Subsection 2 Help from friends through counsel and comfort gentle and harsh methods ingenious devices reassurance changes in the way of life and removal of troubling objects and so forth

When the patient cannot by himself resist or overcome these passions that eat away at the heart, his friends or physician must be ready to supply what he lacks. “It will be the part of their humanity and wisdom”—as Cicero directs in a similar case—“to attend to any error, or by their diligence correct anything unforeseen.” They must all work together. As Hippocrates says, “It is not enough for the physician to have done his duty unless the patient and those attending him also do theirs,” and so forth.

First, they must take special care that a melancholy, discontented person, whatever the kind of melancholy, is never left alone or idle. As physicians prescribe medicine “under supervision,” so let such patients have company rather than be left to themselves, lest their illness thereby grow worse: “Patients of this kind should not be alone, or among strangers, or among people they do not love or do not care about,” as Rodrigo da Fonseca prescribes in volume 1, consultation 35.

“We are accustomed to watch over those who mourn,” says Seneca, “lest they make harmful use of solitude.” We watch a sorrowful person lest he misuse his isolation, and we should do the same for a melancholy man. Give him some business, exercise, or recreation to divert his thoughts and keep his attention elsewhere. His imagination is so restless, active, and swift that, unless it is continually occupied, it will work upon itself, sink into melancholy, and instantly be swept away by some fear, jealousy, discontent, suspicion, or empty notion.

If his weakness prevents him from recognizing what is wrong, correcting it, or finding reassurance, they must turn his mind elsewhere through counsel, comfort, or persuasion, by gentle or harsh means, by some ingenious device or an opposing argument. They must remove any objects, causes, company, or circumstances that distress him, accommodate his wishes, please and distract him, and, if possible, give him security and reassurance by changing his way of life. If he conceals his troubles and refuses to acknowledge them, they must discover what distresses him by observing his expression, gestures, movements, and imagination, and then apply remedies. Many are cured at once when their minds are put at ease.

Alexander mentions a woman who, because her husband had long been away travelling, was exceedingly irritable and melancholy. But when she heard that he had returned, contrary to all expectation, the first sight of him freed her from every fear and restored her former health without any other medicine.

Trincavelli, in book 1, consultation 12, tells a similar story of a Venetian who was deeply afflicted with melancholy and ready to die of grief: when he heard that his wife had given birth to a son, he immediately recovered. As Alexander concludes, if our disordered imaginings have not become deeply rooted, they may be cured by this method, especially when they arise from such a cause.

There is no better way to reassure him than to remove the object, cause, or occasion of his trouble, if we can discover it by any possible skill or means. If he grieves, fears, suspects, waits in uncertainty, or is distressed in any way, make him feel secure: “the trouble is resolved.” Give him reassurance and the cure is complete; change his way of life and no other medicine is needed.

If the person is sad or otherwise troubled, consider, says Trallianus, the nature of the trouble and all its circumstances, and immediately bring about a sudden change by removing its occasions. Avoid everything frightening to hear or see: monstrous and unnatural sights, tales of devils, spirits, and ghosts, and tragic stories. These make a powerful impression on fearful people, often renewing and recalling such chimeras and terrifying inventions to their minds.

Do not even mention them in private conversation or make a gesture suggesting them: such things, says Galateus, distress their imaginations. For those who are already sorrowful, Seneca forbids gloomy companions and people who lament: a groaning companion is an enemy to peace of mind.

If anyone is present whom the patient dislikes, that person must be removed. Gentle words and mild methods must be tried first; use no harsh language or discouraging words. Do not, as some do, drive out one madness with another: anyone who does so is madder than the patient himself. Everything must be settled calmly: “what has been thrown down must not be overthrown, but raised up”—things already down must be lifted, not cast down further, as Crato advises. The patient must be treated calmly and gently; we should accomplish things gradually instead of acting against his wishes.

A horse that shies at a drum or trumpet and cannot endure gunfire may be so skilfully trained and encouraged that it not only tolerates these sounds but becomes more spirited and courageous on hearing them, and takes great pleasure in them. In the same way, these people must not be changed “all at once”; through every skilful and gradual approach, they must be accustomed to company, sights, and objects they formerly could not bear.

Many who at first cannot bear the sight of a fresh wound or a sick person later become good surgeons and confident practitioners. A horse shies at a rotten post in the distance, yet passes it calmly when it comes nearer. Much depends on how such people are trained: however averse to company, bashful, solitary, or fearful they may be, they may eventually, like those Roman matrons, desire nothing more than to see an entire company of gladiators breathe their last in a public show.