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Account of a Singular Atrabilarian or Hypochondriac

IN the “Conversations Academiques” of Abbé Bourdelot, (who warmly attached himself to the study of physic) is to be found an interesting account of a most singular Atrabilarian. The ingenious writer offers many curious conjectures as he proceeds with his description: I give it however as concise as the subject will well admit.

A description of the disorder of an Atrabilarian, in whose mind the melancholy humour produces extraordinary effects; in which there is this remarkable, that while the patient is attacked by these symptoms, he is sensible of them, and attempts to find a remedy.

This extraordinary disease is attended with the most uncommon circumstances. This Atrabilarian is offended with every thing. He reddens, and appears disturbed, when any one looks at him. Every thing displeases, every thing grieves; in a word he has formed such unhappy ideas of every thing, that in whatever place he is, all that he sees and all that he hears becomes insupportable. The slightest action, or the most harmless conversation, make him blush, and he generally draws such terrible consequences from them, that he is obliged to rush from the company abruptly. One day, being at table with some of his friends, who were rallying him, he imagined that a footman glanced at him to ridicule him; this threw him into a dreadful agitation, since which he cannot suffer his presence, though convinced that nothing was meant. Sometimes he persuades himself when he is on horseback or walking, that if he goes to the end of a certain street, he shall meet with persons whose appearance will terrify him; so that this obliges him suddenly to return. In a word, nothing can be more capricious, more parti-coloured, more feeble than his mind; but it is necessary also to observe, that while he perceives this imbecility, he is sensible of it, and attempts to remedy it; so that it may be said of him, that he is strong and feeble, prudent and mad at the same time.

A dreadful indulgence in wine, tobacco, and brandy, has reduced him to this singular state. Having kept concealed from his physicians, during three years, a virulent and obstinate gonorrhea, they were at length obliged to salivate his mouth; which has so much increased the heat and dryness of his bowels, that at all times, and particularly after dinner, he feels a fire which starts into his face, and which so violently agitates his spirits, that he appears perfectly confounded, and loses entirely the power of action. This happens perhaps from the aliments being received into a dry and inflamed stomach, they produce by their humidity the same effect that water does on quick-lime; nor is it improbable that digestion has produced in his stomach a humour which is of the nature of lime. This also occasions his being incapable of sitting after dinner; so that he is obliged, before he can find ease, to dissipate the vapours which agitate him. When he dines on fruit and water he is free from this agitation. In the spring and summer his indisposition is most troublesome, for it is then his humours are most agitated. He feels himself also worse in winter, when the atmosphere is thick, and at a fall of rain or snow. This is owing, probably, that at those times the transpiration is not freely made, because of the ambient air, which fills the pores of the body with its humidity, and closes them by its coldness. The fuliginous and acrid vapours are therefore pent up in the bowels, where they move with violence, and cause an extraordinary heat. In warm weather the least thought ruffles him, and makes his face redden: he is then alarmed at every thing; he becomes a misanthrope, and flies and fears every one. If he goes out he must first drink two or three tumblers of water to tranquillize his mind, because water allays the acrid vapours, and refreshes the heated blood for a short time.

Many persons, from the extraordinary circumstances attending this indisposition, pronounced the patient insane. Our author ingeniously proves that this opinion is unjust; for that on the contrary, in all this appearance of lunacy, the patient gave evident proofs of the sanity of his mind, by attempting to remedy it by various means. He enters into no uninteresting detail of the nature of lunacy, and proves that our Atrabilarian was not so diseased, for that he was fully sensible when he acted wrong; and a real lunatic believes he acts right when he is doing wrong.

I will conclude with some reflections of our sensible observer. We are all subject, more or less (he says) to the irregularities of the hypochondriac humour. Some conceal it better than others. Where it does not appear at all, we may say, those persons have strong heads, whose reflections can dissipate these phantoms, and elude their effects; but we find few of this kind. Every one has a portion of this madness, and we every day perceive its effects; but we conceal, and do not acknowledge them, because there is implanted in us a principle which while it recognizes, condemns them. How various are the alterations which our mind experiences! How many caprices and irresolutions do we endure from our passions, which change as it were our souls and our bodies! We hate to-day what we loved yesterday, without knowing why; we disapprove of what we approved at another time! How many persons are there who, if there was a rigid police observed, would be chained in Bedlam! Do we not every where see what excesses men are led into by their inconstancy, their fantastic hope, their perishable ambition, in a word, their madness? Are the learned exempt from this disorder? Montaigne has said, that between wisdom and folly there was only the turn of a screw. Yet let us be satisfied, for all these caprices, errors, eccentricities, and obstinacy are born with us, because there is no one who has not in himself some portion of this sharp and melancholy humour, which occasions these irregularities, or, to express one’s self more correctly, which is itself the irregularity of our nature.