THE NERVOUS SYSTEM AS THE BALANCE OF POWER IN THE BODY
The Brain the Master Organ of the Body; the Functions of the Brain;
Habit and Automatism; the Physiology of the Brain and Nervous
System; the Hygiene of Work; the Toxins of Fatigue; Overwork; Signs
of Overwork; Nature’s Restoratives; Avocation; the Physiologic
Necessity for Laughter; Vacations and Health; Sleep; Insomnia.
The Eyes; Eye-strain; Description of the Visual Apparatus; Optical
Defects and Their Correction; the Mechanism of Eye-strain; Local
Symptoms of Eye-strain; Artificial Lighting; Hygienic Precautions
in Reading and Sewing; Injuries to the Eyes; Symptoms and Treatment
of Conjunctivitis; Trachoma; Styes.
Functional Nervous Disorders, Headache; Neurasthenia.
=The Brain the Master Organ of the Body.=—The brain is not only
the most important organ in the body, but its essential organ, for
the sake of which all the other organs and tissues exist, and it
is the master of the whole. It not only receives help from every
other organ, but it also largely controls the working of each. By
its mental action alone it can hurry the heart’s beat or slow its
pace; it can make the skin shrivel or flush; it can quicken or stop
digestion; it can stop or change the character of all secretions;
it can arrest or improve the general nutrition. Every organ and
every vital process is represented in the structure of the brain, by
special centers and groups of cells that have a direct relation with
such organs and processes, and through which they are controlled.
=The Functions of the Brain.=—The brain may be said to have four
chief functions; the first is that of motion; it presides over
and stimulates all the voluntary muscular movements of the body,
regulating their force, and coördinating in their working the
different groups of muscles needed to perform them. Mind and
muscular movement have the closest possible connection with each
other. The second function of the brain is that of feeling and
sensation; the third is that of nutrition; through this its own
nourishment and that of the rest of the body is regulated. While mind
is the fourth and highest form of nerve force, it is not created in
the brain, but is absolutely conditioned by that organ.
Different groups of brain-cells have different work assigned them;
some have motion, some have sensation, some have nutrition, and some
have mind. For example, special tracts of brain govern inhibition.
While every group does its own work, it is related to and combined
with others, influencing them, and being influenced by them.
Every kind of mental activity uses up the brain energy of the cells.
To think clearly, plenty of healthy blood must be supplied to the
cells. In order to make healthy blood, there must be an abundance
of fresh air supplied to the lungs, and a vigorous heart to pump it
up to the brain. It has been demonstrated that, during intellectual
work or emotional feeling, there is an increased supply of blood to
the brain, which may become more or less congested, and that there is
an actual rise of temperature; whereas during periods of relaxation,
rest, or fatigue, the brain is pale and anemic.
The brain-cells generally, but particularly those cells involved in
mental activity, are of such a nature and constitution that they
cannot rest absolutely during the waking hours. They may act slowly
or with great rapidity; different brains have different capacities
for energizing, both in regard to speed and force; and, further, the
brain may be pushed to work greatly in excess of its normal activity,
just as an engine may be allowed to go at the rate of 50 or 60 miles
an hour, or may be pushed to go at the rate of 100 miles an hour. In
both cases the danger resulting from speeding are greatly in excess
of going at the normal rate of speed.
In any case, the continuous brain action implies the necessity for
continuous repair. The only complete physiologic rest which the brain
enjoys is during sleep, when the process of repair goes on most
rapidly; during this period the brain-cells absorb their nourishment
from the blood in excess of their needs, and so lay up a store of
energy for the waking hours.
=Habit and Automatism.=—It is one of the innate qualities of every
tissue and of every organ in the body, that when any vital action is
performed, any vital process gone through with, it is easier to do it
the second time, and the continuous exercise of the action makes the
performances more and more easy, until they become automatic.
The physiologic basis of habits consists of the plasticity of the
nerve substance, and in the capacity of nerve substance to receive
and retain impressions. There results the certainty that the nervous
system will act again more easily in those ways in which it has
already acted.
On the one hand, the automatic performance of work saves an enormous
amount of brain energy; on the other hand, bad habits may be formed
whose effects may be most pernicious, and which are gotten rid of
only with the greatest difficulty. An example of the first is the
young child learning to walk; at first he accomplishes the feat
only by the fixed concentration of every power of the brain on the
act; whereas the healthy adult walks automatically, without paying
the least regard to the movements or the manner in which they are
accomplished. Hysteria and ungovernable outbursts of passion furnish
good examples of the bad habits that may be formed, owing to the lack
of discipline and the powers of inhibition; every time that a woman
gives way to one of these outbursts, so much the harder will it be
for her to prevent or control another outbreak. Inhibition is the
highest and most important function of the brain.
Habits woman must have, but it is for her to choose what they shall
be, provided she chooses quickly; the _time limit_ in habits is one
of the strong evidences of the close connection of body and mind. It
is a startling fact to face, that a woman’s habits are largely fixed
before she is twenty; that the chief lines of her future growth and
acquaintance before she is twenty-five; and her professional habits
before she is thirty; yet to something like this James believes that
physiologic psychology points. The woman becomes a bundle of habits,
and her habits settle about her like a plaster cast.
=The Physiology of the Brain and Nervous System.=—The brain, spinal
cord, and spinal nerves constitute the so-called cerebrospinal
nervous system. The brain is that portion of the nervous system
which is contained within the cranial cavity and which it completely
fills. The spinal cord is the continuation downward, from the brain
through the spinal canal, of nerve substances, and from which the
spinal nerves are given off. The nerves may be described as cords and
threads of varying degrees of fineness, distributed to every tissue
and organ in the body.
The nervous system has been likened to the electric telegraph, the
brain being the central station, while, in addition to the special
senses, the body is provided with numerous terminal substations
in the skin and internal organs of the body, which keep the brain
informed of what is going on in the world around it, as well as in
the various parts of the body. The nerves simply act as conductors to
transmit the messages. The body is supplied with two distinct sets of
nerves or wires, one of which carries messages from the outside world
and various organs to the brain, while the other set transmits orders
from the brain.
The spinal cord is the center of reflex acts; that is, if the leg of
a brainless frog is touched with acid, he will take the other leg
to wipe it off with. There are, as we have seen, substations in the
skin, hence the acid causes the sensation of a foreign body, word is
telegraphed the spinal cord, where there is a large central station;
from here word is sent out by another set of nerves, to move the leg
away from the acid, but this being insufficient, word is telegraphed
to the other leg to wipe off the offending substance. Did the same
thing happen in the body, at the same time that the cord telegraphed
word to the affected member to withdraw it, it would telegraph the
brain, and the sensation of pain would be felt.
A message travels along a nerve at the rate of about thirty-six
yards a second, or a mile a minute. This is about the time made
by a lightning express train. The distance in the body being so
short, the time taken is imperceptible, and we say that movement is
instantaneous.
The paths traveled by nerve impulses are made passable by use; the
oftener an impulse traverses a given route, the more adapted such a
route becomes for future traffic.
But all of this has to do with the nerves which are under the control
of the will. There is another set of telegraph wires in the body,
called the sympathetic or vegetative system, so-called because it
presides over the processes of nutrition and is beyond the control of
the will.
=The Hygiene of Work.=—Since the motor centers are located in the
brain, it is natural to expect that all definitely directed movements
will directly affect the brain and the mental development, and so it
is. Du Bois Réymond says that it is easy to demonstrate that such
bodily exercises as gymnastics, fencing, swimming, riding, dancing,
and skating are much more exercises of the central nervous system, of
the brain, and spinal cord than of the muscles.
It is further urged that healthful energy of will is impossible
without strong muscles, which are its organs, and that endurance,
self-control, and great achievement all depend on muscle habits.
The philosophy of work consists in its necessity. The brain-cell in
health cannot cease to be active, except to a partial extent during
sleep. There must be some output of mind from the mind cell and of
motor stimulus from the motor cell. The proper selection of work
for that particular brain to do, and the physiologic regulations of
the work done, is the basis of the hygiene of work. For health, for
happiness, and for efficiency, right work rightly done is the most
important matter in any man’s or any woman’s life.
The physiologic, as well as the moral necessity, has always been
conceded for every man to have a life-work—a vocation; a work for
which he should be fitted, and for which he was capable, sufficiently
congenial not to sink into mere drudgery, and which would, at the
same time, afford ample financial compensation to be remunerative and
a stimulus to his power of endurance.
Important, from a physiologic point of view, as a vocation is for
men, it is equally or even more important for women. It is highly
probable that the unstable nervous system of women and their
emotional extravagance and dissipations, whether of frivolity,
wickedness, or grief, is largely due to lack of mental discipline and
muscular development. It is a psychologic proposition that any woman
who has a toothache suffers less if she keeps busy, and any one will
testify that she suffers much less from the intense heat of summer if
she is busily employed.
One of the great objects of a definite and fixed occupation is
to turn the thoughts out from the ego. Work of some kind is
indispensable to the health and happiness of every one, since it
necessitates an objective instead of a subjective attitude of mind.
Experience teaches that the brain, like the muscles, is subject
to training; occasional excessive efforts, with long intervals of
repose, are rather injurious, while a many-sided activity, constantly
repeated, interrupted by sufficient shorter rests and supported by
sufficient nutrition, is strengthening. A healthy training of the
brain should be as many sided as possible.
Symmetric development and training of every function of the brain
is as essential for mental efficiency and sanity as the development
of all the muscles of the body is for bodily vigor, and a one-sided
training of the mental powers is as certain to produce eccentricities
of habits of thought and actions as those occupations which call into
play only the action of certain groups of muscles is to cause bodily
deformities. Anything which will prove injurious to the delicate
nerve substance must be avoided, as laziness, idleness, and, worst of
all, any form of narcotics.
Many-sided life work, consistently carried through, not only
strengthens the brain, but also its continued power of adaptation,
and one’s whole life is a continuous struggle for adaptation. The
more the brain works, the more capable it is of receiving new
impressions and elaborating old ones, and it retains its elasticity
longer.
Hurry generally implies lack of system in carrying out the routine
of work, or the undertaking of more work than the individual can
accomplish without injury to herself. Few things can more certainly
muddle the brain and produce a sense of physical exhaustion than a
sense of hurry. Without the sense of this insane driver with a lash
in his hands standing over one, she can work more rapidly, with
complete self-possession, and do more accurate and better work. The
peculiar sense of being hurried has a direct benumbing physical
effect, that can often be felt in the brain as distinctly confusing.
=The Toxins of Fatigue.=—By speeding the machinery to the utmost,
a strain is placed on nerves and muscles, and they are kept keyed
up to the greatest possible tension. There is a natural pace that
one can keep up; force the pace, and weariness results. A man can
go for hours at the rate of five miles an hour; he can run at the
rate of six miles an hour for quite a long while; but if he tries to
run eight miles an hour, he will drop out very soon. The powers of
endurance must be gradually developed, but no machine should ever be
run at its utmost speed.
By undue pressure, at any period of life, it is possible to use up
energy that ought to have been spread out over long periods; and
this is emphatically the case during adolescence; too heavy a drain
is made on futurity, which means a serious breakdown, or, at least,
premature old age.
It has long been assumed that during the activity of muscles
substances were produced which exerted a poisonous influence upon the
muscle tissues. Exactly what these substances were was not known,
but it was supposed that they were definite products of metabolism
or tissue waste. It is a well-known phenomenon, observed during the
training of athletes and soldiers, that prolonged and disciplined
exercise makes it possible for individuals to support easily an
amount of work which would prove exhausting or even fatal to the
untrained. Increased work, under any circumstances, means increased
metabolism, and consequently a more rapid accumulation of its
products.
A German investigator, Dr. Weichardt, has shown that if guinea-pigs
were put upon a miniature treadmill and forced to run it until they
dropped dead from exhaustion, a highly poisonous liquid could be
pressed from their muscles, and that the injection of this liquid
or extract into the veins of healthy guinea-pigs produced, when
administered in small doses, rapid fatigue; whereas, larger doses
caused death, accompanied by all the symptoms observed in the
original animal during the process of mechanical tiring.
On the other hand, liquid taken from unworked guinea-pigs had no
such effect. Further, that if these little animals were put upon
a treadmill and worked to just short of exhaustion, and then were
given time to recuperate, as we say, the liquid or extract from their
muscles had no such effect: it was quite harmless.
From the results of these carefully carried out scientific
investigations, Weichardt has come to the conclusion that fatigue
is due to a definite toxin, analogous to that of diphtheria and
tetanus, and he believes that the explanation of the phenomena of
training lies in the fact that in the body of the athlete there must
be a specific “antibody,” which neutralizes the “fatigue toxin” as
soon as it is formed.
In the animals undergoing these experiments of extreme fatigue there
was a fall of temperature. A practical use of this fact could be made
for the individual, by noting the fact that a subnormal temperature
was a grave danger-signal.
Other observers concede that fatigue is due to chemical substances,
produced in the body as the result of brain and muscle activity, and
find that these toxins produce a depressing effect, especially on
the muscular system, and that the sensation of fatigue is in large
part the manifestation of this depression. The action of toxins is
not confined to the tissues in which they arise; excessive activity
of one tissue can cause fatigue of others. The facts of acid
intoxication are noticed as analogous to fatigue phenomena, so far as
the latter are due to toxic substances. As antidotes, only rest and
sleep can be relied upon.
Observations in the electric experiments on nerve-cells have shown
a remarkable shrinking of the nerve-cells, and especially of their
nuclei. After five hours’ continuous work, the cell nucleus was only
half its normal size, and twenty-four hours of rest was necessary in
order to restore it to its normal size, but half that amount of work
does not require half that amount of time for its recovery.
The mental symptoms of normal fatigue are loss of memory; the sense
of perception is less acute; the association centers act less
spontaneously and therefore slower; the vocabulary diminishes; the
emotional tone is lowered; the attention is unstable and flickering.
All these are marked symptoms that the individual is far below her
best. All kinds of perceptions are more acute in the morning.
Fatigue is not, therefore, merely physically uncomfortable; it is
intellectually, physically, and morally dangerous.
=Overwork.=—A surplus nervous energy must be persistently aimed
at—what Emerson calls “plus health.” It must be indelibly impressed
on the intelligence of every one that no fatigued individual can
be at her best; she is doomed to do inferior work, to be mentally
depressed, and to be morally weakened. Hope and courage ooze away,
and all sense of proportions and perspective are lost.
The amount of work that can be performed without fatigue is a
matter of individuality, and the only safe gauge of overwork are
the danger-signals sent out by nature—loss of appetite, insomnia,
increasing exhaustion from day to day without increase in the amount
of work done, mental depression, lack of interest and initiative. No
one can afford to disregard these danger-signals.
Habitual overwork produces fag and a desire for stimulants to act
as a spur to the overworked muscles during the day, and recourse
to increased stimulants or sedatives to act as hypnotics at night.
The inert nerve-centers have no reserve energy to give out, so it
is worse than useless to stimulate them. On the other hand, the
nerve-centers are at too low an ebb to react from the depressing
effects of sedatives, which, to the individual, must be positively
injurious. The aim must be to promote nutrition, and to give complete
rest to the exhausted nerve-centers.
Brain work, to be beneficial, must be regulated with the greatest
care. During the exercise of the brain there is always an increased
blood-supply to it. If the exercise is continued too long, there is
a tendency for the blood to remain in too great quantity, due to the
exhaustion of the nerve-cells, which are no longer able to control
the vessels.
During sleep the blood-supply to the brain is diminished and the
cells recover themselves, but if this hyperemia be persistently
kept up, sleep soon becomes impossible, the brain-cells have no
opportunity to become repaired, and their activity is diminished.
Richardson says: “Making all allowances for differences, even in the
prime of their mental and physical vigor, few individuals can exceed
six, and for most persons prudence would direct not more than four or
five hours of close mental application, without seriously endangering
their health.”
No real advantage is gained by eight or ten hours of daily study,
since the memory and reasoning powers become so exhausted that the
assimilation of ideas becomes slower and more difficult. When in
his prime, Walter Scott declared that six hours a day was all that
he could profitably spend upon his literary compositions. In later
years, because of his pecuniary embarrassment, he worked beyond this
limit, and, as the result of excessive labor, his last years were
spent in hopeless imbecility.
=Signs of Overwork.=—These show themselves in irritability, with a
sense of exhaustion, the irritability being due to an exhaustion
of the nerve-centers. Work becomes irksome. There are periods of
depression and melancholia, which recur at shorter and shorter
intervals and continue for a longer period of time. There is a
slight loss of memory, together with inability to concentrate the
mind upon any given subject for any considerable length of time, and
the power of thought and judgment are impaired. There are sleepless
nights, ringing in the ears, fatigue from the slightest exertion, an
irregular action of the heart, with palpitation and a frequent desire
to urinate. Various forms of pain and neuralgia occur.
There may be as yet no loss of flesh or impairment of the appetite,
but this condition of cerebral anemia furnishes the possessor with
a pair of blue spectacles through which the intelligence must look,
and which throw their own color over everything. Distressing dreams
and unrefreshing sleep allow the brain little opportunity for either
rest or repair. The mind becomes as sensitive as the skin after
a blister, and the calm, vigorous mental labor is superseded by
feverish anxiety, wearing responsibility, and vexing chagrin.
When the brain is well supplied with a powerful circulation, and
a rich blood-supply from a good digestion furnishes it with an
abundance of pabulum, the cares of life are borne with equanimity and
cheerfulness. One of the most unerring signs of failing health is the
inability to withstand the pressure of these same daily cares. When
the cares that formerly sat lightly on the shoulders become well-nigh
an insupportable burden, a state has been reached where the mind
reacts on the body.
_Worry._—It is readily evident that worry is bred of exhaustion,
and is one of the signs of overwork; but, if too often indulged in,
it becomes a fixed habit, and the mind rapidly becomes settled in a
state of gloom.
It is most important for overwrought business and professional women,
but most especially for those women whose vocations in life combine
three distinct occupations or callings—namely, wives who act in the
capacity of housekeepers, ministers of finance to the household,
and the bringing up of children—to realize the importance of not
undertaking more than they can accomplish without fret and worry. The
overconscientious woman may object that it is selfish to consider her
own comfort when she has work to do for others, but to expend too
freely of the nervous energy, even in a good cause, is like giving
so much of our substance to charity that we ourselves are in turn
obliged to lean on others for support. In properly conserving our own
energies, we may ultimately be lightening the burden of others. There
is a proper balance between the duty one owes to one’s self and to
others.
Once bred, worry is an endless chain. Tell such a woman not to worry,
and she worries for fear she may worry. She is afraid that she has
decided wrongly, and regards decisions in regard to the most trivial
affairs of life as though they were matters of vital importance.
The obsession “to arrive” is a fertile source of fret and worry. This
habit of mind leads to frantic and incessant labor and blocks all
pleasure at every point. The person who plays a game only to see who
wins, loses half of the benefit of the recreation.
“The legs of the stork are long, the legs of the duck are short; you
cannot make the legs of the stork short, neither can you make the
legs of the duck long. Why worry?” (Chinese proverb.)
_Insomnia._—This is another symptom of overwork. The mind, worried
and harassed all day, retires at night to struggle in the darkness
and solitude with worries, forebodings, doubts, and regrets, which
now assume gigantic and fantastic shapes. In this case the insomnia
is due to faulty habits of mind.
Another form of insomnia is caused by intellectual work being carried
on at night until time for retiring; the mind is then so fully
saturated with the subject that it is unable to throw it off on going
to bed.
Whatever be the cause of the insomnia, it soon becomes a fixed habit,
and, whether it is a case of laying awake a long time before sleep
comes, or waking up at a regular hour toward morning,—and it is a
curious fact that the habit of waking up recurs at almost precisely
the same hour in the morning,—the longer this habit of insomnia is
indulged in, the more difficult it is to break it up.
_Nervousness._—This is a well-known sign of overwork, which shows
itself in intense nervousness and irritability. Everything jars on
the nerves. The woman gives way to her emotions, over which she loses
control.
To keep placid when overworked to the limit of physical endurance
requires a stolidity of soul and lack of nerves only known to the
North American Indians, and perhaps the Japanese, and it matters not
what the kind of overwork is, whether business, pleasure, or charity.
=Nature’s Restoratives.=—The proper division of the day is eight
hours to be allotted to work, eight to sleep, and the remaining
period of eight hours is to be divided among the various methods of
refreshing body and mind—the toilet, eating, rest, and recreations.
Not only are rest, recreation, and sleep in proper proportions
essential to the health of the body, but they are equally essential
to the quantity and the quality of the output of work. From them
result a feeling of physical well-being, an exuberance of animal
spirits which go into the work. The perspective is more accurate, the
judgment is clearer, and the creative power is greater. Work goes of
itself with a swing. Happiness is an expansive quality, that makes
itself felt throughout the entire body, but its effects are most
manifest in the mental power.
The mother who so honestly works and plans for the good of her family
as to give herself no time to rest after her physical efforts is in
such an exhausted condition as only to be able to give them the tired
and critical side of herself for daily association. There are few
human achievements much finer than to make human beings happy, and
this power woman is endowed with to a very large extent.
_Rest_, to be of value, must be systematically taken. Bearing in mind
the shrinking in size of the nerve-cells after stimulation caused by
work, and that they recovered their normal size in relatively less
time if the shrinkage were less, it becomes obvious that, in order
to accomplish the best work, whether purely mental, or of the more
complex mental and physical work demanded of the mother who is at the
same time the housewife, that a break in the day’s work will aid in
securing the best results.
The exact time of the daily _siesta_ must be adapted to the family
régime, but a fixed hour should be set aside for this purpose, and
this should be known as the mother’s hour, and nothing short of a
catastrophe should be allowed to infringe on it.
The woman should retire to her bed-room, undress, and go to bed.
The room should be darkened, and at the same time there must be an
abundant supply of fresh air. One soon forms the habit of taking a
short nap, of perhaps half an hour; one hour should be spent in bed.
After this, she gets up, takes a shower or other bath, dresses, and
is then ready to enjoy life and be a comfort to her family. In this
way alone can absolute relaxation, rest of mind, and body be secured.
=Avocation.=—Second only to the physiologic necessity for a vocation
in life, is the necessity for an avocation, and this must be in the
nature of a recreation.
It is a well-known fact in farming that any one kind of crop will
exhaust the very best soil, but few people recognize the necessity
for a change of occupation and recreation in order to produce the
best mental and physical results.
Joyless drudgery drains the springs of health. There is a mental
starvation, due to the lack of recreation, as well as the physical,
due to the lack of bread. The French aristocrats, noted for the
gaiety of their pastimes, in spite of their dietetic and other
sins, furnish a remarkable list of longevity. Persons of a cheerful
disposition are generally long-lived, and anything tending to
counteract the influence of worry and discontent directly contributes
to the preservation of the health. Despair, which frequently results
from years of overwork, can paralyze the energies of vital functions
like a sudden poison, while hope fulfilled has cured many a disease.
The nature of the avocation chosen will necessarily depend upon the
character of the vocation. For women whose vocations are intellectual
and sedentary, as writers, teachers, stenographers, etc., some
outdoor employment, which calls into activity the muscles of the
body, rests the eyes and brain, and, at the same time, pleasantly
occupies the mind, is the best, as walking, gardening, lawn-tennis,
golf, rowing, etc.
For all women engaged in sedentary occupations, daily exercise in the
open air is the first essential, and let them be assured that their
feelings of fatigue and disinclination to exercise are no safe guide
as to their ability to take exercise.
The first cause of the feeling of fatigue is due to the lack of
oxygen in the lungs and the impure air of the room. On going
out-of-doors, the woman will be surprised at how much stronger and
better she feels after an hour’s brisk walk than she did on starting
out.
“Fancy work” and lace-making, instead of being classed with
recreations, must be classed with fine hand-sewing of the most
taxing kind. It calls the same groups of muscles into play, and is
productive of the same evils, with a greater tendency to produce
eye-strain and a paralysis similar to writer’s cramp.
The proper avocation of the tired housewife, who has been on her
feet all the time and whose vocation is manual labor, will be the
diversion of the mind by reading a good book, while comfortably
pillowed on a veranda chair, a drive, a visit to some congenial
friend, a game of cards, or music.
Literary clubs for women should be more largely organized through the
country and in country towns. In the cities women have found these
clubs a great boon, not only to the health and happiness, but they
are in the highest degree educational.
Further, women have found that these literary clubs were profitable,
as a means of bringing their minds in contact with other educated
minds, and thus they had not only the additional stimulus to study,
but a broadening of their horizon, which the woman’s heretofore
shut-in household life had precluded. Courses in domestic science
would be a boon to the home.
The greater the number of interests which education and culture have
created, the greater will be the diversity of the recreations open
for the woman’s enjoyment.
Care must be taken that the avocation, which is at first an enjoyment
and relaxation, is not turned into hard labor. The moment that any
one strains every nerve, even to excel in a game, that moment it
ceases to be a relaxation.
History shows that the laws of all nations have always provided a
certain number of days of rest, or at least a change of occupation,
and that these days were fixed at more or less regular intervals.
This was partly from a religious and partly from a hygienic
standpoint. The necessity for the interruption of the regular routine
work has always been recognized, and one day out of every seven has
been set aside for this purpose.
The custom that is so frequently adopted by city folk of going out of
town over Sunday might very well be imitated by country folk by going
into the town or city over Sunday. For not only is the too continuous
application to one’s employment fraught with danger, but it has been
conclusively shown that a monotonous routine of occupation, such as
lived by the average farmer’s wife, is a severe tax on the sanity of
the mind. Statistics show that the heaviest percentage of insanity
falls on farmer’s wives, and the supposed cause of this is the
monotony of their lives.
A horse cannot gallop as many hours as it can walk, and the daily
task should be the sum-total of what man or beast can do compatibly
with health. To combine a day of toil with a second of amusement in
one twenty-four hours does not give the proper allowance for sleep,
and cannot be done without injury to the individual.
Fun and laughter are the most efficacious remedies in the
pharmacopeia, and tired humanity owes a debt of gratitude to the
guild of humorists, be they writers, comedians, or musical composers.
=The Physiologic Necessity for Laughter.=—The attitude of the
individual varies with age, temperament, and the perspective of life.
Grave adults are apt to think of laughter and smiling as something
occasional, a momentary lapse once in a while from the persistent
attitude of seriousness. Healthy children, on the contrary, consider
that a state of laughter is the normal condition of humanity, and
that seriousness is a tiresome necessity, which must be tolerated
from time to time. But very few people have any idea that there
exists a well-defined physiologic necessity for laughter, and the
greater the intellectual labor and the mental strain, the greater is
this necessity.
The deep forcible chest movements increase the rapidity of the
circulation, the force of the heart’s beat, and secures a more
complete oxygenation of the blood.
It is not improbable that this accelerated circulation produces
remote effects on the organism. One of the immediate effects of a
good laugh is that it relieves the brain by the rapidity of the
movements of the blood through the capillary circulation.
In addition to the immediate physiologic effects which result from
laughter it is highly beneficial, by relieving the brain and nervous
system from the intense strain and tension of the daily affairs and
occupations of life, and gives relief to the severely congested
capillaries, which otherwise involve considerable risk to the
individual.
Physiologists hold that pleasurable feelings tend to further the
whole group of organic functions, and that laughter produces a
considerable increase of vital activity by the heightened nervous
stimulation. There is a sense of increased energy, of a high tide of
the fulness of the life current.
=Vacations and Health.=—The secret of success of the old Romans in
conquering the world lay as much in their ability to maintain the
health of their troops in their various campaigns as by the courage
and organization of those troops; or, rather it may be said that
courage is but the coefficient of a good physique and a general
mental vigor.
A rest one day out of seven, with an occasional outing for the
week-end, is good but not sufficient. If one would keep up to her
highest standard of physical and mental efficiency, she must have at
least one month of absolute change of environment and outdoor life in
the year.
The kind of place one chooses for her vacation will depend on where
her home is. To dwellers in cities, the mountains and seaside resorts
are the most beneficial. August is our most trying month, and every
one who can would do well to take her vacation at that time, always
selecting some resort north of her own home, so that she may have the
additional advantage of a more bracing climate.
Maine furnishes many of the most beneficial of our health resorts,
combining as it does so many attractions—its bracing atmosphere of
pine forests, its beautiful scenery with vast expanses of water, and
the great variety of diversions which it affords.
It is always wise to send an advance scout to investigate the place
in which you contemplate spending your vacation. Avoid low and swampy
land; investigate the character of the water-supply and the nature of
the plumbing, together with the sewerage system, for it is all too
frequent that an attack of typhoid fever follows an outing in the
country. Every good summer resort should furnish facilities for a
variety of outdoor sports—golf, tennis, boating, swimming, etc.
During the vacation needless exposure to the direct rays of the sun
must be avoided. There is probably nothing which lowers the vital
resistance, and so prepares the way for disease as much as exhausting
exposure to the hot rays of the sun.
Long hours of sleep should be indulged in. The morning air is the
most beneficial; it is, therefore, a good habit to retire early and
to rise early.
If the vacation is not properly spent, it may be the means of doing
more harm than good. On the other hand, if properly spent, vacations
prepare one as nothing else can to meet and resist the vicissitudes
of the following winter. It is the people who go off on long
vacations who have the least need of the doctor’s care.
=Sleep.=—During sleep all the bodily functions are in abeyance and
the secretions are diminished; respiration is slow and confined to
the chest, so that the amount of inspired air is only one-seventh of
that during the waking hours; the temperature of the body falls; less
blood circulates through the brain; and the sensibility of the nerves
to external stimuli is diminished. Sleep is not only _par excellence_
the time of repose and recuperation of the brain and nerve substance,
but it is the only time when, by the diminution of waste caused by
the incessant activity of the brain, that the organ can be properly
nourished, the deficit in nerve force canceled, and the surplus of
energy stored up.
Without this absolute remission of brain activity every twenty-four
hours an actual destruction of substance would occur, which, if
persisted in, would be so depressing to the nervous functions as to
be inconsistent with life, and this is the case in the concluding
stages of fatal diseases.
The sleepy feeling caused by fatigue is due to the circulation in
the blood of toxins resulting from tissue waste, which benumb the
brain-cells; while the feeling of freshness and _bien-être_ with
which one awakens in the morning is due to the elimination of the
fatigue products from the blood during sleep. If the blood of a tired
dog be transfused into the veins of a perfectly fresh animal, the
latter will immediately show symptoms of somnolence and seek a dark
corner for sleep.
The medical authorities of to-day are pretty well agreed that eight
hours of sleep is the minimum required for the maintenance of health,
and all concede that the brain-worker requires more sleep than the
manual laborer. Every moment after the feeling of languor presents
itself is a strain upon the nerves and muscles which will sooner
or later invalidate for life, and finally bring the victim to a
premature grave. Habitual deficiency of sleep will undermine the
strongest constitution.
It is a matter of great importance to train one’s self in the habits
of sleep, regularity in the hour of retiring, abstinence from active
brain work for the hour immediately preceding going to bed, since, if
active brain work is continued until one goes to her room for the
night, the chances are that the brain will continue its activities
after getting into bed, and sleep may be banished from the pillow for
several hours.
A few minutes spent in breathing exercises, the vigorous use of the
flesh brush or hair glove, a hot plunge or foot-bath are no mean
hypnotics.
A sound sleep is dreamless. Dreams require a certain expenditure
of nerve force and mental energy, so that dreamless sleep is the
most restful. Disagreeable dreams and “night-mares” are generally
associated with indigestion and biliousness, which also occasion
a general restlessness. All this can be overcome by taking some
medicine for the liver. Two grains of calomel taken just before
retiring often works like a charm. The dose must not be repeated
under a month. In case of tendency to insomnia, no coffee should be
taken after breakfast.
=Treatment of Insomnia.=—The mechanical measures for the relief of
insomnia have for their purpose the withdrawing of the blood from
the brain to the surface of the skin. Hot foot-baths; general warm
baths; cold douches to the spine, brisk exercise; light massage, and
cold rooms. Mental work should be laid aside several hours before
retiring; late suppers avoided; coffee, if taken at all, should only
be taken for breakfast, and then only one cup. Reading or amusement
should be selected that does not excite the nerves.
To woo sleep the woman should put herself in a position of rest,
which of itself physiologically induces sleep. Avoid irritations,
noises, bad air, cold feet, overloaded bowels, all of which tend
to wakefulness and to prevent the proper physical rest. Then sleep
usually comes of itself.
=The Eyes: Eye-strain.=—Of all the misfortunes that could befall a
human being, the loss of sight is probably the greatest, and yet no
organ of the body is so constantly abused as the eye.
The trouble is that the possessor of the normal eye does not take
into consideration that in all near work, as in reading, writing,
sewing, etc., the eye is actively engaged as well as the hands and
brain, and that the eye only is at rest when looking into space or
when closed.
=Description of the Visual Apparatus.=—The eyeball is contained and
protected in a bony cavity, formed by the bones of the face and
skull, and is supported by a cushion of fat and other tissues. It
is held in place by its membranes and muscles, by which it is also
moved. It is further protected by the eyelids, the eyebrows, and the
eyelashes. The eyebrows protect the eyes from dust and perspiration
and shade the eyes.
The eyelids are lined by a very delicate mucous membrane, called the
conjunctiva. They are maintained in close apposition to the eyeball
by atmospheric pressure. The tears are secreted by the lacrimal
gland, which is at the upper and outer angle of the orbit. The
lubrication by the tears and the mucus secreted by the conjunctiva
cause them to move smoothly and without friction. An important
function of the lids is to distribute the tears over the front of the
eyeball, and by incessant winking to free the front of the eye from
dust and to keep it moist.
The conjunctiva is continuous with the mucous membrane of the nose
and mouth. Hence, in inflammation of the nasal mucous membrane, as in
an ordinary cold in the head or influenza, the conjunctiva is liable
to become very much congested or inflamed.
The _eyeball_ is spherical in form, having the segment of a smaller
and much more prominent sphere ingrafted on its anterior part. The
segment of the larger sphere, which forms about five-sixths of the
globe, is opaque, and forms the sclerotic coat, the so-called “white”
of the eye. The smaller sphere, which forms the remaining sixth, is
transparent, and is formed by the cornea.
The _iris_ is a circular contracting membrane, suspended from the
edges of the cornea, in front of the eye like a curtain. The iris
gives color to the eye, and when we say that an eye is blue or
brown, we mean that is the color of the iris. The iris is freely
movable, and, according as to whether it dilates or contracts, there
is an alteration in the size of the central aperture, called the
pupil.
The chief function of the iris is to regulate the quantity of light
admitted to the interior of the eye. In a very strong light the pupil
quickly contracts, shutting out the excessive light, while in a
subdued light the pupil dilates, thus allowing more light to enter.
When looking at a distance or when looking languidly into space, the
pupil dilates.
_The Formation of the Image._—The eye is a camera, consisting of
a series of lenses and media arranged in a dark chamber, the iris
serving as a curtain. The object of the apparatus is to form on the
retina a distinct image of external objects.
_The Mechanism of Accommodation._—In the passive condition of the
eye, when it is adjusted for far objects, the anterior surface of the
lens is somewhat flattened. Accommodation for near objects consists
in a contraction of the circular ciliary muscle and an increase in
the convexity of the anterior surface of the crystalline lens.
The light enters the eyeball through the pupil, falls upon the
retina, which has often been compared to the sensitive plate of
a camera, is received and transmitted by the optic nerve to the
visual centers of the brain. The eyeball does not see. It is only a
sensitive end-organ, which receives and transmits the impressions to
the higher centers of sight. The act of vision is performed in the
brain.
The focusing power of the eye is the property of bending nearly
parallel rays of light from distant and divergent rays or from close
range so that they meet exactly on the sensitive retina; this is
called refraction. In the normal eye these rays are focused exactly
on the retina.
=Optical Defects and their Correction.=—In the normal eye the near
limit of accommodation is from 4 to 5 inches, and the far limit may
be put at an infinite distance.
_Myopia or Near-sightedness._—This is one of the most common
refractive defects of the eye. In this condition, because of the
greater length of the eyeball or increased refractive changes of the
media, rays of light from a distance are focused in front of the
retina, producing an indistinct image.
The near-point is brought much nearer—from 2 to 2½ inches—and the far
limit is at a very short distance.
In reading, the myope is obliged to hold her book very close to
the eyes in order to see. In doing so, she strains her muscles of
convergence, producing ocular congestion and compression of the
eyeball.
The predisposing causes of myopia are heredity; it is said that half
of myopics are descended from near-sighted parents; uncorrected
astigmatism, and the effort to read very fine print or figures,
entails severe strain on the eyes, which may result in myopia.
Myopia is corrected by a concave lens, which diverges the rays of
light, prolonging the focal distance, so that the rays of light are
focused exactly on the retina.
Not only are myopic eyes not injured by wearing suitable glasses,
but, on the contrary, are often preserved from injurious pressure on
the globe, due to the indulgence of the habit to nearly close the
lids in order to see better, as is commonly done when glasses are not
worn.
_Hyperopia or Far-sightedness._—In this condition the eyeball
is too short, and the rays of light from a distance are focused
behind the retina. Instead of being distinct, the image is blurred.
Hyperopia is corrected by a convex lens, which converges the rays
of light, bringing them sooner to a focus. In the hyperopic eye the
near-point of accommodation is at some distance, and a far limit of
accommodation practically does not exist.
_Presbyopia._—This is a loss of the power of accommodation, by which
reading, writing, sewing, and other near work is accomplished. This
power of accommodation is greatest in early life, and gradually
diminishes until about the age of forty years, when reading at the
ordinary distance becomes uncomfortable. At about seventy-five years
of age the power of accommodation is practically lost.
Every person over forty-five years, with normal or far-sighted eyes,
should wear glasses to perform near work.
_Astigmatism._—Astigmatism does not depend on the length of the
eyeball, but on the curvature of the cornea, and rarely on that
of the lens. Uncorrected astigmatism necessitates the expenditure
of more muscular effort in the attempt to see distinctly than is
necessary when refraction is normal. This is accompanied by early
fatigue and more or less congestion of the vascular tunics of the
eye. Astigmatism is corrected by a cylindric lens, which has a plane
surface in one axis and a concave surface in the axis at right angles
to it.
[Illustration: Fig. 12.—Astigmatic chart.]
In simple astigmatism, on looking at the accompanying astigmatic
chart with each eye separately, certain lines in the defective
meridian seem very much blurred, while those at exact right angles
appear clear and black. This furnishes a test for astigmatism,
since to the normal eye the lines appear of equal distinctness and
clearness. Astigmatism is a very common ocular defect.
=The Mechanism of Eye-strain.=—Comparatively few eyes are perfect.
Far-sighted or astigmatic eyes can secure perfect vision by means
of accommodation. By constant strain on the ciliary muscle, the
crystalline lens is so increased in curvature as to exactly
counterbalance the optical defect of the eyes.
Healthy eyes should do their work without the consciousness of the
owner, and this is a safe test as to the kind and amount of work
demanded of them.
Perfect rest for the eyes is impossible in the waking state—distant
vision represents rest for the eyes and near vision exertion.
Near work is the chief cause of near-sightedness. Distant vision
should alternate with near work, and in near work the object should
not be brought nearer to the eyes than 12 inches.
=The Local Symptoms of Eye-strain.=—There may be a sense of fatigue
in the eyes after reading for a short time, and this may be followed
by a constant sense of discomfort in the eyes, which is increased on
using them, and which may be accompanied by severe pain in the back
of the head. There is a sensitiveness to light, and inflammation of
the eyelids and conjunctiva. There may be twitching of the eyelids,
and in extreme cases difficulty in keeping the eyes open on account
of drowsiness. The eyes may smart, itch, or burn, and continually
“water.”
As the trouble becomes more pronounced, reading for a short time may
be followed by a blurring of the type, and finally the lines may
run together. There is a constant sense of the eyes feeling for the
lines, and, perhaps one of the first things to call attention to the
condition of the eyes may be the losing of the lines in reading.
The general or reflex symptom of eye-strain is headache, which
frequently takes the form of migraine. This is increased on reading,
sewing, riding in the cars, etc. The headache is usually over the
region of the temples or just above the eyes, but it may be on the
top of the head or at the base of the skull.
Vision is so fundamentally related to all the brain functions that
eye-strain, or anything which interferes with normal sight, may cause
the most varied disturbances of bodily functions.
_The Prevention of Eye-strain._—Persons whose work necessitates much
ocular labor should vary their duties with intervals of rest. In
continued reading or sewing it is well to desist at short intervals
and fix the gaze on some distant object, and to frequently close the
lids.
Lace work, very fine needle work, working on black goods, reading
very fine print, or print on an inferior quality of paper, or
attempting to read in a dim light, are all a severe tax on the eyes,
and should be avoided, as they are certain to cause them permanent
injury.
Defective vision is so common in school-children, it is so often
present without being suspected, and so much harm is done to the eyes
and the general health of the individual before it is discovered,
that there should be a compulsory law requiring the examination of
all school-children; and, again, before boys and girls enter the
normal schools and colleges.
Clear vision gives clear judgment; defective vision in its various
manifestations gives different warps and bents to the mind of their
unfortunate possessors.
_Veils._—The wearing of veils is responsible for not a little
deterioration of vision, particularly when they are thick or dotted.
Unless the meshes of the veil are very large, it holds a layer
of impure air close to the face, so that the wearer is breathing
vitiated air. It hinders clearness of vision, because the external
world is viewed through a narrow lattice.
The best veil for the eyes is one with a single mesh, either without
dots, or the dots so far apart that none shall come over the eyes.
_Protection of the Eyes from the Glare of the Sun._—In very hot
weather the eyes should always be so protected that the rays of the
sun do not shine directly into them. This protection may be afforded
by the brim of the hat or by a parasol. At the sea-shore, or on an
ocean voyage, where the glare of the sun is constant and particularly
trying, the eyes should be protected by wearing slightly tinted
smoked glasses.
=Artificial Lighting.=—The main sources of artificial lighting are
kerosene, gas, and electricity. The principal questions of importance
are the quantity and quality of the light, its steadiness, the
vitiation of the atmosphere by the products of combustion, and the
expense; also the proper arrangement of the light.
Kerosene is the most extensively used means for artificial lighting.
The principal objections are—the heat, the trouble of filling and
keeping the lamps in order, and the danger of explosion and fire if
upset; the odor and the great vitiation of the atmosphere.
The modern lamp gives a brilliant light, and if properly shaded by a
slightly bluish chimney, so as to absorb the excess of yellow rays,
it is very satisfactory.
Illuminating gas, as furnished in cities, has a great excess of
yellow rays, which are very injurious to the eyes, and the vitiation
of the atmosphere is very considerable. Gas-light is modified by the
Argand and Bunsen burners. Of these, the Bunsen burner, a patented
composition burner, heated to incandescence, is the best. It gives
a white light, resembling daylight, and, under proper adjustment,
a far greater volume than any other burner. It is not so hot, does
not consume as much gas, and so there is less vitiation of the
atmosphere. It is intensely brilliant, and must be shaded by ground
glass or a proper shade.
Electricity gives the very best light, with a minimum amount of heat
and vitiation of the atmosphere. For individual use 16-candle power
is sufficient.
The lamp-shade should be opaque, of a dark-green color, and lined
with a white, reflecting surface. Transparent lamp-shades,
especially when patterned, are always bad, whatever their color;
because of the different degree of illumination thrown upon the work,
the light is irritating to the eyes.
=Hygienic Precautions in Reading and Sewing.=—There should be free
access of open daylight. Near the window is obviously the best place
for working, and the seat should be so selected that the window is
to the left of the worker. This prevents the work from being shaded
by the hand, and protects the eyes from being fatigued by the light
falling directly into them.
Any room will have too much light into which the sun shines directly.
Even if the worker’s face is not turned directly toward the sun, yet
the light reflected from the book or other work will be so intense
as to be dazzling. The softest and most pleasant light to work by is
the diffused light from the northern sky. An excess of light may be
easily regulated by a shade.
_Reading._—Very fine type should always be avoided, it is a very
unnecessary strain on the eyes, as are also books printed on a poor
quality of paper with improper spacing. The paper should be unglazed.
_Length of Line._—The length of the printed line should not be more
than 4 inches, nor less than 2¾ inches; that is, not more than 10 or
less than 7 centimeters. If the line is too long, the effort to find
the succeeding line is too great. If, on the other hand, the line is
too short, the lateral movements of the eye are so frequent that the
muscles concerned in these movements soon become fatigued.
The position of the reader should be sitting upright, with the back
toward the light, which should fall over the left shoulder, and the
book held nearly on a level with the eyes. The book should be held
at a distance of about 12 inches from the eyes. The light should be
on a level with the head or slightly above it. In desk work, a shade
should always be worn to protect the eyes.
Reading in the recumbent position is a pernicious habit, and is
particularly bad when convalescing from an illness or when very tired.
Reading in carriages or cars is injurious to all eyes, but especially
so to myopic eyes; because of the constant jolting, the distance
between the type and the eyes is continually changing, necessitating
the frequent and abrupt adjustments of accommodation; besides, the
illumination is apt to be very poor. Reading in a dim light or the
twilight is also very bad for the eyes.
Sewing and embroidery require the most trying ocular labor and
the best conditions for illumination. Working on black goods by
artificial light should be absolutely forbidden.
=Injuries to the Eyes.=—The most common injuries to the eyes are the
entrance of small particles of dust, cinders, steel filings, etc.,
into the conjunctival sac, or into the substance of the cornea.
Frequently, with the aid of a little winking, the tears wash away
these foreign substances, but if the substance lodges in the lining
membrane of the upper or lower lid, or is imbedded in the cornea, it
may be necessary to resort to other means in order to remove them.
The lining membrane of the lower lid is brought into view by simple
tension of the lower lid downward by one finger. If the offending
particle is not seen, the upper lid should be averted. This may be
easily effected by the fingers alone. The patient is told to look
down, the edge of the upper lid and the lashes are seized by the
thumb and forefinger of the right hand, and the lid is drawn at first
forward and then downward away from the eye, then upward over the
point of the thumb or forefinger of the left hand, which is held
stationary on the lid and acts as a fulcrum. The foreign body should
be removed with the handkerchief, but, if it is imbedded, it may be
necessary for a competent physician to remove it.
The habit of opening the eyes when dipping the face into a basin of
water, or when diving, produces congestion and inflammation of the
conjunctiva.
=Symptoms and Treatment of Conjunctivitis.=—The eyes may be
blood-shot and the lining membranes of the lids intensely red. There
is a sense of irritation about the eyes and an intolerance of light,
with a constant sense of discomfort. The sensation produced is that
of having sand in the eyes. The eyes are heavy, and tire after using
them for a short time.
The best treatment for acute conjunctivitis, which is so often
caused by the penetration of dust or other foreign bodies into
the conjunctival sac, is the application of cold water. A folded
handkerchief is wrung out of ice-water and laid on the closed lids.
It must be changed every few minutes, so that it shall not become
warm; two cloths are necessary. When the acute symptoms have begun to
abate, the patient will no longer find these applications grateful,
and they must be discontinued.
For chronic conjunctivitis hot applications are the best. For these,
one teaspoonful of fine table salt may be dissolved in a pint of
hot water, or two teaspoonfuls of boric acid may be used instead;
the last named is a mild antiseptic. The boric acid dissolves very
slowly, so that it is well to prepare enough in the morning for the
entire day. One tablespoonful of boric acid may be put into a quart
bottle of hot water, and be well shaken from time to time, until
there is a perfect solution.
When ready for use, half a pint may be heated, poured into a tumbler,
which is then placed in a basin of hot water; this latter serves as
a water-bath to keep the solution in the glass hot. The application
should be made with a rather thick wad of absorbent cotton or a piece
of fine cheese-cloth. The absorbent cotton should be picked up with
all the water it will hold, and be placed over the closed eyes just
as hot as can comfortably be borne, and held there until it begins
to cool, when the procedure should be repeated. The two eyes can be
treated simultaneously. These hot fomentations should be kept up for
ten minutes, and be repeated four times a day.
=Trachoma.=—This malady, of which so much is heard now, is another
name for granular conjunctivitis or granular lids. The affection is
very contagious. It comes on slowly, and is frequently accompanied by
redness and an appreciable degree of secretion in the early stages.
Presence of secretion or of interference of the vision should always
attract attention.
Strict precautions must be taken that the patient’s handkerchief,
towel, and wash-basin are not used by other members of the family.
Further, the other members of the family should bathe their eyes
several times a day with a solution of boric acid.
=Styes.=—Styes are a very painful species of small boils that
generally form on the edges of the eyelids. They are apt to appear in
succession. Certain persons are liable to them if the system is run
down from general causes. Like boils in other parts of the body, they
give evidence of impaired nutrition.
Hot fomentations of boric acid solution will sometimes abort them if
used early. If pus has formed, the stye must be opened by an incision
parallel to the edge of the lid. This should not be attempted by any
one except a physician.
=Color-blindness.=—As a rule, about 4 per cent. of males and about
one-half of 1 per cent. of females are color-blind. The part of the
color sense that is most often deficient is that for green and red.
=Cataract.=—This is a disease in which the crystalline lens or
its capsule, or both, lose their transparency and become opaque.
Eventually total blindness is the result. Senile cataracts appear
after the forty-eighth year. The only remedy for the disease is the
surgeon’s knife.
=Functional Nervous Disorders.=—Evidences of sound health are: first,
individual adaptability or capacity of the individual to easily
adapt herself to extremely opposite conditions of existence; second,
endurance, or the capacity to do a considerable amount of mental
work for a short time without suffering fatigue, or to be able to
quickly recover from the fatigue; third, to be able to control the
emotions; fourth, to be able to resist morbific influence; that is,
the capacity on the part of sound organs of excretion to quickly
eliminate all poisons from the system.
The signs of debility are just the reverse: first, deformity,
obesity, or leanness; second, personal inadaptability, that is, when
physical or mental discomfort is caused by such slight provocations
as change of food, clothing, or climate; third, lack of endurance,
so that a long rest is required to repair the fatigue incident to
slight exertion; fourth, lack of control of the emotions; fifth, a
proclivity to morbific influences, so that the individual succumbs to
every contagion or miasm that she encounters.
Nervousness is a disease of civilization, coupled with overwork and
indoor life. The more complex the environment in which the individual
finds herself, and to which she must adjust herself, the greater the
demands made on the nervous system.
The extreme dryness of our climate, together with the great
variations of temperature between winter and summer and the rapid
fluctuations of temperature, predisposes to nervous disorders.
=Headache.=—Headache is a symptom rather than a disease, but there
is no symptom which requires more careful investigation of its cause
than that of headache. It occurs at all ages, but is most common from
ten to twenty-five years and from thirty-five to forty-five years.
Women suffer from headache more than men, in the proportion of about
three to one. Headaches are most common in the spring and fall of the
year and in the temperate climates.
_Causes of Headache._—These may be classified into those in which
the blood is at fault; reflex causes; various nervous disorders; and
organic diseases.
The blood may be impoverished, as in the case of anemia, where there
is a deficiency in hemoglobin; but by far the most frequent cause of
headache is where the blood is disordered, as in gout, rheumatism,
kidney diseases, diabetes, and the infectious fevers and malaria.
Among the more common reflex causes are eye-strain, especially errors
of refraction; disorders of digestion, particularly constipation; and
pelvic disorders, as in inflammation of the pelvic viscera.
Functional diseases of the nervous system causing headache are
overwork, neurasthenia, hysteria, epilepsy, and neuritis.
Among the most common of the organic diseases is arteriosclerosis;
other diseases are meningitis and brain tumors.
_Symptoms._—The pain is often dull in character and rendered worse
by stooping; the location of the pain depends on the cause of the
headache. The most common variety is over the forehead or eyes. In
eye-strain the pain may either be in the front or back of the head.
In indigestion, the pain is most frequently over the eyes, but it
may also be on the top of the head. In anemia the pain may be either
frontal or diffuse. In pelvic disorders the pain is generally at the
base of the brain, though it is sometimes in the top of the head.
Neuralgic headaches are generally characterized by sharp paroxysmal
attacks, located in the temporal regions, and associated with pain
in other parts of the body. It is perhaps most frequently caused by
anemia.
In hysteria the headaches are characterized by a circumscribed
pain—it has been likened to the driving of a nail into the head.
In migraine the pain is paroxysmal and intensely severe;
it is frequently caused by some poison in the blood, as in
autointoxication, due to failure of proper regulation of the bowels,
also by pelvic disorders.
_Treatment._—The treatment is constitutional, and is based on the
removal of the cause. First, there should be a regulation of the
diet, a free evacuation of the bowels, and their proper regulation.
In every case of headache there should be an examination of the
urine. Often there is some congestion of the kidneys where it is
least suspected. If the headache is persistently made worse by
reading or sewing, the patient should be referred to a competent
oculist. An inquiry should always be made into the condition of the
menstrual function, backache, and leukorrhea. Any marked disorders
here will necessitate a gynecologic examination.
For the immediate relief of migraine, the patient should go at once
to bed and drink a glass of hot water; sometimes a cup of hot tea
gives great relief. No food should be taken for from six to twelve
hours, according to the severity of the case. The room must be kept
dark and quiet and the head high.
A strip of prepared mustard leaf, 5 inches wide by 8 inches long,
should be cut, and a piece of cheese-cloth, 6 or 8 layers thick,
should be folded the same size. The cheese-cloth is then wrung out of
hot water, and the mustard leaf is quickly dipped into the same. The
cheese-cloth is placed on the back of the neck, between it and the
mustard leaf. The clothes should be kept dry by a folded napkin. In
this way the mustard may be kept on from six to eight minutes, until
it begins to burn and the skin get red. If left on too long, the
mustard may produce the most painful kind of a blister. When taken
off the neck, the mustard may be put on over the stomach.
The medicinal treatment must be directed by the physician, but a
perfectly safe prescription, and one which may be kept on hand,
is the following: Take of sodium bromid, 15 grains; of essence
of peppermint, 10 drops; and of water a sufficient quantity to
make 1 dram. Mix well. The dose may be repeated in three hours if
necessary. This prescription should be put up by a good druggist, in
a three-ounce quantity. Sometimes relief is afforded by 1 teaspoonful
of the aromatic spirits of ammonia, taken in four tablespoonfuls of
water, and this is about the right quantity of water to take any
liquid medicine in. At night 2 grains of calomel should be taken, so
that the patient shall not be disturbed through the night, and it is
not so apt to cause nausea as when taken through the day.
=Neurasthenia or Nervous Prostration.=—This disease first saw light
in the United States, and was christened by Beard as an American
disease that was absent from no household in which the inhabitants
used their brains. It is certainly much more prevalent in this than
in any other country. Americans scarcely treat their bodies with more
consideration than their automobiles; they put on high pressure and
speed them to the utmost. Add to the high pressure under which we
live that other fact of heredity, that many persons are born with
unstable nerve-cells, and may be nervously bankrupt, and it is not
difficult to understand that 50 per cent. of Americans are suffering
in some degree from lowered nerve tone.
_Causes of Neurasthenia._—All classes of men and women who use
their brains severely, and who have seasons of excessive anxiety
and responsibility, are subject to neurasthenia. We have seen that
fatigue was caused by the accumulations of toxins in the body,
due to muscular activity, but these toxins may also be caused by
intellectual overwork or anxiety over domestic or business affairs.
Other causes are the intemperate amount of intellectual work which
is forced on the brain, and the excessive indulgence of the emotions
and the passions. Combined with the strenuousness of life is the
large element of uncertainty, the intense anxiety, and the restless
energy which is the price of success. Added to these may be lack of
suitable and sufficient recreation and short hours of restless sleep;
the restrictions of a narrow lot, loneliness, and isolation, the
frequent repetitions of uninteresting tasks, added to the burdens of
maternity, domestic cares, and worries.
In cities the ear-strain caused by the incessant noises of the
street, the amount of work done by insufficient and improper
lighting, the unsanitary mode of life, the improper diet, the
monotonous and infertile work, the unhappiness and discontent bred
of a life of idleness, or one given to society and gambling, whether
bridge, whist or poker, the senseless bolstering of shattered nerves
with alcoholic stimulants and beverages, patent medicines, and
hypnotics, all add their quota to the breaking down of the nervous
system.
A man can do a prodigious amount of work if he only varies it with
play which really amuses him, or if he substitutes for mental
occupation those which involve bodily exercises.
In so-called latent gout insomnia is a frequent symptom, or insomnia
may develop as the result of bad nervous habits. Insomnia from
whatever cause is followed by the impairment of nerve substance
and an overloading of the body with toxins. This continued nerve
exhaustion leads to oxaluria, uric acid, gout, anemia, gastric and
intestinal dyspepsia, muscular insufficiency, and precordial distress.
Whatever enfeebles the body by overtaxing the nervous system the
waste is in excess of the repair, in all overwork the destructive
metamorphosis is greater than the reparative processes, and so there
is an accumulation of toxic products and a more or less severe and
permanent injury is done the nervous system.
Other causes of neurasthenia, not so generally recognized as
overwork, are to be found in the pathologic conditions of the
intestinal canal, which becomes a veritable culture tube, and
absorption from this into the blood constantly takes place. And this
condition of putrefaction has to be overcome before relief can be
afforded, and in many cases this condition is associated with an
insufficiency of the elimination of urine.
The large intestine is the seat of an enormous bacteriologic flora;
they are not there by millions, but by billions. Some of them are
harmless, but not all of them, and if these pathogenic bacteria are
present in sufficient quantity, they, too, may produce symptoms of
mild poisoning. So, too, may mere indigestion, or the malfunction
of any other organ, torpidity of the liver, a deficiency of the
excretion of bile, which is generally accompanied by constipation.
_The Symptoms of Neurasthenia._—The symptoms are essentially those
of chronic fatigue, which has become exaggerated and pathologic.
They may be classified as sensory, motor, psychic, and somatic. The
sensory symptoms first noticed are those of generalized fatigue, with
such localized sensations as headache, backache, and limbache. The
motor symptoms are muscular fatigue, muscular weakness, and muscular
exhaustion on slight exertion. The psychic symptoms are manifested
by a diminution in the capacity for sustained mental effort and the
spontaneity of thought and exhaustion after slight mental effort. The
somatic symptoms show themselves in atony of the digestive tract and
the circulatory apparatus, with disturbances of the secretions.
Headache is one of the most common symptoms of localized fatigue,
and, associated with this, may be a sense of constriction about the
head, and there may be either a sense of lightness or fulness of the
head.
A woman who is chronically tired loses all her personal vigor, force,
aggressiveness, and, above all, will power. Associated with this lack
of will power are hesitation, indecision, a marked irritability, and
timidity. Neurasthenic patients are subject to spontaneous attacks
of fear, causeless in origin, and generalized in character. These
attacks may be accompanied by pallor of the face and palpitation of
the heart, just as in normal fear. The tired woman is a cross woman.
The irritability shows marked impairment of the power of inhibition.
_The Rational Treatment of Neurasthenia._—First of all, there must
be a removal of the cause which has produced it. There are two
distinct classes of cases—the overworked and the idle. The first
class, and the most important to the world, are the overworked. We
may have to deal with the intellectually overworked, in which the
mental overwork was combined with financial anxieties, domestic
difficulties, or lack of success in their work, or the cause may
have been the tremendous responsibilities of their positions, which
involved the lives or fortunes of many people. Added to this great
strain and overwork, has been a lack of proper intervals for rest,
recreation, and sleep, and the body has become a storehouse for
various toxins, and so is suffering from both acute and chronic
poisoning.
This class of patients must have the most rigid rest treatment, such
as was prescribed by Weir Mitchell years ago. It is most important
that the patient should be removed from her old surroundings; if this
is not possible, she should be isolated on the top floor of the house
with a good nurse. The room selected must be bright and cheerful,
with plenty of sunshine and fresh air; a window should be open
practically all the time, for oxygen and sunshine are two of the best
restoratives. The diet must be easily digested and very nutritious.
The patient should be urged not to use her mind at all. Carefully
selected short stories may be read aloud by the nurse; the reading
should not be continued for more than half an hour at a time.
A great deal may be done to eliminate these toxins from the system
by the proper use of electric-light baths, followed by the shampoo
and the percussion douche; massage with salt water, salt rubs, and
electricity.
In most cases a month of this absolute rest is as long as is
beneficial to the patient. And for most of them the sea-shore is the
best. There should be enough going on to be diverting without being
overtaxing, and a climate should be selected which is warm enough
for the patient to live out-of-doors. There should be short walks,
drives, sails, etc., and this outdoor life, with a contemplation of
nature, is the most powerful restorative. The grandeur of nature,
whether it is the mighty forests, with their refreshing shade and
quiet, or even stretched in a hammock watching the sky and trees, or
the constant surging of the vast sea, bringing rest in its unceasing
restlessness, with the ships sailing lazily along, until the whole
fades away in the distant horizon. In the vastness of the universe,
the _ego_ becomes contemptibly unimportant and insignificant.
After several months spent in this way the body has gotten rid of
its toxins, nerves and muscles are rested, and through the soothing
influence of nature the neurasthenic is gradually trained back to a
healthier habit of thought and a more rational frame of mind. There
is substituted for the morbid emotional complex a feeling of pleasure
and energy. Reason and judgment reassert their sway; outdoor life
quickens the perceptions, and forms tranquilizing memory pictures on
the brain that return later to solace and refresh the individual.
There is another, and a very large class, of cases among women of
leisure who have suffered all their lives from a lack of a vocation;
they have nothing to think of except themselves. They do not know
what it is to be quite well; they travel from one part of the country
to another, and from one country to another, but they never rise
above a certain level of invalidism. They are self centered, and
what they need is the work cure. In the majority of cases, before
these patients can be restored to health, powerful habits must be
eradicated, new interests in others must be supplied to supplant the
most intense egotism, new paths must be hewn out in the brain, the
will must be recreated, and character can only be imparted by those
who possess it.