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Maniacal

mania and patients

MANIACAL mental diseases are accompanied by conditions of great agitation which may arise from various causes. The term " maniacal delirium " is ordinarily used to denote those mental diseases which are the reverse of melancholia, and which are called mania by the alienists. Maniacs are cheerful, lively, and self-conscious ; also restless and unsteady (see Fig. 262). They make themselves conspicuous by quarrelling and mocking, by being garrulous and dissolute, and by being addicted to drunkenness and extravagance. They are intriguing, and they offend the penal, moral. and social codes by their actions. In pronounced cases of mania there is an increased restlessness which degenerates into the uttering of wild yells and insulting remarks. Such patients rave, dance, and jump ; and they rejoice in the wild destruction of property, every vestige of self-respect having disappeared. Patients who suffer from a mild form

of mania are often regarded as unprincipled weaklings on account of their conceit, their witty retorts, and their ungoverned impulses.

Maniacal delirium generally lasts several months. It is usually curable, but is prone to recur (periodical mania), or to alternate with attacks of melancholia in periods lasting weeks or months (manic-depressive insanity). Mention may be made of the supernatural physical strength which these patients, and mentally deranged persons in general, are supposed to possess. Such persons are not physically stronger than persons of normal mentality ; hut their total disregard of others, and the absence of fatigue, simulates an abnormal muscular power. It is indeed a remarkable fact that some maniacs can remain in a state of constant excitement for weeks and months, day and night.