SLEEP AND ITS REGULATION. 417 



the consciousness, with possible morbidity in two directions; too much 

 or too little. Ordinarily it is assumed that the more one gets of sleep 

 the better. This view is so generally accepted that the custom of some 

 physicians, especially those who see much of illness in the extreme 

 periods of life, to order food or employ active measures at regular hours, 

 involving the waking of the patient, verges upon the danger line. Judg- 

 ment must be exercised, and is well within the capabilities of a good 

 nurse. Serious exhaustion has often followed needless interruptions 

 of repose during exhaustive states. 



It is entirely demonstrable that a variety of disorders may result 

 from, or are indicated by, excessive somnolence, partly of developmental 

 and partly of degenerative origin. During infancy sleeping must 

 predominate over waking states, the unconscious reflex life over the 

 conscious intellectual life. It should be remembered, however, that 

 consciousness requires exercise for development. Monotonous meas- 

 ures, such as rocking, swinging, unmusical lullabies, may serve a 

 salutary purpose occasionally, but can readily be carried too far, to the 

 point of lowering normal temperature, inducing excessive anemia of 

 the brain and disturbances of circulation. Sleep should come by op- 

 portunity, comfortable position and customary environment. Habits 

 should be formed sufficient in themselves to invite repose. It ought 

 not to be interrupted needlessly, nor forced by measures or drugs which 

 obtund the consciousness. Normality of sleeping capacity is the prod- 

 uct of intellectual equipoise. Stupid folk are proverbially dull, le- 

 thargic, with large capacities for deep sleep. Some part of this is no 

 doubt the result of over indulgence. The consciousness is often en- 

 feebled by disuse in young or old. In the young the impetus to exercise 

 the faculties demands encouragement; also, as age enfeebles the brain 

 structures, mental stagnation, hence degeneration, is invited by over- 

 much time spent in unconsciousness. Nutritive balance, the expendi- 

 ture of energy, can not be maintained indefinitely. Eenewals must 

 occur, and it is shown that inordinate somnolence makes for exhaustion 

 of body and mind; the kidneys suffer, their vessels become distended 

 and hence enfeebled. In the aged the tone of the tissues, especially of 

 the vessel walls, tends to become devitalized, leading to a stasis in 

 lymph and blood vessels and to various forms of organic derangement. 

 In deep sleep, long continued, this stasis of blood and lymph is unduly 

 encouraged, sometimes to the point of paralysis. The bile becomes 

 thickened, stagnated; the bowels, the intestines, suffer from a surfeit 

 of sleep, impairing the machinery of peristalsis, hence follows consti- 

 pation. The urinary organs also share in this derangement of elimina- 

 tion and gravel, calculi, may form. Anemias are often unaccountable, 

 but it will be found that chlorotics usually sleep too much and are the 

 better for its regulation. 



VOL. LXVII. — 27. 



