Chapter Title: Melancholia in the Seventeenth Century: From Humoral Theory to

Chemical Explanation

Book Title: Melancholia and Depression

Book Subtitle: From Hippocratic Times to Modern Times
Book Author(s): STANLEY W. JACKSON
Published by: Yale University Press

Stable URL: http://www.jstor.com/stable/j.ctt1xp3stn.9

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Melancholia and Depression

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 CHAPTER SIX

Melancholia in the
Seventeenth Century:
From Humoral Theory to
Chemical Explanation

By the mid-seventeenth century melancholia had been an established clinical

syndrome with an intimate, even inseparable, association with the humoral
theory for approximately two thousand years. From the fragmentary passages
in the Hippocratic writings to the important contributions of Rufus to the
influential presentation of Galen, the developing accounts of melancholia the
disease were clearly connected with one another; and the many Galenists of
the succeeding centuries handed down a tradition with a significant degree of
clinical coherence and with explanatory and therapeutic features that were
held together by the humoral theory. As was indicated in the previous chapter,
in I62 I Burton had produced a comprehensive review of these matters that
was representative of medical-psychological thought on melancholia up to and
into the second quarter of the seventeenth century. 1 But the second half of the
century brought important conceptual changes regarding melancholia that
were associated with the waning of the humoral theory.

RICHARD NAPIER
Before turning to these changes, we will take advantage of an unusual
opportunity. From a contemporary of Burton have been passed down mate-
rials for a different perspective on melancholic disturbances in the early
seventeenth century. Richard Napier (I559-I6J4), a physician and clergy-
man in rural England, left more than sixty manuscript volumes of notes on
his years of medical practice, from I 597 to I6J4, which included the records
of his work with more than two thousand mentally disturbed patients.
Among the psychological symptoms that were reasonably common in

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 Melancholia in the Seventeenth Century 105

Napier's mentally troubled patients, the following were both significantly

frequent and particularly relevant to the study of melancholia: "melancholy,"
"took grief," and "grieving," "simply sad" and "all sadness symptoms,"
"suicidal" and "despair." 2 In his fine study of Napier's medical notebooks,
MacDonald has identified several "broad types of mental disorder" that were
also to be found "in drama and poetry, legal records and medical treatises
composed before I64o" (Mystical Bedlam, p. I 20). The severer forms, with
tendencies to raving or violence-madness, mania, lunacy, distraction-
seem to have been relatively uncommon; but other, less extreme mental
afflictions were common, perhaps even more prevalent than they had been
prior to the late sixteenth century, and most of them were emotional distur-
bances. The commoner forms among the latter were melancholy/melan-
cholia, mopishness, anxiety and fear, sadness, and suicidal gloom; and it was
these disorders that tended to entail the symptoms just noted (pp. I48-I49).
Also, in contrast to the more extreme disorders, where the disturbed state
was usually brought to the physician's attention by the complaint of others,
in the latter conditions the "sufferers themselves frequently judged that their
emotions were abnormal" (p. I49).
"Contemporaries believed that the feelings experienced by melancholy
and troubled people were exaggerations of normal states of mind. The sheer
intensity of their moods was abnormal" (ibid.). As Burton noted about melan-
choly people, "the symptoms of the mind are superfluous and continual
cognitations . . . grievous passions, and immoderate perturbations of the
mind" (Anatomy, p. 349). The Stoic notion that any emotion in significant
excess constituted a disorder of the mind had continued over the centuries. It
constituted an aspect of common wisdom, was reflected in the general litera-
ture of the era, and was part of Napier's orientation in considering his mentally
troubled patients. For Napier this could lead to the assessment that someone
was "troubled in mind," and, with the addition of delusions or false percep-
tions, the patient was usually diagnosed as suffering from melancholy (Mystical
Bedlam, p. I so).
As was remarked in the previous chapter, melancholy was much in the
popular mind in Western Europe by this time, and its less severe forms were
considered by many to be a mark of distinction-a sign of intellectual and
moral superiority, if not genius. Some of the moderately melancholic found
comfort in the label, and many merely added the label to enhance themselves.
Approximately twenty percent of Napier's mentally disturbed patients were
recorded as suffering from melancholy, but the percentage was dispropor-
tionately high among those of the higher social ranks and disproportionately
low among the common folk. Those diagnosed as "troubled in mind" and
"mopish" included a disproportionately high number of the ordinary folk and

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106 Tracing the Variations in a Remarkable Consistency

a disproportionately low number of the higher social ranks (ibid., pp. I 5I -

I p). Napier seems to have been sensitive to the social propriety of using the

diagnosis of melancholy for certain social classes, and, further, "persons of

rank and learning frequently judged themselves to be melancholy rather than
merely sad, troubled, or fearful" (p. I p). Also, some of them showed a
significant familiarity with standard medical ideas on melancholy in their
letters to Napier, for example, (I) "Desirous to have something to avoid the
fumes arising from the spleen"; (2) "Deep melancholy fearfulness, almost of
every object. Fumes ascending from the stomach, distempering the brain ....
He feareth that it will turn into mania" (pp. I 52-I 53).
In addition to experiencing the traditional sadness and fear, Napier's
melancholic patients frequently manifested another customary symptom,
namely, delusional belief or hallucination, but it was rare for this to be as
remarkable as the traditionally cited examples (pp. I 53-I 55). As bizarre as any
of the delusions he encountered in his melancholic patients was the following
obsessive-compulsive preoccupation of delusional proportions:

Extreme melancholy, possessing her for a long time, with fear; and sorely
tempted not to touch anything for fear that then she shall be tempted to wash her
clothes, even upon her back. Is tortured until that she be forced to wash her
clothes, be them never so good and new. Will not suffer her husband, child, nor
any of the household to have any new clothes until they wash them for fear the
dust of them will fall upon her. Dareth not to go to the church for treading on the
ground, fearing lest any dust should fall upon them. (p. I 54)

Further regarding the delusions in melancholia, MacDonald has pointed out:

The knowledge that exotic fancies were symptoms of melancholy rather

than of madness or lunacy was spread beyond the expanding circle of readers
familiar with the niceties of psychological medicine by two controversies.
Skeptics argued that the confessions of accused witches were melancholy delu-
sion, and the early opponents of religious enthusiasm declared that the inspira-
tions of the enthusiasts were also melancholy fancies. (p. I 55)

Belief in the Devil was still well enough established that Napier would
consider two significant alternatives in his assessment of those sufferers who
claimed to have seen "the Tempter" or otherwise associated their distress with
Satan:

These, then, were the alternatives: Flat claims that one was in league with
the Devil or had been tempted by him might be evidence that one was suffering
from melancholy, suicidal gloom, or (rarely) another mental disorder; or they
might be true. As long as men continued to believe that Satan could appear to
rational people, encounters with him could not be dismissed simply as symp-
toms of madness. (p. I 56)

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 Melancholia in the Seventeenth Century 107

Similarly, claims of prophecy might be delusions indicative of a melancholy

disorder, but they might well be regarded as valid (pp. I 56- I 57). "Because
Elizabethans believed that the world was vibrant with supernatural forces and
invisible beings, it was understandable that they were reluctant to presume
that fantastic visions and disembodied voices were experienced only by the
most insane madmen" (p. I 57).
The fears and the sorrows of Napier's melancholic patients were emo-
tions known to the least troubled among their contemporaries, but they were
either disproportionate in their intensity or they were "aroused by false
apprehensions and amplified by delusion." To an observer, these were the
fears and sorrows "without cause" or "without apparent cause," to use the
phrases so often found in medical accounts. Instances of grieving or sadness
occasioned by the loss of loved ones (sadness "with cause") were often consid-
ered akin to melancholy without being thought to be indicative of that disease,
but, if they acquired an "unusual intensity or duration," they might well be
considered examples of melancholy the disease (p. I 59). Still other trends
reported in traditional accounts of melancholia, and found with frequency in
Napier's melancholic patients, were summed up by MacDonald as follows:

Whether melancholy crept unprovoked upon the sufferer's affections or

stormed into the void created by the death of a child, a spouse or a parent, its
effect was to draw him away from normal involvement in the emotional and
social world around him. Melancholy men and women lost the capacity to take
pleasure from activities they had previously delighted in or to enjoy the social
relations that gave happiness to others .... The alienation of melancholy men
and women from the pleasures of everyday life was symbolized in literature and
in descriptions of actual sufferers by their love of solitude .... Melancholy
made men and women inner exiles (p. 160).

Parenthetically, it is significant to note that Napier recognized another

disorder, mopishness, that was akin to melancholia. "Mopish men and women
often suffered from the characteristic symptoms of melancholy, especially
gloom and solitude ... 'despairing, heavy-hearted, exceeding sad' ... 'soli-
tary and will do nothing.' ... Indeed, one connotation of the word mopish
current during the seventeenth century was a pale kind of melancholy (p. I 6 I).
In contrast to melancholy there was a "socially pejorative aura" to mopishness.
"The dumpish moods of idle gentlefolk frequently earned the classical appella-
tion [of melancholy]; the sullen inactivity of husbandmen and artisans merited
more often the rude and common word mopish" (pp. I6I-I62). But there was a
category of symptoms often associated with mopishness and usually not
associated with melancholy, namely, disturbances of the senses. Mop ish
patients were noted to be "sottish," "foolish," "not well in his wits," "troubled
in his senses," or "senseless" (p. I62). Such a diagnosis was quite uncommon in

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108 Tracing the Variatiom in a Remarkable Comistency

medical writings, but the nature of the condition was often similar to lethargy,
which was often mentioned in medical works. On the other hand, mopishness
was commonly mentioned in the popular literature of the day.
Early in his years of medical practice Napier made ready and traditional
use of the humoral theory in his efforts to explain melancholy, but his
notebooks suggest that he fell away from this tendency after a while, only to
return to it after his reading of Burton's Anatomy ofMelancholy in I624 (pp. I 52,
I 89). In general, Napier rarely thought that a mental disturbance was due to a

single cause. Usually he held the view that astrological factors had predisposed
a patient to suffer a mental disorder peculiar to his particular temperament,
but such factors were not sufficient to explain the illness. "There was almost
always a more immediate cause as well" (p. I 7 3). And these immediate causes
were as many and varied as Burton suggested (see chap. 5). Although a variety
of supernatural causes, either divine or diabolical, were commonly held re-
sponsible for mental disturbances in Napier's time, he seldom attributed such
disorders to God; but he accepted the view that Satan might well be responsi-
ble in some cases (p. I74). Napier also seems to have thought that
disturbing events affected the physical health and social relationships of their
victims as well as their psychological condition. Like popular medical writers
and philosophers, Napier and his patients assumed a powerful sympathy be-
tween mind and body. Emotional stress could cause physical illnesses as well as
mental disturbances, and almost any sort of bodily sickness could deprive a
person of his reason. The many different events in the natural world that were
deemed potential causes of insanity disturbed the entire lives of the people they
affected, not merely their mental tranquility. (pp. 173-174)

As to treatment, like so many of his contemporaries Napier drew on a variety

of healing traditions in ministering to his mentally disturbed patients, includ-
ing the melancholies.
[He] practiced at a time when it was still possible for learned men to reconcile all
of the main types of causal explanations for insanity and to offer all of the
remedies appropriate to them. The traditional medieval and Renaissance model
of the universe postulated the existence of both natural and supernatural forces at
work in a hierarchical order of powers and beings. Man existed at the point of
convergence between the natural and the supernatural orders, and he was
subject to both kinds of powers. This model permitted contemporaries to
explain mental disorder as the consequence of events that occurred on any of the
several planes of existence, acting singly or in concert. Most people in early
seventeenth-century England saw no theoretical incompatibility among the
different kinds of explanation for mental disorders, and many practitioners
combined therapies justified by medical, magical, and religious beliefs. Napier
was one of these eclectics. (pp. 177-178)
Regardless of their symptoms, almost every one of Napier's mentally
disturbed patients was purged with emetics and laxatives and bled with leeches

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 Melancholia in the Seventeenth Century 109

or by cupping.... The drugs that Napier and his fellow physicians used to
purge their patients were a medley of native and exotic plants, traditional
recipes, and new inorganic compounds. (p. 187)
Napier supplemented his arsenal of traditional organic medicaments with
[Paracelsian] metallic compounds and distillations; he even collected bizarre folk
remedies and occasionally resorted to them .... He became an avid medical
alchemist, preparing his own chemical medicines .... Although Napier was
fascinated by the mystical aspirations of medieval alchemy and probably knew
something about the substance of Paracelsus's medical thought, he nevertheless
remained chiefly interested in the practical side of alchemy and regarded chemi-
cal medicines as a novel and effective complement to traditional therapies ....
Nothing in his notes indicated that he explained any illness in Paracelsian
terms .... He employed Paracelsian preparations, such as compounds of anti-
mony, as substitutes for organic remedies that acted as vomits and purges, and
he often combined modern chemical medicines with traditional substances. The
notes he made about the best treatments for the mentally disturbed illustrate his
eclecticism: A prescription for "all melancholy and mop ish people," for example,
recommends hiera logadii, lapis lazuli, hellebore, cloves, licorice powder, di-
ambra, and pulvis sancti, all of which were to be infused in a solution of white wine
and borage. This olio of plants and chemicals would act as a violent purge.
Napier collected many other recipes for medicines to cure melancholy, the
majority of which were steadfastly traditional. (pp. 189-190).

Napier used opiates to calm and to induce sleep in melancholic patients, but
much less frequently than with the more severely distracted patients (p. I9o).
In addition to purgatives and emetics, he made modest use of phlebotomy to
evacuate noxious humors and restore the humoral balance (pp. I9I-I92). He
used astrological determinations in choosing the herbs and the metals with the
appropriate qualities that would fit them for dealing with the humor, black
bile, and the disease, melancholy; and he similarly determined the propitious
times for the use of medicaments and the drawing of blood (p. I94). Where he
thought that supernatural factors were at work in a melancholic illness, he
might well, guided by astrological principles, have an amulet made for the
sufferer to wear as protection against such forces (pp. 2 I 3-2 I4). Among the
many persons who suffered from anguish or despair about their status in the
eyes of God or other spiritual concerns, and sought Napier's help, some were
distinctly melancholic. Such persons, and those grieving from loss, were
considered candidates for "spiritual physic"-"religious worry" called for
"religious counseling." In this counseling Napier

favored formal prayer to searching self-examination as a means to restore his

patients' confidence in God's mercy. He often prayed together with his troubled
clients, and he sometimes composed prayers for them to repeat to them-
selves. . . . He urged his patients to pray and perform regular religious ex-
ercises, for he felt that they would foster piety and happiness .... Napier's
preference for a style of religious counsel that emphasized ministerial guidance,

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110 Tracing the Variations in a Remarkable Consistency

set prayers, and participation in the rituals and sacraments of the church was a
consequence of his theological conservatism. He preferred to stress the tradi-
tional authority of the church and the value of formal piety rather than to
expound upon the mysteries of the scriptures and the threat of damnation. (pp.
221-222).

In addition, he occasionally had "astrological amulets" made to bolster the

religious faith of melancholic patients (p. 222).
Regarding most of the various symptoms noted by Napier, the syn-
dromic patterns of mental disturbance that guided him, and the details of his
views on melancholy in particular, there was little that was unique to early
seventeenth-century England. Renaissance medical literature and seven-
teenth-century medical writings in other European countries constituted a
whole fabric, of which Napier's materials were a recognizable and essentially
representative part.

THOMAS WILLIS

Against a background of views fairly represented by Burton, with practical

applications akin to those in Napier's notebooks, in the second half of the
century Thomas Willis (1621-1675) approached the subject of melancholia,
among other diseases that affected "The Brain and Nervous Stock," in the
second part of Two Discourses Concerning the Soul of Brutes . . . , which was first
published in 1672. 3 Willis described melancholia in familiar terms, stating
"Melancholy is commonly defined to be, a raving without a Feavour or fury,
joined with fear and sadness." On the traditional theme of melancholic delu-
sions, he stated that "it would be a prodigious work, and almost an endless task
to rehearse the diverse manner of ravings of Melancholy persons; and there are
great Volumes already of Histories and examples of this sort; and more new
and admirable observations and examples daily happen," and then he briefly
noted a few of the familiar instances (Soul of Brutes, p. 1 88). He also differenti-
ated melancholia into two types: a universal type in which "the distemper'd are
Delirious as to all things, or at least as to most; so that they judge truly almost of
no subject"; and a particular type in which "they imagine amiss in one or two
particular cases, but for the most part in other things, they have their notions
not very incongruous."*
When one turns to his theoretical considerations on melancholia, how-

*Willis, Two Discourses, p. 188. Willis seems to have played a role of some consequence in the
history of the concept of particular insani~y or partial insani~y. Matthew Hale probably appropriated
the notion from him for legal use; Willis's student, John Locke, took it up; and various eighteenth-
century medical authorities made it part of the very essence of melancholia. See Stanley W.
Jackson, Melancholia and Partial Insanity,]. Hist. Behav. Sci., 1983, 19, 173-184.

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 Melancholia in the Seventeenth Century I I I

ever, one finds a distinct shift away from traditional views. Briefly, and
notably, he stated, "But we cannot here yield to what some Physicians affirm,
that Melancholy doth arise from a Melancholick humor" (p. 192). Instead Willis
put forth his notions of pathogenesis in terms of his own version of the newer
iatrochemical theories. In a casebook in the early 165os he clearly indicated
skepticism of the humoral theory and began to introduce iatrochemical expla-
nations, but humoral considerations were still prominent in his views.4 And
these trends were developed further in his Lectures in the early 166os. 5 In his
treatise on fermentation (1659) he had argued against the traditional four
elements and the theory of qualities derived from them, 6 and in his treatise on
fevers (1659) he had argued against the traditional humoral theory that had
rested on these notions (Practice of Physick, p. 48). He also declined to espouse
the emerging corpuscularian notions (p. 2). He favored instead the five "Princi-
ples of Chymists" (pp. 3-8), which meant "affirming all Bodies to consist of
Spirit, Sulphur, Salt, Water, and Earth, and from the diverse motion, and
proportion of these, in mixt things, the beginnings and endings of things, and
chiefly the reasons, and varieties of fermentation, are to be sought" (p. 2).
Referring back to his definition cited above, Willis said that it "follows,
that it is a complicated Distemper of the Brain and Heart: for as Melancholick
people talk idly, it proceeds from the vice or fault of the Brain, and the
inordination of the Animal Spirits dwelling in it; but as they become very sad
and fearful, this is deservedly attributed to the Passion of the Heart" (Soul of
Brutes, p. 188). Taking up the first part of this statement, he commented that,
while the animal spirits would ordinarily have been "transparent, subtle, and
lucid," they "become in Melancholy obscure, thick, and dark, so that they
represent the Images of things, as it were in a shadow, or covered with
darkness." He then suggested that the animal spirits, "with the Vehicle to
which they cleave" (namely, the blood), were analogous "to some Chymical
Liquors, drawn forth by distillation from natural mixtures" (ibid., p. 189).
After discussing various chemical notions as bases by analogy for the
formation of the animal spirits and for their pathological alterations in various
mental disorders (ibid.), he continued his explanation of those aspects of the
condition that he viewed as a "Distemper of the Brain." He stated:
That we may deliver the formal reason and causes of Melancholy, let us suppose,
that the liquor instilled into the Brain from the Blood (which filling all the Pores
and passages of the Head, and its nervous Appendix, and watring them, is the
Vehicle and bond of the Animal Spirits) hath degenerated from its mild, benign,
and subtil nature, into an Acetous, and Corrosive, like to those liquors drawn out
of Vinegar, Box, and Vitriol; and that the Animal Spirits, which from the middle
part of the Brain, irradiating both its globous substance, as also the nervous
System, and do produce all the Functions of the Senses and Motions, both interior
and exterior, have such like Effluvia's, as fall away from those Acetous Chymical

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1 12 Tracing the Variations in a Remarkable Consistency

Liquors. Concerning which there may be observed these three things, 1. Their
being in perpetual motion: 2. Not long able to flow forth: 3. not only to be carried
in open ways, but to cut new Porosities in the neighboring bodies, and to
insinuate themselves into them. From the Analogy of these conditions, concern-
ing the Animal Spirits, it comes to pass, that Melancholick persons are ever
thoughtful, that they only comprehend a few things, and that they falsely raise,
or institute their notions of them. (pp. 189-190)

He took up each of these three clinical observations in turn and, on analogy to

his chemical notions, elaborated a physiological psychology to explain them
(pp. 190-191). In summing up, he commented that, in addition to the func-
tioning of the brain being so affected by "the Acetous disposition of the
Spirits," eventually "the conformation of the Brain itself" may be affected and
become "a part of the cause" (p. 191).
Turning to the "fear and sadness" aspects of the condition, Willis
indicated that

Melancholy is not only a Distemper of the Brain and Spirits dwelling in it,
but also of the Praecordia, and of the Blood therein inkindled, from thence sent
into the whole Body: and as it produces there a Delirium or idle talking, so here
fear and sadness.
First, in Sadness, the flamy or vital part of the Soul is straitned, as to its
compass; and driven into a more narrow compass; then consequently, the animal
or lucid part contracts its sphere, and is less vigorous; but in Fear both are
suddenly repressed and compelled as it were to shake, and contain themselves
within a very small spaces; in either passion, the Blood is not circulated, and
burns not forth lively, and with a full burning, but being apt to be heaped up and
to stagnate about the Praecordia, stirs up there a weight or a fainting; and in the
mean time, the Head and Members being destitute of its more plentiful flux,
languishes.

Then he elaborated these matters further in terms of his chemical theories

(ibid.).
At this point he commented that, in some instances, the melancholic
condition began with the acetous disturbance of the animal spirits and then
later caused "the Melancholick disposition of the Blood," and "No less often
doth it come to pass, that the seeds of Melancholy, being at first laid in the
Blood, do at length impart their evil to the Spirits," in which instances he
conceived of the blood as having become "Salino-sulphureous" in nature (p. 192 ).
He then mentioned the three traditional types of melancholia-that which
arose from an original disorder in the brain, that which arose from the
hypochondriac area (he specified the spleen), and that which involved the
whole body-and he added a fourth type which arose from the womb (pp.
192-193). In discussing them he showed some tendency to consider the blood
as the primary locus for all.

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 Melancholia in the Seventeenth Century I I 3

Regarding hypochondriacal melancholy, Willis referred the reader to

his "Tract of Convulsive Diseases," and he suggested that it originated in the
blood, which deposited "Melancholick foulnesses" in the spleen, which in tum
"exalted" these materials "into the nature of an evil Ferment" and returned this
result to the blood, whose condition was then such that it tended to cause this
form of melancholia (ibid.). In this treatise, he included the "hypochondriack
distempers," along with hysterical disorders, among the convulsive diseases
(Practice of Physick, pp. 81-92). He acknowledged as a common view that this
condition was thought to stem from the spleen, from which "vapours" arose to
cause the various symptoms (ibid., p. 81).
As the physiological background to the spleen's role in hypochondriacal
conditions, he referred to the blood as depositing there certain "dregs" that
were "composed of a fixed Salt, and an earthly matter;" these materials were
then transformed into "a juice very fermentive" in the spleen, and this was
returned to the blood to give it "a certain austerity and sharpness, with vigour
of motion." But, in addition to thus influencing "the Brain and nervous stock"
indirectly via the blood, the spleen more directly had an invigorating effect on
the brain and the animal spirits via its intimate nervous connections. To sum it
up, the spleen exercised a "fermenting virtue" that, when things went nor-
mally, had an enlivening effect on "the Blood and nervous Liquor" (p. 84).
Against this background Willis indicated that, if the spleen was not
functioning normally, both the blood and the nervous juice may be either
sharper or duller than usual, with resultant disorders. This may occur either
when the spleen "doth not strain forth the melancholy Recrements of the
Blood" or when it failed to "Cook them into a fermentative matter" once they
were in the spleen (p. 85). Then, elaborating on these basic notions, he
outlined how the various mental and physical symptoms might come about in
the hypochondriacal disorders (pp. 85-86). In view of the blood's direct effect
on the brain, he thought that such disorders may have been "chiefly derived
from the Head" in many instances, and yet the basic fault in those cases would
still lie with the spleen for its failure to "strain forth the atrabilarie dregs from
the blood" (pp. 86-87).
As Burton had so clearly outlined, by the second quarter of the seven-
teenth century explanations of pathogenesis in melancholia were still couched
in terms of disturbances of the traditional humors, usually as an excess of black
bile, the melancholy humor. By the 163os Galenic views had long ago been
effectively challenged in anatomy and more recently in cardiovascular physiol-
ogy. Paracelsian arguments against humoral physiology had been extant for
over a century. Yet the newer views had made very limited inroads into the
explanations of disease. By mid-century the writings of Jean-Baptiste van
Helmont had come to constitute both a new and more persuasive criticism of

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1 14 Tracing the Variations in a Remarkable Consistency

Galenic humoral theory and a more influential advocacy for chemical explana-
tions. 7 Then Franciscus Sylvius (de le Boe), a contemporary of Willis,
emerged as another significant proponent of iatrochemical views (King, Road,
[n. 7], pp. 93- I 12). Yet an influential medical author like Riverius (Lazare
Riviere) continued with a consistently Galenic explanatory scheme, and his
writings were printed and reprinted from just before the mid-century on into
the eighteenth century (ibid., PP· I s-36). He was both a continuing influence
for the persistence of humoral explanations and, in the seventeenth century,
representative of a strong tendency for those explanations to persist. Another
contemporary of Willis who was very influential in the latter half of that
century was Thomas Sydenham (pp. I I 3- I 33). Reputedly independent of the
fetters of traditional explanations, as one might think to be the case from his
discussion of hysteria, 8 he nevertheless explained most diseases in terms of the
humoral theory. 9
Thus, although his views seem to reflect his own synthesis of iatrochem-
ical themes rather than being easily identifiable as Paracelsian, Helmontian, or
whatever, 10 Willis was not new in introducing chemical explanations of dis-
ease. And corpuscularian notions were also emerging as contenders in the
struggle for explanatory preeminence in the realm of pathogenesis (King, pp.
62-86). But traditional humoral theory was still predominant when, in the
I65os, he began to develop a system of chemical explanations. Then, as he
began to replace the four humors with the "Principles of Chymists" as the
cardinal factors in the pathogenesis of nervous disorders, the black bile began
to lose its place in explanations of melancholia. This humor never regained its
previous status in the various theories that were later put forward to explain
the pathogenesis of this disorder.
Parenthetically, it should be noted that neither the term humor nor the
four familiar humors disappeared from Willis's writings. The term humor was
still frequently used by him, and by many after him, to refer to bodily fluids
in general or to this or that body fluid in particular. And blood, yellow bile,
phlegm, and black bile continued in his system and in those of other authors
after him. Perhaps reflecting his assessment of the new status of blood
following Harvey's work (Practice of Physick, p. 45) blood became the humor,
and it was joined by the "Nervous Liquor," the "Chyme or nourishing Juice,
continually coming to the Mass of Blood, and the serous Latex, perpetually
departing from the same" as natural humors or body fluids (ibid., p. 47).
Yellow bile, black bile, and phlegm were relegated to the status of waste
products to be separated from the blood by the liver, the spleen, and the solid
parts, respectively; they became "only the recrements of the Blood, which
ought continually to be separated from it." The "common acception of
humors" was "laid aside," and Willis developed this new view in which these

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 Melancholia in the Seventeenth Century I I 5

"excrementitious" substances were stored in the parts or organs that sepa-

rated them from the blood and that then had the task of their gradual
elimination (p. 48).
Although Willis developed a different theory of melancholia in keeping
with the chemical notions to which he subscribed, he took familiar therapeutic
paths in recommending venesection in moderate quantity, gentle cathartics,
and emetics, with the aim of relieving the body of its burden of pathological
materials. He also wrote about stimulating and strengthening the animal
spirits, which was to be achieved by applying his evacuative remedies and by
diverting the soul from its troubling passions and cheering up the person.
Among other measures he mentioned gentle hypnotics for sleeplessness, and
spa waters that contained iron and various remedies containing steel for the
purpose of strengthening the nervous juice (Soul of Brutes, pp. I93-199).
Otherwise employing traditional remedies, Willis was innovative in advising
these metals for the treatment of melancholia, perhaps reflecting the Paracel-
sian trend toward the use of metals in therapeutics.
During the last quarter of the century the humoral theory continued to
lose ground in favor of other theoretical systems. As noted above, iatrochemi-
cal ideas were prominent in this process, but the new chemical explanations
were short-lived in theories of melancholia. By the 169os mechanical notions
were already displacing them and serving to complete the displacement of
humoral explanations.

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