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Psychology

Humours

Melancholy may be peculiarly an English malady. One could say it is a national characteristic, born out of their long, dark nights and drizzle-wet-infested, indecisive weather. That mugginess of the soul, studious inexactitude of speech, and ambient dejectedness is almost like a national uniform. Recall late-70s rock or the Jacobean poets, the Brontë novels or Francis Bacon. You get the drift.

The undulating 60s, those effervescent lyrics and bright, clear, angular fashions, were not a true expression of English character. Quite the reverse; they were an aberration, a counterphobic paroxysm of, the exact opposite of what the British are really and truly comfortable with.

This British melancholy breeds a different kind of cynicism: rough hewn from an Atlantic gale or blast of sharp rain. It’s earthy, weather-bound and intensely corporal.

You see it might begin in the weather but it concentrates in the body,  the spleen to be exact, or rather because of an ancestral fascination with that mysterious organ, to be found lurking somewhere between the 9th  and 11th ribs on the left-hand side of the chest.

It was the Greek physician, Hippocrates and his Roman imitator, Galen, who made fashionable the diagnosis that the spleen is the source of black bile, that pungent, sluggish humor. A little of it, they surmised, is good for us, balancing out those other humors: blood, yellow bile and phlegm.

But too much leads to splenetic behavior and will blight our sporty proficiency. Pliny describes how the ancient Greeks endeavored to remove its vindictive influence by cauterizing the skin in that area of the body, burning and wasting it with a hot iron.

But it was up to an Englishman, Oxfordian cleric, Robert Burton, to provide us in the 1620s with an anatomical dissection of what it is to be truly splenetic in his Anatomy of Melancholy. He described how black bile builds up in the spleen until it begins to rise up through the chest, its smoky vapors coursing through the body and invading the imagination, until finally black smoke begins wafting through the soul’s every experience, sublime, profane and sacred.

Burton called melancholy "the rust of the soul", capturing the twin torments of spiritual decay and its physical manifestations. Melancholia is no mere "mood disorder" (Burton reminds us of the poverty of modern terminology). Supposedly originating in an excess of black bile, the disease threatens the body with a vile array of sensations.

The Anatomy is a peculiar laboratory in which the human form becomes porous and fluid, subject to terrifying assault. Melancholia can be an accident of astrology, the result of excessive heat or cold, a moist brain or cold stomach.

If one has a melancholic parent, a hot heart or a small head, you are pretty much doomed. So numerous are the causes of melancholy, so universal are its dominion that the book quickly runs into methodological trouble.

Melancholy proliferates; it flowers like rust on every surface Burton touches.

The gloomy aphorist EM Cioran wrote of The Anatomy of Melancholy that it had "the best title ever invented" but the work itself was more or less indigestible.

If the literature of depression tends toward attenuated speech patterns as for instance the crippled syntax of a Beckett or Duras, then Burton's treatise is a gargantuan anomaly: for it a monster of eloquence.

Nicholas Lezard celebrates The Anatomy of Melancholy by claiming it “the best book ever written.” He continues his rhapsody:
I use the word "book" with care. It's not a novel, a tract, an epic poem, a history; it is, quite self-consciously, the book to end all books. Made out of all the books that existed in a 17th-century library, it was compiled in order to explain and account for all human emotion and thought. It is not restricted to melancholy, or, as we call it today, depression; but then a true study of it will have to be - if you have the learning and the stamina - about everything…
 For it is not just Burton's thoughts on the subject of melancholy, but the thoughts of everyone who had ever thought about it, or about other things, whether that be goblins, beauty, the geography of America, digestion, the passions, drink, kissing, jealousy, or scholarship. Burton, you suspect, felt the miseries of scholars keenly.
"To say truth, 'tis the common fortune of most scholars to be servile and poor, to complain pitifully, and lay open their wants to their respective patrons... and... for hope of gain to lie, flatter, and with hyperbolical eulogiums and commendations to magnify and extol an illiterate unworthy idiot for his excellent virtues, whom they should rather, as Machiavelli observes, vilify and rail at downright for his most notorious villainies and vices." And that's a good quote to be getting on with: it shows you that Burton is on the side of the angels, that he's prepared to stick his neck out, and that he is funny.

The Anatomy of Melancholy (1621–51) by Robert Burton is an amazing compendium of classic and renaissance lore about the human condition of melancholy; verbally rich Robert Burton describes melancholy as a disease of the soul, stating that he will address his subject-matter both as a divine and a physician.

Depressive silence gives way to a verbal voraciousness that devours language and learning alike. First published in 1621, The Anatomy ran to a paltry 900 pages. Burton spent the rest of his life revising a book that now clocks in at a potentially soul-destroying 1392 pages.

But sheer size should not put the modern reader off one of the most astonishing books ever written.

Burton demonstrates the significance of the rhetoric healing that mixes religious and medical approaches to melancholy to a degree unique in his time and place. The concept of melancholy comprehended a wide range of characteristics and conditions in seventeenth-century European culture, from the brooding introspection of the genius and the scholar to a condition of delirious and delusory madness.

Its central and most immediately identifiable characteristic, however, was the excessive and unreasonable nature of its symptomologically defining emotions of fear and sorrow. As Robert Burton notes, the melancholic condition was commonly taken to be "a kind of dotage without fever, having for his ordinary companions fear and sadness, without any apparent occasion."

The presence of a pervasive and unreasonable sense of fear and sorrow invariably solicited the melancholic label. Indeed, melancholic emotions were the primary substance of melancholic dotage; the ravings of the melancholically mad and their frequent obsession with a single idea were often driven by an overwhelming feeling of fear and sorrow.

Burton deliberately blurs the boundaries between religious and medical, not only for polemical purposes, but with the pastoral aim of assisting the reader with a cure and solace. The genius of Burton is that he reassigns meanings that depart from his sources so that he creates a model of treatment. Burton's variations in content, style and even genre throughout the Anatomy can be understood as part of a curative response to a variable disease. Sir William Osler, a psychiatric medical historian became deeply interested in Burton, saying, “No book of any language presents such a stage of moving pictures.”

Describing foods that were thought to cause melancholia, he finds that his trawl through the history of dietary literature has exhausted every known meat, fruit and vegetable.

Speculating from his scholarly celibacy on the pleasures of marriage, he drifts into fantasies of endless kisses, listing all the accoutrements of female attractiveness, before turning to the melancholy possibility that one might end up with "a mere changeling, a very monster, an oaf imperfect".

His erotic comprehensiveness is all the more charming, his thick misogyny perhaps pardonable, when we keep in mind that, for this life-long cleric, it was also utterly imaginary. His demonology is de rigor.

The book's genius and success is Burton's plethora of styles as largely of quotations, citations and glosses on other works. From his phenomenal erudition, Burton fashions a book that says everything there is to say about melancholia, by saying everything there is to say about everything else. Burton called it "a rhapsody of rags gathered from several dunghills, excrements of authors, toys and fopperies confusedly tumbled out".

Sounds like an overheated mind of a tarot reader.

“The Anatomy ranks with Tristram Shandy and Moby Dick – a work that takes its subject as an excuse to weave a web of cod-academic treatises, rhetorical performances and baroque anecdotes. It is no more a book about mental illness than Herman Melville's is a novel "about" a whale.”

The lazy browser won't even pick this book off a shelf, let alone open it. When opened at random, it offers not only dense slabs of 17th-century prose, but insane lists that seem to go on forever, meandering digressions, whole chunks of italicised Latin.

The slack browser who gets the gist of the introduction, "Democritus to the Reader" (Democritus was the laughing philosopher; another clue that this is a comedy), will realise that as far as Burton is concerned, everyone on earth is either stupid or mad (himself included). Say that you're taking this on holiday, as poor Alain de Botton did, and you get heaved straight into Pseuds' Corner.

In the 17th century, English prose was in a phase of reckless experiment. The sly dialectics of John Donne's sermons and the rhetorical mazes of Thomas Browne's sentences reveal a literature reveling in sleight of hand. Burton's fans often claim him as a genial counter to this rhetorical dazzle, a master of "conversational" style. But he is much more than that.

Walter Benjamin, who was also born under the melancholy sign of Saturn, dreamed of a book entirely composed of quotations. Like Benjamin, Burton was too great a writer to refrain from filling the gaps between his citations. His prefatory comment on the burgeoning Anatomy is the verdict of an author who knows that his text has got the better of him, but it is also the sigh of a true-born melancholic: "I would willingly retract much, but 'tis too late."

The Everyman editions are full of the Latin that makes the work more forbidding than it should be because it is exceptionally readable, and funny, and full of witch lore (Burton was a divine, a bachelor, misanthrope, and avowed misogynist, astrologer who forecast the day of his death and then on said date, obliged by suicide.

The most accessible modern edition (for the English reader), if you can find a copy, is the reprint George H. Doran Company, 2 volume 1927 edition. It translated the Latin and Greek citations that are mostly paraphrased in the text by Burton himself into neat couplets based on period translations if possible.  There is a Tudor one volume reprint edition that was around in the 60s and 70s and should not be very expensive.  

The Text is available on line in html

Example of text:

On the use of amulets to cure melancholy: (note the reference to his mother, Dorothy Burton, d. 1629,
who introduced her more famous son to empirical techniques for anatomizing physical and psychological ailments)

   ... look for them in Mizaldus, Porta, Albertus, etc. Bassardus Visontinus, Ant. philos., commends hypericon, or St. John’s wort, gathered on a Friday in the hour of Jupiter, “when it comes to his effectual operation (that is about the full moon in July); so gathered and borne, or hung about the neck, it mightily helps this affection, and drives away all phantastical spirits.” Philes, a Greek author that flourished in the time of Michael Palæologus, writes that a sheep or kid’s skin, whom a wolf worried, Haedus inhumani raptus ab ore lupi, ought not at all to be worn about a man, “because it causeth palpitation of the heart,” not for any fear, but a secret virtue which amulets have. A ring made of the hoof of an ass’s right fore-foot carried about, etc.: I say with Renodeus,<marg. 6d> they are not altogether to be rejected. Peony doth cure epilepsy; precious stones most diseases; a wolf’s dung borne with one helps the colic, a spider, an ague, etc. Being in the country in the vacation time not many years since, at Lindley in Leicestershire, my father’s house, I first observed this amulet of a spider in a nut-shell lapped in silk, etc., so applied for an ague by my mother; whom although I knew to have excellent skill in chirurgery, sore eyes, aches, etc., and such experimental medicines, as all the country where she dwelt can witness, to have done many famous and good cures upon divers poor folks, that were otherwise destitute of help, yet, among all other experiments, this methought was most absurd and ridiculous, I could see no warrant for it. Quid aranea cum febre?  For what antipathy? till at length, rambling amongst authors (as often I do), I found this very medicine in Dioscorides, approved by Matthiolus, repeated by Aldrovandus, cap. de aranea, lib. de insectis; I began to have a better opinion of it, and to give more credit to amulets, when I saw it in some parties answer to experience. Some medicines are to be exploded, that consist of words, characters, spells, and charms, which can do no good at all, but out of a strong conceit, as Pomponatius proves; or the devil’s policy, who is the first founder and teacher of them.  (Partition 2, Section 5, Member 1, Subsection 5)

 

Passions and Tempers: A History of the Humours by Noga Arikha (Ecco) The humours—blood, phlegm, black bile, and choler—were substances thought to circulate within the body and determine a person's health, mood, and character. For example, an excess of black bile was considered a cause of melancholy. The theory of humours remained an inexact but powerful tool for centuries, surviving scientific changes and offering clarity to physicians.

This one-of-a-kind book follows the fate of these variable and invisible fluids from their Western origin in ancient Greece to their present-day versions. It traces their persistence from medical guidebooks of the past to current health fads, from the testimonies of medical doctors to the theories of scientists, physicians, and philosophers. By intertwining the histories of medicine, science, psychology, and philosophy, Noga Arikha revisits and revises how we think about all aspects of our physical, mental, and emotional selves.

From Publishers Weekly: Leading medical minds were once convinced that health and sickness resulted from the interplay of the four "humors": blood, phlegm, black bile and yellow bile, each associated with a certain personality trait (e.g., black bile signifies melancholic) and with one of the basic elements of the universe (e.g., yellow bile is linked to fire). The rational mindset naturally recoils at the crudity and superstition of this ancient medical framework, but independent historian Arikha's pleasing historical survey usefully reminds us that our modern theories of the relationship between mind, mood and body rest on gains made by humoral analogy. To investigate the humors is to probe all of Western medicine, starting with the ancient physicians Hippocrates and Galen, the Persian Hunayn ibn-Is'haq, through the bloodlettings of the Middle Ages and Harvey's experiments on blood, to Mesmer and Freud and beyond. If Arikha's defense is occasionally a touch too fervent, her passion, intellectual energy and empathy are laudable. After all, says Arikha, neurotransmitters are today's humors, and pharmaceutical companies are not all that different from the apothecaries of yore. This is a stimulating work that shows the Western mind nobly grappling with the inscrutable nature of the human body. Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Some people say that the magic number is three, and some that it's seven, but there are other possibilities. For instance, Fagin, the con artist of Oliver Twist, pointed out that the only truly magical number was number one -- and his is clearly the preferred modern viewpoint. But the ancients made a case for the number four: The philosopher Empedocles argued, according to Noga Arikha, that "all matter was divided into four opposing pairs of principles (hot and cold, dry and moist) and four elements (air, earth, fire, water)." Moreover, there were four seasons, four points of the compass, and, not least, four humours.

The humours were, in Arikha's words, "substances that circulated within the human body, much like water in pipes. A humour is literally a fluid -- humon in Greek, (h)umour in Latin -- and bodily humours are fluids within a living organism. In the West, the theory developed that the human body was constituted of four of these humours, all central to its functioning.

Phlegm was one of them; the three others were yellow bile, black bile, and blood. They were concocted out of the heat of digestive processes in the stomach: Food turned into so-called chyle in the liver, from where, thanks to the heat produced by these digestive concoctions, particles in the bloodstream called 'vital spirits' were expedited to the heart, and from there to the brain. The cerebellum refined some of these spirits into smaller 'animal spirits.' Heat and cold, dryness and moistness affected the course of the spirits, and determined the effects of each humour on mood, thought, or health. There was thus a continuum between passions and cognition, physiology and psychology, individual and environment."

This theory of the humours has lain at the heart of Western medicine and psychology for well over 2,000 years. Not until the 17th century did science begin to construct a substantially more accurate picture of human anatomy: In this respect, William Harvey's 1628 monograph on the circulation of the blood may be likened in its impact to Copernicus's proof that the planets revolve around the sun. From then on, the theory that good health was determined by humoural balance gradually went into a decline.

Yet even now the humours leave a legacy in our linguistic habits. People can be in a good or bad humour. We speak of bilious and sanguine and phlegmatic temperaments. Melancholy, the most studied of our moods, derives its name from melaina (black) and chole (bile). In some ways, Arikha argues, the humoural view of the self is still very much with us, under o anger, melancholy or lust result in an internal imbalance, one that might lead to serious physical impairment or some form of insanity.

Though the humoural theory of health and temperament provides the connecting thread of this history, Arikha's book is also, by its nature, an overview of Western medicine. She discusses the speculations of such figures as the semi-legendary Asklepios and the vastly influential Galen, traces the impact of Arabic medical study, examines the effectiveness of herbal "simples" and other folk medicines during the Middle Ages, treats seriously the Hermetic lore, alchemy and astrology of the Renaissance, and analyzes the theory of the passions during the 17th and 18th centuries.

There are discussions of witchcraft, mesmerism, phrenology (that the shape of your head discloses your personality), blood transfusions, inoculation, the sympathetic nervous system, and the major medical advances of the 19th century. She ends with a discussion of psychoanalysis and the latest developments in pharmaceutical research. In short, Arikha offers a brief, if occasionally dense, account of how men and women have thought about their bodies and their souls.

She is at her best when discussing melancholy and love-sickness, "uterine fury" and satyriasis. For such are the possible consequences when erotic obsession upsets the proper functioning of the humours. According to the 17th-century antiquary Robert Burton, in a passage from The Anatomy of Melancholy that mirrors the erotic vertigo it describes, many lovers "are carried headlong like so many brute beasts; reason counsels one way, thy friends, fortunes, shame, disgrace, danger, and an ocean of cares that will certainly follow; yet this furious lust precipitates, counterpoiseth, weighs down on the other; though it be their utter undoing, perpetual infamy, loss, yet they will do it, and become at last insensati, void of sense; degenerate into dogs, hogs, asses, brutes; as Jupiter into a bull, Apulei a bear, Elpenor and Gryllus into swine by Circe."

By the Enlightenment, however, when scientists referred to the mind, they clearly meant the brain. "Nerves," says Arikha, "were the humours for an age of cerebral supremacy." By the time of Freud, the humours had again been reconfigured:

"Hysteria occurred when repressed anguish surfaced like a message in a bottle, or indeed like humours within a hydraulic organism. Freud posited the existence of an unconscious driven by the libidinal humour, the locus of repressed conflicts between the parts of a new tripartite soul -- the ego, the id, and the superego, vaguely corresponding to the old appetitive, sensitive, and rational souls. . . . The notion of an unconscious that we somatized in various, sometimes extreme ways was a return to humoural form.

It was an acknowledgment that our organisms were traversed by stuff invisible to the conscious eye, that our innards were as present to our sleeping, dreaming, neurotic, or maddened selves as our skin was smooth.

And it was a recognition that, however much we shoved the terror of our bloody origins beneath the garb of our conscious, thinking minds, the mystery of our primal, humoural embodiment returned, violently or surreptitiously."

Educated at the prestigious Warburg Institute and a specialist in the history of medicine, Arikha doesn't shrink from occasionally voicing her own views, especially about contemporary health care. Modern medicine, she says, "chops us into bits. It has become so specialized that Hippocratic doctors might not recognize today a profession whose goal was the care of illness through the understanding of the whole patient. Localized medicine can work wonders, of course. . . . But ever since we realized that our hearts were pumps and not the seats of vital souls, our medicine has become increasingly mechanistic, focused on soulless pulleys, easily forgetful of our complex humours."

For, as Arikha insists, our inner selves remain singularly elusive. "A map of the brain, or indeed of the humours, can only identify features of the landscape; the experience, meaning, and value remain for the emotional traveler to discover. . . . Chemistry cannot tell us all there is to know about what goes on in a depressed individual, or in any mind; nor can it account for the sense of self. The 'explanatory gap' between a scientific theory and actual experience remains identical through time, whether the scientific theory is based on humours or on hormones."

Passions and Tempers may excite passions and tempers in some of its readers, as a good work of intellectual history should. You will learn a lot from its pages. But one of its lessons most adults already know:

However smart, creative or holy we may think ourselves, we are still fastened to the vexatious flesh, in all its glory and terrible fragility. (Reviewed by Michael Dirda Copyright 2007, The Washington Post. All Rights Reserved.)

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