The Anatomy of Melancholy

Member 3 Subsection 1. The Definition of Melancholy Its Name and Distinctions

Having thus briefly dissected the human body and soul in preparation for what follows, I may now proceed freely to my intended subject in a way most people can understand. After many digressions, I can clearly define what melancholy is, explain its name and distinguish its forms.

Its name comes from its substance: the disease is named after its material cause. As Bruel observes, the Greek word melancholia means, in effect, “black bile.” Whether it is a cause or an effect, a disease or a symptom, I leave Donatus Altomarus and Salvianus to decide; I will not argue about it. It has various descriptions, explanations of its name and definitions.

Fracastorius, in his second book on intellect, calls those people melancholic whom an abundance of this corrupted humour of black bile has so afflicted that it drives them mad and deranges their judgement in most or all matters involving choice, will or other evident operations of the understanding.

Melanelius, drawing on Galen, Rufus and Aetius, describes it as a bad and obstinate disease that reduces human beings to beasts. Galen calls it a loss of function or an impairment of the head’s middle cavity, and so forth, defining it by the part affected. Hercules de Saxonia approves this in book 1, chapter 16, calling it a derangement of the principal function; so do Fuchs in book 1, chapter 23, Arnold in his Breviary, book 1, chapter 18, Guianerius and others. Paulus adds: “caused by black bile.”

Haly Abbas simply calls it a disturbance of the mind. Aretaeus calls it a persistent anguish of the soul, fixed on one thing, without fever. Mercurialis criticizes this definition in On Diseases of the Head, book 1, chapter 10; but Aelianus Montalto defends it as sound and sufficient in chapter 1 on melancholy in his book on diseases.

The usual definition is a kind of mental derangement without fever, ordinarily accompanied by fear and sadness for no apparent reason. Laurentius defines it so in chapter 4; Piso in book 1, chapter 43; Donatus Altomarus in chapter 7 of The Medical Art; Iacchinus in his commentary on book 9 of Rhazes’s To Almansor, chapter 15; Valesius in exercise 17; Fuchs in Institutions, book 3, section 1, chapter 11; and others.

But however widely this common definition is accepted, Hercules de Saxonia will not admit it, nor will David Crusius, who finds it inadequate in Theatrum morborum Hermetis, book 2, chapter 6. It shows what the disease is not rather than what it is, omitting its distinctive features: imagination and the brain. But let me turn to the details.

The highest general category is mental derangement—or anguish of mind, as Aretaeus says. Hercules de Saxonia adds “of a principal part” to distinguish it from cramp, palsy and diseases affecting the external senses and movement. “Deranged” distinguishes it from intellectual incapacity and madness—Montalto makes the distinction by using “anguish of mind”—in which those functions are not deranged but rather abolished.