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Year : 2019  |  Volume : 12  |  Issue : 3  |  Page : 187-188  

Sleep that knits up the Ravel'd sleave of care…Nature's second course…the Bard said it all

Department of Community Medicine, Dr. DY Patil Medical College, Hospital and Research Center, Dr. DY Patil Vidyapeeth, Pune, Maharashtra, India

Date of Web Publication15-May-2019

Correspondence Address:
Amitav Banerjee
Department of Community Medicine, Dr. DY Patil Medical College, Hospital and Research Center, Dr. DY Patil Vidyapeeth, Pune, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_51_19

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How to cite this article:
Banerjee A. Sleep that knits up the Ravel'd sleave of care…Nature's second course…the Bard said it all. Med J DY Patil Vidyapeeth 2019;12:187-8

How to cite this URL:
Banerjee A. Sleep that knits up the Ravel'd sleave of care…Nature's second course…the Bard said it all. Med J DY Patil Vidyapeeth [serial online] 2019 [cited 2023 Mar 23];12:187-8. Available from: https://www.mjdrdypv.org/text.asp?2019/12/3/187/258211

William Shakespeare (1564–1616), also known as the “Bard of Avon,” captured the whole range of human experience during a prolific writing career as a playwright.

In his play, Macbeth, the protagonist, a general in the King's army, is blinded by greed for the throne. This ambition ignited by prophecies of witches and goaded by his wife leads to his nemesis. Macbeth in conspiracy with Lady Macbeth murders King Duncan while he is asleep in their castle. In the manner of Dostoevsky's protagonist in Crime and Punishment (written much later), Macbeth and Lady Macbeth experience severe remorse afterward. During the aftermath, they experience sleep disorders ranging from nightmares to sleepwalking.

Macbeth's nightmare, “I heard a voice cry, - Sleep no more! Macbeth does murder sleep – the innocent sleep; sleep that knits up the ravel'd sleave of care; the death of each day's life; sore labor's bath; balm of hurt minds; great nature's second course; chief nourisher in life's feast.” – “Sleep no more! …Macbeth shall sleep no more.”[1]

Lady Macbeth's sleepwalking “…have seen her rise from her bed, throw her nightgown upon her, unlock her closet, take forth paper, fold it, write upon't, read it, afterward seal it, and again return to bed; yet all this while in a most fast sleep.”” A great perturbation in nature, to receive at once the benefit of sleep and do the effects of watching! In this slumbery agitation, besides her walking and other actual performances what, at any time, have you heard her say?” “Lo you, here she comes! This is her very guise, and upon my life, fast asleep. Observe her; stand close. …you see her eyes are open,…Ay, but their sense is shut…this disease is beyond my practice…unnatural deeds do breed unnatural troubles; infected minds to their deaf pillows will discharge their secrets. More needs she the divine than the physician.”[1]

Macbeth implores the physician to cure his wife, “Canst thou not minister to a mind diseased, pluck from the memory a rooted sorrow, raze out the written troubles of the brain, and with some sweet oblivious antidote, cleanse the stuff'd bosom of that perilous stuff which weighs upon the heart?” The wise doctor replies,” Therein the patient must minister to himself.”

The current issue includes a number of papers illustrating that understanding sleep is as elusive today as it was 400 years ago during the life and times of the Bard.

Chaudhury,[2] in his guest editorial, mentions that sleep facilitates forging of neural connections enhancing memory and helps in repairing various systems including immune, nervous, and musculoskeletal…knitting up the ravel'd sleave of care as Shakespeare would have put it.

Chaudhury also cautions that pharmacological therapy, though often resorted to in sleep disorders, should be used sparingly, if at all, concurring with the Bard, “…More she needs the divine than the physician…therein the patient must minister to himself.”

There is an uncanny resemblance of the description of parasomnias such as night terror and sleepwalking between the description of these conditions in the guest editorial and Shakespeare's play. Macbeth suffers from night terror in the form of hearing voices, “…I heard a voice cry – sleep no more! Macbeth does murder sleep – the innocent sleep…Macbeth shall sleep no more.” Lady Macbeth has spells of sleepwalking, “…Observe her; stand close…you see her eyes are open…Ay, but their sense is shut.”

Shrivastava and Shrivastava[3] propose an undergraduate curriculum on sleep disorders using the Kern model. Perhaps, a dose of humanities from the Bard's writings would enliven this curriculum – great nature's second course.

Mankar and Deshpande[4] screened patients attending medicine outpatient department. Almost half the patients had poor sleep quality. While an appreciable portion of them had psychiatric or medical conditions, there was no association with poor sleep, suggesting there may be other factors at play such as lifestyle…unnatural deeds do breed unnatural troubles… as the Bard penned it.

Nag et al.[5] studied sleep patterns among medical staff who undertake shift duties. More than half had sleep disorders which adversely affected their work performance. Sleep...sore labor's bath; balm of hurt minds; great nature's second course and chief nourisher of life's feast would have improved the performance of overworked sleep deprived staff.

Four hundred years ago.the Bard said it all!


The late Mr Edwin D'souza, the author's high school English teacher, who acted out with his students scenes from Shakespeare's classic play Macbeth. His teachings sustained the rigors of a medical education and a long professional career to enable the author to “… knit a web between ancient and present writings on sleep” as one of the reviewers of this editorial put it.

  References Top

Macbeth SW. World Classics Shakespeare Series. New Delhi: Alpha Editions; 2017.  Back to cited text no. 1
Chaudhury S. Sleep assessment – To be awake to every possibility. Med J DY Patil Vidyapeeth 2019;12:189-92.  Back to cited text no. 2
  [Full text]  
Shrivastava SR, Shrivastava PS. Framing a de novo curriculum on sleep disorders for an Indian graduate using the Kern's model. Med J DY Patil Vidyapeeth 2019;12:202-6.  Back to cited text no. 3
  [Full text]  
Mankar NS, Deshpande SS. Screening for sleep disorders and their medical and psychiatric comorbidities. Med J DY Patil Vidyapeeth 2019;12:209-10.  Back to cited text no. 4
Nag K, Datta A, Karmakar N, Chakraborty T, Bhattacharjee P. Sleep disturbance and its effect on work performance of staffs following shifting duties: A cross-sectional study in a medical college and hospital of Tripura. Med J DY Patil Vidyapeeth 2019;12:211-6.  Back to cited text no. 5
  [Full text]  


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