WHen People are found in a fit of the Night-mare, the most effectual remedy is to rouse them as soon as possible, by changing the position of the Body, and applying some keen stimulus immediately, such as pricking with a pin, speaking loud, &c. and if they recover the least degree of voluntary motion, the happy crisis is for that time obtain’d, as Actuarius and Willis observ’d.
I have often been so much oppress’d by this enemy of rest, that I would have given ten thousand worlds like this for some Person that would either pinch, shake, or turn me off my Back; and I have been so much afraid of its intolerable insults, that I have slept in a chair all night, rather than give it an opportunity of attacking me in an horizontal position.
Doctor Lower relates a remarkable similar case, which I shall here translate. He says, “42 I knew a Gentleman, who, in every other respect, enjoy’d perfect health, but was so subject to the Night-mare, that, whenever he slept on his Back, he was seiz’d with it in such a violent manner, that he was oblig’d to keep a Servant in the same bed with him; who, upon hearing his Master groan and Sigh (with which Symptoms it us’d to begin) immediately turn’d him on his Side; by which means it was, and may be always, remov’d.”
’Tis observable, that people are rous’d out of a fit of the Night-mare, sometimes, by sound alone. I remember to have been under it, when a Servant came in the morning to make a fire, and let the coal-box fall at the door; the noise of which effectually reliev’d me. The vibrations or undulations of the air beating upon the drum of the Ear, may act as a successful stimulus in this case.
As this Disease seems to arise immediately from a supine position of the Body in sleep, we should take care to prevent it before we fall asleep, by composing the Body on either Side. The sagacious Hoffman observes, that the safest posture in sleep, is on either Side, with the Head rais’d, and the Limbs bent inwards to the trunk of the Body43.
Some ingenious men have imagin’d, that the bending of the Limbs in sleep is owing to the strong tendency which the flexor Muscles have to contraction; but I humbly suppose, it is rather a voluntary motion, intended to fix the Body on the Side, without the continued action of any of the voluntary Muscles afterwards; for without the flexion of the Joints in sleep, it would be a kind of labour to keep the Body pois’d on such an narrow surface. To demonstrate this, I shall avoid mathematics, and appeal to common sense, for an easy experiment. Suppose one should endeavour to poise a thin plate of tin on its edge upon a smooth, level table; if he be not an expert equilibrist, he will find it difficult; but if he bends the plate, then the problem becomes as easy as the well known method of making an egg stand on its end.
This easy method, which nature has contriv’d to preserve the human Body on its side, is a sufficient recommendation of that position, and a strong precaution against lying on the Back, which is the posture of dead Bodies.
Before any regular or effectual plan of curing, or rather preventing, this Disease, can be propos’d, it will be always necessary to consider minutely the primary or pre-disposing causes of it, formerly mention’d.
If the primary cause be a weakness of the Fibres, then strengthening or astringent medicines are proper; which, by increasing the cohesion of the constituent particles of the Solids, will make the Fibres more dense, brace them up to a proper pitch, and quicken their vibrations. The principal Medicines of this class are iron, and its preparations, the Bark, the wild Valerian-root, and the cold Bath.
If it arises from an inertia or indolence of the Solids, nervous medicines will best answer that indication; which, by stimulating the lazy inactive Fibres, will increase their elasticity, invigorate their contractions, accelerate the motion, and break the tenacity of the Blood.
If the Blood be too thick, attenuants should be us’d, such as, spiritus Mendereri44, vegetable subacid liquors, saponaceous medicines, and plenty of vinegar at meals, which, according to the great Boerhaave, is a powerful diluent45.
A Plethora or redundance of Blood, is certainly the most general cause of the Night-mare, and requires immediate evacuations, which principally consist in bleeding or purging. But the former is most effectual. However, Bleeding should not be often repeated, unless absolutely necessary, lest, it should become a custom, which might, at the same time, procure a short intermission, and increase the cause of the Disease; and also prove inconvenient and dangerous; for if, at any establish’d period, Bleeding should be omitted, then the person is expos’d to all the bad effects of a Plethora, enumerated by Boerhaave, viz. Inflammations, Suppurations, Gangrenes and Death46.
It is well known, that nothing genenerates Blood faster, or contributes more to a Plethora, than bleeding often, which some are fond of, without assigning any reason for it, except its being a custom, which experience proves a very bad one.
Van Sweiten says, “He saw a Woman, who, being subject to violent affections of the Mind, was bled above sixty times in one year. She by that means grew very fat, and increas’d her weight 150 pounds in a few months. By bleeding often new Blood was generated, and the necessity of bleeding became more frequent, ’till she was so far relax’d, that she fell into a Dropsy47.”
He adds, “That bleeding, which some use by way of precaution, is a bad custom, since it weakens the Solids, and renders the Body more subject to a fresh accumulation of Fluids.”
Experience has convinced me of the truth of this observation; for, while I practis’d bleeding every month or six weeks, I found the Night-mare return’d on me at these periods, rather aggravated than abated. My bad success made me alter my method; and, instead of drawing eight or ten ounces of blood at once, I drew twenty, and liv’d low, on thin, astringent diet, for a few days afterwards; in which time the dilated vessels contracted themselves, and resisted the sudden distension, which taking large quantities of nourishing diet, after plentiful evacuations, must always produce; as our medical Bard justly expresses it,
“Too greedily th’ exhausted Veins absorb The recent Chyle48.”
By observing Boerhaave’s method of curing a Plethora, viz. using a thin, light diet after bleeding, and gradually prolonging the time between each evacuation, I have reduc’d my bleedings to one every autumn; and (thank Heaven) have in a great measure conquer’d that Monster of the night, which so often threaten’d me with immediate destruction.
Experience also assures us, that large evacuations may be made by strong purges; such as Jalap, Scammon. &c. which greatly dissolve, and diminish the quantity of the Blood.
Hence, we see the reason why Paulus Egeneta justly prescrib’d Scammony in this Disease49. But in this kind of evacuations, Boerhaave’s salutary rule should be also observ’d; viz. “Omissione sensim introducta.”
’Tis needless here to take notice of all the ill-adapted farrago of Medicines prescrib’d by many of the old Physicians, who did not know the cause of this Disorder.
I cannot understand why Piony was reckon’d, by them, such a famous specific for the Night-mare, which, taken internally, is only a gentle attenuant: and ’tis very surprising, that Doctor Willis should be so superstitious as to recommend balls made of Piony and Corral to be tied about the Neck, by way of a sacred nostrum against this Disease50.
Temperate living is certainly the most effectual method of preventing this and many other Disorders. Vegetable and flesh meat of easy digestion; thin, subacid, diluent liquors, taken in moderate quantities; light or no suppers; brisk exercise of all kinds; high pillows, and sleeping on the Side, are the most sovereign Prophylactics, or preventives.
If People subject to the Night-mare be so fond of heavy flesh-suppers, that they can neither rest with them nor without them, they should sup early, and sit up or exercise two or three hours afterwards; and when they go to bed, they should lie on the right Side, that the food may have the advantage of its own gravity in passing out of the Stomach into the Guts. In that position the Heart will fall on the Mediastinum, which, being a flexible Membrane, will be an easier support to the Heart than if it play’d against the hard Ribs, which is always the consequence of lying on the left Side.
When the fair Sex is oppress’d with this Disorder, and the precedent cause is an obstruction of the Catamenia, the defect of that natural discharge may be supply’d by a moderate bleeding; and proper remedies should be us’d to clear the obstructed tubes, and open the flood-gates to promote the ebb of the next full tide. But if the cause be common to both sexes, the same methods may be follow’d, proper allowance being made for the delicacy of the female constitution.
Excessive drinking at night, as well as excessive eating, should be avoided; but of the two evils, the former is the lesser, as our British Celsus observes:
“Tutior autem est in potione, quam in esca, intemperantia51.”
As intoxication subjects People to most dreadful fits of this Disorder, as well as to many other accidents, it should, by all means, be shun’d. Lucretius has so well painted its bad effects, that, I presume, my polite reader will think his description of it neither tedious nor foreign.
Denique cur, Hominem cum vini vis penetravit
Acris et in Venas discessit deditus ardor,
Consequitur gravitas membrorum? Præpidiuntur
Crura vacillanti? tardescit Lingua? madet mens?
Nant Oculi? clamor singultus, jurgia gliscunt?
Et jam cætera de genere hoc quæcunq; sequuntur?
Lib. 3.
Besides, when wine’s quick force has pierc’d the Brain,
And the brisk heat’s diffus’d thro’ every Vein,
Why do the members all grow dull and weak?
The Tongue not with its usual swiftness speak?
The Eye-balls swim? the Legs not firm and straight,
But bend beneath the Body’s natural weight:
Unmanly quarrels, noise, and sobs deface
The powers of Reason, and usurp their place.
Creech.
As Nature is the subject of Physic and Poetry, we find, that the sons of Homer and Esculapius generally agree in giving salutary instructions to Mankind; but as the former convey their admonitions in the most agreeable manner, I shall conclude this Essay with two quotations from them.
The first Physicians by debauch were made,
Excess began, and sloth sustains the trade:
By chace our long-liv’d Fathers earn’d their food,
Toil strung their Nerves and purify’d their Blood, &c.
Dryden.
Quæ virtus et quanta, boni, sit vivere parvo,
(Nec meus hic sermo est, sed quem præcepit Ofellus,
Rusticus, abnormis sapiens, crassaque Minerva)
Discite, non inter lances, mensasque nitentes;
Cum stupet insanis acies fulgoribus, & cum
Adclinis falsis animus meliora recusat.
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Accipe nunc, victus tenuis quæ, quantaque secum
Adferat, imprimis valeas bene: nam variæ res
Ut noceant Homini, credas, memor illius escæ
Quæ simplex olim tibi sederit, at simul assis
Miscueris elixa, simul conchylia turdis;
Dulcia se in Bilem vertent, Stomachoque tumultum
Lenta ferat pituita. Vides, ut pallidus omnis
Cæna desurgat dubia? quin corpus onustum
Hesternis vitiis, animumque prægravat una
Atque adfigit humo divinæ particulam auræ.
Alter, ubi dicto citius curata sopori
Membra dedit, vegetus præscripta ad munia surgit.
Horat. Sat.
What, and how great the virtue and the art
To live on little with a chearful Heart!
(A doctrine sage, but truly none of mine)
Let’s talk, my friends, but talk before we dine;
Not when the gilt buffet’s reflected pride
Turns you from sound Philosophy aside,
Not when from plate to plate the Eye-balls roll,
And the Brain dances to the mantling bowl,
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Now hear what blessings temperance can bring;
(Thus said my friend, and what he said I sing)
First health: the Stomach cramm’d with ev’ry dish,
A tomb of boil’d and roast, and flesh and fish,
When Bile and Wind, and Phlegm and Acid jar,
And all the Man is one intestine war,
Remembers oft the School-boy’s simple fare,
The temperate sleeps, and spirits light as air.
How pale each worshipful and rev’rend guest
Rise from a clergy or a city feast!
What life in all that ample Body? say:
What heav’nly particle inspires the clay?
The soul subsides and wickedly inclines
To seem but mortal, ev’n in sound Divines.
On morning wings, how active springs the Mind
That leaves the load of yesterday behind?
Pope.