Part 3

No wonder that in Kipling’s story At the End of the Passage, when Spurstow finds his sleepless friend in the last stage of insomnia, he sadly but severely says, “Sleeplessness of your kind being very apt to relax the moral fibre in little matters of life and death, I’ll just take the liberty of spiking your guns;” and then as a safeguard, robs Hummil of his rifle and revolver.

THEORIES OF SLEEP

Various theories have at one time or another been suggested to account for sleep. Some are both bewildering and absurd. There was a time when it was seriously urged that sleep has in the thyroid gland its special organ, but when someone in the interest of the theory excised the thyroid gland, only to increase in certain instances the tendency to go to sleep and stay asleep, the theory was at once abandoned even by its staunchest advocates.

Finding that sleep usually follows fatigue, and that fatigue is a chemical phenomenon, the so-called chemical theory was next set up, and Sommer was quite sure that sleep comes as a consequence of the exhaustion of the reserve of oxygen in the tissues and the blood, and its replacement by carbonic acid during sleep. But here, too, experimentation has been both inadequate and inconclusive.

The vaso-motor theory, as modified by Howell, that sleep is due to the anæmia of the cortical layer of the brain, which invariably takes place when the blood pressure in the arteries at the base of the brain falls, has had a larger and a longer following. But convincing proof is yet to be secured, and Dr. Percy G. Stiles of the Bellevue Hospital ends his discussion of the subject with a guarded inference that there may be truth in both the theories, and that eclecticism is in consequence the wisest policy for the histologist.

Footnotes

Popular Science Monthly, September, 1903.

WHAT SLEEP REALLY IS

Sleep, however we account for it, is “the resting time of consciousness.” To be sure, there is no absolute arrest of brain activity. There is always, even in the soundest sleep, some cerebral activity. We dream. We have nightmares. We sometimes work out problems in our sleep which have defied our every waking effort. There is on record one instance of a college student who got up at three o’clock to solve successfully, while sound asleep, a problem he could not work out at all before he went to bed. There is another instance well attested of a British consul in Syria who, after tearing up letter after letter which he wrote to a Lebanon emir, went to sleep in sheer despair, only to find when he awoke in the morning, that he had written an elaborate letter which in every way satisfied the multitudinous demands of Arabic diplomacy insistent to the last on all the niceties of Oriental etiquette.

Byron was right. Sleep is neither life nor death. It is a world apart.

Sleep has its own world, A boundary between the things misnamed Death and Existence; sleep has its own world.

Consciousness may be suspended. But the cortical centres are frequently as active when we are asleep as when awake. The attention can be maintained with such unbroken steadiness as to awake some persons with the exactness of an alarm clock on the very minute, even though for purposes of deception the hands of the clock may have been set back without their knowledge. The motor centres can be counted on so confidently that they will drive the somnambulist with the accuracy of a trained chauffeur to his appointed destination. Sleep is, therefore, nothing more than a temporary suspension of a portion of the brain’s activity.

FOOTNOTES

Manaceïne, 62, 69, 70.

Dr. J. Madison Taylor in the Popular Science Monthly, September, 1905.

Thomson’s Brain and Personality, 314.

THE NECESSITY OF SLEEP

But that suspension is an absolute necessity to health of mind and body. Men have been known to go for forty days without nourishment and retain unimpaired all the mental faculties. No man goes for even three days and nights without sleep except he pay a penalty in mental equipoise, and death itself is apt to bring his misery to an end, it is claimed, in five sleepless nights and days. Professors Patrick and Gilbert of the University of Iowa found, some years ago, that in certain cases there were after two nights of complete wakefulness hallucinations, loss of attention, inability to remember, and unmistakable evidences both of mental disorganisation and physical depression. In Kipling’s story, tragically true to life, Hummil died after eighty-four hours of unrelieved insomnia, and the author’s closing words would seem to indicate that madness overtook him at the last: “In the staring eyes was written terror beyond expression of any pain.”

The occasional genius like Napoleon may perhaps get on habitually with four hours of sleep each night, and the mother watching by the sick-bed of her child may go for weeks in an emergency with but an hour or two of sleep at intervals, infrequent and irregular. But the sensible division made by Alfred the Great into eight hours for sleep, eight hours for work, eight hours for play, will be as far as possible observed by the right-minded and far-seeing everywhere.

FOOTNOTES

Psychological Review, September, 1896.

INSOMNIA AND ITS CAUSES

Insomnia reduced to simplest terms is nothing but the inability to sleep. While the causes of insomnia may sometimes be exceedingly complex, ordinarily they are evident both to us and those we love the best. Anything, as we all learn by experience, which accelerates the activity of the mind and increases the congestion of the brain is likely to induce insomnia. Worry, fear, grief, prolonged mental effort, any sort of emotional excitement, social dissipation, the intemperate use of coffee, tea, or alcohol are among the most familiar causes of insomnia. Disturbances of digestion, neuralgic pains, arterial disease, eye-strain, and dental lesions are the hidden causes, oftener than we imagine, of protracted wakefulness.

Many of the more obstinate cases of insomnia are due, we know at last through Dr. Upson’s remarkable book, to some dental lesion unsuspected because, as is not uncommon, it is unaccompanied by the ache habitually associated with all the ills to which the teeth are heirs. In my Emmanuel clinic I have had one case of insomnia which, in spite of all an efficient doctor could do for the body and the Emmanuel worker for the mind, persisted until I at last discovered that the sufferer was in immediate need of a dentist, whose threshold, through a morbid fear, he had not crossed in many years.

FOOTNOTES

Insomnia and Nerve Strain, 12.

THE VALUE OF DRUGS

For insomnia there is no specific known to medicine. While the good family doctor may correct digestive disturbances, banish for the time neuralgic pains, modify arterial disease, relieve with the oculist’s assistance eye-strain, and through the dentist remove the cause of dental lesions, sometimes insomnia persists long after the physical cause has disappeared. I have had in my clinic one case of chronic sleeplessness caused by a headache which appeared incurable though the cause of the headache and insomnia alike had vanished years before.