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