THE ALUMNI JOURNAL. 



27 



only danger signals set by nature to 

 warn the patient of the deeper seated, 

 more insiduous malady which threatens 

 his well-being. 



The American physician is not differ- 

 ent from the rest of his countrymen. His 

 , aim is to produce direct and immediate 

 results, to cut away the shackles that in- 

 capacitate his patient for the race. His 

 patients are accustomed to expect much 

 or him and he does much. He is the 

 most accomplished repairer in the world. 

 He can tinker up a worn out system and 

 keep it running long after it should have 

 been laid away for a thorough rest and a 

 re-creation. 



Not only does the American carry on 

 his work under the spurs of food and 

 climate; he has in the modern magazine 

 and newspaper a mental spur constantly 

 applied, the effect of which it would be 

 impossible to over-rate. 



In a very excellent paper entitled 

 "Neurasthenia and its treatment," Pro- 

 fessor Von Ziemssen, director of the 

 Medical Clinic at Munich, instances two 

 types of the condition. I will describe 

 them in the Professor's words: 



"An old merchant at the head of a 

 large establishment in New York suf- 

 fered for years from sleeplessness, pres- 

 sure in the head, etc. He stated his 

 daily life to have been as follows: 'I 

 work constantly from eight in the morn- 

 ing to ten at night. I have no time for 

 eating; I usually do so standing, and 

 frequently my food is cold and uninviting 

 before I can take it. At ten at night I 

 am so worn out that I have scarcely the 

 strength left to close my books. During 

 the night my daily work repeats itself in 

 my brain, so that it is usually only to- 

 wards morning that I obtain a few hours 

 of restless sleep. In the morning I am 

 therefore still worn out, and lam obliged 

 to resort to brandy in order to put my- 

 self in shape for work.' 



"A young merchant who for- months 

 has been unable to do any mental work 

 and passes sleepless nights, thus sketches 

 the manner of life he has led for years: 

 'We work from eight to six. We have 

 one quarter of an hour's time for lunch. 

 At night, when the day's work is done, 

 we young fellows go to a cafe, and there 

 we eat and drink and are merry up to 

 two or three o'clock in the morning. I 

 naturally obtain but little sleep, since I 

 must be up and doing by seven in the 

 morning. In case I am obliged to travel 

 on business I do so at night in order to 

 have the day for work. Can you wonder, 

 gentlemen, that such an ill-treated brain 

 finally refuses to work ? Where is Kant's 

 golden rule which gives to man out of 

 the twenty-four hours, eight for work, 

 eight for recreation, and eight for sleep ? 

 In case of employees who, when their 

 work is done, need not trouble their 

 brain more, this rule may still be ob- 

 served.' " 



The latter case illustrates purely an 

 over-worked, exhausted condition in 

 which probably no pathological changes 

 have occurred. 



I could repeat these with a dozen in- 

 stances of my own, and to them I will 

 add a third type that was not due to the 

 causes that I have described, and that 

 operated to produce Dr. Von Ziemssen' s 

 cases. 



The third case is that of a young 

 student who inherited a weak digestion. 

 He had always from earliest remem- 

 brance suffered from dyspeptic disorders, 

 and although he was not over-taxed by 

 work, nor did he lead in any way a fast 

 life, his stomach gradually did less and 

 less work until he presented himself to 

 me, suffering from profound anaemia and 

 the usual train of nervous symptoms due 

 to it. 



This latter case is also an exponent of 

 a great many similar cases. In appear- 



