Melancholia

Physiognomy of the melancholic temperament (drawing by Thomas Holloway, c.1789, made for Johann Kaspar Lavater's Essays on Physiognomy)

Melancholia or melancholy (from Greek: µέλαινα χολή melaina chole,[1] meaning black bile)[2] 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.

Melancholy was regarded as one of the four temperaments matching the four humours.[3] 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. Hippocrates and other ancient physicians described melancholia as a distinct disease with mental and physical symptoms, including persistent fears and despondencies, poor appetite, abulia, sleeplessness, irritability, and agitation.[4][5] Later, fixed delusions were added by Galen and other physicians to the list of symptoms.[6][7] In the Middle Ages, the understanding of melancholia shifted to a religious perspective,[8][9] with sadness seen as a vice and demonic possession, rather than somatic causes, as a potential cause of the disease.[10]

During the late 16th and early 17th centuries, a cultural and literary cult of melancholia emerged in England, linked to Neoplatonist and humanist Marsilio Ficino's transformation of melancholia from a sign of vice into a mark of genius. This fashionable melancholy became a prominent theme in literature, art, and music of the era.

Between the late 18th and late 19th centuries, melancholia was a common medical diagnosis.[11] In this period, the focus was on the abnormal beliefs associated with the disorder, rather than depression and affective symptoms.[7] In the 19th century, melancholia was considered to be rooted in subjective 'passions' that seemingly caused disordered mood (in contrast to modern biomedical explanations for mood disorders). In Victorian Britain, the notion of melancholia as a disease evolved as it became increasingly classifiable and diagnosable with a set list of symptoms that contributed to a biomedical model for the understanding mental disease.[12] However, in the 20th century, the focus again shifted, and the term became used essentially as a synonym for depression.[7] Indeed, modern concepts of depression as a mood disorder eventually arose from this historical context.[13] Today, the term "melancholia" and "melancholic" are still used in medical diagnostic classification, such as in ICD-11 and DSM-5, to specify certain features that may be present in major depression.[14][15]

Related terms used in historical medicine include lugubriousness (from Latin lugere: "to mourn"),[16][17] moroseness (from Latin morosus: "self-will or fastidious habit"),[17][18] wistfulness (from a blend of "wishful" and the obsolete English wistly, meaning "intently"),[17][19] and saturnineness (from Latin Saturninus: "of the planet Saturn).[20][21]

  1. ^ Burton, Bk. I, p. 147
  2. ^ Bell M (2014). Melancholia: The Western Malady. United Kingdom: Cambridge University Press. p. 38. ISBN 978-1-107-06996-1. Archived from the original on 2022-08-28. Retrieved 2022-08-28.
  3. ^ "The Four Human Temperaments". www.thetransformedsoul.com. Archived from the original on 2022-07-07. Retrieved 2022-08-28.
  4. ^ Cite error: The named reference :2 was invoked but never defined (see the help page).
  5. ^ Cite error: The named reference :3 was invoked but never defined (see the help page).
  6. ^ Cite error: The named reference Coffee was invoked but never defined (see the help page).
  7. ^ a b c Cite error: The named reference auto was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference :4 was invoked but never defined (see the help page).
  9. ^ Cite error: The named reference :5 was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference :6 was invoked but never defined (see the help page).
  11. ^ Berrios G E (1988) Melancholia and Depression during the 19th Century. British Journal of Psychiatry 153: 289–304
  12. ^ Jansson, Asa (2021). From Melancholia to Depression: Disordered Mood in 19th Century Psychiatry. Springer Nature Switzerland AG. ISBN 978-3-030-54801-8.{{cite book}}: CS1 maint: date and year (link)
  13. ^ Kendler KS (August 2020). "The Origin of Our Modern Concept of Depression-The History of Melancholia from 1780–1880: A Review" (PDF). JAMA Psychiatry. 77 (8): 863–868. doi:10.1001/jamapsychiatry.2019.4709. PMID 31995137. S2CID 210949394. Archived (PDF) from the original on 2022-08-12. Retrieved 2022-08-28.
  14. ^ Cite error: The named reference :7 was invoked but never defined (see the help page).
  15. ^ Cite error: The named reference DSM-5 was invoked but never defined (see the help page).
  16. ^ "Definition of Lugubrious". Merriam-Webster Dictionary. Retrieved 2022-12-07.
  17. ^ a b c Porter, Stanley C.; Malcolm, Matthew R., eds. (2013-04-25). Horizons in Hermeneutics: A Festschrift in Honor of Anthony C. Thiselton. William B. Eerdmans Publishing Company. p. 162. ISBN 978-0-8028-6927-2. Melancholia [is] also translated as "lugubriousness," "moroseness," or "wistfulness".
  18. ^ "Definition of Moroseness". Merriam-Webster Dictionary. Retrieved 2022-12-07.
  19. ^ "Definition of Wistfulness". Merriam-Webster Dictionary. Retrieved December 7, 2022.
  20. ^ "Definition of Saturnine". Merriam-Webster Dictionary. Retrieved December 7, 2022.
  21. ^ Wallace, Ian, ed. (2015). Voices from Exile: Essays in Memory of Hamish Ritchie. Brill. p. 213. ISBN 978-90-04-29639-8. [This is] what humour-based physiology of the renaissance and baroque periods described as saturnine melancholia.