Wednesday, March 16, 2016

Death and his brother Sleep, by Woods Hutchinson 1908


THE CURIOSITIES OF SLEEP BY WOODS HUTCHINSON, M. D.

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Sleep Compared with Death and Fever

Another curiosity of sleep is the many misleading analogies which have been drawn between it and other states. First among them is the beautiful poetic comparison which has almost become an article of faith, embodied in the phrase, "Death and his brother Sleep"; and,

"We are such stuff
As dreams are made on; and our little life
Is rounded with a sleep."

From a physiological point of view, sleep and death are as far apart as the poles. The only similarity between them is that they are both accompanied by unconsciousness. The one is a positive, reconstructive, intensely vital process, self-limited and tending inevitably to an awakening. The other is negative, destructive, utterly lifeless, tending to dissolution and decay, with no possibility of any physical awakening. Nor is there any similarity between true sleep and the drowsy, sleepy, comatose conditions of fevers and fatal illnesses. They are all narcoses or poisonings of the brain by poisonous materials, toxins either of germ origin or manufactured by the abnormal processes of the body tissues themselves. They are not self-limited, but end only when the tissues of the body have succeeded in producing a sufficient amount of antitoxin to neutralize the poisons which cause them. If the body fails to do this, they deepen to coma and, finally, death.

Death Almost Sure to be Painless

This opposition between death and sleep does not, however, destroy one consoling analogy which has been drawn between them, and that is that they are both painless, and cause neither fear nor anxiety by their approach. It is one of the most merciful things in nature that the overwhelming majority of the poisons which destroy life, whether they be those of infectious diseases or those which are elaborated from the body's own waste products, act as narcotics and abolish consciousness long before the end comes. While death is not in any sense analogous to sleep, it resembles it to the extent that it is in the vast majority of instances not only not painful, but welcome. Pain-racked and fever-scorched patients long for death as the wearied toiler longs for sleep. The fear of death which has been so enormously exploited in dramatic literature, sacred and otherwise, is almost without existence in sickness. Most of our patients have lost it completely by the time they become seriously ill. "While many of the processes which lead to death are painful, death itself is painless, natural, like the fading of a flower or the falling of a leaf. Our dear ones drift out on the ebbing tide of life without fear, without pain, without regret, save for those they leave behind. When Death comes close enough so that we can see the eyes behind the mask, his face becomes as welcome as that of his 'twin brother,' Sleep."


The "Winter Sleep" of Animals

Nor is there a much better basis for the generally accepted analogy between true sleep and that curious "winter sleep" known as hibernation. The subject of hibernation is such an enormous one, and there is such a lack of definite information—and consequent difference of opinion—as to its true character, that only the merest outline of the drift of scientific opinion in regard to it can be given here. To put it very crudely, it appears to be a dropping from the animal almost to the vegetable stage of vitality. Every vital process is reduced to the lowest ebb consistent with its continuance. All voluntary muscular movements, of course, cease absolutely, the eyes are closed, the animal, which has usually retired to some sheltered and protected spot, becomes unconscious, the respirations become so shallow that the closest observation fails to detect them. The temperature of warm-blooded hibernators falls toward the cold-blooded level. The heart is slowed down to the lowest possible rate and vigor consistent with life. Even the muscles of the alimentary canal cease to contract rhythmically, its glands cease to secrete, and its terminal opening becomes closed with a plug of dried mucus. Later observations seem to indicate that by cutting off the intake of oxygen, carbon dioxide accumulates in the blood and tissues until it produces a light permanent narcosis or anesthesia, and this condition continues for periods varying from weeks to months, until either change of temperature or the exhaustion of fat or other food material stored up in the body beforehand causes the animal to waken and come forth in search of food. In the majority of cases, the animal goes into this state just at the close of the season of plenty, with his tissues well loaded with fat, and emerges in the spring thin and gaunt, having presumably supported such low grade of life as existed by consumption of the energy stored up in his fat. It must, however, be admitted that there are a number of exceptions to this rule, at both ends, so to speak, some animals going into their winter sleep in very moderate flesh or even thin, and emerging apparently little changed in the spring; others going to sleep plump and fat, and awakening in apparently the same condition. So that the fat-burning hypothesis, plausible as it sounds, cannot be accepted without reservation.

On the other hand, it is only fair to say that in the last-mentioned instance, animals emerging within a few pounds of the same weight which they went to sleep at lose flesh with great rapidity after resuming their activities, and are ravenously hungry, thus raising the suspicion that the maintenance of weight has been due to an accumulation of water in the tissues in place of the fat which has been burnt up and utilized.

Are People Ever Buried Alive?

It might be incidentally mentioned, for the relief of anxious souls, that the risk of any individual passing into a trance and remaining in it long enough to be buried alive is exceedingly slight. There is no authentic instance of this having ever occurred. I took occasion to investigate this question some years ago, and communicated with a number of leading undertakers, and they all unanimously denounced it as one of the myths of the nineteenth century. One of them, at the time president of the National Funeral Directors' Association, informed me that he had carefully investigated every instance of "burial alive" reported in the newspapers for fifteen years past and found every one of them to be, in his own language, "a pure fake." However, I cannot fight that battle to a finish here, tempting as the field is.

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