JHargarrt (Earnegt? Arraraum fa. ^309 7 F. 133 YOURS FOR SLEEP YOURS FOR SLEEP BT WILLIAM Sr WALSH, M.D. "Sleep, thou most gentle of the deities." Chrro NEW YORK ' >>'/>*'*. E. P. DUTTON AND COMPANY 681 FIFTH AVENUE COPYRIGHT, 1920, BY E. P. BUTTON & COMPANY All Rights Reserved Printed in the United States of America TO J. W. K. THIS VOLUME IS AFFECTIONATELY DEDICATED BY THE AUTHOR PHYSICAL toucAiioN DEPART KENT 23097 2052804 PREFACE THE object of this little volume is not only to help the sleepless sleep, but also to instruct them on a few of the principles of right living, a dis- regard of which is most often the sole cause of their disorder. For this purpose the more com- mon causes of insomnia are considered at some length. Many authors have been consulted, not only medical but lay also; for, as Oliver Wendell Holmes remarks: "Medicine, sometimes imper- tinently, sometimes ignorantly, often carelessly called 'allopathy,' appropriates everything from every source that can be of the slightest use to anyone that is ailing in any way, or like to be ailing from any cause. It learned from a monk how to use antimony, from a Jesuit how to cure agues, from a friar how to cut for stone, from a soldier how to treat gout, from a sailor how to keep off scurvy, from a postmaster how to sound the Eustachian tube, from a dairymaid how to prevent smallpox, and from an old mar- ket woman how to catch the itch insect. It rii viii PREFACE borrowed acupuncture from the Japanese, and was taught the use of lobelia by the American savage. It stands ready to accept anything from any theorist, from any empiric who can make out a good case for his discovery or his remedy." If this volume serves but a few of those who may read it the author will feel that his labors have been amply rewarded. W. S. W. "Beside the cloudy confines of the western night and the distant Ethiopians, there is a misty grove, impenetrable to the brightest star, and under the hollow rocks an immense cave descends into the bowels of the mountain, where sluggish nature has placed the halls of lazy sleep and the drowsy god. Motionless Rest and dark Oblivion stand on guard, and torpid Sloth with never wakeful eye. At the porch sits Ease and speechless Silence with close contracted wings, driving the murmuring winds from the roof, forbidding the foliage to rustle or the birds to twitter; here no roaring of the ocean, though all the shores resound, no crashing of the thunder; the stream itself, gliding along the deep valleys close to the grotto, rolls silently between the rocks and cliffs; the sable herds and flocks recline at ease on the ground; the newly sprung grass withers, and the vapors make the herbage languid. Glowing Vulcan has formed a thousand statues of the god within; close by is wreathed Pleasure; here, in attendance, is Toil inclined to rest; here the same couch receives Love and Wine; deep, deep within he lies with his twin-brother, Death, a sad image to none. Beneath the dew-bespangled cavern the god him- self, released from cares, crowned with drowsy flowers, lay on tapestry; his dress sends forth exhalations, his couch is warm with his lazy body, and above the bed a dark vapour rises from his half-shut mouth. The one hand sustains his hair hanging over his left temple, the other has dropped the horn unheeded." r STATIUS: Thebais, X, 84. PREFACE "It covers a man all over, thoughts and all, like a cloak; it is meat for the hungry, drink for the thirsty, heat for the cold, and cold for the hot. It is the current coin that purchases all the pleasures of the world cheap, and the balance that sets the king and the shepherd, the fool and the wise man, even." CERVANTES: Don Quixote. CONTENTS CHAPTER PAGE I. THE PHYSIOLOGY OF SLEEP .... i II. WAKEFUL DISORDERS OF SLEEP . . 18 III. INSOMNIA AND ITS CAUSES .... 36 IV. WORRY 50 V. NEURASTHENIA 78 VI. INDIGESTION AND CONSTIPATION . . 101 VII. HYPERTENSION AND ARTERIOSCLEROSIS 119 VIII. EYE DEFECTS 140 IX. DISEASES OF THE TEETH AND GUMS . 159 X. VALUE OF EXERCISE AND FRESH AIR . 180 XI. HYGIENE OF THE BED AND THE SLEEP- ING ROOM 196 XII. REMEDIES FOR SLEEPLESSNESS . . . 213 YOURS FOR SLEEP CHAPTER I THE PHYSIOLOGY OF SLEEP "What probing deep Has ever solved the mystery of sleep?" T. B. ALDRICH. "HALF our days we pass in the shadow of the earth, and the brother of death extracteth a third part of our lives." So said Sir Thomas Browne. But why an individual must sleep away one-third of his existence no one has yet satisfactorily explained. If abruptly asked the question, "Why do we sleep?" no doubt the first answer that would present itself to us would be, "Because the body needs rest." While it is true that the body needs, and must have, rest, what part of it does rest dur- ing sleep? Is it not true that, asleep or awake, the heart pumps its stream, that the lungs expire and inspire, that the stomach, liver, pancreas, and other organs perform their functions? More- over, is it not true that during sleep the skin ex- cretes practically twice as much as during the waking state; that even the nails and hair con- tinue to grow? Is not hearing still acute, as 2 YOURS FOR SLEEP proved by the fact that any sound capable of at- tracting our attention during the waking period will disturb the sleeper? If the eyes were open would we not see? Will not unsavory odors, or badly tasting material placed in the mouth, awaken the slumberer? Do we not all dream, which goes to show that the mind is not at entire rest? Do we not frequently change position, are we not conscious of pain, do not persons sleep on horseback, etc.? What part of the body, then, does rest during sleep? But before we consider this question, let us first consider some of the phenomena which take place during normal sleep. When we retire for the night we assume an easy attitude, with the muscles all relaxed. We close the eyes to shield them from sensory influ- ences. During sleep respiration becomes slower and less deep, the breathing being distinctly thoracic in character. Inspiration is prolonged and the normal respiratory pause is absent Mosso states that the amount of air inspired dur- ing sleep is one-seventh of that used during a period of quiet wakef ulness. Carbonic acid elim- ination is decreased, while the absorption of oxy- gen is increased. The heart beats more slowly, yet forcibly; the pulse is less rapid, and the gen- eral arterial pressure is lowered. The brain is THE PHYSIOLOGY OF SLEEP 3 anemic, while the blood supply to the skin is greatly increased, which accounts for the in- creased production of sweat. The internal temperature of the body is lessened. The move- ments of the stomach and intestines are en- feebled. All the secretions of the body are diminished, save those of the skin. Thus, while practically all parts of the body still function during sleep, we see that they are working more slowly than is their wont. Sleep is therefore, to use the words of Dr. Church, "a recurring necessary state of lessened muscular, mental, and organic activity, attended by comparative unconsciousness of surround- ings. No physical or mental function is entirely abeyant." Or, in the words of Marie de Mana- ceine, "sleep is the resting time of conscious- ness." Thus, "to sleep is to strain and purify our emotions, to deposit the mud of life, to calm the fever of the soul, to return into the bosom of maternal nature, thence to re-issue, healed, and strong. Sleep is a sort of innocence and purifica- tion. Blessed be he who gave it to the poor sons of man as the sure and faithful companion of life, our daily healer and consoler." (Amiel.) Why is sleep necessary? Because sleep en- ables the body to recuperate from the wear and tear incident to body activity, for during the waking period waste exceeds repair. We sleep because we must, else, die. Animals deprived of food for twenty days, and which have then lost more than half their weight, may still be saved by judicious feeding; but complete deprivation of sleep will cause their deaths in from four to five days this in spite of the most careful feed- ing and other care^ Loss of sleep is therefore worse than starvation. Just as we are still ignorant of many of the phenomena which occur during sleep, so are we also ignorant of the cause of sleep. Though ex- periments galore have been made by many scien- tists in an attempt to answer the question, we must still content ourselves with theories; few of which have sound scientific bases on which to rest, and none of which has as yet received uni- versal acceptance. All sorts of theories have been offered. Some have been so deficient in soundness as to receive no consideration. An example of these is the thyroid gland theory, in which it was claimed that a stasis of blood, which came from the brain, in this gland, caused sleep. That this is not true is easily proved. In total absence of the thyroid, hereditary or acquired, there is not an inability to sleep, as we would expect if this theory were THE PHYSIOLOGY OF SLEEP 5 true. On the other hand, such individuals com- plain of drowsiness and sleep most readily. The chemical theory had for a long time wide recognition. It was based on the claim that the accumulation in the system of the waste products incident to the body's activity served as toxins and sleep followed as a sort of narcosis. We know that sarcolactic acid is formed as a result of muscle work. If a series of electrical stimuli be sent into a muscle so rapidly that the muscle is not permitted to rest, the muscle will soon fail to contract, no matter how strong the stimu- li may be. This is mainly due to the accumula- tion in the muscle of sarcolactic acid, but if this substance be removed by washing the muscle in normal salt solution the muscle will again react. Sarcolactic acid was looked on as the toxic material which produced sleep. Since' waste results from work, if this theory of the accumulation of acid waste products were cor- rect, we would expect to find the lazy man sleepless and the hard worker never an in- somniac ; whereas, from experience we find the reverse is more often true. The biologic theory, formulated by Claparede, supposes that sleep is a defensive factor of the body, that it occurs whether we will it or no, and that its purpose is to ward off fatigue. Sleep, 6 YOURS FOR SLEEP according to this theory, was not always neces- sary, nor was it one of the phenomena of life. We are to suppose that man adapted himself to it to suit his environment. The best that can be said for Claparede's doctrine is that it is a theory, and while it will appeal to evolutionists, it can- not be proved. If faulty, the best theory as to the causa- tion of sleep is that which states that sleep is due to a cerebral anemia. We know that what- ever increases the blood supply to the brain in- hibits sleep, while such measures as draw blood away from the brain as a hot bath, a meal favor sleep. Moreover, in cases where a portion of the skull bone had been removed, either from necessity or for experimental purposes, data very much in accord with this theory were obtained. For instance, it was noted that when drowsiness came on the natural pinkish color of the brain became paler and paler. The brain also be- came reduced in size in consequence of the di- minished supply of blood to the organ. When sleep came on the brain was quite pale. If the sleeper were awakened, it was observed that the brain surface quickly assumed its waking color, that its volume increased likewise, and that mi- nute blood vessels, unseen during sleep, stood out prominently. If the subject again returned to THE PHYSIOLOGY OF SLEEP 7 sleep this state of affairs was reversed. Just how this anemia of the brain is produced that is, what substance or substances influence the nerves controlling the caliber of the cerebral blood ves- sels so as to render that organ anemic we do not know. But inasmuch as the theory has a physio- logical basis it seems worthy of acceptance, pend- ing positive contributions to our knowledge on the subject of sleep. Many other theories, such as the neuron theory which supposed that the connecting links be- tween the nerve endings were severed by means of some chemical substance, this separation of the nerves producing sleep, were at one time or other advanced. All have had their heyday of credulity and incredulity. It will, I think, be of more profit to us to consider some questions which can be answered more dogmatically, such as, How much sleep is necessary? Kant, I believe, derided the necessity of sleep and strove to do with as little of it as he could. We have many examples of characters, famous in the world's history, who have done good work on a minimum of sleep. But while it is well to emulate good example, the example of all men, no matter how prominent they may be, is not to be followed without question. "One man's meat is another man's poison." Because Thomas 8 YOURS FOR SLEEP Edison can work brilliantly on a few hours' sleep, we are not to imagine that we can do like- wise, for our nervous organizations and physical stamina may not be able to stand the strain. It may be interesting to consider the time al- lotted to sleep by some oft-quoted men. Thus, Jeremy Taylor devoted to sleep but three hours out of every twenty-four; Dr. Reid, the meta- physician, could work unceasingly for two days if he got one sound sleep after a full meal; Baxter allowed four hours; Frederick the Great and John Hunter required only five hours' sleep ; Wesley took six hours' sleep ; Sir William Jones, seven; Sir John Sinclair, Dr.Elliotson, Bismarck and Gladstone, eight; Zola, seven. The First Napoleon and M. Thiers slept little, but could command sleep at any time, whether fatigued or not. Lord Brougham, Goethe, Humboldt, Mirabeau, Charles XII, the Duke of Welling- ton, Vergil, Horace, Franklin, Priestly, Park- hurst, Buffon, Sir Thomas More, and many others, could work on less sleep than the vast ma- jority of us need. Temperamental differences, habit, circumstances, etc., explain why so little sleep sufficed these men. Tyrus Cobb, the most famous living baseball player, figures on getting plenty of sleep. He says: "My idea of the best way for anyone, THE PHYSIOLOGY OF SLEEP 9 whether athlete or business man, to keep in good trim is to be careful not to eat too much or sleep too much. I always figure on getting nine hours of sleep." Sam Crawford, ex-team mate, and an athlete of no mean renown, says: "The old saying, 'Early to bed and early to rise,' sounds good to me. I am generally in bed at ten o'clock and up at seven. That gives me nine hours of sleep, and that seems to be about the right amount for stor- ing up energy for use the next day." John Burroughs, the naturalist, who at seventy-seven said he was in better health and more able to work than he was at forty-seven, goes to bed at nine in the winter and is up at six; in the summer he gets up with the sun. Amelia Barr, when in her eighty-third year, went to bed between eight and nine in the even- ing and remained there ten hours, even though she slept but seven. Cardinal Gibbons, whose rules of health are regularity of life; moderation in eating and drinking; exercise; avoidance of worry; and an ever-abiding trust in God's providence, finds from experience, in his own case, that eight and a half hours' sleep at night, with a half-hour's siesta in the afternoon, are necessary. He advises the young to seek enough sleep, since regularity io YOURS FOR SLEEP in that respect insures a long life. Like Barr, even if he does not sleep the whole time he is in bed, he is satisfied with the rest he procures. He prescribes a good day's work for a long and refreshing repose. As a general rule, children require more sleep than adults. While there is little destruction of tissue, growth is rapid, and between growth and repair there is not much essential difference. For the first few days of its existence, the newly born infant sleeps profoundly and almost continu- ously. During the first few weeks, a healthy in- fant sleeps from twenty to twenty-two hours out of the twenty-four. During the first six months, the infant will usually sleep from sixteen to eighteen hours a day. At one year, an infant will sleep eleven or twelve hours at night, and two or three hours during the day; at two years, eleven or twelve hours at night and one or two hours during the day. At four years, twelve hours' sleep is necessary. From six to ten, ten hours' sleep is required, and from ten to sixteen, at least nine hours'. As a rule, adults require from seven to eight hours' sleep out of every twenty-four. Women can do with less sleep than men. In old age the requirement is less. In cold climates more sleep is required than in warm or temperate climates. THE PHYSIOLOGY OF SLEEP n All good rules have their exceptions. The amount of sleep that our own individual make- ups require should be studied. Too much sleep is almost as detrimental as too little sleep. The former tends to weaken the vital processes, to favor the accumulation of waste material, to dis- turb the proper correlation between anabolism and catabolism, and to promote a general leth- argy of mind and body. Too little sleep, on the other hand, puts the body in a state of tension, and is quickly detrimental if long continued. There is an adage to the effect that "early to bed and early to rise, makes a man healthy, wealthy, and wise" ; which leads us to consider the proper hour for rising and retiring. The darkness, stillness, and cessation of busi- ness render night the most favorable and the most convenient time for repose. There are, however, many living things such as the owl, the moth, the bat which work at night and sleep in the day. Many persons find it difficult, often impossible, to sleep in the daytime, but this is mainly due to the effects of light and noise, which arrest the attention and so thwart cerebral quiet. But if the light and noise be such as would not arrest the attention during the waking period, sleep is possible to these. Moreover, one can 12 TOURS FOR SLEEP become accustomed to the effects of light and noise such as are wont to disturb sleep, provid- ing the individual is not by nature a light sleeper, or is not neurotic. Attempts have been made to prove that day sleep is not as beneficial as night sleep, and that night workers suffer thereby. This is not true, however. If the night worker works no more than he ordinarily would in the daytime, if he does not use stimulants to keep himself awake, and if he procures his requisite amount of sleep with daily regularity, no harm is evident. Night policemen, engineers, and conductors on night trains, etc., are, as a rule, well physiqued and healthy. Fielding, the author and poet, is responsible for the proverb, "One hour of sleep before mid- night is worth two after." Considering the fact that most of us have to arise at a certain hour, so as to be at our daily work in time, it necessarily follows that if we do not retire until after midnight we are not apt to procure enough sleep. Moreover, it is not work which keeps men from their beds until the wee sma' hours of the morning, but more often dissipation. From a physiological point of view, Fielding is not supported. The first few hours of undis- turbed sleep, no matter when obtained, are usu- THE PHYSIOLOGY OF SLEEP 13 ally the deepest, the most valuable, and the most refreshing. There is a popular idea that sleep before mid- night tends to favor the development of beauty. If we are to believe Crabbe, whose Parish Regis- ter endeared him to all lovers of poetry, no sleep is beautifying. He says: "Beauties when disposed to sleep Should from the eye of keen inspection keep: The lovely nymph who would her swain surprise May close her mouth, but not conceal her eyes: Sleep from the fairest face some beauty takes, And all the homely features homelier makes." Crabbe was a good poet, but it must have been that his artistic eye was jaundiced when he made the above observations, else the paintings of "Sleeping Beauties," and legendary stories of such a nature, were founded on dreams and not reality. All sleep is beautiful and beauty-giving, save excessive and unnatural sleep. There is no reason why sleep before midnight should be more beauty-giving than sleep obtained at other times ; nor is it. It is wise to regulate the hour of retiring and of rising according to the season of the year. To awake early on a dark, cold, wintry morning does not fill anyone with too joyful thoughts; but i 4 YOURS FOR SLEEP when the springtime is at hand, the chirping of the birds, the balminess of the air, the verdure of the foliage, and a certain indefinable sweetness invite us to jump out of bed, seek the open, and revel in its delights. The awakening of children in the early morning hours, when artificial light must be used, is bound to prove detrimental. There is no good in sending children off to bed immediately after the evening meal. When na- ture's cry for sleep is satisfied they awake, no matter how early it may be, and thus the rest of the remaining members of the family becomes disturbed. Determine the amount of sleep they require and put them to bed at an hour that will have them awake at, or after, the parents' awak- ening. System is the life of trade and the life of life. Good habits are harder to form than bad ones, but once formed they become a pleasure instead of a hardship. In the winter, if we are naturally good sleepers, we should go to bed later than usual but earlier in summer, so as to avoid the dismal morning aspect of the one and enjoy the cheeriness of the other. Those troubled with disturbed sleep should particularly bear in mind the importance of re- tiring at a definite hour regularly. Moreover, they should have a definite time for arising. The THE PHYSIOLOGY OF SLEEP 15 taking of second naps in the morning is not ben- eficial. It is the lazy man's habit. When the appetite for sleep has been appeased a call is sent to consciousness to arouse. The belt is thrown on and you awake. Nature is ready to start the working day. Naps during the day- time are of no value to the insomniac. What the latter most desires is an ability to sleep at night, and day naps are not conducive to such. On what side of the body should we sleep? Most people prefer the right side, but this is largely a matter of habit. Popular opinion favors the right side because it is claimed that by this cardiac action is not embarrassed and the emptying of the stomach is facilitated. Some ob- servers think that the reason inflammation of the right lung is more frequent than that of the left is due to the fact that lying on the right side favors stasis of blood on that side. Pneumonia is very common on the right side. Inflammation of the bases of the lungs occurs more often than inflammation of the apices. We appreciate the fact that tuberculosis is not of frequent occur- rence in persons suffering from heart disease, ex- plained in part, at least because the venous stasis in the lungs is not favorable to the growl i of the tubercle bacilli. It may be that the up- right position during the day and the lying on 1 6 YOURS FOR SLEEP the right side at night protect the bases of the lungs from invasion by tuberculosis, but weaken the apices by lessening its blood supply. Tuber- culosis practically always starts in the apices of the lungs. Sleeping on the back is a fruitful source of dreams, probably due to interference with the cerebral circulation, secondary to a compression of the abdominal aorta by the viscera. Which side to sleep on is, after all, but a minor point. We must choose one side, and there is no weighty reason why one side is not as good as another. A peculiar fact is that during sleep the sense of time is greater than when we are awake. Ex- periments conducted some years ago showed that fifty-nine per cent, of the subjects examined were able to awake in the morning at any time they had decided upon the night before. If any of us decided to call up a friend on the 'phone at a cer- tain hour during the day, if no timepiece were at hand not one in a hundred would fulfill his promise at the designated time. Another curious fact is that the further removed from the brain a part of the body is the less soundly does it sleep. A touch on the toe will awaken one more readily than a touch on the head, a point which police- men seem to have grasped. Sleep has been often likened to death. "Sleep," THE PHYSIOLOGY OF SLEEP 17 says Sir Thomas Browne, "is death's younger brother, and so like him, that I never dare trust him without my prayers." "Sleep," says Donne, "doth fulfill all offices of death save to kill." Many other references might be quoted, but the likeness, if any exists, is more poetry than truth. "Our life is twofold ; sleep has its own world, A boundary between the things misnamed Death and Existence; sleep has its own world." BYROK. CHAPTER II WAKEFUL DISORDERS OF SLEEP "Dreams are but interludes, which fancy makes; When monarch reason sleeps, this mimic wakes." DRYDEN. THE wakeful disorders of sleep are insomnia, troubled dreams, including certain allied con- ditions, as pavor nocturnus, nightmare, and somnolentia, somnambulism and nocturnal en- uresis. The latter cannot truly be classified as a wakeful disorder of sleep, but since it causes much concern to anxious mothers it may be well for us to consider it in this connection. Insomnia, because of its greater frequency, and, therefore, relatively greater importance, will be taken up in the following chapter. Dreams From time immemorial dreams have been regarded with a superstitious awe and mys- terious majesty, not only by the ignorant but the erudite as well. Nor are the views propa- gated by such once mighty men as Panyasis Hali- carnassensis, Achmet, Artemidorus, and many other sages relegated to oblivion; though aged and devoid of much truth, we still have them, 18 WAKEFUL DISORDERS OF SLEEP 19 though clothed in up-to-date garments. Posing as being possessed of supernatural powers, the fortune teller acquaints us with the information that our dreams, properly interpreted, as they alone are competent to do, will give us a knowl- edge of life and death, riches, health, and what not. The only power these present-day sooth- sayers are endowed with is a remarkable adapt- ability in separating the gullible from their money. While it is true that from the nature of a person's dreams a scientist may be able to deduce some idea concerning the individual's health, such facts as are learned are learned by natural methods. He who claims supernatural powers is a fool, a charlatan, a monomaniac, or one de- luded. Hippocrates, styled the father of medicine, and many of whose doctrines still remain true, and who lived from 460 B. C. to 357 B. C., has the following to say concerning dreams: "He who forms a correct judgment of those signs which occur in sleep will find that they have a great efficacy in all respects; for the mind is awake when it ministers to the body, be- ing distributed over many parts; it is not then master of itself, but imparts a certain portion of its influence to every part of the body, namely, to the senses, to the hearing, seeing, touch, walk- 20 YOURS FOR SLEEP ing, acting, and to the whole management of the body, and, therefore, its cogitations are not then in its own power. But when the body is at rest, the soul, being in a state of movement, steals over the organs of the body, manages its own abode, and itself performs all the actions of the body; for the body, being asleep, does not per- ceive, but the soul, being awake, beholds what is visible, hears what is audible, walks, touches, is grieved, reflects, and, in a word, whatsoever the offices of the soul or body are, all these the soul performs in sleep. Whoever, then, knows how to judge of these correctly will find it a great part of wisdom. But with regard to such dreams as are divine, and prognosticate something, either good or evil, to cities, or to particular people, there are persons who have the art of judging of them accurately, without falling into mistakes. But such affections of the body as the soul prog- nosticates, namely, such as are connected with repletion and evacuation, from the excess of cus- tomary things or the change of unusual things, on these also persons pronounce judgment. And sometimes they succeed and sometimes they err, and understand not how this happens, that is to say, how it comes that sometimes they are right, and sometimes they fall into mistakes; but warning people to be upon their guard lest WAKEFUL DISORDERS OF SLEEP 21 some mischief befall them, they do not instruct them how to guard themselves, but direct them to pray to the gods ; and to offer up prayers is no doubt becoming and good, but while praying to the gods a man ought also to use his own exer- tions. With regard to these, then, the matter stands thus : Such dreams as represent, at night, a man's actions through the day, and exhibit them in the manner in which they occur, namely, as performed and justly deliberated, these are good to a man, and prognosticate health, inasmuch as the soul perseveres in its diurnal cogitations, and is not weighed down by any repletion, evacua- tion, or any other external accident. But when the dreams are the very opposite to the actions of the day, and when there is a conflict between them when this happens, I say, it indicates a disorder in the body; when the contrast is great, the evil is great, and when the one is small, the other is small also." Whatever we cannot understand and which cannot be explained we attribute to supernatural agencies. Every true Christian believes that he has a soul, but while much of the above is true, we will be pardoned, I think, for doubting the soul's influence in causing dreams. Somewhat in accord with Hippocrates' belief is that of certain pseudo-psychologists who form- 22 YOURS FOR SLEEP ulated the doctrine that, during a dream, the soul leaves the body and on its return remembers all that it has met with in the spheres it visited. On this presumption Comenius and Swedenborg established religions, Swedenborg greatly influ- encing his followers by claiming that in a dream he visited paradise. In olden days, good folk were wont to believe that during the act of sneezing the soul left the body, and that if it did not quickly return its place would be taken by an evil spirit. To ward against such a ca- tastrophe such charms as saying "God bless us" were used to drive away the creature of evil, which custom is still preserved among peasant folk. This latter belief is quite in accord with that of the pseudo-psychologists concerning dreams. It is a remnant of a superstitious age, and superstition will never die as long as igno- rance abounds. It will be hard to convince believers in the Bible to forswear allegiance to the idea that dreams are supernatural. In the Bible two varieties of dreams are referred to, namely, natural and supernatural dreams. "A dream cometh through the multitude of business" and "For God speaketh once, yea twice, yet man perceiveth it not. In a dream, in a vision of the night, when deep sleep falleth WAKEFUL DISORDERS OF SLEEP 23 upon men in slumbering upon a bed: then he openeth the ears of men and sealeth their instruc- tion," respectively exemplify each variety. God works in wondrous ways. We have no means for ascertaining whether the various miraculous and prophetic dreams recorded in the Holy Writ were God-sent or just material images. How- ever, it does seem plausible that many of the dreams there and elsewhere narrated became actualities either because of coincidence or that the dreams stimulated the dreamers to definite lines of action, which, for a reason we cannot al- ways fathom, proved fruitful. The dreams of Judas Maccabaeus, of Scylla, of Germanicus, to quote only a few, are examples of such. There are, however, innumerable cases on record of prophetic dreams which many of us may attempt to explain, but unsuccessfully. Be these problems as they may, from a medi- cal point of view dreams have much weight. It is probably true that entirely dreamless sleep does not occur, which assertion, unfortunately, cannot be proved. But it is a fact, nevertheless, that it is only the well who have happy, con- tented dreams ; while the sick, mentally or physi- cally, suffer from dreams of an exciting or de- pressing nature. So, even if dreams are sym- bolic of naught else, they are the ways and the 24 YOURS FOR SLEEP means of indexing an individual's state of health, if the dreams are properly studied. In hysteria, neurasthenia, and in melancholia, particularly, dreams of a depressing or otherwise disturbing character are frequently present. An increased supply of blood to the brain, as is seen in inflammation of that organ, arterio-sclerosis, mental excitement, etc., stimulates the brain to extra endeavor and excitable dreams are apt to ensue. Impoverished blood, or the circulation in it of toxic substances, introduced from without or within, interferes with the nutrition of the brain cells, giving rise to dreams generally of a depressing character. Certain physical states are prone to modify the nature of a dream. Thus sensations of pain, in- digestion, an uncomfortable position in bed, are liable to produce dreams of monsters, falling over precipices, etc. Indigestion and impair- ment of the respiratory or cardiac action, make the dream partake of the nature of a nightmare. Pleasing sounds falling on the ear of a sleeper may stir up fancies of the opera, or the buzzing of a mosquito may suggest warfare. Opium and cocaine are reputed as giving their habitues very pleasant dreams, but the pitiable wretches who have been lured into the vice by the stories of De Quincey and others find that this is not al- WAKEFUL DISORDERS OF SLEEP 25 ways the case. Drugs used to promote sleep cause unpleasant, horrifying dreams in certain subjects. Alcohol produces delirious dreams, while Indian hemp and bisulphide of carbon give rise to dreams of murder. Troubled dreaming, associated with disturbed sleep, indicates a low vitality. All dreams not pleasurable in nature and which are remembered, are detrimental in many ways. They interfere with sleep, or, if the sleep remains unbroken, the nutrition and repair going on at the time deviates from the normal. Again harassing dreams may be equivalent to a shock received during the wak- ing state. It therefore behooves such sufferers to give the condition the attention which it deserves. The correction of bad habits of eating or sleep- ing may be all that is necessary, or the disorder may not respond so readily because of a mental problem requiring solution. In any case, a physician should be consulted. Nightmare is a particularly vivid dream, in which the sufferer is oppressed by a sensation of suffocation, of falling, and of great weight in the chest. During the attack the individual may ex- perience a variety of distressing feelings; thus, he may be falling down a mountainside, unable to use hands or legs in an attempt at saving him- self ; he may be pursued by an assassin, by a wild 26 YOURS FOR SLEEP animal, a spirit, or may be about to be horribly tortured, when he awakes with a loud cry and considerable fright. Nightmare is dependent upon some disturbance of the general health, or is the effect of some very vivid mental experi- ence. Indigestion, overeating, bad ventilation, indulgences of any kind, mental shock, worry, etc., are predisposing factors. Lying on the back with the head low may induce an attack. A cure depends upon removal of the cause. Since indigestion, though overrated, may be an etiological factor in its causation, overeat- ing, especially of heavy or indigestible foods, particularly before retiring, is to be absolutely forbidden. Certain articles of food are prone to cause nightmare in certain persons ; it goes with- out saying that if the palate be served in such cases it is at the expense of the individual, who deserves no pity. With nightmare I have had some personal ex- perience. The first attack I remember distinctly. Tired of reading, and, in truth, mentally and physically played out, I threw myself across my bed with the intention of procuring a little rest before dinner. I soon fell asleep, however, but was shortly awakened by some noise which I later took to be the footsteps of a fellow lodger along the hallway, and who was coming in the WAKEFUL DISORDERS OF SLEEP 27 direction of my room. I tried to rise, but all power of motion seemed to have left me, sensa- tion likewise. Hearing, vision, and conscious- ness remained undisturbed. I tried to stimulate my will to control my muscles but again failed, and this time, more or less frightened, endeav- ored to call for aid, only to find that I could not move my mouth, let alone talk. Meanwhile, it seemed as if hours were passing instead of sec- onds. A sudden rap upon my door roused me to activity. On another occasion I went through the same unwelcome experience. I am inclined to think that overwork was responsible. The condition is often called nocturnal paralysis. Pavor nocturnus, commonly known as "night terrors," is a condition only found in childhood, sleep being disturbed, one or more hours after going to sleep, by fright. There are two classes of cases. The first class resembles nightmare and is quite common. The child awakes considerably frightened and excited, but the mind is clear, and parents and surrounding objects are readily and accurately recognized. The child will usually say that he has had a bad dream. The causes are those which produce disturbed sleep in child- hood, chief among which are indigestion, ade- noids, enlarged tonsils, poor ventilation of the 28 YOURS FOR SLEEP sleeping room, malnutrition, exciting stones be- fore bedtime, etc. When the disturbance first puts in an appearance the child should be taken to a physician. The cause for the nocturnal at- tacks may be simple and easily remedied; while, on the other hand, it may be of a serious nature, and require the most careful and prolonged treatment of a specialist. In passing, it may be well to call parents' attention to the fact that children who cry out in the night but who are found sleeping when the parent reaches their side may be suffering from hip disease. Taken early in hand this disease is curable, but if long neglected is only cured after years of trying treatment and with the possibility of a perma- nent deformity. In the second class of night terrors the child is usually found sitting upright in bed, in a very dazed condition, and terrified of a "dog," a "cat," a "bear," or other dream vision or hallu- cination. The objects seen are usually described as being of a red color. The child may run about the room, climb up on bureaus, escaping from the pursuing object of the dream. He can- not be quieted readily, but after a few minutes will return to bed and go to sleep as if nothing had happened. There is no waking recollection WAKEFUL DISORDERS OF SLEEP 29 of the occurrence, and usually no after effects are suffered. The attacks may occur once every few weeks or at intervals of several months. This type is of a very serious nature, inasmuch as it indicates an unstable nervous system. It is of frequent occurrence in children of neurotics, and is one of the stigmata of degeneracy; it may be a forerunner of epilepsy, hysteria, or even in- sanity. No one but a physician is competent to treat this important malady, but in general the child should lead a quiet life, free from mental, nervous, or physical excitation. It is well that someone sleep near the child to prevent accident befalling it. There are many other disorders of sleep as- sociated with or bearing a relation to dreams. Thus the dream state may be cast into the wak- ing state for a long or short period of time. The dream may end in convulsions. A person may, on being awakened from a deep sleep, be maniacal and do acts of violence, for which, of course, he is not responsible. The latter condition is known as somnolentia, or sleep drunkenness. These disturbances are indicative of neurotic in- stability. In somnambulism, of which sleepwalking is the most prominent manifestation, the individual acts his part of a dream. The eyes may be open 30 YOURS FOR SLEEP or shut, and without seeing, the sufferer may per- form most difficult and dangerous actions, but in such a cautious manner as to lead one to be- lieve that all consciousness is not asleep. The individual adapts himself to circumstances, and such acts as are performed are only those which pertain to the dream story. The subjective powers are increased; extraordinary tactile sen- sibility may be combined with anesthesia. In the somnambulistic attack persons have per- formed almost incredible acts, such as they would never think of in the waking existence. They have climbed mountains, walked along the roofs of houses, and have committed murder even. Again, they have gone about their customary daily work, and, strangely enough, the work done is often superior to that accomplished at other times. They usually have no recollection of the attack on the following day. Somnambulism may be inherited and is a neu- rotic stigma. It generally first appears around puberty. The sexes are equally attacked. The sensitive and excitable are predisposed to it. Mental overwork, stories of sleepwalking, oreven a study of the subject, may bring on an attack. An attack may be stopped by a sudden jar, a dash of cold water in the face, clapping of the hands, pressure over the supraorbital foramina, WAKEFUL DISORDERS OF SLEEP 31 etc. It is not always advisable to do any of these things, inasmuch as in highly nervous subjects the shock produced is often seriously harmful. Much can be done either in curing the affection or in, at least, ameliorating the number of at- tacks. The general nervous system should first of all receive attention. A firm determination on the part of the afflicted not to walk in sleep may produce a cure. Children who suffer from the disorder should receive at bedtime a cold spinal douche and be told that the object of it is to stop them from walking in their sleep. Or some other simple procedure may be followed, but the child must be forcibly impressed that it is able to ward off somnambulistic attacks. To stimulate them toward recovery they should be promised re- wards, but are never to be punished. In adults all methods of treatment sometimes prove fruit- less. In such cases precautions are necessary lest accident befall the individual. Talking in sleep is a minor form of somnam- bulism. Double consciousness, a condition in which, during the waking period of the individ- ual's existence, he leads two distinctly separate lives, is somnambulism in its highest form. Those familiar with the story of Dr. Jekyll and Mr. Hyde will have no difficulty in understanding the meaning of the term. It is generally accepted ,32 YOURS FOR SLEEP that one of the personalities is pathological. Hysterics occasionally develop a double per- sonality, and a hypnotic double personality may also occur. In connection with some forms of psychical epilepsy the patient may act for days, weeks, or for only a few minutes in a man- ner entirely foreign from his normal self. Double consciousness represents a disturbed mental state. Another disorder which is common in neurotic children, but which may also be found in hys- terics, epileptics, neurasthenics, and neuropaths, is nocturnal enuresis, or bed wetting. In some cases it is a partial somnambulism. The act is not occasioned simply by a relaxation of the sphincter of the bladder, but the patient dreams he is passing water and, acting his part of the dream, propels the stream with much force. Just what occasion dreams of this nature cannot al- ways be ascertained. Internal sensations or ex- ternal causes, as light, friction, heat, may be re- sponsible. In general, incontinence of the urine in chil- dren is due to any deviation of the system from the normal. It may be caused by a too highly acid urine, to local irritation of the genitals, pin- worms, inflammation of the rectum or of the urinary passages, anemia, malnutrition, spinal WAKEFUL DISORDERS OF SLEEP 33 diseases, etc. Heredity is sometimes very notice- able. In many cases no cause can be discovered. A serious mistake which many mothers make is to punish the child because of the disorder. One little lad, because of frequent punishment, sought to escape more by tying a cord about the genital organ, with the result that gangrene set in. The child is not to blame because of the condition, and punishment serves only to aggra- vate it. Kindness is a valuable medicine, one which can be given and taken ad libitum, with only the best results. There is much that can be done to alleviate, if not cure, the affection. The diet should consist of milk, vegetables, fruits, cereals, and a small amount of meat. Tea, coffee, beer, sweets, highly seasoned foods and fried foods are contraindi- cated. A promise of reward and the giving of some simple substance at night, as a mint tablet, with the declaration that it will cure the trouble, creates a psychical impression which often cures. The emptying of the bladder before going to bed and the elevation of the foot of the bed so as to prevent the urine from irritating the bladder neck are also efficacious. The spinal douche at bedtime, followed by a brisk rubdown, is highly beneficial, especially if the child be sufficiently impressed with its value. The best tonics for 34 YOURS FOR SLEEP the child are fresh air and good, substantial food. Life in the country is contributory to re- covery. Water should be withheld for a few hours before bedtime. Drugs should only be administered by the physician. Sleep ptosis, a condition in which there is a difficulty in opening the eyes on awakening, sometimes occurs in individuals whose nervous systems are below par. It is part of a general muscular weakness, and disappears with the re- moval of, or an improvement in, the underlying disorder. Anemic persons, excessive users of tobacco or alcohol, sufferers from gout, diabetes, neuras- thenia, etc., sometimes awake with a sensation of pricking or numbness in the limbs. Cramps, pain, and loss of power may be present in the affected members. It may occur any time the individual goes to sleep, night or day, and may last for years. The condition is known as acroparasthesia. An attack may be removed by heat, friction, or exercise, but a cure can only be effected when the cause is removed. With the possible exceptions of sleep ptosis and acroparasthesia the various disturbances of sleep enumerated above are important, not only because they interfere with sleep, but because they are indicative of underlying disease. They, WAKEFUL DISORDERS OF SLEEP 35 are signposts warning the sufferer of danger. The longer they remain untreated the more dif- ficult they are to cure. It therefore behooves whosoever is afflicted with any of these ailments to procure the best medical attention he can. De- lays are always dangerous, but profitable not only to the physician but the undertaker as well. "Fly, dotard, fly! With thy wise dreams and fables of the sky." HOMER. CHAPTER III INSOMNIA AND ITS CAUSES "How many thousands of my poorest subjects Are at this hour asleep! O sleep, O gentle sleep, Nature's soft nurse, how have I frighted thee, That thou no more wilt weigh mine eyelids down, And steep my senses in forgetfulness?" HENRY IV. INSOMNIA, briefly defined, is an inability to sleep the average length of time. It manifests itself in various ways. The individual may go to bed tired, and apparently well prepared to sleep, but in spite of all his efforts, or rather be- cause of them, sleep does not come for one, two, or more hours, but once it does come the indi- vidual sleeps soundly until morning. During the time he remains awake, the sufferer may be tranquil in mind or, as is more often the case, peevish and fretful. He may be conscious of the fact that it is pain, worry, or other cause that keeps him awake but in other cases the indi- vidual is mentally quiet and cannot fathom the reason for his sleeplessness. This type of in- somnia is frequent in those given to worry, ner- vousness, or who are over-fatigued. 36 INSOMNIA AND ITS CAUSES 37 On the other hand, the person may readily go to sleep, only to awake in the early morning hours. He may, after an hour or two, again go to sleep; but, as is usually the case, once awak- ened, no more sleep is granted. This type of in- somnia may be due to distressing dreams which the sufferer remembers, either wholly or in part, to the effects of light or noise, to physical discom- forts, to habits, etc. In so far as habit is con- cerned, if one awakes on one or two occasions at a certain time a tendency is formed to awake regularly at that hour. The majority of us, even though our sleep has never been disturbed, can by resolving to awake at a certain hour fulfill that resolve. However, unless we encourage the practice by getting up when we awake this power may be lost. A nervous individual, on the other hand, is inclined constantly to preserve it. He may have been awakened in the early morning hours, by reason of some discomfort, and experi- enced difficulty in again going to sleep. The matter is not treated lightly, but causes much con- cern. His last thought at night is that he will awake too early, and in a person of his tempera- ment this autosuggestion does that very thing. If, on the other hand, he made up his mind that he was going to pass the night undisturbed the chances are that he would. Some individuals 38 YOURS FOR SLEEP have gotten into the habit of getting up at night to smoke; or during a temporary period of in- somnia, have been able to put themselves to sleep by drinking a glass of 'milk, etc. Insomnia is thus maintained, and unless corrected may last a lifetime. There are other individuals who, under a broad conception of the term insomnia, may be said to be insomniacs, who sleep fitfully, and remember having awaked several times dur- ing the night for short periods. Others are only conscious of the fact that their sleep has failed to bring them refreshment; they awake feeling practically as tired as when they went to bed. Sleep is a natural process, opinions to the con- trary notwithstanding. Normal sleep is a gift which we all have had at one time or other, and may still have. There are few insomniacs who can truthfully say that they have never enjoyed such sleep as visits the majority of their fellows. We make sleep a habit, but it differs from all other habits in that it can be easily broken. Nev- ertheless, there are some persons who can abuse this priceless possession continually, almost, and yet not suffer its loss. They are, as a rule, well fortified by physical and mental vigor, and de- void of neurotic stigmata. It would appear that insomnia is not only dependent upon the various INSOMNIA AND ITS CAUSES 39 physical and other general causes that may pro- duce it, but on an underlying nervous instability. In fact, most of the sufferers from insomnia are neurotic. Their insomnia may have begun at a certain time, and may be ascribed to a more or less definite cause; but if a careful study were made of the individuals it would be found, very often, that prior to the insomnia they suffered from, or gave evidences of, nervous inferi- ority. In another place it has been stated that loss of sleep is worse than starvation; an animal experi- ment in proof of this has been quoted. It may also be added that experiments on men have shown that deprivation of sleep for about ninety hours was productive of hallucinations of sight, decreased strength, defective memory, etc. We might go further and state that it used to be, and may still be, a practice of the Chinese to punish criminals by keeping them constantly awake, and that as a result horrible tortures were ex- perienced by such unfortunates; that Tous- saint L'Ouverture, commander-in-chief of the Haytians, reduced Napoleon First't army of 30,000 veterans to 5,000 effectives simply by feigning attacks when the army was asleep. However, there is a vast difference between in- somnia and absolute or almost absolute depriva- ,$0 [TOURS FOR SLEEP tion of sleep, which latter the above cases illus- trate. The pale, thin, fatigued-looking girl who frequents dance halls and exerts herself far into the night is generally able to sleep when her head strjkes the pillow. Her anemia and weak- ness are due to many causes. Over-exercise causes an increased destruction of body tissue; the poor air of the dance hall deprives her of proper oxygenation of the blood; she returns home fatigued, procures a few hours' sleep but not enough for her body's needs, goes to work fatigued, becomes more fatigued as the day pro- gresses, becomes stimulated with the night by a contemplation of her favorite diversion, and, in- stead of paying yesterday the sleep she owes it, contracts new debts. She has not given her body a chance to keep harmony; work has exceeded rest; destruction has exceeded repair. The vital processes become weakened. Becoming over- heated, over-fatigued in the dance hall, she is unmindful of precaution; the change from the stuffy dance hall to the outside air, because of her weakened resistance, causes a cold, which cold may later develop into tuberculosis. She dies, and is held up as a horrible example of the effects of loss of sleep. True, she is an example of such, but not of in- somnia. If this girl had been an insomniac, and INSOMNIA AND ITS CAUSES 41 had acted as she did, her obituary notice would have been written long before. She suffered, in so far as sleep is concerned, because she denied herself her requisite amount of sleep. But even if she were troubled with insomnia, if she set aside seven hours each day to be spent in bed con- tinuously, no matter if not all of them were blessed by sleep, she would have maintained health. The few hours of sleep that she did procure, added to rest, would have sufficed her needs. Insomnia does not kill, per se; neither does it undermine the health. Many individuals who by reason of influenza have been afflicted with intractable insomnia, or who are hereditarily poor sleepers, do not suffer because of it. They give the matter little or no concern. They have a schedule for the night; so many hours to be spent in bed regardless of whether sleep visits them or not. It is the worry over insomnia that kills. Add to this deprivation of rest. Fretful because sleep does not come, the sleepless one reasons that there's no use of going to bed; he works far into the night, walks the floor, or makes himself miserable by his gloomy thoughts. Consequently his health becomes undermined. But if he did go to bed and remained there for seven or eight hours, and kept his mind tranquil, 42 YOURS FOR SLEEP he'd not only always feel competent for mental and physical work, but also maintain health. Insomnia, however, is not to be crowned with a laurel wreath ; not one of us hails it as a friend, though we will as a conqueror. We are all too fa- miliar with the balm of sleep to praise sleep's foe. Nevertheless, we should not form an er- roneous idea of insomnia's supposed ill effects. It is because insomnia tends to occasion worry, and to prompt one to neglect rest, that harm is done the individual. The insomnia may precede the worry, in which case the first causes the second. Or the worry may precede and be the cause of the insomnia; in this case the insomnia gives birth to new worries. But free insomnia from worry and there will be less reason to ascribe to it so many dire consequences. When one comes to consider the various fac- tors capable of producing insomnia he has as- sumed quite a task, for there is no disturbance of the system, whether mental or physical, that is not capable of producing the disorder. One fact that we should be mindful of is that insomnia is not a disease, per se, but simply a warning of some underlying trouble. Remove the underlying cause and the insomnia will take care of itself. In infancy and childhood disturbed or rest- INSOMNIA AND ITS CAUSES 43 less sleep is more common than true insomnia, though both conditions may exist and the causes of each may be the same. The commonest causes of such are hunger and indigestion, the result of bad habits, as exciting games before bedtime, frightening stories, rocking during sleep, irregular feeding. It may result from dentition, pain in any part of the body due to any cause, as the pain of inflammation of the middle ear or the pain from diaper pins. Fully one-half of the cases in later childhood are due to indigestion, the most frequent type being chronic intestinal indigestion. Adenoid growths in the pharynx, enlarged tonsils, worms, lack of sufficient fresh air in the sleeping room, insuf- ficient bed clothing, coldness of the limbs, hip disease, anemia, malnutrition, overstudy, etc., may be provocative of disturbed sleep. To as- certain the direct cause a physician should be consulted. To doctor a growing child by a narcotized "Soothing Syrup" or any paregoric medicine is detrimental in more ways than one. Paregoric to a child is what morphine is to an adult. After middle life the most common cause of insomnia is arterio-sclerosis. What is meant by arterio-sclerosis, its symptoms and treatment, we will consider in a later chapter. 44 YOURS FOR SLEEP The physical causes are indeed many. Passing discomforts, as mosquito bites, ticklings in the throat, may suffice to disturb the sleep or render the night sleepless in emotional, easily disturbed persons. Pain in any part of the body, as rheu- matoid pains, the pain of appendicitis, kidney stone, etc., we can readily appreciate. Any of the acute diseases, as pneumonia, scarlet fever, meningitis, may, by the toxins these diseases gen- erate, so disturb the equilibrium of the body as to produce the disorder; but once the disease has been removed the insomnia is also removed. Poisons in the system, whether due to diseases such as gout, diabetes, constipation, excessive bodily fatigue, or taken into the body in the form of tea, coffee, alcohol, tobacco, cocaine, mor- phine, etc., need be borne in mind. Certain so- called nerve tonics depending upon strychnine and other stimulating drugs, are often causative factors. Disturbances of the circulation, as cold feet, which is in turn but a symptom of anemia, consti- pation, indigestion, or other disease, is probably the most common immediate cause of insomnia. Coldness of the feet is also common in brain workers and in such is not dependent gener- ally upon underlying disease. The drinking of something hot, such as hot cocoa, beef extract, 45 milk, or even hot water, and the holding of the feet for a brief period under hot, then cold water, followed by friction, may produce the thing de- sired sleep. A hot-water bottle to the feet may prove as efficacious. Burning sensations in the feet is a favorite cause of disturbed rest, usually dependent upon some more or less lo- cal derangement of the system, and consequently can only be intelligently treated after the cause has been ascertained. Insomnia from indigestion is by far the most frequent. Probably fifty per cent, of all insom- niacs are dyspeptics, knowingly or unknowingly. Since this is so, we will consider the subject at greater length in a later chapter. Causes least suspected are apt to be causative of the most aggravating and seemingly incurable insomnia. Thus many a case of insomnia has resisted the treatment of renowned specialists simply because the fact that such organs as the eyes, the ears, the nose, the teeth, and the throat were possible etiologic factors was not taken into consideration. That errors of refraction and other eye disturbances may produce insomnia and the insomnia be the only symptom of ocular disorder is a non-disputed fact. Likewise ceru- minia, or wax in the ear, as well as foreign bodies in the ear and other pathological conditions, may 46 YOURS FOR SLEEP prove at fault. Because we suffer no subjective sensations from the teeth, nose, or throat, it is no indication that these parts are normal. An abscess may exist at the roots of the teeth, which abscess can only be detected by an X-ray ex- amination. Similarly spurs may be present on the septum of the nose, or hypertrophic rhinitis exist, which may not only account for insomnia but other maladies as well. Disorders of struc- ture of the throat may prove at fault; the fact to be learned is that all these parts must be re- garded as guilty until proved innocent. Insomnia often results from Ibad habits of sleeping. The leading of an irregular life, with its attendant disturbances of the system and the going to bed at any hour of day or night, are not likely to conduce to natural sleep. When one acquires the habit of retiring at a certain hour each night he can so court sleep as to win her for his own, but the reverse is also true. There are, of course, some who can sleep at any por- tion of day or night, but if we should see some- one, no matter how wise, place his hand in boiling water, we would not follow the ex- ample. We are not all of the same stamina or physical material. We each have a separate existence to live, entirely different from that of others, so it behooves us to learn the requirements INSOMNIA AND ITS CAUSES 47 of our own make-ups, and to live so as to har- monize with them. That much insomnia results from psychic in- fluences solely cannot be doubted; it is a proved fact The carrying to bed with us of business problems, or familial perplexities or misunder- standings, the reliving of events that stir the brain to undue activity, do not favor sleep. By the time we decide to go to sleep we may find it im- possible to do so, and should we then start to worry about the chances of sleep having deserted us, we have placed our best foot forward on the road toward Insomnia Town. Pondering during the day as to whether or not we shall be able to sleep at night begets the idea that we will not be able to sleep at night, which idea soon becomes an obsession, and no matter how much we strive, by fatiguing the body and by other means supposed to favor sleep, sleep is not to be obtained unless the mind is freed of its erroneous belief. To imagine that because we cannot sleep terrible consequences are bound to follow is fallacious; if we die, it is because some other disease has killed us and not insomnia, for insomnia is but a symptom and not a disease. ; Faith can move mountains, and a belief in our own ability to go to sleep is absolutely necessary 48 YOURS FOR SLEEP for those of us whose insomnia is the result of mental causes. Fear is the rock on whicfe many a ship goes down, but hope and determination are the buoys of life. If troubled with sleeplessness the best thing to do is to forget it, to take a sane view of the matter, and, while seeking intelligent advice to free ourselves from its clutches, to re- gard ourselves fortunate if we procure it, but not lost if it is temporarily denied us. We cannot chase sleep, for, as Dr. Paul Dubois says in his book on the Physic Treatment of Mental Dis- orders: "Sleep is like a pigeon. It comes to you if you have the appearance of not looking for it; it flies away if you try to catch it I" Insomnia is of course a symptom of some forms of insanity, but such insomnia is accompanied by such other striking disturbances as to enable the most ordinary physicians to make a diagnosis easily. It is a very insignificant problem, and one that needs no further consideration. Heredity plays a part also. Some of us are born to be poor sleepers, easily awakened by the slightest noise of any kind. To be so afflicted is a misfortune, but much can be done to render sleep more sound by taking adequate precautions against such influences as have proved powerful enough to disturb us. Generally with hereditary insomnia is associated instability of the nervous INSOMNIA AND ITS CAUSES 49 system, but the nervous system may be rendered more stable by simple measures, which measures are a quiet life, freedom from worry, fresh air, sunshine, moderation in all things great and small, each to be taken to the heart's desire. If a compilation of all the causes for insomnia were made, it would be found that indigestion, constipation, neurasthenia, worry, eye defects, sedentary existence, high blood pressure, and arterio-sclerosis would head the list. The acute diseases, overwork, poor teeth, etc., would be smaller in number. It is easy to say "digest your food," "empty your bowels," "don't worry," etc., but it is another thing to do any of these things. In the following chapters I am attempting to deal with the more common causes of insomnia in a manner easily understood by all, not only with the purpose of aiding the sleepless to sleep, but also to aid them, if I can, in leading a life in accord with the laws of nature. "He sleeps well who is not conscious that he sleeps ill." BACOK. "Sleep is no servant of the will: It has caprices of its own: When courted most, it lingers still; When most pursued 'tis swiftly gone." BROWNIKG. CHAPTER IV WORRY "Anguish of mind has driven thousands to suicide; anguish of body none. This proves that the health of the mind is of far more consequence to our happiness than the health of the body, although both are deserving of much more attention than either of them receives." COLTON. IN neurasthenia, as we shall learn, phobias, or fears and fear and worry are practically identical in their effects play a major role. In- deed, in many cases, the pains, discomforts, and other sensations of which the neurasthenic com- plains are almost entirely due to perverted thought, overwork and other factors being of minor import. When this is the case, enforced rest but adds coal to the fire, as the individual does not need rest, but therapy solely directed toward the restoration of mental balance. This balance he may obtain by himself, and how it may be obtained we will consider in this chapter. However, no attempt is made to cover the matter thoroughly, for worry, be it associated with neurasthenia or not, is too stupendous a subject to be treated adequately in a few pages. 50 WORRY 51 By worry is meant undue self-consciousness, introspectiveness. The worrier permits himself unduly and insistently to think of self, and to be harassed by anything that may, in any way, do harm to that self. Yet there are many in- dividuals, known in common parlance as "chicken" or soft hearted, who take other people's troubles to their bosoms and nurse them as their own. The worry habit may be due to many causes. As in neurasthenia, it may be dependent upon a defective heredity or faulty child training. In fact, anything that can cause neurasthenia can cause worry. The two diseases are practi- cally always associated, although worry may ex- ist without the ordinary symptoms of neuras- thenia. Worry may also be provoked by allow- ing the mind to dwell for a long time upon a real or prospective calamity. It is natural for everyone to be solicitous when confronted by or threatened with difficulties, but it is natural too, when these difficulties have been removed, for the worry over them to depart also. But given a susceptible individual, anything that can occupy his mind for even an instant can make a worry, and the source of future worries. Thus a financial difficulty may harass the business man; to it he gives undue thought 52 YOURS FOR SLEEP and attention, picturing only the darker side in case the prospective failure becomes a reality. He neglects sleep, hygiene; may smoke and drink to excess and, as a consequence, even though the problem be finally solved to his sat- isfaction, other worries take the place of that which has been removed. Practically all chronic worriers can recall some period of their ex- istence when they permitted themselves to un- reasonably cogitate and brood over some dif- ficulty, from which time they became the hosts of all sorts of disturbing thoughts. Worry may proceed from allowing the mind to concern itself too much with matters that were not intended for its concern. For instance, con- sider the hypochondriac. This is an individual to whom the subject of health is of paramount importance. He may have started out by paying attention to the laws of hygiene, but in an effort to obey all these laws has become scrupulous. He learns that food should be well masticated, and unless he performs a certain number of chews, or should he inadvertently swallow his food before performing what he thinks are the requisite number, he concludes that ill health will follow; he learns that some persons have indigestion without being conscious of it, and this fact now occupies much of his thoughts : he WORRY 53 studies the pulse rate, becomes acquainted with the signs of cardiac disease, and is ever on the alert for any signs that might indicate disease of that organ; he takes his temperature fre- quently; notes the condition of his tongue; he may become so impressed by the disease-produc- ing powers and ubiquitousness of bacteria as to handle coins with tissue paper, or extract them from his pocketbook by means of pincers; a friend of his undergoes an operation, he con- cludes that he needs one too, etc. The hypochondriac affords a good example of the chronic worrier. The hypochondriac is usually willing to admit the folly of his fears, yet he claims that they are stronger than he and so he is powerless to loosen their fetters. Likewise does the worrier whose worries run in other channels than health. The hypochon- driac always finds something new to occupy his attention ; he will nurse these new loves tenderly for a time and, if he tires of them, will go back to his first love his first worry. The chronic worrier likewise finds new things to give him unreasonable concern, and if these fail or wear themselves out will revert to the first. In this place it may be well to consider, briefly, pain in the heart and kidney regions, since cer- tain patent medicine advertisements, by centering 54 YOURS FOR SLEEP the attention of those who read them on these organs, tend to promote hypochondriasis. All of us are aware of the fact that the heart is a vital organ and that it is situated on the left side of the body. Consequently, if we experi- ence a twinge of pain in the cardiac region we may become alarmed, especially, if we have just finished reading an advertisement elaborate in its descriptions of the signs and symptoms of heart disease, and possibly illustrated by a scare picture labeled, say, "Sudden Death," showing a person falling, apparently in agony, and with hand clasped over the cardiac region. Now, as a matter of fact, there are few dis- eases which cause pain which can be definitely associated with a disturbance of the heart's ac- tion. Pain about the heart is known as angina pectoris. In its mildest form it exists as a feeling of tension beneath the breast bone and is usually associated with emotion. It is common among speakers in public; climbing a stairway rapidly may usher in the unpleasant sensation. A night's rest and a quiet life will do more for this than any drug ever will. Again, there is a pain in the region of the heart which also radiates down the arm. It occurs in nervous persons, in excessive users of tea, coffee, alcohol, tobacco; and in emotional sub- WORRY 55 jects. Like the above form, it is by no means very serious and is usually amenable to treat- ment. There is only one form of cardiac pain that is of any serious consequence. This form of pain is exceedingly agonizing; the heart seems as if pressed in a vise, the pain radiates up the neck and down the arm, the face is pale, the fin- gers tingle, the individual is covered with a clammy sweat, and has a feeling of impending death. Yet this is a comparatively rare disease. If patent medicines were taken only by individ- uals suffering from this form, the profits would be very, very small, and the testimonials con- spicuous by their absence, for the disease is rarely cured. While minor forms of pain may be present in valvular heart disease, most pain about the heart is nothing more than an intercostal neuralgia, or an affection of the chest muscles, which is known as intercostal myalgia. A low-grade dry pleurisy may also cause pain in the chest. These pains occur more frequently on the left side. They have nothing whatsoever to do with heart trouble and can easily and speedily be cured by any physician of the regular school. Even if the pain did originate in the heart, taking medi- cine, while it might relieve the pain, would not 56 YOURS FOR SLEEP cure the organic disease; at least, assuming that it were the proper medicine, not until it were combined with rest and a quiet life. Physicians rarely give medicines to sufferers from organic heart disease unless the sufferer be so sick as to necessitate his seeking the sick bed, because, if they are not sick enough to require bed treatment, it indicates that the heart is doing its work nicely, and medicines to stimulate it do harm; unless these medicines be combined with proper rest they fail utterly, even when re- quired. Pain in the back is, according to some kidney cure advertisements, an infallible sign of kidney disease. Another infallible sign, some of them tell us, is to allow urine to stand for twenty-four hours. If sediment forms, or the urine becomes cloudy, then that individual is in danger unless he at once sends for the panacea recommended. As a matter of fact, the only danger such an in- dividual is in is the possibility of his spending perfectly good money for a perfectly worthless nostrum, or at least sold to him by fraud and deceit. If the urine fails to become cloudy on standing twenty-four hours then there is more likelihood that something is wrong. For all practical purposes there are only three pains in the back which are definitely due to WORRY 57 kidney disease. One of these is due to stone in the kidney or ureter, and another to a kink in the ureter. When a person suffers from either of these he does not stand up with his hand on his back, like the individual in "Every Picture Tells A Story." The pain is so agonizing that only the most powerful narcotics can ease it and these often fail. It is not unusual for the suf- ferer to faint or to roll about the floor like a ma- niac. The other form of pain is due to abscess of the kidney or its neighboring organs. Medi- cine can never cure this ; moreover, when such a state exists, palliative treatment by medicine is dangerous. Surgery is indicated and in surgery the cure lies. When a person suffers from pain in the back it is most often a myalgia ; that is, an affection of the muscles and ligaments of the back. It is common in workingmen and may be due to a variety of causes, such as improper posture, strain, exposure to cold, fallen arches, etc. In women uterine disturbances are most often at fault. But just as a person may become a worrier be- cause of imaginary ills or by magnifying trivial complaints, so also may he be a worrier because of disease of which he is not conscious. This is a point frequently overlooked and the worrier 58 YOURS FOR SLEEP is regarded as a misanthrope, whereas in reality he is sick in body primarily and in mind secon- darily. Remove the first and the second will take care of itself. The body can influence the mind for ill, and the mind the body. Unless the wor- rier has been subjected to a thorough physical examination he should not conclude that his troubles are entirely due to his perverted mental- ity. Practically but one per cent, of all indi- viduals who reach the age of thirty-five or forty are free from disease of one form or other or habits leading to such. The vast majority of people believe themselves to be in the best of health. It is the apparently minor and hidden ailments that are productive of so much harm to the individual. No disorder is so slight that it can be safely disregarded; none is so unim- portant that it may not be causative of future serious disease. However caused, and no matter what is the nature of the worry, there is not the slightest doubt that worry shortens human life. It is a slow but sure suicide and the most painful of all forms of suicide. Every day brings further con- tributions to our knowledge of its baneful effects. The X-ray has demonstrated that it interferes with digestion and the natural movement of the bowels, this, in turn, generating toxins which are WORRY 59 absorbed and which interfere with all forms of body activity; it causes dilatation of the large bowel, followed by atony; it constantly stimulates the adrenal glands, which sooner or later become exhausted, with symptoms of depression, melan- choly, fatigue, etc. ; it causes the liver to throw into the blood stream dextrose, and there is some reason to believe that worry has caused diabetes; it interferes with the natural heartbeat, with res- piration. In short, worry first stimulates and then depresses. And it is a two-edged sword; it works in a vicious circle. Not only does it affect the body for ill, but it also causes lessened mental power and in other ways interferes with cerebral activity. A worrier is indeed a pathetic object. And the things he worries about are both ridiculous and heartrending. Often he is so ashamed of his groundless fears that he will not breathe them to any living being. It is these repressed worries that do particular damage. The cry of the hu- man soul in distress is for confession; when there is something upon the heart which op- presses it, its recital to a friend who sympathizes cannot help but mitigate it, to render it easier to bear. A " sob fest " is the boon of womankind, particularly when all join in on the chorus. If the worrier would confide in someone, no doubt 60 YOURS FOR SLEEP he would find some material comfort; but, as stated, he is often too much ashamed of his fail- ing to do such. Once the worry habit has taken root, it is dif- ficult to cure but by no means incurable. For its eradication the will power of the sufferer is absolutely necessary, but exercise this power the worrier will not. Medicine can boast of but few specifics; the number of such can be counted on the fingers' ends. Yet the worrier feels sure that the doctor, after so many years of study and practice, surely ought to have something for every complaint; that if one doctor fails the old adage, " try, try again," is in order. The moment the worrier begins to think he is getting well he is on the road to recovery; the moment he thinks he is cured, he is cured. Faith in one's own power is a very good faith, and one worth possessing. The less faith in drugs the worrier has, in so far as this disorder is concerned, at least, the better. The first step the worrier should take is to disabuse his mind of the idea that pills or po- tions will help him. Of course, he should make it a point to consult a physician in whom he has confidence; but if his physician can discover no impairment, then he is to rest content that no phy- sical disease is responsible for his state of mind. WORRY 61 Should he be suffering from body disease then medicinal agents may be necessary. As a rule, worriers are free from organic disease. Again, if disease is present it is to the worrier's advan- tage to have its nature thoroughly explained by the physician. It is folly for one to harass him- self by the thought that his disease is serious, or incurable, when such is not at all the case. Yet many worriers do this very thing. A heart-to- heart talk with the physician about one's troubles is often sufficient to dispel them entirely. As a rule, we magnify our woes because, with jaun- diced eye, we look at them through a micro- scope, but once we see them as they are, in their true colors, they do not seem at all insur- mountable, but as pygmies, fit for the waste- basket. One need not be deluded because someone has told him that it will take a long time before cure is effected. Hope can see a nearer star. Worry will never disappear of itself; he who says it will take a long time for a cure fosters this be- lief. A cure should and can be effected in a day, a week, a month, rather than in years. Hygienic measures are of no great importance. For those who take the rules of right living as serious matters it is better that they be dispensed with. But of course, observance of hygiene, '62 YOURS FOR SLEEP while not curative, is an aid, and so is not to be disregarded entirely. A worrier is more or less of a coward. This is a bold statement, but true. He is afraid to face his difficulties, but flees from them, only to ad- vance further into the enemy's country, and hence to meet more foes. If one is to conquer worry he must face it. He must argue with it as he would with an individual with whom he had difficulties. What is there upon the mind that oppresses it? Is it a money stringency? Then he must reason that worry will not solve the problem, but render it more difficult, since worry will impede the proper reasoning that the difficulty requires. And again, half our fore- bodings never come to pass; the devil is not as black as he is painted, and neither are the futures we picture for ourselves. Yesterday is gone, its slate is clean; if not, wipe over it a giant sponge. There is no tomorrow; even if there were, to- morrow would take care of itself. " Sufficient unto each day is its own evil." We must live in the present in the today. Our best is all that we are asked for; God will do the rest. Hurry leads to worry, and worry to the grave. Is it disease of body that concerns us? Then if it be curable, let us do all in our power toward WORRY 63 effecting that cure. But the cure cannot be hur- ried. Nature will remedy matters in her own good time, unaided by the mind. All she asks of the mind is that it be patient, tranquil, tend its own business. If the mind be turbulent na- ture is sidetracked. The organs of the body can always do their work without the individual's direction, or rather misdirection; if not, to use a Hibernianism, we would all wake up dead. Let the brain remain under the skullcap where it belongs; do not employ it as a watchdog, to chase all around the body to see if the organs are shirking or not. The body must be trusted ; we must not examine it every few minutes, like a boy his first watch. Is the disease incurable? If so it is unfortu- nate; we are more sinned against than sinning, maybe. But that is no reason why we should mope away an existence, cursing fate, or what we will ; envious of our fellows who possess that which we are denied. There are many whose state is much worse than ours, a selfish view- point, but love of self rules the universe, and misery not only loves company but gets much comfort from that company. Happiness lies within, but it needs frequent aeration, else, be- coming stagnant, is seduced by melancholy. True happiness is obtained by doing good, and no mat- 64 YOURS FOR SLEEP ter how sorry the plight of an individual there is always some useful office he may perform which will not only benefit mankind in general but himself as well. There are many people to- day who positively know that they cannot live more than a few years at the most. Some of them are young, within striking distance of fame and fortune. Yet they are not overwhelmed by their misfortune, but go about their work as usual, perform it faithfully, quietly, without whimpering, as if wholly unmindful of the fact that ere long others would be in their places. Indeed, the incurable have innumerable ex- amples to follow, and, sick or well, it is by a contemplation of the achievements of others beset by difficulties that we all can learn a well- needed lesson. Consider the epileptic Napo- leon, Caesar, Mohammed, Alexander the Great; the rickety Pope; the scrofulous Byron; the neurotic Bach, Handel, Alfred de Musset; the hypochondriacal Johnson; the melancholy Burns, Cromwell, Cowper, Newton; the som- nambulists Shelley, Condillac; the tubercular Trudeau, Stevenson; the blind, deaf Helen Keller; and many, many others. Their infirmities did not hinder them from making the world better for their having lived; they conquered the devils which tempted them unceasingly to WORRY 65 shed crocodile tears, even if they could not con- quer their physical disabilities. It is not only from those afflicted by body in- firmities that we can learn, but from those who have suffered trials akin to those we may be forced to bear. For instance, Charles Lamb, beset by domestic sorrow but who would not be downed ; the bereaved Tennyson ; the imprisoned Galileo; the poor Dante. We need not search history's pages for examples; we can find them readily in our everyday life. True, all these in- dividuals are not the happiest of mortals; nev- ertheless, they are not constantly groaning over their misfortunes. They have found work a pan- acea for the ills of idleness. It is a good plan, when Mr. Worry puts in his appearance, to keep him waiting as long as possible; to give him plenty of cold shoulder but very little tongue. He's human after all; he's riled by curtness, even though his bland counte- nance belies it and his insistence leads one to be- lieve that he's one of those individuals who do not know when they are insulted. In other words, refuse to be bothered by worry for fifteen minutes, during which time you go about your ordinary work with tranquil mind. At the ex- piration of that time, try it for another fifteen minutes. You may be caught napping; Mr. 66 YOURS FOR SLEEP Worry may this time enter without the formality of sending in his card. But be not discouraged. Say that that's your busy day, and whistle an air from " Lohengrin " to prove it. Worry will soon take his departure, seeking other fertile fields for his presence, even though he knows he's about as welcome as a leper. And when Worry takes his departure, let him take with him, or throw after him, his valise labeled " Mr. Worry. Guide to the Insane Asylum." Worry can't guide you or drag you to such an institution. Insanity is caused by definite organic disease of the brain; worry is a functional disease. You act natural; the in- sane man doesn't. You think you will go insane ; the insane man thinks nothing at all about it, doesn't admit he is insane, and is also quite con- tent. In fact, the possibility of a worrier be- coming insane is so slight as to be disregarded entirely. It is a good thing, too, to read and re-read, to make notes, of worry's pernicious influence. There are a number of popular works on this subject which may be consulted, such as Sala- bee's Worry and Walton's Why Worry? If one keeps repeating to himself the fact that worry about his woes will not make them lighter or dispel them, rather make them worse, he may WORRY 67 resolve not to worry. And at the same time books may be procured that are antidotes for worry; for instance, Epicurus, Epictetus, Mar- cus Aurelius, Seneca, St. Augustine. Repeating such expressions as " I should worry " is, of course, no charm against worry, no more than a rabbit's foot in one's pocket is against ill luck. However, it has some value, though slight. If, when one finds himself be- ginning to worry, he repeats " I should worry," or " I don't give a hang," he may find the auto- suggestion he is practicing helpful. Worry, be- ing occasioned by insistent thought, can be re- placed by the insistent thought not to worry. A psychic disease such as worry is to be cured by psychic measures. Psychotherapy consists mainly of suggestive treatment; while others can apply it to better advantage, the worrier can practice it on himself, often succeeding not only in cur- ing himself, but others as well. It is a very good thing for those who are inclined to take life too seriously to begin and end each day by making a confession of their faith in the futility of worry, and to resolve not to worry. Of greater value than all else in worry's eradi- cation is the cultivation of a hobby or fad, to be practiced in the individual's spare time. The majority of worriers have plenty of time at their 68 YOURS FOR SLEEP disposal, which, being spent in idleness, predis- poses to introspectiveness. Even if the individ- ual has to work nine or ten hours a day, his ex- cuse, " I have no time," does not hold good. He has time or makes time for worry, and he has or can make time for the cultivation of a hobby. What this hobby is to be is a matter for him to decide. If he is an indoor worker it is prefer- able that he choose one which carries him out into the open, and which compels him to walk, since the exercise and fresh air will be of some benefit. In this case he might procure an ele- mentary work on botany, geology, or animal life great or small. He may enter into these studies with more or less aversion, but if he applies himself, interest will soon manifest itself. If he can find someone to undertake the study with him, particularly an individual of a jovial dis- position, so much the better. However, one should not make of his hobby a work, or .strive to learn all he can of his subject in the shortest possible time. The hobby is intended as a form of play; once it loses this aspect it may cause worry, rather than cure it. There are many ways of practicing a hobby. Each one can consult his own tastes and choose one that will be of interest. He may take up painting or drawing; make a collection of an- WORRY 69 tiques, postage stamps, coins; become interested in photography; write verses or stories; study history, or literature in general; learn to play a musical instrument; study the things a micro- scope can reveal; develop a chemical or electri- cal laboratory; cultivate a garden, etc. The hobby does good by taking the individu- al's mind off his woes, real or imaginary, and focusing it on other matters. It is the best rem- edy for worry, and the worrier should not be in- credulous of its efficacy but believing. Its practice depends entirely upon himself, and un- less he is willing to do everything in his power to rid himself of his malady, he deserves scarcely a scintilla of sympathy. Nursing one's woes makes them fat and sleek; by starving them they'll die of inanition. One need have no re- grets on the latter score, though many individ- uals feel hopelessly lonely unless they have something to worry about. There is much truth in the following lines of Phillips Brooks: There is many a trouble Would break like a bubble, And into the waters of Lethe depart, Did we not rehearse it And tenderly nurse it, And give it a permanent place in the heart There's many a sorrow Would vanish tomorrow . 7 p YOURS FOR SLEEP Were we but willing to furnish the wings; But, sadly intruding, And quietly brooding, It hatches out all sorts of horrible things. The value of play should not be overlooked. A few holes of golf daily, a horseback ride, hill climbing, are beneficial. Card playing, checkers, chess, quoits, croquet, are free from strain and so can be recommended. Good, wholesome comedy and music are also valuable. The worrier is very often of a retiring dispo- sition. He does not like the crowds, probably because his false reasoning leads him to believe that the people he meets will talk about him, that he is particularly conspicuous, that his pres- ence is objectionable, etc. This antipathy he must overcome. For the worrier it is a good maxim not to care about the opinion of anyone. People are too busy with the business of life to be minding other people's business. But if they don't choose to busy themselves with their own affairs then one can call to mind the old nursery rhyme: " Sticks and stones may break my bones, but names will never hurt me." The worrier should be bold: there is little danger of his be- ing overbold. By mingling with people instead of seeking solitude he will be pleasantly surprised to find that the world is a happy sphere after all, WORRY 71 and its creatures are happy likewise. The for- mation of a pure, honest friendship is a potent antidote for worry, and often renders one as im- mune to worry as tuberculosis does to a life insurance agent. To frequent such places as men are wont to frequent as clubs, fraternal organ- izations to join in the song or merriment, to treat those we meet as being above suspicion, will help to counteract the fear of crowds. As aids toward the regaining of mental bal- ance various means are at the worrier's disposal. Rhythmic breathing and muscular relaxation are very good. Working out puzzles of different kinds, reading a book upside down, skipping every other word, crossing out a certain letter; writing with the two hands, with the left hand, with the eyes closed; balancing a stick on the finger, are useful. Reading nursery rhymes, composing similar ones; picking out tunes on the piano or other musical instrument are also of service. Of the value of religion there is no doubt. Most " mind cures " have about them a mysteri- ous halo of religion and accomplish whatever good they do in this way. In prayer the indi- vidual can give free utterance to his thoughts; such thoughts as he would not dare reveal to mortals, supported by the belief that if no one 72 YOURS FOR SLEEP else understands them God does. Faith is all- powerful, and prayer alone has healed the sick. Worry is particularly more prevalent among the idle than among the busy. To combat the evils of idleness one should strive to be always busy about some pleasant, useful work. The cultivation of a hobby has this object. It is women particularly who suffer from absence of occupation, or from monotonous occupation. Many of the hobbies mentioned above might not particularly appeal to them; there is, however, a work for which women are naturally adapted and from which they can derive much comfort This is the noble work of philanthropy. To be a philanthropist, some of us imagine that the founding of hospitals, schools, libraries, is neces- sary. While this form of philanthropy is praise- worthy, there is another form which requires only sympathy and understanding. There are thousands of individuals friendless, alone, suffer- ing, in our hospitals, asylums, institutions, for whom a word of cheer and encouragement will do more good than the pills and potions they may be receiving. It is surprising how few of us know anything whatsoever concerning the insti- tutions our taxes support; some of us can hardly mention more than one such institution. Yet WORRY 73 every State has its infant asylums, hospitals, schools, almshouses, where visitors are not only welcomed, but where they have a right to go. Few know that the almshouses are in particular need of kindly visitors; in them can be found children who, though they may have been born in the poorhouse, will not fail to arouse the sympathies ; interesting old characters, men and women, whose experiences, if written, would make interesting volumes; wayward girls whose steps might be directed in the proper path by well-meaning, sincere persons; sick and dying who never have a visitor. Truly, it costs noth- ing, save a little time and charity, to visit these unfortunates occasionally; the good done will react on the donor appreciably, surely, lastingly. The aged and invalids are often denied em- ployment by reason of sympathy, and are thus afforded opportunities for worry. It is far bet- ter that their minds be kept tranquil by some sort of occupation. Books describing occupa- tions suitable for the old and invalids may be procured at most public libraries. A mind that is turbulent during the day is prone to be likewise at night. In fact, its turbu- lency is likely to be more appreciated. Pain which we have borne patiently during the day- time often appears aggravated at night. This is 74 YOURS FOR SLEEP due, in part at least, to the absence of noise, in- dividuals, and other factors which occupy the mind's attention from time to time during the waking period. And so with worry. With night everything is conducive to worry's entertainment, and it is not wont to overlook so favorable an op- portunity. Worry thwarts cerebral quiet and thus sleep is defeated. While worry of any kind may pro- duce insomnia, there is a particular worry as- sociated with sleep. An individual finds, on one or two occasions, that he has had difficulty in going to sleep. Instead of treating the matter lightly, it causes him great concern. He cogi- tates on the ill effects of sleeplessness, and may believe even that it leads to insanity. During the day he frequently entertains his experience of the night before, and approaches night with fear and trembling. He convinces himself that he will not be able to sleep, which may finally be- come an obsession. By constantly suggesting to himself his inability to sleep, it is natural that he will not sleep. As we have learned, all individuals do not re- quire the same amount of sleep. Many live long and usefully, and maintain mental and physical health on as little as three or four hours of sleep out of each twenty-four. But the hours that are WORRY 75 sleepless they devote to rest in bed. Taking seven hours' sleep as the amount ordinarily re- quired, the three or four hours which lack sleep are not devoted to tossing about the bed, fretting, worrying, walking the floor, reading, working, but to rest in bed. The mind is kept tranquil by pleasant thoughts, by sane reasoning that even if sleep is denied them no one can cheat them out of rest. A few hours of sleep and there is no one, no matter how confirmed an insomniac he may be, who does not sleep a few hours out of every twenty-four combined with rest in bed, are powerful enough to ward off whatever ill effects insomnia would otherwise cause. Add to these a daily neutral bath and an admirable trio is formed. Worry about sleep will not aid one to sleep; that fact is unquestionable. That it will hinder sleep is also a certainty. In place of worrying about sleep, we should give it no concern what- ever. By avoiding deeply intellectual pursuits for a few hours before bedtime, and spending these hours in simple games, or in reading a book of light verse, the mind is placed in a re- ceptive mood for sleep. One should seek his bed at his regular time and make up his mind that if he can't sleep he'll rest, anyway. By dis- regarding sleep it is won. In place of the thought, " I won't be able to sleep," replace it by, " I don't give a hang whether I sleep or not." Life is short and fleeting. It may be true, as Job tells us, that " man is born into trouble as the sparks fly upward," but most of man's troubles man makes for himself. Those who see life as a vale of tears need to remove the band- age from their eyes and neutralize the teardrops with the water of joy. It is our duty to enjoy our stay on this planet as much as is possible; to get out of our probationary period here below as much pure, innocent, wholesome delight as is in the world's power to give. Happiness for many lies at the end of a circle; they seek it but never find it. There are many roads to happi- ness; that in which some are traveling content- edly and happily may not be ours. Which is our road we must learn for ourselves. And we can if we will, but we must will hard enough. Others may point out the way; they may offer suggestions which may prove valuable, but they cannot ease us of our burden. That we must bear, or discard like a rusty old coat; the latter is better. The cure of worry depends much upon the worrier. This fact cannot be too often repeated. There is no use in waiting for a miracle ; miracles may still be performed in these days of unbe- WORRY 77 lief, but, even so, they may not come to us. A cure is possible; there is no doubt about it. But it does not lie in any medicine yet discovered, nor is there likely to be any specific medicine for it. No doctor has a prescription that will " fix " it. It is said that there is a salve for every sore; if we could open up the skull and grease the brain we might try out any number of them, but hopelessly, fruitlessly. "Life is like a street-car line: if you miss the first car don't go down in the dumps there'll be another along pretty soon." HUBBARD. CHAPTER V NEURASTHENIA "Absence of occupation is not rest; A mind quite vacant is a mind distressed." COWPER. PRIOR to Beard's popularization of the word neurasthenia (from v&jpov, nerve, and 177. Murder, dreams of, 25. Muscles, sleep ptosis due to weakness of, 34; soreness in, due to mouth disease, 160, 165. See Myalgia. Music, value of, in worry, 70; as a soporific, 231. de Musset, affliction of, 64. Mustard, use of, pack, 210; in evening meal, 221. Myalgia, heart pain and, 55; backache due to, 55; mouth disease a cause of, 160, 165 ; relief of, in obese, 207; re- lief of, by posture on awak- ing, 219. Nails, growth of the, in sleep, i. Napoleon, control of sleep by, I ; effect of sleep loss on army of, 39; affliction of, 64; on the bed, 212. Naps, morning, of no value, 15- Nature, as to, 63, 80, 118, 140, 188, 245- Nerve tonics, insomnia due to, 44 ; use of, in neurasthenia, 88, 89. Nervous, enuresis in the, 32; type of insomnia common in the, 36 ; heart pain in the, 54; inheritability of, de- rangements, 89 ; remedies for insomnia of the, 205, 228, 230, 241-242. Nervous system, effect of pa- rental disease on, of off- spring, 80, 88-89 : how to strengthen the child's, 90-93 ; effect of eye defects on, 141, 153-154; effect of mouth dis- ease on, 165-166; effect of moderate exercise on, 185 ; effect of deficient exercise on, 186. Neuralgia, intercostal, mistaken for heart pain, 55 ; tooth ab- scess a cause of, 163. Neurasthenia, dreams in, 24; enuresis in, 32; acropares- thesia from, 34; fears in, 50, 82; rest and, 50, 93-97; causes of, 51, 81-82, 88-89, 91, 154; worry and, 51, 82; derivation of word, 78; synonyms for, 78, 79; dis- eases overlooked in, 79; defi- nition of, 79-80; time of ap- pearance, 80, 81 ; symptoms 264 INDEX in, 82-86; sleep in, 82; drugs for, 86-87, 88, 99; prognosis of, 87-88; prevention of, 89- 93; water for, 98; baths for, 98 ; exercise for, 98 ; massage for, 98; electricity for, 99; diet for, 99 ; remedies for insomnia due to, 99-100, 154, 205, 228, 230, 241-242. Neuritis, mouth disease a cause of, 166. Neuron theory of sleep, 7. Neuroses, nerve instability due to, 80; eyestrain a cause of, 141. Newton, affliction of, 64. Nicotianin, in tobacco, 130. Nicotine, percentage of, in to- bacco smoke, 131 ; effect of, on rabbit, 131 ; in Havana cigars, 131 ; as cause of high blood pressure, 133. Night air, erroneous views concerning, 187, 199-200. Nightcap, use of, 206, Nightmare, dreams resembling, 24; sensations in, 25-26; causes of, 26, 215 ; cure of, 26 ; author's experiences with, 26 ; indications of, 35- 36. Night sleep, compared to-day, 12. Night terrors, 27. See Pavor Nocturnus. Noise, effect of, on sleep, n ; insomnia due to, 37 ; effect of, in neurasthenia, 83-84; effect of, on pain, 74; pre- cautions against, 199. Norway, value of, for neuras- thenia, 94. Nose, insomnia due to the, 45, 46; cleaning the, 219. Numbness, causes of, 34, 84. Nutrition, effect of deep breathing on, 190. Obese, use of abdominal sup- ports in the, 204 ; use of spe- cial shoes for the, 207. Occupation, value of, in worry, 72; for aged and invalids, 73; best, for neurotic child, 93- Odors, complaints of, in neu- rasthenia, 84. See Fetor Oris. Offsprings, as to limitation of, 89. Old age, sleep requirements in, 10 ; blood pressure in, 121 ; arterio-sclerpsis as sign of, 124; sleep in, 125-126. See Age. Operations, hypochondriac and, 53- Ophthalmia neonatorum, blind- ness due to, 148; means of preventing, 148. Ophthalmologist, difference be- tween, and optician, 146-147; which, to consult, 155-156. Opium, dreams attributed to, 24 ; use of, for insomnia, 216. Osier, on heredity, 80 ; on the platter, 107. Otalgia, mouth disease a cause of, 166. Outdoor sleeping, 194, 200, 203. Overeating, nightmare due to, 26; value of not, 107-108; constipation due to, 113, 114; arterio-sclerosis due to, 124; protein, 135-136; at evening meal, 221 ; before retiring, 226. Overexercise, ill effects of, 186. Overfatigue, type of insomnia common in, 36; remedies for insomnia due to, 205, 228- 229. Overstudy, insomnia in chil- dren due to, 43. Overwork, somnambulism due INDEX 265 to mental, 30; insomnia due to, 49; neurasthenia and, 50, 80, 81, 95-97; arterio-sclero- sis due to muscular, 124; nerve trouble and, 153. Owl, sleep habits of the, II. Oxygen, absorption of, in sleep, 2 ; absorption of, in work and rest, 184. Pain, sense of, in sleep, 2; dreams due to, 24; cry of, from hip disease, 28; in limbs, 34, 125 ; insomnia due to, 43, 44 ; heart, 54-56 ; back, 56, 57, 84, 207, 219; kidney, 56-57 ; aggravation of, at night, 73-74; from arterio- sclerosis, 125 ; glaucoma a cause of eye or head, 149 ; from mouth disease, 160, 165, 1 66 ; in the obese, 207 ; cry- ing in infants due to, 211; relief of certain kinds of, by posture, 219. Painting, as a hobby, 68. Pallor, mouth disease a cause of, 164. Pancakes, indigestion due to, 107. Pancreas, in sleep, I. Pancreatitis, swallowed germs as a cause of, 162. Panza, Sancho, on inventor of sleep, 245. " Paradise Lost," quotation from, on the mind, 231 ; read- ing, for insomnia, 231. Paraldehyde, use of, for in- somnia, 217. Paralysis, arterio-sclerosis a cause of, 125, 126. Paregoric, use of, in children, 43- Paresthesia, mouth disease a cause of, 166. Paris, not advisable for neu- rasthenia, 94. Parkhurst, sleep needs of, 8. Parsnips, laxative value of, 114. Pastries, indigestion due to, 107; avoidance of, in consti- pation, 115. Patent and proprietary medi- cines, as to the use of, 43, 53-57, 106, 117, 129, 147, 177. Pavor nocturnus, definition of, 27; varieties of, 27, 28; causes of, 28, 29; indications of, 28, 29, 35; treatment of, 28, 29; hip disease not to be mistaken for, 28. Pepper, use of, in evening meal, 221. Peppermint, use of, for indi- gestion, 106. Perfume, as to the use of, in motion picture theaters, 157; value of, as a soporific, 205. Peroxide of hydrogen, use of, as a mouth wash, 174. Pettenkofer and Voit, on oxy- gen absorption in rest and work, 184 Philanthropy, as a work for women, 72; meaning of, 72- v? 3 ' Phosphates, increase of, a cause of milky urine, 85. Photography, as a hobby, 69. Pies, indigestion due to, 107. Pillows, number of, necessary, 203, 204 ; posture for doing without, 203; value of hop or balsam, 205 ; value of medicated, 205 ; Chinese and Japanese, 205. Pin and needle sensation, from mouth disease, 166. Pinworms, enuresis due to, 32. Pipe smoke, nicotine in, 131. Pipe smoking, compared to cigar and cigarette, 131, 132. Plants, use of, in bedroom, 198. Plato, reading, for insomnia, 231- 266 INDEX Plautus, on the best course, 100. Play, value of, 70, 187. Plays, value of, for mental quiet, 221. Pleurisy, mistaken for heart pain, 55 ; from mouth disease, 164. Pneumonia, relation of, to sleeping posture, 15 ; insom- nia due to, 44; prevalence of, germs in healthy mouths, 161 ; cold air as a predispos- ing cause of, 190. " Poet at Grass, A," reading, for insomnia, 231. Poisons, dreams due to, 24, 25 ; alcohol, 25, 34, 44, 52, 54, 80, 81, 88, 107, I2i, 124, 128- 130, 225; insomnia due to, 44; from constipation, 44, 109- 110; tobacco, 44, 121, 130- 134 ; worry a generator of, 58; neurasthenia due to, 81- 82; high blood pressure due to, 121, 133; arterio-sclerosis due to, 124; excessive use of proteins a cause of, 135-136; from mouth disease, 159, 163- 166; mouth a source of, 160- 162 ; " growing pains " due to, 165 ; some ways of germ transmission, 170-171, 222; from poor ventilation, 200- 202; soporific drugs as, 215- 216, 217. Pool playing, as mind exer- cise, 194. Poor, ways for the, to over- come neurasthenia, 95. Poorhouse, good to be done in a, 73- Pope, affliction of, 64. Porter, use of, for insomnia, 225. Postage stamps, collecting, as a hobby, 69. Posture, frequent changes of, in sleep, 2; dreams due to, 16, 24; as to, in sleep, 15, 16, 203 ; nightmare due to, 26; backache due to faulty, 57; sleeping, for doing with- out pillows, 203 ; evils of slouching, 203-204 ; treatment of certain insomnias by, 204- 205, 232; sleep, for infants, 21 1 ; blood stasis of sleep overcome by, 219. Potatoes, avoidance of, in con- stipation, 115. Power, loss of, in limbs on waking, 34. Practices, neurasthenia due to unnatural, 82. Prayer, value of, 71-72. Precipices, dreams of falling over, 24. Prevention, of neurasthenia, 00-93; of eyestrain, 156-158; of tooth and gum disease, 168-174; of infection, 170- 171, 222. Pricking, in limbs, 34; from neurasthenia, 84. Priestly, sleep needs of, 8. Pronger, Dr. C. Ernest, on eye defects, 142, 153-1 54- Protein, poisoning by excessive use of, foods, 135-136. Prunes, use of, for constipa- tion, 114, Pseudo-psychologists, views of, on dreams, 22. Psoriasis, emetin as a cure for, 176. Psychic causes of insomnia, 37, 41, 47, 74, 83. Psychotherapy, application of, for worry, 67. Pulse, in sleep, 2; attitude of hypochondriac toward, 53 J in neurasthenia, 85. Punishment, as to, in somnam- bulism, 31 ; in enuresis, 33. Pyorrhea, indigestion due to, INDEX 267 105, 159-160; cause of, 162, 175-177; action of, 163-164; signs of, 164; prevalence of, 164; results of, 164-166; oc- currence of, in children, 170; prevention of, 170-174; use of emetin for, 175-177; cure of, 177-178. Pyridin in tobacco smoke, 130. Quarles, on putting off cares, 213 ; on conscience, 245. Quilts, use of, 197. Quoits, use of games of, for worry, 70. Rabbit, effect of nicotine on, 131- Rage, easily excited in neuras- thenia, 82. Rainbow tints, seeing, around lights from glaucoma, 149. Raspberries, avoidance of, in constipation, 114. Reading, toilet, to be avoided, 112-113; habits of, causing eyestrain, 157. See Books. Rectum, inflammation of the, a cause of enuresis, 32. Reed, Dr., sleep needs of, 8. Refraction, insomnia due to er- rors of, 45, 142-145, 154. See Eye Defects. Religion, value of, for worry, 71 ; neurasthenia a founder of, 79. Remire, Sir John, sleep method of, 224. Respiration, in sleep, I, 2; im- paired, a cause of dreams, 24; influence of worry on, 59; amount of air left in lungs after ordinary, 189; failure of ordinary, to empty lungs, 189. See Air, Lungs. Rest, sleep and, 1-3 ; neglect of, the cause of ill health in in- somnia, 41 ; value of, in bed in insomnia, 41, 74-75, 243; value of, for neurasthenia, 50, 93-97; effect of, on blood pressure, 121. "Rest and Pain," Hilton's, quoted, 95-97- Rest cure of Weir Mitchell, 94- Restlessness, tobacco a cause of, 133- Rewards, value of, in somnam- bulism, 31 ; in enuresis, 33- Rheumatism, insomnia due to, 44; parental, a cause of weak offsprings, 80 ; mouth disease a cause of, 165. Rhinitis, insomnia due to, 46. Riggs' disease, 105, 163. See Pyorrhea. Robe, use of buffalo, in pre- venting bed sores, 209. Rocking, insomnia in children due to, in sleep, 43; avoid- ance of, in infants, 218; so- porific value of, 231. Romeo and Juliet, quotation from, on care and sleep, 119. Round shoulders, prevention and cure of, by sleeping without pillows, 203-204. Rousseau, on abstaining, 139. Rowing, best indoor exercise, 192. Ruskin, on the eye, 158. Salabee, reading, " Worry " of, for worry, 66. Saliva, functions of the, 102- 103. Sanatorium, for neurasthenia, 94; as to, treatment for con- stipation, no; motto of the, 200. Sarcolactic acid, sleep supposed to be due to, 5. " Sartor Resartus," reading, for insomnia, 231. 268 INDEX Scandinavians, neurasthenia common in, 81. Scarlet fever, insomnia from, 44- Scene, change of, for insomnia, 242. Schoolwork, insomnia in chil- dren due to overstudy, 43 ; to be limited in neurotic chil- dren, 92. Sciatica, from mouth disease, 166. Science, attitude of medical, to- ward disease, 78-79. Scylla, dreams of, 23. Season, regulating sleep ac- cording to, 13-14. Sea voyage, value of a, for neurasthenia, 94; for eye de- fects, 156; for insomnia, 242. Secretions, body, in sleep, 2, 3 ; alteration in body, in neu- rasthenia, 85, 98. Sedentary living, constipation due to, no. Seneca, reading, for worry, 67. Sensations, kinds of, in night- mare, 25-26 ; enuresis due to external, 32 ; pricking and numbness in limbs, 34 ; burn- ing, in the feet, 45, 206-207; varieties of, complained of in neurasthenia, 84-85 ; burn- ing, of the urine, 85 ; pin and needle, from mouth dis- ease, 1 66. Sensitiveness, overcoming, in worry, 70-71 ; deficient exer- cise a cause of, 186. Sex, and sleep, 10; and som- nambulism, 30; and neuras- thenia, 81 ; worry in the fe- male, 72. Sexual practices causing neu- rasthenia, 82 ; disturbances in neurasthenia, 85-86. Sheets, use of cotton, 197; use of straw matting, for insom- nia of heat, 209 ; use of moist and dripping, for insomnia, 229. Shelley, affliction of, 64. Shock, relation of, to dreams, 25; mental, a cause of night- mare, 26 ; insomnia due to, 145 ; cold baths a cause of, 209; means of overcoming, due to leaving bed, 219. Shoes, use of special, for the obese, 207. Sick, attitude of the, toward the doctor, 60, 77, 86-87, 140- 141, 156, 172 182-183; appli- cation of heat or cold to the, 206; restlessness in the, 209; preventing bed sores in the, 209 ; use of an ice cap on the, 209-210; waking the, for medicine, 212. Side to sleep on, 15-16. See Posture. Sight, sense of, in sleep, 2; hallucinations of, from loss of sleep, 39; disturbances of, in neurasthenia, 84; dimness of, from tobacco, 133 ; causes of loss of, 148; effect of glaucoma on, 149. Silver nitrate, as a cure of tobacco habit, 134 ; use of, in preventing blindness, 148. Sinclair, Sir John, hours slept by, 8; sleep method of, 224. Skin, excretion by the, in sleep, 1,3; blood supply to the, in sleep, 3 ; effect of moderate exercise on the, 184; ill effects of deficient exercise on the, 185 ; benefits of deep breathing on the, 100. Slavs, neurasthenia common in, 81. Sleep, and rest, 1-3, 41, 74-75, 243 ; definitions of, 3 ; neces- sity of, 3-4, 7, 39-40 ; theories INDEX 269 of, 4-7 ; requirements in chil- dren, 10, 218; requirements in adults, 10; effects of ex- cessive and deficient, n, 39- 40; proper time for, 11-12, 13-14; day and night, com- pared, 12 ; before and after midnight, 12-14; beauty and, 13; posture in, 15-16; death and, 17; importance of good, habits, 14, 46, 217-218; fitful, 38; unref resning, 38; effect of mental attitude on, 37, 41, 47, 74, 75, 83, 243. See In- somnia. Sleep drunkenness 29. Sleeping outdoors, 92, 194, 200, 203, 208. Sleeping room. See Bedroom. Sleeping together, possible ill effects of two, 222. Sleep ptosis, 34. Sleepwalking, 29. See Som- nambulism. Slippers, use of, for cold feet, 206. Smell, sense of, in sleep, 2 ; dis- orders of, in neurasthenia, 84- Smokers heart, 132. Smokers' sore throat, 131. Smoking, insomnia prolonged by, on waking, 38 ; evils of tobacco, 34, 44, 54, 81, 121, 132, 134; cigar, cigarette and pipe compared, 131-132. Sneezing, superstition concern- ing, 22. Snowstorms, as a cause of death, 200. Socrates, on eating to live, 118. Soda, indigestion due to, water, 107; use of bicarbonate of, for burning feet, 206-207. Somnambulism, relation of, to dreams, 29-30; feats per- formed in, 30; causes of, 30; means of stopping an attack of, 30-31; treatment of, 31; indications of, 30, 34-35, enuresis a partial, 32; talk- ing in sleep a form of, 31; double consciousness the highest form of, 31-32; fa- mous men afflicted by, 64. Somnolentia, 29. Soothing syrups, avoidance of, 215-217. Soreness, complaints of, in neurasthenia, 84 ; mouth dis- ease a cause of muscle, 160, 165. Soul, as to the, in dreams, 20- 24. Sounds, dreams due to, 24. Sour milk, as secret of lon- gevity, 135; use of, for pro- tein poisoning, 136. Speakers in public, angina pec- toris in, 54. Specialist, the failing of the, 145-146; consulting a, in other cities, 155-156; family doctor and the, 214, Specifics, as to, in medicine, 60; no, for worry, 77; no, for insomnia, 213. Spencer, quotation from auto- biography of, 244. Sphygmomanometer, use of the, I20-I2I ; in arterio- sclerosis, 124. Spinach, laxative value of, 115. Spinal douche, uses of the, 31, 33, 98. Spinal weakness, 78. See Neu- rasthenia. Spine, complaints of the, in neurasthenia, 84. Sponge bath, uses of the, 209. Spray and shower bath, use of, in insomnia, 230. Stairway, angina pectoris due to rapidly climbing a, 54. St. Augustine, reading, for worry, 67. 270 INDEX Stamps, collecting postage, as a hobby, 69. Stasis, sleep due to, of blood in thyroid gland, 4; means of overcoming effects of blood, in sleep, 219. Sterne, on pearly teeth, 159. Stevenson, affliction of, 64. St. Francis of Assisi, reading, for insomnia, 231. Stiffness, complaint of, in neu- rasthenia, 84. Stillness, night sleep favored by, ii. Stimulants, insomnia due to tonics containing, 44 ; use of, in neurasthenia, 99 ; consti- pation due to, 113; tobacco, I33-U4; use of, in evening meal, 221. Stomach, actions of the, in sleep, i, 3, 226 ; effects of mastication on the, 102-105 ; disturbances of the, causing indigestion, 106 ; cancer of the, 106, 178; distention of the, from constipation, no; effect of water at meals on the, 113; passage of swal- lowed germs through the, 161-162; effect of moderate exercise on the, 185 ; sleep influenced by food in the, 224, 225; sleep disturbed by overloading the, 226. Stories, exciting, a cause of pavor nocturnus, 28 ; som- nambulism due to, of sleep- walking, 30 ; frightening, a cause of insomnia in chil- dren, 43 ; writing, as a hobby, 69 ; bogy, to be avoided, 92 ; kinds of, to be avoided in insomnia. 230 Strain, pain in the back due to, 57- Strawberries, avoidance of, in constipation, 114. Strength, increase of, by proper mastication, 105 ; ef- fect of exercise on mental, 185. "Sudden Death," 54. Suffocation, infant deaths due to, 222. Suggestion, insomnia due to, 37, 4i, 47, 74, 75, 83, 243; in treating insomnia, 47, 182, 242; use of, in overcoming worry, 67. Suicide, worry a form of, 58; eye defects as a cause of, 154- Sun, and the doctor, 199; means of overcoming early waking due to the, 207. Supraorbital foramina, pres- sure over, for somnambu- lism, 30. Sweat, increase of, in sleep, 3 ; clammy, in cardiac pain, 55 ; increase of, by exercise, 184; absorption of, by feather mattress, 197; remedies for insomnia due to, 208-209; contamination of under- clothes by, 223. Sweating, localized, in neuras- thenia, 85 ; excessive, a cause of burning feet, 206. Swedenborg, dreams of, 22. Swift, on the best doctors, 242. Syphilis, parental, a cause of weak offsprings, 80 ; Bible reference to, 89; arterio- sclerosis due to, 124. System, importance of, 14. Talking in sleep, 31. Tarts, indigestion due to, 107. Taste sense, in sleep, 2 ; in neu- rasthenia, 83. Taylor, Jeremy, hours slept by, 8. Tea, insomnia from, 44; heart pain from, 54; neurasthenia INDEX 271 from, 81 ; use of, for chil- dren, 91 ; use of, in neuras- thenia, 99; use of beef, 99, 100, 139; indigestion from, 107; constipating action of, 114; high blood pressure from, 121 ; use of, in evening meal, 221 ; before retiring, 221. Tears, neurasthenic easily ex- cited to, 82. Teeth, insomnia due to, 45, 46, 159. 167, 179; diseased, over- looked in neurasthenia, 79; purpose of the, 102; painful feet caused by diseased, 153; effects of diseased, 164-166; growing pains due to dis- eased, 165 ; nervousness due to unerupted and misplaced, 166; importance of milk, 168; care of infants' and children's, 169-170; times for cleansing the, 172; method of cleansing the, 173; folly of saving diseased, 175 ; treat- ment of diseased, 177-178. Teething, erroneous views con- cerning, 1 68. Temper, cry of, 211. Temperament, differences of, explains ability to do with little sleep, 8. Temperature, body, in sleep, 3; hypochondriac and body, 53; proper, of the sleeping room, 208 ; of various baths, 227. Temple, Sir William, on exer- cise, 180. Tennis, as exercise, 192. Tennyson, affliction of, 65; reading, for insomnia, 230. Terror, experiences of, a cause of nightmare, 26. Theater, value of the, for worry, 70; for neurasthenia, 95 ; as to the motion picture, 157-158; for insomnia, 221. Thiers, M, control of sleep by, 8. Thought, neurasthenia and per- verted, 50; insistent, the cause of worry, 67. Throat, insomnia due to the, 44, 45, 46; smokers' sore, 131 ; germs causing sore, transmitted by kissing, 171 ; value of inspecting infant's, 169. Throbbings, from high blood pressure, 122. Thyroid gland theory of sleep, 4-5- Tightness, complaint of, in neurasthenia, 84. Tilton, Theodore, sleep method of, 224. Time sense in sleep, 16. Tingling, arterio-sclerosis a cause of, 125. Tobacco, acroparesthesia due to, 34; insomnia due to, 38, 44> J 33 : use of, for insomnia, 38, 226 ; heart pain due to, 54 ; neurasthenia due to, 81 ; high blood pressure due to, 121, 132, 133; composition of, 131 ; nicotine in, 131 ; ill ef- fects of, 131-132, 133-134; cure of, habit, 134-135; use of, in arterio-sclerosis, 138. Tobacco heart, 132. Tobacco smoke, percentage of nicotine in, 131. Toilets, as to, in sleeping rooms, 198. Tongue, study of the, by hypo- chondriac, 53 ; coating of the, from constipation, no. Tonics, the best, for children, 33-34; strychnine, a cause of insomnia, 44 ; use of, in neu- rasthenia, 88, 99. Tonsils, as cause of pavpr noc- turnus, 27; insomnia in chil- 272 INDEX dren due to, 43 ; disease of, overlooked in neurasthenia, 79; as cause of painful feet, !S3 ; growing pains due to, 165. Toothbrush, use of, in in- fants, 169; in children, 170; care of the, 170, 173; kind of, to purchase, 172-173; method of using the, 173. Tooth pastes and powders, 173. Touch sense, in sleep, 16. Towels, germs on, 171 ; use of wet Turkish, for insomnia of heat, 209. Trachoma, danger in using eye remedies for, 147. Trional, use of, for insomnia, 217. Trudeau, affliction of, 64. Tuberculosis, in frequency of, in heart disease, 15 ; relation of, to posture, 15-16; some famous men afflicted by, 64; some ways of transmitting, 171, 222 ; influence of hygiene on mortality from, 191. Turnips, value of, for constipa- tion, 115. Ulcer of the stomach, indiges- tion due to, 106 ; appendici- tis a stimulator of, 153. Underwear, kind of, for ar- terio-sclerosis, 139 ; sleeping in, to be avoided, 223. Ureter, stone and kink in, as cause of pain, 57. Urinary passages, enuresis due to inflammation of, 32. Urinate, frequent desire to, in neurasthenia, 85. Urine, incontinence of the, 32 ; enuresis due to highly acid, 32 ; fake test of the, for kid- ney disease, 56; milky, 85; influence of exercise on the, 185. Uterine disturbances, back pain in women due to, 57. Vasomotor, disturbance of, mechanism in neurasthenia, 85 ; functions and kinds of, nerves, 123. Vegetables, use of, in enure- sis, 33 ; in neurasthenia, 99 ; in constipation, 114-115; so- porific, 221. Venery, neurasthenia due to, 82. Ventilation, nightmare due to poor, 26; pavor nocturnus due to poor, 27-28; insom- nia in children due to poor, 43; evils of poor, 186, 187- 188, 190-191, 199-202; effect of poor, on sleep, 200; mod- ern views on ill effects of poor, 202 ; proper, of the sleeping room, 202-203 ; tem- perature for the sleeping room, 208; crying in infants due to poor, 211. Venus, high blood pressure in worshipers of, 121. Vergil, sleep needs of, 8. Veronal, use of, for insomnia, 217. Verses, writing, as a hobby, 69; for mental balance, 71- Vertigo, some causes of, no, 133, 141, 166. Vinegar, use of, in evening meal, 221. Vision, disturbances of, in neu- rasthenia, 83; dimness of, from kidney disease, 133; dim and foggy, from to- bacco, 133 ; dim and foggy, from glaucoma, 149. Vital fluid, fear of loss of, in neurasthenia, 85. Voltaire, on the fate of a na- tion, 10 1. INDEX 273 Von Noorden's treatment of constipation, 114. Walking, as exercise, 191 ; as an appetizer, 220; for fa- tigue, 221. Wallpapers, kinds of, for use in bedroom, 199. Walton, reading, for worry, 66 ; for insomnia, 231. Watch, ticking of a, under pil- low, for insomnia, 225. Water, use of dash of cold, for somnambulism, 30; with- holding, in enuresis, 34; use of hot and cold, for cold feet, 45 ; use of, in neuras- thenia, 08; ice, a cause of indigestion, 107; as a cause and cure of constipation, 113; drinking, with meals, 113; getting up at night to pass, 125 ; use of, in arterio- sclerosis, 138. Wax in the ears, insomnia due to, 45. Weakness, sleep ptosis a mus- cular, 34 ; on awaking, 83 ; arterio-sclerosis a cause of muscular, 125 ; due to mouth disease, 164; deficient exer- cise a cause of general, 185; hypnotism a cause of men- tal, 241. Weariness after eating, in neu- rasthenia, 85. Weather, value of changes in the, 187-188; remedies for in- somnia due to cold and hot, 208-209. Weir Mitchell treatment of neurasthenia, 94. Wellington, Duke of, sleep needs of, 8. Wesley, hours slept by, 8. West Indies, value of, for in- somnia, 242. Wheaten grits, use of, for con- stipation, 114. Whisky, use of, for insomnia, 225. Wife, loss of affection for, in neurasthenia, 82. Will, muscles trained to re- spond to, by exercise, 185. Will power, need of, for cure of worry, 60; for alcohol habit, 130; for tobacco habit, 134- Window blinds, precautions necessary against rattling, 209. Window boards, use of, 203. Windows, use of, for ventila- tion, 202-203. Window shades, use of, to pre- vent early waking due to light, 207. Window tent, use of, 194. Windstorms, as cause of death, 200. Wines, constipation due to, 113; use of, in arterio- sclerosis, 138. Winter, need of exercise in, 193 ; remedies for insomnia due to, 208. Women, sleep needs of, 10; work suitable for, 72. Wool, use of, for bed clothing, 197- Work, value of, 65, 68, 72, 73; capacity for, diminished in neurasthenia, 82 ; need of va- riety in, 95, 187 ; tobacco and mental, 133-134; as to talk- ing about, 221. Workers, high blood pressure in hard, 121. Workingmen, back pain com- mon in, 57. Worms, enuresis due to, 32; insomnia in children due to, 43- Worry, nightmare due to, 26; 274 INDEX type of insomnia common in, 36; insomnia due to, 36, 37- 38, 41, 47, 74, 83, 145; reme- dies for insomnia due to, 37, 47-48, 75, 205. 228, 243; in- somnia's ill effects due to, 41- 42; definition of, 51; causes of, 51-58, 166, 169; resem- blance between hypochon- driac and worrier, 53 ; effects of, 58-59; cure of, 60-77; in- sanity and, 66; value of bobbv for, 67-69; arterio- sclerosis due to, 124; influ- ence of, on arterio-sclerosis, 138; glaucoma due to, 149. X-ray, value of, in teeth exami- nation, 46, 167, 179; worry's ill effects shown by, 58. Yawn, exercising in manner of a, on waking, 219. Youth, effect of smoking on, 131 ; age sleeping with, 222. Zola, hours slept by, 8. University of California SOUTHERN REGIONAL LIBRARY FACILITY Return this material to the library from which it was borrowed. IS MAR '90 m W'L JAN 07 2309 A 000 035 649 3 613.7 (23097) v228y