SOMNOLENCE.
Somnolence or drowsiness is generally regarded, when persistent, as being more strongly indicative of organic changes in the structure of the brain than is any other derangement of sleep.
This opinion is mainly, if not entirely, due to the fact that it is confounded with stupor, from which, both in its causes and effects, as has already been shown, it differs in every essential respect.
Somnolence is nothing more than an inordinate tendency to sleep. When manifested in a slight degree it is difficult, without careful examination and a thorough inquiry into the history of the case, to distinguish it from moderate stupor. It is of course very important that the distinction should be made; for, in reality, somnolence is ordinarily no very serious disorder, and is generally symptomatic of eccentric disease, whereas stupor almost invariably results from organic brain affections, from cerebral injuries, or the circulation of poisoned blood through the encephalic blood-vessels.
Whatever lessens the amount of blood normally circulating through the cerebral vessels, tends to the production of somnolence. It is hence a conditionfrequently witnessed in those whose powers of life have been reduced by long-continued disease, by excesses of various kinds, or by affections which essentially consist in enfeeblement of the organism. It is generally met with in the aged, in whom the circulatory organs have lost their pristine vigor.
Many cases of very troublesome and persistent somnolence, having an origin such as I have mentioned, have come under my notice: ordinarily they present no difficult features of treatment, the indications being to increase the tone of the system by stimulants, tonics, nutritious food, and moderate exercise in the open air. These measures will invariably succeed if there be no organic difficulty.
Somnolence, however, is sometimes due to structural changes which interfere with the free passage of blood through the cerebral vessels. It may hence be caused by emboli, which, obstructing the arteries, prevent the normal amount of blood reaching the brain substance. It may also be caused by tumors, which, pressing on the arteries supplying the brain, act in like manner. In such cases it is of secondary importance.
A very curious affection, known as the “Sleepy Disease,” has been described as endemic in certain regions of Africa. The following extract[143]gives a graphic description of the malady:
“Having procured a guide, we crossed the river,and at the mouth of Logan’s Creek we exchanged our boat for a large canoe, in which we followed the windings of the deep and narrow inlet for nearly two miles. This brought us to a village of six huts. Without ceremony we entered the dwelling of the old queen (who was busied about her household affairs), and looked around for her granddaughter, to see whom was the principal object of our excursion. On my former visit to Maumee’s town, four or five months ago, this girl excited a great deal of admiration by her beauty and charming simplicity. She was then thirteen or fourteen years of age—a bright mulatto, with large and soft black eyes, and the most brilliantly white teeth in the world. Her figure, though small, is perfectly symmetrical. She is the darling of the old queen, whose affections exhaust themselves upon her with all the passionate fire of her temperament, and the more unreasonably because the girl’s own mother is dead.
“We entered the hut, as I have said, without ceremony, and looked about us for the beautiful granddaughter; but, on beholding the object of our search, a kind of remorse and dread came over us, such as often affects those who intrude upon the awfulness of slumber. The girl lay asleep in the adjoining apartment, on a mat that was spread over the hard ground, and with no pillow beneath her cheek. One arm was by her side, the other above her head, and she slept so quietly, and drew such imperceptible breath, that I scarcely thought her alive.
“With some little difficulty she was aroused, and awoke with a frightened cry,—a strange and broken murmur,—as if she were looking dimly out of her sleep, and knew not whether our figures were real, or only the fantasies of a dream. Her eyes were wild and glassy, and she seemed to be in pain. While awake, there was a nervous twitching about her mouth and in her fingers; but, being again extended upon the mat, and left to herself, these symptoms of disquietude passed away, and she almost immediately sank again into the deep and heavy sleep in which we found her. As her eyes gradually closed their lids, the sunbeams struggling through the small crevices between the reeds of the hut glimmered down about her head. Perhaps it was only the nervous motion of her fingers, but it seemed as if she were trying to catch the golden rays of the sun and make playthings of them, or else to draw them into her soul and illuminate the slumber that looked so misty and dark to us.
“This poor doomed girl had been suffering—no, not suffering; for, except when forcibly aroused, there appeared to be no uneasiness,—but she had been lingering two months in a disease peculiar to Africa: it is called the ‘Sleepy Disease,’ and is considered incurable. The persons attacked by it are those who take little exercise, and live principally on vegetables, particularly cassady and rice. Some ascribe it altogether to the cassady, which is supposed to be strongly narcotic—not improbably theclimate has much influence, the disease being most prevalent in low and marshy situations. Irresistible drowsiness continually weighs down the patient, who can be kept awake only for the few moments necessary to take a little food. When this lethargy has lasted three or four months, death comes with a tread that the patient cannot hear—and makes the slumber but a little more sound.
“I found the aspect of Maumee’s beautiful granddaughter inconceivably affecting. It was strange to behold her so quietly involved in sleep from which it might be supposed she would awake so full of youthful life, and yet to know that this was no refreshing slumber, but a spell in which she was fading away from the eyes that loved her. Whatever might chance, be it grief or joy, the effect would be the same. Whoever should shake her by the arm—whether the accents of a friend fell fully on the ear, or those of strangers like ourselves,—the only response would be that troubled cry, as of a spirit that hovered on the confines of both worlds and could have sympathy with neither. And yet, withal, it seemed so easy to cry to her, ‘Awake! Enjoy your life! Cast off this noontide slumber!’ But only the peal of the last trumpet will summon her out of that mysterious sleep.”
Another and later account of this singular disease has recently been given by M. Dumoutier,[144]surgeon in the French Navy.
According to this observer, the affection commonly called the “sleep-disease” (maladie du sommeil) is met with only among the negroes of the coast, and principally those of the Gaboon and of Congo, becoming more rare towards the north. The most prominent symptoms are an irresistible tendency to sleep, and a feeling of torpor and numbness. The patient does not complain of pain, and yet there is a general weakness of the limbs, the gait is tottering, the sensibility is perverted, and the hands imperfectly grasp the objects they attempt to seize. During the sleep the fecal matters and the urine are passed involuntarily. The respiration is normal, and the digestion regular. These were the principal symptoms observed in those cases which came under M. Dumoutier’s notice: observing the disease only in the persons of captives coming from the interior, he ascribes it to nostalgia,ennui, and other moral causes. Two autopsies made by his colleagues revealed no abnormal condition of the brain, the spinal cord, or their membranes.
The treatment employed—quinia, strychnia, and iron—had no effect. A temporary improvement was obtained by causing the patients to take part in the amusements of their companions. Electricity seemed likewise to retard somewhat the progress of the disease.
The fact that no organic difficulty of the brain was discovered after death, is strong proof that the somnolency was due to some cause affecting theintra-cranial circulation. That the amount of blood was lessened, and that thus a permanent anæmia of the brain was produced, can scarcely be doubted, when regard is had to the observations and experiments recorded in the foregoing pages of this work. Probably the primary derangement was seated in the sympathetic nerve and its ganglia, it having been well settled by familiar observations, and by recent contributions to physiology and pathology, that one of the chief functions of this system is to regulate the caliber of the blood-vessels, and thus to determine the amount of blood circulating through an organ or part of the body.
Numerous cases of protracted sleep are on record. Some of them are evidently fanciful and exaggerated, but others are doubtless well founded. One of the most remarkable of these is related, among many others, by Wanley.[145]
“One Samuel Chelton, of Finsbury, near Bath, a laboring man, about twenty-five years of age, of a robust habit of body, not fat, but fleshy, and of dark-brown hair, happened, on the 13th of May, 1694, and without visible cause, to fall into a very profound sleep, out of which he could by no means be aroused by those about him till after a month’s time, when he arose of himself and went to his husbandry business as usual. He slept, ate, and drank as before,but did not speak a word till about a month after. All the time he slept, victuals and drink stood by him, which were spent every day, and used by him, as was supposed, though no person saw him eat or drink all the while. After this period he continued free from drowsiness or sleepiness till the 9th of April, 1696, when he fell into his sleeping fit again, as he had done before. After some time his friends were prevailed on to try what effect medicines might have upon him. Accordingly, Mr. Gills, an apothecary, bled, blistered, cupped, and scarified him, and used all the external irritating medicines he could think of, but to no purpose; and after the first fortnight he was never observed to open his eyes: victuals stood by him as before, which he ate of now and then, but no one ever saw him eat or evacuate, though he did both very regularly, as he had occasion; and sometimes he was found fast asleep with the pot in his hand in bed, and sometimes with his mouth full of meat. In this manner he lay about ten weeks, and then he could eat nothing at all, for his jaws seemed to be set, and his teeth clinched so close that, notwithstanding all the art that could be used with instruments, his mouth could not be opened to put anything into it to support him. At last, those about him observing a hole in his teeth, made by holding his pipe, they now and then poured some tent into his mouth through a quill. And this was all he took for six weeks and four days; but it amounted to no more than three pints or two quarts.He had made water only once, and never had a stool all that time.
“On the 7th of August, which was seventeen weeks from the 9th of April, when he began to sleep, he awaked, put on his clothes, and walked about the room, not knowing he had slept above a night; nor could he be persuaded he had lain so long, till, going into the fields, he found everybody busy getting in their harvest, and he remembered very well when he fell asleep that they were sowing their barley and oats, which he then saw ripe and fit to be cut down. There was one thing remarkable: though his blood was somewhat wasted with lying so long in bed and fasting for about six weeks, yet a gentleman assured Dr. Oliver that when he saw him—which was the first day of his coming abroad—he looked brisker than ever he saw him in his life before; and on asking him whether the bed had made him sore, he assured this gentleman that he never felt this or any other inconvenience, and that he had not the least remembrance of anything that passed, or what was done to him, all that while. So that he went again to his husbandry, as he was wont to do, and remained well till August 17th, 1697, when, in the morning, he complained of a shivering and a coldness in his back. He vomited once or twice, and the same day fell into his sleeping fit again. Dr. Oliver, going to see him, found him asleep, with a cup of beer and a piece of bread and cheese upon a stool by his bed, within his reach. The doctor felthis pulse, which at that time was regular, and he also found his heart beat very regular, and his breathing easy and free. The doctor only observed that his pulse beat a little too strong. He was in a breathing sweat, and had an agreeable warmth all over his body. The doctor then put his mouth to his ear, and called him as loud as he could several times by his name, pulled him by the shoulders, pinched his nose, stopped his nose and mouth together as long as he could without choking him, but to no purpose, for all this time he did not give the least sign of being sensible. The doctor lifted up his eyelids, and found his eyeballs drawn up under his eyebrows and fixed without any motion. The doctor then held under one nostril, for a considerable time, a vial with spirits of sal ammoniac, extracted from quicklime; he then injected it several times up the same nostril; and though he had poured into it almost half an ounce of this fiery spirit, it only made his nose run, and his eyelids shiver and tremble a little. The doctor, finding no success with this, crammed that nostril with white powder of hellebore, and waited some time in the room to see what effects all these together might have upon him; but he never gave any sign that he felt what the doctor had done, nor discovered any manner of uneasiness, by stirring any part of his body, that the doctor could observe.
“After all these experiments the doctor left him, being pretty well satisfied that he was asleep, and nosullen counterfeit, as some people supposed. On the doctor’s relating what he had observed, several gentlemen from Bath went out to see him, and found him in the same condition the doctor had left him in the day before, only his nose was inflamed and very much swelled, and his lips and the inside of his nostrils were blistered and scabby, occasioned by the spirits and the hellebore. About ten days after the doctor had seen him, Mr. Woolner, an apothecary, finding his pulse beat very high, drew about fourteen ounces of blood from the arm, and tied it up, and left it as he found him; and Mr. Woolner assured the doctor that he never made the least motion when he pricked him, nor all the while his arm was bleeding. Several other experiments were tried by those who went to see him from Bath, but all to no purpose. The doctor saw him again the latter end of September, and found him just in the same position, lying in his bed, but his pulse now was not so strong, nor had he any sweats, as when the doctor saw him before. He tried him again by stopping his nose and mouth, but to no purpose; and a gentleman ran a large pin into his arm to the very bone, but he gave no signs of his being sensible to what was done to him. During all this time the doctor was assured that nobody had seen him either eat or drink, though they watched him as closely as possible,—but food and drink always stood by him, and they observed that sometimes once a day, and sometimes once in two days, all was gone. It was further observed that he neverdirtied his bed, but always went to the pot. In this manner he lay till the 19th of November, when his mother, hearing him make a noise, immediately ran up to him and found him eating. She asked him how he did. He replied, ‘Very well, thank God.’ She asked him again which he liked best, bread and butter, or bread and cheese. He answered, ‘Bread and cheese.’ Upon this the woman, overjoyed, left him to acquaint his brother, and both coming straight up into the chamber to speak to him, they found him as fast asleep as ever, and could not by any means awake him. From this time to the end of January, or beginning of February, he did not sleep so profoundly as before; for, when they called him by his name, he seemed to hear them, and became somewhat sensible, though he could not make them any answer. His eyes were not shut so close, and he had frequently great tremblings of his eyelids, upon which they expected every day that he would awake, which did not happen till about the time mentioned, when he awoke perfectly well, but remembered nothing that had happened all the while. It was observed that he was very little altered in his flesh; he only complained that the cold hindered him more than usual, but he presently went to his labor, as he had done before.”
The case of Mary Lyall is quoted by Macnish, from the 8th volume of the Transactions of the Royal Society of Edinburgh, as follows:[146]
“This woman fell asleep on the morning of the 27th of June, and continued in that state till the evening of the 30th of the same month, when she awoke and remained in her usual way till the 1st of July, when she again fell asleep, and continued so till the 8th of August. She was bled, blistered, immersed in the hot and cold bath, and stimulated in almost every possible way, without having any consciousness of what was going on. For the first seven days she continued motionless, and exhibited no inclination to eat. At the end of that time she began to move her left hand, and, by pointing to her mouth, signified a wish for food. She took readily what was given to her. Still she evinced no symptoms of hearing, and made no other kind of bodily movement than of her left hand. Her right hand and arm particularly appeared completely dead and bereft of feeling, and even when pricked with a pin, so as to draw blood, never shrunk in the least degree. At the same time she instantly drew back her left arm whenever it was touched by the point of the pin. She continued to take food whenever it was offered to her. For the first two weeks her pulse generally stood at 50, during the third and fourth week about 60, and on the day before her recovery at 70 or 72. Her breathing was soft and almost imperceptible, but during the night-time she occasionally drew it more strongly, like a person who has just fallen asleep. She evinced no symptom of hearing till about four days before her recovery.On being interrogated after this event upon her extraordinary state, she mentioned that she had no knowledge of anything that had happened—that she had never been conscious of either having needed or received food, or of having been blistered; and expressed most surprise on finding her head shaved. She had merely the idea of having passed a long night in sleep.”
Many other cases might be referred to; but as their general features are similar to the two cited, it is unnecessary to quote them. The following instance occurring in this country presents some features of interest. It is reported by Dr. C. A. Hart,[147]of this city.
“Miss Susan C. Godsy, aged 22, of bilious temperament, has been in a somnolent state since 1849, being then eight years of age. Up to within a year of that period she had enjoyed excellent health, she being then attacked with intermittent fever, in the treatment of which opium was extensively used. This was erroneously supposed to have induced her present condition. Soon after her recovery, excessive somnolency began to develop itself, which in 1857 became more profound after an attack of scarlatina anginosa, followed by measles. The lucid intervals will occur from four to six times a day, and last for from five to six minutes; at which periods she will generally take some nourishment, and thenrelapse into a profound slumber, from which it is impossible to arouse her.
“In point of general physique there is nothing specially worthy of note, except the comparative plumpness during such a long maintenance of the recumbent posture, with very little muscular exercise. She is about the average height of her sex, with cranial development possibly a little in excess. The hands and feet are both exceedingly small, the nails of which have not grown any since her present condition began.
“The catamenia commenced between the fourteenth and fifteenth years, and are generally very irregular and painful; but, when anything like regularity is attained, the flow occurs about every six weeks.
“None of the special senses are in the least diminished or perverted; there has been neither squinting nor excessive dilatation of the pupils. The irides both respond readily to the stimulus of light. While interrogating the mother, a convulsive movement of the entire body took place, apparently more violent in the upper than in the lower extremities. The arms, hands, and feet were in rapid motion. At the subsidence of this, consciousness was established; and the young lady herself, being questioned about her condition, replied in a clear and comprehensible manner, though merely using monosyllables. When asked if she suffered any pain inher head, she replied yes, but without locating it; if in the back, yes; if about the chest or abdomen, no. She was lucid about five minutes, during which time a number of questions were asked her, but without eliciting any further information. She took no food or medicine during this interval of consciousness, and went to sleep while being questioned, remaining in that state during the rest of the time we were there—about half an hour—her rest being perfectly tranquil with the exception of a slight convulsive movement.”
These cases of protracted sleep present many analogies with the condition of hibernation which certain of the lower animals enter into at stated periods. Doubtless the state of the brain is the same, and is one of anæmia.
It has never been my fortune to witness a case of protracted sleep. Regarding the starting-point of the disorder as being situated in the sympathetic system, I should be disposed to employ the direct galvanic current in the treatment—placing the positive pole over the sympathetic nerve in the neck, and the negative over the opposite scapula. This I would do, using a battery of thirty-two or a less number of pairs, every day, for from five to ten minutes.
SOMNOLENTIA, OR SLEEP DRUNKENNESS.
By somnolentia, or sleep drunkenness, is understood a condition in which some of the mental faculties and senses are fully aroused, others partially so, while others remain as they are in profound sleep. It is therefore an imperfect sleep, or rather a combination of wakefulness and sleep. The phenomena peculiar to it are frequently met with in children, in whom they may be excited through the influence of a dream, but which at other times have no such origin. The condition in question is only induced by the sudden waking of a person.
A very excellent account of sleep drunkenness, in its medico-legal relations, is given by Wharton and Stillé,[148]who have quoted several interesting cases from German and other authors, which I do not hesitate to transfer to these pages.
“A sentry fell asleep during his watch, and, being suddenly aroused by the officer in command, attacked the latter with his sword, and would havekilled him but for the interposition of the by-standers. The result of the medical examination was, that the act was involuntary and irresponsible, being the result of a violent confusion of mind consequent upon the sudden waking from a profound sleep.
“A day-laborer killed his wife with a wagon-tire, the blow being struck immediately on his starting up from a deep sleep from which he was forcibly awakened. In this case there was collateral evidence that the defendant was seized, on awaking, with a delusion that a ‘woman in white’ had snatched his wife from his side and was carrying her away, and that his agony of mind was so great that his whole body was bathed in perspiration.
“A young man, named A. F., about twenty years of age, was living with his parents in great apparent harmony, his father and himself being alike distinguished for their great fondness for hunting. In consequence of danger from nocturnal attacks, they were in the habit of taking their arms with them into their chambers when they went to bed. On the afternoon of September 1st, 1839, the father and son having just returned from hunting, their danger became the subject of particular conversation. The next day the hunting was repeated, and on their return, after taking supper with every evidence of good feeling, they retired for the night, the son to his own room, and his father and mother to theirs. Both father and son took their loaded arms withthem. At one o’clock the father got up to go into the entry, and on his return jarred against the door, on which the son instantly sprang up, seized his gun, and discharged it at his father, giving him a fatal wound in the breast, at the same time exclaiming, ‘Dog, what do you want here?’ The father immediately fell to the ground; and the son, then recognizing him, sank on the floor, crying, ‘Oh, Jesus! it is my father!’
“The evidence was that the whole family were subject to great restlessness in their sleep, and that the defendant in particular was affected with a tendency to be easily distressed by dreams, which lasted for about five minutes, on waking, before their effect was entirely dissipated. His own version of the affair was: ‘I must have fired the gun in my sleep; it was moonshine, and we were accustomed to talk and walk in our sleep. I recollect hearing something jar; I jumped up, seized my gun, and fired when I heard the noise; I recollect seeing nothing, nor am I conscious of having spoken. The night was so bright that everything could have been seen. I must have been under the delusion that thieves had broken in.’ The opinion of the medical experts was, that the act was committed during the condition of sleep drunkenness, and that, accordingly, it was not that of a free and responsible agent.”
The same authors quote the following case of Dr. Meister, from Herke’s Zeitschrift:
“I was obliged,” says the doctor, “to take ajourney of eight miles on a very hot summer’s day—my seat being with my back to the horses, and the sun directly in my face. On reaching the place of destination, and being very weary and with a slight headache, I laid myself down, with my clothes on, on a couch. I fell at once asleep, my head having slipped under the back of the settee. My sleep was deep, and, as far as I can recollect, without dreams. When it became dark, the lady of the house came with a light into the room. I suddenly awoke, but, for the first time in my life, without collecting myself. I was seized with a sudden agony of mind, and, picturing the object which was entering the house as a specter, I sprang up and seized a stool, which, in my terror, I would have thrown at the supposed shade. Fortunately I was recalled to consciousness by the firmness and tact of the lady herself, who, with the greatest presence of mind, succeeded in composing my attention until I was entirely awakened.”
Hoffbauer[149]relates the particulars of a case which has passed into the annals of medical jurisprudence as one of great importance.
“Bernard Schidmaizig awoke suddenly at midnight. At the same moment he saw a frightful phantom (at least so his imagination depicted it)standing near him. That which appeared to his vision seemed to be a veritable specter; and fear and the darkness of the night prevented him recognizing anything with distinctness. With a feeble voice, he twice called out, ‘Who goes there?’ He received no answer, and imagined that the apparition was approaching him. Deprived for the instant of his reason, he jumped from his bed, seized a hatchet which he generally kept near him, and with this weapon attacked the imaginary specter. To see this apparition, to cry, ‘Who goes there?’ to seize the hatchet, were all done in a moment: he had not an instant for reflection. At the first blow the phantom was struck to the earth; Schidmaizig heard a deep groan. This sound, and the noise of the imaginary phantom falling to the ground, fully awakened him; and suddenly the thought struck him that he had assaulted his wife, who slept with him. He threw himself on his knees, raised the head of the wounded person, saw the injury he had inflicted, and the blood which flowed, and with a voice full of anguish cried, ‘Susannah! Susannah! come to yourself!’ He then called his eldest daughter, aged about eight years—ordered her to see if her mother was recovering, and to tell her grandmother what he had done. It was in reality his wife; and she died the next day from the effects of the blow.”
As Hoffbauer remarks, “This man did not enjoy the free use of his senses; he did not know what he saw; he believed that he was repulsing a suddenattack. He very soon recognized the place where he ordinarily slept; it was natural that he should seize his hatchet,—since he had taken the precaution to place it near him,—but the idea of his wife, and of the possibility of having killed her, were the last thoughts that entered his mind.”
Seafield[150]quotes from the Express (London) of January 5th, 1859, the following case of sleep drunkenness:
“Yesterday the Marylebone Police Court was crowded to excess, in consequence of a report which had been circulated, that a woman was in custody for killing her child by throwing it from a first-floor window into the street. The rumor in regard to the murder happily turned out to be untrue; but it will be seen from the subjoined evidence that it was a providential circumstance that the lives of three children were not sacrificed by their mother while acting under the influence of a dream.
“At two o’clock the prisoner, Esther Griggs, was placed at the bar before Mr. Broughton.
“Mr. Lewis, of Ely Place, appeared for her; and Mr. Tubbs, relieving officer of Marylebone, attended on behalf of the board of guardians of the parish, to watch the case.
“The prisoner, who evidently felt the serious situation in which she was placed, was seated during the proceedings.
“The first witness called was Sergeant Simmons, 20 D, who said, ‘At half-past one o’clock this morning, while on duty in East Street, Manchester Square, I heard a female voice exclaim, “Oh, my children! Save my children!” I went to the house, No. 71, from whence the cries proceeded, and the landlord opened the door. I went up-stairs, accompanied by two other constables, and, while making our way to the first floor, I heard the smashing of glass. I knocked at the door, which I found was fastened, and said, “Open it; the police are here.” The prisoner, who was in her night-dress, kept on exclaiming, “Save my children!” and at length, after stumbling over something, let me and my brother officers in. When we entered, we found the room in total darkness; and it was only by the aid of our lanterns that we could distinguish anything in the room. On the bed there was a child five years old, and another, three years of age, by her side. Everything in the room was in confusion. She kept crying out, “Where’s my baby? Have they caught it? I must have thrown it out of the window.” The baby must have been thrown out as I was going up-stairs; for before getting into the room I heard something fall. I left a constable in charge of the prisoner; and I ascertained that the child which had been thrown from the window had been taken to the infirmary of Marylebone Workhouse. She told me she had been dreaming that her little boy had said that the house was on fire,and that what she had done was with the view of preventing her children from being burned to death. I have no doubt,’ added the witness, ‘that if I and the other constable had not gone to the room all three of the children would have been thrown into the street.’
“Mr. Broughton.—‘How long do you suppose the cry of “Oh, save my children!” continued?’
“Witness.—‘I should think about five minutes.’ (In continuation, he said he went to 38 Harley Street, where the husband lives, in the service of a gentleman, and gave him information of what had occurred. The injured infant was only eighteen months old.)
“By Mr. Lewis.—‘From the excited state in which the prisoner was, I did not at the time take her into custody. She went to the infirmary along with her husband, to see how the child was going on, and what hurt it had sustained. I had understood that the surgeon had said it was a species of nightmare which the prisoner was laboring under when the act was committed. The window had not been thrown up. The child was thrust through a pane of glass, the fragments of which fell into the street.’
“Humphreys, 180 D.—‘I heard the breaking of glass, and saw what I imagined to be a bundle come out of the window, and, on taking it up, I found it to be a female infant. There was blood running from its temples, and it was insensible. I took it to the infirmary.’
“Pollard, 314 D.—‘I heard loud cries of “Oh, save my children!” and when I was in her room she said, “Has anybody caught my baby Lizzie?” One of the little boys, about three years old, and who was clinging to his mother, had blood upon his clothes. He had upon his breast some marks, which appeared to have been caused by cuts from glass. He left me to take care of the prisoner while he went for her husband. She told me she had no wish to hurt any of her children, and that it was all through a dream.’
“Mr. Henry Tyrwhitt Smith, surgeon of the Marylebone Infirmary, was next called, and said, ‘That when the infant was brought to him, soon after one in the morning, he found, upon examining it, that it was suffering from concussion of the brain. It was quite insensible, and decidedly in danger now. The parietal bone is broken, and death might ensue in the event of an effusion of blood on the brain.’
“By Mr. Lewis.—‘I cannot say that I have not heard of an instance where parties have committed acts to which a dream had impelled them.’
“Mr. Lewis submitted to the magistrate that there had been no attempt to murder the infant. The prisoner had always evinced a kindly feeling toward her children, and he (the learned gentleman) hoped that the magistrate would allow the husband to have her under his care during the temporary remand which would of course take place. The dreamunder which the act was committed showed that she had not, at the time, any consciousness of what she was doing.
“Mr. Tubbs said he did not attend in the capacity of a prosecutor, but he appeared on behalf of the board of guardians; and he put it to the magistrate whether there would be any objections, under the circumstances, to allow the prisoner to be bailed, her husband being security for her reappearance.
“Mr. Broughtonconsidered that it would be a most dangerous doctrine to lay down, to say that because a person was dreaming while committing an offense, that they were not culpable for their acts. A woman, on these grounds, might get up in the middle of the night and cut her husband’s throat, and, when brought up for the offense, turn round and say that she had done the act while under the influence of a dream. He (the worthy magistrate) considered the case to be one of a serious nature; and in the event of death ensuing, an inquest would be held on the body. He could not think of taking bail in so serious a case, but would remand the prisoner till Tuesday next, and during her present excited state she would be taken care of in the infirmary.
“The prisoner was then removed to the cells by Ansted, the jailer, sobbing most bitterly.
“The recorder, at the subsequent sessions at the Central Criminal Court, in his address to the grand jury, took a somewhat more rational view of the case than that entertained by Mr. Broughton.
“‘If the prisoner,’ said the recorder, ‘really did the act under the idea that it was the best mode of insuring the safety of the child, it appeared to him that, under such circumstances, it would be a question whether the grand jury would be justified in coming to the conclusion that the criminal was guilty of a criminal act.’
“The grand jury threw out the bill.”
Several cases of sleep drunkenness have come under my own notice.
A gentleman was roused one night by his wife, who heard the street-door bell ring. He got up, and, without paying attention to what she said, dragged the sheets off of the bed, tore them hurriedly into strips, and proceeded to tie the pieces together. She finally succeeded in bringing him to himself, when he said he thought the house was on fire, and he was providing means for their escape. He did not recollect having had any dream of the kind, but was under the impression that the idea had occurred to him at the instant of his awaking.
Another was suddenly aroused from a sound sleep by the slamming of a window shutter by the wind. He sprang instantly from his bed, and, seizing a chair that was near, hurled it with all his strength against the window. The noise of the breaking of glass fully awakened him. He explained that he imagined some one was trying to get into the house and had let his pistol fall on the floor, thereby producing the noise which had startled him.
A lady informed me that upon one occasion she had gone to bed very tired, but was suddenly startled from her sleep by a voice calling her by name. Without stopping a moment, she arose, put on her shoes and stockings, lit a candle, took a loaded pistol from a shelf near her husband’s head, cocked it, and was leaving the room, the pistol in one hand and the candle in the other, when she was seized by her husband. She turned, recognized him at once, and would have fallen to the floor had he not caught her in his arms. Her husband, who slept in the same bed with her, had heard one of the children cry in an adjoining room, and had called her. She, hearing his voice, had partially awakened, but had conceived the idea that he had called to her from another part of the house, where some danger menaced him. She had acted upon this supposition, and was perfectly conscious of every movement she had made.
It does not appear that some persons are more liable to attacks of sleep drunkenness than others. Neither do I know of any means by which its occurrence could be prevented. It is a natural phenomenon, to which all are liable. It is more important in its medico-legal relations than any other.
ADDITIONAL OBSERVATIONS RELATIVE TO THE PHYSIOLOGY OF SLEEP.[151]
Since the chapter on the Physiology of Sleep was written, I have, by additional experiments, satisfied myself that the theory then enunciated is correct in every essential particular.
By means of an instrument adapted to show the extent of cerebral pressure, and which I first described nearly two years ago, I have been enabled to arrive at very positive results. In every instance the pressure was lessened during sleep and was increased during wakefulness. The experiments were performed upon dogs and rabbits. Briefly, the instrument consists of a brass tube, which is screwed into a round hole made in the skull with a trephine. Both ends of this tube are open, but into the upper is screwed another brass tube, the lower end of which is closed by a piece of very thin sheet india-rubber, and the upper end with a brass cap, intowhich is fastened a glass tube. This inner arrangement contains colored water, and to the glass tube a scale is affixed.
This second brass tube is screwed into the first, till the thin rubber presses upon the dura mater and the level of the colored water stands at 0, which is in the middle of the scale. Now, when the animal goes to sleep, the liquid falls in the tube, showing that the cerebral pressure has been diminished,—an event which can only take place in consequence of a reduction in the quantity of blood circulating through the brain. As soon as the animal awakes, the liquid rises at once. Nothing can exceed the conclusiveness of experiments of this character. No mere theorizing can avail against them.
Footnotes:
[1]See the author’s Treatise on Hygiene, page 92.
[2]La Théorie des Songes. Paris, 1766, p. 206.
[3]On Obscure Diseases of the Brain, etc. London, 1860, p. 604, note.
[4]Physiologie de la Pensée. Recherche Critique des Rapports du Corps à l’Esprit. Deuxième édition. Paris, 1862, t. ii. p. 440.
[5]Du Sommeil, des Rêves et du Somnambulisme, etc. Lyon, 1857, p. 14.
[6]Observations in Medicine. Second Series, p. 27.
[7]Art.Sleep. Cyclopedia of Anatomy and Physiology, vol. iv. part 1, p. 681.
[8]Chapters on Mental Physiology. London, 1852, p. 105.
[9]Essays on Life, Sleep, Pain, etc. Philadelphia, 1852, pp. 63 and 64.
[10]Epilepsy and Epileptiform Seizures. London, 1858, p. 123.
[11]Nouveaux Éléments de la Science de l’Homme. 3me édition. Paris, 1858, vol. ii. p. 7, et seq.
[12]Rapports du Physique et du Morale de l’Homme. Paris, 1824, p. 379.
[13]The Physiology of Common Life. New York, 1860, vol. ii. p. 305.
[14]Philosophy of Sleep. Second edition, 1850, p. 5.
[15]The Haven of Health, chiefly made for the comfort of Students, and consequently for all those that have a care for their health, etc. By Thomas Cogan, Master of Arts and Batchelor of Physic. London, 1612, p. 332.
[16]Sketches of the Philosophy of Life. London, 1819, p. 262.
[17]Elements of Physiology. Translated by John Elliotson, M.D., etc. 4th edition. London, 1828, p. 191.
[18]Op. cit. p. 282, et seq.
[19]Northern Journal of Medicine, No. 1, 1844, p. 34.
[20]The Philosophy of Mystery. London, 1841, p. 283.
[21]British and Foreign Medico-Chirurgical Review, Am. ed., April, 1855, p. 404.
[22]American Journal of the Medical Sciences, October, 1860, p. 399.
[23]The Physiology of Sleep. By Arthur E. Durham. Guy’s Hospital Reports, 3d Series, vol. vi. 1860, p. 149.
[24]Recherches sur la Système Nerveux Cerebro-Spinal, sa Structure, ses Fonctions et ses Maladies. Paris, 1865, p. 448.
[25]Cyclopedia of Practical Medicine, articleCold.
[26]Cyclopedia of Anatomy and Physiology, vol. iv., part 1, p. 681, articleSleep.
[27]Essays on Life, Sleep, and Pain. Philadelphia, 1852, p. 87.
[28]The Doctor, etc., edited by Rev. John Wood Warter. London.
[29]Op. cit., p. 5.
[30]Rapports du Physique et du Morale de l’Homme. Paris, 1825, tome ii. p. 381.
[31]Medicina Statica; or Rules of Health, etc. London, 1676, p. 106 et seq.
[32]Op. cit., p. 6.
[33]Op. cit., tome ii. p. 385.
[34]An Essay concerning Human Understanding. Book ii. sect. 17.
[35]Encyclopedia Americana,—Philadelphia, 1832, vol. xii. p. 143, art. Tartini; and L’Imagination considérée dans ses Effets directs sur l’Homme et les Animaux, etc. Par J. B. Demangeon. Seconde édition. Paris, 1829, p. 161.
[36]The Soul and the Future Life. Appendix viii. Quoted by Seafield in “The Literature and Curiosities of Dreams,” etc. London, 1865. Vol. ii. p. 229.
[37]Confessions of an English Opium-eater. Boston, 1866, p. 109.
[38]Journal of Psychological Medicine and Mental Pathology. July, 1859, p. 44.
[39]Inquiries concerning the Intellectual Powers and the Investigation of Truth. Tenth edition. London, 1840, p. 304.
[40]History of Dreams, Visions, Apparitions, etc. Philadelphia, 1855, p. 184.
[41]Macario, Du Sommeil, des Rêves et du Somnambulisme. Paris, 1857, p. 59.
[42]Op. cit., tome ii. p. 395.
[43]Ancient Metaphysics. Quoted in Dr. Forbes Winslow’s Medical Critic and Psychological Journal. No. vi., April, 1862, p. 206.
[44]Op. cit., p. 283.
[45]Dream Thought and Dream Life. Medical Critic and Psychological Journal, No. vi., April, 1862, p. 199.
[46]Account of the Life and Writings of Thomas Reid, D.D., p. cxliv., prefixed to Essays on the Powers of the Human Mind. By Thomas Reid, D.D., etc. Edinburgh, 1803, vol. i.
[47]Dissertations, Moral and Critical. London, 1783, art. Dreaming, p. 222.
[48]Syntagma Philosophicum. Pars 71, Lib. viii. Opera Omnia, tome i. Lugduni, 1658.
[49]Philosophy of Mystery. London, 1841, p. 208.
[50]Op. cit., p. 286.
[51]Psychologie; oder der Wissenschaft von Subjectiven Geist. 2ten Auflage. Ebberfeld, 1843, p. 144.
[52]The Principles of Medical Psychology, etc. Sydenham Society Translation, p. 167.
[53]Elements of Physiology. Translated from the German, with Notes, by William Baly, M.D., etc. London, 1842, vol. ii. p. 1417.
[54]Op. cit., p. 1418.
[55]Psychological Inquiries. Part i. London, 1856, p. 153.
[56]Du Sommeil—Mélanges Philosophiques. Seconde édition. Paris, 1838, p. 301.
[57]Sleep Psychologically considered with reference to Sensation and Memory. New York, 1850, p. 74.
[58]An Inquiry into the Nature of Sleep and Death. London, 1834, p. 152. (Reprinted from the Philosophical Transactions for 1833.)
[59]Zoonomia; or, The Laws of Organic Life. Am. ed., vol. i. Philadelphia, 1818, p. 153.
[60]Elements of the Philosophy of the Human Mind. Am. ed. Boston, 1818, vol. i. p. 184.
[61]Op. cit., t. ii. p. 376, et seq. Article Du Sommeil en particulier.
[62]An Essay Concerning Human Understanding, chapter xxi. section 30.
[63]Essays on the Powers of the Human Mind, vol. iii. Edinburgh, 1803, p. 77.
[64]Op. cit., p. 155.
[65]An Essay Concerning the Human Understanding, book ii. section 17.
[66]Op. et loc. cit., section 11.
[67]Historia Naturalis, lib. x. cap. lxxv., “De Somno Animalium.”
[68]De defectu oraculorum.
[69]De Vita, xii. Cæsarum, Nero, cap. xlvi.
[70]Op. cit., p. 63.
[71]Lectures on Metaphysics, vol. i. p. 323.
[72]Inquiries Concerning the Intellectual Powers and the Investigation of Truth. Tenth edition. London, 1840, p. 283.
[73]Op. cit., p. 10.
[74]Quoted in Dendy’s Philosophy of Mystery. London, 1841, p. 225.
[75]The Principles of Medical Psychology, etc. Sydenham Society Translation. London, 1847, p. 163.
[76]Op. cit., book ii. sec. 17.
[77]Cited by M. l’Abbé Richard inLa Théorie des Songes. Paris, 1766, p. 32.
[78]De Rerum Natura, l. iv. v. 959.
[79]Satyricon. Bohn’s edition. London, 1854, p. 307.
[80]In the above quotation I have slightly altered Kelly’s version in Bohn’s edition of Petronius. The original Latin is fully as forcible and true to nature as the translation.
[81]Op. cit., p. 275, et seq.
[82]Journal of Psychological Medicine. July, 1856.
[83]Le Sommeil et les Rêves; Études Psychologiques, etc. Troisième édition. Paris, 1865.
[84]Sermon on the Office of the Holy Angels toward the Faithful, quoted by Seafield. Op. cit., vol. i. p. 157.
[85]Op. cit., p. 86.
[86]Op. cit., p. 88, et seq.
[87]On Obscure Diseases of the Brain and Disorders of the Mind, etc., London, 1860, p. 611, et seq.
[88]Anatomie Comparée du Système Nerveux, etc. Par MM. Leuret et Gratiolet. Paris, 1839-1857, t. ii. 517, et seq.
[89]Art. Rêves, in Grand Dictionnaire de Médecine.
[90]Des Maladies Mentales et des Asiles d’Aliénés, etc., Paris, 1864, p. 221.
[91]Traité des Maladies Mentales, Paris, 1860, p. 457.
[92]On Obscure Diseases of the Brain and Disorders of the Mind, etc., London, 1860, p. 614.
[93]The Principles of Medical Psychology. Being the Outlines of a Course of Lectures, by Baron Ernst von Feuchtersleben, M.D. Sydenham Society Translation, p. 198.
[94]Medical Press and Circular; also Quarterly Journal of Psychological Medicine and Medical Jurisprudence, vol. i. p. 276.
[95]Medical Investigator; also Quarterly Journal of Psychological Medicine, etc., April, 1868, p. 405.
[96]Op. cit., art.Rêves.
[97]Op. cit., p. 95.
[98]Rapports du Physique et du Morale de l’Homme. Paris, 1824, tome second, p. 359.
[99]Chapters on Mental Physiology. London, 1852, p. 126.
[100]B. D. S. Opera Posthuma, 1677, Epistola xxx. p. 471. In the course of this letter to his friend, Peter Balling, Spinoza says:
“Quum quodam mane, lucesente jam cælo, ex somnio gravissima evigilarem imagines, quæ mihi in somnio occurrerant, tam vividè ob oculos versabantur, ac si res finissent veræ, et præsertim cujusdam nigri et scabiosi Brasiliani, quem nunquam antea videram. Hæc imago partem maximam disparebat, quando, ut me alia re oblectarem, oculus in librum, vel aliud quid defigibam; quamprimium verò oculos à tali objecto rursus avertebam, sine attentione in aliquid oculos defigendo, mihi eadem ejusdem Æthiopis imago eâdem vividètate, et per vices apparebat, donec paulatim circa caput disparetet.”
[101]Elements of Physiology, translated by Baly, vol. ii. p. 1394.
[102]Op. cit., p. 93.
[103]Περὶ ἱερῆς νοσο.
[104]Quoted from I. Franck by Macario, op. cit., p. 100.
[105]De quelques Phénomènes du Sommeil. Œuvres Complets, tome v. p. 170-175.
[106]Grand Dictionnaire de Médecine, t. xxxiv., art. Incubi, par M. Parent.
[107]Nouveau Dictionnaire de Médecine et de Chirurgie Pratiques, tome sixième, Paris, 1867, art. Cauchemar.
[108]Gazette Médicale de Lyon, 15 Mai, 1856; also Macario, op. cit., p. 104.
[109]British and Foreign Medico-Chirurgical Review, April, 1845, vol. xix. p. 441.
[110]Traité du Somnambulisme et des différentes Modifications qu’il présente. Paris, 1823.
[111]Op. cit., p. 117.
[112]Op. cit., p. 2.
[113]Quoted by Bertrand, op. cit., p. 15.
[114]Cyclopædia of Practical Medicine. American edition, vol. iv. p. 196, article Somnambulism.
[115]Della Forza della Fantasia Umana. Venezia, 1766.
[116]Op. cit., p. 127.
[117]Article Somnambulism, in the Cyclopædia of Practical Medicine, vol. iv. p 198, American edition.
[118]Bertrand, op. cit., p. 17.
[119]Op. cit., p. 18.
[120]Op. cit., p. 132.
[121]The Scenery and Poetry of the English Lakes. By Charles Mackay, LL.D.
[122]Life of Sir Isaac Newton. By Sir David Brewster, vol ii. p. 240.
[123]On Obscure Diseases of the Brain, etc. London, 1860, p. 609.
[124]Sur l’Influence Pathologique de l’Insomnie. Annales Médico-Psychologiques, 3me Série, t. iii. p. 384, et seq.
[125]Le Sommeil et les Rêves. 3me éd. Paris, 1865, p. 9.
[126]Mental Hygiene. Boston, 1863, p. 97.
[127]A Manual of Psychological Medicine, etc. London, 1858, p. 375.
[128]Psychological Inquiries. Third edition, London, 1856, p. 141.
[129]Op. cit. p. 142.
[130]On Obscure Diseases of the Brain, etc. By Forbes Winslow, M.D. London, 1860, p. 604.
[131]Medical Logic, p. 81, quoted in Cyclopedia of Anatomy and Physiology, vol iv. part i. p. 686.
[132]Clinical Observations on Functional Nervous Disorders. London, 1864, p. 284.
[133]A History of Dreams, Visions, Apparitions, etc. American edition. Philadelphia, 1855.
[134]The Philosophy of Mystery. By Walter Cooper Dendy. London, 1841, page 290.