Table of Contents
Experiments on Children
THE experiments on animals were followed by experiments on children. The subjects were of different ages ranging from infants a few days old, to children twelve and thirteen years of age.
It is well known that children usually fall asleep more easily than adults; they sleep longer and also more soundly, This is specially the case with young children and particularly with infants. We know that an infant passes most of its time in sleep, when it does not eat. We should expect therefore that the material would readily lend itself to our present purpose of experimentation,—to the induction of sleep-states. Now as a matter of fact, I find that in a number of my cases dealing with children it is no difficult task to put them to sleep, or to induce some form of subwaking state, hypnoidal or other closely allied to it. The child easily falls into a subwaking hypnoidal state which may either pass into hypnosis or into sleep. When trying to put children to sleep I have often obtained a hypnotic condition and on the other hand when attempting to put my little patients into a hypnotic state I have only succeeded in putting them to sleep. Before going, however; into either the hypnotic or sleep-state, I observed by close examination the presence of the hypnoidal state induce under the conditions of monotony and limitation of voluntary movements.
Since limitation of the voluntary activity, limitation of the field of consciousness and inhibition all help to a greater, monotony, we may characterize the whole set of conditions requisite for the induction of sleep as the conditions of monotony. In children and especially in infants voluntary activity and the field of consciousness are undeveloped an limited, we should expect that the child would form a far better soil than the adult for the induction of the intermediary sub-waking states and sleep. This is precisely what we find to be the case.
Moreover, the mind of the child, and more particularly of the infant, specially depends on muscular activity and on the wealth of incoming sensory impressions. That is why the child and the infant take such delight in motor activity,—in tasting, testing and handling things. If now the motor activity is limited and the main source of sensory impressions, such as sight, is restricted, and if the environment is kept in a state of monotony, such as darkness and lack of auditory stimulations, or monotony is brought about by a continuous noise and buzzing of some instruments producing a uniform noise, the child, on account of the poverty of its inner mental life, easily falls into a subwaking hypnoidal state and then into sleep.
This ease of induction of sleep is furthered by the comparatively small amount of variability of conscious activity present in the child—the variability of mental content being an important factor in keeping up the freshness, continuity and qualitative intensity of consciousness. Now as the child depends entirely for the variability of its consciousness on muscular activity and external impressions, we can well realize that when those sources become limited and monotonous, the child falls under the influence of all the important conditions requisite for the induction of sleep. The child in short, has no inner wealth of mental life to fall upon; it has little, if any inner resources; that is why it falls an easy prey to sleep and hypnosis, when the external resources lose their variability, become uniform and monotonous.
It may be well, however, to point out the fact that the conditions of sleep are somewhat different in the case of infants of a few days or of but a few weeks old. Young infants sleep most of the time. The waking periods are brief and alternate with long periods of sleep. Really the infant’s state is one of sleep and he only wakes to eat.
We may characterize the infant’s waking states as feeding periods. The perceptual world may be regarded as practically non-existent for the infant—ego and non-ego are absent. The external world is in a chaotic state with no interests, even instinctive ones, as yet present. The sensory organs are as yet undeveloped and the sensory elements are all incoordinated and unrelated. Even the raw material going to make up the future world of the individual is still in an extremely imperfect state. In short, material presented by the undeveloped sense-organs, chaotic, undifferentiated and is at its minimum. There is really no external world for the infant and whatever sensory impressions are present lack meaning and interests.
But if the sense-material coming from the sense-organs which is to build up the infinite wealth of the external world is still undeveloped and lacks all significance, it quite different with the sensations coming from the internal organs, from the viscera. The visceral, organic sensations stand out in the foreground of what may be regarded as the infant’s consciousness. Visceral, sensory material forms the main substance of the infant's universe. Coenaesthesis plays the predominant, if not the only role, in the life of the newborn. We can fully realize the importance and significance of co-anaesthetic sensations in the case of the infant, because the processes of growth and nutritive functions are all engrossing. The newborn is a vegetative being; it is all belly, stomach; it is a little glutton, it has to grow and that very rapidly; it lives for that purpose—it eats and sleeps. The waking periods are sparse, short and far between, the infant wakes to eat, and when filled to the point of regurgitation, it sleeps.
In this respect it may be well to observe the characteristic motor reactions of the newborn; the sucking movements are the only ones that are well coordinated, responding regularly to external impressions. Thus in my experiments I have long ago described the interesting fact that in his early life the newborn responds to external stimulations with sucking movements. If the infant, for instance, is put to the breast and has his fill and the sucking movements stop, they will again be reinstated by any stimulations of his sense-organs. Make noise close to the infant’s ears or throw some rays of light on his eyes, or tickle him, or cause him pain, or tug at the nipple, and the infant responds with sucking movements. In other words, all reactions of the newborn are coordinated and essentially adapted to nutritive purposes. Nutrition and its psychic correlative, co-anaesthesis, form the essence of the infant's early life.
It is therefore clear that the conditions of monotony of external sensations and of limitations of voluntary activity, an activity really absent, as well as limitation of the field of consciousness, can hardly be of any import in the young infant. The gnawing of hunger, intestinal discomfort and pain play the only important role. In the early life of the baby visceral activity and its concomitant co-anaesthesis possess the greatest amount and intensity of qualitative variability that keep up the limited consciousness of the waking state. When the child is hungry, it is fidgety, cries and is awake; when hunger is appeased, the waking state lapses and the baby falls asleep. The waking state is a brief passing phase in the feeding of the baby, a feeding phase which begins and terminates in sleep.
If now we take all that into consideration, we should not expect to meet with clearly defined subwaking states and sleep under the conditions of monotony and limitation in the case of the newborn as we find it to be the case in the lower animals a couple of weeks old, or as we find it in the fully developed man. The young of the lower animals have a shorter training period and have a far larger amount of ready made and easily developed instincts or psychomotor reactions than the baby. When the newborn is put under the conditions of monotony and limitation of the incoming external impressions and under restriction of voluntary activity which does not as yet exist in him, the results are necessarily unsatisfactory. If the infant is full to the point of regurgitation, it goes to sleep, and if it is hungry the closing of the eyes and the attempts to hold it down by force are often quite ineffectual. The baby keeps on crying to the great discomfiture of the experimenter. The easiest and possibly the best way to bring about monotony in the newborn is to soothe the youngster’s bowels. It again the young baby has indigestion, stomach-ache and cramps, closure of the eyes and holding the little one quiet without permitting him to kick will hardly do. In such cases the best way is to bring about monotony and limitation of co-anaesthesis. Giving the baby to suckle may appease temporarily the active peristalsis of the intestines and the little fellow may pass into the land of Nod; or we may press uniformly on the abdomen and keep on rocking the little body at a uniform rate. By thus effecting a monotony are limitation of the bowel-consciousness and intestinal activity we can bring about a state of sleep. Still, even in the young infants I succeeded, when the little one happened be specially well disposed, in putting it to sleep by keeping it very quiet and closing its eyes. In one case I succeed, in putting to sleep a refractory infant under the usual conditions of monotony and limitation by closure of eyes a holding down the baby’s extremities from being too active. Usually, however, in very young babies I somewhat modified my proceedings of monotony and limitation by addressing myself to the baby’s inner intestinal consciousness. In older babies and young children of over a year, I did not vary my usual proceedings in the induction of sleep under the conditions of monotony, limitation of voluntary activity and of the field of consciousness.
We may now pass to the experiments. I shall follow here the same course as in my account of the experimental work performed on the lower animals, I shall not burden the reader with unnecessary details, but shall give a few cases of experiments, typical of the rest.
Boy of twelve days; he was quiet; he looked in empty space, seemed not to be specially hungry nor ill disposed. I covered his eyes with my hand and restrain the movements of his limbs. He wriggled a little under the restraint, but soon became very quiet. When after a minute’s time I removed my hand from his eyes, the eyelids remained shut. Breathing was quiet and uniform. I tried to pull apart the eyelids and found them resistive. When I forcibly separated his eyelids, I found the eyeballs rolled up, pupils contracted. He slept this way for a few minutes. When he awoke I made a second attempt to put him to sleep, but this time with no success. The little fellow wriggled and squirmed. The eyes rolled incoordinately and looked vacantly into space. Closure of his eyes was of no avail. I then modified the procedure, patted his back, soothed his belly, and shut out the light from his vacantly blinking eyes. Gradually the little man relaxed his eyelids, began to work them and fell asleep. This time he slept for about a quarter of an hour. I then awakened him by summation of slight stimulations. During the course of awakening, I observed a short state of resistance in the extremities. He was again put to sleep in the same way and when going into sleep the same state of resistance and catalepsy of the extremities was observed. The sleeping state was very deep, inasmuch as the little fellow was not disturbed by any sensory stimulations and only a good shaking brought him out of this deep state of sleep.
A girl of ten days; very quiet. I restrained her motor exuberance and with the other hand I closed her eyes; she at first resisted and cried, but after a couple of minutes she fell asleep. Respiration, quiet and equable. Eyelids resisted attempts to pull them apart. Eyeballs were found rolled up; pupils were contracted. I made another attempt and found it somewhat more difficult, but the child became quiet, had eyes closed for a couple of minutes and opened them again. The third time the success was even less marked. I then once more resorted to my method of back patting, bowel-soothing, by rubbing and patting the abdomen and monotonous rocking movements. The little girl was evidently pacified and went to sleep. When falling asleep, there was a short stage of catalepsy, the raised hand remained for a short period, a few seconds, in the position given to it, then a state of relaxation set in. This relaxation of the limbs did not persist during sleep, but now and then I could succeed in giving a cataleptic attitude to the arm. Soon the arm dropped and then again it was possible to put it into a cataleptic condition. The sleep was evidently not stable; the little girl apparently kept on oscillating between sleep and waking state. It seems to me, however, that it is more probable that the sleep-state in young infants is not differentiated as it is in the case of adults or of older children.
The phenomena of sleep also present some characteristics of hypnosis and hypnoidal states, possibly, because the states of hypnosis proper are as yet embryonic—hypnotic or hypnoidal manifestations thus appearing in sleep.
Boy of ten days. I had great difficulty in putting him to sleep by the ordinary methods of closure and restriction of muscular activity. I had to resort to my modified method—patting, tapping and rocking until he asleep. In passing into sleep there was a slight state rigidity and catalepsy of the limbs which soon changed one of relaxation, but in the middle of sleep, when tested again for catalepsy, he developed one but it passed off and could not be again noticed until several minutes later tested during that interval; limbs were found to be in a state of relaxation.
The interesting fact about the infant's sleep is that once asleep the infant is not so easily roused. This fact is sometimes very striking, especially, when the child has had its fill, and still more, when it has had its bath. To arouse the infant from its sleep is then pretty difficult and I have worked hard over the baby before I could disturb its peaceful repose. Some of the infants I have occasionally found so deeply immersed in sleep that even shaking could not arouse them. I had to give up all attempts to bring them out of the state of Nirvana and had to wait for a more favorable occasion.
Girl seven days old. Ordinary ways of putting sleep did not work here and I had to resort to the rocking patting and tapping before my efforts were crowned with success. The girl fell asleep in a state of rigidity and catalepsy soon replaced by relaxation. The eyeballs were roll up, but the child was restless. I put her again under the same conditions of monotony and this time she slept more peacefully—I had in fact, some difficulty in waking her. The state of awakening was characterized by a greater resistance of the limbs than the sleep-state. Still, even in her sleep I could now and then discover a cataleptic state. The sleep of the infant appears to have a mixed symptomatology of sleep and hypnosis. The characteristic manifestations sleep, however, predominate.
Boy two weeks old. I left him in the same position, but only shut his eyes forcibly with my fingers for not more than twenty seconds. He opened the right eye after thirty seconds, and the left eye remained closed for a minute and a half. This incoordination is observed in young infants. He did not fall asleep, however, before I tried the monotonous rocking, the baby being placed with his belly downwards resting on the palms of my hands thus causing a uniform pressure. In sleep I observed a cataleptiform state. Hands remained in the attitude given to them. This lasted for but a few seconds.
I can induce sleep in the boy by the following procedure which is really another modification of the conditions of monotony and limitation of muscular activity. I either rock him for a time, while sitting quietly in the chair or take him in my hands and walk around with him, which also induces monotonous rocking movements. During all this time I sing to him some monotonous ditty. Sleep is more rapid in its onset, when the belly is pressed with my hands uniformly. The boy's eyes begin to close, first becoming as if fixed, hazy and vacant. He closes the eyelids, opening and closing them alternately, the eye is fixed in the same direction. The eyelids then close, then half open. The slit of the eye becomes narrower and narrower and finally the eyelids close and open no more; the little fellow is sound asleep. If his position is left unchanged, he remains asleep for a very long time. If, however, he is put in the crib, he wakes in about five or ten minutes.
When the boy is six weeks old, I can induce in him sleep, by simply closing his eyelids and singing to him some monotonous ditty. When the boy is not tired and has had a good sleep before, he falls into a peculiar state. He is apparently not asleep and still he is unable to open his eyes for a couple of minutes and even more. When he is fatigued, he immediately goes into a deep sleep.
Boy three months old. Can easily be put to sleep by monotonous stimulations usually of the character described. When asleep, he is slightly cataleptic; the lethargic condition, however, predominates. The limbs remain for some time in the position given to them, although the position is a very uncomfortable one. When he rapidly falls into deep sleep, he often retains the limbs, especially the arms in the same position, however awkward, in which they were put at the moment when he fell asleep.
In following the course of the child's sleep-states, I find that between the sleeping and waking states there is frequently, in fact there is almost always present, an intermediary period of semi-waking, semi-sleeping state, or is found by me to be present in lower animals as well as man, when falling asleep, namely a subwaking, inter mediary hypnoidal state. This state is of long duration, sometimes lasting several minutes. It begins with the contraction the levator palpebrarum, with twitching and trembling the eyelids, the eyes gazing vacantly into space. The lids open and close unequally, the eyeballs begin to up, the pupil is contracted. If in this state, he is address in a caressing way with which he is familiar and which the full waking state he greets with a smile and a kick now starts violently, the limbs going up, and he utters peculiar cry of great fright. Often, however, when he is in this intermediary hypnoidal condition instead of passing back to the waking state, he falls into a deep sleep from this hypnoidal state into sleep, he is often seen to smile and almost laugh, occasionally he makes movements of mastication, sometimes gives a start and a cry, and keeps on sleeping. It is a form of hypnagogic or even dream-hallucinations.
As to the states which form the transition stages between sleep and full awakening or the intermediary state in his getting out of sleep, I have often had the opportunity to observe the following spontaneous manifestations. When the soundly sleeping child is awakened by a noise, he throws up his arms, as if in fright, half opens his eyes and falls immediately asleep again. The fingers of the hands remain open and extended, as if in a cataleptic state. When I to close them, I find them resisting and after a time the close gradually. The rest of the body is in a state relaxation. I observed it accidentally as the result of unintended noise, but I since tried to reproduce some similar sudden noises and obtained like results.
When the boy was three and a half months old, I him to sleep under the usual conditions of monotony a limitations of muscular activity. He fell asleep, his right hand and fingers remaining in cataleptic state, he kept the in the same position when he went to sleep. The finger were outstretched and the arm raised. I tried to bend one of the fingers, there was no resistance, but curiously enough as we find it to be in hypnosis, the finger soon returned to its former position. The arm remained in the raised position for about three and a half minutes and then gradually dropped. The child remained quiet in this position of fully relaxed limbs for about four minutes then suddenly gave a subdued cry of distress, probably due to some dream; the arms went suddenly up, especially the left one which remained in a raised position with fingers tightly closed. This lasted for about two minutes and a half. I tried to open one of the fingers, and met with no resistance. I kept the finger in state of extension for about a minute: as soon as I let the finger go, it returned to its original bent position. I soon observed him roll his eyeballs under the still tightly shut eyelids; then he opened his eyes, smiled at me and fell asleep again. As he was falling asleep with eyelids closed I could see the eyeballs roll, while the face retained its smile for a couple of minutes longer, as if smiling in his sleep at me. The state is evidently an almost fully developed subwaking, hypnoidal phase, bordering on waking, hypnosis and sleep. In fact we observe here already the suggestibility of hypnosis which is on the way to become differentiated from sleep and hypnoidal state.
We may now give a rapid review of experiments carried out on older children ranging from the age of four to the age of fourteen. The hypnoidal states become more marked, the hypnotic and even somnambulistic states come to the foreground, and we find that when sleep is induced we often get mixed manifestations of a subconscious order. Mixed, however, and still ill-defined as they are, when compared with the adult states, both the subconscious and sleep states are induced under similar conditions of monotony and limitation of voluntary movements. In trying to induce sleep we may get a subconscious hypnotic state and on the other hand in making an attempt to bring about a hypnotic state, we may get a state of sleep. A good deal depends on the fact whether or not we have eliminated the other conditions requisite for hypnosis, but not for sleep. The indispensable conditions, however, both for hypnosis and sleep are monotony and limitation of voluntary activity. These conditions are all the more indispensable as we have demonstrated from our experiments that in order to reach either hypnosis or sleep the intermediary, subwaking waking, hypnoidal state must first be passed through. This intermediary state between waking on the one hand and sleep and hypnosis on the other can only be induced under the conditions of monotony limitation of voluntary activity.
A boy of four was put in a dark room; the metronome was set going, beating slow measure. The child told to lie down on a lounge, stretch out his hands legs and keep perfectly quiet. His eyes were then shut. After a few minutes his respiration became lowered regular. He ceased to reply when talked to. At his arm showed some slight rigidity, but soon after, the arm fell into a state of relaxation. He was not in a hypnotic state as he did not answer any questions and did take any suggestions. When after a quarter of an hour he was awakened, he did not remember anything a talking to him, nor could we obtain it of him by any methods reaching the subconscious. He was really asleep and not perceive anything during that period. These experiments were repeated a number of times with the same results. I observed that unlike hypnosis which can be induced in rapid succession, one state not differing very much from the other, in this particular case as the induction of the state was repeated, it was more difficult to bring about, the state became lighter and lighter and the child was brought out of it by talking to him.
Boy of seven. I put him in a darkened room. My electric battery was set going. I told him to keep quiet and shut his eyes. After a few minutes he began to yawn told him to stop. He stopped and I soon observed that little hand clutched mine convulsively, I tried the arm, raised it; it remained in the same position. I then challenged him to open his eyes. He could not do it. I him alone in a very passive condition; respiration regular and quiet. When after ten minutes I came to him again I called him by name; he did not answer. When I began to talk to him, he woke up. During the ten minutes he passed into sleep. This transition from hypnosis into sleep was effected through the intermediacy of the hypnoidal state which forms the borderland of the waking and sleeping states. The general conditions of monotony and limitation of voluntary activity that favor hypnosis also favor sleep.
Boy nine years of age. I put him into a chair, told him to be quiet and then closed his eyes. He was passive, answered my questions; could open his eyes when challenged. When, however, left alone with his eyes shut and his limbs relaxed, he was found to be fast asleep. He did not answer any questions, did not take any suggestions, did not react to stimulations of medium intensity. When spoken to sharply, he woke up. Both before and after the sleep-state there was a short period when the passivity was quite marked and some resistance as well as disposition to leave the limb where it was placed, although he changed the position of the limb when challenged. In passing then into sleep as well as out of it he passed through the intermediate hypnoidal state.
Girl of thirteen. When put under the conditions of monotony and limitation of voluntary activity, she fell from the transient hypnoidal state into hypnosis and thence into deep somnambulism. After an hour, when left to the monotonous state of her somnambulistic consciousness, she passed into typical sleep, as she ceased to answer questions and woke up when the questions and suggestions were given to her in the usual insistent way. From somnambulism she passed into sleep. On other occasions, when closely watched, it was observed that this transition was effected through the intermediary hypnoidal state. The girl passed from the waking state into hypnosis and somnambulism and then again back into the hypnoidal state and then fell into sleep.
Boy aged thirteen. I put him into a quiet state. Metronome was beating slowly. Voluntary movements of the boy were restricted. The boy was then told to close his eyes. I put my fingers over them and kept them shut for a few minutes. When I raised my hand, I found that his eyes remained closed. His arm, when raised remained in the same position. When his arm was bent, he could not extend it, but when after a few minutes I began to talk to him, he woke up. He was evidently in the hypnoidal state on the way to hypnosis or to sleep. On another occasion he actually fell into hypnosis not being able to move eyelids or his arms and even took various suggestions. After a few minutes he ceased to be in communication with and when suggestions were given to him as they had been given to him before, he did not take them, but woke when loudly spoken to. In other words he fell asleep, and the loud voice disturbed his sleep.
Boy of fourteen; he had difficulty in going to sleep under the conditions of monotony and limitation, but when these conditions were long continued, he finally went in the hypnoidal state. As I feared to disturb him by too much questioning I left him without change to his monotonous environment. After about a quarter of an hour was fast asleep, snoring in the chair.
Thus we find that in infants and children, as in lower animals, sleep, hypnosis, and hypnoidal states intimately related, sleep presenting complex manifestation of subconscious states which become fully developed in adult.