SECT. IV. MEMB. I.

Prognostics of Melancholy.

Prognostics, or signs of things to come, are either good or bad. If this malady be not hereditary, and taken at the beginning, there is good hope of cure, recens curationem non habet difficilem, saith Avicenna, l. 3, Fen. 1, Tract. 4, c. 18. That which is with laughter, of all others is most secure, gentle, and remiss, Hercules de Saxonia. [2716]If that evacuation of haemorrhoids, or varices, which they call the water between the skin, shall happen to a melancholy man, his misery is ended, Hippocrates Aphor. 6, 11. Galen l. 6, de morbis vulgar. com. 8, confirms the same; and to this aphorism of Hippocrates, all the Arabians, new and old Latins subscribe; Montaltus c. 25, Hercules de Saxonia, Mercurialis, Vittorius Faventinus, &c. Skenkius, l. 1, observat. med. c. de Mania, illustrates this aphorism, with an example of one Daniel Federer a coppersmith that was long melancholy, and in the end mad about the 27th year of his age, these varices or water began to arise in his thighs, and he was freed from his madness. Marius the Roman was so cured, some, say, though with great pain. Skenkius hath some other instances of women that have been helped by flowing of their mouths, which before were stopped. That the opening of the haemorrhoids will do as much for men, all physicians jointly signify, so they be voluntary, some say, and not by compulsion. All melancholy are better after a quartan; [2717]Jobertus saith, scarce any man hath that ague twice; but whether it free him from this malady, 'tis a question; for many physicians ascribe all long agues for especial causes, and a quartan ague amongst the rest. [2718]Rhasis cont. lib. 1, tract. 9. When melancholy gets out at the superficies of the skin, or settles breaking out in scabs, leprosy, morphew, or is purged by stools, or by the urine, or that the spleen is enlarged, and those varices appear, the disease is dissolved. Guianerius, cap. 5, tract. 15, adds dropsy, jaundice, dysentery, leprosy, as good signs, to these scabs, morphews, and breaking out, and proves it out of the 6th of Hippocrates' Aphorisms.

Evil prognostics on the other part. Inveterata melancholia incurabilis, if it be inveterate, it is [2719]incurable, a common axiom, aut difficulter curabilis as they say that make the best, hardly cured. This Galen witnesseth, l. 3, de loc. affect. cap. 6, [2720]be it in whom it will, or from what cause soever, it is ever long, wayward, tedious, and hard to be cured, if once it be habituated. As Lucian said of the gout, she was [2721]the queen of diseases, and inexorable, may we say of melancholy. Yet Paracelsus will have all diseases whatsoever curable, and laughs at them which think otherwise, as T. Erastus par. 3, objects to him; although in another place, hereditary diseases he accounts incurable, and by no art to be removed. [2722]Hildesheim spicel. 2, de mel. holds it less dangerous if only [2723]imagination be hurt, and not reason, [2724]the gentlest is from blood. Worse from choler adust, but the worst of all from melancholy putrefied. [2725]Bruel esteems hypochondriacal least dangerous, and the other two species (opposite to Galen) hardest to be cured. [2726]The cure is hard in man, but much more difficult in women. And both men and women must take notice of that saying of Montanus consil. 230, pro Abate Italo, [2727]This malady doth commonly accompany them to their grave; physicians may ease, and it may lie hid for a time, but they cannot quite cure it, but it will return again more violent and sharp than at first, and that upon every small occasion or error: as in Mercury's weather-beaten statue, that was once all over gilt, the open parts were clean, yet there was in fimbriis aurum, in the chinks a remnant of gold: there will be some relics of melancholy left in the purest bodies (if once tainted) not so easily to be rooted out. [2728] Oftentimes it degenerates into epilepsy, apoplexy, convulsions, and blindness: by the authority of Hippocrates and Galen, [2729]all aver, if once it possess the ventricles of the brain, Frambesarius, and Salust. Salvianus adds, if it get into the optic nerves, blindness. Mercurialis, consil. 20, had a woman to his patient, that from melancholy became epileptic and blind. [2730]If it come from a cold cause, or so continue cold, or increase, epilepsy; convulsions follow, and blindness, or else in the end they are moped, sottish, and in all their actions, speeches, and gestures, ridiculous. [2731]If it come from a hot cause, they are more furious, and boisterous, and in conclusion mad. Calescentem melancholiam saepius sequitur mania. [2732]If it heat and increase, that is the common event, [2733]per circuitus, aut semper insanit, he is mad by fits, or altogether. For as [2734]Sennertus contends out of Crato, there is seminarius ignis in this humour, the very seeds of fire. If it come from melancholy natural adust, and in excess, they are often demoniacal, Montanus.

[2735]Seldom this malady procures death, except (which is the greatest, most grievous calamity, and the misery of all miseries,) they make away themselves, which is a frequent thing, and familiar amongst them. 'Tis [2736]Hippocrates' observation, Galen's sentence, Etsi mortem timent, tamen plerumque sibi ipsis mortem consciscunt, l. 3. de locis affec. cap. 7. The doom of all physicians. 'Tis [2737]Rabbi Moses' Aphorism, the prognosticon of Avicenna, Rhasis, Aetius, Gordonius, Valescus, Altomarus, Salust. Salvianus, Capivaccius, Mercatus, Hercules de Saxonia, Piso, Bruel, Fuchsius, all, &c.

[2738]Et saepe usque adeo mortis formidine vitae
Percipit infelix odium lucisque videndae,
Ut sibi consciscat maerenti pectore lethum.

And so far forth death's terror doth affright,
He makes away himself, and hates the light
To make an end of fear and grief of heart,
He voluntary dies to ease his smart.

In such sort doth the torture and extremity of his misery torment him, that he can take no pleasure in his life, but is in a manner enforced to offer violence unto himself, to be freed from his present insufferable pains. So some (saith [2739]Fracastorius) in fury, but most in despair, sorrow, fear, and out of the anguish and vexation of their souls, offer violence to themselves: for their life is unhappy and miserable. They can take no rest in the night, nor sleep, or if they do slumber, fearful dreams astonish them. In the daytime they are affrighted still by some terrible object, and torn in pieces with suspicion, fear, sorrow, discontents, cares, shame, anguish, &c. as so many wild horses, that they cannot be quiet an hour, a minute of time, but even against their wills they are intent, and still thinking of it, they cannot forget it, it grinds their souls day and night, they are perpetually tormented, a burden to themselves, as Job was, they can neither eat, drink or sleep. Psal. cvii. 18. Their soul abhorreth all meat, and they are brought to death's door, [2740]being bound in misery and iron: they [2741]curse their stars with Job, [2742]and day of their birth, and wish for death: for as Pineda and most interpreters hold, Job was even melancholy to despair, and almost [2743]madness itself; they murmur many times against the world, friends, allies, all mankind, even against God himself in the bitterness of their passion, [2744]vivere nolunt, mori nesciunt, live they will not, die they cannot. And in the midst of these squalid, ugly, and such irksome days, they seek at last, finding no comfort, [2745]no remedy in this wretched life, to be eased of all by death. Omnia appetunt bonum, all creatures seek the best, and for their good as they hope, sub specie, in show at least, vel quia mori pulchrum putant (saith [2746]Hippocrates) vel quia putant inde se majoribus malis liberari, to be freed as they wish. Though many times, as Aesop's fishes, they leap from the frying-pan into the fire itself, yet they hope to be eased by this means: and therefore (saith Felix [2747]Platerus) after many tedious days at last, either by drowning, hanging, or some such fearful end, they precipitate or make away themselves: many lamentable examples are daily seen amongst us: alius ante, fores se laqueo suspendit (as Seneca notes), alius se praecipitavit a tecto, ne dominum stomachantem audiret, alius ne reduceretur a fuga ferrum redegit in viscera, one hangs himself before his own door,—another throws himself from the house-top, to avoid his master's anger,—a third, to escape expulsion, plunges a dagger into his heart,—so many causes there are—His amor exitio est, furor his—love, grief, anger, madness, and shame, &c. 'Tis a common calamity, [2748]a fatal end to this disease, they are condemned to a violent death, by a jury of physicians, furiously disposed, carried headlong by their tyrannising wills, enforced by miseries, and there remains no more to such persons, if that heavenly Physician, by his assisting grace and mercy alone do not prevent, (for no human persuasion or art can help) but to be their own butchers, and execute themselves. Socrates his cicuta, Lucretia's dagger, Timon's halter, are yet to be had; Cato's knife, and Nero's sword are left behind them, as so many fatal engines, bequeathed to posterity, and will be used to the world's end, by such distressed souls: so intolerable, insufferable, grievous, and violent is their pain, [2749]so unspeakable and continuate. One day of grief is an hundred years, as Cardan observes: 'Tis carnificina hominum, angor animi, as well saith Areteus, a plague of the soul, the cramp and convulsion of the soul, an epitome of hell; and if there be a hell upon earth, it is to be found in a melancholy man's heart.

For that deep torture may be call'd an hell,
When more is felt, than one hath power to tell.

Yea, that which scoffing Lucian said of the gout in jest, I may truly affirm of melancholy in earnest.

[2750]O triste nomen! o diis odibile
Melancholia lacrymosa, Cocyti filia,
Tu Tartari specubus opacis edita
Erinnys, utero quam Megara suo tulit,
Et ab uberibus aluit, cuique parvidae
Amarulentum in os lac Alecto dedit,
Omnes abominabilem te daemones
Produxere in lucem, exitio mortalium. Et paulo post
Non Jupiter ferit tale telum fulminis,
Non ulla sic procella saevit aequoris,
Non impetuosi tanta vis est turbinis.
An asperos sustineo morsus Cerberi?
Num virus Echidnae membra mea depascitur?
Aut tunica sanie tincta Nessi sanguinis?
Illacrymabile et immedicabile malum hoc.

O sad and odious name! a name so fell,
Is this of melancholy, brat of hell.
There born in hellish darkness doth it dwell,
The Furies brought it up, Megara's teat,
Alecto gave it bitter milk to eat.
And all conspir'd a bane to mortal men,
To bring this devil out of that black den.
Jupiter's thunderbolt, not storm at sea,
Nor whirlwind doth our hearts so much dismay.
What? am I bit by that fierce Cerberus?
Or stung by [2751]serpent so pestiferous?
Or put on shirt that's dipt in Nessus' blood?
My pain's past cure; physic can do no good.

No torture of body like unto it, Siculi non invenere tyranni majus tormentum, no strappadoes, hot irons, Phalaris' bulls,

[2752]Nec ira deum tantum, nec tela, nec hostis,
Quantum sola noces animis illapsa.

Jove's wrath, nor devils can
Do so much harm to th' soul of man.

All fears, griefs, suspicions, discontents, imbonites, insuavities are swallowed up, and drowned in this Euripus, this Irish sea, this ocean of misery, as so many small brooks; 'tis coagulum omnium aerumnarum: which [2753]Ammianus applied to his distressed Palladins. I say of our melancholy man, he is the cream of human adversity, the [2754] quintessence, and upshot; all other diseases whatsoever, are but flea-bitings to melancholy in extent: 'Tis the pith of them all, [2755] Hospitium est calamitatis; quid verbis opus est?

Quamcunque malam rem quaeris, illic reperies:

What need more words? 'tis calamities inn,
Where seek for any mischief, 'tis within;

and a melancholy man is that true Prometheus, which is bound to Caucasus; the true Titius, whose bowels are still by a vulture devoured (as poets feign) for so doth [2756]Lilius Geraldus interpret it, of anxieties, and those griping cares, and so ought it to be understood. In all other maladies, we seek for help, if a leg or an arm ache, through any distemperature or wound, or that we have an ordinary disease, above all things whatsoever, we desire help and health, a present recovery, if by any means possible it may be procured; we will freely part with all our other fortunes, substance, endure any misery, drink bitter potions, swallow those distasteful pills, suffer our joints to be seared, to be cut off, anything for future health: so sweet, so dear, so precious above all other things in this world is life: 'tis that we chiefly desire, long life and happy days, [2757]multos da Jupiter annos, increase of years all men wish; but to a melancholy man, nothing so tedious, nothing so odious; that which they so carefully seek to preserve [2758]he abhors, he alone; so intolerable are his pains; some make a question, graviores morbi corporis an animi, whether the diseases of the body or mind be more grievous, but there is no comparison, no doubt to be made of it, multo enim saevior longeque est atrocior animi, quam corporis cruciatus (Lem. l. 1. c. 12.) the diseases of the mind are far more grievous.—Totum hic pro vulnere corpus, body and soul is misaffected here, but the soul especially. So Cardan testifies de rerum var. lib. 8. 40. [2759]Maximus Tyrius a Platonist, and Plutarch, have made just volumes to prove it. [2760]Dies adimit aegritudinem hominibus, in other diseases there is some hope likely, but these unhappy men are born to misery, past all hope of recovery, incurably sick, the longer they live the worse they are, and death alone must ease them.

Another doubt is made by some philosophers, whether it be lawful for a man in such extremity of pain and grief, to make away himself: and how these men that so do are to be censured. The Platonists approve of it, that it is lawful in such cases, and upon a necessity; Plotinus l. de beatitud. c. 7. and Socrates himself defends it, in Plato's Phaedon, if any man labour of an incurable disease, he may despatch himself, if it be to his good. Epicurus and his followers, the cynics and stoics in general affirm it, Epictetus and [2761]Seneca amongst the rest, quamcunque veram esse viam ad libertatem, any way is allowable that leads to liberty, [2762]let us give God thanks, that no man is compelled to live against his will; [2763] quid ad hominem claustra, career, custodia? liberum ostium habet, death is always ready and at hand. Vides illum praecipitem locum, illud flumen, dost thou see that steep place, that river, that pit, that tree, there's liberty at hand, effugia servitutis et doloris sunt, as that Laconian lad cast himself headlong (non serviam aiebat puer) to be freed of his misery: every vein in thy body, if these be nimis operosi exitus, will set thee free, quid tua refert finem facias an accipias? there's no necessity for a man to live in misery. Malum est necessitati vivere; sed in necessitate vivere, necessitas nulla est. Ignavus qui sine causa moritur, et stultus qui cum dolore vivit. Idem epi. 58. Wherefore hath our mother the earth brought out poisons, saith [2764]Pliny, in so great a quantity, but that men in distress might make away themselves? which kings of old had ever in a readiness, ad incerta fortunae venenum sub custode promptum, Livy writes, and executioners always at hand. Speusippes being sick was met by Diogenes, and carried on his slaves' shoulders, he made his moan to the philosopher; but I pity thee not, quoth Diogenes, qui cum talis vivere sustines, thou mayst be freed when thou wilt, meaning by death. [2765]Seneca therefore commends Cato, Dido, and Lucretia, for their generous courage in so doing, and others that voluntarily die, to avoid a greater mischief, to free themselves from misery, to save their honour, or vindicate their good name, as Cleopatra did, as Sophonisba, Syphax's wife did, Hannibal did, as Junius Brutus, as Vibius Virus, and those Campanian senators in Livy (Dec. 3. lib. 6.) to escape the Roman tyranny, that poisoned themselves. Themistocles drank bull's blood, rather than he would fight against his country, and Demosthenes chose rather to drink poison, Publius Crassi filius, Censorius and Plancus, those heroical Romans to make away themselves, than to fall into their enemies' hands. How many myriads besides in all ages might I remember, qui sibi lethum Insontes pepperere manu, &c. [2766]Rhasis in the Maccabees is magnified for it, Samson's death approved. So did Saul and Jonas sin, and many worthy men and women, quorum memoria celebratur in Ecclesia, saith [2767]Leminchus, for killing themselves to save their chastity and honour, when Rome was taken, as Austin instances, l. 1. de Civit. Dei, cap. 16. Jerome vindicateth the same in Ionam and Ambrose, l. 3. de virginitate commendeth Pelagia for so doing. Eusebius, lib. 8. cap. 15. admires a Roman matron for the same fact to save herself from the lust of Maxentius the Tyrant. Adelhelmus, abbot of Malmesbury, calls them Beatas virgines quae sic, &c. Titus Pomponius Atticus, that wise, discreet, renowned Roman senator, Tully's dear friend, when he had been long sick, as he supposed, of an incurable disease, vitamque produceret ad augendos dolores, sine spe salutis, was resolved voluntarily by famine to despatch himself to be rid of his pain; and when as Agrippa, and the rest of his weeping friends earnestly besought him, osculantes obsecrarent ne id quod natura cogeret, ipse acceleraret, not to offer violence to himself, with a settled resolution he desired again they would approve of his good intent, and not seek to dehort him from it: and so constantly died, precesque eorum taciturna sua obstinatione depressit. Even so did Corellius Rufus, another grave senator, by the relation of Plinius Secundus, epist. lib. 1. epist. 12. famish himself to death; pedibus correptus cum incredibiles cruciatus et indignissima tormenta pateretur, a cibis omnino abstinuit; [2768]neither he nor Hispilla his wife could divert him, but destinatus mori obstinate magis, &c. die he would, and die he did. So did Lycurgus, Aristotle, Zeno, Chrysippus, Empedocles, with myriads, &c. In wars for a man to run rashly upon imminent danger, and present death, is accounted valour and magnanimity, [2769]to be the cause of his own, and many a thousand's ruin besides, to commit wilful murder in a manner, of himself and others, is a glorious thing, and he shall be crowned for it. The [2770] Massegatae in former times, [2771]Barbiccians, and I know not what nations besides, did stifle their old men, after seventy years, to free them from those grievances incident to that age. So did the inhabitants of the island of Choa, because their air was pure and good, and the people generally long lived, antevertebant fatum suum, priusquam manci forent, aut imbecillitas accederet, papavere vel cicuta, with poppy or hemlock they prevented death. Sir Thomas More in his Utopia commends voluntary death, if he be sibi aut aliis molestus, troublesome to himself or others, ([2772] especially if to live be a torment to him,) let him free himself with his own hands from this tedious life, as from a prison, or suffer himself to be freed by others. [2773]And 'tis the same tenet which Laertius relates of Zeno, of old, Juste sapiens sibi mortem consciscit, si in acerbis doloribus versetur, membrorum mutilatione aut morbis aegre curandis, and which Plato 9. de legibus approves, if old age, poverty, ignominy, &c. oppress, and which Fabius expresseth in effect. (Praefat. 7. Institut.) Nemo nisi sua culpa diu dolet. It is an ordinary thing in China, (saith Mat. Riccius the Jesuit,) [2774]if they be in despair of better fortunes, or tired and tortured with misery, to bereave themselves of life, and many times, to spite their enemies the more, to hang at their door. Tacitus the historian, Plutarch the philosopher, much approve a voluntary departure, and Aust. de civ. Dei, l. 1. c. 29. defends a violent death, so that it be undertaken in a good cause, nemo sic mortuus, qui non fuerat aliquando moriturus; quid autem interest, quo mortis genere vita ista finiatur, quando ille cui finitur, iterum mori non cogitur? &c. [2775]no man so voluntarily dies, but volens nolens, he must die at last, and our life is subject to innumerable casualties, who knows when they may happen, utrum satius est unam perpeti moriendo, an omnes timere vivendo, [2776] rather suffer one, than fear all. Death is better than a bitter life, Eccl. xxx. 17. [2777]and a harder choice to live in fear, than by once dying, to be freed from all. Theombrotus Ambraciotes persuaded I know not how many hundreds of his auditors, by a luculent oration he made of the miseries of this, and happiness of that other life, to precipitate themselves. And having read Plato's divine tract de anima, for example's sake led the way first. That neat epigram of Callimachus will tell you as much,

[2779]Calenus and his Indians hated of old to die a natural death: the Circumcellians and Donatists, loathing life, compelled others to make them away, with many such: [2780]but these are false and pagan positions, profane stoical paradoxes, wicked examples, it boots not what heathen philosophers determine in this kind, they are impious, abominable, and upon a wrong ground. No evil is to be done that good may come of it; reclamat Christus, reclamat Scriptura, God, and all good men are [2781]against it: He that stabs another, can kill his body; but he that stabs himself, kills his own soul. [2782]Male meretur, qui dat mendico, quod edat; nam et illud quod dat, perit; et illi producit vitam ad miseriam: he that gives a beggar an alms (as that comical poet said) doth ill, because he doth but prolong his miseries. But Lactantius l. 6. c. 7. de vero cultu, calls it a detestable opinion, and fully confutes it, lib. 3. de sap. cap. 18. and S. Austin, epist. 52. ad Macedonium, cap. 61. ad Dulcitium Tribunum: so doth Hierom to Marcella of Blesilla's death, Non recipio tales animas, &c., he calls such men martyres stultae Philosophiae: so doth Cyprian de duplici martyrio; Si qui sic moriantur, aut infirmitas, aut ambitio, aut dementia cogit eos; 'tis mere madness so to do, [2783]furore est ne moriare mori. To this effect writes Arist. 3. Ethic. Lipsius Manuduc. ad Stoicam Philosophiaem lib. 3. dissertat. 23. but it needs no confutation. This only let me add, that in some cases, those [2784]hard censures of such as offer violence to their own persons, or in some desperate fit to others, which sometimes they do, by stabbing, slashing, &c. are to be mitigated, as in such as are mad, beside themselves for the time, or found to have been long melancholy, and that in extremity, they know not what they do, deprived of reason, judgment, all, [2785]as a ship that is void of a pilot, must needs impinge upon the next rock or sands, and suffer shipwreck. [2786]P. Forestus hath a story of two melancholy brethren, that made away themselves, and for so foul a fact, were accordingly censured to be infamously buried, as in such cases they use: to terrify others, as it did the Milesian virgins of old; but upon farther examination of their misery and madness, the censure was [2787]revoked, and they were solemnly interred, as Saul was by David, 2 Sam. ii. 4. and Seneca well adviseth, Irascere interfectori, sed miserere interfecti; be justly offended with him as he was a murderer, but pity him now as a dead man. Thus of their goods and bodies we can dispose; but what shall become of their souls, God alone can tell; his mercy may come inter pontem et fontem, inter gladium et jugulum, betwixt the bridge and the brook, the knife and the throat. Quod cuiquam contigit, quivis potest: Who knows how he may be tempted? It is his case, it may be thine: [2788]Quae sua sors hodie est, eras fore vestra potest. We ought not to be so rash and rigorous in our censures, as some are; charity will judge and hope the best: God be merciful unto us all.