The Anatomy Of Melancholy
Robert Burton
1621 AD

1. In 1621 AD, Robert Burton wrote a book called The Anatomy Of Melancholy which described mental illness as caused by the mind which then in turn affects the brain, heart and other organs. He notes that different people handle common everyday life events in vastly different ways. The melancholy are unable to deal with these common life events without anxiety and loss of sleep: "In Disposition, is that transitory Melancholy, which goes and comes upon every small occasion of sorrow, need, sickness, trouble, fear, grief, passion, or perturbation of the Mind, or any manner of care, discontent, or thought, which causeth anguish and vexation of the Spirits, any ways opposite to pleasure, mirth, joy, delight, or causing frowardnesse in us, or a dislike. ... For that which is but as a flea-biting to one, cause unsufferable torment to another, and that which one by his singular moderation, and well-composed carriage can happily overcome, a second is no whit able to sustain : but upon every small occasion of grief, disgrace, loss, cross, rumor, &c. yields so far to passion, that his complexion is altered, his digestion hindred, his sleep gone, his spirits obscured, and his heart heavy, his Hypocondries missaffected, wind, crudity on a sudden overtake him, and he himself overcome with Melancholy." Burton shows that madness is caused by the mind, not the body: "but forasmuch as this malady is caused by precedent Imagination, and the Appetite, to whom Spirits obey, are subject to those principall parts, the Braine must needs be primarily misaffected, as the seate of Reason, and then the Heart, as the seate of Affection". Burton believed that the devil began deceiving the mind of those who were predisposed to melancholy and affected both mind and body. Burton correctly rejects the concept of demon possession causing insanity, but his view of the devil being like a "lion seeking someone to devour" is clearly biblical. This is quite different from demon possession. "Many think he can worke upon the body, but not upon the minde. But experience pronounceth otherwise, that he can work both upon body and mind . . . He begins first with the phantasie, and moves that so strongly that no reason is able to resist. Now the Phantasie he moves by mediation of humors : Although many Physitians are of opinion that the Devil can alter the minde, and produce this disease of himselfe .. . Agrippa and Lavater are perswaded that this humour invites the Divell to it, wheresoever it is in extremity, and of all other Melancholy persons are most subject to diabolical temptations, and illusions, and most apt to entertain them and the Devil best able to work upon them." Burton further states that mental illness happens in family groups and is hereditary. He notes that it is not the physical body that transmits the disease, but the manner, personality, temperament of the mind. It is clear that through all ages mental illness runs in families. But so does religion. Just as religion can be learned so too mental illness: "it being an hereditary disease : for as he justices . . . Such as the temperature of the father is, such is the sons; and look what disease the father had when he begot him, such his son will have after him . . . Now this doth not so much appear in the composition of the Body . . . but in manners and conditions of the Mind". Burton shows that the etiology of mental illness is upbringing. If parents are too harsh "Fathers, do not exasperate your children, so that they will not lose heart" Col 3:21 or mothers who are too permissive "He who withholds his rod hates his son, But he who loves him disciplines him diligently." Proverbs 13:24. "Education of these accidental causes of melancholy, may justly challenge the next place : for if a man escape a bad Nurse, he may be undone by evil bringing up. Jason Pratensis, puts this of Education for a principal cause, bad parents, step-mothers, Tutors, Masters, Teachers, too rigorous and too severe, Of too remiss or indulgent on the other side, are often fountains and furthers of this disease. Parents and such as have the tuition and oversight of children, offend many times in that they are too stern, alway threatning, chiding, brawling, whipping, or striking; by meanes of which their poore children are so disheartned & cowed that they never after have any courage, or a merry houre in their lives, or take pleasure in any thing .. Others againe in that other extreame doe as much harme . . . Too much indulgence causeth the like, many fond mothers especially, dote so much upon their children like Aesops ape, till in the end they crush them to death." Remarkably, Burton identifies hypochondria and paranoia as two key indicators of mental illness. "Some are afraid that they shall have every fearefull disease they see others have, heare of, or read. If they see one possessed, bewitch't, or an Epileptick Paroxisme, a man shaking with the palsy, or giddy-headed, reeling, or standing in a dangerous place &c. for many dayes after it runs in their mindes, they are afraid they shal be so too, they are in the like danger .. . they applie all they see, heare, read, to themselves . . . and will be sick, and apply all symptomes they find related of others, to their owne persons" ... Paranoia: "If two talke together and whisper, or jest, or tell a tale in generall, he thinks presently they meane him, applies all to himselfe . . . Or if they talk with him, he is ready to misconstrue every word they speak, and interpret it to the worst . . . He thinks they laugh or point at him, or doe it in disgrace of him, circumvent him, condemn him" It is easy to see why Burton's book was a standard text that was widely distributed over two centuries. (The Anatomy Of Melancholy, Robert Burton, 1621 AD)
2. This great book was destined to become the most frequently reprinted psychiatric text. It may properly be called the first psychiatric cyclopaedia for nearly one thousand authors are cited, about half of them medical. It was so popular that five editions appeared in Burton's lifetime and three more in the seventeenth century. It then fell into oblivion together with the all embracing Elizabethan concept of melancholy, but in the Romantic Period at the turn of the nineteenth century was reinstated as a classic of English literature and more than sixty editions and reissues have appeared since 1800. As in the case of so many writers on melancholy Burton's interest in the malady was aroused by having suffered the pangs of it himself. In fact he wrote the book not only to `helpe others out of a fellow feeling' but to rid himself of its symptoms : 'I write of Melancholy, by being busie to avoid Melancholy . . . to exercise my selfe . . . to ease my mind . . . for I had gravidum cor, foetum caput, Which I was very desirous to be unladen of, and could imagine no fitter evacuation than this. Besides I could not well refraine, for ubi dolor ibi digitus, one must needs scrat[ch] where it itches'. And although 'many excellent Physitians have written just Volumes and elaborate Tracts of this subject' he had the advantage of personal experience : `they get their knowledge by bookes, I mine by melancholi sing . . . that which others heare of or read of, I felt and practised my selfe' . From the embarrassing wealth of observations, quotations and discussions often witty as befits an author styling himself Democritus, Hippocrates's laughing philosopher, selections have been made from his accounts of contemporary views on the seats, causes and divisions of melancholy, a term which included everything from temperament to insanity; the then topical 'difficult question' whether `Divels . . . cause Melancholy . . . by obsession, or possession, or otherwise' ; the importance of hereditary factors — a more modern theme; the influence of childhood experiences by what present-day psychologists call overprotecting or rejecting parents ; and a description of ideas of reference and paranoid traits — Kretschmer's sensitiver Beziehungswahn — including Rusticus Pudor' or uncontrollable blushing, a not uncommon symptom. (300 years of Psychiatry, Richard Hunter, 1963, p94)

The Anatomy Of Melancholy, Robert Burton, 1621 AD

Robert Burton (1577-1640)

BD Oxon, divine of Christ Church, Oxford

The anatomy of melancholy, what it is. With all the kinds, causes, sympti prognostickes, and severall cures of it . . . by Democritusjunior, 1621 OA Cripps (pp. lxxxciii +784 +viii) pp. 16, 18-9, 47-9, 52-3, 57, 68-9, 122, 192-3, 233, 235, 237, 239, 479

Melancholy, the subject of our present Discourse, is either in Disposition, or in Habite. In Disposition, is that transitory Melancholy, which goes and comes upon every small occasion of sorrow, neede, sicknesse, trouble, feare, griefe, passion, or perturbation of the Minde, or any manner of care, discontent, or thought, which causeth anguish and vexation of the Spirits, any wayes opposite to pleasure, mirth, joy, delight, or causing frowardnesse in us, or a dislike; In which Equivocall and improper sence, we call any man Melancholy, that is dull, heavy, sad, sowre, lumpish, ill-disposed, solitary, or any way mooved, or displeased. And from these Melancholy Dispositions, no man living is free, no Stoicke, none so wise, none so happy, so patient, so generous, so godly, so divine, that can vindicate himselfe, so well composed, but more or lesse, somtime or other, he feels the smart of it . . . it falleth out oftentimes that these Dispositions become Habits, and many Affects contemned, as Seneca notes, makes a Disease . . . For that which is but as a flea-biting to one, cause unsufferable torment to another, and that which one by his singular moderation, and well-composed carriage can happily overcome, a second is no whit able to sustain : but upon every small occasion of grief, disgrace, loss, cross, rumor, &c. yields so far to passion, that his complexion is altered, his digestion hindred, his sleep gone, his spirits obscured, and his heart heavy, his Hypocondries missaffected, winde, crudity on a sudden overtake him, and he himselfe overcome with Melancholy. So that as the Philosophers make eight degrees of heate and colde. Wee may make 88. of Melancholy, as the parties affected are diversly seased with it, or have beene plunged more or lesse into this Infernall gulfe, or waded deeper into it.

Some difference I sinde amongst Writers, about the principall part affected in this disease, whether it be the Brain or Heart, or some other Member. Most are of opinion, that it is the Braine, for being a kinde of Dotage, it cannot otherwise be . . . The Heart indeed is affected, as Melanelius proves out of Galen, by reason of his vicinity; and so is the Midriffe, and many other parts. They doe compati, and have a fellow feeling by the Law of Nature : but forasmuch as this malady is caused by precedent Imagination, and the Appetite, to whom Spirits obey, are subject to those principall parts, the Braine must needs be primarily misaffected, as the seate of Reason, and then the Heart, as the seate of Affection .. .

As many doubts almost arise about the Affection, whether it be Imagination or Reason alone, or both. Hercules de Saxonia proves out of Galen, 1V,tius, and Altomarus, that the sole fault is in Imagination. Bruel is of the same mind: Montaltus in his second Chapter of Melancholy, confutes this Tenet of theirs, and illustrates the contrary, by many examples, as of him, that thought he was a shell-sish, of a Nunne, of a desperate Monke, that would not be perswaded, but that he was damned. Reason was in fault as well as Imagination, which did not correct this Error; they make away themselves often-times, and suppose many absurd and ridiculous things. Why doth not Reason detect the Fallacy, settle and perswade if shee be free ? Avicenna therefore holdes both corrupt, to whom most Arabians subscribe. The same is maintained by Areteus, Gordonius, Guianerius &c. To end the controversie, no man doubts of Imagination, but that it is hurt and mis-affected heere ; for the other I determine with Albertinus Bottonus, a Doctor of Padua, that it is sirst in Imagination, and afterwards in Reason, if the Disease be inveterate, or as it is more or lesse of continuance.

The most received division is into three kindes. The first proceeds from the sole fault of the Braine, and is called Head melancholy: the second sympathetically proceedes from the whole Body, when the whole temperature is Melancholy: The third ariseth from the Bowels, Liver, Splene, or Membrane, called Mesenterium, named Hypochondriacall, or windy melancholy, which Laurentius subdivides into three parts, from those three Members, Hepaticke, Splenaticke, Mesariacke. Love melancholy .. . and Lycanthropia . . . are commonly included in Head Melancholy .. . with that of Religious melancholy.

How farre the power of Devils doth extend, and whether they can cause this or any other Disease, is a serious question and worthy to be considered . . . Many think he can worke upon the body, but not upon the minde. But experience pronounceth otherwise, that he can work both upon body and mind . . . He begins first with the phantasie, and moves that so strongly that no reason is able to resist. Now the Phantasie he moves by mediation of humors : Although many Physitians are of opinion that the Devil can alter the minde, and produce this disease of himselfe .. . Agrippa and Lavater are perswaded that this humour invites the Divell to it, wheresoever it is in extremity, and of all other Melancholy persons are most subject to diabolical temptations, and illusions, and most apt to entertain them and the Devil best able to work upon them. But whether by obsession, or possession, or otherwise, I will not determine, t'is a difficult question.

That other inward inbred cause of Melancholy, is our temperature in whole or part, which wee receive from our parents, which Fernelius cals praeter naturam, or unnaturall, it being an hereditary disease : for as he justisies . . . Such as the temperature of the father is, such is the sons; and looke what disease the father had when he begot him, such his son will have after him . . . Now this doth not so much appeare in the composition of the Body . . . but in manners and conditions of the Minde .. . And that which is more to be wondred at, it skippes in some Families the Father, and goes to the Sonne, or takes every other, and sometimes every third in a lineall descent, and doth not alwayes produce the same, but some like, and a symbolizing disease.

Education of these accidental causes of melancholy, may justly challenge the next place : for if a man escape a bad Nurse, he may be undone by evil bringing up. Jason Pratensis, puts this of Education for a principal cause, bad parents, step-mothers, Tutors, Masters, Teachers, too rigorous and too severe, Of too remiss or indulgent on the other side, are often fountains and furthers of this disease. Parents and such as have the tuition and oversight of children, offend many times in that they are too stern, alway threatning, chiding, brawling, whipping, or striking; by meanes of which their poore children are so disheartned & cowed that they never after have any courage, or a merry houre in their lives, or take pleasure in any thing .. Others againe in that other extreame doe as much harme . . . Too much indulgence causeth the like, many fond mothers especially, dote so much upon their children like Aesops ape, till in the end they crush them to death.

Some are afraid that they shall have every fearefull disease they see others have, heare of, or read. If they see one possessed, bewitch't, or an Epileptick Paroxisme, a man shaking with the palsy, or giddy-headed, reeling, or standing in a dangerous place &c. for many dayes after it runs in their mindes, they are afraid they shal be so too, they are in the like danger .. . they applie all they see, heare, read, to themselves . . . and will be sick, and apply all symptomes they find related of others, to their owne persons . .

Suspition and Jelousie, are generall symptomes, they are commonly distrustfull, apt to mistake, facile Irascibiles, testy, pettish, peevish, and ready to snarle upon every smal occasion, cum amicissimis, and without a cause. If two talke together and whisper, or jest, or tell a tale in generall, he thinks presently they meane him, applies all to himselfe . . . Or if they talk with him, he is ready to misconstrue every word they speak, and interpret it to the worst . . . He thinks they laugh or point at him, or doe it in disgrace of him, circumvent him, condemn him . . . Many of them are immovable and fixed in their conceipts, and others vary upon every object heard or seene .. . Rusticus Pudor, bashfulnesse, slushing in the face high colour, ruddinesse are common greivances which much torture many melancholy men, when they meet a man or come in company of their betters, strangers, or after a meale, or if they drinke a cup of wine or stronge drinke, they are as red and flect and sweat, as if they had beene at a Maiors feast, praesertim si metus accesserit, it exceedes, they thinke every man observes it, tak notice of it, & feare alone wil effect it, suspition without any other cause.

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