Only Montanus, consultation 241, opposes it: “To other men,” he says, “this opening of the haemorrhoidal vessels seems a beneficial remedy. For my part, I do not approve of it, because it draws off the thinnest blood and leaves the thickest behind.”

Aëtius, Vidus Vidius, Mercurialis and Fuchs recommend diuretics, or substances that promote urination, such as aniseed, dill, fennel, germander and ground pine, boiled in water or taken in powder with a drink. Yet P. Bayerus opposes them, as does Hollerius: “All melancholic people,” he says, “must avoid substances that promote urination, because they remove the fine or thinnest material, while the thicker matter remains.”

Enemas are much favoured. Trincavelli, book 3, chapter 38, ranks them first for a young nobleman, and Hercules de Saxonia, Pantheum, book 1, chapter 16, strongly approves of them. “I have found by experience,” he says, “that many people with hypochondriacal melancholy have been cured by enemas alone.” Recipes can be found in his work.

Besides those warm applications, washings, anointings and aromatic preparations prescribed for the head, similar ones must be used for the liver, spleen, stomach and regions beneath the ribs. “For imperfect digestion,” says Piso, “it is good to bind the stomach tightly to prevent wind and help digestion.”

I need not discuss internal medicines: use the same cordials as before. In this kind of melancholy some, such as Avicenna, prescribe theriac in winter, especially before or after purging, or in spring; Trincavelli prescribes mithridate; Montaltus, peony seeds, unicorn’s horn, bone from a stag’s heart, and so on.

Among topical or external medicines, none are more valuable than baths, but I have discussed them already. Warm applications to the regions beneath the ribs are very good: wine and water in which southernwood, melilot, thyme dodder, mugwort, senna and polypody have been boiled. So too are wax ointments, plasters, liniments and ointments for the spleen, liver and regions beneath the ribs. For examples, consult Laurentius; Joubert, Medical Practice, book 3, chapter 1; Montanus, consultation 231; Montaltus, chapter 33; Hercules de Saxonia; and Faventinus.

The same applies to liquid dressings, digestive powders, sachets and oils. Octavius Horatianus, book 2, chapter 5, prescribes relaxing poultices, or dry purging medicines; Piso, pitch plasters with oil of rue, applied at certain times to the stomach and to the metaphrenon, the part of the back opposite the heart; Aëtius, mustard plasters.

Montaltus, chapter 35, would have the thighs cauterised; Mercurialis prescribes it below the knees. Laelius Eugubinus, consultation 77, for a German with hypochondriacal melancholy, would have the cautery applied to the right thigh, as does Montanus, consultation 55. The same Montanus, consultation 34, approves of issues in the arms or back of the head. Bernardus Paternus, in Hildesheim, Gleanings 2, would have issues made in both thighs; Lod. Mercatus prescribes them near the spleen, “or near the stomach’s governing region,” or in either thigh.

Binding, rubbing, and cupping glasses applied over or around the belly without scarification, which Felix Plater so strongly approves, may be used as before.