Crutches
In this poem, Gilman argues that, between caffeine and soporific consumption, neurasthenic men weaken themselves by resisting natural waking and sleeping states. In this way, men are constantly trying to cheat the system as well as nature in their effort to wrestle sleep to submission.
In the 1915 treatise Sleep and Sleeplessness, Bruce Addington observes:
"From the foregoing it should be evident that any treatment of insomnia which places its main reliance in the use of drugs is foredoomed to failure. Some students of the insomnia problem would go even further, and say that, so far as regards the actual cure of sleeplessness, drugs used specifically for that purpose always do more harm than good. At all events, it is the consensus of the most authoritative opinion that drugs should be used only when it is indispensable to bring about immediate unconsciousness as a relief from physical pain or the shock of some great bereavement.
This of itself suggests one of the great shortcomings of the so-called 'narcotics,' or "sleeping-drugs." What they produce is always unconsciousness, not natural sleep, an altogether different matter. "The effect of narcotics," Marie de Manacei'ne pointed out nearly twenty years ago, 'only resembles sleep by producing a temporary interruption of consciousness. At this point the resemblance ceases.' More elaborately, Mortimer-Granville, writing still earlier, specifies: 'It should be remembered that these remedies are capable of destroying life, and it is only by the exercise of their poisonous properties in a low degree that they produce the results for which they are given. The action is destructive to life, and the only reason they do not kill is that we do not take enough of them. The state they produce is not sleep, but a condition of narcotism that counterfeits sleep. When a man says: 'I want a quiet night; I will take a sleeping-draught,' he speaks in parables. To express the fact plainly, he should say: 'I want a quiet night; I cannot obtain it by going to sleep, or I am afraid to trust to the chances of natural rest, so I will poison myself a little, just enough to make me unconscious, or slightly paralyze my nerve centres, not enough to kill.'
To be sure, it often happens that a drug-induced unconsciousness passes over into a state of natural sleep ; and this fact is responsible for the recklessness with which many physicians still prescribe drugs to patients who complain of inability to sleep. But it also happens that once the practice of taking drugs is started, there is a gradually increasing tendency to resort to them at the least sign of wakefulness, until at last the insomnia habit is replaced by a still more disastrous drug habit. Indeed, to be quite accurate, the drug habit is superimposed on the insomnia habit; for it is a matter of common observation that, in the course of time, those addicted to the use of narcotics find it increasingly difficult to go to sleep, despite a steady increase in the quantity of the drug daily taken by them."