Melancholy Baby
17th Century Cures for Melancholy

While at the 9th Annual Blackbeard Festival in Hampton, VA this past June, the topic of 'mental cures' came up during a conversation with Mission, the Suregon of the Mercury Crew. Though the conversation was a bit on the comical side, it did get me thinking; how did one of the 17th Century come to grips with melancholia?

Off to the local library I went to see if I would have any luck finding anything on the topic. I first had to ask myself, what exactly was Melancholia? It was then I found out that there are four types of conditions that correspond to a different personality type.

Sanguine
Sanguine indicates the personality of a person who's temperament of blood, (or season of spring - wet and hot - basic element is air). This person is generally light hearted, fun loving, a people person, who love to entertain, who is spontaneous and confident. However, they can also be arrogant, cocky and indulgent. Other negative traits can be one of a day-dreamer, impulsive, acting on whims in an unpredictable fashion. This can also be classified as manic or bipolar disorder. The humour of Sanguine was usually treated with leeches!

Choleric
Choleric is consistent to the fluid of yellow bile (or season of summer - dry and hot - basic element of fire). This person is a doer and a leader. They are know to have a lot of ambition, energy and passion and try to instill this trait in others. They can be quite dominate in their personality, making great military and political leaders. Oh the down side, they are easily angered and known to have bad tempers. In folk medicine, a baby referred to as having "colic" is one who cries frequently and seems to be constantly angry. This is an adaptation of "choleric," although no twentieth/twenty-first century scholar or doctor of medicine would attribute the condition to bile. Similarly, a person described as "bilious" is mean-spirited, suspicious, and angry. The disease Cholera gained its name from choler (bile).

Phlegmatic
A phlegmatic person is calm and unemotional. Phlegmatic means "pertaining to phlegm",(or season of winter -wet and cold - basic element of water). While people with these traits are generally self-content and kind, their shy personality can often inhibit enthusiasm in others and make themselves lazy and resistant to change. These people are very consistent, relaxed, rational, curious, and observant, making them good administrators and diplomats. Like the sanguine personality, the phlegmatic has many friends. However, the phlegmatic is more reliable and compassionate; these characteristics typically make the phlegmatic a more dependable friend.

Melancholic
Melancholic is the personality of an individual characterized by black bile; (Greek for "black"- the season of autumn - dry and cold - the element of earth. This person is often very kind and considerate, and melancholics can be highly creative; such as in poetry and the arts, but also can become overly pre-occupied with the tragedy and cruelty in the world, thus becoming depressed.

A person with such a trait is also often a perfectionist, being very particular about what they want and how they want it in some cases. This often results in being unsatisfied with one's own artistic or creative works and always pointing out to themselves what could and should be improved. This temperament describes the depressed phase of a pi polar disorder. There is no bodily fluid corresponding to black bile; the medulla of the adrenal glands, which decomposes very rapidly after death, can be associated with it.

Reach for a Leech!
With the four (4) types of conditions being described; what, when and how were leeches used?

The word leech comes from an Old English word "laece" meaning physician. In 1668, the veterinarian was known as a "horse-leech". The spelling later became leech and was used to name a worm used in bloodletting. The leech belongs to the class "Hirudinea" and phylum "Annelida." The technical name for the medicinal leech is "Hirudo medicinalis."Leeches release an anticoagulant known as hiruden, and are found in many parts of the world including North America, Sweden, and Portugal. The Swedish leeches were said to draw four times the blood an American leech could extract. The leeches were stored in special porcelain jars with perforated lids, which contained spring water and were kept in a cool place. An instrument known as an artificial leech was used for the over-sensitive patient who objected to live leeches; the device consisted of a pointed lancet inside a glass syringe cylinder or "sucker." Leeches usually fell off when they became engorged with blood. If not, salt, snuff, or vinegar was applied to discourage their hold. The bleeding was arrested by pressure, a drop of perchloride of iron, a suture, or cautery with a red hot needle.

One of the most popular sources of melencholy was published in England back in 1621. The Anatomy of Melancholy (Full title The Anatomy of Melancholy, What it is: With all the Kinds, Causes, Symptomes, Prognostickes, and Several Cures of it, a book by Robert Burton.
After searching a bit, I did finally acquire an on-line copy through the inter-library exchange site. Though this book delves into the subject of "melancholia", which by today's terms would be called clinical depression, it also went a bit further. The author noted that he was a lifelong sufferer of depression. The book not only touches on his personal accounts, but gives the reader the over all climate of the culture and social mind-set of England during 17th century.

Robert Burton does mention a number of surgical remedies in his book, such as blood letting, sleep, exercise, diet, a lot of common sense things that a 21st Century physician would in fact prescribe. Burton has many more cures up his sleeves and they were all equally eclectic ranging from illegal charms and spells from witches, to the more traditional option of seeking help from God or your Physician. My personal favorite remedy that he suggests is the wearing of a ring made from the right forefoot of an ass! Or this...

"The vein above the thumb is good against all fevers or moments of melancholy....The vein between the thumb and the forefinger, let blood for the hot headache, for frenzy and madness of wit. ''Rules concerning Blood-letting to be observed'' Also be ye always well advised, and wary, that ye let no blood, nor open no vein, except the Moon be either in Aries, Cancer, the flirst half of Libra, the last half of Scorpio, or in Sagittarius, Aquarius, or Pisces..."(Peter Levens, master of arts In Oxford, and student in physick and chirurgery The Pathway to Health 1664).

Robert Burton also states the boring of holes in the skull; which of course is the modern remedy for raised intracranial pressure so it’s actually extremely interesting to look at that sort of early modern discussion of mental illness and what the causes were thought to be and what the remedies were thought to be.

Just remember...if you're feeling a little blue...Reach for a Leech!