Emotions and the Body in Early Modern Medicine

Abstract

Drawing on Latin treatises, letters, and autobiographical writings, this article outlines the changes in the—thoroughly somatic—learned medical understanding of the emotions (or “affectus/passiones animi”) between 1500 and 1800 and their impact on lay experience. The mixture of the four natural humors explained individuals’ different propensity to certain emotions. The emotions as such, however, were described primarily as movements of the spirits and the blood towards or away from external objects. The term “e(s)motion” emerged. The final part highlights the 18th-century shift from spirits and blood to the nerves as the principal site of the emotions. Physicians and laypersons alike now associated the emotions closely with the peculiar nervous sensibility and irritability of individuals and groups.

Keywords

early modern medicine etymology history of emotions lay experience

The language we use in modern Western societies to talk about our emotions is pervasively shaped by terms and images that refer to physical, bodily qualities, as well as sensations and changes. We are “burning” with ambition or curiosity and our love or anger are “inflamed.” We know things “in our hearts.” We are “light-hearted” or have a “troubled heart.” We act in “cold blood,” while fear makes our blood “freeze.” Our spirits may be “good,” “high,” or “low”; our mood “dark” or “gloomy.”

There are countless expressions like these in the various European languages. They are commonly perceived as “merely” metaphorical today and may, at best, be taken to refer vaguely to bodily manifestations or effects of emotions such as blushing, sweating, or a rapid heartbeat. As historians of the emotions have pointed out, however, many of our emotion words have only become metaphorical in the course of time (K. Harvey, 2017; Leemans, 2016; Schoenfeldt, 1999, p. 8). Far into the 18th century, they referred quite literally to what people thought was happening inside their bodies. When the heart almost “burst” with joy, this was attributed to the fact that it was literally filled to the point of bursting with blood or spirits. When blood “froze” in the vessels, this resulted from it being cold, deprived of its heat, in a very material, physical sense. When contemporaries described “spirits” as “rising,” they took these “spirits”—not to be confused with the “spirit” used in the singular for the mind—to be very fine, warm, material substances that could indeed “rise” upward or turn “dark” when they were mixed with impure vapors or fumes.

Historians of the emotions have frequently pointed to humoral medicine as a major source of emotional concepts and expressions in the early modern period but relatively little work has been done so far on the details. Gail Kern Paster and other historians of early modern drama (Paster, 2004; Paster, Rowe, & Floyd-Wilson, 2004; see also Schoenfeldt, 1999) have offered important insights. They have highlighted, in particular, the crucial place of “temperament” and its associated primary qualities—cold, warm, wet, and dry—in the early modern understanding of emotional responses and of what we would call personality or character. They have paid little attention, however, to the profound changes that took place in the 16th and 17th centuries. In fact, the differences between medieval medical concepts of the emotions, which still focused primarily on the krasis or mixture of the four natural humors and the resulting temperament (Riha, 2009; Siraisi, 1981, pp. 204–206, 226–229), and the much more “dynamic” notions of a moving heart, blood, humors, spirits, and vapors that came to dominate the medical understanding of the emotions in the 16th and 17th centuries have so far been all but ignored.

Extant research in this area suffers, in addition, from a heavy geographical and linguistic bias, namely a strong predilection for English vernacular sources. The physiology and pathophysiology of the emotions (“passions” or “affectus animi” in contemporary terms) were an important topic of learned medical writing all over Europe, not only in England, and this writing was predominantly in Latin. The pitfalls of relying only on English vernacular sources are exemplified in the only recent survey on the topic published by a medical historian that I am aware of, by Fay Bound Alberti (2006; reproduced almost verbatim in Bound Alberti, 2010, pp. 16–33). Drawing, for this period, almost exclusively on the vernacular works of two 17th-century English authors, Thomas Wright and John Downame, neither of whom was a physician, she surprises her readers with claims like “Traditionally, emotions were perceived capable of causing profound structural changes in the body” that are very difficult to reconcile with what we find in the medical literature of the time.

Yet, a thorough acquaintance with the early modern ideas about the physiology and pathophysiology of emotions is indispensable for an adequate interpretation of emotion terms in historical sources and if we want to understand the roots of their—mostly metaphorical—usage today. For, as Inger Leemans (2016, p. 280) has recently argued against the influential work of G. Lakoff (2016; see also Lakoff & Johnson, 1980): “emotion metaphors do not so much reflect what is happening in our brain or in other parts of the body: they reflect what people think or thought is/was happening in and outside their body.”

What is more, an intrinsically somatic understanding of emotions as primarily physical, embodied phenomena inevitably also had a major impact on the ways in which contemporaries experienced emotions and the corporeal changes and sensations that came with them. Yet, with the exception of an important seminal article by Ulinka Rublack (Rublack, 2002), we so far know very little about the lay understanding of the emotions and their relationship with the body in that period.

As a medical historian with a long-standing interest in early modern learned medicine and the premodern experience of illness and the body, I want to approach and link both issues in this article. I will start by outlining 16th- and 17th-century learned medical ideas about the physiology and pathophysiology of emotions. After a brief discussion of the etymology and early modern meaning of terms like “emotion,” “affectus animi,” and “passions,” I will trace the effects of this pervasively somatic understanding of the emotions on the experience of laypersons. In the third and final part of my article, I will highlight the changes in the interpretation and experience of emotions that occurred with the rise of new body concepts since the late 17th century and, in particular, the profound effects of the rise of the “nerves” on the understanding and experience of the emotions in the 18th century.

This article will draw on a wide range of sources but with a certain geographical focus, especially when it comes to manuscript sources, on the German- and French-speaking areas. I will base my analysis of learned, academic discourse primarily on (mostly Latin) textbooks, treatises, and student notes, and on (mostly vernacular) letters of advice that physicians like the Brandenburg court physician Leonhard Thurneisser sent to their patients when requested to do so. These letters frequently addressed emotions as a potential cause of the disease in question or in the context of dietetic recommendations. I will approach the lived, embodied experience of the emotions based on a survey of about 80 early modern (mostly German) autobiographies and of many hundreds of letters of consultation from the 16th to the early 19th centuries. Requests for epistolary counsel were quite common among the more affluent classes at the time and frequently patients or their families themselves addressed the physician whose advice they sought directly rather than through their local doctor. In their letters, they often proposed their own opinions on the nature and the causes of the disease. Since lay people, just like the physicians, considered strong and especially negative emotions an important cause of illness, these letters quite frequently also mentioned emotional experiences and the bodily changes they effected.

The Physiology of Emotions

The emotions—or “affectus animi” or “passiones animi” in contemporary learned terminology—were rarely made the topic of independent medical treatises of their own until the late 17th century. However, they were frequently mentioned and discussed in learned medical works on a wide range of topics in anatomy—which, at the time, included physiology—and in dietetics or regimen in particular. Drawing on the works of Aristotle and Thomas of Aquinas, physicians usually attributed the “affectus animi” to the “anima sensitiva,” which humans shared with animals (Dixon, 2003; James, 1997, pp. 54–64). In man, the human brain with its “anima rationalis” was involved by transmitting its evaluation of sensory input or by actually causing emotions through imagination and memory. The principal site of the sensitive soul, however, and of the emotions with it, was the heart. In fact, according to the widely shared premodern view, the heart performed or was subject to two different kinds of movement: the constant, regular movement caused by (or responsible for) the movement of the hot vital spirits that originated from the heart and vivified the body, and the passing, ephemeral affective movement that varied with the kind and intensity of the emotion (Steinitzer, 1889, pp. 8–9).

Drawing on traditional notions of temperament and the importance of the primary qualities, medieval physicians thus found, in the words of Nancy Siraisi (1981, p. 205), that “anger was nothing but a certain rising of blood around the heart, and this rising is caused by heat,” while joy was equivalent to “a diffusion of heat throughout the body.” 16th- and 17th-century learned writers continued to rely heavily on the relatively static notions of temperament and elementary qualities. However, these now served primarily to explain why individuals—men and women and different animals—showed considerable variation in their propensity to the various emotions (e.g., Montaña de Monserrate, 1551, fol. XCVIIv). Those of a cold and dry temperament, for example, continued to be described as more prone to sadness. When it came to individual emotional responses and their bodily correlates, however, 16th- and 17th-century medical writers focused much more than their medieval predecessors on the movement of the heart, of the spirits, and of the blood in the vessels.

Moderate joy, hope, and love—it was now commonly held—made the heart expand and prompted the spirits and the blood to move towards the object of present or future pleasure; at the time, physicians commonly associated the heartbeat or pulse with the dilatation of the heart rather than with its contraction, as today (Melanchthon, 1556, fol. 118v; Vives, 1543/1990, p. 51). The skin became warm and assumed a lively color (Paré, 1585, p. XXXVI).

Sadness, by contrast, made the spirits and the blood withdraw from an unpleasant object and collect in and around the heart (Dresserus, 1581, p. 70). As a result, the face and the limbs turned pale and cold, as young Georg Handsch (ca. 1552, fol. 68r) learnt already as a medical student in Gabriele Falloppia’s anatomy lessons in Padua. The heart and indeed the whole chest, in turn, could hardly accommodate the accumulating blood and spirits, causing sensations of tightness and cramping. Due to the compression, the heart also could no longer generate sufficient amounts of pure vital spirits, which were essential for maintaining the vital faculties in the different parts of the body. Moreover, troubled, dark, raw spirits ascended to the brain and gave rise to further sad thoughts.

Fear had similar effects but the blood and the spirits withdrew from the rest of the body to the heart much more abruptly. The heart started beating heavily and the flame of life—the innate heat—threatened to be literally “suffocated” by the sudden influx of blood and spirits, sometimes with fatal consequences. At the same time, the body’s exterior became cold and the pores of the skin contracted, causing the body hair to stand up (Lemnius, 1587, fol. 64r; Paré, 1585, p. XXXVII). The vital faculties—and the “retentive” faculty in particular—were weakened so abruptly that some people, in their fright, urinated or even defecated into their clothes (Handsch, ca. 1552, fol. 68r).

Anger, in turn, students learnt in Padua (Handsch, ca. 1552, fols. 68v, 171v), was characterized by hot blood which, in turn, generated burning hot spirits that were disseminated throughout the vessels. The whole body became warm and the pulse was strong. On top of that, according to Melanchthon (1556, fol. 121v), burning hot red bile was mobilized and “infected” (“inficit”) the blood, which was already burning from the hot spirits coming from the “angered heart” (“irati cordis”). In his Libro de la Anothomia del hombre, Montaña de Monserrate (1551, fol. XCVIv) assumed, more precisely, a twofold motion in anger: First, sadness made the spirits withdraw towards the heart and the face grew pale. Then the hope of taking revenge made them return to the various parts of the body, which explained why anger was less detrimental to health than sadness.

Shame combined elements of fear and anger, Ambroise Paré (1585, p. XXXVII) explained. Depending on which of the two prevailed, the face might turn pale or rosy.

The emotions and the physical, material movement of the blood and the spirits were so closely linked in contemporary medical writing that it is often virtually impossible to distinguish the two. Philipp Melanchthon (1556, fol. 116r) in his Liber de anima, which drew heavily on medical sources (Helm, 1996, 1997) and profoundly influenced generations of Protestant philosophers and physicians after him, defined the “adfectus” as “movements of the heart that, following recognition, follow or flee the objects” (“motus cordis, noticiam sequentes, prosequentes aut fugientes obiecta”). Later writers used almost identical words. Johannes Magirus, for example, described the “affectus” as a “movement of the heart that is aroused by the perception and knowledge of an object and either follows or flees it” (“motus cordis a notitia cognitione obiecti excitatus, illudque aut prosequens aut fugiens”; Magirus, 1593, p. 342; see also Casmann, 1594, p. 406). Matthaeus Dresserus (1581, p. 70) saw joy accordingly as “a mild movement of the heart, by which the heart embraces a present good and approves of it.” What happened in the brain was, according to Melanchthon (1556, fol. 118v), a secondary effect. Thus, in anger, it was the hot blood and the burning spirits that came from the heart which excessively heated the brain and disturbed its functions. Similarly, Vives (1543/1990, p. 69) explained that anger “is not present until the hot spirits from the heart penetrate our brain.” Rejecting Daniel Cellarius’s claim that anger was caused by an effervescence of the spirits, Georg Handsch (ca. 1552, fol. 171r) argued more specifically that “the effervescence of the spirits in the heart is the very anger itself, not the cause of anger” (“effervescentia spirituum in corde est ipsissima ira, non autem causa irae”).

Pathophysiology: Emotions as Causes and Effects of Disease

A major reason for the sustained medical interest in the emotions was their crucial place in early modern dietetics. The “affectus animi” or “passiones animi” ranked among the six “nonnaturals.” Like food, drink, air, sleep, and physical exercise they were believed to exert a powerful influence on health and disease (Burmannus, 1719; Stolberg, 2005). Johan van Beverwijk (1672, pp. 24–84), for example, devoted about 60 folio pages of his Schat der Gesontheyt just to the emotions and their impact on health. In principle, physicians made no strict distinction between positive and negative emotions. Not the emotions per se were considered as dangerous but their intensity. Even great joy could kill by depriving the heart abruptly of the vital spirits (Paré, 1585, p. XXXVI; Sennert, 1611/1653, p. 388); and vice versa, negative, unpleasant emotions could have a positive effect in certain cases. Worries, fear, or sadness, for example, could bring some beneficial cooling to those who were of an excessively inflammable, angry temperament (Vallesius, 1600, p. 426; van Beverwijk, 1672, p. 25). Intense fear could even cure paralytics, as F. Valleriola (1573, pp. 77–83) explained, citing the case of a citizen of Arles who had been paralyzed and bedbound for years. When a fire broke out, he regained his mobility all of a sudden and was able to jump up and to run out of his house.

In practice, however, joy was usually welcomed as wholesome and invigorating. The body and its parts were supplied with good, healthy blood and vital spirits (Paré, 1585, p. XXXVI). On the other hand, fear and sadness, as well as anger, were generally considered as harmful and dangerous, and all kinds of diseases were attributed to them. Sadness (Paré, 1585, pp. XXXVI–XXXVII; Vives, 1543/1990, p. 96) dried up the body and made the heart contract and wither. Even the pericardial fluid, which moistened the heart from the outside, could entirely dry up in those who were very sad, Handsch (ca. 1552, fol. 16r) learnt in Padua. Anger, on the other hand, could cause fatal putrid fevers by inflaming the spirits and causing their excessive movement (Paré, 1585, p. XXXVI).

The crucial role of the innate heat in the heart, and the vital spirits and their close association, in Galenic physiology, with the passions or emotions opened up the possibility of a reversed relationship between cause and effect: Diseases and other physical changes in the body could, in turn, generate emotions (see also Leemans, 2016). People suffering from the disease “melancholia” (rather than just being of a “melancholic” temperament) provided the most striking example. “Melancholia,” in this sense, was framed in distinctly negative, somatic terms rather than being associated with the idea of an ennobling predominance of black bile in the bodies of outstanding thinkers (Sullivan, 2016, pp. 95–110). By the 16th century, probably due in particular to the influence of Avicenna’s Canon (Jackson, 1986, pp. 62–64), the disease was commonly attributed to some sharp, burnt black bile in the body or even to yellow bile which had been exposed to excessive heat (Schurf, 1546–1547). From this burnt black or yellow bile, dark and hot vapors and fumes were set free. They ascended to the head where they accumulated under the skull. Like clouds, the vapors and fumes could even condense into peculiar forms in the brain and mimic the forms of people, animals, or objects to the point of deluding the patient’s imagination. In marked contrast to Albrecht Dürer’s famous, much more positive, Neoplatonic interpretation in “Melancholia I,” Lukas Cranach’s four “Melancholia” paintings offer a masterful visual representation of this somatic genesis of delusions, which also made those who suffered from melancholia easy victims of the Devil and his helpers (Stolberg, 2007).

The Brandenburg court physician and Paracelsian Leonhard Thurneisser (1531−1596) provided his patients with particularly detailed explanations of the links between pathological changes in their bodies and the unpleasant or disturbing emotions from which they suffered. In the case of sick Hans von Löben, for example, Thurneisser (1575−1583, Ms. germ. fol. 106, fols. 83r–87v) diagnosed a kind of calcareous, “tartarous” quality of the whole body which had also taken hold of the “cardiac capsule” (“Herzkapsel”). From this, “a sad anxiety” (“traurige bangigkeit”) of the heart originated, which, with time, might affect the patient with a lot of profound ponderous thoughts (“dieffsinniger, schwerer gedancken”) and strange musings (“wunderliche speculationes”) from which eventually a “melancholic disease” might develop. Urinalysis showed that the patient’s inner heat had become overly concentrated within the small space of the heart, Thurneisser (1575−1583, fols. 45r–55v) found in the case of sick Christoph von Meyenburg, kindled even more by an “inflamed” liver. Due to this excessive heat, the blood was cooked too much. It became sharp and burnt and a biliary humor and some bitter, phlegmatic matter also called “cholera,” were produced. For this reason, the patient sometimes experienced “an abrupt (though at present still quite mild and small) beating and trembling of the heart, with some inner anxiety [banngigkheit], fear and sadness” Thurneisser (1575−1583, Ms. germ. fol. 106, fols. 45r–55v) without knowing why. A melancholia had “crept in,” just as if a man was aggrieved by some external mishap.

In the same way, “vapors” resulting from the corruption or putrefaction of other kinds of matter in the body could bring forth certain passions or emotions and sometimes even hallucinations. By the mid-16th century, the notion that diseases were due to an imbalance of the four natural humors had become marginal. Most diseases were now attributed to some impure, corrupted, or indeed putrid morbid matter in the body that accumulated in it and could not adequately be excreted, usually due to an obstruction in the natural pathways. This morbid matter could ultimately also affect the mind and the emotions. Hysteria and hypochondria, both interpreted in decidedly somatic terms at the time, and frequently diagnosed, were prime examples. Consulted about a female patient, the Nuremberg physician Georg Fabricius (1647) explained that she was affected by manifold obstructions, particularly of the smallest passages in the stomach, the liver, the spleen, and the intestines. Some corrupt, phlegmatic matter had accumulated there and had eventually produced an “unnatural heat” which had, in turn, burnt the matter, resulting in coarse, thick vapors. As a result, “not only the body [leib] but also the mind [gemüth]” were affected. She was subject to ebullition and fermentation in her belly with sensations of tension and pressure. At the same time, the vapors spread from the lower body towards the other parts of her body and in particular to her head. Here they “confused” the animal spirits and made the patient “sad, depressed [schwermütig], distrustful, and angry” (Fabricius, 1647).

Since emotions could affect bodily processes and bodily processes could, conversely, bring forth emotions, they could also mutually reinforce each other. “Sadness causes black bile, and is intensified by black bile or any thought of evil,” J. L. Vives (1543/1990, p. 95) summarized the typical vicious circle in cases of melancholia.

Repressed Emotions

One feature of premodern accounts of diseases from emotions strikes us, at first sight, as particularly modern: at times, not the emotion as such but rather its “repression” was declared the real danger. Especially anger, Timothy Bright (1586, p. 88) wrote, had to

be delivered by word and deede, whereby liberty is given for the passion to break foorth, which restrained in any sort, breedeth an agony of such fervency, as it may resemble the scalding of a boyling chaldron not uncovered, or an hote furnace close up in all vents.

It was important to vent one’s anger, to satisfy one’s lust for revenge, C. F. Richter (1705, pp. 131–132) warned his German readers about a century later. Anger or wrath, he explained, made the blood fiery and move fast, and a fiery bilious principle might be separated from the blood, which, in turn, made the blood move even faster and acted like a poison. Getting rid of this poison by venting one’s anger was harmful for the soul, Richter admitted, but it was good for the body. If the poison was allowed to remain inside, nature would take its revenge on the body and the alteration of the blood would be all the worse.

These ideas may reflect a growing awareness of the need for self-control in contemporary civic society, of the price to pay for the “process of civilization.” There is also a remarkable analogy, however, between the notion of illness from repressed emotions and the traditional humoral idea that most diseases were caused by the “suppressed” or “obstructed” evacuation of peccant matter. In many ways, “holding back” emotions was like preventing the healthy, natural flow of bodily excretions. Occasionally, writers explicitly linked the two. In this sense, Sénac de Meilhan’s (1787, pp. 177–178) fictional physician diagnosed an “ambition rentrée” as the true disease of his patient, a disgraced minister, and compared it to the fatal effects of peccant matter of smallpox that was retained in the body rather than being excreted through the skin.

“Motion” and “Emotion”: The Historical Roots of a Modern Term

Taking into account the prominent place of the movement of blood and spirits in the early modern understanding of the passions is crucial, not least, for an adequate interpretation of the shifting meanings of the term “emotion.” Derived from the Latin word “emovere,” “to move” or “to move out,” we find the term with minor variations in a fair number of modern Western languages. It has a long history. Terms like “esmotion” and “esmouvoir” were widely used in medieval French already, long before they entered the English language in the 17th century (Diller, 2010). “Esmotion” was associated primarily with the notion of an “uprising” or a violent disturbance. The much more common term “esmouvoir,” however, could refer to all kinds of movements, including movements inside the body. A ship voyage, for example, could “move” (“esmeut”) the humors in the body (de Saint-Gille, 1362–1365/1954, p. 73). By the 15th century, we find “esmouvoir” increasingly employed closer to the modern, emotional sense of “moving” or “being moved.” Angry, trembling, and turning pale, the personification of “art” in a letter by Jean Robertet (1476/1970, p. 170), seemed “frightened and moved” (“effrayée et esmue”). Demoscenes, in turn, in Guillaume Fillastre’s work on giving and receiving advice (Fillastre, 1472/1994, p. 249), was not “moved” by anything (“de rien ne s’esmeut”), not even by a handsome young man who told him he himself would long have been hanged if people hated him as much as they hated Demoscenes. By the 16th century, the noun “e(s)motion,” likewise came to be used in French in the context of emotions in a modern sense, a development that historians have found in the English language only much later (Dixon, 2012, p. 340). Some writers even began to use the term quite specifically to describe the material movement of the spirits and the heart in the body that characterized, constituted, or was caused by the passions. The surgeon must not disregard the “accidents” or “perturbations” of the soul, readers of the French edition of the famous French surgeon Ambroise Paré’s collected works (1585, p. 61) learnt, for “they cause great emotions” (“elles causent de grandes émotions”). Joy, hope, and love “made” (“font”) movements by which the spirits were spread out in the body, and these movements were made (“sont faits”) by the dilatation of the heart as if to embrace the welcome object, and the face became rosy, joyful, and laughing. The object, according to Paré, moved (“esmeut”) the faculty (“puissance”) by which the heart was moved (“esmeu”).

In Latin medical writing, terms like “passiones animi” (or, from the Greek word “pathos,” “pathemata animi”) and “affectus,” “affectiones,” or “perturbationes animi” continued to predominate. While “e(s)motion” and “e(s)mouvoir” stressed the element of motion, these Latin terms highlighted the relative passivity of the “patient” and his or her body; “patient” and “passion” are both derived from the Latin word “pati,” “to suffer” or to “be subject to.” For obvious reasons, this terminology suited medical writers whose interest in the emotions was driven above all by their prominent place among the nonnaturals that affected the body from the outside and played a major role in the genesis of many illnesses.

My findings are somewhat at odds with those of Thomas Dixon (2003). Dixon has argued that premodern writers distinguished between the more rational affections or “affectus animi” and the more negative “passiones animi” that tended to escape the power of reason. Like others before me (Diller, 2010), I have not been able to trace any evidence for this distinction in my (predominantly medical) sources, however. In general, medical writers in the 16th and 17th centuries used “affectus”/“affectio” and “passio” and their vernacular translations interchangeably in this context. This is not surprising either. After all, “affectus” and “passio” (without an added “animi”) were familiar terms for “disease” at the time. In fact, Montaña de Monserrate (1551, fols. XCVv–XCVIr) could as easily speak of emotions like joy and fright as “passions of the heart” (“passiones del coraçon”) as Jean Fernel (1555, fols. 145v–147r), around the same time, could use “affectus cordis” as the title of a chapter on palpitations, syncope, wounds, and other diseases (“morbi”) of the heart.

The early modern understanding of the emotions as dynamic and, to a large degree, somatic phenomena and as an important cause of disease did not only give the emotions and the words used to describe them a very different, more bodily meaning compared to that of today, it also medicalized the question of “affect control.” For good reasons, a leading theologian like Philipp Melanchthon, in his work on the human soul, discussed the anatomy and physiology of the human body in great detail. Detailed knowledge about the body, he explained (Melanchthon, 1556, fol. 121v), was indispensable if one was to rule the “adfectus”—including religious faith, which, for Melanchthon, also had its place in the heart. At the same time, the prominent place of the affects as a cause of disease turned keeping violent, and in particular violent negative emotions like anger in check, into more than moral obligation. It was a key to preserving one’s health and thus, ultimately, a matter of life and death (Lemnius, 1587, fols. 64r–64v).

The Lay Experience

The emotions or passions of the mind were the object of lively debates in early modern learned medicine as natural phenomena per se and as causes and effects of diseases. In order to assess the impact of these learned theories on ordinary people, we would ideally study detailed lay accounts of emotional experiences. Unfortunately, authors of early modern autobiographies and patient letters who described such experiences tended to focus on the situations and events that aroused their emotions rather than on their emotional reactions and bodily sensations. Within these limits, their accounts do suggest a profoundly somatic understanding of the emotions, however, similar to the one that we find in learned medical writing.

Occasionally, lay writers even referred to specific physiological notions such as that of an outward movement or a withdrawal of blood and spirits towards the heart. The story that Johannes Bozenhart (1876, pp. 238–239) told about his encounter with a wolf in the early 17th century is already unusually explicit in this respect. He was convinced, he wrote, that no blood would have come out of his vessels if he had been stabbed at that moment. Clearly, he was suggesting that the fright had made all his blood withdraw towards the heart.

The heart as the site of emotions played a major role in many lay autobiographies and patient letters. Sometimes, the reference is clearly metaphorical, for example, when patients announced that they would “lay open” their heart. However, it is frequently virtually impossible to distinguish, in retrospect, references to concrete physical sensations and processes that the writers believed to take place in their hearts from “merely” metaphorical usage. Thus Sebastian Schertlin’s heart felt “restless” one early morning in 1546 (Schertlin von Burtenbach, 1910, p. 72). Later, he interpreted this as a premonition of the murderous attack he was to experience that very day. Similarly, J. H. Hummel (1950, pp. 44–45), in his account of his beloved child’s death in 1650, repeatedly linked his feelings to his heart. That death, he wrote, went very much “to my heart” and when someone only mentioned his dead son, he felt a “stabbing” in his heart.

The markedly somatic understanding of the emotions that also informed the lay experiences comes very strikingly to the fore when even the terminological boundaries between what we would consider the somatic and the mental or psychological, between physical sensation and “feeling” or “mood,” were blurred. The German term “Angst”—one of the few German words that has also entered the English language—offers a good illustration. The term is ultimately derived from the Latin word “angustus” for “narrow” or “tight” or, in German, “eng.” German language lay accounts of “Angst” tended to combine inseparably what appears to us as a fairly concrete sensation of tightness or oppression around the heart with what we would consider the emotional states of fear or anxiety today. For example, according to her husband’s account (Thurneisser, 1575−1583, Ms. germ. fol. 425, fols. 350r–351r), Frau von Lentzen was unable to find any rest because of her great “anxiety, mixed with great pain in her chest and sometimes also in the back” (“Angst, mit Vermischung groser Weetage in der Brust, und unter Zeiten auch im Rücken”). At times, a purely bodily sensation of tightness was even the principal meaning of “Angst.” Thus, Hinrich van Jagow (Thurneisser, 1575−1583, Ms. germ. fol. 420a, fols. 280r–280v) complained, in 1571, that he suffered from “great anxiety towards the heart and under the short ribs” (“grosse angst tzu dem hertzenn und unter denn kurtzen ribben”). A century later, H. W. Lüders (1671) wrote in similar terms about a painful flux that had descended from the head and settled around the heart, causing incessant “Angst” and pain (“Angst undt Wehen”). J. L. Vives (1543/1990, p. 103), who heavily relied on medical sources but was not a physician himself, concluded along very similar lines: “Any form of heart oppression caused by grief, fear, irritation, or inhibited desire is called anxiety. One can also be anxious without feeling any emotion [“sine affectu”], when a thick humor weighs upon the heart.”

Patients and other lay writers tended to stress the somatic, physical aspects of emotions especially when they attributed bodily diseases to a strong, negative emotion. Simon Roter (Thurneisser, 1575−1583, Ms. germ. fol. 421a, fols. 368r–369r) reported, for example, how he had suffered great sorrow and grief from an “unexpected death.” As a result, his left thigh was struck by disease in the middle of the night and all night long he felt a tearing in the leg. The next morning he could no longer lift his leg and needed a stick to walk. Gotschalk von Weinsberg, in turn, attributed his long feverish illness to the terrible fright he got when he drank wine and a spider suddenly fell into his glass (von Weinsberg, 1886–1887, Vol. 2, p. 84). Those who were already sick were believed to be particularly prone to experience the negative bodily effects of strong emotions. In dramatic terms, Hermann von Weinsberg (1886–1887, Vol. 1, p. 84), for example, described his terror when his landlady rudely woke him up one day telling him about rumors that the enemy had taken the nearby town of Emmerich. He had already been sick before but now things turned much worse: “That very hour I had the fever and coldness on the neck [and I] could not do much because I was trembling so hard.”

Sometimes, fright was even found to be deadly. Duke Wolfgang of the Palatinate, for example, in 1569, was said to have contracted a deadly “Bräune” (presumably a diphtheria-like inflammation of the throat) from excessive fear and fright (Schertlin von Burtenbach, 1910, p. 213). Klara Staiger (1981, p. 49) reported, in 1632, how the prioress of her convent heard the news that one of the convent’s farms had been ransacked by soldiers. The fright, she wrote, went “through all her limbs.” The same night she complained about feeling very cold and fell seriously ill. She could hardly breathe anymore and lost conscience for some time. The next morning she was just able to receive the last sacraments before she died. Even an official inquest on the death of two women in Onolzbach who had encountered a wild wolf (or werewolf; Report, 1685) attributed their death not to their injuries—three other women who had actually been bitten survived—but to the tremendous fright the two women had experienced.

By contrast, the idea that emotions could also have beneficial physical effects can only occasionally be found in lay writing, and even then, it is not quite clear how seriously the idea was actually taken. One senses a sarcastic note, for example, in Rittmeister Hieronymus von Holsten’s story of a nobleman who had to be carried around because his gout was so bad that he could neither walk nor stand. Yet, during the siege of Warsaw, when he saw the enemy already within the city walls, he suddenly jumped to his feet, ran to his castle, and never suffered from gout again (von Holsten, 1971, pp. 11–12).

The profoundly somatic lay understanding of the emotions also found its expression in the corresponding belief that painful, tormenting emotions and moods could be fought accordingly by purely “somatic” means. Philipp von Farnrode, for example (Thurneisser, 1575−1583, Ms. germ. fol. 421b, fols. 274r–276r), complained that he was assailed by “constant sadness and pusillanimity” (“stettiger traurikeytt vnd kleynmhuetikeitt”). He had already spent a lot of money on their medical treatment and tried many different things. Brandy with saffron had brought some relief but overheated his body and made him drunk. Now he hoped that Thurneisser’s “aurum potabile” and “tinctura corallorum” would help him.

“Whether an etiological theory is humoral, neurological, or hormonal,” Steven Mullaney (2015, p. 21) has recently argued (undoubtedly he is referring to pathogenesis rather than etiology), “it has little to tell us about emotional experience.” My analysis of early modern lay accounts leads to a very different conclusion. Their distinctly somatic understanding of the emotions as closely linked to (or indeed identical with) the movement of humors and spirits or to nervous irritation pervasively shaped their emotional language as well as their actual experience of the emotions as bodily phenomena.

Repressed Emotions: The Lay Point of View

Lay experience also confirmed the physicians’ belief in the unwholesome effects of repressing emotions. In the fall of 1714, a 21-year-old man (Anonymous, 1714) complained about winds in his belly, toothache, and a sensation as if the “heated blood” rose on the side of his neck upwards towards the right side of his head where he sometimes felt considerable heat. This, he believed, was due to his having lived for 20 months already in a “secret anger” without having been able to vent his passions (“meine gemieths passionen niemahls habe außlassen khönnen”). A German noble woman (von Görzengrien, 1716) reported how a “grudge” (“Unwillen”) had shown itself in her sick sister one night, which she had mostly “swallowed down” without letting it out. From this time, it began to ferment inside her body. The blood raged and beat, the heart pulsated, and her whole body was restless. Madame de Moncharlé (ca. 1796), in turn, dated the beginning of her respiratory problems, tight chest, winds, and cramps to her wedding 30 years before. “Like so many others” she had experienced much disquiet at that time and she felt that the “constraint and violence” which she imposed upon herself on that occasion might have contributed to her bad health.

From the Heart to the Nerves

Many of the assumptions and observations which guided 16th- and early 17th-century writing about the physiology and pathology of passions remained important and influential far into the 19th century. This may seem surprising at first sight. After all, these notions were profoundly shaped by Galenist physiology, and learned medicine witnessed a massive process of pluralization from the late 17th century onwards. New anatomical, physiological, and pathoanatomical findings changed the prevailing ideas about the body and its diseases. A range of new theories and medical systems were proposed, from iatrochemistry and iatromechanism to Stahlianism (Stahl, 1719) and vitalism, and their representatives frequently also approached the nature and the effects of emotions (Bound Alberti, 2010, pp. 23–33; Rather, 1965). Just as the new theories and discoveries did not easily do away with well-established therapeutic practices like bloodletting and purging, many of the traditional explanatory elements that had been used to account for the emotions and their effects remained very much alive. In the eyes of physicians and patients alike, emotions remained major causes of disease. Indeed, if anything, the belief in their pathogenic powers increased and they continued to be linked with or indeed identified with the material, physical movement of the heart, the blood, and the spirits in the body.

Even the impact of William Harvey’s discovery of the blood circulation (W. Harvey, 1628)—with its fundamental reinterpretation of the role of the heart in the body—was remarkably limited. Harvey’s work did by no means turn references to the heart into mere metaphors, as Barbara Duden (1995, p. 136) and others have claimed. Many references to the heart as a site of emotional experience and sensation retained their “physiological,” nonmetaphorical connotations long after Harvey’s discovery. From an 18th-century point of view, the heart could still change its beat, it could still be “dilated” or “constricted,” and get “warmer” or “colder” if only due to the amount of blood in it. Rather than invalidating the traditional account, Harvey’s discovery enriched the explanatory arsenal with references to yet another kind of motion and its effects on matter inside the body: The emotions were now believed to exert their harmful influence also by affecting the circulatory movement of the blood (Burmannus, 1719, p. 16). Sorrow and sadness made the blood thick and sluggish, Christian Friedrich Richter (1705, p. 122) explained. Joy, the Jesuit Leopold Neystifter (1721, pp. 166, 201–202, 217–218) specified, dilated the heart and widened the arteries and the viscera, making it easier for the blood to pass through. Hate and sadness had the opposite effect, making the heart and the vessels contract. Patients were diagnosed and treated accordingly. “Passions of the soul,” explained Giovanni Maria Lancisi (ca. 1695) in the case of a lady with “suppressed” menstruation had deprived the blood of its “fermentative” as well of its “circulatory” motion. Similarly, the famous French physician Charles Barbeyrac (1693) commented on the case of a severely dropsical lady that her chagrin and sadness had contributed to her disease by making the movement of her blood too sluggish.

In 18th-century autobiographical writing and in the thousands of German and French patient letters from that period that I have seen, I have not been able to identify a decisive impact of the new medical theories and findings either. From mid-18th century, however, another medical innovation did leave a profound mark on the learned medical understanding of the “passions” as well as on lay accounts of emotional experience: the rise of the “nervous system” and its associated new concepts of “sensibility” and “irritability.”

By that time, the nerves in general had assumed a central place in learned medical theory and practice (Stolberg, 2011, pp. 159–195). Initially, this was part of a gradual shift in late 17th- and 18th-century medicine from concepts of humors and spirits towards the solid parts, the organs, and the fibers. The solid parts in general came to be seen as the principal sites of physiological and pathological phenomena. In the second half of the 18th century, however, the “nerves” assumed unprecedented explanatory power when they were linked to the new physiological concepts of sensibility and irritability. Cartesian writers on the emotions had already for some time underlined the role of the nerves as mediators, but they conceived them as hollow pathways for the movement of the spirits (van Hogelande, 1676, p. 98). The new paradigm of “nerves” and “nervous diseases,” by contrast, circled around the nerves as solid structures that were endowed with specific vital properties. Experiments had shown that, even for some time after the death of the organism, the fibers of muscles and nerves reacted to stimuli from the outside in a very specific manner, most obviously by a muscular contraction. Soon the new concepts were not only applied to nerves and fibers but to the entire nervous system and ultimately to the person as a whole. Medical writers now attributed many physical and “moral” characteristics of individuals—and in particular their emotion responses—to their peculiar sensibility (Williams, 1994). Depending on the sensibility and irritability of their nerves, individuals were more easily moved to compassion and sympathy, but also more likely to be irritated even by minor occurrences like the sound of a glass of water that was put on a table. The new framework also offered an explanation for differences in the affective life and emotional qualities according to class and gender. Members of the upper class and women—and more than anyone, upper class women—and their nerves were seen to be endowed with a particularly high degree of sensibility and irritability (Stolberg, 2011).

The belief in the strong pathogenic powers of the emotions remained pervasive. Only the explanations changed. Strong passions were now thought to damage health, above all, through their effects on the irritable nervous fibers (Tissot, 1790, pp. 322–430). Even the impact of the emotions on the heart could now be described as mediated through the nerves. “The emotions [“Affecten”] have great influence on the body,” the major 19th-century German encyclopedia by Ersch and Gruber (1818, pp. 135–137) pronounced, “they act on the nerves and by that on the heart and on the circulation of the blood, slowing it down or accelerating it suddenly.”

Within a few decades, the “nerves” likewise shaped markedly how laypersons described—and presumably experienced—themselves and their loved ones. The profound influence of the new concepts of nervous disease and nervous sensibility or irritability can be traced in contemporary novels, autobiographies, as well as in hundreds of patient letters. Patients and their families came to interpret virtually every kind of ailment as “nervous,” though there were some symptoms which were associated particularly closely with “nervous” disease, such as cramps and convulsions, headaches, dizziness, eye disturbances, tinnitus (ear ringing), and bad sleep. Under the impact of the new nervous paradigm, patients even complained of new, previously unheard of symptoms: patients reported how they felt an unpleasant “tightening,” “contraction,” or even “trembling” of their nerves (Stolberg, 2011).

The new paradigm did not entirely replace older notions. In their letters, some patients or their relatives combined the new nervous concept with older notions of the heart as the primary site of emotion. It was not so much that violent passions affected the health of his sick sister, a patient’s worried brother wrote (Tissot, 1772–1791). When her mother died, her convulsions had only increased a little, but sadness had “taken root in her heart” and “mined” it so to say. At the slightest disagreement, she burst into tears—in fact, she probably had spent half of her life crying. In the end, if he was allowed to say it this way, she had “no more nerves in her heart.” In most letters, however, more specifically “nervous” effects of emotions dominated, and references to the heart increasingly became exclusively metaphorical. Patients and their families described, in particular, headaches and other painful sensations, dizziness, ringing ears, cramps, and convulsions as resulting from strong emotions. Thus the Countess of Non (Tissot, 1772–1791), a mother of seven, linked the beginning of her illness very precisely to the death of one of her children. From that time, she suffered from dizziness, yawning, bad taste in her mouth, trembling knees, grinding of her teeth, hot flushes, swellings, a sensation of heaviness, restlessness, and other signs of an extreme nervous irritability, as she took it, which was aggravated right before and during her periods. Mme de Rays, a 24-year-old lady from Strasbourg (Tissot, 1772–1791), to cite another example, was tormented by frequent attacks of “vapors,” cramps, and panic during the 2 years of her unhappy marriage. Her nerves were “affected” and she suffered from melancholia. When her husband suddenly died, she experienced an even ghastlier “revolution” in her body, with “convulsions” over several days. Field marshal Grivel (Tissot, 1772–1791), in turn, according to his family, felt that the popular uprising during the French Revolution and the sacking of castles in his neighborhood—even though his own castle was spared—had made him more sensitive and restless and had attacked his “nervous fluid.”

The negative effects of repressing emotions now also were expressed in nervous terms. M. Larrei (Tissot, 1772–1791) reported that his efforts to master himself at games, to play with “noblesse,” that is, “losing one’s money gracefully” without showing distress had done him no good. Winds, colic, and an excessive sensibility of his nerves were the result.

The shift of focus in emotional physiology from the mobile humors and spirits to the more solid nervous system also seems to have encouraged a new understanding of remote and/or chronic emotional trauma. Childhood experiences came to be described as something that could leave a lifelong mark on the physical constitution and on the nerves. “In a singular manner,” a middle-aged woman (Tissot, 1772–1791) informed Tissot in a detailed account of her life,

just a word or an unaccustomed glance cause me disquiet, and for this reason I can regard it as my greatest calamity that I lost my father and mother very early and was left to the care of people who in no way took account of my naturally given apprehensive character.

Similarly, the Count de Las Cases (1832) traced the beginnings of his suffering back to his difficult childhood. His parents’ harsh, severe manners had brought him into a general state of weakness and exhaustion. At age 10, he was given away to relatives for 2 years, where he was always alone and not allowed to leave the house. He became sad and melancholic, his head felt heavy, he was constipated, his sight and appetite deteriorated, and he experienced spells of mental “absence.” Back with his parents, he suffered once more from his father’s harsh ways. He had attacks of ravenous hunger, his limbs felt restless, his heart beat violently, and he began to experience cramp-like sensations, which forced him to pause on his walks for fear his heart would otherwise burst.

Conclusion

As this article has shown, the physiology and pathophysiology of the emotions was an important topic in early modern learned medical writing. Temperament and the associated notions of humors and qualities explained individuals’ varying disposition for certain emotions. The physical processes and changes that were believed to accompany or indeed to constitute the emotions, by contrast, were attributed primarily to movements—of the heart, the spirits, the blood, the humors, which moved towards pleasant objects and withdrew from unpleasant ones. Only with the rise of the nerves in the 18th century, a new paradigm began to take the place of these ideas. The emotions were still not located primarily in the brain, but the movement of the heart and the spirits receded into the background and the more solid—though still somewhat moveable—irritable and sensitive nerves took their place. A closer look at lay sources showed that the explanatory models that we find in learned medical writings were, to a large part, shared by laypersons and shaped the ways in which they described and presumably experienced their emotions.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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