Medicines, among which opium was the chief, had been employed without success. On the contrary, his condition was manifestly rendered worse through their influence. Laudanum, of which he had taken large quantities, always caused headache, without producing the least amelioration in his symptoms. Notwithstanding the palpable connection which existed between the wakefulness and his former intense mental application, he had been allowed to continue his studies, and when he came to me had a Latin grammar in his hand, which he had been diligently studying in the street railway car!
After some very plain conversation with the father, relative to the great danger to which he was subjecting his son, by thus inordinately taxing his mind, I directed the entire cessation of all studies for the present, and an entire change of associations by a visit to the sea-shore, and free indulgence in bathing, fishing, and other recreations. I likewise advised the use, for a few nights, of small doses of bromide of potassium. My advice was implicitly followed, and a few days since I received a visit from the boy’s father, and was told by him that his son’s health had been completely restored. I recommended that the visit to the sea-side should be prolonged a week or two, that the return to study should be gradual, and that the boy’s eagerness to learn should be somewhat restrained by occupations and amusements requiring but little mental exertion.
Case VII.—An eminent banker consulted me for the purpose of being, as he said, “put to sleep.” He informed me that he was engaged in a series of financial operations which, if successful, would be the means of adding largely to his fortune, but that owing to loss of sleep he was unable to give them that careful and full attention which their importance demanded. “I go to bed,” he said, “feeling very much exhausted, and dead with sleep, but I am kept awake nearly the whole night by the activity of my thoughts, which run on with a rapidity which astonishes me. Toward morning I get a little sleep, but I arise unrefreshed, and go to my business with a feeling of fullness in my head, and a sensation of weariness, which altogether unfit me for the duties of the day. The consequence is that I cannot concentrate my attention upon the matters which ought to engage it, and that I am in danger of losing a great deal of money simply from lack of mental power to follow the train of operations which I have set in action.”
On examining this gentleman, I found his face flushed, his eyes bloodshot, his pulse small, weak, and frequent (104), and his manner excited. He complained of almost constant vertigo, and a feeling when he walked as though his feet did not rest firmly on the ground or support his entire weight. His appetite was capricious, and he maintained his strength mainly by drinking champagne, of which he imbibed two bottles a day, taking in addition “brandy and soda,” as occasion seemed to require.
I informed him that his case was a very simple one, and that I could safely promise to put him to sleep provided he would agree to follow my directions implicitly.
This he said he would do.
I told him that in the first place he must leave town and travel for a week, and in the second place take the oxide of zinc. To the first condition he objected strenuously; but the argument which I adduced, that if he did not he would probably go to an insane asylum within the period specified, somewhat startled him, and he yielded a reluctant consent.
He started off that day, and returned in exactly a week, having, as he said, slept eight hours every night during his absence. All his disagreeable symptoms had disappeared, and he was enabled to resume his business with his mental faculties in their full vigor.
2d. Those positions of the body which tend to impede the flow of blood from the brain, and at the same time do not obstruct its passage through the arteries, while causing hyperæmia, also produce insomnia.