Evening star. [volume] (Washington, D.C.) 1854-1972, 1889-07-19
On Wakefulness.
From Medical Classics.


The primary cause of wakefulness is an in
crease in the quantity of blood circulating in
the brain; hence, any condition or cause capa-
BILE of inducing this state of the cerebral circu-
lation may give rise to it. As these causes are
more or less under the control of the individ-
ual. it is important that they should be gen.
orally known. /. Excessive and long-continued
intellectual action, or powerful mental emo
tions. q 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 to the BRAIN Many physicians have
noticed the connection existing between bodily
position and wakefulness. 1t is evident that
the recumbent position is more conducive to a
state of congestion of the brain than the erect
or semi-erect. DR.. Forbes Winslow. DIR. Ham,
mond and other physicians have noticed an
increase in the number and intensity
of hallucinations of insane patients
or persons suffering from delirium tremens
as soon as they assume the recumbent position.
These patients have been found to sleep quietly
for some time in an armchair, but to be an
noyed by Authorizations as soon as they lie
down. 3. Certain substance used as medicine
or food. The chief agents of this class are
alcohol, tea-especially strong green tea
coffee, opium, beiladonna, stramonium, and
Indian hemp or hashish. Opium in small doses
is often especially potent in inducing wakeful-
ness. single dose of half grain has been
known to keep patient awake for three con-
secutive nights. All the so-called narcotics in
small doses induce wakefulness rather than
sleep. T. Functional arrangements of certain
organs of the body, whereby an increase in the
amount of blood in the brain is produced. As,
however, such cases as these are beyond the
control of the sufferer, need not discuss
them here. In all those cases of wakefulness
dependent upon severe and long continuous
mental exertion-and these are the cases to
which we especially wish to draw the attention
of our readers-all means of relief will
be utterly useless until the patient con-
sents to give his brain entire relaxation for a
time. Whenever it is possible, a course of
travel through a romantic country, a visit
to the seaside, should be regarded as impera-
tive. An early dinner, followed by hearty
supper of plain and nutritious dishes, is pre-
ferable to heavy late dinner; and a glass or
two of imperial crown sherry or some equally
choice and good wine at both meals, or a glass
of good whisky or brandy and water after
supper may often be taken with advantage.
The value of physical exercise-and especially
rldlng-in the open air, can scarcely be over
estimated, and should be carried on to the
point of incipent fatigue. shower bath in
the morning. and a warm bath before retiring
to rest, useful auxiliaries; a somewhat high
and not too soft pillow should be used; and,
if the feet are very cold, hot-water bottle
should be placed at the bottom of the bed. If
the preceding means-all or most of which the
patient can try for himself-fail, recourse
should at once be had to professional advice.