Insanity: Its Causes and Prevention

by Henry Putnam Stearns

It is not intended to imply that there may not be exceptions to this rule. There have been some who could do with four or five hours’ sleep for many years and do good work, and there are probably such men to-day, but they are using up the nervous energy and strength with which they have been endowed far too rapidly; and they are exceptions to the mass of people, who require much more sleep in order to enjoy good mental health.

Sleep is to the brain what rest is to the body:

“Sleep, that knits up the ravelled sleeve of care,
The death of each day’s life, sore labor’s bath,
Balm of hurt minds, great Nature’s second course,
Chief nourisher in life’s feast.”

No words could paint more beautifully or effectively the office of sleep, than these of England’s greatest poet. But we need not turn to the writers of prose or poetry in the past for instruction in this matter; all nature teaches the importance of sleep. Every tree, and shrub, and vine, has its period of sleep, and, if stimulated into ceaseless activity, would soon die; and every portion of the human system is subject to the same great law of necessity.

The stomach must have its periods of inactivity and rest; and there are periods during every twenty-four hours when the kidneys secrete very little, if any, urine. It is sometimes said the heart is an exception to this rule; that its beat never ceases from more than six months before birth until nature’s last great debt is paid in death. But, in truth, it is at entire rest nearly if not quite one third of the whole time. Its action consists of a first and a second sound, covering the contraction of right and left auricles and ventricles, and then a rest,—and so far as we know a perfect one. Reckoning this at one third the time occupied in each full action of the heart, and we have more than twenty years of perfect quiet out of the threescore and ten.

The same is true to even a larger extent of other involuntary processes and movements; for instance, that of respiration. The muscles concerned in this operation are at entire rest during more than one third of the time, and if the process of respiration be much quickened in frequency for any considerable period of time, weariness and languor ensue.

Now the brain is no exception to this same law. During every moment of consciousness this is in ceaseless activity. The peculiar process of cerebration, whatever that may consist in, is taking place; thought after thought comes forth, with no volition on our part; long trains of meditation come forth unbidden, one after another, from the hidden recesses of the brain; sometimes things supposed to be long since forgotten, which have for years been consigned to the rubbish lumber-heap of dead plans and disappointed expectations, rise up suddenly, like a frightened bird before the hunter. Then, again, the sound of some voice, or the strain of some music long unheard, or the glance of an eye, will call up the memories of some bitter and suffering experience with its ten thousand harrowing associations, which go marching forward and backward through the trackless channels of the brain like a vast army of ghosts.

All this when the brain has no set task to perform, no intent purpose to follow out, and the body is at ease; and it is only when the peculiar connection or chain of connection of one brain-cell with another is broken, and consciousness fades away into the dreamless land of perfect sleep, that the brain is at rest. In this state it recuperates its exhausted energy and power, and stores them up for future need.

The period of wakefulness is one of constant wear; every thought is generated at the expense of brain-cells, which can be fully re-energized only by periods of properly regulated repose. It not unfrequently happens, however, that sleep is only partial; that the brain still continues in some degree of activity, and when we wake, we have dim memories of sub-conscious thought, which has been moving through the brain. Such rest, for the brain, is imperfect, and we are conscious of the conditions of fatigue, which shows how imperative is the necessity for sound, healthy sleep; and if this is not secured, if the brain, through over-stimulation and thought, is not left to recuperate, its energy becomes rapidly exhausted; debility, disease, and finally, loss of power supervene.

Hence the story is almost always the same in the history of the insane; for weeks or months before the active indications of insanity appear, the patient has been more than usually anxious about some subject or other, and worried and wakeful, not sleeping more than four or five hours out of the twenty four. The trains of thought have been left too long moving on in certain channels of the brain, some experience has made too profound an impression, and the effects of what we call the will have been unable to control it; or there has been perhaps some source of eccentric irritation which has been reflected; or it may be that the blood, upon which every organ depends for nourishment and strength, has been poisoned, or its nutrient properties impaired; and the poor brain, unable to do its constant work under such influences, begins to waver, to show signs of weakness or aberration; hallucinations or delusions hover around like floating shadows in the air until, finally, disease comes and