For insomnia there is no specific known to medicine. While the good family doctor may correct digestive disturbances, banish for the time neuralgic pains, modify arterial disease, relieve with the oculist’s assistance eye-strain, and through the dentist remove the cause of dental lesions, sometimes insomnia persists long after the physical cause has disappeared. I have had in my clinic one case of chronic sleeplessness caused by a headache which appeared incurable though the cause of the headache and insomnia alike had vanished years before.

Drugs which induce sleep induce it merely for the time. Doctor CaillÉ in his large experience has found morphia invaluable for the inhibiting of pain or of severe dyspnoea, chloral and the bromides useful in cases of visceral neuralgia, codein and urethan in arteriosclerosis, and in pulmonary tuberculosis, where beer and porter failed to bring the longed-for sleep, dionin, trional, and hyoscin. But in ordinary cases of insomnia, where the cause is evidently more psychical than physical, he is inclined to turn rather to suggestion in one form or another.7

Drugs are sure to make a difference in the morning. The dulness and depression which they leave behind, in spite of all the claims of those who put on the market their proprietary hypnotics, offset to some extent the artificial sleep they have the night before produced. Sometimes they fill the mind for days with morbid fancies and with dangerous obsessions. Dr. J. Madison Taylor describes in some detail the case of a lunatic under his care who developed homicidal tendencies as a consequence of the administration of large doses of bromide, and who lost the same the moment the bromide was withdrawn from him.8 On credible authority I am informed that there is among the alienists a growing disposition, on this account, to give no drugs at all to induce sleep in patients in the higher class of hospitals for the insane.

Morphia is not only no specific; it sometimes causes both a mental and a physical depression worse than the insomnia it would relieve. In my clinic I have one woman from whom morphia, administered to relieve acute pain, took away the power to sleep at all, and for years she stoically bore her pain rather than resort to morphia, until last winter she found in the Emmanuel treatment immediate and unfailing relief from pain, followed by sound sleep, which has only at rare intervals been interrupted in months past.

Powerful as chloral is and useful in the thoughtful doctor’s hands in various emergencies, especially in fevers where there is cerebral excitement, it is a depressant, and he who contracts the chloral habit invariably wishes at the last that he had waited for damnation till after he was dead. Sulphonal, trional, veronal, paraldehyde, and those proprietary hypnotics whose composition is withheld from the public appear to be least harmful of all sleeping drugs. But they all inebriate or stupefy the fragile cells of the brain, none too solid in the best of us; and in the psychically weak or emotionally excitable they may even put the delicately constructed thinking organ altogether out of commission.