New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1915-01-17
BY y. ADDINGTON BRUCE.

catalogue OF medical works WSa
struck by the great number OF books
and ESSAYS on sleep and seeplessness
hat have been published since the middle OF
last century Procuring some OF these l was
esDecisilv impressed by the marked change IN
viewpoint represented by the latest studies OF
the subject and those made as recently as ten
or fifteen years sGo.
Whereas the earlier works, in discussing the
eternal problem Of insomnia. stressed physical
conditions as the dominant causes OF sleepess-
ness. the most recent ones. while recognizing
the invariable presence of the physical factor
shifted the emphasis to mental states. And
with respect TO remedies. there was an equal
w noticeable diminution OF reliance on the use
Of drugs as sleep bringing agents To quote
from one Of the latest publications, prize eS-
saw. contributed to the New York Medical
Journal" by Dr. Arthur S Riser:
NV watchword is avoid narcotics.
If drugs arc deemed necessary, their suggestive
action must be made use OF to enhance and pro
Ions their effects. But drugs are only palla-
tive. They cannot cure. They should never
be used for any length OF time and as II IS
especially difficult to prevent these patients
from, becoming drug habitues, 1t is usually
wiser 10 dispense entirely with their use.
THE DRUG POSTPONES SLEEPLESS-
NESS-IT NEVER CURES IT.
The best modern medical practice undoubt-
edly is i'm accord with this view. As time
masses and knowledge widens, all physicians
arc certain 70 come into agreement with It. and
resort 10 drugs only when the sleeplessness IS
definitely known 10 be caused by some acute or
chronic abnormal condition OF the physical or
esnisrn-as in liver. kidney, lung or brain d.
sesse-or when. 10 relieve shock OF any kind
il is absolutely necessary to produce an I'M
mediate state Of Inconsistencies.
Nor will decreasing use Of drugs result only
rom increasing appreciation of the ease with
which they give rise TO drug habit; It will
-esut rather from increasing appreciation OF
he truth OF Dr.. Rissers statement, that drugs
10 not cure.
They do not cure because, in nine cases out
# ten. chronic sleeplcssness IS the product OF
ondtions which drugs cannot possibly affect
ince these conditions relate not so much to the
uferer's internal organic state as 10 his mode
# life or his attitude toward life Usually, IN
eed. sleeplessness IS at bottom nothing more
nan a symptom of nervous irritation, provoked
w unhveienic physical or mental habits. For
hat matter. it almost always may itself be de-
.cribed as nothing more than bad habit based
m q gradually developing fixed idea that one
annot sleep
EVOLUTION OF HARMLESS CITIZEN
INTO AN INSOMNIA VICTIM,
Recent scienth- investigation shows that the
.volution of a typical case OF insomnia-eX-
eptng only in the small percentage OF cases
aused by organic disease-is about as follows;
Indiscreton in diet the smoking Of one cigar
90 many. or worry over some unexpected
BUSINESS or domestic problem, causes lew
leepless nights This interference with the
ordinary sleep habit being annoying deter
mined effort is made TO 90 to sleep. AS a
General thing. unhappily, the sleepless one IS
enorant of the conditions with which he must
-omply in order to insure sleep and so he con-
.inues to tumble and toss at best falling into
6tul doze. When, after the recognized cause
IF his temporary insomnia is removed he still
ais TO sleep with his odtime regularity he
becomes frightened
Consciously or subconsciously the idea now
occurs 20 him that do what he will, he cannot
gsin sleep; and in proportion as this idea takes
loot in his mind, he acquires a habit OF sleep
'essness. If. as generally happens, he has re-
course 20 drugs either on his own initiative or
9- nc advice OF some unthnkng physician his
,l;obt becomes far worse For the drugs can
not effect that change in his state OF mind in
jispensable 20 cure, but they can and do
eriouslv affect his physical system, perhaps 10
ne exten. of causing a chronic craving tor
,hem.
Or the habit OF sleeplessness may be en-
rendered and kept up by persistent excessive
expenditure of the nervous forces during the
dav. leading TO the production OF state OF
mental tension destructive OF repose at night
This is particularly common cause OF IN
somnia among women especially society
women who are continually on the go, con-
,inually in a state OF excitement. Under this
condition the baneful fixed idea OF sleepless-
ness becomes readily established in their
minds and is reinforced by their unwillngness
10 let down during the daytime. The same. OF
course. holds true Of these numerous business
men. who. constantly planning. straning and
Worrying find themselves. soon or late, I'M
willing recruits TO the great army OF insomnia
victims.
From all o. which it would seem TO follow
that in the great majority Of cases the proper
treatment OF insomnia is by psychological
rather than medicinal means. Such decidedly