Mania

In medical jurisprudence. This is the most common of all the forms of recent insanity, and consists of one or both of the following conditions, viz., intellectual aberration, and morbid or affective obliquity. In other words, the maniac^ either misapprehends the true relations ' 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 medium; 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 a degree that one or the other may scarcely be perceived at all. According as the intellectual or moral element prevails, the disease is called "intellectual" or "moral" mania. Whether the former is ever entirely wanting has been stoutly questioned, less from any dearth of facts than from some fancied metaphysical incongruity. The logical consequence of the doubt is that, in the absence of intellectual disturbance, there is really no insanity, — ■ the moral disorders proceeding rather from unbridled passions than any pathological condition. Against all such reasoning it will be sufficient here to oppose the very common fact that in every collection of the insane may be found many who exhibit no intellectual aberration, but in whom moral disorders of the most flagrant kind present a marked contrast to the previous character and habits of life. Both forms of mania may be either general or partial. In the latter, the patient has adopted some notion having a very limited influence upon his mental movements, while outside of that no appearance of impairment or irregularity can be discerned. Pure "monomania," as this form of insanity has been often called, — that is, a mania confined to a certain point, the understanding being perfectly sound in every other respect, of the insane, constituting insane belief, are of two kinds, — "delusions" and "hallucinations." By the former is meant a Arm belief in something impossible, either in the nature of things or in the circumstances of the case, or, if possible, highly improbable, and associated in the mind of the patient with consequences that have to it only a fanciful relation. By "hallucination" is meant an impression supposed by the patient, contrary to all proof or possibility, to have been received through one of the senses. For instance, the belief that one is Jesus Christ or the pope of Rome is a delusion; the belief that one hears voices speaking from the walls of the room, or sees armies contending in the clouds, is a hallucination. The latter implies some morbid activity of the perceptive powers; the former is a mistake of the intellect exclusively.

In Medical Jurisprudence. The most common of all forms of insanity. Consisting in a condition of exaltation which affects the emotion and intellect, and which expresses itself by increased activity, mental and physical. 3 Witth. & Beck. A chronic affection of the brain, ordinarily without fever, characterized by the perturbation and exaltation of the sensibilities, the intelligence, and will. Esqulrol. A condition of exaltation which aifects the emotions and the Intellect, and expresses itself by increased activity, — mental and physical. 3 Witth. & Beck. Med. Jur. 250. A condition in which the perversion of the understanding embraces ail kinds of objects and is accompanied with a genei-al mental excitement. In re Gannon’s Will, 2 Misc. 320, 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 exaltation of the mental, sensory, and motor functions. 1 Clevenger, Med. Jur. of Insan. 953. Two toms 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. Monomanias are now classed as physical degenerations and arc not considered with mania proper, which Is described as a functional neurosis or a disease without 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 another person, to prove the truth of the delusional beliefs. It would appear to be of easy diagnosis, but the excitent of other forms of insanity is constantly 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 explosion is usually unexpected. Id. either 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 medium, 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 degree that one or the other may scarcely be perceived 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 vagije and shifting delusions, or, where these are not manifest, has lost all nicety of intellectual discernment, and the ability to perform any continuous process of thought with its customary steadiness and correctness. It is usually accompanied by feelings of estrangement or indifference towards those who at other times were objects of affection and interest. A common feature of the disease is either more or less nervous exaltation, manifested by loquacity, turbulencd, and great muscular activity, or depression. Indicated by silence, gloom, painful apprehensions, 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, irritability. Then follows a period of restless but undirected and uhconcentrated 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 appetite; 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 drinking. Itv is said that “there is always, however, finally a failure of nutrition with loss of flesh, the tongue becomes coated and the bowels are constipated. The pulse may be somewhat rapid, but frequently, even during great excitement, there is little change, it often being slow and small. Insomnia 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 anaesthesia. This applies also to pain perception, as exposure 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 appreciated by the patient.” 8 Wltth. & Beck. Med. Jur. 251. This form of mental disorder may be acute with frenzy and raving, in which case there is entire mental confusion and delirium; or it may be chronic 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 generally 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, 263. With respect to the effect of this form of mental disorder, whether, general or partial, upon criminal responsibility and civil incapacity, see Insanity. See DipsomaniX; Erotic Mania; Kleptomania; Morphinomania; Pryomania; Monomania.

“Mania is that form of insanity where the mental derangement is accompanied with more or less of excitement. Sometimes the excitement amounts toa fury. The individual in such cases is subject to hal- Jucinations and illusions. He is impressed with the reality of events which have never occurred, and of things which do not exist, and acts more or less in conformity with his belief in these particulars, The mania may be general, and affect all or most of the operations of the mind; or it may be partial, and be confined to particular subjects. Inthe latter case it is generally termed * monomania.’ ” Per Field, J.. 2 Abb. (U. S.) 510.

A form of insanity, consisting, according to the classification of Esquirol, as restated by Hammond, in perversion of the understanding, embracing all kinds of objects, and attended with mental excitement.