Insomnia : its causes and treatment / by E. Mansel Sympson.

  • Sympson, Edward Mansel, 1860-1921.
Date:
[1889?]
Catalogue details

Licence: Public Domain Mark

Credit: Insomnia : its causes and treatment / by E. Mansel Sympson. 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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    reasons such patients readily pass into mania and melancholy. 1 And perhaps here a more modern quotation may be allowed from Dr. Hood (who was once of the Bethlehem Hospital), given in Hilton's classic work on Kest and Pain. He says, I am fre- quently applied to for the admission of lunatics into this hospi- tal whose insanity is caused by over-mental work, anxiety, or exertion, and for whose cases nothing is required to restore the mental equilibrium but rest. Passing now to the action of drugs in causing insomnia, first and foremost comes alcohol. Anstie tells us,2 and I have fre- quently ascertained the same fact from patients, that in con- firmed topers, a considerable time before any symptoms of deli- rium tremens appear, a motor restlessness, turning from side to side, has robbed them of their rest. This loss of control over the muscles does not manifest itself so much while the patient is uwake, but it is probable that it runs on almost imperceptibly into the tremors of the later stages of alcoholism. Sleep generally has failed a man entirely for some few days before the onset of delirium tremens, and this alcoholic insomnia, and the hard task of feeding the patient, are the worst and most difficult symptoms to tackle in this dangerous complaint. Herein, truly, of all diseases, do we echo the maxim of Hippocrates, that when sleep puts an end to delirium, it is a good symptom. 3 Sleep that can put an end to the feverish and useless workings of mind and body, the exertions to escape from fancied terrors—sleep indeed then is the welcome, the thrice-prayed for, the most fair.' With regard to opium, morphine, and cannabis indica as hypnotics, no very uncommon, and quite a sufficiently disagree- able, experience is to find one's patients only excited the more, instead of being soothed by these drugs. All of them have an exciting stage, and in some individuals they never seem to get beyond this. Another drug—of little use now medicinally—which acts in widely varying ways on different people, is tobacco. To some, I know it is a decided cerebral stimulant, like snuff-taking or the process mentioned by Dean Swift:— You beat your pate and fancy wit will come ; Knock as you will, there's nobody at home. To others it is a narcotic from the first. Under the second heading its action on the heart will be noticed. One of the chief objections I have found to the treatment of 1 Aretseus: Sydenham Society's translation, p. 466. 1 Reynolds : System of Medicine, vol. ii. p. 71. 3 Hippocrates : Sydenham Society's translation, vol. ii. p. 705.