THERE is almost no part of the body, which being distempered, doth not cause this malady, as the brain and his parts, heart, liver, spleen, stomach, matrix or womb, pylorus, mirache, mesentery, hypochondries, meseraic veins; and in a word, saith Arculanus, "there is no part which causeth not melancholy, either because it is adust, or doth not expel the superfluity of the nutriment. Savanarola, Pract. major. rubric. 11. Tract. 6. cap. 1. is of the same opinion, that melancholy is engendered in each particular part, and Crato in consil. 17. lib. 2. Gordonius, who is instar omnium, lib. med. partic. 2. cap. 19. confirms as much, putting the matter of melancholy, sometimes in the stomach, liver, heart, brain, spleen, mirache, hypochondries, when as the melancholy humour resides there, or the liver is not well cleansed "from melancholy blood."
The brain is a familiar and frequent cause, too hot, or too cold, "through adust blood so caused," as Mercurialis will have it, "within or without the head," the brain itself being distempered. Those are most apt to this disease that have a hot heart and moist brain," which Montaltus, cap. 11. de Melanch. approves out of Halyabbas, Rhasis, and Avicenna. Mercurialis, consil. 11. assigns the coldness of the brain a cause, and Salustius Salvianus, med. lect. l. 2. c. 1. will have it "arise from a cold and dry distemperature of the brain." Piso, Benedictus Victorius Faventinus, will have it proceed from a "hot distemperature of the brain;" and Montaltus, cap. 10. from the brain's heat, scorching the blood. The brain is still distempered by himself, or by consent: by himself or his proper affection, as Faventinus calls it, "or by vapours which arise from the other parts, and fume up into the head, altering the animal faculties."
Hildesheim, spicel. 2. de Mania, thinks it may be caused from a "distemperature of the heart; sometimes hot; sometimes cold." A hot liver, and a cold stomach, are put for usual causes of melancholy: Mercurialis, consil. 11. et consil. 6. consil. 86. assigns a hot liver and cold stomach for ordinary causes. Monavius, in an epistle of his to Crato in Scoltzius, is of opinion, that hypochondriacal melancholy may proceed from a cold liver; the question is there discussed. Most agree that a hot liver is in fault; "the liver is the shop of humors, and especially causeth melancholy by his hot and dry distemperature. The stomach and meseraic veins do often concur, by reason of their obstructions, and thence their heat cannot be avoided, and many times the matter is so adust and inflamed in those parts, that it degenerates into hypochondriacal melancholy." Guianerius, c. 2. Tract. 15. holds the meseraic veins to be a sufficient cause alone. The spleen concurs to this malady, by all their consents, and suppression of hemorrhoids, dum non expurget altera causa lien, saith Montaltus, if it be "too cold and dry, and do not purge the other parts as it ought," consil. 23. Montanus puts the "spleen stopped," for a great cause. Christopherus a Vega reports of his knowledge, that he hath known melancholy caused from putrefied blood in those seed-veins and womb; "Arculanus, from that menstruous blood turned into melancholy, and seed too long detained (as I have already declared) by putrefaction or adustion."
The mesenterium, or midriff, diaphragma is a cause which the Greeks called φρεναι [phrenai] because by his inflammation the mind is much troubled with convulsions and dotage. All these, most part, offend by inflammation, corrupting humours and spirits, in this non-natural melancholy: for from these are engendered fuliginous and black spirits. And for that reason Montaltus cap. 10. de causis melan. will have "the efficient cause of melancholy to be hot and dry, not a cold and dry distemperature, as some hold, from the heat of the brain, roasting the blood, immoderate heat of the liver and bowels, sad inflammation of the pylorus. And so much the rather, because that," as Galen holds, "all spices inflame the blood, solitariness, waking, agues, study, meditation, all which heat: and therefore he concludes that this distemperature causing adventitious melancholy is not cold and dry, but hot and dry." But of this I have sufficiently treated in the matter of melancholy, and hold that this may be true in non-natural melancholy, which produceth madness, but not in that natural, which is more cold, and being immoderate, produceth a gentle dotage. Which opinion Geraldus de Solo maintains in his comment upon Rhasis.