The Anatomy of Melancholy. Robert Burton

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 causes.

      SECT. II. MEMB. I.

      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 adventure to guess as near as I can, and rip them all up, from the first to the last, general and particular, to every species, that so they may the better be described.

      General causes, are either supernatural, or natural. "Supernatural are from God and his angels, or by God's permission from the devil" and his ministers. That God himself is a cause for the punishment of sin, and satisfaction of his justice, many examples and testimonies of holy Scriptures make evident unto us, Ps. cvii, 17. "Foolish men are plagued for their offence, and by reason of their wickedness." Gehazi was stricken with leprosy, 2 Reg. v. 27. Jehoram with dysentery and flux, and great diseases of the bowels, 2 Chron. xxi. 15. David plagued for numbering his people, 1 Par. 21. Sodom and Gomorrah swallowed up. And this disease is peculiarly specified, Psalm cxxvii. 12. "He brought down their heart through heaviness." Deut. xxviii. 28. "He struck them with madness, blindness, and astonishment of heart." [1100]"An evil spirit was sent by the Lord upon Saul, to vex him." [1101]Nebuchadnezzar did eat grass like an ox, and his "heart was made like the beasts of the field." Heathen stories are full of such punishments. Lycurgus, because he cut down the vines in the country, was by Bacchus driven into madness: so was Pentheus and his mother Agave for neglecting their sacrifice. [1102]Censor Fulvius ran mad for untiling Juno's temple, to cover a new one of his own, which he had dedicated to Fortune, [1103]"and was confounded to death with grief and sorrow of heart." When Xerxes would have spoiled [1104]Apollo's temple at Delphos of those infinite riches it possessed, a terrible thunder came from heaven and struck four thousand men dead, the rest ran mad. [1105]A little after, the like happened to Brennus, lightning, thunder, earthquakes, upon such a sacrilegious occasion. If we may believe our pontifical writers, they will relate unto us many strange and prodigious punishments in this kind, inflicted by their saints. How [1106]Clodoveus, sometime king of France, the son of Dagobert, lost his wits for uncovering the body of St. Denis: and how a [1107]sacrilegious Frenchman, that would have stolen a silver image of St. John, at Birgburge, became frantic on a sudden, raging, and tyrannising over his own flesh: of a [1108]Lord of Rhadnor, that coming from hunting late at night, put his dogs into St. Avan's church, (Llan Avan they called it) and rising betimes next morning, as hunters use to do, found all his dogs mad, himself being suddenly strucken blind. Of Tyridates an [1109]Armenian king, for violating some holy nuns, that was punished in like sort, with loss of his wits. But poets and papists may go together for fabulous tales; let them free their own credits: howsoever they feign of their Nemesis, and of their saints, or by the devil's means may be deluded; we find it true, that ultor a tergo Deus, [1110]"He is God the avenger," as David styles him; and that it is our crying sins that pull this and many other maladies on our own heads. That he can by his angels, which are his ministers, strike and heal (saith [1111]Dionysius) whom he will; that he can plague us by his creatures, sun, moon, and stars, which he useth as his instruments, as a husbandman (saith Zanchius) doth a hatchet: hail, snow, winds, &c. [1112]Et conjurati veniunt in classica venti: as in Joshua's time, as in Pharaoh's reign in Egypt; they are but as so many executioners of his justice. He can make the proudest spirits stoop, and cry out with Julian the Apostate, Vicisti Galilaee: or with Apollo's priest in [1113]Chrysostom, O coelum! o terra! unde hostis hic? What an enemy is this? And pray with David, acknowledging his power, "I am weakened and sore broken, I roar for the grief of mine heart, mine heart panteth," &c. Psalm xxxviii. 8. "O Lord, rebuke me not in thine anger, neither chastise me in thy wrath," Psalm xxxviii. 1. "Make me to hear joy and gladness, that the bones which thou hast broken, may rejoice," Psalm li. 8. and verse 12. "Restore to me the joy of thy salvation, and stablish me with thy free spirit." For these causes belike [1114]Hippocrates would have a physician take special notice whether the disease come not from a divine supernatural cause, or whether it follow the course of nature. But this is farther discussed by Fran. Valesius, de sacr. philos. cap. 8. [1115] Fernelius, and [1116]J. Caesar Claudinus, to whom I refer you, how this place of Hippocrates is to be understood. Paracelsus is of opinion, that such spiritual diseases (for so he calls them) are spiritually to be cured, and not otherwise. Ordinary means in such cases will not avail: Non est reluctandum cum Deo (we must not struggle with God.) When that monster-taming Hercules overcame all in the Olympics, Jupiter at last in an unknown shape wrestled with him; the victory was uncertain, till at length Jupiter descried himself, and Hercules yielded. No striving with supreme powers. Nil juvat immensos Cratero promittere montes, physicians and physic can do no good, [1117]"we must submit ourselves unto the mighty hand of God," acknowledge our offences, call to him for mercy. If he strike us una eademque manus vulnus opemque feret, as it is with them that are wounded with the spear of Achilles, he alone must help; otherwise our diseases are incurable, and we not to be relieved.

      SUBSECT. II.—A Digression of the nature of Spirits, bad Angels, or Devils, and how they cause Melancholy.

      How far the power of spirits and devils doth