CHAPTER VI. ON MADNESS
THE modes of mania are infinite in species, but one alone in
genus. For it is altogether a chronic derangement of the
mind, without fever. For if fever at any time should come
on, it would not owe its peculiarity to the mania, but to some
other incident. Thus wine inflames to delirium in drunkenness;
and certain edibles, such as mandragora and hyoscyamus,
induce madness: but these affections are never called mania;
for, springing from a temporary cause, they quickly subside,
but madness has something confirmed in it. To this mania
there is no resemblance in the dotage which is the calamity of
old age, for it is a torpor of the senses, and a stupefaction of
the gnostic and intellectual faculties by coldness of the system.
But mania is something hot and dry in cause, and tumultuous
in its acts. And, indeed, dotage commencing with old age
never intermits, but accompanies the patient until death;
while mania intermits, and with care ceases altogether. And
there may be an imperfect intermission, if it take place in
mania when the evil is not thoroughly cured by medicine, or
is connected with the temperature of the season. For in certain
persons who seemed to be freed from the complaint, either
the season of spring, or some error in diet, or some incidental
heat of passion, has brought on a relapse.
Those prone to the disease, are such as are naturally passionate,
irritable, of active habits, of an easy disposition, joyous,
puerile; likewise those whose disposition inclines to the opposite
condition, namely, such as are sluggish, sorrowful, slow
to learn, but patient in labour, and who when they learn
anything, soon forget it; those likewise are more prone to
melancholy, who have formerly been in a mad condition. But
in those periods of life with which much heat and blood are
associated, persons are most given to mania, namely, those
about puberty, young men, and such as possess general
vigour. But those in whom the heat is enkindled by black
bile, and whose form of constitution is inclined to dryness,
most readily pass into a state of melancholy. The diet which
disposes to it is associated with voracity, immoderate repletion,
drunkenness, lechery, venereal desires. Women also sometimes
become affected with mania from want of purgation of the
system, when the uterus has attained the development of
manhood; but the others do not readily fall into mania, yet,
if they do, their cases are difficult to manage. These are the
causes; and they stir up the disease also, if from any cause
an accustomed evacuation of blood, or of bile, or of sweating
be stopped.
And they with whose madness joy is associated, laugh, play,
dance night and day, and sometimes go openly to the market
crowned, as if victors in some contest of skill; this form is
inoffensive to those around. Others have madness attended
with anger; and these sometimes rend their clothes and kill
their keepers, and lay violent hands upon themselves. This
miserable form of disease is not unattended with danger to
those around. But the modes are infinite in those who are
ingenious and docile,--untaught astronomy, spontaneous philosophy,
poetry truly from the muses; for docility has its good
advantages even in diseases. In the uneducated, the common
employments are the carrying of loads, and working at clay,--they
are artificers or masons. They are also given to extraordinary
phantasies; for one is afraid of the fall of the oilcruets
..... and another will not drink, as fancying himself
a brick, and fearing lest he should be dissolved by the liquid.
This story also is told:--A certain joiner was a skilful
artisan while in the house, would measure, chop, plane, mortice,
and adjust wood, and finish the work of the house correctly;
would associate with the workmen, make a bargain with them,
and remunerate their work with suitable pay. While on the
spot where the work was performed, he thus possessed his
understanding. But if at any time he went away to the
market, the bath, or on any other engagement, having laid
down his tools, he would first groan, then
shrug his shoulders
as he went out. But when he had got out of sight of the domestics,
or of the work and the place where it was performed,
he became completely mad; yet if he returned speedily he recovered
his reason again; such a bond of connection was there
between the locality and his understanding.
The cause of the disease is seated in the head and hypochondriac
region, sometimes commencing in both together, and the
one imparting it to the other. In mania and melancholy,
the main cause is seated in the bowels, as in phrenitis it is
mostly seated in the head and the senses. For in these the
senses are perverted, so that they see things not present as if
they were present, and objects which do not appear to others,
manifest themselves to them; whereas persons who are mad
see only as others see, but do not form a correct judgment
on what they have seen.
If, therefore, the illness be great, they are of a changeable temper,
their senses are acute, they are suspicious, irritable without
any cause, and unreasonably desponding when the disease
tends to gloom; but when to cheerfulness, they are in excellent
spirits; yet they are unusually given to insomnolency; both are
changeable in countenance, have headache, or else heaviness
of the head; they are sharp in hearing, but very slow in
judgment; for in certain cases there are noises of the ears,
and ringings like those of trumpets and pipes. But if the
disease go on to increase, they are flatulent, affected with
nausea, voracious and greedy in taking food, for they are
watchful, and watchfulness induces gluttony. Yet they are
not emaciated like persons in disease (
embonpoint is rather
the condition of melancholics) and they are somewhat pale.
But if any of the viscera get into a state of inflammation, it
blunts the appetite and digestion; the eyes are hollow, and do
not wink; before the eyes are images of an azure or dark colour
in those who are turning to melancholy, but of a redder
colour when they are turning to mania, along with purplecoloured
phantasmata, in many cases as if of flashing fire;
and terror seizes them as if from a thunderbolt. In other
cases the eyes are red and blood-shot.
At the height of the disease they have impure dreams, and
irresistible desire of venery, without any shame and restraint
as to sexual intercourse; and if roused to anger by admonition
or restraint, they become wholly mad. Wherefore they are
affected with madness in various shapes; some run along
unrestrainedly, and, not knowing how, return again to the
same spot; some, after a long time, come back to their relatives;
others roar aloud, bewailing themselves as if they had experienced
robbery or violence. Some flee the haunts of men,
and going to the wilderness, live by themselves.
If they should attain any relaxation of the evil, they become
torpid, dull, sorrowful; for having come to a knowledge of
the disease they are saddened with their own calamity.
ANOTHER SPECIES OF MANIA.
Some cut their limbs in a holy phantasy, as if thereby propitiating
peculiar divinities. This is a madness of the apprehension
solely; for in other respects they are sane. They are
roused by the flute, and mirth, or by drinking, or by the
admonition of those around them. This madness is of divine
origin, and if they recover from the madness, they are cheerful
and free of care, as if initiated to the god; but yet they
are pale and attenuated, and long remain weak from the pains
of the wounds.
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