Tice predisposition to mania is marked by peculiar sen sibility, accompanied with a diapusition in the person to conceal the manner in which he is affected; and sometimes by absence of mind. A determination to the head, which predisposes to apoplexy, is also a predisposing cause of mania, and probably terminates in the one disease or in tii.e other, according to the conjoined operation of other causes. The same thing may be said of that tendency to inflamma tion in the brain, which is the predisposing cause of phreni tis. Madness is well known to be sometimes occasioned by organic injuries in the head.
Excessive sensuality, and intemperance in the use of intoxicating liquors, or other narcotics, are frequent causes of this disease. Their immediate operation is, to produce a temporary state nearly allied to it ; and, where this is fre quently repeated, the tendency becomes at last livened in the system. The suppression of various secretions is numbered among the causes of mania, as obstructions of the menses, checks given to the perspiration, and the dry ing up of a long continued discharge from scrophulous sores. That disturbance of all the functions which is inci dent to the puerperal state, is a very frequent cause of ma nia. When we consider the extreme delicacy of many fe males in the higher and middling rank of society, we can not be surprised at any effect that follows the shock which all their sensations must sustain in childbirth.
One question has been agitated as of the greatest im portance ; whether the disease is ever strictly mental, or is always dependent on faults or peculiarities or injuries of organization? The degree of importance attached to this question is in some measure to be regulated by the meaning which we attach to terms. It is evident that it might be so managed as to involve the whole doctrines which relate to the nature of matter and of mind, and might thus lead us into the most unsatisfactory regions of meta physical discussion. This must be avoided when we are in quest of real information. In so far as the question is practical y useful, it may be resolved into this, Whether is insanity. supervening from the application of a mental cause, without any apparent bodily defect or ailment, al ways the effect of this cause only, or in conjunction with some fixed and very particular predisposition in the organs by which the powers of the mind operate ? We do not adopt the latter part of this alternative. We grant, in deed. that insanity owes its origin to certain relaticns which the external cause has with the state of the subject operated on. But we contend that the predisposition is most commonly founded in a delicacy which is very gene ral ; that the increase of this delicacy in any individual is chiefly owing to a series of external impres sions, and that even the organic peculiarities which the most strongly marked are the consequences of such im pressions, either communicated to the individual or to his progenitors. This susceptibility, which in one nation pro duces insanity, may, in another, appear to be absent, from being operated on in such a form as prevents variety of mental exercise, and renders the individual entirely the creature of a limited set of habits; and it is questiona ble, whether any abrupt attempts to change the habits of individual ndividual thus situated would not readily induce in sanity. They would certainly occasion unhappiness, or
probably death. If insanity were not the effect, lie would probably owe this exemption to the want of that sort of mental employment which exists in those tlibes among which that malady is common. Very few persons, per haps none, are exempt from the symptoms of madness during particular moments of their lives. Dreaming is a state of madness. Reverie, or vague musing, is nearly al lied to it. The irregularity and imbecility of thought so often experienced while a person disposes himself for sleep is a state which every one understands, and whi .1), if it were perpetual, would constitute madness. The univer sal liableness of mankind to this state shows that the weak nesses which lead to madness may be regarded as radi cally universal, and that external circumstances operat ing on the senses and intellectual powers, and through these on the material organs which lie hid from our view, are by far the most efficient causes of the appearance of this malady.
The mental causes which evidently occasion madness are, restless ambition, jealous love, and frequent or severe disappointments. Harassing changes are well known to be unfavourable to soundness of mind. It has been said that a sudden change of fortune from low to high has occa sioned madness more frequently than a change from high to low. This was remarked in the mental effects of the celebrated mercantile speculation called the South Sea scheme, which gave occasion to numerous sudden changes of both kinds. Reverses of fortune are particularly apt to affect persons destitute of all taste for rational occupation, to whom wealth and its attendant honours form the whole interest of existence. The dreadful reverses which took place in France in the course of the revolution, formed a fruitful source of madness ; some interesting cases of this sort are described in the treatise of The effect of affronts is often to produce mania in per sons acutely senaibie to the treatment which they receive from others. Some have been suddenly seized with this disease, in its most dreadful form, immediately after being made the objects of a torrent of ridicule from their compa nions. This effect often follows a long course of ill treat ment in those natives of the East who live in the service of harsh masters They bear it long with seeming patience, but at last they ate suddenly infuriated to such an exit cote de gree, aS to lay hold of a murderous weapon, with which they perpetrate as many outrages as they can, with the certain prospect of terminating their caret]. by an immediate vio lent death. This is commonly called " running a muck." A person seen in such a state unfortunately excites no commiseration, but is pursued and dispatched as speedily as possihle.