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BMJ. 2007 August 18; 335(7615): 351.
PMCID: PMC1949452
Medical Classics

The Anatomy of Melancholy

George Dunea, president and chief executive officer, Hektoen Institute of Medicine, Chicago, Illinois, USA

According to the “Advertisement” (or preface) of its 1893 reprinting, The Anatomy of Melancholy was at the time of its publication (1621) “of great celebrity,” going through at least eight editions “by which the bookseller got an estate.” It was highly recommended by Dr Samuel Johnson, who advised Boswell to divert distressing thoughts by having a “lamp constantly burning in his bed-chamber at night and if wakefully disturbed . . . compose himself to rest” by reading from this “valuable work.”

Published under the pseudonym Democritus Junior by Robert Burton, an Oxford scholar and clergyman who wrote to assuage his own melancholy, it has an 165 page rambling introduction in which the author quotes innumerable authorities (in Latin), explaining that as a mere spectator of other peoples' lives (and follies) he like Democritus laughs at them or pities them all. He thinks that most people are mad, their brains afflicted by melancholy, especially those who pursue glory, money, and power in “the tumults and chances of this wavering world.” Wisdom indeed comes too late if at all, coming to Theophrastus at the age of 107 and causing him therefore to “lament his departure.” The author faintly apologises for transgressing into subjects dealing with the diseases of the body, but argues that after all physicians intrude into his business of caring for the mind or soul. He advocates a simple life, indicting the rich for their natural contempt for learning and deriding them for having “as much wit in their heels as in their brains.” He then presents his own version of utopia, and concludes that the excesses and foolishness of the world are symptoms of this all pervasive madness or melancholy that afflicts not only individuals but also states and kingdoms—and even dogs, who die of grief for the loss of their masters.

What then is this melancholy? It is an excess of black bile, one of the humours of the body, and to understand it the reader must first be subjected to a chapter on anatomy as understood in the 17th century. Then the book covers the causes, symptoms, “prognostics,” and treatment of this “disease” and its various subdivisions (including love melancholy, jealousy, religious melancholy, and despair), reflecting the 1000 year old humoral theory of disease, which already in Burton's time was beginning to be discredited. Much is tedious and absurd, but much is also amusing or instructive, exposing the reader to a panorama of quotations from distinguished ancient and medieval writers and philosophers.

Few modern readers will want to read the Anatomy from beginning to end. But for many a reader tasting a few pages should prove pleasurable and instructive. Those in the thrall of love melancholy are advised as a last resort to see their beloved naked and observe certain defects of her body, notice her bad breath, remember that “beauty fades as a tree in the winter,” and look at her aged parents and presume that she too will “be molested in like manner.” But this is only for the victims of extremely refractory love melancholy. The unaffected may merely want to relax with an open mind, enjoying the wisdom and excusing the errors of the many who went before us.


Articles from The BMJ are provided here courtesy of BMJ Publishing Group