Madness: A Brief History

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Authors: Roy Porter
brain and stimulating it along with its membranes.’ Addressing its varieties, he explained their distinct features and causes. It was a good sign if mania involved laughter; whereas when the mixture of blood and choler (yellow bile) was ‘burned’—that is, appeared especially heavy and thickened—there would be ‘brutal madness and this is the most dangerous mania of all’.
    Fontanon’s younger contemporary at Montpellier, Felix Platter (1536-1614), similarly identified mania with excess. As in melancholia, its victims would ‘imagine, judge and remember things falsely’. The maniac would also ‘do everything unreasonably’:
Sometimes they are the authors of relatively modest words and deeds which are not accompanied by raving; but more frequently, changed into rage, they express their mental impulse in a wild expression and in word and deed. Then they come out with false, obscene and horrible things, exclaim, swear, and with a certain brutal appetite, undertake different things, some of them very unheard of for men under any circumstances, even to the point of bestiality, behaving like animals. Some of them seek sexual satisfaction particularly intensely. I saw this happen to a certain noble matron, who was in every other way most honorable, but who invited by the  basest words and gestures men and dogs to have sex with her.
     

    7 The sixteenth-century Swiss physician, Felix Platter, is shown seated, with two companions, at a table covered with surgical instruments and books. Below are the figures of Hippocrates and Galen, on either side of flayed human skin.
     
    In his portrait of melancholia, Platter foregrounded anxiety and delusion. Echoing Aretaeus, he cast it as a ‘kind of mental alienation, in which imagination and judgement are so perverted that without any cause the victims become very sad and fearful’. The disorder thus involved a crazy gothic castle of delusion founded upon false images.
    Another contemporary, Timothie Bright, published the first English treatise on melancholia in 1586— Shakespeare’s familiarity with psychiatric writings probably came through reading Bright. The climax of the humoral approach to mental disorder lies, however, in the encyclopaedic Anatomy of Melancholy (1621) by Robert Burton, an Oxford don who spent his entire life researching, writing, and revising his magnum opus. In creating a gloomy portrait-gallery of taciturn, solitary, deluded, and often dangerous melancholics, Burton, in addition to the classic distemperature of the spleen, brain, and blood, included the following possible causes or precipitants of the condition: ‘idleness, solitariness, overmuch study, passions, perturbations, discontents, cares, miseries, vehement desires, ambitions, etc.’. His encyclopaedic curative recommendations similarly ran the gamut of remedies suggested ever since the Ancients: diet, exercise, distraction, travel, purgatives, bloodletting, and so on, including literally hundreds of herbal remedies. Marriage was the best cure for melancholy maids, wrote the bachelor Burton, and he also urged music therapy, which went back at least to Old Testament times:
And it came to pass, when the evil spirit from God was upon Saul, that David took the harp, and played with his hand: so Saul was refreshed, and was well, and the evil spirit departed from him. (1 Sam. 16: 23)
    Like many other writers on the subject, Burton was himself a sufferer: ‘I write of melancholy by being busy to avoid melancholy.’ And with an eye to fellow sufferers, his mammoth work concluded with the admonition, ‘Be not solitary, be not idle’, advice the author himself had evidently but half-followed. Burton’s great work conveys the melancholy impression that there are as many theories of insanity as there are mad people, and that they all contradict each other: Polonius vindicated once more! The Renaissance thus brought no Copernican revolution in psychiatry, which would finally lay bare the

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