Doctors and ‘Educational Overpressure’ in Nineteenth-Century Britain: A Fatigue State that Divided Medical Opinion

The expansion of education in the later nineteenth century led to concerns that ‘educational overpressure’ was damaging the health of children. Overpressure was an ill-defined condition which presented nosological problems and diagnostic difficulties. These were further clouded by political and sociocultural issues which included malnutrition, learning disabilities and postulated hereditable physical and mental degeneration. Uncertainty about the true nature of overpressure divided the British medical profession with a vocal minority alleging that it was common and could result in serious illness, another group who thought that the consequences were minor, and some who altogether doubted its existence. In Britain the debate was intensified by politically motivated funding decisions which put pressures on elementary schoolchildren. In continental Europe the emphasis was on secondary schoolchildren but in other respects the condition was similar, though severe symptoms were more commonly described in Britain. Comparisons with neurasthenia and similar states show that overpressure was what is now recognized as a fatigue state. Nosological difficulties are common in these conditions and often result in conflicting opinions. Disputes about overpressure temporarily damaged the British profession’s credibility at a time when some doctors were pressing for further medical involvement in the educational arena. However, schools could now no longer be regarded as exclusively pedagogical and overpressure had contributed to wider concerns about child health and welfare.