522 PRACTICE OF PHYSIC. 



are particularly directed towards these. And although this 

 should not be the case, they commonly soon lose that respect 

 and regard which they formerly had for their friends and rela- 

 tions. With all these circumstances, it will be readily perceiv- 

 ed, that the disease must be attended very constantly with that 

 incoherent and absurd speech we call raving. Further, with 

 the circumstances mentioned, there is commonly joined an un- 

 usual force in all the voluntary motions ; and an insensibility or 

 resistance of the force of all impressions, and particularly a re- 

 sistance of the powers of sleep, of cold, and even of hunger ; 

 though indeed in many instances a voracious appetite takes 

 place. 



MDLIX. It appears to me, that the whole of these circum- 

 stances and symptoms point out a considerable and unusual 

 excess in the excitement of the brain, especially with respect to 

 the animal functions ; and it appears at the same time to be 

 manifestly in some measure unequal, as it very often takes 

 place with respect to these functions alone, while at the same 

 time the vital and natural are commonly very little changed 

 from their ordinary healthy state. 



MDLX. How this excess of excitement is produced, it may 

 be difficult to explain. In the various instances of what Sau- 

 vages has named the Mania metastatica, and in all the instances 

 I have mentioned in my Nosology under the title of the Mania 

 corporea, it may be supposed, that a morbid organic affection 

 is produced in some part of the brain ; and how that may pro- 

 duce an increased or unequal excitement in certain parts of it, 

 I have endeavoured to explain above in MDLII. But I must 

 at the same time acknowledge, that such remote causes of mania 

 have very rarely occurred; and that, therefore, some other 

 causes of the disease must be sought for. 



The effects of violent emotions or passions of the mind have 

 more frequently occurred as the remote causes of mania ; and 

 it is sufficiently probable, that such violent emotions, as they do 

 often immediately produce a temporary increase of excitement, 

 so they may, upon some occasions of their permanent inherence 

 or frequent repetition, produce a more considerable and more 

 permanent excitement, that is, a mania. 



With respect to those causes of mania which arise in conse- 



