Sleep and Society

Sociological Ventures into the Un(known)

Simon J. Williams

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781134258475
• Edition: 1
• Topic: Medicine
• Subtopic: General Health

First sociological examination of sleep

Author is a key figure internationally in medical sociology

Chapter 1 Changing theories and explanations of sleep From ancient to modern times

DOI: 10.4324/9780203000885-1

Introduction

Sleep has always been one of those great mysteries of life, something we all do but no less mysterious for that. In this chapter I take a preliminary look at the nature and status of sleep, and at attempts to unravel its causes, complexities and mysteries, with particular reference to some of the main philosophical, scientific and literary sources and contributions to this debate through the ages, from ancient to modern times: a history of changing ideas, theories and explanations of sleep, or the social construction of sleep if you like, including past and present discourses and debates on the pains if not the pathologies of sleep and the weird and wonderful world of dreams and dreaming, albeit as subsidiary themes. The chapter, in this respect, provides a first stab at the nature and status of the phenomenon under investigation and a backdrop to some of the other more sociological themes and issues that follow.

What then do we ‘know’ about the nature and status of sleep, and how have these ideas, theories and explanations changed or evolved over time?

Past theories and evolving ideas: from ‘passive’ to ‘active’ sleep?

Sleep has fascinated (and frustrated) people since time immemorial, with many different ideas and explanations put forward as to its nature and its causes through the ages, both Eastern and Western, ‘passive’ and ‘active’ in kind, including ancient Mesopotamian, Egyptian and Chinese beliefs and practices dating way back to 3000bc.

For our purposes, however, somewhat arbitrarily perhaps, it is to Ancient Greek thought that we first turn in search of answers to these questions. Theories and explanations of sleep were clearly and systematically articulated at this time by many great writers in the history of Western thought. Alcmaeon, for example, in the fifth century BC, has been credited with what is possibly the ‘first theory of the cause of sleep’, postulating that sleep occurred when the blood vessels of the brain filled with blood, with wakefulness restored through withdrawal of blood from the brain: an early vascular ‘congestion’ theory, that is to say (Thorpy 1991: xvi). Hippocrates (460–370bc), the father of Western medicine, also speculated on the cause of sleep, believing, contra Alcmaeon, that it was due to blood going in the opposite direction, from the limbs to the inner regions or central parts of the body, where it was warmed, thereby resulting in sleep (Dannenfeldt 1986; Thorpy 1991).

Aristotle (384–322bc) contributed further to these debates through his own deliberations on sleep and dreams in Parva Naturalia. Sleep, Aristotle reasoned, in an early formulation of what later came be known as a ‘chemical’ theory, was due to the effects of food digestion. ‘Fumes’ produced through digestion, he believed, were transported in the blood vessels to the brain, which subsequently cooled and descended to the lower parts of the body, thereby taking heat away from the brain and hence inducing sleep. As he put it:

… sleep is not every incapacity of the sensitive faculty. This affection arises from the evaporation of food; for that which is vaporized must be driven forward for a space, and then turn and change its course, like the tide in a narrow strait. Now in every animal the hot tends to rise; when it reaches the upper parts, it turns back and descends in a dense mass. So sleepiness mostly occurs after food, for then both liquid and solid matter are carried up in considerable bulk. As this becomes stationary it weighs one down and makes him nod; when it has shifted downwards, and by its return has driven back the hot, then sleep occurs, and the animal falls asleep.

(1957: 337)

As to the question of the prophecy of dreams, Aristotle was rightly cautious. Most cases of the fulfilment of dreams, he reasons, are probably pure coincidence. Dreams may have medical significance, however, given that slight physical disturbances may trigger the imagination. The experiences of dreams, moreover, may modify subsequent waking conduct. There is no evidence though, Aristotle concluded, that dreams have a divine origin.

Aristotelian views, to be sure, were influential. Other theories based on ‘atomism’, however, were also evident in classical Roman times. Leucippus (c. 430bc), for instance, regarded sleep as a product of the partial or complete spinning-off of ‘atoms’; a theory subsequently revived by Epicurus (c. 300bc), whose extensive writings on sleep and dreams have, sadly, been lost (Thorpy 1991).

Perhaps the next major landmark, as far as theories of sleep go, takes us through the Middle Ages and late Renaissance, where Hippocratic, Aristotelian and Galenic theories held sway (see, for example Dannenfeldt 1986), to the ‘mechanistic’ deliberations of René Descartes in Treatise of Man (1971): what Thorpy (1991: xviii) dubs a ‘hydraulic model’ of sleep. The brain, for Descartes, exists in two states: waking, in which its fibres are strong yet rapidly exhausted (due both to the fact that the spirit’s source, in the blood, is used rapidly and not adequately recirculated, and that in wakefulness the admixture of blood with chyle has a ‘coarsening effect’); and sleeping, in which its fibres are lax and its spirits gradually replenished. Exhaustion of these strong or forceful spirits in a waking person results in sleep. As this supply of spirits increases in the sleeping person, they awaken. Descartes, interestingly, resorts to a slack-sail analogy here to illustrate these processes, with dream sleep associated with general laxness, dreaming with local tension or turgor, and waking with general tension or turgor (i.e. the fully stretched sail). As Descartes puts it, in his own inimicable machine-like way:

… during sleep the substance of the brain, being in repose, has leisure to be nourished and repaired, being moistened by the blood contained in the little veins and arteries that are apparent on its external surface. When, after some time, the pores, having narrowed, the spirits need be less strong to keep the brain substance quite tense (just as the wind need be less strong to inflate the ship’s sails when damp than dry). And yet these spirits [in the brain] are stronger [during sleep than at other times], inasmuch as the blood producing them purified while passing and repassing several times through the heart. … When it follows that this machine must naturally wake itself up after it has slept for some time, just as, reciprocally, it must also go to sleep again after it has been for some time awake; for, during waking, the substance of the brain is dried out and its pores are gradually enlarged by the continual action of the spirits [Whence it also follows], that, if it [the machine] happens to eat (which hunger will incite it to do at times, if something to eat can be found), the juice of the food, on admixture with the blood, render the latter more coarse and this makes it produce fewer spirits.

(1971: 110)

These views were subsequently elaborated by the famous neurologist Thomas Willis (1621–75), amongst others, whose book The London Practices of Physick, published in 1692, devoted considerable space to sleep-related matters. In keeping with Descartes, the animals spirits were seen to undergo rest during sleep. Some animals’ spirits, however, remained ‘active’ in the cerebellum during sleep, in order to maintain ‘control’ over physiology, whilst others became intermittently ‘unrestrained’, resulting in dreams (Thorpy 1991: xix). The essence of sleep, Willis states:

… consists in this, that the corporeal soul withdrawing itself a little, and contracting the sphere of its Irradiation, in the first place renders destitute the outward part of the Brain or its cortext, and then all the outward Organs of Sense and Motion of the Emanation of the Spirits, and closes the Doors as it were; so that they being called in for refreshment sake, lye down, and indulge themselves to rest; mean while the pores and passages of the outward part of the brain being free, and void of Excursions of the Spirits afford a passage to the Nervous Liquour distilled from the Blood for new Stores of Spirits: In natural and usual sleep, these two concauses conspire and happen together as it were by some compact of Nature: viz. at the same time the Spirits recede, and that Nervous humour enters: but in nonnatural, or extraordinary Sleep, sometimes this cause, sometimes that is first: for either the Spirits being weary or called away withdraw themselves first, and afford an enterance to the Nervous humour heaped together in a readiness for it; or a plenty of Nervous humour coming to those places, and making a way by force as it were, repells the Spirits, and entering their Passages, floats them as it were.

(1692: 390)

These ideas, it seems, were still very much in evidence in the eighteenth century, albeit with further unresolved questions. Francis de Valangin, for example, in his Treatise on Diet, or the Management of Human Life (1768), proclaimed that sleep:

… is a natural Cessation of all external Perceptions, necessary for the Preservation of the animal economy. The cause of such an extraordinary State, in which external senses are thus overcome, has been the object of the Inquiries of many Philosophers. It certainly appears to proceed from Diminution or Cessation of the Influx of the animal Spirits or nervous Fluid, from the Brain into the Organs of Sense. But how this comes about, and what in reality the Impediment is that prevents the nervous Influence from the Brain into the Organs of Sensation, is a Matter not yet clearly understood. …

(1768: 268)

Experiments with plants may sound like something of a detour in this context, but the ‘chronobiological experiments’ of Jean Jacques d’ortous de Mairan in 1729 were also something of landmark as far as latter-day sleep science is concerned (Dement 2000). By placing a heliotrope plant in a darkened closet, and observing that the plant still opened its leaves during the day and closed them at night, without external time cues, the presence of circadian rhythms was first demonstrated.

Other important developments in the eighteenth century, included Albrecht von Haller’s (1708–77) ‘vascular’ theory of sleep, based on pressure on the brain – a variant, in effect, on Alcmaeon’s fifth century BC theory – which itself was expanded in the nineteenth century into a full-fledged ‘congestion’ theory of sleep (Thorpy 1991: xx). Perhaps most important of all, however, was Luigi Galvini’s (1737–98) demonstration of the electrical activity of the nervous system, which subsequently led to the development of electrophysiology and the electroencephalograph (EEG).

The nineteenth century may be regarded as the ‘age of sleep theories’ (Thorpy 1991), including the flowering of ‘vascular’ (mechanical, anaemic, congestive), ‘chemical’ (humoural), ‘neural’ (histological) and ‘behavioural’ (psychological, biological) theories (see Kleitman 1963/1939 for a definitive account).

The congestive theory (i.e. pressure on the brain), for example, was the most accepted vascular theory in the first half of the nineteenth century: a theory supported by the likes of Robert MacNish, a member of the Faculty of Physicians and Surgeons of Glasgow, who wrote an influential volume on sleep and its disorders entitled The Philosophy of Sleep (first published in 1830 and subsequently revised and updated as a second edition in 1859). Sleep, MacNish states on the opening pages of the book of the second edition:

… is the intermediate state between wakefulness and death; wakefulness being regarded as the active state of all the animal intellectual functions, and death as that of their total suspension.

(1859: 9)

Sleep, he continues, exists in two states: one ‘complete’ the other ‘incomplete’. The former is said to be characterised by a ‘torpor of the various organs which compose the brain, and that by the external senses and voluntary motion’. Incomplete sleep or dreaming, in contrast, is said to be the ‘active’ state of the one or more of the cerebral organs, while the remainder are in repose: the senses and the volition being either suspended or in action according to the circumstances of the case. Complete sleep, MacNish boldly proclaims, ‘is a temporary metaphysical death, though not an organic one – the heart and lungs performing their offices with their accustomed regularity under the control of the voluntary muscles’ (1859: 9).

This, Dement comments, exemplifies the overarching historical dichotomy of sleep research – ‘sleep as a passive process versus sleep as an active process’ (2000: 2). Studies by physiologists in the early to mid-1800s, for instance, including Luigi Rolando and Marie-Jean-Pierre Flourens’ experiments on the brains of birds (chickens, cocks, ducks, hawks and pigeons), strengthened the idea of sleep as a passive process (i.e. the subtraction of wakefulness). Johannes Evangelistica Purkinje (1787–1869) – a Czechoslovakian physiologist who emphasized the importance of lower brain centres for some activities in the upper parts of the brain – was likewise inclined to believe that ‘only waking – and not sleep – was an active state of the brain, with its own function’ (Hobson 1995: 5–6). With ‘one or two exceptions’, indeed, most thinkers, up until the mid-twentieth century, regarded sleep as either an inevitable result of reduced sensory input (with the consequent diminution of brain activity and the occurrence of sleep) or the product of blood leaving (anaemia) or putting pressure (congestion) on the brain (Dement 2000: 2). No real distinction, moreover, was ‘drawn between sleep and other states of quiescence such as coma, stupor, intoxication, hypnosis, anaesthesia and hibernation’ (2000: 2).

The intriguing ‘hypnotoxin’ theory was also formulated around the turn of the twentieth century, particularly through the work of the French physiologists Rene Legendre (1912) and Henri Pieron (1913) who conducted experiments showing how blood serum extracted from sleep-deprived dogs could induce sleep in non-sleep deprived dogs. Th...

Table of contents

• Cover Page
• Half Title Page
• Frontmatter Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Acknowledgements
• Preface
• Introduction
• 1 Changing theories and explanations of sleep: from ancient to modern times
• 2 Sleep through the centuries: historical patterns and practices
• 3 Sleep, embodiment and the lifeworld (Lebenswelt)
• 4 The social patterning and social organisation of sleep: inequalities, institutions and injustices
• 5 Colonising/capitalising on sleep? Medicalisation and beyond …
• Conclusions: remaining questions and the challenges ahead
• References
• Index