British Medical Journal, Volume II for 1877, July 14 1877, P47.

Queen's Hospital, Birmingham - Dr Sawyer

Ordinary cases of insomnia can be divided into three classes: Senile, toxic and psychical.   In the senile form of the affection, the disorder depends on degeneration of the cerebral arteries, and is difficult to cure; in the toxic abuse of alcohol, tea or tobacco, and ceases upon the removal of the cause; in the psychical it arises from continued and excessive mental strain, grief, anxiety, worry, etc and is usually successfully treated by full doses of bromides conjoined with tinctures of ergot and cod liver oil.  If the insomnia be serious, it must be stopped at once by hypnotics, preferably by opium.

Sleeplessness 1894
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