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← ExitThe Anatomy of Melancholy

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Subsection 4. Causes of Hypochondriacal, or Windy, Melancholy.

Subsection 4. Causes of hypochondriacal, or windy, melancholy.

In repeating these causes, I must “serve up twice-cooked cabbage”—say again what I have said before as I apply them to their proper kinds. Hypochondriacal, or flatulent, melancholy is what the Arabians call myrachial. In my judgment it is the most distressing and frequent kind, though Bruel and Laurentius consider it the least dangerous and less difficult to recognize or cure.

Its causes are internal or external. Internal causes arise from various parts or organs: midriff, spleen, stomach, liver, pylorus, womb, diaphragm, mesenteric veins, the stopping of discharges, and so on.

Montaltus, in chapter 15, cites Galen in naming heat and blockage of those mesenteric veins as an immediate cause: in this way the passage of chyle to the liver is delayed or stopped, or the chyle is corrupted and turned into rumbling and wind.

Montanus gives a clear example in consultation 233, Trincavelius another in book 1, chapter 12, and Plater a third in book 1 of his observations: a doctor of law afflicted with this illness from the same blockage and heat of the mesenteric veins and bowels, “because the veins between the stomach and liver grow hot”—the veins are inflamed around the liver and stomach.

Sometimes those other parts are disordered together and combine to produce this malady: a hot liver and a cold stomach or cold abdomen. Look for examples in Hollerius; Victor Trincavelius, consultation 35, book 3; Hildesheim, collection 2, folio 132; Solenander, consultation 9, “for a citizen of Lyons”; Montanus, consultation 229, for the Earl of Montfort in Germany in 1549; and Frisimelica, in consultation 233 of the same Montanus.

J. Caesar Claudinus gives examples of a cold stomach and an overheated liver in almost every consultation: in consultation 89, for a certain count, and 106, for a Polish baron. The heat inflames the blood and sends thick vapours to the heart and brain.

Mercurialis agrees with them in consultation 89: the stomach is disordered, which he calls the king of the abdomen, because if it is disordered all the rest suffer with it, being deprived of nourishment or fed with bad nourishment. This brings about undigested matter, blockages, wind, rumbling, cramps, and so on.

Besides heat, Hercules de Saxonia considers weakness and blockage of the liver a cause—“a weakened power of the liver,” which he calls the mine of melancholy. Laurentius gives this reason: the overheated liver draws food out of the stomach undigested and burns the humours. Montanus, in consultation 244, proves that a cold liver may sometimes be a cause.

Laurentius, chapter 12, Trincavelius, “book 12, consultation,” and Gualter Bruel seem to place the greatest blame on the spleen. Too large or too small, it fails in its duty to cleanse the liver as it should, sometimes drawing too much blood to itself without expelling it, as P. Cnemiandrus noted in one of his consultations. He calls it “a swelling of the spleen” and the fountain of melancholy.

Diocles supposed this kind of melancholy to have its origin in inflammation of the pylorus, which is the lower opening of the stomach. Others name the mesentery or midriff disordered by heat, a disordered womb, suppression of haemorrhoidal bleeding, and many similar causes.

Laurentius, in chapter 12, reduces all these to three: mesentery, liver and spleen, from which he names hepatic, splenic and mesenteric melancholy. External causes are bad diet, worry, griefs, discontents—in a word, all those six non-natural things, as Montanus found from experience, consultation 244.

Solenander, in consultation 9 for a citizen of Lyons in France, tells his reader that he knew this affliction to be caused by a medicine made from cantharides, which an unskilful physician gave his patient to drink “to arouse sexual desire.”

But most commonly it begins with fear, grief or some sudden disturbance or agitation of the mind, especially in bodies already poorly disposed. Melanchthon, in treatise 14, chapter 2 on the soul, holds that it is as common in men as the disorder called “the mother” is in women, arising from some grievous trouble, aversion, passion or discontent.

For, as Camerarius records in his life of him, Melanchthon himself suffered greatly from it and could therefore speak from experience. Montanus, in consultation 22, “for a delirious Jew,” confirms it: grievous symptoms of the mind brought the patient to it.

Randolotius relates that one day, while deeply intent on copying out a physician’s notes, he was troubled by some incident and fell into a hypochondriacal attack. To escape it he drank a decoction of wormwood and was relieved.

Melanchthon, since the disease is so troublesome and frequent, considers it most necessary and useful for everyone to study its manifestations, and dangerous to be ignorant of them. He would therefore have everyone understand its causes, symptoms and cures to some degree.

4282.The cabbage proverb admits tiresome repetition. Compare Erasmus, Adages I.5.38 (438), and Juvenal, Satire 7.154. Burton’s Latin is translated before his own English explanation. Myrachial is derived from mirach, the abdomen or its containing wall; “windy” and “flatuous” refer to wind or vapours in this historical kind of melancholy.

4283.Midriff and diaphragm both appear in Burton’s list and are retained. “Issues” is broad here, covering bodily discharges rather than naming one specific outlet. The distinction between internal and external causes organizes the discussion that follows.

4285.Chyle is the milky product of digestion, thought in this model to pass through the mesenteric veins to the liver for further preparation. Burton’s grammar blurs the passage of chyle with the chyle itself; the modern wording makes the implied subject of “corrupted” explicit.

4286.A “demonstration” here is an illustrative case. Burton’s English gloss gives a looser location than the Latin “between the stomach and liver”; both are retained, with a fresh translation of the Latin first.

4287.The initial I in I. Cæsar Claudinus is represented as J in the modern column. “Grosse” means thick or coarse, not disgusting. The compressed consultation references, names and 1549 date are retained as Burton prints them; the underlying cases remain to be collated.

4289.“Crudities” are incompletely digested materials or humours; “griping” means abdominal cramps. The king image makes the other organs dependent on the stomach’s provision of nourishment.

4290.“Minerall” here is a mine or source from which melancholy is produced, rather than an inorganic substance in the modern sense. Facultatem debilem jecinoris means a weakened power or function of the liver. Burton again allows rival hot and cold explanations.

4292.The printed “Trincavelius Lib. 12. consil.” is an incomplete or displaced reference. It is retained literally in the modern column rather than silently changed to a particular consultation. The margin names Hildesheim as the intermediary for Cnemiandrus; the exact account remains uncollated.

4293.“Ventricle” here means the stomach, whereas it meant a brain cavity earlier. “Neather mouth” is the lower outlet. Mesentery or midriff repeats the anatomical conflation on printed page 175, explained there in the Editor’s note. This wording and the theory of suppressed haemorrhoidal bleeding are retained.

4294.Hepatic, splenic and mesenteric mean associated with the liver, spleen and mesentery. Burton lists the organs in one order and the named forms in another; the translation preserves both sequences.

4295.Cantharides are blister beetles used in historical medicines, including supposed aphrodisiacs. Here Burton cites a case in which their administration produced illness. The statement remains a reported case, not an endorsement of the remedy.

4296.“The mother” is the historical disorder attributed to the womb, often called the suffocation of the mother. The analogy reflects the sex-based physiology of Burton’s sources. The printed “tract. 14. cap. 2. de animâ” remains unresolved; it is not silently converted into a different reference.

4298.The pronoun in “brought him to it” refers to the patient in Montanus’s case. The margin adds a detail absent from the body: mental symptoms impede digestion, reinforcing the reciprocal influence of mind and abdominal organs.

4299.A decoction is a preparation made by boiling material in liquid. “An occasion” leaves the disturbing incident unspecified. The reported relief belongs to Randolotius’s account; the precise source and case remain to be checked.

4301.“Accidents” here means the disease’s manifestations or attendant disorders. The margin speaks specifically of “this internal organ” without naming it; the body broadens the point into a recommendation that everyone learn something of melancholy.