Bond, who places his principal dependence for cure on blood-letting. I do
not deny but there are subjects in whom this remedy might be admissible,
and perhaps advantageous; but I do not doubt, at the same time, that in
far the greatest number of persons habitually affected with this disease,
it would add fresh vigour to the monster, while it drains the vital
powers of the struggling patient, and increases his danger. Bond carried
this practice to a great length in his own person, but did not cure the
disease. It is at best but a doubtful and a dangerous remedy. To those
persons who are only occasionally subject to it, and who are generally
most alarmed at it, as the disease comes upon them unexpectedly, and
without their being always able to assign any cause for it, it appears
difficult to apply a remedy, as the mischief is generally over before they
are aware of its approach. A little attention however to the state of the
digestive organs will generally point out to them, that it was connected
with indigestion, flatulence, or costiveness; or perhaps all these
together: frequently it is the consequence of having eaten some particular
kind of food, which experience shews always to disagree with the stomach.
There are certain kinds of food which will constantly produce this
disease in such as are at all liable to it. Hildesheim, in his _Spiceleg.
De Affectibus Capitis_, says: _Qui scire cupit, quid sit Incubus? is ante
somnum comedat castaneas, et superbibat vinum fæculentum._ “He who wishes
to know what Night-Mare is, let him eat chestnuts before going to sleep,
and drink after them feculent wine.” I found by experience in the West
Indies, that eating a particular fruit, called the alligator pear, would
at any time of the day produce Night-Mare. This is a pulpy fruit, which,
when cut into, resembles a custard, and is frequently spread upon bread,
and eaten instead of butter, whence it has obtained amongst military men
the name of subaltern’s butter, and it is certainly no contemptible
substitute for fresh butter. I used frequently to eat it beat up with the
juice of Seville oranges and sugar, in which case its action was almost
instantaneous. So great a propensity to sleep came upon me, that I could
not resist the temptation, though well aware of the consequences; so that
I generally kept some person by me to awake me as soon as the Night-Mare
came on, which was always in the course of a few minutes. I have
frequently shewn this experiment to my medical friends, as I have hinted
above. The articles most likely in this country to produce Night-Mare, I
conceive to be cucumbers, nuts, apples, and all such things as generally
produce flatulence. Whenever a person has discovered the offending
article, it is certainly prudent to abstain from it, more especially in
the evening. If however that state of stomach and bowels which gives rise
to Night-Mare, should be perceived, there will be just reason to apprehend
that it will occur, and it will be advisable to have recourse to some
preventative. The paroxysm of Night-Mare does not always immediately
follow the eating any improper food, b℥ut sometimes several days elapse
before its attack. In this case it is easier to foresee, and consequently
to prevent it. The signs by which its approach may be known, are unusual
drowsiness, disagreeable dreams, and disturbed sleep, with wind in the
stomach and bowels. In this case I would recommend immediate recourse to
be had to the carbonate of soda, as I have described above, or to the
following draught, which may be taken at bedtime.
No. 1. ℞. _Potassæ Carbonatis._ gr. x.
_Tinct. Cardam. Comp._ f. Ʒ iij.
_Syrupi Simplicis._ f. Ʒ j.
_Aquæ Menth. Pip._ f. ℥ j.
_M. fiat haustus._
Or this,
No. 2. ℞. _Ammon. pp._ gr. x.
_Tinct. Capsici._ f. Ʒ j.
_Syr. Croci._ f. Ʒ j.
_Aqua Cinnamom._ f. Ʒ x.
_M. fiat haustus._
Should these medicines not produce any relaxation of the bowels, it would
be necessary to take next morning a dose of some of the neutral purging
salts, or, what will answer equally well, the following aperient draught.
No. 3. ℞. _Magnesiæ._
_Pulv. Rhabarb._ a. gr. xv.
_Potassæ Carbonat._ gr. viij.
_Syr. Simpl._ f. Ʒ j.
_Aquæ Menth. Pip._ f. Ʒ xj.
_M. fiat haustus._
To those persons however, who are habitually subject to Night-Mare, I
would advise the frequent repetition of one or other of the draughts, No.
1 or No. 2, for several nights in succession, after which the aperient
draught, No. 3, may be taken, if necessary. And this plan I would
recommend to be adopted whenever the symptoms of predisposition mentioned
above are perceived, paying great attention at the same time to regularity
and choice of diet. Intemperance of every kind is hurtful, but nothing is
more productive of this disease than drinking of bad wine. Of eatables,
those which are most prejudicial, are all fat and greasy meats, most
vegetables, fruit, and pastry. These ought to be avoided, or eaten with
caution. The same thing may be said of salted meats, for which dyspeptic
patients have frequently a remarkable predilection, but which are not, on
that account, the less noxious. Moderate exercise contributes in a
superior degree to promote the digestion of food, and prevent the
formation of flatulence: to those however who are necessarily confined to
a sedentary employment, I would recommend particularly to avoid applying
to study, or any other sedentary occupation immediately after eating. If a
strong propensity to sleep should occur after dinner, it will be certainly
better to indulge it a little, as the process of digestion frequently goes
on much better asleep than awake. I have always felt at sea an
irresistible propensity to sleep after dinner, whenever the dyspeptic
symptoms were considerable, and I never, in any one instance, was
attacked with Night-Mare under those circumstances.
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.
[3] _Forrestus incubo affectus putabat, pectus suum comprimi a cane nigro,
unde respirare non potuit, utut fæmina videret esse somnium fallax, uti de
se refert._--L. 10. Obs. 51.