returned at last to treat in brief of the three particular species, and
such causes as properly appertain unto them. Although these causes
promiscuously concur to each and every particular kind, and commonly
produce their effects in that part which is most ill-disposed, and
least able to resist, and so cause all three species, yet many of them
are proper to some one kind, and seldom found in the rest. As for
example, head-melancholy is commonly caused by a cold or hot
distemperature of the brain, according to Laurentius cap. 5 de melan.
but as [2433]Hercules de Saxonia contends, from that agitation or
distemperature of the animal spirits alone. Salust. Salvianus, before
mentioned, lib. 2. cap. 3. de re med. will have it proceed from cold:
but that I take of natural melancholy, such as are fools and dote: for
as Galen writes lib. 4. de puls. 8. and Avicenna, [2434]a cold and
moist brain is an inseparable companion of folly. But this adventitious
melancholy which is here meant, is caused of a hot and dry
distemperature, as [2435]Damascen the Arabian lib. 3. cap. 22. thinks,
and most writers: Altomarus and Piso call it [2436]an innate burning
intemperateness, turning blood and choler into melancholy. Both these
opinions may stand good, as Bruel maintains, and Capivaccius, si
cerebrum sit calidius, [2437]if the brain be hot, the animal spirits
will be hot, and thence comes madness; if cold, folly. David Crusius
Theat. morb. Hermet. lib. 2. cap. 6. de atra bile, grants melancholy to
be a disease of an inflamed brain, but cold notwithstanding of itself:
calida per accidens, frigida per se, hot by accident only; I am of
Capivaccius' mind for my part. Now this humour, according to Salvianus,
is sometimes in the substance of the brain, sometimes contained in the
membranes and tunicles that cover the brain, sometimes in the passages
of the ventricles of the brain, or veins of those ventricles. It
follows many times [2438]frenzy, long diseases, agues, long abode in
hot places, or under the sun, a blow on the head, as Rhasis informeth
us: Piso adds solitariness, waking, inflammations of the head,
proceeding most part [2439]from much use of spices, hot wines, hot
meats: all which Montanus reckons up consil. 22. for a melancholy Jew;
and Heurnius repeats cap. 12. de Mania: hot baths, garlic, onions,
saith Guianerius, bad air, corrupt, much [2440]waking, &c., retention
of seed or abundance, stopping of haemorrhagia, the midriff
misaffected; and according to Trallianus l. 1. 16. immoderate cares,
troubles, griefs, discontent, study, meditation, and, in a word, the
abuse of all those six non-natural things. Hercules de Saxonia, cap.
16. lib. 1. will have it caused from a [2441]cautery, or boil dried up,
or an issue. Amatus Lusitanus cent. 2. cura. 67. gives instance in a
fellow that had a hole in his arm, [2442]after that was healed, ran
mad, and when the wound was open, he was cured again. Trincavellius
consil. 13. lib. 1. hath an example of a melancholy man so caused by
overmuch continuance in the sun, frequent use of venery, and immoderate
exercise: and in his cons. 49. lib. 3. from a [2443]headpiece
overheated, which caused head-melancholy. Prosper Calenus brings in
Cardinal Caesius for a pattern of such as are so melancholy by long
study; but examples are infinite.
SUBSECT. IV.—_Causes of Hypochondriacal, or Windy Melancholy_.
In repeating of these causes, I must crambem bis coctam apponere, say
that again which I have formerly said, in applying them to their proper
species. Hypochondriacal or flatuous melancholy, is that which the
Arabians call mirachial, and is in my judgment the most grievous and
frequent, though Bruel and Laurentius make it least dangerous, and not
so hard to be known or cured. His causes are inward or outward. Inward
from divers parts or organs, as midriff, spleen, stomach, liver,
pylorus, womb, diaphragma, mesaraic veins, stopping of issues, &c.
Montaltus cap. 15. out of Galen recites, [2444]heat and obstruction of
those mesaraic veins, as an immediate cause, by which means the passage
of the chilus to the liver is detained, stopped or corrupted, and
turned into rumbling and wind. Montanus, consil. 233, hath an evident
demonstration, Trincavelius another, lib. 1, cap. 1, and Plater a
third, observat. lib. 1, for a doctor of the law visited with this
infirmity, from the said obstruction and heat of these mesaraic veins,
and bowels; quoniam inter ventriculum et jecur venae effervescunt, the
veins are inflamed about the liver and stomach. Sometimes those other
parts are together misaffected; and concur to the production of this
malady: a hot liver and cold stomach, or cold belly: look for instances
in Hollerius, Victor Trincavelius, consil. 35, l. 3, Hildesheim Spicel.
2, fol. 132, Solenander consil. 9, pro cive Lugdunensi, Montanus
consil. 229, for the Earl of Montfort in Germany, 1549, and Frisimelica
in the 233 consultation of the said Montanus. I. Caesar Claudinus gives
instance of a cold stomach and over-hot liver, almost in every
consultation, con. 89, for a certain count; and con. 106, for a
Polonian baron, by reason of heat the blood is inflamed, and gross
vapours sent to the heart and brain. Mercurialis subscribes to them,
cons. 89, [2445]the stomach being misaffected, which he calls the king
of the belly, because if he be distempered, all the rest suffer with
him, as being deprived of their nutriment, or fed with bad nourishment,
by means of which come crudities, obstructions, wind, rumbling,
griping, &c. Hercules de Saxonia, besides heat, will have the weakness
of the liver and his obstruction a cause, facultatem debilem jecinoris,
which he calls the mineral of melancholy. Laurentius assigns this
reason, because the liver over-hot draws the meat undigested out of the
stomach, and burneth the humours. Montanus, cons. 244, proves that
sometimes a cold liver may be a cause. Laurentius c. 12, Trincavelius
lib. 12, consil., and Gualter Bruel, seems to lay the greatest fault
upon the spleen, that doth not his duty in purging the liver as he
ought, being too great, or too little, in drawing too much blood
sometimes to it, and not expelling it, as P. Cnemiandrus in a
[2446]consultation of his noted tumorem lienis, he names it, and the
fountain of melancholy. Diocles supposed the ground of this kind of
melancholy to proceed from the inflammation of the pylorus, which is
the nether mouth of the ventricle. Others assign the mesenterium or
midriff distempered by heat, the womb misaffected, stopping of
haemorrhoids, with many such. All which Laurentius, cap. 12, reduceth
to three, mesentery, liver, and spleen, from whence he denominates
hepatic, splenetic, and mesaraic melancholy. Outward causes, are bad
diet, care, griefs, discontents, and in a word all those six
non-natural things, as Montanus found by his experience, consil. 244.
Solenander consil. 9, for a citizen of Lyons, in France, gives his
reader to understand, that he knew this mischief procured by a medicine
of cantharides, which an unskilful physician ministered his patient to
drink ad venerem excitandam. But most commonly fear, grief, and some
sudden commotion, or perturbation of the mind, begin it, in such bodies
especially as are ill-disposed. Melancthon, tract. 14, cap. 2, de
anima, will have it as common to men, as the mother to women, upon some
grievous trouble, dislike, passion, or discontent. For as Camerarius
records in his life, Melancthon himself was much troubled with it, and
therefore could speak out of experience. Montanus, consil. 22, pro
delirante Judaeo, confirms it, [2447]grievous symptoms of the mind
brought him to it. Randolotius relates of himself, that being one day
very intent to write out a physician's notes, molested by an occasion,
he fell into a hypochondriacal fit, to avoid which he drank the
decoction of wormwood, and was freed. [2448]Melancthon (being the
disease is so troublesome and frequent) holds it a most necessary and
profitable study, for every man to know the accidents of it, and a
dangerous thing to be ignorant, and would therefore have all men in
some sort to understand the causes, symptoms, and cures of it.
SUBSECT. V.—_Causes of Melancholy from the whole Body_.
As before, the cause of this kind of melancholy is inward or outward.
Inward, [2449]when the liver is apt to engender such a humour, or the
spleen weak by nature, and not able to discharge his office. A
melancholy temperature, retention of haemorrhoids, monthly issues,
bleeding at nose, long diseases, agues, and all those six non-natural
things increase it. But especially [2450]bad diet, as Piso thinks,
pulse, salt meat, shellfish, cheese, black wine, &c. Mercurialis out of
Averroes and Avicenna condemns all herbs: Galen, lib. 3, de loc.
affect. cap. 7, especially cabbage. So likewise fear, sorrow,
discontents, &c., but of these before. And thus in brief you have had
the general and particular causes of melancholy.
Now go and brag of thy present happiness, whosoever thou art, brag of
thy temperature, of thy good parts, insult, triumph, and boast; thou
seest in what a brittle state thou art, how soon thou mayst be
dejected, how many several ways, by bad diet, bad air, a small loss, a
little sorrow or discontent, an ague, &c.; how many sudden accidents
may procure thy ruin, what a small tenure of happiness thou hast in
this life, how weak and silly a creature thou art. Humble thyself,
therefore, under the mighty hand of God, 1 Peter, v. 6, know thyself,
acknowledge thy present misery, and make right use of it. Qui stat
videat ne cadat. Thou dost now flourish, and hast bona animi, corporis,
et fortunae, goods of body, mind, and fortune, nescis quid serus secum
vesper ferat, thou knowest not what storms and tempests the late
evening may bring with it. Be not secure then, be sober and watch,
[2451]fortunam reverenter habe, if fortunate and rich; if sick and
poor, moderate thyself. I have said.
SECT. III. MEMB. I.
SUBSECT. I.—_Symptoms, or Signs of Melancholy in the Body_.
Parrhasius, a painter of Athens, amongst those Olynthian captives
Philip of Macedon brought home to sell, [2452]bought one very old man;
and when he had him at Athens, put him to extreme torture and torment,
the better by his example to express the pains and passions of his
Prometheus, whom he was then about to paint. I need not be so
barbarous, inhuman, curious, or cruel, for this purpose to torture any
poor melancholy man, their symptoms are plain, obvious and familiar,
there needs no such accurate observation or far-fetched object, they
delineate themselves, they voluntarily betray themselves, they are too
frequent in all places, I meet them still as I go, they cannot conceal
it, their grievances are too well known, I need not seek far to
describe them.
Symptoms therefore are either [2453]universal or particular, saith
Gordonius, lib. med. cap. 19, part. 2, to persons, to species; some
signs are secret, some manifest, some in the body, some in the mind,
and diversely vary, according to the inward or outward causes,
Capivaccius: or from stars, according to Jovianus Pontanus, de reb.
caelest. lib. 10, cap. 13, and celestial influences, or from the
humours diversely mixed, Ficinus, lib. 1, cap. 4, de sanit. tuenda: as
they are hot, cold, natural, unnatural, intended, or remitted, so will
Aetius have melancholica deliria multiformia, diversity of melancholy
signs. Laurentius ascribes them to their several temperatures,
delights, natures, inclinations, continuance of time, as they are
simple or mixed with other diseases, as the causes are divers, so must
the signs be, almost infinite, Altomarus cap. 7, art. med. And as wine
produceth divers effects, or that herb Tortocolla in [2454]Laurentius,
which makes some laugh, some weep, some sleep, some dance, some sing,
some howl, some drink, &c. so doth this our melancholy humour work
several signs in several parties.
But to confine them, these general symptoms may be reduced to those of
the body or the mind. Those usual signs appearing in the bodies of such
as are melancholy, be these cold and dry, or they are hot and dry, as
the humour is more or less adust. From [2455]these first qualities
arise many other second, as that of [2456]colour, black, swarthy, pale,
ruddy, &c., some are impense rubri, as Montaltus cap. 16 observes out
of Galen, lib. 3, de locis affectis, very red and high coloured.
Hippocrates in his book [2457]de insania et melan. reckons up these
signs, that they are [2458] lean, withered, hollow-eyed, look old,
wrinkled, harsh, much troubled with wind, and a griping in their
bellies, or bellyache, belch often, dry bellies and hard, dejected
looks, flaggy beards, singing of the ears, vertigo, light-headed,
little or no sleep, and that interrupt, terrible and fearful dreams,
[2459]Anna soror, quae, me suspensam insomnia terrent? The same
symptoms are repeated by Melanelius in his book of melancholy collected
out of Galen, Ruffus, Aetius, by Rhasis, Gordonius, and all the
juniors, [2460]continual, sharp, and stinking belchings, as if their
meat in their stomachs were putrefied, or that they had eaten fish, dry
bellies, absurd and interrupt dreams, and many fantastical visions
about their eyes, vertiginous, apt to tremble, and prone to venery.
[2461]Some add palpitation of the heart, cold sweat, as usual symptoms,
and a leaping in many parts of the body, saltum in multis corporis
partibus, a kind of itching, saith Laurentius, on the superficies of
the skin, like a flea-biting sometimes. [2462]Montaltus cap. 21. puts
fixed eyes and much twinkling of their eyes for a sign, and so doth
Avicenna, oculos habentes palpitantes, trauli, vehementer rubicundi,
&c., lib. 3. Fen. 1. Tract. 4. cap. 18. They stut most part, which he
took out of Hippocrates' aphorisms. [2463]Rhasis makes headache and a
binding heaviness for a principal token, much leaping of wind about the
skin, as well as stutting, or tripping in speech, &c., hollow eyes,
gross veins, and broad lips. To some too, if they be far gone, mimical
gestures are too familiar, laughing, grinning, fleering, murmuring,
talking to themselves, with strange mouths and faces, inarticulate
voices, exclamations, &c. And although they be commonly lean, hirsute,
uncheerful in countenance, withered, and not so pleasant to behold, by
reason of those continual fears, griefs, and vexations, dull, heavy,
lazy, restless, unapt to go about any business; yet their memories are
most part good, they have happy wits, and excellent apprehensions.
Their hot and dry brains make them they cannot sleep, Ingentes habent
et crebras vigilias (Arteus) mighty and often watchings, sometimes
waking for a month, a year together. [2464]Hercules de Saxonia
faithfully averreth, that he hath heard his mother swear, she slept not
for seven months together: Trincavelius, Tom. 2. cons. 16. speaks of
one that waked 50 days, and Skenkius hath examples of two years, and
all without offence. In natural actions their appetite is greater than
their concoction, multa appetunt pauca digerunt as Rhasis hath it, they
covet to eat, but cannot digest. And although they [2465]do eat much,
yet they are lean, ill-liking, saith Areteus, withered and hard, much
troubled with costiveness, crudities, oppilations, spitting, belching,
&c. Their pulse is rare and slow, except it be of the [2466]Carotides,
which is very strong; but that varies according to their intended
passions or perturbations, as Struthius hath proved at large,
Spigmaticae. artis l. 4. c. 13. To say truth, in such chronic diseases
the pulse is not much to be respected, there being so much superstition
in it, as [2467]Crato notes, and so many differences in Galen, that he
dares say they may not be observed, or understood of any man.
Their urine is most part pale, and low coloured, urina pauca acris,
biliosa (Areteus), not much in quantity; but this, in my judgment, is
all out as uncertain as the other, varying so often according to
several persons, habits, and other occasions not to be respected in
chronic diseases. [2468]Their melancholy excrements in some very much,
in others little, as the spleen plays his part, and thence proceeds
wind, palpitation of the heart, short breath, plenty of humidity in the
stomach, heaviness of heart and heartache, and intolerable stupidity
and dullness of spirits. Their excrements or stool hard, black to some
and little. If the heart, brain, liver, spleen, be misaffected, as
usually they are, many inconveniences proceed from them, many diseases
accompany, as incubus, [2469]apoplexy, epilepsy, vertigo, those
frequent wakings and terrible dreams, [2470]intempestive laughing,
weeping, sighing, sobbing, bashfulness, blushing, trembling, sweating,
swooning, &c. [2471]All their senses are troubled, they think they see,
hear, smell, and touch that which they do not, as shall be proved in
the following discourse.
SUBSECT. II.—_Symptoms or Signs in the Mind_.