Black bile and psychomotor retardation: shades of melancholia in Dante's Inferno.

The history of melancholy depression is rich with images of movement retardation and mental dysfunction. The recent restoration of psychomotor symptoms to the diagnostic terminology of affective disorder is not novel to the students of medieval melancholia. The move back to the biology of this psychomotor dysfunction with the technical advances in brain imaging in recent years only echoes centuries-old writings on the centrality of movement changes in the depressive condition. The Inferno, the first cantica of Dante Alighieri's Commedia, has a wonderful abundance of allusions to the importance of psychomotor symptoms in describing the depressed individual. Slowed steps, garbled speech, frozen tears, these and many other images keep the physical manifestations of psychomotor suffering in the forefront of the reader's mind. Considering Medieval and Renaissance writings on melancholy suffering, it is fitting that Dante shows a bodily illness reflected in the hellish torments visited on the damned. From the souls of the sullen to those of the violent, the panorama of psychomotor symptoms plays a prominent role in the poem as well as in the medical and literary prose of succeeding centuries.