y, is generally
untrue; that is, the object is a mistaken fact. As when a patient is
persuaded he has the itch, or venereal disease, of which he has no symptom,
and becomes mad from the pain this idea occasions. So that the object of
madness is generally a delirious idea, and thence cannot be conquered by
reason; because it continues to be excited by painful sensation, which is a
stronger stimulus than volition. Most frequently pain of body is the cause
of convulsion, which is often however exchanged for madness; and a painful
delirious idea is most frequently the cause of madness originally, but
sometimes of convulsion. Thus I have seen a young lady become convulsed
from a fright, and die in a few days; and a temporary madness frequently
terminates the paroxysms of the epilepsia dolorifica, and an insanity of
greater permanence is frequently induced by the pains or bruises of
parturition.

Where the patient is debilitated a quick pulse sometimes attends insane
people, which is nevertheless generally only a symptom of the debility,
owing to the too great expenditure of sensorial power; or of the paucity of
its production, as in inirritative, or in sensitive inirritated fever. See
III. 1. 1.

But nevertheless where the quick pulse is permanent, it shews the presence
of fever; and as the madness then generally arises from the disagreeable
sensations attending the fever, it is so far a good symptom; because when
the fever is cured, or ceases spontaneously, the insanity most frequently
vanishes at the same time.

The stimulus of so much volition supports insane people under variety of
hardships, and contributes to the cure of diseases from debility, as
sometimes occurs towards the end of fevers. See Sect. XXXIV. 2. 5. And, on
the same account, they bear large doses of medicines to procure any
operation on them; as emetics, and cathartics, which, before they produce
their effect in inverting the motions of the stomach in vomiting, or of the
absorbents of the bowels in purging, must first weaken the natural actions
of those organs, as shewn in Sect. XXXV. 1. 3.

From these considerations it appears, that the indications of cure must
consist in removing the cause of the pain, whether it arises from a
delirious idea, or from a real fact, or from bodily disease; or secondly,
if this cannot be done, by relieving the pain in consequence of such idea
or disease. The first is sometimes effected by presenting frequently in a
day