Hypochondriac Melancholy

Hypochondriac Melancholy, also referred to as Windy Melancholy, is a type of Melancholy caused by poor digestion. It was often confused or not well covered in traditional texts. Some claimed it harder to treat than regular Melancholy, others said it was easier. The causes and symptoms were also often confused. Therefore, it is worth taking some passages from Praxis medicinæ (Bruel, 1632) which describes Hypochondriac Melancholy in detail:

‘The Hypochondriac, or windy melancholy is often caused by the overboiling of dreggish blood, which was settled near unto the stomach, or gristles of the short ribs, by a distemper of the Liver, Stomach, or Mesenteric Veins; hence it is, that gross and burnt humour, are carried up to the principal seat of the Brain and so do disquiet it, and stir up Melancholy. By the self same cause, as in a suffusion, the symptoms of that mischief are stirred up by sharp, and smoky vapours, proceeding from the lower parts: for it so happens, that the temperature of the brain is altered by dark and foggy vapors arising from the Stomach, Liver, Mesentary, or from some other adjacent part near unto them; whereby the imagination is hurt, memory and cogitation remaining perfect’.

The Signs

‘Besides the ordinary signs of melancholians, by the excessive heat of the humors, the parts about the heart are inflamed, and seem to be somewhat mitigated by cold meats: oftentimes the patient doth feel pain in his stomach, and short ribs, after he hath eaten such meats that are not easy of digestion, for from hence much crudity is caused, whereof the more plenty there is, by so much the more doth this mischief rage. They doe eat much, but in the mean while they have their bellies bound: they break wind often, and belch very much, which is caused by raw and melancholy humors contained in the aforesaid places. In those places are very frequent rumblings, & murmurs heard; and this is an especial sign of this disease. Sometimes they have pains in their shoulder, the Midrif is drawn upwards, the arteries beat strongly, and disorderly; Ringing in the ears, and inflammations of veins and eyes, are caused by vapours which are carried up thither. Their sleep is short and troublesome. They are troubled with a dizziness, and palpitation. Vomit of crude phlegm is caused, wherewith choler is sometime mixed. They are eased of their pain, after they have digested that which they have eaten, after stools, vomits, and belchings.’

The Cause:

‘It is caused by the default of the spleen, when it doth not draw away the melancholy blood made by the Livers distemper. Sometimes it doth happen, that the blood, which is in the veins of the Stomach, Mesentery, Spleen, Bowels, Guts, and adjacent parts, is burnt up by too much heat, caused by some obstruction, or some other cause; and then the blood doth degenerate into black juice which runs over the Mesentery, Spleen, and other parts thereto adjoining, whereof follows a great heat of the bowels, and from thence vapours are conveyed to the brain, from whence these Symptoms break out.’

The diet is very important in these cases. After overeating and chew food well and avoid eating between meals. Chicken, Capons, Lamb and Veal are all good. Broth and soup in suitable in moderation, Raisins, Cherries, Prunes and roast Apples are good; Barley water with Cinnamon and Aniseed or white wine diluted with half water are good drinks. Whey is also very good. Enemas, Purging and Bloodletting were amongst other treatments employed.

‘Because of the stubborness of the disease, we will concoct and purge humors, and will strengthen the aforesaid parts’


Balm	Hops
Pennyroyal	Calamint
Centuary	Fumitory
Wormwood	Agrimony
Dodder	Polypody
Caper root-bark	Basil seed
Agnus Castus	Cyperus rotundus

To Purge

Arabian Confect Purging Melancholy (Confectio Hamech)
Electuary of Senna (Diasenna) (Nicholas)
Pills of Fumitory
Pills of Lapis Lazuli
Indian Pills
Hiera Logadii
Greater Polycrest Pills

Formulas to Strengthen

Aromaticum Rosatum
Powder of Galangal Compound (Diagalanga) (Mesue)
Electuary of Cumin (Diacyminum)
Electuary of Dates (Diaphoenicum) (Mesue)
Compound Cooling Pearl Powder
Electuary of Gems

Chinese Classification
Simples

123

Formulas
Xiao Yao San
Dan Zhi Xiao Yan San (Jia Wei Xiao Yao San)
Chai Hu Shu Gan San

SYRUP FOR HYPOCHONDRIAC MELANCHOLY
Syrup of Dodder
Syrup of Violet 1 oz. each
Syrup of Borage
Byzantine Syrup
(without Vinegar) 1 ½ oz. each
DECOCTION FOR HYPOCHONDRIAC MELANCHOLY
Borage root 1 ½ oz.
Centaury
Pennyroyal 1 ½ handful each
Aniseed
Fennel seed 3 drams each
Raisins 1 ½ oz.
Senna
Polypody 1 oz. each
Dodder ½ oz.
DECOCTION:
Mercury leaf
Mallows
Pennyroyal
Elder flower
Camomile
Melilot
Centaury the less 1 handful each
Broom 1 ½ handfuls
Beet leaf
Cabbage
Hops ½ handful each
Dodder 1 handful
Aniseed
Fennel seed
Safflower 6 drams each
Polypody ½ oz.
Senna 1 oz.
Dodder 5 drams
Form a decoction.
ELECTUARY
Darrhodon abbatis 2 scruples
Rosata Novellae
Aromaticum rosatum 1 scruple each
Bugloss flowers 1 ½ scruple
Orange peel 1 dram
Aniseed 3 drams
Sugar of Violet
Sugar of Rose
Conserve of Bugloss roots, 1 oz. each
With sufficient syrup of the juice of Borage, form an Electuary. (Praxis medicinæ, Bruele, 1632)

Hypochondriac Melancholy