Past exam of the medicine course of the University of Oxford / 1864 / Second examination / Medical translations / Greek translation

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Μανίης τρόποι εἴδεσι μὲν μυρίοι, γένει δὲ μοῦνος εἷς· ἔκστασις γὰρ ἐστι τὸ σύμπαν χρόνιος, ἄνευθεν πυρετοῦ· εἰ γάρ κοτε καὶ πυρετὸς ἐπιλάβοι, οὐκ ἀπὸ μανίης ἂν ἴδιος γίγνοιτο, ἀλλ’ ἐκ συντυχίης ἄλλης· ἐκφλέγει γὰρ καὶ οἶνος ἐς παραφορὴν ἐν μέθῃ· ἐκμαίνει δὲ καὶ τῶν ἐδεστῶν μετεξέτερα, ἡ μανδραγόρη, ἡ ὑοσκύαμος, ἀλλ’ οὔ τί πω μανίη τάδε κικλήσκεται. ἐπὶ γὰρ σχεδίου γιγνόμενα καθίσταται θᾶττον· τὸ δὲ ἔμπεδον ἡ μανίη ἴσχει· τῇδε τῇ μανίῃ οὐδέν τι ἴκελοι ἡ λήρησις, γήραος ἡ ξυμφορή. αἰσθήσιος γὰρ ἐστι νάρκη, καὶ γνώμης νάρκωσις ἠδὲ τοῦ νοῦ ὑπὸ ψύξιος· μανίη δὲ θερμόν τι καὶ ξηρὸν τῇ αἰτίῃ, καὶ ταραχῶδες τῇσι πρήξεσι· ἡ μὲν γὰρ λήρησις ἀρχομένη ἀπὸ γήραος οὔτε διαλείπει, καὶ ξυναποθνήσκει· μανίη δὲ καὶ διαλείπει καὶ μελεδῶνι ἐς τέλος ἀποπαύεται· διάλειψις δὲ ἀτελής, ἢν τῷ τῆς μανίης λόγῳ γίγνηται, οὐκ εἰκότως ἀκεομένου τοῦ κακοῦ ἰητρείῃ, ἢ τῆς ὥρης εὐκρασίῃ. μετεξετέρους γὰρ δοκέοντας ἀσινέας ἔμμεναι, ἡ ὥρη τὸ ἔαρ, ἢ ἁμαρτωλὴ διαίτης, ἢ ὀργὴ ἐκ συντυχίης ἐς ἀνάκλησιν ἤγαγε.

Aretæus. Χρον. Παθ. Α. ϛʹ.

The forms of ancient mania are innumerable in their varieties, but there is only one general kind: taken as a whole, it is a lasting derangement of the mind without fever. For if fever should at some time also occur, it would not arise as a feature peculiar to the ancient mania, but from some other coinciding cause. Thus wine also inflames the mind into delirious behaviour in drunkenness, and some things that are eaten, such as mandrake and henbane, drive people out of their minds. Yet these conditions are not called ancient mania: arising from a temporary cause, they settle more quickly, whereas ancient mania has persistence.

The senile dotage that is a misfortune of old age is quite unlike this ancient mania. It is a torpor of sensation and a numbing of judgement and intellect through coldness; ancient mania, by contrast, has something hot and dry in its cause and is turbulent in its actions. For senile dotage beginning in old age neither remits nor leaves the sufferer before death, whereas ancient mania does remit and, with care, can come to a complete end.

But a remission is incomplete when it occurs in keeping with the course of the ancient mania, without the illness having been properly cured by treatment or by the mildness of the season. For in some people who seemed to be unharmed, the spring season, an error in their way of life, or anger arising from some incident has brought the condition back.

Aretaeus of Cappadocia distinguishes persistent mental illness, transient intoxication and the cognitive decline attributed to old age. The opening of On the Causes and Signs of Chronic Diseases by Aretaeus of Cappadocia, I.6, organizes these distinctions by persistence, attributed cause and course, ending with examples of relapse. ^[ref]

Several terms need historical interpretation. “Derangement” renders a displacement from one's ordinary mental state, not a diagnosis based on a modern symptom checklist. “Way of life” includes diet and regimen; it is wider than a single meal. The sentence about incomplete remission concerns an apparent improvement within the illness's course, distinguished from a thorough cure through treatment or favourable seasonal conditions. A quiet interval can therefore be followed by recurrence. The hot, dry and cold explanations are historical physiology, not established modern causes.

The scope of ancient mania is broader than present-day mania. Current assessment examines the course of mood and activity changes, symptoms between episodes, medication and substance exposure, physical illness and alternative diagnoses; it does not define the disorder simply as every persistent mental disturbance without fever. Nor should historical senile dotage be equated with a precise diagnosis of one modern dementia, or the passage's assertions about old age be accepted as a modern prognosis. ^[ref]