THE ANATOMY OF MELANCHOLY

BY DEMOCRITUS JUNIOR

[ROBERT BURTON]

1621

MEMB. II.

SUBSECT. I.-- Symptoms of Head-Melancholy.

"IF no symptoms appear about the stomach, nor the blood be misaffected, and fear and sorrow continue, it is to be thought the brain itself is troubled, by reason of a melancholy juice bred in it, or otherwise conveyed into it, and that evil juice is from the distemperature of the part, or left after some inftammation," thus far Piso. But this is not always true,for blood and hypochondries both are often affected even in headmelancholy. Hercules de Saxonia differs here from the common current of writers, putting peculiar signs of head-melancholy, from the sole distemperature of spirits in
the brain, as they are hot, cold, dry, moist, "all without matter from the motion alone, and tenebrosity of spirits;" of melancholy which proceeds from humours by adustion, he treats apart, with their several symptoms and cures. The common signs, if it be by essence in the head, "are ruddiness of face, high sanguine complexion, most part rubore saturato, one calls it a blush, and sometimes full of pimples," with red eyes. Aviceona, l. 3, Fen. 2, Tract. 4, c. 18. Duretus and others outof Galen, de affect. l. 3, c. 6. Hercules de Saxonia to this of redness of face, adds "heaviness of the head, fixed and hollow eyes. If it proceed from dryness of the brain, then their heads will be light, vertiginous, and they most apt to wake, and to continue whole months together without sleep. Few excrements in their eyes and nostrils, and often bald by reason of excess of dryness," Montaltus adds, c. 17. If it proceed from moisture: dulness, drowsiness, headache follows; and as Salust. Salvianus, c. 1, l. 2, out of his own experience found, epileptical, with a multitude of humours in the head. They are very bashful, if ruddy, apt to blush, and to be red upon all occasions, præsertim si metus
accesserit. But the chiefest symptom to discern this species, as I have said, is this, that there be no notable signs in the stomach, hypochondries, or elsewhere, digna, as Montaltus terms them, or of greater note, because oftentimes the passions of the stomach concur with them. Wind is common to all three species, and is not excluded, only that of the hypochondries is more windy than the rest, saith Hollerius. Ætius, tetrab. l. 2, sc. 2, c. 9, and 10, maintains the same, if there be more signs, and more evident in the head than elsewhere, the brain is primarily affected and prescribes head-melancholy to be cured by meats amongst the rest, void of wind, and good juice, not excluding wind, or corrupt blood, even in head-melancholy itself: but these species are often confounded, and so are their symptoms, as I have already proved.
The symptoms of the mind are superfluous and continual cogitations: "for when the head is heated, it scorcheth the blood, and from thence proceed melancholy fumes, which trouble the mind," Avicenna. They are very choleric, and soon hot, solitary, sad, often silent, watchful, discontent, Montaltus, cap. 24. If any thing trouble them, they cannot sleep, but fret themselves still, till another object mitigate, or time wear it
out. They have grievous passions, and immoderate perturbations of the mind, fear, sorrow, &c., yet not so continuate, but that they are sometimes merry, apt to profuse laughter, which is more to be wondered at, and that by the authority of Galen himself, by reason of mixture of blood, prærubri jocosis delectantur et irrisores plerumque sunt, if they be ruddy, they are delighted in jests, and sometimes scoffers themselves, conceited: and as Rodericus a Vega comments on that place of Galen, merry, witty, of

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a pleasant disposition, and yet grievously melancholy anon after: omnia discunt sine doctore, saith Areteus, they learn without a teacher: and as Laurentius supposeth, those feral passions and symptoms of such as think themselves glass, pitchers, feathers, &c., speak strange languages, proceed a calore cerebri (if it be in excess), from the brain's distempered heat.

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SUBSECT. II.-- Symptoms of windy Hypochondriacal Melancholy.

"IN this hypochondriacal or fatuous melancholy, the Symptoms are so ambiguous," saith Crato in a counsel of his for a noblewoman, "that the most exquisite physicians cannot determine of the part affected." Matthew Flaccius, consulted about a noble matron, confessed as much, that in this malady he with Hollerius, Fracastorius, Fallopius, and others, being to give their sentence of a party labouring of hypochondriacal melancholy, could not find out by the symptoms which part was most especially affected; some said the womb, some heart, some stomach, &c., and therefore Crato, consil. 24. lib. 1. boldly avers, that in this diversity of symptoms, which commonly accompany this disease, "no physician can truly say what part is affected." Galen, lib. 3. de loc. affect. reckons up these ordinary symptoms, which all the Neoterics repeat of Diodes; only this fault he finds with him, that he puts not fear and sorrow amongst the other signs. Trincavellius excuseth Diocles, lib. 3. consil. 35. because that oftentimes in a strong head and constitution, a generous spirit, and a valiant, these symptoms appear not, by reason of his valour and courage. Hercules de Saxonia (to whom I subscribe) is of the same mind (which I have before touched) that fear and sorrow are not general symptoms; some fear and are not sad; some be sad and fear not; some neither fear nor grieve. The rest are these, beside fear and sorrow, "sharp belchings, fulsome crudities, heat in the bowels, wind and rumbling in the guts, vehement gripings, pain in the belly and stomach sometimes, after meat that is hard of concoction, much watering of the stomach, and moist spittle, cold sweat, importunus sudor, unseasonable sweat all over the body," as Octavius Horatianus, lib. 2. cap. 5. calls it; cold joints, indigestion, "they cannot endure their own fulsome belchings, continual wind about their hypochondries, heat and griping in their bowels, præcordia sursum convelluntur; midriff and bowels are pulled up, the veins about their eyes look red, and swell from vapours and wind."
Their ears sing now and then, vertigo and giddiness come by fits, turbulent dreams, dryness, leanness, apt they are to sweat upon all occasions, of all colours and complexions. Many of them are high-coloured, especially after meals, which
symptom Cardinal Cæcius was much troubled with, and of which he complained to Prosper Calenus his physician, he could not eat, or drink a cup of wine, but he was as red in the face as if he had been at a mayor's feast. That symptom alone vexeth many.
Some again are black, pale, ruddy, sometimes their shoulders, and shoulder blades ache, there is a leaping all over their bodies, sudden trembling, a palpitation of the heart, and that cardiaca passio, grief in the mouth of the stomach, which maketh the patient think his heart itself acheth, and sometimes suffocation, difficultas anhelitus, short breath, hard wind, strong pulse, swooning. Montanus, consil. 55, Trincavellius, lib. 3. consil. 36, et 37. Fernelius, cons. 43. Frambesarius, consult. lib. 1. consil. 17. Hildesheim, Claudinus, &c., give instance of every particular. The peculiar
symptoms, which properly belong to each part be these. If it proceed from the stomach saith Savanarola, 'tis full of pain and wind, Guianerius adds vertigo, nausea, much spitting, &c. if from the myrach, a swelling and wind in the hypochondries, a loathing, and appetite to vomit, pulling upward. If from the heart, aching and trembling of it, much heaviness. If from the liver, there is usually a pain in the right hypochondrie. If from the spleen, hardness and grief in the left hypochondrie, a

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rumbling, much appetite and small digestion, Avicenna. If from the meseraic veins and liver on the other side, little or no appetite, Herc. de Saxonia. If from the hypochondries, a rumbling inflation, concoction is hindered, often belching, &c. And from these crudities, windy vapours ascend up to the brain which trouble the imagination, and cause fear, sorrow, dulness, heaviness, many terrible conceits and chimeras, as Lemnius well observes, l. 1. c. 16. "as a black and thick cloud covers the sun, and intercepts his beams and light, so doth this melancholy vapour obnubilate the mind, enforce it to many absurd thoughts and imaginations," and compel, good, wise, honest, discreet men (arising to the brain from the lower part; "as smoke out of a chimney") to dote, speak, and do that which becomes them not, their persons, callings,
wisdoms. One by reason of those ascending vapours and gripings, rumbling beneath, will not be persuaded but that he hath a serpent in his guts, a viper, another frogs. Trallianus relates a story of a woman, that imagined she had swallowed an eel, or a serpent, and Felix Platerus, observat. lib. 1. hath a most memorable example of a countryman of his, that by chance falling into a pit where frogs and frogs' spawn was, and a little of that water swallowed, began to suspect that he had likewise swallowed frogs' spawn, and with that conceit and fear, his phantasy wrought so far, that he verily thought he had young live frogs in his belly, qui vivebant ex alimento suo, that lived by his nourishment, and was so certainly persuaded of it, that for many years following he could not be rectified in his conceit: He studied physic seven years
together to cure himself, travelled into Italy, France and Germany to confer with the best physicians about it, and Anno 1609, asked his counsel amongst the rest; he told him it was wind, his conceit, &c., but mordicus contradicere, et ore et scriptis probare nitebatur: no saying would serve, it was no wind, but real frogs: "and do you not hear them croak?" Platerus would have deceived him, by putting live frogs into his excrements; but he, being a physician himself would not be deceived, vir prudens alias, et doctus, a wise and learned man otherwise, a doctor of physic, and after seven years' dotage in this kind, a phantasia liberatus est, he was cured. Laurentius and Goulart have many such examples, if you be desirous to read them. One commodity above the rest which are melancholy, these windy flatuous have, lucida intervalla, their symptoms and pains are not usually so continuate as the rest, but come by fits, fear and sorrow, and the rest: yet in another they exceed all others; and that is, they are luxurious, incontinent, and prone to venery, by reason of wind, et facile amant, et quam libet fere amant. (Jason Pratensis.) Rhasis is of opinion, that Venus doth many of them much good; the other symptoms of the mind be common with the rest.

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SUBSECT. III.-- Symptoms of Melancholy abounding in the whole body.

THEIR bodies that are affected with this universal melancholy are most part black, "the melancholy juice is redundant all over," hirsute they are, and lean, they have broad veins, their blood is gross and thick. "Their spleen is weak," and a liver apt to engender the humour; they have kept bad diet, or have had some evacuation stopped, as hæmorrhoids, or months in women, which Trallianus, in the cure, would have carefully to be inquired, and withal to observe of what complexion the party is of; black or red. For as Forrestus and Hollerius contend, if they be black, it proceeds from abundance of natural melancholy; if it proceed from cares, agony, discontents, diet, exercise, &c., these may be as well of any other colour: red, yellow, pale, as black, and yet their whole blood corrupt: prærubri colore sæpe sunt tales, sæpe flavi, (saith Montaltus, cap. 22) The best way to discern this species, is to let them bleed, if the blood be corrupt, thick and black, and they withal free from those hypochondriacal symptoms, and not so grievously troubled with them, or those of the head, it argues they are melancholy, a toto corpore. The fumes which arise from this corrupt blood, disturb the mind, and make them fearful and sorrowful, heavy hearted as the rest, dejected, discontented, solitary, silent, weary of their lives, dull and heavy, or merry, &c., and if far gone, that which Apuleius wished to his enemy, by way of imprecation, is true in them; "Dead men's bones, hobgoblins, ghosts, are ever in their minds, and meet them still in every turn: all the bugbears of the night, and terrors, fairy-babes of tombs, and graves are before their eyes, and in their thoughts, as to women and children, if they be in the dark alone." If they hear, or read, or see any tragical object, it sticks by them, they are afraid of death, and yet weary of their lives, in their discontented humours they quarrel with all the world, bitterly inveigh, tax satirically, and because they cannot otherwise vent their passions or redress what is amiss, as they mean, they will by violent death at last be revenged on themselves.

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SUBSECT. IV.-- Symptoms of Maids, Nuns, and Widows' Melancholy.

BECAUSE Lodovicus Mercatus in his second book de mulier. affect. cap. 4. and Rodericus a Castro de morb. mulier. cap. 3. lib. 4. two famous physicians in Spain, Daniel Sennertus of Wittenberg, lib. 1. part. 2. cap. 13. with others; have
vouchsafed in their works, not long since published, to write two just treatises de Melancholia Virginum, Monialium et Viduarum, as a particular species of melancholy (which I have already specified) distinct from the rest; (for it much differs from that which commonly befalls men and other women, as having one only cause proper to women alone) I may not omit in this general survey of melancholy symptoms, to set down the particular signs of such parties so misaffected.

The causes are assigned out of Hippocrates, Cleopatra, Moschion, and those old Gynæciorum Scriptores, of this feral malady, in more ancient maids, widows, and barren women, ob septum transversum violatum, saith Mercatus, by reason of the midriff or Diaphragma, heart and brain offended with those vicious vapours which come from menstruous blood, inflammationem arterias circa dorsum, Rodericus adds, an inflammation of the back, which with the rest is offended by that fuliginous exhalation of corrupt seed, troubling the brain, heart and mind; the brain, I say, not in essence, but by consent, Universa enim hujus affectus causa ab utero pendet, et a sanguinis menstrui malitia, for in a word, the whole malady proceeds from that inflammation, putridity, black smoky vapours, &c., from thence comes care, sorrow, and anxiety, obfuscation of spirits, agony, desperation, and the like, which are intended or remitted; si amatorius accesserit ardor, or any other violent object or perturbation of mind. This melancholy may happen to widows, with much care and
sorrow, as frequently it doth, by reason of a sudden alteration of their accustomed course of life, &c. To such as be in childbed ob suppressam purgationem; but to nuns and more ancient maids, and some barren women for the causes aforesaid, 'tis more familiar, crebrius his quam reliquis accidit, inquit Rodericus, the rest are not altogether excluded.

Out of these causes Rodericus defines it with Areteus, to be angorem animi, a vexation of the mind, a sudden sorrow from a small, light, or no occasion, with a kind of still dotage and grief of some part or other, head, heart, breasts, sides, back, belly, &c., with much solitariness, weeping, distraction, &c., from which they are sometimes suddenly delivered, because it comes and goes by fits, and is not so permanent as other melancholy.

But to leave this brief description, the most ordinary symptoms be these, pulsatio juxta dorsum, a beating about the back, which is almost perpetual, the skin is many times rough, squalid, especially, as Areteus observes, about the arms, knees, and knuckles. The midriff and heart-strings do burn and beat very fearfully, and when this vapour or fume is stirred, flieth upward, the heart itself beats, is sore grieved, and faints, fauces siccitate præcluduntur, ut difficulter possit ab uteri strangulatione decerni, like fits of the mother, Alvus plerisque nil reddit, aliis exiguum, acre, biliosum, lotium flavum. They complain many times, saith Mercatus, of a great pain in their heads, about their hearts, and hypochondries, and so likewise in their breasts,

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which are often sore, sometimes ready to swoon, their faces are inflamed, and red, they are dry, thirsty, suddenly hot, much troubled with wind, cannot sleep, &c. And from hence proceed ferina deliramenta, a brutish kind of dotage, troublesome sleep, terrible dreams in the night, subrusticus pudor et verecundia ignava, a foolish kind of bashfulness to some, perverse conceits and opinions, dejection of mind, much discontent, preposterous judgment. They are apt to loathe, dislike, disdain, to be weary of every object, &c., each thing almost is tedious to them, they pine away, void
of counsel, apt to weep, and tremble, timorous, fearful, sad, and out of all hope of better fortunes. They take delight in nothing for the time, but love to be alone and solitary, though that do them more harm: and thus they are affected so long as this vapour lasteth; but by-and-by as pleasant and merry as ever they were in their lives, they sing, discourse, and laugh in any good company, upon all occasions, and so by fits it takes them now and then, except the malady be inveterate, and then 'tis more frequent, vehement, and continuate. Many of them cannot tell how to express themselves in words, or how it holds them, what ails them, you cannot understand them, or well tell what to make of their sayings; so far gone sometimes, so stupified and distracted, they think themselves bewitched, they are in despair, aptæ ad fletum,
desperationem, dolores mammis et hypochondriis. Mercatus therefore adds, now their breasts, now their hypochondries, belly and sides, then their heart and head aches, now heat, then wind, now this, now that offends, they are weary of all; and yet will not, cannot again tell how, where or what offends them, though they be in great pain, agony, and frequently complain, grieving, sighing, weeping, and discontented still, sine causa manifesta, most part, yet I say they will complain, grudge, lament, and not be persuaded, but that they are troubled with an evil spirit, which is frequent in Germany, saith Rodericus, amongst the common sort: and to such as are most grievously affected (for he makes three degrees of this disease in women), they are in despair, surely forespoken or bewitched, and in extremity of their dotage (weary of their lives), some of them will attempt to make away themselves. Some think they see visions, confer with spirits and devils, they shall surely be damned, are afraid of some treachery, imminent danger, and the like, they will not speak, make answer to any question, but are almost distracted, mad, or stupid for the time, and by fits: and thus it holds them, as they are more or less affected, and as the inner humour is intended or remitted, or by outward objects and perturbations aggravated, solitariness, idleness, &c.

Many other maladies there are incident to young women, out of that one and only causes above specified, many feral diseases. I will not so much as mention their names, melancholy alone is the subject of my present discourse, from which I will not swerve. The several cures of this infirmity, concerning diet, which must be very sparing, phlebotomy, physic, internal, external remedies are at large in great variety in Rodericus a Castro, Sennertus, and Mercatus, which whoso will, as occasion serves, may make use of. But the best and surest remedy of all, is to see them well placed, and married to good husbands in due time, hinc illæ lachrymæ, that is the primary cause, and this the ready cure, to give them content to their desires. I write not this to patronise any wanton, idle flirt, lascivious or light housewives, which are too forward many times, unruly, and apt to cast away themselves on him that comes next, without all care, counsel, circumspection, and judgment. If religion, good discipline, honest education, wholesome exhortation, fair promises, fame and loss of good name, cannot inhibit and deter such (which to chaste and sober maids cannot choose but avail much), labour and exercise, strict diet, rigour and threats, may more opportunely be used, and are able of themselves to qualify and divert an ill-disposed temperament.

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For seldom should you see an hired servant, a poor handmaid, though ancient, that is kept hard to her work, and bodily labour, a coarse country wench troubled in this kind, but noble virgins, nice gentlewomen, such as are solitary and idle, live at ease, lead a life out of action and employment, that fare well, in great houses and jovial companies, ill disposed peradventure of themselves, and not willing to make any resistance, discontented otherwise, of weak judgment, able bodies, and subject to passions, (grandiores virgines, saith Mercatus, steriles et viduæ plerumque melancholicæ), such for the most part are misaffected, and prone to this disease. I do not so much pity them that may otherwise be eased, but those alone that out of a strong temperament, innate constitution, are violently carried away with this torrent of
inward hmnours, and though very modest of themselves, sober, religious, virtuous, and well given (as many so distressed maids are), yet cannot make resistance, these grievances will appear, this malady will take place, and now manifestly show itself and may not otherwise be helped. But where am I? Into what subject have I rushed?
What have I to do with nuns, maids, virgins, widows? I am a bachelor myself and lead a monastic life in a college, noe ego sane ineptos qui hæc dixerim, I confess 'tis an indecorum, and as Pallas a virgin blushed, when Jupiter by chance spoke of love matters in her presence, and turned away her face; me reprimam, though my subject necessarily require it, I will say no more.

And yet I must and will say something more, add a word or two in gratiam Virginum et Viduarum, in favour of all such distressed parties, in commiseration of their present estate. And as I cannot choose but condole their mishap that labour of this infirmity, and are destitute of help in this case, so must I needs inveigh against them that are in fault, more than manifest causes, and as bitterly tax those tyrannising pseudo-politicians superstitious orders, rash vows, hard-hearted parents, guardians, unnatural friends, allies (call them how you will), those careless and stupid overseers, that out of worldly respects, covetousness, supine negligence, their own private ends (cum sibi sit interim bene) can so severely reject, stubbornly neglect, and impiously contemn, without all remorse and pity, the tears, sighs, groans, and grievous miseries of such poor souls committed to their charge. How odious and abominable are those superstitious and rash vows of Popish monasteries! so to bind and enforce men and women to vow virginity, to lead a single life, against the laws of nature, opposite to religion, policy, and humanity, so to starve, to offer violence, to suppress the vigour of youth by rigorous statutes, severe laws, vain persuasions, to debar them of that to which by their innate temperature they are so furiously inclined, urgently carried, and sometimes precipitated, even irresistibly led, to the prejudice of their soul's health, and good estate of body and mind: and all for base and private respects, to maintain their gross superstition, to enrich themselves and their territories, as they falsely suppose, by hindering some marriages, that the world be not full of beggars, and their parishes pestered with orphans; stupid politicians, hæccine fieri flagitia? ought these things so to be carried? better marry than burn, saith the Apostle, but they are otherwise persuaded. They will by all means quench their neighbour's house if it be on fire, but that fire of lust which breaks out into such lamentable flames, they will not take notice of, their own bowels oftentimes, flesh and blood shall so rage and burn, and they will not see it: miserum est, saith Austin, seipsum non miserescere, and they are miserable in the mean time that cannot pity themselves, the common good of all, and per consequens their own estates. For let them but consider what fearful maladies, feral diseases, gross inconveniences, come to both sexes by this enforced temperance, it troubles me to think of, much more to relate those frequent abortion and murdering of infants in their nunneries (read Kemnitius and others), their

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notorious fornications, those Spintrias, Tribadas, Ambubeias, &c., those rapes, incests, adulteries, mastuprations, sodomies, buggeries of monks and friars. See Bale's visitation of abbeys, Mercurialis, Rodericus a Castro, Peter Forestus, and divers physicians; I know their ordinary apologies and excuses for these things, sed viderint Politici, Medici, Theologi, I shall more opportunely meet with them elsewhere

"Illius viduæ, aut patronum Virginus hujus,
Ne me forte putes, verbum non amplius addam."

("Lest you may imagine that I patronise this widow or that virgin, I shall not add
another word")

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The Anatomy of Melancholy

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