ERRORS OF THE AFFECTIONS.

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ERRORS OF THE AFFECTIONS AND PASSIONS.

With regard to the state of the affections and inclinations, it may be observed, that a change in the former very frequently ushers in the disease; for instance, an affectionate mother will repulse or abandon her infant,-a kind husband forsake his wife, or a dutiful child abuse his parent. Former love and affection are, without assignable motive, converted into hatred, indifference, or jealousy.

The inclinations and propensities are, in like manner, changed; and disgust of society, of occupation, and of former pleasures, takes place. So long as these altered inclinations continue, an apparent cure is not to be depended on; notwithstanding there may be every other appearance of restored reason.

The appetites, and the passions dependent on them, may become ungovernable, being no longer kept in subjection by a sense of propriety, or of right and wrong; and they frequently modify the character of the delirium. Thus, violent desire of sexual intercourse may produce the variety of partial insanity termed Erotomania; and sometimes the extreme degree of this state produces Satyriasis, and Nymphomania. The passion of pride raises the

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ERRORS OF PASSIONS.

madman to an imaginary throne,-that of ambition makes him a conqueror,—while that of vanity makes a queen. The passion of joy, grief, fear, and other powerful emotions, have corresponding effects in inducing varieties of partial insanity, to be afterwards more fully considered.

CHAPTER VII.

PHYSICAL SYMPTOMS AND DIAGNOSIS.

SECTION I.

SYMPTOMS.

I shall now proceed to consider the other symptoms generally occurring in the insane state, in addition to the disorder of the intellectual faculties, which I have endeavoured to describe in the preceding pages; and the first of these I shall notice, is

WANT OF SLEEP.

This is a very striking symptom of the insane state. Those who are in a state of Dementia or Idiocy, are

not generally affected by this symptom; but in those who labour under Mania, or Monomania, the sleep is almost always much disturbed, and sometimes totally lost for weeks together.

It frequently accompanies the disease from the commencement, and is particularly distressing in the incipient stage. It also, for the most part, continues during the active stage of the disorder; and may not cease, until its termination in convalescence, or in Dementia; so that madmen have been for months, or years, with scarcely an interval of rest or sleep. Their minds, however, appear to be in a passive state, so that ideas pass through them without exertion, whilst it lasts, and hence, probably, the capability of the mind enduring such a protracted state of waking.

There may be other causes, which, together with the diseased action in the brain, contribute in some measure to produce this state of continual wakefulness; such as the agitation of the patient himself; the nature of his delusions; pains, or uneasy sensations in the head; and lastly, (where numbers are kept together) the noise and cries of other patients.

As already observed, some cannot fall asleep at all; others, when they do slumber, are very frequently troubled with frightful dreams.

The cessation of this state of disturbed sleep, with an abatement of delirium, is, in general, a sign of convalescence. But the return of quiet sleep, without a corresponding abatement of delirium, is by

AFFECTIONS OF THE HEAD.

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no means so favorable, since it not unfrequently denotes a termination in Dementia. And, again, if wakefulness continue, notwithstanding an evident amendment in other respects, or if during convalescence, it returns, we may conclude that the patient is not progressing favorably, and that a relapse is to be apprehended.

Persons who feign insanity, are unable to simulate this symptom for any length of time.

AFFECTIONS OF THE HEAD.

Another assemblage of symptoms, occurring in the insane state, are certain affections of the head. In some cases, deep seated pain is complained of for months, before the occurrence of delirium. As the disorder increases, and the stage of excitement prevails, this pain is less complained of, although great heat about the head, and the activity of the circulation, indicate, that the causes from which it originated, have not diminished in intensity. As convalesence takes place, this symptom of headache abates. When it remains after the diminution of the other symptoms, therefore, it must be regarded as very unfavorable.

A sense of tightness, as if the head were encircled with a cord, is not unusual; a deep seated pain, with throbbing, and a sense of fulness, increased by rapid

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