M.D. John Bond

“ While we are awake, lie on our Backs, and feel any uneasiness in that position, we immediately alter it: but, in sleep, we are not so soon conscious of the Blood’s stoppage in the Lungs, nor have we the means of removing that dangerous obstruction so much in our power, because the voluntary motions are then suspended, without which, the position of the Body cannot be changed, nor the cause of the obstruction remov’d. ”

“ When Women pass the fruitful seasons of life, and the delicate uterine Tubes, contracting themselves, become too rigid, and resist the impetus of the Fluids so as to prevent the usual discharges; then the Fluids, which were formerly periodically evacuated, are amass’d, and collected in the Body, and occasion a Plethora. Hence, Women, about that time, often grow fat, heavy, and sickly, and become more subject to the Night-mare; because the Heart, swell’d with redundant Blood, will bear more heavily on the Pulmonary Veins and left Auricle, when they happen to sleep in a supine position. ”

“ Hence Melancholy persons, profound Mathematicians, and fond pining Lovers, are most subject to that affection. Such people are also very liable to many Hypochondriac and Chronic Diseases; which often proceed from a defective respiration, or a too slow motion of the Blood through those parts which are agitated by the alternate dilatation and contraction of the Thorax. Hence the Liver and Spleen and the Lungs themselves must suffer most when the attention of the Mind is engag’d by some Disease of its own, and it becomes less sensible of the Disorders of the Body. ”

“ In a fit of the Night-mare, the Mind, conscious of the dangerous situation of the Body, in vain endeavours to alter it, [25] because its power over the Voluntary Muscles is some way suspended, by the obstruction of the Blood; yet the Mind may exert itself as much as if it strove to remove the greatest obstacle. ”

“ Some ingenious men have imagin’d, that the bending of the Limbs in sleep is owing to the strong tendency which the flexor Muscles have to contraction; but I humbly suppose, it is rather a voluntary motion, intended to fix the Body on the Side, without the continued action of any of the voluntary Muscles afterwards; for without the flexion of the Joints in sleep, it would be a kind of labour to keep the Body pois’d on such an narrow surface. ”

“ When the Soul is first united with the Body, and receives command over [32] the organs of Motion, it seems to have been laid under a kind of necessity, by which it is compell’d to exert these organs in avoiding whatever is hurtful, and in chusing whatever is apparently beneficial, to the Body.
’Tis evident, from the laws of the Circulation, that when the Motion of the Blood through the Lungs is stop’d, for a short time, the right Ventricle of the Heart must be violently distended, and consequently severely stimulated. ”

“ A Gentleman, about forty-five years old, of a corpulent phlegmatic habit of Body, and an inactive disposition of Mind, complain’d of a vast oppression which he felt in his sleep; upon which he consulted a Physician, who prescrib’d both bleeding and purging, to be repeated as often as it return’d. This prescription was follow’d with success at first, but it became so often necessary, that the patient was not able to bear such evacuations. He therefore was obliged to sleep in a chair all night, to avoid the Night-mare. ”

“ In this agony they sigh, groan, utter indistinct sounds, and remain in the jaws of death, till, by the utmost efforts of nature, or some external assistance, they escape out of that dreadful torpid state. ”

“ WHen People are found in a fit of the Night-mare, the most effectual remedy is to rouse them as soon as possible, by changing the position of the Body, and applying some keen stimulus immediately, such as pricking with a pin, speaking loud, &c. and if they recover the least degree of voluntary motion, the happy crisis is for that time obtain’d, as Actuarius and Willis observ’d. ”

“ Accordingly we find, that most of the brute, as well as the human Species, chuse some easy posture of this kind to sleep in.
When the human Body lies horizontally, the Blood must flow in greater abundance to the Head; and with a greater momentum, cæteris paribus, through the Carotid and Vertebral Arteries, than when the Body stands erect; because the Blood, moving through these tubes in an horizontal direction, will not so much resist the force of the Heart, as when it ascends perpendicularly contrary to its own gravity. ”

“ Galen says, “That the Night-mare is a kind of an Epilepsy, which happens in sleep; and that if it continues long, it will turn to a real Epilepsy38.”
“An accidental Night-mare is not dangerous; but if it be habitual, it threatens an Epilepsy, Apoplexy, or Melancholy, especially if the Person be subject to a Vertigo in the daytime. If it attacks one between sleeping and waking, it denotes the Epilepsy to be very near; but it is remarkably dangerous, when a cold Sweat, a palpitation of the Heart, [68] a Spasm, or a Fainting fit, succeed it39.” ”

“ However, every one knows that the harmony and connection between the Body and the Mind are so establish’d and constituted, while they are united, that the Diseases of the one always affect the other in a very sensible manner; and experience daily demonstrates, that violent passions of the mind produce Fevers, Fainting Fits, and other severe effects on the Body ”

“ By observing Boerhaave’s method of curing a Plethora, viz. using a thin, light diet after bleeding, and gradually prolonging the time between each evacuation, I have reduc’d my bleedings to one every autumn; and (thank Heaven) have in a great measure conquer’d that Monster of the night, which so [79] often threaten’d me with immediate destruction.
Experience also assures us, that large evacuations may be made by strong purges; such as Jalap, Scammon. &c. which greatly dissolve, and diminish the quantity of the Blood. ”

“ The Night-mare generally seizes people sleeping on their backs, and often begins with frightful dreams, which are soon succeeded by a difficult respiration, a violent oppression on the breast, and a total privation of voluntary motion. ”

“ This easy method, which nature has contriv’d to preserve the human Body on its side, is a sufficient recommendation of that position, and a strong precaution against lying on the Back, which is the posture of dead Bodies. ”

“ A corpulent Clergyman, about fifty years old, who is very fond of strong beer and flesh suppers, but so subject to the Night-mare, that he is obliged to stint himself to a certain quantity every night; whenever he happens to take an over-dose, he groans so loudly that he often awakes all the People in the house. He has assur’d me, that, in these fits, he imagin’d the Devil came to his bedside, seiz’d him by the Throat, and endeavour’d to choak him. ”

“ IN order to shew how persons recover out of a fit of this Disease, by the mere efforts of nature, I shall beg leave to premise a few of the most probable opinions, and best establish’d propositions, concerning Animal Motion, which I shall here take for granted, and refer the reader, for a physical demonstration of them, to the ingenious Essays of Doctors Porterfield, Whytt, Simson, and Haller. ”

“ Heavy sighs and groans are the emphatic expressions of nature in distress, and generally arise from some obstruction in the Lungs; but in a fit of the Night-mare there appears a great accumulation of Blood in the vessels of that part, whence these Symptoms are easily accounted for. ”

“ No one, I presume, will doubt the truth of this proposition, who reflects, that it is much easier to move any spherical body on an horizontal plane, than to raise the same body up against a perpendicular wall. ”

“ Experience declares, that there is not a more frequent primary Cause of the Night-mare than heavy suppers of tough animal food, and large quantities of soft, thick malt liquors, which distend, and lie long in the Stomach; whose pressure may contribute, in many respects, to produce this Disorder. ”

“ Hence we sometimes hear of people dropping down dead, upon stooping to buckle their shoes. These instances should deter some from putting their pillows under their feet, in order to make the Blood settle in their faces, and to decorate the external part of their Heads at the expence of the internal. ”

“ As this Disease seems to arise immediately from a supine position of the Body in sleep, we should take care to prevent it before we fall asleep, by composing the Body on either Side. The sagacious Hoffman observes, that the safest posture in sleep, is on either Side, with the Head rais’d, and the Limbs bent inwards to the trunk of the Body43. ”

“ Suppose one should endeavour to poise a thin plate of tin on its edge upon a smooth, level table; if he be not an expert equilibrist, he will find it difficult; but if he bends the plate, then the problem becomes as easy as the well known method of making an egg stand on its end. ”

“ If the Blood be too thick, attenuants should be us’d, such as, spiritus Mendereri44, vegetable subacid liquors, saponaceous medicines, and plenty of vinegar at meals, which, according to the great Boerhaave, is a powerful diluent45. ”

“ It is remarkable, that this Disorder attacks People only in sleep; which, Doctor Young says27, is owing to the effect that sleep has in increasing all the symptoms of a Plethora. It is true, that sleep retards the motion of the Blood, and checks the serous secretions. ”

“ There is no occasion to go about proving that the secretion of urine is lessened in bed, for common experience sufficiently evinces it. And it appears, by the experiments of Doctor Robinson29 and Gorter30, that perspiration is considerably less in the night than in the day. ”

“ These, I believe, are the reasons that the principal Writers in Physic have taken so little notice of it. These omissions however render an enquiry into the nature of this Disease the more interesting and necessary, and, at the same time, the more difficult. ”

“ A robust servant Girl, about eighteen years old, was severely oppress’d with the Night-mare, two or three nights before every eruption of the Menses, and us’d to groan so loudly as to awake her Fellow-servant, who always shook or turn’d her on her Side ”

“ The general primary Causes of this Disease are a Plethora, or a too great quantity of Blood, a viscidity or tenacity of the Fluids, and a weakness or inertia of the Solids. Hence, young persons of gross full habits, the robust, the luxurious, the drunken, and they who sup late, are most subject to the [47] Night-mare19. Also Women who are obstructed ”

“ Anatom. tom. 1. p. 180.
8 Comment in aphoris. 578.
9 De Dieta, scol. xxxv.
10 Haller, Prim. lin. DLXXII. Boerhaave, prelect. academ. de somno.
11 Winslow, de Poitrine, sect. 74. Eustachius, tab. xv. fig. 2. and tab. xxv.
12 Macrob. in som. sup. lib. v. cap. 3.
13 To say that Voluntary Motions by custom become Involuntary, may appear a contradiction; but if we reflect on several phænomena of Animal Motion, that assertion will not appear so absurd. ’Tis universally allow’d, that the Muscles of the Larynx and Tongue, Adductors and Abductors of the Eyes are of the Voluntary kind ”