Part 6

Hoffman says, “Plethoricos omni cura fugere opportet decubitum supinum, facile enim Incubo premuntur, cujus causa a Sanguinis stagnatione in Pulmones deducenda est.”

Doctor Haller assigns a different reason for heavy suppers preventing rest, viz. “Sed etiam cibi immeabiles particulæ in Cerebro minus facile trajactæ, comprimendo Medullam somnum minus benignum faciunt.”

It is remarkable, that this Disorder attacks People only in sleep; which, Doctor Young says, is owing to the effect that sleep has in increasing all the symptoms of a Plethora. It is true, that sleep retards the motion of the Blood, and checks the serous secretions. “.In vasis vero serosis, Lymphaticis et Nervosis circulatio parva, et sæpe nulla est.”

There is no occasion to go about proving that the secretion of urine is lessened in bed, for common experience sufficiently evinces it. And it appears, by the experiments of Doctor Robinson and Gorter, that perspiration is considerably less in the night than in the day. It must be allow’d, that the heat of the bed-cloaths will rarify the Blood, and also contribute to an universal distension of the Vessels: but all these seem to be rather the effects of lying quiet in a warm bed, than of sleep alone. If so, People might be as readily seiz’d with the Night-mare while they are awake in these circumstances, as when they are asleep, which never happens.

I really can find no way of accounting for this Phænomenon, unless we have recourse to the Soul, or that active principle within us, whose operations, during sleep, are either greatly impeded, or altogether suspended. It is therefore less sensible of any uneasiness in the Body than when we are awake, and the faculties of the Mind are in action, which is compell’d, by some innate necessity, to avoid any pain, as soon as it perceives it in the Body.

While we are awake, lie on our Backs, and feel any uneasiness in that position, we immediately alter it: but, in sleep, we are not so soon conscious of the Blood’s stoppage in the Lungs, nor have we the means of removing that dangerous obstruction so much in our power, because the voluntary motions are then suspended, without which, the position of the Body cannot be changed, nor the cause of the obstruction remov’d.

The insensibility of the Lungs too may contribute to render the obstruction greater, before the Mind becomes conscious of it; for we don’t find, that obstructions and inflammations of the Lungs are attended with such an acute pain, as when these Disorders attack other parts of the Body, the Liver, Spleen, and Omentum excepted.

The Night-mare may sometimes seize very plethoric Persons, when they don’t lie directly on the Back; for part of the Heart’s weight may fall on the Pulmonary Veins, in a lateral position of the Body.

By way of a brief recapitulation of what has been offer’d concerning the Causes in general of this Disorder, I shall conclude this Chapter with the following corollaries.

COR. 1. That they who have a very sensible system of Fibres, and are soon affected by a stimulus, are least subject to the Night-mare.

COR. 2. That sluggish, inactive constitutions are most liable to it.

COR. 3. That the severity of the fit will be always proportional to the sensibility of the Fibres, and the quantity of Blood.

COR. 4. That the duration of a fit will be proportional to the sensibility and vigour of the constitution.

COR. 5. That they who sup sparingly, and never sleep on their Backs, are seldom or never afflicted with it.

COR. 6. That it is most common in those seasons of the year, which most increase the volume of the Fluids: hence spring and autumn are its most fertile periods.

CHAP. VI.

Of the Prognostics of this Disorder.

Lest this Disorder should be thought altogether the work of Imagination, and necessary precautions should be neglected to prevent frequent returns of it; I have collected the sentiments of the ancient Physicians concerning its consequences; whose authority, in this Disease, as well as in many others, I believe, we may safely rely on; because they were wholly ignorant of its immediate cause, and had no favourite theory to support, but faithfully related facts of this kind as they really appear’d.

We find that most of the old observators who have mention’d the Night-mare, reckon it a forerunner of some terrible Disorder: I shall here translate these quotations, for the benefit of my English readers, and add the originals by way of notes, for the perusal of the learned.

“We should endeavour to stop it in the beginning; for, when it returns every night, it portends either Madness, the Epilepsy, or a Mortification.”

“The Night-mare is a Disorder which attacks People sleeping, and is of no trifling nature, but precedes dreadful Disorders; viz. the Epilepsy, a kind of Melancholy, and an Apoplexy; and if it returns frequently, it shews that they are not far off.”

“The Disease call’d the Night-mare is not a Dæmon, but rather the fore-runner of the Epilepsy, Madness, or a Mortification. We should stop it in the beginning; for, when it continues long, and returns often, it produces some of the above-mention’d Disorders.”

“If they, whom the Night-mare seizes in sleep, have cold Sweats, and a palpitation of the Heart after they awake, they are very bad symptoms. They who are long affected with it, have great reason to fear some desperate Disorder of the Head, viz. a Vertigo, an Apoplexy, Madness, a Palsy, an Epilepsy, or some sudden Death: and there are many instances of People being found dead in their beds of this Disorder.”

The celebrated Boerhaave has mention’d the Night-mare among the principal symptoms of an Apoplexy.

In order to illustrate these prognostics by modern instances, I have collected several cases, but shall confine myself to the two following.

CASE I.

A Gentleman, about thirty years old, of a full sanguineous habit, and a little intemperate, was tormented with the Night-mare almost every night for two years. He bled often, which gave him short ease; but was at length seiz’d with an Apoplexy, while he had the glass in one Hand and the pipe in the other, and expir’d immediately.

CASE II.