(From to rage,) delirium maniacum, paruphrosyne; phrenitis apyreta, heracleius, madness. (See also Melancholia.) This disease receives different appellations, according to its violence, its causes, and attending circumstances. Melancholy is the primary disorder, and madness is supposed, though inaccurately, to be the higher degree.
Madness, in all its species, is a chronical disorder, and has been defined,"the perception of objects not existing, or at least not corresponding to the senses," and is consequently a preternatural state of sensation. Dr. Cullen places it in the class neuroses, and order vesaniae, defining it an universal insanity. This definition is, however, very defective, since the chief term is the object of the definition. That of Sauvages is still more exceptionable, as he confines madness to errors of judgment with fury. Those of Linnaeus, Vogel, and Sagar, either define mania by insania, or confine it to fury and boldness. Dr. Bailie, who styles it false perception, is equally imperfect. It may, perhaps, be more correctly defined an irregular exertion of the mental powers, particularly those of perception and judgment, without fever, often with great violence. Dr. Cullen distinguishes three species; the mania mentalis, when wholly from the affections of the mind; mania corpo-rea, or inanitorum, when evidently from a fault in the body; mania obscura, when not preceded by any evident mental affection or disorder of the body.
These species are, however, incorrect; but a mere nosological disquisition would not have detained us, had not this view of the subject led to erroneous ideas of the disease. Perhaps there is no disorder purely mental. When affections of the mind produce corporeal complaints, they first act by injuring the functions of the body; when the mind also is diseased, bodily changes first appear; and, in the case before us, the most purely mental maniae are found to arise from topical affections of the brain. (See Mens and Mentales.) There is not even a sufficient foundation for distinguishing those species which arise from atonic gout, repelled eruptions, syphilis, &c; for, though originating from bodily causes, they continue like the apparently mental diseases. In short, there is no foundation for the subdivision of species in this complaint; since, like many other reputed genera, it is only itself a species.
The union of mania with melancholy is, we have said, equally inaccurate; for the melancholic mania is a variety only. We shall find melancholy distinguished as a peculiar temperament, marked by languor and inactivity in all the functions; and, while it occasionally rises to insanity, even in its last stage, it is clearly distinguishable from other varieties of mania. The phlegmatic, the sanguine, the bilious, as well as the melancholic temperament, are subject to insanity.
Some authors have unnecessarily varied the species from the circumstances or causes of the disease, almost realizing the axiom of the porch, that all fools are mad; but these are only varieties, and scarcely admit of any difference in the practice.
Dr. Battie, we have said, considers madness to consist in false perception; but this is a partial view; for the perceptions are often correct, but the reasoning or the judgment are defective; yet the perception is more frequently in fault than the reasoning. The mind is all alive, but its exertions are irregular; indeed the mental excitement is so great, that mad persons are often not subject to the effects of cold, nor generally susceptible of the infection of fever. On the contrary, other diseases are cured by madness coming on. We remember to have seen a most inveterate asthma immediately relieved by a maniacal paroxysm, and the asthma returned when the madness lessened. It has been said, on the contrary, that madness is itself removed by the access of an intermittent; but we hesitate in admitting observations made at a time when intermittents were thought highly salutary.
M. Pinel, in a late work on insanity, has hazarded a more singular opinion, viz. that the violence of maniacal paroxysms may be only efforts of nature to relieve some latent disease. Though this idea may be, in some measure, countenanced by the facts mentioned respecting asthma, yet its general absurdity is too striking to require our employing a moment in its refutation. The species of mania, according to this author, are less exceptionable. These are melancholia, or delirium, on one subject exclusively; mania without or with delirium; dementia, or the abolition of the thinking faculty; and idiotism, or the obliteration of the intellectual faculties or affections. The second species only requires a remark. It is defined"a perversion of the active faculties, marked by abstract and sanguinary fury, with a blind propensity to acts of violence, without any sensible change in the intellectual functions." There is, however, some doubt, whether this is properly a species. The instances are, in part, those of violent passions, in support of the axiom ira furor brevis; and, in part, of paroxysms truly delirious. Periodical mania, according to M. Pinel, is only a form of madness, and not a distinct species, classed as a variety of the third.
The false perception, or false reasoning, which distinguishes mania, sometimes pervades every subject, but very frequently one only. Of the latter Don Quixotte affords an admirable specimen, drawn in a style truly interesting and correct, and supported with the precision which the most minute medical observation could not improve. In Le Sage and Smollet we have pictures of the same kind delineated with equal skill, though not equally extended. In general, the subjects on which this kind of insanity is conspicuous, are those less familiar to the patient's general habits of life, and on which he is imperfectly informed. The tradesman is bewildered in his calculations for paying the national debt; and the debauchee in investigating the mysterious ways of Providence, or reconciling the sublime truths of revelation with the shallow views allotted to human reason. As religion is of all subjects the most interesting, and least within the powers of the human mind, it is the most common cause of insanity, and of the most obstinate cases of the disease.