MENTAL OVER-WORK AMONG PUBLIC MEN. 11 



mature disease from mental overstrain and over-work. Some lose 

 their health from broken rest, irregular meals, physical fatigue, and 

 the continual incurrence of the responsibilities of life and death ; 

 but the variety in their lives, the alternation between in-door and 

 out-door existence, and the knowledge of health and disease which 

 they are able to apply for their own behoof, serve in some measure 

 to counterbalance these injurious influences. The physicians who 

 succumb to mental over-work are usually those who, not content 

 Avith the ordinary labors and rewards of an arduous profession, 

 strive, in addition, for literary, scientific, or professorial honors. 

 In this country it is the rule, rather than the exception, to find the 

 professorships and the subordinate teaching positions in our medical 

 colleges filled by men actively engaged in practice. We have not 

 here, as abroad, scientific i:)hysicians in well-endowed professor- 

 ships, or comfortably quartered on the Government in positions, the 

 routine duties of which can be performed by deputy. The young 

 American physician who, without means, influence, or friends, sets 

 out for the high places of his profession, has before him a prospect 

 Avhich only fails to appall, because it is veiled by his ambition. In- 

 tellectual labor must be prolonged, encroaching upon intervals 

 which should be given to rest or recreation ; special appointments 

 must be kept, no matter what the cost ; the brain must be forced 

 to constantly augmenting and multiplying tasks. Besides all this, 

 he has, to a greater or less extent, the responsibility, the physical 

 fatigue, and the irregularity in eating and sleeping, which belong 

 to medical practice. Science and literature may be made instru- 

 ments of health and happiness to the working physician ; but when 

 turned to for the purposes of ambition by those already sufficiently 

 taxed by practical work, great care must be taken, or they Avill 

 assist in sowing the seeds of disease and death. Five of six physi- 

 cians in my list w^ere engaged both in teaching and in literary or 

 scientific work, besides attending to private and hospital practice. 

 In the case of two of them, valuable contril^utions, the result of 

 much labor, appeared about the time their health gave way. 



