Arbitrary hygienic rules are as apt to be wrong as right when indiscriminately applied. It is a very common thing to say, that it is injurious to eat before going to bed. This statement has become commonly accepted as applicable in all cases. In cases where there is faulty digestion, where the patient is inclined to plethora with no nervous symptoms, the advice is proper. It is also proper after great muscular exhaustion. In the latter case the patient should be well fed with highly nutritious food, but it should be eaten from an hour and a half to two hours before sleeping.
There are however many cases of nervous exhaustion and mental overwork where constant nutrition are essential. In these cases, if the patient desires to sleep well and be refreshed by the sleep, he must take some nutritious, easily digested and easily assimilated food, and sleep with his head low. A few dry crackers, a bowl of bread and milk slowly eaten, a bowl of hot beef tea or rice, will secure a refreshing night's sleep, much better than any known hypnotic. A table-spoonful of bovinine will often do more than a quarter of a grain of morphin.
Apropos with this is the custom of riding in a sleeping car. We are constantly informed that it is necessary to sleep with the head toward the engine. In the first class of cases above mentioned, or where there is a tendency to cerebral hyperaemia this is the proper method, but where the latter condition is observed, or where there is insomnia from cerebral anaemia, or where there is brain exhaustion or nervous irritation, most generally speaking, very desirable results and a refreshing night's sleep can be obtained by sleeping with the feet toward the engine. The reasons for this are plainly apparent to any thinking individual.
Ellingwood's Therapeutist, Vol. 3, 1909, was edited by Finley Ellingwood M.D.