130 HYPHASIS HYPOCHONDBIASIS trophy of the ventricles of the heart is often dependent on narrowing of the cardiac orifices by disease of the valves, giving the organ dou- ble work to do, and increasing its activity, as in other muscles. (See HEART, DISEASES OF THE.) When any of the voluntary muscles are specially exercised, hypertrophy is observed in them, as in the arm of the blacksmith or the legs of a professional dancer; and such hyper- trophied muscles generally cause an increased nutrition of the bones to which they are at- tached, and an enlargement of the points of origin and insertion. There are certain en- largements of glands, in which their proper tissue is increased without structural change, which unite physiological hypertrophy with pathological tumors, as in the case of the mam- mary, thyroid, and prostate glands. Certain tumors of the uterus contain only an excess of the normal muscular and fibrous tissues of the organ, and yet cannot be regarded as ex- amples of hypertrophy, as they observe no regular growth, subserve no physiological pur- pose, and constitute a positive deformity and disease; such abnormal growths may exist upon a uterus itself hypertrophied from in- creased functional activity, and must not be confounded with the latter. Supernumerary parts, as additional fingers and toes and vari- ous outgrowths developed during fatal life, must in like manner be referred to local hy- pertrophy from excess of formative activity. Dr. Carpenter sees in this whole series of ab- normal production the operation of a similar power; that which in simple hypertrophy is confined to increasing the size of an organ by the development of new tissue according to the morphological type of the part, in the for- mation of supernumerary tissues also imparts to them an independent existence; on the other hand, while in ordinary hypertrophy the tissues in excess are incorporated in the affect- ed organ, in the structure of a tumor the per- fectly formed and independently growing tis- sues constitute a mass whose shape is deter- mined more by surrounding conditions than by any tendency of their own the formative power undirected by the normal morphological nisui. In malignant growths, the development of tissues stops short of the limit by which formative power produces the normal tissues, and their vital endowments are not sufficient to resist the tendency to degeneration. HYPHASIS, a river of ancient India. See PUNJAUB. im'OUIOMHiltsiS (Gr. ford, under, and x6vSpof, cartilage), a disease generally classed r.mong neuroses, characterized by derangement of various organic functions, and accompanied by an habitual sadness, often bordering on de- spair, and a disposition to exaggerate every trifling symptom into a sign of dangerous malady ; probably so called because it was formerly attributed to disorder of the spleen, an organ situated in the left hypochondrimn. It occurs principally in persons of melancholic temperament, and in those whose moral and intellectual faculties have received high and unnatural development ; it is said to be com- mon in proportion to the elevation of the hu- man mind and to the progress of civilization. Men of letters, overtasked students and men of business, and those whose naturally delicate constitutions and ardent imaginative minds have been abnormally stimulated, are the most frequent subjects of hypochondria ; but it may arise at any ago and in the strongest persons after profound grief or other moral emotion, whether of love, hope, jealousy, or fear, de- bilitating excesses of any kind, the suppression of any habitual discharge, a sudden change of habits of life, or unceasing devotion to any philanthropic, political, or intellectual pursuit. The symptoms are as various as its causes and the constitutions of men ; there is not a part of the body which may not be the subject of the hypochondriac's complaint ; the senses are ordinarily very acute, and the sight, hearing, smell, taste, and touch are preternaturally ex- citable, and the sources of great real or ima- ginary suffering from the slightest causes ; there is almost always digestive disturbance, which enters largely into the explanation of the causes ; without fever or local lesion, the sensibility is exalted, with flatulence, nausea, spasms, palpitations, illusions of the senses, aches and pains simulating most diseases, fear of trifling dangers, exaggeration of all the moral sentiments, extreme instability of con- duct, and anxiety in regard to the health. The head is full of painful sensations, as fugi- tive as passing clouds, agonizing at one moment and forgotten the next; sleep is disturbed and unrefreshing, and the waking hours rendered miserable by imaginary troubles. Expressing complete disgust with life, the sufferers yet run to the physician with an account of every fugitive pain, and consider themselves neg- lected if not listened to, and insulted if their ailments be called imaginary. Both sexes suffer from hypochondria, and the female specially in the reproductive system. Though in the beginning the disorder may have been wholly in the digestive organs, and that only of a functional and curable character, by con- stant and morbid attention to these and other fancied ailments real and organic disease may be produced, and a return to health be im- possible. It is generally slow in coming on and of long duration, and is not incompatible with long life; if the digestion be tolerably good, the prognosis is favorable, as such per- sons are apt to observe most rigidly the or- dinary rules of hygiene; in some impression- able but resolute natures, it degenerates into a settled melancholy, which a slight cause may convert into temporary insanity and suicidal mania. It cannot be said to have any special organic lesions, though in severe and fatal cases there have been found various alterations of the digestive, circulating, and nervous systems. There are two opinions as to the nature and
