The Anatomy of Melancholy

MEMBER 3. SUBSECTION 1 Treatment of hypochondriacal melancholy

In this treatment, as in the others, what is required above all is the proper regulation of those six non-natural things, especially a good diet. Montanus, consultation 27, tells a French nobleman to take particular care over it, without which all other remedies are useless.

Bloodletting should not be used unless the patient’s body is very full of blood and it is carried from the liver and spleen to the stomach and its vessels. Then, to draw it back, cut the inner vein of either arm—some say the salvatella—and if the illness persists, open a vein in the forehead.

Preparatory medicines and alteratives may be used as before, except that attention must be paid to the liver, spleen, stomach and regions beneath the ribs, as well as to the heart and brain. To strengthen the stomach and internal parts against wind and obstructions, Aretaeus, Galen, Aëtius, Aurelianus and many later writers regularly prescribe decoctions of wormwood, centaury, pennyroyal and betony boiled in whey and drunk daily. Many have been cured by this medicine alone.

Prosper Altinus and some others praise Nile water just as highly against this illness, as an especially good remedy for windy melancholy. Presumably for this reason, when Ptolemy Philadelphus married his daughter Berenice to the king of Assyria—as Celsus records in book 2—“he ordered Nile water to be brought at great expense”: at great cost to himself, he had Nile water carried with her, and commanded that throughout her life she should drink nothing else.

I find writers who recommend apples in disorders of the spleen and in this kind of melancholy—some call the preparation “lamb’s wool.” However highly it is praised, its cold, raw quality and tendency to produce wind must certainly be corrected.

Codronchus, in his book On Salt of Wormwood, praises wormwood oil and salt above all other remedies: it works better and faster than any simple medicine whatsoever, and is greatly to be preferred to all those nauseating decoctions and infusions, whose sheer quantity must cause discomfort. A small dose of this alone expels wind with great force, promotes urination, cleanses the stomach of all thick humours and undigested matter, helps the appetite, and so on.

Arnoldus has a wormwood wine that he recommends using; every pharmacopoeia describes it.

Gentle purgatives and purging medicines may be taken as before, of hiera, manna and cassia, which Montanus, consultation 230, for an Italian abbot, prefers to all other simple medicines in this kind of illness. These must be used frequently, always avoiding the more violent ones, lest they irritate the stomach and thereby increase the trouble.