The Anatomy of Melancholy Part 27

O blessed health! "thou art above all gold and treasure," Ecclus. x.x.x. 15, the poor man's riches, the rich man's bliss, without thee there can be no happiness: or visited with some loathsome disease, offensive to others, or troublesome to ourselves; as a stinking breath, deformity of our limbs, crookedness, loss of an eye, leg, hand, paleness, leanness, redness, baldness, loss or want of hair, &c., _hic ubi fluere caepit, diros ictus cordi infert_, saith [2386]Synesius, he himself troubled not a little _ob comae defectum_, the loss of hair alone, strikes a cruel stroke to the heart. Acco, an old woman, seeing by chance her face in a true gla.s.s (for she used false flattering gla.s.ses belike at other times, as most gentlewomen do,) _animi dolore in insaniam delapsa est_, (Caelius Rhodiginus _l. 17, c. 2_,) ran mad. [2387]Brotheus, the son of Vulcan, because he was ridiculous for his imperfections, flung himself into the fire. Lais of Corinth, now grown old, gave up her gla.s.s to Venus, for she could hot abide to look upon it. [2388]_Qualis sum nolo, qualis eram nequeo_. Generally to fair nice pieces, old age and foul linen are two most odious things, a torment of torments, they may not abide the thought of it,

[2389] ------"o deorum Quisquis haec audis, utinam inter errem Nuda leones,"

"Antequam turpis macies decentes Occupet malas, teneraeque succus Defluat praedae, speciosa quaerro Pascere tigres."

"Hear me, some gracious heavenly power, Let lions dire this naked corse devour.

My cheeks ere hollow wrinkles seize.

Ere yet their rosy bloom decays: While youth yet rolls its vital flood, Let tigers friendly riot in my blood."

To be foul, ugly, and deformed, much better be buried alive. Some are fair but barren, and that galls them. "Hannah wept sore, did not eat, and was troubled in spirit, and all for her barrenness," 1 Sam. 1. and Gen. 30.

Rachel said "in the anguish of her soul, give me a child, or I shall die:"

another hath too many: one was never married, and that's his h.e.l.l, another is, and that's his plague. Some are troubled in that they are obscure; others by being traduced, slandered, abused, disgraced, vilified, or any way injured: _minime miror eos_ (as he said) _qui insanire occipiunt ex injuria_, I marvel not at all if offences make men mad. Seventeen particular causes of anger and offence Aristotle reckons them up, which for brevity's sake I must omit. No tidings troubles one; ill reports, rumours, bad tidings or news, hard hap, ill success, cast in a suit, vain hopes, or hope deferred, another: expectation, _adeo omnibus in rebus molesta semper est expectatio_, as [2390]Polybius observes; one is too eminent, another too base born, and that alone tortures him as much as the rest: one is out of action, company, employment; another overcome and tormented with worldly cares, and onerous business. But what [2391]tongue can suffice to speak of all?

Many men catch this malady by eating certain meats, herbs, roots, at unawares; as henbane, nightshade, cicuta, mandrakes, &c. [2392]A company of young men at Agrigentum in Sicily, came into a tavern; where after they had freely taken their liquor, whether it were the wine itself, or something mixed with it 'tis not yet known, [2393]but upon a sudden they began to be so troubled in their brains, and their phantasy so crazed, that they thought they were in a s.h.i.+p at sea, and now ready to be cast away by reason of a tempest. Wherefore to avoid s.h.i.+pwreck and present drowning, they flung all the goods in the house out at the windows into the street, or into the sea, as they supposed; thus they continued mad a pretty season, and being brought before the magistrate to give an account of this their fact, they told him (not yet recovered of their madness) that what was done they did for fear of death, and to avoid imminent danger: the spectators were all amazed at this their stupidity, and gazed on them still, whilst one of the ancientest of the company, in a grave tone, excused himself to the magistrate upon his knees, _O viri Tritones, ego in imo jacui_, I beseech your deities, &c. for I was in the bottom of the s.h.i.+p all the while: another besought them as so many sea G.o.ds to be good unto them, and if ever he and his fellows came to land again, [2394]he would build an altar to their service. The magistrate could not sufficiently laugh at this their madness, bid them sleep it out, and so went his ways. Many such accidents frequently happen, upon these unknown occasions. Some are so caused by philters, wandering in the sun, biting of a mad dog, a blow on the head, stinging with that kind of spider called tarantula, an ordinary thing if we may believe Skeuck. _l. 6. de Venenis_, in Calabria and Apulia in Italy, Cardan, _subtil. l. 9._ Scaliger _exercitat. 185._ Their symptoms are merrily described by Jovia.n.u.s Ponta.n.u.s, _Ant. dial._ how they dance altogether, and are cured by music. [2395]Cardan speaks of certain stones, if they be carried about one, which will cause melancholy and madness; he calls them unhappy, as an [2396]_adamant, selenites_, &c. "which dry up the body, increase cares, diminish sleep:" Ctesias in Persicis, makes mention of a well in those parts, of which if any man drink, [2397]"he is mad for 24 hours." Some lose their wits by terrible objects (as elsewhere I have more [2398]copiously dilated) and life itself many times, as Hippolitus affrighted by Neptune's seahorses, Athemas by Juno's furies: but these relations are common in all writers.

[2399] "Hic alias poteram, et plures subnectere causas, Sed jumenta vocant, et Sol inclinat, Eundum est."

"Many such causes, much more could I say, But that for provender my cattle stay: The sun declines, and I must needs away."

These causes if they be considered, and come alone, I do easily yield, can do little of themselves, seldom, or apart (an old oak is not felled at a blow) though many times they are all sufficient every one: yet if they concur, as often they do, _vis unita fortior; et quae non obsunt singula, multa nocent_, they may batter a strong const.i.tution; as [2400]Austin said, "many grains and small sands sink a s.h.i.+p, many small drops make a flood,"

&c., often reiterated; many dispositions produce an habit.

MEMB. V.

SUBSECT. I.--_Continent, inward, antecedent, next causes and how the body works on the mind_.

As a purlieu hunter, I have hitherto beaten about the circuit of the forest of this microcosm, and followed only those outward advent.i.tious causes. I will now break into the inner rooms, and rip up the antecedent immediate causes which are there to be found. For as the distraction of the mind, amongst other outward causes and perturbations, alters the temperature of the body, so the distraction and distemper of the body will cause a distemperature of the soul, and 'tis hard to decide which of these two do more harm to the other. Plato, Cyprian, and some others, as I have formerly said, lay the greatest fault upon the soul, excusing the body; others again accusing the body, excuse the soul, as a princ.i.p.al agent. Their reasons are, because [2401]"the manners do follow the temperature of the body," as Galen proves in his book of that subject, Prosper Calenius _de Atra bile_, Jason Pratensis _c. de Mania_, Lemnius _l. 4. c. 16._ and many others. And that which Gualter hath commented, _hom. 10. in epist. Johannis_, is most true, concupiscence and originals in, inclinations, and bad humours, are [2402]radical in every one of us, causing these perturbations, affections, and several distempers, offering many times violence unto the soul. "Every man is tempted by his own concupiscence (James i. 14), the spirit is willing but the flesh is weak, and rebelleth against the spirit," as our [2403]apostle teacheth us: that methinks the soul hath the better plea against the body, which so forcibly inclines us, that we cannot resist, _Nec nos obniti contra, nec tendere tantum sufficimus_. How the body being material, worketh upon the immaterial soul, by mediation of humours and spirits, which partic.i.p.ate of both, and ill-disposed organs, Cornelius Agrippa hath discoursed _lib. 1. de occult. Philos. cap. 63, 64, 65._ Levinus Lemnius _lib. 1. de occult. nat. mir. cap. 12. et 16. et 21.

inst.i.tut. ad opt. vit_. Perkins _lib. 1. Cases of Cons. cap. 12._ T. Bright _c. 10, 11, 12._ "in his treatise of melancholy," for as, [2404] anger, fear, sorrow, obtrectation, emulation, &c. _si mentis intimos recessus occuparint_, saith [2405]Lemnius, _corpori quoque infesta sunt, et illi teterrimos morbos inferunt_, cause grievous diseases in the body, so bodily diseases affect the soul by consent. Now the chiefest causes proceed from the [2406]heart, humours, spirits: as they are purer, or impurer, so is the mind, and equally suffers, as a lute out of tune, if one string or one organ be distempered, all the rest miscarry, [2407]_corpus onustum hesternis vitiis, animum quoque praegravat una_. The body is _domicilium animae_, her house, abode, and stay; and as a torch gives a better light, a sweeter smell, according to the matter it is made of; so doth our soul perform all her actions, better or worse, as her organs are disposed; or as wine savours of the cask wherein it is kept; the soul receives a tincture from the body, through which it works. We see this in old men, children, Europeans; Asians, hot and cold climes; sanguine are merry, melancholy sad, phlegmatic dull, by reason of abundance of those humours, and they cannot resist such pa.s.sions which are inflicted by them. For in this infirmity of human nature, as Melancthon declares, the understanding is so tied to, and captivated by his inferior senses, that without their help he cannot exercise his functions, and the will being weakened, hath but a small power to restrain those outward parts, but suffers herself to be overruled by them; that I must needs conclude with Lemnius, _spiritus et humores maximum noc.u.mentum obtinent_, spirits and humours do most harm in [2408]troubling the soul. How should a man choose but be choleric and angry, that hath his body so clogged with abundance of gross humours? or melancholy, that is so inwardly disposed? That thence comes then this malady, madness, apoplexies, lethargies, &c. it may not be denied.

Now this body of ours is most part distempered by some precedent diseases, which molest his inward organs and instruments, and so _per consequens_ cause melancholy, according to the consent of the most approved physicians.

[2409]"This humour" (as Avicenna _l. 3. Fen. 1. Tract. 4. c. 18._ Arnoldus _breviar. l. 1. c. 18._ Jacchinus _comment. in 9 Rhasis, c. 15._ Montaltus, _c. 10._ Nicholas Piso _c. de Melan._ &c. suppose) "is begotten by the distemperature of some inward part, innate, or left after some inflammation, or else included in the blood after an [2410]ague, or some other malignant disease." This opinion of theirs concurs with that of Galen, _l. 3. c. 6. de locis affect_. Guianerius gives an instance in one so caused by a quartan ague, and Monta.n.u.s _consil. 32._ in a young man of twenty-eight years of age, so distempered after a quartan, which had molested him five years together; Hildesheim _spicel. 2. de Mania_, relates of a Dutch baron, grievously tormented with melancholy after a long [2411]ague: Galen, _l. de atra bile, c. 4._ puts the plague a cause.

Botaldus in his book _de lue vener. c. 2._ the French pox for a cause, others, frenzy, epilepsy, apoplexy, because those diseases do often degenerate into this. Of suppression of haemorrhoids, haemorrhagia, or bleeding at the nose, menstruous retentions, (although they deserve a larger explication, as being the sole cause of a proper kind of melancholy, in more ancient maids, nuns and widows, handled apart by Rodericus a Castro, and Mercatus, as I have elsewhere signified,) or any other evacuation stopped, I have already spoken. Only this I will add, that this melancholy which shall be caused by such infirmities, deserves to be pitied of all men, and to be respected with a more tender compa.s.sion, according to Laurentius, as coming from a more inevitable cause.

SUBSECT. II.--_Distemperature of particular Parts, causes_.

There is almost no part of the body, which being distempered, doth not cause this malady, as the brain and his parts, heart, liver, spleen, stomach, matrix or womb, pylorus, mirach, mesentery, hypochondries, mesaraic veins; and in a word, saith [2412]Arcula.n.u.s, "there is no part which causeth not melancholy, either because it is adust, or doth not expel the superfluity of the nutriment." Savanarola _Pract. major. rubric. 11.

Tract. 6. cap. 1._ is of the same opinion, that melancholy is engendered in each particular part, and [2413]Crato _in consil. 17. lib. 2._ Gordonius, who is _instar omnium, lib. med. partic. 2. cap. 19._ confirms as much, putting the [2414]"matter of melancholy, sometimes in the stomach, liver, heart, brain, spleen, mirach, hypochondries, when as the melancholy humour resides there, or the liver is not well cleansed from melancholy blood."

The brain is a familiar and frequent cause, too hot, or too cold, [2415]

"through adust blood so caused," as Mercurialis will have it, "within or without the head," the brain itself being distempered. Those are most apt to this disease, [2416]"that have a hot heart and moist brain," which Montaltus _cap. 11. de Melanch._ approves out of Halyabbas, Rhasis, and Avicenna. Mercurialis _consil. 11._ a.s.signs the coldness of the brain a cause, and Sal.u.s.tius Salvia.n.u.s _med. lect. l. 2. c. 1._ [2417]will have it "arise from a cold and dry distemperature of the brain." Piso, Benedictus Victorius Faventinus, will have it proceed from a [2418]"hot distemperature of the brain;" and [2419]Montaltus _cap. 10._ from the brain's heat, scorching the blood. The brain is still distempered by himself, or by consent: by himself or his proper affection, as Faventinus calls it, [2420]"or by vapours which arise from the other parts, and fume up into the head, altering the animal facilities."

Hildesheim _spicel. 2. de Mania_, thinks it may be caused from a [2421]

"distemperature of the heart; sometimes hot; sometimes cold." A hot liver, and a cold stomach, are put for usual causes of melancholy: Mercurialis _consil. 11. et consil. 6. consil. 86._ a.s.signs a hot liver and cold stomach for ordinary causes. [2422]Monavius, in an epistle of his to Crato in Scoltzius, is of opinion, that hypochondriacal melancholy may proceed from a cold liver; the question is there discussed. Most agree that a hot liver is in fault; [2423]"the liver is the shop of humours, and especially causeth melancholy by his hot and dry distemperature." [2424]"The stomach and mesaraic veins do often concur, by reason of their obstructions, and thence their heat cannot be avoided, and many times the matter is so adust and inflamed in those parts, that it degenerates into hypochondriacal melancholy." Guianerius _c. 2. Tract. 15._ holds the mesaraic veins to be a sufficient [2425]cause alone. The spleen concurs to this malady, by all their consents, and suppression of haemorrhoids, _dum non expurget alter a causa lien_, saith Montaltus, if it be [2426]"too cold and dry, and do not purge the other parts as it ought," _consil. 23._ Monta.n.u.s puts the [2427]

"spleen stopped" for a great cause. [2428]Christophorus a Vega reports of his knowledge, that he hath known melancholy caused from putrefied blood in those seed-veins and womb; [2429]"Arcula.n.u.s, from that menstruous blood turned into melancholy, and seed too long detained (as I have already declared) by putrefaction or adustion."

The mesenterium, or midriff, diaphragma, is a cause which the [2430]Greeks called [Greek: phrenas]: because by his inflammation, the mind is much troubled with convulsions and dotage. All these, most part, offend by inflammation, corrupting humours and spirits, in this non-natural melancholy: for from these are engendered fuliginous and black spirits. And for that reason [2431]Montaltus _cap. 10. de causis melan._ will have "the efficient cause of melancholy to be hot and dry, not a cold and dry distemperature, as some hold, from the heat of the brain, roasting the blood, immoderate heat of the liver and bowels, and inflammation of the pylorus. And so much the rather, because that," as Galen holds, "all spices inflame the blood, solitariness, waking, agues, study, meditation, all which heat: and therefore he concludes that this distemperature causing advent.i.tious melancholy is not cold and dry, but hot and dry." But of this I have sufficiently treated in the matter of melancholy, and hold that this may be true in non-natural melancholy, which produceth madness, but not in that natural, which is more cold, and being immoderate, produceth a gentle dotage. [2432]Which opinion Geraldus de Solo maintains in his comment upon Rhasis.

SUBSECT. III.--_Causes of Head-Melancholy_.

After a tedious discourse of the general causes of melancholy, I am now 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. Sal.u.s.t. Salvia.n.u.s, 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 advent.i.tious 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 Salvia.n.u.s, is sometimes in the substance of the brain, sometimes contained in the membranes and tunicles that cover the brain, sometimes in the pa.s.sages 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 Monta.n.u.s 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 Trallia.n.u.s _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 Lusita.n.u.s _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 pa.s.sage of the chilus to the liver is detained, stopped or corrupted, and turned into rumbling and wind."

Monta.n.u.s, _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 effervesc.u.n.t_, 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_, Monta.n.u.s _consil. 229_, for the Earl of Montfort in Germany, 1549, and Frisimelica in the 233 consultation of the said Monta.n.u.s. 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 a.s.signs this reason, because the liver over-hot draws the meat undigested out of the stomach, and burneth the humours. Monta.n.u.s, _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 a.s.sign 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 Monta.n.u.s 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, pa.s.sion, or discontent. For as Camerarius records in his life, Melancthon himself was much troubled with it, and therefore could speak out of experience. Monta.n.u.s, _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, sh.e.l.lfish, 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 G.o.d," 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 sec.u.m 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 pa.s.sions 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 Jovia.n.u.s Ponta.n.u.s, _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 p.r.o.ne 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 princ.i.p.al 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 appet.i.te 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 pa.s.sions 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 superst.i.tion 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 quant.i.ty; 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, blus.h.i.+ng, 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_.