You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Dr. Gillespie's clinical classification of the methods of treatment of sleeplessness he advocates is sensible and valuable. He rightly condemns the view that sleeplessness is the only symptom to be considered in a sufferer, and that sleeplessness in itself makes for insanity, suicide, etc. But insomnia, like other symptoms which gain ascendancy, often requires adequate treatment in itself. Sleeplessness is not, however, always distressing or unwelcome; periods of mental alertness in some individuals are accompanied by lessened need of sleep, two or three hours being often sufficient for several weeks on end; in the same individual states of inactivity and lethargy are accompanied by increasing sleep—eight to ten hours or more.
Dr. Gillespie observes that the mental causes of insomnia are various. Clinically two main types may be recognized—one accompanied by not unpleasurable excitement, the insomnia due so frequently to sexual tension, and the other accompanied by restlessness and great displeasure, this form so frequently due to some feeling of unconscious guilt inhibiting sleep.
In the pathology of sleep the author deals very thoroughly with the major forms of morbid sleeplessness, but I think something might have been said about the sleepiness which is so common a symptom in the psychoneuroses—perhaps as common as insomnia in this condition. It has happened to the analyst to find his patient asleep during the greater part of the hour's treatment. Such patients awake from prolonged sleep quite unrefreshed and find in sleep a sure retirement from all activity.
The section on the treatment by drugs contains all that any practitioner could require—there is put on the market some new variety of the barbitone group nearly every month.
The last chapter on the theories of the nature of sleep is perhaps the most interesting and the least satisfactory. After reviewing the various psychological views the author concludes that sleep is in fact a positive process with cha