2. - 1. Mania may be divided into intellectual and moral.
1.
Intellectual mania is that state of mind which is characterised by
certain hallucinations, in which the patient is impressed with the
reality of facts or events which have never occurred, and acts in
accordance with such belief; or, having some notion not altogether
unfounded, carries it to an ex- travagant and absurd length. It may be
considered as involving all or most of the operations of the
understanding, when it is said to be general; or as be-ing confined to a
particular idea, or train of ideas, when it is called partial.
3.
These will be separately examined. 1st. General intellectual mania is a
disease which presents the most chaotic confusion into which the human
mind, can be involved, and is attended by greater disturbance of the
functions of the body than any other. According to Pinel, Traite
d'Alienation Mentale, p. 63, "The patient sometimes keeps his head
elevated and his looks fixed on. high; he speaks in a low voice, or
utters cries and vociferations without any apparent motive; he walks to
and fro, and sometimes arrests his steps as if fixed by the sentiment of
admiration, or wrapt up in profound reverie. Some insane persons
display wild excesses of merriment, with immoderate bursts of laughter.
Sometimes also, as if nature delighted in contrasts, gloom and
taciturnity prevail, with involuntary showers of tears, or the anguish
of deep sorrow, with all the external signs of acute mental suffering.
In certain cases a sudden reddening of the eyes and excessive loquacity
give presage of a speedy explosion of violent madness and the urgent
necessity of a strict confinement. One lunatic, after long intervals of
calmness, spoke at first with volubility, uttered frequent shouts of
laughter, and then shed a torrent of tears; experience had taught the
necessity of shutting him up immediately, for his paroxysms were at such
times of the greatest violence. "Sometimes, however, the patient is not
altogether devoid of intelligence; answers some questions very
appropriately, and is not destitute of acuteness and ingenuity. The
derangement in this form of mania is not confined to the intellectual
facul-ties, but not unfrequently extends to the moral powers of the
mind.
4.
- 2d. Partial intellectual mania is generally known by the name of
monomania. (q. v.) In its most usual and simplest form, the patient has
conceived some single notion contrary to common sense and to common
experience, generally dependent on errors of sensation; as, for example,
when a person believes that he is made of glass, that animals or men
have taken their abode in his stomach or bowels. In these cases the
understanding is frequently found to be sound on all subjects, except
those connected with the hallucination. Sometimes, instead of being
limited to a single point, this disease takes a wider range, and there
is a class of cases, where it involves a train of morbid ideas. The
patient then imbibes some notions connected with the various relations
of persons, events, time, space, &c., of the most absurd and
unfounded nature, and endeavors, in some measure, to regulate his
conduct accordingly; though, in most respects, it is grossly
inconsistent with his delusion.
5.
Moral mania or moral insanity, (q. v.) is divided into, first, general,
where all the moral faculties are subject to a general disturbance and
secondly, partial, where one or two only of the moral powers are
perverted.
6.
These will be briefly and separately examined. 1st. It is certain that
many individuals are living at large who are affected, in a degree at
least, by general moral mania. They are generally of singular habits,
wayward temper, and eccentric character; and circumstances are
frequently attending them which induce a belief that they are not
altogether sane. Frequently there is a hereditary tendency to madness in
the family; and, not seldom, the individual himself has at a previous
period of life sustained an attack of a decided character: his temper
has undergone a change, he has become an altered man, probably from the
time of the occurrence of something which deeply affected him, or which
deeply affected his bodily constitution. Sometimes these alterations are
imperceptible, at others, they are sudden and immediate. Individuals
afflicted with this disease not unfrequently "perform most of the common
duties of life with propriety, and some of them, indeed, with
scrupulous exactness, who exhibit no strongly marked features of either
temperament, no traits of superior or defective mental endowment, but
yet take violent an- tipathies, harbor unjust suspicions, indulge strong
propensities, affect singularity in dress, gait, and phraseology; are
proud, conceited, and ostentatious; easily excited and with difficulty
appeased; dead to sensi- bility, delicacy, and refinement; obstinately
riveted to the most absurd opinions; prone to controversy, and yet
incapable of reasoning; always the hero of their own tale, using
hyperbolic, high flown language to express the most simple ideas,
accompanied by unnatural gesticulation, inordinate ac- tion, and
frequently by the most alarming expression of countenance. On some
occasions they suspect sinister intentions on the most trivial grounds;
on others are a prey to fear and dread from the most ridiculous and
imaginary sources; now embracing every opportunity of exbibiting
romantic courage and feats and hardihood, then indulging themselves in
all manner of excesses. Persons of this description, to the casual
observer, might appear actuated by a bad heart, but the experienced
physician knows it is the head which is defective. They seem as if
constantly affected by a greater or less degree of stimulation from
intoxicating liquors, while the expression of countenance furnishes an
infallible proof of mental disease. If subjected to moral re- straint,
or a medical regimen, they yield with reluctance to the means proposed,
and generally refuse and resist, on the ground that such means are
unnecessary where no disease exists; and when, by the system adopted,
they are so far recovered, as to be enabled to suppress the exhibition
of their former peculiarities, and are again fit to be restored to
society, the physician, and those friends who put them under the
physician's care, are generally ever after objects of enmity, and
frequently of revenge." Cox, see cases of this Pract. Obs. on Insanity,
kind of madness cited in Ray, Med. Jur. 112 to 119; Combe's Moral
Philos. lect. 12.
7
.- 2d. Partial moral mania consists in the derangement of one or a few
of the affective faculties, the moral and intellectual constitution in
other respects remaining in a sound state. With a mind apparently in
full possession of his reason, the patient commits a crime, without any
extraordinary temptation, and with every inducement to refrain from it,
he appears to act without a motive, or in opposition to one, with the
most perfect consciousness of the impropriety, of his conduct, and yet
he pursues perseveringly his mad course. This disease of the mind
manifests itself in a variety of ways, among which may be mentioned the
following: 1. An irresistible propensity to steal. 2. An inordinate
propensity to lying. 3. A morbid activity of the sexual propensity. Vide
Erotic Mania. 4. A morbid propensity to commit arson. 5. A morbid
activity of the propensity to destroy. Ray, Med. Jur. ch. 7.
8.
- 2. In general, persons laboring under mania are not responsible nor
bound for their acts like other persons, either in their contracts or
for their crimes, and their wills or testaments are voidable. Vide
Insanity; Moral Insanity. 2 Phiilim. Ecc. R. 69; 1 Hagg. Cons: R. 414; 4
Pick. R. 32; 3 Addams, R. 79; 1 Litt. R. 371.
MANIA A POTU. Insanity arising from the use of spirituous liquors. Vide Delirium Tremens.
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