In this form of mental disease nearly all the mental faculties are generally affected. The patient suffers with illusions, hallucinations, and delusions. The controlling influence of the will over the mental faculties is lost. The patient is subject to impulses of various kinds. The mind may be either morbidly excited and exalted, or in the opposite condition. The disease generally begins with depression and a disposition to be alone, sleeplessness, symptoms of dyspepsia, and of other derangements of health. The patient complains of pain and fullness of the head, confusion of thought, and the usual symptoms of congestion of the brain. He also manifests irritability of temper and such peculiarities of behavior as are likely to attract the attention of friends, and arouse a suspicion that something is wrong with him. As the disorder becomes fully developed, mental disturbances make their appearance, and may assume almost any form, from simply harmless delusions or hallucinations to an uncontrollable disposition to commit violence upon himself or upon his attendants. There is generally a marked change in disposition. The patient will frequently hate, with great intensity, persons and things for which he has entertained great fondness. A mother will conceive a desire to kill her child, a husband to take the life of his wife. More often, however, the disposition to violence is turned upon the individual himself, as in suicidal mania. A person suffering with acute mania has a frequent, feeble pulse, and sometimes some fever. Speech is noisy and incoherent; he will often refuse to eat or drink, making it necessary, in many cases, to employ force in order to prevent starvation. Mania may become chronic, though it has a general tendency to recovery. Finally the most active symptoms subside, some settled delusion taking possession of the patient. When recovery takes place, it is generally within a year and a half or two years. The longer the disease continues after two years, the less the likelihood of recovery. When the disease continues for a long time, there is generally a gradual loss of intelligence which finally results in dementia or imbecility.


This is one of the most terrible forms of mental disease. Like mania, it is preceded by premonitory symptoms which are essentially the same as those given for the disease just described. Patients suffer with many of the symptoms of mania, but, as a general rule, there is less activity. The state of depression continues. The patient seldom develops violent symptoms; he is usually passive and easily controlled, but is haunted continually by hallucinations and illusions, often of the most terrible character. Melancholia, when attended by paralysis or imbecility, is an almost hopeless disease. It usually terminates in dementia.


This is a condition toward which all forms of insanity tend. There is a general loss of intelligence, or failure of all the mental powers. When confirmed, it is an entirely hopeless condition.