506 THE TREATMENT OF DISEASES. 



We have already had occasion to refer to the influence of monotonous sounds in 

 producing sleep. Soothing sounds will lull adults as well as children. Brushing 

 the hair, friction of the skin, rubbing the palms of the hands or the backs of the 

 arms, will have a quieting influence on some persons. In exceptional cases sleep 

 may sometimes be conciliated by the monotonous biddings of mesmerism, when 

 drugs might fail to procure it, and such sleep may become in certain diseases a mode 

 and an instrument of cure. "What has been called " hypnotism " may occasionally 

 have its uses. The following extract from a paper on the subject will explain 

 the modus operandi : " My usual mode of inducing sleep," says the writer, " is 

 to hold any small bright object about ten or twelve inches above the middle of 

 the forehead, so as to require a slight exertion of the attention to enable the 

 patient to maintain a steady, fixed gaze on the object ; the subject being either 

 comfortably seated or standing, stillness being enjoined, and the patient requested 

 to engage his attention, as much as possible, on the single act of looking at the 

 object, and yield to the tendency to sleep which will steal over him during this 

 apparently simple process. I generally use my lancet- case, held between the 

 thumb and first two fingers of the left hand; but any other small bright object will 

 answer the purpose. In the course of about three or four minutes, if the eyelids do 

 not close of themselves, the first two fingers of the right hand, extended and a little 

 separated, may be quickly, or with a tremulous motion, carried towards the eyes, so 

 as to cause the patient involuntarily to close the eyelids, which, if he is highly 

 susceptible, will either remain rigidly closed or assume a vibratory motion the eyes 

 being turned up, with, in the latter case, a little of the white of the eye visible 

 through the partially-closed eyelids. If the patient is not highly susceptible, he will 

 open his eyes, in which case request him to gaze at the object, &c., as at first ; and 

 if they do not remain closed after a second time, desire him to allow them to remain 

 shut after you have closed them; and then endeavour to fix his attention on 

 muscular effort, by elevating the arms if standing, or both arms and legs if seated, 

 which must be done quietly, as if you wished to suggest the idea of muscular action 

 without breaking the abstraction, or concentrative state of mind, the induction of 

 which is the real origin and essence of all that follows." 



One of the best remedies for sleeplessness is bromide of potassium. It has been 

 found of especial use in obviating that sleeplessness and wandering at night not un- 

 frequently occurring during convalescence from acute diseases. In sleeplessness from 

 other causes, as worry, over-work, grief, or indigestion, it may be employed with every 

 expectation of success. It is especially indicated if besides sleeplessness the patient, 

 although of abstemious habit, suffers from delirium resembling that of delirium 

 tremens. In the sleeplessness of delirium tremens itself the bromide is of con- 

 spicuous benefit. It is to be given in a single dose of twenty grains at bed-time or 

 three table-spoonfuls of the mixture (Pr. 31). 



Chloral is another valuable remedy for the relief of sleeplessness. It should be 

 given shortly before bed-time, and the patient should avoid excitement, and keep quite 

 quiet, or it will produce restlessness instead of sleep. It is very efficacious in subduing 

 the sleeplessness of old people, and the wakefulness induced by excessive mental 

 fatigue. The dose is a tea-spoonful of the syrup of chloral. There is not the slightest 



