18th-Century Theories of Melancholy & HypochondriaDaniel Dufala
Melancholy was a term that described a condition of deep sadness and lethargic behaviors leading to experiences of delusion and sometimes accompanied by a temptation to suicide (Midelfort 302). It reigned as one of the most common diseases of sixteenth- and early seventeenth-century Europe and encouraged a great mass of literature that remains today a testimony to the extent of discontent in the human experience (145). Melancholy can easily be compared in contemporary terms to the mental illnesses defined as depression and manic depression and is considered by some to be a disease exclusively associated with sadness. Because of the widespread nature of the disease the term melancholy became generally applied to mental illnesses characterized by disturbances such as rage, anxiety, apathy or deep sadness (147). This led to the need for more accurate and reliable methods of diagnosis and separately defined symptoms and causes (221).
There were two types of melancholy: natural and unnatural. The first was a condition considered to be brought on primarily by a black bile produced in the human body that could be dried up over time. This was the result of certain foods that would cause such bile to manifest. Strong wines were thought to act in this way (28). These things were also accompanied by lifestyles that would nourish the condition. Excesses of intoxication and indulgent, compulsive behaviors could lead to an imbalance of the many areas of living that promote health. One treatment for melancholy was a routine that brought balance between the patterns of sleep, play, exercise, human company, sexual activity, and intellectual stimulation, as well as the pressing need for the practitioner to keep the patient from being sad (147). In such cases it was believed that if these elements became out of order the black bile would be enabled to exceed normal levels. If balance were brought back into the afflicted person’s life then the bile would eventually dissipate, restoring to the individual the capacity to think clearly and with effective sharpness.
The second type of melancholy, described as unnatural, was the result of a corruption from demons and spirits. The possession of an individual by such outside forces would lead to symptoms of sadness that in many cases graduated towards manic episodes and the other behaviors of rage and eventual absolute madness (154). This was considered in some instances when the patient could not be cured of the disease. In such circumstances the demonic possession was of such a nature that the spirits had taken their form in the manifestation of a disease with symptoms similar to that of melancholy. But as it was believed that the devil could create infinite disguises, it was assumed that the source of the ailments was not natural and must have come from without (386).
Melancholy was foremost a disorder of the imagination. Samuel Johnson defined it in A Dictionary of the English Language as a “kind of madness in which the mind is always fixed on one object” prone to “sundry contemplation” resulting in a “most humorous sadness.” This was the result of one who becomes separated from his fulfillments. It seems that as memories are made from life experiences they are obsessed upon as they were in the past as being happy experiences. In an acceptance of loss, the afflicted person resorts to dwelling upon the memories in order to create a strange and synthesized happiness of a reality no longer existent in the present moment. In this manner people suffering from melancholy would become withdrawn and engulfed in the object of fixation, which in the example above would be fulfilling moments of gone time. This kind of fixation can lead to a state of being that, if not controlled, can lead to various forms of madness including full optical and aural hallucinations (147). Such was the case with many of the characters found in the plays of Shakespeare, in which dreams and imagination fuel the solitary insanity under which they suffered (Salkeld 27).
Samuel Johnson defined hypochondria as that which produces melancholy. This was condition of suspicion in which great fears were given to thought and induced a relaxation or as Johnson described “a forsaking of the spirits.” Many cases portrayed this condition as having an intense fear of some sort of sickness that led to the symptoms of melancholy. One case was with a woman who thought she had a snake living in her intestines. With no physical signs of such a thing the doctors proceeded to show her a snake that they claimed to have removed from her intestines. The woman was cured. Another case had a man that feared small frogs were eating his insides and the doctors gave him an enema and staged frogs in his feces (Midelfort 170). These kinds of cases were not uncommon.
As the real disease of melancholy has progressed throughout the centuries its name has changed and so have its treatments. The causes have been freed from superstition and religious myth, but have remained much the same when compared with the nature of the illness. It comes from a feeling of satisfaction that has been absent in the present and seems to be found in the past. Or it is the longing for satisfaction that seems only attainable in the future. This leaves the diseased individual hopelessly hanging in the present moment with a second hand happiness knowing that the things that bring him pleasure are not real but can still be experienced in thought.
Johnson, Samuel. A Dictionary of the English Language. London: Times Books Ltd.,1983.
Midelfort, H. C. Erik. A History of Madness in Sixteenth Century Germany. Stanford, California: Stanford University Press, 1999.
Salkeld, Duncan. Madness and Drama in the Age of Shakespeare. New York: Manchester University Press, 1993.
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