_Of the Cure._
When People are found in a fit of the Night-mare, the most effectual
remedy is to rouse them as soon as possible, by changing the position
of the Body, and applying some keen stimulus immediately, such as
pricking with a pin, speaking loud, &c. and if they recover the least
degree of voluntary motion, the happy crisis is for that time obtain’d,
as Actuarius and Willis observ’d.
I have often been so much oppress’d by this enemy of rest, that I
would have given ten thousand worlds like this for some Person that
would either pinch, shake, or turn me off my Back; and I have been so
much afraid of its intolerable insults, that I have slept in a chair
all night, rather than give it an opportunity of attacking me in an
horizontal position.
Doctor Lower relates a remarkable similar case, which I shall here
translate. He says, “[42]I knew a Gentleman, who, in every other
respect, enjoy’d perfect health, but was so subject to the Night-mare,
that, whenever he slept on his Back, he was seiz’d with it in such
a violent manner, that he was oblig’d to keep a Servant in the same
bed with him; who, upon hearing his Master groan and Sigh (with which
Symptoms it us’d to begin) immediately turn’d him on his Side; by which
means it was, and may be always, remov’d.”
’Tis observable, that people are rous’d out of a fit of the Night-mare,
sometimes, by sound alone. I remember to have been under it, when a
Servant came in the morning to make a fire, and let the coal-box fall
at the door; the noise of which effectually reliev’d me. The vibrations
or undulations of the air beating upon the drum of the Ear, may act as
a successful stimulus in this case.
As this Disease seems to arise immediately from a supine position of
the Body in sleep, we should take care to prevent it before we fall
asleep, by composing the Body on either Side. The sagacious Hoffman
observes, that the safest posture in sleep, is on either Side, with the
Head rais’d, and the Limbs bent inwards to the trunk of the Body[43].
Some ingenious men have imagin’d, that the bending of the Limbs in
sleep is owing to the strong tendency which the flexor Muscles have to
contraction; but I humbly suppose, it is rather a voluntary motion,
intended to fix the Body on the Side, without the continued action of
any of the voluntary Muscles afterwards; for without the flexion of
the Joints in sleep, it would be a kind of labour to keep the Body
pois’d on such an narrow surface. To demonstrate this, I shall avoid
mathematics, and appeal to common sense, for an easy experiment.
Suppose one should endeavour to poise a thin plate of tin on its edge
upon a smooth, level table; if he be not an expert equilibrist, he will
find it difficult; but if he bends the plate, then the problem becomes
as easy as the well known method of making an egg stand on its end.
This easy method, which nature has contriv’d to preserve the human Body
on its side, is a sufficient recommendation of that position, and a
strong precaution against lying on the Back, which is the posture of
dead Bodies.
Before any regular or effectual plan of curing, or rather preventing,
this Disease, can be propos’d, it will be always necessary to consider
minutely the primary or pre-disposing causes of it, formerly mention’d.
If the primary cause be a weakness of the Fibres, then strengthening
or astringent medicines are proper; which, by increasing the cohesion
of the constituent particles of the Solids, will make the Fibres more
dense, brace them up to a proper pitch, and quicken their vibrations.
The principal Medicines of this class are iron, and its preparations,
the Bark, the wild Valerian-root, and the cold Bath.
If it arises from an inertia or indolence of the Solids, nervous
medicines will best answer that indication; which, by stimulating the
lazy inactive Fibres, will increase their elasticity, invigorate their
contractions, accelerate the motion, and break the tenacity of the
Blood.
If the Blood be too thick, attenuants should be us’d, such as, spiritus
Mendereri[44], vegetable subacid liquors, saponaceous medicines, and
plenty of vinegar at meals, which, according to the great Boerhaave, is
a powerful diluent[45].
A Plethora or redundance of Blood, is certainly the most general
cause of the Night-mare, and requires immediate evacuations, which
principally consist in bleeding or purging. But the former is most
effectual. However, Bleeding should not be often repeated, unless
absolutely necessary, lest, it should become a custom, which might, at
the same time, procure a short intermission, and increase the cause
of the Disease; and also prove inconvenient and dangerous; for if, at
any establish’d period, Bleeding should be omitted, then the person is
expos’d to all the bad effects of a Plethora, enumerated by Boerhaave,
viz. Inflammations, Suppurations, Gangrenes and Death[46].
It is well known, that nothing genenerates Blood faster, or contributes
more to a Plethora, than bleeding often, which some are fond of,
without assigning any reason for it, except its being a custom, which
experience proves a very bad one.
Van Sweiten says, “He saw a Woman, who, being subject to violent
affections of the Mind, was bled above sixty times in one year. She by
that means grew very fat, and increas’d her weight 150 pounds in a few
months. By bleeding often new Blood was generated, and the necessity of
bleeding became more frequent, ’till she was so far relax’d, that she
fell into a Dropsy[47].”
He adds, “That bleeding, which some use by way of precaution, is a bad
custom, since it weakens the Solids, and renders the Body more subject
to a fresh accumulation of Fluids.”
Experience has convinced me of the truth of this observation; for,
while I practis’d bleeding every month or six weeks, I found the
Night-mare return’d on me at these periods, rather aggravated than
abated. My bad success made me alter my method; and, instead of drawing
eight or ten ounces of blood at once, I drew twenty, and liv’d low,
on thin, astringent diet, for a few days afterwards; in which time
the dilated vessels contracted themselves, and resisted the sudden
distension, which taking large quantities of nourishing diet, after
plentiful evacuations, must always produce; as our medical Bard justly
expresses it,
“Too greedily th’ exhausted Veins absorb The recent Chyle[48].”
By observing Boerhaave’s method of curing a Plethora, viz. using a
thin, light diet after bleeding, and gradually prolonging the time
between each evacuation, I have reduc’d my bleedings to one every
autumn; and (thank Heaven) have in a great measure conquer’d that
Monster of the night, which so often threaten’d me with immediate
destruction.
Experience also assures us, that large evacuations may be made by
strong purges; such as Jalap, Scammon. &c. which greatly dissolve, and
diminish the quantity of the Blood.
Hence, we see the reason why Paulus Egeneta justly prescrib’d Scammony
in this Disease[49]. But in this kind of evacuations, Boerhaave’s
salutary rule should be also observ’d; viz. “Omissione sensim
introducta.”
’Tis needless here to take notice of all the ill-adapted farrago of
Medicines prescrib’d by many of the old Physicians, who did not know
the cause of this Disorder.
I cannot understand why Piony was reckon’d, by them, such a famous
specific for the Night-mare, which, taken internally, is only a
gentle attenuant: and ’tis very surprising, that Doctor Willis should
be so superstitious as to recommend balls made of Piony and Corral
to be tied about the Neck, by way of a sacred nostrum against this
Disease[50].
Temperate living is certainly the most effectual method of preventing
this and many other Disorders. Vegetable and flesh meat of easy
digestion; thin, subacid, diluent liquors, taken in moderate
quantities; light or no suppers; brisk exercise of all kinds;
high pillows, and sleeping on the Side, are the most sovereign
Prophylactics, or preventives.
If People subject to the Night-mare be so fond of heavy flesh-suppers,
that they can neither rest with them nor without them, they should sup
early, and sit up or exercise two or three hours afterwards; and when
they go to bed, they should lie on the right Side, that the food may
have the advantage of its own gravity in passing out of the Stomach
into the Guts. In that position the Heart will fall on the Mediastinum,
which, being a flexible Membrane, will be an easier support to the
Heart than if it play’d against the hard Ribs, which is always the
consequence of lying on the left Side.
When the fair Sex is oppress’d with this Disorder, and the precedent
cause is an obstruction of the Catamenia, the defect of that natural
discharge may be supply’d by a moderate bleeding; and proper remedies
should be us’d to clear the obstructed tubes, and open the flood-gates
to promote the ebb of the next full tide. But if the cause be common to
both sexes, the same methods may be follow’d, proper allowance being
made for the delicacy of the female constitution.
Excessive drinking at night, as well as excessive eating, should
be avoided; but of the two evils, the former is the lesser, as our
British Celsus observes:
“Tutior autem est in potione, quam in esca, intemperantia[51].”
As intoxication subjects People to most dreadful fits of this Disorder,
as well as to many other accidents, it should, by all means, be shun’d.
Lucretius has so well painted its bad effects, that, I presume, my
polite reader will think his description of it neither tedious nor
foreign.
Denique cur, Hominem cum vini vis penetravit
Acris et in Venas discessit deditus ardor,
Consequitur gravitas membrorum? Præpidiuntur
Crura vacillanti? tardescit Lingua? madet mens?
Nant Oculi? clamor singultus, jurgia gliscunt?
Et jam cætera de genere hoc quæcunq; sequuntur?
Lib. 3.
Besides, when wine’s quick force has pierc’d the Brain,
And the brisk heat’s diffus’d thro’ every Vein,
Why do the members all grow dull and weak?
The Tongue not with its usual swiftness speak?
The Eye-balls swim? the Legs not firm and straight,
But bend beneath the Body’s natural weight:
Unmanly quarrels, noise, and sobs deface
The powers of Reason, and usurp their place.