e—psychic insomnia (emotional and sensational).
f—insomnia of cerebral and physical fatigue.
g—genito-urinary insomnia.
h—febrile, infectious, autotoxic insomnia.
i—toxic insomnia (coffee, tea, alcohol).[10]
Among the causes of insomnia those of a predisposing character are the female sex, old age, nervous temperament, intellectual pursuits.
Of exciting causes may be enumerated organic or functional diseases of the brain, worry, anxiety, grief, and bodily pain; noise, if not monotonous, fever, coffee, tea, etc.
Among the insane, insomnia is one of the most frequent symptoms, except in chronic dementia. In melancholia it is the most distressing accompaniment of the disorder, and is especially marked in the early morning.
A careful analysis of the conditions or causes of insomnia has been made by Dr. Folsom (U. S.). The principal ones may be briefly enumerated as follows: Habit, reflex causes, as indigestion, genito-urinary disorders; autotoxic causes, as gout, lithæmia, syphilis, habitual constipation; anæmia, vaso-motor changes, neurasthenia, hallucinations of sight or hearing, astigmatism—the strain of the eye which in health may be unnoticed, producing “in states of debility, headache, dizziness, spasmodic muscular action or wakefulness” and the neurotic temperament.[11]