In Baryta provers, one notices among many other symptoms the following: “Great mental and bodily weakness, childish department, shy before others, she imagines that strangers are laughing at her or are criticising her, therefore she is so timorous that she does not want to look up”.
Remedies for inducing sleep, outside of the hypnotics and the narcotics which induce a narcosis or a sleep that is not normal (at the most, they only prepare the way for a true sleep), are all those drugs and measures which influence the organism in the sense of organ integrity or in the sense of carrying through the will to sleep. Therefore, hypnotics and narcotics should only be thought of when a patient is so disturbed mentally that he becomes dangerous to himself or to the environment and must, for this reason, be quieted for the time being; or when all other measures have proven useless and the life and health of the patient are more endangered through the lack of sleep than through the hypnotic remedy.
The danger of not using soporifics conscientiously lies, on the one hand, in the psychical injury to the patient who through the artificial dulling will, fundamentally, becomes still more restless, and, on the other hand in the physical injury. Substances foreign to the system cause, as a reaction the formation of antagonistic substances. Weigert was able to demonstrate quite generally that the reaction was always longer and more severe than the stimulation. “Antagonistic substances” in a chemical sense are also often antagonistic in a functional sense as well. Experience shows, moreover, the after the torporific effect, an intensified reaction of excitement sets in.
With regard to somnolence or insomnia, one must decide in individual cases whether the shortest way to relief is through the use of drugs or by means of psychical treatment. It is indeed striking how a patient will exclaim in regard to a drug or some other measure that has been peculiarly suited to his case: “That must have been a strong sleep remedy! I have not slept so well for a long time.” It was in this connection that Samuel Hahnemann, with his inspired appreciation of the psycho-physical working of the organism, showed the selective action of drugs by giving special emphasis to the mental state of his prover or patient as the guiding symptom for the selection of the remedy, and, more than a hundred years ago, pointed out the fact that, under certain premises, every drug–regardless of any suggestive effect in its administration–can serve as a sleep-producing remedy; this effect, in certain cases, can be interpreted as a dynamic action on the subconscious processes.
In most cases of disordered sleep caused by a disturbed psyche, either the drug is insufficient, or the improved sleep conditions which it inaugurated are constantly being annulled through the urge exercised by repressed psychical activities upon the physical system. This indicates that we must bring order into the psychical life of the patient. According to an old adage: “A clear conscience makes a good nights rest.” This homely wisdom coincides with the interpretation of the modern psychology of sleep as being as thymogenic process, the mechanics of which were revealed especially through the research of Liebault, Bernheim, Kraft-Ebing, Vogt and Forel, that psychology which was so brilliantly broadened and developed by Sigmund Freud, the creator of psychoanalysis as a method of research and healing.
Following are some illustrations and short characterizations of certain practical points of view. In the following case histories all of the details and explanations have been omitted in so far as they deal with the psychological aspect or a differential diagnostic analysis.
Mrs. A., forty-five years of age, comes for treatment on account of insomnia, periods of which have been recurring for the last ten years. She was treated during this time by skin specialists and by internists with salves, Roentgen rays, and medicine by mouth, but her condition was only temporarily palliated. She has suffered from severe Pruritus vaginae with occasional attacks of eczema around the genitalia. Physical examination gave no clue as to the cause of her condition. For many weeks she had little sleep on account of the pruritus. The fact that she was often in a state of anxiety and suffered from other neurotic symptoms indicated the necessity for psychoanalysis, which was successful. After one year, sleep is normal and neither the eczema nor the pruritus has returned.
Mr. B., thirty-five years of age, Basedow with insomnia as the most prominent symptom. Tuberculinum 200th, Iodine 6th, and Spongia 3d, administered in sequence in the course of a few weeks, caused the Basedow symptoms to disappear and the sleep to become normal.
Mrs. C., forty-four years of age, has suffered for years from insomnia which constant use of sleeping potions only alleviated. She is now under psychoanalytic treatment on account of dyspareunia. During the early weeks of this treatment, the insomnia (inability to get to sleep) was relieved. There existed numerous conflicts in the psychical life of the patient, consisting especially of homosexual tendencies which, consciously, she had conquered, but which her subconscious occupied itself almost every night, causing her insomnia.
Miss D., thirty-two years of age, has been under drug treatment for months on account of chronic tonsillitis and the fact that it takes several hours for her to get to sleep. For the last eight years, she has been taking the usual sleeping potion without effect. Constitutional drugs which I prescribed for her, did not help. Casually, during a consultation, the patient remarked that for the last few years she could not go to a concert and could not bear to make music herself, as she was intensely affected thereby (excited and then tired, or unable to get to sleep). Thereupon instead of the Sepia which had been prescribed, Natrum carbonicum 30th was given, one powder every second evening. This drug has, in the proving on healthy persons, the symptom: Aggravation through music. The result was remarkable. The patient has been able to sleep well at night for the last three years.
Mr. E., forty years of age, awakens every morning at about four oclock with cramplike pains in the stomach and afterwards cannot get to sleep. He was treated for a long time for various gastric secretory disturbances. An organic involvement could not be established. A neurotic conditions was most probable. No drug treatment. He had, as a short but successful psychical treatment brought to light, at the time of puberty experienced severe conflicts from which he was still suffering without being conscious of them. The hour from four to five in the morning was at that time very distressing to him. Recently, owing to conscious conflicts, old experiences were again lived through and expressed themselves in this peculiar early morning disturbance.
Those who have an interest in the psychoanalytical side of this subject should read: “Vorlesung zur Einfuhrung in die Psychoanalyse,” S. Freud; Int. Psychoanalytical. Verlag, Vienna, Austria. For the relationship between toxins and the neurotic mechanism: “Medizinische Psychologie,” Paul Schilder, Verlag Julius Springer, Berlin, Germany.
Concerning the valuation of the subjective symptom in drug proving and at the sick bed, see Paul Dahlke, in the “Berlin Homoopathische Zeitschrift,” after 1900. For the natural- scientific relationship between Hahnemanns drug therapy, modern medicine, and psychoanalysis, see Otto Leeser in the “Grundlagen der Heilkunde,” Lehrbuch der Homoopathie (Konkordia, A. G., Bahl- Baden) see also the chapter on “Moderne, dynamische Psychologie” in “Einfuhrung in das Studium der Homoopathie,” Vannier-Meng (Hahnemannia-Verlag, Stuttgart, Germany) and “Grundlagen der seelischen Behandlung,” Paul Federn and Heinrich Meng, in the first volume of “Das arztliche Volksbuch,” Meng-Fiessler (Wagnersche Verlaganstalt, Stuttgart, Germany, Anton Bippl). As a model for proving drugs on healthy people see “Oesterreichische Zeitschrift fur Homoopathie” published by Fleischmann, Hampe, Watzke, Wurmb (Verlag Braumuller und Seidel, Vienna 1844 and following years).
