oped in all cases of mania. Anything done "with a will" is powerful. Most of the sane man's acts are only half-acts. Motives there always are which suggest inaction, and these are almost as powerful as those which urge to action. It is, as it were, with the force of the difference between these that a man works. An ordinary sane man is always half-hearted in all his doings, and this makes him weak. The maniac is in earnest about whatever he does. Consequences do not weigh with him as they do with his sane neighbor. He is not careful either of others or himself. It is this that makes him strong. Enthusiasm is, as it were, a sort of direction of mania to a single purpose.

108. Voice, Eye, Skin, and Appetite of Maniacs.— [88]Some other symptoms which are occasionally overlooked are worthy of mention. The voice of the individual is changed; the eye has a strange expression which the words "wild" and "glassy" but inefficiently convey. Again, the odor of the skin is to be noted in any complete enumeration of symptoms. As the perfume of the skin of healthy individuals is a source of pleasure, and is intimately connected with the sexual functions, so the odor of individuals who labor under mania is disagreeable, and is, along with peculiarly offensive odor of the intestinal excretions, to be accounted for by some chemical change produced in the organism by the nervous disturbance. Again, the appetite is generally good, or, rather, voracious. The patients become thinner. They occasionally pass a good night, but sometimes pass weeks without indicating the least necessity for slumber. The tongue may be foul, but, on the whole, the general health is good. Enough, however, has been said to enable those who are brought into relation with the insane to recognize this form of insanity. And while it was necessary to say something concerning the most prominent symptoms of mania, it will be understood that this is not the place to dwell particularly upon the phases of each of the kinds of mania which may be distinguished.

109. Classification of Mania.-Some general description was necessary before classifying the species of mania ac

cording to their mental symptoms. This classification is not difficult. There is evidently a well-marked distinction in nature between the cognitive powers of mind and the desiring and feeling powers or faculties. The one is the intellectual part of a man's nature; the other the emotional part. As the operations of these two parts of humanity upon the outside nature which is presented to them are very different, so effects of external nature upon those two classes of powers vary infinitely. This enables us to introduce a broad distinction between the morbid conditions of the brain, which is founded upon the fact that in many cases the intellectual nature of a man alone seems to be affected by disease; while, in other cases, the intellectual faculties are to all appearance intact, while the emotional are manifested through or by means of a diseased organism. Thus, then, we distinguish between intellectual and moral (emotional) mania.

110. Further Classification.-But it will be understood by those who know anything of mind that neither health nor disease is a constant quantity in all the [87] faculties of mind. Habit digs trenches, and healthy or diseased energy runs through them as water does in the river course. One man has a good memory, and another has a bad memory. One man has a memory for dates, another for faces, and so on. And as we find that men have skill in certain acts in health, we would expect to find that they were incapacitated from doing certain acts by disease. As men argue from the height of the Himalayas and Andes to the depths of the sea, so might we have arrived at some conclusion as to the characteristics of disease from the known qualities of health. And the fact is that observation enables us to confirm our expectations. We find that as the mind may sometimes be said to be wholly sane, so may it be said, upon occasion, to be wholly mad. And as we find one faculty in health towering like a mountain above its neighbors, so in disease we find that, as it were, depths of disease sink below the ordinary healthy level of a sound mind. So we find that we have arrived at another principle of classification, and we have under intellectual mania, general intellectual mania and partial intellectual mania; and under moral mania we have general moral

mania and partial moral mania. Of these, then, in their order.

PART L

? 111. General Intellectual Mania.- [88] We have seen that mania is often preceded by depression-that it is marked by a great change in the desires and feelings and habits of the individual. In this form of the disease, however, we would expect to find not only a disordered state of the cognitive faculties, but a total perversion of all the emotional qualities of the individual. The maniac becomes indifferent to those whom he loved most, insensible to ties which formerly influenced his whole being, and all the kindly affections and noble desires are replaced by the worst characteristics of a depraved disposition and the most filthy propensities. But still the terrible chaos of thought, broken-as a storm-cloud is by shafts of light-by periods of coherence, is the most marked feature in some cases; and these are the cases of which we would speak in this chapter. We have already alluded to the psychical symptoms of the early stages of the disease, but a more minute description is necessary.

112. Mental Symptoms of Mania.-At first, the individual may show symptoms of irritability, and along with this there is a more rapid succession of ideas. This is not simply the healthy increase of mental activity. Almost at once there are signs of peculiarity in the association of ideas. Memory is exalted. As after an earthquake fishes are found on the shore that were never seen before, so in this state of mania, recollections and reminiscences which have not been in consciousness for years return to it. Sometimes at this stage of the disease there is a development of powers of which the individul had not made any use. Thus grave, sad men become humorous, kindly men become sarcastic, dull men become eloquent, and shy men bold. Griesinger mentions a case in which a patient, under these (89)conditions, could strikingly delineate any slight resemblance to animals in the physiognomies of those around him. These

1 Griesinger on Mental Diseases, New Syd. Soc. ed., p. 283.

symptoms are not by any means common. As we have stated above, incoherence is observable, in most cases, from the beginning. Most ideas which pass through the mind of the maniac are crude, half-thought, "deformed, unfinished, and scarce half made up." They are governed and determined to a certain extent by the impressions of sense. We find, however, that the laws which govern the association of these ideas are not those which govern the ideas of a sane man. Sane men's thoughts cling together. There are affinities in their thoughts. They enter, as it were, into chemical combination, but the thoughts of the individual who labors undor general intellectual mania seem to resemble a mechanical mixture in their mental relations. We hear scraps of songs, isolated words, figures, cries, sentences, rhymes, and the like, all jumbled in the conversation of the maniac. Sometimes a similarity of sound seems to have for a time the power of rescuing something from chaos, and the individual may continue to speak in verse. Utter confusion, then, is the characteristic of general intellectual mania. Persistent delirious conceptions cannot be said to exist in it: the false impressions are as unstable as everything else. The condition of mind is apparently a constant stampede of ideas. The fleeting delusive and illusive beliefs are constant in this disease. They may exist with regard to the surroundings of the individual-they may affect the feeling of self. Thus, we frequently find the patient believes himself to be a king, or Mahomet, or God. The extraordinary increase of mental activity conveys the impression of pleasure, of grandeur, of magnificence, to the individual, and influences his delusions. Not uncommon are such assertions as, "I am made of wood," "I am in everything," "The world is my body," which are connected with the same mental impressions, and are due to a want of the power of discriminating between the objective and the subjective. It is evident that to subjectivity aloneif a separate existence of subjectivity in the flesh was possible-self would be the all; and in this diseased state, subjectivity is more prominent than objective existences. But in all these delusions and illusions there is the characteristic of instability. They do not remain. Maniacs are "to one thing constant never." There is no time allowed for the BR. INS.-14

formation of a habit. There is generally a want of conviction in the reality of the delusions present to the consciousness of the individual himself. Maniacs often laugh at the incongruity of what they themselves say. Still some circumstances remain to be mentioned with regard to the intellectual peculiarities of this disease.

113. The Incoherence of Mania.-It frequently happens that in spite of incoherence of the most marked character, the memory seems to be under the influence of the ordinary laws of association. The individual remembers many events and circumstances with perfect accuracy. Dr. Guy relates the case of a lady concerning whom he was consulted. She had suffered from mania for a long term of years, and was subject to paroxysms of extreme violence. "In one of these paroxysms, she had destroyed some valuable papers belonging to her husband, and yet, after the lapse of twenty years, during an interval of extreme tranquillity, she reverted to the occurrence, and expressed her regret at what had happened;" and what Mr. Erskine said shows that the fact has been appreciated by lawyers. He said: "In all cases which have filled Westminster Hall with the most complicated considerations, the lunatics and other insane persons who have been the subjects of them have not only had memory in my sense of the expression-they have not only had the most perfect knowledge and recollection of all the relations they stood in towards others, and of the acts and circumstances of their lives, but have in general been remarkable for subtlety and acuteness. Defects in their reasonings have seldom been traceable-the disease consisting in delusive sources of thought-all their deductions within the scope of their malady being founded on immoveable assumptions of matters as realities either without any foundation whatever, or so distorted and disfigured by fancy as to be nearly the same thing as their creation." This not only shows what it was quoted to indicate, but it also shows that in the legal profession the matter is only very partially understood even by those who have brought much ability to

Guy's Forensic Medicine, p. 179, 2d ed.

8 Hargrave's State Trials, 322.