practice is fully, and as it appears to me, very ju diciously delivered. I have never indeed carried the trial so far as seems to be requisite to an entire cure but I have frequently employed in some maniacal cases, large doses of opium; and when they had the effect of inducing sleep, it was manifestly with advantage. At the same time, in some cases, from doubts, whether the disease might not depend upon some organic lesions of the brain, when the opium would be superfluous; and in other cases, from doubts, whether there might not be some inflammatory affection joined with the mania, when the opium would be hurtful, I have never pushed this remedy to the extent that might be necessary to make an entire cure.

1572. Camphire has been recommended as a remedy of mania, and there are instances alleged of its having performed an entire cure. As it appears from the experiments of Beccaria, that this substance is possessed of a sedative and narcotic virtue, these cures are not altogether improbable; but in several trials, and even in large doses, I have found no benefit from it; and excepting those in the Philosophical Transactions, N°. 400, I have hardly met with any other testimonies in its favour.

1573. I have been informed that some maniacs have been cured by being compelled to constant

and even hard labour; and as a forced attention to the conduct of any bodily exercise is a very certain means of diverting the mind from pursuing any train of thought, it is highly probable that such exercise may be useful in many cases of

mania.

I must conclude this subject with observing, that even in several cases of complete mania I have known a cure take place in the course of a journey carried on for some length of time.

1574. These are the remedies which have been chiefly employed in the mania that has been above described, and I believe they have been employed promiscuously, without supposing that the mania was to be distinguished into different species. Indeed I am not ready to say how far it is to be so distinguished, but I shall offer one observation which may possibly merit attention.

It appears to me that there are two different cases of mania that are especially different according to the original temperament of the persons whom the disease affects. It perhaps occurs most frequently in persons of a melancholic or atrabilarian temperament; but it certainly does also often occur in persons of that very opposite temperament which physicians have named the Sanguine. According as the disease happens to occur in persons of the one or other of these temperaments, I apprehend it may be considered as of a different nature; and I

believe, that accurate observation, employed upon a sufficient number of cases, would discern some pretty constant difference, either of the symptoms, or at least of the state of symptoms, in the two cases. I imagine that false imaginations, particular aversions and resentments, are more fixed and steady in the melancholic than in the sanguine; and that somewhat inflammatory is more commonly joined with mania in the sanguine than in the melancholic. If such difference, however, does truly take place, it will be obvious, that it may be proper to make some difference also in the practice. I am of opinion, that in the mania of sanguine persons, blood-letting and other antiphlogistic measures are more proper, and have been more useful, than in the melancholic. I likewise apprehend that cold bathing is more useful in the sanguine than in the melancholic: but I have not had experience enough to ascertain these points with sufficient confidence.

I have only to add this other observation, that maniacs of the sanguine temperament recover more frequently and more entirely than those of the me Jancholic.

CHAP. III.

OF MELANCHOLY, AND OTHER FORMS OF INSANITY.

1575. MELANCHOLY has been commonly considered as partial insanity; and as such it is defined in my Nosology: but I now entertain doubts if this be altogether proper. By a partial insanity, I understand à false and mistaken judgment upon one particular subject, and what relates to it; whilst, on every other subject, the person affected judges as the generality of other men do. Such cases have certainly occurred; but, I believe, few in which the partial insanity is certainly limited. In many cases of general insanity, there is one subject of anger or fear, upon which the false judgment more particularly turns, or which is at least more frequently than any other the prevailing object of delirium and though, from the inconsistency which this principal object of delirium must produce, there is therefore also a great deal of insanity with regard to most other objects; yet this last is in very different degrees, both in different persons, and in the same person at different times. Thus * persons considered as generally insane, will, however, at times, and in some cases, pretty constantly judge properly enough of present circumstances and incidental occurrences; though, when these

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objects engaging attention are not presented, the operations of imagination may readily bring back a general confusion, or recal the particular object of the delirium. From these considerations, I am inclined to conclude, that the limits between general and partial insanity cannot always be so exactly assigned, as to determine when the partial affection is to be considered as giving a peculiar species of disease, different from a more general insanity.

1576. When insanity, neither strictly partial, nor entirely nor constantly general, occurs in persons of a sanguine temperament, and is attended with agreeable, rather than with angry or gloomy emotions, I think such a disease must be considered as different from the mania described above; and also, though partial, must be held as different from the proper Melancholia to be mentioned hereafter.

1577. Such a disease, as different from those described 1554, requires, in my opinion, a different administration of remedies; and it will be proper for me to take particular notice of this here.

Although it may be necessary to restrain such insane persons as we have mentioned (1576) from pursuing the objects of their false imagination or judgment, it will hardly be requisite to employ the same force of restraint that is necessary in the im petuous and angry mania. It will be generally