Burton’s ability to locate real ties between philosophy and medicine, and between science and metaphysics, started us on the path to a unifying theory of mind and matter. And yet one cannot credit Burton so much with reconciling conflicting views as with tolerating their contradictions; he is quite capable of giving six discrepant explanations for a single phenomenon without ever suggesting that the phenomenon might be overdetermined. To the modern reader, this sometimes seems bizarre; but the same reader, examining texts recently issued by the National Institute of Mental Health, will find that the complexity of depressive complaints lies precisely in that they are usually overdetermined—that depression is the common destination to which many pathways lead, and that in any individual, a certain set of symptoms may be the result of one or any several of these pathways.

Burton comes up with a physical explanation for melancholy: “our body is like a Clocke, if one wheele be amisse, all the rest are disordered, the whole Fabricke suffers.” He acknowledges that “as the Philosophers make eight degrees of heat and cold: we may make 88 of Melancholy, as the parties affected are diversely seized with it, or have been plunged more or lesse into this infernall gulfe.” Later he says, “Proteus himself is not so diverse; you may as well make the Moona new coat, as a true character of a melancholy man; as soon find the motion of a brin in the air as the heart of a melancholy man.” Burton makes a general distinction among brain-based “head melancholy,” “whole body melancholy,” and that which comes from the “Bowels, Liver, Spleene, or Membrane,” which he calls “windie melancholy.” These he then divides and subdivides, creating a map of distress.

Burton distinguishes melancholy from simply being “dull, sad, sowre, lumpish, ill disposed, solitary, any way moved, or displeased.” Such qualities, he says, are within the scope of any man alive and should not by themselves be taken as evidence of the complaint. “Man that is borne of a woman,” he says, quoting the Book of Common Prayer,“is of short continuance and full of trouble.” This does not mean that we are all melancholiacs. Indeed Burton says, “These miseries encompasse our life. And ’tis most absurd and ridiculous for any mortall man to looke for a perpetuall tenor of happinesse in this life. Nothing so preposterous, and he that knowes not this, and is not armed to indure it, is not fit to live in this world. Get thee hence, if thou canst not brook it, there is no way to avoid it, but to arme thy self with magnamitie, to oppose thyself unto it, to suffer affliction, constantly to bear it.”

You cannot live in the world unless you can tolerate misfortune, and misfortune comes to us all; but misfortune easily runs out of control. While a simple cough is tolerable, “continual and inveterate causeth a consumption of the lungs; so doe these our Melancholy provocations.” And Burton identifies the very modern principle that everyone has a different level of tolerance for trauma, and that it is the interaction of the quantity of trauma and the level of tolerance that determines illness. “For that which is but a flea-biting to one, causeth insufferable torment to another, & which one by his singular moderation, & well composed carriage can happily overcome, a second is no whit able to sustaine, but upon every small occasion of misconceived abuse, injurie, griefe, disgrace, losse, crosse, rumor, &c. yeelds so farre to passion, that his complexion is altered, his digestion hindered, his sleepe gone, his spirits obscured, and his heart heavy . . . and he himselfe overcome with Melancholy. And as it is with a man imprisoned for debt, if once in the gaole, every Creditor will bring his action against him, and there likely to hold him: If any discontent sease upon a patient, in an instant all other perturbations will set upon him, and then like a lame dogge or broken winged goose hee droopes and pines away, and is brought at last to that malady of melancholy it selfe.” Burton recapitulates the experience of anxiety as well, correctly including it in his description of depression: “In the daytime they are affrighted still by some terrible object, and torne in pieces with suspicion, feare, sorrow, discountents, cares, shames, anguish, &c., as so many wild horses, that they cannot be quiet an houre, a minute of the time.”

Burton describes melancholiacs variously as “distrustful, envious, malicious,” “covetous,” “repining, discontent,” and “prone to revenge.” The selfsame Burton writes that “melancholy men of all others are most witty, and [their melancholic disposition] causeth many times divine ravishment, and a kind of enthusiasmus. . . which causeth them to be excellent Philosophers, Poets, Prophets, &c.” He defers to the censors of his time by addressing the religious issues around the illness in a tactful fashion—but he also asserts that excessive religious enthusiasm can be a sign of melancholy or can engender mad despair; and he affirms that sad people who receive from God scary commands to which they feel inadequate are probably experiencing melancholy delusions. And he says, finally, that melancholy is really an illness of both body and soul, but then, like Du Laurens, avoids suggesting any loss of reason (which render his subjects inhuman and therefore animal) by saying that illness is a “default of the Imagination” rather than of reason itself.

Burton classifies the then current treatments for depression. There were the illegal ones “from the Divel, Magicians, Witches, &c., by charmes, spels, incantations, Images, &c.,” and the legal ones, “immediately from Goda Jove principium, metiatelly by Nature, which concernes & works by 1Physician;2. Patient;3. Physicke.” Though he rambles through dozens of categories of treatment, he does in the end say that the “chiefest” consists in trying to address directly the “passions and perturbations of the mind,” and he commends “opening up” to friends and seeking out “mirth, music, and merry company.” He recommends his own catalog of treatments: marigold, dandelion, ash, willow, tamarisk, roses, violets, sweet apples, wine, tobacco, syrup of poppy, featherfew, Saint-John’s-wort if “gathered on a Friday in the hour of Jupiter,” and the wearing of a ring made from the right forefoot of an ass.

Solomon

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.

Du Laurens is perhaps best known for his complicated idea that people see backward: that their eyes roll inward and look at their brain. He fails to make clear what rainbow spectacular the cheery individual might find when he looks backward into his brain, but he does stipulate that, since the brain of the melancholic is suffused with black bile, the eyes of the melancholic, when they roll backward, see darkness everywhere. “The spirits and blacke vapours continually passe by the sinews, veines and arteries, from the braine unto the eye, which causeth it to see many shadows and untrue apparitions in the aire, whereupon from the eye the formes thereof are conveyed unto the imagination.” Then the unpleasantness really gets going, these black visions continuing to flash on the eye even when it is directed at the outside world, and the melancholic sees “many bodies flying, like to Ants, flyes, and long haires, the same also does such as are readie to vomit.”

Solomon

This passage develops one of Robert Burton’s most strikingly modern insights: depression is not caused by one thing. As Andrew Solomon explains, Burton does not truly reconcile competing explanations for melancholy so much as allow many explanations to coexist. What initially appears intellectually chaotic begins to resemble modern psychiatry’s idea of “overdetermination” — the recognition that depression can arise from multiple interacting causes at once: biological, psychological, social, and existential.

Burton’s “clock” metaphor is especially important:

“our body is like a Clocke, if one wheele be amisse, all the rest are disordered”

This anticipates systems thinking in medicine. Emotional suffering is not isolated in one faculty; disturbance in one part of the human organism affects the whole. Solomon emphasizes that Burton repeatedly refuses simple categorization. Melancholy has “88” forms because individuals experience distress differently. Burton’s comparison to Proteus — the shape-shifting sea god — suggests that melancholy constantly changes form and resists stable definition.

Burton’s subdivisions (“head melancholy,” bodily melancholy, “windie melancholy”) now sound medically obsolete, but the underlying impulse is recognizable: he is trying to map different symptom clusters and etiologies. In effect, he is building an early taxonomy of mental illness.

The next major theme is the distinction between ordinary sadness and pathological depression. Burton insists that suffering is universal:

“Man that is borne of a woman… is of short continuance and full of trouble.”

But ordinary sorrow is not itself disease. This is psychologically sophisticated. Burton rejects the fantasy of permanent happiness and argues that resilience — “magnamitie” — is necessary for life. In modern terms, he distinguishes:

• normal emotional pain,
• chronic dysregulated suffering,
• and clinical collapse.

The cough analogy is crucial:

a simple cough is tolerable, but continual coughing becomes consumption.

Likewise, ordinary grief or stress can accumulate until it overwhelms the system. Solomon highlights Burton’s proto-modern understanding of stress vulnerability: people possess different tolerances for adversity. What devastates one person may scarcely trouble another. This anticipates contemporary ideas about:

• stress thresholds,
• resilience,
• trauma sensitivity,
• vulnerability factors,
• and the diathesis-stress model in psychology.

Burton also captures the cascading nature of depression and anxiety. Once destabilized, the sufferer becomes vulnerable to everything:

“every Creditor will bring his action against him”

That metaphor resembles modern accounts of depressive spirals, where sleep disruption, anxiety, shame, physical exhaustion, social withdrawal, and cognitive distortions reinforce one another.

His description of anxiety is remarkably contemporary:

• constant dread,
• hypervigilance,
• racing thoughts,
• inability to rest,
• bodily agitation,
• fear without relief.

The “wild horses” image vividly conveys what modern clinicians would call anxious rumination or autonomic overactivation.

What makes Burton enduringly compelling is not that his medical theories were scientifically correct in detail; many were not. It is that he observed human suffering with extraordinary psychological precision. Solomon’s argument is that Burton’s genius lies in recognizing complexity before modern medicine possessed the tools to explain it formally.

Here André du Laurens appears as another transitional thinker in the history of depression — suspended between medieval humoral medicine, religious doctrine, and something approaching psychological observation. Andrew Solomon presents him as important not because his physiology was correct, but because his framework helped preserve the humanity of mentally ill people.

Du Laurens still accepts the classical humoral model:

melancholy is “a cold and drie distemperature of the brain”

That means depression is tied to black bile and bodily imbalance. Yet he simultaneously argues that melancholy may arise not merely from bodily constitution but from:

• lifestyle,
• habits,
• intellectual pursuits,
• and obsessive study.

This is a major shift toward psychological and environmental causation. Melancholy becomes not only a bodily disease but a condition shaped by how one lives and thinks.

His division of the mind into:

• reason,
• imagination,
• memory

is especially significant. By locating melancholy in the imagination rather than in reason itself, Du Laurens preserves the melancholic person’s rational soul. In the religious context of early modern Europe, this mattered enormously. If reason remained intact, then the sufferer was not spiritually annihilated, not wholly mad, and not excluded from moral humanity. Solomon suggests this distinction helped create space for compassion rather than condemnation.

Du Laurens also recognizes gradations of illness. Some “melancholike constitutions” remain within healthy bounds, while others become pathological. This anticipates modern spectrum thinking:

• temperament versus disorder,
• personality traits versus clinical illness,
• sadness versus incapacitating depression.

The anecdote about the Sienese gentleman is fascinating because it dramatizes delusional anxiety. The man believes urinating will drown the town, so he physically restrains himself despite the danger to his own body. The physicians cure him not by arguing logically but by entering the structure of his delusion and redirecting it:

• if urinating destroys the town, then not urinating will destroy it first through fire;
• therefore urinating becomes heroic rather than catastrophic.

This resembles modern therapeutic insight into symbolic thinking and irrational fears. The patient’s anxiety centers on exaggerated responsibility and imagined destructiveness — themes still recognizable in severe anxiety disorders and depression.

The second half of the passage shows the strange mixture of imaginative speculation and proto-neurology characteristic of the period. Du Laurens’ theory that people “see backward” into the brain sounds bizarre now, but symbolically it is revealing. The melancholic literally perceives the world through inner darkness. External reality becomes contaminated by internal suffering.

His description:

• shadows,
• apparitions,
• floating forms,
• insects and hairs in the air,

mixes physiological speculation with phenomenological observation. Some of these experiences may correspond to:

• visual distortions,
• migraine aura,
• eye floaters,
• anxiety-related perceptual disturbances,
• or depressive derealization.

What matters to Solomon is not whether Du Laurens understood optics correctly. It is that he grasped a profound psychological truth: depression alters perception itself. The melancholic does not merely think differently; he experiences reality as darkened, haunted, and threatening. The world becomes an extension of inward suffering.