Sleep in its relations to diseases of the skin / by L. Duncan Bulkley.

  • Lucius Duncan Bulkley
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Sleep in its relations to diseases of the skin / by L. Duncan Bulkley. 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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    with eczema may have sleep largely interrupted by itching; indeed the noctural sufferings of these patients will oft( n far exceed those of the day, and after a night of real agony, with only snatches of broken sleep, the patient enters on the day wholly unrefreshed. The reasons for the greater distress from itcliing during the night, in many skin disorders, seem to be numerous: 1. The exhaustion of the nervous system by the activity of the day renders it more liable to disturbances, until the loss of nervous energy has been restored by fclcep. 2. During sleep there is a certain withdrawal of tlie general nervous control of the system, which allows si^ecial irritations to assert tlu m- selves; this is observed also in relation to other disordei-s of the system, as in asthma, in certain neuralgias, in urinaiy and bladder affections, etc. 3. During the condition of somno- lence there is also an absence of self control, which leads the patient, perhaps unconsciously at first, to so'fitch and rub, even for a slight pruritus, and thus to excite an already irritated skin to an increased erethism and to the dewlo])- ment of new lesions, requiring fresh scratching. 4. Just as the brain is especially excited at night by the products of faulty metabolism, resulting from digestive disorders, and even the nerve elements of the healthy skin suffer a like irri- tation during the period of sleep (manifested by restlessness and even burning and moderate itching), in like manner patches of diseased skin are especially irritated at night by the circulation of imperfectly elaborated blood. 5. Finally, the warmth of the bed favors a congestion of the skin, which congestion, pressing upon nerve elements already in a state of irritation, excites them to renewed activity. I have known cases where complete nervous exhaustion has thus occurred, and remember vividly a lacly who, having tried an infinity of remedies to get relief, had finally been given chloroform repeatedly by her husband for this purpose, with disastrously prostrating effects. Other diseases—urticaria, pruritus, dermatitis herpetiform- is, etc.—will oftei\ act in the same manner, and the re- sources of the jjhysician will frequently be taxed to the ut- termost in meeting this element of tlie case. In some in- stances, as in zoster, derraatalgin, and syphilis, the sleep will be broken by pain, which, indeed, may be also a formidable obstacle to overcome; various ulcerative affections and also