"For him that hath lost his mind,” the bestselling Tudor writer Thomas Moulton recommended shaving the top of the patient’s head, then applying a mat of plant fibre to the bald patch. After a sleep, he reassured, “he shall be right weak, and sober enough”. While this treatment seems bizarre today, it reveals a crucial element of Elizabethan beliefs about mental wellbeing: the mind and body were intrinsically connected, so any disorders of the brain could be treated via remedies that were applied to the body.


As well as consulting medical books such as Moulton’s, many Elizabethans sought the advice of Simon Forman, a popular London physician. Forman, too, sometimes prescribed physiological remedies for mental afflictions. But his chief diagnostic method was – to our eyes – decidedly unusual. He always began by casting a patient’s astrological chart, reflecting the contemporary belief that both mind and body were affected by the movements of the stars and planets.

These practices exemplify the co-existence of diverse explanations for mental conditions in this period. They could be caused by internal factors, especially wayward humours – bodily fluids whose proportions and balance determined character and mood – or by external forces such as astral influences.

A doctor examines a patient’s urine in this 1519 woodcut.
A doctor examines a patient’s urine in this 1519 woodcut. The physician Simon Forman said “the diseases of the mind are not seen in a piss-pot”. (Image by AKG Images)

Other examples from Forman’s casebooks reveal yet more competing theories about the mind. One woman brought him a urine sample for analysis, but Forman “found no other disease in her body, but only in her head”. He told her that “the diseases of the mind are not seen in a piss-pot”, and that what she needed was “good counsel”.

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Another patient, Susan Crosbe, whom he described as suffering from a “desperate melancholy disease”, engaged in what we would call self-harm. She “could abide no knives nor pins nor shears nor needles nor nails, but she must cut herself or thrust the pins into her flesh”, and she was tormented by suicidal thoughts. Yet in her case Forman diagnosed supernatural intervention, saying “the devil would speak oftentimes within her”, inciting her to self-destruction.

Theories of the mind

The Elizabethans were keen to understand the “inward self ”. Much as today many of us seek to manage our minds by reading books on self-help and mindfulness, in a similar way the burgeoning print industry of the Elizabethan era produced a host of works concerned with the inner functions of the mind. Titles such as Thomas Rogers’s 1576 The Anatomy of the Mind, and The Passions of the Mind by Thomas Wright (1601) flooded the market. These texts contained an intense and tumultuous ferment of ideas drawn from disparate intellectual frameworks, making this a fascinating period in the history of ideas about the mind. Medieval medical theories vied with revived classical philosophies, while new religious practices jostled against emerging scientific discoveries.

Mental conditions were thought to be caused by wayward humours and the position of the stars

Take the Elizabethans’ understanding of brain anatomy. The traditional model divided the brain into three ventricles or chambers, with Imagination at the front, Reason in the middle, and Memory at the back. That classical system was still widely taught in the period, but in 1543 it was upended when Vesalius published his anatomical discoveries based on human dissections. These included a radically new, more accurate account of brain structure, identifying two large ventricles to the left and right, another two below them in the centre, and, controversially, no “special cavity” for reason to distinguish human brains from those of animals. These conflicting theories co-existed in Tudor England: in 1553, the illustrations for Vesalius’s work were published alongside incompatible text from medieval anatomy books that subscribed to the classical three-chamber model.

The Elizabethans also attributed different types of mind to different categories of people. Women in general were thought to have a humoral constitution that was cold and moist, or phlegmatic. This was good for fertility, but bad for the intellect. Disparagement of the female mind was commonplace: in 1597, for instance, a work named The Haven of Pleasure deplored “the weakness of [women’s] minds, and the imbecility of their understandings and judgments”. This seems astonishing in view of the impressive accomplishments of female scholars of the period, such as Anne Cooke Bacon, who translated from Latin John Jewel’s Apology of the Church of England, a major theological work.

Localised disorders

Because the humours were connected to temperature and moisture, it was also believed that geographical origin affected mental disposition. Many authorities, including the French philosopher Jean Bodin, asserted that the hot climate of Africa had an evaporating effect on its people, leaving them cold and dry, and hence melancholic: not only inclined to sadness, but also endowed with acute intellect. On stage this produced characters such as Aaron the Moor in William Shakespeare’s Titus Andronicus (c1592), and Eleazar in The Spanish Moor’s Tragedy (1600), each of them by far the cleverest character in their play. The abhorrent forms of racism associated with the trans-Atlantic slave trade had not yet fully emerged, but the Elizabethans were not free of racial prejudice: these stage-Moors were ruthless villains, using their intellectual gifts to devise torments for their enemies. Nevertheless, they were among the most compelling characters on the Elizabethan stage.

Sixteenth-century personifications of the four humours
Sixteenth-century personifications of the four humours (L–R): phlegm, connected with inactivity; and black bile, identified with the intellect. Too much of one humour was thought to result in disease, with black bile causing melancholy. (Image by AKG Images)

Frenzies of rage

The Elizabethans had many anxieties about the mind’s potential to go wrong and felt the passions must be strenuously governed by reason. In The Castle of Health by Sir Thomas Elyot, one of the most popular medical books of the period, the author warned of the “apoplexies, or privation of senses, trembling palsies… frenzies, [and] deformity of visage” arising from rage. The reader could avoid these if “before he speak or do anything in anger, he do recite in order, all the letters of the A. B. C., and remove somewhat out of the place that he is in, and seek occasion to be otherwise occupied”.

The imagination, too, was thought to be a destabilising force. Today we celebrate the imagination as an exciting creative power, but 16th-century belief in the link between mind and body meant that it could have alarming effects. If a woman saw a striking image at the moment of conceiving a child, or during pregnancy, the force of her imagination would imprint this on the infant. Many medical books attributed the case of “a maid, rough and covered with hair like a bear” to her mother’s eyes having fallen, during sex, on a picture at the foot of her bed of St John the Baptist “clothed with a beast’s skin”.

The Elizabethans followed the Bible’s teaching that “the imagination of man’s heart is evil, even from his youth” – it was unruly, deceptive and a provocation to sin. This was especially so in dreams: in waking hours the imagination formed mental images from sense-impressions of the real world, but in sleep it became “fantasy” or “fancy”, drawing on its own resources to produce images that were false and bizarre. According to Thomas Nashe in The Terrors of the Night (1594): “A dream is nothing else but a bubbling scum or froth of the fancy, which the day hath left undigested; or an after-feast made of the fragments of idle imaginations.”

Meanwhile, other Elizabethans persisted in ancient beliefs that some special dreams could be prophetic messages from God, making Thomas Hill’s 1576 manual The Interpretation of Dreams a bestseller. According to Hill, to dream of drinking mustard meant that one was about to be accused of murder; to dream of a white ox “signifieth honour or advancement”; but to dream of elephants “signifieth sorrow”. However, even dream-interpreters like Hill acknowledged the difficulty of determining whether any particular dream was of the meaningful or meaningless type.

The Elizabethans devoutly followed the Bible’s teaching that “the imagination of man’s heart is evil, even from his youth

The imagination was thought to be especially over-active and uncontrolled in those whose reason was weak, such as melancholics and women. Medical works eagerly recounted the delusions of melancholics. According to The Touchstone of Complexions (1576), one “thought himself to have a nose so big, and of such a prodigious length, that he thought he carried about with him the snout or muzzle of an elephant”. Another patient “thought his buttocks were made of glass, insomuch that he durst not do anything but standing, for fear lest if he should sit, he should break his rump, and the glass fly into pieces”.

Reginald Scot, author of The Discovery of Witchcraft (1584), dismissed supposed witches as “poor melancholic women” suffering foolish fantasies of magical powers; “the stopping of their monthly melancholic flux or issue of blood” (the menopause) had made them cold and dry, hence melancholic, and vulnerable to disordered imaginations.

Scot was on the sceptical side of a raging debate about the role of supernatural factors in mental disorders. So was Edward Jorden, a physician who tried to exonerate Elizabeth Jackson, on trial for witchcraft in 1602, by proposing a medical explanation for the strange symptoms of her supposed victim, Mary Glover. Jorden argued that “suffocation of the mother” – the supposed volatility and mobility of the womb within the body – affected the mind, causing “frenzies, convulsions, hiccups, laughing, singing, weeping, crying, etc”. (This would later be called “hysteria”.) Jorden’s defence of Jackson failed in court, but many shared his doubts about her guilt, and she was released after a short time in prison.

In thrall to demons

Many Elizabethans attributed mental instability to the devil. A discussion of madness in Andrew Boorde’s mid-16th-century Breviary of Health distinguished between “maniac persons”, whose condition “cometh of infirmities of the body”, and “demoniac persons”, who were “possessed of some evil spirit”. Among the victims of demonic possession was one Alexander Nyndge, who in 1573 was apparently terrifyingly transformed, “his chest and body swelling, with his eyes staring, and his back bending inward to his belly”. A hollow voice intoned from within him: “I come for his soul.”

Sceptics questioned the reality of demonic possession; indeed, some supposed de-moniacs confessed to faking symptoms. Yet there was general assent that all minds were vulnerable to incursions by Satan, for whom black bile – the substance in the body that caused melancholy – was thought to provide a congenial habitat. The Touchstone of Complexions explained how evil spirits could “slyly and secretly glide into the body” like a “fulsome stench” or “a noisome and ill air”, then interfere with the “inward dispositions and thoughts”, introducing sinful and criminal intentions. One of the chief reasons for the Elizabethans’ intense interest in the mind was the need for everyone to be on constant guard against evil thoughts implanted by the devil, by looking within and assiduously monitoring their own mental and spiritual state.

Elizabethan beliefs about supernatural influences on the mind, as well as their medical theories, can seem remote from our modern age of psychology and neuroscience. Yet they were wrestling with many questions about the relations between mind, body and selfhood that continue to perplex us today. Poised at the intersection between classical, medieval and emerging scientific systems of thought, this was a momentous period in the history of ideas about the mind.

Helen Hackett is a professor of English literature at University College London. Her latest book is The Elizabethan Mind (Yale University Press, 2022)


This article was first published in the June 2022 issue of BBC History Magazine