And a melancholy man is the true Prometheus, bound to the Caucasus; the true Tityus, whose entrails a vulture continually devours, as the poets imagine. For Lilio Giraldi interprets it in this way, as anxieties and those gnawing cares, and so it should be understood.

In all other illnesses we seek help. If a leg or an arm aches through some disorder or wound, or we have an ordinary disease, above everything else we desire help and health, an immediate recovery, if it can possibly be obtained. We will freely part with all our other possessions and wealth, endure any misery, drink bitter potions, swallow those unpleasant pills, allow our limbs to be cauterized or cut off—anything for future health. So sweet, so dear, so precious above everything else in this world is life: it is what we chiefly desire, long and happy days. “Grant me many years, Jupiter”: everyone wishes for more years. But to a melancholy man nothing is so wearisome, nothing so hateful. What others seek so carefully to preserve, he alone abhors; his pains are so intolerable.

Some debate “whether illnesses of the body or of the mind are more severe,” but there is no comparison, no room for doubt: “For the torment of the mind is much fiercer and far more terrible than that of the body” (Lemnius, book 1, chapter 12). Diseases of the mind are far more severe. “Here the whole body is one wound”: body and soul are afflicted here, but especially the soul. So Cardan testifies in On the Variety of Things, book 8, chapter 40. Maximus of Tyre, a Platonist, and Plutarch have written entire volumes to prove it. “Time takes people’s grief away”: in other diseases there is generally some hope, but these unhappy men are born to misery, beyond all hope of recovery, incurably ill. The longer they live, the worse they become, and death alone must ease them.

Some philosophers raise another question: whether it is lawful for a man in such extreme pain and grief to kill himself, and how those who do so should be judged. The Platonists approve it, holding it lawful in such cases and under necessity: Plotinus, On Happiness, chapter 7. Socrates himself defends it in Plato’s Phaedo: “If anyone suffers from an incurable disease, he may kill himself, if it is for his good.”

Epicurus and his followers, and the Cynics and Stoics generally, affirm it—Epictetus and Seneca among the rest: “Any path is a true path to freedom,” any way is allowable that leads to liberty. “Let us thank God that no man is compelled to live against his will.” “What do bars, prison or guards matter to a man? He has an open door”: death is always ready and at hand. “Do you see that steep place, that river?” Do you see that steep place, that river, that pit, that tree? Freedom is at hand: “They are ways of escape from slavery and pain.” So that Spartan boy threw himself headlong to be freed from his misery: “I will not be a slave,” the boy said.

Every vein in your body will set you free, if these are “too laborious exits.” “What does it matter to you whether you bring about your end or receive it?” There is no necessity for a man to live in misery. “It is an evil to live under necessity, but there is no necessity to live under necessity. He is a coward who dies without cause, and a fool who lives in pain.” The same author, Letter 58.

Why has our mother earth produced poisons in such abundance, says Pliny, except that men in distress might kill themselves? Kings of old always kept these ready, Livy writes, “poison kept under guard, ready for the uncertainties of fortune,” and executioners always at hand. When Speusippus was ill and being carried on his slaves’ shoulders, Diogenes met him. He complained to the philosopher, but Diogenes said, “I do not pity you, since you endure living in such a condition”: you may be freed whenever you choose, meaning by death.

Seneca therefore commends Cato, Dido and Lucretia for their noble courage in doing so, and others who die voluntarily to avoid a greater evil, free themselves from misery, preserve their honour or defend their good name—as Cleopatra did; as Sophonisba, Syphax’s wife, did; as Hannibal did; as Junius Brutus, Vibius Virius and those Campanian senators in Livy, third decade, book 6, did when they poisoned themselves to escape Roman tyranny. Themistocles drank bull’s blood rather than fight against his country, and Demosthenes preferred to drink poison. Publius, the son of Crassus, Censorinus and Plancus, those heroic Romans, chose to kill themselves rather than fall into their enemies’ hands.

How many tens of thousands more from every age might I recall, “who, though innocent, brought death upon themselves by their own hand,” and so forth. Razis in Maccabees is praised for it, Samson’s death approved. So Saul and Jonah sinned, and many worthy men and women “whose memory is honoured in the Church,” says Lemnichius, by killing themselves to preserve their chastity and honour when Rome was taken, as Augustine gives examples in The City of God, book 1, chapter 16. Jerome defends the same in his commentary On Jonah, and Ambrose, On Virginity, book 3, commends Pelagia for doing so. Eusebius, book 8, chapter 15, admires a Roman matron for the same deed, to save herself from the lust of the tyrant Maxentius. Aldhelm, abbot of Malmesbury, calls them “blessed virgins who thus,” and so forth.

Titus Pomponius Atticus, that wise, prudent and renowned Roman senator, Cicero’s dear friend, had long been ill with what he supposed was an incurable disease, “and was prolonging his life only to increase his pains, without hope of recovery.” He resolved voluntarily to starve himself to death to be rid of his pain. When Agrippa and his other weeping friends earnestly begged him, “kissing him and beseeching him not to hasten himself what nature would compel,” not to do violence to himself, “he firmly asked them in return to approve his good intention and not try to dissuade him.” And so he died steadfastly, “silencing their prayers by his unspoken obstinacy.”