Therefore we may say that sleep comes when the instinctive conquers the conscious. In many cases of illness, on account of physical debilitation and psychical fission, the subconscious is so powerful with its primeval wishes that the establishing of its mastery, as we have remarked in the case of sleeping, causes a conflict. The patient will consciously, perhaps, have the desire to fall asleep, but it is impossible for him to do so. On the other hand, another is over powered with sleep as an expression of strong suppression of conscious desires, a refusal to recognize the conflict in which his psyche is involved, an example of contrary reaction.
We are of the opinion that insomnia develops when in reality unrealizable, forbidden wishes are feared by ones conscience even during sleep; somnolence, when wishes are feared which though truly realizable are at the same time objectionable and forbidden. Conscious conflict makes rather for insomnia when it is painful to dwell upon, for somnolence, perhaps, when the conflict is associated with a pleasurable sensation. This can go so far that hysterical persons may, for years, suffer from insomnia or somnolence which will have quite the appearance of insomnia with an organic basis.
We know that in the city of Oknoe in Sweden, a young woman continued in an hysterical somnolent condition for thirty-two years (this case was described in the Nouvelle Iconographie de la Salpetriere, 1912) For the particulars of this case, see “Der Wille zum Schlaf,” Steckel. Verlag Paul Knepler, Vienna, Austria. and we conclude that this peculiar rejection of reality was the result of subconscious, suppressed psychical processes of the young woman.
It seems natural to associate the physical effect of the hysterical disturbances with the phylogenetic portion of the brain, lying deep in the cerebrum, especially with the thalamus optics whose importance with regard to sleep has been definitely established, especially through the observations made in cases of encephalitis epidemica. In this affliction, there is also sleeplessness and somnolence, likewise sleepiness during the day and wakefulness during the night, as is sometimes the case with beginning dementia paralytica. I refrain purposely, at this point, from speaking of a “sleep-center.” We know indeed that sleep automatism, similarly to the automatism of the vegetative centers, originates in the subcortex; but it is improbable that there exists a “sleep-center” in the sense of a group of brain cells, it seems more reasonable to speak rather of definite “associations” that lead to sleep.
In experiments with drugs in which an artificial illness is created, sleep disturbances are brought about in a similar way as those seen in natural illness. Certain drugs disturb the integrity of the organs, so that sleep is organically prevented. In the experiment with the poison from the Lachesis serpent, the following symptom appears: “sleepy throughout the day as well as at night; he sleeps well when the cough does not annoy him.” To be sure Lachesis has, along with the above, still other symptoms which speak for the fact that under its effect there is also an influence exerted upon the subconscious, as expressed in the symptom that has often been found in experiments and confirmed ate the bedside: “The state of mind is always worse after sleeping”.
In the first number of the commemorative addresses of the North American Academy for Homoeopathic Therapy, entitled: “Effects of Snake Poison,” Constantine Hering has gathered together numerous symptoms found during drug experiments. He relates, among many others, the following symptoms observed in healthy persons who submitted themselves to the drug tests: “It is extremely difficult for him to pay attention to others even though his sense of hearing be not diminished–the words that have just been spoken to him are as though wiped away without his noticing them himself. This happened in one who usually, even when in the greatest hurry, would not make such mistakes.Dull in the head, so that he could not remember what had happened just a short time before”.
Lachesis belongs also to that group of drugs among whose actions are to be enumerated definite disturbances in the emotions. The following well-known drugs are to be included in this list: Alcohol, cocaine, opium, morphinum, carbon monoxide, bisulphide of carbon, ergotin, lead, mercury,. We know from the materia medica at which numerous reliable research workers have labored since Hahnemann as, for instance, the Viennese under Watzke and Fleischmann and the Americans under the great drug prover, Hering, that mental symptoms were observed to quite a remarkable extent under the action of various drugs, among which can be counted numerous sleep and dream symptoms.
It is not necessary that I should present to you here the clinical picture of the different exogenous intoxication psychoses, nor the fine details making up the picture of the emotional disturbances produced by gold and lead. All these changes are comparable to the “eruption waves” (Einbruchswellen) of Schilder which project the processes of metabolism and of the internal secretions into the psychical. The toxic eruption of the physical into the personality and, on the other hand, of the psychical into the physical, shows that at bottom the physical and psychical are both functions of a common vital quality.
Not a few drugs strengthen or eliminate inhibitions, there are also those which with the sleep-wish, stand in relation to the “sleep-associations.” Others affect the regions of the senses whose somatic and psychical stimulation produces hallucinations, delirium, disorientation, vertigo, etc. Still others, as for instance, alcohol, cause, by acting upon the cortex a release of the inhibitions and a breaking through of the dormant passionate impulses.
If Bonhoeffers assumption is correct, that alcoholic hallucinations occur especially in people with a marked inherited acoustical analogue, similarly as the psychical disturbances in a case of Basedow occur almost exclusively in those of a psychopathic disposition, then we can understand certain observations made in drug experiments; for in these experiments it is shown that certain substances develop remarkable and characteristic symptoms in particular constitutions or races, for instance: Phosphorus in an asthenic constitution or sulphur in the black races.
The activation of the mechanics of delirium or of hallucinations depends therefore upon the specificity of the poison and upon the susceptibility of the individual, and most of all, upon the state in which the individual is in, when the toxic eruption takes place. We understand, therefore, why all trustworthy researchers in drug-proving lay so much stress upon the value of knowing, as accurately as possible, the previous personal and family history of the individuals who act as provers and why it is always insisted upon that the same drug should be proven upon different constitutions, various ages, etc.
The symptom-complex of paralysis, tuberculosis, tabes, etc., is dependent for part of the symptoms, even in their anatomical aspect, upon the previous physical wear and tear and upon the symptoms is dependent upon the specific action of the disease toxin; similarly in drug experiments, do the personality, the drug, and the constitution shape the symptom-complex. We know much more concerning the foregoing than we do of the bio- chemical processes in the brain or spinal cord of a sleeping man, for of these we know practically nothing.
When we speak of sleep and drug experiment, two further observations are of interest. Oppenheim observed that sleep itself can cause pains which the afflicted one never had when awake, or which he felt again later (Hypnalgien); further, the recognition of symptoms which occur in cases of long-continued insomnia: Increase in the acuteness of vision, disturbance of the alertness and the attention, and hallucinations, especially those of vision.
In drug experiments, sleep disturbances are therefore, an expression of self-defense on the part of the individual against eruptions of a toxic nature which, through their dynamic action on the subconscious as through the derangement of the integrity of the organs, call forth characteristic symptoms in different constitutions.
As in the list of physical symptoms, we recognize the point of least resistance of the organism, a certain oversensitiveness of the organs or organ systems, an inherited or acquired lack of resistance of the organs in their ontogenetic or phylogenetic development, so also does it seem that a number of earlier experiences in the subjective existence of the prover are again lived through. In the action of Baryta, for instance, a trait that reminds one of a neurotic symptom- complex is met with repeatedly. As the neurotic decides, when he cannot avoid a conflict, to pursue the way of regression and finds his relief by withdrawing into one of the stages of his development that has already been established, so it appears that under the influence of Baryta, the toxic eruption has its greatest effect on the personality in a regressive sense.
