Insanity Part 4

In this respect, I believe the educational process of fifty years ago was better than that of to-day. The teacher had a much smaller number of pupils, and, consequently, had better opportunity to study the peculiarities and tendencies of individual minds: he was better able to appreciate their deficiencies and the consequent needs each had. Fewer books were read, and these of such a character as was adapted to strengthen the memory; fewer subjects were studied, and there was time to more thoroughly understand and fully master them. Facts and processes attained were clear and definite, and there were less confused and half-understood lessons and theories, so that, as the mind became more mature, it went out for larger fields and broader pastures of knowledge.

They, doubtless, did not have much information as to the movements of the heavenly bodies, or of the names of insignificant towns, hamlets, or rivers on the eastern or western coast of Africa. They might not be able to define the boundaries of Kamtchatka, nor give the pluperfect of a large number of irregular verbs; but, on the other hand, their brains were clear and active, and possessed a recipient capacity. They were not crammed or confused by the dim memories of a vast mult.i.tude of names or facts which, by no possibility, could have any important bearing on their future lives or fortunes.

Knowledge, to be of much practical value to its possessor, must be clear and definite in the mind. When only partially understood or dimly perceived by the mind, it tends rather to confuse and weaken than invigorate; consequently, during the earlier periods of life, study in our schools should be confined to a comparatively few subjects, and there should be opportunity for the teacher to see that the scholar receives such individual attention as will enable him to fully master the allotted tasks. We must ever bear in mind that the grand object in attending school is, physiologically considered, to make the brain vigorous and stable in its operations, and as little liable to instability and irregular action as possible. Any course of training, during this early formative period of life, which tends to crowd the brain or stimulate it to over-activity, must tend to after-weakness and instability.

This leads me to protest against the modern tendency to continually increase the requirements for entering and continuing in the graded schools of our cities. The number of dates and names, relating as they often do to many different subjects of study, and the amount of writing in a short s.p.a.ce of time, tend to mental confusion; and while the number of studies is increased, the time for their acquisition must remain unchanged, so that the scholar is hurried on through or dropped by the way. To avoid this latter result, too great and too protracted mental effort is necessary on the part of some children, while in many cases the results are manifested in a state of mental confusion and uncertainty, or a nervous, hysterical condition.

I have in mind at this writing cases which will ill.u.s.trate my point. One was that of a young lady of ordinary mental endowments, whose parents usually brought her to me for advice as often as every two or three weeks, because she was nervous, and suffered from frequent and protracted headaches. Inquiry elicited the fact that she was obliged to study during the evening until ten or eleven o'clock to accomplish the tasks which were a.s.signed to her cla.s.s. It was thought by the parents that this practice was all right, that it evinced faithfulness and ambition, and it was with much difficulty that I could convince either her or her parents that her ill-health was due to the constant violation of the laws of health; that her brain and whole nervous system required longer periods of repose and quiet at her age than it would be likely to need later; that the future of her whole life as a member of society might, and must, in a large degree, depend, not on the grade of the marks she might receive in her daily recitations, but largely on the nervous and physical strength she might be able to build up before she should become twenty-one years of age. This young lady was of a healthy parentage, and inherited a good physique, and with proper habits of life and study would have had excellent health. As it is, her system will not for years, if ever, recover from the effects of her habits of excessive hours of study.

The name of another patient occurs to me: a young man of good parentage, and apparently inheriting a good const.i.tution. He was ambitious in study, and his parents permitted him to do all he might choose to. He entered college at sixteen, standing among the best scholars of his cla.s.s, but before the end of the first year, began to be troubled with noises in his head and confusion of mind. He was removed from college, and remained out till the end of the year, but partially kept up his studies at home. He entered the soph.o.m.ore cla.s.s but was obliged to leave earlier in the course than before. He tried the junior year with a like result, and from this time exhibited more p.r.o.nounced indications of mental impairment. He travelled both in this country and in Europe; he consulted some of the most eminent physicians, but all to no purpose; the mischief had been too effectually accomplished. The delicate tissues of the brain had been over-strained, and so impaired that when his parents awoke to the gravity of his condition, it was too late to repair the mischief.

I have under my care at the present time a young girl, thirteen years of age, who has come to me from one of the seminaries for girls in New England. She informs me that the pupils in that inst.i.tution are required to spend eight or more hours a day in study and recitation, and some portion more of every day in household work, and that _she_ was permitted to study and recite some ten hours a day, as she was behind her cla.s.s in some of the studies when she entered.

It is not surprising that in less than one year she returned to her home, suffering from headaches, cold feet, nervousness, and inability to sleep, and in a short time became so excitable and incoherent in thought and language, that it became necessary to remove her from home. After a long period of rest with appropriate treatment, she has become so strong that she will soon go into the country, where I have directed that she remain for one or two years without study, in the hope that the nervous system may regain its health under the influence of a life spent largely in the open air.[5]

A young man, standing, so far as was indicated by marks, in the front rank of his cla.s.s, had strength of brain barely to graduate, and then for years was able to do but little study, and spent his time in a vain search for that health which by judicious habits in study he would never have lost.

Many other cases of similar character could be cited if it was necessary to adduce additional confirmation of my views.

I desire, however, not only to call attention to, and greatly emphasize, the effects of study so far as they may manifest themselves on the individuals themselves, but the effects which these persons are certain to transmit to their posterity. The brain may and does, in many cases, so far recover that it may fairly do the work, or _a_ work in life, but it has attained a bias--a twist,--which will be seen to manifest itself in the next generation in something more than a twist; it will be an insane diathesis--a brain const.i.tuted in so unstable a manner, that the friction of ordinary life will upset it, ending in insanity.

I have often thought that teachers are only partially to blame, as they are countenanced and encouraged by the parents in this injudicious course of mental stimulation in early life. Especially is this the case if a child happens to be so fortunate--I perhaps should rather say _unfortunate_--as to have in any measure a higher order of mind than his fellows; he is likely to be the theme of conversation, in relation to his studies, not only in his own home, but with all the cousins, aunts, and neighbors, until finally the child comes to form altogether a false estimate as to the importance of its own attainments and ability. It is quite possible, also, that the freedom of our educational and governmental inst.i.tutions may serve to help it on. Every child is taught, at home and in school, that all the prizes of life are within his grasp, _if he will only make the requisite effort_, while every parent is anxious to have his child higher up in the social scale than he is. These conditions not unfrequently serve to stimulate those specially ambitious to over-exertion, while again, there is less of the controlling element, both at home and in social life, than exists under most other forms of government.

It becomes necessary here to refer to the system, so universally prevalent in our colleges, of compet.i.tion in grades of scholars.h.i.+p. I do this with greater reluctance, knowing very well how fully men of long experience have studied the subject, and how extremely difficult it may be to devise and carry into operation any plan which may prove to be more desirable for all concerned.

In any considerable number of boys, from the ages of fifteen to twenty-two years, there will be some who realize so little the objects and benefits to be obtained through the discipline of study, that they will care little for honors or standards of scholars.h.i.+p, and are in no possible danger of over-exertion to obtain them. With such persons we need not concern ourselves at present.

On the other hand there are those who so fully appreciate the grand advantages resulting from an education, that they would be sure to do a fair amount of labor, and honestly employ their time, under almost any system of management. Now it is from the latter cla.s.s, that come the students who are to attain to and hold the positions of influence in after-life, and too great care cannot be exercised that their characteristics of mind be judiciously brought into exercise and strength.

They are, for the most part, ambitious; and in many cases this ambition stimulates them to the largest effort to carry off the prizes which may come in the way of scholars.h.i.+p during their college course.

These prizes frequently depend on extremely small differences in proficiency which may be obtained, in many cases, over long periods of time. It is understood that it is commonly the case that the differences in scholars.h.i.+p of those who obtain the highest five or six honors in college are often very small, and that these honors may be a.s.signed to one or to another by failure or success on some point, the knowledge concerning which could by no possibility have any influence in after-life, and which must be but an imperfect indication of true scholars.h.i.+p and mental ability; and yet so strong is the power of ambition as to lead some few of the highest minds, in almost every cla.s.s, to neglect the commonest laws of health in reference to physical exercise and sleep, that they may secure these temporary honors. The brain is stimulated to long and weary hours of study by the effects of tea or coffee, or in some cases by the use of more objectionable substances, when regard for health would require it to be in a state of repose and sleep; and this is during the period of life when it has not yet attained to its full growth, and while its substance is still in a more sensitive and delicate condition, and consequently more likely to be unfavorably affected by such treatment than in the maturity of later life.

From personal observation I am satisfied that some of the brightest minds are essentially ruined for the accomplishment of any large work in life by such a course of conduct in their education, who, under some other course of management, in which these mental tendencies could have been better understood and guided, might have been saved; and that often these are minds with the best natural endowments.

How it is possible that instructors of young persons can suppose that any larger power of intellect, or any greater capacity for usefulness in after-life, can possibly be secured by such treatment, or rather by such abuse of the organ of the mind, or why they have not been more careful to instruct those under their care as to this most important of all subjects to them in their future work, it is not easy to imagine, and can only be accounted for by the supposition that they have not studied the subject carefully enough in its physiological relations.

It should always be borne in mind that excessive use or stimulation of any part or organ of the system can in no sense be considered as education of it, but as a sin against its nature, which will be sure to require retribution. It may be made to accomplish more in a given time, but it must be at a discount on its future activity; there must come a reaction, that is, a condition in which there will be performed less of function than before; and that such a course of treatment has a tendency to produce a condition of _instability_, and more or less of _uncertainty of action_.

Within the last twenty years there appears to have come, in some measure, a reaction in reference to exclusive attention to brain discipline, and in favor of more attention to physical exercise during the college curriculum. There have been organized in most of the colleges and academies, boating clubs, base-ball clubs, and other a.s.sociations with the avowed object of securing a higher state of physical development and education. This has been a step in the right direction, and none too soon have we come to realize the fact that the brain depends very largely upon the health of the body for its exercise of the best thought. The importance of a physical education will be more fully referred to hereafter, but at this stage of the subject it is pertinent to suggest that violent use of the muscles for short periods is generally not the best mode of exercise; that the sudden expenditure of so much nervous force in training and in contests, as is necessary in order to secure the highest attainable power in rapidity, skill, and strength of stroke, during a half or one hour; or to attain the highest skill in throwing a ball, or in receiving it in hand, or in many other of the manoeuvres of base-ball playing, which require such quick changes of position, and violent motion of the body, is in great danger of ultimately defeating the very object for which they are ostensibly practised.

The skill and power may be obtained, and the winning crew or club may have the satisfaction of receiving the welcome plaudits or the crowning laurels bestowed on victors, but how far all this will prove to be of service in securing either strength or health of body, may be a question; or rather it will not be a question at all. In nine out of every ten cases there exists almost a certainty that a larger measure of physical health and capacity of endurance in after-life would have been attained by some other course, or method, attended with less stimulation and expenditure of nerve-force. The period of reaction no less surely comes than in cases of other kinds of stimulation, and is frequently manifested in functional or organic derangements of the heart and other organs. Healthy and continuous muscular power comes more surely by the expenditure of a medium amount of nerve-force, and no other method can properly be considered as physical education.

Lest, however, it may be thought I have placed too much importance in this matter of over-study and nervous exertion, and to show that we Americans are not the only ones at fault, I will here introduce some statements from an English physician[6] of the highest authority.

He says: "The master of a private school informs me that he has proof of the effects of overwork in the fact of boys being withdrawn from the keen compet.i.tion of a public-school career, which was proving injurious to their health, and sent to him, that they might, in the less ambitious atmosphere of a private school, pick up health and strength again. He refers to instances of boys who had been crammed and much pressed in order that they might enter a certain form or gain a desired exhibition, having reached the goal successfully and then stagnated." He further says: "Too many hours' daily study, and the knowledge of an approaching examination, when the system is developing and requiring an abundance of good air and exercise, easily accounts for pale and worn looks, frequent headache, disturbed sleep, nightmare, and nervous fears. When the career of such students does not end in graduating in a lunatic asylum, they lose for years, possibly always, the elasticity and buoyancy of spirits essential to robust health. A strong const.i.tution may be sacrificed to supposed educational necessities."

"Mr. Burndell Carter,[7] in his 'Influence of Education and Training in Promoting Diseases of the Nervous System,' speaks of a large public school in London from which boys of ten to twelve years of age carry home tasks which would occupy them till near midnight, and of which the rules and laws of study are so arranged as to preclude the possibility of sufficient recreation. The teacher in a high school says that the host of subjects in which parents insist on instruction being given to their children is simply preposterous, and disastrous alike to health and to real steady progress in necessary branches of knowledge. The other day I met an examiner in the street with a roll of papers consisting of answers and questions. He deplored the fas.h.i.+on of the day; the number of subjects crammed within a few years of growing life; the character of the questions which were frequently asked, and the requiring a student to master, at the peril of being rejected, scientific theories and crude speculations which they would have to unlearn in a year or two. He sincerely pities the unfortunate students. During the last year or two, the public have been startled by the number of suicides which have occurred on the part of young men preparing for examination at the University of London, and the press has spoken out strongly on the subject. Notwithstanding this, the authorities appear to be disposed to increase instead of diminish the stringency of some of the examinations."

These statements were made as showing a tendency on the part of the prevalent modes of education in England, to produce in its subjects either insanity or a tendency toward it. I here reproduce them as confirmatory of my own views already expressed, and would especially call attention to the fact that though this influence may fail in producing actual insanity, yet it is of such a character as will tend to develop instability of brain tissue, and in the coming generation the insane diathesis. Parents transmit acquired tendencies toward disease as well as, and indeed I think more frequently than, disease itself.

I must beg, however, not to be misunderstood. I think I appreciate the importance of an education for the development and discipline of the brain as profoundly as any one. I believe the lack of brain discipline for those who are to compete in the midst of such a civilization as that of the present, is one of the greatest misfortunes; but I do desire to protest with much emphasis against the system of indiscriminate cramming toward which the schools appear to be so rapidly drifting. It defeats one of the most important ends to be sought. It tends to confusion and weakness of mind instead of strength. Children have so many subjects to learn about, that they do not have time to fully understand subjects studied. The brain is occupied so many hours daily that its energy is exhausted, and there remains little ability to accurately appreciate, discriminate, or fix the attention.

The same conditions result, as there would from the too long and continuous use of the muscles of the arm, when one is learning to execute a piece of delicate work--the drawing of a picture, or making a work of art. In such a case the importance of only limited periods of application would be readily appreciated; great care would be exercised by the teacher lest the pupil should continue the work too long, or after the muscles had become weary and consequently incapable of accurate work.

We observe the same care in our treatment of the young of domestic animals, and are watchful that they be not over-driven or over-worked while their systems are undeveloped and in the growing period. When one is looking for the best growth, or the highest strength or speed attainable, if judicious, much vigilance will be exercised lest the animal be over-driven or worked many hours a day, until the system is developed and firmly knit together. Shall we be less careful or less wise in our treatment of children?

Surely, there should not be need that I plead for such a course of education as will render the brain stronger and more capable of vigorous work in life, and of transmitting to another generation a sound mental organization, instead of, as is too often the case, a tendency to unstable and irregular action, which will have a final ending in insanity. That this may be the outcome of education there must be changes in the present system, and I plead earnestly that these may relate to at least two things, if no more: first, a larger measure of _individuality_,--smaller schools and fewer pupils for each teacher, that each may have more special a.s.sistance and _special_ training; and, second, _a less number of subjects of study_. Let there be fewer subjects studied, and let what is studied be more thoroughly mastered. Have fewer half-understood problems and half-remembered lessons, and I believe we shall have more stable brains and stronger intellects in after-life.

CHAPTER VI.

INDUSTRIAL EDUCATION.

I have lifted at random from my table five yearly reports of inst.i.tutions.

The first is that of the Conn. Hospital for the Insane at Middletown. By reference to the table of occupations of persons admitted last year it appears that more than thirty-four per cent. were of persons, the larger portion of whom had never been educated in any regular method of obtaining a living. Some of them had been accustomed to depend upon the precarious results attending common labor, and some upon domestic labor, while others were without any regular occupation. Probably some of these persons may have had a measure of education in some occupation in early life, but if so, this does not appear in the statistics.

The second is the report of the Hospital for the Insane at Taunton, Ma.s.s.

Of those who were admitted last year to this inst.i.tution, it appears that thirty per cent. would be included in the same general cla.s.ses of the population.

The third is that of the new Hospital for the Insane at Worcester, Ma.s.s.; and of the admissions here last year, we find that more than forty-two per cent. were from the above-named cla.s.ses.

The fourth is that of the Western Pennsylvania Hospital, and of the admissions here, thirty per cent. were of these cla.s.ses; while an examination of the occupations of those admitted to the Somerset and Bath Asylum, England, shows that nearly forty per cent. were of persons similarly circ.u.mstanced.

In these statistics I have included those persons who, in the reports, are cla.s.sed as _domestics_, _laborers_, and persons of _no occupation_. I have not included wives of laborers, or persons whose occupation was "_unknown_." I think it may fairly be a.s.sumed that, in the case of laborers, those who dig and shovel and labor on the public works, or in other places, under supervision, and in the case of domestics generally throughout the country, not one in ten has ever had any training or education in any special line of service before they undertook to earn a living in following these avocations; that, in fact, they could not do any thing else.

Possibly reports of other asylums might show statistics varying somewhat from these, but I take it that these are sufficiently accurate for my purpose, which is to show from what cla.s.s of persons, so far as an education in any of the ordinary employments is concerned, a very large percentage of the admissions to our State hospitals comes. Without doubt a still larger per cent. of the admissions to some of the county asylums in England comes from this cla.s.s of persons.

But so far we have shown only the per cent. the admissions of this cla.s.s sustain to that of all admissions to asylums. Their true significance will appear only when we bear in mind the percentage this cla.s.s of persons sustains to the whole population. The whole number of domestics, common laborers, and persons of no occupation, must be small as compared with the whole number of persons above fifteen years of age, and from whom admissions to asylums come. If, therefore, this amounts to more than one third of all admissions, it must amount to a very much higher per cent.

than comes from any other cla.s.s in the community to these asylums.

It may be proper to add to the above cla.s.ses of persons the no inconsiderable number who, throughout the States, are engaged as mere operatives in our factories and manufacturing establishments. Many of these are engaged, and have been for years, in tending to some portion of machinery which is nearly automatic in its operations, and which requires little or no special training or education on the part of the operative.

There might also be included, for my present purpose, that not inconsiderable cla.s.s whose education for any business has been only partial, and who, with little previous training, have a.s.sumed the full responsibilities of such business.

The fact that more than one third of all admissions to those State hospitals which are located in the older portions of our country are from those who have never been properly educated in any of the regular occupations of life, is certainly significant, and I think will appear more so as we proceed. This, however, is only one element or factor in their condition, and it would be far from correct to conclude that this lack of education is in all, or nearly all, the only cause of their insanity. Doubtless many other causes have united in producing this result, as in other cla.s.ses of society; but in many cases these other causes would have proved to be insufficient of themselves to effect such a result.

The amount of brain irritation, and consequent stimulation; the worry and anxiety attendant on the lives of the above-named cla.s.ses of persons is oftentimes very great, and that there may not result actual injury to the brain, there can hardly be any thing of so much importance as an education and training in some regular pursuit. Without this, the individual is left at a large disadvantage in the use of all the ordinary means of success, or even of securing a living by any honorable course of life; while, having had such a training, he always has the consciousness of possessing these resources; and not only this, but the brain remains in an undeveloped and comparatively weak condition without it.

Mental operations have been more or less active, as this is a necessity during the hours of consciousness, but they have proceeded in an exceedingly limited sphere of thought; they have gone on day after day in a few channels only, while the larger portion of that part of the brain which is connected with thought, or, more accurately speaking, many of the faculties of the mind, have been left in a comparatively undeveloped and inactive condition. The result is similar to that which would occur if only a portion of any other part of the system should be brought into exercise, for instance, one hand or arm, while the remaining portion should be left in an inactive state for a long period.

So true is it that certain trains of thought proceed only in limited channels of the brain, that it is found in experience, that a change of study from a subject which has long been under consideration, to another which has not been, and which is of a different character, and which requires combinations of memories and reasonings of a different order, is almost equivalent to a period of rest. After a period of application in the solution of mathematical problems, and the mind begins to weary of this study, it may, with ease and pleasure be turned to the study of some language; so that persons whose duties cover a wide range of thought and subjects of diverse character, are frequently able to employ themselves with ease more hours in the day than others whose occupations are more uniform and less diversified in character. The law of health and strength applies alike to all portions of the system, and requires a certain degree of activity in all portions, else they remain in an undeveloped or weak condition.

Besides, in the case of the brain and nervous system in general, this lack of education in the direction of labor tends largely to produce too frequent self-distrust and introspection. The individual has little range of mental vision, or measure of that self-confidence which arises from ability in skilled labor, and not having any training in those activities and occupations of life which tend to develop and strengthen the nervous system; and, consequently, being unable to engage in these with any degree of satisfaction, if at all, is likely to pa.s.s into a state of self-distrust, doubt, and, after a few years, actual inability to take on any considerable measure of education of the nervous system.

It is, therefore, not surprising that, in the adult period of life, when the care and responsibility of providing for others in addition to one's self, come upon such persons; and especially when periods of uncertainty and long-continued depression in the market of simple manual labor occur, individuals so illy equipped and helpless amid the compet.i.tions of society should become insane in large numbers. And I think it must be confessed that there are in operation certain tendencies, in the progress of modern civilization, which are at present very potent in their influence, as against remedies for this condition; influences which tend to push out of sight the individual, or merge him into a large whole, which moves forward for the accomplishment of purposes, regardless of the individualities which may fall out by the way.

In the strife and compet.i.tion attending life in all our large towns and cities, there have been developed new methods of conducting business, as well as most of the occupations. Formerly the trades were conducted vastly more by individuals, either alone or in small numbers. Work was done by hand, and frequently at home, so that every father could easily have his child or children, from an early age, in some measure under his own supervision. The natural outcome of this was that children very often followed avocations similar in character to those of their fathers, and began to learn them early in life. Beginning thus early, though the progress toward any considerable degree of proficiency was slow, yet there resulted a symmetrical training and consequent strengthening of the nervous system, during its growing period, which tended to render it largely self-reliant, and was of inestimable value in after-life in securing stability of action. In cases, too, where the children followed other lines of employment, they were early placed in training for them, while the influence of home-life was still strong, and before other habits of thought and less definite and profitable purposes of life had become developed.