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Art and Images in Psychiatry
Sep 2012

Albrecht Dürer's Melencolia I

Author Affiliations


Arch Gen Psychiatry. 2012;69(9):874. doi:10.1001/archgenpsychiatry.2012.108

Why is that all those who have become eminent in philosophy or poetry or the arts are clearly melancholics, and some of them to such an extent as to be affected by diseases caused by black bile? –Aristotle (384-322 BCE), Problema XXX.11(p18)

As psychopathology, melancholy refers to a deep and enduring depression, a sense of profound and painful emptiness that is relentless and cannot be long endured. Untreated melancholic depression may result in suicide. Yet, in common parlance, melancholy may refer to a passing state of mind, sometimes emotionally painful and at other times a pensive or nostalgic state of mind. Metaphorically, it is a dark feeling that may be projected onto the night or the seasons, the melancholic months of winter, or on a place where a tragedy occurred. Yet its etymology is more ancient. Melancholy is derived from melanos and khole —black bile, a secretion of the spleen and one of the body's 4 humors (blood, phlegm, choler [or yellow bile], and melancholy [or black bile]) recognized by Hippocrates (460-370 BCE). Such qualities were linked to the 4 elements: earth, water, fire, and air. In antiquity, the humors corresponded to the cosmic elements and divisions of time. The humors, according to how they were combined, controlled one's existence and behavior and defined one's character.1 Saturn held sway over the realm of melancholy, of the mind that contemplates and investigates; the mood engendered was saturnine.

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