I know another man with whom melancholia began from the burning of the blood. He was a man of leisure. The anxiety and sorrow that he suffered were not great, for a little joy was mixed with them. The reason [for the melancholia] was his constant preoccupation with mathmatical sciences. He was also a courtier. Because of these things, bilious matter collected in him at the age that it is customarily created, that is in the period of decline. Besides, he had a fiery temperament in his youth, so that as he advanced in age, black bile collected in him. He had fits mostly at night because of his insomnia and an the morning. When he slept at daybreak, he saw evil phantoms in his sleep because of lethargy caused by the insomnia. He was treated by an inexperienced physician who evacuated him many times with strong emetics. He neglected the balance of the patient's temperament. The restoration of the temperament in diseases like these is the best treatment because the badness of the temperament produces such a humour as this one. The creation of the humour is not stopped except by the restitution of the temperament. When his temperament was agitated by these treatments, the burning in his body increased. His condition led to madness; he continued not to eat or drink until he died.
 

Case two

Another man who was 21 years old was rescued from drowning. He suffered from melancholia on account of the fear caused by it. A physician treated him with methods like the ones that have been described, i.e. repeated evacuation by means of emetics. In the end, the doctor evacuated him with black hellebore, but he didn't know any better. Then, another physician treated him by moistening, nourishment, and amusement. The man was rightly guided and recovered. His recovery was really due to both the doctors because the first physician evacuated the matter and the second corrected the temperament.
 

Melancholy by Edvard Munch