As a Lute out of Tune
Robert Burton’s Melancholy
By Noga Arikha
May 1, 2013

In 1621 Robert Burton first published his masterpiece The Anatomy of Melancholy, a vast feat of scholarship examining in encyclopaedic detail that most enigmatic of maladies. Noga Arikha explores the book, said to be the favorite of both Samuel Johnson and Keats, and places it within the context of the humoural theory so popular at the time.

Robert Burton might well have loved the Internet. His Anatomy of Melancholy, whose first of six editions published during the Oxford clergyman’s lifetime appeared in 1621, is the apogee of Renaissance scholarship — at once the summa of classical learning spliced and rendered in the vernacular for the delight of its early modern audience, and a dense network of embedded quotations, a seemingly infinite set of hyperlinks. This never-ending gathering of scholarship could seem a testimony to the ultimate vanity of human knowledge, as melancholy as the endless sea of information that our screens indifferently project to our digital onlookers’ tired eyes. One would be hard-put to read the entirety of this enormous tome online, but online and public it needs to be, because it is one of the greatest works in the English language, because it is a good book to browse via a search word, and because it addresses a theme that is still dear to our late modern civilization.
Melancholy is an old concept; in ancient Greek, melan means black, and hole is the word for bile. Melancholy literally means black bile: however ancient, we still know what that means. One can imagine black bile running through unpleasant states and negative emotions, from existential malaise and bitterness to common depression and despondency. Earlier, melancholy also covered madness and mania. Anyone could be afflicted — lovers, scholars, rulers. Monomaniacs were melancholics. And poets of course: melancholy at its best was a fount of inspiration and creativity. There are many famous melancholics — the author of Ecclesiastes was one, so was Hamlet (Shakespeare probably had read an earlier treatise on the subject, published in 1586 by the physician and clergyman Timothie Bright).

Burton was a deeply literary man who wanted to show how the words of others had described the melancholy aspects of the human predicament. As he warns in his book-length preamble, Democritus Junior to the Reader:
So that take melancholy in what sense you will, properly or improperly, in disposition or habit, for pleasure or for pain, dotage, discontent, fear, sorrow, madness, for part, or all, truly, or metaphorically, ‘tis all one. Laughter itself is madness according to Solomon, and as St. Paul hath it, Worldly sorrow brings death. The hearts of the sons of men are evil, and madness is in their hearts while they live, Eccl. ix. 3. Wise men themselves are no better. Eccl. i. 18. In the multitude of wisdom is much grief, and he that increaseth wisdom, increaseth sorrow, chap. ii. 17.
The book is a catalogue of passions as well as a compendium of quotes and stories — not so much a medical treatise, even though there are, and must be pages on anatomy and physiology. For black bile was a medical concept, one of the four bodily humours or fluids that coursed through the organism and determined its constitution, and along with it, our appearance and character, our strengths and weaknesses, our tastes, propensities and illnesses. To talk about melancholy was to engage in and endorse humoural theory. In its terms, black bile was a “cooked” version of yellow bile, or choler. The other two humours were phlegm, and blood. Mooted by the Hippocratics in 5th-century BC Greece on the basis of the view of the pre-Socratic philosopher Empedocles that all matter was composed of the four elements, the humoural system that developed in the West (China and India each have their own humoural systems as well) had been systematized in the 2nd century by the Roman physician Galen, who associated humours with temperaments. Black bile might be noble, in some of its manifestations. But it was at first a crass outcome of digestive processes. Burton explained: “The gall, placed in the concave of the liver, extracts choler to it: the spleen, melancholy; which is situate on the left side, over against the liver, a spongy matter, that draws this black choler to it by a secret virtue, and feeds upon it, conveying the rest to the bottom of the stomach, to stir up appetite, or else to the guts as excrement.” (I, 12,4)
All humours arose in the liver out of the stomach-based concoction of so-called chyle from food, before being further refined with their spirits in the heart, then the brain. The melancholic would have a preponderance of black bile, the choleric, of yellow bile, the phlegmatic, of phlegm, the sanguine, of blood. To each of these humours was associated a corresponding element, along with its qualities: earth, cold and dry; fire, hot and dry; water, cold and humid; blood, warm and humid. In turn, these were in correspondence with the stars — one could be born under a constellation that conditioned one’s bodily constitution, astral and terrestrial bodies in close, one-way causal correspondence. And how we lived, what we ate, how much we drank, moved, studied, slept, loved; where we lived, in hot or cold or dry or humid climates; what gender one was, what age — all this influenced the humoural balance. One was born with all the humours in a certain proportion, whose constancy guaranteed psychical and physical health; any change in that proportion could signify the fall into a state of holistically conceived ill-health. Balance was all. In itself, black bile did not warrant any more attention than the other humours.
But its excess bred the states catalogued in Burton’s book. As he put it, “[T]he tower of Babel never yielded such confusion of tongues, as the chaos of melancholy doth variety of symptoms” (I-3 1-II). Melancholy brought forth a plethora of words in the Anatomy just as it had triggered authors before him to try and account for this powerful state — from the “pseudo-Aristotle” who first honoured its particular, potentially noble nature in the so-called “Problem XXX”, to Rufus of Ephesus and the 11th-century Constantinus Africanus, who translated at the Montecassino monastery near Naples the text, itself a translation of Rufus, written at the Tunisia court by the 9th-century Jewish Baghdadi physician, scholar and translator Ishâq ibn ‘Imran. Many others participated in enriching this tradition that Burton so ravenously plundered. Geographically and chronologically extended, the long lineage of humoural knowledge guaranteed its authority: humours were imagined entities that were general enough to explain everything about the interlocked body and psyche, but too general to correspond to any real bodily substances. We emitted tears, blood, mucus, saliva, sweat, urine, sperm or milk, but those were not humours per se. No one had ever seen humours on either side of skin; only their purported effects on complexion, and on bowel movement, urine colour, temperature, pulse, mood. That partly explains their hold on popular and learned imaginations alike.
By the time Burton was writing, though, humoural theory, such as it had developed in the West, was in jeopardy: his book pre-dates by just seven years the publication in 1628 of William Harvey’s An Anatomical Essay Concerning the Movement of the Heart and the Blood in Animals, the Royalist physician’s revolutionary account of blood circulation, based on lectures he gave in 1616 to the College of Physicians. The humoural system was grounded in anatomical assumptions derived from Galen, who had never dissected a human being — such as that of a vascular connection between heart and liver. These assumptions had begun to be overturned in the 16th century thanks to advances in anatomy by the likes of Andreas Vesalius ; and they simply did not cohere with the notion of blood circulation via the lungs. Yet it still made perfect sense to Harvey to write that people afflicted with melancholy or mania manifested symptoms “according to their temperament or krasis, which they had from the stars and those celestial influences, variety of wits and dispositions”, and these symptoms proceeded “from the temperature itself and the organical parts, as head, liver, spleen, meseraic veins, heart, womb, stomach, etc., and especially from distemperature of spirits (which, as Hercules de Saxonia contends, are wholly immaterial), or from the four humours in those seats, whether they be hot or cold, natural, unnatural, innate or adventitious, intended or remitted, simple or mixed, their diverse mixtures and several adustions, combinations. . .”.
One could not forget such a sophisticated corpus of established knowledge from one day to the next. The process that led to the demise of humours was halting. It took time, and in some ways humoural culture is still with us. We are not foreign to the notion that melancholy can be a positive as well as a nefarious force. Some years before Burton, Reverend Thomas Walkington had distinguished the two in a treatise entitled Optick Glasse of Humors, or the Touchstone of a Golden Temperature, or the Philosophers Stone to make a Golden Temper. Wherein the four Complections, Sanguine, Choleriche, Phligmaticke, Melancholicke are succinctly painted forth  (1607): so melancholy could be a “precious balme of witte and policy: the enthusiasticall breath of poetry, the foyson of our phantasies, the sweete sleepe of the senses, the fountaine of sage advise and good purveiance”; but it also “causeth men to bee aliened from the nature of man, and wholly to discarde themselves from all societie, but rather heremits and olde anchorets to live in grots, caves, and other hidden celles of the earth”.
Today just as in Burton’s, or indeed Galen’s day, we seek remedies for our most troubled states. We might forget how embodied are our “mental” disturbances and think it best to dope our brains with targeted pills, but in most cases and in our ordinary daily lives we know that our states of mind are deeply affected by the condition of our whole bodies, by what we eat, by how much we exercise or sleep — and by how well we are loved.
Love-melancholy was an important category of melancholy, and Burton devoted a long chapter to it. It had an ambivalent reputation — bad if one leaned toward stoicism or aspired to chastity, but good if one believed that a capacity for strong passions was the mark of a fine soul that recognized beauty and goodness. It was the foundation of chivalry, the source of sonnets, the harbinger of creativity and the promise of fertility. In its long-studied negative form, it could be an illness at worst whose consequences could be devastating and called for medical treatment. That sort of love-melancholy was condemnable as blind lust, the product of painfully unrequited love, of desire unfulfilled. It was a state in which humoural flows ruled the brain, and whose “symptoms are either of body or mind; of body, paleness, leanness, dryness, etc” — the cause of extreme joys and fears, of “fire” and “ice”, in Burton’s words. It had been the reason for Dido’s suicide, and, as Burton reports, the fount of rash, mad behaviour, such as Medea’s, in whom “Reason pulls one way, burning lust another, / She sees and knows what’s good, but she doth neither”. (III-2 3)
Pure reason is as unlikely to exist as a brain in a vat. We are embodied through and through, and our thought processes are not immune from our physiology. “For as the distraction of the mind, amongst other outward causes and perturbations, alters the temperature of the body, so the distraction and distemper of the body will cause a distemperature of the soul, and ‘tis hard to decide which of these two do more harm to the other”, writes Burton. “Now the chiefest causes proceed from the heart, humours, spirits: as they are purer, or impurer, so is the mind, and equally suffers, as a lute out of tune; if one string or one organ be distempered, all the rest miscarry, Corpus onustum Hesternis vitiis, animum quoque praegravat una [By yesterday’s excesses still oppressed, The body suffers not the mind to rest]”. [I-2V-I]
Humoural theory did not accommodate dualism. And nor does modern psychology. Except for those who still believe in rational choice theory, we know how deeply emotional we are. Hormones and neurotransmitters are the new humours, mysteriously conditioning our emotional responses and, to an extent, our decision-making. No one understands yet how substances and actions are connected, how our newly identified, chemically mapped humours help make up our consciousness, how the mind is an instance of the body-brain. Those questions remain at the heart of Burton’s infinite book and its countless stories of human endeavours, battles, miseries, and hopes.
The text of this essay is published under a CC BY-SA license, see here for details.