ἢν δὲ καὶ κεφαλὴν ἐς ξυμπαθείην ἄγῃ, καὶ ἀμείβεται τὸ παράλογον τῆς ὀξυθυμίης ἐς γέλωτα καὶ ἡδονὴν ἐς τὰ πολλὰ τοῦ βίου, οἱ δὲ μαίνονται αὔξῃ τῆς νούσου μᾶλλον ἢ ἀλλαγῇ πάθεος.
Ἐπ’ ἀμφοῖν δὲ ξηρότης αἰτίη. ἄνδρες μὲν οὖν μαίνονται καὶ μελαγχολῶσι, ἢ καὶ ἀνδρῶν ἐλάσσους· κάκιον δὲ ἀνδρῶν αἱ γυναῖκες ἐκμαίνονται· ἡλικίη, πρὸς ἀκμὴν, καὶ οἱ ἀκμάζοντες· ὥρη θέρος μὲν καὶ φθινόπωρον τίκτει, ἔαρ δὲ κρίνει.
Τεκμήρια μὲν οὖν οὐκ ἄσημα. ἢ γὰρ ἥσυχοι, ἢ στυγνοὶ, κατηφέες, νωθροὶ ἔασι ἀλόγως, οὔ τινι ἐπ’ αἰτίῃ, μελαγχολίης ἀρχή. ἔτι δὲ καὶ ὀργίλοι προσγίγνονται, δύσθυμοι, ἄγρυπνοι, ἐκ τῶν ὕπνων ἐκθορυβούμενοι.
Ἔχει δὲ αὐτέους καὶ τάρβος ἔκτοπον, ἢν ἐς αὔξησιν τὸ νόσημα φοιτῇ, εὖτε καὶ ὄνειροι ἀληθέες, δειματώδεες, ἐναργέες. ὁκόσα γὰρ ὑπὰρ ἐκτρέπονται ὁποίου ὦν κακοῦ, τάδε ἐνύπνιον ὁρέουσι ὥρμησε· πρὸς τὸ ῥηΐδιον μεταγνῶναι εὔκολοι, αἰσχροὶ, σμικρολόγοι, ἄδωροι, καὶ μετ’ οὐ πολὺ ἁπλοῖ, ἄσωτοι, πολύδωροι, οὐκ ἀρετῇ ψυχῆς, ἀλλὰ ποικιλίῃ νοσήματος· ἢν δὲ ἐπὶ μᾶλλον τὸ κακὸν πιέζῃ, μῖσος, φυγανθρωπίη, ὀλόφυρσοι ἐς κενεὰ, ζωῆς κακήγοροι· ἔρανται δὲ θανάτου. πολλοῖσι δὲ ἐς ἀναισθησίην καὶ μώρωσιν ἡ γνώμη ῥέπει, ὄκως ἀγνῶτες ἁπάντων, ἢ ἐπιλήσμονες ἑωυτέων, βίον ζώωσι ζωώδεα· ξυντρέπεται δὲ καὶ τοῦ σκήνεος ἐς πονηρὸν ἡ ἕξις· χροιὴ μελάγχλωρος, ἢν μὴ διεξίῃ κάτω ἡ χολὴ, ἀλλὰ ἀναχέηται ξὺν τῷ αἵματι ἐς τὸ πᾶν· βοροὶ μὲν, ἰσχνοὶ δέ· ὕπνος γὰρ αὐτέοισι τε πόσει οὔτε βρωτῷ συγκρατέει τὰ μέλεα· ἀγρυπνίη δὲ σκίδνησι ἐς τὴν ἔξω φορήν· τοιγαρο ῦν κοιλίη ξηρὴ οὐδὲν διεῖσα. ἢν δέ κοτε ἐκδιδῷ, ξηρὰ, στρογγύλα, ξὺν περιρρόῳ μέλανι, χολώδεα, οὖρα σμικρὰ, δριμέα,
χολόβαφα· φυσώδεες καθ’ ὑποχόνδριον, ἐρυγαὶ κακώδεες, βρωμώδεες, ὡς ἐξ ἁλὸς ὀρυγμίη· ἀνέπλω κοτὲ καὶ ὑγρὸν δριμὺ ξὺν χολῇ. σφυγμοὶ ὡς ἐπίπαν σμικροὶ, νωθροὶ, ἀδρανέες, πυκνοὶ, ἴκελοι τῷ ψύχεϊ.
Λόγος ὅτι τῶν τοιῶνδέ τις ἀνηκέστως ἔχων, κούρης ἤρα τε καὶ τῶν ἰητρῶν οὐδὲν ὠφελούν των , ὁ ἔρως μιν ἰήσατο· δοκέω δ’ ἔγωγε ἐρᾶν μὲν αὐτὸν ἀρχῆθεν, κατηφέα δὲ καὶ δύσθυμον ὑπ’ ἀτυχίης τῆς κούρης ἔμμεναι, καὶ μελαγχολικὸν δοκέειν τοῖσι δημότῃσιν· οὗτος οὔτε μὴν ἦν ἔρωτα ἐγγιγνώσκων· ἐπεὶ δὲ τὴν ἔρωτα ξυνῆψε τῇ κούρῃ, παύεται τῆς κατηφείης, καὶ διασκίδνησι ὀργήν τε καὶ λύπην, χάρμῃ δὲ ἐξένηψε τῆς δυσθυμίης· καθίσταται γὰρ τὴν γνώμην ἔρωτι ἰητρῷ.
But if it also affects the head from sympathy, and the abnormal irritability of temper change to laughter and joy for the greater part of their life, these become mad rather from the increase of the disease than from change of the affection.
Dryness is the cause of both. Adult men, therefore, are subject to mania and melancholy, or persons of less age than adults. Women are worse affected with mania than men. As to age, towards manhood, and those actually in the prime of life. The seasons of summer and of autumn engender, and spring brings it to a crisis.
The characteristic appearances, then, are not obscure; for the patients are dull or stern, dejected or unreasonably torpid, without any manifest cause: such is the commencement of melancholy. And they also become peevish, dispirited, sleepless, and start up from a disturbed sleep.
Unreasonable fear also seizes them, if the disease tend to increase, when their dreams are true, terrifying, and clear:
for whatever, when awake, they have an aversion to, as being an evil, rushes upon their visions in sleep. They are prone to change their mind readily; to become base, mean-spirited, illiberal, and in a little time, perhaps, simple, extravagant, munificent, not from any virtue of the soul, but from the changeableness of the disease. But if the illness become more urgent, hatred, avoidance of the haunts of men, vain lamentations; they complain of life, and desire to die. In many, the understanding so leads to insensibility and fatuousness, that they become ignorant of all things, or forgetful of themselves, and live the life of the inferior animals. The habit of the body also becomes perverted; colour, a darkish-green, unless the bile do not pass downward, but is diffused with the blood over the whole system. They are voracious, indeed, yet emaciated; for in them sleep does not brace their limbs either by what they have eaten or drunk, but watchfulness diffuses and determines them outwardly. Therefore the bowels are dried up, and discharge nothing; or, if they do, the dejections are dried, round, with a black and bilious fluid, in which they float; urine scanty, acrid, tinged with bile. They are flatulent about the hypochondriac region; the eructations fetid, virulent, like brine from salt; and sometimes an acrid fluid, mixed with bile, floats in the stomach. Pulse for the most part small, torpid, feeble, dense, like that from cold.
A story is told, that a certain person, incurably affected, fell in love with a girl; and when the physicians could bring him no relief, love cured him. But I think that he was originally in love, and that he was dejected and spiritless from being unsuccessful with the girl, and appeared to the common people to be melancholic. He then did not know that it was love; but when he imparted the love to the girl, he ceased from his dejection, and dispelled his passion and sorrow; and with joy he awoke from his lowness of spirits, and he became restored to understanding, love being his physician.