Nov. 11, ISSl.] 



KNOWLEDGE 



BRAIX TEOUBLES. 



IN these days, when the energies of the mind have 

 become more important tlian those of tlie body, and 

 when even the health of the body is chiefly of value be- 

 cause of its direct association with the health of the mind, 

 it is well that all who liave much brain-work to do should 

 know and understand the symptoms mdicating derange- 

 ment or ovenvork of mental powere. Of course, in all cases 

 where, througli wliatever cause, any specific mental malady 

 is in question, the assistance of physicians who have given 

 special attention to cerebral diseases must be obtained. But 

 fortunately with most, even of those who work the brain 

 hardest, no more real occasion arises (whatever some 

 doctors would assure us) for medical advice respecting 

 mind troubles, than commonly arises in the case of 

 corporal troubles among men who pass their days in 

 hard but healthy bodUy toils. Tlie saying that every 

 jnan is either a fool or a physician at forty (thirty 

 would, perhaps, be nearer the mark) may be applied 

 at least as well to the case of the mind as to that of 

 the body. It is as easy for one who is not the fool of 

 the proverb to understand the signs which indicate mind- 

 mischief, and to minister to the mmd wlien out of sorts 

 (not actually diseased), as it is for him to note the signs of 

 bodily ill-health, and apply the remedies which experience 

 has shown him to be appropriate. And here we would 

 note generally, what it is one object of this article to indi- 

 cate specifically, that the analogy may be carried somewhat 

 further. There are few greater mistakes, so far as the 

 body is concerned, than to imagine every little ailment to 

 be a sign of actual disease, and to have recourse for such 

 slight troubles either to medical advice, or (which may 

 prove more mischievous still) to active medicines or other 

 strong remedies. The physician of the proverb, that is, the 

 man who, not being a fool, has learned to understand his 

 ovm constitution under ordinary conditions, may be watch- 

 ful, if he so pleases, of even the slightest indications of ill- 

 health, general or local, so long as such watchfulness does 

 not degenerate into hypochoncfria. But most of these in- 

 dications should suggest to him only such changes of diet, 

 exercise, hours of resting, and so forth, as his experience 

 has found to be suitable, and should in the greater number 

 of cases suggest negative rather than positive remedies even 

 of this kind. Many signs of illness, indeed, which obtrude 

 themselves on the attention even of those who watch them- 

 selves least in such matters, may far better be dealt with 

 by the patient himself than by the physician. For 

 instance, the present writer has learned to regard severe 

 headaches of a certain type simply as affording evidence 

 that certain articles of food (milk, butter, cheese, and the 

 like) must either be given up altogether for several dajs, or 

 taken in much-reduced quantity. When this course is 

 followed, he is freed from all such attacks, imtil after the 

 lapse, perhaps, of two or three months, a headache of this 

 particular kind shows him that he has taken such articles 

 of food in greater quantity than is desirable for one of his 

 constitution. A doctor might prescribe with advantage for 

 the cure of the attack itself, and there can be no reason 

 why a person troubled by some severe attack of headache, 

 muscular rheumatism, or the like, should not obtain from 

 a doctor some active medicine by which to diminish the 

 pain from which he suffers ; but it is a far more important 

 matter to ascertain the regimen by which such attacks 

 may be prevented from occurring, and this is a matter 

 which a man (not being the " fool "' of the proverl)) should 

 manage for himself. Kow what is true of bodily troubles 

 is true of mental mischief, short of actual disease, though 

 doctors who have learned, rather late, to leave men a good 



deal to themselves, so far as the former are concerned, are 

 by no means ready to admit that mental troubles can also 

 for the mo.<;t part l)e remedied witliout calling in the phy- 

 sician. Writers like Forbes Winslow, and others who 

 have dealt with obscure diseases of the mind, have done 

 ser\-ice in calling attention to cei-tain signs of cerebral 

 mischief wliich laymen might be apt to overlook ; but they 

 insist rather too strongly on these as indicative of actual 

 disease, whereas it is within the e.Kperience of thousands 

 that such signs, in the majority of cases, are no more to be 

 regarded as necessarily indicating disease, than a passing 

 feeling of nausea necessarily indicates an approaching 

 fever, or than a pain in the bowels necessarily indicates an 

 approaching attack of Asiatic cholera. 



It should also be noted, that much mischief may lie 

 caused by suggesting that tricks and failings of the mind, 

 whicli are quite common, are signs of serious cerebral 

 mischief. Xot long after the first edition of Forbes 

 Winslow's treatise on "Obscure Diseases of the Mind ' 

 appeared, a friend of the writer's, who had begun to read 

 the book only because of his interest in matters scientific, 

 found that it possessed for him a strange fascination, 

 because nearly all the phenomena mentioned by Winslow 

 as indicative of approaching insanity were such as he had 

 fi-equently noticed in his own case. Thereafter regarding 

 these symptoms in the light in which they were thus pre- 

 sented, this unfortunate student of cerebral science found 

 himself presently possessed by a strange terror lest the 

 state which Winslow seemed to indicate as a necessary 

 sequel of these familiar signs should be close at hand in 

 his own case. The evil progressed until his mind was 

 really endangered by these mistaken fears ; but, fortunately 

 for him (if madness is rightly regarded as the greatest of 

 all evils), a series of misfortunes befell him which for a 

 time altogether withdrew his attention from the mental 

 phenomena which had so excited his fears. For two or 

 three years he had to contend against great pecuniary 

 difficulties, and to endure a series of domestic calamities of 

 no ordinaiy order. Compelled to withdraw his attention 

 from his owti mind, he forgot that, according to the 

 teachings of mental physiologists, he had been fairly on 

 the way towards either mania or idiocy. Four or five years 

 later, chancing to take down Forbes Winslow's Ixiok from 

 his library shelves, he read with amusement the passages 

 which had fonnerly excited his fears. He knew that tlie 

 mental symptoms graphically described by Winslow still 

 presented themselves from time to time — when, for instance, 

 he was tired or imwell bodily — but he had learned in a 

 very practical way that they are not quite so ominous as 

 the mind-doctors assert. It is indeed possible (perhaps 

 probable, or even certain) that no cases of acute mania may 

 be noticed wliich have not been preceded by such symptoms ; 

 but assuredly these symptoms are not in every case — pro- 

 bably not in one case out of hundreds of thousands — the 

 signs of actual mental disease, nor in one case out of 

 millions followed either by acute mania or by apoplectic 

 seizure, as in the exceptional cases dealt with by Dr. Forbes 

 Winslow. 



We propose hereafter briefly to consider some of the 

 signs which show that the mind is temporarily out of order, 

 requiring rest, relaxation, or change of employment. We 

 may in some cases have to enforce the lesson we wish to 

 inculcate by citing cases in which such symptoms have 

 been followed by serious mental disturbance ; but we wish 

 at the outset to persuade our readers that, in far the greater 

 number of cases, these signs suggest only the necessity for 

 ordinary precautions, not for medical advice or active 

 remedial measures. 



(To ie cordinued.) 



