In addition to these important distinctions, it is easy to grasp the fact that the bodies of women differ very widely from those of men, both in respect to the dissimilarity of their diseases and in respect to one’s hopefulness or despair of a cure. For the bodies of men are well-knit and sinewy, since they have been trained by toils and exercises, and by an open-air life; but those of women are weak and soft from being reared indoors, and white for lack of blood, deficiency of heat, and an excessive supply of the moist humour. They are therefore more susceptible than those of men, prone to diseases, intolerant of medical treatment, and above all, more liable to attacks of insanity ; for since women have much bad temper, frivolity, and instability, but little physical strength, they easily fall into this affection.

It is not right, then, to ask of the physicians the same treatment for both, when we know that there is a great gulf between them, dissociated as they have been from the very first in their entire mode of life, and in all their activities and all their pursuits. So when you say “It is a case of insanity,” add, “insanity in a woman,” and do not confuse all these variations by subsuming them under the title of insanity, which seems always one and the same thing, but distinguish them, as is right, in their nature and see what can be done in each case. That is what we do, for, as I remember telling you in the beginning of my speech, the first thing that we consider is the constitution and temperament of the patient’s body, what quality predominates in it, whether it is inclined to be hot or cold, whether it is vigorous or senile, tall or short, fat or lean, and everything of that sort. In short, if a man examines into these matters to begin with, he will be very trustworthy when he expresses any doubt or makes any promise.

To be sure, of madness itself there are countless varieties, with many causes and even dissimilar names; for perversity, eccentricity, delirium, and lunacy are not the same thing, but are all names that signify whether one is more or less in the grip of the disease. The causes, too, are of one sort with men, another with women, and even among men they are of one sort with the young and different with the aged; for instance, with the young usually excess of humours, whereas in the case of the old, groundless prejudice and insensate anger against members of the family, attacking them frequently, disturbs them at first, then gradually deranges them to the point of insanity. Women are affected by many things which easily incline them to this ailment, especially by excessive hatred of someone, or jealousy of an enemy who is prospering, or grief of some sort, or anger; these passions, slowly smouldering and acquiring strength in a long lapse of time, produce madness.

That, father, is what has happened to your wife, and it may be that something has grieved her recently, for she, of course, hated nothing at all. However that may be, she has a seizure, at all events, and in the circumstances cannot be cured by a physician. If anyone else should engage to do it, if anyone — should relieve her, you may then hate me as offending against you. Indeed, father, I shall not hesitate to say further that even if her case were not so wholly desperate, but some hope of saving her still were in sight, even then I should not have undertaken her case lightly or ventured to prescribe for her out of hand, fearing mischance and the slanderous tongues of the common sort. You are aware that everybody thinks that all stepmothers entertain some hatred of their stepsons, even if they are good women, and that in this they suffer from a sort of insanity affecting women in common. Perhaps someone would have suspected, if the ailment had gone badly and the’ remedies had not been effective, that the treatment had been malevolent and treacherous.

As regards your wife, father, the case stands thus, and I tell you so after careful observation—she will never be better, even if she takes medicine a thousand times. For that reason it is not proper to make any attempt, unless you are trying to force me into sheer failure and wish to give me a bad name. Let me continue to be envied by my fellow-practitioners ! If, however, you disown me again, I certainly, though totally alone in the world, will not pray that any adversity may befall you; but what if (Heaven forfend !) your affliction returns once more? Somehow it often happens that such afflictions, under irritation, do recur. What shall I be required to do? I will treat you even then, you may be sure, and shall never desert the post which Nature has commanded sons to hold, nor ever, so far as in me lies, forget my origin. And then, if you recover your mind, may I expect you some day to take me back again? Look! even now by these actions of yours you are bringing on the disorder and provoking the ailment. You have only just recovered from that terrible plight, and yet you strain your lungs shouting; more than that, you are angry, you take to hatred, and you invoke the laws. Ah, father, that is the way your former seizure began!