Insomnia; and other disorders of sleep

Preface

— Yottng.

The regularly recurring incidence of natural sleep forms one of the most important subjects for physiological investigation. Were it an event of rare occurrence, it would excite a degree of astonishment and alarm equal to the agitation now experienced by the spectator of an ordinary attack of syncope or of epileptic convulsion. But, so completely does the recurrence of sleep harmonize with all the other facts of life that Ave are as indifferent to its nature as we are to every other healthy function of the body. It is only when the mind has undertaken a critical observation of the bodily and mental changes which accompany and condition the phenomenon that we begin to comprehend its wonderful character. Ushered in by a waning activity of body and mind that no effort of the will can long resist, nothing could more forcibly suggest the idea of approaching dissolution if, from the very earliest period of unconscious infancy, we had not been accustomed to the dominion of this imperious necessity. The remarkable likeness between the fading of consciousness in sleep and its extinction

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IV PREFACE.

in death has, in all ages and among all people, arrested the attention of poets and philosophers of every degree.

Soft repose, A living semblance of the grave,

sang old Thomas Miller; and, describing, in Milton's stately verse, the close of his first day in the garden of Eden, Adam says:

Gentle sleep First found me, and with soft oppression seized My drowsy sense, untroubled, though I thought I then was passing to my former state Insensible, and forthwith to dissolve.

How wonderful is death, Death and his brother, Sleep!

exclaims Shelley, echoing the marvellous strains that have come down to us from the days of Homer and Hesiod. In that venerable literature Sleep and Death are represented as twin brothers, sons of Night ; dwelling in the lower world of spirits, whence they come forth to perform the will of the Olympian Gods.

The prosaic genius of our scientific generation no longer tolerates such lively exercise of the imagination. The splendid anthropomorphism of the Hebrew poet, looking out upon the silent night, and cheering his soul with the sonorous exclamation,

Behold, he that keepeth Israel Shall neither slumber nor sleep

For so he giveth his beloved sleep,

has become a mere memory of childhood. Words-

PREFACE. V

worth understood the full significance of this change when he wrote:

There was a time when meadow, grove, and stream, The earth, and every common sight, To me did seem Apparelled in celestial light, The glory and the freshness of a dream. It is not now as it has been of yore; Turn whereso'er I may, By night or day, The things which I have seen I now can see no more!

. . . I know, where'er I go, That there has passed away a glory from the earth.

If, however, despite the loss of much that was beautiful and attractive in the myths of antiquity, we take advantage of the

Years that bring the philosophic mind,

we shall surely find in the - scientific investigation of sleep enough to awaken " thoughts too deep for " words.

Chapter I. The Nature And Cause Of Sleep

Definition of sleep — The invasion of sleep — The hypnagogic state — Depth and duration of sleep — Diagrammatic illustration of the phases of sleep — Modifications of physiological functions produced by sleep — Effect of sleep upon the processes of respiration, circulation, calorification, secretion, and nutrition — Consequences of the progressive invasion of the nervous system by sleep — Effect upon the organs of special sense — Effects observed in the muscular apparatus of the body — Conditjpn of intellectual functions during the invasion of sleep — Does the mind ever sleep? — Arguments adduced by Sir William Hamilton and others to prove the continued activity of the mind during the sleep of the brain — Reasons for supposing that the mind may sleep — Variability of the depth of sleep — Experiments of Kohlschuter to estimate the degree of variation — Alternation of day and night considered as a cause of sleep — Diminution of sensation a cause of sleep — Illustrative observation by Strumpell — Fatigue a cause of sleep — Hypothesis of Obersteiner regarding the cause of sleep — Hypothesis of Pfliiger — Production of artificial sleep by impregnation of the brain with narcotic substances — Analogous production of natural sleep by accumulation of cerebral waste-products — Observations regarding the duration of sensory impressions requisite for the excitement of conscious perception — Difference between syncope and sleep — Observations of Mosso regarding the state of the cerebral circulation during sleep — Cause of the change in the cerebral circulation during sleep — Molecular conditions necessary for the production of sleep — Somnolence — Sleeping Dropsy, or Maladie du Sommeil — Coma — Lethargy — Apparent death — Lucid lethargy, (vil)

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Chapter II. Insomnia, Or Wakefulness

Causes of insomnia — Affections of the organs of special sense — Effects of light — Effect of sound — Impressions upon the organs of smell and taste — Disturbances caused by a high temperature — Atmospheric and electrical disturbances — Effects produced by cold — Hibernation of animals — Disturbances of sleep occasioned by painful sensations — Disorders of the sympathetic nerves — Morbid states of the central nervous organs — Disorders of circulation and nutrition — Hyperemia of the brain — Anaemia and starvation of the brain — Effects of tea and coffee — Effect of alcohol — Inflammations, degenerations, and tumors affecting the brain — Excitement of the brain by diseased conditions of of the blood. - - - - 33

Chapter III. Remedies For Insomnia

Serious consequences of insomnia — Its relation to cerebral diseases — Treatment of insomnia by moderation and control of the cerebral circulation *- Remedial agents — Nervous stimulants and nervous sedatives — Heat — Baths — Massage — Electricity — Counter-irritants — Food — Digitalis — Camphor — Musk — Valerian — Cannabis indica — Belladonna — Hyoscyamus — Stramonium — Phosphorus — Acids — Opium — Cold — Alcohol — Paraldehyde — Ether — Chloroform — Chloral — Buty lch loral hydrate — Amyl nitrite — Opium and opiates — Bromides — Hops — Gelsemium — Conium. -- 56

Chapter IV. Treatment Of Insomnia In Particular Diseases

Insomnia in acute affections of the brain — In insanity — In chronic alcoholism and delirium tremens — In diseases of the heart and blood-vessels — In angina pectoris — In diseases of the respiratory organs — In asthma — In renal diseases — In diseases of the liver — In gastro-intestinal diseases — In febrile conditions — In rheumatism and gout — In lithaemia — In syphilis — In disorders of nutrition — During pregnancy and after parturition — In spasmodic diseases — In childhood — In old age. - - - 92

CONTENTS. IX

Chapter V. Dreams

Physiology of perception and of dreaming— Definition of the act of dreaming — Revery — Production of illusions and hallucinations by drugs and by disease — Effects of hasheesh — Effects of acute disease — Association of ideas — Memory of past sensations — Dreams produced by excitement of the different organs of sense — Persistence of dream-impressions after waking — Experience of M. Baillarger — Of Professor Jessen — Belief of savages in the reality of dreams — Sensory dreams — Intellectual dreams — Repetition of dreams — Incoherence of dreams — Cause of the superior vividness of certain dreams — Duration of dreams — Dreams excited by morbid states of the body — Prophetic dreams — Their causes — Clairvoyant dreams — Hallucinatory dreams — Sir Edmund Hornby's experience — Hallucinations — Case related by Dr. E. II. Clarke — Revelation through dreams — Revival of memory in dreams. - - - - - 116

Chapter VI. Somnambulism

Causes of somnambulism — Physiology of somnambulism — Varieties of the disorder — Maury's classification — Classification of Ball and Chambard — Diagrammatic representation of their classification — Somnambulic lethargy — Illustrative cases — Somnambulic dreams — Night terrors — Somnolentia or sleep-drunkenness — Sleep-walking — Illustrative cases — Condition of the special senses in somnambulism — Relation of memory to the somnambulic paroxysm — Illustrative cases — Occasional recollection of incidents connected with the somnambulic dream— Resemblances between the somnambulic state and the condition of post-epileptic mania — Somnambulic visions — J. P. Frank's case — Mesnet's case — Somnambulic life — Its likeness with the double-consciousness of certain forms of epilepsy — Illustrative cases — General theory of somnambulism. - - - - 166 x CONTENTS.

Chapter VII. Artificial Somnambulism Or Hypnotism

Antiquity of the phenomena of hypnotism — Modern observations — Physical conditions favorable to the phenomena — Methods of inducing the hypnotic state — Duration of hypnotic sleep — Rudimentary states of hypnotism — Investigations of the Society for Psychical Research — Mind-reading — Physiological explanation of the process — Charcot's observations on artificial somnambulism — Cataleptic variety of the hypnotic state — Lethargic variety — Somnambulic variety — Hypnotic clairvoyance — Exalted sensibility of the brain in hypnotic states — Susceptibility to suggestions from without — Phenomena of so-called spiritualism — Table-rapping — Planchette — Therapeutical employment of hypnotism — Metaphysical healing. - - - 212