The Anatomy of Melancholy

Subsection 3. Causes of head melancholy.

After a tedious discussion of the general causes of melancholy, I have now returned at last to deal briefly with its three particular kinds and the causes that properly belong to them. Although these causes combine indiscriminately in each particular kind, commonly producing their effects in the part that is weakest, most disordered and least able to resist, and so cause all three kinds, many are nevertheless peculiar to one kind and seldom found in the others.

For example, head melancholy is commonly caused by a cold or hot disorder of the brain, according to Laurentius, chapter 5 on melancholy; but Hercules de Saxonia contends that it comes from that disturbance or disorder of the animal spirits alone.

Sallustius Salvianus, mentioned before, holds in his medical work, book 2, chapter 3, that it proceeds from cold; but I take that to mean natural melancholy, in people who are foolish and mentally impaired. For, as Galen writes in book 4, chapter 8 on the pulse, and as Avicenna also says, a cold and moist brain is an inseparable companion of folly.

But this acquired melancholy, which is meant here, is caused by a hot and dry disorder, as Damascenus the Arabian thinks in book 3, chapter 22, along with most writers. Altomarus and Piso call it an inborn, burning imbalance that turns blood and yellow bile into melancholic humour.

Both opinions may hold good, as Bruel and Capivaccius maintain: “if the brain is hotter”—if the brain is hot, the animal spirits will be hot, and from this comes madness; if cold, folly.

David Crusius, in his Hermetic Theatre of Diseases, book 2, chapter 6 on black bile, allows that melancholy is a disease of an inflamed brain, though cold in itself: “hot through an incidental condition, cold in its own nature”—hot only incidentally. For my part, I agree with Capivaccius.

Now this humour, according to Salvianus, is sometimes in the substance of the brain, sometimes contained in the membranes and coverings around it, sometimes in the passages of the brain’s ventricles or the veins of those ventricles.

It often follows delirium, long illnesses, fevers, a long stay in hot places or under the sun, or a blow to the head, as Rhazes tells us. Piso adds solitude, sleeplessness and inflammations of the head, proceeding mostly from heavy use of spices, heating wines and heating foods—all of which Montanus lists in consultation 22 for a melancholic Jew, and Heurnius repeats in chapter 12 on mania.

Hot baths, garlic and onions, says Guianerius; bad, corrupt air; much sleeplessness, and so on; retention or excess of semen, suppression of bleeding, a disordered midriff; and, according to Trallianus, book 1, chapter 16, excessive worries, troubles, griefs, discontent, study and meditation—in a word, the misuse of all those six non-natural things.