There is another class of cases in which there is a disposition to melancholy and dejection of the mind without any illusion of the understanding connected with it Surrounded by every comfort, a feeling of gloom and sadness shrouds all their prospects. Then-darkened sky is illumined by no golden ray of hope, nature has no cheering word for them, but crushing, dark despair and melancholy weighs them down.

Sometimes the chilling thought of suicide, steals in upon them, or there arises in their mind a fear that they shall be led to the commission of some great crime. This thought continually gains strength, haunting them whenever alone, hurrying them on with an almost irresistible power, until at length, too often, alas, the fearful deed is consummated.

A propensity to theft is often a distinctive feature of moral insanity, and not unfrequently the sole characteristic of the disease. Cases are on record where persons possessed of wealth, surrounded by every comfort, would steal every thing they could lay their hands on, even articles they could never use, and the use of which they were entirely ignorant. A case is on record where a lady, beautiful, amiable, highly educated and accomplished, surrounded by every luxury, wealth and taste could furnish, the mother of two beautiful children, a devoted husband ready to supply every want, yet would pilfer whenever she had an opportunity, articles too, she could never put to any use. Her husband, devotedly attached to her, reasoned with her upon the guilt of her conduct. With bitter tears she would confess the fault and solemnly promise never to be guilty of the like offence again, and yet the very next hour, if opportunity offered, commit the same offence. She became known throughout the community, and in the stores she was watched on making her appearance, and if after leaving, any little article was missed, a bill was made out, sent to her husband, and immediately paid.

Another form of moral insanity displays itself in an entire want of self-government, in constant excitement, and thoughtless and extravagant conduct. These persons frequently become drunkards, their drunken attacks being followed by periods of raving madness. After the attack has passed off, they will again in a short time indulge in intoxicating drinks, notwithstanding they know the inevitable consequence.

2. Intellectual insanity, or madness attended with hallucinations. When a morbid delusion is impressed on the mind, but little doubt can be entertained of the existence of insanity. There are two entirely different states of disease attended with this symptom. In the one case the understanding, when exercised on most subjects, is comparatively clear, and the morbid impressions only partial; in the other, the disturbance of the intellectual faculties involves all the other operations of the mind. The former is called monomania, the latter, mania.

Monomania

It is very common to see persons perfectly sane on every subject but one, but touch that and you open wide the floodgates of insanity. Some persons are deranged on the subject of religion, and display the utmost bitterness, and indulge in the harshest invective against all who dare to differ from them. Others are deranged on some particular science, or upon some of the great moral and philanthropic questions of the day. It is denounced by some as wild fanaticism. and is in reality a species of insanity, properly classed under the head of monomania.

The patient laboring under this affection, is often gloomy, morose, and excessively melancholy.

Mania

The characteristics of this variety of insanity are too well known to require much description. They may either be highly excitable, raving in violent delirium, or perhaps the insanity may be of a milder kind; they are generally firmly convinced that they have either performed some mighty deeds, that they are some illustrious characters, or troubled with other illusions equally devoid of truth. Thus, one believes he is Jesus Christ, another that he is Jehovah, and another perhaps, that he is Mahomet, or a king.

3. Incoherent madness. - In this form of madness the disease commences with great excitement; the patient is restless, active, and generally sleeps but little. Ideas follow each other in the most astonishing rapidity, but without the slightest connection. Words and sentences are half uttered, and this unmeaning jargon is kept up almost constantly, the patient scarcely allowing himself to eat or sleep. This state of excitement, after having continued for some time, frequently gradually decreases; the patient becomes more quiet, obtains sleep, and may in time become perfectly rational.

Causes - The causes of the various forms of insanity are exceedingly numerous. One fruitful cause is an erroneous and unsuitable method of education. The bad qualities are nurtured and allowed to grow without restraint, until they choke the good, or the good feelings of the heart are warped and bittered, by an iron will and the cold harsh control of narrow and prejudiced minds. But I have already referred to this matter in the chapter on the "Causes of Disease."

Among the other causes of insanity we may enumerate abuse of ardent spirits, blows on the head, and exposure to the heat of the sun; intestinal irritation; irregularity of the uterine functions, not unfrequently produces temporary derangement, especially where the catamenia are suppressed, irregular, or attended with agonizing pain. Insanity of a violent form is sometimes developed in connection with child-bearing.

Of the moral causes of insanity it will be unnecessary for me to speak here. Cases are familiar to all, where disappointments in business, or love, the workings of a troubled conscience, ill-judged religious advice, tending alone to excite fear, have sent the poor victim to the madhouse for life.

All experience shows that civilized man is far more subject to insanity than the savage, and the inhabitants of large cities, as a general thing, than those of the country.

Treatment

The condition of the violently insane now, and half a century ago, is entirely different, then they were treated more like brutes, loaded with chains, scourged, abused in every way, and seldom met with kindness. Now they are treated like human beings, unfortunate it is true, but yet deserving care and kindness.

It will be impossible to detail fully in a work like this, the treatment required in the various forms of insanity, and indeed, it would not be necessary as this disease is one that requires the skill of the physician, of one too who is versed in human nature, and knows how to administer to a mind diseased.

The patient should be surrounded by a proper moral influence, blending firmness with the utmost kindness, and watching the leading traits of character developed, acting accordingly. Mental alienation occasioned by "opressing emotions, such as anger, fear, mortification, or vexation, usually requires: Bell., Hyos., Ign., Phos.-ac., Nux-v., Plat.

When the result of excessive study: Loch., Plat., Stram., or Nux-v., Op., Sulph., Bell., Hyos.

From religious notions attended with melancholy; Lack., Sulph., Verat., Ars., Aur., Bell.

For the delirium of drunkards: Nux-vom., or Op,, or Hell., Hyos., Stram., and Puls. (See also Delirium Tremens).

In Females, from a derangement of the sexual functions: Acon., Bell., Plat., Puls, Stram, and Verat., or Cup., Sec. (See also Diseases of Females.)

Melancholy, of an excessively gloomy character, may require: Ars., Aur., Lach., or Nux.-v.

Melancholy, of a more gentle and placid character, may require: Cocc, Bell., Ign., Hell., Con., Phos..ac, Puls., Sil.

Symptomatic Indications

Belladonna. - Great distress with agitation and inquietude. Frightful visions, fear of death, repugnance to conversation and society; haggard eyes, fixed and furious look, burning thirst, trembling of the limbs, sleeplessness with agitation; or gloomy, tearful humor, with apathy and indifference.

Hyosciamus - Paroxysms of violent delirium, alternating with epileptic fits; sleeplessness with constant talking, great anguish and fear, visions of the dead; jealousy; fury with impulse to kill.

Lachesi

Talkative delirium with rapid change of ideas; suspicion, jealousy or pride, and fear of death; or despondency and great disposition to give way to grief.

Nux-Vom

Anguish and inquietude, with disposition to wander abroad; congestion, bewilderment and heaviness of the head; pressure or fullness in the abdomen and stomach; constipation or watery diarrhoea; sleeplessness with starts.

Opium

Great drowsiness; visions of mice and scorpions, convulsive movements; inability to sleep, notwithstanding there is sleepiness, constipation, congestion of the head, epileptic fits.

Platina

Ravings of past events, with singing, dancing, or weeping; quarrelsomeness; contempt for others, with great self-esteem; increased sexual desire; dread of death and frightful visions.

Stramonium

Dizziness or loss of consciousness, belief that the body is divided into two parts; delirium with frightful visions; religious movements; lascivious ideas, or affected manners; conversation with spirits, ridiculous antics, or wild and ungovernable fury; bloated-ness of the face, with silly expression.

Veratrum

Great anguish and despondency; taciturn with violent oaths on the slightest provocation; loss of consciousness with singing, whistling, and religious mania, lascivious ideas, proud and haughty.

Arsenic

Great anguish; fear of spectres, robbers, solitude, etc. Aversion to conversation; inclination to commit suicide, or dread of death, tearfulness and fear offending.

Cantharis

Violent rage; renewal of paroxysms at the sight of water: excitement of the sexual organs.

Pulsatilla

Stupor, nocturnal delirium, sleeplessness with anguish, or agitated sleep with anxious dreams; great melancholy with weeping; despair of eternal happiness, with constant prayers. Tendency to fear and disposition to hide.

Sulphur

Confusion of the intellect, indifference, apathy, or uneasy about domestic or religious affairs.

( Cuprum - Want of moral energy; imaginary occupations; wildness and redness of the eyes, during the paroxysm, tears, anxiety and disposition to hide.

Administration

Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or a powder, or three globules on the tongue. In violent cases give once in from one to three hours. In cases less violent, or where the symptoms are comparatively mild, or the affection only partial every twelve or twenty-four hours.