André du Laurens stated that melancholy was “a cold and drie distemperature of the brain” that could proceed “not of the disposition of the bodie,” but of patients’ “manner of living, and of such studies as they bee most addicted unto.” Du Laurens divided up the mind into three parts: reason, imagination, and memory. Concluding that melancholia was an illness of imagination, he left to the melancholic an intact reason, which meant that in the eyes of the Church the melancholic was not deprived of his humanity (his “immortal rational soul”) and was therefore not cursed by God. He took on board the idea that melancholy can come in degrees, separating “melancholike constitutions which keep within the bounds and limits of health” from the ones that did not keep within those bounds. Like most other writers on the subject, his book is full of anecdotal descriptions of individuals, including “one Sienois a Gentleman, who had resolved with himselfe not to pisse, but to dye rather, and that because he imagined that when he first pissed, all his towne would be drowned.” The man was apparently paralyzed with a depressive anxiety and a sense of his own destructiveness and was causing trauma to his bladder; eventually, his physicians built a fire next door, persuaded the man that the town was burning down and that only by his relieving himself could he save it, and so brought him through this particular anxiety. 

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This is a fascinating snippet of medical history! André du Laurens (a prominent French physician who lived from 1558 to 1609) was deeply influential in shaping how the early modern world understood mental illness.

His work captures a brilliant, pivotal moment where Renaissance medicine was trying to balance strict religious doctrine with practical, psychological treatment.

A few things stand out as incredibly modern about his approach, despite the 400-year-old terminology:

The Early Modern "Bio-Psycho-Social" Model

Du Laurens was pushing back against the idea that your mental state is purely determined by the physical "humors" you were born with. By pointing to a patient's "manner of living, and of such studies as they bee most addicted unto," he was essentially identifying burnout and environmental stress. He recognized that obsessively studying or living an isolated lifestyle could physically alter the brain's state—turning it "cold and dry."

Saving the Soul via the Imagination

His division of the mind was a brilliant tactical move in the eyes of the Church:

• Memory & Reason: Intact.

• Imagination: Damaged / Glitched.

By framing melancholia as a disease of the imagination rather than a loss of reason, he protected his patients from being labeled as subhuman, demon-possessed, or cursed by God. If a person still had their "immortal rational soul," they retained their humanity, dignity, and right to care.

Meeting the Patient in Their Reality

The anecdote about the gentleman from Siena who wouldn't urinate is a classic example of "beguiling the patient"—a common therapeutic tactic at the time.

Rather than arguing with the man's delusion or trying to logically prove that his bladder couldn't drown a town (which rarely works with deep-seated anxiety), the doctors accepted the "rules" of his delusion. By inventing a fire, they reframed his act of urinating not as a destructive force, but as a heroic, town-saving necessity. They used his own sense of responsibility to cure his physical ailment.

It shows that even back then, effective physicians understood that you sometimes have to enter a patient's world to help them find a way out of it.