Popular Science Monthly/Volume 10/January 1877/Mental Overwork

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TO hit off the happy medium between over-and under-work is no easy task even to those who have the necessary knowledge, on the one hand, and the liberty to arrange their own scheme of occupation, on the other. But, for one person who is injured by doing too much, I quite believe with Dr. Wilkes that many may be found who are sustaining serious damage from not having enough mental stimulus. The listless vacuity in which so many of the well-to-do classes spend their lives, the want of any incentive to exertion, and the absence of any attempt at real thought which the wide-spread prevalence of ready-made opinions in our periodical literature directly encourages, must cause more or less degeneration of intellectual power. Under these conditions the brain gradually loses its healthy tone, and, although quite equal to the daily calls of a routine and uneventful existence, it is unable to withstand the strain of special sudden emergency, and, when a heavy load of work is unexpectedly thrown upon it in its unprepared state, then we see all the worst consequences of what may be called overwork develop themselves. It is no uncommon experience to meet with cases in which damage has been done to the bodily constitution by indulging too recklessly in athletic exercises and active physical exertion when the muscles have become flabby and feeble from disuse. A man accustomed to sedentary pursuits takes suddenly to boating or running, or the horizontal bar, and, if he escapes straining his heart, he is certain to make himself stiff and uncomfortable. Or he has been told that there is nothing like Switzerland for reviving the faded Londoner, so, without the slightest attempt at preparation, he devotes himself enthusiastically to climbing ice-peaks and traversing snow-passes; and, when his brief holiday is over, he comes back, worn and jaded, and astonished to find that the glacial air, which has proved so beneficial to many, has done nothing for him.

Now, the fault here lies in the want of proper preliminary training. Even as we do not prescribe quinine as a tonic until we have ascertained that the digestive functions of our patient are in good working order, so it is most improper for any one to attempt active muscular exertion without bracing up the previously-unused muscles by carefully-graduated exercise. And in mental operations the same analogy holds good. If the brain is not habituated to the constant gymnastic influence of steady work, it is liable to give way or suffer more or less injury from any sudden and spasmodic effort. If, on the other hand, however, its healthy nutrition is insured by the free supply of pure blood and the true balance between destruction and repair, we shall find ourselves in possession of an organ which will bear almost any amount of steady strain, so long as certain conditions are fulfilled. So long as a brain-worker is able to sleep well, to eat well, and to take a fair proportion of out-door exercise, it may safely be said that it is not necessary to impose any special limits on the actual number of hours which he devotes to his labors. But when what is generally known as worry steps in to complicate matters, when cares connected with family arrangements, or with those numerous personal details which we can seldom escape, intervene, or when the daily occupation of life is in itself a fertile source of anxiety, then we find one or other of these three safeguards broken down. Probably the man of business or the successful advocate cannot shake himself free from his business thoughts at night. Slumber becomes fitful and disturbed. The sympathetic system, unsettled by the mental strain, brings about various defects in nutrition; the appetite fails, and the vigor of the nervous tissues is no longer able to withstand the endless round; and then we meet with the sleeplessness, the dyspepsia, the irresolution, the irritability, and the depression, which are among the chief miseries of those who we are in the habit of saying are overworked.

Now, the Lancet has lately laid before its readers some interesting statements which would lead us to believe that damage is being done to many boys in preparatory schools by the strong competition imposed upon them by the entrance-examination to the larger institutions, and by the ambition of their masters, who hope to derive profit and honor from their success. This is indeed a serious consideration, and the possibility of a large section of our most promising lads being thus mentally stunted in early life would demand instant interference did we deem the charge fully proved. Now, with all deference, I would venture to express my opinion, based on some experience, that, although we must not neglect so timely a warning of probable rocks ahead, there is no specific evidence of present injury. During my residence at Rugby I was in medical charge of several preparatory schools where the educational standard was very high, and where the success was proportionate when the boys came to be drafted off into the big school. I may truly say that no case was brought under my notice during the space of three years which I could in any way trace to overwork. And this I attribute to the perfect manner in which the counterbalancing conditions of health were sustained, the good food, satisfactory hygienic conditions, ample time for recreation and active sports, and frequent holidays. Boys of that age do not fret or worry over their work—they throw it off in their intervals of repose, sleep well, eat well, play well, and so do not suffer. Depend upon it, it would be little to the credit of any proprietor of a private educational establishment were he to neglect the laws of health, and send his boys home enfeebled and worn out from too heavy mental strain.

As regards the larger public schools the same remarks apply, and I met with very few instances at Rugby of any bad consequences from overwork; and in the three or four well-marked cases which came under my care I was enabled to detect some other equally operative cause which predisposed to the seizure. Thus one lad, ambitious of distinction both at classics and foot-ball, had undergone violent physical exertion while exhausted by study, and the supply of nerve-force, not being available for this double strain, gave way, and a sharp, feverish attack ushered in long-continued mental prostration. A second boy, who suffered from a precisely similar attack, had been sitting up late at night, and felt some anxiety about a future prize; and the third lad, who completes the catalogue, had also consumed the midnight oil to an undue extent. But, as a general rule, the typically healthy life and surroundings of our great public schools enable their inmates to withstand a much greater amount of work than lads brought up at home, who are often unduly spurred on, and who have not the healthful stimulus of enforced active exercise. Among this class I have seen a much greater proportionate extent of temporary break-down from the effects of mental exertion too long sustained and too little relieved.

Although the standard of the School Board is not very high, we may foresee a possible source of danger in forcing the minds of wretchedly feeble, ill-fed, and ill-housed children suddenly into educational grooves. I think I have seen an increase of headaches and nervous complaints among the children of the poor since compulsory attendance has been enforced, and would only wish to record the warning against attempts to make bricks too rapidly out of the straw which has fallen into our hands to mould for good or evil.

Coming to the universities, cases of overwork are, I imagine, more common there, for not only are the young men at a more sensitive period of life, but they naturally feel that to many of them this is their great opportunity—the great crisis of their existence—and that their success or failure will now effectually make or mar their career. Here the element of anxiety comes into play, sleep is disturbed, exercise neglected, digestion suffers, and the inevitable result follows, of total collapse, from which recovery is slow, and perhaps never complete. Others, again, endeavor in their last year to make up for the frivolities of the first two; but when Dr. Morgan takes up for us the history of the intellectual life of the universities in the same exhaustive way in which he has traced the statistics of their leading oars, I doubt not that we shall find that the indictment of overwork brought against them has also been much exaggerated.

But, although less common than is generally supposed, instances of this class of break-down do occur from time to time, and I should like to ask those who have devoted special attention to nervous diseases what is their view of the pathology of such cases as the following:

A student, or an artist, or the master of a public school, after a very heavy mental strain, suddenly gives way, and is seized with sharp illness, comparable in some degree to the old-fashioned brain fever. On his recovery he takes a prolonged rest, and his general health is perfectly restored; he looks strong and hearty, and has even gained flesh, and so at last he thinks himself well enough to resume his duties. But it is found that, although he can do a little, anything like his old power of concentrated attention and steady application is gone, and if he tries to do a full day's work, he breaks down again in minor degree, and at last is obliged to content himself with taking only a very slight share in those occupations in which he used specially to excel, and in many cases his powers are never fully regained. With all the outward appearances of health, he well knows the very narrow limits within which he is now compelled to restrict his intellectual exercise. What, then, is the precise pathological condition here? Various diseases are also known to weaken the mental powers for long periods after convalescence is established, and of these scarlet and enteric fevers rank among the principal.—Lancet.