the consciousness, with possible morbidity in two directions; too much or too little. Ordinarily it is assumed that the more one gets of sleep the better. This view is so generally accepted that the custom of some physicians, especially those who see much of illness in the extreme periods of life, to order food or employ active measures at regular hours, involving the waking of the patient, verges upon the danger line. Judgment must be exercised, and is well within the capabilities of a good nurse. Serious exhaustion has often followed needless interruptions of repose during exhaustive states.
It is entirely demonstrable that a variety of disorders may result from, or are indicated by, excessive somnolence, partly of developmental and partly of degenerative origin. During infancy sleeping must predominate over waking states, the unconscious reflex life over the conscious intellectual life. It should be remembered, however, that consciousness requires exercise for development. Monotonous measures, such as rocking, swinging, unmusical lullabies, may serve a salutary purpose occasionally, but can readily be carried too far, to the point of lowering normal temperature, inducing excessive anemia of the brain and disturbances of circulation. Sleep should come by opportunity, comfortable position and customary environment. Habits should be formed sufficient in themselves to invite repose. It ought not to be interrupted needlessly, nor forced by measures or drugs which obtund the consciousness. Normality of sleeping capacity is the product of intellectual equipoise. Stupid folk are proverbially dull, lethargic, with large capacities for deep sleep. Some part of this is no doubt the result of over indulgence. The consciousness is often enfeebled by disuse in young or old. In the young the impetus to exercise the faculties demands encouragement; also, as age enfeebles the brain structures, mental stagnation, hence degeneration, is invited by overmuch time spent in unconsciousness. Nutritive balance, the expenditure of energy, can not be maintained indefinitely. Renewals must occur, and it is shown that inordinate somnolence makes for exhaustion of body and mind; the kidneys suffer, their vessels become distended and hence enfeebled. In the aged the tone of the tissues, especially of the vessel walls, tends to become devitalized, leading to a stasis in lymph and blood vessels and to various forms of organic derangement. In deep sleep, long continued, this stasis of blood and lymph is unduly encouraged, sometimes to the point of paralysis. The bile becomes thickened, stagnated; the bowels, the intestines, suffer from a surfeit of sleep, impairing the machinery of peristalsis, hence follows constipation. The urinary organs also share in this derangement of elimination and gravel, calculi, may form. Anemias are often unaccountable, but it will be found that chlorotics usually sleep too much and are the better for its regulation.
