The Anatomy of Melancholy

MEMBER 2 Treatment of melancholy throughout the body

When melancholic blood affects the whole body as well as the brain, it is best to begin with bloodletting. The Greeks prescribe opening the median, or middle, vein and removing as much blood as the patient can comfortably spare, making the incision wide enough. The Arab physicians consider it best to take blood from the arm on the side where there is more pain and heaviness in the head. If black blood flows out, continue bleeding; if it is clear and good, stop it immediately, because the harmfulness of melancholy is greatly moderated by the goodness of the blood.

If the person’s strength will not allow much blood to be removed at once, it must be attempted repeatedly. If blood cannot conveniently be taken from the arm, it must be taken from the knees and ankles, especially in men whose haemorrhoidal bleeding has stopped, or women whose monthly periods have stopped.

If the illness continues, it is worth drawing blood from a place on the forehead, and from the ankles in unmarried women who are melancholic over love affairs; likewise in widows greatly distressed and troubled by sorrow and cares, for bad blood flows in the heart and so torments the mind. The haemorrhoidal vessels are to be opened with an instrument or medicinal leeches, and so on. See further in Montaltus, chapter 29. Schenck gives an example of someone cured by an accidental wound in his thigh: heavy bleeding freed him from melancholy.

Diet, gentle purgatives, alteratives, cordials and corrective medicines are to be used as before, combined as circumstances require. All their efforts must be directed towards making the melancholic person fat; then the cure is complete.

Some prescribe diuretics, or medicines to increase urination, for this kind of melancholy, both hot and cold: hot ones where the liver’s heat does not forbid them; cold ones where the liver’s heat is very great. Among the hot are parsley roots, lovage, fennel and so on; among the cold, melon seeds and the like, with goat’s-milk whey as the usual vehicle.

To purge and purify the blood, use sow-thistle, chicory, senna, endive, blessed thistle, dandelion, hops, maidenhair fern, fumitory, bugloss, borage and so on, with their juices, decoctions, distilled waters, syrups and the like.

Oswald Croll, in his Chemical Basilica, greatly admires salt of coral in this case; and Aëtius, Tetrabiblos, section 2, chapter 114, admires Archigenes’ hiera, an excellent medicine for purifying the blood. For all melancholic disorders and epilepsy, nothing compares with it.