Melancholy, Ecstasy, Phantasma:

The Pathologies of Macbeth

SUPARNA ROYCHOUDHURY

Mount Holyoke College

In a room overrun with humming insects sits a young man with sharp staring eyes, caught in a swarm of fantasies; another, visiting an elderly patient,
unhappily notices the vigor draining from his own body; a crazed courtier
sees nightly apparitions of greed and debauchery; a woman unhinged by
erotic rejection is nursed by indulging her delusion. These images, taken
in turn from Edmund Spensers Faerie Queene (1590), Michel de Montaignes essay on imagination (158088), John Marstons The Malcontent
(1603), and William Shakespeares Two Noble Kinsmen (ca. 161314), represent the kinds of stories that were told about the harmful power of imagination in the English Renaissance. The cognitive theorists of the period
physicians, natural philosophers, theologians, and demonologistsgrappled with the challenge of elucidating the mysteries of the minds imagemaking faculty and the diseases to which this faculty gave rise. It was a difficult problem, requiring the negotiation of folklore, faculty psychology, the
Galenic theory of humors, and narratives of the occult. The literary representations of the imagination in this period are attuned to these efforts, yet
they do not simply iterate contemporary psychology. This essay considers
how Shakespeares Macbeth (1606) reflects but also interrogates the early
modern discourse of the pathological imagination. Three maladies featured in the texthumoral melancholy, alienating ecstasy, and the phantasma of intenthighlight a question lurking in clinical and other accounts of the rogue imagination: To what extent do our mental images
belong to us? This is an anxiety over the border between the interior and
exterior, the native and the alien, sanity and sickness. Macbeths representation of imagination stresses the fine line between hallucinatory fantasy
and ordinary subjectivity; the difficulty of diagnosing mental diseases as
such; and the limitations of the conception of personhood as contained
interiority.

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FANTASTICAL MELANCHOLY

The psychosomatic influence of the fantasy over the body was an idea already centuries old in the Renaissance and one that remained a source of
fascination. According to the theory of mental faculties, imagination was
one of the souls several intellective functions, the others being common
sense, understanding, and memory. This model of cognition had had a
long history, stretching back to Aristotles ideas about the soul, which were
subsequently filtered through Islamic philosophy and medieval scholasticism and thus handed down to the thinkers of early modern Europe.1 Imagination was lodged in an anterior ventricle of the brain, and its role was to
convert sense data into intelligible species or phantasms; other names for
this faculty included fantasy and fancy.2 These phantasms could then
be put to the service of more abstract activities of ratiocination and commemoration; they were, in essence, the building blocks of cognitive experience or, as Ioan Couliano has put it, the words of the souls language.3
Throughout this history, the imagination retained its pathological associations. The faculty could corrupt the body and bewilder the mind, as
proven by the freakish stories of its potency. Montaignes essay on the imagination, for example, recounts several ancient case studies of false perception and delusion. In it are gathered anecdotes about psychosomatic
ailments, self-fulfilling superstitions, and crafty placebosamong them
1. See Aristotle, On the Soul, Parva Naturalia, On Breath, trans. W. S. Hett, Loeb Classical
Library (Cambridge, MA: Harvard University Press, 1936), 424b1432a14; Ibn S!na (Avicenna), The Cure, in Classical Arabic Philosophy: An Anthology of Sources, trans. and ed. Jon McGinnis and David C. Reisman (Indianapolis: Hackett, 2007), 17986; Thomas Aquinas, Summa
theologiae, in On Human Nature, ed. Thomas S. Hibbs (Indianapolis: Hackett, 1999), 13491.
For discussion of the premodern imagination, see Thomas Kjeller Johansen, Phantasia, in
The Powers of Aristotles Soul (Oxford University Press, 2012), 199220; Deborah Black, Psychology: Soul and Intellect, in The Cambridge Companion to Arabic Philosophy, ed. Peter Adamson
and Richard C. Taylor (Cambridge University Press, 2005), 31217; Simon Kemp, The Medieval Soul, in Medieval Psychology (New York: Greenwood, 1990), 1130. For scholarship on
early modern reception, see Ruth Harvey, The Inward Wits: Psychological Theory in the Middle Ages
and the Renaissance (London: Warburg Institute, 1975); Stuart Clark, Fantasies: Seeing Without What Was Within, in Vanities of the Eye: Vision in Early Modern European Culture (Oxford
University Press, 2007), 3977; and Katharine Park, The Organic Soul, in The Cambridge History of Renaissance Philosophy, ed. Quentin Skinner and Eckhard Kessler (Cambridge University
Press, 2008), 46484.
2. The idea of the brains ventricular system goes back to Galen, but it was amended by subsequent commentators, so much so that by the sixteenth century the number and function of
the cerebral cellulae was uncertain. As a result, in early modern texts imagination is used
interchangeably with fantasy, which had historically been a separate faculty. For more on
Galens ventricular model, see Julius Rocca, Galen on the Brain: Anatomical Knowledge and Physiological Speculation in the Second Century AD (Leiden: Brill, 2003), 24547.
3. Ioan P. Couliano, Eros and Magic in the Renaissance, trans. Margaret Cook (University of
Chicago Press, 1987), 5.

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fetuses mutated by their mothers wandering minds, an about-to-be pardoned man who falls dead at the sight of the scaffold, a bull-fight spectator
whose delight causes him to grow horns overnight, and a falconer who
summons his bird using only his eyes.4 Another catalog of tales is presented
in the Swiss theologian Ludwig Lavaters Of Ghostes and Spirites Walking by
Nyght (1572): You shal find some that imagine them self as it were armed
with horns of an Oxe: other apeere to them selues to be erthen vessells,
and therefore they will shun euerie thing for feare they be broken. . . .
Other suppose them selues deade, other thinke them selues great Princes,
other to be learned men, other to be Prophets & Apostles.5 The profusion
of fantasy-aided transformations carries into Robert Burtons Anatomy of
Melancholy (1621), in which we hear of a man who thinks himself so little,
that he can creep into a mouse-hole, another who fears heaven will fall
on his head, and yet another who thinks he is a nightingale, and therefore sings all the night long.6
Taxonomies of mental phenomena such as dreams, visions, and hallucinations were expressed in terms of the minds image-making faculty. Lavaters text opens with a list of definitions for words like spectrum (a thing
which offereth it selfe to be seene, eyther truely, or by vaine imagination);
visum (which signifieth an imagination or a certayne shewe, which men being in sleep, yea and waking also, seeme in their iudgemente to beholde);
and phantasma (an appearance of a thing which is not, like those sightes
which men in their sleepe do thinke they see).7 In a similar way, the
English translation of Pierre Le Loyers Treatise of Specters or Straunge Sights
(1605) distinguishes between phantosme (a thing without life), specter
(which hath a substance hidden and concealed, which seemeth to moue
the fantastique body), and several types of vision (literal, imaginative,
and intellectual).8 Thomas Coopers thesaurus (1565) uses phantasy as a
synonym for various Latin words, including animus (intellect), consilium
( judgment), ratio (reason), simulacrum (likeness), stomachus (ill temper),
and visum (vision).9 Needless to say, the categorical distinctions are not

4. Michel de Montaigne, The Complete Essays of Montaigne, trans. Donald M. Frame (Stanford University Press, 1957), 119.
5. Ludwig Lavater, Of Ghostes and Spirites Walking by Nyght (London, 1572), 11.
6. Robert Burton, The Anatomy of Melancholy (New York Review of Books, 2001), 1.3.1.3. But
Michael MacDonald notes in his study of the sixteenth-century physician Richard Napier:
None of the famous examples of melancholy delusion was native, and English doctors seem
to have encountered very few fabulous fancies in practice (Mystical Bedlam: Madness, Anxiety,
and Healing in Seventeenth-Century England [Cambridge University Press, 1981], 154).
7. Lavater, Of Ghostes, 12.
8. Pierre Le Loyer, A Treatise of Specters or Straunge Sights (London, 1605), 12.
9. Thomas Cooper, Thesaurus linguae romanae et britannicae (London, 1565). Some examples: obsequi animo, to folow his phantasie (I1r); consilium sibi capere, to do after his own

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always crisp. But even if the theory of imagination did not present a definitive map of cognitive experience, it offered a framework for theorizing
mental states.
Imaginative disorders were frequently rationalized by recourse to the
humoral system, particularly with respect to excesses of melancholy, the
black bile. This connection was inherited by the early moderns from the
ancients. Aristotle noted that confused and monstrous visions tended to
appear in the dreams of the melancholic, the feverish, and the intoxicated.10 Galen found that the psychosomatic power of the fantasy was most
developed in the case of people suffering from melancholy, phrenitis, or
mania.11 The irrational fear that often went with melancholic disorder,
Galen wrote, produced outlandish delusions. More than just acknowledging a correlation between hallucination and melancholy, Galenic theory
accounted for the connection in concrete terms: melancholic symptoms
gave rise to erroneous phantasmata in the brain, which in turn induced misperceptions.12
This link between perceptual distortion and humoral imbalance was
tight. Sixteenth-century health manuals, even those with no specialist focus
on mental illness, associate melancholy with altered cognitive states. For
instance, Thomas Elyots Castel of Helth (1539), a reference work listing beneficial foods and simple medical procedures, includes insomnia (Much
watch) and Dreames fearfull among the side effects of the Melancholike complexion.13 Andrew Boordes Breuiary of Helthe (1547), similarly
focused on diet and other environmental contributors to well-being, describes melancholy madness as a sicknes full of fantasies, in which the
patient believes himself to here or to se that thynge that is nat harde nor
sene.14 Philip Barroughs Methode of Phisicke (1583), a guide to ailments
from nosebleeds to epilepsy, says that the common signs of melancholy are
strange imaginations, such as when some think them selues brute
beastes, and do counterfaite the[ir] voice and noise.15

phantasie (Q5r); mea est sic ratio, this is my phantasie (MMMmm6v); simulachra inania,
vaine phantasies (Ppp1v); stomachus, minde: phantasie (BBBbbb1r); visum, a dreame: a
phantasie (OOOooo3r).
10. Aristotle, On Dreams, trans. W. S. Hett, Loeb Classical Library (Cambridge, MA: Harvard University Press, 1957), 461a.
11. Galen, Galen: Selected Works, trans. P. N. Singer (Oxford University Press, 1997), 160.
12. Galen, On the Affected Parts, trans. and ed. Rudolph E. Siegel (Basel: Karger, 1976),
3.10.93. See also Rudolph E. Siegel, Galen on Psychology, Psychopathology, and Function and Diseases of the Nervous System: An Analysis of His Doctrines, Observations, and Experiments (Basel: Karger, 1973), 195.
13. Thomas Elyot, The Castel of Helth (London, 1539), 21.
14. Andrew Boorde, The Breuiary of Helthe (London, 1547), Aa3r.
15. Philip Barrough, The Methode of Phisicke (London, 1583), 3537.

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The connection is also registered in other kinds of texts. William Perkinss Cases of Conscience (1604), for example, explains how mental images
are produced by the traffic of fumes and spirits between the brain and body:
the black bile being corrupted, it sends vp noisome fumes as cloudes or
mists which doe corrupt the imagination, and makes the instrument of
reason vnfit for vnderstanding and sense. Hence followes the first effect,
strange imaginations, conceits and opinions framed in the minde.16 A
more colorful version of this account appears in Thomas Nashes Terrors of
the Night (1594):
euen as slime and durt in a standing puddle, engender toads and frogs,
and many other unsightly creatures, so this slimie melancholy humor still
still [sic] thickning as it stands still, engendreth many misshapen obiects in
our imaginations. Sundry times wee behold whole Armies of men
skirmishing in the Ayre, Dragons, wilde beasts, bloody streamers, blasing
Commets, firie streakes with other apparitions innumerable, whence haue
all these their conglomerate matter but from fuming meteors that arise
from the heart, so from the fuming melancholy of our spleene mounteth
that hot matter into the higher Region of the braine, whereof manie
fearfull visions are framed. Our reason euen like drunken fumes it
displaceth and intoxicates, & yeelds vp our intellectiue apprehension to be
mocked and trodden vnder foote, by euerie false obiect or counterfeit
noyse that comes neere it.17

With words like facultie, imagination, and reason, Perkins and Nashe
invoke the theory of the inward wits. With words like humour, melancholy, hot matter, fumes, and spleen, however, they allude to a paradigm of pathology premised on the distribution of spirituous fluids and
complexions.
Needless to say, melancholic imagination also appears widely in literary
works of the period. It is allegorized in The Faerie Queene as Phantastes,
sorely distracted with sharpe staring eyes and full of melancholy.18 The
melancholic protagonist of Marstons The Malcontent, when asked how he
passes his sleepless nights, answers, Oh no, but [I] dream the most fantastical, adding, maniacally: Dreams, dreams, visions, fantasies, chimeras,
imaginations, tricks, conceits!19 Similarly, in Shakespeares Two Noble Kins16. William Perkins, The First Part of The Cases of Conscience (London, 1604), 192.
17. Thomas Nashe, The Terrors of the Night; or, a Discourse of Apparitions (London, 1594),
C2vC3r. In examining Nashes possible influence on Macbeth, Ann Pasternak Slater says he
uses melancholy as a vague blanket term for psychological disturbance (Macbeth and
the Terrors of the Night, Essays in Criticism 28 [1978]: 119). Such uncertainty, however, is
symptomatic of the overall Renaissance discourse on the topic, not particular to Nashe.
18. Edmund Spenser, The Faerie Queene (London: Penguin, 1978), 2.9.51.
19. John Marston, The Malcontent 1.3.4556, in English Renaissance Drama, ed. David Bevington, Lars Engle, Katharine Eisaman Maus, and Eric Rasmussen (New York: Norton, 2008).

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men, the fancy-ridden Jailers daughter is diagnosed with a most thick

and profound melancholy (4.3.4142).20 Just as we might hear of serotonin or dopamine levels in ordinary parlance today, it seems it was possible
in early modern England to allude to the hallucinations of the melancholic
and be instantly understood.
The long-standing association of melancholy with imagination becomes
especially emphatic in the Renaissance; it is increasingly impossible to
understand melancholy without an appreciation of the complexities of hallucination.21 The French physician Andre du Laurens states in his Discourse
of the Preservation of Sight (1599) that the melancholic man is alwaies disquieted both in bodie and spirit, assayled with a thousand vaine visions,
and hideous buggards, with fantasticall inuentions, and dreadfull dreames.
All melancholike persons, he continues, have their imagination troubled.22 Likewise, the French surgeon Ambroise Pare writes: Signes of a
Melancholicke Person: they are troubled with terrible dreames, for they
are observed to seeme to see in the night Devils, Serpents, darke dens and
caves, sepulchers, dead corpses, and many other such things full of horror,
by reason of a blacke vapour, deversly moving and disturbing the Braine.23
Burtons Anatomy too underlines the significance of imagination in the
pathology of the black bile. At the end of a subsection listing the many
symptoms of melancholia, he concludes, If you will describe melancholy,
describe a phantastical conceit, a corrupt imagination, vain thoughts and
different, which who can do?24
The Anatomy characterizes melancholy as unimaginably widespread and
complex. Merely scanning the table of contents we encounter realms of
the natural and supernatural world; the headings invoke devils, stars, education, liberty, and gender. In a wide-ranging contextual study of Burtons
work, Angus Gowland attributes this perceived epidemic of melancholy to
a growing interest in psychology, to the increased diagnostic significance
of the disease in medical practice, and, more broadly, to the social, political, and intellectual conditions created by humanism and the Reforma-

20. All Shakespeare references are taken from The Norton Shakespeare, ed. Stephen Greenblatt, Walter Cohen, Jean E. Howard, and Katharine Eisaman Maus (New York: Norton,
2008). Subsequent references are incorporated into the text.
21. For more on the relation between imagination and melancholy, see Clark, Fantasies,
53, 6163, which notes that the two influenced one another: chaotic image making became
melancholias primary psychological malfunction, while the melancholy debate in turn
altered the meaning of the word phantasy from simply image to illusion. See also Winfried
Schleiner, Laesa imaginatio, in Melancholy, Genius, and Utopia in the Renaissance (Wiesbaden:
Harrassowitz, 1991), 98108.
22. Andre du Laurens, A Discourse of the Preservation of Sight (London, 1599), 82, 86.
23. Ambroise Pare, The Workes of that Famous Chirurgion Ambrose Parey (London, 1634), 18.
24. Burton, Anatomy of Melancholy, 1.3.2.1.

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tion.25 It seems, then, that roughly around the time that melancholy was
perceived as epidemic, examinations of its relation to imagination were
developing in nuance and complexity. There was a need to map the connection between the fantasy and the black bile more extensively than ever
before; this connection was itself part of a broader cultural investigation of
the far-reaching significance and complexity of mental imagery.
These developments, I submit, are reflected in the relation between
Hamlet (1600) and Macbeth, two plays in which imagination and melancholy receive extended treatment. Both point to the limits of early modern
diagnostic practice. Much of the dramatic intrigue of Hamlet has to do with
the attempt to discern what other people see, or think they seebecause,
according to the medical logic of the period, the sorts of phantasms one
perceives can provide clues as to ones general state of health. That these
clues can be misleading is demonstrated by the ease with which Hamlet
evades his observers. Whereas in Hamlet fantasy and melancholy are bound
by a conceptual link that can be manipulated by a skilled actor, in Macbeth
the certainty of the connection is questioned. The later play, whose melancholy is not identified explicitly as such, asks in a more open-ended way
what precisely imaginative distortion is symptomatic of, pressing on the distinction between pathological and nonpathological perceptions.
Of the two, Hamlet is the play more frequently associated with melancholy.26 In recent years, critics have situated the play in the medical contexts
of Shakespeares time. Carol Falvo Heffernan, for example, has argued that
Hamlet represents a sufferer from melancholy disease as it was understood
by physicians like Timothy Bright, du Laurens, and Boorde.27 Being a disease of both body and soul, melancholy invokes the difficulty of reconciling
the material and immaterial; this struggle, shows Mary Thomas Crane, is
reproduced in Hamlet.28 Gail Kern Pasters influential study of the psychophysiology of early modern emotion has established the subtlety and complexity of Galenic medicine; Hamlets volatility, she argues, may be under-

25. Angus Gowland, The Worlds of Renaissance Melancholy: Robert Burton in Context (Cambridge University Press, 2006), 1618. For an earlier study, see Lawrence Babb, The Elizabethan
Malady (East Lansing: Michigan State College, 1951).
26. A. C. Bradley, for example, suggests melancholy is the cause of Hamlets inaction in
Shakespearean Tragedy: Lectures on Hamlet, Othello, King Lear, Macbeth (1904; London:
Penguin, 1991), 12026. See also Mary OSullivan, Hamlet and Dr. Timothy Bright, PMLA
41 (1926): 66779; W. I. D. Scott, Shakespeares Melancholics (1962; repr., Folcroft Library Editions, 1974), chap. 7.
27. Carol Falvo Heffernan, The Melancholy Muse: Chaucer, Shakespeare and Early Medicine
(Pittsburgh: Duquesne University Press, 1995), 123.
28. Mary Thomas Crane, Shakespeares Brain: Reading with Cognitive Theory (Princeton University Press, 2001), 131.

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stood as the inevitable fluctuations of humoral embodiment.29 Subsequent

critics have further explored the relation between Hamlets character and
his body, among them Douglas Trevor, who sees the princes skepticism as a
symptom of scholarly melancholy, and David Hillman, who finds Hamlet
profoundly ambivalent about visceral corporeality, particularly bodily enclosure.30
What the discourse of the pathological imagination adds to these interpretations is that, in accordance with contemporary medical wisdom, Hamlets inner psychological state is tied to what others guess to be the phantasms circulating in his minds eye. In the play the black bile is mentioned
twice as an explanation for the princes inscrutable and erratic temperament: Hamlet privately muses on my melancholy (2.2.578), and Claudius
speaks of something in his soul / Oer which his melancholy sits on
brood (3.1.16364). Hamlet partly fits Burtons profile of melancholic
sufferers: prone to revenge, soon troubled, and most violent in all their
imaginations; though they laugh many times, and seem to be extraordinary merry (as they will by fits), yet [they are] extreme lumpish again in an
instant; they feign a company of antic, phantastical conceits.31 Whether
or not Hamlet suffers from melancholic disease, others are searching him
for its imaginative symptoms. The prince is watched collectively by Claudius, Gertrude, Polonius, Rosencrantz and Guildenstern, and Ophelia,
who attempt to determine his motives not just by judging his demeanor
but, more specifically, by trying to work out the contents of his fantasy. With
wry self-consciousness, the play invites us too into this trap, coaxing us to
guess at what is going on in Hamlets head:
HAMLET
HORATIO
HAMLET

My fathermethinks I see my father.

O where, my lord?
In my minds eye, Horatio.
(1.2.18384)

These lines can elicit laughter in performance on account of their irony.

Hamlet, who has yet to hear of the sighting of his dead fathers ghost, says
that he has already seen it; the joke plays on the difference between a
supernatural phantom and a mental phantasm. A similarly comic moment
29. Gail Kern Paster, Humoring the Body: Emotions and the Shakespearean Stage (University of
Chicago Press, 2004), 45.
30. Douglas Trevor, The Poetics of Melancholy in Early Modern England (Cambridge University
Press, 2004), 66; David Hillman, Shakespeares Entrails: Belief, Skepticism, and the Interior of the Body
(New York: Palgrave Macmillan, 2007), 87.
31. Burton, Anatomy of Melancholy, 1.3.1.2. Bridget Gellert Lyons furthermore argues that
the proof of Hamlets melancholy lies in his evasive and aggressive performance of a great
variety of stereotyped melancholy parts (Voices of Melancholy: Studies in Literary Treatments of
Melancholy in Renaissance England [London: Routledge, 1971], 78).

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comes when Hamlet toys with Polonius, casting a camel-like cloud into a
weasel and then into something very like a whale (3.2.34551). There is
a logic to Poloniuss questioning, which is probing Hamlets mind for its
psychological contents; where Polonius fails is in not realizing that the
prince suspects as much.
Hamlet is a play of tests, in which imagination and melancholy are consistently presented in the context of a search for proof: the need to reproduce
the apparition of Hamlet Senior; the theatrical mousetrap that will expose
Claudiuss guilt; the baiting of Ophelia to decide whether Hamlet is really
mad. Hamlet himself must take into account the possibility that his imaginative faculty is being duped:
the devil hath power
Tassume a pleasing shape; yea, and perhaps,
Out of my weakness and my melancholy
As he is very potent with such spirits
Abuses me to damn me.
(2.2.57680)

To distinguish between potent spirits and melancholic weakness would

have been critical, even more so given the developing view that the supposed vassals of Satan were themselves delusional. Witch-hunters like Lambert Daneau and Henry Holland agreed with skeptics and moderates like
Reginald Scot and George Gifford in thinking that women claiming to be
witches were oftentimes melancholic, thinking to ride the air or change
shape when they were more likely having vivid hallucinations while lying
in their beds.32 Vigorous affirmations of the actuality of witchcraft had
been around since the Malleus maleficarum (ca. 1486);33 in the Renaissance,
demonological texts included taxonomies of false perception as compre32. Lambert Daneau, A Dialogue of Witches (London, 1575), K3r; Henry Holland, A Treatise
Against Witchcraft (Cambridge, 1590), F3r; Reginald Scot, The Discouerie of Witchcraft (London,
1584), 58; George Gifford, A Dialogue Concerning Witches and Witchcraftes (London, 1593), G2v.
See also Lynn Thorndike, Mental Disease and Magic, in History of Magic and Experimental Science, 8 vols. (192358; repr., New York: Columbia University Press, 1966), 8:50338; Stuart
Clark, Believers and Sceptics, in Thinking with Demons: The Idea of Witchcraft in Early Modern
Europe (Oxford University Press, 1997), 198210; Katharine Eisaman Maus, Sorcery and Subjectivity in Early Modern Discourses of Witchcraft, in Historicism, Psychoanalysis, and Early Modern Culture, ed. Carla Mazzio and Douglas Trevor (New York: Routledge, 2000), 32535; Claudia Swan, Trouble in the Ventricles: Phantasia, Melancholy, Witchcraft, in Art, Science, and
Witchcraft in Early Modern Holland: Jacques de Gheyn II (15651629) (Cambridge University Press,
2005), 17594.
33. See pt. 2, chap. 3 (On the method by which they are transferred in location from place
to place) and chap. 8 (The methods by which they change humans into the shapes of wild
beasts) in The Hammer of the Witches: A Complete Translation of the Malleus Maleficarum, trans.
and ed. Christopher S. Mackay (Cambridge University Press, 2009).

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hensive as those of the physicians. We might count among these Lavaters

Of Ghoste and Spirites and Le Loyers Treatise of Specters. Lavater explains the
strategy: to persuade skeptics of the existence of angels and demons by
demystifying natural illusions like phosphorescence and volcanoesand so
lend support to his argument that divine manifestations are real, though
rare.
On the other side of the divide is English physician Edward Jordens tract
on female hysteria, the disease known as the suffocation of the mother
(1603). Jordens thesis is apparent in the title of his work: that strange
actions and passions of the body of man, which in the common opinion are
imputed to the Diuell, haue their true naturall causes. Like Lavater, he
walks the line between the natural and the supernatural carefully, balancing
qualificationI doe not deny but that God doth in these days work
extraordinarilywith exhortationI would in the feare of God aduise
men to be very circumspect in pronouncing of a possession.34 Jorden decouples treatment and diagnosis: even if a disease is initiated supernaturally,
he says, the symptoms (convulsions, fits, suffocation) must be tackled using
medical methods.
If we did not at least hypothetically believe it possible to prove or disprove the nature of Hamlets disposition, Poloniuss inability to keep up
with the princes diversions would be rather less entertaining. Yet, Shakespeares play also demonstrates why such tactics are liable to fail. Not only
are phantasms shifting and insubstantial things, our sense of other peoples minds is woefully conjectural. The pervasive theatricality of the play
and the performative acumen of its protagonist in particular drive the
point homefor if there is certain proof that we cannot know what goes
on in the heads of others, it is surely the chimerical actor, who demonstrates two sensibilities inhabiting one mind, that of himself and the phantom being he portrays. Beneath the playful morphing of camels into
whales, then, lies a more serious acknowledgment of the difficulty of distinguishing between what the patient sees and what he thinks he seesand
doing so from a necessarily external vantage point.
What Hamlet does quite brilliantly in this regard is to multiply the observational viewpoints, presenting the same reality from different attitudes.
For instance, consider Ophelias description of the prince soon after his
encounter with the ghost:
He falls to such perusal of my face
As a would draw it. Long stayed he so.
At last, a little shaking of mine arm,

34. Edward Jorden, A Brief Discovrse of a Disease Called the Suffocation of the Mother (London,
1603), A3r.

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And thrice his head thus waving up and down,

He raised a sigh so piteous and profound
That it did seem to shatter all his bulk
And end his being. That done, he lets me go,
And, with his head over his shoulder turned,
He seemed to find his way without his eyes,
For out odoors he went without their help,
And to the last bended their light on me.
(2.1.91101)

Why are we provided with this description when we just saw Hamlet speaking to the ghost? Ophelia draws our attention to the princes affective attitude (a sigh so piteous and profound), but she is also struck by his trancelike state, a spectacle in itself. In her account, Hamlets sight weaves between
the literal and imaginaryHe falls to such perusal of my face; He
seemed to find his way without his eyes. Galenic physiognomy thought
it possible to discern medical symptoms through facial observation,35 but
here it seems that the object of Hamlets gaze is of as much interest as his
countenance.
Whereon do you look? is the way Gertrude puts it later, in the closet
scene. The reappearance of the ghost and its effect on Hamlet drive this
scenes phantasmatic energy, but so too does the queens alternating
inward and outward gaze. Hamlet, determined to expose what he sees as
his mothers moral blindness, thrusts at her images of his uncle and dead
father: This was your husband. Look you now what follows (3.4.6263).
The pictures force her to look within:
O Hamlet, speak no more!
Thou turnst mine eyes into my very soul,
And there I see such black and graine`d spots
As will not leave their tinct.
(7881)

The dark tinct evokes the black bile, as though just by manipulating Gertrudes inward eye Hamlet has engendered in her a melancholic fume.
When the ghost enters, the perspectival arrangement shifts. Now Gertrude
is observing Hamlet:
Alas, how ist with you,
That you do bend your eye on vacancy,
And with thincorporal air do hold discourse?
Forth at your eyes your spirits wildly peep,
And, as the sleeping soldiers in thalarm,
35. Siegel, Galen on Psychology, 202.

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Your bedded hair, like life in excrements,

Start up and stand on end. O gentle son,
Upon the heat and flame of thy distemper
Sprinkle cool patience! Whereon do you look?
(10715)

We might again ask, why does Gertrude describe her son at this moment,
when we see him directly? She calls attention to the invisible and immaterialthe spirits peeping in Hamlets wild eyes; the alarm that rouses
the sleeping soldiers of his hair; the internal heat and flame of his distemper. The point, it seems, is to draw attention to what we cannot see or
feel: the force that gives life to his hair, the heat of his blood. This is interiority represented from outside, as a set of secrets never to be laid bare, and
for a moment we register the insuperable distance that remains between us
and Shakespeares most eloquent protagonist:
GERTRUDE

This is the very coinage of your brain.

This bodiless creation ecstasy
Is very cunning in.
(12729)

There are two phantom entities in the room: the ghost, and Hamlets
ecstasy, here personified as a possessor of cunning skill. Ecstasy?
retorts the prince. It is not madness, he says. Bring me to the test.
Hamlets representation of melancholy, then, tests the notion that the
phantasmatic imagination provides a notional means of penetrating the
minds interior. In practice it is almost impossible to do this, the play
showsnot just with its metatheatrical reminders of the illusions of performance but also by repeatedly challenging us to question and to monitor
Hamlets inward and literal vision. It is not just Hamlets fantasy that is of
interest; at other moments, we are called on to surmise what Claudius sees
in the The Murder of Gonzago,36 the black spots ingrained in Gertrudes
soul, and the nameless actors of mad Ophelias bawdy lyrics. The plays tangle of sightlinesits apparitions, hallucinations, introspections, and scrutinizing staresdramatizes the problem of making judgments about the
trustworthiness of another persons judgment on the basis of his or her
perceptions. Hamlet alludes to the connection between mental imagery

36. In a famous essay, Hamlets Hallucination, Modern Language Review 12 (1917): 417,
W. W. Greg deduced from Claudiuss lack of response to the dumb show that he did not recognize in it his own murder of Hamlet Senior, and that therefore the ghosts credibility is questionable. Gregs argument hinges on what Claudius seesprecisely the kind of supposition
that I argue Shakespeares play invites us to perform.

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and mental health widely accepted in contemporary discourse, while also

conveying the difficulty of establishing the presence of such connections.
Macbeth is in some sense a continuation of these themes, though its
treatment is significantly different. With its pervasive hallucinatory intensity, it is a more comprehensive and yet more abstract representation of
melancholy. Whereas Hamlets melancholy is more individual and affective, roiling inside him, the melancholy of Macbeth, if we may call it that, is
impersonal and perceptual, residing in the border that separates the inward and the outward. Whereas in Hamlet the diagnostic link between melancholy and hallucination is open to manipulation, Macbeth obscures the
link by never mentioning melancholy explicitly. The point is not that
Macbeth may be melancholic but rather to ask what it is about the hallucinatory ecstasies that normally go with melancholy that denotes danger and
disorder. We are no longer speaking only of black bile, Macbeth seems to
say. There are other questions being negotiated under the sign of melancholy, as it were, having to do with the distinction between illness and ordinary human impulses, between figments in the mind and things in the
world.
A MODERN ECSTASY

William Hazlitts view that Macbeth is about the wildness of the imagination is true in several senses.37 The plays imagery, studied by Caroline
Spurgeon and Kenneth Muir, is startlingly vivid.38 Its vexed epistemology of seeing underlines the difficulty of interpreting vision.39 Dramaturgically, it toys with the viewers imagination, casting the audience as Macbeths
visionary accomplices, as Thomas Cartelli says.40 Most frequently emphasized, perhaps, is Macbeths own extraordinary power of fantasy, which is
often taken as his essential flaw: R. A. Foakes calls him a prisoner of his
own imagination, bound into doubts and fear, while Arthur F. Kinney,
including Lady Macbeth, holds that both man and wife employ visual

37. William Hazlitt, Characters of Shakespeares Plays, in The Selected Writings of William Hazlitt,
vol. 1 (1817; repr., London: Pickering & Chatto, 1998), 99.
38. Caroline Spurgeon, Shakespeares Imagery and What It Tells Us (New York: Macmillan,
1935); Kenneth Muir, Image and Symbol in Macbeth, Shakespeare Survey 19 (1966): 4554.
See as well Richard S. Ide, Theatre of the Mind: An Essay on Macbeth, ELH 42 (1975): 343.
39. See also D. J. Palmer, A New Gorgon: Visual Effects in Macbeth, in Focus on Macbeth,
ed. John Russell Brown (London: Routledge, 1982), 5469; Lucy Gent, The Self-Cozening
Eye, Review of English Studies 34 (1983): 41928; Houston Diehl, Horrid Image, Sorry Sight,
Fatal Vision: The Visual Rhetoric of Macbeth, Shakespeare Studies 16 (1983): 191203.
40. Thomas Cartelli, Banquos Ghost: The Shared Vision, Theatre Journal 35 (1983): 393.

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thinking.41 Still more critics, among them Marjorie Garber and Kevin Curran, have parsed the plays phantasmagoria from the methodological standpoints of psychoanalysis and modern phenomenology.42
To this range of approaches we must add a consideration of mental
imagery as it was conceived in early modern psychology. When Lady Macbeth decides to drug the chamberlains such that memory, the warder of
the brain, / Shall be a fume, and the receipt of reason / A limbeck only
(1.7.6567), she likens the ventricles of the brain to vessels of liquid distillation: reason can be clouded by vapors of memory. And when she rebukes
Macbeth for indulging his minds sorriest fancies, Using those thoughts
which should indeed have died / With them they think on (3.2.1113),
she is accusing him of clinging to figments that ought to have been relinquished. Faculty psychology is firmly embedded in Macbeth and stands to
illuminate the plays theme of mental pathology. Indeed, psychic distress
threatens often to undo the protagonists: on the night of Duncans murder
Lady Macbeth warns her husband not to unbend your noble strength to
think / So brain-sickly of things (2.2.4344); he in turn tries to clear the
perilous stuff that weighs upon [her] heart (5.3.4647). Life itself is a
fitful fever (3.2.25)a complex, multifaceted ailment, according to early
modern physic. Whatever presses on the heart of this play, it is masked by
vague designations such as disease, affliction, or fit.
One diagnosis that may well have struck Jacobean audiences is melancholy. Modern critics have not tended to associate melancholy with Macbeth as much as other Shakespearean protagonists,43 but the plays many
phantasmatic eventsthe vanishing witches, the floating dagger, the ghost
at the banquet table, the pageant of apparitionsmust have evoked the
disorder of the black bile. Troubled sleep, insomnia, and visual and auditory hallucinations were known symptoms, as was terror: the present
fears that unfix Macbeths hair chime with contemporary discourse
strange imaginations . . . do cause the interiour spirits of the braine to waxe
41. R. A. Foakes, Images of Death: Ambition in Macbeth, in Brown, Focus on Macbeth, 7
29; Arthur F. Kinney, Lies Like Truth: Shakespeare, Macbeth, and the Cultural Moment (Detroit:
Wayne State University Press, 2001), 26872.
42. Marjorie Garber analyzes the play as a parade of forbidden images gazed upon at
peril, illustrative of what she calls the Medusa complex (Macbeth: The Male Medusa, in
Shakespeares Ghost Writers [New York: Methuen, 1987], 95, 112). Other psychoanalytic readings
include David Willbern, Phantasmagoric Macbeth, in Poetic Will: Shakespeare and the Play of
Language (Philadelphia: University of Pennsylvania Press, 1997), 97124; and Marina Favila,
Mortal Thoughts and Magical Thinking in Macbeth, Modern Philology 99 (2001): 125. For
a phenomenological interpretation, see Kevin Curran, Phenomenology and Law: Feeling
Criminal in Macbeth, Criticism 54 (2012): 391401.
43. Scott, Shakespeares Melancholics, for example, includes chapters on Pericles and Timon
but not Macbeth. Kinney, Lies Like Truth, 18688, however, suggests that the Macbeths anger,
despair, ambition, and jealousy can be attributed to melancholy.

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verie wilde and fearefull.44 The paranoia that leads Macbeth to slaughter
Macduffs family was a sign of the melancholic: his phantasia workes, and
he imagineth, that the thing is already, or shall befall him.45 And melancholy exacerbates ambition, producing rebellion, arrogancie, murmuring, and vnsatiable desires.46 Certain events from the play seem even to
echo anecdotes from Lavater. In one story, a murderer sees his victim in a
fishs head on his dinner platerecalling the return of Banquo at the banquet table; another story tells of an outnumbered military leader dismayed
to see an approaching mass of pikes and spears, only to realize he is looking
at an overgrowth of shrubsparallel to the moving forest of Birnam.47
Of course, the moving forest in Macbeth is a real army; some of the plays
most alarming visions and scenes are not hallucinated. As noted earlier, it
would have been possible to imagine the wayward sisters are melancholic
sufferers; yet, their occult power might just as easily be taken as authentic.
It is also hard to diagnose Macbeth as melancholic, especially as we have
such little insight into his psychological condition before he met the
witches; he has only two lines before the prophecies are delivered. The fantastical aspect of the play is oppressive, and yet it avoids interrogating cognitive phenomena too strongly: Macbeth is quick to call the floating dagger a
figment of his brain; the physician avoids treating Lady Macbeth for what
he deems a spiritual illness; and the existence of the witches is never in
question. Whereas the ghost of Hamlet makes demands and issues instructions, communication with otherworldly realms is abortive in Macbeth: invocations are made unto air; ghosts will not be addressed. With its melancholy remaining unmarked, and its hallucinations not easily interpreted as
such, the plays portrayal of pathological imagination is situated outside, or
alongside, the terms of contemporary medical discourse. It forces its audience to consider the nature of imaginative disease more abstractly, in terms
of the relation between mind and world.
Powerful fantasies are being had, but it is not always clear to whom they
belong. Upon first meeting the three hags, Banquo asks, Are ye fantastical
or that indeed / Which outwardly ye show? (1.3.5152). The two possible
meanings of fantastical sum up the perceived ambiguity in the agency of
witches: that which is fantastic or unreal, and she who is susceptible to fantasy. While Banquo is questioning the bearded women, something strange
comes over Macbethrapt withalas though he were the transfixed
fantastical. He is smothered in surmise, we learn:
44. John Deacon, Dialogicall Discourses of Spirits and Divels (London, 1601), 160.
45. Perkins, Cases of Conscience, 194.
46. Pierre de la Primaudaye, The French Academie (London, 1586), 427.
47. Lavaters text was available in English before the publication of Holinsheds Chronicles,
which of course also posits the moving forest.

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why do I yield to that suggestion

Whose horrid image doth unfix my hair
And make my seated heart knock at my ribs
Against the use of nature?
(1.3.13336)

Banquo repeats his earlier observation: Look how our partners rapt
(141). Indeed, both the Macbeths are enthralled by the somatic effects of
imaginationLady Macbeths invitation of spirits to unsex her is a plea
for physical transformation: fill me from the crown to the toe; Make
thick my blood; take my milk (1.5.3848). In between these bursts of
feeling, they provide little insight into their minds. A churning interior, we
know, underlies Hamlets elliptical rejoinders; this is less apparent with the
Macbeths, who resemble automatons. Their bodies would be filled up with
foreign spirits; they walk and talk while asleep; their eyes wink at the
doings of their hands (1.4.52).
What is happening to me? Hamlet seems to wonder, caught between
his own psychological fragility and the supernatural manifestations at Elsinore. What is happening to the world, is the implicit observation of Macbeth, whose protagonists are said to murder sleep, incarnadine the ocean,
and raise the dead from their graves. Let the frame of things disjoint, says
Macbeth:
Better be with the dead,
Whom we to gain our peace have sent to peace,
Than on the torture of the mind to lie
In restless ecstasy.
(3.2.2124)

And it seems it is not only Macbeth who is gripped by ecstasy. In the plays
second scene, the Thane of Ross, coming from battle, is described as rapt:
What haste looks through his eyes! So should he look / That seems to
speak things strange (1.2.4647). When, on the morning of the murder,
the chamberlains awake, we are told they stared and were distracted
(2.3.101). Duncan says of the executed Cawdor, Theres no art / To find
the minds construction in the face (1.4.1112). In Hamlet, homicidal
guilt or lovesickness can be discerned through careful scrutiny; in Macbeth
the enraptured mind is too easily spirited away from its bodily home.
This kind of rapture seems moreover to be endemic rather than isolated, inescapable rather than occasional, as is confirmed in Rosss lament
for ailing Scotland:
Alas, poor country,
Almost afraid to know itself.
!!!!!!!!!!!!!!!!!!!!

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Where sighs and groans and shrieks that rend the air
Are made, not marked; where violent sorrow seems
A modern ecstasy. The dead mans knell
Is there scarce asked for who, and good mens lives
Expire before the flowers in their caps,
Dying or ere they sicken.
(4.3.16574)

Ecstasy, which means literally to stand outside oneself, renders unrecognizable what should be familiar. The bells for the dead go unheeded, the
groans of sufferers are not marked, and death precedes sickness. Rosss
vision extrapolates Macbeths restless ecstasy, which is the self-alienation
of a single mind, into a universal condition, modern in the sense of being
commonplace as well as current.48 It is not a complete breakdown of human
relations. The knells are still tolled, after all; sorrow indicates feeling; and
good men exist, if only to die. But the ecstasy is alarmingly faceless. Pain
and suffering have become disjoint from individuals, leaving the country
awash with a distress that seems to belong to everyone and no one.
The idea of ecstasy surfaces in Neoplatonic accounts of fascination, sympathy, and inspiration. Aristotle had said that sibyls and soothsayers exhibit
the frenzy of a brain overheated by melancholy.49 In the Renaissance, the
connection between melancholia and Platonic furor was theorized by Marsilio Ficino, who delineated the links between frenzy, genius, and the intellectual temperament.50 Rosss collective ecstasy also evokes Pietro Pomponazzi, who held that, when performed before credulous and receptive
minds, imaginative acts could alter the flow of spirits in the air and so form
visions.51 That said, the imaginings of Macbeth are not generally taken as
48. OED, s.v. modern, adj. and n. See sense 4, Everyday, ordinary, commonplace, and
sense 2a, Of or relating to the present and recent times.
49. Aristotle, Problems, trans. W. S. Hett and H. Rackham, Loeb Classical Library (Cambridge, MA: Harvard University Press, 1965), 30.1.
50. Marsilio Ficino, De vita 1.5.812, repr., Marsilio Ficino: Three Books on Life, ed. and trans.
Carol V. Kaske and John R. Clark (Binghamton, NY: Renaissance Society of America, 1989).
Ficino writes that melancholy terrifies the soul, and dulls the intelligence, yet, when properly tempered, enables the mind to explore eagerly, with sound judgment, and longer retention (117, 121). See Noel L. Brann, The Debate over the Origin of Genius during the Italian Renaissance (Leiden: Brill, 2002), 82107; Guido Giglioni, Coping with Inner and Outer Demons:
Marsilio Ficinos Theory of the Imagination, in Diseases of the Imagination and Imaginary Disease
in the Early Modern Period (Turnhout: Brepols, 2011), 1951.
51. Like Lavater, Pomponazzi suggested that many apparently paranormal phenomena
were either illusions crafted by priests or produced by natural properties of the air. See
Martin L. Pine, Pietro Pomponazzi: Radical Philosopher of the Renaissance (Padua: Editrice
Antenore, 1986), 24445; Daniel Pickering Walker, Spiritual and Demonic Magic: From Ficino to
Campanella (University Park: Pennsylvania State University Press, 2000), 1078; Thorndike, History of Magic, 5:97, 1067.

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instances of divine furor; the play has little to do with Ficinian transcendence, with the soul rising closer to God. Its malaise seems more to do with
not knowing oneself than with self-knowledge. And unlike the collective
hallucinations of Pomponazzi, Scotlands ecstasy is burdened with real loss.
Faculty psychology implicitly stresses the notional difference between intrinsic and extrinsic effects. The body was a fortressa castle of health
besieged from without as well as from within, by humoral imbalances
as much as contagious miasmas.52 The inner/outer distinction is deeply
inscribed in Renaissance psychologytheories of the inward wits as
opposed to the outward senses. The devils power, writes Pierre Le Loyer,
lies in his ability to straddle the gap, to cast himself . . . into the inward and
interior senses, and into the fantastie of men, and [move] them in the
same sorte as hee dooth the externall, thus causing a certayne extasie
and alienation of their spirites.53 Of course, this limen between inward
and outward is one that no anatomist could ever find. But having creating
it, the discourse must keep affirming it, schematizing it through elaborate
classifications that try to segregate the two realms. Staved off is the notion
that the mind encompasses elements both internal and externalthe
notion that our cognitive selves inevitably shape and become shaped by
things that we superficially perceive as being outside of ourselves. Macbeth
is concerned with what Stephen Greenblatt calls the membrane between
imagination and the world, but the border is maddeningly unsecure.54
The scene in which Lady Macbeth sleepwalks foregrounds the way the
psyche extends beyond its bodily vessel. In this scene, her speeches drift
forward and backward in time and in and out of the first, second, and third
person:
Out, damned spot; out, I say. One, twowhy, then tis time to dot. Hell is
murky. Fie, my lord, fie, a soldier and afeard? What need we fear who
knows it when none can call our power to account? Yet who would have
thought the old man to have had so much blood in him?
(5.1.3034)

Within a single utterance, we move from the spot of blood on Lady Macbeths hand, after the murder, to the imperatives she issued her husband
just before the crime, to a tremor of religious guilt, Hell is murky. It con-

52. This was the thinking of sixteenth-century French physician Jean Fernel. See John M.
Forrester, ed., Jean Fernels On the Hidden Causes of Things: Forms, Souls, and Occult Diseases in
Renaissance Medicine (Leiden: Brill, 2005), 43.
53. Le Loyer, Treatise of Specters, 123v.
54. Stephen Greenblatt, Shakespeare Bewitched, in New Historical Literary Study: Essays on
Reproducing Texts, Representing History, ed. Jeffrey N. Cox and Larry J. Reynolds (Princeton University Press, 1993), 123.

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tinues in this vein: I tell you yet again, Banquos buried; To bed, to bed.
Theres knocking at the gate (53, 56). Though the lines are lurching and
incoherent, their sentiments are not unfamiliar: Lady Macbeth says almost
nothing we have not heard her express before. Something is not right
but what?
In Hamlet, we see mad Ophelia in the onstage attitude of the female
mind unraveled. Her hair is down; she is strumming on a lute and singing
haunting ditties. In that scene, however, we understand that Ophelia is
crazed with grief; she recognizes the other characters on stage, acknowledging their presence with gifts of imaginary flowers. Lady Macbeths madness
is represented in a more clinical context than Ophelias poetic dissolution;55 we are, to some degree, made to consider the case as would a physician. Burton does list somnambulism as one of the possible side effects of
melancholic disorder,56 but what would be the cognitive explanation of
what is happening in Lady Macbeths mind? We hear that she receives the
benefit of sleep while do[ing] the effects of watching (5.1.9); her eyes
are open but their sense are shut (2122). Is she having a bad dream, or
recalling past events? What, and how, does she see?
Lady Macbeths case might have fascinatedand perhaps challenged
contemporary theorists. She supports Michael MacDonalds observation
that scenes of onstage madness were a means through which the early moderns pondered deeply the nature and nuances of psychological disorder.57
The doctor stops short of a certain diagnosis, pronouncing the matter to
be more suited to the divine than the physician (5.1.64). This view would
have been legitimate in the period: Timothy Bright, for instance, held
firmly that pangs of conscience were not the same as symptoms of melancholy.58 Christopher Tilmouth, though, points out that conscience too
involves an attitude of exteriorized self-scrutiny, the subject suddenly
becoming a detached viewer of himself.59 Accordingly, we might say that
55. Ophelias distraction has also been read in clinical terms, as erotomania or hysteria;
see Carol Thomas Neely, Distracted Subjects: Madness and Gender in Shakespeare and Early Modern
Culture (Ithaca, NY: Cornell University Press, 2004), 5253. Ophelias madness builds on existing conventions but is innovative too, being gender-inflected in the context of bodily illness,
lost love, and family and presenting altered speech as a symptom of mental disorder.
56. The fumes move the phantasy, the phantasy the appetite, which moving the animal
spirits causeth the body to walk up and down as if [the walker] were awake (Burton, Anatomy of
Melancholy, 1.2.3.2). OED dates the earliest usage of hallucination to 1646; the word derives
from the Latin alucinari, meaning to wander.
57. MacDonald implies that the incidence of madness on the English stage was disproportionate to reality, given the relative smallness of Londons Bethlem Hospital (Mystical Bedlam,
12122).
58. Timothy Bright, A Treatise of Melancholie (London, 1586), 189.
59. Christopher Tilmouth, Shakespeares Open Consciences, Renaissance Studies 23
(2009): 503, 511. On conscience, see also Frederick Kiefer, Written Troubles of the Brain:

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Lady Macbeths imagination has become unhinged not by guilt but by the
ecstasy of guilt, by that part of herself that has come to stand against or outside herself. The physician speaks of something very like Rosss universal
ecstasy, of foul whisprings abroad and infected minds (5.1.6162).
Why is this image of Lady Macbeth framed by the presence of the doctor
at all? Surely the spectacle of her derangement would be as effective without him. It cannot be that his role is to interpret her behavior for the benefit of the audience, for he refuses to do that. It may be that the doctor
senses there is nothing pathologically wrong with Lady Macbeth, and he
must in any case negotiate carefully the social complexities of treating a
royal patient.60 Another view is that the diagnosis is simplistic, overly confident of the distinction between spiritual and pathological maladies.61 I
would say that one point being made here is the mediating role of the medical profession: the physician stands, literally, between the patient and our
understanding of her. More strikingly, the dramaturgy undoes the idea that
inwardness is a type of containmentan assumption that the phenomenon
of hallucination itself makes problematic. We realize that the turmoil enclosed within Lady Macbeth is also inscribed invisibly in the room around
her. Observing the observers, we notice their exterior stance. Given our
invariable position as outsiders to others, it is no wonder that the metaphor
of self as interior is as intuitive as it is.
In his subsequent interview with the king, the doctor says nothing of
summoning a divine. He notes instead that the queen is Not so sick . . . /
As she is troubled with thick-coming fancies / That keep her from her rest
(5.3.3941). Macbeth responds:
Cure her of that.
Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain,
And with some sweet oblivious antidote
Cleanse the fraught bosom of that perilous stuff
Which weighs upon the heart?
(5.3.4247)
Lady Macbeths Conscience, in Reading and Writing in Shakespeare, ed. David M. Bergeron
(Newark: University of Delaware Press, 1996), 6481; Abraham Stoll, Macbeths Equivocal
Conscience, in Macbeth: New Critical Essays, ed. Nick Moschovakis (New York: Routledge,
2008), 13250.
60. These suggestions are made respectively by David Hoeniger, Medicine and Shakespeare in
the English Renaissance (Newark: University of Delaware Press, 1992), 65, and Todd H. J. Pettigrew, Shakespeare and the Practice of Physic: Medical Narratives on the Early Modern English Stage
(Newark: University of Delaware Press, 2007), 66, 88.
61. See Paul H. Kocher, Lady Macbeth and the Doctor, Shakespeare Quarterly 5 (1954):
341; Neely, Distracted Subjects, 57.

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The physician, perhaps sensing they may no longer be talking about Lady
Macbeth, switches to the male pronounTherein the patient / Must
minister to himself echoing Macbeths use of minister, a word that
ambiguously implies both medical and religious dispensation. Macbeth
goes on:
If thou couldst, doctor, cast
The water of my land, find her disease,
And purge it to a sound and pristine health,
I would applaud thee to the very echo,
That should applaud again.
(5.3.5256)

The irony is deep given the complexity of mental illness, so well represented throughout the play. The cure that Macbeth searches forrhubarb, cyme, or some purgative drugis somewhat inapposite. Historically,
fancies were not easily eliminated by purgative drugs;62 rather, fire had to
be fought with fire. Galen found sympathetic trickery an effective device,
and Jorden suggested something similar for patients unresponsive to clarifying reason and perswasions: we may politikely confirme them in their
fantasies, that wee may the better fasten some cure vpon them.63
Macbeth knows only too well that sorrow cannot so easily be extracted,
or oblivion so easily induced. His lines express a desperate wishin some
ways, a very modern-seeming wishto medicalize mental anguish such
that we might at least hope to raze it with scientific means. The passage
also registers the collectivized distress noted throughout the play. In fact,
Scotland is indeed about to be purged but not by Macbeths doing: Malcolm, the medicine of the sickly weal, is mobilizing his forces (5.2.25).
There is a blind spot in Macbeths characterization of diseased Scotland,
for it diminishes the role that he himself has played. Medicine does not
emerge as a means of resolution because the pathological imagination is
partly sourced in human volition. Even if Macbeth refuses to confront this
truth, Shakespeare ensures that we see it.
HIDEOUS PHANTASMA

Early modern accounts of imagination cast the fantasy as a creature somehow separate from the rest of ones person, a wayward and uncontrollable

62. Senna and rhubarb are mentioned as possible cures in Burton, Anatomy of Melancholy,
2.4.2.3, 2.5.1.3.
63. See Winfried Schleiner, Medical Ethics in the Renaissance (Washington, DC: Georgetown
University Press, 1995), 22; Jorden, Suffocation of the Mother, 24v.

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beast. Pierre Charrons Of Wisdom (1608) describes the faculty thus: it

worketh not only in it [sic] owne proper bodie and Soule, but in that of
another man; it killeth and makes abortiue the fruit within the wombe;
it inspireth a man with the foreknowledge of things secret and to come;
it rauisheth with extasies.64 Similarly, Le Loyer notes that the imagination doth imprint in it selfe many things by reason of Maladies, Fevers,
Melancholics, Doatings, and Frensies, and then it communicateth them
vnto the minde.65 Possessed of the kind of imagined malevolence that we
might ascribe to viruses or cancers today, the rogue fantasy raises the troubling idea that, suspended as we are between the tyranny of our mortal
shells and the pitiless wars of angels, our thoughts are not our own. We are
not ourselves, have never been ourselves.
Macbeth reproduces the periods conflicting attributions of causality and
agency. Whether the source of the illness is the body, the mind, or some
external influence, the imperative remains to guard the self from alien
agents. Yet, missing in the early modern psychopathology of imagination is
the kind of hallucination that has nothing to do with demons and hags.
This is a point made by the famous illusion of the plays second act:
Is this a dagger which I see before me,
The handle toward my hand? Come, let me clutch thee.
I have thee not, and yet I see thee still.
Art thou not, fatal vision, sensible
To feeling as to sight? Or art thou but
A dagger of the mind, a false creation
Proceeding from the heat-oppresse`d brain?
I see thee yet, in form as palpable
As this which now I draw.
Thou marshallst me the way that I was going,
And such an instrument I was to use.
Mine eyes are made the fools othother senses,
Or else worth all the rest. I see thee still,
And on thy blade and dudgeon gouts of blood,
Which was not so before. Theres no such thing.
It is the bloody business which informs
Thus to mine eyes.
(2.1.3349)

Even as Macbeth articulates the question Is this a dagger, he is already

grasping at it: let me clutch thee. He barely hesitates in deciding that
the hallucination is pathological and not preternatural, born of a qualita-

64. Pierre Charron, Of Wisdom (London, 1608), 6667.

65. Le Loyer, Treatise of Specters, 96v.

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tive imbalance in his head. This crucial decision, which would have given
Shakespeares more medically and religiously minded contemporaries
some pausein Hamlet it took four men to verify the vision of the ghost
Macbeth makes within moments. He speaks to the dagger: art thou
not . . . sensible. Sensible can mean perceptible, but it can also mean
capable of sensationas though the dagger were itself a thinking thing.
These are not cautious addresses unto the supernatural realm, the words
of a man glancing furtively about for diabolic antagonists; rather, this is a
man in dialogue with a projection of himself.
Macbeth registers the dagger no less than three times: yet I see thee
still; I see thee yet; I see thee still. The triple chiming of see thee protracts the vision almost uncomfortably. Time seems to slow down. Then,
with theres no such thing he almost wills it away, now revising the cause
of the illusion: it is no longer a perceptual error; it is the bloody business
which informs / Thus to mine eyes. Inform subtly echoes in form from
an earlier line, hinting at the formation of inward phantasms. Bloody business, however, is a disingenuous formulation that skips lightly over what is
essentially a decision to commit murder. The tone of the entire speech is
somewhat disingenuous. The questions are not really questions; the second
person pronouns convey familiarity rather than alarm; the explanations
offered are too assured.
The speech does not end when the dagger disappears. It takes a turn:
Now oer the one half-world
Nature seems dead, and wicked dreams abuse
The curtained sleep. Witchcraft celebrates
Pale Hecates offerings, and withered murder,
Alarumed by his sentinel the wolf,
Whose howls his watch, thus with his stealthy pace,
With Tarquins ravishing strides, towards his design
Moves like a ghost.
(2.1.4956)

Gone is the perceiving first person voice. We now have a ghoulish nocturne
populated with dreams, witchcraft, and murder. Pagan mythology
collides with folkloric superstition; nature mingles with the afterworld.
How have we come from theres no such thing to this mythical landscape
filled with ghosts and wolves? As we watch Macbeth clouding his mind with
conjured demons, we wonder about the relation between these inward
images and his earlier hallucination. It is as though he is now purposefully
burying that dagger of his mind in a slew of supernatural phantoms.
The episode depicts the formation of intent as the manifestation of a
mental image. The dagger, which denotes the idea of killing Duncan, is
not a verbal articulation, nor a purely abstract cogitation; it is a partial visu-

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alization of an eventan event in some sense heralded by that visualization. A comparable moment arises earlier in the play:
Present fears
Are less than horrible imaginings.
My thought, whose murder yet is but fantastical,
Shakes so my single state of man that function
Is smothered in surmise, and nothing is
But what is not.
(1.3.13641)

In a series of inversions, future imaginings dominate present fears; function is subjugated to surmise; and nothing is / But what is not. The
force that shakes Macbeths state is not yet a fully formed thought,
being still but fantastical. The surmising of a crime seems to have been
essential to Shakespeares conception of imagination. Compare the speech
above with this one from Julius Caesar (1599):
Between the acting of a dreadful thing
And the first motion, all the interim is
Like a phantasma or a hideous dream.
The genius and the mortal instruments
Are then in counsel, and the state of man,
Like to a little kingdom, suffers then
The nature of an insurrection.
(2.1.6369)

These words, spoken by Brutus, might as well have come from the early acts
of Macbeth. It is the only time Shakespeare uses the word phantasma, in fact,
and he has used it to represent a man distracted by the enveloping haze of
his own intentions. Brutus and Macbeth use the same metaphorical vehicle: to conceive of insurrection, it seems, induces insurrection of another
kind in the little kingdom of the self. G. Wilson Knight finds in both
speeches a sickly sense of nightmare unreality, a black abyss of nothing.66 Yet, if anything, imagining entails too much rather than too little;
both mind and body, genius and mortal instruments, are wholly taken
over by the hideous dream.
There are other instances in Shakespeare where imagination and political designs go together. In 1 Henry IV (ca. 159697), the Earl of Northumberland notes of Hotspur: Imagination of some great exploit / Drives him
beyond the bounds of patience (1.3.19798). In 2 Henry IV (ca. 159798),
Bardolph says, again of Hotspur, that he with great imagination / Proper
66. G. Wilson Knight, Brutus and Macbeth, in The Wheel of Fire (1930; repr., London:
Routledge, 2001), 138.

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to madmen, led his powers to death, / And, winking, leapt into destruction (1.3.3133). In The Tempest (1611), Sebastian says to Antonio, My
strong imagination sees a crown / Dropping upon thy head (2.1.203
204). And Hamlet confesses, I am very proud, revengeful, ambitious, with
more offences at my beck than I have thoughts to put them in, imagination
to give them shape, or time to act them in (3.1.12528).67 In a way, the
tragedy of king killing is the generic form perfect for depicting the hallucinatory phantasma that forms the bridge between inception and execution.
As Christopher Pye has noted in his analysis of the raptures of Macbeth, it
comes to no surprise that a play about regicide is also about fantasyfor
the difference between thinking and doing forms the basis of treason.68
This link between imagination and political ideology might also have
something to teach us about the pathology of the fantasy. Macbeths murderous hallucination offers a hypothesis about the mechanics of cognition:
every act, horrific or otherwise, is to some degree first imaged in the mind
before it is done. The morally damning hallucinations of Macbeththe
dripping dagger and spot of bloodrepresent the mental extrusions of
the two guilty protagonists. As James Calderwood phrases it, these are the
workings of a self-protective consciousness as it projects inner impulses outward to create a behavioristic world to whose stimuli it can then react.69
But this comes at a cost, as Shakespeare shows. Ultimately, the Macbeths
become stranded in the mesmeric limbo of intention, where past and future
are interchangeablein which one may utter the extraordinary statement,
I go, and it is done (2.1.62). Lady Macbeth becomes trapped in this
placealways on the brink of murder and also always scrubbing at its
stainwhile Macbeth faces the dull misery of an infinity of tomorrows.
Being the most heinous of imaginable offenses, the killing of the king
requires the most reckless of ambitions, the staunchest of wills, the most
vivid and phantasmagoric of premeditations. Macbeths hallucinatory motivation therefore draws attention to an aspect of psychopathological discourse glossed over by Shakespeares medical peers, namely, that imagination, even when it is corruptespecially if it is corruptmay be the most
startling expression of the human minds agency rather than a symbol of
its cowering passivity. It is tempting but also too facile to dismiss the imagi67. With imagination placed in between thought and action, the syntax points to
a distinction made by James Calderwood: for Hamlet, imagination is an impediment to
action, whereas for Macbeth it is the genesis and agency of action (If It Were Done: Macbeth
and Tragic Action [Amherst: University of Massachusetts Press, 1986], 3, 7).
68. Christopher Pye, The Regal Phantasm: Shakespeare and the Politics of Spectacle (London: Routledge, 1990), 15357. Currans Phenomenology and Law goes a step further, positing that
Macbeths nondualistic phenomenology blurs the distinction between criminal thought
and criminal acts; the intent is, for him, equivalent to the act of murder (39193).
69. Calderwood, If It Were Done, 38.

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native faculty as inhuman, victim to the rush of humors, and slavish to the
will of the devil. In this play, the process whereby fantasy is translated into
reality, whereby internal pictures become inscribed on the world, is marshaled in service of a morally untenable aim. But perhaps it is only through
the most godless monuments of the imagination that the full force of the
human will can be represented.
The pathologies of Macbeth illustrate how deeply imagination was involved in early modern ideas about disorder, whether in regard to the
inward balance of bodily humors or the alienating influence of the supernatural and the metaphysical. More than that, the play points to the challenges
with which Renaissance physicians were wrestling as they sought to refine
their etiologies of false perception: the limits of diagnosis, the construed
perimeter around what we take to be a human being, the link between private torment and collectivized syndrome. There remain the problems of distinguishing the diseases of imagination from its ordinary operations and of
determining how we relate, or ought to relate, to our unruly minds. It may
no longer be possible to speak of the mind as a closed alembic; to grasp the
complexity of a mind that extends beyond the body will require the revision
of intuitive assumptions about the psychic interior. It may be that we are
enclosed microcosms needing always to be guarded from the external and
internal bodies that threaten to unravel us. But it is more likely that this very
matrix of interlocking effectsthe impressions that infect us from without
as well as those that we devise ourselves and send out into the worldprecisely constitutes the entirety of a person.

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