[Footnote 51: “As stimulation of the brain causes dilatation of its vessels, and increases the flow of blood through them, mental action of itself not only attracts more blood to the brain, but provides to some extent for the removal of waste products. Hence sleeplessness is normal for a clogged brain. The movements induced by the cardiac pulsations are not so extensive as those caused by the respiratory movements or by muscular exertion, and therefore, when the brain is overworked and the respiratory and muscular movements are restricted, the cerebral nutrition will be diminished by the imperfect removal of waste from its substance. But if, in addition to this, the cerebral cells and fibers are actually poisoned by the circulation within the vessels which supply them, of noxious substances due to imperfect digestion or assimilation, matters will become very much worse.”——T. L. BRUNTON, M.D., F.R.S. (ibid.)]
“Let no sleepless person be discouraged. Maintain hope under all circumstances. Remember that there are many worse cases of suffering than your own in the world, although to you it seems impossible. Keep up your general health by all sanitary means possible; walk much in the open air, if you can walk; ride, if you can not walk. Above all measures, keep the functions of the skin in prime condition; cleanliness is antagonistic to sleeplessness. Dry friction over the body by the use of the hand, or better by the use of the French hair mitten, twice a day, we have found of great service. The air-bath should not be neglected. A few minutes after the employment of friction over the body, walk about without clothing in a cool room, and if possible let the sun strike upon the body. Do not remain uncovered too long, so as to become chilled. Keep the digestion good; eat only such forms of food as suit the digestive organs. Surround yourself with cheerful company if possible, read such books as do not tax or weary the mind, and life will cease to be a burden, even if you do not sleep as others do. Avoid above all things constant dosing; throw into the ditch, or into the sea, all nostrums that may fall into your hand.”
Comparatively few, even of the so-called hopelessly insane, but might in the early stages of their disease be completely restored; and at any period, so long as there is great vital force, or what would commonly pass for robust physical health, no case need be set down as hopeless. But while the present system of treatment prevails (it is not worthy the appellation of “system,”) the present small proportion of “cures” will continue to be the rule. The inmates are confined more or less closely, often in imperfectly ventilated apartments, deprived of the exercise in the open air they so much need, to the lack of which in their own homes is, in part, attributable their present condition; they are fed generously, even to plethora; and this, through the fault of the ignorance of their attending physicians, although, if these were wise enough to know when and how their patients needed “dieting,” the friends of these sufferers would never submit to anything bordering upon a strictly abstemious diet in their treatment. In visiting lunatic asylums in this and other countries, I have been struck with the appearance of groups of patients——the similarity of their _physique_, as compared with the men and women seen on our streets every day——fat or lean, seldom medium——all exhibiting clearly the physical characteristics of disease, as emaciation, obesity, lack of, or ravenous, appetite, usually the latter. Meal-time comes every five or six hours, and if the appetite is good, all are permitted to eat very much in excess of their needs; they are urged to eat when they desire to fast; and food is forced into their stomachs if they are inclined to abstain for any length of time. It is not uncommon to find patients who upon entering an asylum begin to fatten, though already in an abnormal condition in this regard, their symptoms becoming more and more discouraging as their weight increases, although neither physician nor friends connect the two facts in any way. The latter feel thankful that “poor dear J———— gets enough to eat!” In this connection I introduce an incident of recent occurrence, not as indicating that a compulsory fast for an extended period should be resorted to generally, nor my own belief that it is a specific for all mind-troubles, by any means, but as a fact of great significance which all interested in this question may well pause a moment to contemplate.