The language of melancholia and mania
One of the most interesting fields to develop and amplify our knowledge of the world is the dialog with the texts of the past, with the history of ideas that remain contemporary. The interpretation of classic Latin texts could be a source of experience, a hermeneutic pathway to understand the cultural loading of concepts (as melancholia). Notions that we are tempted to face as objective, easily accessible and measurable; this bias takes place in psychiatry mainly in the so called a-theoretic pragmatism that underlies the ordering and classification of pseudo-objective categories (psychic and behavioural) into nosologic entities. In fact, there is an essential part of our representations whose source is not the immediate experience similar to the objects of the material world. Its nature is related with the method or process of apprehension used by the observer. It is a reality that is not formed by objective facts or data but of subjective, inner and intimate phenomena, changing with the perspective of the subject of knowledge, depending of the cultural and historical moment. Our knowledge is embedded in a process of transformation of meanings carried out through language, instrument of communication which helps us to reconstruct and define the objectivity, to find the substantiality of images. Bringing to light classic texts give us the possibility of finding interpretative schemes of past phenomena converted into words in a form of metaphoric thought. In this regard the book “The Figures of Melancholia and Mania” edited by Mario Di Fiorino and Mirko Martinucci is exemplar. Trough its pages one will be transported to the variety of conceptions and beliefs associated with temperament, melancholia (depression) and mania. Fundamental questions could then be raised.
Could we grasp the several meanings the concepts of melancholia and mania assumed through the history of ideas? How can we be aware of the complexity recovered by these terms? The history of the ideas and believes underling the metaphoric figures of melancholia and mania is not linear. The man’s attitude and position facing the destiny, the natural world, the loss and the dead gives some clues to approach the multiplicities of interpretations attributed to these terms.
Particularly the term melancholia is a repository of knowledge. It was used in so many contexts after its origin as an equivalent of a state reflecting the natural laws and regularities of nature, consequence of a disequilibrium of internal fluids or humours that is virtually impossible to follow. One can quote an interesting but vague synthesis: “La dépression, terme qui recouvre aujourd’hui celui de mélancolie, n’est que la patine d’un monument vieux de plus de deux mille ans, auquel chaque époque a apporté sa pierre. Ce qu’est la mélancolie, et qui affleure encore sous la persistance du mot, évoque une réalité complexe qui seule l’histoire du mot et des différents sens qu’il a successivement pris éclaire » (H. Prigent).
Just a single example of the complexity of the hermeneutic approach to the language used in relation with melancholia. The latter term, formed by the association of two Greek terms: kholê (bile) and mêlas (black) means literally “black bile”. What transitions and changes suffered since its use by Hippocrates in a naturalist medical perspective? This term refers a real substance or it has a metaphoric sense? In fact, “black bile” is a concept with an irrational content beyond its apparent realism within the humorous theory. Its physical qualities and moral power are a “postulat de l’imagination” (J. Starobinsky). It has an existence more dreamed than observed. The black colour represents the force and evil characters of the “bile” that is equivalent to rage, grief, despair, discouragement. The word “black” preserved some of its qualities in the negative and shady meaning on the sentence “black days” in reference to depressive mood or “to have black ideas” as equivalent to pessimism. It is more a noun that carries the properties of an evil darkness than a real substance. The metaphoric meaning of “black bile” is visible in Aristotle for whom it is an instable mixture of “cold” and “hot”. Galen considered it as a potent “acid” with a corrosive power of attacking the earth and producing a toxic steam that will affect the brain leading to a melancholic state. The examples could be multiplied but it will be beyond the scope of this introduction.
Even with a creative approach to the successive meanings of the words used for melancholia its role in the moral, theological or mechanistic theories is an immense intellectual challenge. Its intelligent understanding is one of the objectives of the texts written and compiled by the editors. It is a book on the cultural basis of our present and sometimes unaware use of psychiatric terminology. It is also a very informative book on our Latin roots with precious unpublished texts.
Since the beginning of history we can trace the roots of melancholia and mania. It is a fascinating “parcours” through the human spirit that this book offers to us.
Professor Maria Luísa Figueira
Chief of Department of Psychiatry
Faculty of Medicine of the University of Lisbon