Sleep and Its Derangements

symptomatic, or those which occur in the course of diseases; and the essential, or those which constitute the main features of

racter of the approaching morbid condition. Many instances of the kind which have been reported-especially by the earlier authors-are, however, i

ferred to by Macario.[86] The instance of Galen's patient, who dreamed that his leg had become c

t side by a venomous serpent. In a short time a severe carbuncl

and who finally died in the Conciergerie, dreamed three days before his death that h

dim as through a thin cloud, and was immediately thereafter

of her menstrual flow that she spoke to a man who could not answer her, for th

in in his throat. On awaking he felt very well; but a few

ck cat bit him in the side. The next day

g down precipices, and of being torn to pieces by wild beasts. One gentleman dreamed that his house was in flames, and that he was gradually being consumed to a cinder. This occurred a few days before an attack of inflammation of the

sleep in a condition of great alarm and terror without being able to explain the reason for his apprehen

nd entirely naked, who attacked him with fury, threw him to the ground after a severe contest, and, holding him between his thighs, vomited into his mouth. Three days afterward he was seized with the plague a

is no other evidence of their presence. Macario states that a young lady was under his care in whom viole

eral months for threatened chronic pericarditis, and who was at first tormented every night by painful and frightful dreams. These dreams

ther trouble during sleep. As he advanced in years, the hemorrhages were not so frequent, but were always preceded by a condition of general irritation, characterized during wakefulness by heat of skin and frequen

isorder by becoming firmly fixed in the patient's mind. Thus, he relates that Odier of Geneva was consulted in 1778 by a lady, who, during the night preceding the outbreak of her insanity, dreamed that her step-mother approached her with a dagger in order to kill her. This dream made so strong an impression upon her that she u

ms, which they regard as evidences that they are about to lose their reason. Sometimes the

y Dr. Forbes Winslow,[92] are

t, he maintained that they were actually in the house. He begged and implored his wife to protect him. He walked about the bed-room in a state of great agitation, apprehension, and alarm, stamping his feet, and wringing his hands in the wildest agony of despair. Upon inquiring into the history of the case, his wife said that she had not observed any symptoms that excited her suspicions as to the state of her husband's mind, but upon being questioned very closely, she admitted that during the previous night he appeared to have

nd belonged to the Wesleyan persuasion. On the morning of the narrator's visit, he found the woman in a state of great mental excitement and under the influence of hallucinations. She had gone to bed apparently well, but during the night was the subject of a vivid dream, imagining that she saw her sister, long since dead and to whom she was much attached, suffering the pains of hell. When quite awake, no one could persuade h

o another division of the subject,-"sleep-drunkenness," as

n the following summary, and which I quote from a very learned and philosop

neral a sign of the exci

on of the head; often in nervous fevers an

a sign of determinatio

e in women signs of a

red objects are signs of

are often signs of diseased

equently a sign of abdominal obst

ny part of the body especially suff

apoplexy, which is connected with

ith great sensitiveness, is a sign of

homas More Madden,[94] has been recently publi

erienced this in my own person, and heard it confirmed by other sufferers on the African Coast. The following case of morbid dreaming ushering in yellow fe

d had been intimately acquainted with her history and much interested in it. Her body had been found on the floor near the door and in front of a window. After a fatiguing excursion to some of the adjoining British settlements on the Coast, having retired to rest, I awoke disturbed by a dream of a very vivid character, in which I imagined that

l at once became evident and obvious that no body was there-that I must have been dreaming of one. I returned to bed, and had not long fallen asleep when the same vivid dream recurred; the same wakin

E. L.'s lamentable end, and of her remains in the same s

ess, when a conviction seized on my mind that it was absolutely essential to my life that I should not pass another night in Cape Coast Castle. I caused the negro servant I had fortunately brought out with me from England to have a litter prepared for me at dawn, and stretched on

, and the intervals shorter. A couple of days before the attack his sleep becomes broken by unpleasant dreams, and when the paroxysm has attained its height, he invariably dreams that he is the helpless victim of a persecutor, who finishes a series of torments by driving a stake through his skull. During his recovery from each attack, he states that his dreams are of a most agreeable character,

erament, went to bed at 11 P. M., feeling as well as usual. Between 12 and 1 o'clock he dreamed that he saw his child lying at his side, dead. He was very much frightened, an

material bearing upon the subject. With reference to the point under consideration, the data in my possession are exceedingly importan

vided surfaces was obtained, but he could only move one side. On awaking, a little numbness existed in the side which he had dreamed was paralyzed. This soon passed off, and c

d the man continued to beat him. In the morning he felt nothing, with the exception of a slight headache. Nothing unusual was observed about the leg, and all went

a boy threw a stone at her, which, striking her on the face, inflicted a very severe injury. The next day violent inflammation of the tissues around the facia

swallow melted lead. In the morning she felt as well as usual, but

ningitis, he had dreamed that he was seized by banditti while traveling in Sp

res she distinctly recollected. Holding the crown at arm's length, he said: "My daughter, during my lifetime I was forced to wear this crown; death relieved me of the burden, but it now descends to you." Saying which, he placed the crown on her head and disappeared gradually from her sight. Immediately she felt a great weight and an intense feeling of constriction in her head. To add to her distress, she imagined that the rim of the crown was studded on the inside with sharp points which wounded her forehead, so that

at she had heard her father say one day, that in his youth, while being in England, his native country, he had been subject to epileptic convulsio

onscious, and fell upon the floor in a true epileptic convulsion. This paroxysm was not a very severe one. It was followed in about a week by another; and, strange to say, this was preceded as the other by a dream of her fath

e fits are invariably preceded by dreams of difficulties of the he

eration was performed; but as she was released, a large dog sprang at her and fastened his teeth in her thigh. She screamed aloud and awoke in her terror. Nothing unusual was perce

y irreconcilable with the normal mental phenomena of the wakeful state, that it is difficult to say that such or such a dream is evidence of a diseased mind. As, in some of the cases I have brought forward, a dream may take so firm a hold of the reason as to be the exciting cause of insanity, and not simply a

and applied a match. Instead of exploding, smoke issued slowly from the orifices of the skull, and was resolved into a human form, which turned out to be that of a police officer sent to arrest her. She was imprisoned, tried, and sentenced to execution, by being drowned in a lake of melted sulphur. While the preparations were being made for the punishment she awoke. She related the particulars of he

nnot, therefore, be said that the dream produced the mental aberration. On the contrary, the dream was in all probabilit

imilar to the foregoing

d wealth, and who was, moreover, possessed of great musical talent. One evening, as he in his dream was paying her a visit, she placed herself at the piano and began to sing. He remarked that he did not admire the piece of music she was singing, and asked her to sing something else. She indignantly refused. Angry words followed, and in the midst of the dispute she drew a dagger from her

ential feature of the insane condition. This point has already been elucidated to some exte

steamer was expected, the gentleman was observed to become very anxious and excited, and was continually talking of his expected fortune. At last the steamer arrived. He then began asking the postman for letters from California, went several times a day to the post-office to make like inquiries, and finally went aboard the steamer and questioned the officers on the same subject. Th

ld her mother she had committed the "unpardonable sin," and that there was consequently no hope of her salvation. She based her idea on a dream she had had, in which an angel appeared to her, and sorrowfully informed her of her sin and her destiny. When asked to tell what her sin was, she refused to d

es during sleep are exaggerated by the partially awakened brain. The first evidence of approaching paralysis may be a very minute degree of numbness-so minute that the brain when awake and engaged with the busy thoughts of active life fails to appreciate it. During sleep, however, the brain is quiescen

dreams. They are invariably based upon actual sensations, u

rain and nervous system, that I never examine a patient without questioning him closely on this point. The inform

g, and that there is probably some organic affection present. My own experience agrees with that of Macario,[97] to the effect of not confirming thes

ly short, and, as Macario remarks, relate to approaching death. The patient starts from sl

nied by a sense of impending suffocation, and ordinarily consist of frightful images, such as devils, demons, s

ly they are of a pleasant character, but in the

ams are so mixed up with those which arise during the waking condition, that the patient is unable to separate them and to determine which are the consequence of erroneous sensations received when awake, and which are the results of dreams. The careful examination of almost

at all, acts in the most erratic manner; we are rarely surprised at the occurrence of the most improbable circumstances; our characters for the time being often undergo a radical change, and we perform imaginary acts in our sleep which are altogether at variance with our actual dispositions. The hallucinations of sleep we accept as realities just as the insane individual believes in all the erroneous impressions mad

mained through the entire day. With children this influence is still more strongly shown. As Sir Henry Holland[99] remarks, the corrections from reason and experience are less complete in them than in adults. As a consequence, they not infrequently confuse their dr

tarting-point in a dream. He dreamed that he was visited by a tall, thin, and black Brazili

referring to suc

he inquiries which I make every year of the students attending my lectures as to whether they have experienced anything of the kind, have convinced me that it is a phenomenon known to comparatively few persons. For among a hundred students, two or three only, and sometimes only one, have observed it. This rarity of the phenomena is, however, more apparent than real. I am satisfied that many persons would perc

lthy brains, the greater liability of the insa

are ordinarily sad and depressing, and leave a deep and lasting impression; in expansive monomania they are gay and exciting; in mania they gi

re. It has been my good fortune to have had the opportunity of carefully studying the phenomena of this singular affection in several persons of intellig

ures of which are a sense of suffocation, a feeling of pain or of constriction in some part of the body, and a

he following words: "I have often seen persons in their sleep utter groans and cries, appear as if suffocated, and throw th

e were due to excess of bile and dryness of the blood. This view origina

by a demon, who, for the time being, took possession of his body. Oribasius, in the fourth century, combated this idea, and endeavor

cal agency in nightmare. He considered it a

d to be the active agents in producing the affection. The treatment was in accordance with the theory, and consisted of prayers and exorcisms. Not unf

e. Thus Jansen[104] relates that a clergyman came to consult him. "Monsieur," said he, "if you do not help me I shall certainly go into a decline, as you

" said Jansen. "And to what d

to me, comes and throws herself on my breast, and embraces me with such power that I can scarcely breathe. I endeavor to cry out, but she stifles my v

e least surprising. Your visitor is an imaginary bein

her as she attacks me, and I try to contend with her, but fear, anxiety, and languor prevent me. I have been to every one asking for aid to bear up against my horrible fate, and, among others, I have consulted an old woman, who has the reputation of b

ing on my sufferings, to follow the advice I had received. I did so, and, sure enough, on the same day the wicked woman who had so tormented me came to my ap

inally, after two hours' conversation, he made him have some just concepti

forms. Thus vampirism, a belief in which exists in different parts of the world, is nothing but a kind of nigh

and prevents him appreciating his degraded condition. The vukodlack, on the contrary, appreciates all the horror of his morbid perception; he fears and detests it; he combats it with all his power; he has recourse to medicine, to prayers, to division of a muscle, to the amputation of a limb, and sometimes even to suicide. H

and lovable traits of character. It is only during his sleep, when visited with his terrible dreams, that he is a mon

ing the soul of the sleeper quits the body to visit the ce

from their visitations, he was advised to avail himself of the company of an old priest, who had never previously heard of these horrible dreams, and who did not believe that God would give such power to the enemies of mankind. After using various forms of exorcism, the priest went peacefully to sleep in the same room with the patient whom he was commissioned to defend against the sorcerers. Hardly, however, had sleep descended upon his eyelids than he t

ilar attacks. What the one dreamed he s

ny persons at the same time, the circumstance

d disturbed other regiments quartered there. We laughed at their credulity; but what was our surprise to hear, about midnight, the most frightful cries issuing from every corner of the abbey, and to see the soldiers rushing terrified from the building. I questioned them in regard to the cause of their alarm, and all replied that the devil lived in the building; that they had seen him enter by an opening into their room, under the figure of a very large dog, with long black hair, and, throwing himself upon their chests for an instant, had disappeared through another opening in the opposite side of the apartment. We laughed at their consternation, and endeavored to prove to them that the phenomenon was due to a very simple and natural cause, and was only the effect of their imagination; but we failed to convince them, nor could we persuade them to return to their barracks. They passed the night scattered along the sea-shore, and in various parts of the town. In the morning I questioned anew the non-commissioned officers and some of the oldest soldiers. They assured me that they were not accessible to fear; that they did not believe in dreams or ghosts, bu

uced. We are of opinion that the forced march which the troops had been obliged to make during a very hot day, by fatiguing the organs of respiration, had weakened the men, and consequently disposed them to expe

rage, he confessed that during his paroxysms he was the most arrant coward in the world. Indeed, so powerful an impression had his frequent fright

nutes after he fell asleep, and lasted sometimes for more than an hour. During their continuance he remained perfectly still and quiet, giving no evidence of the tumult within, beyond the appearance of a cold sweat over the w

case in which there are no ve

ion appears, especially on his forehead, and he is sometimes seized with a general trembling of the whole body. The respiration appears to be particularly disturbed; he gasps for air, and occasionally th

sense of his utter helplessness. His will is actively engaged in endeavoring to bring his muscles into action, but they c

of the dreamer. At other times they are demons of various forms. A gentleman, whose case came under my notice, was visited almost nightly by a huge black walrus, which appeared to roll off of a large ca

hus a lady informs me that she is subject to frequent attacks of nightmare, during which she imagines she is standing on the top of a high mast, and in extreme fear

, and intense mental excitement of any kind may produce it. I have known a young lady to have a severe attack the night after a school examination, in which she had been unduly tasked. Another young lady is sure to be attacked after witnes

ficulty of digestion. Let an individual, habitually systematic, depart for one day from the accustomed regularity of his meals, let him change the hour of his dinner, and go to bed before the work of digestion is completed, and it is proba

rong liquors and sparkling wines and coffee are equally so. I have several times known it produced by

d diseases of the digestive or urinary apparatus are often exciting causes of nightmare. It may originate from painful sensations in

illow being under the head and not under the shoulders, thus putting the head at such an angle with the body as to constrict the blood-vessels of the neck, and by the head falling over the side of the bed. I h

from the brain, or by impeding the respiratory movements. The effects of emotion, of mental fatigue, and of severe and long-continued muscular exertion are such that the nervous influence to the muscles of respiration is increased, or the muscles themselves are debilitated through this general fatigue of the organis

consulted as to their cure. Undoubtedly, however, much can be done to abate them when they belong to the category of prodromic dreams, as well as when they are symptomatic of existing disease. Hygienic measures, such as open

he course of life followed by the patient, and more or less sacrifice on his part. Among hygienic measures, I have several times found relief follow a sojourn at the sea-shore, and ocean bathing. Change of air is almost invariably beneficial, and moderate physical exercise, just to the point of fatigue, can scarcely be dispensed with. A gentleman, at this moment under my care

cs are indicated in cases of an?mia or exhaustion. As the disease is sometimes induced in children by the presence of worms in the alimentary canal, diligent

y, was recently under my care. No exciting causes could be discovered, except the

o nights at the bedside of a sick daughter. Every night, at the same hour, he was awakened by frightful dreams, which, irritating his brain, produced cramps, c

and his whole appearance showing the exhaustion consequent upon the battle which he was obliged continually to fight with h

vening, to drink only cold water, to use friction over the whole surface of the body, to apply mustard plasters to the extremities, to sleep with his head elevated and uncovered, to bathe his head frequently during the night with cold water, to give up the study of poetry, and to devote himself

administered in doses of from twenty to forty grains, three times a day. I have seen a number of cases which had

up the acquired habit. In these cases, the plan so successfully employe

should be as much as possible controlled, and the reading of sensational stories, or hearing sensational plays, should be discouraged. By severe mental training, individuals can do much to regulate the c