For centuries, Shakespeare's tragedies have swept audiences up in dramatic intensity, achieving what Aristotle described as catharsis, the purging of emotional tension through drama. They draw us into the psyche of the protagonist--the angst of Hamlet, the guilt-ridden soul of the Macbeths, and the torment of Lear--with an evocative language of feeling and Shakespeare's use of a most powerful image: the human mind in a state of madness.What drove Shakespeare's characters into insanity? Certainly, it can be argued that outside influences played their part. In the case of Othello, the scheming Iago used his cunning and manipulation to lead his victim into self-doubt and despair. The same could be said for King Lear, who was driven to madness by his ungrateful daughters. Did Shakespeare's tragic protagonists, however, have some pre-disposed disorder? The answers could be in a many centuries old belief that the human body is driven by a state of chemical balance. An imbalance of chemistry could effect the mood of the individual and if not corrected, could lead to permanent illness, madness and/ or death.Body Chemistry: Having a Sense of Humor(s)The theory of body chemistry or humors theory goes back to the 4th century BC. There were earlier cultures in Egypt and Mesepotamia which fluctuated between natural and supernatural explanations of disease, but it took Empedocles to develop theories based on four basic elements and characterized by a quality and a corresponding body humor or liquid:Element Quality HumorFire Heat Blood (in the heart)Earth Dryness Phlegm (in the brain)Water Moisture Yellow bile (in the liver)Air Cold Black bile (in the spleen)These humors were also tied into the seasons as well. Black bile was considered to be a part of autumn, blood was associated with spring, phlegm with winter and summer with yellow bile. Each humor was identified with its corresponding season due to the belief that each humor contained certain qualities. These qualities were closely related to the conditions of the seasons. Thus yellow bile was thought of as hot and dry like summer. Its opposite, phlegm was cold and moist like winter. Black Bile was cold and dry, while its opposite, blood, was hot and moist, like their counterparts, autumn and spring. (http://www.planetpapers.com/Assets/2722.php)The humors, according to medics and physiologists such as Robert Burton, are fluent throughout the body and work to maintain a sense of bodily homeostasis (or equilibrium), preserving one's life and ability to function as such. In The Anatomy of Melancholy, possibly the first major treatise on psychological problems, ever to be published, Burton identifies the humors and their purposes and origins (Burton, 139)."Blood, is a hot, sweet, temperate, red humor, prepared in the meseraicke veins, and made of the most temperate parts of the Chylus in the liver, whose office is to nourish the whole body, to give it strength and colour, being dispersed by the veins, through every part of it. And from it Spirits are first begotten in the heart, which afterwards by the Arteries, are communicated to other parts" (Burton 140)."Pituita, or Fleagme, is a cold and moist humour, begotten of the colder part of the Chylus, (or white juyce coming of the meat digested in the stomacke) in the Liver; his office to nourish, and moisten the members of the body, which as the tongue, are moved, that they may not be over dry "(Burton 140)."Choler, is hot and dry, bitter, begotten of the hotter parts of the Chylus, and gathered to the Gall: it helps the natural heat and senses, and serves to the expelling of excrements" (Burton 141)."Melancholy, cold and drie, thicke, blacke, and sowre, begotten of the more faeculent part of nourishment, and purged from the spleene, is a bridle to the other two hot humors, Blood and Choler, preserving them in the Blood, and nourishing the bones" (Burton, 141).Thus, the humors can control the personality and temperament of human beings: a predominance of the humor Blood results in passionate emotions that emanate from the spleen (the source of this particular humor); an excess of Choler would result in anger and irritability and the like; dryness, or lack of Pituita results in a variety of physical ailments including madness and insanity; and the presence of Melancholy results in various forms of depression (Burton 136).The imbalance of humors and their subsequent conditions were controlled in numerous ways. The most popular (and least painful) method of humor regulation was changing a person's dietary habits. In accordance with the seasons, physicians in Shakespeare's time prescribed additional servings of certain meats, breads, vegetables (carrots cabbages and onions) and herbs. Ales, which were typically low in alcohol were also recommended. Wine was used for a drink, but primarily reserved for the upper-class. In addition, there were butter and cheeses (typically made from sheep's milk), hen and goose eggs. Wild berries would be a delicacy in the Anglo-Saxon diet although they would have to be in season. The lack of refrigeration would lead to a diet deficient in Vitamin C for much of the year, especially during the winter when meals largely made up of salted meat would lead to symptoms of scurvy. A lack of Vitamin A and niacin undoubtedly led to common skin and eye problems, and smoky living conditions probably exacerbated both.(http://www.strangehorizons.com).In terms of herbal remedies, most were designed to purge the body of excess humor, either through coughing, excretion, vomiting or perspiration. Potions were made and in excessive doses, could be lethal. The expressed thick oil of the Castor Oil Plant (Ricinus communis) was used as a powerful laxative and purgative. Fennel Plant (Foeniculum vulgare) stalks were eaten like celery while the seeds were used for the relief of intestinal colic and gas. It was also very beneficial for the liver, aiding regeneration of liver cells. Juniper (Juniperus communis) berries were used as a diuretic, antiseptic, carminative and anti-inflammatory. (http://www.planetherbs.com/articles/herbhist.html).Finally, the most drastic form of balancing the humors was through the practice of phlebotomy or bloodletting. Because humoral theories of illness were believed to be related to an excess of one particular humor, the solutions were to either balance the body with its opposite humor or drain off the extra humor being produced. Bleeding a patient allowed for the control of humors in a particular part of the body. Phlebotomy was administered in two ways, via derivation or revulsion. Derivation meant letting of blood at a point close to the affected area, and revulsion meant that blood was let at the most remote point to the affected area. Both methods had specific indication for use in the case of different illnesses and were widely employed by medieval and Renaissance physicians. (www.intermaggie.com/med/humors.php) There were three main techniques for bloodletting: leeching, venesection, and cupping. In leeching, the physician attached an annelid worm of the species Hirudo medicinalis to the patient, probably on that part of the body most severely affected by the patient's condition. These worms were called leeches because they were used extensively by Anglo-Saxon physicians. (The word for "doctor" in Old English is læce). The worms would suck off a quantity of blood before falling off. Venesection was the direct opening of a vein, generally on the inside of the arm, for the draining of a substantial quantity of blood. Cupping involved the application of glass cups over the skin. When heated, these cups would act as small vacuums, drawing blood toward and then through the surface of the skin. Regardless of the method used, the purpose was the same: alleviating the excess blood in the body in an effort to restore balance and health. (www.strangehorizons.com/2003/20030317/medicine.shtml)The dangers of blood-letting were obvious; infection, weakening of the already sick organism, cutting up an artery instead of a vein causing unstoppable bleeding, accidental cutting of nerves, and the loss of consciousness by the patient were the most common issues a medieval doctor had to deal with while administering phlebotomy. More often than not, the result of blood-letting was either continual sickness or death of a patient. (www.intermaggie.com/med/humors.php)Humors and Shakespeare's Tragic Figures: HamletHamlet is a fine example of humoral imbalance. In today's world, he would probably be diagnosed as clinically depressed. In the world of humors, however, he would have an excess of black bile, thus giving him a case of melancholy. Melancholy had a specialized and essential role in the function of the body. It served to feed the spleen and protect the blood from becoming too thin. (Hoeniger 106). Andreas Laurentius (1558-1609) describes in his Discourse of the Preservation of Sight: of Melancholike Diseases: of Rhuemes and of Old Age, the symptoms of a man with a dangerous excess of melancholy:"The melancholike man... is out of heart... fearfull and trembling... he is afraid of everything... a terror unto himselfe... he would runne away and cannot goe, he goeth always fighting, troubled with... an unseperable sadnesse which turneth into dispayre... disquieted in both body and spirit... subject ot watchfullness, which doth consume him... dreadful dreams... he is become as a savadge creature haunting the shadowed places, suspicious, solitarie, enemie to the sunne, and one whom nothing can please, but only discontentment, which forgeth unto inselfe a thouand false and vain imaginations." (Laurentius 82).According to Laurentius' symptomatology, Hamlet is suffering from severe humoral imbalance. Evidence from Shakespeare's text directly and convincingly correlates to the portrait of Laurentius' melancholike. Hamlet is "out of heart" all the other characters in the play notice how "th'exterior nor the inward man Resembles what it was"(2.2.7) and they are puzzled by his words and actions. When he visits Ophelia he is fearful and trembling. "Pale as his shirt, his knees knocking each other" (2.1.81). It seems to Ophelia, that he is "afraid of everything". She describes he had "a look so piteous in purport, As if he had been loosed out of hell To speak of horrors"(2.1.82). Hamlet's conflict is within himself; berating his indecision he calls himself an "ass" , a "coward" , indeed, he is "a terror within himself...he would runne away and cannot goe." Hamlet is "troubled with ...an unseperable sadnesse which turneth into dispayre" to the point of considering suicide:O that this too too sullied flesh would meltThaw, and resolve itself into a dew,Or that the Everlasting had not fixedHis canon 'gainst self-slaughter (1.2.129).Hamlet is "disquieted in both body and spirit" telling his mother "I have that within which passes show; These but the trappings and the suits of woe." (2.1.86) Hamlet is not sleeping well, he is "subject of watchfullness, which doth consume him" , describing to Horatio "Sir in my heart there was a kind of fighting That would not let me sleep" (5.2.4). He complains of "dreadful dreams" to Rosencrantz, complaining magnificently: "O God, I could be bounded in a nutshell and count myself a king of infinite space, were it not that I have bad dreams."(2.2.258). Hamlet is "suspicious" , grilling Rosencratnz and Guildenstern: "Were you not sent for? Is it your own inclining? Is it free visitation?" (3.1.280) Hamlet is "one whom nothing can please, but only discontentment" . Damning all the world, he exclaims:...O God, God,How weary, stale, flat, and unprofitableSeem to me all the uses of this world?Fie on't, ah fie, 'tis an unweeded gardenThat grows to seed. Things rank and gross in naturePossess it merely (1.2.132)Horatio observes how this distress "forgeth unto itselfe a thousand false and vain imaginations", noting "He waxes desperate with imagination" (1.4.87) and that Hamlet speaks in "wild and whirling words" (1.5.131).Using Laurentius' description as a checklist provides ample evidence for a melancholic diagnosis. Hamlet's behavior was indicative of his melancholic imbalance; his depression, anguish and reticence in avenging his father are distinct symptoms of his humoral disorder.Othello: Epilepsy , Choler Imbalance or Both?Othello's personality is difficult to decipher. It is somewhat logical to argue that the Moor of Venice is intrinsically evil... no more than an "old black ram" (1.1.88), which implies his dark nature and therefore, prone to committing evil acts. It is also quite plausible to claim that Othello has been "infected" with evil by his ensign, Iago ...or even the possibility that Othello's actions (e.g. the murder of Desdemona) were simply logical ramifications of what he can't help but believe. However, Robert Burton offers an impeccable medical explanation for Othello's precarious state of mind..."Most are of the opinion that it is the Braine: for being a kinde of Dotage, it cannot otherwise bee, but that the braine must be affected, as a similar part, be it by consent or essence, not in his Ventricles, or any obstructions in them, for then it would be an Apoplexie, or Epilepsie... but in a cold, dry distemperature of it in his substance, which is corrupt and become too cold, or too dry, or else too hot, as in madmen, and such are inclined to it." (Burton, 163).It is made very clear in The Tragedy of Othello the Moor of Venice, that Othello suffers from the same epileptic fits described above.As Iago says...My lord has fall'n into an epilepsy.This is his second fit. He had one yesterday...The lethargy must have his quiet course.If not, he foams at mouth, and by and byBreaks out to savage madness. Look, he stirs.Do you withdraw for a while,He will recover straight. ...(4.1.45-54)Othello must then be suffering from a lack of pituita, resulting in dryness and also of Sanguine, or blood, resulting in coldness that he would suffer such fits. Othello's epileptic seizures would have other ramifications, as well, for, according to Burton, "our body is like a Clocke, if one wheele be amisse, all the rest are disordered, the whole Fabricke suffers..."(Burton, 164). With the disturbance of the original two humours would most likely come the imbalance of Choler, which would manifest itself in severe bouts of anger, as seen in the plotting and actual murder of Desdemona, his wife."Ay, let her rot and perish, and be damned tonight, for she shall not live. No, my heart is turned to stone; I strike it, and it hurts my hand"...(4.1.174-175)."I will chop her into messes. Cuckold me!" (4.1.190)Othello's condition is referred to by his name in today's psychiatric circles. According to www.medterms.com, "Othello syndrome" can best be described as: "The delusion of infidelity of a spouse or partner. The Othello syndrome affects males and, less often, females. It is characterized by recurrent accusations of infidelity, searches for evidence, repeated interrogation of the partner, tests of their partner's fidelity, and sometime stalking. The syndrome may appear by itself or in the course of paranoid schizophrenia, alcoholism, or cocaine addiction. As in Othello, the play , the syndrome can be highly dangerous and result in disruption of a marriage, homicide and suicide. The Othello syndrome is also known as delusional jealousy, erotic jealousy syndrome, morbid jealousy, Othello psychosis, or sexual jealousy.(http://www.medterms.com/script/main/art.asp?articlekey=25111)The Othello syndrome was named by the English psychiatrist John Todd (1914-1987) in a paper he published with K. Dewhurst entitled "The Othello Syndrome: a study in the psychopathology of sexual jealousy" (Journal of Nervous and Mental Disorder, 1955, 122: 367). (http://www.medterms.com/script/main/art.asp?articlekey=25111)King Lear: Those Who "Dote" Too MuchIn Shakespeare's The Tragedy of King Lear, the character of Lear descends into madness upon the division of his kingdom between his two vile, elder daughters.My wits begin to turn.Come on, my boy. How dost, my boy? Art cold?I am cold myself--(3.2 67-69)At this particular instant in this tragedy, Lear is trapped outside in the midst of a terrible storm during which, his insanity is officially established. It is feasible, as well, that in addition to being cold, (as Lear states above while noting his own madness,) that he is also entirely wet. These characteristics of "wet" and "moist" are direct causes, in addition to other factors, of Lear's insanity. These are symptoms of an excess of pituita, or fleagme. This mental states results from, according to Robert Burton, an "over-moiste braine" , which causes a form of insanity called dotage. Webster's dictionary defines dotage as: Feebleness of mind due to old age; senility. (http://dictionary.reference.com/wordoftheday/archive/2003/09/16.html)Likewise, Lear's very age puts him at risk for such a fiasco. "Distemperance, caused by old age, which being cold and dry, and of the same quality as melancholy is, must needes cause it, by dimunition of the spirits and substance, and increasing of adust humours" (Burton, 164). From the start of the play, it is made clear to the audience that Lear is, in fact, an elderly man. The very reason for the division of his kingdom is that Lear is old and tired. Ironically, this seemingly possible escape from the duties of his kingship results in Lear's demise.Lear's poor decisions ultimately lead to his death, which was a rather sudden surrender of his life in the final scene of King Lear. Lear's death is so sudden, in fact, that he is mistaken for having fainted:EDGAR. He faints. My Lord, my lord!KENT. Break, heart, I prithee break.EDGAR. Look up, my lord.KENT. Vex not his ghost. O let him pass. He hates himThat would upon the rack of this tough worldStretch him out longer.EDGAR. He is gone indeed.KENT. The wonder is that he hath endured so long.He but usurped his life. (5.3.287-292)Lear's disrupted homeostasis of his humours, mixed with his old age would naturally result in an excess of "black bile" resulting in his unhealthy mental state and subsequent, instantaneous death. "Our intemperance it is, that pulls so many several incurable diseases upon our heads, that hastens old age, perverts our temperature, and brings upon us sudden death." (Burton, 128).