On the treatment of sleeplessness and pain / by Sir Lauder Brunton.

  • Brunton, Thomas Lauder, Sir, 1844-1916.
Date:
[between 1890 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of sleeplessness and pain / by Sir Lauder Brunton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    stomach by the diaphragm, and the local heat passing through and stimulating the heart directly will raise the arterial pressure, and undo the good that might be otherwise obtained by dilating the vessels of the stomach. Where the action of the heart is kept up by a high temperature, as in fevers, sponging the skin with hot water, dabbing it afterwards with a soft napkin and leaving the patient’s body exposed under a cradle, with only one blanket over it, will lower the temperature and bring on sleep. In place of this, antipyretics, such as phenacotin, antipyrin, etc., will sometimes act as hypnotics when more purely narcotic substances entirely fail. Chloral hydrate, by its depressing action upon the heart, combined with its sedative action on the nerve cells themselves, is a powerful hypnotic, either alone or ■combined with others, and where the tension is high may be more - successful than others which act only upon the nerve cells. We must now pass on from the circulation to consider the effect of drugs upon the nerve cells. Some of them appear to increase the power of the cells to put forth protoplasmic prolongations, while others lessen or abolish it. . Amongst those which increase the power of the cells to put forth protoplasmic prolongations, or perhaps to prevent their retraction, the most powerful appear to be certain sub- stances nearly allied to uric acid, and belonging to the so-called .xanthin group. These are the active principles of tea, coffee, cocoa and Paraguay tea, etc. In many people tea or coffee tends to produce great wakefulness, so that they may either lie quiet in comparative comfort or toss about without any apparent reason, and in all such cases it is well for the patient to avoid taking tea or coffee for a good many hours before going to bed. Some people, indeed, are so sensitive that it is unsafe for them to take it later than breakfast time. Perhaps, in place of drugs, 1 ought to say chemical sub- stances, for lactic acid, which is a product of muscular w’aste, appears, according to Preyer, to have a considerble power to lessen cerebral activity and produce sleep without exerting any marked influence upon the circulation. The most abundant nitrogenous product of muscular waste is urea. This, when pute, does not seem to act as a soporific, but some bodies allied to it in chemical composition are powerful and useful hypnotics. The first of those to be introduced was urethane, or perhaps ought rather to say urethanes, which are compounds of various alcohols with urea. The one to which the name of urethane is given is a compound of ordinary ethyl-alcohol with urea. Another, hedonal, contains methyl and propyl-alcohols, while one lately introduced, veronal, which is diethyl-malonyl-urea, appears to be the most efficacious of this group hitherto