INSANITY. 
112 
a clear account of the fuppofed caufes, fymptoms, and 
varieties, of the malady of which it profeffes to treat. 
Af etas us adopted, with fome modifications, the phyfiolo- 
gical doftrines of Hippocrates. He appears not, however, 
to have been a ftranger to the more metaphyfical and lefs 
ufeful fpeculations of the methodifts; at the fame time 
that his writings are principally valuable for the fimple 
and unexaggerated fafts which they contain. A chapter 
by this author on mania appears deferving of a fimilar cha¬ 
racter. His method of treatment accords with his the¬ 
oretical principles, and ferves to illuftrate the influence of 
'■thofe principles upon his praftice. It is to be regretted, 
that a great part of his tract on the cure of melancholia 
has been loft. In what remains of it, though very judi¬ 
cious fo far as it goes, (and as to phyfical means it com¬ 
prehends almoft all the indications which have ever been 
offered on the fubjeft,) we meet not with a Angle obfer- 
vation on the management or moral treatment of maniacs 
and melancholics. 
Cornelius Celfus, a Roman phyfician of very general 
and extenfive information, has left us a ftvort but very 
valuable traft upon mental diforders. His precepts, 
which are not alloyed by any theoretical difquifitions, 
appear to be the dictates of obfervation and experience ; 
and what gives them an additional value, is, that they 
chiefly relate to the moral management of the infane. 
His nofological diftribution of the different fpecies of in- 
fanity is, however, unfcientific and confuted. Coelius 
Aurelianus, greatly inferior to Celfus in elegance and 
purity of language, has rendered his feCtion on mania va¬ 
luable, by a more detailed account of the fymptoms, ac- 
ceffory circumftances, and treatment, of infinity. Alex¬ 
ander Traliianus wrote at a time when Galenifin was 
fpreading its crude and complicated fpeculations over the 
world. He therefore occafionally adverts to the doctrines 
of the numerous fefts which diftinguifhed the profeflion 
of medicine in the fourth century, and fpeaks of Galen in 
terms of the profoundeft veneration. Trallian, however, 
who was a man of original genius, ftudied his profeflion 
analytically, and acquired his knowledge of human nature 
and human diforders by the fame method, and from the 
fame inexhauftible fources. In his trad de melancholia, 
he does not altogether rejeCt the offices of the bile; but 
it is evident that his leading theory of the proximate 
caufe of infanity was that of an exce[five determination of 
blood to the head. The remedies which he recommends are 
fimple, fuitable, and aftive. 
It was believed by mod of the phyficians of antiquity, 
that mania and melancholia are only degrees or varieties 
of one and the fame affeCtion. Both forms of mental de¬ 
rangement were diftinguiflied from phrenitis by the ab- 
fence of fever. The diagnoftic fymptoms between mania 
furibunda and the melancholic paflion were the fame that 
are adopted by the nofologifts of the prefent day. They 
afford the belt rujes, perhaps, that the nature of the fub- 
jeCt will admit of, and are fufficiently difcriminating for 
all ufeful and practical purpofes. 
The leading indication of cure by the ancients was 
.•evacuation by hellebore, which generally operated both as 
an emetic and a purgative. From the confident language 
that was made ufe of by the poets of antiquity, and by 
the phyfioians of the middle ages, relative to the antima- 
niacal efficacy of the hellebore, it has been believed by 
fome, that the moderns are either ignorant of the real ve¬ 
getable fo celebrated in former times, or have loft the art 
of preparing it after the ancient manner. In oppofition 
to this miftaken idea it may be obferved, that the medical 
authors of antiquity, whofe teftimony alone can be con- 
iidered of any weight in this cafe, do not in a Angle in¬ 
stance exprefs an empirical exclufive confidence in the 
virtues of any one remedy. AlexanderTrallianus prefers, 
.indeed, in a very decided’manner, the fubftitution of other 
evacuants to the ufe of white hellebore, which he confi- 
dered as a very uncertain and dangerous remedy. Acrid 
and veficating rubefacients were advifed by the phyficians 
of Greece to be applied to the crown and back part of the 
heads of maniacs at repeated intervals. Cupping of the 
temples, the extraction of blood by leeches, and general 
venaefeftion, were remedies of infanity with which they 
were likewife well acquainted. Bathing was deemed by 
mod of them a powerful remedy in difeafes of the mind, 
and was employed in various forms, to meet different in¬ 
dications, and in conjunftion with other proceffes, chiefly 
unftuous, which were intended to aft on the furface of 
the body. With refpeft to narcotics, it may be obferved, 
that they were not favourite remedies among the ancients. 
Cornelius Celfus informs us, that an infufion of the poppy 
employed externally in the way of lotion to the head, 
was reprobated by his great malter Afclepiades, as calcu¬ 
lated to induce a dangerous lethargy The means which 
were generally recurred to, to procure deep and to alle¬ 
viate pain, were the warm bath, friftion, geftation, fuf- 
penfory beds, monotonous mufic, and fuch other methods 
as were adapted to footh the feelings and the fenfes. The 
rules preferibed by the ancients, in refpeft to exercife and 
regimen, are for the moft part tedious and unimportant; 
and in the great objeft of moral management they are all 
exceedingly deficient. Cornelius Celfus is the only an¬ 
cient writer who has incorporated, with his other indica¬ 
tions of cure, any praftical direftions in regard to the 
moral treatment of lunatics. 
Such is a general outline of the leading principles of the 
ancients, in refpeft both to tlieir theories and. treatment 
of mental diforders. To have engaged in a more minute 
analyfis of them, would have rendered thefe introduftory 
obfervations unneceflarily tedious. From what has been 
faid, the intelligent reader will find no difficulty in afeer- 
taining the portion of merit due to their fucceffors in the 
fame route. 
The Arabian phyficians adopted the fpeculations of their 
Greek and Roman predeceffors, exercifing the right, no 
doubt, of modifying them according to circumftances, fo 
as to rendqr them accordant to their own prejudices, and 
fubfervient to their temporary credit and confequence. 
The praftical obfervation and beautiful fimplicity of Are- 
tteus and Celfus were now Loft amid the difputations of 
medical feftarianifm and the farrago of ridiculoufly-compli- 
cated formula. Among the produftions of thefe times, 
we do not, therefore, meet with .any eflays upon mental 
diforders which are not miferable compilations from the 
works of the ancients, obfeured by falfe phyfiology and 
pharmacy The contefts which fucceeded in the latter 
centuries between the Galenifts and the Alchemifts, caufed 
much wrangling and animofity in the medical fchools on 
the continent, without adequately contributing to the 
progrefs of genuine medical fcience. The writers of t 
thofe times, fuch as Sennertus, Riverius, Plater, Heurnius, 
Ilorllius, Bonnetus, and many others, who were pro¬ 
foundly verfed in the learning of the Arabians, devoted 
their time and their talents in the fabrication of medical 
cyclopaedias, or fyftematic works containing difquifitions 
upon all the difeafes to which the human frame is fubjeft. 
Thofe writers, amongft their other laboured and volu¬ 
minous produftions, have left fome not-contemptible effays 
upon the fubjeft of the prefent article. Their theories 
of infanity are, for the moft part, founded upon the fup- 
pofed influence of four or five different principles in the 
human conftitution, viz. the bile, the pituita, the element 
of fire, and what they called the animal fpirits, and in fome 
inftances an infidiotts poifon. In their indications of 
cure are enumerated, in different relations to the ftates 
and ftages of the malady, almoft all the articles of their 
fuperabundant materia medica. 
Van Helmont, equally celebrated for his genius and ex- 
centricities, had the merit of being the firft to emancipate 
the profeflion of phyfic from the (hackles of Galenifin, and 
to advance new and original ideas upon the fubjeft of in 
fanity. Upon applying the root of the monk’s-hood to 
the tip of his tongue, that father of modern medical ana¬ 
lytical enquiry experienced new and indefcribable fenfa- 
tions. 
