Mental Exaltation, Mania.—The question of the Prognosis in Mental Exaltation—Mania—in its various forms, is a far more debatable and uncertain matter than in melancholia. The symptoms in melancholia being of a negative character due to a lowering or suspension of brain activity, we do not look for all those diversities, endless varieties and aspects which we may find in mania, be it simple, acute, or chronic. Generally there is an increased vitality, a state of hyperæsthesia, an increase in the activity of the brain, generally of the whole brain, and we must believe that these states will not so easily end in complete resolution as the condition of merely depressed action, or rather no action, which obtains in melancholia—I mean in melancholia generally, and not those states of acute melancholia which are supposed to be closely allied to the state which in other brains and under other subjective circumstances would give rise to mania from a pathological point of view. If this increased activity does not rapidly terminate in resolution, one of two things must occur—either exhaustion or atrophy, resulting in death or dementia, will supervene, or abnormal tissue will invade or replace healthy nerve paths or areas, and chronic aberration of mind ensue.
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