By Dr. Kuehner in Koburg
Insomnia is a symptom of very various morbid states, as well as of such as take their origin in the respiratory take their origin in the respiratory organs, as of those originating in the circulatory and digestive apparatus, or primarily in the nervous system. Although the latter is the most frequent cause of Agrypnia, nevertheless a rational treatment which is guided by causal indications must also draw into account the possibility of the reflex action of the disease of other organs on the operation of the brain which in sleep ought to be more or less suspended. “Only when we cannot satisfy the causal indications,” says Stinting, “ and when furthermore hygienic-dietetic, climatic measures and physical curative measures have proved useless, and when through the long continued disturbance in sleep the whole organism threatens to be injured, only then is it permissible to draw to our aid pharmaceutical remedies.” New soporifics, which perhaps grow old within a year, owing to unpleasant after-effects, are offered us by pharmacotherapy in ever increasing number and variety, but of old and tried remedies there are but few. As to the physico-dietetic measures, and the hydrotherapeutical measures, we sometimes obtain good results from wet packing of both the feet and the legs up to the knee. In cases where disturbances of the digestion are the cause of insomnia, a wet packing of the abdomen, a bandage around the body, called Neptune’s girdle, is of good service. In such cases also certain exercises of the muscles of the abdomen, movements towards the abdomen and then again motions away from it, movements constricting and then expanding the abdomen, voluntary drawing and thrusting out the abdomen, a method which I have described elsewhere as vital massage of the abdomen are useful. A good aid in many cases is laying the head low. I recommended this procedure already in my work which appeared in the year 1888. “On Insomnia” following Meuli-Hiltz, for those poor in blood and for nervous people, and I have since then found its effects useful in many cases. A number of psychical aids favor the return of sleep; thinking of the murmuring of a brook, the rustling of leaves, the movement of a boat, the waving of a field of grain, the fluttering of a flag, the calling up and reciting of a poem, counting forwards and backwards. But inasmuch as we must think even while counting, Naegeli recommends the physiological circumstances which precede or accompany the act of going to sleep. We get the one who is courting slumber to observe everything in which we are able to imitate those who are slumbering, first of all the position of the eyes and the respiration. The first direction is therefore to force the eyes to roll upward, the second is to inhale slowly and deeply as we do in sleep. For this purpose we are recommended to say to ourselves quietly, but uninterruptedly, at every inspiration, “Go to sleep,” and at every expiration, “finish sleeping!” If we have a sleeping companion in the room, we should endeavor to breathe as much as possible in the same tempo with him, or since nodding the head and a slight rocking favor sleep, the person seeking sleep should describe with his head small elliptic curves. Besides these many suggestions which may prove useful, I would empirically recommend as a dietetic soporific a cup of cold tea made of Baldrian, and also pure bee-honey, one or two tablespoonfuls taken by themselves or on bread.
Also Homoeopathy recommends Valeriana, ten drops of the tincture, in nervous insomnia; where the patient only falls asleep towards morning, and has anxious dreams.