For example, a mother loses an only son in the prime of manhood and at the height of his career. It will not be surprising if, for a considerable period, she is unable to take up once more the thread of life where it was so rudely interrupted. For weeks she may react very little to her surroundings and may prove to be so moody as to arouse suspicion of her mental condition. After a time, however, she begins to have some of her old interest in affairs around her. Her depression of spirits may not entirely disappear for long years, perhaps never; but her affective state does not go beyond a simple sorrow. On the other hand, under the same circumstances, a mother may give way to transports of grief that after a while settle down into a persistent state of dejection. Every thought, every word, every motive, has a sorrowful aspect to her. After a time she may begin to think and even to state that the misfortune of the loss of her son has come because of her own exceeding wickedness. She may consider it a punishment from on high and think that she has committed the unpardonable sin and absolutely refuse any consolation in the matter. This state of mind is distinctly abnormal, and if it persists for some time must lead to the patient's being kept under careful surveillance. The immediate cause of the development of such a melancholic state is always some unfortunate event in the course of life. Worry and sorrow are important causative factors. Mostly, however, these causes are only capable of producing their serious effects upon the mental state of predisposed individuals, or at times when the health of the subject is decidedly below the normal. Emotional disturbances are not liable to have such serious effects, except when anaemia, or continued dyspepsia, or some serious nutritive drain upon {216} the system, like frequently continued hemorrhages, persistent dysenteric conditions, or too prolonged lactation, have brought the system into a condition of lowered vital resistance. Unfortunately, in ordinary life these run-down physical conditions are prone to be associated with the worry and overwork that precede disaster. The effect of grief as a cause of melancholia may best be realised from the fact that in something over one-half of all the cases of melancholia the death of a near relative, father or mother, or even more frequently husband or wife, or child, is found in the clinical history of the patient shortly before the development of the mental disturbance. Serious business troubles, however, loss of property, actual want of proper nourishment, failure to succeed in some project on which the mind has been set, and similar conditions, so common in our modern hurried life, are also capable of producing the mental depression that assumes an insane character in certain individuals.