INSOMNIA AND ITS TREATMENT.

Auckland Star, Volume XXXI, Issue 65, 17 March 1900, Page 2 (Supplement)

INSOMNIA AND ITS TREATMENT.

Insomnia without pain is an affection both common and annoying, which can often be relieved by very simple means;

Insomnia may be characterised by, troubles in the duration of sleep,, or by troubles in the intensity of sleep.

In the first case the sufferer sleeps with difficulty, or, as more frequently happens with children, gives way to invincible fatigue, then quickly wakes up and can sleep no more.

The best treatment is relative resi*: exercise without fatigue, quiet and the absence of all violent emotion^ Air cures and rest at an average altitude are extremely tiseful, but all stations more than 3000 feet high should be avoided, also all sorts of society where one cannot obtain the necessary quiet and rest.

Food should be at the same time' substantial and light; the evening meal, in particular, should be care- ; fully studied. It should be taken atleast three hours before retiring1 : to s rest, and-all exciting- food should be proscribed; tea, coffee, alcohol and tobacco should be absolutely prohibited; The regular working- of the stomach " and intestines and the regularity of the functions of circulation should be carefully observed. When the pulse is firm and strong-, iodide of sodium acts like a hypnotic agent. In the purely nervous insomnia o£ children, the application of cold compresses to the trunk, repeated several, times during the night, produces a good result. Bromide of antipyrine also may be used, bearing in mind that the last named remedy acts better if there is fever or agitation. In the case of old men a little nourishment, or a small quantity of alcoholic stimulant, during the night should be recommended. A tepid bath o-f 35 deg. Cent, may also be given for v about ten minutes before retiring1 * but v sulphonal, trional or hydrate of chloral should not be used.

In the second category of insomnia, sleep only lasts two or three hours, at the end of which time the patient remains in a semi-somnolent state, Which the least noise disturbsi In such a case, if the sleep is disturbed by congestion of the head, galvanism has been' recommended. Placing the positive pole against the forehead, and the negative pole at the nape of the neck, a Aveak current is passed from one to five minutes. If, on the contrary, the face is pale and the brain, anaemic, douches on the head are in-; dicated.

In both cases a general massage of the trunk and limbs may be useful, great care being taken to give light friction from the extremities of the limbs toward the trunk. An attempt may also be made to act on the imagination of the patient. , _ As regards medicines, alkaline bromides are placed in the first rank in' doses of three gTammes to begin with,? and diminished doses at the end'of three or four days. A cold infusion.ot valerian, or, better still, a simple tincture, to be .taken in. doses of fifteen to twenty drops three times ia the evening; bitter almond or orange flower water, antipyrine, salipvrine, / or phenacetine, in closes of" onegramme if there is pain, or antifebrinein doses of 0.50 centigramme in cases of anaemia.

Sulphonal and trional succeed verfj well in cases of nervous insomnia, in. doses of from one to two grammes; they^ are not advisable in cases of albummuria. Morphia should be reserved for insomnia due to violent pain which cannot, be relieved by any." other means. J

In the many cases of insomnia due to the excessive acidity of the gastric; juice nitrate of bismuth and bicarbonate of soda render the greatest ser-: ES? B -t c Patien* may also eat a little bread, an egg or a small quantity of chocolate.