OF the matter of melancholy, there is much question betwixt Avicen and Galen, as you may read in Cardan's Contradictious, Valesius' Controversies, Montanus, Prosper Calenus, Cappivaccius, Bright, Ficinus, that have written either whole tracts, or copiously of it, in their several treatises of this subject. "What this humour is, or whence it proceeds, how it is engendered in the body, neither Galen, nor any old writer, hath sufficiently discussed, as Jacchiuus thinks: the Neoterics cannot agree. Montanus, in his Consultations, holds melancholy to be material or immaterial: and so doth Arculanus: the material is one of the four humours before mentioned, and natural. The immaterial or adventitious, acquisite, redundant, unnatural, artificial; which Hercules de Saxonia will have reside in the spirits alone, and to proceed from a "hot, cold, dry, moist distemperature, which, without matter, alter the brain and functions of it." Paracelsus wholly rejects and derides this division of four humours and complexions, but our Galenists generally approve of it, subscribing to this opinion of Montanus.
This material melancholy is either simple or mixed; offending in quantity or quality, varying according to his place, where it settleth, as brain, spleen, meseraic veins, heart, womb, and stomach; or differing according to the mixture of those natural humours amongst themselves, or four unnatural adust humours, as they are diversely tempered and mingled. If natural melancholy abound in the body, which is cold and dry, "so that it be more than the body is well able to bear, it must needs be distempered," saith Faventius, "and diseased;" and so the other, if it be depraved, whether it arise from that other melancholy of choler adust, or from blood, produceth the like effects, and is, as Montaltus contends, if it come by adustion of humours, most part hot and dry. Some difference I find, whether this melancholy matter may be engendered of all four humours, about the colour and temper of it. Galen holds it may be engendered of three alone, excluding phlegm, or pituita, whose true assertion Valesius and Menardus stiffly maintain, and so doth Fuschius, Montaltus, Montanus. How (say they) can white become black? But Hercules de Saxonia, lib. post. de mela. c. 8, and Cardan are of the opposite part (it may be engendered of phlegm, etsi raro contingat, though it seldom come to pass), so is Guianerius and Laurentius, c.1. with Melanct. in his Book de Anima, and Chap. of Humours; he calls it Asininam, dull, swinish melancholy, and saith that he was an eye-witness of it: so is Wecker. From melancholy adust ariseth one kind; from choler another, which is most brutish; another from phlegm, which is dull; and the last from blood, which is best. Of these some are cold and dry, others hot and dry, varying according to their mixtures, as they are intended, and remitted. And indeed as Rodericus a Fons. cons. 12. 1. determines, ichors, and those serous matters being thickened become phlegm, and phlegm degenerates into choler, choler adust becomes æruginosa melancholia, as vinegar out of purest wine putrefied or by exhalation of purer spirits is so made, and becomes sour and sharp; and from the sharpness of this humour proceeds much waking, troublesome thoughts and dreams, &c. so that I conclude as before. If the humour be cold, it is, saith Faventinus, "a cause of dotage, and produceth milder symptoms: if hot, they are rash, raving mad, or inclining to it." If the brain be hot, the animal spirits are hot; much madness follows, with violent actions: if cold, fatuity and sottishness, Cappivaccius. The colour of this mixture varies likewise according to the mixture, be it hot or cold; 'tis sometimes black, sometimes not, Altomarus. The same Melanelius proves out of Galen; and Hippocrates in his Book of Melancholy (if at least it be his), giving instance in a burning coal, "which when it is hot, shines; when it is cold, looks black; and so doth the humour." This diversity of melancholy matter produceth diversity of effects. If it be within the body, and not putrefied, it causeth black jaundice; if putrefied, a quartan ague; if it break out to the skin, leprosy; if to parts, several maladies, as scurvy, &c. If it trouble the mind; as it is diversely mixed, it produceth several kinds of madness and dotage: of which in their place.