In all chronic affections of the alimentary canal opiates must be used with great caution, for fear of the opium habit, unless the case be incurable. Cancer of the stomach requires their free use. The milder disorders should be managed largely with hygienic treatment. The diet should be so regulated as to prevent the liberation of gas in the intestines, for their distention in this way is fatal to refreshing sleep. A gentle aperient or a large injection of warm water, often proves itself decidedly soporific in such cases. Catarrhal conditions of the mucous membrane prohibit the entire class of alcoholic and ethereal soporifics. Nervous and atonic dyspepsias are often benefitted by the use of bitter beer, and by drachm doses of brandy or whisky largely diluted. These should be taken at mealtime, or with food at bedtime. A glass of hot water shortly before retiring is often useful. The relief of insomnia in dyspeptic derangement, however, must not be sought through the administration of anodynes and hypnotics alone. Only when the entire life of the patient has been regulated upon a physiological basis can refreshing sleep be obtained. Change of habits, change of occupation, change of locality--these are the only curative measures in a vast number of the cases of wakefulness that occur in modern life. Alcohol, tobacco, tea, coffee, foul air, late hours, and mental excitement, are the principal causes which must be abolished before healthy sleep can be enjoyed. _Insomnia in febrile conditions._--In the early stages of all acute fevers wakefulness is a very common incident. It is then occasioned by irritation of the brain, and must, therefore, be relieved with opiates. If the patient is not depressed by the disease, the opium should be associated with tartar emetic or aconite, or ipecac. Dover’s powder is very useful in such conditions. In malarial fevers wakefulness should be combatted with full doses of quinine in addition to the opiate. Gelsemium is sometimes a very satisfactory remedy--especially in the febrile attacks to which children are liable. If any evidence of cerebral hyperæmia be observed, it is well to give chloral hydrate and the bromides. Hyoscyamus, belladonna, and cannabis indica are useful when the pupils are contracted and when spasmodic symptoms are present. Lukewarm baths, wet packs, and cool sponging are exceedingly grateful, and often assist in the evolution of a suppressed eruption in the exanthematous fevers. In the later stages of fever a condition of cerebral exhaustion is sometimes encountered. Irritable weakness caused by starvation of the brain is the prominent feature. The pulse is small and weak. The patient tosses and rolls from side to side. He is perhaps greatly emaciated by an illness of considerable duration. An elevated temperature requires frequent sponging of the body.