Insanity Part 8

II. So far, it will be observed, we have referred only to the indirect effect of alcohol upon the brain, which results from its influence upon the heart-action. I wish now to refer, in a few words, to its direct physiological effect upon the mind, when used as a beverage. Its primary effect is to cause a more rapid flow of thought. It is, as if that portion of a watch which holds its spring and prevents its too rapid uncoiling should be removed; the result would be a quickening of movement, and its power of action would be greatly increased for a little time. So it is with the mind under the primary influence of alcohol; as the blood flows through the brain more freely, thought becomes more accelerated, and there is an excitement of utterance and imagination. This period, however, soon pa.s.ses by, and before long the mind becomes less clear and accurate in its perceptions; it is partially clouded; it loses the nicety of its moral sense; it does not perceive the moral side of conduct so clearly and definitely as formerly; it does not judge so accurately in reference to the claims of friends and society; and there is not that sense of propriety as to personal conduct which formerly existed. Moreover, the rapidity of impressions becomes lessened, and consecutiveness of thought is impaired, so that the mind fails to carry through a train of thought, or conduct a course of reasoning, as it would do when free from the influence of alcohol. This effect may continue under the repeated influences of alcohol until impressions, both objective and subjective, become less and less vivid and more circ.u.mscribed, and ultimately there may result partial paralysis of the power of thought. It becomes more and more liable to irregularity, confusion and weakness; the will loses its power of control in a large degree over mental operations, and insanity in some of its forms not infrequently ensues.

III. There is reason to believe that there results a further action of alcohol upon the electrical currents of the body, which originate in and proceed from the brain. Dr. Mulvaney, Staff Surgeon of the Royal Navy of England, conducted some experiments upon the effects of alcohol on these electrical currents, with the following results: "He discovered that an ounce of brandy, equal to about half an ounce of alcohol, taken by a healthy man, raised the galvanometer in a few minutes, in one case twenty-five degrees, and in another case forty-five degrees. He concluded that the thermo-electric currents of the system were strongly excited by small doses of alcohol, and that this excitement may be profitably employed when there is 'clear evidence of derangement of function springing from enfeeblement of the organic system of nerves'; but that 'in health, when function, nutrition, and blood and nerve influence are harmonized by structural integrity,' such artificially excited currents, by tending to abstract an undue amount of water from the brain-cells, 'must interfere with their normal working.'"[17]

It appears, then, that there are three well-recognized and clearly p.r.o.nounced effects upon the elements of brain-structure which must result from the use of alcohol even in small doses. It will be observed that nothing has been said as to its physiological effects upon membranes in other portions of the body. I hardly need enter upon this branch of the subject in order to establish proof of its very great effect as an agent in producing a changed and unstable condition of brain-action. And yet we need to bear in mind how greatly its effects on the nervous system in general are increased by its affinity for water; and how it absorbs this from all portions of the body with which it may come in contact, thus tending to leave them in a shrivelled and dry condition,--one unfavorable to discharge of function.

That this may be more clearly understood in relation to the membranes of other portions of the system, as well as those of the brain, I quote from Dr. Richardson[18] a few sentences:

"Upon all these membraneous structures alcohol exerts a direct perverting power of action. It produces in them a thickening, a shrinking, and an inactivity that reduces their functional power. That they may work rapidly and equally, the membranes require to be at all times properly charged with water. If into contact with them any agent is brought that deprives them of water, then is their work interfered with; they cease to separate the saline const.i.tuents correctly; and if the evil that is thus started be allowed to continue, they contract upon their contained matter, in whatever organ it may be situated, and condense it.

"By its effects upon these membranes, envelopes, and coverings, alcohol becomes one of the most extreme causes of modification of animal function, and one of the greatest sources of structural degeneration."

In the consideration of the subject as above, reference has been made to the effect of alcohol upon the adult system. But there can be no question that it is vastly greater and more ruinous in its effects upon the brain, when used during the period of youth and early manhood. At this time, the whole system is much more susceptible to unfavorable influences of all kinds, and especially is this the case with the brain, and that portion of it which is concerned in mentality.

The more highly sensitive and delicately organized any portion, or the substance of any part of the system may be, the more easily and rapidly are impressions and changes of a permanent character made upon it. The brain, being more highly organized than any other organ or portion of the body, and the metamorphosis of its tissues being more rapid during the earlier periods of life, becomes greatly more susceptible to the bad effects of alcohol, and a diathesis is more rapidly created. And, it may be added, that, when this diathesis has once become developed during early life, there exists almost no hope of eradicating it, or of again rendering the brain healthy.

Improvement may take place while abstinence from alcohol continues and the person is under restraint, but when once again the unfortunate victim is thrown upon his own resources, and left to his self-control, he always falls, and returns again to his cups, as a sow to her wallowing in the mire.

In the preceding chapter upon Heredity in its relation to the Insane Diathesis, it was shown that the effects of alcohol are such, that they are most surely transmitted from parent to child; and that its effects, both moral and physical, are of the most serious character.

We have now seen how it comes to pa.s.s that such is the nature of its effects. By its too frequent use there results a changed condition of the coats of the blood-vessels, and an abnormal state of the brain-cells and fibres. In accordance with the laws of heredity, a tendency to this condition is transmitted from parent to child, to the third or fourth generation, unless it be sooner eliminated, and may manifest itself in any one of the many forms mentioned, all of which are of a serious nature and generally exist through life. The importance therefore of abstinence from the use of alcoholic beverages by all parents, and especially by the young of both s.e.xes in its relation to the subject of healthy brain action, can hardly be overestimated. No one change in the customs of society and the habits of individuals could occur, which would exert a larger influence toward the prevention of insanity.

CHAPTER XI.

TOBACCO.

As this substance is so generally used and so often referred to in connection with alcohol as to its effects upon the human system, it appears proper to allude to its physiological effects upon the brain in this immediate connection.

Views of an opposite character as to its use have long prevailed. Much has been written in relation to its baneful effects upon the human system, the active poisons it is known to contain, and its demoralizing tendencies in general. It has been accused of being the cause of numerous diseases of a grave nature, such as cancer, chronic bronchitis, insanity, diseases of the throat and the mucous membranes of the mouth and nose, etc., etc.

It bears the blame of causing filthy, and ofttimes disgusting, habits, and of being not only a useless but a pernicious and expensive luxury.

On the other hand, much has been and continues to be said as to its comforting and soothing effects, and the sense of enjoyment and luxury resulting from it, when used in the form of smoke and with moderation.

And if an opinion as to its excellencies and value to the human race could be formed from the amount yearly consumed, or the vast sums of capital invested in its culture, manufacture, and sales in the United States alone, it would take rank as an article possessed of the highest value to mankind.

This, however, cannot be considered as a fair criterion by which to judge of its virtues or its vices; neither can we look for an impartial judgment as to its influence upon individuals or society, from those who may form opinions founded on impressions or prejudices only. It becomes necessary, therefore, to study its physiological effects as accurately and impartially as possible, and accept such results as this course may lead to.

For my present purpose it does not become necessary to go into details as to the effects of all the elements of tobacco, or of the effects of any of these elements, except as observed in their action upon the nervous system. I shall not, therefore, enter upon any minute a.n.a.lysis of the substance, preferring to leave this for those who write with a view of covering a more extended field of research.

When tobacco, in substance, or in the form of smoke, comes in contact with the mucous membrane of the mouth, throat, and nose, there results a more or less distinct biting sensation on the tongue and in the throat, unless these parts have already become accustomed to its effects. This increases in the case of the beginner, until in a few minutes a feeling of warmth and faintness comes on, often attended with nausea, vomiting, and headache. If the dose has been sufficient, the person becomes faint and unable to stand, the skin becomes cool, a perspiration appears on the forehead, the heart acts feebly, the respiration is short and hurried, and life itself is in danger.[19]

One of the elements of tobacco, nicotine (which is itself composed of several bases), pa.s.ses into the blood, and is conveyed in it to the brain.

As this is one of the most active poisons of which we have any knowledge, and, as such, acts directly on the brain, rapidly inducing the conditions mentioned, and overpowering the functions of the nervous system, it will readily be comprehended how profound its influence must be upon the nervous filaments and brain-cells. This influence is one of paralysis--a deadening of the functional activity of certain portions of the brain, and, if continued long enough, is radiated through the nerves to the heart and other organs.

If, however, a small quant.i.ty only has been absorbed into the circulation, the effect upon the brain is less permanent than would be expected from its profound influence. It soon becomes eliminated from the system through the agency of the lungs, the skin, and the kidneys,[20] and the nervous system resumes its normal activity.

Subsequent experiences after the first few are widely different. The brain becomes _tolerant_ of the poison, so far as relates to its more manifest and paralyzing effect, and in the process of time the smoker realizes very little, if any, other than a sense of soothing, and, therefore, grateful influence upon the system. The brain even comes, in the process of time and experience, to crave its influence. A condition, abnormal as to experiences and cravings, has resulted, which will demand the frequent and continued repet.i.tion of those pleasing sensations which result from its use. When this influence pa.s.ses off, there comes again into operation a more acute activity of nerve function, and a consequent sensation bordering upon or akin to pain as the brain begins to act under the freedom and force of a vitality not blunted or partially paralyzed by the presence of the poison. To relieve this there must be a repet.i.tion of its use, and this process continues until there becomes developed a true _diathesis_ of the nervous system, as in the case of alcohol and opium, though one not, in general, so difficult to overcome.

Moreover, the influence of tobacco upon the brain is essentially different from that of alcohol. From the effect of the latter there results a vast increase of functional activity of the heart, and, in the primary stage of its influence, of that portion of the brain which is concerned in mentality, while no such increase of functional activity of any portion of the nervous system results from the physiological effects of tobacco. On the contrary, these are of a paralyzing nature while they continue. The field of consciousness is less broad, the imagination and reason less keen and active.

But, on the other hand, the immediate effects of tobacco are much less permanent than those of alcohol; its elements are more speedily eliminated through the action of the lungs, to which they pa.s.s in the blood, and also by the skin and kidneys, toward which organs the essential oil contained in tobacco has a much stronger tendency than alcohol has.

It must be borne in mind, however, that the effect of tobacco upon the brain-cells is essentially and directly that of a narcotic, and in this respect differs from that of alcohol, which acts only indirectly as such, through its paralyzing influences upon the vaso-motor system; and therefore its immediate effects, while they continue, are more injurious, than would be those of alcohol, though, in reality, they are much less so, as they so soon pa.s.s off.

It is the narcotic influence upon the brain which renders tobacco so injurious when used by young children and youth. The frequent repet.i.tion of this narcotic upon the nervous system in early life, serves to partially check its growth and development, and consequently must impede very greatly its normal activity and power of application and mental attainment. Both the intellectual and moral powers of the mind become less keen and sensitive, so that a less high standard in these departments of mentality is reached by those children who use tobacco than would otherwise be possible for them; and I am not surprised, therefore, to learn that, in consequence of observations as to the influence of tobacco upon the youth in the schools of both Germany and France, legal enactments, as against its use by these scholars, have been made. Such enactments ought to exist in the schools of all civilized countries, and I have no doubt the time will come when they will.

It appears to me to be especially important that such legal enactments as against its use by children should obtain in this country, where the facilities for obtaining it are greater than in most others. The example of its use is almost constantly before little children when on the street.

It is generally and lavishly used by a large proportion of men; the tax on it is lower, and the price cheaper, than elsewhere; and there exists a custom of throwing away half-used cigars on the streets and sidewalks, so that children can easily obtain the article without cost. It is rarely the case when in town that I do not see boys from six to twelve years of age, smoking together these half-used cigars.

The children of the poor are frequently or nightly on the street long after dark, and are, consequently, very little under the restraint of parental government; they are constantly under the influence of the example of older persons in reference to this habit of smoking, and, therefore, are in danger of contracting it very early in life. In the absence of other restraint they specially need that of the guardians of law, and the highest interests of society require that they have it.

The _Boston Journal_ has recently published the results of investigations concerning the number of boys in the public schools of that city who use tobacco. The master of the Latin School informs the reporter that one half of the boys from fourteen to eighteen years of age had used the weed, though probably few had fully contracted the habit. Many of them smoke on the sly, though some have the permission of their parents to use it. In the English High School, it is thought that few of the boys smoke, and none are allowed to chew. The master's view, however, is that a teacher's precepts are of little use in preventing the habit unless they are reinforced by his example. The princ.i.p.al of the Dudley School, Boston Highlands, is of the opinion that something like forty per cent. of his boys use it more or less. The master of the Emerson School, East Boston, having studied the subject, concludes that out of four hundred boys there are forty habitual smokers, and that one third of the whole number occasionally smoke. He thinks that it is rarely the case that boys begin smoking _before they are eight years of age_. In the Grammar School at Charlestown it is estimated that forty of the three hundred boys use tobacco habitually, and that many more have occasionally smoked. Master Harrington, of the Eliot School does not think that a larger proportion than one third of all his boys have yet contracted the habit.

Not a few young men have consulted me professionally, whose nervous systems have been greatly impaired from the habit of smoking, and who say they formed the habit when not more than eight or ten years of age, and they would gladly give it up, and undo its influence if such a thing were possible. In such cases society should protect itself, at least until the individual has become old enough to realize, in some measure, the results of his action.

Of the effects of the use of tobacco upon other portions of the system than the brain it is not within my province, or necessary to my purpose, to refer at this time, though they may be, and doubtless are of a grave character in some cases. To sum up its effects upon the mental and moral character of the young, when it is daily or frequently used, I cannot do better than use the words of a pamphlet published by Monsieur Fievee in relation to its general effects upon society:

"We do not insist princ.i.p.ally on the material disasters resulting from tobacco, knowing very well that any reasoning on this subject will not produce conviction. A danger of far greater interest to those concerned in the preservation of the individual, is the enfeeblement of the human mind, the loss of the powers of intelligence and of moral energy; in a word, of the vigor of the intellect, one of the elements of which is memory. We are much deceived if the statistics of actual mental vigor would not prove the lower level of the intellect throughout Europe since the introduction of tobacco. The Spaniards have first experienced the penalty of its abuse, the example of which they have so industriously propagated, and the elements of which originated in their conquests and their ancient energy.

The rich Havana enjoys the monopoly of the poison which procures so much gold in return for so many victims; but the Spaniards have paid for it also by the loss of their political importance, of their rich appanage of art and literature, of their chivalry, which made them one of the first peoples of the world. Admitting that other causes operated, tobacco has been one of the most influential. Spain is now a vast tobacco-shop, and its only consolation is, that other nations are fast approaching its level.

"Tobacco, as the great flatterer of sensuality, is one of the most energetic promoters of individualism--that is, of a weakening of social ties. Its appearance coincides fatally with reform and the spirit of inquiry. Man inaugurates the introduction of logic in matters inaccessible, at the same time that, as Montaigne says, he gives way to a habit destructive of the faculty of ratiocination--a contradiction which shows us that necessity of defect by which he is tortured."[21]

Two inferences may be drawn from the results of our discussion.

1. It does not appear from the considerations presented above, that tobacco is an agent _directly_ responsible in any large degree for the production of insanity, nor does this appear to be the case as indicated by the statistics of asylums for the insane, nor by observation or experience. It rather appears that it is responsible as an agent which, in some measure, from its effects as a poison on the brain, must tend to check the growth and development of the intellectual and moral power in the individual, especially when indulged in during the period of youth and early manhood; and thus it becomes allied with other agencies which, in many cases, would not otherwise become operative in the production of insanity.

2. It also becomes a factor of importance in indirectly producing disease of the nervous system, through hereditary influence. As we have so frequently had occasion to observe hitherto, any abnormal condition which has existed sufficiently long to become a true diathesis, not only may, but is very likely to be transmitted in some form or other to those who come after. This has been shown in relation to the influence of over-stimulation from application to study, and from the effects of alcohol; and though the effects of both these are essentially different from that of tobacco, yet we can but consider the latter as very injurious in its influence. Indeed, I am inclined to regard the physiological effects of tobacco when used to excess as likely to appear in offspring in the form of a lower grade of intellectual and moral character, though to a less extent than are those of alcohol.

CHAPTER XII.

s.e.x IN RELATION TO INSANITY.

The relative frequency of insanity in the s.e.xes varies somewhat in different countries and under the differing conditions of civilization.

There can be no doubt that under circ.u.mstances and surroundings adapted equally to the maintenance of the health of both s.e.xes, there would be as little disease of brain in the one as in the other. The conditions of life, however, nowhere exist bearing alike on both. While there are certain hardships, exposures, and dangers to be endured by the male to which the female is little liable, on the other hand there are many unfavoring experiences growing out of the nature of her labor and duties as arranged in modern civilization, as well as from the const.i.tution of her system, from which the male s.e.x is exempt. While the male is more often exposed to the inclemency of weather, the cold of winter and the heat of summer; while he must endure the hardships of war by sea and land, and the larger expenditure of physical force in the performance of his labor; while he is much more liable to injury of the nervous system from accidents arising in connection with his exposures in the larger sphere of locomotion; on the other hand the female is much less favorably situated in relation to the beneficial effects arising from living much in the open air. The sphere of her activities is much more circ.u.mscribed, and the larger portion of her time is pa.s.sed in-doors, and often in an atmosphere less favorable as to its hygienic conditions.

There are, however, certain physical conditions of the female s.e.x which are intimately connected with the s.e.xual system, and which have been supposed, by both lay and professional persons, to be closely allied, as causes, to mental derangements, to which I desire to call attention for the present. These will relate more especially to the unmarried.

In a general way the s.e.xual system in the female exerts a much larger influence on the whole physical and mental economy, than in the male. A very intimate sympathy exists between it and both the stomach and the brain. This becomes especially manifest at the period of p.u.b.erty, and continues until after the cessation of menstruation. The whole moral nature appears to become changed, or rather it appears to come into existence and activity when the child becomes a woman, and thereafter, for thirty or thirty-five years, the whole person is largely affected one fourth of the time by the functional activity of the pelvic organ.

The amount and quality of the blood, and its physiological effect upon the vessels and cells of the brain, must largely depend upon the regularity and perfect discharge of this function; and in the case of married women the whole economy is subject to the large changes which come from conception, pregnancy, child-birth, and lactation.