_Valerian_ and its different preparations form a typical class of agents which indirectly favor sleep by their gently stimulant effect upon the brain. They are all useful in quieting that form of hysterical excitement to which women are liable during the “change of life.” That form of restlessness, usually resulting from fatigue, in which the patient feels as if she cannot sit still, is often relieved very promptly by the valerianate of ammonia. Wakefulness caused by neuralgic pains, or by exhaustion, often yields readily to scruple doses of valerianate of zinc or ammonia. The elixir of the valerianate of ammonia is a very elegant preparation of the drug.
_Cannabis Indica._--A cerebral stimulant which produces, at first, an agreeable exaltation of the mental faculties. This is followed by a condition of delirium, succeeded in its turn by sleep. It is, therefore, impossible to use the drug for merely hypnotic purposes; but it is a useful adjuvant, in small doses, to other hypnotic remedies. Given in doses of ½-1 grain, it may be advantageously associated with opiates, or with hyoscyamus or belladonna in cases which do not easily tolerate the preparations of opium. The tannate of cannabin, given in doses varying from five to ten grains, has been recommended as an hypnotic; but, like the extract from which it is derived, its effects are rather uncertain. The pure alkaloid, cannabin, has been recently introduced as a soporific, in doses of three-quarters of a grain to a grain and a half. According to Stillé and Maisch, the wakefulness caused by the itching of eczema may be relieved by the use of cannabis indica. The uneasy sleep attendant upon ungratified sexual appetite may also be relieved in the same way, since the drug is decidedly anti-aphrodisiac.
_Belladonna_ is not directly hypnotic, unless given in poisonous doses, but its medicinal operation tends to overcome certain conditions that hinder sleep. By its anti-spasmodic effects it relieves many forms of spasm which would otherwise interfere with sleep. Spasmodic asthma furnishes an example of such an affection. This may be relieved by the hypodermic injection of atropine. Whooping cough is another disease which may be largely controlled by the internal administration of the drug, especially by inhalation of a spray that has been medicated with belladonna. Neuralgia, especially the form that involves the head, face, and intercostal nerves, is greatly mitigated by the use of belladonna, or its alkaloid, atropia. Its association with opiates seems to increase their hypnotic effect, while at the same time neutralizing their disagreeable action. According to Curci,[41] it opposes the tendency of opiates to cause cerebral hyperæmia. For this reason it is generally advisable to combine sulphate of atropia with sulphate of morphia for hypodermic use. Of the former 1-100--1-80 grain may be used with ¼ grain of the latter. Certain patients are exceedingly intolerant of belladonna and its derivatives, a fact that must be kept in mind, especially when using the alkaloid, atropia. Fatal consequences are very rare, but uncomfortable dryness of the throat, dilatation of the pupils, and some degree of delirium are not uncommon. At the same time it must be admitted that in many instances relief from suffering is not obtained until these physiological effects of the drug have been manifested.