The Anatomy of Melancholy

I do not know what al-Kindi, Capivaccius, Montagna and Simon Eitover, the best and most rational of them all, have said on this subject; but neither he nor they nor any one of them gives the reader, in my judgement, the satisfaction he should. Why these ingredients, and why so many? Roger Bacon has criticized many errors in his treatise On Degrees, explaining some things without making them clear.

Mercurialis, in his book On the Composition of Medicines, takes as examples Hamech and Philonium Romanum, compounded long ago by Hamech, an Arabian, and Philonius, a Roman, but as unsound as the rest. If they are so exact, as his account suggests, and the mixtures so perfect, why does Fernel alter one, and why has the other fallen out of use? Cardano criticizes Galen for ambitiously presuming to correct Andromachus’ theriac, and we may find fault with all the others just as fairly.

Galen’s medicines are now discredited and rejected. Most of what Nicholas Meripsa, Mesue, Celsus, Scribanius, Actuarius and others wrote long ago is despised. Mellichius, Cordus, Wecker, Quercetanus and Renodaeus, and the Venetian and Florentine states, have their respective recipes and special formulations. Nuremberg has its own, and the Augsburg Pharmacopoeia has medicines peculiar to that city’s meridian.

London has its own; every city, town and almost every private individual has his own mixtures, compounds, recipes, special formulations and rules, as though he scorned antiquity and everyone else in comparison with himself. Each must correct and alter things to display his skill; every opinionated fellow must defend his own paradox, whatever it may be. “The kings act madly; the Greeks suffer for it.” They rave, while the poor patients pay for their new experiments: ordinary people bear the cost.

These are the objections others raise, and the conclusions I may draw through the weakness of my understanding. Yet in truth there is no such fault, ambition, novelty or ostentation as some suppose. As one writer answers, the practice of compound medicines “is a most noble and useful invention, devised and introduced into medicine with great judgement, wisdom, deliberation and discretion.”

Mixed diseases require mixed remedies. The substances commonly combined relate to the affected part, some to temper its condition, others to strengthen it, some acting on one part and some on another. Cardano and Brasavola both maintain that “no single medicinal substance is without harm”: no simple medicine is free from hurt or injury. Although Hippocrates, Erasistratus and Diocles, in the infancy of this art, were content with ordinary simples,

now, says Aetius, “necessity compels us to seek new remedies and combine single substances: to correct their harmful properties, whether cold, dry, hot, thick, thin, tasteless or foul-smelling; to make them agreeable to the palate and pleasant to taste and take; and, by adding sugar or honey, to preserve them for months or years for various uses.”