Necromancer's Disease

Nevertheless, the reference that needs further explanation is Galen's citation, because, in fact, it does not match any of his texts directly but is derived from a contamination of Galen's classification of melancholy exposed in De interioribus caused by the Latin-Arabic medical tradition.

The departure point is the division into three types of melancholy discussed in Galen's De interioribus: one form of melancholy spreads throughout the body and passes into the brain, another one only affects the brain (encephalic), gen­erated in the same or in another organ, and a third one, called flatulent dis­ease or hypochondriac, originated in the upper abdomen or hypochondria.¹² This categorization became canonical among the medical authors of late Antiquity and the Arabic and Latin Middle Ages. Ibn ‘Imran and Constantine reproduce the same classification without explicitly citing Galend³ But what is its origin? We do not know for certain, but it seems to have precedents in previous authors such as Aretaeus of Cappadocia, who might have lived in the mid first century or around 120 AD, and Rufus of Ephesus, who probably lived during Trajan's rule. Aretaeus already considered two kinds of melancholy: one caused in the hypochondria and another one passing into the head by sympathy.1⁴ This distinction established by Aretaeus is not indicated as a prec­edent of Galen's in the literature that I have consulted, but it clearly is in my view.

12 “Sed illud demum determinare prius necessarium mihi esse videtur quod derelictum est a medicis, quemadmodum enim et in partibus corporis que apparent quandoque quidem omnibus eadem apparet crasis [...], quandoque vero una aliqua particula aut colericum aut flegmaticum aut melancolicum suscipiens humorem, ipsa sola exalteratur crasi. Ita contingere potest et cerebrum quandoque verso qui secundum venas sanguine melancolico facto communi ratione nocumenti et ipsum noceri. Secundum alium vero modum impassibili permanente sanguine, qui secundum totum hominem et alteratur qui secundum cerebrum solum et contingere hic dicitur vel melancolico humore fluente in id aliunde vel generato in illo loco; generatur autem a calore multiplicato locali super coquentem aut calefactam coleram aut crassiorem et nigriorem sanguinem. Differunt autem ad curam no parum determinatio hec [...]. Item tertia melancolie [corr. manie] species est que fit propter stomacum, sicut epilentia que fit propter stomacum, quam quidem medici vocant lateralem aut inflativam”, De interioribus, 3, 7, Galen, in Opera, 2, [i25vb-i26ra] (=Kuhn, 8, 181-186). I use the “hypocondriac” of the Greek text, although in this Arabic-Latin version it is replaced by “lateral”, because Constantine and other medi­eval authors do employ it.

13 “Melancolica igitur passio triplex est: alia enim est in ore stomachi et hypocondriis, alia in cerebro, in quo duae sunt considerandae: aut enim in essentia cerebri, aut in toto cor­pore, quae a pedibus ad cerebrum solet ascendere. In essentia cerebri vel est cum acuta febre, quod plurimum fit in phrenesi”, Constantine, De melancholia, p. 107, cf. the German translation of Ibn ‘Imran’s Maqalafil-malthuliya, pp. 17-18 in the same volume.

14 111, 5, 4, Aretaeus, p.

by other authors, although it became the main source of the Arabic discus­sions on this disease. Another cause for such uncertainty is given in a quota­tion of Rufus by Ibn ‘Imran, according to which the Greek physician focused solely on the hypochondriac type, since he felt that such an approach was suf­ficient for a skilled physician to find out the description and therapeutics con­cerning the other two types of melancholy.^{[767] [768] Even though he does not mention what the other two are in the extant text, the recognition of a threefold divi­sion has been seen by some scholars as proof that Rufus was already consider­ing the classification later discussed by Galend6}

What concerns us, however, are some ideas regarding the first of the above­mentioned species of melancholy. This is Ibn ‘Imran's text:

We have seen how this kind of melancholy that ascends from the lower body into the brain, when it occurs, is hidden and occult. Only one com­mentator among physicians reports it for two reasons: one is the diversity of human temperaments according to their nature and the other is that the experience with human temperaments can only achieve an indisput­able solidity thanks to a longer time spent with the patient and more frequent visits after numerous examinations and revisions. Regarding the knowledge of human nature, the humoral complexion and structure, experience with the patient's normal state offers considerable help in exploring him and seeking a medical treatment for him. For, when the physician knows the predisposition of the person while he is healthy, he is able to distinguish the onset of the disease in the moment, as well as the severity of the damage suffered in his soul and his body. [...]

[F5] We noticed that Rufus, the physician who composed the book On Melancholy, discussed the symptoms and incidents occurring to melan­cholics at great length in the first treatise. Finally, after he discussed at great length the things which occur to each single one of those suffering from melancholy, he said (having cut short his discussion): ‘In this trea­tise of ours, we have just listed in a reliable fashion the symptoms occur­ring in melancholics, so that, if the reader understands our book well, he will even be able to comprehend all those symptoms present in those suffering from this disease which we have not mentioned in this work.'

By saying this, Rufus, the physician, indicated that the symptoms of this disease can hardly be ascertained or elucidated to their full extent. This is the case not because the symptoms of melancholy, when they dominate the body, are hidden. Rather, the way in which the soul is affected is hidden, because the substance of the soul is concealed and difficult to perceive and it is unclear how one arrives at a knowledge of the choices of the soul, and how one comes to measure whether the soul's thought is good or bad, whether the imagination is sound or not, whether the memory is strong or weak, and, in general, whether the intellect urges something on, is opposed to it, or fails in it. The situation is similar as concerns the soul's character traits and their diversity in it. All this is subject to disagreement and diverse opinions, since even intelligent physicians are at a loss, and do not have knowledge of this illness with all its different symptoms.^{[769] [770]}

Therefore, Ibn ‘Imran explicitly stresses the difficulty faced by physicians when diagnosing the kind of melancholy that ascends from the lower body into the brain. He gives a quotation from Rufus' treatise as support for his discussion, but it seems to me that Rufus' words are interpreted by the author in an abu­sive way in order to turn them to his advantage. He perhaps (this is not very clear in the text) generalizes the indicated difficulty to melancholy in general. In fact, in another passage, transmitted by Rhazes, Rufus does clearly warn of the possibility that melancholy goes unnoticed during its early stages if the physician is not skilled enough to detect its signs immediately?⁸ In any case, Rufus must mean the hypochondriac kind, the only one he discusses, and not that rising from the lower body, to which Ibn ‘Imran refers.

When compared, Constantine’s version is shorter and introduces significant differences in meaning, which are indicated in italics in this particular passage:

This kind of melancholy and the other one that ascends from the lower body into the brain, when they are fully developed, are very hidden and obscure. Thus, with these words Rufus manifests that melancholic symp­toms are imperceptible. The reason for such imperceptibility is that mel­ancholy, when it has dominated the body, is hidden. Likewise passions of the soul are hidden because of the imperceptibility of their essence and the difficulty of them being found.^{[771] [772]}

If we compare Ibn ‘Imran’s text with the version of it given by Constantine, it becomes clear that the latter is the source for qualifying some of the three types of melancholy as ‘hidden’. Constantine first transforms the varieties of melancholy that “are very hidden and obscure” into two, whereas Ibn ‘Imran only refers to the kind “that ascends from the lower body into the brain” or maybe to melancholy in general. In fact, Constantine’s text also seems to only be discussing this type and, in my view, the sudden duplication should be considered a simple mistake. Secondly, whereas the discovery of the accidents or symptoms of melancholy in Ibn ‘Imran’s text is described as extraordinarily difficult, in Constantine’s version it is an impossibility: the symptoms (acciden­tia) become imperceptible (incomprehensibilia) and the melancholy hidden (occulta est) in the absolute sense, without any nuance.

The Constantinian origin of Arnau’s reference to “hidden species of mel­ancholy” is therefore clear. Moreover, it becomes evident that in the previ­ous parts of De reprobacione terms such as vesania or alienatio are not used generically, with a “low level of medical language”,^{[773] [774] [775] as they were used by other detractors of necromancy such as William of Auvergne and Roger Bacon: William blames the insanity (vesania) of magicians and astrologers, which leads them to believe that they perform their marvelous works in virtue of God’s name; likewise Bacon denounces “the dementia of false astrologers” several times.21 However, there is no doubt that such terms are employed in Arnau’s epistle with the technical precision of a professional physician. This can be observed in his Pars operativa, when Arnau enumerates the kinds of mental alienation according to the patient’s damaged operations, simple if the operations of only one faculty of the brain are affected, and composite if more than one. In the simple category, the alienation that solely affects the rational faculty (estimatio) is properly called vesania or insania.22 This is the case with necromancer’s melancholy, as seen. Of course, we have seen another name employed in Arnau’s epistle: melancolia. This is not contradictory with the previous name, because it is due to the cause of this disorder: melancholic humor, harming either the rational faculty (vesania) or another faculty.[776] [777] [778] [779]}

However, despite finding the real origin of Arnau's reference, the problems are not over. We still have two questions to answer. Firstly, why does he quote the species of melancholy under Galen's name? We can only speculate. As far I can see, there are three possible reasons:

It may be a simple mistake, perhaps due to the circumstances in which De reprobacione seems to have been written, while the author was far from his library and therefore forced to quote from memory. Maybe he was confused because the modalities of melancholy were discussed in the third book of De interioribus, a treatise that Arnau knew or would know perfectly well in the future because years later he would write a summary of the first two books?⁴

The ascription to Galen could also be explained by the possible circula­tion of De melancholia under his name. This false attribution is demonstrated by William of Auvergne, when he claims to base his discussion of religious melancholy on Galen's De melancholia, although this disease is dealt with in Constantine's treatise, and not in any of Galen's works?⁵

Finally, we can also note that Constantine's name is hardly ever mentioned by Arnau (or Bernard of Gordon), even though he uses him as a source, prob­ably due to the poor reputation of his versions and work among medieval phy­sicians or to his reluctance to mention medieval Latin authors?⁶

The second problem is how Arnau explains “the hidden species of melan­choly”. In fact, as we have seen in other medical authorities (and unlike what Arnau affirms in his epistle), Constantine never states, anywhere, that the only symptom of any of the kinds of melancholy is injury to reason. On the contrary, the African provides a list of the general symptoms (accidentia) of melancholy, including fear, and the particular symptoms of each type of this disease.^[780] In fact, Arnau himself does not include any hidden species of melancholy in his late Pars operativa when he discusses this disease, characterized with the symptoms of “irrational fear and anxiety”?^[781] Such disagreements seem to be related to his objective of diagnosing necromancers with melancholy.