V. "On the Surgical Complications and Sequels of the Continued Fevers." By Dr. WILLIAM W. KEEN. Delivered February 17, 1876. Published March, 1877. 8vo., 70 pp.

VI. "Sub-cutaneous Surgery." By Dr. WILLIAM ADAMS. Delivered September 13, 1876. Published April, 1877. 8vo., 17 pp.

VII. "The Nature of Reparatory Inflammation in Arteries after Ligatures, Acupressure, and Torsion." By EDWARD O. SHAKESPEARE. Delivered June 27, 1878. Published March, 1879. 8vo., 70 pp. and 7 plates.

VIII. "Suggestions for the Sanitary Drainage of Washington City." By GEORGE E. WARING, Jr. Delivered May 26, 1880. Published June, 1880. 8vo., 24 pp.

IX. "Mental Over-Work and Premature Disease among Public and Professional Men." By Dr. CHARLES K. MILLS. Delivered March 19, 1884. Published January, 1885. 8vo., 36 pp.

As it has been found quite impossible to supply gratuitously the large demand from medical men and others for these Lectures, (in addition to the liberal grant to the leading public Libraries and other Institutions in this and foreign countries,) the uniform price of 25 cents has been fixed for each, by which probably their more equitable personal distribution is secured.

SMITHSONIAN INSTITUTION,

SPENCER F. BAIRD,

WASHINGTON, January, 1885

Secretary Smithsonian Institution.

LECTURE IX.

Delivered March 19, 1834.

MENTAL OVER-WORK AND PREMATURE DISEASE AMONG PUBLIC AND PROFESSIONAL MEN.

By CHARLES K. MILLS, M. D.

For my subject this evening I am indebted to the suggestion of the public-spirited founder of the "Toner Lectures," who, during his long residence in Washington, having seen many striking instances of break-down among public and professional men, had been led to feel that a study of the causes and the earliest indications of over brain work in these walks of life might prove an interesting investigation, and assist in the development of some new facts.

Extreme mental activity, overstrain, and excitement must be regarded as characteristics of American civilization. In this country every one feels that he is an important possibility in politics, law, medicine, theology, business, science, or literature, so that our very liberties and opportunities become sources of peril to health and life. From the cradle to the grave the American too often lives in an atmosphere of unnatural emulation, while, in other countries, the traditional usages and the more absolute divisions of society into grades and castes prevent so fierce a struggle among the many for high position.

Mr. Herbert Spencer, whom all admit to be entitled to consideration as a close observer of human nature, during his visit to this country, was everywhere struck with the number of faces he met which spoke in strong lines of the burdens that had to

be borne. In every circle he saw the sufferers from nervous collapse, or heard of the victims of over-work. Mitchell, Beard, Jewell, and others have dwelt upon the same fact, and have shown that brain work and brain strain are, in this country, the not infrequent cause of the downfall of health.

That intellectual work per se does not injure health or shorten life may, I think, at once be admitted. The longevity of inte!lectual workers is a subject that has frequently claimed the attention of statisticians, psychologists, and alienists. Madden' gives a series of tables showing the relative longevity of medical authors, philologists, authors on revealed and natural religion, and on law and jurisprudence, miscellaneous and novel writers, moral philosophers, dramatists, natural philosophers, poets, artists, and musical composers. The general average age at death for the whole list is 66 years.

Tuke has collected from various sources the ages at death of fifty-four men who were distinguished for intellectual achievements. These ages gave an average of 80 years.

Caspar (quoted by Tuke) gives the average age of clergymen at 65; merchants, 62; clerks and farmers, 61 each; military men, 59; lawyers, 58; artists, 57; medical men, 56.

Beard3 ascertained the longevity of five hundred of the greatest men of history-poets, philosophers, authors, scientists, lawyers, statesmen, generals, physicians, inventors, musicians, actors, orators, and philanthropists. His list was prepared impartially, and included those who, like Byron, Raphael, Pascal, Mozart, Keats, etc., died young. The average age was found to be 64.20 years. Sherwood (quoted by Beard) ascertained at great labor the ages at death of ten thousand clergymen, the average being 64 years. The average

1 Infirmities of Genius.

2 Illustrations of the Influence of the Mind upon the Body in Health and Disease. By Daniel Hack Tuke, M. D., etc. Second Edition. 1884.

A Practical Treatise on Nervous Exhaustion (Neurasthenia). By George M. Beard, A. M., M. D. Second and Revised Edition. 1880.

age at death of all classes of those who live over twenty is about

50 years.

Statistics of this kind, which could be multiplied without limit, are decisive as to the beneficial rather than injurious effects of pure mental labor, conducted upon a proper basis, upon longevity: In our public and professional classes, nevertheless, every physician of experience has seen instances of premature break-down from causes peculiar to these largely intellectual vocations. Even if the instances were few, as claimed by some, their discussion would still be of interest, because any sources of peril to those in the front ranks of society must always demand earnest attention.

In all I have collected a series of sixty cases in which loss of health or life has been largely attributable to excessive brain work and brain strain incident to the callings of those considered. These cases may be arranged into two classes: (1,) Men in political and official life, including cabinet officers, senators, representatives, department officials, governors, and candidates for office; (2,) Professional men, including physicians, lawyers, clergymen, journalists, scientists, and teachers. I have drawn not alone from my own. experience, but have obtained the records of cases and corroborative facts from professional friends.' The inferences and conclusions of this paper are largely based upon a study of these cases, although time will permit details to be given in but a few instances.

With a subject so wide in scope, limitations must be set, in order to arrive at any practical conclusions in a single lecture. In the first place, then, will be considered some of the causes which lead to mental over-work and break-down in American public and professional life; and, secondly, the early warnings of such over-work, and the forms of disease most likely to result.

Men engaged in commerce and speculation have not been included in the present study, although, by including them, the list

1 Especial obligations are due to Drs. S. Weir Mitchell, W. A. Hammond J. M. Toner, A. Y. P. Garnett, D. L. Huntington, J. H. Baxter, H. C. Yarrow, and J. T. Johnson.

of cases could have been largely increased. Premature failure of health, and especially sudden and severe collapse are quite as likely to occur in business life as in any other sphere of action, owing to the protracted labors, and great anxieties and excitements attendant upon pursuits involving the getting and losing of wealth. Brain work and brain strain of a peculiarly destructive kind attend upon the devotees of the counting-house and the exchange; but our present design is to deal only with those whose vocations are in major part intellectual, in the higher meaning which is given to the word intellectual-the men of affairs, of books, and of the laboratory.

The actual occupations embraced within my study were cabinet officer, 1; senators, 8; representatives in Congress, 10; department officials, 5; governors, 2; candidates for important offices, 2; physicians, 6; lawyers, 7; clergymen, 2; journalists, 4; scientists, 6; teachers, 7.

Twenty-eight of the sixty, therefore, were men in political and official life, and eighteen of these were members of Congress.

The average longevity of men in the higher walks of political life in this country is, I am inclined to believe, considerably below the average of those who occupy similar positions in England. Comparing, so far as information was available, the ages at death of United States Congressmen and members of the English Parliament, who have died since 1860, I obtained the following results:' Fifty-nine United States Senators gave an average of 61 years; one hundred and forty-six United States Representatives an average of 55 years; the average for both being, therefore, 58 years. One hundred and twenty-one members of Parliament gave the remarkable average age at death of 68 years.

Taking twenty-five of those that might be regarded as the most eminent American statesmen of the last one hundred years and

The sources of information for these statistics were chiefly, as follows: Lanman's Biographical Annals of the United States Civil Government; Ben Perley Poore's Registry of the United States Government; the Congressional Directories; Foster's Collectanea Genealogica; the British Almanac and Companion; and the Statesman's Year Book.