The severe forms of melancholia are apt to be associated with delusions. Fear becomes a prominent factor, and the patient is afraid of every one who approaches, or concentrates his timidity with regard to certain persons or things. Delusions of persecution are not unusual, and this sometimes leads to homicidal tendencies. After enduring supposed persecution for as long as he considers it possible, the melancholic turns on his persecutors and inflicts bodily harm. The simplest actions, even efforts to benefit the patient by enforcement of the regulations of the physician, may be misconstrued into serious attempts at personal injury, for which the patient may execute summary vengeance. At times the hallucinations take on the character of the supposition that attempts to poison them are being made. The patient may conceal his supposed knowledge of these attempts until a favourable opportunity presents itself for revenging them. On the other hand, it is not an unusual thing to have melancholic patients commit homicide with the idea of putting friends out of a wicked world. The stories so common in the newspapers of husbands who kill wives and children, of mothers who murder their children, are often founded on some such delusion as this. A mother argues with herself, that her own unworthiness is to be visited on her children, and that they are to be still more unhappy than she is. Out of maternal solicitude, then, but in an acute excess of melancholia, she puts them out of existence and ends her own life at the same time. When the melancholia is founded on supposed incurable ills in the body, patients are sometimes known to mutilate themselves, or to have recourse to alcohol, or some narcotic drug, in order to relieve them of their pain, which is mostly imaginary, and make life somewhat more livable during its continuance. Alcoholic excesses are especially common in {222} cases of recurrent or periodical melancholia. Many of the cases of so-called periodical dipsomania are really due to recurring attacks of severe depression of spirits, in which men take to alcohol as some relief for their intense feelings of inward pain and discouragement.