry with him what is essential. Camping out in districts other than these is very apt to end in disappointment. Certain flying excursions on foot to the mountain regions of the Adirondacks are advisable, for the sake of the beautiful scenery ; but it is better to make a central camp, from which the voyageur may radiate. Even, however, with the most careful laying out of such trips, I think the com- REST IN RECREATION. IO9 mon experience will confirm my decided verdict in favor of well-watered districts. The life of a man who is travelling through a wil- derness is one of constant activity. During the day canoes to paddle, portages to make, deer to be stalked, hounds to be followed, and, as evening draws on, tents to be pitched, fires to be made, supper to be got ready, wood to be cut for the night, to say nothing of making beds and the various other minor duties — these manifold occupations constitute a round of work that ceases only when the time of sleep draws nigh. All this is most healthful to a reasonable being, but campers-out sometimes injure themselves by their ambitious attempts to equal the guide in labor. To shirk work is to deprive the pastime of half its pleas- ure ; but it is foolish to attempt to rival the trained muscles of the woodman. Even when moderation is practised, the first days of camp life are apt to be severe to the man whose muscles are soft and flabby from a year's disuse. It is a wise precaution to " train" moderately for a few weeks before setting out; an hour a day spent in active exercise will allow the muscles to get rid of their flabbiness before being called upon for the strenuous work of the wilderness. CHAPTER VI. REST IN SLEEP. AS sleep is a state or condition of which most of mankind have sufficient of personal experience, it is hardly necessary to define it. Nevertheless, it is perhaps allowable to call attention to some of the more important of its varieties as well as to discuss its nature. I remember once having been utterly confounded in my attempt to make a very intelligent publisher believe that it is possible for one piece of ice to be colder than another. Ice was not only to his mind ice, but also the personification or realiza- tion of cold, and could not be colder. So with re- gard to sleep. To many minds it is the realization of rest, and only some unfortunate victims fully com- prehend that there is a sleep which does not refresh, and has in it only the mockery of rest. Probably every one who reads these pages Can, however, remember moments in which he was him- self hardly able to determine whether he was waking or sleeping. Periods of quiet, in bed it may have been, when, in endless succession, through the brain no REST IN SLEEP. 1 1 1 whirled troublous or possibly pleasant dreams, scarcely affected by consciousness, though not absolutely freed from it ; times when the outer world seemed half for- gotten, but had only half withdrawn itself, so that even the slight impression of a mosquito on the face, the rustle of the bed-clothes, the puff of air, served to recall all the bitter and the sweet of life. To very many persons this state is the prelude of true sleep ; in times of sorrow or of anxiety it may be almost all the rest the sufferer can find. Then again there is a sleep that is a terror of unrest to its victim — when horrible dreams, or busy dreams — dreams of death, remorse, business — drive along in a hurried rush so vividly that the sleeping moments, when looked back upon by the memory, seem more real and full of life than do the waking hours. It is plain such sleep is not tired nature's sweet restorer. Certainly any one who has ever had a nightmare, when the death fray is lived through over and over again, when the whole being is con- vulsed with agony and the cold sweat starts from every pore, will agree that all sleep is not rest. Dreams have power to torture, to depress, almost in proportion as they are beyond our control. I well remember the pangs of being fed in a darkened chamber for a feast of cannibals ; and the expiring look that my youngest boy, whom I had vivisected, once gave me, will never be forgotten. Sleep, there- 112 BRAIN-WORK AND OVERWORK. fore, is not always rest, but trouble, and a troubled sleep brings to the brain-worker loss of power of labor. As sleep passes, on the one hand, into wakefulness, so, on the other hand, it may deepen into coma. Some writers speak of coma and sleep as entirely different. Possibly they are ; and yet we cannot draw the line separating them. We call a condition of uncon- sciousness, out of which the patient can be aroused, sleep ; one out of which we cannot awaken him, coma. A patient takes a small dose of chloral or opium. He sleeps, and is easily aroused. Increase the dose ; again he sleeps, but is less easily awakened. Let the dose be larger still, and only by violent shakings, loud shoutings in the ear, and other excessive disturb- ances, can a degree of consciousness be restored, and the restoration is but momentary. A little more of the poison and consciousness has fled, it may be never to return ; or by and by the coma grows less profound, the patient can be momentarily aroused, and after a time passes into a state of simple sleep. The sleep and the coma have been produced by the same agent, the opium or the chloral, and have, by insensible gradations, passed into one another. It would seem, therefore, difficult to believe that the states are essentially different from one another. It is difficult, if not impossible, to decide fully in what lies the beneficial effect of natural, untroubled REST IN SLEEP. 1 1 3 sleep; but it would seem to be in the suspension of con- sciousness. I do not believe that the cerebral proto- plasm ever ceases during health to evolve thought. I am not able, it is true, to prove the truth of my belief on this point ; but no one can disprove it, and the drift of the evidence seems to me to indicate that dream- ing is always going on in natural sleep. Certainly, the forgetfulness of having dreamed is no proof that dreaming has not occurred. Any one who has slept with a person who, when asleep, habitually expresses his feelings in talk, must have heard snatches of con- versation, even boisterous laughter or sorrow-laden sighs, of which, in the morning, the sleeper has had no memory. Again, most of us can call in mind some sudden waking, in which we have a definite, unmis- takable feeling of an interrupted dream, but no knowledge of what the dream was. There are some persons who are such inveterate sleep-talkers that they will answer questions rationally in their sleep without awaking. I have known important secrets revealed to a bed-fellow, no memory of the talk re- maining. It is by no means certain that even in coma the " thought cells M cease their action. Other portions of the brain labor on through life. The centres which govern respiration maintain in continuous action the respiratory muscles. The brain cells which preside over the heart's action never cease 10* II 114 BRAIN- WORK AND O VER WORK. from their censorship. It is far from being proven that the rest to the mind during sleep is due to a ces- sation of activity in the thought cells ; it is, indeed, most probable that no such arrest of activity occurs. Rest would seem to come largely from the relaxation of effort, from withdrawal of consciousness and of external impulses, and the consequent freedom for the protoplasmic movements to run on uncontrolled. In this way the balance of nervous energy may re- store itself, a sort of equalization taking place be- tween the various cells which have been irregularly constrained and active during the day. As unconsciousness is so important an element in sleep, one of the best tests at our command as to the character and the real value of a certain sleep is to be found in its unconsciousness. The sleep which rests most is that which is quietest, and of which there remains no memory during waking hours. The sleep that rests most is that which the brain-worker especially needs, and the quiet, so-called dreamless sleep is that which he must seek. From time to time various theories have been pro- pounded to account for the production of sleep, and some of them have been made the basis of discussion as to the proper treatment of wakefulness. Of these speculations, there are only two of which, at present writing, it seems necessary to speak. According to the teachings of one of these theories, there is de- REST IN SLEEP. 1 1 5 veloped, by the activities of the waking hours and the consequent destruction of tissue, one or more substances or principles, which have a peculiar rela- tion to the nerve cells, comparable to that possessed by morphia, by reason of which they lull the cerebral centres into sleep. The idea of this theory is, per- haps, more lucidly expressed by the statement that the destruction of tissue which takes place during mental and bodily exercise produces a narcotic prin- ciple which puts a man to sleep. This theory rests upon no experimental or other evi- dence of any scientific value whatever. As the nar- cotic principle cannot be isolated, its existence is a gratuitous supposition. Sleepiness is by no means always proportionate to the waste of tissue during the waking hours past. When a physiological theory rests upon no firm foundation, and is at the same time unnecessary and improbable, it is best abandoned without too much waste of time or words. The second theory is more plausible, and has re- ceived more wide-spread assent. It is that sleep is dependent upon anaemia of the brain, or, to speak less technically, upon the presence of less than the proper amount of blood in the brain. It is a well- known fact, that for a part to perform actively its duties, it must have an abundance of blood. Fur- ther, it is abundantly proven by the phenomena of disease, that if the supply of blood be cut off from a 1 1 6 BRAIN- WORK AND O VER WORK. portion of the cerebrum, that part of the man at once loses all power of action ; also, that if the supply of blood be taken away from any considerable portion of the upper brain, complete unconsciousness results. Led by these facts, certain physiologists invented the instrument which has been known as a cerebrometer. This consists of a glass tube, ending below in an expan- sion or hemispherical bulb, whose bottom is cut off. Over the ground edges of this is secured a piece of flexible sheet-rubber or membrane. A round opening having been made in the skull of the animal, the bulb is fitted tightly, so that the membrane rests upon the brain. Mercury is then poured into the upper open end of the tube, until it fills the bulb and reaches to a certain height in the tube. It is evident that when the brain contains little blood, and the pressure in- side of the skull is small, the mercury will be low in the tube, and that when a rush of blood into the brain raises the pressure, the mercury will be forced up the tube. By means of the cerebrometer it has been shown that during sleep there is little blood in the brain, whilst during the waking moments the pressure rises. These facts do not, however, prove the truth of the theory. It is perfectly possible that the lessened flow of blood is due to the sleep, and not the sleep to the lessened flow of blood. When any organ is in active exercise there is, as already stated, a flow of blood to it. When a salivary gland secretes spittle, it fills with REST IN SLEEP. l\J blood; but it is abundantly proven that the flow of blood is not the cause of the secretion, but the se- creting impulse the cause of the flow of blood. So, probably, is it with the brain; the awaking out of sleep brings blood to its active protoplasm, "and when the latter becomes quiescent, the vital fluid no longer needed inside of the skull seeks other quarters. Unconsciousness can undoubtedly be produced by a great excess of blood in the brain, and, as already shown, the line between sleep and coma is not a clear one. The anaemia theory of sleep is certainly not as yet demonstrated, and to me it seems improbable. The simplest and most probable explanation of sleep- production seems to be, that the highest brain proto- plasm is so constructed that at certain times it rests from active exercise, because it has exhausted its en- ergy, and that the impulse to sleep is from within, not from without, the nerve-centres. The law of habit, which was discussed in the earlier part of this book, has, in all probability, much to do with the production of sleep. A brain may not really have done much work, but composes itself to sleep at a certain time in the twenty-four hours, because such has been its habit for many years. Whatever may be the correct theory of sleep, I think observation has clearly shown that, for sleep to be perfectly obtained, the following accessories are re- quired : — First, the power of shutting off the imme- 1 1 8 BRAIN- WORK AND O VER WORK. diate past, and breaking away from the work the mind has been most intently engaged upon during the day. Second, the power of locally regulating the supply of blood in the brain, so that it shall be adapted to the wants of the brain, and be neither too much nor too little for the needs of the moment. When the regulation of the blood supply is seri- ously deranged, the doctor should be seen at once. To discuss in detail such a medical point is beyond the scope of the present volume. It is only necessary to say that by exercise, proper living, and all other methods which are described in works on general hygiene, the brain-worker must endeavor to keep up the general health, and prevent any disturbance of the circulation. So far as the voluntary acts of the individual are concerned, " going to sleep " is usually simply a shut- ting out both of the past and of the outer world of the present. The methods of doing this are various — some direct, some indirect. By a stern effort of the will, some people seem able to quiet the attention. It is largely by possession of this power that these in- dividuals are able to go to sleep whenever they desire. More mysterious than this, although in some way re- lated to it, is the power which various individuals have of waking out of sleep at a time upon which they have previously determined. Counting numbers backwards, imagining some REST IN SLEEP. I 1 9 pleasant but not exciting "castle in the air," even the physical acts of getting quiet and shutting the eyes, are simply useful as indirect aids in lulling the atten- tion, by shutting out all disturbances which shall ex- cite it. With a clear idea as to what it is 7 desired to do, those who do not go to sleep easily are much more apt to hit upon some effective device. With some a short period of cheerful converse, with others a reli- gious meditation, or the calmative effect of a cigar, or a chapter or two out of a light book, or a medi- tative glass of ale and its companion crackers, or even, as I have known of, a cold bath, answer the desired end of breaking off the thread of the day's work and excitement. Beyond such simple expedi- ents as these, it is not well to go without medical advice. A vital question, which must offer itself for solu- tion to every brain-worker, is, how much sleep must I take, and when shall I take it? In a previous chap- ter, the opinion has already been expressed that the time is not a matter of much moment, provided that enough of sleep is taken with regularity. If a part of the night's sleep is replaced by an afternoon nap, well and good ; provided that the nap be taken sys- tematically and not intermittently. There is no real objection to sitting up late at night or to getting up early in the morning, provided sufficient time for 1 20 BRAIN - WORK AND O VER WORK. sleep is allowed. It is of little importance in the life history of a candle at which end you begin to burn it ; but to burn both ends simultaneously is soon to finish the candle. If you go to bed late, don't get up early. In the amount of sleep required, individuality counts for a good deal, but not for so much as many persons claim. There may have been men born since the creation with heads under their arms, but I have never seen one. There may have been men who could work hard and continuously on four or five hours' daily sleep, but it has never been my lot to know one. I have watched a number of indi- viduals who affirmed that five or six hours were suf- ficient for them, and have been convinced that, in a few of these cases, the amount named was really all that was taken ; but have in every instance seen the individual, by some form of breakdown, suf- fer the penalty of having endeavored to cheat Na- ture. There are not many men who are able to per- form severe mental work year after year, without suffering, on less than an actual daily sleep of seven hours. Any who, except in advanced years, can get along with less than six hours is a lusus natarcz ; and there are many who require more than seven hours. This rule is especially modified by two factors, whose importance is not always recognized — the first of these is age ; the second, work. The child who REST IN SLEEP. 121 is using his brain at school should have all the sleep he will take; less than nine hours is not rarely a scanty allowance. The grown youth or the middle-aged man require less sleep than does the child. It is to them that the rule just enunciated especially applies. As middle life is passed, the daily need of sleep is lessened. A man at sixty usually requires less rest than he did at thirty-five. Why this is so is not altogether clear. It is possibly because a man at sixty usually works less than he does at forty. Even if he accomplished the same results, by long habit the work has become easier and without effort. It is quite possible, that if a man at sixty engage in a new kind of labor, his sleep-needs will equal those of the younger man. As old age draws on, there is a steady increase in the sleep requirements, until finally nine, ten, or twelve hours daily are well passed in forget- ful ness. Every one recognizes that severe physical work must be followed by a corresponding rest; but it is not so universally remembered that the one law rules mental and physical labor. When a man works hard with his brain, he must rest hard not only in recrea- tion, but also in sleep. If a personal allusion may be pardoned as an illustration, I have found that, when using my brain vigorously, about one hour more of sleep was required daily than when, for a number of successive days, no effort was put forth. ii CHAPTER VII. CONCLUSION. THERE are one or two still untouched subjects upon which it seems right to say a few words before closing this brief essay. In the lives of most men who struggle upwards, there come periods when it is necessary to perform a great deal of labor in a short time. If the object to be gained is sufficiently important, it is perfectly justifiable to take a certain amount of risk of suffering from overwork. The risk is, however, comparatively slight, if the principle of a compensating rest after the exertion be borne in mind. Acute brain exhaustion following a spell of work is an entirely different condition from the breakdown which results from a long-continued strain. In the acute attack, the brain almost invariably recovers itself en- tirely in a comparatively short time. There is, how- ever, great danger in a too frequent repetition of this spendthrift process of paroxysmal labor. When a large production is necessary in a short time, it is important to reduce the strain to the lowest degree possible by attention to the various principles CONCLUSION. 123 already discussed in this Primer. In most cases, ex- ercise is for the time being to be neglected; but only under the most extraordinary circumstances is it wise to curtail the amount of sleep. The question as to the use of stimulants always presses itself to the man jaded with overwork. They are, if possible, to be avoided, or, at most, to be used with the greatest caution. Tobacco, though it some- times seems to soothe, is a most dangerous friend, and its free use during a spell of hard work is very apt to increase sensibly the peril. Alcoholic stimulants are likewise dangerous allies, which should be treated with the utmost caution. In some persons they do aid in mental effort, but any use for such purpose is but too apt to lead to dependence upon them, with its resultant progressive demoralization. To lawyers over- wrought by the exigencies of a great trial, they are especially attractive, because there is at such times a distinct physical as well as mental basis of exhaustion. In the case of generals during a hard campaign, the temptation is even more urgent. Indeed, it may be stated as a general principle, that the more the brain- work is performed under circumstances of excitement and bodily fatigue, the more forcibly does alcohol pre- sent itself. It should, however, never be forgotten that alcoholic stimulants do not give real power, except when taken along with food, whose digestion they facili- tate. A dish of raw oysters, with a bumper of claret or 1 24 BRAIN- WORK AND O VER WORK. a glass of ale, may afford the often-needed sustenance during the labor of a protracted speech, or of an ex- citing political or military contest. It seems to me very important to the advocate that he should never spend many hours in court without light but sustain- ing food. Indeed, it should always be a guiding principle, when physical labor and mental labor go hand in hand, always to take simple food at not too long intervals. I certainly have seen injury from the habit of going from breakfast to a late dinner without food, or only with a very light lunch. Tea or coffee is to many, if not to the majority of persons, a better stimulant to mental effort than alco- hol, and certainly far safer. The abuse of them is very much less perilous than is that of whiskey or brandy, but it certainly does increase the penalty to be paid for the excess of labor. Coffee is perhaps more apt to produce unpleasant symptoms than is tea, though individual peculiarities here play an important part. Both to the paroxysmal and steady brain-worker it is important to be able to perceive the indications of the coming storm, and so avert evil. The fore warn- ings of nervous breakdown are sometimes very plain, and sometimes so obscure, as to be read only by the most skilful physician. To discuss them at all satis- factorily, would carry one far beyond the bounds and CONCLUSION. 125 scope of this Primer \ all that can be done is simply to outline a few of the more important. Excessive nervousness, or irritability, as every un- fortunate wife of a hard driven brain-worker well knows, is a very common result of overwork. Its meaning is that the over-taxed nervous system is so exhausted that the least discord or unnecessary effort is painful to it. It is often preservative of health, because it becomes so annoying to the man himself as to drive him to rest. What pain is to the broken limb, such is nervous irritability to the exhausted brain j by suffering, it forces the worker to let his nervous systemrest. It rarely presages those serious disasters which come suddenly after a prolonged strain lasting for years. The dangerous brain condition is that in which the cerebrum has become so benumbed as not to feel the peril, and demand a halt. Headache is another of those fortunate symptoms which are of a character to make themselves so felt as to force the attention of the brain-worker. The head is often the seat of unpleasant sensations which are not headache, but which, as the signs of mental over-driving, are of even more serious meaning than is headache. Such are a sense of weight on the top of the head, a feeling of constriction of the forehead, or a more general cephalic distress. Such phenomena, occurring after long-continued strain, are very sig- nificant, and should always be heeded. 126 BRAIN-WORK AND OVERWORK. Sleeplessness is a very common indication of over- work, which, when pronounced, demands medical ad- vice. Of still more importance are the following manifestations, and the only counsel I can give those who suffer from them is, to lose no time in trifling, but to seek at once the best medical attention. Such are numbness in one or more of the extremities, per- manent slight loss of control over some groups of muscles, momentary loss of consciousness, failure of memory, or loss of the power of fixing the attention.. In some cases the forewarnings consist simply of momentary losses of power in the arms or legs. THE END. " Mr. Blakiston aeeervee the thanks of the public for the remarkably interesting and valuable series of works on Hygiene which he has recently issued. They are all written in a popular style, and contain information of great value to every reader. They are cheap, and can scarely fail to save their cost many times over in any family, if the directions given in them are carried out." — From a Leading Canada Journal. Catalogue No. 5. Select List of Books FOR GENERAL AND SCIENTIFIC READERS, INCLUDING WORKS ON THE CARE AND MANAGEMENT OF OUR HEALTH; NURSING; THE PROPER CARE OF CHILDREN; PERSONAL AND DOMESTIC CLEANLINESS; HOW TO PREVENT DISEASES; DRAIN- AGE OF HOUSES AND LANDS, ETC., AND CHEMISTRY, MICROSCOPY, AND POPULAR SCIENCE. PUBLISHED BY P. BLAKISTON, SON & CO., SCIENTIFIC, MEDICAL AND CHEMICAL BOOKS, 1012 Walnut Street, Philadelphia. r M^Any of the books in this Catalogue unll be sent, postpaid, upon receipt of the price or they can be procured of most booksellers throughout the United States and Canada, Seepages 14 and 15 for SPECIAL OFFER. P. Blakistoriy Son & Co.'s NEW BOOKS BY DR. J. F. EDWARDS. ** Plain and straightforward."— Baltimore Sun. VACCINATION AND SMALLPOX. Showing the reasons why we should be Vaccinated and the fallacy of the arguments ad- vanced against it, with hints as to the management and care of smallpox patients. 32mo. Cloth. Price 60 cents. MALARIA : Where Found ; Its Symptoms and How to Avoid It. Cloth. Price 75 cents. " A forcible, logical, and sensible little book."— Philadelphia Times. DYSPEPSIA. How to Avoid It. By Joseph F. Edwards, m.d. Discusses food and digestion. States how food should be cooked, and plainly shows how and what we ought to eat. Second Edition. 16mo. Cloth. Price 76 cents. " Among the admirable publications of Presley Blakiston, there Is none that will be more welcome than Dr. Joseph F. Edwards' little treatise on 4 Dyspepsia/ It is, in fact, a handbook of cooking and eating, practical and excellent in every way."— Boston Globe. CONSTIPATION, Plainly Treated and Relieved without the Use of Drugs. By Joseph F. Edwards. 16mo. Cloth. Price 75 cents. M It is one of those useful little books which every one ought to read."— Philadelphia Inquirer. BRIGHT'S DISEASE. How Persons Threatened or Afflicted with this Disease Ought to Live. By J. F. Edwards, m.d. Second Edition. 16mo. 96 pages. Cloth. Price 75 cents 11 It encourages the sufferer as well as instructs him."— Congregationalist. " Dr. Edwards is doing a good work in these volumes, and their wide dis tribution among the people can but be productive of the best results ; he neither employs nor advocates any quack methods or treatment, but plainlj tells how to avoid and how to cure or alleviate suffering from disease."— New Haven Palladium. Any of the above sent by mail, postpaid, upon receipt of price. Select List oj Books. THE MANAGEMENT OF CHILDREN in Health and Disease. By Mrs. Amie M. Hale, m.d. A book for Mothers. Second Edition. 12mo. Cloth. Price 75 cents. THE PRB88 COMMEND IT AS FOLLOWS: "Altogether, it is a book which ought to be put into every baby basket, even if some lace-trimmed finery is left out, and should certainly stand on every nursery bureau." — Philadelphia Public Ledger. 11 Admirable common-sense ad vice, which mothers would do well to have." —Southern Churchman. " Contains invaluable instruction." — Evening News, Detroit. "The importance of this book cannot be over estimated."— N. E. Journal of Education. " A work for mothers, full of wisdom."— Congregationalist. " Ought to be the means of saving many a young life."— Phila Inquirer. "Abounds in valuable information."— Therapeutic Gazette. 11 Emphatically a book for mothers, and cannot fail to be useful to all who read it."— Indiana Farmer. "Admirably simple, clear, sensible, and safe in its teachings."— Friends'' Review. " It should be upon every household table."— Nashville Jour. Med. and Sur. BIBLE HYGIENE ; or, Health Hints. By a Physician. This book has been written, first, to impart in a popular and condensed form the elements of Hygiene. Second, to show how varied and important are the Health Hints contained in the Bible, and third, to prove that the secondary trendings of modern philosophy run in a parallel direction with the primary light of the Bible. 12mo. Cloth. Price $1.00. Paper covers 50 cents. NOTICES OV THE PRESS. " The anonymous English author of this volume has written a decidedly readable and wholesome book."— Philadelphia Press. "The scientific treatment of the subject is quite abreast of the present day, and is so clear and free from unnecessary technicalities that readers of all classes may peruse it with satisfaction and advantage."— Edinburgh Medical Journal. DRAINAGE FOR HEALTH; Or, Easy Lessons in Sanitary Science, with numerous Illustrations. By Joseph Wilson, m. d m Late Medical Director, United States Navy. One vol. Octavo. Price $1.00. " Dr. Wilson is favorably known as one of the leading American writers on hygiene and public health. The book deserves popularity."— Medical «nd Surgical Reporter. NAVAL HYGIENE and Human Health ; the Means of Pre- venting Disease. By Joseph Wilson, m.d., Late Medical Director, U. S. Navy. Illustrated. 8vo. Cloth. Price $3.00. P. Blakiston, Son & Co J 8 THE AMERICAN HEALTH PRIMERS. Edited by W. W. Keen, m.d. Bound in Cloth. Price 60 cents each. Paper covers 3^ cents each. PRICE, SECURELY BOUND IN PAPER, 30 CENTS. I. II carl ns and How to Keep It. With illustrations. By Ohas. H. Burnett, m.d., of Philadelphia, Aurist to the Presby- terian Hospital, etc. II. IiOnf? Iiile, and How to Reach It. By J. G-. Richardson, m.d., of Philadelphia, Professor of Hygiene in the University of Pennsylvania. III. Tbe Summer and Its Diseases. By James O. Wilson, m.d., of Philadelphia, Lecturer on Physical Diagnosis in Jefferson Medical College. IV. Eyesight, and How to Care for It. With Illustrations. By George C. Harlan, m.d., of Philadelphia, Surgeon to the Wills (Eye) Hospital. T. The Throat and the Toiee. With illustrations. By J. Solis Cohen, m.d., of Philadelphia, Lecturer on Diseases of the Throat in Jefferson Medical College, etc. VI. The Winter and Its Dangers. By Hamilton Osgood, m.d., of Boston, Editorial Staff Boston Medical and Surgical Journal. Til. The Month and the Teeth. With illustrations. By J. W. White, m.d., D.D.8., of Philadelphia, Editor of the Dental Cosmos. Till. Brain Work and Overwork. By H. C. Wood, Jr., m.d., of Philadelphia, Clinical Professor of Nervous Diseases in the University of Pennsylvania, etc. IX. Onr Homes. With illustrations. By Henry Hartshorne, m.d., of Philadelphia, formerly Professor of Hygiene in the University of Pennsylvania. X. The Skin in Health and Disease. By L. D. Bulkley, m.d., of New York, Physician to the Skin Department of the Demilt Dispensary and of the New York Hospital. XI. Sea Air and Sea Bathing-. By John H. Packard, m.d., of Philadelphia, Surgeon to the Episcopal Hospital. XII. School and Industrial Hygiene. By D. F. Lincoln, m.d., of Boston, Mass., Chairman Department of Health, American Social Science Association. This series of American Health Primers is prepared to diffuse as widely and cheaply as possible, among all classes, a knowledge of the elementary facts of Preventive Medicine, and the bearings and applications of the latest and best researches in every branch of Medical and Hygienic Sci- ence. They are intended incidentally to assist in curing disease, and to teach people how to take care of themselves, their children, pupils, em- ployes, etc. They are written from an American standpoint, with especial reference to our Climate, Sanitary Legislation and Modes of Life. Select List of Book NOTICES OF THK PRB88. 44 As each little volume of this series has reached our hands we have found each in turn practical and well-written. "—New York School Journal. 44 Each volume of the 'American Health Primers' The Inter-Ocean has had the pleasure to commend. In their practical teachings, learning, and sound sense, these volumes are worthy of all the compliments they have received. They teach what every man and woman should know, and vet what nine-tenths of the intelligent class are ignorant of, or at best, have but a smattering knowledge of." — Chicago Inter-Ocean. 44 The series of American Health Primers deserves hearty commenda- tion. These handbooks of practical suggestion are prepared by men whose professional competence is beyond question, and, for the most part, by those who have made the subject treated the specino study of their lives. Such was the little manual on 'Hearing,' compiled by a well-known aurist, and we now have a companion treatise, in Eyesight and How to Care for It, by Dr. George C. Harlan, surgeon to the Wills Eye Hospital. The author has contrived to make his theme intelligible and even interesting to the young by a judicious avoidance of technical language, and the occasional introduction of historical allusion. His simple and felicitous method of handling a difficult subject is conspicuous in the discussion of the diverse optical defects, both congenital and acquired, and of those injuries anddiseases by which the eyesight may be impaired or lost. We are of the opinion that this little work will prove of special utility to parents and all persons intrusted with the care of the eyes."— New York Sun. "The series of American Health Primers (now entirely completed) is presenting a large body of sound advice on various subjects, in a form which is at once attractive and serviceable. The several writers seem to hit the happy mean between the too technical and the too popular. They advise in a general way, without talking in such a manner as to make their readers begin to feel their own pulses, or to tinker their bodies without medical advice." — Sunday-school Times. 44 Brain Work and Overwork, by Dr. H. O. Wood, Clinical Professor of Nervous Diseases in the University of Pennsylvania, to city people, will prove the most valuable work of the series It gives, in a condensed and practical form, just that information which is of such vital importance to sedentary men. It treats the whole subject of brain work and overwork, of rest, and recreation, and exercise in a plain and practical way, and yet with the authority of thorough and scientific knowledge. No man who values his health and his working power should fail to supply himself with this valuable little book."— State Gazette, Trenton, N. J. 41 An unexceptional household library."— Bost on Journal of Chemistry. 44 Every family should have the entire series; and every man, woman, and child should carefully read each book."— Alabama Baptist. M Everybody knows that it is uncomfortable to be cold, but few know that undue exposure to cold shortens life, and still fewer the nature of the safe- guards that ought to be taken against it, . . . This little book, Winter and Its Dangers, contains a mass of well digested and practical informa- tion."— St. Louis Globe Democrat, in a two-column review, Nov. 24th, 1881. "The whole series Is a particularly useful one, and should be added to the reference books of Academies and High Schools."— Zion'? Herald, Boston. P. Blakiston, Son <fc Co.'s WHAT TO DO FIRST in Accidents and Poisoning. By Charles W. Dulles, m.d. Illustrated. 18mo. Cloth. Price 50 cents. PREFACE. Whoever has seen how invaluable, in the presence of an accident, is the man or woman with a cool head, a steady band, and some knowledge of what is best to be done, will not fail to appreciate the desirability of possess- ing these qualifications. To have them in an emergency one must acquire them before it arises, and it is with the hope of aiding any who wish to prepare themselves for such demands upon their own resources that the following suggestions have been put together. OPINIONS. "Of special practical value, and we commend it to all."— Lutheran Ob. server. 44 Ought to be in everybody's hands."— Times, Philadelphia. WATER ANALYSIS For Sanitary Purposes; With Hints for the Interpretation of Results. By E. Frankland, ph.d., d.o.l. With Illustrations, Tables, etc., etc. 12mo. Cloth. $1.00. 44 The name of the author, who is a distinguished Chemist, and has had great experience in sanitary matters, is a sufficient testimonial to its ac- curacy and its great practical value."— Bost on Journal of Chemistry. EYESIGHT, GOOD AND BAD. The Preservation of Vision. By Robert Brudenel Carter, m.d. , p.r.c.s. Second Edition. With many explanatory Illustrations. 12mo. Price: paper covers, 75c; cloth, $1.25. pbepace. A large portion of the time of every ophthalmic surgeon is occupied, day after day, in repeating to successive patients precepts and injunctions which ought to be universally known and understood. The following pages contain an endeavor to make these precepts and injunctions, ana the reasons for them, plainly intelligible to those who are most concerned in their observance. WHAT 18 THOUGHT OF IT. M A very valuable book, and should be in everybody's hands."— tforflk American. 44 A valuable book for all who are interested in the best use and preser* vation of the vision."— N. E. Journal of Education. 44 A compact volume, full of information to all classes of people."— Book- seller and Stationer. 44 A comprehensive treatise, well calculated to educate the public."— Kansas City Review. 44 G-ives excellent advice."— Chicago Journal. 44 To teachers particularly the book is of interest and importance."— Educational Weekly. Select List of Books. VACCINATION AND SMALLPOX. A NEW BOOK BY DR. JOS. F. EDWARDS. 3£mo, CLOTH. PRICE 50 CENTS. This is a most timely monograph, for, owing to the spread of this dread disease, the subject is of interest to every one. The author's aim is to sho n the advantages of being vaccinated and the fallacy of the arguments used by those opposing it, with advice as to the care and management of Small- pox patients. BIBLE HYGIENE; OB, HEALTH HINTS. BY A PHYSICIAN. 12mo, Cloth. JPrice $1.00. Paper, 50 cts. This is a most curious book, interesting in an historical as well as a theo- logical and sanitary light. It has a threefold purpose : First : To impart, in a popular and easily understood form, those elements of health preservation which are fast taking the place of medicines. Second : To show the importance of the health hints contained in the Bible. Third : To prove that modern ideas on the preservation of disease run in a parallel direction with the laws of Moses and other Biblical writers. The author has consulted many books and different editions of the Bible in preparing his work, compressiog into the volume a great amount of valuaDle information and the conclusions of many other writers. WHAT EVERY MOTHER SHOULD KNOW. Bv Edward Ellis, m.d., Author of a Practical Manual on the Diseases of Children. 16mo. Cloth. Price 75 cents. '« As it is only too true that our children have to dodge through the early part of life as through a sort of pathological labyrinth, we must be thank- ful to meet with such a sensible guide for them as Dr. Ellis. He is emi- nently a practitioner among doctors, and a doctor among practitioners ; that is to say, he is learned and well knows what is known, can do what should be done, and can put what he has to say in plain and comprehensive language."— Pall Mall Gazette. "The author has a faculty of sketching out the characteristics of dis- eases and their treatment in striking outlines, and of making his points ve r" *"^, r and impressive."— A". Y. Medical Record. P. Blakiston, Son & CoJs DRUGS THAT ENSLAVE. The Opium, Morphine, Chloral, and Hashisch Habits. By H. H. Kane, m.d., of New York City. One volume. 12mo. With Illustrations. Price $1.60. A curse that is daily spreading, that is daily rejoicing in an increased number of victims, that entangles in its hideous meshes such great men as Coleridge, De Quincey, William Blair, Robert Hall, John Randolph, and William Wilberforce, besides thousands of others whose vice is unknown, should demand a searching and scientific examination. 41 A vivid and startling expose* of the increase of this form of intemper- ance, and the terrible sufferings endured by those trying to free them, selves from this habit."— Pittsburg Telegraph. " It is well that such a warning as is contained in this book should be sounded." — Albany Evening Journal, c 44 The volume seems to be a summary of the results of the most approved practice, both in Europe and this country."— New York World. M A work of more than ordinary ability and careful research. . . . For the first time, reliable statistics on the use of chloral are classified and published. . . . And it is shown that the use of chloral causes a more complete and rapid ruin of mind and body than either opium or morphine." .—Druggists' Circular and Gazette. M The effects of the habits described are set forth boldly and clearly, and the book must have a beneficial effect. It will do still better service in de- terring persons from experimenting 'to see what it is like.'" — Charleston (S. C.) News and Courier. "The subject of the chloral habit has not been investigated by any one, we believe, so thoroughly as by Dr. Kane."— Af edical Record. 44 There is ground for a new temperance movement here. The book is a valuable one. It is written in a practical manner, and has nothing of a sensational character."— Philadelphia Ledger. THE OCEAN AS A HEALTH RESORT. A handbook of Practical Information as to Sea Voyages, for the use of Tourists and Invalids. By Wm. S. Wilson, l.r.c.p.. Lond , m.r.c.s.e. With a Chart showing the Ocean Routes, and Illustrating the Plr sical Geo, graphy of the Sea. Crown 8vo. Price $2.50. HEALTH RESORTS. Health Resorts for ,the Treatment of Chronic Diseases. A Hand-Book, the result of the author's own obser- vations durinar several years of health travel in many lands; contain- ing also remarks on climatology and the use of mineral waters. By T. M. Madden, m.d. 8vo. Price $2.60. 44 Rarely have we encountered a book containing so much information for both invalids and pleasure seekers."— The Sanitarian. ON NURSING. A Manual for Hospital Nurses and all engaged in attending to the sick. 4th Edition. With Recipes for Sick Room Cookery, etc. Price 75 cents. Gives complete directions for the management of the sick room, for feed- ing, washing and dosing patients, about accidents and operations, use of Aheromet^r, cupping, etc., etc., etc. Select List of Boohs. HOW TO LIVE. A GUIDE TO HEALTH AND HEALTHY HOMES. By GEORGE WILSON, M.D. Second Edition. Edited by Joseph G. Richardson, Professor of Hygiene University of Pennsylvania. 314 Pages. Price, cloth, $1.00; Paper covers, 75 Cents. SCOPE OF THE WORK. The object of the author in writing this book is to advance the art of preserving health; that is, of obtaining the most perfect action of body and mind during as long a period as is consistent with the laws of nature. Though many books have been written analogous to the subject, there is none like this; sufficiently simple, and at the same time systematic and comprehensive. A glance at the table of contents will convince the reader of its completeness and reliability as a guide to all those wishing to lead a happy, healthy and long life. Chapter I is a general introduction to the whole subject, giving a few statistics in regard to death rates, and remarks showing the great number of preventable diseases and the possibility of reducing the many early deaths by a proper regard of simple health rules. Chapter II is explana- tory of the different functions of the human body, for the more thorough understanding of the following chapters. Chapter III is headed Causes of Disease, self induced and social ; treating of intemperance in food as well as drink and tobacco, mental overwork, immorality, idleness, irregular modes of living, sleep and clothing, contagious diseases, consumption, etc.; unsound food, impure air, etc., e**. * Chapter IV is more particularly devoted to food and diet, their proper choice, digestive qualities and prepar- ation. Chapter V treats the subjects of cleanliness and clothing. It is astounding, the ignorance displayed by the majority of people on these points, and Dr. Wilson gives many useful hints invaluable to every one. Chapter VI is on Exercise, Recreation, etc., giving the proper amount of exercise to be taken by boys and girls, young and old, explaining its necessity and good effects ; details are also given lor the proper training for racing and athletic sports as recommended at various universities. Chapter VII treats of the more general theme of the Home and its sur- roundings, drainage, water supply, ventilation, warming, outside premises, ana innumerable hints of value about choosing or building a new home, and the alteration and healthful arrangement of an old one. Chapter VIII, Diseases and their prevention, and concluding remarks. Only an outline of the scope of this book can be had from these few gen- eral headings, but it would De impossible to give in so limited a space the thousand and one subjects handled, popular errors corrected, ana useful hints given by Dr. Wilson, in these three hundred and fourteen closely printed pages. A general index completes the volume, and the well known name of Prof. Richardson on the title page, as editor, is an additional guar- antee of its trustworthiness as a guide in all things relative to health and How we should live. , PRESS NOTICES. 11 The book aims at the prevention of Disease. It abounds in sensible suggestions, and will prove a reliable guide."— Churchman. " A most useful and, in every way, acceptable book."— New York Herald. " Full of good sense and sound advice."— Educational Weekly. ** Deserves wide and general circulation."— Chicago Tribune. P. Blakiston, Son & Co.'s ON HEADACHES. The Nature, Causes, and Treatment of Headaches. By Wm. H. Day, m.d. Third Edition. Illustrated. Price, in paper covers, 75 cents ; cloth, $1.25 "The work is one that will be read with interest by those who are called on to treat the disease — and even more by those who are at the same time personally acquainted with its tortures."— Ohio Medical Recorder. THE MANUFACTURE OF PERFUMES, POWDERS, Soaps, etc. The Art of Perfumery ; or, the Methods of Obtaining the Odors of Plants, and Instruction for the Manufacture of Perfumery, Dentifrices, Soap, Scented Powders, Odorous Vinegars and Salts, Snuff, Cosmetics, etc., etc. By Gr. W. Septimus Piesse. Fourth Edi- tion. Enlarged. 366 Illustrations. 8vo. Cloth. Price $5.50 "An excellent book." — Commercial Advertiser. 44 It is the best book on Perfumery yet published."— Scientific American. 44 Exceedingly useful."— Journal of Chemistry. 4 ' Is in the fullest sense comprehensive."— Medical Record. POISONS AND THEIR ANTIDOTES. A Memoranda of Poisons and their Antidotes and Tests. By Dr. Thomas Hawkes Tan- ner. Fourth Edition. Revised and Enlarged. Price 75 cents. This most complete manual should be within reach of all ; for, as an addi- tion to every family library it would be the means of saving life and allay- ing pain when the delay of sending for a physician would prove fatal. It shows at a glance the treatment to be adopted in each particular instance of poisoning. INTERMARRIAGE. A Scientific Inquiry into the Causes why Beauty, Health, and Intellect result from certain unions, and Deform- ity, Disease, and Insanity from others. By Alexander Walker. Illus- trated. 12mo. Cloth. Price $1.00 The work is not of that empiric character which its title might lead some readers to suppose ; but a careful philosophical treatise . It is entitled to great consideration; and even if the author's theory as applied to the hu- man species be wrong, the facts here accumulated, on the subject of cross breeding, etc., cannot fail to be of high value and interest to stock farmers and others. There is nothing indelicate in the work, to an enlightened reader. MARRIAGE, In its Social, Moral and Physical Relations. By Dr. Michael Ryan, Member of the Royal College of Physicians and Sur- geons, London. 12mo. Cloth. Price $1.00 DANGERS TO HEALTH. * A Pictorial Guide to Sanitary Defects, showing the many defects in Sewers, Drain Pipes, etc., and how they may be detected. By T. Pridgin Teale. 8vo. Illustrated. Price $3.60 With 70 illustrations, most of them colored, showing in the clearest way the dangers to health arising from carelessly laid drains and old sewers. If any testimony is needed to show the increasing interest taken by the public in such commonplace matters as drains and waste pipes, it is to be found in the fact that two large editions of this book have already been sold. Select List of Books. LONG LIFE. The Art of Prolonging Life. By C. W. Hufe- land. New Edition. Edited by Erasmus Wilson, m.d. 12mo. Price 81.00 4 * We wish all doctors and all their intelligent clients would read It, for surely its persual would be attended with pleasure and benefit."— Ameri- can Practitioner. *• We all desire long life, and the attainment of that object, as far as it can be accomplished by an adherence to the laws prescribed by nature, may be furthered by a perusal of Dr. Hufeland's book, which is written in a style so perspicuous and free from technicalities as to be readily compre- hended by non-professional readers."— Philadelphia Evening Bulletin. "The work is a rational and well ordered presentment on a subject of moment to all. It prescribes no panacea, but puts in requisition instru- mentalities that are in everyone's reach. It should be read by all."— North American. ALCOHOL AND TOBACCO. Alcohol; its Place and Power. By James Miller, f.r.o.s.; and, Tobacco; its Use and Abuse. By John Lizars, m.a. The two essays in one volume. Cloth, Price $1.00 Either essay separately. Price 50 cents. M A perusal of this work rather startles a smoker and chcwer, and gives one an idea of the silent work going on in the system. It certainly shows that a man must sooner or later feel the pernicious influences of alcohol and tobacco. Let smokers and absorbers read it, and then make their cal- culations on the length of time they will last under a continuation of the evils, and whether it is not best to heed the facts there laid down and * mod- erate' a little."— Calif ornian. M They are full of good, strong, medical sense, and ought to be very influ- ential agents against the vices they assault."— Cvngregationalist. 44 We have seldom read an abler appeal against the demon of intemper- ance, or one enforced by more cogent arguments. "— Philadelphia Inquirer. THE MENTAL CULTURE AND TRAINING OF CHIL- dren. By Pye Henry Chavasse. 12mo. Price $1.00 ; paper cover, 60 cts. The mental culture and training of children is of immense importance. Many children are so wretchedly trained, or rather, not trained at all, and so mismanaged, that a few thoughts on this subject cannot be thrown away, even upon the most careful. ON INDIGESTION. Indigestion: What It Is ; What It Leads To ; and a New Method of Treating It. By John Beadnell Gill, m.d. Second Edition. 12mo. Price $1.2& 44 Indigestion, pure and simple, is responsible for almost all the other dis- eases that flesh is heir to. Rheumatism and gout are the direct conse- quences of this disorder, as well as heart and lung3 troubles. To care this diseased state of digestive and assimilating organs Dr. Gill, a distinguished English physician, has written this able treatise. He has summed up some eighty-eight cases and their natural remedies, besides a system of eliminanta and tonics. Great stress is laid on proper bathing, as a curative agent, and on drinking hot water and its other uses. The fact of a seeond edition being required within a few months of the first, needs no comment, and points the demand."— Philadelphia Ledger. P. Blakiston, Son & Co.'s RULES OF ORDER; A LEGISLATIVE MANUAL. Kules for Conducting Business in Meetings of Societies, Legislative Bodies, Town and Ward Meetings, etc. By Benj. Mathias, a.m. Seventeenth Edition. 16mo. Cloth. Price 60 cts. DOMESTIC MEDICINE. A Condensed Compend of Domes- tic Medicine, and Companion to the Medicine Chest. By Drs. Savory and Moore. Illustrated. 32mo. Cloth. Price 50 cents. ON HEADACHES. Ninth Thousand. Headaches, Their Causes, Nature and Treatment. By Henry C. Wright, m.d. Cloth. Price 50 cents. CHEMISTRY PRIMER. A Primer of Chemistry, including Analysis. By Arthur Vacher. 18mo. Cloth. Price 60 cents. PRACTICAL MINERALOGY. Practical Mineralogy, Assay- ing and Mining, with a description of the Useful Minerals, and in- structions for Assaying and Mining according to the simplest methods. By Frederick Overman. 12mo. Cloth. Price $1.00 ON COPPER. The Chemistry and Metallurgy of Copper ; the art of mining and preparing ores for market, and the various pro- cesses of Copper Smelting, etc. By A. Snowden Piggott, Analytical and Consulting Chemist. Illustrated . 12mo. Cloth. Price $1.00 THE MICROSCOPIST. A Manual of Microscopy, and Com- pendium of Microscopic Sciences, Micro-Mineralogy, Micro-Chemistry, Biology, Histology, etc. By Joseph H. Wythe, a m., m.d. Fourth Edition. 252 Illustrations. Price, Cloth, $6.00; Leather, $6.00 " Its text is well written, concise and comprehensive, but its chief value is to be found in the two hundred and five illustrations, whose scope embraces almost every class of subjects the amateur is likely to desire knowledge upon." — Philadelphia Medical Times. " The work is clearly written and its matter presented systematically and in very judicious proportions. It contains a great number of beautifully colored plates, which will prove helpful to the student."— Popular Science Monthly. HOSPITALS AND THEIR MANAGEMENT. Pay Hospi- tals and Paying Wards throughout the World. Facts in support of a system of medical relief. By Henry C. Burdett, m.d. 8vo. Cloth. Price $2.25 BY SAME AUTHOR. PROGRESS, MANAGEMENT AND WORK OF COTTAGE Hospitals; with many Plans and Illustrations. Demi 8vo. Cloth. Price $4.50 " Mr. Burdett displays and discusses the whole scheme of hospital accom- modation, with a comprehensive understanding of its nature and extent."— American Practitioner. DEAFNESS, GIDDINESS, ETC. Deafness, Giddiness, and Noises in the Head. By Edward Woakes, m.d. Illustrated. 12mo. Price $2.50 Select List of Books. LIFE THEORIES. Life Theories and their Influence upon Religious Thought. By Lionel S. Beale, m.d. Six colored plates. 12mo. Price $2 OO BY SAME AUTHOR. PROTOPLASM ; or, Matter and Life. Third Edition. En- larged. 16 Colored Plates. Cloth. Price $3.oo BIOPLASM. An Introduction to the Physiology of Life. Illus- trated. 12mo. Price $2.26 THE MICROSCOPE AND ITS REVELATIONS. The most Complete Text-Book on the Use of the Microscope. By W. B. Carpenter, m.d., f.r.s. Sixth Edition. Enlarged. 600 Illustrations (some colored). 882 pages. Cloth. Price $5.50 WATER ANALYSIS. Potable Water; How to form a Judg- ment on Water for Drinking Purposes. By Chas. Ekin. Second Edi- tion. 12mo. Price 76 cents. PRACTICAL HYGIENE. A Complete Text-Book of Practical Hygiene. By Edward Parkes, m.d. Fifth Enlarged Edition. Illus- trated. Thick Octavo. Cloth. Price $6.00 "Altogether it is the most complete work on hygiene which we have seen." — New York Medical Record. 44 We find that it never fails to throw light on any hygienic question which, may be proposed."— Boston Medical and Surgical Journal. 44 We commend the book heartily to all needing instruction (and who- does not) in hygiene."— Chicago Medical Journal. A HANDBOOK OF SANITARY SCIENCE. Hygiene and Sanitary Science. By George Wilson, m.d.. Medical Officer of Health. With Illustrations. Fourth Edition Revised. Demi 8vo. Cloth. Price $2.15 CHEMISTRY FOR BEGINNERS. Progressive Exercises in Practical Chemistry. By Chas. L. Bloxam. 89 Illustrations. Cloth. Price $1.75 This book is intended for those commencing the study of Chemistry. 41 A great amount of practical information is here condensed, such as only a practical teacher could prepare." — New England Journal of Education. CHEMISTRY, ORGANIC AND INORGANIC. A Complete Text-Book. By Prof. Charles L. Bloxam. Fourth Edition. Nearly 300 Illustrations. 8vo. Cloth. Price $4.00 Recommended at many schools and colleges throughout the United States. JOS" These Books can be procured from Booksellers generally, or will be sent, postage paid, upon receipt of the price by the Publishers. P. Blakiston, Son & Co.'s POPULAR SCIENTIF IC BOOKS. JS^ 3 " Either of the following books sent, postpaid, to any address, upon receipt of ANY SIX BOOKS FOR FIVE DOLLARS. HOW TO PROLONG LIFE. By C. W. Hufeland. Cloth. DRAINAGE FOR HEALTH. ( Excellent advice about the draining of land and dwellings, pipes to be used, etc. Cloth. WATER ANALYSIS, for Sanitary Purposes. A practical ex- position of the subject. By Prof. Ed. Frankland. Cloth. INTERMARRIAGE. Why beauty, health and intellect result from certain unions, and deformity, disease and insanity, from others. Cloth. BIBLE HYGIENE. The relation between the Laws of Moses and other Biblical writers and the Hygiene of the present. Cloth. COPPER; Its Chemistry and Metallurgy. Piggott. Cloth. MENTAL CULTURE AND TRAINING OF CHILDREN. By Henry Chavasse. Cloth. MARRIAGE; Its History and Philosophy. By Dr. Michael Ryan. Cloth. HOW TO LIVE. A useful home book, containing many valu- able suggestions. Wilson. Cloth. PRACTICAL MINERALOGY. Assaying and Mining. Over- man. Cloth. ALCOHOL AND TOBACCO. Their Use and Abuse. Miller and Lizars. Cloth. ftf^T Either of the following books sent, postpaid, to any address, upon receipt of SEVENTY-FIVE CE3STTS. Any Six Books for Three Dollars and Seventy-five Cents. HEADACHES: Their Causes and Treatment. Dr. Day. Paper. POISONS AND THEIR ANTIDOTES. Should be in every family library. Tanner. Cloth. DYSPEPSIA: HOW TO AVOID IT. Edwards. Cloth. SLIGHT AILMENTS: Their Nature and Treatment. Beale. Paper. Select List of Boohs. HOW TO LIVE. A useful home book, containing many valu- able suggestions. Wilson. Paper. INFANTS; Their proper Management in Health and Disease. Hale. Cloth. MALARIA ; Where Found, its Symptoms, and How to Avoid it. Edwards. Cloth. GOOD AND BAD EYESIGHT. A popular exposition of the physiology of vision. Illustrated. Carter. Paper. CONSTIPATION. Its relief by habits of living, eating, and exercise. Edwards. Cloth. DISEASES OF CHILDREN. What every mother should know about them ; in plain, comprehensive language. Ellis. Cloth. WATER. How to form a judgment on the suitableness of water for drinking and cooking. Ekin. Cloth. BRIGHT'S DISEASE. How persons afflicted with this disease ought to live. Edwards. Cloth. NURSING OF THE SICK, with Rules for Diet, Hygiene, In- valid Cooking, etc. Domville. Cloth. &T Either of the following boohs sent, postpaid, to any address, upon receipt of FIFTY CEZSTTS. Any Six Books for Two Dollars and Fifty Cents. A PRIMER OF CHEMISTRY. Vacher. Cloth. RULES OF ORDER, for Conducting Business in Meetings of Societies, Legislative Bodies, Town and Ward Meetings, etc. Mathias. Cloth. AMERICAN HEALTH PRIMERS. (See special list.) Cloth. ALCOHOL, Its Place and Power. Miller. Cloth. EMERGENCIES. What to do first in accidents, poisoning, etc. Dulles. Cloth. BIBLE HYGIENE. The relation between the Laws of Moses and other Biblical writers and the Hygiene of the present. Paper. COMPEND OF DOMESTIC MEDICINE. By Savory & Moore. Cloth. HEADACHES ; Their Causes and Treatment. Wright. Ninth Thousand. Cloth. TOBACCO. Its Use and Abuse. Lizars. Cloth. VACCINATION AND SMALLPOX. Edwards. Cloth. Select List of Books. SLIGHT AILMENTS: THEIR NATURE AND TREATMENT. By LIONEL S. BEALE, M.D. Second Edition, Revised and Enlarged. OCTAVO. PRICE, CLOTH BINDING, $1.25; BOUND IN PAPER, 76 CENTS, Every one suffers from time to time with slight derangements of the health ; derangements not dependent upon or likely to determine any important change in any organ or tissue of the body, but du^ to some temporary disturbance which, though painful and unpleasant, may be easily relieved by any one understanding their nature and cause. A little too much food, or food of a bad kind, or food badly cooked, 01 eaten at the wrong time or too quickly, a glass of bad wine, bad milk 01 water, to say nothing of the disturbances occasioned by changes of atmos- phere, and a hundred other causes, bring about such normal changes in the body as to make even the strongest and healthiest among us to feel for a time unwell ; almost every one, in fact, experiences such departures from the healthy condition. It is about these Slight Ailments, which cause sc much discomfort, and often a great deal of pain, that Dr. Beale treats, The old adage, that " prevention is better than cure," applies pertinently to slight ailments, as it is these which are often the forerunners of disease and doctor's bills. OPINIONS OF THE PRESS. " It abounds in information and advice, and is written for popular use." — Philadelphia Bulletin. " A valuable work for the family library." — Boston Transcript. " Clear, practical, and a valuable instructor." — Baltimore Gazette. " In a very important sense, a popular book." — Chicago Advance. " An admirable treatise upon the minor ills which flesh is heir to." — Spri?igjiela Republican. Any book in this Catalogue will be sent, postage prepaid, upon receipt of price. See pp. 14 and 15 for SPECIAL OFFER. Money should be sent by Draft, Post Office Money Order, or Registered Letter. The publishers have an extensive stock of books in all branches of Medi. cine and Scienoe. Catalogues furnished upon application, correspond* ence solicited. P. BLAKISTON, SON & CO., BOOKSELLERS, PUBLISHERS AND IMPORTERS, 1012 WALNUT ST.' PHILADELPHIA, CO • U i C BE, "<EL III