CHAPTER X.
THE TREATMENT OF WAKEFULNESS.
The principles which should prevail in the treatment of wakefulness are indicated to some extent by the remarks which have already been made. If the views which I have given relative to the pathology of this affection be correct, there can be no doubt in regard to the means to be employed for its cure. Happily, theory and practice are in perfect accord in respect to the therapeutical measures to be adopted. These may be arranged into two classes:
1st. Those which by their tendency to soothe the nervous system, or to distract the attention, diminish the action of the heart and blood-vessels, or correct irregularities in their function, and thus lessen the amount of blood in the brain.
2d. Those which directly, either mechanically or through a specific effect upon the circulatory organs, produce a similar effect.
Under the first head are embraced many agencies which from time immemorial have been known to cause sleep. Among them are music, monotonous sounds, gentle frictions of the surface of the body, soft undulatory movements, the repetition by the insomnolent of a series of words till the attention is diverted from the exciting emotion which engages it, and many others of similar character which individuals have devised for themselves. In slight cases the measures belonging to this class often prove effectual, but in persistent insomnia they are generally altogether nugatory.
Under the second head we shall find comprehended the means which are chiefly to be relied on in the treatment of cases of morbid wakefulness.
Chief among them are embraced those measures which tend to improve the general health of the patient, and which are chiefly of a hygienic character. Whatever causes produce an irritable condition of the nervous system, indirectly at least increase the disposition to wakefulness. It is important, therefore, that these should be thoroughly understood and avoided, and I accordingly propose to consider them at some length.