SPEC. I. Ecphronia. Melan cholia. GEN. I. instance, greatly modified by the prevailing idiosyncrasy, and hence, though a love of solitude, gloom, fear, suspicion and taciturnity are the ordinary signs of the present species, these signs often yield to symptoms widely different, and sometimes even of an opposite character ; and we hence become possessed of the four following varieties: Melancholy. These va rieties ob. served by a Attonita. Gloomy melancholy. B Errabunda. Restless melancholy. 7 Malevolens. Mischievous melancholy. ♪ Complacens. melancholy. Mute, gloomy, retiring melancholy. Roving, restless melancholy, evincing a constant desire to change the abode. Morose or mischievous melancholy; occasionally terminating in suicide or the injury of others. Self-complacent and affable melancholy occasionally rejoicing in a visionary superiority of rank, station, or endowment. The same variety of symptoms, as chiefly modified by the prevailing temperament, are noticed by Fracastorio. Fracastorio. "The phlegmatic", says he, "are heavy; the sanguine, lively, cheerful, merry, but not witty; the choleric are in rapid and perpetual motion, impatient of dwelling upon any subject. An acuteness of wit belongs to most of the By Diocles. varieties, but not to all"*. And hence Diocles in opposing Galen for holding, after Hippocrates, that gloom and terror are pathognomic signs of melancholy, observes, Singular modification Upon serious consideration I find some patients that have nothing of these qualities: and others that exhibit every diversity of feeling for some are sad without being fearful; others fearful without being sad; some neither, and some both." Besides these modifications there is another of a very * De Intellectione. Lib. II. SPEC. I. cholia. Spurzheim. peculiar kind noticed by Dr. Spurzheim in order to show GEN. I. that the faculties of the mind are double, and that each Ecphronia. hemisphere of the brain contains a distinct set. As I Melanhave never met with an instance of this variety I must Melancholy. describe it in his own words. "Tiedemann," says he, noticed by "relates the example of one Moser, who was insane on one side, and who observed his insanity with the other. Gall attended a minister who, having a similar disease for three years, heard constantly on his left side reproaches and injuries, and turned his head to that side in order to look at the persons. With his right side he commonly judged of the madness of his left side: but sometimes in a fit of fever he could not rectify his peculiar state. Long after being cured, if he happened to be angry, or if he had drank more than he was accustomed to do, he observed, in his left side, a tendency to his former alienation"*. How wit or shrewdness of remark may exist. with little judgement. It may appear strange to those who have not studied the subject with much attention that persons who are possessed of a diseased or even a defective judgement should at any time be of quick and lively apprehension, and thus be witty without being wise. But the faculty of wit is dependent not so much on the judgement as on the imagination, and particularly on the memory, on the possession of a large stock of ideas stored up for ready use, and brought forth with rapidity. "And hence," says Mr. Illustrated Locke," some reason may perhaps be given of that com- from Locke. mon observation, that men who have a great deal of wit and prompt memories, have not always the clearest judgement or deepest reason. For wit lying most in the assemblage of ideas, and putting those together with quickness and variety, wherein can be found any resemblance or congruity, thereby to make up pleasant pictures and agreeable visions in the fancy; judgement, on the contrary lies quite on the other side, in separating carefully, one from another, ideas wherein can be found the least differ GEN. I. SPEC. I. Ecphronia. Melan cholia. Melancholy. Hence the occasional vivacity of insane per sons. Yet taciturnity and common to them. ence, thereby to avoid being misled by similitude, and by affinity to take one thing for another"*. And hence, we may easily account for that gaiety and those ebullitions of a vivid fancy which so often assume the character of wit in persons whose minds are deranged, and especially in the sober faculty of the judgement. Mirth and wit, however, though sometimes found in the present species of insanity, are by no means its common characters; but on the contrary, as we have already observgloom more ed, a love of solitude, gloom, and taciturnity, and an indulgence in the distressing emotions of the mind. And hence, whenever hypochondrism merges into actual insanity, it almost always takes this form; as melancholy, from a sort of natural connexion between the two, often assumes many of the symptoms that essentially appertain to the hypochondriac disease; the morbid state of the brain influencing the abdominal organs in the latter case, as the morbid state of the abdominal organs influences the brain in the former. Common progress of The disease shows itself sometimes suddenly, but more melancholy. generally by slow and imperceptible degrees. Among the earliest symptoms may be mentioned head-aches, frequent attacks of giddiness, sudden confusion of ideas, a great disposition to anger, violent agitations when irritated, and an uncommon sensibility of nerves, whereby the patient is apt to be carried to as great excesses from causes of joy as from those of grief. There is a desire of doing well, but the will is wayward and unsteady, and produces an inability of firmly pursuing any laudable exertion or even purpose, on account of some painful internal sensation, or the perverseness of the judgement led astray by false or erroneous ideas which command a firm conviction in the mind. And if the disease occur in a person possessing that temperament which has been conceived to predispose to it, and was by the Greeks denominated melancholic, the external signs become peculiarly marked External signs sometimes very strong. * On Human Understanding, Book 11. Ch. xi. § 2. GEN. I. SPEC. I. and prominent, "the patient", says Hippocrates, in his book on insanity, "is emaciated, withered, and hollow- Ecphronia. eyed and is at the same time troubled with flatulency Melanand acid eructations, with vertigo and singing in the ears: Melancholy. gets little sleep, and when he closes his eyes is distracted with fearful and interrupted dreams." cholia. E. Melancholia at tonita. Mute retiring me. Often commences gradually dismis lancholy. taken for hypochon Well de scribed in Hamlet. The FIRST VARIETY most commonly commences with this character, and creeps on so gradually that it is for some time mistaken for a mere attack of hypochondrism or lowness of spirits*, till the mental alienation is at length decided by the wildness of the patient's eyes, the hurry of his step whenever he walks, his extraordinary gestures, and the frequent incongruity of his observations and remarks. The first stage of the disease is thus admirably expressed by Hamlet: "I have of late, but wherefore I know not, lost all my mirth, forgone all custom of exercise; and indeed, it goes so heavily with my disposition, that this goodly frame, the earth, seems to me a sterile promontory; this most excellent canopy, the air, look you, this brave o'erhanging firmament, this majestical roof fretted with golden fire, why it appears no other thing to me than a foul and pestilent congregation of vapours." But while the external world is thus in general falsely recognized by the perception or falsely discriminated by the judgement, the mind is so completely possessed by some particular trains of imaginary ideas that the attention is perpetually turned to them, and the judgement mistakes them for substances; and, so far as it is sensible of surrounding objects or scenery, is perpetually blending the vision with the reality. It is not that the patient's ideas are incongruous with themselves but with the world around him; for the remarks of the melancholy man, when his attention is once correctly fixed, are for the most part peculiarly shrewd and pointed. But in the gloom that hangs over him under the variety we are now contemplating, he can rarely be brought into conversation, seeks for solitude, silence and Predomisome single trains of nance of some ideas. Love of * Falret, de l'Hypochondrie et du Suicide, passim. 8vo. Paris, 1822. solitude. GEN. I. SPEC. I. cholia attonita. Mute retiring melancholy. as noticed sits moping in one continued posture from morning to & E. Melan- night; or if he walk at all, seeks for orchards, back-lanes, and the gloomiest places he can find. "One of the chief reasons", says Hippocrates in his epistle to Philopœmenes, "that induced the citizens of Abdera to suspect Democritus of craziness, was that he forsook the city, and lived in groves and hollow trees, upon a green bank by a brook side, or by a confluence of waters all day and all night." by Hippo crates. Extreme case from Sauvages. Exciting causes. Sauvages under the variety of melancholia attonita gives an extreme case of the present modification, though not from personal knowledge. "The patient", says he, 66 never moves from place to place nor changes his po3ture; if he be seated he never stands up; if standing he never sits; if lying he never rises. He never moves his feet unless they are pushed aside by a bye-stander: but he does not shun the presence of man; if asked a question he does not answer, and yet appears to understand what is said. He does not yield to admonition nor pay any attention to objects of sight or touch: he seems immersed in profound thought, and totally occupied by foreign matters. Yet at times he is more awake: if food be put to his mouth he eats, and if liquor be presented he drinks." M. de Sauvages then adds, that this rare modification of the disease occurred once to Dr. James, physician to the elector of Saxony, in a man about thirty years old, who was terrified with the thought that the Deity had condemned him. It continued for four months during the autumn and winter; but the patient was at length restored to his right understanding *. Grief, and particularly for the loss of friends, discontent, severe disappointment, the dread of some real or imaginary evil, a violent and long continued exertion of any of the passions, and deep uninterrupted study, have frequently proved accidental causes or accessories of this variety of melancholy, where the peculiarity of the con Nosol. Med. Class viii. 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