THEORIES ABOUT SLEEP.
• ONE of the chief characteristics of this time of specialisa- tion, town-life, and highly wrought nervous organisation • is a growing inability to sleep. The development of insomnia is a fatal drawback to the many gains which modern life has brought us. The thinker whose brain is seething all day long with ideas, and whose nights are apt to be filled with restless horrors, looks with envy on the strong, healthy labourer who can fall asleep on a doorstep in a crowded street in the full blaze of mid-day. He would at times give all the knowledge be has acquired, all the ideas which exalt his intellect, for the rower to drop asleep at will, and so secure that repair of tissue, that sense of refreshment, which only deep and quiet sleep can bring. We doubt if any misery which man is called on to undergo is, on the whole, worse than that of persistent insomnia. The sleeper can at least forget the misery of the day in the calm slumber or, as sometimes happens, the brilliant and happy dreams of the night. But the sleepless man looks forward with vague dread to nightfall. He
• knows that it will bring to him no repose, no steeping c•f the senses in oblivion. He thinks about what he must • do to court sleep, and his very efforts in that direc- tion repel the visitant he desires. He sits up reading, thinking that he will tire his brain out, but he grows more and more excited, more full of the spirit of intel- dectual attention, which is fatal to sleep. He puts the light oat, determined to forget the world, when some worrying problem, some tormenting memory which in the light of day
• would vanish to a pin's point, assumes vast and dread propor- Cons, hovers over him, causes his head to burn as with fever, while his feet grow correspondingly cold, and he tosses %from side to side until the dawn steals faintly into the 200111, when, perchance, the victim sinks into a brief and un-
• refreshing sleep of a couple of hours, and then rises, yawning, -dull, and miserable, to face the trials of another day, and to apprehend the long agonies of another wretched night. Of course, there come occasional breaks, for no human organism could stand against absolute sleeplessness prolonged for months: sheer bodily and mental exhaustion intervene to -mecum that which should be the gift of Nature to all her children. But it is a source of fatal weakness and misery to know that only once in a while one will be able to Bleep. The mind loses its fine edge, the temper breaks out in alarming forms, periods of deep depression being followed by paroxysms of anger, the moral nature is partly undermined, the grasshopper becomes a burden, desire fails, and even thoughts of self-destruction may come to the best and wisest men. As the growth of insomnia in our crowded, noisy, nervous civilisation is an undoubted fact, we can scarcely help entertaining some apprehension for the future unless this fatal phenomenon can be dealt with, unless the spectre can be laid.
There is a most interesting study of the phenomena of sleep contained in the latest volume of the "Contemporary Science Series," written by Madame Marie de Manaceine, of St. Petersburg (" Sleep : its Physiology, Pathology, Hygiene, and Psychology." London : Walter Scott.) We suppose it is an unhappy sign that such a work should be needed, for it means that the analysis of our own misery is interesting to many readers. Just as we wake from innocence to a knowledge of good and evil, and then probe our moral nature to discover a balm for the wound evil has made, so we fall from health, with its normal and refreshing sleep, to a condition of nervous disorder and lack of sleep, and we then take note of our symptoms with a view to discover how we may regain the lost paradise. The author, perhaps, scarcely recognises to what a degree the victim of insomnia is, in our modern cities, at the mercy of others. For while insomnia has many causes, it is always kept alive by noise, and in cities like London and Paris noise is always going on day and night. Neigh- bours, too, are frequently thoughtless, and so add to the almost inevitable street noises tortures of their own. To begin playing the piano at 11 o'clock in a semi-detached London house, with its thin walls, is really a refinement of cruelty compared with which the tortures of barbarians seem almost merciful. The persons who come home late rarely consider the just rights of those who go to bed early and who need that deep sleep which Madame de Manaceine declares generally sets in in the earlier part of the night. Cats, we suppose, will stray abroad at night and make music on the roof or on broken walls. But the keeper of noisy dogs who bay at the moon, and the piano-organist with his fiendish instrument and his exasperating patron who flings down coppers in response to the grinding of tunes, have much to answer for, and neither ought to be tolerated in a properly ordered society. We must rely, in fact, for a better chance to the sleepless, in part at least, on the growth of a social feeling which will never willingly inflict misery on other people. Only by such a growth, reinforced by law where social feeling fails, can the crowded life of modern cities be made tolerable. No doubt people are adapting themselves in some degree to city life, or else they are dying out because they cannot so adapt themselves to a hated environment. But it is not well that the adaptation should be complete, or man will lose touch with the more beautiful manifestations of Nature, and be content with what is noisy, vulgar, and health-destroying. An absolute city civilisation without any great reserve of natural persons would speedily perish.
But, apart from the one great curse of city life with its injurious effect on delicate nervous organisations, there are other causes of sleeplessness within the control, to some degree, of the victim of insomnia. It was at one time supposed that in sleep the brain was richly charged with blood. How that supposition can ever have arisen we con- fess we do not understand, but we assume that the theory was that a kind of paralysis overtook those who were wrapped in sleep. This is now confessed to be an error. Sleep ensues when the brain is largely denuded of blood, when cerebral anmmia is established. To partly empty the brain of its blood-supply, to keep the head cool, the body sufficiently warm, and to send the blood rather to the lower extremities,—this is the physical problem of the sleepless. It is interesting to note that during sleep a great number of the bodily functions continue quite normally without interfering with sleep itself, and therefore sleep is not so like death as some of the poets have imagined. Man asleep is not so pro- foundly different from man awake ; the two chief points of difference, however, being these : a greater indrawing of oxygen and exhalation of carbonic acid, and a complete Tail0 motor rest. The bedroom and the state of the occupant (assuming the absence of external noise) are the chief factors in the problem. The sleeping room should be airy and cool, never, for adult persons, reaching a higher temperature than 600, though young children need greater warmth. The head should never be under the sheets, but exposed and cooL The feet should be kept warm by a little extra clothing at the foot. With a heavy sleeper there should be no thick curtains, but with a light sleeper curtains are essential, as sunlight plays upon the optic nerve and rouses that atten- tion which it is the one object of the sleeper to keep in suspended animation. The bed should never be between fire- place and door or it catches the draughts, and it is more dangerous and more easy to contract a chill in bed than in the daytime, the specially chilly period being about 3 a.m. So far as the sleeper is concerned, what should be his condition? If he is a good sleeper he has no problem to consider, though Madame de Manaceine is of opinion that too much sleep is fully as bad as too little ; and she gives hints to the very sleepy as to the way in which they may rouse themselves. She even defends angry feelings as being sometimes the only means by which a heavy, lethargic person can be aroused from his stertorous slumbers or prevented from falling asleep when he should be wide awake. We con- fess to having little sympathy with people who can sleep all day long, though doubtless, as the undergraduate said, they too are God's creatures. On the whole, immense lethargy is connected with a rather low intellectual development, often aided by foolish parents who allow their children to sleep longer than is good for them. As town life extends and intellect is aroused, the problem will be more and more that of too little, not of too much, sleep. Perfect, or nearly perfect, health is of course the first con- dition of sound sleep. But scarcely any one is quite healthy, and so we must aid the sleepless to acquire that which is lacking. The one great thing to do is to fatigue the atten- tion; not only to tire out the body, bat to fatigue the active mind, to quiet the vaso-motor centre and so drive the con- gested blood from the brain. Quiet and regular habits, a certain monotony of light evening occupation, will tend in this direction ; while a great variety of evening engagements is generally fatal to the victim of insomnia. It is unwise to go to bed on either an empty or a very full stomach; a slight meal before rest is the wise course. A hot bath the last thing, taken under the following conditions, is perhaps the very best aid to sleep :—" As recommended by Eccles and others, the bath should be taken in a room with a temperature of 65° to 70° Fahr. The patient should stand with his head over the edge of the tub, douching head and face with water at 100°. The cooling of the body by the air and the hot sponging of the head first send blood to the brain, dilating its vessels. Then the entire body, except the head, is immersed in a bath at 980, rapidly raised to 105' or 1100; in a few minutes the bath is left, and the body wrapped in blankets, which absorb the moisture, and with the least possible exertion the patient gets into his night clothes, and to bed, with a warm bottle to his feet, and perhaps a little warm liquid food." There is no better means than this for meeting the untold ills of insomnia, but the writer has also found the good old proverb of walking a mile after the last meal useful. It goes without saying that a late London dinner-party meets with absolute condemnation. On the other hand, we are glad to find the author very reasonable about sending children to bed very early and shoat early rising. Not a little harm has been done to mankind by forcing children to bed in broad daylight, and in routing people out of their warm beds to face the dank chill of an early winter morning. There is a mean between these applications of old " saws" and the case of a celebrated French mathematician who, in the latter years of his life, spent twenty hours in bed. The object of sleep is to restore nervous tissue ; as much sleep as is needful for that purpose is both good and necessary, but more is purely mischievous. The problem, the difficult problem, of modern life is to secure enough.
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