The Anatomy of Melancholy

Member 2, Subsection 1 Symptoms of head melancholy

If no symptoms appear around the stomach, and the blood is not disordered, yet fear and sorrow continue, we must suppose that the brain itself is troubled by a melancholic fluid generated in it or otherwise conveyed into it; and that this harmful fluid comes from the disordered constitution of the part, or remains after an inflammation. So far Piso. But this is not always true, for both the blood and the hypochondria are often affected even in head melancholy.

Hercules de Saxonia differs here from the general run of writers, assigning distinctive signs of head melancholy to the disordered condition of the spirits in the brain alone, according as they are hot, cold, dry or moist: all without humoral matter, arising solely from the motion and darkness of the spirits. He treats separately the melancholy that proceeds from humours through scorching, with its respective symptoms and cures.

The common signs, if it originates in the head itself, are a ruddy face and a strongly sanguine complexion, usually “with a deep flush.” One writer calls it bluish, and sometimes covered with pimples, with red eyes: Avicenna, book 3, fen 2, treatise 4, chapter 18; Duretus and others, from Galen, On Affected Parts, book 3, chapter 6. To this redness of the face Hercules de Saxonia adds heaviness of the head and fixed, sunken eyes.

If it proceeds from dryness of the brain, their heads will feel light and dizzy, and they will be especially prone to wakefulness, remaining without sleep for whole months together. Montaltus adds, in chapter 17, that they have few discharges from the eyes and nostrils and are often bald through excessive dryness. If it proceeds from moisture, dullness, drowsiness and headache follow; and, as Salustius Salvianus found from his own experience, in book 2, chapter 1, epileptic symptoms, with an abundance of humours in the head. They are very bashful, ruddy, ready to blush and turn red on every occasion, “especially if fear comes upon them.”

But the chief sign by which to distinguish this type, as I have said, is the absence of notable signs in the stomach, hypochondria or elsewhere—“significant,” as Montaltus calls them, or of greater importance—because disorders of the stomach often occur along with it. Wind is common to all three types and is not excluded; only the type arising from the hypochondria is windier than the rest, says Hollerius. Aetius, Tetrabiblos, book 2, section 2, chapters 9 and 10, maintains the same: if the signs are more numerous and evident in the head than elsewhere, the brain is primarily affected. Among other treatments, he prescribes foods that produce no wind and yield good bodily fluid. He does not exclude wind or corrupted blood even from head melancholy itself. But these types are often mingled, and so are their symptoms, as I have already shown.