4.  Sleeplessness, Milk Will Stop.—­“Sip a glass of hot milk just before retiring.  This is very soothing to the nerves, and a good stimulant for the stomach,”

Physicians’ treatment.—­Remove the cause and be careful in using drugs.  In the organic kind the treatment is not very successful.  In the toxic kind drugs must be given to correct other diseases and also tonics given.  For brain congestion and anemia kind other means must be used first, and the drugs as the last resort.  Treatment of the congestive insomnia.—­1.  Hot or warm general body-baths are very advantageous to stimulate the circulation and restore its balance alike in congestion and anemic cases.  After such baths the patient must go to bed at once and not get chilled in cold rooms or by drafts.  They must be properly covered and kept warm.

2.  Cold spongings, cold shower baths, or cold plunge baths are given when the hot or warm bath does not produce the correct result.  If this does not depress it is better than the warm bath.  The person should be rubbed with warm rough towels until the skin is aglow.  If he feels rested and quieted, the reaction is proper; if depressed, the treatment is too vigorous and not suitable.

3.  The patient should stand ankle deep in a tub of hot water and a “drip sheet,” from water at 75 to 80 degrees temperature, thrown over him.  Then rub the patient’s back and abdomen hard and a general brisk rub-down immediately after leaving the tub.  This treatment should quiet, not excite or depress.

4.  The cold abdominal pack is valuable.  Flannel is wrung out in water, 75 to 80 degrees temperature and laid in several thicknesses upon the abdomen; place a dry towel over this, cover all with oiled silk, overlapping widely in order to protect the bed.  Tie or bandage all this firmly.  The effect of this work is first that of a cold then of a warm poultice.

5.  Exercise.  This should be in the open air when possible.  A fast walk, horseback ride or ride on bicycle for a half hour before bedtime, followed by a rub-down will frequently give a good sleep.  Dumb-bell, Indian club exercise, chest weight, are good in some cases.

Diet.—­A light easily digested supper is often better than a heavy meal.  Sometimes a little eaten before bed-time will give sleep.  A piece of toast, for instance.  It draws the blood from the brain and more to the stomach.

[Nervous system 301]

Medicines.  If you must use them.—­The bromides are the best.  Sodium and strontium bromide are first choice.  Twenty to thirty grains in water one-half hour before retiring.  Chloral hydrate should not be used often.  Sulphonal, trional, etc., should always be given with a little food-never alone.  Sometimes bread pills do just as well.

Anemic congestion.  Diet.—­A light supper before retiring, like hot milk, broths, milk punch, etc., will very frequently promote sleep by removing the cause and quickening the circulation.  Give nutritious, easy food to digest.  The baths are not so valuable for this kind of insomnia.  A cold sponge bath or plunge may be of service.