ABSTRACT: In ancient Greek theories of health, it was the equal balance or mixing of the humors or elements (i.e., the isonomic mean) that comprised the ideal healthy state. In the Aristotelian Problema XXX.1, however, there is a description of a form of melancholic constitution that is both 1) itself characterized as a mean, and 2) thought to lead to intellectual outstandingness. This is theoretically problematic since the melancholic constitution was by definition a constitution in which there was a natural preponderance of black bile. Thus, there appear to be two incompatible means that are descriptive of the ideal in ancient Greek medicine: the isonomic mean that underlies the ideal healthy state, and the melancholic mean that describes the melancholic who is capable of greatness. This paper attempts to understand the melancholic mean as described in Problema XXX.1 by considering the two different but related models of this mean that are suggested in the text. A reconciliation of the two somatic ideals is argued for on the basis of what else is said in the Problema, as well as ideas found in the Hippocratic work Airs, Waters, Places and other Aristotelian Problemata.

Why is it that all those who have become eminent in philosophy or politics or poetry or the arts are clearly of an atrabilious temperament, and some of them to such an extent as to be affected by diseases caused by black bile, as is said to have happened to Heracles among the heroes? (Problemata XXX.1 953a10-14) (1)

So begins the Aristotelian Problema XXX.1. Why indeed! The atrabilious temperament or melancholia is, according to Aristotle, a natural disposition in which there is a preponderance of black bile over the other humours. The healthy somatic ideal, however, was conceived by Greek medical theorists as the equality of the humours, either with respect to their quantity or their relative strengths (quality); disease was by definition an excess of one of the humours or elements. If the ideal state with respect to the humours was equality or isonomic proportion, but "all those who have become eminent in philosophy or politics or poetry or the arts..." be melancholics, then which state is the ideal — health or melancholia?

The explicit association of melancholia with genius is found for the first time in this Problema. The author was working within a long tradition that linked the ideal state with a mean. According to some thinkers, the mean was conceived simply as kairos, or due measure; in other authors this mean was numericized, and thus conceived as a proportion or ratio between two or more opposites (logos, summetria, harmonia, isonomia, etc.). Wherever the idea of a mean is found (whether it be in writings on ethics, medicine, rhetoric, the crafts, cosmology, music, geometry), it describes the state at which one should aim (the virtuous, health, beauty, etc.) which lies between an excess and a deficiency.

While it doesn't strike me as strange that genius be characterized as a mean (given that so many other ideal states in Greek thought were so characterized), what I do find puzzling and interesting is that melancholia is, by definition, an excess compared to the state of health. Therefore there are two competing states for the ideal psychological/somatic state; on the one hand health, and on the other hand, a certain kind of melancholia. (2)

This discrepancy wouldn't be at all strange if health had been defined simply as the 'normal'. After all, the normal is just what is common, and of course melancholic geniuses weren't common. In this case, the genius, as a mean, would be the ideal, and health, as a mean, would really just be constitutive of mediocrity.

But health wasn't mediocrity! Being healthy was something that was very difficult to achieve in the ancient world (indeed it still is). Health was something to strive for, something fleeting and valued. As Ludwig Edelstein wrote, "The balance of health could necessarily never be permanently sustained, but attained only for the moment"; "...there [was] neither in theory nor in practice a healthy Man. For health [had] no being but [was] a continuous becoming". (3)

Perhaps because of the long-standing tradition that associated ideal states with a mean, the author of the Problema XXX.1 described a certain form of melancholia itself as being constituted by a kind of mean:

For as men differ in appearance not because they possess a face but because they possess such and such a face, some handsome, others ugly, others with nothing extraordinary about it (hoi de methen echontes peritton) (i.e. those whose looks are ordinary (hoitoi de mesoi ten phusin)); so those who have a little of [the melancholy] temperament are ordinary (mesoi eisin), but those who have much of it are unlike the majority of people (tois pollois). For if their melancholy habitus is quite undiluted they are too melancholy; but if it is somewhat tempered they are outstanding (perittoi). (954b21-27) (4)

Melancholia, as it is described in this Problem, is an excess of black bile. Everyone has some black bile, but the melancholic has too much of it. Further black bile is the carrier of the qualities of hot and cold in the body, and it itself is very variable. Since black bile is prone to great fluctuations in temperature, and it is the temperature of the black bile that affects, more than anything else, the character (955a33), there is great variety in the temperaments of melancholics. On the one hand, those melancholics whose black bile is very cold by nature are "dull and stupid" (nothroi kai moroi), whereas melancholics who have a large quantity of very hot black bile become "frenzied, or clever or erotic or easily moved to anger and desire" (954a31-34). It is between these two extremes that a third kind of melancholia is found — between the melancholic who is 'dull and stupid' and the melancholic who is frenzied. In between the overheatedness of the soothsayer and overly chilled dull melancholic is the melancholic genius whose temperature is a mean between theirs.

There are two passages in the Problema XXX.1 that describe this melancholic mean. I shall quote both and then examine two possible models of this mean and the relative explanatory virtues of each model. My goal is to determine how the Greeks, and in particular, the author of the Problemata, reconciled the two psychological/somatic ideals: health and melancholia.

The Passages:

(1) Those in whom the excessive heat dies down to a mean temperature (to meson) are atrabilious, but they have more practical wisdom and are less eccentric (ektopoi) and in many respects superior to others either in education or in the arts or in public life. (954b1-3) (5)

(2) And since it is possible for a variable state to be well tempered (eukraton) and in a sense a favourable condition, and since it is possible for the condition to be hotter and then again cold, when it should be so, or to change to the contrary owing to excess, the result is that all atrabilious persons have remarkable gifts, not owing to disease but from natural causes. (955a35-39) (6)

The first of these two passages provides evidence that indeed, the author of this Problema did conceive of a certain form of melancholia as both a mean and an ideal insofar as the affected was superior to others in many respects. The second passage gives us the same impression. Melancholia, the author writes, even though it is so variable (anomalian), can be 'well-tempered' (eukraton) and favourable (kalos), and thus all melancholics have 'remarkable gifts'.

The Greek word here translated as 'remarkable gifts' is perittos, and the English 'outstanding' or 'out of the ordinary' may be closer to the original meaning. Perittos commonly meant 'above or more than the average or the common', and thus could have either positive or negative connotations — extraordinary or outstanding when used positively, and monstrous, superfluous or excessive when used negatively. (7) What the use of perittos in this context tells us is that the author of the Problemata thought that it was only those melancholics whose black bile was hotter than normal who were superior to others. Regardless of whether perittos is used positively or negatively, it means an excess, not a deficiency. We are thus working with a melancholic 'mean' that is on the excessive side of the isonomic, healthy state, not the deficient. That this is what the author envisioned is confirmed in passage (1) where he writes that it is those melancholics in whom the black bile's excessive heat is 'relaxed towards a mean' who are superior. Therefore it is those melancholics who are more prone to fits of frenzy and divine inspiration than those who are dull and stupid who are by nature closer to the melancholic mean.

As I see it, there are two possible models for this favourable melancholic mean that is excessive of the isonomic proportion. On the one hand, passage (1) suggests that the gifted melancholic's black bile is just slightly hotter than the normal person's: "the black bile's excessive heat is relaxed towards a mean" or "the excessive heat dies down to a mean temperature." But the Greek in this phrase is corrupt. (8) While it is clear that the general meaning is that the favourable melancholic state is an intermediate state between those who are frenzied and those who are dull, it is unclear whether this intermediate state is to be characterized by a mean itself that is excessive of the isonomic mean of the healthy state, or whether the excessive heat is relaxed towards the isonomic mean and so the melancholic state is to be characterized by an impure ratio or incommensurable relation. On either alternative, however, the favourable melancholic state is excessive of the healthy mean. I shall call this model the 'Just a little off the mark' model.

This model fits passage (1) rather well. On this view, the favourable melancholic temperament is characterized by a state (conceived as a mean or otherwise) that has too much black bile, and whose temperature is just slightly hotter than the isonomic healthy state. And there are benefits to having a temperature slightly warmer than the isonomic mean. Given the chilling effects of many environmental influences, being a 'warm' melancholic will have a net result of balancing the external cold. Moreover, Aristotle believed that having more warmth in the region around the heart was conducive to a more active imagination.

This model is also compatible with the beginning of passage (2). Indeed, in the second passage, it is more strongly suggested that the favourable melancholic state is a mean of sorts, and not just a state that is close to the isonomic mean; the variable melancholic state is here described as eukraton — good mixture, indeed, an adjective often used in medical treatises to describe the blending of the humours or elements constitutive of the state of health. (9)

The elucidation of what the author meant by eukraton and kalon when applied to the melancholic state, however, makes the 'Just a little off the mark' model of melancholic genius inadequate. Explaining how these terms can be applied to the melancholic state, the author wrote,

...that is to say, to be now in a warmer and then again a colder condition, or vice versa, just as required (hopou dei), owing to its tendency to extremes... (955a32-34) (10)

Far from being a static mixture of hot and cold that is slightly excessive of the isonomic healthy mean, the favourable melancholic constitution appears to have wide fluctuations in the heat of its black bile. Furthermore, the author of the Problema wrote that these temperature fluctuations occur 'just as required' (hopou dei). With the 'Just a little off the mark' model, there appears to be no way to understand this. If the melancholic mean is a static mixture of humours in which the black bile is slightly hotter than it should be, then there is no room for now hotter and now colder black bile, and the meaning of 'the temperature changing "just as required"' is obscure.

One final point about the 'Just a little off the mark' model of the melancholic mean. We must recall the problem that the author posed for himself at the beginning of XXX.1: What is the reason why some melancholics are exceptional? The author is attempting to explain why a slight preponderance of hot black bile is favourable, indeed even desirable. And he is, in passage (2), giving us an explanation of the physiological mechanism or principle that leads the melancholic to greatness. If this static model of the melancholic mean is correct, then it would seem that the gifted melancholic is always just a little hotter than the healthy 1:1:1:1 ratio. Slightly heated black bile will explain a more vivid imagination, but this, presumably would also be caused by living in a slightly cool climate. This model, it seems then, cannot explain why the melancholic is exceptional. It is clear that we need an explanation that will account for the variability of the melancholic's mean as suggested in passage (2), and his or her greatness. Let's look at passage (2) further. (11)

In passage (2) the author wrote that the gifted melancholic has a mixture that is sometimes hotter, sometimes colder. What possible benefit could this sort of temperature variability give to the melancholic? In order to answer this question, we must look at a passage found early in Problema XXX.1. The author, in a discussion of the behaviour of melancholics in different sorts of situations, wrote:

Such a constitution makes for great differences in behaviour in dangerous situations in that many of these people react inconsistently in frightening circumstances; for according to the condition of their bodies at a given time in relation to their temperament, they behave now one way now another...

(954b3-8, trans. Klibansky)

Melancholics are, by nature, susceptible to great temperature variations. The author goes on to give examples of the variable reactions to situations given different temperatures of the black bile. For example, if something fearful occurs when the black bile is cold, the individual will be very cowardly. The reason is that the pre-existing cool state of the black bile is made even colder by fear. Fear has a chilling effect, and indeed, cowardliness is associated with cold black bile. The association of fear with cold is backed up by empirical evidence: people who are cold tremble, and so too do those who are frightened.

If, however, a person encounters a fearful situation when his/her black bile is hotter than normal, then "fear reduces it to a moderate temperature and causes a man to be in his senses and unexcited" (954b14-15). Therefore, a hotter than normal constitution can be beneficial to an individual in some situations, i.e. when it counteracts the environment to his/her benefit. Further, slightly excessive heat can also produce valued personality traits, such as cheerfulness and hope, whereas coldness 'beyond due measure' can lead to "groundless despondency" and sometimes, wrote the author, the afflicted will hang him/herself (954b34-36).

What these examples suggest is that a melancholic whose black bile is slightly hotter than normal will be better equipped to function in some situations. The temperature of the black bile is extremely susceptible to environmental influence. When these influences have chilling effects, the melancholic's hotness will counteract the external coldness, and the result will be black bile with a moderate temperature, and consequently, behaviour and an emotional state that is useful, desirable or ideal.

Such is the author's explanation of why warmer than normal black bile is beneficial. What, then, of his claim that it is melancholics' susceptibility to be now in a warmer condition, now colder or vice versa, "just as required" that gives them their outstandingness? From this assertion in passage (2), it would appear that there are benefits to being slightly colder than normal, even though cold black bile has already been associated with despondency, stupidity, etc.

While the author gives no explicit examples of favourable cold states of black bile-indeed, cold black bile is only associated with undesirable states in this Problem-there will, presumably, be environmental influences that make a person too hot, influences that should be tempered; it would seem plausible that having a cool disposition in the face of very hot environmental influences would be beneficial in that, like the case of the hot disposition facing the cooling effects of fear, a moderate temperature will ultimately result.

Take the case of Socrates, who is mentioned explicitly in this Problema as having a melancholic disposition. We know that he was mentally outstanding and courageous, both qualities that could be explained by slightly excessive heat. But we also read in the Symposium (214a) and elsewhere that he was supposedly unaffected by wine. This is one of the things that makes him exceptional in the eyes of Alcibiades. Now, we know that the Greeks believed wine to have a heating effect on the body. (12) So it is at least plausible that Socrates was thought to have been immune from the heating effects of alcohol by being cooler than the isonomic mean (at least in this situation). If this were so, the natural heating effects of the wine would be counteracted by Socrates' coolness, and he would thus not be prone to the usual excessive talkativeness, boisterousness and frenzy of drinking bouts. This, then, is one example of the potential positive effects of a cool-ish internal temperature. (13) But Socrates is not cool by nature all the time. If he were, he would be dull and stupid instead of courageous and clever.

Therefore, it is clearly beneficial to have this variability of internal temperature so that one can counteract whatever environmental effects are prevalent "just as required". So far so good. But a question remains: How can the melancholic genius do this? It appears that the ideal melancholic has some sort of regulating principle that keeps the temperature for the most part slightly above the 1:1:1:1 (isonomic) ratio, but yet also allows it to be sometimes hotter and sometimes colder, depending on what external factors need to be counteracted.

Unfortunately, nowhere in this Problem is such a regulating principle mentioned. But, if we look slightly further afield, we can start to see that this sort of principle might have been what the author had in mind.

Elsewhere in the Problemata the author again makes use of such a regulating principle. Consider Book XIV, chapter 16:

Why are the inhabitants of warm regions cowardly, and those who dwell in cold regions courageous? Is it because human beings have a natural tendency which counteracts the effect of locality and season (for, if both had the same tendency, they would soon be destroyed)? Now those who are hot by nature are courageous and those who are cold are cowardly. The effect of hot regions upon their inhabitants is to cool them (for, their bodies having rarities, the heat escapes out of them), but those who live in a cold climate become heated in their nature, because their flesh is condensed by the external cold, and when it is in this condition the heat collects internally. (910a37-b6) (14)

Working with an alloiopoetic understanding of the environment, the author theorizes that all people naturally counteract the prevailing temperature of the environment. Moreover, whatever internal temperature results from this counteraction causes one's temperament. Interestingly, a physiological mechanism is given-the pores are constricted by external cold, capturing the internal heat, whereas they are dilated by a hot environment, allowing the natural heat generated by a living body to escape. (15)

If it is the case that everyone counteracts climatic temperature to a certain degree, then could it not be possible that the melancholic's greatness is attributable to an ability to counteract the temperature of the environment more quickly than most? That melancholics are described as being plagued by sores at the beginning of Problema XXX.1 fits nicely with this idea. If we take seriously the idea that behind the alloiopoetic understanding of environmental influence is the constriction and dilation of the pores, then when problems arise in the mechanism, the eruption of sores would seem a likely consequence. In Book II of the Problemata (on problems associated with perspiration), this is suggested. The idea found in chapters 21, 33, 40 and 42 is that sweating is not only found more often in summer than in winter, but that it must be induced if it is not occurring naturally, since moisture of all kinds is more likely to putrefy and cause illness in the heat of the summer.

So far, then, we have seen that variability may be more conducive to health, insofar as the melancholic can more effectively counteract the predominant environmental quality than the 'normal' person, and thus can better maintain an overall balance between the internal and the external environment. And this ability will have both somatic as well as psychological effects. Not only should the melancholic be healthier, but (s)he should also be more 'mentally balanced'. Or will she? There are still some questions surrounding the meaning of the idea that the melancholic's black bile is now warmer, now colder "just as required". From the textual evidence, it seems safe to conclude that the melancholic's body, in particular its pores, react to the external temperature with the result of an overall balance between the external and internal — somatic health. And so the meaning of "just as required" is to be understood in terms of the body's adjustment. But what consequence does this have on one's mental life? While it is clear that being hot in the face of something fearful, and cool in the face of drinking alcohol are valuable, there is no guarantee that the melancholic will be so lucky as to be already cool before drinking, and already hot before getting a scare. It would seem that the melancholic would be wise to drink only after having had a hot bath, and be sent to war on ice. But one cannot have complete control over such things, nor, presumably, would one want to. Therefore, the consequence for one's mental life of these internal temperature variations is a temperament that is full of change — mood swings, we would call it-bipolar disorder.

That dramatic mood swings are beneficial is an idea that is alien to late 20th century psychiatry; it is an illness to be cured by pills and electric shock treatment. Yet Greek authors believed that external climatic variability (with the result of internal character variability) was extremely beneficial to one's character, and that it led to intellectual outstandingness. It was written in Airs, Waters, Places that frequent changes in the climate cause a certain wildness, unsociability and spirit in the inhabitants. For this reason, wrote the author,

Europeans are also more courageous than Asiatics. For uniformity engenders slackness, while variation fosters endurance in both body and soul; rest and slackness are food for cowardice, endurance and exertion for bravery. (xxiii.19-28)

Further, in chapter 24 he wrote that people who live in rich, soft, well-watered, temperate lands are fleshy, ill-articulate, lazy, cowardly, slack, sleepy, thick-witted in the arts, and neither subtle nor sharp (xxiv.46ff)

Similar ideas are found in Politics VII.vii. There Aristotle wrote that the virtue associated with living in cold regions is courage but that inhabitants of these areas are usually deficient in skill and intelligence. The opposite is the case with those who live in warm countries: there is found dexterity and wisdom, but there is a deficiency in spirit. This, Aristotle wrote, is the reason why the peoples of Europe have remained free, but the peoples of Asia "continue to be peoples of subjects and slaves". He continued,

The Greek stock, intermediate in geographical position, unites the qualities of both sets of peoples. It possesses both spirit and intelligence: the one quality makes it continue free; the other enables it to attain the highest political development, and to show a capacity for governing every other people.... (Politics 1327b29-32) (16)

What the Greeks as a people were known for, the melancholic had as an individual. Given that certain internal temperatures are associated with certain virtues or ideal character traits, it makes sense that only she who has internal variability can have the potential for the best qualities of all the temperaments.

What then, can we say about the two somatic ideals — health and melancholia — based on the views found in the Aristotelian Problemata and elsewhere? If seems that while the isonomic proportion is still the somatic ideal, moderate melancholics are more likely to achieve this ideal than those who are naturally disposed to have their humours in equal balance when the environment is added into the equation. Why this is so is because of the extreme susceptibility that humans have to environmental influence, and the fact that one needs to counteract the environment's temperature in order to achieve health.

So melancholics have a better chance of counteracting the environment and are thus more likely to achieve an overall isonomic healthy balance. Because of this, their internal temperature is quite variable. And this is the cause of their changes in mood and mental aptitude. The moderate overheatedness of melancholic geniuses ensures that they are more susceptible to bouts of imaginative fancy, but this mean temperature is not always present, nor, I think, would it be beneficial if it were. The ideas and fancies would remain undeveloped if the melancholic were not then able to look at these ideas with a critical eye-a sober eye-a cool eye. As one hears of the creative process today, there are moments of inspiration and moments of rational analysis, editing, criticism. It is only the melancholic who will naturally have both.


(1) All translations of the Problemata are E.S. Forster's as found in The Complete Works of Aristotle Vol. II (ed. Jonathan Barnes), Princeton (1984) unless otherwise indicated.

(2) There was not, for the Greeks, the great split between the mental and physical that there is today. Melancholia was a state in which there was a natural preponderance of a physical substance in the body, and this preponderance had both somatic effects (the eruption of sores, epilepsy, etc.) as well as psychic effects (depression, etc.).

(3) Ludwig Edelstein, Ancient Medicine (eds. Owsei Temkin and C. Lilian Temkin) Baltimore (1967): 70, 84.

(4) Translated by Raymond Klibansky, Erwin Panofsky and Fritz Saxl in Saturn and Melancholy: Studies in the History of Natural Philosophy, Religion and Art (1964).

(5) A slightly different translation is found in Saturn and Melancholy. It reads: "Those, however, in whom the black bile's excessive heat is relaxed towards a mean, are melancholy..." (p. 24).

(6) The Klibansky et. al. translation of this passage is: "Since it is possible for this variable mixture to be well tempered and well adjusted in a certain respect — that is to say, to be now in a warmer and then again a colder condition, or vice versa, just as required, owing to its tendency to extremes — therefore all melancholy persons are out of the ordinary, not owing to illness, but from their natural constitution" (p. 29).

(7) See Liddell and Scott's Greek-English Lexicon, Abridged Edition, Oxford (1989): perissos.

(8) See footnote 58 of Saturn and Melancholy, p. 24.

(9) See, for example, the Hippocratic work Nature of Man iv. 4-7.

(10) As translated by Klibansky, p. 29. Forster's translation is as follows: "...since it is possible for the condition to be hotter and then again cold, when it should be so, or to change to the contrary owing to excess...".

(11) There is a third model of the favourable melancholic mean that I will not consider in any great detail in this paper because it too cannot accommodate the variability of the gifted melancholic's mean. It is a model based on the (superficial) similarities between the melancholic state and the man with 'greatness of soul' (megalopsuchia) as described in Aristotle's Nicomachean Ethics IV.3. The man that is megalopsychic can quite easily be accommodated by Aristotle's relative mean whereas the melancholic cannot, given the textual evidence. The megalopsychic is "an extreme in respect of the greatness of his claims, but a mean in respect of the rightness of them; for he claims what is in accordance with his merits, while the others go to excess or fall short" (NE 1123b13-15). Thus the proud man can be characterized by a mean that is in between different extremes than the common person, but it is still the same proportion (in all likelihood a geometric proportion). The melancholic, on the other hand, does not fit this model given that (s)he has a preponderance of black bile that is prone to wild temperature fluctuations. The two states — melancholia and megalopsuchia — are similar insofar as they are both perittos, but they are outstanding or excessive in different ways.

(12) See, for example, Plato's Timaeus 60a, and the Aristotelian Problemata Book III. Interestingly, wine (as well as excessive talking!) was believed to be an antidote to hemlock poison, which worked by cooling the body. (See Plato's Lysis 219e and also Plato's Phaedo 63d-e.)

(13) The author of the Problemata explicitly links internal coolness with sobriety in XIV.15. Further, in addition to engendering fearfulness, a cool temperament is thought to be the mark of wisdom and inquisitiveness! This seems to be at odds with what is written in XXX.1 where a cool temperament is associated with stupidity. I shall return to this discrepancy shortly.

(14) See Herodotus' Histories IX.122 and the pseudo-Platonic work Epinomis 987d.

(15) There is another, different understanding of how the climate affects an individual's constitution in ancient humoural writings — one in which the body assimilates itself to the environment. For example, if one lives in a cold environment, one's internal temperature will too be cold. This homeopoetic understanding of the effect of climatic temperatures is thought to be present in the Hippocratic Airs, Waters, Places (see in particular chapter xxiv where the author wrote, "The things also that grow in the earth all assimilate themselves to the earth" (64-65)). However, it appears to me that what is most strikingly 'homeopoetic' in this work is that a variable climate produces a variable temperament, a static climate a static temperament. And this idea is consistent with an alloiopoetic understanding of environmental effects on internal temperature. A clearer example of this homeopoetic notion is found in Regimen II. It is interesting to compare the Problems' notion of epidermal pores with the Regimen explanation: "...the air which is breathed, being dry, attracts the moisture from our bodies for its own nourishment, having nothing moister to assail in order to nourish itself therefrom" (xxxvii.24-26). Ancient humoural theory contains both alloiopoetic and homeopoetic understandings of environmental effects. It is a muddle that torments the historian of medicine..., which is why I restrict my discussion to the alloiopoetic.

(16) As translated by Ernest Barker in The Politics of Aristotle, Oxford (1946), (4th printing 1961): 296. See Herodotus' Histories IX.122 on the idea that courage and freedom is to be associated with inhabiting cold, rugged regions, and the Platonic work Epinomis 987d for the idea that the geographical location of Athens engenders excellence.