Monomania.—This is a term belonging to common speech, but there is not an agreement of opinion as to the existence of such a special form of insanity, nor among those who believe in it, as to what it is and what are its symptoms.
Monomania really means an insanity with but one, or, at most, a small class of delusions of the same character, the rest of the mind showing no disease. Hardly any one believes in the existence of such a narrow limit to insanity, and, getting beyond this point, there is no agreement where the limit should be set up to mark and bound it.
Some think there is a special insanity of the emotions only, and call it “emotional insanity.” There is not an agreement of opinion as to what emotional insanity is; the idea seems to be that the emotions, or one of them, so overpower reason and will as to make the person irresponsible. This condition is supposed to exist without disturbances of the intellectual faculties, and to be unaccompanied by delusions, hallucinations, or illusions. Others see in these cases no evidence of insanity; nothing but over-indulgence of the emotions, or a want of exercise of self-control, or an excuse for crime.
Some persons believe that the appetites over-indulged become morbid and produce disease of the nervous system, and as a consequence the reason and will are weakened in relation to this indulged appetite, and the opinion is reached that it is a form of insanity. An indulged appetite for drink is called dipsomania. Others believe that unless there are present the usual symptoms, associated as they generally appear in insanity, these cases are nothing but unbridled appetites or vices.
Moral Insanity.—There are those who claim that the moral nature alone may be diseased, and the persons in whom this occurs are said to lose the appreciation of right and wrong, or have an uncontrollable propensity to do some wrong act, and take a peculiar pleasure in so doing. Special names are given to these acts, according to their character, as “kleptomania, an impulse that prompts to steal”; or “pyromania, love of setting things on fire”; or “homicidal mania, an intense desire to kill.” Other persons considering these cases and finding no delusions, or intellectual disturbances, or change in feeling, thinking, or acting due to disease, call the condition one of crime only.
These are difficult matters to understand, and those who make a life-study of insanity do not fully understand them, or agree together as to what they know. They are, however, terms of common speech, and it is well to have some idea of them, as it will add interest to the study of the patients under care and charge.
CHAPTER IV.
THE DUTIES OF AN ATTENDANT.