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two words comprehend all, and they are good or bad, accordingly as they are
directed, and some of them freely performed by himself; although the stoics
absolutely deny it, and will have all things inevitably done by destiny,
imposing a fatal necessity upon us, which we may not resist; yet we say
that our will is free in respect of us, and things contingent, howsoever in
respect of God's determinate counsel, they are inevitable and necessary.
Some other actions of the will are performed by the inferior powers, which
obey him, as the sensitive and moving appetite; as to open our eyes, to go
hither and thither, not to touch a book, to speak fair or foul: but this
appetite is many times rebellious in us, and will not be contained within
the lists of sobriety and temperance. It was (as I said) once well agreeing
with reason, and there was an excellent consent and harmony between them,
but that is now dissolved, they often jar, reason is overborne by passion:
_Fertur equis auriga, nec audit currus habenas_, as so many wild horses run
away with a chariot, and will not be curbed. We know many times what is
good, but will not do it, as she said,

[1021] "Trahit invitum nova vis, aliudque cupido,
Mens aliud suadet," - - -

Lust counsels one thing, reason another, there is a new reluctancy in men.
[1022]_Odi, nec possum, cupiens non esse, quod odi_. We cannot resist, but
as Phaedra confessed to her nurse, [1023]_quae loqueris, vera sunt, sed
furor suggerit sequi pejora_: she said well and true, she did acknowledge
it, but headstrong passion and fury made her to do that which was opposite.
So David knew the filthiness of his fact, what a loathsome, foul, crying
sin adultery was, yet notwithstanding he would commit murder, and take away
another man's wife, enforced against reason, religion, to follow his

Those natural and vegetal powers are not commanded by will at all; for "who
can add one cubit to his stature?" These other may, but are not: and thence
come all those headstrong passions, violent perturbations of the mind; and
many times vicious habits, customs, feral diseases; because we give so much
way to our appetite, and follow our inclination, like so many beasts. The
principal habits are two in number, virtue and vice, whose peculiar
definitions, descriptions, differences, and kinds, are handled at large in
the ethics, and are, indeed, the subject of moral philosophy.


SUBSECT. I. - _Definition of Melancholy, Name, Difference_.

Having thus briefly anatomised the body and soul of man, as a preparative
to the rest; I may now freely proceed to treat of my intended object, to
most men's capacity; and after many ambages, perspicuously define what this
melancholy is, show his name and differences. The name is imposed from the
matter, and disease denominated from the material cause: as Bruel observes,
[Greek: Melancholia] quasi [Greek: Melainacholae], from black choler. And
whether it be a cause or an effect, a disease or symptom, let Donatus
Altomarus and Salvianus decide; I will not contend about it. It hath
several descriptions, notations, and definitions. [1024]Fracastorius, in
his second book of intellect, calls those melancholy, "whom abundance of
that same depraved humour of black choler hath so misaffected, that they
become mad thence, and dote in most things, or in all, belonging to
election, will, or other manifest operations of the understanding." [1025]
Melanelius out of Galen, Ruffus, Aetius, describe it to be "a bad and
peevish disease, which makes men degenerate into beasts:" Galen, "a
privation or infection of the middle cell of the head," &c. defining it
from the part affected, which [1026]Hercules de Saxonia approves, _lib. 1.
cap. 16._ calling it "a depravation of the principal function:" Fuschius,
_lib. 1. cap. 23._ Arnoldus _Breviar. lib. 1. cap. 18._ Guianerius, and
others: "By reason of black choler," Paulus adds. Halyabbas simply calls it
a "commotion of the mind." Aretaeus, [1027]"a perpetual anguish of the
soul, fastened on one thing, without an ague;" which definition of his,
Mercurialis _de affect. cap. lib. 1. cap. 10._ taxeth: but Aelianus
Montaltus defends, _lib. de morb. cap. 1. de Melan._ for sufficient and
good. The common sort define it to be "a kind of dotage without a fever,
having for his ordinary companions, fear and sadness, without any apparent
occasion." So doth Laurentius, _cap. 4._ Piso. _lib. 1. cap. 43._ Donatus
Altomarus, _cap. 7. art. medic_. Jacchinus, _in com. in lib. 9. Rhasis ad
Almansor, cap. 15._ Valesius, _exerc. 17._ Fuschius, _institut. 3. sec. 1.
c. 11._ &c. which common definition, howsoever approved by most,
[1028]Hercules de Saxonia will not allow of, nor David Crucius, _Theat.
morb. Herm. lib. 2. cap. 6._ he holds it insufficient: as [1029]rather
showing what it is not, than what it is: as omitting the specific
difference, the phantasy and brain: but I descend to particulars. The
_summum genus_ is "dotage, or anguish of the mind," saith Aretaeus; "of the
principal parts," Hercules de Saxonia adds, to distinguish it from cramp
and palsy, and such diseases as belong to the outward sense and motions
[depraved] [1030]to distinguish it from folly and madness (which Montaltus
makes _angor animi_, to separate) in which those functions are not
depraved, but rather abolished; [without an ague] is added by all, to sever
it from frenzy, and that melancholy which is in a pestilent fever. (Fear
and sorrow) make it differ from madness: [without a cause] is lastly
inserted, to specify it from all other ordinary passions of [fear and
sorrow.] We properly call that dotage, as [1031]Laurentius interprets it,
"when some one principal faculty of the mind, as imagination, or reason, is
corrupted, as all melancholy persons have." It is without a fever, because
the humour is most part cold and dry, contrary to putrefaction. Fear and
sorrow are the true characters and inseparable companions of most
melancholy, not all, as Her. de Saxonia, _Tract. de posthumo de
Melancholia, cap. 2._ well excepts; for to some it is most pleasant, as to
such as laugh most part; some are bold again, and free from all manner of
fear and grief, as hereafter shall be declared.

SUBSECT. II. - _Of the part affected. Affection. Parties affected_.

Some difference I find amongst writers, about the principal part affected
in this disease, whether it be the brain, or heart, or some other member.
Most are of opinion that it is the brain: for being a kind of dotage, it
cannot otherwise be but that the brain must be affected, as a similar part,
be it by [1032]consent or essence, not in his ventricles, or any
obstructions in them, for then it would be an apoplexy, or epilepsy, as
[1033]Laurentius well observes, but in a cold, dry distemperature of it in
his substance, which is corrupt and become too cold, or too dry, or else
too hot, as in madmen, and such as are inclined to it: and this [1034]
Hippocrates confirms, Galen, the Arabians, and most of our new writers.
Marcus de Oddis (in a consultation of his, quoted by [1035]Hildesheim) and
five others there cited are of the contrary part; because fear and sorrow,
which are passions, be seated in the heart. But this objection is
sufficiently answered by [1036]Montaltus, who doth not deny that the heart
is affected (as [1037]Melanelius proves out of Galen) by reason of his
vicinity, and so is the midriff and many other parts. They do _compati_,
and have a fellow feeling by the law of nature: but forasmuch as this
malady is caused by precedent imagination, with the appetite, to whom
spirits obey, and are subject to those principal parts, the brain must
needs primarily be misaffected, as the seat of reason; and then the heart,
as the seat of affection. [1038]Capivaccius and Mercurialis have copiously
discussed this question, and both conclude the subject is the inner brain,
and from thence it is communicated to the heart and other inferior parts,
which sympathise and are much troubled, especially when it comes by
consent, and is caused by reason of the stomach, or _mirach_, as the
Arabians term it, whole body, liver, or [1039]spleen, which are seldom
free, pylorus, mesaraic veins, &c. For our body is like a clock, if one
wheel be amiss, all the rest are disordered; the whole fabric suffers: with
such admirable art and harmony is a man composed, such excellent
proportion, as Ludovicus Vives in his Fable of Man hath elegantly declared.

As many doubts almost arise about the [1040]affection, whether it be
imagination or reason alone, or both, Hercules de Saxonia proves it out of
Galen, Aetius, and Altomarus, that the sole fault is in [1041]imagination.
Bruel is of the same mind: Montaltus in his _2 cap._ of Melancholy confutes
this tenet of theirs, and illustrates the contrary by many examples: as of
him that thought himself a shellfish, of a nun, and of a desperate monk
that would not be persuaded but that he was damned; reason was in fault as
well as imagination, which did not correct this error: they make away
themselves oftentimes, and suppose many absurd and ridiculous things. Why
doth not reason detect the fallacy, settle and persuade, if she be free?
[1042]Avicenna therefore holds both corrupt, to whom most Arabians
subscribe. The same is maintained by [1043]Areteus, [1044]Gorgonius,
Guianerius, &c. To end the controversy, no man doubts of imagination, but
that it is hurt and misaffected here; for the other I determine with [1045]
Albertinus Bottonus, a doctor of Padua, that it is first in "imagination,
and afterwards in reason; if the disease be inveterate, or as it is more or
less of continuance;" but by accident, as [1046]Herc. de Saxonia adds;
"faith, opinion, discourse, ratiocination, are all accidentally depraved by
the default of imagination."

_Parties affected_.] To the part affected, I may here add the parties,
which shall be more opportunely spoken of elsewhere, now only signified.
Such as have the moon, Saturn, Mercury misaffected in their genitures, such
as live in over cold or over hot climes: such as are born of melancholy
parents; as offend in those six non-natural things, are black, or of a high
sanguine complexion, [1047]that have little heads, that have a hot heart,
moist brain, hot liver and cold stomach, have been long sick: such as are
solitary by nature, great students, given to much contemplation, lead a
life out of action, are most subject to melancholy. Of sexes both, but men
more often; yet [1048]women misaffected are far more violent, and
grievously troubled. Of seasons of the year, the autumn is most melancholy.
Of peculiar times: old age, from which natural melancholy is almost an
inseparable accident; but this artificial malady is more frequent in such
as are of a [1049]middle age. Some assign 40 years, Gariopontus 30.
Jubertus excepts neither young nor old from this adventitious. Daniel
Sennertus involves all of all sorts, out of common experience, [1050]_in
omnibus omnino corporibus cujuscunque constitutionis dominatar_. Aetius and
Aretius [1051]ascribe into the number "not only [1052]discontented,
passionate, and miserable persons, swarthy, black; but such as are most
merry and pleasant, scoffers, and high coloured." "Generally," saith
Rhasis, [1053]"the finest wits and most generous spirits, are before other
obnoxious to it;" I cannot except any complexion, any condition, sex, or
age, but [1054]fools and stoics, which, according to [1055]Synesius, are
never troubled with any manner of passion, but as Anacreon's _cicada, sine
sanguine et dolore; similes fere diis sunt_. Erasmus vindicates fools from
this melancholy catalogue, because they have most part moist brains and
light hearts; [1056]they are free from ambition, envy, shame and fear; they
are neither troubled in conscience, nor macerated with cares, to which our
whole life is most subject.

SUBSECT. III. - _Of the Matter of Melancholy_.

Of the matter of melancholy, there is much question betwixt Avicen and
Galen, as you may read in [1057]Cardan's Contradictions, [1058]Valesius'
Controversies, Montanus, Prosper Calenus, Capivaccius, [1059]Bright,
[1060]Ficinus, that have written either whole tracts, or copiously of it,
in their several treatises of this subject. [1061]"What this humour is, or
whence it proceeds, how it is engendered in the body, neither Galen, nor
any old writer hath sufficiently discussed," as Jacchinus thinks: the
Neoterics cannot agree. Montanus, in his Consultations, holds melancholy to
be material or immaterial: and so doth Arculanus: the material is one of
the four humours before mentioned, and natural. The immaterial or
adventitious, acquisite, redundant, unnatural, artificial; which [1062]
Hercules de Saxonia will have reside in the spirits alone, and to proceed
from a "hot, cold, dry, moist distemperature, which, without matter, alter
the brain and functions of it." Paracelsus wholly rejects and derides this
division of four humours and complexions, but our Galenists generally
approve of it, subscribing to this opinion of Montanus.

This material melancholy is either simple or mixed; offending in quantity
or quality, varying according to his place, where it settleth, as brain,
spleen, mesaraic veins, heart, womb, and stomach; or differing according to
the mixture of those natural humours amongst themselves, or four unnatural
adust humours, as they are diversely tempered and mingled. If natural
melancholy abound in the body, which is cold and dry, "so that it be more
[1063]than the body is well able to bear, it must needs be distempered,"
saith Faventius, "and diseased;" and so the other, if it be depraved,
whether it arise from that other melancholy of choler adust, or from blood,
produceth the like effects, and is, as Montaltus contends, if it come by
adustion of humours, most part hot and dry. Some difference I find, whether
this melancholy matter may be engendered of all four humours, about the
colour and temper of it. Galen holds it may be engendered of three alone,
excluding phlegm, or pituita, whose true assertion [1064]Valesius and
Menardus stiffly maintain, and so doth [1065]Fuschius, Montaltus, [1066]
Montanus. How (say they) can white become black? But Hercules de Saxonia,
_lib. post. de mela. c. 8_, and [1067]Cardan are of the opposite part (it
may be engendered of phlegm, _etsi raro contingat_, though it seldom come
to pass), so is [1068]Guianerius and Laurentius, _c. 1._ with Melanct. in
his book _de Anima_, and Chap. of Humours; he calls it _asininam_, dull,
swinish melancholy, and saith that he was an eyewitness of it: so is
[1069]Wecker. From melancholy adust ariseth one kind; from choler another,
which is most brutish; another from phlegm, which is dull; and the last
from blood, which is best. Of these some are cold and dry, others hot and
dry, [1070]varying according to their mixtures, as they are intended, and
remitted. And indeed as Rodericus a Fons. _cons. 12. l. 1._ determines,
ichors, and those serous matters being thickened become phlegm, and phlegm
degenerates into choler, choler adust becomes _aeruginosa melancholia_, as
vinegar out of purest wine putrified or by exhalation of purer spirits is
so made, and becomes sour and sharp; and from the sharpness of this humour
proceeds much waking, troublesome thoughts and dreams, &c. so that I
conclude as before. If the humour be cold, it is, saith [1071]Faventinus,
"a cause of dotage, and produceth milder symptoms: if hot, they are rash,
raving mad, or inclining to it." If the brain be hot, the animal spirits
are hot; much madness follows, with violent actions: if cold, fatuity and
sottishness, [1072]Capivaccius. [1073]"The colour of this mixture varies
likewise according to the mixture, be it hot or cold; 'tis sometimes black,
sometimes not," Altomarus. The same [1074]Melanelius proves out of Galen;
and Hippocrates in his Book of Melancholy (if at least it be his), giving
instance in a burning coal, "which when it is hot, shines; when it is cold,
looks black; and so doth the humour." This diversity of melancholy matter
produceth diversity of effects. If it be within the [1075]body, and not
putrified, it causeth black jaundice; if putrified, a quartan ague; if it
break out to the skin, leprosy; if to parts, several maladies, as scurvy,
&c. If it trouble the mind; as it is diversely mixed, it produceth several
kinds of madness and dotage: of which in their place.

SUBSECT. IV. - _Of the species or kinds of Melancholy_.

When the matter is divers and confused, how should it otherwise be, but
that the species should be divers and confused? Many new and old writers
have spoken confusedly of it, confounding melancholy and madness, as [1076]
Heurnius, Guianerius, Gordonius, Salustius Salvianus, Jason Pratensis,
Savanarola, that will have madness no other than melancholy in extent,
differing (as I have said) in degrees. Some make two distinct species, as
Ruffus Ephesius, an old writer, Constantinus Africanus, Aretaeus, [1077]
Aurelianus, [1078]Paulus Aegineta: others acknowledge a multitude of kinds,
and leave them indefinite, as Aetius in his _Tetrabiblos_, [1079]Avicenna,
_lib. 3. Fen. 1. Tract. 4. cap. 18._ Arculanus, _cap. 16. in 9. Rasis_.
Montanus, _med. part. 1._ [1080]"If natural melancholy be adust, it maketh
one kind; if blood, another; if choler, a third, differing from the first;
and so many several opinions there are about the kinds, as there be men
themselves." [1081]Hercules de Saxonia sets down two kinds, "material and
immaterial; one from spirits alone, the other from humours and spirits."
Savanarola, _Rub. 11. Tract. 6. cap. 1. de aegritud. capitis_, will have
the kinds to be infinite; one from the mirach, called _myrachialis_ of the
Arabians; another _stomachalis_, from the stomach; another from the liver,
heart, womb, haemorrhoids, [1082]"one beginning, another consummate."
Melancthon seconds him, [1083]"as the humour is diversely adust and mixed,
so are the species divers;" but what these men speak of species I think
ought to be understood of symptoms; and so doth [1084] Arculanus interpret
himself: infinite species, _id est_, symptoms; and in that sense, as Jo.
Gorrheus acknowledgeth in his medicinal definitions, the species are
infinite, but they may be reduced to three kinds by reason of their seat;
head, body, and hypochrondries. This threefold division is approved by
Hippocrates in his Book of Melancholy, (if it be his, which some suspect)
by Galen, _lib. 3. de loc. affectis, cap. 6._ by Alexander, _lib. 1. cap.
16._ Rasis, _lib. 1. Continent. Tract. 9. lib. 1. cap. 16._ Avicenna and
most of our new writers. Th. Erastus makes two kinds; one perpetual, which
is head melancholy; the other interrupt, which comes and goes by fits,
which he subdivides into the other two kinds, so that all comes to the same
pass. Some again make four or five kinds, with Rodericus a Castro, _de
morbis mulier. lib. 2. cap. 3._ and Lod. Mercatus, who in his second book
_de mulier. affect. cap. 4._ will have that melancholy of nuns, widows, and
more ancient maids, to be a peculiar species of melancholy differing from
the rest: some will reduce enthusiasts, ecstatical and demoniacal persons
to this rank, adding [1085] love melancholy to the first, and lycanthropia.
The most received division is into three kinds. The first proceeds from the
sole fault of the brain, and is called head melancholy; the second
sympathetically proceeds from the whole body, when the whole temperature is
melancholy: the third ariseth from the bowels, liver, spleen, or membrane,
called _mesenterium_, named hypochondriacal or windy melancholy, which
[1086]Laurentius subdivides into three parts, from those three members,
hepatic, splenetic, mesaraic. Love melancholy, which Avicenna calls
_ilishi_: and Lycanthropia, which he calls _cucubuthe_, are commonly
included in head melancholy; but of this last, which Gerardus de Solo calls
_amoreus_, and most knight melancholy, with that of religious melancholy,
_virginum et viduarum_, maintained by Rod. a Castro and Mercatus, and the
other kinds of love melancholy, I will speak of apart by themselves in my
third partition. The three precedent species are the subject of my present
discourse, which I will anatomise and treat of through all their causes,
symptoms, cures, together and apart; that every man that is in any measure
affected with this malady, may know how to examine it in himself, and apply
remedies unto it.

It is a hard matter, I confess, to distinguish these three species one from
the other, to express their several causes, symptoms, cures, being that
they are so often confounded amongst themselves, having such affinity, that
they can scarce be discerned by the most accurate physicians; and so often
intermixed with other diseases, that the best experienced have been
plunged. Montanus _consil. 26_, names a patient that had this disease of
melancholy and caninus appetitus both together; and _consil. 23_, with
vertigo, [1087]Julius Caesar Claudinus with stone, gout, jaundice.
Trincavellius with an ague, jaundice, caninus appetitus, &c. [1088]Paulus
Regoline, a great doctor in his time, consulted in this case, was so
confounded with a confusion of symptoms, that he knew not to what kind of
melancholy to refer it. [1089]Trincavellius, Fallopius, and Francanzanus,
famous doctors in Italy, all three conferred with about one party, at the
same time, gave three different opinions. And in another place,
Trincavellius being demanded what he thought of a melancholy young man to
whom he was sent for, ingenuously confessed that he was indeed melancholy,
but he knew not to what kind to reduce it. In his seventeenth consultation
there is the like disagreement about a melancholy monk. Those symptoms,
which others ascribe to misaffected parts and humours, [1090]Herc. de
Saxonia attributes wholly to distempered spirits, and those immaterial, as
I have said. Sometimes they cannot well discern this disease from others.
In Reinerus Solenander's counsels, (_Sect, consil. 5_,) he and Dr. Brande
both agreed, that the patient's disease was hypochondriacal melancholy. Dr.
Matholdus said it was asthma, and nothing else. [1091]Solenander and
Guarionius, lately sent for to the melancholy Duke of Cleve, with others,
could not define what species it was, or agree amongst themselves. The
species are so confounded, as in Caesar Claudinus his forty-fourth
consultation for a Polonian Count, in his judgment [1092]"he laboured of
head melancholy, and that which proceeds from the whole temperature both at
once." I could give instance of some that have had all three kinds _semel
et simul_, and some successively. So that I conclude of our melancholy
species, as [1093]many politicians do of their pure forms of commonwealths,
monarchies, aristocracies, democracies, are most famous in contemplation,
but in practice they are temperate and usually mixed, (so [1094]Polybius
informeth us) as the Lacedaemonian, the Roman of old, German now, and many
others. What physicians say of distinct species in their books it much
matters not, since that in their patients' bodies they are commonly mixed.
In such obscurity, therefore, variety and confused mixture of symptoms,
causes, how difficult a thing is it to treat of several kinds apart; to
make any certainty or distinction among so many casualties, distractions,
when seldom two men shall be like effected _per omnia_? 'Tis hard, I
confess, yet nevertheless I will adventure through the midst of these
perplexities, and, led by the clue or thread of the best writers, extricate
myself out of a labyrinth of doubts and errors, and so proceed to the


SUBSECT. I. - _Causes of Melancholy. God a cause._

"It is in vain to speak of cures, or think of remedies, until such time as
we have considered of the causes," so [1095]Galen prescribes Glauco: and
the common experience of others confirms that those cures must be
imperfect, lame, and to no purpose, wherein the causes have not first been
searched, as [1096]Prosper Calenius well observes in his tract _de atra
bile_ to Cardinal Caesius. Insomuch that [1097]"Fernelius puts a kind of
necessity in the knowledge of the causes, and without which it is
impossible to cure or prevent any manner of disease." Empirics may ease,
and sometimes help, but not thoroughly root out; _sublata causa tollitur
effectus_ as the saying is, if the cause be removed, the effect is likewise
vanquished. It is a most difficult thing (I confess) to be able to discern
these causes whence they are, and in such [1098]variety to say what the
beginning was. [1099]He is happy that can perform it aright. I will

Online LibraryRobert BurtonThe Anatomy of Melancholy → online text (page 18 of 138)