Another and more serious question for the clergyman is that of the vocation in life of those who are weak mentally. By vocation is meant not only religious calling, but the occupation in life generally. Young people of unstable mentality and especially those of insane heredity should be advised against taking up such professions as that of actor or actress, or broker, or other life duties that entail excitement and mental strain. As far as possible they should be discouraged from taking up city life, and should be advised to live quietly in the country. Mania is apt to follow certain severe infectious diseases in delicate individuals. Pneumonia, for instance, or typhoid fever or chorea, and sometimes consumption or rheumatism, may be followed by a period of maniacal excitement. Severe injury to the brain or the pressure due to the presence of a brain tumour, may also be a cause of mania. A certain number of good authorities in mental diseases have called attention to the fact that mania is a little more liable to occur in patients who are suffering from heart disease. By this is meant in persons who have some organic lesion of the valvular mechanism of the heart. This leads to disturbance of the circulation and interferes with cerebral nutrition, thus predisposing to functional brain disturbance. While melancholia occurs very frequently in older people, mania is almost essentially a mental disease of the young. The vast majority of cases occur between the twelfth and thirty-fifth year. The subjects of the disease are usually those who possess what is called the sanguine temperament, that is, hopeful, enthusiastic people, easily excited and aroused, easily cast down. Mania is much more common in females than in males. One of the important characteristics of mania is the super-excitation of the sexual faculty. In many individuals the first sign of their mental disequilibration noticed by friends is a tendency to sexual excess. This is true of women as well as of men, and the extent to which this may manifest itself is almost unlimited. At the beginning of the disease this symptom is often a source of serious misunderstanding, and may be the cause of family disruption. Usually, before {227} there are any open insane manifestations, there are definite symptoms that would point to a pathological excitement in the sexual sphere.