The initial introduction of the term "idée fixe", according to intellectual historian Jan E. Goldstein, was as a medical term around 1812 in connection with monomania. As originally employed in the nineteenth and early twentieth centuries, "idée fixe" was "a single pathology of the intellect", distinct from "monomania", a broader term that included "idée fixe", but also a wider range of pathologies that did not stem from "a single compelling idea or from an emotional excess". A second difference is that the victim of "idée fixe" was understood to be unaware of the unreality of their frame of mind, while the victim of monomania might be aware. At that time, "idée fixe" was discussed as a form of neurosis or monomania.