Insomnia : $b its causes and cure

Description

Insomnia by Sir James Sawyer is a medical treatise, adapted from clinical lectures, written in the early 20th century. It examines the nature of sleep and the problem of sleeplessness, aiming to explain why people fail to sleep and how best to restore healthy rest. The book first sketches the physiology of sleep and then classifies sleeplessness into symptomatic insomnia (due to pain, fever, cough, dyspnea, and other evident illnesses) and intrinsic insomnia, which is divided into psychic (from emotional shock, mental strain, and the “nervous temperament”), toxic (from tobacco, alcohol, tea or coffee, constipation/copræmia, gout, and renal inadequacy), and senile (from vascular degeneration) forms. Sawyer describes hallmark features of nervous insomnia—persistent wakeful thought, headaches, tinnitus, slight sensory and visual disturbances, restless sensitivity to light and noise—and explains how disordered cerebral activity and vascular tone perpetuate wakefulness. Treatment is individualized and chiefly causal: remove or relieve the precipitating factor; use hypnotic drugs sparingly and under close control; prefer bromides for calm, sometimes with ergot or digitalis; correct anemia with iron/arsenic; and, in select weakly patients, cautiously use alcohol. He adds adjuvants and hygienic measures—regular sleep hours, outdoor exercise and sunshine, simple monotonous mental tasks at bedtime, careful bedroom ventilation and tailored bedclothes, a little food or hot water, brief cold applications—and insists toxic and senile cases be managed by eliminating offending agents and supporting vascular function, with bromides and mild sedatives like hop or henbane where needed. (This is an automatically generated summary.)

Subjects

• Insomnia
• RC