1. Pre- Kraepelin
1. History records recognition of profound disturbances of emotions in its most ancient accounts of the human condition.
1. Gilgemesh the first single-case report
2. Hippocrates Melancholia = Humoral Imbalance (5th century BC)
1. Ancient concepts of melancholia bear little correspondence to its modern meaning or to the idea of depression or even mood. The historical idea of melancholia most nearly conveys the same meaning as “madness”. Hippocrates observed symptoms of delirium in patients suffering from quartan malaria and noted their darkened skin. He ascribed this over abundance of black bile, melancholia. This term like depression became nonspecific as it became associated with character traits, grief, and illness.
1. Divine Affliction
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1. The severity of suffering was interpreted even by many otherwise physicianly experts as evidence of punishment by the gods rather than the result of a lesion like other disease states. Galen (2nd century) attempted to correct this asserting his belief that the causes of mental illness was based on the same principles as other medical illness. Unfortunately through the middle ages the prevailing view (adopted by the church) followed Malleus Maleficarum (1486, The Hammer of witchcraft).
2. Burton’s Anatomy of Melancholia (1621)
1. Sadness among symptoms but not the defining characteristic.
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