It will be observed that, based somewhat on the conceptions of Griesinger, states of mental excitement were generally characterized as mania and all depressions as melancholia. As has been shown, the view that there was some definite relation between these two conditions had been gaining ground for many years and culminated in the "circular insanity" concept. In the meanwhile over fifty varieties of mania and thirty forms of melancholia were described by various authors. Aside from an emotional exaltation and increased psychomotor activity, few definite characteristics were insisted upon in a consideration of mania. There was almost invariably a disturbance of sleep but always with a sense of well-being and no feeling of exhaustion. The milder type of the disease was often referred to as "hypomania." In the more severe forms varying grades of violence developed. There was at times a clouding of the sensorium, a temporary appearance of hallucinations of sight and hearing, delusions of a persecutory or grandiose nature and incoherence of speech. Impulsive acts occasionally were noted during the height of the excitement. These attacks were frequently preceded by brief periods of depression. Many cases made rather early recoveries—others, however, were spoken of as having reached a chronic stage. Many terminated in dementia. These very often showed stereotypies, verbigeration, impulsive excitements, mannerisms and other symptoms now held to be characteristic of dementia praecox. Melancholia was looked upon as including all emotional depressions with hallucinations and delusions as the prominent symptoms. The mental state was essentially one of sadness but with fear, agitation and anxiety appearing at times. There was, however, no attempt at any differentiation between psychomotor retardation with genuine depression and apathetic states or actual mental dulness. Mutism and resistiveness were common. A refusal of food was rather to be expected. Stuporous states with muscular rigidity frequently occurred. Various physical changes were described. Cyanosis of the extremities was emphasized, with loss of weight and a lowered temperature. Many of the cases were untidy in their habits. Brief initial attacks of excitement were mentioned as usually ushering in the disease. These depressions recovered, became chronic, lasting for years, or terminated in a partial or complete dementia. These were in substance the views of practically all of the earlier writers on insanity.