Such is the description of one type of case that we often meet, but there is another and a sadder class, where unfavourable circumstances through the greater part of life, pressure of poverty and ceaseless anxiety for others, produce a careworn existence, with no joy or colour in it, and often insomnia. Such as these, in spite of a sober, abstemious life, often get sclerosis. Their pulses are small and thready, but hard, and often deceive the finger. Paralysis from small cerebral hæmorrhage is the frequent end. We may take it as an axiom that happiness lowers pressure, while grief and care raise it. We must all of us feel this as a personal truth, though we may not be able to test it with a manometer. It is not only the cat that care kills. In melancholia the pressure is almost always well above normal; in maniacal conditions generally below.
Few of us know how to work with our brains; psychology has as yet taught us but little of method and of practical value, though for this we must blame ourselves rather than the psychologists. We drive our conscious minds with few or no intervals of rest till brain exhaustion comes; then the machinery gets out of control and the screw races; so come insomnia and poor, confused results, with disappointment and depression. We talk glibly about the sub-conscious mind, and are now and again struck with some evidence of its working existence, but we few of us use it systematically as our servant—the most competent servant that exists, and one that never gives notice as long as life lasts. Our upper story, in which we suppose our conscious-thought machine works, is like a loft full of noisy machinery that often needs oiling and that often gets out of order. Its physical motor power gets slack or runs right down, and the output is poor or ceases. Sleep and rest alone will restore it and set it going again.
Our sub-conscious mind seems to be almost independent of our physical life; it works more or less continuously while the conscious mind is working, fooling or sleeping. To continue the loft simile: beneath the machine loft, with its clatter and dust, is a quiet darkened room, in which our sub-conscious mind lives and functions in its own quiet way. Men who know how to use it say that, when their conscious minds become exhausted and have come to an impasse, all they have to do is to open the trapdoor and pass the apparently insoluble problem down into the quiet room below. They then banish the subject from their minds completely, rest, play, or take up some other line of thought, and by and by, in a day or two perhaps, when they are not thinking of it, the problem turns up solved. There is no sense of fatigue or of conscious effort in this process: it is just the old adage of sleeping over a difficulty. Many of the world’s great inventors have, knowingly or sometimes unknowingly, made their great discoveries in this way. Our conscious minds are limited in motive power and always subject to fatigue, but our sub-conscious minds rarely tire and are unlimited in scope and power, for they are a part of our Divine inheritance, a portion of the great undivided spiritual force that moves and governs the universe, that slumbers not nor sleeps. To get into close touch with this power needs persevering practice, but it is clearly of inestimable value. We must not expect a clear and useful response unless we have given concentrated attention to the matter in point; a mass of ill-digested, uncertain data will remain as such; we must be perfectly honest with our alter ego; it is of no use trying to take him in. The more often and thoroughly we accustom what we call ourselves and our sub-conscious minds to work together in a friendly way, the better and the quicker will be the response.
The above is only a cursory sketch of a profound subject, but will serve to show what great economies can be made in the working of our limited human understandings.
The condition of our arteries that we call sclerosis is much more common in the sedentary brain-worker than it is in the outdoor man. We see it rarely in the farmer, the sailor, the labourer, unless it is as the result of habitual intemperance; we see it rarely in the athlete. The average blood-pressure of the indoor worker is certainly higher than that of the open-air worker, even in perfect health.
It follows, therefore, that the more we systematize and economize in our brain work, the less the strain on the arteries that supply that organ with its life-blood. Few of us realize what can be done in this direction. A much advertised system, which I need not further particularize, has got hold of some of the right ideas and methods, and its teaching will have a big effect in many directions. It is no new system; like almost all wisdom, it comes from the East. The old Hindu and Persian philosophers knew and practised it thousands of years ago, and got results which we have not approached as yet. The foundation is concentrated attention: we talk about giving attention to a thing, but we most of us do it in a very perfunctory, superficial way. Kipling’s Kim, which is full of old, out-of-the-way, unsuspected philosophy, gives us a wonderful picture of concentrated attention in the contest of observation and memory between Kim and the native boy in Lurgan Sahib’s shop. We talk admiringly of a man with “singleness of purpose,” but what is that but concentrated attention? We admire him because he achieves his object, he gets there, while the ordinary man with half-a-dozen half-concentrated purposes wanders down all sorts of side ways and seldom arrives anywhere. In this world of keen competition and of little leisure, waste of brain-power leads inevitably towards disease and failure, while economy leads to health and attainment.
Beyond the question of the nature of our mental work lies the thing worked for—the object: the importance of this from the health and disease standpoint is very great. If the object is a worthy one, something of use, something elevating, not only for ourselves but for others, attainment will bring happiness and peace, and so tend towards a healthy condition of brain. If, on the other hand, we strive for an ignoble, selfish object, one that is almost certain to harm others, attainment will be like Dead Sea fruit in our mouths, dry and unsatisfying; there will be in us no sense of joy, and the injury we have done to others will recoil on ourselves, bringing disappointment and sorrow. These are they who walk in slippery places, while the unthinking world, seeing not their end, regards them with envy.
By learning to use our minds wisely, intelligently and economically, we shall accomplish far more and with far less expenditure of force; we shall grow in the true philosophical love of a high and simple life. The false aims, the conflicts, the disharmonies of this world will pass us by and leave us at peace.
Arterio-sclerosis, then, except in the sad cases of heredity, is very much of our own making; it almost comes under the heading of “an occupation disease”; it is a natural result of non-natural conditions of life. In the words of Isaiah: “Wherefore do ye spend money for that which is not bread, and your labour for that which satisfieth not?”
Writers have for descriptive purposes, and in most cases rightly, divided arterio-sclerosis into the two main types that I have described on p. [50]—the hyperpiesis type and the atheromatous; but in general everyday practice we shall often come across cases that fall under neither head. Raised blood pressure, even to a considerable degree, 170 mm. to 180 mm., is frequently a temporary affair only, brought about by temporary causes, such as grief, anger, excitement or injudicious feeding. An altered mental outlook or a dose of calomel may banish it quickly; these cases are functional only. The wiser ones get to recognize their symptoms and the causes: these symptoms are chiefly a worried state of mind, irritability about little things, a sense of brain hurry, without the power to accomplish, and there may be passing vertigo and tinnitus. Such is the day of small things which should never be ignored, for the day of small errors unheeded may pass on into the long night of disease.