MANIA. In Medical Jurisprudence. The most common of all forms of insanity. Con sisting in a condition of exaltation which af fects the emotion and intellect, and which expresses itself by increased activity, men tal and physical. 3 Witth. & Beck.
A chronic affection of the brain, ordinarily without fever, characterized by the perturba tion and exaltation of the sensibilities, the intelligence, and, will. Esquirol.
A condition of exaltation which affects the emotions and the intellect, and expresses it self by increased activity,—mental and phy sical. 3 Witth. & Beck. Med. Jur. 250.
A condition in which the perversion of the understanding embraces all kinds of ob jects and is accompanied with a general men tal excitement. In re Gannon's Will, 2 Misc. 329, 21 N. Y. 'Supp. 960.
It is in one form mere excitement, or this may have developed into the other,—frenzy. It is the reverse of melancholia, and as well developed as the depression of the latter, is the opposite feeling which characterizes the former ; id.
An insanity in which there is general ex altation of the mental, sensory, and motor functions. 1 Clevenger, Med. Jur. of Insan. 953.
Two forms or degrees are usually recognized: Mania with exaltation, and mania with frenzy ; it is the exact opposite of melancholia and shows a rapid succession of ideas, never a fixed idea. Mo nomania') are now classed as physical degenerations and are not considered with mania proper, which is described as a functional neurosis or a disease with out a pathological basis.
Manias, further, may be acute or chronic; in the former, an actual frenzy is the condition; in the latter, some more or less fixed delusion is present, the result of the previous delusional state; there being no attempt, however, in intercourse with an other person, to prove the truth of the delusional belief's.
It would appear to be of easy diagnosia, but the excitement of other forma of insanity is con stantly mistaken for that of simple mania. The beginning is very gradual, and weeks, months, or even years of bad health may precede an outbreak, and the mental exploaion is usually unexpected. Id. The maniac either misapprehends the true rela tions between persons and things, in consequence of which he adopts notions manifestly absurd, and believes in occurrences that never did and never could take place, or his sentiments, affections, and emotions are so perverted that whatever excites their activity is viewed through a distorting me dium, or, which is the most common fact, both these conditions may exist together, in which case their relative share in the disease may differ in such de gree that one or the other may scarcely be perceiv ed at all.
In mania, excepting that form of it called raving, it is not to be understood that the mind is irrational on every topic, but rather that it is the sport of vague and shifting delusions, or, where these are not manifest, has lost all nicety of intellectual discern ment, and the ability to perform any continuous process of thought with its customary steadiness and correctness. It is usually accompanied by feel
ings of estrangement or indifference towards those who at other times were objects of affection and in terest. A common feature of the disease is either more or leas nervous exaltation, manifested by lo quacity, turbulence, and great muscular activity, or depression, indicated by silence, gloom, painful ap prehensions, and thoughts of self-destruction. Mania is usually a growth, rather than a sudden development (though sometimes the latter), and Its incipient stages are characterized by more or less of morbid depression, or, in some cases, irri tability. Then follows a period of restless but un directed and unconcentrated activity. Delusions and hallucinations are common, and may extend to an entire change of personality.
The physical condition, like the mental, indicates early an appearance of vigor with excessive appe tite; and the use of alcoholic stimulants, while not in itself a cause, may hasten the attack, so that in many cases which resemble alcoholic mania it is found that the mental disorder preceded the drink ing. It is said that "there is always, however, finally a failure of nutrition with 'loss of flesh, the tongue becomes coated and the bowels are consti pated. The pulse may be somewhat rapid, but fre quently, even during great excitement, there is little change, it often being slow and small. Insom nia is a marked symptom, days passing without sleep despite the ceaseless activity. There is one peculiarity about this constant activity, in that there seems to be no sense of fatigue accompanying it. There is, in fact, apparently a cerebral anres thesia. This applies also to pain perception, as ex posure to cold does not seem to be recognized, and even painful operations can be carried on without apparent suffering. Acts of self-mutilation, which are especially common where sexual disturbance is associated with the mania, are often done, which are harrowing in the extreme and yet are not ap preciated by the patient." 3 Wittb. & Beck. Med. Jur. 251.
This fork' of mental disorder may be acute with frenzy and raving, in which case there is entire mental confusion and delirium ; or it may be chron ic in which case there is usually some more or less settled delusion with periodic excitability easily aroused and liable quickly to subside. "There is almost always associated with this condition a gen erally happy-go-lucky state of mind. There is in fact more or less dementia (q. v.), the state toward which all cases tend which do not end in recovery." Id. 253.
With respect to the effect of this form of mental disorder, whether general or partial, upon criminal responsibility and civil incapacity, see INSANITY. See DIPSOMANIA; EROTIC MANIA; KLEPTOMANIA; MORPHINOMANIA ; PRYOMANIA ; MONOMANIA.