I have chosen as the title of my paper " On Being Tired" rather than "On Fatigue," because the word "fatigue" carries with it the idea that some previous exertion has produced it, while many people are tired without any exertion whatever. For brevity's sake, however, I may possibly use the terms "being tired," "fatigue," or "weariness" as interchangeable.

One constantly hears the complaint from patients that they are "always tired," and indeed some people avoid working on the ground that they are "constitutionally tired." Other people term them simply lazy, but it is quite possible that, in many of these cases, there is some physical condition in the person which renders exertion specially distasteful to them, although other people cannot observe it. I remember perfectly well an eminent medical professor, who was acknowledged to possess brilliant abilities, but was accused by his friends of being lazy. It was only when he died, at a comparatively early age, from heart disease, which had been present for a number of years, that some of his friends, who had previously blamed him, were willing to admit that there might have been some excuse for his laziness. Like hunger and thirst, tiredness is a systemic sensation, although, just as hunger has its local set in the stomach, and thirst in the mouth and throat, fatigue has it more especially in the eyes and muscles. Hunger, thirst and fatigue are amongst the overpowering sensations of the body, and fatigue may be so great as to overpower the other two. Excessive weariness is so painful that it destroys the desire for life.

Many years ago I used to write for a medical periodical. On returning home one day, after a very heavy day's work at the hospital, and feeling completely exhausted, I found a note from the editor, "Please let me have an article on such and such a subject to-night." I sat down with pen and paper before me, but not a word could I write. Then I lay back lazily, and began to speculate as to the cause of my want of ideas. I thought "the brain is the same as it was yesterday, but yesterday I was not tired, perhaps it is the feebler circulation that prevents the brain from acting. If the blood does not go up to the brain, I may bring the brain down to the blood."

I therefore placed my head flat on the table, looking sideways at the paper, and began to write easily. On raising my head again every idea fled, so I placed my head again down on the table, and finished the article with my head in that position.

 

Mr. Lecky

A similar instance was afforded by the practice of the late Mr. W.G. Lecky, the historian. He had, as every reader of Punch knows, a large magnificent head, mounted upon a long neck and willowy body. He found out that his circulation was not sufficiently strong to raise the blood to his brain in sufficient quantity for its functional activity in the upright position. A mutual friend informed me that he wrote his History lying on the sofa. I was so much interested in the question that I asked Mr. Lecky himself. He told me that this was a mistake, that he did not lie down, but actually wrote kneeling on a sofa which had a large broad head to it. This served him for a writing table, and, in this kneeling position, he wrote all his works, the blood having thus to travel to his brain in a horizontal line, instead of upwards against the force of gravity as it would have had to do in the sitting position. Involuntarily people adapt their position to the intensity of their brain functions, so that a man engaged in argument, is apt to bring his head forward and downwards into a position in which the blood can be driven more freely into the cerebral vessels by the heart.