TheBurton Anatomy and Osler of Melancholy Henry N. Claman, MD The author (AΩA, University of Colorado, 1979) is And even so, no matter how charming Robert Burton’s Distinguished Professor of Medicine and Associate Director company may be—perhaps he is another Montaigne—why of the Medical Humanities Program at the University of spend1338pagesonthesubjectofdepression(awordhedidn’t Colorado, Denver. He is a member of the editorial board of use),evenifthebookdidturnouttobeaninstantbestseller? The Pharos. LetusstepbackalittleandlookatBurtonandhisfam- ily. He was born in 1576 to Dorothy and Ralph Burton, the squireofLindley,asmalllandholdingaboutfiftymilesnorth ofOxford.Robertwasthefourthofelevenchildrenandthe he Anatomy of Melancholy,writtenbyRobertBurton secondson.Helatercalculatedtheexactmomentofhiscon- in1621,isprobablythemostfantasticalbookthatyou ception,andlearnedtheminuteofhisbirth(8:44am).Thus haven’tread.It’srightuptherewithFinnegan’s Wake, hecoulddeterminethathewasbornunderthesignofSaturn perhapsalsowithThe Life and Opinions of Tristram Shandy, (the“star”ofmelancholy)andwecangetahintofhisinterest Gentleman.Theverysizeofthebookisitselfsomewhatofan inastrology,andhisanalysisofhisowncharacter. obstacle;T itweighsinatalmost2¾pounds,andstretcheson In 1593, he entered Brasenose College, Oxford, and then for1,132pagesoftextfollowedby206morepagesofnotes— in1599hebecameaStudent(likeaFellow)ofChristChurch, mostofwhichareinLatin.1 Furthermore, because of its unusually dense style, one Right, Frontispiece from the 1632 edition of The Anatomy of cannotreallyreadthisbookasyouwouldreadotherbooks. Melancholy. From top left, Zelotypia (jealousy?), Democritus Instead,youaremorelikelyto dipintothetext,to strollby of Abdera in his garden, Solitude, the Lover, title material, the Hypochondriac, the Superstitious (with a rosary and crosses), the introductory poems, to peruse the complex outlines of portrait of the author, named Democritus Junior, the Maniac, thebook’sstructure,orto minethealmostendlessquotations Borage, publisher’s identification, Hellebore. Note the numerous from the Greek and Roman classics, the Bible, the Church signs of the zodiac and other astrological symbols in the clouds. Fathers,andsoon. Courtesy of the National Library of Medicine. 20 The Pharos/Spring2012 The Anatomy of Melancholy Robert Burton (after the portrait at Brasenose College, Oxford). Courtesy of the New York Public Library. Oxford,wherehelivedfortherestofhislife.Heearnedthe Therewere,inGreekantiquity,twophilosophers,Democritus degreesofBachelorandthenMasterofArts,andthenin1614 andHeraclitus.Democrituswas“theLaughingPhilosopher” becameaBachelorofDivinity(asbefittedasecondson).He (although Burton calls him melancholic, like himself ). heldseveralchurchofficesandreferredtohimselfas“adivine,” Heraclitus was “the Weeping Philosopher.” Democritus buthealwayslivedinChristChurchCollege.Henevermar- laughed at the activities and condition of humankind while riedanddidlittletraveling,preferringtoliveamongbooks, Heraclituscriedoverthem.BurtoncallshimselfDemocritus whichwereindeedhislife.Asheputit,hedidhistraveling“by Juniortoindicatehisowntendencytoridiculehisfellowsand cardandmap.”Andofbookshehadplenty—hisowncollec- alsotoconnecthimselfwiththeclassicaltradition.Thisdevice tion,thenthosevolumesandmanuscriptsbelongingtoChrist isalsoasignaltothereaderthatThe Anatomyisnotinitses- Church(wherehehimselfbecameLibrarianin1626)andmost senceamedicalbookbutaphilosophical treatise. notablytheBodleianLibrary,whichhadopenedin1602. Thepreface,ononehand,doesramblesomewhat,buton Indeedhewas“amanofthebooks.” theother,itdropsinformationaboutwhatistocomeinthe TheorganizationofThe Anatomyiscrucialtoitsobjective, Partitions.Indeed,onpage39,Burtonalreadytipshishandby thestudyofmelancholy.Itisinfourparts;alongprefaceand declaring(withthepoet,Horace,)thatallmankindis“mad” three“partitions.” “Forindeedwhoisnotafool,melancholy,mad?. .whoisnot The 123-page preface is titled “Democritus Junior to the brain-sick? Folly, melancholy, madness, are but one disease, Reader.” (The author is supposed to be Democritus Junior.) deliriumisacommonnametoall.”1Preface,p39Later(page114 22 The Pharos/Spring2012 andon),heindulgeshispassionforenumerationbymention- • Melancholy—coldanddry,thick,black,sour(bile) ing that the following (and others) are all mad: great men, Illness is made manifest by imbalances between the hu- philosophers,scholars,teachers,poets,lovers,mostwomen, mors,anditisthephysician’stasktorebalancethemcorrectly; youths,theaged,therich,thecovetous,aswellastheprodigal, this will then lead back to health. These four humors have indeed,thelot.BynowithasbecomeclearthatBurtonhas someanalogywiththefourelementsandalsothefourages chosen for the subjects of his analysis not only the sad and ofman. fearfulbut,indeed,allofhumanity. Ofcourse,asanacademic,Burtonisconcernedtodefine Afterthepreface,Burtongetsrighttowork,buthepro- hissubject.What,indeed,ismelancholy?Hereheis: ceedsslowly,startingPartitionIwiththecausesofmelancholy. It would be hard to improve Of the matter of melan- upon the characterization of choly, there is much ques- Burton’smodusoperandimade tion betwixt Avicenna and by another very noted biblio- —hot,dry,bitter(gall) Galen, as you may read in phile,HolbrookJackson: Choler Cardan’s Contradictions, —coldandmoist(liver) Valesius’ Controversies, Like most interesting men, Phlegm M o n t a n u s , P r o s p e r he is not quite consistent. He —hotandmoist(blood) Calenus, Capivaccius, preaches the happy mean and Sanguineous Bright, Ficinus, that have does not practise it. His book —coldanddry,thick,black,sour(bile) written either whole tracts, is always excessive. He over- Melancholy or copiously of it in their loads every statement. It is the several treatises of this sub- most sententious book ever ject. “What this humour is, written, yet it reads trippingly as a novel. It is packed with or whence it proceeds, how it is engendered in the body, common sense and uncommon nonsense. He is never tired neither Galen nor any old writer hath sufficiently discussed,” of apologizing for his long-windedness, and immediately as Jacchinus thinks.1PtI,p173 starts expatiating again. He fears that he will go too far in his exposition of love-melancholy, and does. He was never Now this is classical Burton; author after author is men- married, but marriage has no mysteries for him.2pxxi tioned,andquoted,everycauseisenumerated,everypossi- bilityisaired—yetnothingisconcluded,nothingisdefinitive. First, he lauds man’s excellence and nobility above all Buttheridegallopson. creaturesoftheworld.Immediately,however,hebewailsthe WeseeBurton’sdilemma.Intellectually,hestands“onthe miserablestatethismagnificentcreaturefindshimselfin. cusp”(astheysay)oftheAgeofReason.Hisbookwaspub- lished just after The Advancement of Learning (1603–1605) The impulsive cause of these miseries in man, the priva- and The Novum Organon (1620) of Francis Bacon and just tion or destruction of God’s image, the cause of death and before A Discourse on Method (1637) of Descartes. Bacon diseases, of all temporal and eternal punishments, was the and Descartes urged observation, experience, experiment, sin of our first parent Adam, in eating of the forbidden fruit, and doubt—the essentials of the rational method. In their by the devil’s instigation and allurement.1PtI,p131 scientificapproach,however,whilethereismuchdiscussion ofnewermethods,notenoughtimehadelapsedforextensive ShadesofSt.Augustine(calledSt.Austininourversion)—we fact-findingandexperiment.Thatisyettocome.But,asan havenotarrivedattheAgeofReasonquiteyet!)Theinstru- Englishmanofthecloth,Burtonisalsofirmlycommittedto mental causes(bymeansofwhichGod’spurposesarecarried the Christian beliefs in revealed truth. He juggles thesetwo out)includethestars,heavens,elements,oftenwithdiabolical positions—the scientific and the religious—through his far- helpfrommagicians,witches,poisons,etc. rago of quotations, and in general, medicine and physic are Then, having digressed into anatomy (both of body and seen as the servants of divinity. But here, too, the causesof soul)Burtongivesusaneatandprecisesummaryofthebases melancholyarecomplex—theyincludenotonlydivinitybut of health and disease, i.e., the concept of the Four Humors, itsopposite,malignity(intheformofwitchesandmagicians) thattheoryofHippocrates,Galen,Celsus,andAvicennathat andofcoursethestarsandplanets—andoldage. predominatedrightthroughtheMiddleAgesandRenaissance. Burton,perhapssurprisingly,eventacklesgenetics,saying Wenote: thatthereisnodoubt“butthatit[melancholy]isaninherited • Choler—hot,dry,bitter(gall) disease,”1PtI,p212promotedbyconsanguinity;thus“theChurch • Phlegm—coldandmoist(liver) andcommonwealth,humananddivinelaws,haveconspired • Sanguineous—hotandmoist(blood) toavoidhereditarydiseases,forbiddingsuchmarriagesasare The Pharos/Spring2012 23 The Anatomy of Melancholy anywhitallied.”1PtI,p212 PartitionIIIisentitled“Love-Melancholy.”Itisalmostas Having mentioned the above “natural” causes of melan- longasthefirstsection.Asitiswrittenbyasingle(andpre- cholia(i.e.,those“accordingtonature”)thatarehardtoavoid, sumably celibate) curate, (yet one who advocates marriage), Burton then turns to causes and influences he calls “non- onestartsreadingitandwonderswhathewillsayaboutlove. natural”(i.e.,notordainednorinnate),whichtodaywemight Most readers will be disappointed, as his earlier instructive describeasthoseof“lifestyle.”Hementionssix:diet,retention andentertainingstylebecomesmorelaboredand,ifpossible, and evacuation, air (climate),