A medieval scholar named Constantine the African wrote one of the earliest detailed guides about melancholy (what we now call depression) around 1,000 years ago. His work, based on even older Arabic medical texts, explained melancholy as an imbalance of bodily fluids, particularly something called “black bile.” Constantine recommended treating it with diet changes, exercise, bathing, and some medicines. Interestingly, while his explanation about fluids isn’t how we understand depression today, many of his treatment ideas—like exercise and lifestyle changes—are still recommended by modern doctors. This historical look shows how medical thinking has evolved while some basic wellness principles have stayed the same.

The Quick Take

  • What they studied: How a medieval doctor named Constantine the African explained and treated melancholy (depression) in his medical writings from around 1,000 years ago
  • Who participated: This is a historical analysis of Constantine’s written medical texts, not a study with human participants. Researchers examined his two books about melancholy and compared them to other medieval and modern medical writings
  • Key finding: Constantine described melancholy as caused by an imbalance of body fluids (especially black bile), which could result from poor lifestyle choices, emotional stress, or being born with a tendency toward it. He treated it mainly with diet, exercise, bathing, and some medicines
  • What it means for you: While the medieval explanation about body fluids isn’t accurate by today’s science, Constantine’s focus on lifestyle factors like diet and exercise for treating depression aligns with modern medical advice. This shows that some wellness principles have been recognized as helpful for centuries

The Research Details

This research is a historical analysis rather than a medical experiment. Researchers examined Constantine the African’s medieval medical texts, particularly his two books about melancholy, and studied how his ideas compared to earlier Arabic medical writings and later medieval works. They looked at what Constantine wrote about the causes, symptoms, and treatments of melancholy to understand how medieval doctors thought about mental health.

The researchers weren’t testing Constantine’s ideas on real patients. Instead, they were analyzing historical documents to understand how medical thinking about depression has changed over time. This type of research helps us see which medical ideas have lasted and which ones have been replaced by better understanding.

Understanding how doctors treated mental health in the past helps us appreciate how far medicine has come. It also shows us which basic ideas about health—like the importance of exercise, good food, and managing stress—have been recognized as important for over 1,000 years. This historical perspective can help us understand why certain treatments work and how medical knowledge develops over time.

This is a scholarly historical analysis published in an academic journal, which means it was reviewed by experts. However, it’s important to understand that this research examines old texts rather than testing new medical treatments. The findings tell us about medieval medical thinking, not about how well Constantine’s treatments actually worked. Modern depression treatment is based on much more recent scientific research about how the brain works.

What the Results Show

Constantine the African created one of the first organized, detailed writings about a single mental disorder—melancholy. His work was important because it appeared in Latin (the common language of educated Europeans at the time) before most other writings about mental illness. Constantine explained that melancholy came from an imbalance of body fluids, especially something called black bile, which he believed could be caused by poor lifestyle choices, emotional shock, or being born with a tendency toward the condition.

Constantine’s treatment plan focused on practical lifestyle changes. He recommended adjusting what patients ate, having them exercise regularly, and taking therapeutic baths. He also included some pharmaceutical remedies (medicines made from plants and other substances). This combination of lifestyle and medical treatments was considered comprehensive for the time.

Many of Constantine’s ideas spread throughout medieval Europe and influenced how other doctors and religious scholars thought about mental illness for centuries. His systematic approach to describing and treating one specific mental disorder was unusual and influential for medieval medicine.

The research shows that Constantine’s work was based on earlier Arabic medical texts, demonstrating that medieval European medicine built on knowledge from other cultures. His writings also show that medieval doctors recognized the connection between emotions, lifestyle, and mental health—understanding that emotional shock or stress could contribute to melancholy. Additionally, Constantine acknowledged that some people might be born with a predisposition to melancholy, suggesting an early recognition of what we might now call genetic or constitutional factors.

Constantine’s work was groundbreaking for medieval Europe because it provided a systematic, organized account of a single mental disorder. While earlier medical texts discussed various illnesses, Constantine’s focused approach was distinctive. His ideas built on Arabic medical knowledge, showing how medieval European medicine incorporated and adapted ideas from other civilizations. Later medieval doctors and theologians continued to reference and build upon Constantine’s framework for understanding melancholy.

This research analyzes historical texts, not actual patient outcomes, so we don’t know how well Constantine’s treatments actually worked. The medieval understanding of body fluids and black bile is not scientifically accurate by modern standards. Additionally, we can’t directly compare Constantine’s approach to modern depression treatment because the underlying science is completely different. This historical analysis tells us about medieval medical thinking, but it shouldn’t be used to guide modern mental health treatment decisions.

The Bottom Line

This historical research doesn’t provide recommendations for treating modern depression. However, it supports what modern medicine already recommends: lifestyle factors like diet, exercise, and stress management are important for mental health. If you’re experiencing depression or melancholy feelings, consult with a modern healthcare provider who can offer evidence-based treatments. (Confidence level: Historical perspective only—not a basis for treatment decisions)

This research is most interesting for people curious about medical history, students studying how science has evolved, and healthcare professionals interested in the history of psychiatry. It’s not meant to guide anyone’s personal health decisions. People with depression should rely on modern medical treatments, not medieval approaches.

This is historical research, not a guide for treatment timelines. Modern depression treatment timelines vary greatly depending on the type of treatment used and individual factors. Consult with a healthcare provider for realistic expectations about your specific situation.

Want to Apply This Research?

  • Track lifestyle factors that medieval and modern medicine both recognize as important: daily exercise minutes, sleep quality, diet quality, and stress levels. Monitor how these factors correlate with your mood over weeks and months
  • Use the app to set reminders for evidence-based wellness practices: regular physical activity (30 minutes most days), consistent sleep schedule, balanced meals, and stress-reduction activities like meditation or time in nature. These align with both medieval and modern health wisdom
  • Create a long-term wellness dashboard that tracks the lifestyle factors mentioned above alongside mood ratings. Look for patterns over 4-8 week periods to see which lifestyle changes correlate with improved mood. Share this data with your healthcare provider

This article discusses historical medical perspectives on melancholy and is intended for educational purposes only. It is not a guide for treating modern depression or any mental health condition. Constantine’s medieval explanations about body fluids are not scientifically accurate by modern standards. If you are experiencing depression, anxiety, or other mental health concerns, please consult with a qualified mental health professional or physician who can provide evidence-based diagnosis and treatment. Modern mental health treatment is based on contemporary neuroscience and psychology, not medieval medical theory.