This week in honor of Halloween we are returning to an obsession with lycanthropy. There is a trove of ancient Greek medical treatises on the diagnosing and treatment of the disease.
Oribasius (Pergamum, c. 4th Century CE)
Oribasius is said to have studied medicine in Alexandria; he later served as the court doctor to Julian the Apostate. He wrote several encyclopedic summaries of medical knowledge at the time. The text produced for a friend’s son (Synopsis ad Eustathium) is identical to that attributed to Paulus of Aegina and seems to form the core of medical treatises on lycanthropy.
“Men who are afflicted with lycanthropy go out at night and imitate wolves in every way, spending time until daybreak among the gravestones. You will recognize that someone is suffering from this by the following symptoms. They appear pale and look weak; they have dry eyes and cannot cry. You may observe that their eyes are hollow and their tongue is especially dry: they cannot really produce saliva. They are thus thirsty and in addition they have wounded shins from scraping the ground frequently.
These are the symptoms; for treatment it is important to recognize that this is a type of melancholy which you may treat at the time the disease is noticed by cutting open the veins and draining blood until the patient almost passes out. Let him be washed in a sweet bath. After rubbing him down with milk-whey for three days, apply a pumpkin salve* to him on the second and third day. Following these cleansings, anoint him with the antidote for viper-venom and do the rest of the things prescribed for melancholy. When they disease has already come over those who are accustomed to sleepwalk, anoint them with lotion. And rub opium on their ears and nostrils when they are ready to sleep.”
Οἱ τῇ λυκανθρωπίᾳ κατεχόμενοι νυκτὸς ἐξίασι τὰ πάντα λύκους μιμούμενοι καὶ μέχρις ἡμέρας περὶ μνήματα διατρίβουσιν. γνωριεῖς δὲ τὸν οὕτω πάσχοντα διὰ τῶνδε· ὠχροὶ τυγχάνουσι καὶ ὁρῶσιν ἀδρανὲς καὶ ξηροὺς τοὺς ὀφθαλμοὺς ἔχουσι καὶ οὐδὲ δακρύουσιν· θεάσῃ δ’αὐτῶν κοίλους τοὺς ὀφθαλμοὺς καὶ τὴν γλῶσσαν ξηροτάτην, καὶ σίελον οὐδ’ ὅλως προχωροῦν αὐτοῖς· εἰσὶ δὲ καὶ διψώδεις καὶ τὰς κνήμας διὰ τὸ πολλάκις προσπταίειν ἀνιάτως ἡλκωμένας ἴσχουσιν.
τοιαῦτα μὲν αὐτῶν τὰ γνωρίσματα· γινώσκειν δὲ χρὴ εἶδος μελαγχολίας εἶναι τὴν λυκανθρωπίαν, ἣν θεραπεύσεις κατὰ τὸν χρόνον τῆς ἐπισημασίας τέμνων φλέβα καὶ κενῶν τοῦ αἵματος ἄχρι λειποθυμίας καὶ διαιτῶν τὸν κάμνοντα εὐχύμοις τροφαῖς. κεχρήσθω δὲ τοῖς λουτροῖς γλυκέσιν· εἶτ’ ὀρῷ γάλακτος χρησάμενος ἐπὶ τρεῖς ἡμέρας κάθαιρε τῇ διὰ τῆς κολοκυνθίδος ἱερᾷ, καὶ δεύτερον καὶ τρίτον· μετὰ δὲ τὰς καθάρσεις καὶ τῇ διὰ τῶν ἐχιδνῶν θηριακῇ χρήσῃ καὶ τὰ ἄλλα παραλήψῃ ὅσα ἐπὶ τῆς μελαγχολίας εἴρηται. ἐπερχομένης δ’ ἤδη τῆς νόσου τοῖς ὕπνους ἐμποιεῖν εἰωθόσιν ἐπιβρέγμασι χρήσῃ· καὶ ὀπίῳ δὲ χρῖσον ὦτα καὶ μυκτῆρας εἰς ὕπνον τρεπομένοις.
* The pumpkin or gourd (Gr. kolokunthos) was associated with life and health due to its “juicy nature”; see LSJ s.v. This may explain its ritual/therapeutic use both in cleansing an association with death and with treating a patient exhibiting extreme symptoms of dryness.
Aëtius (Amida, 6th Century CE)
Aetius was a Byzantine doctor and writer who may have lived as early as the fifth century CE.He also studied at Alexandria and collated sixteen books of medicine—much of which was drawn from Galen and Oribasius. His indebtedness to the latter is clear from his passage on lycanthropy, but there are interesting additions. I have marked the significant additions in bold.
On Lykanthropy or Kynanthropy, following Marcellus*
Those who are afflicted by the disease once-called kynanthropy or lycanthropy go out at night during the month Pheurouarion** and imitate wolves or dogs in every way as they spend time until daybreak around gravestones especially. You will recognize people who suffer in this way from the following symptoms: They are pale, they look weak, they have dry eyes and a dry tongue and they don’t completely secrete saliva. They are thirsty and they have festering wounds on their shins from falling continuously and from dog bites.
Such are the symptoms. For treatment, you need to understand that lycanthropy is a type of melancholy. You treat it at the time the disease is noticed by cutting open the veins and draining the blood until the point when the patient passes out, then treat the sick with well-flavored food. Let him be washed in a sweet bath, and after rubbing him with milk-whey for three days, apply a pumpkin salve to him from [Rouphos, Archigenos, or Ioustos]. After these cleansings, anoint him with the viper-venom antidote. Also do all the other things that are prescribed earlier for melancholy.
When the disease comes on in the evening, rub down the heads of those who tend to sleepwalk with a lotion and for those who hunt by scent, smear some opium on their nostrils. Sometimes it is also necessary to administer a sleeping medicine.”
Περὶ λυκανθρωπίαϲ ἤτοι κυνανθρωπίαϲ Μαρκέλλου.
οἱ τῇ λεγοένῃ κυνανθρωπίᾳ ἤτοι λυκανθρωπίᾳ νόϲῳ κατεχόμενοι κατὰ τὸν Φευρουάριον μῆνα νυκτὸϲ ἐξίαϲι τὰ πάντα μιμούμενοι λύκουϲ ἢ κύναϲ καὶ μέχριϲ ἡμέραϲ περὶ τὰ μνήματα μάλιϲτα διατρίβουϲι. γνωρίϲειϲ δὲ τοὺϲ οὕτω πάϲχονταϲ διὰ τῶνδε· ὠχροὶ τυγχάνουϲι καὶ ὁρῶϲιν ἀδρανὲϲ καὶ ξηροὺϲ τοὺϲ ὀφθαλμοὺϲ ἔχουϲι καὶ οὐδὲν δακρύουϲι. θεάϲῃ δὲ αὐτῶν καὶ κοίλουϲ τοὺϲ ὀφθαλμοὺϲ καὶ γλῶϲϲαν ξηρὰν καὶ οὐδὲ ὅλωϲ ϲίελον προχέουϲιν. εἰϲὶ δὲ καὶ διψώδειϲ καὶ τὰϲ κνήμαϲ ἔχουϲιν ἡλκωμέναϲ ἀνιάτωϲ διὰ τὰ ϲυνεχῆ πτώματα καὶ τῶν κυνῶν τὰ δήγματα.
τοιαῦτα μὲν αὐτῶν τὰ γνωρίϲματα· γινώϲκειν δὲ χρὴ μελαγχολίαϲ εἶδοϲ εἶναι τὴν λυκανθρωπίαν, ἣν θεραπεύϲειϲ κατὰ τὸν χρόνον τῆϲ ἐπιϲημαϲίαϲ τέμνων φλέβα καὶ κενῶν τοῦ αἵματοϲ ἄχρι λειποθυμίαϲ καὶ διαιτῶν τὸν κάμνοντα ταῖϲ εὐχύμοιϲ τροφαῖϲ. κεχρήϲθω δὲ λουτροῖϲ γλυκέϲιν, εἶτα ὀρρῷ γάλακτοϲ χρηϲάμενοϲ ἐπὶ τρεῖϲ ἡμέραϲ κάθαιρε τῇ διὰ τῆϲ κολυκυνθίδοϲ ἱερᾷ ῾Ρούφου ἢ ᾿Αρχιγένουϲ ἢ ᾿Ιούϲτου, δεύτερον καὶ τρίτον παρέχων ἐκ διαϲτημάτων. μετὰ δὲ τὰϲ καθάρϲειϲ καὶ τῇ διὰ τῶν ἐχιδνῶν θηριακῇ χρηϲτέον. καὶ τὰ ἄλλα παραληπτέον ὅϲα ἐπὶ τῆϲ μελαγχολίαϲ προείρηται. εἰϲ ἑϲπέραν δὲ ἐπερχομένηϲ ἤδη τῆϲ νόϲου τοῖϲ ὕπνον εἰωθόϲιν ἐμποιεῖν ἐπιβρέγμαϲι τῆϲ κεφαλῆϲ χρῆϲθαι καὶ ὀϲφραντοῖϲ τοιούτοιϲ καὶ ὀπίῳ διαχρίειν τοὺϲ μυκτῆραϲ, ἐνίοτε δὲ καὶ ποτίζειν τινὰ τῶν ὑπνωτικῶν.
*According to the Suda, Marcellus was a doctor of Marcus Aurelius (2nd Century) who wrote two books on medicine in dactylic hexameter.
**Presumably this coincides with the month February and may have a special connection with Lycanthropy due to the Lupercalia.
Paulus (of Aegina, c. 7th Century CE) A 7th Century CE Byzantine Physician who wrote De Re Medica Libri Septem) The Suda (s.v. Paulus) writes: Παῦλος, Αἰγινήτης, ἰατρός. ἔγραψεν ἰατρικὰ βιβλία διάφορα (“Paulos, from Aeigina, a doctor. He wrote various medical books”).
The text below is identical to that attributed to Oribasius:
“Men who are afflicted with lycanthropy go out at night and imitate wolves in every way, spending time until daybreak among gravestones. You will recognize that someone is suffering from this by the following symptoms. They appear pale and look weak; they have dry eyes and cannot cry. You may observe that their eyes are hollow and their tongue is especially dry: they cannot really produce saliva. They are thus thirsty and in addition they have wounded shins from scraping the ground frequently.
These are the symptoms; for treatment it is important to recognize that this is a type of melancholy, which you may treat at the time the disease is noticed by cutting open the veins and draining blood almost until the patient passes out. Let him be washed in a sweet bath. After rubbing him down with milk-whey for three days, apply a pumpkin salve to him on the second and third day. Following these cleansings, anoint him with the antidote for viper-venom and do the rest of the things prescribed for melancholy. When the disease has already come over those who are accustomed to sleepwalk, anoint them with lotion. And rub opium on the ears and nostrils of those preparing to sleep.”
Περὶ λυκάονοϲ ἢ λυκανθρώπου.
Οἱ τῇ λυκανθρωπίᾳ κατεχόμενοι νυκτὸϲ ἐξίαϲι τὰ πάντα λύκουϲ μιμούμενοι καὶ μέχριϲ ἡμέραϲ περὶ τὰ μνήματα διατρίβουϲι. γνωριεῖϲ δὲ τὸν οὕτω πάϲχοντα διὰ τῶνδε· ὠχροὶ τυγχάνουϲι καὶ ὁρῶϲιν ἀδρανὲϲ καὶ ξηροὺϲ τοὺϲ ὀφθαλμοὺϲ ἔχουϲι καὶ τὴν γλῶϲϲαν ξηροτάτην, καὶ ϲίελον οὐδ’ ὅλωϲ προχωροῦν αὐτοῖϲ· εἰϲὶ δὲ καὶ διψώδειϲ, καὶ τὰϲ κνήμαϲ διὰ τὸ πολλάκιϲ προϲπταίειν ἀνιάτωϲ ἡλκωμέναϲ ἴϲχουϲιν. τοιαῦτα μὲν τὰ γνωρίϲματα·
γινώϲκειν δὲ χρὴ εἶδοϲ μελαγχολίαϲ εἶναι τὴν λυκανθρωπίαν, ἣν θεραπεύϲειϲ κατὰ τὸν χρόνον τῆϲ ἐπιϲημαϲίαϲ τέμνων φλέβα καὶ κενῶν τοῦ αἵματοϲ ἄχρι λειποθυμίαϲ καὶ διαιτῶν τὸν κάμνοντα ταῖϲ εὐχύμοιϲ τροφαῖϲ· κεχρήϲθω δὲ τοῖϲ λουτροῖϲ γλυ-κέϲιν. εἶτα ὀρῷ γάλακτοϲ χρηϲάμενοϲ ἐπὶ τρεῖϲ ἡμέραϲ κάθαιρε τῇ διὰ τῆϲ κολοκυνθίδοϲ ἱερᾷ καὶ δεύτερον καὶ τρίτον· μετὰ δὲ τὰϲ καθάρϲειϲ καὶ τῇ διὰ τῶν ἐχιδνῶν θηριακῇ χρήϲῃ καὶ τὰ ἄλλα παραλήψῃ, ὅϲα ἐπὶ τῆϲ μελαγχολίαϲ εἴρηται. ἐπερχομένηϲ δὲ ἤδη τῆϲ νόϲου τοῖϲ ὑπνοποιεῖν εἰωθόϲιν ἐπιβρέγμαϲι χρήϲῃ· καὶ ὀπίῳ δὲ χρῖϲον τοὺϲ μυκτῆραϲ εἰϲ ὕπνον τρεπομένοιϲ.
Joannes Actuarius, De Diagnosi (Constantinople 13th to 14th Century)
Johannes Zacharias Actuarius was also a Byzantine doctor. He composed many works on medicine that drew on Galen, Aëtius and Paulus—which is clear from his text on lycanthropy. Significant differences from Aëtius’ text are in bold.
De Diagnosi 1.34.24
“A type of this madness is called lycanthropy—it convinces those so afflicted to go outside in the middle of the night, among the graves and desolate places, like wolves and to return at night, to become themselves again, and to remain at home. But some of them have feet and shins marked up from touching stones and thorns and they have dry eyes and tongue. They are thirsty, and they look weak. I will pass over how much the others suffer—but some of them die after fearing death for long while others desire it fiercely. In the same way, some avoid large groups of people and maintain the strictest silence, while the others, if they are not among a crowd where they remain calm, they make a racket and seem out of their minds. These things happen when some kind of humor is imbalanced, and the place which reddens when it comes to the surface and returns energy to the person’s spirit.”
Ταύτης δέ γε εἶδος καὶ ἡ λυκανθρωπία καλουμένη, ἀναπείθουσα τοὺς ἁλόντας μέσον νυκτῶν ὧδε κἀκεῖσε περιϊέναι, ἔν τε μνήμασι καὶ ἐρημίαις κατὰ τοὺς λύκους, μεθ’ ἡμέραν δὲ ἐπιστρέφειν τε καὶ πρὸς ἑαυτοὺς γίνεσθαι, καὶ οἴκοι διατρίβειν. ἀλλ’ οἵδε μέν, τούς τε πόδας καὶ τὰς κνήμας ἔχουσιν ἡμαγμένους τῷ προσπταίειν τοῖς λίθοις καὶ ταῖς ἀκάνθαις, καὶ ξηροὶ τοὺς ὀφθαλμοὺς καὶ τὴν γλῶτταν καὶ διψώδεις, καὶ ἀδρανὲς βλέπουσιν. ἐῶ δὲ λέγειν ὅσα πάσχουσιν ἕτεροι, ὧν οἱ μὲν ἀεὶ τὸν θάνατον φοβούμενοι διατελοῦσιν, οἱ δ’ αὖ τούτου ἐπιθυμοῦντες, ὥσπερ ἕτεροι τὰς τῶν πολλῶν ὁμιλίας φεύγουσι, καὶ ἄκραν σιωπὴν ἀσκοῦσιν, αὖθις δὲ ἕτεροι, ἢν μὴ ὁμιλῶσιν ἄλλοις καὶ διαχεόμενοι ὦσι, θορυβούμενοί τε καὶ ἐκθαμβούμενοι. καὶ ταῦτα γίνεται παρὰ τὸ ποιὸν τοῦ ἐνοχλοῦντος χυμοῦ, ἔτι τε τὸν τόπον, ὃν ἐγγίσας ἐρεθίζει καὶ διανιστᾷ τὴν κατ’ ἐκείνον τῆς ψυχῆς ἐνέργειαν.
Anonymi Medici, A Collection of ancient treatises on disease and treatments. Some tracts are dated to the first century CE. There are some textual issues I have only barely tried to solve. The additions and differences seem to imply a text later than Paulus or Aëtius.
“Lycanthropy is a type of madness when people go out at night and spend time among graves. You will recognize those who suffer from it thus. Their skin is pale and they appear weak. They have dry eyes and they neither cry nor produce moisture. You may note that their eyes are hollow and their forehead is damp; they may have an extremely dry tongue and may not completely produce saliva. They are thirsty and they have open wounds on their shins from striking them frequently. Their body bears the particular marks of melancholy sometimes, since this is melancholic in nature, and they have been afflicted [with this] by some thought or sleeplessness, or spoiled food, or contact with birth fluids [?], bloody discharge, or menstrual blood. These are the indications and signs of lycanthropy.
This is how you treat it: I cut the veins at the elbows and I drain blood almost until the patient passes out then treat the sick with well-flavored food. Let him be washed in a sweet bath. After rubbing him down with milk-whey for three days, apply pumpkin salve to him on the second and third day. After running him down with milk-whey for three days, apply a pumpkin salve to him on the second and third day. After these cleansings, I would anoint him with the antidote for viper-venom and do the rest of the things prescribed for melancholy. In addition, I would suggest draining off any bloody discharge and avoiding any menstrual blood in order to stop the conditions that created the disease. Also commendable is furnishing diuretics and cleaning any pustules.”
Εἶδος μανίας ἐστὶν ἡ λυκανθρωπία, καὶ νυκτὸς ἐξίασι τὰ πάντα καὶ τάφους διατρίβουσι. γνωριεῖς δὲ τοὺς οὕτω πάσχοντας. τοῖς δὲ ὠχροὶ τυγχάνουσιν καὶ ὁρῶσιν ἁδρανὲς καὶ ξηροὺς τοὺς ὀφθαλμοὺς ἔχουσι, οὔτε δακρύουσιν
οὔτε ὑγραίνονται. θεάσῃ δὲ αὐτῶν καὶ κοίλους τοὺς ὀφθαλμοὺς καὶ τὸ πρόσωπον ὑγρὸν καὶ τὴν γλῶτταν ξηροτάτην καὶ σιέλον οὐδ’ ὅλως προχωρῶν αὐτοῖς. εἰσὶ δὲ καὶ διψώδεις ξηροὶ καὶ τὰς κνήμας, διὰ τὸ πολλάκις προςπίπτειν ἀνία αὐτοὺς καὶ ἑλκομένας ἔχουσιν. ἴδια δὲ σημεῖα τῶν μελαγχολικῶν τότε κατισχναίνειν τὸ σῶμα καὶ μελαγχολικὸν εἶναι τῇ φύσει, ἢ καὶ ἐξεπήκτη [?] τὸν διά τινος φροντίδος ἢ ἀγρυπνίας ἢ μοχθηρῶν σιτίων ἢ προφορᾶς ἢ ἐπίσχεσιν αἱμορροΐδων καὶ καταμηνίων γυναικῶν. τοιαῦτα μὲν δεῖ συμβαίνειν καὶ τὰ τῆς λυκανθρωπίας σημεῖα.
Πῶς οὖν θεραπεύσεις. Κατὰ μὲν οὖν τὸν πρῶτον χρόνον τῆς ἐπισημασίας τέμνω φλέβα τὴν ἐξ ἀγκώνων καὶ κενῶ τοῦ αἵματος ἄχρι λειποθυμίας καὶ διαίτησιν τὸν κάμνοντα ταῖς εὐχύμοις τροφαῖς· καὶ χρῆσθαι λουτροῖς γλυκέσι ἢ ὀρρῷ γάλακτος χρησάμενος ἐπὶ τρίτην ἡμέραν. καὶ καθαίρων δὲ τῇ διὰ τῆς κολοκυνθίδος ἱερᾷ καὶ β′ καὶ γ′ καὶ μετὰ τὰς καθάρσεις τῇ διὰ τῶν ἐχιδνῶν θηριακῇ χρήσομαι καὶ τὰ ἄλλα παραλήψομαι ὅσα ἐπὶ τῆς μελαγχολίας εἴρηται καὶ τὰς αἰμορροΐδας ἀναστομῶσαι καὶ καταμήνια γυναικῶν προπέσθαι κελεύω διὰ τὴν τούτων ἐπίσχεσιν, τὴν γεγενημένην εἰς τὸ πάθος· ἀγαθὰ δὲ καὶ αἱ διουρητικαὶ δυνάμεις καὶ τῶν ἱδρώτων κάθαρσις.
As a Homerist, my experience in late Greek prose is limited; my experience in medical terminology is worse. I believe I have made sense of all of this, but I am happy to have suggestions or additions.
- τῇ διὰ τῆς κολοκυνθίδος ἱερᾷ: This phrase has given me fits. I at first made the mistake of taking ἱερᾷ to mean something sacred (e.g. rite, but not “shrine”, because that would be neuter!). But the LSJ lists ἱερὰ ἡ: a kind of serpent adding “II. A name for many medicines in the Greek pharmacopia…of a plaster; esp. of aloes.” So, since it does not seem likely that the treatment being prescribed is a “snake through a pumpkin”. In addition, later Greek prose uses dia + genitive to denote the thing from which something was made (LSJ s.v. dia A.III.c.2). So, I have settled on a “pumpkin salve”
- τῇ διὰ τῆϲ κολυκυνθίδοϲ ἱερᾷ ῾Ρούφου ἢ ᾿Αρχιγένουϲ ἢ ᾿Ιούϲτου: I have no idea what is going on with the three proper names here: are these places or people that produce the pumpkin poultice?
One thought on “Werewolf Week, JAMA Edition: Diagnosis and Therapy”