In the 10th century Persian physician Al-Akhawayni Bokhari described melancholia as a chronic illness caused by the impact of black bile on the brain. Aretaeus of Cappadocia, in turn, believed that melancholia involved both a state of anguish, and a delusion.
Galen also believed that melancholia caused cancer. In ancient Rome, Galen added "fixed delusions" to the set of symptoms listed by Hippocrates. The Hippocratic clinical description of melancholia shows significant overlaps with contemporary nosography of depressive syndromes (6 symptoms out of the 9 included in DSM diagnostic criteria for a Major Depressive). Other symptoms mentioned by Hippocrates include: poor appetite, abulia, sleeplessness, irritability, agitation. Hippocrates, in his Aphorisms, characterized all "fears and despondencies, if they last a long time" as being symptomatic of melancholia. Melancholia was described as a distinct disease with particular mental and physical symptoms in the 5th and 4th centuries BC. In astrology it showed the influence of Saturn, hence the related adjective saturnine.
In the complex elaboration of humorist theory, it was associated with the earth from the Four Elements, the season of autumn, the spleen as the originating organ and cold and dry as related qualities. According to Hippocrates and subsequent tradition, melancholia was caused by an excess of black bile, hence the name, which means "black bile", from Ancient Greek μέλας ( melas), "dark, black", and χολή ( kholé), "bile" a person whose constitution tended to have a preponderance of black bile had a melancholic disposition. Personality types were similarly determined by the dominant humor in a particular person. The name "melancholia" comes from the old medical belief of the four humours: disease or ailment being caused by an imbalance in one or more of the four basic bodily liquids, or humours. Related concepts in historical medicine include: lugubriousness, from Latin lugere, "to mourn" moroseness, from Latin morosus, "self-will or fastidious habit" wistfulness, from obsolete English whist and saturnineness, from Latin Sāturnīnus, "under the influence of the planet Saturn." įrontispiece for the 1628 3rd edition of The Anatomy of Melancholy Until the 18th century, doctors and other scholars classified melancholic conditions as such by their perceived common cause – an excess of a notional fluid known as "black bile", which was commonly linked to the spleen.īetween the late 18th and late 19th centuries, melancholia was a common medical diagnosis, and modern concepts of depression as a mood disorder eventually arose from this historical context. Melancholy was regarded as one of the four temperaments matching the four humours. Melancholia or melancholy (from Greek: µέλαινα χολή melaina chole, meaning black bile) is a concept found throughout ancient, medieval and premodern medicine in Europe that describes a condition characterized by markedly depressed mood, bodily complaints, and sometimes hallucinations and delusions.
A man whose face exemplifies the melancholic temperament (1789)
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