Dr Neil Stanley Independent Sleep Expert
BACK William Acton, The Functions and Disorders of the Reproductive Organs in Childhood, Youth, Adult Age and Advanced Life: Considered in their Physiological, Social, and Moral Relations, 4th edn (1857; Philadelphia, 1865), 228.  here  Let me further remark, that if a man is disposed to emissions he should not allow himself to fall into a second  sleep, but should rise early ; in following out this plan there is no difficulty if the patient goes to bed at a  reasonable hour. No doubt can exist that emissions most frequently take place in this second sleep ; and it is equally certain that although a man awakes thoroughly refreshed from his first sleep, he may arise after having taken a second doze thoroughly prostrated. An early call, or an alarum clock, may cure many a patient better than all the preparations in the pharmacopoeia. At first these early hours may disagree with him, but they soon become as natural as late ones were, and the patient feels a disinclination to lie in bed, equal to his old  disinclination to get up early. Of course large numbers of patients will tell you that they feel so fatigued in the morning that they cannot get up. If more sleep is required—should be the answer—let it be taken in the daytime. It would be a curious and important question for physiologists to investigate why the second sleep refreshes us so slightly when compared with the first? On awaking the first thing in the morning, most persons, and especially convalescents, feel refreshed by their night's rest ; but if they go to sleep again, and rise say at ten, they remain languid all day. Perhaps it may depend in a great measure upon the first sleep being sounder and quieter, and not being disturbed by the dreams to which those who indulge in the second are liable. The recommendation may be difficult, then, for young men to follow, but I have often thought of advising some of my confirmed cases to take a voyage on board ship, and keep the watches with the sailors, which allow of taking only four hour's sleep at a time, in the belief that this interruption of rest would break through the almost inveterate habit ; but it is difficult in these, the worst forms, to induce the patient to use any self- restraint to cure himself ; he wishes to rely on medicine, and will not give himself the trouble to exert self-will. Another very valuable suggestion is to desire the patient to practise the habit of waking early in the morning, turning out of bed, and emptying the bladder. It is in the early morning, when the bladder is full, that emissions and erections take place. In such cases, if a patient rises at 5 or 6, and goes to bed early, he may altogether avoid emissions. London Encyclopedia, xx, 464; here This is a repeat from footnote 31 In dreaming, as in the soundest sleep, the action of the external senses is suspended ; but the internal faculties are active in greater or less number. Volition takes place, but the muscles do not obey the will. That dreaming is a less sound species of sleep appears from the familiar fact, which has probably been observed by every individual ; viz. that the first sleep is much freer from it than the second. We retire to rest, fatigued by the exertions of the day, and sleep soundly for five or six hours; we wake, and then fall asleep again towards the morning, and dream the whole time of this second sleep. This example could on the face of it conceivably be taken as evidence of Ekirch’s idea of ‘segmented sleep’ however the phrase used is “this second sleep” which seems odd rather than “the second sleep” which would be more indicative that it was actually referring to ‘segmented sleep’ but it does not provide evidence of the prolongation of ‘first sleep’ John Adams, ‘Clinical Lecture on  Retention  of Urine from Enlargement of the Prostate Gland  and  on  Spermatorrhoea  in Connexion with Irritable Prostate’, The Medical Times and Gazette, new ser., xiv (1857), 454–5; here   Let me explain to you what I conceive to be the rationale of this condition. Nocturnal emissions occur almost invariably under  the influence of a dream, and, as far as I can ascertain from the history of patients, are always accompanied by a sensation pleasurable or otherwise. I believe they never occur without exciting or being accompanied by some sensation. My inquiries also lead me to the conclusion that they generally occur just at the termination of the first natural sleep, and usually in the early part of the morning. They are, therefore, matutinal rather than nocturnal emissions. This is rather an essential point to understand, as you will see in the sequel. It is difficult to say whether they occur as the consequence of a dream, or whether they are of themselves the cause of the dream. My opinion is that in this regard they vary. I cannot go into a lengthened discussion as to the true nature of dreams. I believe that dreams frequently originate in the mind in imperfect sleep as a consequence of the powerful influence upon the mind of some past event; and every one knows that dreams are readily excited by some physical impression; thus school boys excite to mictarition by placing the hands of  their school fellows in cold water during sleep. Now, in the case of seminal emissions, at least such as occur night after night, or morning after morning, I think it is the mental impression which excites the dream, and the emission is the consequence. The patient is always thinking of his condition; it haunts him day and night; he gets a habit of thinking of his state, and hence in a weakened state of parts the habit of secretion and emission is also attained. That dreams are also excited by an overcharged state of parts must be evident at once, and such dreams are also accompanied by seminal emissions. I need scarcely allude to the natural mode of relief in such cases - but even these cases admit of considerable melioration by suitable means. The  phenomena of dreams constitute a most interesting department of  psychology. I shall not enter into the subject here; it is admirably  treated by the late Dr. Abercrombie, and has also been particularly elucidated by Lord Brougham in his Discourse on Natural Theology. In reference to our own subject, however, I may be permitted to allude to a well-attested phenomenon connected with dreams; I mean the rapidity with which, as Lord Brougham expresses it, a long succession of images passes through the mind with perfect distinctness and liveliness. In a dream, which occupies only an instant of time, a series of ideas relating to many events will frequently pass before us. The proof on which this assertion rests illustrates at the same time the fact that dreams generally happen just at the termination of sleep, and whilst, it may be said, we are half asleep and half awake. I am certain that this is the case with dreams attended by seminal emissions; and it is a belief in the correctness of this assertion that has led me in very many instances to recommend a simple procedure, which often alone effectually puts a stop to those discharges. I could enumerate many cases in which, by simply directing a patient to rise early in the morning, and immediately after his first sleep, a discharge, to which he has been accustomed for many days and weeks in succession, has been wholly put a stop to, and has not recurred. I believe that the first sleep is always the soundest; and if this be so, the mind may best rest as well as the body, and no dreams occur; but if the patient indulges in a second sleep, the mind wanders, dreams take place, and that impression which weighs heaviest on the mind.  Ringer, Handbook of Therapeutics, 104; here  Dr. George Bird has pointed out that seminal emissions occur from undue indulgence in bed, the emissions taking place very generally early in the morning, during the second sleep. He recommends, therefore, that the patient should be roused after six or seven hour's sleep, and should never give in to a second sleep. Dr. Hardman of Blackpool tells me that he has cured some obstinate cases of spermatorrhoea, by directing the patient to empty his bladder on waking- from the first deep sleep. ‘Dreams and Dream Stories’, 335; Given that the 3rd edition only has 300 pages I am not sure what page Ekirch is referring to, the only occurrence of the phrase ‘second sleep’ is much earlier in the book  here  It may, perhaps, be worthy of remark that by far the larger number of the dreams set down in this volume, occurred towards dawn; sometimes even, after sunrise, during a "second sleep."  A condition of fasting, united possibly, with some subtle magnetic or other atmospheric state, seems therefore to be that most open to impressions of the kind.   ‘The Privateer’, 799; here This is a repeat of footnote 34 Then at seven this morning, just as I was in the middle of my second sleep, there comes a thundering rat-tat  Current Literature (Apr. 1889),   277. here This is a repeat of footnote 34 Philostratus, in his Life of Apollonius Tyaneus, represents the latter as informing King Phraotes that ‘the Oneiropolists, or Interpreters of Visions, are wont never to interpret any vision till they have first inquired the time at which it befell; for, if it were early, and of the morning sleep, they then thought that they might make a good interpretation thereof (that is, that it might be worth the interpreting), in that the soul was then fitted for divination, and disencumbered. But if in the first sleep, or near midnight, while the soul was as yet clouded and drowned in libations. they, being wise, refused to give any interpretation. Moreover, the gods themselves are of this opinion, and send their oracles only into abstinent minds. BACK
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