MEDICINE. 
151 
tion ; and this variation, which constitutes 
every shade of difference in intellectual cha- 
racter, must necessarily arise either from dif- 
ference in the perceptive organs, or com- 
bining and retaining faculty. When then, 
without any apparent deficiency of the ex- 
ternal senses, which are the inlets to know- 
ledge, we find an individual not to have ar- 
rived at a given standard of intelligence by 
the constant employment of such senses, not 
to have obtained a due knowledge of “ the 
relations of things,” we place him out of the i 
range of intelligent existences* have an ob- 1 
scure conception of something defective in j 
the interior structure of his sentient organi- 
zation, and denominate him an ideot. 
This is the amentia congenita of Cullen, 1 
ideocy from birth. 
Ideocy, however, may be produced. Fa- ! 
tuity may succeed to intellectual vigour, and 1 
the whole fabric of acquired knowledge be 
undermined and overthrown. Thus man! 
may be literally reduced to the humiliating ] 
condition of second childhood. This state j 
may be engendered abruptly and visibly, or j 
gradually, and almost in an imperceptible J 
manner. It may follow violent agitations of 
the frame, as desolation succeeds to tem- 
pest, or may be brought about by the gra- 
dations of natural decay. 
The causes of ideocy, when it is not the 
result of original malconformation, are, all 
kinds of intemperance, more especially in- 
dulgence in the use of spirituous liquors: “ it 
has been traced up to somnolence too much 
indulged.” The media through which it is 
principally occasioned are mania, apoplexy, 
and above all epilepsy. When firmly es- 
tablished even in youth, very little hope of ; 
recovery can be entertained by the friends! 
ot the unfortunate victim to his own impru- | 
dence. The condition of ideocy is a condi- j 
tion beyond the reach either of physical or 
moral influences! 
Genus II. Melancholia. 
Genus III. Mania. 
We have placed these two genera of Dr. 
(fallen together, as we deem our author 
fundamentally erroneous in considering them 
distinct affections. Melancholia is defined 
“ partial madness without dyspepsia.’' From 
this mode of reasoning, mania, instead of 
being distinguished by the character of uni- 
versal madness, would have been with as 
much propriety denominated partial madness 
without fever. 
Insanity is intensity of idea, converting 
imagination into implicit belief, and thus 
produchg an incongruity of action ; incon- 
gruity is it respects former, consistency as 
it relates to present, impressions and associa- 
tions. It partakes of the character of mania 
or mehncholia, of violent rage or gloomy 
desponlency, according to the previous 
temperament of the sufferer, and the nature 
of the prevailing idea. In each the disor- 
dered associations are engendered upon pre- 
cisely tie same principles. 
M adiess differs from ideocy, as the con- 
clusion: derived from erroneous principles, in 
philosophising, differ from the conceptions of 
ignorance: the one is correct reasoning from 
erroneous premises, the other is defective 
judgmeit from defective information. 
How this intensity of idea is produced, 
we have no means of ascertaining : we do 
not indeed feel it difficult to comprehend, 
that an absorbing attachment to one object, 
or an exclusive attention to one particular 
pursuit, may come at last to make shipwreck 
of the understanding ; but it is the suscepti- 
bility of being carried away by this idea, that 
constitutes the difficulty in question. Like 
the deve’opement of intellectual character, 
the disposition to run into the state of in- 
sanity may perhaps depend upon the most 
minute circumstances of accidental asso- 
ciations: “ il lie taut qu’un leger accident, 
qu’un atome dfeplacG, pour te fail pth ir, pour 
te degrader, pour te ravir cette intelligence 
dont tu parois si tier !” So precarious is the 
tenure, even of the most exalted possessions 
of man ! 
Madness, however, like ideocy, may be 
produced through the medium of bodily dis- 
orders ; thus, fever will often occasion de- 
lirium, which is a species of temporary in- 
sanity. Thus, an obstruction of the men- 
strual discharge will frequently be the 
means of developing the latent disposition 
to maniacal disorder, occasioned by previous 
disease, resulting from erroneous education, 
or depending upon hereditary conformation. 
Indeed, almost the whole range of nervous 
diseases may, under predisposing circum- 
stances, come to be exciting causes of genu- 
ine insanity. When lunacy has been brought 
on by bodily disorder, the complexion of the 
derangement shall be formed by the p e- 
vious temperament, or natural disposition, of 
the sufferer; thus, the favourite ideas of 
health shall, in their increase, be the pre- 
dominant and overwhelming ideas of mad- 
ness ; again, when the insane state lias more 
immediately proceeded from passions of the 
mind, or moral rather than physical causes, 
the idea that has vanquished the intellect 
shall continue to reign. The imaginary mo- 
narch shall preserve his dominions and sway, 
and through the medium of his distempered 
fancy, shall observe menials and attendants 
in the persons who surround him ; the melan- 
choly lover shall require but a female form 
to pass before his cell, to be persuaded of 
the actual presence of the object of his affec- 
tions ; and the religious enthusiast shall read 
a speci.i embassy from heaven, in the counte- 
nance of every compassionate visitor. 
Prognosis. “ The chances of recovery are 
against those madmen, who can trace their 
indisposition to lunatic ancestry. When the 
causes are accidental, or obviously corporeal, 
a favourable termination may be expected. 
“ The insanity subsequent to parturition, is 
generally curable if the curative attempts be 
rational.” (Cox.) “ Patients who are in a furi- 
ous slate recover in a larger proportion, 
than those who are depressed and melan- 
cholic. When the furious state is succeeded 
by melancholy, and after this shall have 
continued a short time the violent paroxysm 
returns, the hope of recovery is very slight. 
Indeed whenever these states of the diseased 
frequently change, such alteration may be 
considered as unfavourable. When insanity 
supervenes on epilepsy, or where the latter 
disease is induced by insanity, a cure F very 
seldom effected.” (tiaslam.) “ When a per- 
son becomes insane who has a family of small 
children to solicit his attention, the prog- 
nostic is very unfavourable, as it shews the 
maniacal hallucination to be more powerful 
than those ideas that generally interest us the 
most.” (Darwin.) “ Though individuals of 
every temperament become insane, it has 
been observed that those of the sanguine 
more frequently recover.” 
M. M. Endeavour to draw off the mind 
from the prevailing idea, or otherwise to 
convince tiie maniac of the errors of his con- 
ceptions, and fallacy of his pretensions, by 
relating the incongruous conceits of oilier 
maniacs which have some affinity with his- 
own. M. Pinel states, that in the Bicetre of 
Paris, a maniac was cured of the hallucina- 
tion of supposing his head had beeu taken off 
by th ' guillotine, and that another had been 
placed on his shoulders, by a person judi- 
ciously ridiculing in his hearing the miracle 
of St. Dennis, who was said to carry his head 
under his arm, and to kiss it. When the 
maniac was endeavouring to prove the pos- 
sibility of the fact by an appeal to his own 
case, the narrator of the story suddenly ex- 
claims, “ Why, how, youwol, could he kiss 
his own head ? was it with h':s heel r” In in- 
cipient and equivocal madness, cautiously 
abstain from expressing suspicions in the 
hearing of the patient. “ Nothing is more 
calculated to make a person mad than the 
idea of being thought so.” (Reid.) On this 
account, premature confinement is to be de- 
precated, not merely as cruel, but as injudi- 
cious in the extreme. Those who are placed, 
over the insane as guardians, should unite 
decision and firmness of character with ten- 
derness of disposition and gentleness of man- 
ners. 
In strong plethoric habits, venesection. 
Cathartics. These last, especially in melan- 
choly, often require to be of the drastic kind*, 
and united with calomel. “ Diarrhoea very 
often proves a natural cure of insanity.” (PI as- 
lam.) Vomits, Camphor. Opium in large 
doses. Cold bathing during the violence of 
the paroxysms, and in some cases warm 
bathing in the intervals. 1 firing the ur- 
gency of phrenzy, apply cold water to the 
head. Clay cap. Blisters to the scalp. In 
some cases the production of a vertiginous, 
state bv a rotatory swing, has lately been 
found effectual in breaking the morbid asso- 
ciations constituting phrenetic and melan- 
choly paroxysms. Digitalis in very large 
doses, but regulated with care. Introducing, 
a new disease, which is of a trivial nature, 
and easy of cure. “ I should place consi- 
derable hopes on inoculation, had the party 
not previously had the small-pox, taking 
care, by proper medicines and management, 
to increase the symptoms that usually attend, 
this last disease to such a degree, that the 
whole system should be considerably affect- 
ed without the life being endangered.” (Cox.) 
In instances where madness has originated 
from corporeal diseases, it scarcely requires 
to be observed, that a considerable part of the 
treatment must be constituted by the admi- 
nistration of those remedies that in common 
cases of these affections have been found to, 
be effectual. 
Genus IV. Oneirodynia. This genus is 
defined by Dr. Cullen “ a violent and dis- 
tressing imagination in time of sleep.” It is 
divided into two species: lire active, or that 
exciting to walking and various other mo- 
tions ; and the gravans, with a sense ot' weight 
or pressure on the chest. This., last is . the 
