Insomnia : its causes and treatment / by E. Mansel Sympson.

  • Sympson, Edward Mansel, 1860-1921.
Date:
[1889?]
Catalogue details

Licence: Public Domain Mark

Credit: Insomnia : its causes and treatment / by E. Mansel Sympson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted from St. Bartholomew's Hospital Reports, Vol. XXV.] ■ / '3 INSOMNIA: ITS CAUSES AND TREATMENT.1 Bt E. MANSEL SYMPSON, M.B. Normal sleep we may fairly regard as the outcome of two conditions—rest of the brain-cells, and anaemia of the brain. The first of these depends evidently and greatly on the absence of any external stimulus, as in the case of the lad (mentioned by Professor M. Foster) who could be put to sleep at will by closing his solitary eye and stopping his one ear. Perhaps, too, this quiet may be partly toxic ; the products of nerve-work may prove inhibitory to nerve-energy, as the lack of intra-molecular oxygen or the bye-products of contraction are to a muscle. And from exhaustion of the brain-cells may naturally come spasm of the cerebral arterioles, producing the second condition, i.e., of cerebral anaemia. Granting that this state—whether primary or secondary is of no moment here—obtains in sleep, the ingenious experiment of Chapin,2 quoted by Dr. Long Fox, becomes intelligible and confirmatory. He administered nitrite of amyl with the greatest care to a number of sleepers, with the effect of waking them most successfully—presumably by dilating the smaller cerebral arteries, and so flooding the brain with blood. In considering the causes of insomnia, we may consequently and conveniently divide them into corresponding classes:— (a.) Where the cerebral cells are in an excited state ; and (b.) Where the blood-supply to the brain does not permit of sleep. Under the first heading, then, will come cases of damage to the brain from cerebral haemorrhage, thrombosis, and embolism. Here, whether owing to the shock to the brain generally, or to the irritation around the lesion, it is not uncommon to get 1 A paper road before the Lincoln Medical Society, October 30, 1889. 2 The Influence of the Sympathetic in Disease, by E. Long Fox, M.D., p. 217.