Robert Burton was an Oxford clergyman and scholar. His book was first published in 1621. He adopts the title Democritus Junior after the Greek philosopher who was also “an expert physician, a politician, and an excellent mathematician”. Hippocrates described him as “a little wearish old man, very melancholy by nature”. In the preface, the author says: “I write of melancholy by being busy to avoid melancholy.” (Burton, 1621)

The book begins with an account of the Fall of Man:

Burton believes that melancholy is inevitable and universal:

Causes of melancholy

Melancholy is caused by the wrath of God, but also by the actions of spirits, devils and the influence of the stars and the moon. Old age is a common cause: “After 70 years (as the Psalmist saith) all is trouble and sorrow.” With regard to heredity: “I need not make any doubt of melancholy, but that it is an hereditary disease.”

Burton warns that various items of diet are liable to produce melancholy: venison is ‘melancholy and begets bad blood.’ Most types of fowl are forbidden as well as some varieties of fish. He particularly warns about cabbage: “It sends up black vapours to the brain.’ He agrees with Pythagoras that one should eat no peas nor beans.

The list of causes of melancholy seems endless: envy, hatred, ambition, love of gambling, loss of liberty, poverty, bereavement, an unhappy marriage. Excessive study causes melancholy “by drawing spirits to the brain, so that the stomach and the liver are left destitute…’.

Symptoms of melancholy

Fear and sorrow are present in most cases. According to Galen, many fear death, and yet in a contrary humour, make away themselves. Some are “equally tormented in mind as if they have committed a murder”; they may confess to crimes of which they are innocent.

Sufferers from ‘windy hypochondriacal melancholy’ have many abdominal symptoms, including sharp belchings, heat in the bowels, wind and rumbling in the guts, vehement gripings and pain in the belly. Some believe they have a serpent in the abdomen, or frogs. One such patient, told by his physician that it was only wind, was unconvinced and asked: ‘Do you not hear them croak?”

Burton embarks on a confused account of the melancholy of maids, nuns and widows, but soon stops to ask himself:

Suicide

Burton believes that suicide should not be unlawful. He quotes Plato: “if any man labour of an incurable disease, he may dispatch himself.” Seneca writes:

Cure of melancholy

The need for prayer is stressed, and the avoidance of everything he has pointed to as a cause of melancholy. Burton is enthusiastic about herbal remedies for the condition, such as marigold, hops, black hellebore, mugwort, liverwort and dandelion. He claims that many melancholic men have been cured by the frequent use of wormwood, centaury and pennyroyal.

A cup of wine or strong drink may help, if it be “soberly and opportunely used”.

Other remedies are blood-letting, horse-leeches (especially if applied to haemorrhoids), hot irons or cauteries, and boring holes in the head in two or three places (to let out the ‘vapours’).

Love melancholy

This is dealt with at great length (194 pages!).

Despair

The principal agent and procurer of this mischief is the Devil… melancholy and the fear of God's judgment and hell fire drives men to desperation. Most part these kind of persons make away themselves. They must not be left solitary…. They are tormented by the burdens of their sins.

Discussion

One assumes from the title of the book that it is about depressive illness, and there are good descriptions of this. Much of the book, however, concerns unhappiness rather than melancholy in a medical sense. The wrath of God, sin, hell-fire and the work of the Devil feature prominently, as one would expect in a work by a 17th-century clergyman.

Burton evidently feared that his book would meet with a hostile reception. In the Preface he writes:

He warns the reader:

It is unlikely that a depressed person would be helped by the book, and Burton warns such a person “not to read this tract of symptoms, lest he become more melancholy than he was before”. He hoped that, by writing the book, his own melancholy might be relieved, but apparently this did not prove to be the case.

In spite of the author's doubts about the book, its generally gloomy tone, its inordinate length, and its innumerable quotations from the works of poets, divines, philosophers and the Bible, the Anatomy of Melancholy was a great success, running to eight editions over half a century. The publisher was able to buy an estate from the proceeds.

The very long preface (entitled ‘Democritus Junior to the reader’) is, in some respects, more interesting than the book itself. In it Burton describes his plans to improve living conditions generally, so that there will be less discontent. He will make “An Utopia of mine own, a new Atlantis, a poetical commonwealth of mine own, in which I will freely domineer, make laws and statutes… I will choose a site, whose latitude will be 45 degrees, or perhaps under the equator… There will be 12 or 13 provinces, each with a metropolis containing churches, prisons, public halls, theatres and sports fields”. He proposes recreations and holidays for all, and good schools, especially for grammar and languages. He plans hospitals of all kinds, for children, orphans, old people, physically sick people and mad people. These hospitals will be built and maintained not by collections and donations, but out of the public purse. But:

For wrong-doers there were severe punishments: hanging for murderers, adulterers and persistent debtors, excision of the tongue for perjurers and those who bear false witness and amputation of the hands for sacrilege.

Many of Burton's views reflect the climate of opinion of the age in which he lived, but in advocating a welfare state, with social security and old-age pensions, and a national health service, he was centuries ahead of his time, as he was in urging that suicide should be decriminalised.