disease, is that of the mind, and therefore the organ of the mind can alone be the seat of its proximate cause.

Having now discussed both the essential and secondary symptoms of Hypochondriasis, and found them all in accordance with the view of its cerebral seat, we proceed to an examination of the causes which most frequently give rise to it; and here, too, we shall find our theory confirmed and supported by undeniable facts: For, on comparing those of Hypochondriasis and dyspepsia, we invariably find those which act most directly upon the mind, or its material organ the brain, to be most productive of the former, and those to be most productive of dyspepsia which act most directly upon the stomach itself; thus obtaining another safe and certain proof of the difference of their seats.

The principal predisposing causes of Hypochondriasis mentioned by authors are the melancholic temperament and mature age. When we look, on the one hand, to the qualities which characterize the hypochondriacal state of mind, and, on the other, to those characteristic of the melancholic temperament, we perceive at once that the latter is distinguished by the marked predominance of those very mental qualities, the morbid activity of which constitutes the former ; and hence the frequency of the disease in such persons naturally explains itself. That this proclivity of the melancholic to Hypochondriasis does not arise from any natural weakness of the digestive organs is evident from the fact, that dyspepsia occurs most frequently and severely in youth, and in persons of a sanguine temperament, who are least of all subject to the invasion of this disease or of melancholia,— the very reverse of which ought to happen if the disease were one of the stomach and not of the brain.

The paramount influence of mental character, as a predisposing cause, is so admirably stated by M Villermay, one of the latest and ablest champions of the abdominal seat of Hypochondriasis, that it is difficult to conceive how he could see it so clearly, and yet be blind to its consequences.

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"If we consider," says he, "the influence of character, as predisposing to this disease, we shall see the gay, active, and courageous, "little subject to its attack; and, on the contrary, the morose, idle, "and apprehensive, very frequently its victims. In like manner, "and for the same reason, whole nations and generations are much "more susceptible than others. Warlike nations suffer little from "it, as do those of a frank, cheerful, and jovial character. But "the Briton, naturally sombre and pensive, the Spaniard and the "Italian, who are more prone to jealousy and sloth, show a much greater tendency to this disease than the Swiss, the French, and "the inhabitants of the United States. Besides the national "character," he continues, "the state of civilization, the form of "government, have also an influence. Polished nations, which "breathe only for liberty and glory, whose feelings are more acute, "and whose passions are mobile and imperious, are exposed in a "high degree to disappointments and sorrows, which often give rise "to this disease.'

"

Such is the literal account of the causes assigned by a writer, who contends for the abdominal seat of Hypochondriasis! M. Villermay's descriptions and observations of facts are remarkable for perspicuity and general fidelity; but such inferences as the above are perfectly inexplicable, except on the supposition of a deficient Causality, and a consequent natural blindness to the connexion between cause and effect. Under the present erroneous systems of philosophy, when an author displays great superiority, in observing, for instance, or in reasoning, he is immediately held to be equally great in all other departments, and his opinions and statements on every subject are received with a deference due only to ascertained excellence in one; and in this way the errors of principle committed by an observing, but not a reasoning mind, are published and received by the public with all the submission and respect which the individual has a right to only as an observer; and thus the most hurtful doctrines are often elaborated and diffused to the great detriment of the public. Whether M. Villermay is an author of this kind, and also whether the influence of civilization and of different forms of government, ought most naturally to show itself upon the abdomen and its contents, or upon the mind and its organ, the brain, we leave our readers to decide for themselves.

• Diction. des Sciences Med. tome xxiii. p. 112.

The same author, we may further observe, gives an explanation of the more frequent occurrence of Hypochondriasis in mature than in early life, which, on our view of its nature and seat, is equally conclusive and satisfactory. He refers it, not, as might be expected from his own opinions, to any dif ference in the condition of the digestive organs, but solely and justly to a different state of the mind. The adult age, he informs us, is the period at which the most tempestuous pas sions and the most powerful interests are at work, and at which all our resources are put in motion. It is the epoch of ambition, and of the storms and disappointment which follow in its train. It is consequently, he adds, at that period of life that this disease ought to be most frequent. If Hypochondriasis is a disease having its seat in the brain, or organ by the medium of which these tempestuous passions, ambition, &c. manifest themselves, then M. Villermay's inference is unquestionably sound; but it is positively absurd when applied to his own view of its abdominal seat. How can ambition, disputes, or political revolutions, possibly reach the stomach, except through the medium of the mind?

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M. Villermay goes on, unconsciously adding strength to the opinion which he disavows, and states, in opposition to his own view, that Hypochondriasis chooses its victims chiefly among literary men, poets, artists, and those who are engaged in severe study, and who are remarkable for an ardent and lively imagination. The mode of life which such individuals habitually lead is itself a very potent cause of cerebral disHow often do we observe them, intensely absorbed in the creations of their own fancy, engage in the severest and most protracted study, especially towards night, allotted by nature for repose, till the brain gets into a state of excitement and irregular action, which ceases not with the removal of its first cause, and effectually banishes that sleep and repose of which they stand so much in need. Is it wonderful, then, admitting the cerebral seat of Hypochondriasis, that such causes should often give rise to the disease in its most obstinate and intractable form?

Among the exciting, also, as well as among the predispos ing, causes, those which act directly upon the mind and its material organ stand pre-eminent, as is once more distinctly proved by M. Villermay. He gives the history of about forty cases; and it is worthy of particular notice, that there is scarcely one of them which does not appear to have been, in part at least, produced by anxiety of mind. We are therefore not surprised to find him, with his usual accuracy of observation, enumerating mental distress, the torments of ambition, the loss of parents, of a darling child, of a friend or benefactor, reverses of fortune, unrequited love, the daily indulgence of anger, the torments of envy and of jealousy, political chagrin, the terrible effects of foreign invasion, civil broils, &c. &c., as the most fruitful sources of this and other nervous diseases; and we leave to the reader again to decide whether such exciting causes are best calculated to affect the brain or the abdominal viscera.

We have borrowed thus liberally from M. Villermay, chiefly that we might not be suspected of twisting facts to support our own theory; and we have left no room to add any thing from our own experience, farther than to say, that one of many cases which have come under our notice, and which arose from grief and mental fatigue, terminated in apoplexy, after occasional attacks of epistaxis, and the appear. ance of other symptoms indicating an affection of the brain, while the functions of digestion, &c. were scarcely at all impaired; thus shewing in the clearest manner the true seat of the disease.

Reading medical works is another very prolific cause of Hypochondriasis, the chief action of which is undoubtedly on the mind and brain. Few medical men escape a greater or less degree of it on commencing their professional studies; and as it is in them purely a disease of the mind, the subject of their alarm varies as they proceed from the study of one dangerous malady to that of another. Thus, Falret tells us, that when the celebrated Corvisart fixed strongly the attention

of his pupils upon the organic lesions of the heart, a true epidemic of Hypochondriasis was observed to prevail; the subject of which was in all of them a fear of dying of disease of the heart; and that, when Bayle, on the other hand, drew the earnest attention of his hearers to the consideration of pulmonary consumption, they also became hypochondriacal, and fancied themselves dying of phthisis. This fact also shews that the affection is truly one of the organ of mind, and not of the subordinate parts of the body, over whose functions the brain is known to preside.

It may, however, be alleged, that many causes which exert no immediate influence on either mind or brain, nevertheless sometimes occasion Hypochondriasis, and it may be thence inferred that its corporeal seat is not cerebral. To this we answer, that there are many indirect causes of this as of every other disease, which, taken alone, throw no light upon its seat. Among these may be reckoned the sudden retrocession of eruptions, the suppression of accustomed evacuations, sedentary life, abuse of spirituous or vinous liquors, &c. all of which are enumerated among the occasional causes of Hypochondriasis, but might with much greater propriety be ranked among those of disease in general, since they act not upon any part in particular, but upon that which is either constitutionally or accidentally the weakest and most susceptible of a morbid change; and as the weak part differs in every individual, hence the variety of diseases to which the same general cause may give rise. The suppression of hemorrhoids, for instance, will in one individual give rise to apoplexy, in another to inflammation of the chest, and in a third to dropsy; but it is perfectly evident that the mere knowledge of hemorrhoids being suppressed is not sufficient to inform us what part is to suffer the consequences. When such general causes, therefore, do produce Hypochondriasis, we can fairly infer, that there must be some weakness or predisposition to

* Falret de l' Hypochondrie, et du Suicide, p. 389.