Innumerable are the causes which may induce this most dreadful of human maladies ; but there is one materialcircumstance,w hich, independently of the mental state, always occurs, and evidently operates in all melancholic patients ; namely, an accumulation of impurities in the alimentary canal, consisting chiefly of black bile. Hence originate, want of appetite; a disturbed sleep 3 obstructions of the intestines 5 hemorrhoidal and gouty symptoms ; irregular circulation of the blood; dulness and gloom of mind, without any apparent cause; at length, stupefaction and insensibility, terminating in madness.—. Indeed, the melancholic and hypochondriac are so nearly allied, that it is not always easy to discriminate between the two diseases ; a distinction which is the more important, as the proper method of curing the former would inevitably be attended with fatal effects to the latter : hence we shall point out the essential difference subsisting between them. In hypochondriac persons, the nerves are primarily affected, and contribute to generate all those spasmodic and other concomitant symptoms which disorder the organs of the lower belly : whereas, in the melancholic,there already exists in the same organs a material and local cause that produces similar effects, of which the nervous system of the hypochondriac partakes only so far as he is susceptible of such impressions, in the debilitated state of his mind.
Cure.—If the patient be young, robust, and of a full habit, bloodletting will first be necessary. Next, he ought to take resolvent emetics and purgatives, consisting of neutral salts, especially tartarized kali, in doses of from two to three drams every morning and evening, for several day s.—Acidulated drinks, and a vegetable diet, will be of essential service, if combined with exercise and cheerful company. Among the most proper articles of the table are, ripe fruit in a fresh or dried state, honey, bulbous roots, salad, and well baked bread; but animal food should be carefully avoided. For common drink, the patient may use sweet whey, decoctions of barley acidulated with mead-vinegar, or cur-.
raut fant-jelly ; infusions of tamarinds or rennets, etc. On the contrary, tart wines and spirituous liquors or mixtures of every description, especially punch, always aggravate the complaint.—When habitual cos-tiveness prevails, Grant recommends the following draughts, which are grateful and efficacious, without debilitating the stomach or bowels : Take one' ounce of manna ; half an ounce of tartarized kali; eight blanched sweet-almonds; end six ounces of rose-water; let the whole be duly incorporated in a mortar, and a tea-cupful be taken every hour, till it operates. After the desired effect is produced, a glass of good old wine, and nutritive mucilaginous food, may be.safely allowed.
By a strict adherence to this regimen, there is reason to hope for a complete cure, in three months. If, however, the patient be intractable, and averse to adopt any regular plan (as is too frequently the case in this complaint), he should be prevailed upon to travel ; to .drink purgative mineral waters ; to use the cold bath ; to have his head shaved, for the purpose of applying a sponge or cloths dipped in cold water; and to receive gentle electric shocks, directed from a wooden point through the region of the lower belly. On the whole, experience has evinced, that cold bathing is most conducive to the recovery of hypochondriacs, while the tepid bath best agrees with maniacs.
Lastly, it is remarkable, that the - .propensity to suicide is, strictly speaking, a characteristic symptom of black melancholy; the principal seat of which appears to be in the nervous texture of the spleen, and the. left arch of the colon. Many writers consider this dreadful complaint to be peculiar to the English; as it more rarelyoccurs among other nations of Europe. It is farther worthy of notice, that such gloomy disposition of mind, not unlike the true mania, generally manifests itself itself at certain changes in the atmosphere; for instance, when southern winds prevail, and the barometer sinks till near the mark which indicates storm:—then the fatal crisis either takes place in nine days, or the patient overcomes the attack, which terminates in calm, placid, melancholy, or a stupid in-.sensibility.— On such occasions, profuse draughts of cold and pure spring water; a strong, well-fitted waistcoat; and a blister, applied to the region of the spleen, will be the most appropriate remedies. If the left side, under the short ribs, should be perceptibly warmer to the touch than the opposite side, the blister ought to be nine inches long and six inches broad, in order to cover exactly the left hypochon-driac region, where the spleen is situated. Unexpected relief has often been thus obtained; and the cure has been promoted by light, though nutritive food, exercise, diversions, music, etc.