Dr Neil Stanley Independent Sleep Expert
BACK William A. Hammond, On Wakefulness. With an Introductory Chapter  on the Physiology of Sleep (Philadelphia, 1866). here As a symptom of various diseases which affect the human organism, wakefulness is sufficiently well recognized by systematic writers on the practice of medicine, though, even here, it is very certain that its pathology  has seldom been clearly made out. As a functional disorder of the brain, arising from inordinate mental  activity, it has received scarcely any 'notice. This neglect has, doubtless, been in a great measure due to the  fact that it is only within late years that the condition in  question has become so common as to attract much attention. At present there am, probably, but few physicians engaged in extensive practice in any of our large  cities who do not in the course of the year meet with  several cases of obstinate wakefulness, unaccompanied in the early stages at least, by any other prominent disorder of the system. Although Ekirch writes that “virtually every instance” “detailed by Hammond pertained to the difficulty of falling asleep after first retiring to bed” this is totally incorrect. Hammond details only 8 cases in the monograph and of these only case III (p47) and case VI (p62-65) come close to describing sleep onset insomnia. While the book garnered a few positive reviews when published (for example here, here, here,) this passage from The Medical Times and Register. v.8 1877-1878. here would suggest that it was not “influential” as claimed by Ekirch For the last twelve years, or, in fact, ever since the publication of Dr. Hammond's monograph on wakefulness, —we draw our facts from the book before us,— very few observers have carried out the suggestive ideas then presented by him —one might almost say—for the first time; and, unfortunately, — the book is still our authority, —the few observations " made by others have been from wrong stand-points, and hence devoid of satisfactory therapeutical results." While this is greatly to be regretted, it is perhaps less so from the fact that Dr. Hammond has been induced, for this very reason, to again turn his eye and bend his mind upon this and kindred topics, with the result, among others, now before us. The author has entered upon that great field, so hazardous to cultivators, which may be termed creative medicine, and introduces to us hyperaemia of the brain, not temporary fulness or temporary congestion, but a disease, capable of sustained action ; in other words, a distinct, permanent pathological condition of hyperaemia. BACK
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