INCIPIENT MELANCHOLIA.

New Zealand Graphic, Volume XX, Issue XVI, 16 April 1898, Page 494

INCIPIENT MELANCHOLIA.

Melancholia is a grave disease, especially because of its strange anil terrible tendency to induce suicide and homicide. As the patient’s reasoning processes seem to lie perfectly clear, friends are seldom sufficiently on their guard. The danger is always present, however, nor is the highest degree of intelligence or of moral worth any safeguard against it. A medical journal has a report of a lecture on the importance of recognising melancholia in its earlier stage by Doctor Burnet, lecturer in the Kansas (,’ity Medical College, of which report we make free use. ‘ There is a marked difference lietween sadness and melancholia,’ says Dr. Burnet. ‘ In ordinary sadness there is a cause comprehensible to the individual, and he will seek to remove it. In melancholia there is no apparent cause ; there is some implication of the higher faculties, and the patient is usually indifferent to his condition. surroundingsand future progress.' There are several forms of the affection ; simple melancholia, melancholia agitata, melancholia attonita and melancholia with stupor. The first two are the most difficult of recognition, ami it is these that especially endanger the lives of the patient and his friends.

The first important symptom of simple melancholia is sleeplessness. Another symptom of the greatest importance, is a dull pain in the liack of the neck, extending to the liack of the head. It is only within a few years that this symptom has lieen recognised. The third symptom is depression of spirits, accompanied by slower mental movements and retarded speech and actions. When the first ami the last symptoms are connected with pain in the neck, the diagnosis may l>e considered as conclusive. In melancholia agitata, these three symptoms are very marked, but it is not so difficult to diagnose the disease, since the agitation is of itself a strong indication. There are generally terrifying hallucinations. an utter indifference to one’s self and one's surroundings, aversion to food and inability to sleep except under the influence of drugs. The propensity to take life may come on suddenly, or lie gradually developed. It is not uncommon to see melancholiacs whose morbid tendencies are first brought out by some suggestion. One such patient was thought to have the ‘bines,’ and on his remarking that he wished he was dead, a friend carelessly said, ‘Go throw yourself over the stair railing.’ He acted u|>on the word, fell through three floors, and was killed. Every case of melancholia should at an early date lie put into the hands of a comj>etent physician, who can have the entire control of it.