Melancholy and the Care of the Soul: Religion, Moral Philosophy and Madness in Early Modern England (review)

It was a commonplace early modern observation that the disease of melancholy affected the operations of the soul as well as the body, but histories of the condition in this era—largely concentrating on medical physiology or literary-artistic expression, or being subsumed within general accounts of madness—have rarely performed sustained and technically competent analysis of its ethical and spiritual dimensions. Jeremy Schmidt’s book goes a long way toward filling this gap for the case of England, demonstrating that a serious theological and moral engagement with the condition is to be found in the writings of English divines and physicians throughout the seventeenth and eighteenth centuries. Schmidt’s retrieval of this approach focuses on the complex interplay of medical and moral language and concepts in works on melancholy (and the associated conditions of hypochondria and hysteria) by such well-known authors as William Perkins, Robert Burton, Henry More, Thomas Willis, Richard Baxter, Bernard Mandeville, and George Cheyne. But he also includes admirably detailed discussions of works by less celebrated physicians and a host of minor Puritan, Anglican, and Dissenting figures and analyzes some revealing case histories.

The book has two obvious merits. The first is that it is consistently sensitive to the nuances of spiritual discourse on the subject. As anyone who has studied the subject knows well, themes recur in contemporary writing about melancholic symptoms and therapies with tedious regularity, but Schmidt has a sharp eye for variations in and deviations from the standard topoi, and often these turn out to reveal significant differences in attitude toward the afflicted. This enables him to construct some tentative but generally persuasive arguments about the divergences and continuities among the ways in which melancholics were viewed and treated by different groups across time. A persistent tension existed between interpretations of extreme emotions as spiritually valuable or medically pathological—but on this issue it is not the case, as Michael MacDonald has suggested, that the lines are drawn between “spiritual” Puritans and a “secular” Anglican establishment.¹ In fact, as Schmidt shows, the therapies for melancholy presented by Anglicans and latitudinarians such as Gilbert Burnet and Simon Patrick combined medicine with theology in a way that cannot straightforwardly represent secularization. Instead, Schmidt argues that a pervasive Calvinist psychology associating aspects of the condition with the “godly sorrow” of the afflicted conscience and future salvation, along with its attendant demonology, was gradually displaced after the Restoration by more practical Anglican and Dissenting models encouraging psychological moderation and moral–spiritual self-management.

The second merit of Schmidt’s approach is its inclusion of the religious and social contexts influencing writing on melancholy. The former are clearly essential to an understanding of the works of practical divinity under discussion, and the later chapters of the book effectively illustrate the moral and spiritual dimensions of melancholy when it becomes associated with concerns about sociability, commerce, and luxury from the later seventeenth century onward. Schmidt is also attentive to the ways in which writing about the disease was gendered, incorporating notions of female sensitivity and saintliness as well as weakness and sinfulness, and expressing eighteenth-century concerns about national enfeeblement through growing effeminacy.

Understandably in a relatively short book covering two centuries, there are some areas that would benefit from closer attention. A large part of the work is concerned with practical divinity, and although physicians feature prominently in early and late chapters, the impact of the “new science” on medical theories of melancholy is registered only indirectly in discussions of individual authors rather than in fully consolidated analysis. We must look elsewhere to understand the fate of the traditional Galenic account of the condition. Similarly, although the subtitle leads us to expect discussion of moral philosophy, what is presented is for the most part the...