SUBSEC. 4. Of the species or kindes of Melancholy.

When the matter is divers and confused, how should it otherwise be, but that the species should be divers and confused? Many new and old writers have spoken confusedly of it, confounding Melancholy and Madness, as Heurnius, Guianerius, Gordonius, Salustius, Salvianus, Iason Pratensis, Savanarola, that will have Madness no other then Melancholy in extent, differing (as I have said) in degrees.

Some make two distinct species, as Ruffus Ephesius and old writer, Constantinus Africanus, Areteus, Aurelianus, Paulus Ægineta: others acknowledge a multitude of kinds, and leave them indefinite, as Ætius in his Tetrabiblos, Avicenna lib. 3. Fen. 1. Tract. 4. cap. 18. Arculanus cap. 16. in 9. Rasis. Montanus med. part. 1.

If naturall Melancholy be adust, it maketh one kinde; if blood, another; if choler, a third, differing from the first; and so many severall opinions there are about the kindes, as there be men themselves. Hercules de Saxonia sets down two kinds, materiall and immateriall; one from spirits alone, the other from humors and spirits.

Savonarola Rub. 11. Tract. 6. cap. 1. de ægritud. capitis, will have the kindes to be infinite; one from the myrach, called myrachialis of the Arabians; another stomachalis, from the stomack; another from the liver, heart, wombe, hemrods; one beginning, another consummate.

Melancthon seconds him, as the humor is diversly adust and mixt, so are the species divers: but what these men speak of species, I think ought to be understood of symptomes, and so doth Arculanus interpret himself: infinite species, id est, symptomes; and in that sense, as Io. Gorrheus acknowledgeth in his medicinal definitions, the species are infinite, but they may be reduced to three kindes, by reason of their seat, Head, Body, and Hypocondries.

This threefold division is approved by Hippocrates in his book of Melancholy, (if it be his, which some suspect) by Galen lib. 3. de loc. affectis cap. 6. by Alexander lib. 1. cap. 16. Rasis lib. 1. Continent. Tract. 9. lib. 1. cap. 16. Avicenna, and most of our new writers. Th. Erastus makes two kindes; one perpetual, which is Head melancholy; the other interrupt, which comes and goes by fits, which he subdivides into the other two kindes, so that all comes to the same pass.

Some again make four or five kindes with Rodericus à Castro de morbis mulier. lib. 2. cap. 3. and Lod. Mercatus, who in his second book de mulier. affect. cap. 4. will have that melancholy of Nuns, Widowes, and more ancient maids, to be a peculiar species of Melancholy differing from the rest: some will reduce Enthusiasts, extaticall and dæmoniacall persons to this rank, adding Love melancholy to the first, and Lycanthropia.

The most received division is into three kindes. The first proceeds from the sole fault of the Brain, and is called Head melancholy: the second sympathetically proceeds from the whole body, when the whole temperature is Melancholy: The third ariseth from the Bowels, Liver, Spleen, or Membrane, called Mesenterium named Hypocondriacal, or windy Melancholy, which Laurentius subdivides into three parts, from those three Members, Hepatick, Splenatick, Meseraick.

Love melancholy, which Avicenna calls Ilishi: and Lycanthropia, which he cals Cucubuthe, are commonly included in head Melancholy: but of this last, which Gerardus de Solo cals Amoreos, and most Knight melancholy, with that of Religious melancholy, Virginum, & Viduarum, maintained by Rod. a Castro and Mercatus, and the other kinds of Love melancholy, I will speak apart by themselves in my third Partition.

The three precedent species are the subject of my present discourse, which I will anatomize, and treat of, through all their causes, symptomes, cures, together, and apart; that every man that is in any measure affected with this malady, may know how to examine it in himself, and apply remedies unto it.

It is a hard matter, I confess, to distinguish these three species one from the other, to express their several causes, symptomes, cures, being that they are so often confounded amongst themselves, having such affinity, that they can scarce be discerned by the most accurate Physicians; & so often intermixt with other diseases, that the best experienced have been plunged.

Montanus consil. 26. names a patient that had this disease of Melancholy & Caninus Appetitus both together: And consil. 23. with Vertigo. Iulius Cæsar Claudinus with Stone, Gout, Jandice. Trincavellius with an Ague, Jandice, Caninus Appetitus, &c. Paulus Regoline, a great Doctor in his time, consulted in this case, was so confounded with a confusion of symptomes, that he knew not to what kinde of Melancholy to refer it.

Trincavellius, Fallopius, and Francanzanus, famous doctors in Italy, all three conferred with about one party, at the same time, gave three different opinions. And in another place, Trincavellius being demanded what he thought of a melancholy young man, to whom he was sent for, ingenuously confessed, that he was indeed melancholy, but he knew not to what kinde to reduce it. In his 17. consultation, there is the like disagreement about a melancholy Monke.

The symptomes, which others ascribe to misaffected parts and humors, Herc. de Saxonia attributes wholly to distempered spirits, & those immaterial, as I have said. Sometimes they cannot well discerne this Disease from others. In Reinerus Solinanders counsels, Sect. consil. 5. he and Dr. Brande both agreed, that the patients disease was hypocondriacal melancholy. Dr. Matholdus said it was Astma, and nothing else.

Solinander and Guarionius, lately sent for to the melancholy Duke of Cleve, with others could not define what species it was, or agree amongst themselves. The species are so confounded, as in Cæsar Claudinus his 44. consultation for a Polonian Count, in his judgment he laboured of head melancholy, and that which proceeds from the whole temperature both at once. I could give instance of some that have had all three kindes semel & simul, and some successively.

So that I conclude of our melancholy species, as many Politicians do of their pure formes of Commonwealths, Monarchies, Aristocracies, Democracies, are most famous in contemplation, but in practice they are temperate and usually mixt, (so Polybius enformeth us) as the Lacedæmonian, the Roman of old, German now, and many others.

What Physicians say of distinct species in their books, it much matters not, since that in their patients bodies they are commonly mixt. In such obscurity therefore, variety and confused mixture of symptomes, causes, how difficult a thing is it to treat of several kindes apart; to make any certainty or distinction among so many casualties, distractions, when seldome two men shall be like affected per omnia?

’Tis hard, I confess, yet nevertheless I will adventure through the midst of these perplexities, & led by the clue or thread of the best writers, extricate my self out of a labyrinth of doubts and errors, and so proceed to the Causes.