Anomalies and Curiosities of Medicine

by George M. Gould; Walter L. Pyle

Somnambulism, or, as it has been called, noctambulation, is a curious phase of nocturnal cerebration analogous to the hypnotic state, or double consciousness occasionally observed in epileptics. Both Hippocrates and Aristotle discuss somnambulism, and it is said that the physician Galen was a victim of this habit. Horstius, ab Heers, and many others of the older writers recorded interesting examples of this phenomenon. Schenck remarks on the particular way in which somnambulists seem to escape injury. Haller, Hoffmann, Gassendi, Caelius Rhodiginus, Pinel, Hechler, Bohn, Richter,—in fact nearly all the ancient physiologists and anatomists have written on this subject. The marvelous manifestations of somnambulism are still among the more surprising phenomena with which science has to deal. That a person deeply immersed in thought should walk and talk while apparently unconscious, excites no surprise, but that anyone should when fast asleep perform a series of complicated actions which undoubtedly demand the assistance of the senses is marvelous indeed. Often he will rise in the night, walk from room to room, go out on porticoes, and in some cases on steep roofs, where he would not dare to venture while awake. Frequently he will wander for hours through streets and fields, returning home and to bed without knowledge of anything having transpired.

The state of the eyes during somnambulism varies considerably. They are sometimes closed, sometimes half-closed, and frequently quite open; the pupil is sometimes widely dilated, sometimes contracted, sometimes natural, and for the most part insensible to light.

Somnambulism seems to be hereditary. Willis cites an example in which the father and the children were somnambulists, and in other cases several individuals in the same family have been afflicted. Horstius gives a history of three young brothers who became somnambulistic at the same epoch. A remarkable instance of somnambulism was the case of a lad of sixteen and a half years who, in an attack of somnambulism, went to the stable, saddled his horse, asked for his whip, and disputed with the toll-keeper about his fare, and when he awoke had no recollection whatever of his acts, having been altogether an hour in his trance.

Marville quotes the case of an Italian of thirty, melancholic, and a deep thinker, who was observed one evening in his bed. It was seen that he slept with his eyes open but fixed and immovable. His hands were cold, and his pulse extremely slow. At midnight he brusquely tore the curtains of his bed aside, dressed himself, went to his stable, and mounted a horse. Finding the gate of the court yard closed he opened it with the aid of a large stone. Soon he dismounted, went to a billiard room, and simulated all the movements of one playing. In another room he struck with his empty hands a harpsichord, and finally returned to his bed. He appeared to be irritated when anybody made a noise, but a light placed under his nose was apparently unnoticed. He awoke if his feet were tickled, or if a horn was blown in his ear. Tissot transmits to us the example of a medical student who arose in the night, pursued his studies, and returned to bed without awaking; and there is another record of an ecclesiastic who finished his sermon in his sleep.

The Archbishop of Bordeaux attests the case of a young ecclesiastic who was in the habit of getting up during the night in a state of somnambulism, taking pen, ink, and paper, and composing and writing sermons. When he had finished a page he would read aloud what he had written and correct it. In order to ascertain whether the somnambulist made any use of his eyes the Archbishop held a piece of cardboard under his chin to prevent his seeing the paper upon which he was writing. He continued to write without being in the slightest degree incommoded. In this state he also copied out pieces of music, and when it happened that the words were written in too large characters and did not stand over the corresponding notes he perceived his error, blotted them out, and wrote them over again with great exactness.

Negretti, a sleep-walker, sometimes carried a candle about with him as if to furnish him light in his employment, but when a bottle was substituted he carried it, fancying that he had the candle. Another somnambulist, Castelli, was found by Dr. Sloane translating Italian and French and looking out words in his dictionary. His candle was purposely extinguished, whereupon he immediately began groping about, as if in the dark, and, although other lighted candles were in the room, he did not resume his occupation until he had relighted his candle at the fire. He was insensible to the light of every candle excepting the one upon which his attention was fixed.

Tuke tells of a school-boy who being unable to master a school-problem in geometry retired to bed still thinking of the subject; he was found late at night by his instructor on his knees pointing from spot to spot as though he were at the blackboard. He was so absorbed that he paid no attention to the light of the candle, nor to the speech addressed to him. The next morning the teacher asked him if he had finished his problem, and he replied that he had, having dreamt it and remembered the dream. There are many such stories on record. Quoted by Gray, Mesnet speaks of a suicidal attempt made in his presence by a somnambulistic woman. She made a noose of her apron, fastened one end to a chair and the other to the top of a window. She then kneeled down in prayer, made the sign of the cross, mounted a stool, and tried to hang herself. Mesnet, scientific to the utmost, allowed her to hang as long as he dared, and then stopped the performance. At another time she attempted to kill herself by violently throwing herself on the floor after having failed to fling herself out of the window. At still another time she tried poison, filling a glass with water, putting several coins into it, and hiding it after bidding farewell to her family in writing; the next night, when she was again somnambulistic, she changed her mind once more, writing to her family explaining her change of purpose. Mesnet relates some interesting experiments made upon a French sergeant in a condition of somnambulism, demonstrating the excitation of ideas in the mind through the sense of touch in the extremities. This soldier touched a table, passed his hands over it, and finding nothing on it, opened the drawer, took out a pen, found paper and an inkstand, and taking a chair he sat down and wrote to his commanding officer speaking of his bravery, and asking for a medal. A thick metallic plate was then placed before his eyes so as to completely intercept vision. After a few minutes, during which he wrote a few words with a jumbled stroke, he stopped, but without any petulance. The plate was removed and he went on writing. Somnambulism may assume such a serious phase as to result in the commission of murder. There is a case of a man of twenty-seven, of steady habits, who killed his child when in a state of somnambulism. He was put on trial for murder, and some of the most remarkable facts of his somnambulistic feats were elicited in the evidence. It is said that once when a boy he arose at night while asleep, dressed himself; took a pitcher and went for milk to a neighboring farm, as was his custom. At another time he worked in a lumber-yard in a rain-storm while asleep. Again, when about twenty-one, he was seen in a mill-pond wading about attempting to save his sister who he imagined was drowning. The worst phase of his somnambulism was the impending fears and terrible visions to which he was subjected. Sometimes he would imagine that the house was on fire and the walls about to fall upon him, or that a wild beast was attacking his wife and child; and he would fight, screaming inarticulately all the while. He would chase the imaginary beast about the room, and in fact had grasped one of his companions, apparently believing he was in a struggle with a wild beast. He had often injured himself in these struggles, and had often attacked his father, his wife, sister, fellow-lodgers, and while confined in jail he attacked one of his fellow-prisoners. His eyes would always be wide open and staring; he was always able to avoid pieces of furniture which were in his way, and he occasionally threw them at his visionary enemies. At the time of the murder of his child, in a somnambulistic attack, he imagined that he saw a wild beast rise up from the floor and fly at his child, a babe of eighteen months. He sprang at the beast and dashed it to the ground, and when awakened, to his horror and overwhelming grief he found that he had killed his beloved baby. A similar record has been reported of a student who attempted during the night to stab his teacher; the man was disarmed and locked up in another portion of the building; but he had not the slightest remembrance of the events of the night.

Yellowlees speaks of homicide by a somnambulist. According to a prominent New York paper, one of the most singular and at the same time sad cases of somnambulism occurred a few years ago near Bakersville, N.C. A young man there named Garland had been in the habit of walking in his sleep since childhood. Like most other sleep-walkers when unmolested, his ramblings had been without harm to himself or others. Consequently his wife paid little attention to them. But finally he began to stay away from the house longer than usual and always returned soaking wet. His wife followed him one night. Leaving his home he followed the highway until he came to a rough, narrow pig-trail leading to the Tow River. His wife followed with difficulty, as he picked his way through the tangled forest, over stones and fallen trees and along the sides of precipitous cliffs. For more than a mile the sleeper trudged on until he came to a large poplar tree, which had fallen with its topmost branches far out in the river. Walking on the log until he came to a large limb extending over the water, he got down on his hands and knees and began crawling out on it. The frightened wife screamed, calling to him to wake up and come back. He was awakened by the cries, fell into the river, and was drowned. Each night for weeks he had been taking that perilous trip, crawling out on the limb, leaping from it into the river, swimming to the shore, and returning home unconscious of anything having happened.

Dreams, nightmare, and night terrors form too extensive a subject and one too well known to be discussed at length here, but it might be well to mention that sometimes dreams are said to be pathognomonic or prodromal of approaching disease. Cerebral hemorrhage has often been preceded by dreams of frightful calamities, and intermittent fever is often announced by persistent and terrifying dreams. Hammond has collected a large number of these prodromic dreams, seeming to indicate that before the recognizable symptoms of disease present themselves a variety of morbid dreams may occur. According to Dana, Albers says: "Frightful dreams are signs of cerebral congestion. Dreams about fire are, in women, signs of impending hemorrhage. Dreams about blood and red objects are signs of inflammatory conditions. Dreams of distorted forms are frequently a sign of abdominal obstruction and diseases of the liver."

Catalepsy, trance, and lethargy, lasting for days or weeks, are really examples of spontaneously developed mesmeric sleep in hysteric patients or subjects of incipient insanity. If the phenomenon in these cases takes the form of catalepsy there is a waxy-like rigidity of the muscles which will allow the limbs to be placed in various positions, and maintain them so for minutes or even hours. In lethargy or trance-states the patient may be plunged into a deep and prolonged unconsciousness lasting from a few hours to several years. It is in this condition that the lay journals find argument for their stories of premature burial, and from the same source the fabulous "sleeping girls" of the newspapers arise. Dana says that some persons are in the habit of going into a mesmeric sleep spontaneously. In these states there may be a lowering of bodily temperature, a retarding of the respiration and heart-action, and excessive sluggishness of the action of the bowels. The patients can hear and may respond to suggestions, though apparently insensible to painful impressions, and do not appear to smell, taste, or see; the eyes are closed, turned upward, and the pupils contracted as in normal sleep.