There is no circumstance to which the sufferers under this disease ought to pay more attention than to their sleep, for every irregularity in this particular, will increase the violence of the disease. It is almost always produced by sleeping too long, frequently by sleeping too sound, and generally after having lain long awake in the night. These things ought therefore to be carefully avoided. Going to bed before the usual hour is a frequent cause of Night-Mare, as it either occasions the patient to sleep too long, or to lie awake in the night. Passing a whole night, or part of a night, without rest, likewise gives birth to the disease, as it occasions the patient on the succeeding night to sleep too sound. Indulging in sleep too late in the morning is an almost certain method to bring on the paroxysm; and it should be remembered, that the more frequently the paroxysm returns, the greater strength it acquires. I am aware that the propensity to sleep is at this time almost irresistible, and indeed, without rising from bed, it is altogether so; but a little resolution is required to be employed here.
Those who are habitually subject to the attacks of Night-Mare ought never to sleep alone, but to have always some person near them and within reach, so as to be immediately awoke by their groans or struggles; and the person to whom this office may be entrusted, should be instructed to rouse the patient as early as possible, that the paroxysm may not have time to gain strength; for the frequent repetition of the paroxysms gives greater strength to the disease, and that in proportion to the length of their duration. A long and obstinate paroxysm of Night-Mare will be found to differ not much from Epilepsy, and I have seen some to which it would be difficult to apply the proper appellation. The patient cannot pay too much attention to this circumstance, that is, the prevention, as much as possible, of the paroxysms: crescit eundo. If he has not the means at hand of preventing the paroxysms when they make their appearance, it will be better to rise and walk about for an hour, or until the sense of weight about the præcordia shall have disappeared. I have before observed, that any thing which will procure the discharge of a quantity of wind from the stomach, will for the time, put off the return of Night-Mare: I have frequently effected it by a glass of common gin, when nothing else was at hand; but either of the draughts, No. 1 or 2, will more effectually answer the purpose, and for that reason should be kept in readiness by such as are frequent sufferers from this disease. But it is not the temporary relief from the paroxysms merely, that the patient ought to keep in view, but the permanent amendment of his constitution, and the preventing, as much as possible, the formation of that trash in the alimentary canal, which gives rise to it. The tendency to convert every thing into an acid that exists in the stomachs of these patients, is generally too obstinate to be easily removed; it will require a long perseverance in the plan here laid down in order to eradicate the disease. Indeed I would recommend them never to drink any malt liquor without a portion of the Carbonate of soda, or some other alkaline salt in it, and to pay the greatest attention to regularity and choice of diet. One of the draughts, No. 1 or 2, or any thing of the same nature which may be found more agreeable, should be taken whenever the dyspeptic symptoms are at all urgent, and repeated as often as occasion may require. Costiveness should be always obviated by such means as the patient finds most agreeable to himself. If the constant use of the Soda will not keep the bowels sufficiently open, aperients must be had recourse to, and the draught, No. 3, will, I think, answer the purpose sufficiently, if not, its strength maybe increased. Where there is much languor and debility, with loss of appetite, I would recommend the Pilulæ Ferri Comp. of the London Pharmacopæia, and a decoction of bark, or infusion of Gentian or Quassia, but the cure cannot be wholly entrusted to tonics.
By steadily persisting in the plan above laid down, I have succeeded in bringing this monster under some kind of control, so as to be able to commit myself to the arms of sleep with a degree of confidence unknown to me for years before; and if in consequence of irregularity, fatigue or ill health, I am occasionally visited by this fiend of darkness, I fly with equal confidence to the antidote, which fails to chase him from my couch.
What has been said with respect to the treatment of Night-Mare, will apply equally to the other kinds of disturbed sleep which I have noticed in this work. They originate from the same cause, and will be removed by the same remedies. In children, frightful dreams frequently result from worms, and consequently will be remedied by any kind of treatment which removes the worms themselves, and with them the trash which forms their nest. This trash of itself frequently exists without the worms, and produces all the symptoms which they occasion, and amongst others, Night-Mare and disturbed sleep. By the treatment above recommended it will be evacuated, and its further formation prevented.
If any unfortunate sufferer from this distressing complaint shall obtain relief by the method here laid down, the end of writing this little Treatise will be fully answered, which is to restore the blessings of repose to those who are deprived of it by this hideous fiend.
FINIS.
Footnotes:
[1] The learned Theophilus Bonetus observes, that this disease was unknown to Hippocrates and Galen.—Vide Polyath. Lib. ii. Cap. xxviii. De Incubo et Catalepsi. Unknown it could not be to such observers of nature, although they may not have written upon it. In the book however, ascribed to Galen, entitled “De Utilitate Respirationis,” the following short, but comprehensive notice, is to be found concerning it.—Et Ephialtes quædam Epilepsia, quæ fit in somno: fit autem ex mistione tanquam Epilepsia. Ideoque non in vigilante, sed in dormiente: ut enim, prædictum est somnus et epilepsia fiunt in eodem loco, et ex simili causâ: unde Aristoteles dicit epilepsiam esse somnum quendam: verum ephialtes longo tempore perdurans in Epilepsiam convertitur.
[2] Memorat denique Silimachus Hippocratis sectator, contagione quâdam, plurimos ex istâ passione, (i. e. Incubo) velut lue, apud Urbem Romam confectos.—Cœl. Aurel. lib. i. cap. iii. de Incubone.