Tudor Medicine and the Mind: Melancholy, Music, and What Help Actually Looked Like

Added: 2026-05-09

[00:00:00]Imagine you're living in a tutor household sometime in the 1540s and there's someone in your family who hasn't been [music] sleeping. They're not eating. They keep saying that God has turned his face away from them, that they're damned, and that there's [music] no point to anything. And you're scared.

[00:00:19]You don't know what's happening to them.

[00:00:21]So, what do you do? Do you call a doctor, a priest? Do you just [music] kind of wait and hope it passes? Here's the thing that blew my mind when I started digging into this. You actually did have options. There's a whole system for understanding what was happening to that person [music] and what to do about it. It wasn't our system. Some of it was wrong in ways that we can clearly see now. But it existed and it was taken very seriously by very smart people and it was very much trying to help. That is what we're going to talk about today. How did the tutor world understand mental health and mental suffering? What did they think was happening when someone's mind seemed [music] to turn against them? And what did help actually [music] look like?

[00:01:12]Let's dig in to the tutor brain.

[00:01:23]Hey friend, welcome back to the Renaissance English History [music] Podcast. I am your host Heather and I've been podcasting on Tutor England since 2009 with my show which makes me the original Tutor History podcaster. I am as always just delighted that you are here with me today. It is mental health awareness month in May and more recently even since I was a kid back in the 80s and 90s I think people have become much more aware of mental health and are much more uh able to talk about it. And so I wanted to do an episode on the tutors and how the tutors saw mental health. So let's get started. But first, a quick word. If you are listening to this in May of 2026, which is right now, I am running the completely free Anbolin scavenger hunt right now. 15 days, 15 clues following Ann's story from her arrival at the English court all the way up to May 19th, the anniversary of her execution. As I am recording this, we are on day two. There are a dozen prizes up for grabs, too, including a signed book from the tutor novelist Sandra Bird. It's totally free to join. You can catch up at your own pace, and the link is in the description. All right, back to the 16th century. Okay, so if you've spent any time at all in tutor history, you've heard of the four humors: blood, flem, yellow bile, black bile. The idea is that your body contains these four fluids and your health, your personality, your mood, literally everything about you depends on how they are balanced. Too much blood and you're cheerful and ready. Too much flem and you're sluggish and pale. But here's what I didn't appreciate fully until just recently. This wasn't just a theory about physical illness. The humors were also a complete theory of the mind.

[00:03:12]Black bile was the humor of the mind.

[00:03:15]Black bile when it was out of balance caused melancholy. And melancholy in the tutor sense wasn't just feeling a bit sad. It was a recognized medical condition with a whole spectrum of presentations. On one end, you had what we might recognize as depression, persistent sadness, loss of appetite, inability to sleep, withdrawal from life, a conviction that God had abandoned you. On the other end, you had something closer to what we would call psychosis today. Irrational fears, delusions, seeing things that weren't actually there.

[00:03:52]Timothy Bright published a whole book on this in 1586. It's called a treatise of melancholy and it is a serious medical text, actually the very first English treatise on mental illness. He is distinguishing between different types of melancholy, describing their symptoms, proposing treatments. This was not folk wisdom. This was the medical establishment taking mental suffering seriously as a real thing that happened to real people and required real intervention.

[00:04:23]And here's a detail I also find fascinating. Melancholy had a complicated reputation. Yes, it was a disease, but it was also associated with intellectual depth. The tortured genius idea, the brooding scholar who sees things that others can't. The artist who is suffering and is connected to their brilliance. This whole idea of this brooding depressed scholar artist, it has its idea in tutor roots. An excess of black bile was thought to sharpen the mind even as it darkened the soul. So there was this strange duality to it where you might be diagnosed with melancholy and also in a weird way sort of respected for it.

[00:05:09]So where it gets complicated and also kind of interesting is where medicine ended and religion began. Spoiler alert, nobody knew the difference between the two. In Tutor England, the line between a medical problem and a spiritual problem was blurry. People knew it was blurry. This wasn't confusion or ignorance. It was a coherent worldview in which the body, the mind, and the soul were all connected, all affecting each other, all subject to both physical and spiritual forces. So, if you were that person in the tutor household who wasn't sleeping and thought God had abandoned them, here's roughly what might happen. First, probably a physician. Andrew Bour, one of the most prominent medical writers of the period, wrote extensively about melancholy and its treatments. Bour was actually a physician to the Duke of Norfolk and had access to Henry VII's court. So, this wasn't just fringe thinking. The treatments were physical, dietary changes, herbal remedies, rest, adjustments to your daily routine. Black bile was thought to be worsened by certain foods, by excessive study, by sitting for too long. So, you would change what you were eating. You'd be encouraged to move around, to get air, to change your environment, which honestly for a lot of people who are feeling depressed, who maybe haven't received a medical diagnosis, maybe even if they have, that's something that they often say is go out and exercise, get your endorphins flowing, get some fresh air, get some sunshine, vitamin D, all of that kind of thing. So, you know, kind of similar to what we would say today. And then there was also music. I cannot stress enough how seriously the tutors took music as a medical treatment for melancholy. I've actually done a whole episode on the music of the spheres maybe seven or eight years ago.

[00:07:01]Th this was a whole system. This wasn't put on something cheerful and you'll feel better. This was formal therapeutic intervention grounded in humoral theory.

[00:07:11]The idea was that music could literally rebalance the humors through its effect on the body. specific modalities, specific instruments, specific rhythms were prescribed for specific conditions.

[00:07:24]So, it wasn't just, oh, put on some, I don't know, Jason Morazz or something and you'll feel more upbeat. This was like, listen to a piece in C major for a headache or something, right? You can, of course, dig much deeper into that in the episode I did on the music of the spheres. Anyway, the connection between music and the humors was taught in universities, written about by physicians, taken as established fact by educated people across Europe. So, music was medicine, not metaphor. It was an actual prescribed treatment. Now, if the physical interventions weren't working or if the presentation seemed more spiritual than physical, that's when a priest would enter the picture. And this wasn't just the physician giving up and handing off. It was more like an integrated approach to the whole person.

[00:08:16]Confession was considered therapeutic.

[00:08:18]Prayer was considered therapeutic.

[00:08:20]Certain saints were associated with healing the mind. There were shrines that people traveled to specifically for that purpose. The demonic possession interpretation existed, too. And I don't want to pretend that it didn't cause harm because sometimes it did.

[00:08:38]But there's a thing that complicates the simple narrative, which is that the official church position in Tutor England was actually quite cautious about diagnosing possession. There was a real concern about false attribution.

[00:08:52]The instructions for investigating a potential possession case involved ruling out natural and medical explanations first. That's not the image we usually carry around of how this worked. So, here's something else I think we get wrong about the past when we think about mental differences. We assume that because there was no formal diagnosis, because there was no DSM, because people couldn't walk into a therapist's office, that people who thought or behaved differently were just abandoned, ostracized, left to suffer alone. And sometimes that happened. I'm not going to pretend that tutor society was some kind of utopian ideal, but there were also structures, real social structures that created space for people who didn't fit the norm. The holy fool is one. This is a figure who appears across many cultures. someone whose unusual behavior is interpreted as a kind of divine simplicity, a person outside the ordinary social rules precisely because they seem closer to God than to worldly concerns. Tutor England had this category and being placed in it offered a a kind of protection. You weren't punished for being strange. You were in a complicated way valued for it. The melancholic scholar is another one. We just talked about how melancholy had intellectual prestige attached to it. So that meant that if your differences manifested as obsessive study, unconventional thinking, social withdrawal, those things could be accommodated and even admired within a particular social role.

[00:10:30]And then there was of course Will Summers. I've done an episode on Will Summers. He was Henry VII's court jester. One of the most fascinating figures in the entire tutor period. He served at court from at least the 1530s until Henry's death in 1547. And he was clearly beloved, clearly protected, clearly given a latitude that nobody else at court had, including the ability to say things to Henry's face that would have gotten anybody else imprisoned or worse. When you read the accounts of Will Summers, the details are striking.

[00:11:03]the way he's described interacting with people, the particular kind of humor that he had, the degree to which he seemed genuinely sheltered from court politics in a way that required active protection from Henry himself. There's actually a 2023 biography of him by Peter Anderson, the first full biography ever written about him that examines his possible abilities, disabilities, and his role as what contemporaries called a natural fool. Look, I'm not about to diagnose a man who died in 1560 with a modern condition. That's not what we do here. I'm really not a fan of that and I've said that many times. But I will say that Tutor Society looked at Will Summers and said, "This person has value. This person deserves protection.

[00:11:49]This person has a place." And that, my friend, is not nothing.

[00:11:55]So, I've been giving you the more generous picture of how this worked, and I want to hold that alongside the harsher reality because both are true.

[00:12:02]Just like honestly, both are true today.

[00:12:04]We want to think that we've evolved so far past all of this, but in many ways, we haven't always. So let's talk about the harsher picture in tutor England.

[00:12:15]Bethleam hospital which most people know as Bethleam was founded in 1247 as a priaryy but by the late 14th century it was already caring for people with mental illness. By the tutor period it had been taking people in for over a century. The records from this period are sparse and grim. The conditions were poor. The treatments were sometimes quite brutal. The line between care and containment was not always clear, and it fell more heavily on people with no money and no family connections, which is exactly what you'd expect. It's what you'd expect today as well, to be honest. In 1547, Henry VIII actually granted Bethleam to the city of London specifically as a hospital for the mentally ill, which tells you that it had become established enough that the crown felt it needed formal administration.

[00:13:07]The poor laws created a parallel track.

[00:13:09]Someone who was wandering, disoriented, unable to work could be classified as a vagrant. And the response to vagrancy in tutor England was not compassionate.

[00:13:20]This is where the worst outcomes lived in the gap between this person has a community around them that can accommodate their difference and this person is alone and the state has to do something. Family confinement was common. If you had a family member whose mind was failing, keeping them at home, supervised, managed was often the best realistic option available to you. It could be loving, it could be brutal. It depended entirely on the family.

[00:13:48]And yes, possession diagnosis when it was applied could lead to exorcism. And exorcism could involve things that we would today recognize as abuse. I don't want to sand that down. The honest picture is tutor society had a framework for understanding mental suffering that was more coherent and more humane than we usually give it credit for. And that framework failed people regularly especially people without resources or community. Both of those things are true at the same time. I have to mention Henry here too because it would be almost irresponsible not to given what we've been talking about. You probably know the broad outline. And Henry VIII in his younger years was by all accounts a charming, intellectually curious, physically impressive person. Henry VIII in his later years was a paranoid, cruel, physically deteriorating person who executed people he'd loved and trusted for decades. What happened to him? Modern physicians and historians have been arguing about this for years, and I want to be clear that it's very much contested. The leading theories involve a jousting accident in 1536, January 1536, in which Henry was unconscious for two hours, which would today be classified as a very serious traumatic brain injury. Historians like Lucy Worsley have argued that this accident explains the personality shift.

[00:15:12]But other historians point out that Henry showed plenty of tyrannical behavior well before 1536, including his treatment of Katherine of Aragon through years of deliberate cruelty, which complicates the clean accident changed him narrative. There's also been serious work done on Kell blood group syndrome, Cushing syndrome, and other conditions.

[00:15:34]Here's the tutor read on it. A physical injury or physical disease disrupted the balance of the humors which disrupted the mind. That framework actually maps onto what modern medicine is describing.

[00:15:48]A brain injury changes personality and cognition. A hormonal disorder changes mood and judgment. The mechanism that they proposed was wrong, but the observation that the body and the mind were connected, that physical damage could produce psychological change, that was very much correct. This actually deserves its own video and it's going to get one. There's enough Henry health rabbit hole for a full episode for like a month's worth of episodes to be honest. But I do want to flag it here because it's the perfect illustration of what we've been talking about. The tutor saw something real. They named it in the language that they had available and they tried to respond to it.

[00:16:27]So, back to the household that we started with, that person in the tutor household in the 1540s, not sleeping, not eating, convinced that they're damned. Here's what would probably happen to them. Someone would call a physician or at least consult one of the many printed medical guides that were circulating by this period. The physician would assess the hummeral balance. They'd probably recommend dietary changes, specific foods to avoid, possibly a change of scene. They might prescribe music as a formal treatment. They'd encourage rest and gentle movement. If the spiritual dimension seemed prominent, a priest would likely be involved, too. Not instead of the physician, but alongside confession, prayer, possibly a pilgrimage if the family had the means.

[00:17:16]If there were people around this person who loved them, those people would stay very close to them and they'd watch and they'd adjust. Tutor households, especially prosperous ones, were not individualistic in the way that we are.

[00:17:29]You lived in very close proximity to a lot of people. Someone struggling rarely struggled entirely alone. So, would it work? Sometimes, not always. The tools that they had were limited and some of them were wrong. But the impulse behind them, figure out what's happening to this person, find something that helps keep them inside the community rather than casting them out. That impulse is completely recognizable. We're not as different from them as we like to think.

[00:17:59]We just have different, perhaps more advanced, better tools most of the time.

[00:18:05]Not always.

[00:18:07]So, we will leave it there, my friend.

[00:18:09]If you enjoyed this, please subscribe wherever you are listening and leave a comment letting me know what aspect of tutor medicine you would like to most explore next. And again, if you are listening to this in May 2026, don't forget the ambulance scavenger hunt is running right now through May 19th. It's completely free. There are prizes. We're only on day two right now, so you have plenty of time to catch up. Link in the description or comment below.

[00:18:38]All right, my friend. Thank you so much for joining me. I very much appreciate your time. I hope you learned something new or thought about something you already knew in a different sort of way.

[00:18:47]I am going to link to that Music of the Spheres episode as well because it's something I have always been very much interested in and I find it fascinating.

[00:18:55]So, check that out as well. Thanks for being here. [music] Thanks for spending this time with me. I am so very grateful that we got to hang out together and talk about tutor mental [music] health.

[00:19:05]I'll be back very very soon. In the meantime, don't forget to drink your water, friend. Bye-bye.

[00:19:14][singing] Northern wind may be sweating. Blown northern wind.

[00:19:20][music] Blow blow blow.

[00:19:28][singing and music] Hidden of me, fair and free to [music] in all this war. [singing]