In The Anatomy of Melancholy (1621), Robert Burton refers to anger only as a mental perturbation, endorsing the much-quoted Horatian dictum that it is a short-lived form of madness and Areteus’s view that if it is excessive, it produces insanity. Yet this notion of anger stands in contrast to the much more complex and nuanced views which emerge from medieval and early modern medical works. My work highlights enlightening but understudied references to anger in Galenic medical treatises, surgical handbooks, plague tracts and popular regimens of health circulating in Latin, English, Spanish, French, Catalan, Italian and German between 1250 and 1700.

Etching of an angry man, by W. Hebert, c1770, Wellcome Library

In these medical sources, anger is discussed as one of the factors of health and disease related to lifestyle, and as a movement that arises from a mental image or cognitive judgement and manifests internally in the body, altering it even before it becomes manifest externally, and before any action is taken. The most standard medical approach was to describe anger, like all other ‘accidents of the soul’, as a movement of natural heat and vital spirit (the subtle vapour in the arterial blood which was thought to mediate between mind and body). As Arnald of Villanova (d. 1311) explains in his influential physiological account of anger (based on Avicenna, and still echoed in Nicolas de la Framboisière, d. 1636), spirit first moves towards the heart, building up the courage to attack, and making the heart heat up and expand and contract very fast. This produces a rush of heat to the surface of the body in preparation for revenge.

Drawing on Galen, medical authors often distinguish between wrath (associated with manly
courage and abundance of heat) and a more moderate form of anger. Some authors, such as Roger Bacon (d. 1294) and Estéfano de Sevilla (d. 1387), argue that moderate anger can be healthy for all kinds of people (all temperaments) in helping the body to maintain its natural heat in a moderate effervescence, thus ensuring that the blood reaches and vivifies all the bodily organs. Others, such as Helkiah Crooke (d. 1648), dismiss the anger experienced by faint-hearted people as fretfulness and pettishness.

The regimens of health published in Latin and in vernacular languages tend to emphasise that the heat of anger dries up the body and that the swelling it produces in the heart can lead to mental confusion. However, they also suggest that an outburst of anger might be beneficial for people who are cold by temperament or as the result of poisoning or sickness. To these uses of anger William Bullein (d. 1576) adds that it can be a remedy for idle people who have little natural heat in their body, and that it can also help to counteract the effects of cold weather.

The principle that bodily coldness could be counteracted with the warmth produced by anger is exemplified, for instance, in the anecdote Lluis Alcanyís recounts in his plague tract (1490) of a physician curing the extreme weakness of a patient by constantly reminding him of events from his past, which provoked his anger. It is also applied by Taddeo Alderotti (d. 1296) in his Consilia, when he suggests that anger is not always harmful, and that it can even be beneficial for patients suffering from weak nerves. Following the Hippocratic and Galenic principle of curing by contraries, we can see why anger (hot and dry) might have been thought to be more helpful than joy (warm and moist) in counteracting the assumed causes of weak nerves (excessive cold and moisture).

By contrast, later medical authors tend to warn against the deleterious effects of anger on physical health. For instance Álvarez de Miraval (d. 1598) draws on the authority of Avicenna to stress that anger can cause heart palpitations and heart disease, and refers to Averroes in noting that it can also make people spit or cough blood and produce ephemeral fevers and epilepsy. Jacob Joseph Joepser (d. 1695) suggests that it can also produce acute pain in the male genitals, apoplexy and paralysis. Despite such warnings, belief in the therapeutic use of anger in dealing with cold diseases seems to have survived into the late 18th century, when the popular medical author William Corp (d. 1790) acknowledged the benefits of anger in conditions such as paralysis and intermittent fevers.

In examining continuities and changes of perspective in medical discussions of the impact of anger, fear, sadness and joy on physical and mental health, I take a wide chronological
and geographical approach, which I hope will prepare the ground for further comparative work in medieval and early modern medical history.

Elena Carrera is Senior Lecturer in the Spanish Golden Age, and a member of the steering committee of the Centre for the History of Emotions at Queen Mary, University of London. This piece first appeared in Wellcome History magazine.