ADYNAMIA. 391 



such temperaments, may be considered as perhaps always a 

 symptom of the affection of the stomach ; so to this combination 

 of dyspepsia and vapours, I would still apply the appellation of 

 Dyspepsia, and consider it as strictly the disease treated of in 

 the preceeding chapter. 



But the combination of dyspepsia and vapours in melancholic 

 temperaments, as the vapours or the turn of mind peculiar to 

 the temperament, nearly that described above in MCCXXIL, 

 are essential circumstances of the diseases ; and, as this turn of 

 mind is often with few, or only slight symptoms of dyspepsia ; 

 and, even though the latter be attending, as they seem to be 

 rather the effects of the general temperament, than of any 

 primary or topical affection of the stomach ; I consider this 

 combination as a very different disease from the former, and 

 would apply to it strictly the appellation of Hypochon- 

 driasis. 



MCCXXVIII. Having thus pointed out a distinction be- 

 tween Dyspepsia and Hypochondriasis, I shall now, using these 

 terms in the strict sense above mentioned, make some observa- 

 tions which may, I think, illustrate the subject, and more 

 clearly and fully establish the distinction proposed. 



MCCXXIX. The dyspepsia often appears early in life, and 

 is frequently much mended as life advances : but the hypo- 

 chondriasis seldom appears early in life, and more usually in 

 more advanced years only ; and more certainly still, when it 

 has once taken place, it goes on increasing as life advances to 

 old age. 



This seems to be particularly well illustrated, by our observ- 

 ing the changes in the state of the mind which usually take 

 place in the course of life. In youth, the mind is cheerful, 

 active, rash, and moveable ; but as life advances, the mind by 

 degrees becomes more serious, stow, cautious, and steady ; till 

 at length, in old age, the gloomy, timid, distrustful, and obsti- 

 nate state of melancholic temperaments is more exquisitely form- 

 ed. In producing these changes, it is true, the moral causes 

 have a share ; but it is at the same time obvious, that the tem- 

 perament of the body determines the operation of these moral 

 causes, sooner or later, and in a greater or less degree, to have 



