Melancholia and the Hypochondrium: A Curious Cultural Convergence

Depression, or melancholia as it was once called, is one of the more common patient complaints encountered by
practitioners of both Oriental and Western medicine. Even if the patient’s chief complaint does not centre on his or
her mood, many patients are often as sick at heart as they are in body. Melancholia transcends culture, and both
East and West have closely examined this devastating disease, which has physical as well as emotional ramifications.
Through the centuries, practitioners from the East and West have noted the symptoms and signs of the depressed
patient and were struck by the state of the patient’s hypochondrium. This paper discusses this anatomical area,
its role in the diagnosis and treatment of melancholia, and how both medical traditions have similarly seen the
hypochondrium as an important hallmark of a patient’s physical and emotional state. The case of Abraham Lincoln,
the 19th century American president, is used as an illustration of classic melancholia and an example of cultural
convergence regarding the hypochondrium.