Abstract
Morbid mental exaltation and excitement, differing
in degree and nature, are phenomena of so frequent
occurrence among the insane, and present so many problems for solution as to their causation, prevention and
treatment, that I have been induced to offer the
following statements and observations regarding them in
the form of a Thesis.
In the course of my experience as an Assistant-
Physician, first in the Royal Edinburgh Asylum and
latterly in the Royal Aberdeen Asylum, a very large
number of cases, occurring in both sexes, have come
under my care, in which maniacal excitement has been a
prominent feature. Such cases present many difficulties, not only to the Asylum physician, but also to the
general practitioner whose patients they may have been
before their admission to the Asylum, and also, but
much less frequently, to the lawyer, whose intervention
may be called for on account of conduct by the patient
that brings him within the arm of the Law.
The treatment of maniacal excitement, in its acute
or delirious, impulsive, and chronic or recurrent forms,
is one of the most difficult problems in asylum medical
work. My experience so far seems to teach me that it
is futile to lay down any hard and fast rule as to the
treatment of any one form of mania. In the treatment
of mental disease, even more so than in the general
practice of medicine, it is of the utmost importance to
treat the individual as well as the form of disease from
which he suffers .
Much uncertainty and difference of opinion exist at
present among alienists as to the precise meaning to be
attached to many of the terms employed in the description and classification of mental diseases. The term
mania itself has been a frequent and hitter hone of
contention. On the one hand, its meaning has been so
extended by some as to include almost any form of mental
disturbance exhibiting excitement or exaltation: on the
other, so restricted, that other authorities state that
mania is the rarest form of mental disease.
