"Madness cometh sometime of passions of the soul, as of business and of great thoughts, of sorrow and of too great study, and of dread: sometime of the biting of a wood-hound [mad dog], or some other venomous beast; sometime of melancholy meats, and sometime of drink of strong wine. And as the causes be diverse, the tokens and signs be diverse. For some cry and leap and hurt and wound themselves and other men, and darken and hide themselves in privy and secret places. _The medicine of them is, that they be bound, that they hurt not themselves and other men. And namely such shall be refreshed, and comforted, and withdrawn from cause and matter of dread and busy thoughts. And they must be gladded with instruments of music and some deal be occupied._" (Italics ours.) Bartholomew recognizes the two classes of causes of mental disturbance, the mental and the physical, and, it will be noted, has nothing to say about the spiritual--that is, diabolic possession. Writing in the thirteenth century, diabolism was not a favourite thought of the men of his time, and Bartholomew omits reference to it as a cause of madness entirely. Food and drink, and especially strong spirituous liquor, are set down as prominent causes. It may seem curious in our time that the bite of a mad dog, or a "wood hound," as Bartholomew put it, should be given so important a place; but in the absence of legal regulation rabies must have been rather common, and the disease was so striking from the fact that its onset was often delayed for a prolonged interval after the bite, that it is no wonder that a popular encyclopædist should make special note of it. The effect of alcohol in producing insanity was well recognized during the Middle Ages, and many writers have alluded to it. Pagel, in the chapters on Medieval Medicine in Puschmann's "Handbook," says that Arculanus, of whom there is mention in the chapter on Oral Surgery and the Minor Surgical Specialities, has an excellent description of alcoholic insanity. The ordinary assumption that medieval physicians did not recognize the physical factors which lead up to insanity, and practically always attributed mental derangement to spiritual conditions, especially to diabolic possession, is quite unfounded so far as authoritative physicians were concerned. Their suggestions as to treatment, above all in their care for the general health of the patient and the supplying of diversion of mind, was in principle quite as good as anything that we have been able to accomplish in mental diseases down to the present time. Their insanity rate, and above all their suicide rate, was much lower than ours, for life was less strenuous and conscious, and though men and women often had to suffer from severe physical strains and stresses, their free outdoor life made them more capable of standing them.