(IRRESISTIBLE SLEEPINESS)
“SUDDENLY she fell asleep.” The daily papers are always out after medial curiosities, and have been making a front page incident of a young woman in the early twenties who falls asleep every time she laughs. She went to the pictures, laughed at the jokes, fell asleep suddenly and could not be awakened, so that she had to be taken home in an ambulance, and then slept for four hours.
Any sudden shock affects her in the same way, it may be anger or laughter. This mental disorder has been recently studied by Dr. Adie, who, since 1926, examined some fifty cases in the following four years: and described this affliction which he called narcolepsy under the following terms. “It is characterized by attacks of irresistible sleep without apparent cause, and curious attacks of emotion, in which the muscles relax suddenly, so that the victim falls to the ground, often fully conscious, and yet unable to move.” There are two different kinds of attacks:.
(1) Sleep attacks. Spontaneous seizures, the patient remains more or less unconscious.
(2) Catalepsy. This is caused by violent emotions, anger, joy, laughter — really a case of helpless laughter. He becomes stiff and helpless, knows what happens, but cant help himself and does not always lose consciousness. This condition may come on after a period of stress and strain, when the patient has not been having sufficient sleep for a considerable time. The sufferer gets “sleepy attacks” during the daytime at first, specially after eating — heavy the daytime at first, specially after eating– heavy lunches in the middle of the day– when the brain is naturally anaemic, nearly all the blood being required for the processes of digestion.
The sleep lasts from fifteen to twenty minutes, and in no way differs from ordinary sleep. On the Continent the siesta after the mid-day meal is encouraged rather than otherwise, and the German calls this post-prandial somnolence” nur ein Viertelstundchen.” These sleepy attacks are liable to come on at such times when normal people feel sleepy, only in a more exaggerated form, say in a hot close room or in an overheated railway compartment during a long journey. The normal person can be roused, but the narcoleptic cannot.
The usual professional advice is not to fight against this irresistible desire for sleep, but to give way to it and have a short nap. Again, it has been noted that narcoleptics fall asleep the moment they get into bed and sleep well and long.
A cataleptic attack is usually caused by laughter. Everything goes limp, the knees give way, the arms drop to the side, the eyelids close and the patient falls to the ground, helpless, unable to speak, but well aware of everything that goes on around him. Such an attack, it is stated, can be warded off by not giving way to emotions, to anger or to laughter. What a dull life; not even to be allowed to laugh at Mickey Mouse or the antics of Charlie Chaplin !.
This condition of narcolepsy, even though apparently quite a new disorder, and which has only recently been fully studied and classified by the medical scientist, must have been met with years ago, for that keen observer of human nature and its frailties– Charles Dickens — gives a good description of a narcoleptic in the fat boy of Dingley Dell in the Pickwick Papers. This boy would drop off to sleep at the most unexpected moments, while standing and serving at table, while sitting in the front seat of a coach, in the very act of knocking for admission at a door, he would go to sleep.
He fell into a deep sleep even during mealtimes while indulging in the very heavy repasts which Dickens relates with such loving detail. Narcolepsy is therefore not a modern disease.
It was known to the homoeopathic physicians as well, for in the large Repertory of Kent, that symposium of multiple exact symptoms, a column and a half is devoted, not to narcolepsy or catalepsy (these scientific names have only recently been coined), but to the simple term “falling asleep”, which does neither daze nor mystify, but is good plain English and can be understood by all and sundry. There are separate items for falling asleep in the morning, noon-tide while eating, afternoons while sitting, evenings after eating, and so on.
For the information of the colonial readers of this magazine and others interested who are far away from the pen of a homoeopathic physician, I shall give some of these rubrics and the remedies (Kent, 4th ed.):.
Falling asleep, mornings: Coca., hep., lyc.
” forenoons: Calc.
” ” while reading: Nat. sulph.
” noon: Aloe.
” ” while eating: Puls.
” afternoons: Bar. carb., cin. dios., hyos., mag. c., nat. m., phys., sabad., sep.
” ” while sitting: Nat. mur.
” evenings: Ammon. carb., mez.
” ” after eating: Ammon. carb., gels.
” while reading: Mez.
” while sitting: Apis. hep., NUX VOM., talc.
” 5 p.m., while sitting: Nat. mur.
” when answering: ARN., Bapt., hyos.
(N.B.– You find this state in serious cases of pyrexia, such as typhoid, intermittent fevers, tropical fevers, influenza, etc.)
” after beer: Thea.
” breakfast: Samb.
” during conversation: Caust., tarax.
” after dinner: Ant. t., caust., coca., car., Mag. carb.m tobacco.
” after eating: Arum tig., bor., calc. p., gamb., lyc., mur. ac., nat. m.
” during heats: Ant.t., apis., CALAD., EUP. PER., gels., ign., LACH., lyc., MER., NAT. MUR., Nux m., Op., Post., Rob., SAMB., stram.
” after laughing: Phos.
(N.B.– You see this curious condition of falling asleep after laughing was known to the early homoeopaths, and unless there are other symptoms contra-indicating Phos.– phos. should cure narcolepsy after laughing.)
” from the least mental exertion: ARS., chloral., ferr., HYOS., ign., kali br., kali. c., nat. s., nux v., tarax.
” after pain: Phyt.
” while reading: Arg., cimic., colch., ign., iris, lyc., mez., nat. m., nat. s., plat., ruta., sep.
” while sewing: Ferrum
” while sitting: Acon., arg., ant. t., apis., ars., arum.t., aur., calc. p., chim., cimic., cina, ferr., form., hep., ign., kali br., kali carb., lyc., merc., muriat. at., nat. c., nat. m., nat. p., NUX VOM., puls., sep., tell., thuj., tarent.
Falling asleep while standing: Acon., corr. r., mag. c., morph.
” ” after dinner: Mag. c.
” after stool: Aeth., elaps., sulph.
” while talking: Caust., chel., mag. c., morph., ph. ac.
” ” after dinner: Mag. c.
” after vomiting: AEth., bell. (N.B.– “This precious little symptom, falling asleep after vomiting has saved many a life in very acute cases of infantile diarrhoea and vomiting”).
” from weakness: Petr., phos.
” after wine: Thea.
” while writing: Ph. ac., thuja.
You see, this gives quite a full and detailed account of what are or might be the concomitant symptoms of sudden dropping asleep.
For example, if I had been asked to do something for the fat boy in Pickwick Papers, I should have taken the rubrics after dinner, while standing, while standing after dinner, while talking, while talking after dinner– and the remedy working through all this would be Mag. carb. I should then look up Mag. carb., and there one finds inordinate craving for meat — and there you are. I should expect to cure this “fat boy” of his sleepiness and overeating and eventually of his obesity.
One remembers a case which happened years ago, long before narcolepsy and catalepsy were officially recognized and classified. I diagnosed it then as an automatic state in a case of pituitary obesity: A young woman, very stout, big and pale, used to be suddenly seized with attacks of sleepiness, drowsiness and automatic behaviour during her menstrual periods.
She was an active, intelligent girl, a clerk, well thought of at her firm, who every month was suddenly taken like this. She became drowsy, dazed, could not answer, stared stupidly when addressed, heard and saw everything, could remember everything afterwards, but was quite speechless and unable to move. Everything seemed far off, she did not seem to recognize her friends even.
I saw her once in this state, and very pitiful she looked. In between she was always bright, active and happy, though very worried about these peculiar attacks which invariably happened every month during the periods. Very much afraid of losing a good job, as she always had to have two or three days off.
There were other symptoms present which led me to the right remedy: she complained of a dry mouth, the tongue literally stuck to the roof of her mouth, and yet she was never thirsty; she was flatulent, very constipated before and during her periods, the stool was soft, not hard as a constipated stool usually is: she felt the cold weather, specially the cold, damp weather and yet hated a close, warm room, which always made her more sleepy and dazed: she fainted easily, when she had to stand, and then there was this automatic conduct, this sleepiness, drowsiness and confusion of mind.
The only remedy that covered all these symptoms was Nux moschata the common nutmeg. She was given Nux moschata cm., the only potency I had got, for three months she had no return of her attacks, which had been troubling her for two years at least; then another severe attack, during which I saw her. Then another dose of Nux moschata cm. which held her for six months this time; she had only a slight return of her old trouble, then three doses of Nux moschata; and then no more.
