Though we may declaim,"what a wonderful piece of work is man !" yet, when we view him in this state, where his boasted reason, instead of assisting, misleads him; when we see him exposed to elemental war, insensible of cold, of the comforts of cleanliness, of the dictates of religion, of even common decency; when we hear him uttering blasphemous execrations, employing the grossest and most obscene language, language abhorred in the lucid moments, when recollection often adds to the horrors of his situation, we may truly exclaim, "Alas, poor humanity !"

We have sketched only the outline of the picture, the discriminating features of the object. To fill it would require a volume; for, so various, so singular, and so numerous are the eccentricities, when judgment no longer guides, that it is impossible to detail them. In the general conduct of the human mind, when the balance of judgment or of authority is wanting, the wildest absurdities are equally the consequence; and, within the pale of reason, we observe conduct which almost realizes the stoical maxim already alluded to.

Mania often remits, and at times recurs periodically. It has been found to return at the full and new moon, or, at least, to be exasperated at those seasons. Mania is, however, always considered as varied by lucid intervals, and in a certain degree is so; but this seems rather a salutary fiction of the law (see Medicina fo-hensis) than the result of medical observation. The violence of the maniacal patient, indeed, often remits, and is exasperated.

We know no peculiar constitution predisposed to mania except the melancholic. A tendency to the sanguine variety of this disease is shown by a flighty, irregular, and variable conduct, rising to exuberant spirits from the lowest depression, and again sinking, from the former, into grief and despondency.; to the melancholic, by a fixed attention to one object, from deep thought, never alternating with cheerfulness, and seldom varying its views. The idiotic frenzy appears from a generally variable, trifling temper, with little reflection, and less judgment. This kind is, however, unfrequent; nor would we condemn every trifling male or female because they are such. Our receptacles must, in that case, be particularly numerous and roomy.

A very frequent corporeal remote cause is gout; either not brought out, repelled, or not properly supported. Repelled eruptions, or a check of any usual discharge, are by no means uncommon causes. Mania sometimes attends each succeeding pregnancy, and, in turn, the melancholia lactantium, as we have said, is cured by pregnancy. An asthmatic fit has, on its recession, been succeeded by madness; and a maniacal paroxysm has, in turn, yielded to a spasmodic asthma. The mind is intimately connected, as we have seen, with the genital system; and the denial of those enjoyments which nature claims, is a frequent cause, though an unsuspected one, of mania; in men chiefly of the melancholic, in women of the sanguine, kind.

Among the mental, remote, causes, or rather the causes originating from mind, we may mention disappointment, grief, hope long delayed, or destroyed by unexpected reverses, wild extravagant joy from unexpected prosperity. These produce the corporeal changes, which often induce madness.

Mania is undoubtedly constitutional, and propagated from parents to children, sometimes leaving one whole generation unaffected, and appearing again in the next. It is apparently propagated with the form, the features, and complexion, like scrofula; nor is this the only argument in favour of its being a truly corporeal, organic affection.

The most striking and constant corporeal change in mania, is fulness of the vessels of the brain; and, though this is less apparent in the wandering, idiotic mania, it very frequently exists. In that wandering, which arises from weakness and inanition, no such fulness occurs; but this cannot be called mania, and in those temporary derangements of intellect, which arise from deleterious substances taken into the stomach, it is equally absent. These, also, our definition excludes. Yet, when even these are separated from our view, it would be rash to assert that a distention of the vessels of the brain is constantly found in mania.

Dissection certainly discovers such distentions in a great variety of instances; but we are informed also, that sometimes a preternatural dryness and hardness of the medullary part, sometimes an undue softness, is found in the contents of the cranium. More frequently tumours, sometimes abscesses at the base of the cerebrum, sometimes exostoses from the cranium, are discovered, though the last are more commonly the cause of convulsive paroxysms. The leading symptoms of mania are inconsistency and a disturbance of the usual associations, and these necessarily arise from a want of communication between its different parts, or an irregular distribution of the nervous power. The want of communication may arise from mechanical obstruction, from a destruction of the organization of some part of the brain, perhaps from a change in the qualities of what we have styled the nervous fluid. The irregular distribution may be owing to increased excitement of one portion of the medullary substance, or to the diminished power of another. Dissections countenance all these opinions; but unfortunately we have few cases in which the symptoms are connected with the appearances on dissection, so as to explain the influence of the organic changes in different circumstances. In general, we know that the medullary substance, in cases of idiotic insanity, is usually soft and watery; in melancholic cases, hard and dry; while in the wild, furious mania, some active irritating power is generally discoverable. Abscesses at the basis of the brain are usually attended with a low muttering delirium.

The form of the cranium has been supposed a cause of mania, and it has engaged much of the attention of Pinel. He finds, however, no very striking connection between its form and maniacal affections, except in idiots, where the upper part of the head is shortened, the sides flattened, and the whole cranium elongated. In general, the most distinguishing marks of the skulls of maniacs are a flatness of the temporal bones, and a retracted occiput. A thickness of the skull is sometimes found on the dissection of maniacs; but this is by no means a peculiar or a constant attendant. Pinel seems not to have observed the softness or dryness of the medullary portion of the brain, mentioned by other authors. In his dissections, the fulness of the vessels appears to have chiefly attracted his notice.