SECTION 2 MEMBER 1 SUBSECTION 1 Causes of melancholy God as a cause

It is useless to speak of cures or think of remedies until we have considered the causes: this is Galen’s advice to Glaucon. The common experience of others confirms that treatments must be incomplete, deficient and ineffective when the causes have not first been investigated, as Prosper Calenius rightly observes in his treatise On Black Bile, addressed to Cardinal Cesi.

Indeed, Fernel makes knowledge of the causes a kind of necessity: without it, no disease can be cured or prevented. Empirical practitioners may relieve a disease, and sometimes give help, but cannot root it out completely. As the saying goes, “Remove the cause and the effect disappears”: once the cause is removed, the effect is overcome as well.

I admit that it is extremely difficult to distinguish these causes and their origins, and, amid such variety, to say where the disease began. Happy is the person who can do this correctly. I shall venture to come as close as I can, laying them all open, from first to last, general and particular, for every kind of the disease, so that they may be more clearly understood.

General causes are either supernatural or natural. Supernatural causes come from God and his angels, or, with God’s permission, from the devil and his servants. Many examples and testimonies in Holy Scripture make it clear to us that God himself causes disease to punish sin and satisfy his justice: Psalm 107:17, “Foolish people are afflicted for their offences and because of their wickedness.”

Gehazi was struck with leprosy, 2 Kings 5:27; Jehoram with dysentery, diarrhoea and severe bowel disease, 2 Chronicles 21:15; David with a plague for taking a census of his people, 1 Chronicles 21. Sodom and Gomorrah were swallowed up. And this particular disease is expressly mentioned in Psalm 107:12: “He brought their hearts low through distress”; and in Deuteronomy 28:28: “He struck them with madness, blindness and bewilderment of heart.”

An evil spirit was sent upon Saul by the Lord to torment him. Nebuchadnezzar ate grass like an ox, and his mind became like that of the beasts of the field. Pagan stories are full of such punishments. Bacchus drove Lycurgus mad because he cut down the vines in the country; Pentheus and his mother Agave were likewise driven mad for neglecting their sacrifice.

The censor Fulvius went mad after taking the roof tiles from Juno’s temple to cover a new temple of his own, dedicated to Fortune; grief and anguish overwhelmed him and brought him to his death. When Xerxes tried to plunder Apollo’s temple at Delphi of its immense riches, terrible thunder came from heaven and struck four thousand men dead; the rest went mad. A little later, Brennus met with lightning, thunder and earthquakes on a similarly sacrilegious undertaking.

If we may believe our papal writers, they tell us of many strange and extraordinary punishments of this kind inflicted by their saints. They tell how Clovis, once king of France, the son of Dagobert, lost his reason for uncovering the body of Saint Denis; and how a sacrilegious Frenchman who tried to steal a silver image of Saint John at Birgburg suddenly went mad, raging and savaging his own flesh;

of a lord of Radnor who, returning late at night from hunting, put his dogs in Saint Avan’s church, which they called Llan Avan, and, rising early the next morning as hunters do, found all his dogs mad and himself suddenly struck blind; and of Tiridates, an Armenian king, who was similarly punished with the loss of his reason for violating some holy nuns.

But poets and papists may be classed together as tellers of fables; let them put their own credit at risk. Whatever stories they invent about their Nemesis and their saints, or however the devil may deceive them, we find it true that “God the avenger follows close behind.” “He is God the avenger,” as David calls him; and it is our flagrant sins that bring this and many other diseases down upon our own heads.

Through his angels, who are his servants, he can strike and heal whomever he chooses, says Dionysius. He can afflict us through his creations—the sun, moon and stars—which he uses as tools, as a farmer uses a hatchet, says Zanchi; through hail, snow, winds and so on:

And the winds, sworn allies, answer the battle trumpets:

as in Joshua’s time, as in Pharaoh’s reign in Egypt. They are simply so many agents carrying out his justice. He can humble the proudest spirits and make them cry out with Julian the Apostate, “You have conquered, Galilean!” or with Apollo’s priest in Chrysostom, “O heaven! O earth! Where has this enemy come from?” What an enemy is this!

And make them pray with David, acknowledging his power: “I am weak and utterly broken; I cry aloud from the anguish of my heart; my heart pounds,” and so on, Psalm 38:8. “O Lord, do not rebuke me in your anger or punish me in your wrath,” Psalm 38:1. “Let me hear joy and gladness, so that the bones you have broken may rejoice,” Psalm 51:8; and verse 12, “Restore to me the joy of your salvation, and sustain me with your generous spirit.”

For these reasons, presumably, Hippocrates would have a physician pay particular attention to whether a disease comes from a divine, supernatural cause or follows the course of nature. How this passage in Hippocrates should be understood is discussed further by Francisco Vallés in chapter 8 of his Sacred Philosophy, by Fernel and by Giovanni Cesare Claudini; I refer you to them.

Paracelsus believes that such spiritual diseases—for so he calls them—must be cured by spiritual means, and by no others. Ordinary means will do no good in such cases: “There must be no struggling against God.” When the monster-taming Hercules defeated everyone at the Olympic games, Jupiter finally wrestled with him in an unfamiliar shape. The outcome was uncertain until Jupiter at last revealed himself, and Hercules yielded. There is no contending with supreme powers.

It is no use promising Craterus enormous mountains of wealth,

Physicians and medicine can do no good: we must submit ourselves beneath the mighty hand of God, acknowledge our offences and call on him for mercy. If he strikes us, “one and the same hand will bring the wound and its relief.” As with those wounded by Achilles’ spear, he alone must help; otherwise our diseases cannot be cured, and we cannot be relieved.