The Anatomy of Melancholy

Love melancholy, which Avicenna calls Ilishi, and lycanthropy, which he calls Cucubuthe, are commonly included in head melancholy. But love melancholy, which Gerardus de Solo calls Amoreos and most call knight’s melancholy, together with religious melancholy, the melancholy of virgins and widows described by Rodericus a Castro and Mercatus, and the other kinds of love melancholy, I shall discuss separately in my Third Partition.

The three preceding species are the subject of my present discussion. I shall dissect them and treat all their causes, symptoms and cures, together and separately, so that everyone affected by this disease in any degree may know how to examine it in himself and apply remedies.

It is difficult, I confess, to distinguish these three species from one another and describe their respective causes, symptoms and cures. They are so often confused with one another and so closely related that even the most exact physicians can scarcely tell them apart. They are also so often mixed with other diseases that the most experienced physicians have been baffled.

Montanus, in consultation 26, mentions a patient who had melancholy and ravenous hunger together, and in consultation 23, melancholy with vertigo. Julius Caesar Claudinus describes it with stone, gout and jaundice; Trincavellius with fever, jaundice, ravenous hunger and so forth. Paulus Regoline, a distinguished doctor of his day, was consulted about such a case and found the tangle of symptoms so bewildering that he did not know which kind of melancholy it belonged to.

Trincavellius, Fallopius and Francanzanus, famous physicians in Italy, were all consulted about the same patient at the same time and gave three different opinions. Elsewhere, asked for his view of a melancholic young man whom he had been called to see, Trincavellius frankly admitted that the man was indeed melancholic but that he did not know which kind to assign him to. His seventeenth consultation contains a similar disagreement about a melancholic monk.

The symptoms that others attribute to disordered organs and humours, Hercules de Saxonia attributes entirely to disordered spirits, and those immaterial, as I have said. Sometimes physicians cannot readily distinguish this disease from others. In Reinerus Solenander’s consultations, section, consultation 5, he and Dr Brande agreed that a patient had hypochondriacal melancholy. Dr Matholdus said it was asthma and nothing else.

Solenander and Guarionius, recently called with other physicians to the melancholic Duke of Cleves, could neither determine the species nor agree among themselves. The species are so entangled that in Caesar Claudinus’s forty-fourth consultation, concerning a Polish count, he judged that the patient suffered at once from head melancholy and from the kind arising from the whole temperament. I could give examples of people who have had all three kinds at once, and others who have had them successively.

So I conclude about our species of melancholy as many political writers do about their pure forms of government. Monarchies, aristocracies and democracies are most prominent in theory, but in practice they are modified and usually mixed, as Polybius tells us: the Spartan and ancient Roman states, the German state today, and many others.