THE ANATOMY OF MELANCHOLY

BY DEMOCRITUS JUNIOR

[ROBERT BURTON]

1621

SUBSECT. II. -- The Definition, Number, Division of Diseases.

WHAT a disease is, almost every physician defines. Fernelius calleth it an "Affection of the body contrary to nature." Fuschius and Crato, "an hinderance, hurt, or alteration of any action of the body, or part of it." Tholosanus, "a dissolution of that league which is between body and soul, and perturbation of it; as health the perfection, and makes to the preservation of it." Labeo in Agellius, "an ill habit of the body, opposite to nature hindering the use of, it." Others otherwise, all to this effect.

Number of Diseases.] How many diseases there are, is a question not yet determined; Pliny reckons up 300 from the crown of the head to the sole of the foot: elsewhere he saith, morborurm infinita multitudo, their number is infinite. Howsoever it was in those times, it boots not; in our days I am sure the number is much augmented:

-- "macies, et nova febrium
Terris incubat cohors."

-- "Emaciation, and a new cohort of fevers
Broods over the earth."

For besides many epidemical diseases unheard of, and altogether unknown to Galen and Hippocrates, as scorbutum, small-pox, plica, sweating sickness, morbus Gallicus, &c., we have many proper and peculiar almost to every part.

No man free from some Disease or other.] No man amongst us so sound, of so good a constitution, that hath not some impediment of body or mind. Quisque suos patimur manes, we have all our infirmities, first or last, more or less. There will be peradventure in an age, or one of a thousand, like Zenophilus the musician in Pliny, that may happily live 105 years without any manner of impediment; a Pollio Romulus, that can preserve himself "with wine and oil;" a man as fortunate as Q. Metellus, of whom Valerius so much brags; a man as healthy as Otto Herwardus, a senator of Augsburg in Germany, whom Leovitius the astrologer brings in for an example and instance and certainty in his art; who because he had the significators in his geniture fortunate, and free from the hostile aspects of Saturn and Mars, being a very cold man, "could not remember that ever he was sick." Paracelsus may brag that he could make a man live 400 years or more, if he might bring him up from his infancy, and diet him as he list; and some physicians hold, that there is no certain period of man's life; but it may still by temperance and physic be prolonged. We find in the meantime, by common experience, that no man can escape, but that of Hesiod is true;

"Th'earth's full of maladies, and full the sea,
Which set upon us both by night and day."

Division of Diseases.] If you require a more exact division of these ordinary diseases which are incident to men, I refer you to physicians; they will tell you of acute and chronic, first and secondary, lethales, salutares, errant, fixed, simple,
compound, connexed, or consequent, belonging to parts or the whole, in habit, or in disposition, &c. My division at this time (as most befitting my purpose) shall be into

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those of the body and mind. For them of the body, a brief catalogue of which Fuschius hath made, Institut. lib. 3, sect. 1, cap. 11. I refer you to the voluminous tomes of Galen, Areteus, Rhasis, Avicenna, Alexander, Paulus Ætius, Gordonerius: and these exact Neoterics, Savanarola, Capivaccius, Donatus Altomarus, Hercules de Saxonia, Mercurialis, Victorius Faventinus, Wecker, Piso, &c., that have methodically and elaborately written of them all. Those of the mind and head I will briefly handle, and apart.

SUBSECT. III. -- Division of the Diseases of the Head.

THESE diseases of the mind, forasmuch as they have their chief seat and organs in the head, which are commonly repeated amongst the diseases of the head which are divers, and vary much according to their site. For in the head, as there be several parts, so there be divers grievances, which according to that division of Heurnius (which he takes out of Arculanus,) are inward or outward (to omit all others which pertain to eyes and ears, nostrils, gums, teeth, mouth, palate, tongue, wesel, chops, face, &c.) belonging properly to the brain, as baldness, falling of hair, furfaire, lice. &c. Inward belonging to the skins next to the brain, called dura and pia mater, as all head-aches, &c., or to the ventricles. caules, kels, tunicles, creeks, and parts of it, and their passions, as caro, vertigo, incubus, apoplexy, falling sickness. The diseases of the nerves, cramps, stupor, convulsions, tremor, palsy: or belonging to the excrements of the brain, catarrhs, sneezing, rheums, distillations: or else those that pertain to the substance of the brain itself, in which are conceived frenzy, lethargy, melancholy, madness, weak memory, sopor, or Coma Vigilia et vigil Coma. Out of these again I will single such as properly belong to the phantasy, or imagination, or reason itself, which Laurentius calls the diseases of the mind; and Hildesheim, morbos imaginationis, aut rationis læsæ, (diseases of the imagination, or of injured reason,) which are three or four in number, phrensy, madness, melancholy, dotage, and their kinds: as hydrophobia, lycanthropia, Chorus sancti viti, morbi dæmoniaci, (St. Vitus's dance, possession of devils,) which I will briefly touch and point at, insisting especially in this of melancholy, as more eminent than the rest, and that through all
his kinds, causes, symptoms, prognostics, cures: as Lonicerus hath done de apoplexia, and many other of such particular diseases. Not that I find fault with those which have written of this subject before; as Jason Pratensis, Laurentius, Montaltus, T. Bright. &c., they have done very well in their several kinds and methods; yet that which one
omits, another may haply see; that which one contracts, another may enlarge. To conclude with Scribanius, "that which they had neglected, or profunctorily handled, we may more thoroughly examine; that which is obscurely delivered in them, may be perspicuously dilated and amplified by us:" and so made more familiar and easy for every man's capacity, and the common good, which is the chief end of my discourse.

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SUBSECT. IV. -- Dotage, Phrensy, Madness, Hydrophobia, Lycanthropia, Chorus sancti Viti, Extasis.

Delirium, Dotage.] DOTAGE, fatuity, or folly, is a common name to all the following species, as some will have it. Laurentius and Altomarus comprehended madness, melancholy, and the rest under this name, and call it the summum genus of them all. If it be distinguished from them, it is natural or ingenite, which comes by some defect of the organs, and over-much brain, as we see in our common fools; and is for the most part intended or remitted in particular men, and thereupon some are wiser than others: or else it is acquisite, an appendix or symptom of some other disease, which comes or goes; or if it continue, a sign of melancholy itself.

Phrensy.] Phrenitis, which the Greeks derive from the word φρην [phren], is a disease of the mind, with a continual madness or dotage, which hath an acute fever annexed, or else an inflammation of the brain, or the membranes or kels of it, with an acute fever, which causeth madness and dotage. It differs from melancholy and madness, because their dotage is without an ague: this continual, with waking, or memory decayed, &c. Melancholy is most part silent, this clamorous; and many such like differences are assigned by physicians.

Madness.] Madness, phrensy, and melancholy are confounded by Celsus and many writers; others leave out phrensy, and make madness and melancholy but one disease, which Jason Pratensis especially labours, and that they differ only secundum majus or minus, in quantity alone; the one being a degree to the other, and both proceeding from one cause. They differ intenso et remisso gradu, saith Gordonius, as the humour is intended or remitted. Of the same mind is Areteus Alexander Tertullianus, Guianerius, Savanarola, Heurnius; and Galen himself writes promiscuously of them both by reason of their affinity: but most of our neoterics do handle them apart, whom I will follow in this treatise. Madness is therefore defined to be a vehement dotage; or raving without a fever, far more violent than melancholy, full of anger and clamour, horrible looks, actions, gestures, troubling the patients with far greater vehemency both of body and mind, without all fear and sorrow, with such impetuous force and boldness, that sometimes three or four men cannot hold them.
Differing only in this from phrensy, that it is without a fever, and their memory is most part better. It hath the same causes as the other, as choler adust, and blood incensed, brains inflamed, &c. Fracastrius adds, "a due time, and full age to this definition, to distinguish it from children, and will have it confirmed impotency, to separate it from such as accidentally come and go again, as by taking henbane, nightshade, wine," &c. Of this fury there be divers kinds; ecstasy, which is familiar with some persons, as Cardan saith of himself, he could be in one when he list; in which the Indian priests deliver their oracles, and the witches in Lapland, as Olaus Magnus writeth, 1. 3. cap. 18. Extasi omnia prædicere, answer all questions in an extasis you will ask; what your friends do, where they are, how they fare, &c. The
other species of this fury are enthusiasms, revelations, and visions, so often mentioned by Gregory and Beda in their works; obsession or possession of devils, sibylline prophets, and poetical furies; such as come by eating noxious herbs, tarantulas stinging, &c., which some reduce to this. The most known are these, lycanthropia, hydrophobia, chorus sancti viti.

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Lycanthropia.] Lycanthropia, which Avicenna calls Cucubuth, others Lupinam insaniam, or Wolf-madness, when men run howling about graves and fields in the night, and will not be persuaded but that they are wolves, or some such beasts. Ætius and Paulus call it a kind of melancholy; but I should rather refer it to madness, as most do. Some make a doubt of it whether there be any such disease. Donat ab Altomari saith, that he saw two of them in his time: Wierus tells a story of such a one at Padua 1541, that would not believe to the contrary, but that he was a wolf. He hath another instance of a Spaniard, who thought himself a bear; Forrestus confirms as much by many examples; one amongst the rest of which he was an eye-witness, at Alemaer in Holland, a poor husbandman that still hunted about graves, and kept in churchyards, of a pale, black, ugly, and fearful look. Such belike, or little better, were King Prætus' daughters, that thought themselves kine. And Nebuchadnezzar in Daniel, as some interpreters hold, was only troubled with this kind of madness. This disease perhaps gave occasion to that bold assertion of Pliny, "some men were turned into wolves in his time, and from wolves to men again:" and to that fable of Pausanias, of a man that was ten years a wolf, and afterwards turned to his former shape: to Ovid's tale of Lycaon, &c. He that is desirous to hear of this disease, or more examples, let him read Austin in his 18th book de Civitate Dei, cap. 5. Mizaldus, cent. 5. 77. Sckenkius, lib. 1. Hildesheim, spicel. 2. de Mania. Forrestus. lib. 10. de morbis cerebri. Olaus Magnus, Vicentius' Bellavicensis, spec. met. lib. 31. c. 122. Pierius, Bodine, Zuinger, Zeilger, Peucer, Wierus, Spranger, &c. This malady, saith Avicenna, troubleth men most in February, and is now-a-days frequent in Bohemia and Hungary, according to Heurnius. Schernitzius will have it common in Livonia. They lie hid most part all day, and go abroad in the night, barking, howling, at graves and deserts; "they have usually hollow eyes, scabbed legs and thighs, very dry and pale," saith Altomarus; he gives a reason there of all the symptoms, and sets down a brief cure of them.

Hydrophobia is a kind of madness, well known in every village, which comes by the biting of a mad dog, or scratching, saith Aurelianus; touching, or smelling alone sometimes as Sckenkius proves, and is incident to many other creatures as well as men: so called because the parties affected cannot endure the sight of water, or any liquor, supposing still they see a mad dog in it. And which is more wonderful; though they be very dry, (as in this malady they are) they will rather die than drink: Cælius Aurelianus, an ancient writer, makes a doubt whether this Hydrophobia be a passion of the body or the mind. The part affected is the brain: the cause, poison that comes from the mad dog, which is so hot and dry, that it consumes all the moisture in the body. Hildesheim relates of some that died so mad; and being cut up, had no water, scarce blood, or any moisture left in them. To such as are so affected, the fear of water begins at fourteen days after they are bitten, to some again not till forty or sixty days after: commonly saith Heurnius, they begin to rave, fly water and glasses, to look red, and swell in the face, about twenty days after (if some remedy be not taken in the meantime) to lie awake, to be pensive, sad, to see strange visions, to bark and howl, to fall into a swoon, and oftentimes fits of the falling sickness. Some say, little things like whelps will be seen in their urine. If any of these signs appear, they are past recovery. Many times these symptoms will not appear till six or seven months after, saith Codronchus; and sometimes not till seven or eight years, as Guianerius; twelve as Albertus; six or eight months after, as Galen holds. Baldus the great lawyer died of it: an Augustine friar, and a woman in Delft, that were Forrestus' patients, were miserably consumed with it. The common cure in the country (for such at least as dwell near the sea-side) is to duck them over head and ears in sea water; some use

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charms: every good wife can prescribe medicines. But the best cure to be had in such cases, is from the most approved physicians; they that will read of them, may consult with Dioscorides, lib. 6. c. 37, Heurnius, Hildesheim, Capivaccius, Forrestus, Sckenkius, and before all others Codronchus an Italian, who hath lately written two exquisite books on the subject.

Chorus sancti Viti, or S. Vitus' dance; the lascivious dance, Paracelsus calls it, because they that are taken from it, can do nothing but dance till they be dead or cured. It is so called, for that the parties so troubled were wont to go to S. Vitus for help, and after they had danced there awhile, they were certainly freed. 'Tis strange to hear how long they will dance, and in what manner, over stools, forms, tables; even great bellied women sometimes (and yet never hurt their children) will dance so long that they can stir neither hand nor foot, but seem to be quite dead. One in red clothes
they cannot abide. Music above all things they love, and therefore magistrates in Germany will hire musicians to play to them, and some lusty sturdy companions to dance with them. This disease hath been very common in Germany, as appears by those relations of Sckenkius, and Paracelsus in his book of madness, who brags how many several persons he hath cured of it. Felix Platerus de mentis alienat. cap. 3. reports of a woman in Basil whom he saw, that danced a whole month together. The Arabians call it a kind of palsy. Bodine in his 5th book de Repub. cap. 1, speaks of this infirmity; Monavius in his last epistle to Scoltizius, and in another to Dudithus, where you may read more of it.
The last kind of madness or melancholy, is that demoniacal (if I may so call it) obsession or possession of devils, which Platerus and others would have to be preternatural: stupend things are said of them, their actions, gestures, contortions,
fasting, prophesying, speaking languages they were never taught, &c. Many strange stories are related of them, which because some will not allow, (for Deacon and Darrel have written large volumes on this subject pro and con.) I voluntarily omit.

Fuschius, institut. lib. 3. sec. 1. cap. 11, Felix Plater, Laurentius, add to these another fury that proceeds from love, and another from study, another divine or religious fury; but these more properly belong to melancholy; of all which I will speak apart, intending to write a whole book of them.

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MELANCHOLY, the subject of our present discourse, is either in disposition or habit. In disposition, is that transitory melancholy which goes and comes upon every small occasion of sorrow, need, sickness, trouble, fear, grief; passion, or
perturbation of the mind, any manner of care, discontent, or thought, which causeth anguish, dulness, heaviness and vexation of spirit, any ways opposite to pleasure, mirth, joy, delight, causing frowardness in us, or a dislike. In which equivocal and improper sense, we call him melancholy that is dull, sad, sour, lumpish, ill-disposed, solitary, any way moved, or displeased. And from these mclancholy dispositions, no man living is free, no stoic, none so wise, none so happy, none so patient, so generous, so godly, so divine, that can vindicate himself; so well composed, but more or less, some time or other he feels the smart of it. Melancholy in this sense is the character of mortality. "Man that is born of a woman, is of short continuance, and full of trouble." Zeno, Cato, Socrates himself, whom Ælian so highly commends for a moderate temper, that "nothing could disturb him, but going out, and coming in, still Socrates kept the same serenity of countenance, what misery soever befel him," (if we may believe Plato his disciple) was much tormented with it. Q. Metellus, in whom Valerius gives instance of all happiness, "the most fortunate man then living, born in that most flourishing city of Rome, of noble parentage, a proper man of person, well qualified, healthful, rich, honourable, a senator, a consul, happy in his wife, happy in his children," &c., yet this man was not void of melancholy, he had his share of sorrow. Polycrates Samius, that flung his ring into the sea, because he would participate of discontent with others, and had it miraculously restored to him again shortly after, by a fish taken as he angled, was not free from melancholy dispositions.
No man can cure himself; the very gods had bitter pangs, and frequent passions, as their own poets put upon them. In general, "as the heaven, so is our life, sometimes fair, sometimes overcast, tempestuous, and serene; as in a rose, flowers and prickles; in the year itself, a temperate summer sometimes, a hard winter, a drought, and then again pleasant showers: so is our life intermixed with joys, hopes, fears, sorrows, calumnies;" Invicem cedunt dolor et voluptas, there is a succession of pleasure and pain.

--"medio de fonte leporum,
Surgit amari aliquid in ipsis floribus angat."

"Even in the midst of laughing there is sorrow" (as Solomon holds): even in the midst of all our feasting and jollity, as, Austin infers in his Com. on the 41st Psalm, there is grief and discontent. Inter delicias semper aliquid sævi nos strangulat, for a pint of honey thou shalt here likely find a gallon of gall, for a dram of pleasure a pound of
pain, for an inch of mirth an ell of moan; as ivy doth an oak, these miseries encompass our life. And it is most absurd and ridiculous for any mortal man to look for a perpetual tenure of happiness in this life. Nothing so prosperous and pleasant. but it hath some bitterness in it, some complaining, some grudging; it is all γλυχυπιχρον

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[glychopichron], a mixed passion, and like a chequer table, black and white men, families, cities, have their falls and wanes; now trines, sextiles, then quartiles and oppositions. We are not here as those angels, celestial powers and bodies, sun and moon, to finish our course without all offence, with such constancy, to continue for so many ages: but subject to infirmities, miseries, interrupted, tossed and tumbled up and down, carried about with every small blast, often molested and disquieted upon each slender occasion, uncertain, brittle, and so is all that we trust unto. "And he that
knows not this is not armed to endure it, is not fit to live in this world (as one condoles our time), he knows not the condition of it, where with a reciprocalty, pleasure and pain are still united, and succeed one another in a ring." Exi e mundo, get thee gone hence if thou canst not brook it; there is no way to avoid it, but to arm thyself with patience, with magnanimity, to oppose thyself unto it, to suffer affliction as a good soldier of Christ; as Paul adviseth constantly to bear it. But forasmuch as so few can embrace this good counsel of his, or use it aright, but rather as so many brute beasts give a way to their passion, voluntary subject and precipitate themselves into a labyrinth of cares, woes, miseries, and suffer their souls to be overcome by them, cannot arm themselves with that patience as they ought to do, it falleth out oftentimes that these dispositions become habits, and "many affects contemned (as Seneca notes) make a disease. Even as one distillation, not yet grown to custom, makes a cough; but continual and inveterate causeth a consumption of the lungs;" so do these our melancholy provocations: and according as the humour itself is intended, or remitted in men, as their temperature of body, or rational soul is better able to make resistance; so are they more or less affected. For that which is but a flea-biting to one, causeth insufferable torment to another; and which one by his singular moderation, and wellcomposed carriage can happily overcome, a second is no whit able to sustain, but upon every small occasion of misconceived abuse, injury, grief; disgrace, loss, cross, humour, &c. (if solitary, or idle) yields so far to passion, that his complexion is altered, his digestion hindered, his sleep gone, his spirits obscured, and his heart heavy, his hypochondries misaffected; wind, crudity, on a sudden overtake him, and he himself overcome with melancholy. As it is with a man imprisoned for debt, if once in the gaol, every creditor will bring his action against him, and there likely hold him. If any discontent seize upon a patient, in an instant all other perturbations (for -- qua data porta ruunt) will set upon him, and then like a lame dog or broken-winged goose he droops and pines away, and is brought at last to that ill habit or malady of melancholy itself. So that as the philosophers make eight degrees of heat and cold, we may make eighty-eight of melancholy, as the parts affected are diversely seized with it, or have been plunged more or less into this infernal gulph, or waded deeper into it.
But all these melancholy fits, howsoever pleasing at first, or displeasing, violent and tyrannizing over those whom they seize on for the time; yet these fits I say, or men affected, are but improperly so called, because they continue not, but come and go, as by some objects they are moved. This melancholy of which, we are to treat, is a habit, morbus sonticus, or chronicus, a chronic or continuate disease, a settled humour, as Aurelianus and others call it, not errant, but fixed; and as it was long increasing, so now being (pleasant, or painful) grown to an habit, it will hardly be removed.

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The Anatomy of Melancholy

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