is indispensable to health, and that is not to be compassed by medicines, but by orderly customs of life, which should be wisely formed, and rigorously observed. This is a frequent occasion of disturbance which should on no account be overlooked. It is possible, as was noticed under another heading, to so fatigue the several organs by overloading, or not relieving them, that they fall asleep too heavily, and set up irritation by becoming, as it were, dead weights in the system.

We have thus far been speaking of sleeplessness from perverted modes of life and nutrition; the several parts of the organism having ways of their own, which prevent all being in a condition to rest at the same time, and, therefore, general sleep is impossible. Work, nutrition, and repose should, so far as may be possible, go on simultaneously in the several organs and systems. Such harmony constitutes the habit of health. The remedy for sleeplessness of this variety is, in principle, the formation of new habits which will harmonise the processes of function, rest, and nutrition throughout the system, and indirectly cure the evil by replacing the old and vicious habits on which the trouble of sleeplessness depends.

2. Disorderly habits may be set up by circumstances; for example:-1. A particular cause of

anxiety, a special press of business or run of mental dissipation. 2. Some exceptionally disturbing force falling on the automatic system and sense-organs. 3. An unusual strain upon the muscular system which is resented because the muscles have not been properly trained to the exertion required of them. And 4, inordinate or irregular taxing the powers of the viscera, by unaccustomed, or excessive, eating and drinking, either overfeeding or starving particular viscera or the system in general. Any of these misfortunes or errors will produce sleeplessness, and even when the cause may have ceased to operatefor example, after watching by the bedside of a sick person through a protracted illness, or after dissipation which has been abandoned, in fact, after any disturbance of sufficient duration to set up a habit— the effect may remain. It is in these cases drugs expertly employed are sometimes useful, but the practised skill of the acute physician is needed to search out the seat of the pernicious habit, and determine how or where it may be interrupted. If this be accomplished, it will remain for the sufferer to recover the old habits of health, or to form new ones consistent with the life he is compelled to lead.

3. Sleeplessness, as the effect of a morbid state, is a symptom of existing disease with which, in this little manual of health, I have no immediate concern.

The only useful hint it seems possible to give is not to forget that the trouble we are considering may be a very significant symptom; and it is one which ought never to be disguised from the medical attendant, because it may form part of the "indications for treatment" in any disease. Again, being a symptom it must not be regarded, still less treated, by the sufferer himself, as a separate malady. We frequently hear of patients taking "sleeping draughts," habitually, for the relief of sleeplessness which, although they are not aware of the circumstance, is an integral part of some state wherefrom it cannot be disassociated in remedial management with any prospect of success.

4. Sleeplessness may be, and often is, a premonitory symptom. When it occurs without any discoverable cause, and cannot be cured by the methods of self-help to which I have alluded, there should be no delay in seeking advice. Sleeplessness means restlessness, and without due repose there can be neither safety, comfort, nor health.

The principles of conduct which I have tried to lay down are necessarily broad, and require to be applied with greater precision in any special instance, than a general statement of their nature can suffice to indicate. Enough has, however, been said to point the reader to the main lines of re

covery, and to warn him against the serious perils to be avoided in the escape from disease. I can never too strongly insist that the sole legitimate purpose of the physician who dares to address the public is to preach the gospel of health, not to promulgate what must necessarily be inadequate and impracticable notions of treatment among those who are not armed with that knowledge of the organism and its functions in health, which alone can qualify any one to treat it in, and for, disease.

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SLEEP AND FOOD.

THE relations between sleeping and feeding have been incidentally alluded to in the course of the previous chapters. In conclusion, we may set out as concisely as possible the principles underlying those relations, a knowledge of which can scarcely fail to be useful in the ordering of a daily life.

It has been commonly supposed that the tendency to sleep which often follows a meal is due to the attraction of blood to the stomach by the food and a relatively bloodless state of the brain. This theory is, I am convinced, erroneous. Blood may be "drawn away from the head," as the phrase goes, by other causes, and sleep will not

follow! Speaking generally, after-dinner naps are, I think, referable to habits personal or ancestral, or they are the direct effect of the food and drink taken on the nerve-centres, producing sleep by some specific influence, instead of by the circuitous process alleged to be the mode of their causation.1

It is with food, I believe, as with drugs, often supposed to produce sleep by inducing an anæmic or bloodless condition of the brain. Vulpian sums up the results of a series of carefully made and admirably recorded experiments with chloroform, ether, opium, and chloral, administered separately, and in some cases in combination, as follows:-"Le sommeil chloralique n'est donc pas dû, plus que celui qui est provoqué par l'ether, le chloroforme ou l'opium, à une anémie ainsi produite dans le cerveau. Nous pouvons donc dire que l'action hypnotique des diverses substances, que nous avons étudiées sous ce rapport, s'exerce sans que les effets qu'elle produit puissent être rattachés à des modifications vasculaires des centres nerveux. Ces substances n'agissent pas, en effet, sur ces centres, par l'intermédiare des vaso-moteurs, comme on l'a admis sans la moindre preuve directe; c'est sur les éléments anatomiques mêmes des centres nerveux que porte leur influence. Ce sont ces éléments qui sont directement modifiés, probablement parceque les agents en question y pénètrent et y produisent une altération histo-chimique." When articles of food act as soporifics, they doubless operate in the same way directly and specifically on the nerve centres. It is also possible that there may be a reflex action on the medulla and brain through the pneumo-gastric nerve; besides which an associative influence is likely to be exerted through the sympathetic. I make no apology for introducing these technical details. Most intelligent readers know something of physiology, and this is one of the matters relating to health, not disease, which cannot be too generally understood.