The Anatomy of Melancholy

Hildesheim, Gleanings 2, On Melancholy, considers it less dangerous if only imagination is damaged, not reason. “The mildest comes from blood; worse is that from scorched choler, but worst of all is that from putrefied melancholy.” Bruel considers the hypochondriacal form the least dangerous and the other two forms the hardest to cure, contrary to Galen. The cure is difficult in men, but much more difficult in women. Both men and women must take note of Montanus’s saying in consultation 230, for an Italian abbot: “This illness commonly accompanies them to the grave. Physicians may ease it, and it may lie hidden for a time, but they cannot cure it completely. It will return more violent and severe than at first, at every small occasion or error.”

As with Mercury’s weather-beaten statue, once gilded all over, whose exposed parts were bare but which still had “gold in the fringes”—a remnant of gold in its crevices—some remains of melancholy will be left in the purest bodies, once affected, and will not be easily rooted out. It often degenerates into epilepsy, apoplexy, convulsions and blindness. On the authority of Hippocrates and Galen, all affirm this if it once occupies the brain’s ventricles; Frambesarius and Sallustius Salvianus add blindness if it gets into the optic nerves. Mercurialis, consultation 20, had a woman patient who became epileptic and blind after melancholy.

If it comes from a cold cause, or continues cold, or increases, epilepsy, convulsions and blindness follow; otherwise they eventually become stupefied and foolish, ridiculous in all their actions, speech and gestures. If it comes from a hot cause, they are more frenzied and violent, and finally mad. “Mania quite often follows melancholy as it grows hot.” If it heats and increases, that is the usual outcome: “He is mad periodically, or continually”—mad in fits or all the time. For, as Sennert maintains on Crato’s authority, this humour contains “a seed-bearing fire,” the very seeds of fire. If it comes from natural melancholy that has been scorched, and in excess, they are often possessed by demons: Montanus.

This illness seldom causes death, except when—which is the greatest and most grievous calamity, the misery of all miseries—they kill themselves, a frequent and familiar occurrence among them. It is Hippocrates’ observation and Galen’s judgment: “Although they fear death, they nevertheless very often bring death upon themselves,” On the Affected Parts, book 3, chapter 7. It is the verdict of all physicians: Rabbi Moses’ aphorism, the prognosis of Avicenna, Rhazes, Aetius, Gordonius, Valescus, Altomarus, Sallustius Salvianus, Capivaccius, Mercatus, Hercules de Saxonia, Piso, Bruel, Fuchsius—all of them.

And often, through fear of death, the unhappy man Conceives such hatred of life and of seeing the light That with grieving heart he brings death upon himself.

Death’s terror frightens him so far That he kills himself and hates the light; To end his fear and grief of heart, He dies by choice to ease his pain.