Brain Research Bulletin 85 (2011) 4253

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Brain Research Bulletin

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Review

Sadness as a passion of the soul: A psychopathological consideration of the

Cartesian concept of melancholy
Francisco Lpez-Munoz a,b, , Gabriel Rubio c , Juan D. Molina b,d , Cecilio Alamo a
a
Neuropsychopharmacology Unit, Department of Pharmacology, Faculty of Medicine, University of Alcal, Ctra. Madrid- Barcelona, Km. 33,600,
Alcal de Henares 29971, Madrid, Spain
b
Health Sciences Faculty, Camilo Jos Cela University, C/Castillo de Alarcn, 49, Villafranca del Castillo 28692, Madrid, Spain
c
Department of Psychiatry, Doce de Octubre University Hospital, Complutense University, Avda. Crdoba, s/n, Madrid 28041, Spain
d
Acute Inpatient Unit, Doctor R. Lafora Psychiatric Hospital, Ctra. de Colmenar Viejo, Km. 13,800, Madrid 28049, Spain

a r t i c l e i n f o a b s t r a c t

Article history: The relationship between the passions (emotions or feelings) and psychopathology has been a constant
Received 8 June 2010 throughout the history of medicine. In this context, melancholy was considered a perversion of the soul
Received in revised form 12 January 2011 (corruption of the passions). One of the most inuential authors on this subject was Ren Descartes, who
Accepted 31 January 2011
discussed it in his work The Treatise on the Passions of the Soul (1649). Descartes believed that passions
Available online 18 February 2011
were sensitive movements that the soul experienced due to its union with the body (res extensa). Accord-
ing to this theory, the soul was located in the pineal gland, where it was actively involved in overseeing the
Keywords:
functions of the human machine and kept its dysfunctions under control, by circulating animal spirits.
Descartes
History of psychiatry
Descartes described sadness as one of the six primitive passions of the soul, which leads to melancholy
Melancholy if not remedied. Cartesian theories had a great deal of inuence on the way that mental pathologies were
Passions considered throughout the entire 17th century (Spinoza, Willis, Pitcairn) and during much of the 18th
Pineal gland century (Le Cat, Tissot). From the 19th century onwards, emotional symptomatology nally began to be
Sadness used in diagnostic criteria for mood disorders.
Soul 2011 Elsevier Inc. All rights reserved.

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
2. Historical background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
3. The Cartesian psychophysiological perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
3.1. Cartesian dualism vis--vis the soul and the body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
3.2. The functionalism of the human body according to the theories of Descartes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
3.3. The pineal gland as the Cartesian anatomical centre of human psychophysiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
4. The passion of the soul in Cartesian philosophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
4.1. Sadness as a passion of the soul . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
4.2. The symptomatological manifestations of sadness as a passion of the soul . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
5. Psychopathology in the Cartesian universe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
6. The legacy of the Cartesian theories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
7. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

1. Introduction of human nature ever since classical Antiquity. This is to a large

extent due to their close spiritual links with the concept of the
The passions, or the feelings and emotions as dened in mod- human soul [5]. Indeed, both Plato (427347 B.C.) and Aristotle
ern scientic terms, have played a key role in the conceptualization (384322 B.C.) thought that the passions created distortion and
a lack of balance, as they were thought to be the animal part of
man. As a result, in Greek culture the belief took root that the pas-
Corresponding author at: C/Gasmetro, 11, Portal 3, 2 , A, 28005 Madrid, Spain. sions altered the cognitive processes mainly the emotions and
Tel.: +34 91 5300553; fax: +34 91 5300553. were the cause of madness. For this reason, it was impossible for
E-mail address: francisco.lopez.munoz@gmail.com (F. Lpez-Munoz). the diseases of the soul, including melancholy, regardless of their

0361-9230/$ see front matter 2011 Elsevier Inc. All rights reserved.
doi:10.1016/j.brainresbull.2011.01.018
 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
cause, to be anything but a perversion of the amina [23], a corrup-
tion of the passions, the animal part of the human being the
result of a process of disorder and chaos. This idea, as dened by
various authors, was common currency until almost the end of the
19th century [5].
One of the historys most inuential authors in this eld was
the great philosopher Ren Descartes (15961650), who provided
an entire neuropsychophysiological doctrine on this subject. As is
well known, Descartes postulated that the human soul must have
a specic anatomical location. He believed that from this posi-
tion, the soul supervised the communication between the human
machine and its surroundings, and acted as an internal inuence
which exerted control over the precise functioning of the human
body, including the passions. In the French philosophers opinion,
the divine spirit exercises its functions in the pineal gland [37]. He
believed that the pineal gland was actively involved in the dysfunc-
tions of the human machine, and because it was where the soul
was located, it played a key role in psychiatric disorders. Indeed,
Descartes believed sadness to be a passion of the soul, which led
to melancholy if it was not remedied.
However, it was not until the 19th century, as a result of roman-
tic and positivist medical trends, that the emotions began to be used
in the denition and construction of mental illnesses on a scientic
basis [5]. From that point on, emotional symptomatology became
part of the diagnostic criteria for numerous pathologies in the psy-
chiatric eld, and especially those of an emotional nature. Likewise,
and especially from a semantic perspective, the idea of melancholy
began to be supplanted by the idea of a mood disorder, or more
simply, a depressive disorder. This entity is now considered to be
the most common psychiatric disorder, and according to various
epidemiological estimates, may affect up to 25% of the population
[40].
In this study, we will consider the Cartesian theories on the
passions and their corruption as the root of melancholic mood dis-
orders. These theories are based on a physiological explanation of
the functioning of the human body which is especially thought-
provoking in modern times, despite its errors, historical limitations
and nuances.
2. Historical background
Mood disorders, described in classical terms as melancholy,
were possibly the clinical entities that were the rst of all the
mental illnesses to be subjected to analysis. However, the under-
standing of human spirituality has undergone profound changes
throughout the history of western culture. The various theories
of the philosophers and physicians of classical Antiquity and the
imposition of Christian doctrine during the High Middle Ages led
to the creation of a seedbed, which made the emergence of
the Cartesian psychophysiological and psychopathological theories
possible. These factors will be analyzed in more depth below.
From the neurophysiological perspective, the School of Alexan-
dria in Ptolemaic Egypt, the most distinguished representatives of
which were Herophilus of Chalcedon (325280 B.C.) and Erasistra-
tus of Keos (310250 B.C.), established a way of understanding how
the nervous system worked that could be described as pneumatic-
ventricular. These authors believed that after being transported
from the lungs to the heart, air (cosmic pneuma) was turned into
pneuma zootikon (spiritus vitalis, in Latin) in the heart, and was sub-
sequently sent by means of the blood to the brain, where it became
pneuma psychikon (spiritus animalis, in Latin) in the cerebral ven-
tricles. However, it was Claudius Galenus, or Galen of Pergamon
(131200), who adapted this pneumatic theory, and created a phys-
iological doctrine that would endure until the age of Descartes [21].
Like Plato, Galen divided the soul into three parts: appetitive, spir-
43
ited and rational (located in the liver, heart and brain respectively)
and talked about the three types of spirits or pneumatas (physi-
cal or natural, vital and psychic) that made up the human faculties
(dynamis). He believed that these spirits were very subtle physi-
cal substances, which circulated in the various liquids of the body.
The blood pumped in the heart was therefore directed to the rete
mirabile of the brain, and created psychic pneuma or spiritus ani-
malis in the lateral ventricles. This pneuma was then transferred to
the spinal cord and the nerves (which were thought to be hollow)
as an inductor of the dynamis psykhik, which caused a muscular
action [28]. As Spillane [55] points out, Galens hydraulic theory
of the spirits was the most enduring idea in the history of science.
In psychopathological terms, the doctrinal corpus of the Corpus
Hippocraticum (5th and 4th centuries B.C.) maintained that the var-
ious parts of the organism, including the soul, were formed by the
mixture of the four humors (blood, phlegm, yellow bile and black
bile) in varying proportions (Fig. 1). Health was the result of a bal-
anced mixture, while diseases, including those of the soul, were to
due to an imbalance in the mixture of the humors, and the con-
sequent predominance or lack of one or more humors and their
respective qualities. In specic terms, humoralist thinkers believed
that melancholy was caused by an excess of black bile (melas chole)
or atrabilis (dark bile, in Latin). Meanwhile, following Alexandrian
pneumatic doctrine, Aretaeus of Cappadocia (1st and 2nd centuries
A.D.) considered the illness to be a dyscrasia in the correct mixture
of the four elemental qualities (heat, cold, dryness and moisture).
This led to an alteration in the dynamic of the pneuma or spiritus, a
rened product of inhaled air, through the ducts of the body [23].
These theories were the foundations on which Descartes built his
psychophysiological doctrine.
Aristotelian philosophical ideas were also the cornerstone of
approved medieval philosophy. With the rise of Christianity, dur-
ing rst the Patristic and subsequently the Scholastic period, the
theological properties of the soul became more important, and its
functional properties were of less interest. In an accomplished exer-
cise in syncretism, Saint Thomas Aquinas (12251274) [50] made a
distinction between a number of biological and relational functions
(such as sensory perceptions) common to both men and animals,
and the cognitive powers (or passions) that only human beings pos-
sessed, which he said were manifestations of the power of the soul
over the body. This perspective was changed forever by Descartes,
who dened the passions in Article XXVII of The Passions of the Soul
as apprehensions, resentments or emotions of the soul [1,15].
However, physicians advocating reformed ideas based on the
Galenic school, such as Arnau de Vilanova (12351313), maintained
that mental disorders were not the result of changes in the soul, but
instead its bodily instrument, i.e. the brain. Indeed, the intangible
and divine nature of the soul made it difcult to explain why mental
pathologies were a consequence of its involvement. These disorders
were therefore believed to be essentially organic cerebral disorders,
despite their hypothetically psychical origin, and were caused by
imbalances in the emotions or passions. In his Breviarium Practicae
Medicinae (1483), Arnau de Vilanova specically attributes the ori-
gin of melancholy to an internal dysfunction of the animal spirits,
which can lead to fear (timor), sadness (tristitia) and mutism [59].
Medieval ideas on the nature of the human soul continued to
predominate during the Renaissance, as did theories on mental ill-
ness based on Galenism (as well as a new strand resulting from
Christianity, which was based on moral factors, such as divine pun-
ishment and the superstitious belief in the intervention of evil).
Among the leading advocates of the classical Galenic theory of the
humors and their involvement in the origin of mental disorders
was Juan Huarte de San Juan (15291588). In his only work, Exa-
men de ingenios para las ciencias (The Examination of Mens Wits)
(1575), Huarte de San Juan says that the proportion in which the
humors are combined determines the various temperaments, i.e.
44 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253

Liver

Yellow bile Summer

FIRE
Heat Dryness

Blood Black bile

Heart WIND EARTH Spleen

Spring Autumm

Moisture Cold

WATER
Phlegm Winter

Brain

Fig. 1. Diagram showing the classical Galenic theory of the four elements, and the items associated with each one; four qualities, four humors, four organs and four seasons.
Adapted from Finger [19].

the predisposition towards the impressions caused by either envi-
ronmental factors, or by endogenous factors (memories, ideas, etc.)
[41,47]. According to this theory, the predominance of a partic-
ular humor led to differences in wit, with madness considered a
special type of wit according to this hypothesis. The various men-
tal disorders, such as mania, melancholy or frenzy were therefore
the result of a change in the temperament of the patients brain.
This temperament was reversed when the patient was treated and
cured.
The role of animal spirits in human physiology, as tools for com-
munication between the upper strata of the being and corporeality,
which was even defended by Andreas Vesalio (15141564) in his
magnum opus De humani corporis fbrica (Book VII, 1543) [51], and
the role of the humors in the origin of melancholy, were therefore
major topics of scientic debate in the age of Descartes.
3. The Cartesian psychophysiological perspective
in particular, as discussed below. In his Mditations Mtaphysiques
(1641), Descartes says:
I have a vivid and clear idea of myself as something that
thinks and isnt extended, and one of body as something that
is extended and does not think. So it is certain that I am really
distinct from my body and can exist without it (6th Meditation)
[14, p. 27].
Descartes thus removes the soul and intelligence from his
concept of the cosmos. The soul (res cogitans), is therefore outside
the external world, which includes the human body (res extensa)
and animals. On this point, the French philosopher differs from the
classical Greek theories [27], and adopts the dogmas of some of
the great Fathers and Doctors of the Church, such as Augustine of
Hippo (Saint Augustine) (354430) [25], who believed that human
beings consisted of body and spirit, although the body was not

Ren Descartes (Fig. 2) was one of the most important men

of science of the 17th century. Like the great geniuses of the
Renaissance, Descartes worked in the elds of philosophy, math-
ematics, physiology, physics, astronomy and even music, and his
Discours de la mthode (1637) was the key scientic manual of
his time. Descartes was not only the founder of contemporary
philosophy [26], but was also the father of analytical geome-
try (Cartesian algebra). In addition, he formulated laws for the
refraction of light (the Laws of Descartes) and was a great
scholar of mans vital signs and physiological activities (Diop-
trique, 1637; Descriptio Corporis Humani, 1648; Les Passions de
lme, 1649; De Homine, 1662 and Trait de lHomme, 1664;
La Formation du Foetus, 1664).

3.1. Cartesian dualism vis--vis the soul and the body

The principles of Cartesian philosophy are based on deciphering

the essence of the cosmos, which has a purely mechanical nature
from this perspective. Descartes sees the universe (res extensa)
as a material and mechanical system which is governed by the
inexible laws of mathematics [15]. However, Descartes uses Greek
philosophical analysis to leave the way open for a duality of the
human body and soul [8,58]. This would be very important in his Fig. 2. Ren Descartes, from an engraving by William Holl, based on an original
etiopathogenic interpretation of mental disorders, and depression portrait by Frans Hals (1648) in the Muse du Louvre (Paris).
 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
Fig. 3. Covers of the rst editions of The Treatise of Man and The Passions of the Soul: (A) The Henry Le Gras edition of Les Passions de lAme (Pars, 1649). (B) The Florent Schuyl
edition of LHomme published in Latin, entitled De Homine (Leiden, 1662).
the prison of the soul: the soul was located in each part of the
body (De Trinitate, 399419). Descartes also acknowledged the
existence of an intangible mind or soul (res cogitans), which was
completely unencumbered by the laws of mechanics, and which
had inner perceptions that he called passions. As well as this res,
and subordinate to it, there was a material entity or animal body
(res extensa); both res existed in perfect harmony to constitute the
human being [32]. In his work The Treatise of Man (1664) Descartes
says: I assume the body to be but a statue, an earthen machine,
formed intentionally by God to be as much as possible like us [Art.
2]. When God will later join a rational soul to this machine, He
will place its chief seat in the brain (Art. 28) [1,16]. It is therefore
precisely the acknowledgement of the principle of spirit-matter
dualism which opens up a small chink in Descartes determined
defense of his mechanistic doctrine.
This dualist stance by Descartes has been openly criticized by
some contemporary authors, including the neurologist Antonio
Damasio (1944). In his work Descartes Error: Emotion, Reason, and
the Human Brain (1994), Damasio says that the separation of mental
activity from the structure of the brain and its inner workings is a
serious error [12]. This is because the brain and the rest of the organ-
ism form an inseparable entity consisting of numerous neuronal
and biochemical channels that relate the subject to its surround-
ings, and mental activity is a result of this interaction. However, in
his nal work published during his lifetime (The Passions of the Soul,
1649), Descartes makes it clear that the relationship between the
soul and the body is something more than the sum of its two parts.
For this reason, some authors [31] mention triadism when dis-
cussing the Cartesian theories advocated in this work, as it suggests
a third distinction or quality, which is the interaction between
the two substances that make up human beings, as an experience of
unity. In fact, regardless of whether the souls functions has a spe-
cic inuence on particular anatomical structures, in Article XXX
of The Passions of the Soul, Descartes states that the soul is really
joined to all the body, but it cannot properly be said to be in any of
the parts thereof, excluding the rest, because it is one, and in some
sort indivisible [1,15].
45
3.2. The functionalism of the human body according to the
theories of Descartes
First, it must be emphasized that Descartes used two types of
technical sources. On the one hand, in his philosophical work he
adopted most of the theories that had been common currency since
classical Antiquity, which were essentially the ideas of the Alexan-
drian pneumatic school as regards the so-called animal spirits
(copula animae cum corpore), which were subsequently Chris-
tianized by Saint Augustine: Et aer, qui nervis infusus est, paret
voluntati, ut membra moveat, non autem ipse voluntas est (De Genesi
ad Litteram, 401415). These spirits are the biochemical founda-
tions for all Cartesian neuropsychophysiological doctrine, which
is the same as Augustinian neurophysiology in many aspects [52].
However, the physiological sources upon which he based his doc-
trine were entirely contemporary. As Brett [7] correctly points out,
in the eld of physiology, Descartes had the advantage of coming
after Vesalius, and the luck to nd out about Harveys discovery.
Much of Cartesian physiological doctrine is contained in the
Trait de lHomme (Fig. 3), which was possibly the most inuential
work on the conception of human psychophysiology in the entire
17th century, and is considered the rst European physiology text-
book [48]. The Treatise of Man was originally supposed to be chapter
XVIII of a more extensive work, The Treaty of Light or The World (Du
Monde). However, Descartes never published this magnum opus,
as he stopped working on it when he heard that the Inquisition
had condemned Galileo Galilei (15641642) (Dialogo sopra i due
massimi sistemi del mondo, tolemaico e copernicano, 1632) in 1633.
The extent to which the philosophers state of mind was affected
by the guilty verdict passed on Galileo can be seen in the letter
he wrote to his friend, Father Marin Mersenne (15881648), on
28 November 1633, in which he said that this condemnation for
the Copernican heresy . . . has shocked me so much that I have
almost to burn all my papers, or at least not to let anyone see them.
However, just as I would not want for anything in the world to
produce an essay containing the least word that would be disap-
proved by the Church, so I would rather suppress it than publish
46 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
Fig. 4. Engraving by Louis de la Forge to illustrate Article 61 of The Treatise of Man
(1667), entitled On the structure of the brain of this machine. The pineal gland is
marked by the letter H.
it maimed. [1,46, p. 93]. Some authors have even suggested that
the trial of Galileo, which was held in September 1633, inuenced
Descartes thought to such an extent that it made him tone down
the neurophysiological theories he set out in The Treatise of Man,
in which the body-mind materialist dualism is apparent. When he
wrote The Treatise on the Passions of the Soul, his neurophysiological
theories gave the rational soul the role of controlling the functions
of the human machine, which was more in line with the ofcial
Augustinian doctrine of the Church [42].
As a counterpoint to the architectonic Renaissance anatomy of
Vesalius, Descartes proposed a completely mechanical concept of
the activity of the human body, the functioning of which could be
explained without the need for considering external possibilities.
Indeed, the French philosopher is considered to be the inventor of
the man-machine, a concept which considers the human being
to be an organism consisting of several parts, of which it is the
sum. Furthermore, based on these theories, the movement of the
parts comprising the living being must obey the same laws as those
that govern the rest of the universe [8]. In The Treatise of Man,
Descartes mentions the major breakthroughs in what were known
as automata during the Renaissance (clocks, religious and courtly
gures, mills, etc.), and formulates a complex mechanistic phys-
iological doctrine. However, in Descartes opinion there is a clear
difference between the moving machines that human industry can
make and human beings, as this machine, having been made by
the hands of God, it is incomparably better organised and capable
of movements that are much more wonderful than any that can
be devised by man (Discourse on the Method, Part 5) [1,13, p. 22]
For Descartes, the nervous system consisted of the brain and
the nerves. He believed that the brain (Fig. 4) was formed by three
different parts; the outer layer (surrounded by the pia mater), the
inner layer (the ventricle walls) and the substance of the brain,
located between the two layers. In his anatomical view, the inner
layer is the most important part of the brain and is completely
Fig. 5. Diagram by Louis de la Forge for The Treatise of Man (1667), showing the
Cartesian anatomical structure of the nerves. Based on Art. 18: Explanation of the
production of nerves.
covered with pores, which are the spaces between the nervous l-
aments which make up a type of grid or network. These laments
go straight to the outer layer of the brain (the shorter ones), or form
part of the nerves in the stricter sense which are located through-
out the body (the longer ones). Instead of the classical concept,
which associated nerves with hollow channels and was still preva-
lent during the 17th century, Descartes advocated a system that
also included the existence within them of a delicate network of
laments or bers that mingled with the laments comprising the
brain, and enabled the existence of spaces between them for the
appropriate ow of animal spirits (Fig. 5):
Observe, for example nerve A, whose external membrane is like
a large tube containing several other small tubes, b, c, k, l, and
so on, composed of a thinner, internal membrane; and observe
that these two skins are continuous with the two, K and L, which
envelop the brain M, N, O.
Observe also that in each of the little tubes there is a sort of
marrow composed of several very ne brils which come from
the actual substance of the brain and whose [two] extremities
end [one] at the internal surface of the cavities of the brain and
[the other] at the membranes and esh on which the tubule
containing them terminates (Art. 19) [1,16].
The nerves ended in the muscular mass and at this level, had
valves that enabled the animal spirits to enter the muscle. On their
journey around the body, the nerves also had a distal valvular mech-
anism, similar to that proposed by William Harvey (15781657) in
his description of blood circulation, to maintain and control the
spiritual ow [53]. Although the philosopher had absolutely no
knowledge of the motor tract and only describes a sensory nervous
tract, it is easy to deduce a logical explanation for this problem
based on his theory: the cords or small laments making up the
nerves (the continent) are therefore responsible for sensitivity, and
animal spirits (the content) account for motility.
As a result, according to Descartes psychophysiological theo-
ries, the tranquil harmony between the desire of the mind and the
 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
Fig. 6. Anatomical location of the pineal gland, according to the theories of Descartes and the interpretation of the illustrator, Florent Schuyl (Figure XXXIV of De Homine,
1662).
movement of the body required perfect communication, for which
the Galenic spiritus animalis were responsible. However, the nature
of these spirits is not made particularly clear in Descartes works.
Like Tertullian of Carthage (155230), Descartes thought that ani-
mal spirits were not a liquid substance, but instead subtle uids
inside the cerebral ventricles and the nerves as rapidly mov-
ing particles. In short, he saw them as a type of quintessence
caused by a loss of blood density. It therefore appears that
Descartes was unaware of the discovery of cerebrospinal
uid by Niccol Massa (14851559), in 1536 (Anatomiae Libri
Introductorius).
3.3. The pineal gland as the Cartesian anatomical centre of
human psychophysiology
In the Cartesian theories, in order for this harmonious relation-
ship between the mind and body to exist, it is necessary for the res
cogitans or human soul to have a corporal and physical seat, from
where it would be possible for it to undertake this mysterious com-
munication. Descartes therefore established the seat of the soul in
the innermost of the parts of the brain, i.e. the pineal gland (the
classical epiphysis cerebri) [37].
However, it should be pointed out that the anatomical location
of the pineal gland in The Treatise of Man is erroneous. Descartes
situated this organ in the rostral part of the sulcus lateralis cere-
bri, which connected the third cerebral ventricle with the fourth
ventricle [8], a well protected place, which is almost immune
to diseases [19]. Within this anatomical region, the pineal gland
physically hangs from arterioles and is not attached to the sub-
stance of the brain (Fig. 6). Although the illustrations in The Treatise
of Man include an obvious error, by showing the pineal gland as
being inside the ventricles, they are possibly not the result of a gap
in the anatomical knowledge of Descartes himself. Claude Clerse-
lier (16141684), the philosophers brother-in-law and friend, who
published of the French version of the treatise, commissioned Louis
de la Forge (16321666), a doctor in medicine in La Flche, and
Grard van Gutschoven (16151668), a professor of anatomy at
Louvain and an advocate of the mechanistic Cartesian theories,
to produce these illustrations fourteen years after the authors
death. As a result, the drawings were simply the interpretations of
the illustrators, supervised by Clerselier, of Descartes posthumous
work (in fact, by drawing the pineal gland much larger than its nat-
ural size, the illustrators highlighted the importance that Descartes
conferred on this organ) (Fig. 4) [6,54]. Furthermore, according to
Carter [8], the anatomical dissection techniques of the time were
not sophisticated enough to be able to ascertain the precise location
47
of the pineal gland, and as a result many authors suggested that it
was located inside the substance of the brain.
In any case, Descartes believed that the inner structure of the
pineal gland, like that of the rest of the brain, consisted of la-
ments separated by pores through which blood from the plexus
choroideus and the epiphysary arterioles owed [53]. In order to
carry out its function, the pineal gland exuded ne particles sus-
pended in the blood and created in the left ventricle of the heart,
by the heat of the myocardium (a very subtle wind, or rather a
ame which is very pure and very vivid, in Descartes own words)
(Art. 14) [1,16] which transformed them into esprits animaux. The
larger particles, meanwhile, as they were not ltered by the pineal
gland, went to the surface of the brain cortex for nutritional pur-
poses [6]. These spirits had two fundamental properties: they are
very small particles and move very quickly as the parts of a ame
issuing from a torch (Art. X) [1,15].
In Cartesian physiology, gures from the outside world rst
affected the surface of the ventricles and then, due to the animal
spirits within them, they marked the surface of the gland like a
seal in wax [58]. The pineal gland was in turn responsible for the
movements of the distal muscles, which also took place by means
of animal spirits [38]. Active movements of the gland sent them
to the cerebral ventricle system (the Cartesian cerebral cavities)
and from there to the outer regions of the body, passing through
the vast amount of pores that in theory were within the walls of
the ventricles. According to this physiological theory, the ventric-
ular pores were able to open or close depending on the type and
degree of sensory stimulation, and could thereby limit the ow of
animal spirits from the pineal gland to the muscles along the nerve
tubes. Once these spirits reached the muscle, they made it change
its shape, producing movement of the muscle. The entire process
is summarized in The Treatise of Man with the help of a drawing
(Fig. 7):
You can see in the diagram that the spirits that leave the gland,
having dilated the part of the brain marked A and having partly
opened all its pores, ow thence to B, then to C, and nally into
D, whence they spill out into all the nerves. And by this means
they keep all the laments that compose the nerves and the
brain so tense that even those actions that have barely force
enough to move them are easily communicated from one of
their extremities to the other, nor do the roundabout routes
they follow prevent this (Art. 65) [1,16].
When providing this mechanical explanation for the physio-
logical phenomenon, Descartes had the advantage of an assumed
mobility of the pineal gland (Fig. 7) [20], as: . . . it is composed
48 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253

Fig. 7. Engraving by Gerard van Gutschoven, based on Art. 64 of The Treatise of Man
(1667) (How ideas of objects are formed in the place destined for imagination and
for common sense).

of matter which is very soft and that it is not completely joined

and united to the substance of the brain but only attached to cer-
tain little arteries, whose membranes are rather lax and pliant; it
is sustained as if in balance by the force of the blood which the
heat of the heart pushes thither (Art. 72) [1,16]. This ability of the
epiphysis to move in order to regulate the ow of animal spirits is
similar to the role of a valve in mechanical terms, and could also
be caused by the force of the animal spirits which pass through it
and by the action of the objects that reach the senses. However,
Descartes was not the pioneer of this valvular concept, accord-
ing to some authors [49], as it had been proposed by Jean Fernel
(14971558), a modern advocate of the Galenic medical system
(Universa medicina, 1554) a century earlier. However, Lokhorst and
Kaitaro [36] maintain that the anatomical structure that Fernel dis-
cusses is not the pineal gland, but in fact the cerebellar vermis (as
postulated by Galen and Costa ben Luca or Constabulus, 864923),
which would mean that Descartes theory is in this case completely
original.
However, as well as physical factors, the gland could also be
moved directly by the force of the soul, an idea which is directly
related to Descartes psychological theories. Descartes discusses
this role in detail in his work The Passions of the Soul, in which he
states that it:
. . . hangs so between the cavities which contain these spir-
its, that it may be moved by them as many several fashions as
there are sensible diversities in objects. But withal, that it may
be moved several ways by the soul too, which is of such a nature,
that it receives as many various impressions (that is, has as many
several apprehensions) as there come several motions into this
kernel. As also on the other side, the machine of the body is so
composed that this kernel being only divers ways moved by the
soul, or by any other cause whatsoever, it drives the spirits that
environ it towards the pores of the brains, which convey them
by the nerves into the muscles (Art. XXXIV) [1,15].
As a result, all the action of the soul consists in this, that it
merely by willing anything can make the little kernel, whereunto it
is strictly joined, move in the manner requisite to produce the effect
relating to this will (Art. XLI) [1,15], so that it could cause muscle
movements by positioning itself in such a way that the spirits slide
through different pores in the ventricular walls. In short, Descartes
believed that every change in the position of the pineal gland leads
to a different perception of the soul, and the soul in turn could also
move the gland merely as a result of perception [8].
However, . . . the little kernel in the middle of the brain, being
driven on one side by the soul, and on the other by the animal
spirits (which are only bodies, as I laid down before) it happens
oftentimes that these two impulsions are contrary and that the
Fig. 8. Drawing included in Art. 76 of The Treatise of Man (1667), showing How an
idea can be formed from several movements.
strongest hinders the operation of the other (Art. XLVII) [1,15].
For Descartes, there were therefore two types of movements by
the pineal gland that could have been caused by spirits; those that
present the objects captured by the senses to the soul (Fig. 8) and
those that cause the passions (Art. XLVII) [1,15]. The former have
no power over the will, while the latter do have this power. A soul
will therefore be stronger when its will can easily prevail over the
passions and can neutralize the movements of the body that accom-
pany them. However, . . . even those who have the weakest souls,
may acquire a most absolute empire over all their passions, if art
and industry be used to manage and govern them (Art. L) [1,15].
However, why did Descartes believe that the pineal gland was
the control centre of the body, and the seat of the sensorium com-
mune (the point of convergence of all the sensations in the brain)
and the seat of the soul (sige de lme)? His choice was possibly
based on anatomical reasons [18], although mathematical reasons
cannot be ruled out, as Descartes selected an organ located in the
exact geometric centre of the brain. Descartes was possibly aware
of the work and opinions of the famous professor of Anatomy at
Utrecht University, Ysbrand van Diemerbroeck (16091674), who
was a contemporary of the French philosopher. Van Diemerbroeck
had already postulated the pineal gland as the possible location
of the sensorium commune, the place where all types of sensory
stimuli converge. In any event, Descartes believed that there were
two of each of the sensory and cephalic organs, except for this
single small gland (where the seat of common sense and imag-
ination is, the store of past experiences and the organ responsible
for appetites and passions) located in the geometrical centre of
the brain (primus inter pares) and suspended over the channels that
contained the animal spirits (Figs. 4, 6 and 8) [9]. This central loca-
tion enabled it to receive any stimulus from the peripheral organs,
while its unitary nature means that the process of assimilating per-
ceptions and sensations from double organs is possible (Fig. 8).
Taking these physiological ideas as their cornerstone, the Carte-
 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
sian theories reached one of the greatest landmarks in mechanistic
philosophy, which takes us back to the preface of The Treatise of
Man, in which he compares these men-machines to the fountains
that adorn royal gardens [38]. Descartes was also one of the rst
scientists to consider the problem of the location of the cerebral
functions, albeit erroneously in the light of current knowledge [37].
In this area, his theories presaged the major work done by Thomas
Willis (16221675).
4. The passion of the soul in Cartesian philosophy
One of the major controversies in Cartesian philosophical doc-
trine is the inuences that act on thought (res cogitans) and
extension (the human body-machine) [2,24,57]. In the philoso-
phers opinion, the possible relationship between both entities is
twofold, as it is possible that the soul moves the body, and that
the body is in turn able to inuence the soul. Descartes uses the
term passion to refer to this interaction, and denes these as the
sensitive movements experienced by the soul as a consequence
of its union with the body. It must be borne in mind that the
meaning of the word passion in Cartesian doctrine would be the
equivalent of the concept of emotion in modern psychology [56].
Descartes focused on this issue in his nal work published during
his lifetime, The Treatise on the Passions of the Soul (Fig. 3). Some
authors have suggested, from psychophysiological point of view,
this may be a type of continuation of The Treatise of Man [35],
although its starting point is the correspondence that Descartes
maintained with Princess Elizabeth of Bohemia (Elisabeth von der
Pfalz) (16171680), the abbess of Herford, and his meditations
on happiness. Indeed, in a letter dated 21 May 1643, Elizabeth of
Bohemia asked Descartes about the internal interactions of the soul
and matter. The philosopher replied:
In view of my published writings, the question that can most
rightly be asked is the very one that you put to me. All the knowl-
edge we can have of the human soul depend on two facts about
it: the fact that it thinks, and the fact that being united to the
body it can act and be acted on along with it. I have said almost
nothing about, focussing entirely on making better understood.
That is because my principal aim was to show that the soul is
distinct from the body [1,4, p. 2].
This led to Descartes nal work, which was originally entitled
Les Passions de lme, and was published simultaneously in Holland
in 1649 by Louis Elzevier (15401617), and in France by Henry Le
Gras (15901662), just a year before the philosophers death. The
general theme of this work is a description of how the soul is joined
to the body. However, when considering this problem, Descartes,
as he makes clear in the prologue, does not do so from a moral-
istic or philosophical point of view, but instead from the physical
point of view. He therefore considered it in specically scientic
and physiological terms [15]. For Descartes, thoughts were among
the exclusive properties of the soul. These may in turn be of two
types; actions of the soul, i.e. volitions that come directly from the
soul, and passions of the soul. The latter are our perceptions of
objects that stimulate the nerves, or are due to other less common
causes, such as fantasies of the imagination that stir the soul, the
temperament or the intellectual emotions.
Descartes dened the passions of the soul, of which he lists
49, as . . . apprehension, resentments, or emotions of the soul,
attributed particularly to it, and caused, fomented, and fortied
by some motion of the spirits (Art. XXVII) [1,15]. The French
thinker felt that the best denition of the three alternatives was
that of an emotion of the soul, i.e. a movement or change of the
soul due to the thoughts reaching it. However, a distinction must
be made between these sensations and those that refer to phys-
49
ical objects (odors, colors, sounds), and those that involve the
body itself (thirst, hunger, pain), as these emotions, called pas-
sions, are created by the soul itself. The function of the passions
of the soul is also perfectly explained by Descartes when he says
that . . . use of all the passions consists only in this, that they
dispose the soul to will the things which nature dictates are prof-
itable to us, and to persist in this will. . . to dispose the body to
the motions that further the execution of those things (Art. LII)
[1,15].
4.1. Sadness as a passion of the soul
In Descartes opinion, there were only six primitive or primary
passions, which are indivisible, as referred to in Art. LXIX in his
work The Passions of the Soul: . . . it may easily be noted that
there are but six such, to wit: admiration, love, hatred, desire, joy
and sadness, and all the others are compounded of some of these
six, or are sorts of them [1,15]. Sadness is therefore one of the
six pure passions of the soul. He also established the existence of
two sorts of sadness (Art. LXII), pity and envy, both of which are
described as a consequence of our impressions of other people or
groups.
Sadness is dened as an unpleasant languishing, wherein con-
sists the discommodity the soul receives from evil, or defect, which
the impressions of the brain represent unto her, as belonging to her.
And there is also an intellectual sadness, which is not the passion,
but which wants but little of being accompanied by it (Art. XCII)
[1,15]. However, Descartes says that it oft falls out, that a man is
sad or joyful, and yet he cannot distinctly observe the good or evil
which are the cause of it (Art. XCIII) [1,15]. This is for two reasons:
because they are associated with the perceptions of the body (a
sadness associated with a bodily dysfunction or the perception of
pain, for example) rather than the soul, or because the soul does
not recognize them as good and evil, but thinks of them in another
way, but they act in a similar way on the brain.
For Descartes, except for admiration, the other primitive pas-
sions, including sadness, not only originated in the brain, but also
. . . in the heart, spleen, liver, and all other parts of the body, in as
much as they serve to the production of the blood, and afterwards
of the spirits (Art. XCVI) [1,15], as the force of the blood in the veins
varies under different circumstances, as does the extent to which
the entry cavities to the heart are opened. At the base of the heart
are some small nerves which narrow or widen the entries to the
cardiac cavities. As a result, the blood can spread to a greater or
lesser extent in the cardiac cavities, in order to produce spirits of
various moods and different qualities. Hence:
. . . in sadness, the pulse is weak and slow, and a man feels
strings about his heart, which bind it close, and icicles that freeze
it and communicate their cold to the rest of the body. Yet despite
that he has sometimes a good appetite, and feels his stomach not
failing of its duty, provided there be no hatred mingled with the
sadness (Art. C) [1,15].
According to Descartes, when a joyful thought affects the brain,
animal spirits are conveyed intensively towards the nerves located
around the chambers of the heart. These orices are enlarged, mak-
ing the blood circulate more quickly, producing spirits, whose
parts being very equal and subtle, are t to form and fortify the
impressions of the brain, which deal lively and quiet thoughts to
the soul (Art. CIV) [1,15] (this explanation suggests a type of posi-
tive feedback). However, in sadness the opposite is true; the cardiac
cavities are narrowed, the blood is no whit agitated and very
little of it reaches the heart. Furthermore, the passages through
which the juice of meats glides from the stomach and entrails to
the liver are open, wherefore the appetite diminishes not (Art.
CV) [1,15]. Descartes suggested a hypothesis of a psychoanalytical
50 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
nature, when he states that the rst sadness is associated with
lack of food. Indeed, the lack of food supplying the heart causes
its entry orices to contract, as a result of receiving little blood.
As a compensatory measure, the spirits contribute to a reduction
in blood from the spleen, as this organ is the last reserve which
serves to supply the heart, when there comes none to it from any
where else (Art. CX) [1,15].
As can be deduced from all the psychological theories men-
tioned above, for Descartes the heart was the source of the passions
seeing it prepares the blood and spirits to produce them (Art. CXIV)
[1,15].
4.2. The symptomatological manifestations of sadness as a
passion of the soul
In the Treatise on the Passions of the Soul, Descartes also gave
thorough consideration to the physical manifestations of these
passions, which he calls corporeal movements. According to
Descartes, sadness is usually accompanied by paleness, trembling,
listlessness, tears and sighs. Paleness is an intrinsic characteristic
of sadness and is physiologically justied:
On the contrary, sadness, by contracting the orices of the
heart, makes the blood ow more slowly into the veins, and that
becoming colder and thicker has not need of so much room; so
that retreating into the largest, which are nearest the heart, it
deserts the remotest. The most apparent whereof being those of
the face, that makes it look pale and wan, especially when the
sadness is great . . .. (Art. CXVI) [1,15].
The cause of the trembling that accompanies sadness is that the
blood of individuals experiencing this passion is too thick, so that
not enough spirits are produced to reach the nerves from the brain.
Meanwhile, languishing, which is a disposition to ease ones self,
and be without motion, which is felt in all the members (Art. CXIX)
[1,15], was caused, like trembling, by too few spirits reaching cer-
tain muscles. Although there is no decline in their numbers, the
pineal gland sends them to different muscles. The languishing
that accompanies sadness was in Descartes opinion mainly due
to the presence of desire of a thing, to the acquisition whereof a
man cannot contribute anything for the present (Art. CXXI) [1,15].
Astonishment or swooning takes place when the life-giving heat
of the heart decreases. According to this hypothesis, although this
symptom is usually thought of as common in people affected with
sadness, the French philosopher thought that it happened very
rarely. In theory, sadness could close the chambers of the heart, so
that it could extinguish its re. However, under no circumstances
could there be so little blood inside it that its heat was completely
stied, even when the entry cavities were almost entirely closed.
According to Descartes, tears usually accompany moderate sad-
ness, especially when it is followed by another passion, such as love
or happiness. Tears are caused by the vapors that come from the
eyes, due to the large size of the optic nerves. Sadness per se is due to
a cooling of the blood, which contracts the pores of the eyes, which
in turn leads to a decrease in the amount of vapors that have to
come out through these pores. However, in order for the vapors to
become tears, the amount of them must increase very quickly. This
is caused by an increase in the volume of blood sent to the heart by
the passion of love. According to Descartes this is why they who are
sad do not continually shed tears, but only by intervals when they
make any new reection on the objects they affect (Art. CXXXI)
[1,15]. This sudden abundance of blood makes the lungs also sud-
denly swell, thereby forcing out the air they contained. When it
leaves the throat, this causes the groans that accompany tears.
Finally, sighs are also usually associated with sadness. The
physiological justication for this symptom is relatively complex.
Descartes himself explains it thus in Art. CXXXV:
For whereas a man is excited to weep when the lungs are full
of blood, he is incited to sigh when they are almost empty and
when some imagination of hope, or joy opens the orice of the
venous artery which sadness had contracted; because then the
small remainder of blood in the lungs, falling all together into
the left side of the heart through this venous artery, and driven
on by a desire to attain this joy, which at the same time agitates
all the muscles of the diaphragm and breast, the air is suddenly
blown through the mouth into the lungs to ll up the vacant
place of the blood. And this is called sighing [1,15].
The French philosopher includes a wide range of particular pas-
sions as subgenres of the primitive passions. He mentions several
particular passions of sadness, including fear, desperation, indeci-
sion, remorse, envy, compassion, regret, shame and distaste. With
regard to the latter, which is also known as disgust or revulsion,
Descartes says that:
. . . it is a sort of sadness, proceeding from the same cause
whereof joy came before. For we are so made up that the
most part of the things we enjoy are only good to us for a
season, and afterwards become incommodious (Art. CCVIII)
[1,15].
The passions all relate to the body, and are not given to the
soul, but as joined to it. So that their natural use is to incite the soul
to consent and contribute to the actions, which may be useful to
conserve the body, or make it in some kind more perfect. In this
respect, Descartes believes that all the passions are necessary (they
are benecial by nature, he says, in this case agreeing with the Aris-
totelian theories) and even that sadness is in some sort superior
to, and more necessary than joy. . ., because it is of more moment
to repel things noxious and destructive, than to acquire such as
add some kind of perfection, without which it is possible to sub-
sist (Art. CXXXVII) [1,15]. Furthermore, he maintains that sadness
is not in itself necessarily bad for the soul (contrary to the doctrines
of Stoicism, to which attempts have been made to associate him)
as it is what informs the soul of the ill it is suffering from.
5. Psychopathology in the Cartesian universe
According to the humor-based characterology used by most
Renaissance authors, and deal with most extensively by Huarte
de San Juan in his The Examination of Mens Wits, there are four
types of temperaments, which are the result of the combination
of the different humors: the sanguine, the choleric, the phlegmatic
and the melancholic temperament. The latter is associated with
sleep disorders, such as insomnia and nightmares, and stubborn
behavior.
On this point, Descartes differed from the classical writers and
the prevailing humoralist theories and provides a new explana-
tion for human temperaments, by making animal spirits directly
responsible for these inclinations, and for their properties in par-
ticular; the amount, consistency and level of agitation (Art. 55 of
The Treatise of Man). As a result, if the spirits are very agitated, they
create promptness, diligence and desire, and otherwise, tranquility of
spirit; an abundance of them creates liberality, generosity and love;
if their consistency is strong and coarse, they generate condence
and courage; if they are uniform in shape, force and size, they
lead to constancy; nally, if these qualities are lacking, this will lead
to tardiness, restlessness, malice, timidity and ruthlessness. Descartes
states that the natural inclinations or temperaments depend on the
combination of these qualities, so that for example, the sad humor
is composed of tardiness and restlessness, and can be augmented
by malice and timidity. However, from a pathological perspective,
Descartes also made it clear that whatever can cause any change in
the blood can also cause change in the spirits (Art. 60 of The Trea-
 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
tise of Man) [1,16], such as digestive, hepatic, biliary or respiratory
disorders.
There is a clear psychosomatic aspect to Cartesian theories in
terms of the etiopathogeny of diseases [2,34]. Indeed, in a letter
sent to princess Elizabeth of Bohemia dated 18 May 1645, Descartes
says that the most common cause of a low-grade fever [that she
was suffering] is sadness [1,4, p. 12]. Descartes was aware of the
personal misfortunes that the princess had suffered, and in his let-
ter he recommended that as well as conventional treatment, he
should free her mind of sad thoughts. At this point, it should also
be mentioned that Descartes himself had experienced the effects
of depression. After graduating in law, as a young student he had
suffered from depression and an identity crisis, which led him to
question the theoretical value of his marvelous education, which
was of hardly any use to him in real life. At that point, Descartes
did not know in which direction to focus his personal and pro-
fessional life and withdrew into himself. His anxiety to discover
the world and his physical laws with his own eyes and using his
own discernment was what enabled him to overcome his depres-
sion, when he was 22 years old [60]. The French philosopher may
have suffered from another episode of depression in his adult life,
after the early death of his daughter Francine, at 5 years old, after
contracting scarlet fever.
Descartes explained other psychopathological disorders, such as
phobias, from the same psychosomatic perspective, when he sug-
gested that the strange aversions of some, who cannot endure the
smell of roses, the sight of a cat, or the like, come only from hence;
that when they were but newly alive they were displeased with
some such like objects (Art. CXXXVI of The Passions of the Soul)
[1,15]. As a result, some authors have suggested that Descartes was
a type of pioneer in the eld of psychoanalysis [22].
The only danger that passions can cause to the health lies in
their excess or misuse. Descartes proposed premeditation and skill
as remedies for excesses of passions. Individuals should be able to
use these to control the movements of the blood and the spirits
of thoughts which are linked to the passions. However, even with
these measures for ghting excesses in passions, they arent suf-
cient to prevent bodily disorders; but they may sufce to prevent
the soul from being troubled and losing its capacity for free judg-
ment (Letter to Princess Elizabeth of Bohemia, May 1646) [1,4, p.
46]. Descartes thereby concludes his Treatise with an article enti-
tled That from them [the passions] alone all the good and evil
of this life depends (Art. CCXII), in which he says that wisdom
teaches us so to make ourselves masters of them, and manage
them with so much dexterity, that the evils they cause may be easily
endured [1,15]. When dealing with stress, it is essential to avoiding
thinking about stressful things, while on the other hand, thinking
about very pleasant situations and objects is very positive. As a
result, although Descartes did not systematize the psychosomatic
theories in his philosophy, he was a pioneer in this eld (a type of
primitive cognitive-behavioral therapy). Unlike the theories of his
detractors, the body and soul are closely linked in his theories, and
act in unison.
Other remedies suggested by Descartes in his Treatise are
hygienic or dietetic, taking into account that food is the basis of
all organic elements, including, of course, the animal spirits. As a
result, depending of the food consumed, the composition and con-
sistency of the blood varies, so that when its consistency is ner,
this will lead to joy, while if its consistency is coarser, its slow
movement will lead to sadness. Likewise, drinking spring water
could make it ner, while dry air makes the blood more subtle.
Sleep and exercise enable the blood to nourish the substance of the
brain, making it more susceptible to the movement of the spirits.
From another perspective, all these remedies stress the classical
theories of illness as a consequence of an alteration in the balance
of the humors.
51
The pineal gland also plays a role in the French thinkers
physiopathological explanations. In a letter to doctor Lazare
Meyssonnier (16111673), dated 29 January 1640, Descartes writes
about the relationship between the pineal gland and memory, and
suggests that the gland may be less mobile (with all the conno-
tations that that entails) in people whose minds are sluggish.
Likewise, in another letter written to father Mersenne two months
later, he discusses the possibility of a decline in the functionality of
this organ in human beings as a result of age.
6. The legacy of the Cartesian theories
The spirit of Cartesian physiology, which despite being inge-
nious had the twin shortcomings of being excessively deductive
and not sufciently experimental, is not limited merely to the
work of Descartes and contemporaries. Indeed, it provided a frame-
work and inspiration for the way man was understood throughout
the entire 17th century (the iatromechanical and iatrochemical
currents) and conditioned much of the 18th century (the vitalist
current of the Enlightenment) [5,61]. By way of an example, some
authors continued to defend Descartes ideas in the 18th century,
such as Claude-Nicolas Le Cat (17001768), who believed that the
material that owed in the nerves was not a known material
(water, blood, vapor, electricity, light, re, etc.), but was instead a
Universal Fluid, that arose from the ltering of the blood in the
cerebral cortex, where he believed the human soul was located [33].
Likewise, Samuel-Auguste Tissot (17281797), in his renowned
Trait des Nerfs (1784), undertook a detailed defense of the theory
of animal spirits. Similarly, the explanations of nerve function and
their relationship to psychological phenomena by Charles Bonnet
(17201793), a pioneer of 18th century mechanistic dualism, also
owe much to Descartes, despite of the Swiss scientic scepticism
concerning animal spirits [30]. However, this theory was discarded
as a result of the major breakthroughs in the eld of microscopy
and electrophysiology in the late 18th century. In 1780, Luigi Gal-
vani (17371798) observed how the muscles of a frog contracted
when an electrical current was applied to them, and in 1781 Felice
Fontana (17301805) microscopically described the structure of
the nerve bers, thus conrming that the nerves were not hollow.
Finally, our understanding of the way the brain and nervous sys-
tem functions has changed for good since the mid-19th century,
thanks to the rise of cellular biology and the histological disciplines.
This process culminated in the late 1880s with the postulation of
neuronal theory by Santiago Ramn y Cajal (18521934) [39].
From the purely psychological perspective, the so-called occa-
sionalists were the direct heirs to the Cartesian doctrine [7] and
included the cleric Nicolas Malebranche (16381715), who tried
to produce a symbiosis between Cartesianism and Augustianism.
However, Baruch de Spinoza (16321677) was the most inuen-
tial critical heir of Cartesianism. Spinoza was a strict mechanicist,
although unlike Descartes, he adopted a monist philosophical posi-
tion, i.e. he rejected the existence of a body-soul dualism. He
thought that man was the sum of the body and mind, in the form of
a universal substance with innite attributes, which could resem-
ble both Nature and God (Deus sive Natura). This approach has
the advantage compared to Cartesian theory of no communica-
tion being necessary between the res cogitans and extensa in the
pineal gland to explain human consciousness, as both attributes,
like the passions and emotions, are forms of the same divine or
natural substance. There is an obvious determinism underlying this
explanation, which Spinoza was unable to avoid.
Cartesian inuence was also apparent in the specic eld of psy-
chopathology. The major inuence of Descartes work on that of
Willis is striking. The latter, who beneted from the very favorable
conditions for scientic study prevailing in Great Britain at that
52 F. Lpez-Munoz et al. / Brain Research Bulletin 85 (2011) 4253
time, was able to perfect the Cartesian neurophysiological model.
Willis, who ruled out the pineal gland as the location of the soul
and the seat of reason, believed that Descartes animal spirits were a
concept as classical as the corporeal soul, and that they were made
of light [62]. Likewise, he thought that melancholy was the conse-
quence of a disorder in the brain and the animal spirits inside it.
However, according to Willis, sadness and the trembling associated
with the disorder arose from a cardiac dysfunction which corrupted
these spirits and made them dark, opaque, gloomy, instead of trans-
parent, subtle and light [17]. These ows, which are in continuous
movement, led to a permanent agitation of thought when they
entered the brain and nervous system, which was responsible for
some of the symptoms of melancholy. Likewise, Archibald Pitcairn
(16521713), founder of the Edinburgh School and one of the most
fervent advocates of iatromechanic thought based on the Cartesian
physiological theories, turned to a disorder of the blood hydrody-
namics which affected the ow of animal spirits that circulated in
the nerves, leading to disordered and delirious thoughts in melan-
choly [44]. The idea of a slowing down of this disorder is also
linked with mechanistic philosophy, and related to the movement
of uids.
The inuence of Cartesian psychopathological theories was so
great that some authors continued to use these theories to explain
the origins of mental disorders even as late as the late 18th century.
Among these authors was Johann Friedrich Meckel (17141774),
who published an essay in the Mmoires de lAcadmie Royale de
Prusse in 1760, in which he maintained that psychoses were sec-
ondary symptoms to an increase in the brains consistency which
limited the free ow of animal spirits. Likewise, the theory pio-
neered by Descartes on the role of the passions in the origin of
mental illnesses began to assume scientic importance at the end
of the 18th century. This can be deduced from the comment by Sir
Alexander Crichton (17631856):
The passions are to be considered, in a medical point of view,
as part of our constitution, which is to be examined with the
eye of the natural historian and the spirit and impartiality of a
philosopher. It is of no concern in this task [that of the doctor]
to clarify whether these disorders should be esteemed natural
or unnatural, or moral or immoral. They are phenomena. that
cause benecial or harmful effects on the faculties of the mind
[10, vol. 2, p. 97].
After the age of Descartes, madness gradually came to be seen
as an abnormal way of associating ideas. This is apparent in the
fact moral treatment that was predominant in 18th century psy-
chiatry was based to a large extent on the importance attributed
to the passions in the origin of mental disorders [45]. In fact, it
was based on manipulation of the emotions for therapeutic ends.
One of its leading exponents, Philippe Pinel (17451826), said that
melancholy consists of a false judgment that is formed by the
patient on the state of his body, which he believes to be endan-
gered by trivial things, and fears that interests will be unsuccessful,
and talks about a depression of the spirit [43]. During the 19th
century, the role of the passions or emotions in psychopathol-
ogy, either as a direct cause of diseases or as a consequence of
them, became clearer. However, thanks to the major breakthroughs
in the biological sciences that took place in the late 19th cen-
tury, a process began, which has been called the somatization
of mental illness, in which madness came to be considered a
result of an organic injury and ceased to be thought of as the
result of a disorder in the sphere of the ideas and the passions
[3,29]. Nonetheless, despite the triumph of these somaticist and
biologicist schools, which reached its height with the works by
Wilhelm Griesinger (18171868) and Emil Kraepelin (18561926),
Descartes theory of the passions can be closely correlated with the
theories of emotions of contemporary authors (19242007). These
include the psychoanalytical theories of Hartvig Dahl (19242007),
who also used the pairings of emotions model, and who in con-
trast to the Cartesian happinesssadness pairing, postulates the
happinessdepression pairing [11].
7. Conclusions
Descartes is undoubtedly one of the most widely read and stud-
ied philosophers in history, and can be considered one of the
cornerstones of the scientic and intellectual revolution of the 17th
century. According to George S. Brett, dualism, atomism, psychol-
ogism, introspectionism, intellectualism, mechanical physiology
these are the main legacies that Descartes left us [7, p. 345]. How-
ever, despite his enormous contributions, there is currently a school
of thought that is critical of his legacy, and especially of its biological
aspect. Among these are Antonio Damasio, who says in his popular
book Descartes Error.:
It is paradoxical to think that Descartes, despite his contribu-
tion to changing the course of medicine, helped to divert the
organismic, mind-in-the-body approach, which prevailed from
Hippocrates to the Renaissance. How annoyed Aristotle would
have been with Descartes, had he known. [12, p. 251].
However, despite the scientic foundations that Descartes used
to describe the functionalism of the human body being by any reck-
oning rudimentary, and completely lacking the thoroughness that
modern techniques and science demand for the positive assess-
ment of a theory, the French philosophers intuitive perceptiveness
when talking about the mechanisms of its functioning is remark-
able when considered with the benet of almost four centuries of
hindsight. On this subject, Sir Michael Foster (18361907), one of
the great pioneers of modern physiology, commented that if we
read between the lines of what Descartes wrote, we could substi-
tute the terms subtle uid, animal spirits or system of tubes
with their valvular arrangements by molecular changes, ner-
vous impulse or synaptic connexions [20]. In this sense, the
Cartesian theories would not be so different from the one which
Neuroscience teaches us today.
But, what is beyond any doubt is that the Cartesian theories
on the passions and their role in the disorders of the mind out-
lived their author by 200 years. While today we have dispensed
with Descartes philosophical ideas on the soul, we still continue
to witness an astonishing similarity between the ideas of the
French philosopher and the most recent discoveries in neuropsy-
chophysiology and psychopathology. In fact, the modern concept
of passion, unlike that of emotion, is closely linked to the psy-
chopathology of thought, in that it assumes a deformation (an
overvaluation) of the subjects ideas. In any case, the Cartesian
description of sensory perception and the passions, including sad-
ness, may be an unsettling premonitory metaphor for the scientic
breakthroughs that took place in the 20th century.
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