Hypochondriasis is a still slighter form of mental derangement, and which is characterized by a preposterous anxiety and solicitude with regard to the patient’s own health, which in these cases is often little if at all disturbed, with the exception of occasional uneasiness at the stomach, arising from flatulency and other effects of indigestion.  This disorder in the state of the digestive function, is generally considered by the patient as the real and primary disease, though 99 times in 100 it is merely secondary, the result of torpor of the alimentary canal altogether.  This torpor is the consequence of an oppressed condition of brain, proceeding, for the most part, from increased arterial action in this organ.  Thus the effect is taken for the cause, and a treatment directed in conformity with this mistaken notion.  Happily, the practice usually pursued on those occasions, and which is directed to the state of the stomach and intestinal canal, is, as far as it goes, beneficial to the primary disease; for occasional purging, whether with the blue pill or Plummer’s pill, and the use of a simple and abstemious mode of living, are as well calculated to relieve affections of the brain, as those of the stomach.  But the fault of such a mistaken view of the subject is, that the treatment is confined too exclusively to one organ, and that the one not primarily affected; to the neglect of other means that may be as much or more required for the relief of the head.  Where, for example, the patient complains of throbbing headach, with other marks of increased arterial action in and about the brain, it is dangerous to rely solely upon cathartics, and to neglect bleeding, a neglect, which, I have more than once seen reason to believe, has been the occasion of fatal apoplexy ensuing.

The precise difference in the condition of the brain, in the three forms of insanity now mentioned, is not at all known.  Dissection hitherto has not thrown any light upon the subject; nor is it probable that it will do so hereafter.  The derangement of intellect in all of them, and the mutual convertibility of one into the other, prove that there is no essential or fundamental difference between them; and the same is true with regard to their medical treatment.  The moral management of the patient calls for nicer discrimination, and requires much penetration and judgment on the part of the practitioner, as well as extensive experience in mental disorders altogether—­Clutterbuck’s Lectures on the Nervous System.

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THE GATHERER.

“I am but a Gatherer and disposer of other men’s stuff.”—­Wotton.

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A celebrated comedian dining at a tavern in the neighbourhood of Covent-garden, after asking the waiter several times for a glass of water without obtaining it, rang the bell violently, and swore “He would knock his eye out, if he did not immediately bring some.”  A gentleman present remonstrated, and said, “He would be less likely of getting it, if he did so.”  “Oh dear, no, sir; for if you take eye (i) from waiter, you will get water directly.”