Encyclopaedia Britannica, or, a Dictionary of arts, sciences, and miscellaneous literature : enlarged and improved. Illustrated with nearly six hundred engravings > Volume 13, MAT-MIC

Practice. M EDI
Vef*niae. Amentia, Lift. Gj.
■<>' v Delirium maniacum, tlojfm. III. 251.
Although thefe diftempers may be confidered as di-
ftinft genera, yet they are fo nearly allied, and fo rea¬
dily change into each other, that it fufficiently juftifies
the treating all of them together.
The diftinguifhing charadteriltic of madnefs, accord-
, ing to Dr Battie, is a fulfe perception ; and under this
general chara&er may be comprehended all kinds of
what is called madnefs, from the moil lilly Cupidity and
idiotifm to the muft furious lunacy. Frequently the
different kinds of madnefs are changed into each other
by the cafual excitement of fome paffion : thus, an idiot
may become furioully mad, by being put in a violent
paffion 5 though this does not fo often happen as the
change of melancholy into the raving madnefs, and vice
Verfa.
It is a very furprifing circumflance, that mad people
are not only lefs liable to be feized with infectious dif-
orders than thofe who are in perfedl health 5 but even
when labouring under other difeafes, if the patients
chance to be feized with madnefs, they are fometimes
freed from their former complaints. Of this kind Dr
Mead relates two very remarkable inftances.
On the other hand, it has been known, that an in¬
termittent fever, fupervening upon madnefs of long
ftanding, has proved a cure for the madnefs •, the fcnfes
having returned when the fever terminated. Dr Monro
faw two inftances of this himfclf $ and mentions it as an
obfervation made alfo by his predcceffor in the care of
Bethlehem hofpital.
Another remarkable circumftancc is, that immode¬
rate joy, long continued, as effectually diforders the
mind as anxiety and grief. For it was obfervable in
the famous South Sea year, when fo many immenfe
fortunes were fuddenly gained, and as fuddenly loft,
that more people had their heads turned, from the pro¬
digious flow of unexpefted riches, than from the entire
lofs of their whole fubftance.
Mad people, efpecially of the melancholic kind,
fbmetimes obftinately perfevere in doing things which
muft excite great pain } whence it ftiould feem as if
their minds were troubled with fome diftra6Hng no¬
tions, which make them patiently bear the prefent di-
ftrefs, left more fevere tortures fliould be inflicted 5 or
poffibly they may think, that, by thus tormenting the
body, they render themfelves more acceptable to the
divine Being, and expiate the heinous fins of which
they may imagine themfelves to have been guilty.
It is, however, alfo highly probable that their feel¬
ings differ exceedingly from what they are in a natural
ftate ; at leaft they are every day obferved to endure,
apparently without the fmalleft uneafinefs, watching,
hunger, and cold, to an extent which in a ftate of
health would not only be highly diftrefling, but to the
greater part of individuals would even prove fatal.
And this refiftance of hunger, cold, and fleep, affords
perhaps the beft teft for diftinguifhing cafes of real
~ infinite, from cafes where the difeafe is only feigned,
jjnd appearances of it put on, to anfwer particular pur¬
poses •, at leaft where this power of refiftance is prefent,
yve have good reafon to conclude that the affedlion is
not feigned.
Cure. Although we be well acquainted with many
CINE. 41 r
of the remote caufes of this difeafe, fome of the princi- Mania,
pal of which have already betn mentioned, yet we _u"'v 1 J'
are ftill fo ignorant of the influence of thefe upon the
fyftem, as giving a derangement of the mental facul¬
ties, that no general principles on which the cure
may be conducted, can wTith any confidence be pointed
out.
It may, however, be obferved, that while fume reme¬
dies feem to operate by producing an artificial termi¬
nation of this complaint, many others have effect only
as aiding a natural termination. And where a re¬
covery from this difeate does take place, it molt fre¬
quently happens in eonfequence of a natural conva-
lefcence. All the fpecies and degrees of madnefs
which are hereditary, or that grow up with people from
their early youth, are out of the power of phyfic j
and fo, for the moft part, are all maniacal cafes of
more than one year’s ftanding, from whatever feurce
they mav arife. Very often mere debility, the dregs of
fome particular difeafe, fueh as an ague, the fmall-pox,
or a nervous fever, fhall occafion dift'erent degrees of
foolifhnefs or madnefs. In thefe cafes, the cure muff
not be attempted by evacuatic.ns \ but, on the contrary,
by nourifning diet, clear air, moderate exercife, and
the ufe of wine . whereas, in aimoit all the other ma¬
niacal cafes, which arife from different fources, and
which come on m confequence of intemperate liv ing,
violent paflions, or intenfe thinking, it is generally
held, that evacuations of every kind are neeeffaiy, un-
lefs the conftitution of the patient be fuch as ablolutely
forbids them.
Blood is moft conveniently drawn either from the
arm or jugulars •, and if the weaknefs be fuch as ren¬
ders it improper to take away much blood, we may ap¬
ply cupping-glaffes to the occiput.
Vomiting, in weakly people, muft be excited by the
vinum ipecacuanhae *, but in the more robuft by emetic
tartar or antimonial wine : the moft efficacious cathar¬
tics are the infufion or tinffure of black hellebore, or
infufion of fenna quickened with tinfture ot jalap; but
if there be iuppreffion of the menfes, or of an habitual
haemorrhoidal difeharge, then aloetic purges will be more
proper ; and in fome inftances cooling faline purgatives,
fuch as lixiviated tartar, are of great fervice. In ge¬
neral, mad people require very large dofes, both of the
emetics and cathartics, before any confiderable operation
enfues.
Dr Monro affures us, that the evacuation by vomit*
ing is infinitely preferable to any other : the prodigi¬
ous quantity of phlegm with which the patients in
this difeafe abound, he fayc, is not to be overcome but
by repeated emetics; and he obferves, that the purges
have not their right effeft, or do not operate to fo good
purpofe, until the phlegm be broken and attenuated
by frequent emetics. He mentions the cafe of a gentle¬
man who had laboured under a melancholy for three
years, from which he was relieved entirely by the ufe
of vomits and a proper regimen. Increafing the dif¬
eharge by urine, is alfo of the greateft moment, efpe¬
cially when any degree of fever is prefent. The cuta¬
neous difeharges are alfo to be promoted ; for which
purpofe the hot bath is of the higheft fervice in mania¬
cal cafes. Hoffman afferts, that he has feen numerous
inftances, both of inveterate melancholy and raging
madnefs, happily cured by means of warm bathing j
3 F 2 bleeding