While working on a sermon the pastor heard a knock at his office door. "Come in," he invited. A sad-looking man in threadbare clothes came in, pulling a large pig on a rope. "Can I talk to you for a minute?" asked the ma... Read more of Lessons From The Ark at Free Jokes.caInformational Site Network Informational
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THE OCCUPATION AND EXERCISE CURE






From: How To Write Special Feature Articles
(Category: PART II)

BY FRANK MARSHALL WHITE

The nerve specialist leaned back in his chair behind the great mahogany
desk in his consulting-room and studied the features of the capitalist
as that important factor in commerce and industry explained the symptoms
that had become alarming enough to drive him, against his will, to seek
medical assistance. The patient was under fifty years of age, though
the deep lines in his face, with his whitening hair--consequences of the
assiduity with which he had devoted himself to the accumulation of his
millions and his position in the Directory of Directors--made him appear
ten years older. An examination had shown that he had no organic disease
of any kind, but he told the physician that he was suffering from what
he called "inward trembling," with palpitation of the heart, poor sleep,
occasional dizziness, pain in the back of the neck, difficulty in
concentrating his attention, and, most of all, from various
apprehensions, such as that of being about to fall, of losing his mind,
of sudden death--he was afraid to be alone, and was continually tired,
worried, and harassed.

"You present merely the ordinary signs of neurasthenia," said the
specialist. "These symptoms are distressing, but not at all serious or
dangerous. You have been thinking a great deal too much about yourself
and your feelings. You watch with morbid interest the perverted
sensations that arise in various parts of your body. You grow
apprehensive about the palpitation of your heart, which is not at all
diseased, but which flutters a little from time to time because the
great nerve of the heart is tired, like the other great nerves and
nerve-centers of your body. You grow apprehensive over the analogous
tremor which you describe as 'inward trembling,' and which you often
feel all through your trunk and sometimes in your knees, hands, and
face, particularly about the eyes and mouth and in the fingers."

The capitalist had started at the mention of the word neurasthenia, and
had seemed much relieved when the physician had declared that the
symptoms were not dangerous. "I had been under the impression that
neurasthenia was practically an incurable disease," he said. "However,
you have described my sensations exactly."

"One hundred per centum of cases of neurasthenia are curable," responded
the specialist. "Neurasthenia is not, as is usually supposed, an equally
diffused general exhaustion of the nervous system. In my opinion, it is
rather an unequally distributed multiple fatigue. Certain more
vulnerable portions of the nervous system are affected, while the
remainder is normal. In the brain we have an overworked area which,
irritated, gives rise to an apprehension or imperative idea. By
concentration of energy in some other region of the brain, by using the
normal portions, we give this affected part an opportunity to rest and
recuperate. New occupations are therefore substituted for the old
habitual one. A change of interests gives the tired centers rest."

"I have heard the 'rest cure' advocated in cases like mine," suggested
the capitalist.

"In the treatment of neurasthenia we must take the whole man into
consideration," said the physician. "We must stimulate nutrition, feed
well the tired and exhausted organism, and, above all, provide some sort
of rest and distraction for the mind. The mind needs feeding as well as
the body. The rest cure is a kind of passive, relaxing, sedative
treatment. The field is allowed to lie fallow, and often to grow up with
weeds, trusting to time to rest and enrich it. The 'exercise and
occupation cure,' on the other hand, is an active, stimulating, and
tonic prescription. You place yourself in the hands of a physician who
must direct the treatment. He will lay out a scheme with a judicious
admixture of exercise which will improve your general health, soothe
your nervous system, induce good appetite and sleep, and of occupation
which will keep your mind from morbid self-contemplation. One of the
best means to this end is manual occupation--drawing, designing,
carpentry, metal-work, leather-work, weaving, basket-making,
bookbinding, clay-modeling, and the like--for in all these things the
hands are kept busy, requiring concentration of attention, while new
interests of an artistic and ćsthetic nature are aroused. The outdoor
exercise, taken for a part of each day, if of the right sort, also
distracts by taking the attention and creating interest."

The capitalist had called upon the specialist braced for a possible
sentence of death, prepared at the least to be informed that he was
suffering from a progressive mental malady. Now, while a tremendous
weight was lifted from his mind with the information that he might
anticipate a complete return to health, the idea of devoting his trained
intelligence, accustomed to cope with great problems of trade and
finance, to such trivialities as basket-making or modeling in clay
appeared preposterous. Nevertheless, when the physician told him of a
resort near at hand, established for the treatment of cases just such as
his, where he might be under continuous medical supervision, without
confinement indoors or being deprived of any of the comforts or luxuries
of life, he decided to put himself in the other's hands unreservedly.
The specialist informed him that the length of time required for his
cure would depend largely upon himself. He might, for instance, even
keep in touch with his office and have matters of import referred to
him while he was recuperating his mental and physical strength, but such
a course would inevitably retard his recovery, and possibly prevent it.
To get the best results from the treatment he ought to leave every
business interest behind him, he was told.

The fee that the capitalist paid the specialist made his advice so
valuable that the other followed it absolutely. The next evening saw the
patient in the home of the "occupation and exercise cure." He arrived
just in time to sit down to dinner with a score of other patients, not
one of whom showed any outward sign of illness, though all were taking
the cure for some form of nervous trouble. There were no cases of
insanity among them, however, none being admitted to the institution
under any circumstances. The dinner was simple and abundant, and the
conversation at the tables of a lively and cheerful nature. As everybody
went to bed by ten o'clock--almost every one considerably before that
hour, in fact--the newcomer did likewise, he having secured a suite with
a bath in the main building. Somewhat to the surprise of the capitalist,
who was accustomed to be made much of wherever he happened to be, no
more attention was paid to him than to any other guest of the
establishment, a condition of affairs that happened to please him. He
was told on retiring that breakfast would be served in the dining-room
from 7:30 to 8:30 in the morning, but that, if he preferred to remain in
his room, it would be brought to him there at nine o'clock.

The capitalist had a bad night, and was up to breakfast early. After he
had concluded that repast the medical superintendent showed him about
the place, but did not encourage him to talk about his symptoms. The
grounds of the "occupation and exercise cure" comprised a farm of forty
acres located among the hills of northern Westchester County in the
Croton watershed, with large shade trees, lawns, flower gardens, and an
inexhaustible supply of pure spring water from a well three hundred feet
deep in solid rock. The main building, situated on a knoll adjacent to a
grove of evergreen trees, contained a great solarium, which was the
favorite sitting-room of the patients, and the dining-room was also
finished with two sides of glass, both apartments capable of being
thrown open in warm weather, and having the advantage of all the sun
there was in winter. In this building were also the medical offices,
with a clinical laboratory and hydro- and electro-therapeutic equipment,
and accommodations for from twelve to fifteen guests. Two bungalows
under the trees of the apple orchard close at hand, one containing two
separate suites with baths, and the other two living-rooms with hall and
bath-room, were ideal places for quiet and repose. Situated at the
entrance to the grounds was a club-house, with a big sitting-room and an
open fireplace; it also contained a solarium, billiard-room, bowling
alleys, a squash court, a greenhouse for winter floriculture, and the
arts and crafts shops, with seven living-rooms. Every living-room in the
main building, the club-house, and the bungalows was connected with the
medical office by telephone, so that in case of need patients might
immediately secure the services of a physician at any hour of the day or
night.

The arts and crafts shops being the basic principle of the "occupation
and exercise cure," the capitalist was introduced to an efficient and
businesslike young woman, the instructress, who explained to him the
nature of the avocations in which he might choose to interest himself.
Here he found his fellow-patients busily and apparently congenially
employed. In one of the shops a recent alumnus of one of the leading
universities, who had undergone a nervous breakdown after graduation,
was patiently hammering a sheet of brass with a view to converting it
into a lampshade; a matron of nearly sixty, who had previously spent
eight years in sanatoriums, practically bedridden, was setting type in
the printing office with greater activity than she had known before for
two decades; two girls, one sixteen and the other twelve, the latter
inclined to hysteria and the former once subject to acute nervous
attacks, taking the cure in charge of trained nurses, were chattering
gayly over a loom in the construction of a silk rug; a prominent
business man from a Western city, like the New York capitalist broken
down from overwork, was earnestly modeling in clay what he hoped might
eventually become a jardiniere; one of last season's debutantes among
the fashionables, who had been leading a life of too strenuous gayety
that had told on her nerves, was constructing a stamped leather
portfolio with entire absorption; and half a dozen others, mostly young
women, were engaged at wood-carving, bookbinding, block-printing,
tapestry weaving, or basket-making, each one of them under treatment for
some nervous derangement.

The new patient decided to try his hand at basket-making; and, although
he figured out that it would take him about four days to turn out a
product that might sell for ten cents, he was soon so much interested in
mastering the manual details of the craft that he was disinclined to put
the work aside when the medical superintendent suggested a horseback
ride. When, at the advice of the specialist, the capitalist had decided
to try the occupation and exercise cure, he did so with little faith
that it would restore him to health, though he felt that there was
perhaps a slight chance that it might help him. The remedy seemed to him
too simple to overcome a disease that was paralyzing his energies. To
his great surprise, he began to improve at once; and though for the
first week he got little sleep, and his dizziness, with the pain in the
back of his neck and his apprehensions, continued to recur for weeks,
they did so at always increasing intervals.

He learned bookbinding, and sent to his library for some favorite
volumes, and put them into new dress; he made elaborate waste-paper
baskets, and beat brass into ornamental desk-trays, which he proudly
presented to his friends in the city as specimens of his skill. Work
with him, as with the others of the patients, was continually varied by
recreation. In the summer months there were lawn-tennis, golf, croquet,
canoeing, rowing, fishing, riding, and driving. In winter, such outdoor
sports as skating, tobogganing, coasting, skeeing, snowshoeing, and
lacrosse were varied by billiards, bowling, squash, the medicine ball,
and basket and tether ball. The capitalist was astonished to discover
that he could take an interest in games. The specialist, who called upon
his patient at intervals, told him that a point of great importance in
the cure was that exercise that is _enjoyed_ is almost twice as
effective in the good accomplished as exercise which is a mere
mechanical routine of movements made as a matter of duty.

The net result was that, after four months of the "occupation and
exercise cure," the capitalist returned to New York sound in mind and
body, and feeling younger than he had before in years. Complete cures
were effected in the cases of the other patients also, which is the less
remarkable when the circumstance is taken into consideration that only
patients capable of entire recovery are recommended to take the
treatment.

Of course the institution that has been described is only for the
well-to-do, and physicians are endeavoring to bring the "occupation and
exercise cure" within the reach of the poor, and to interest
philanthropists in the establishment of "colony sanatoriums," such as
already exist in different parts of Europe, for those suffering from
functional nervous disorders who are without means. Contrary to the
general opinion, neurasthenia, particularly among women, is not confined
to the moneyed and leisure class; but, owing to the fact that women have
taken up the work of men in offices and trades as well as in many of
the professions, working-women are continually breaking down under
nervous strain, and many, under present conditions, have little chance
for recovery, because they cannot afford the proper treatment. As a
speaker at the last annual meeting of the American Medical Association
declared, "Idiots and epileptics and lunatics are many; but all together
they are less numerous than the victims of nervousness--the people
afflicted with lesser grades of psychasthenic and neurasthenic
inadequacy, who become devoted epicures of their own emotions, and who
claim a large share of the attention of every general practitioner and
of every specialist."

Scientists declare that this premature collapse of nerve force is
increasing to such an extent as to become a positive menace to the
general welfare. The struggle for existence among the conditions of
modern life, especially among those found in the large centers of
industrial and scientific activity, and the steady, persistent work,
with its attendant sorrows, deprivations, and over-anxiety for success,
are among the most prolific causes--causes which are the results of
conditions from which, for the large mass of people, according to a
leading New York alienist, there has been no possibility of escape.

"Especially here in America are people forced into surroundings for
which they have never been fitted," the alienist asserts, "and
especially here are premature demands made upon their nervous systems
before they are mature and properly qualified. The lack of proper
training deprives many of the workers, in all branches, of the best
protection against functional nervous diseases which any person can
have, namely, a well-trained nervous system. This struggle for existence
by the congenital neuropath or the educationally unfit forces many to
the use, and then to the abuse, of stimulants and excitants, and herein
we have another important exciting cause. This early and excessive use
of coffee, tea, alcohol, and tobacco is especially deleterious in its
action upon the nervous system of those very ones who are most prone to
go to excess in their use.

"Therefore, predisposition, aided by the storm and stress of active
competition and abetted by the use of stimulants, must be looked upon as
the main cause for the premature collapse of nerve force which we call
neurasthenia; so it will be found that the majority of neurasthenics are
between twenty-five and fifty years of age, and that their occupations
are those which are attended by worry, undue excitement, uncertainty,
excessive wear and tear, and thus we find mentally active persons more
easily affected than those whose occupation is solely physical. Authors,
actors, school-teachers, governesses, telegraph and telephone operators,
are among those most frequently affected, and the increase of
neurasthenia among women dates from the modern era which has opened to
them new channels of work and has admitted them more generally into the
so-called learned professions. But whatever may be the occupation in
which persons have broken down, it is never the occupation alone which
has been the cause.

"This cannot be too often repeated. The emotional fitness or unfitness
of an individual for his occupation is of the utmost importance as a
causative factor, and overwork alone, without any emotional cause and
without any errors in mode of life, will never act to produce such a
collapse. It is therefore not astonishing that this class of functional
nervous diseases is not confined to the wealthy, and that the rich and
the poor are indiscriminately affected. But certain causes are of
greater influence in the one class, while different ones obtain in the
other. Poverty in itself, with its limitations of proper rest and
recuperation, is a very positive cause. Years of neurological dispensary
work among the poor have convinced me that nervousness, neurasthenia,
hysteria, etc., are quite as prevalent among the indigent as among the
well-to-do."

Physicians agree that the prime requisite in the treatment of these
disorders is the removal of the patient from his or her habitual
surroundings, where recognition of the existence of actual disease is
generally wanting, where the constant admonitions of well-meaning
friends to "brace up" and to "exert your will power" force the sick man
or woman to bodily and mental over-exertion, and where the worries about
a livelihood are always dominant. Such a change alone, however, the
experts say, will help but few, for it is being recognized more and more
that these functional diseases of the nervous system can receive
satisfactory treatment only in institutions, where constant attention
may be had, with expert supervision and trained attendants.

The "occupation and exercise cure" is applicable also to epilepsy, and
is the therapeutic principle of the Craig Colony for Epileptics at
Sonyea, in Livingston County, supported by the State, and that
institution furnishes a general model for the "colony sanatoriums"
suggested for indigent patients suffering from functional nervous
disorders. The Craig Colony was the idea of Dr. Frederick Peterson,
Professor of Psychiatry at Columbia University, and former President of
the New York State Commission of Lunacy and of the New York Neurological
Society, which he based upon the epileptic colony at Beilefeld, Germany,
that was founded in 1867. The Craig Colony was founded in 1894, and
there are now being cared for within its confines more than thirteen
hundred patients, who have turned out this year agricultural products,
with bricks, soap, and brooms, to the value of $60,000. The colony is
named after the late Oscar Craig, of Rochester, who, with William P.
Letchworth, of Buffalo, purchased the two-thousand-acre tract of land on
which it is situated from the Shaker colony at Sonyea and presented it
to the State, Dr. Peterson devoting several months of each year for nine
years to getting the institution into working order. The first patients
were housed in the old Shaker buildings, which were well constructed and
fairly well arranged for the purpose, but as additional applications for
admission have been made new buildings have been erected. To-day there
are eighty buildings in the colony, but a thousand patients are waiting
for admission, eight hundred of whom are in New York City.

Epilepsy, the "falling sickness," is a most difficult malady to treat
even in an institution for that purpose, and it is impossible to treat
it anywhere else. An epileptic in a family is an almost intolerable
burden to its other members, as well as to himself. The temperamental
effect of the disease takes the form in the patient of making frequent
and unjust complaints, and epileptics invariably charge some one with
having injured them while they have been unconscious during an attack.
Then, too, living at home, they are often dangerous to younger members
of a family, and they are fault-finding, exacting, and irritable
generally. The seizures frequently come on without warning, and the
patient drops where he stands, often injuring himself severely. The last
annual report of the Craig Colony records more than four hundred
injuries within the year to patients during seizures which required a
surgeon's attention, the injuries varying from severe bruises to
fractures of the skull.

The object of the Craig Colony is to remove the burden of the epileptic
in the family from the home without subjecting the patient to the
hardship of confinement with the insane. "Very few epileptics suffer
permanent insanity in any form except dementia," says the medical
superintendent of the Colony. "Acute mania and maniac depressive
insanity not infrequently appear as a 'post-convulsive' condition, that
generally subsides within a few hours, or at most a few days. Rarely
the state may persist a month. Melancholia is extremely infrequent.
Delusions of persecution, hallucinations of sight or hearing,
systematized in character, are almost never encountered in epilepsy."

Only from six to fifteen per cent of epileptics are curable, and hence
the work of the Craig Colony is largely palliative of the sufferings of
the patients. Each individual case is studied with the utmost care,
however, and patients are given their choice of available occupations.
The Colony is not a custodial institution. There are no bars on the
windows, no walls or high fences about the farm. The patients are housed
in cottages, men and women in separate buildings some distance apart,
about thirty to each cottage. In charge of each of these families are a
man and his wife, who utilize the services of some of the patients in
the performance of household work, while the others have their duties
outside. Kindness to the unfortunates under their care is impressed upon
every employee of the Colony, and an iron-bound rule forbids them to
strike a patient even in case of assault.

Besides the agricultural work in the Craig Colony, and that in the soap
and broom factories and the brick-yard, the patients are taught
blacksmithing, carpentry, dressmaking, tailoring, painting, plumbing,
shoemaking, laundrying, and sloyd work. It is insisted on that all
patients physically capable shall find employment as a therapeutic
measure. The records show that on Sundays and holidays and on rainy
days, when there is a minimum of physical activity among the patients,
their seizures double and sometimes treble in number. Few of the
patients know how to perform any kind of labor when they enter the
Colony, but many of them learn rapidly. It has been repeatedly
demonstrated that boys from eighteen to twenty years of age can spend
two years in the sloyd shop and leave it fully qualified as
cabinet-makers, and capable of earning a journeyman's wages.

There are about two hundred children in the colony of epileptics at
Sonyea, more than half of whom are girls. As children subject to
epileptic seizures are not received in the public schools of the State,
the only opportunity for any education among these afflicted little ones
whose parents are unable to teach them themselves or provide private
tutors for them is in the schools of the Colony. Some of the children
are comparatively bright scholars, while the attempt to teach others
seems a hopeless task. For instance, it took one girl ninety days to
learn to lay three sticks in the form of a letter A.

Every effort is made to encourage recreation among the patients in the
Craig Colony, both children and adults. The men have a club of 250
members, with billiards, chess, checkers, cards, and magazines and
newspapers. The boys have their baseball and football, and play match
games among themselves or with visiting teams. The women and girls play
croquet, tennis, and other outdoor games. There is a band composed of
patients that gives a concert once a week, and there are theatricals and
dancing, with occasional lectures by visiting celebrities. As the
Colony, with the medical staff, nurses, and other employees, has a
population of 2,000, there is always an audience for any visiting
attraction. The maintenance of the Colony is costing the State $225,000
the present year.

Since the founding of the Craig Colony similar institutions have been
established in Massachusetts, Texas, Michigan, Ohio, New Jersey,
Pennsylvania, Illinois, and Kansas, and other States are preparing to
follow their example. There are other private sanatoriums throughout the
country similar to the one in Westchester County, where the nervous or
neurasthenic patient who is well-to-do may obtain relaxation and
supervision, but there is no place at all to-day where the man or woman
suffering from curable nervous disorders who is without means can go for
treatment.

* * * * *

_(McClure's Magazine)_

Five illustrations: two wash drawings by André Castaigne showing
mono-rail trains in the future, five half-tone reproductions of photographs
of the car on its trial trip, and one pen-and-ink diagram of the
gyroscopes.





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