[15]. We come now to those motions which depend on irritation. The motions of the arterial and glandular systems continue in our sleep, proceeding slower indeed, but stronger and more uniformly, than in our waking hours, when they are incommoded by external stimuli, or by the movements of volition; the motions of the muscles subservient to respiration continue to be stimulated into action, and the other internal senses of hunger, thirst, and lust, are not only occasionally excited in our sleep, but their irritative motions are succeeded by their usual sensations, and make a part of the farrago of our dreams. These sensations of the want of air, of hunger, thirst, and lust, in our dreams, contribute to prove, that the nerves of the external senses are also alive and excitable in our sleep; but as the stimuli of external objects are either excluded from them by the darkness and silence of the night, or their access to them is prevented by the suspension of volition, these nerves of sense fall more readily into their connexions with sensation and with association; because much sensorial power, which during the day was expended in moving the external organs of sense in consequence of irritation from external stimuli, or in consequence of volition, becomes now in some degree accumulated, and renders the internal or immediate organs of sense more easily excitable by the other sensorial powers. Thus in respect to the eye, the irritation from external stimuli, and the power of volition during our waking hours, elevate the eye-lids, adapt the aperture of the iris to the quantity of light, the focus of the crystalline humour, and the angle of the optic axises to the distance of the object, all which perpetual activity during the day expends much sensorial power, which is saved during our sleep.
Hence it appears, that not only those parts of the system, which are always excited by internal stimuli, as the stomach, intestinal canal, bile-ducts, and the various glands, but the organs of sense also may be more violently excited into action by the irritation from internal stimuli, or by sensation, during our sleep than in our waking hours; because during the suspension of volition, there is a greater quantity of the spirit of animation to be expended by the other sensorial powers. On this account our irritability to internal stimuli, and our sensibility to pain or pleasure, is not only greater in sleep, but increases as our sleep is prolonged. Whence digestion and secretion are performed better in sleep, than in our waking hours, and our dreams in the morning have greater variety and vivacity, as our sensibility increases, than at night when we first lie down. And hence epileptic fits, which are always occasioned by some disagreeable sensation, so frequently attack those, who are subject to them, in their sleep; because at this time the system is more excitable by painful sensation in consequence of internal stimuli; and the power of volition is then suddenly exerted to relieve this pain, as explained Sect. [XXXIV. 1. 4].
There is a disease, which frequently affects children in the cradle, which is termed ecstasy, and seems to consist in certain exertions to relieve painful sensation, in which the voluntary power is not so far excited as totally to awaken them, and yet is sufficient to remove the disagreeable sensation, which excites it; in this case changing the posture of the child frequently relieves it.
I have at this time under my care an elegant young man about twenty-two years of age, who seldom sleeps more than an hour without experiencing a convulsion fit; which ceases in about half a minute without any subsequent stupor. Large doses of opium only prevented the paroxysms, so long as they prevented him from sleeping by the intoxication, which they induced. Other medicines had no effect on him. He was gently awakened every half hour for one night, but without good effect, as he soon slept again, and the fit returned at about the same periods of time, for the accumulated sensorial power, which occasioned the increased sensibility to pain, was not thus exhausted. This case evinces, that the sensibility of the system to internal excitation increases, as our sleep is prolonged; till the pain thus occasioned produces voluntary exertion; which, when it is in its usual degree, only awakens us; but when it is more violent, it occasions convulsions.
The cramp in the calf of the leg is another kind of convulsion, which generally commences in sleep, occasioned by the continual increase of irritability from internal stimuli, or of sensibility, during that state of our existence. The cramp is a violent exertion to relieve pain, generally either of the skin from cold, or of the bowels, as in some diarrhœas, or from the muscles having been previously overstretched, as in walking up or down steep hills. But in these convulsions of the muscles, which form the calf of the leg, the contraction is so violent as to occasion another pain in consequence of their own too violent contraction; as soon as the original pain, which caused the contraction, is removed. And hence the cramp, or spasm, of these muscles is continued without intermission by this new pain, unlike the alternate convulsions and remissions in epileptic fits. The reason, that the contraction of these muscles of the calf of the leg is more violent during their convulsion than that of others, depends on the weakness of their antagonist muscles; for after these have been contracted in their usual action, as at every step in walking, they are again extended, not, as most other muscles are, by their antagonists, but by the weight of the whole body on the balls of the toes; and that weight applied to great mechanical advantage on the heel, that is, on the other end of the bone of the foot, which thus acts as a lever.
Another disease, the periods of which generally commence during our sleep, is the asthma. Whatever may be the remote cause of paroxysms of asthma, the immediate cause of the convulsive respiration, whether in the common asthma, or in what is termed the convulsive asthma, which are perhaps only different degrees of the same disease, must be owing to violent voluntary exertions to relieve pain, as in other convulsions; and the increase of irritability to internal stimuli, or of sensibility, during sleep must occasion them to commence at this time.
Debilitated people, who have been unfortunately accustomed to great ingurgitation of spirituous potation, frequently part with a great quantity of water during the night, but with not more than usual in the day-time. This is owing to a beginning torpor of the absorbent system, and precedes anasarca, which commences in the day, but is cured in the night by the increase of the irritability of the absorbent system during sleep, which thus imbibes from the cellular membrane the fluids, which had been accumulated there during the day; though it is possible the horizontal position of the body may contribute something to this purpose, and also the greater irritability of some branches of the absorbent vessels, which open their mouths in the cells of the cellular membrane, than that of other branches.
As soon as a person begins to sleep, the irritability and sensibility of the system begins to increase, owing to the suspension of volition and the exclusion of external stimuli. Hence the actions of the vessels in obedience to internal stimulation become stronger and more energetic, though less frequent in respect to number. And as many of the secretions are increased, so the heat of the system is gradually increased, and the extremities of feeble people, which had been cold during the day, become warm. Till towards morning many people become so warm, as to find it necessary to throw off some of their bed-clothes, as soon as they awake; and in others sweats are so liable to occur towards morning during their sleep.
Thus those, who are not accustomed to sleep in the open air, are very liable to take cold, if they happen to fall asleep on a garden bench, or in a carriage with the window open. For as the system is warmer during sleep, as above explained, if a current of cold air affects any part of the body, a torpor of that part is more effectually produced, as when a cold blast of air through a key-hole or casement falls upon a person in a warm room. In those cases the affected part possesses less irritability in respect to heat, from its having previously been exposed to a greater stimulus of heat, as in the warm room, or during sleep; and hence, when the stimulus of heat is diminished, a torpor is liable to ensue; that is, we take cold. Hence people who sleep in the open air, generally feel chilly both at the approach of sleep, and on their awaking; and hence many people are perpetually subject to catarrhs if they sleep in a less warm head-dress, than that which they wear in the day.
[16]. Not only the sensorial powers of irritation and of sensation, but that of association also appear to act with greater vigour during the suspension of volition in sleep. It will be shewn in another place, that the gout generally first attacks the liver, and that afterwards an inflammation of the ball of the great toe commences by association, and that of the liver ceases. Now as this change or metastasis of the activity of the system generally commences in sleep, it follows, that these associations of motion exist with greater energy at that time; that is, that the sensorial faculty of association, like those of irritation and of sensation, becomes in some measure accumulated during the suspension of volition.