VESANI^E. 533 



ed from one another, whilst the same temperament is common 

 to both. 



MDLXXXVII. I apprehend, however, that the distinction 

 may be generally ascertained in the following manner : 



The hypochondriasis I would consider as being always at- 

 tended with dyspeptic symptoms ; and though there may be, at 

 the same time, an anxious melancholic fear arising from the 

 feeling of these symptoms ; yet while this fear is only a mistak- 

 en judgment with respect to the state of the person's own health, 

 and to the danger to be from thence apprehended, I would still 

 consider the disease as a hypochondriasis, and as distinct from 

 the proper melancholia. But when an anxious fear and de- 

 spondency arises from a mistaken judgment with respect to 

 other circumstances than those of health, and more especially 

 when the person is, at the same time, without any dyspeptic 

 symptoms, every one will readily allow this to be a disease 

 widely different from both dyspepsia and hypochondriasis ; and 

 it is what I would strictly name Melancholia. 



MDLXXXVIII. In this there seems little difficulty: but 

 as an exquisitely melancholic temperament may induce a torpor 

 and slowness in the action of the stomach, so it generally pro- 

 duces some dyspeptic symptoms ; and from thence there may 

 be some difficulty in distinguishing such a case from hypochon- 

 driasis. But I would maintain, however, that when the cha- 

 racters of the temperament are strongly marked; and more 

 particularly when the false imagination turns upon other sub- 

 jects than that of health, or when, though relative to the per- 

 son's own body, it is of a groundless and absurd kind ; then, 

 notwithstanding the appearance of some dyspeptic symptoms, 

 the case is still to be considered as that of a melancholia rather 

 than a hypochondriasis. 



MDLXXXIX. The disease of melancholia, therefore, man- 

 ifestly depends upon the general temperament of the body : 

 and although, in many persons, this temperament is not at- 

 tended with any morbid affection either of mind or body ; yet 

 when it becomes exquisitely formed, and is in a high degree, it 

 may become a disease affecting both, and particularly the mind. 

 It will therefore be proper to consider in what this melancholic 

 temperament ^especially consists ; and to this purpose, it may 



