Alone among the four, the melancholic complexion acquired a prestige that had nothing to do with health. A problem text transmitted under Aristotle's name asks why it should be that all men who have become outstanding in philosophy, poetry or the arts are melancholic, and the question, together with the assumption inside it, was taken up with enthusiasm in Renaissance Italy. Marsilio Ficino, who was both a physician and a Platonist, developed the connection at length and tied it to Saturn, the planet astrological medicine already assigned to the cold dry complexion.
The result was a temperament that was at once an affliction and a mark of distinction. Albrecht Dürer's engraving of 1514, in which a winged figure sits surrounded by unused instruments of measurement, is the best known image of that double sense: the melancholic is the one who sees furthest and acts least. Robert Burton's enormous Anatomy of Melancholy, first published in 1621, catalogues the condition, its causes and its cures across more than a thousand pages, and reads as often like a literary work as a medical one.
What English kept is the mood without the physiology. Melancholy now names a kind of sadness, usually a gentle and reflective one, and the older sense of a bodily state with a bodily cause has gone entirely, taking with it the claim that the same state disposes a person to genius.