SOME difference I find amongst writers, about the principal part affected in this disease, whether it be the brain, or heart, or some other member. Most are of opinion that it is the brain: for being a kind of dotage, it cannot otherwise be but that the brain must be affected, as a similar part, be it by consent or essence, not in his ventricles, or any obstructions in them, for then it would be an apoplexy, or epilepsy, as Laurentius well observes, but in a cold, dry distemperature of it in his substance. which is corrupt and become too cold, or too dry, or else too hot, as in madmen, and such as are inclined to it: and this Hippocrates confirms, Galen, the Arabians, and most of our new writers. Marcus de Oddis (in a consultation of his, quoted by Hildesheim) and five others there cited are of the contrary part; because fear and sorrow, which are passions, be seated in the heart. But this objection is sufficiently answered by Montaltus, who doth not deny that the heart is affected (as Melanelius proves out of Galen) by reason of his vicinity, and so is the midriff and many other parts. They do compati, and have a fellow feeling by the law of nature: but forasmuch as this malady is caused by precedent imagination, with the appetite, to whom spirits obey, and are subject to those principal parts, the brain must needs primarily be misaffected, as the seat of reason; aad then the heart, as the seat of affection. Cappivaccius and Mercurialis have copiously discussed this question, and both conclude the subject is the inner brain, and from thence it is communicated to the heart and other inferior parts, which sympathize and are much troubled, especially when it comes by consent, and is caused by reason of the stomach, or myrach, as the Arabians term it, whole body, liver, or spleen, which are seldom free, pylorus, meseraic veins, &c. For our body is like a clock, if one wheel be amiss, all the rest are disordered; the whole fabric suffers: with such admirable art and harmony is a man composed, such excellent proportion, as Ludovicus Vives in his Fable of Man hath elegantly declared.
As many doubts almost arise about the affection, whether it be imagination or reason alone, or both, Hercules de Saxonia proves it out of Galen, Ætius and Altomarus, that the sole fault is in imagination. Bruel is of the same mind: Montaltus in his 2 cap. of Melancholy confutes this tenet of theirs, and illustrates the contrary by many examples: as of him that thought himself a shell-fish, of a nun, and of a desperate monk that would not be persuaded but that he was damned; reason was in fault as well as imagination, which did not correct this error: they make away themselves oftentimes, and suppose many absurd and ridiculous things. Why doth not reason detect the fallacy, settle and persuade, if she be free? Avicenna therefore holds both corrupt, to whom most Arabians subscribe. The same is maintained by Areteus, Gorgonius, Guianerius. &c. To end the controversy, no man doubts of imagination, but that it is hurt and misaffected here; for the other, I determine with Albertinus Bottonus, a doctor of Padua, that it is first in "imagination, and afterwards in reason; if the disease be inveterate, or as it is more or less of continuance; but by accident" as Herc. de Saxonia adds; "faith, opinion, discourse, ratiocination, are all accidentally depraved by the default of imagination."
Parties affected.] To the part affected, I may here add the parties, which shall be more opportunely spoken of elsewhere, now only signifieth. Such as have the moon, Saturn, Mercury misaffected in their genitures, such as live in over cold, or over hot climes: such as are born of melancholy parents; as offend in those six non-natural things, are black, or of a high sanguine complexion, that have little heads, that have a hot heart, moist brain, hot liver and cold stomach, have been long sick: such as are solitary by nature, great students, given to much contemplation, lead a life out of action, are most subject to melancholy. Of sexes both, but men more often; yet women misaffected are far more violent, and grievously troubled. Of seasons of the year, the autumn is most melancholy. Of peculiar times: old age, from which natural melancholy is almost an inseparable accident; but this artificial malady is more frequent in such as are of a middle age. Some assign 40 years, Gariopontus 30. Jubertus excepts neither young nor old from this adventitious. Daniel Sennertus involves all of all sorts, out of common experience, in omnibus omnino corporibus cujuscunque constionis dominatur. Ætius and Aretius ascribe into the number "not only discontented, passionate, and miserable persons, swarthy, black; but such as are most merry and pleasant, scoffers, and high coloured." "Generally," saith Rhasis, "the finest wits and most generous spirits, are before other obnoxious to it;" I cannot except any complexion, any condition, sex, or age, but fools and Stoics, which, according to Synesius, are never troubled with any manner of passion, but as Anacreon's cicada, sine sanguine et dolore; similes fere diis sunt. Erasmus vindicates fools from this melancholy catalogue, because they have most part moist brains and light hearts; they are free from ambition, envy, shame and fear; they are neither troubled in conscience, nor macerated with cares, to which our whole life is most subject.