Melancholic

Black bile is the strangest of the four. Blood, yellow bile and phlegm each correspond to something a physician could point at; black bile does not. It was assigned a seat in the spleen and held to be cold and dry, which places it with earth among the elements, with autumn among the seasons, and with maturity among the ages of life, but no fluid answering the description was ever produced.

The doctrine survived the difficulty for two millennia because it explained too much to be given up. An excess of a cold dry humour accounted for the settled, heavy, fearful and sorrowful states that had no obvious external cause, and it did so inside the same framework that explained fevers and catarrhs, which is a considerable economy. Darkened blood and the residues of certain diseases were pressed into service as evidence, but the humour was in practice inferred from the condition it had been invoked to explain.

That circularity is worth stating plainly, because it is the clearest single case in the scheme of a category kept for its usefulness rather than for its evidence. The temperament built on it, however, was described with real observational care, and the accounts the older writers give of the melancholic habit, its wakefulness, its fixity of attention and its dread without an object, remain recognisable to anyone reading them now.

Alone among the four, the melancholic complexion acquired a prestige that had nothing to do with health. A problem text transmitted under Aristotle's name asks why it should be that all men who have become outstanding in philosophy, poetry or the arts are melancholic, and the question, together with the assumption inside it, was taken up with enthusiasm in Renaissance Italy. Marsilio Ficino, who was both a physician and a Platonist, developed the connection at length and tied it to Saturn, the planet astrological medicine already assigned to the cold dry complexion.

The result was a temperament that was at once an affliction and a mark of distinction. Albrecht Dürer's engraving of 1514, in which a winged figure sits surrounded by unused instruments of measurement, is the best known image of that double sense: the melancholic is the one who sees furthest and acts least. Robert Burton's enormous Anatomy of Melancholy, first published in 1621, catalogues the condition, its causes and its cures across more than a thousand pages, and reads as often like a literary work as a medical one.

What English kept is the mood without the physiology. Melancholy now names a kind of sadness, usually a gentle and reflective one, and the older sense of a bodily state with a bodily cause has gone entirely, taking with it the claim that the same state disposes a person to genius.