A treatise of melancholie
1586 AD
Timothy Bright ( ?1551-1615)
(physician to St Bartholomew's Hospital London, 1585-91
subsequently Anglican priest
inventor of modern shorthand)

1. In 1586 AD, Timothy Bright, doctor and priest, viewed that the spirit could make the body sick and the body could make the mind delusional. He focuses on how the mind causes the body to become melancholy and forbids the taking medicines as a cure. "The dayly experience of phrensies, madnesse, lunasies, and melancholy cured by .. . art in that kinde, hath caused some to judge more basely of the soule... I have layd open howe the bodie, and corporall things affect the soule, & how the body is affected of it againe : what the difference is betwixt natural melancholie, and that heavy hande of God upon the afflicted conscience, tormented with remorse of sinne, & feare of his judgement. ... The mad man, of what kinde soever he be of, as truly concludeth of that which fantasie ministreth of conceit, as the wisest : onely therein lieth the abuse and defect, that the organicall parts which are ordained embassadours, & notaries unto the mind in these cases, falsisie the report, and deliver corrupt recordes. This is to be helped, as it shall be declared more at large hereafter, by counsell only sincerely ministred, which is free from the corruptions of those officers, and delivereth truth unto the mind, wherby it putteth in practise contrary to these importunate and furious sollicitors. ... Here it first proceedeth from the mindes apprehension: there from the humour, which deluding the organicall actions, abuseth the minde, and draweth it into erronious judgement, through false testimony of the outward reporte. Here no medicine, no purgation, no cordiall, no tryacle or balme are able to assure the afflicted soule and trembling heart, now panting under the terrors of God : there in melancholy the vain opened, neesing powder or bearefoote ministred, cordialls of pearle, Saphires, and rubies, with such like, recomforte the heart throwne downe, & appaled with fantasticall feare. In this affliction, the perill is not of body, and corporall actions, or decay of servile, and temporall uses, but of the whole nature soule and body cut of from the life of God, and from the sweet influence of his favour, the fountaine of all happines and eternall felicity." (A treatise of melancholie, Timothy Bright, 1586 AD)
2. "This was the first treatise by an English physician on mental illness and being addressed to men 'not ignorant of good letters' was intended as a scientific contribution. That such a work was needed is shown by the fact that a second corrected edition was issued by Windet within six months of the first, followed by an unchanged third in 1613. Burton (1621) in the most famous book on melancholy quoted it more frequently than any other English source. Bright distinguished two kinds of melancholy: the first where 'the perill is not of body' but `proceedeth from the mindes apprehension' requiring 'cure of the minde' that is psychotherapy. The second 'being not moved by any adversity present or imminent' in which the melancholy humour 'deluding the organicall actions, abuseth the minde' needed physical treatment, since 'if either humor, or excrement should have part in moving affections, no counsel of philosophy, nor precept of wise men were comparable to calme these raging passions, unto the purging potions of Physitians, & in this case the Elleborans of Anticera; the Colocynthis of Spaine, and the Rhubarb of Alexandria, above all the schools of Divinitie or Philosophy'. This concept of two types of melancholy is similar to present-day classification of depression into reactive where the patient knows what depresses him although he cannot throw it off, and endogenous where no precipitating psychological cause is evident and which for this reason is sometimes presumed to be caused by some organic or biochemical disturbance. Bright made the distinction partly on clinical grounds but also to meet the theological contention that mind equated with immortal soul was incorruptible and not susceptible of disease. There was no objection to allowing the body to produce 'Perturbations and afflictions of the minde', but where this was not so he attributed 'the mindes apprehension' to the 'heavy hande of God upon the afflicted conscience' — expressed in modern terms depression and anxiety due to guilt feelings." (300 years of Psychiatry, Richard Hunter, 1963, p36)

MD Cantab., physician to St Bartholomew's Hospital London, 1585-91; subsequently Anglican priest; inventor of modern shorthand

A treatise of melancholie, 1586 London, V autrollier (PP. [xxii] +284) pp. [iii, V-Vi], 1-2, 90, 93-4, 112, 187-90

MELANCHOLY AND THE CONSCIENCE OF SIN

Of all other practise of phisick, that parte most commendeth the excellency of the noble facultie, which not only releeveth the bodily infirmity, but after a sort even also correcteth the infirmities of the mind . . . The dayly experience of phrensies, madnesse, lunasies, and melancholy cured by .. . art in that kinde, hath caused some to judge more basely of the soule, then agreeth with pietie or nature, & have accompted all maner affection thereof, to be subject to the phisicians hand, not considering herein any thing divine, and above the ordinarie events, and naturall course of thinges : but have esteemed the vertues them selves, yea religion, no other thing but as the body hath ben tempered, and on the other side, vice, prophanenesse, & neglect of religion and honestie, to have bene nought else but a fault of humour. For correcting the judgement of such as so greatly mislike the matter, and partly for the use of many that may neede instruction and counsel, in the state of melancholy, & affection of braine and heart, & wold have both to satissie their owne doubts, and to answer the prophane objections of others, I have taken this paines to confute the absurde errour of the one, & to satissie the reasonable and modest inquiry of the other that seek to be enformed. I have layd open howe the bodie, and corporall things affect the soule, & how the body is affected of it againe : what the difference is betwixt natural melancholie, and that heavy hande of God upon the afflicted conscience, tormented with remorse of sinne, & feare of his judgement.

It signifieth in all, either a certayne fearefull disposition of the mind altered from reason, or else an humour of the body, commonly taken to be the only cause of reason by feare in such sort depraved. This humour is of two sorts : naturall, or unnaturall . . . these two according to the diversitie of setling, do ingender diversitie of passions, & according therunto do diverslie affect the understanding, & do alter the affection, especially if by corruption of nature or evill custome of manners the partie be over passionate.

We doe see by experience certaine persons which enjoy all the comfortes of this life whatsoever wealth can procure, and whatsoever friendship offereth of kindnes, and whatsoever security may assure them : yet to be overwhelmed with heavines, and dismaide with such feare, as they can neither receive consolation, nor hope of assurance, notwithstanding ther be neither matter of feare, or discontentment, nor yet cause of daunger, but contrarily of great comfort, and gratulation. This passion being not moved by any adversity present or imminent, is attributed to melancholie the grossest part of all the blood, either while it is yet contained in the vaines : or aboundeth in the splene, (ordained to purge the blood of that drosse and setling of the humours) surcharged therwith for want of free vent, by reason of obstruction, or any wayes else the passage being let of cleare avoydance. The rather it seemeth to be no lesse, because purgation, opening of a vayne, diet, and other order of cure and medicine, as phisick prescribeth, have bene meanes of chaunging this disposition, and mitigation of those sorrowes, and quieting of such feares, as melancholie persons have fancied to themselves, & have as it seemeth restored both wit and courage. . . .

Of all partes of the body, in each perturbation, two are chiefly affected : first the brain, that both apprehendeth the offensive or pleasaunt object, & judgeth of the same in like sort, and communicateth it with the heart, which is the second part affected : these being`troubled carie with them all the rest of the panes into a simpathy, they of all the rest being in respect of affection of most importance. The humours then to worke these effectes, which approch nigh to naturall perturbations grounded upon just occasion, of necessity, alter either brayne or hart . . . if both panes be overcharged of humour, the apprehension & affection both are corrupted, and misse of their right action, and so all thinges mistaken, ingender that confused spirite, and those stormes of outragious love, hatred, hope or feare, wherewith bodies so passionate are here and there, tossed with disquiet .. .

The mad man, of what kinde soever he be of, as truly concludeth of that which fantasie ministreth of conceit, as the wisest : onely therein lieth the abuse and defect, that the organicall parts which are ordained embassadours, & notaries unto the mind in these cases, falsisie the report, and deliver corrupt recordes. This is to be helped, as it shall be declared more at large hereafter, by counsell only sincerely ministred, which is free from the corruptions of those officers, and delivereth truth unto the mind, wherby it putteth in practise contrary to these importunate and furious sollicitors.

By that hath bene before declared it may easily appeare the affliction of soule through conscience of sin is quite another thing then melancholy : but yet to the end it may lie most cleare, I wil lay them together, so shall their distinct natures thus compared bewray the error of some, and the prophanes of othersome, who either accompt the cause naturall, melancholy, or madnes, or else having some farther insighte, with a Stoicall prophanes of Atheisme, skoffe at that kinde of affliction, against which they themselves labour to shut up their hard heartes . . . let them consider that this is a sorrow and feare upon cause, & that the greatest cause that worketh misery unto man : the other contrarily a meere fancy & hath no ground of true and just object, but is only raised upon disorder of humour in the fancy, and rashly delivered to the heart, which upon naturall credulity faireth in passion, as if that were in deede wherof the fancy giveth a false larume. In this the body standeth oft times in sirme state of health, perfect in complexion, and perfect in shape, & al symmetrie of his partes, the humors in quantitie and quality not exceeding nor wanting their naturall proportion. In the other, the complexion is depraved, obstructions hinder the free course of spirits & humors, the blood is over grosse, thick, & impure, & nature so disordered, that diverse melancholicke persons have judged themselves some earthie pitchers, othersome cockes, other some to have wanted their heades &c, as if they had bin transported by the evill quality of the humor into straunge natures : here the senses are oft times perfect both outward & inward, the imagination sound, the heart well compact & resolute, & this excepted, want no courage. In the other, the inward sense and outward to feebled, the fancy overtaken with gastly fumes of melancholy, and the whole force of the spirite closed up in the dungion of melancholy darkenes, imagineth all darke, blacke and full of feare, their heartes are either overtender and rare, & so easily admitte the passion, or over closse of nature serve more easily to imprison, the chearefull spirites the causes of comforte to the rest of the bodie : whereby they are not in one respect only fainte harted, and full of discourage: but everie smal occasion, yea though none be, they are driven with tide of that humour to feare, even in the middest of security. Here it first proceedeth from the mindes apprehension: there from the humour, which deluding the organicall actions, abuseth the minde, and draweth it into erronious judgement, through false testimony of the outward reporte. Here no medicine, no purgation, no cordiall, no tryacle or balme are able to assure the afflicted soule and trembling heart, now panting under the terrors of God : there in melancholy the vain opened, neesing powder or bearefoote ministred, cordialls of pearle, Saphires, and rubies, with such like, recomforte the heart throwne downe, & appaled with fantasticall feare. In this affliction, the perill is not of body, and corporall actions, or decay of servile, and temporall uses, but of the whole nature soule and body cut of from the life of God, and from the sweet influence of his favour, the fountaine of all happines and eternall felicity. Finally if they be deligently compared in cause, in effect, in quality, in whatsoever respect these unreverent and prophane persons list to match them, they shall appeare of diverse nature, never to be coupled in one felowship.

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