Hoffman, with great propriety, contends, that hypochondriasis is not the same disease as hysteria. He observes, that a strangulation of the fauces, a quick and difficult respiration, endangering suffocation, loss of speech and motion, are the proper and essential symptoms of the hysteria: that the hypochondriasis is inveterate, and rarely so effectually relieved as not to be again easily excited; that though many of their symptoms arc the same, yet they each have such as is essential to it Many others comprehend these two disorders under the general title nervous; and think that they only differ as affecting different sexes, or by the flatulence of the stomach, which distinguishes hysteria. Dr. Cullen places hypochondriasis in the class neuroses, and order adynamia; and defines it indigestion, with langotir, sadness, and fear, from uncertain causes, in a melancholic temperament. One idiopathic species is only known. The slate of mind peculiar to hypochondriacs is thus described by Dr. Cullen."a languor, listlessness, or want of resolution and activity, with respect to all undertakings; a disposition to seriousness, sadness, and timidity; as to all future events, an apprehension of the worst or most unhappy state of them; and, therefore, often upon slight grounds an apprehension of great evil. Such persons are particularly attentive to the state of their own health, to every the smallest change of feeling in their bodies; and from any unusual sensation, perhaps of the slightest kind, they apprehend great danger, and even death itself. In respect to these feelings and fears, there is commonly the most obstinate belief and persuasion." He adds, that it is only when the state of mind just described is joined with indigestion, in either sex, somewhat advanced in years, of a melancholic temperament, and a firm and rigid habit, that the disease takes the name of hypochondriac. The seat of the hypochondriac passion is in the stomach and bowels; for, first, these parts are disordered, then the others suffer from the connection. In this Hoffman agrees, by saying the peristaltic motion in the bowels is retarded by spasms.

The causes are, sorrow, fear, or excess of any of the passions; too long continued watching; irregular diet. Those habitually disposed to it - and these causes have little effect in other constitutions - have generally a sallow or brown complexion, and a downcast look, a rigidity of the solids, and torpor of the nervous system. Whatever may occasion nervous disorders, in general, may be the cause of this in particular.

The signs of this complaint are so various, that to describe them is to describe almost every other disease; but in general there is an insurmountable indolence, dejected spirits, dread of death, costiveness, a slow and somewhat difficult inspiration, flatulencies in the primae viae, and various spasmodic affection. It is seldom fatal; but if neglected, or improperly treated, may bring on melancholy, jaundice, madness, or vertigo, palsy, and apoplexy.

The hypochondriac disease is very difficult to cure: it rarely occurs early in life, generally in more advanced years only; and when once it has taken place, it increases as life advances. Indigestion, accompanied with vapours, distinguishes the disease when the temperament is of this peculiar kind.

If the disease admits of a cure, it is by means slow and steady in their operation; for the whole constitution must be corrected before any expectation of relief can be obtained. In these cases the mind must be cheered by every pleasing prospect; by assurances of a cure; by change of place and objects; by engaging it in any employment which will interest without fatiguing. For these purposes the fashionable mineral waters may be drunk on the spot, and they should be of the mildly cathartic kind, as those of Cheltenham, Seltzer, or Tunbridge; but the cathartic waters are, on the whole, preferable to those which contain steel among their impregnations, though this medicine is not particularly injurious.

If these plants cannot be admitted, an active emetic should be given, and repeated every three or four days; a small blister applied to the neck; and the bowels kept freely loose by the pillulae ex aloe cum myrrha, or the tinctura aloes. Dr. Cullen observes, that in the hypochondriasis there is a want of activity, not a loss of lone, in the fibres, but, on the contrary, a rigidity in them; and he recommends warm bathing; drinking tea and coffee; exercise, not merely to excite the activity of the stomach, but to divert the mind from its despondency.

Astringents are generally improper. As there is usually an acid in the stomach, bitters may be given with the alkaline salts and rhubarb: but chalybeates are of more uncertain efficacy; and bark, in general, is injurious; though, when attended with flatulence, aro-matics may be sometimes allowed.

In managing the minds of hypochondriacs, any intimation that their complaints are imaginary, must be avoided, and neither raillery nor reasoning in addressing them employed. Their attention should be engaged with any object but their own feelings; diverted with any employment not attended with emotion, anxiety, or fatigue. Diversion, in which some skill is required; exercise in the air, which requires some dexterity, are both to be admitted: riding is better than either walking, sailing, or travelling in a carriage; and a distant journey is the best. The study of botany, which combines exercise with employment, has been highly salutary.

If pain and flatulence, accompanied with an head-ach, attend, a slight anodyne may be admitted; and if spasmodic symptoms are considerable, tending to convulsions, relief may be obtained by means of opiates, joined with fetid gums, or with musk.

Warm bathing in pure water, heated sufficiently to raise Fahrenheit's thermometer to ninety or ninety-two, should be continued until some relief is obtained, and then gradually the cold bath may be substituted. Cheerful company conduces much to relief; but boisterous mirth, or any exercise carried so far as to fatigue, are injurious. A dry warm air is almost universally proper. See Nervous diseases; Hoffman on the Morbus Hypochondriacus; Cullen's First Lines, vol. iii. edit. 4.