The Anatomy of Melancholy

The spleen contributes to this malady, as they all agree, as does the suppression of haemorrhoidal bleeding. “The spleen is another cause when it fails to purge,” says Montaltus—if it is too cold and dry and does not cleanse the other parts as it should. In consultation 23, Montanus names a blocked spleen as a major cause.

Christophorus à Vega reports from his own knowledge that he has seen melancholy caused by putrefied blood in the seminal vessels and womb; Arculanus, by menstrual blood turned into melancholic humour, and by semen retained too long, through putrefaction or scorching, as I have already explained.

The mesentery, or midriff, the diaphragm, is a cause—the part the Greeks called phrenas—because its inflammation greatly disturbs the mind with convulsions and derangement. In this unnatural melancholy, most of these parts do harm through inflammation, corrupting the humours and spirits, for from them soot-laden and black spirits are generated.

For that reason Montaltus, in chapter 10 on the causes of melancholy, holds that its active cause is a hot and dry disorder, not a cold and dry one, as some maintain: the heat of the brain roasting the blood, excessive heat of the liver and bowels, and inflammation of the pylorus.

All the more so because, as Galen holds, all spices inflame the blood, as do solitude, sleeplessness, fevers, study and meditation, all of which produce heat. He therefore concludes that this disorder causing acquired melancholy is not cold and dry, but hot and dry.

But I have discussed this sufficiently in treating the material of melancholy. I hold that it may be true of unnatural melancholy, which produces madness, but not of natural melancholy, which is colder and, when excessive, produces a milder derangement. Geraldus de Solo maintains this opinion in his commentary on Rhazes.