Ancient Greek Depression and the Brain: Galen and Hippocrates

Ah, pandemic Fall 2, when we ask:

  1. Is this normal depression, because I am going to die some day?
  2. Is this seasonal depression, because the trees are dying?
  3. Is this depression from trauma of the past 2 years overloading my body?
  4. Is this depression from a lack of agency in modern politics and economics?
  5. Is this generational depression because the planet is dying?

The Greeks have different questions: is your melancholy tortoise, rooster, or Atlas based?

Galen, De Locis Affectis 8.190-191

“Fear always plagues people with melancholy but they don’t always have the same kind of abnormal (para phusin) thoughts. For example, one person believes that he has grown a shell and because of this he avoids everyone who nears him so that he might not break it. When another hears the roosters singing, just as if the birds strike their wings before their song, he also slaps his arms against his sides and imitates the animals’ voice. Fear comes to another that Atlas who is supporting the universe might drop it because he is worn out and for this reason he will be crushed and he will destroy us with him.

But there are ten thousand other fantasies. The melancholic differ from one another, but even though they all exhibit fear, despair, blaming of life and hatred for people, they do not all want to die. For some, fear of death is the principle source of their depression. Some will seem paradoxical to you because they fear death and desire death at the same time.

For this reason it seems right that Hippocrates divided all of these symptoms into two groups: fear (phobos) and despair (dusthumia). Because of this sort of despair, they hate everyone they see and are always gloomy and they are afraid like children are frightened in deep darkness and uneducated adults too. As external darkness makes nearly all people afraid, except for those who are bold by nature or have been well-educated for it, so too the color of the black bile overshadows places of thought with darkness and makes people afraid.

The fact that the humors and altogether the equilibrium (krâsis) of the body may alter the reality of the mind is agreed upon by the best doctors and philosophers and I have shown already in one publication in which, by pursuing the body’s balances, I demonstrated the abilities of the mind. For this reason, those who are ignorant about the power of humors do not dare to write anything about melancholy. Of these, there are also those of the school of Erasistratos. It is right to be amazed at him for people’s common thoughts, as with many other beliefs about which not a few philosophers and doctors are ignorant. Therefore, nearly everyone calls melancholy a sickness, indicating through this name that its cause is bile.”

ἀεὶ μὲν οὖν  οἱ φόβοι συνεδρεύουσι τοῖς μελαγχολικοῖς, οὐκ ἀεὶ δὲ ταὐτὸν εἶδος τῶν παρὰ φύσιν αὐτοῖς γίγνεται φαντασιῶν, εἴγε ὁ μέν τις ὀστρακοῦς ᾤετο γεγονέναι, καὶ διὰ τοῦτ’ ἐξίστατο τοῖς ἀπαντῶσιν, ὅπως μὴ συντριβείη· θεώμενος δέ τις ἄλλος ἀλεκτρυόνας ᾄδοντας, ὥσπερ ἐκεῖνοι τὰς πτέρυγας προσέκρουον πρὸ ᾠδῆς, οὕτω καὶ αὐτὸς τοὺς βραχίονας προσκρούων ταῖς πλευραῖς ἐμιμεῖτο τὴν φωνὴν τῶν ζώων. φόβος δ’ ἦν ἄλλῳ, μή πως ὁ βαστάζων τὸν κόσμον ῎Ατλας ἀποσείσηται κεκμηκὼς αὐτὸν, οὕτως τε καὶ αὐτὸς συντριβείη καὶ ἡμᾶς αὐτῷ συναπολέσειεν·

ἄλλα τε μυρία τοιαῦτα φαντασιοῦνται. διαφέρονται δὲ ἀλλήλων οἱ μελαγχολικοὶ, τὸ μὲν φοβεῖσθαι καὶ δυσθυμεῖν καὶ μέμφεσθαι τῇ ζωῇ καὶ μισεῖν τοὺς ἀνθρώπους ἅπαντες ἔχοντες, ἀποθανεῖν δ’ ἐπιθυμοῦντες οὐ πάντες, ἀλλ’ ἔστιν ἐνίοις αὐτῶν αὐτὸ δὴ τοῦτο κεφάλαιον τῆς μελαγχολίας, τὸ περὶ τοῦ θανάτου δέος· ἔνιοι δὲ ἀλλόκοτοί σοι δόξουσιν, ἅμα τε καὶ δεδιέναι τὸν θάνατον καὶ θανατᾷν. ὥστε ὀρθῶς ἔοικεν ὁ ῾Ιπποκράτης εἰς δύο ταῦτα ἀναγαγεῖν τὰ συμπτώματα αὐτῶν πάντα, φόβον καὶ δυσθυμίαν· ἐπί γέ τοι τῇ τοιαύτῃ δυσθυμίᾳ  μισοῦσιν πάντας, οὓς ἂν βλέπωσιν, καὶ σκυθρωποὶ διὰ παντός εἰσι, δειμαίνοντες, ὥσπερ ἐν σκότῳ βαθεῖ τά τε παιδία φοβεῖται καὶ τῶν τελείων οἱ ἀπαίδευτοι. καθάπερ γὰρ καὶ τὸ ἔξωθεν σκότος εἰς φόβον ἄγει σχεδὸν ἅπαντας ἀνθρώπους, πλὴν τῶν ἤτοι πάνυ φύσει τολμηρῶν, ἢ πεπαιδευμένων, οὕτως καὶ τῆς μελαίνης χολῆς τὸ χρῶμα παραπλησίως σκότῳ τὸν φρονοῦντα τόπον ἐπισκιάζον ἐργάζεται τοὺς φόβους.

ὅτι γὰρ οἵ τε χυμοὶ καὶ ὅλως ἡ τοῦ σώματος κρᾶσις ἀλλοιοῖ τὰς ἐνεργείας τῆς ψυχῆς, ὡμολόγηται τοῖς ἀρίστοις ἰατροῖς τε καὶ φιλοσόφοις, ἐμοί τε δι’ ἑνὸς ὑπομνήματος ἀποδέδεικται, καθ’ ὃ ταῖς τοῦ σώματος κράσεσιν ἀκολουθούσας ἀπέδειξα τὰς τῆς ψυχῆς δυνάμεις· ὅθεν οὐδὲ γράψαι τι περὶ μελαγχολίας ἐτόλμησαν οἱ τὴν τῶν χυμῶν δύναμιν ἀγνοήσαντες, ἐξ ὧν εἰσι καὶ οἱ περὶ τὸν ᾿Ερασίστρατον.  ἄξιον δέ ἐστι κᾀν τούτῳ θαυμάσαι τὰς κοινὰς ἐννοίας τῶν ἀνθρώπων, ὥσπερ καὶ τἄλλα πολλὰ δόγματα, περὶ ὧν ἠγνόησαν οὐκ ὀλίγοι φιλοσόφων τε καὶ ἰατρῶν· ἅπαντες γοῦν ὀνομάζουσιν τὸ πάθος τοῦτο μελαγχολίαν, ἐνδεικνύμενοι διὰ  τῆς προσηγορίας τὸν αἴτιον αὐτοῦ χυμόν.

*Erasistratos was a doctor and author during the Hellenistic period.

I found this passage from reading: Patricia A. Clark and M. Lynn Rose. 2016. “Psychiatric Disability in the Galenic Medical Matrix.” In Christian Laes, Chris Goodey, and M. Lynn Rose (eds.). Disabilities in Roman Antiquity: Disparate Bodies a Capite Ad Calcem. Leiden: 45-72.

The modern debate about “mind” verses “brain” has its origins in antiquity and notions of the “soul” and the “body”. Hippocrates presents one of the earliest arguments that everything is physical and biological.

Hippocrates of Cos, On the Sacred Disease 14

 “People should know that our pleasures, happiness, laughter, and jokes from nowhere else [but the brain] and that our griefs, pains, sorrows, depressions and mourning come from the same place. And through it we think especially, and ponder, and see and hear and come to perceive both shameful things and noble things and wicked things and good things as well as sweet and bitter, at times judging them so by custom, at others by understanding what is advantageous based on distinguishing what is pleasurable and not in the right time and [that] these things are not the same to us.

By this very organ we become both sane and delirious and fears and horrors attend us sometimes at night and sometimes at day. This brings us bouts of sleeplessness and makes us mistake-prone at terrible times,  bringing thoughts we cannot follow, and deeds which are unknown, unaccustomed or untried.

Yes, we suffer all these things from or brain when it is not health but is hotter than natural, too cold or too wet or too dry or suffers any other kind of thing contrary to its custom. We go insane because of its moistness. For whenever it is wetter than natural, it is forced to move. And when it moves, neither sight can be still nor hearing. Instead, we hear and see different things at different times and the tongue talks about the kinds of things it sees and hears each time. But a person can think as long as the brain remains still.”

 Εἰδέναι δὲ χρὴ τοὺς ἀνθρώπους, ὅτι ἐξ οὐδενὸς ἡμῖν αἱ ἡδοναὶ γίνονται καὶ αἱ εὐφροσύναι καὶ γέλωτες καὶ παιδιαὶ ἢ ἐντεῦθεν καὶ λῦπαι καὶ ἀνίαι καὶ δυσφροσύναι καὶ κλαυθμοί. Καὶ τούτῳ φρονεῦμεν μάλιστα καὶ νοεῦμεν καὶ βλέπομεν καὶ ἀκούομεν καὶ γινώσκομεν τά τε αἰσχρὰ καὶ τὰ καλὰ καὶ τὰ κακὰ καὶ ἀγαθὰ καὶ ἡδέα καὶ ἀηδέα, τὰ μὲν νόμῳ διακρίνοντες, τὰ δὲ τῷ ξυμφέροντι αἰσθανόμενοι, τῷ δὲ καὶ τὰς ἡδονὰς καὶ τὰς ἀηδίας τοῖσι καιροῖσι διαγινώσκοντες, καὶ οὐ ταὐτὰ ἀρέσκει ἡμῖν. Τῷ δὲ αὐτῷ τούτῳ καὶ μαινόμεθα καὶ παραφρονέομεν, καὶ δείματα καὶ φόβοι παρίστανται ἡμῖν τὰ μὲν νύκτωρ, τὰ δὲ μεθ’ ἡμέρην, καὶ ἐνύπνια καὶ πλάνοι ἄκαιροι, καὶ φροντίδες οὐχ ἱκνεύμεναι, καὶ ἀγνωσίη τῶν καθεστεώτων καὶ ἀηθίη καὶ ἀπειρίη. Καὶ ταῦτα πάσχομεν ἀπὸ τοῦ ἐγκεφάλου πάντα, ὅταν οὗτος μὴ ὑγιαίνῃ, ἀλλ’ ἢ θερμότερος τῆς φύσιος γένηται ἢ ψυχρότερος ἢ ὑγρότερος ἢ ξηρότερος, ἤ τι ἄλλο πεπόνθῃ πάθος παρὰ τὴν φύσιν ὃ μὴ ἐώθει. Καὶ μαινόμεθα μὲν ὑπὸ ὑγρότητος· ὅταν γὰρ ὑγρότερος τῆς φύσιος ᾖ, ἀνάγκη κινεῖσθαι, κινευμένου δὲ μήτε τὴν ὄψιν ἀτρεμίζειν μήτε τὴν ἀκοήν, ἀλλ᾿ ἄλλοτε ἄλλα ὁρᾶν καὶ ἀκούειν, τήν τε γλῶσσαν τοιαῦτα διαλέγεσθαι οἷα ἂν βλέπῃ τε καὶ ἀκούῃ ἑκάστοτε· ὅσον δ᾿ ἂν ἀτρεμήσῃ ὁ ἐγκέφαλος χρόνον, τοσοῦτον καὶ φρονεῖ ὁ ἄνθρωπος.

On the Sacred Disease, 9

“For these reasons I think that the brain has the most power in the human being. For when it happens to be healthy, it is our interpreter of all the things that happen from the air. And air furnishes intelligence. The eyes, and ears, and tongue and hands and feet do the kinds of things the brain decides. Indeed, the portion of intelligence distributed throughout the body comes from the air. The brain is the emissary to understanding. For whenever a person draws breath inside it rushes first to the brain and then it spreads through the rest of the body once it leaves its distilled form in the brain, that very thing which is thought and has judgment. If it were to enter the body first and the rain later, it would leave understanding in the flesh and the arteries and then go hot and impure into the brain, all mixed up with the bile from flesh and blood, with the result that it would uncertain.”

Κατὰ ταῦτα νομίζω τὸν ἐγκέφαλον δυναμιν ἔχειν πλείστην ἐν τῷ ἀνθρώπῳ· οὗτος γὰρ ἡμῖν ἐστι τῶν ἀπὸ τοῦ ἠέρος γινομένων ἑρμηνεύς, ἢν ὑγιαίνων τυγχάνῃ· τὴν δὲ φρόνησιν ὁ ἀὴρ παρέχεται. οἱ δὲ ὀφθαλμοὶ καὶ τὰ ὦτα καὶ ἡ γλῶσσα καὶ αἱ χεῖρες καὶ οἱ πόδες οἷα ἂν ὁ ἐγκέφαλος γινώσκῃ, τοιαῦτα πρήσσουσι·† γίνεται γὰρ ἐν ἅπαντι τῷ σώματι τῆς φρονήσιος, ὡςἂν μετέχῃ τοῦ ἠέρος.† ἐς δὲ τὴν σύνεσιν ὁ ἐγκέφαλός ἐστιν ὁ διαγγέλλων· ὅταν γὰρ σπάσῃ τὸ πνεῦμα ὥνθρωπος ἐς ἑωυτόν, ἐς τὸν ἐγκέφαλον πρῶτον ἀφικνεῖται, καὶ οὕτως ἐς τὸ λοιπὸν σῶμα σκίδναται ὁ ἀήρ, καταλελοιπὼς ἐν τῷ ἐγκεφάλῳ ἑωυτοῦ τὴν ἀκμὴν καὶ ὅ τι ἂν ᾖ φρόνιμόν τε καὶ γνώμην ἔχον· εἰ γὰρ ἐς τὸ σῶμα πρῶτον ἀφικνεῖτο καὶ ὕστερον ἐς τὸν ἐγκέφαλον, ἐν τῇσι σαρξὶ καὶ ἐν τῇσι φλεψὶ καταλελοιπὼς τὴν διάγνωσιν ἐς τὸν ἐγκέφαλον ἂν ἴοιθερμὸς ἐὼν καὶ οὐκ ἀκραιφνής, ἀλλ᾿ ἐπιμεμιγμένος τῇ ἰκμάδι τῇ ἀπό τε τῶν σαρκῶν καὶ τοῦ αἵματος, ὥστε μηκέτι εἶναι ἀκριβής.

Image result for ancient greek medicine hippocrates of cos

Edmund Wilson. “On Free Will and How the Brain is Like a Colony of Ants.” Harper’sSeptember 2014, 49-52.

“The self does not exist as a paranormal being living on its own within the brain. It is, instead, the central dramatic character of the confabulated scenarios. In these stories, it is always on center stage—if not as participant, then as observer and commentator—because that is where all of the sensory information arrives and is integrated.”

For a good overview of issues of brain, mind and consciousness from multiple disciplinary perspectives, see Dennett, Dale C. 2017. From Bacteria to Bach and Back: The Evolution of Minds. New York.

Ancient Greek Depression and the Brain: Galen and Hippocrates

Galen, De Locis Affectis 8.190-191

“Fear always plagues people with melancholy but they don’t always have the same kind of abnormal (para phusin) thoughts. For example, one person believes that he has grown a shell and because of this he avoids everyone who nears him so that he might not break it. When another hears the roosters singing, just as if the birds strike their wings before their song, he also slaps his arms against his sides and imitates the animals’ voice. Fear comes to another that Atlas who is supporting the universe might drop it because he is worn out and for this reason he will be crushed and he will destroy us with him.

But there are ten thousand other fantasies. The melancholic differ from one another, but even though they all exhibit fear, despair, blaming of life and hatred for people, they do not all want to die. For some, fear of death is the principle source of their depression. Some will seem paradoxical to you because they fear death and desire death at the same time.

For this reason it seems right that Hippocrates divided all of these symptoms into two groups: fear (phobos) and despair (dusthumia). Because of this sort of despair, they hate everyone they see and are always gloomy and they are afraid like children are frightened in deep darkness and uneducated adults too. As external darkness makes nearly all people afraid, except for those who are bold by nature or have been well-educated for it, so too the color of the black bile overshadows places of thought with darkness and makes people afraid.

The fact that the humors and altogether the equilibrium (krâsis) of the body may alter the reality of the mind is agreed upon by the best doctors and philosophers and I have shown already in one publication in which, by pursuing the body’s balances, I demonstrated the abilities of the mind. For this reason, those who are ignorant about the power of humors do not dare to write anything about melancholy. Of these, there are also those of the school of Erasistratos. It is right to be amazed at him for people’s common thoughts, as with many other beliefs about which not a few philosophers and doctors are ignorant. Therefore, nearly everyone calls melancholy a sickness, indicating through this name that its cause is bile.”

ἀεὶ μὲν οὖν  οἱ φόβοι συνεδρεύουσι τοῖς μελαγχολικοῖς, οὐκ ἀεὶ δὲ ταὐτὸν εἶδος τῶν παρὰ φύσιν αὐτοῖς γίγνεται φαντασιῶν, εἴγε ὁ μέν τις ὀστρακοῦς ᾤετο γεγονέναι, καὶ διὰ τοῦτ’ ἐξίστατο τοῖς ἀπαντῶσιν, ὅπως μὴ συντριβείη· θεώμενος δέ τις ἄλλος ἀλεκτρυόνας ᾄδοντας, ὥσπερ ἐκεῖνοι τὰς πτέρυγας προσέκρουον πρὸ ᾠδῆς, οὕτω καὶ αὐτὸς τοὺς βραχίονας προσκρούων ταῖς πλευραῖς ἐμιμεῖτο τὴν φωνὴν τῶν ζώων. φόβος δ’ ἦν ἄλλῳ, μή πως ὁ βαστάζων τὸν κόσμον ῎Ατλας ἀποσείσηται κεκμηκὼς αὐτὸν, οὕτως τε καὶ αὐτὸς συντριβείη καὶ ἡμᾶς αὐτῷ συναπολέσειεν·

ἄλλα τε μυρία τοιαῦτα φαντασιοῦνται. διαφέρονται δὲ ἀλλήλων οἱ μελαγχολικοὶ, τὸ μὲν φοβεῖσθαι καὶ δυσθυμεῖν καὶ μέμφεσθαι τῇ ζωῇ καὶ μισεῖν τοὺς ἀνθρώπους ἅπαντες ἔχοντες, ἀποθανεῖν δ’ ἐπιθυμοῦντες οὐ πάντες, ἀλλ’ ἔστιν ἐνίοις αὐτῶν αὐτὸ δὴ τοῦτο κεφάλαιον τῆς μελαγχολίας, τὸ περὶ τοῦ θανάτου δέος· ἔνιοι δὲ ἀλλόκοτοί σοι δόξουσιν, ἅμα τε καὶ δεδιέναι τὸν θάνατον καὶ θανατᾷν. ὥστε ὀρθῶς ἔοικεν ὁ ῾Ιπποκράτης εἰς δύο ταῦτα ἀναγαγεῖν τὰ συμπτώματα αὐτῶν πάντα, φόβον καὶ δυσθυμίαν· ἐπί γέ τοι τῇ τοιαύτῃ δυσθυμίᾳ  μισοῦσιν πάντας, οὓς ἂν βλέπωσιν, καὶ σκυθρωποὶ διὰ παντός εἰσι, δειμαίνοντες, ὥσπερ ἐν σκότῳ βαθεῖ τά τε παιδία φοβεῖται καὶ τῶν τελείων οἱ ἀπαίδευτοι. καθάπερ γὰρ καὶ τὸ ἔξωθεν σκότος εἰς φόβον ἄγει σχεδὸν ἅπαντας ἀνθρώπους, πλὴν τῶν ἤτοι πάνυ φύσει τολμηρῶν, ἢ πεπαιδευμένων, οὕτως καὶ τῆς μελαίνης χολῆς τὸ χρῶμα παραπλησίως σκότῳ τὸν φρονοῦντα τόπον ἐπισκιάζον ἐργάζεται τοὺς φόβους.

ὅτι γὰρ οἵ τε χυμοὶ καὶ ὅλως ἡ τοῦ σώματος κρᾶσις ἀλλοιοῖ τὰς ἐνεργείας τῆς ψυχῆς, ὡμολόγηται τοῖς ἀρίστοις ἰατροῖς τε καὶ φιλοσόφοις, ἐμοί τε δι’ ἑνὸς ὑπομνήματος ἀποδέδεικται, καθ’ ὃ ταῖς τοῦ σώματος κράσεσιν ἀκολουθούσας ἀπέδειξα τὰς τῆς ψυχῆς δυνάμεις· ὅθεν οὐδὲ γράψαι τι περὶ μελαγχολίας ἐτόλμησαν οἱ τὴν τῶν χυμῶν δύναμιν ἀγνοήσαντες, ἐξ ὧν εἰσι καὶ οἱ περὶ τὸν ᾿Ερασίστρατον.  ἄξιον δέ ἐστι κᾀν τούτῳ θαυμάσαι τὰς κοινὰς ἐννοίας τῶν ἀνθρώπων, ὥσπερ καὶ τἄλλα πολλὰ δόγματα, περὶ ὧν ἠγνόησαν οὐκ ὀλίγοι φιλοσόφων τε καὶ ἰατρῶν· ἅπαντες γοῦν ὀνομάζουσιν τὸ πάθος τοῦτο μελαγχολίαν, ἐνδεικνύμενοι διὰ  τῆς προσηγορίας τὸν αἴτιον αὐτοῦ χυμόν.

 

*Erasistratos was a doctor and author during the Hellenistic period.

I found this passage from reading: Patricia A. Clark and M. Lynn Rose. 2016. “Psychiatric Disability in the Galenic Medical Matrix.” In Christian Laes, Chris Goodey, and M. Lynn Rose (eds.). Disabilities in Roman Antiquity: Disparate Bodies a Capite Ad Calcem. Leiden: 45-72.

Image result for Ancient Greek medicine
A relief from Ephesus

The modern debate about “mind” verses “brain” has its origins in antiquity and notions of the “soul” and the “body”. Hippocrates presents one of the earliest arguments that everything is physical and biological.

Hippocrates of Cos, On the Sacred Disease 14

 “People should know that our pleasures, happiness, laughter, and jokes from nowhere else [but the brain] and that our griefs, pains, sorrows, depressions and mourning come from the same place. And through it we think especially, and ponder, and see and hear and come to perceive both shameful things and noble things and wicked things and good things as well as sweet and bitter, at times judging them so by custom, at others by understanding what is advantageous based on distinguishing what is pleasurable and not in the right time and [that] these things are not the same to us.

By this very organ we become both sane and delirious and fears and horrors attend us sometimes at night and sometimes at day. This brings us bouts of sleeplessness and makes us mistake-prone at terrible times,  bringing thoughts we cannot follow, and deeds which are unknown, unaccustomed or untried.

Yes, we suffer all these things from or brain when it is not health but is hotter than natural, too cold or too wet or too dry or suffers any other kind of thing contrary to its custom. We go insane because of its moistness. For whenever it is wetter than natural, it is forced to move. And when it moves, neither sight can be still nor hearing. Instead, we hear and see different things at different times and the tongue talks about the kinds of things it sees and hears each time. But a person can think as long as the brain remains still.”

 Εἰδέναι δὲ χρὴ τοὺς ἀνθρώπους, ὅτι ἐξ οὐδενὸς ἡμῖν αἱ ἡδοναὶ γίνονται καὶ αἱ εὐφροσύναι καὶ γέλωτες καὶ παιδιαὶ ἢ ἐντεῦθεν καὶ λῦπαι καὶ ἀνίαι καὶ δυσφροσύναι καὶ κλαυθμοί. Καὶ τούτῳ φρονεῦμεν μάλιστα καὶ νοεῦμεν καὶ βλέπομεν καὶ ἀκούομεν καὶ γινώσκομεν τά τε αἰσχρὰ καὶ τὰ καλὰ καὶ τὰ κακὰ καὶ ἀγαθὰ καὶ ἡδέα καὶ ἀηδέα, τὰ μὲν νόμῳ διακρίνοντες, τὰ δὲ τῷ ξυμφέροντι αἰσθανόμενοι, τῷ δὲ καὶ τὰς ἡδονὰς καὶ τὰς ἀηδίας τοῖσι καιροῖσι διαγινώσκοντες, καὶ οὐ ταὐτὰ ἀρέσκει ἡμῖν. Τῷ δὲ αὐτῷ τούτῳ καὶ μαινόμεθα καὶ παραφρονέομεν, καὶ δείματα καὶ φόβοι παρίστανται ἡμῖν τὰ μὲν νύκτωρ, τὰ δὲ μεθ’ ἡμέρην, καὶ ἐνύπνια καὶ πλάνοι ἄκαιροι, καὶ φροντίδες οὐχ ἱκνεύμεναι, καὶ ἀγνωσίη τῶν καθεστεώτων καὶ ἀηθίη καὶ ἀπειρίη. Καὶ ταῦτα πάσχομεν ἀπὸ τοῦ ἐγκεφάλου πάντα, ὅταν οὗτος μὴ ὑγιαίνῃ, ἀλλ’ ἢ θερμότερος τῆς φύσιος γένηται ἢ ψυχρότερος ἢ ὑγρότερος ἢ ξηρότερος, ἤ τι ἄλλο πεπόνθῃ πάθος παρὰ τὴν φύσιν ὃ μὴ ἐώθει. Καὶ μαινόμεθα μὲν ὑπὸ ὑγρότητος· ὅταν γὰρ ὑγρότερος τῆς φύσιος ᾖ, ἀνάγκη κινεῖσθαι, κινευμένου δὲ μήτε τὴν ὄψιν ἀτρεμίζειν μήτε τὴν ἀκοήν, ἀλλ᾿ ἄλλοτε ἄλλα ὁρᾶν καὶ ἀκούειν, τήν τε γλῶσσαν τοιαῦτα διαλέγεσθαι οἷα ἂν βλέπῃ τε καὶ ἀκούῃ ἑκάστοτε· ὅσον δ᾿ ἂν ἀτρεμήσῃ ὁ ἐγκέφαλος χρόνον, τοσοῦτον καὶ φρονεῖ ὁ ἄνθρωπος.

On the Sacred Disease, 9

“For these reasons I think that the brain has the most power in the human being. For when it happens to be healthy, it is our interpreter of all the things that happen from the air. And air furnishes intelligence. The eyes, and ears, and tongue and hands and feet do the kinds of things the brain decides. Indeed, the portion of intelligence distributed throughout the body comes from the air. The brain is the emissary to understanding. For whenever a person draws breath inside it rushes first to the brain and then it spreads through the rest of the body once it leaves its distilled form in the brain, that very thing which is thought and has judgment. If it were to enter the body first and the rain later, it would leave understanding in the flesh and the arteries and then go hot and impure into the brain, all mixed up with the bile from flesh and blood, with the result that it would uncertain.”

Κατὰ ταῦτα νομίζω τὸν ἐγκέφαλον δυναμιν ἔχειν πλείστην ἐν τῷ ἀνθρώπῳ· οὗτος γὰρ ἡμῖν ἐστι τῶν ἀπὸ τοῦ ἠέρος γινομένων ἑρμηνεύς, ἢν ὑγιαίνων τυγχάνῃ· τὴν δὲ φρόνησιν ὁ ἀὴρ παρέχεται. οἱ δὲ ὀφθαλμοὶ καὶ τὰ ὦτα καὶ ἡ γλῶσσα καὶ αἱ χεῖρες καὶ οἱ πόδες οἷα ἂν ὁ ἐγκέφαλος γινώσκῃ, τοιαῦτα πρήσσουσι·† γίνεται γὰρ ἐν ἅπαντι τῷ σώματι τῆς φρονήσιος, ὡςἂν μετέχῃ τοῦ ἠέρος.† ἐς δὲ τὴν σύνεσιν ὁ ἐγκέφαλός ἐστιν ὁ διαγγέλλων· ὅταν γὰρ σπάσῃ τὸ πνεῦμα ὥνθρωπος ἐς ἑωυτόν, ἐς τὸν ἐγκέφαλον πρῶτον ἀφικνεῖται, καὶ οὕτως ἐς τὸ λοιπὸν σῶμα σκίδναται ὁ ἀήρ, καταλελοιπὼς ἐν τῷ ἐγκεφάλῳ ἑωυτοῦ τὴν ἀκμὴν καὶ ὅ τι ἂν ᾖ φρόνιμόν τε καὶ γνώμην ἔχον· εἰ γὰρ ἐς τὸ σῶμα πρῶτον ἀφικνεῖτο καὶ ὕστερον ἐς τὸν ἐγκέφαλον, ἐν τῇσι σαρξὶ καὶ ἐν τῇσι φλεψὶ καταλελοιπὼς τὴν διάγνωσιν ἐς τὸν ἐγκέφαλον ἂν ἴοιθερμὸς ἐὼν καὶ οὐκ ἀκραιφνής, ἀλλ᾿ ἐπιμεμιγμένος τῇ ἰκμάδι τῇ ἀπό τε τῶν σαρκῶν καὶ τοῦ αἵματος, ὥστε μηκέτι εἶναι ἀκριβής.

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Edmund Wilson. “On Free Will and How the Brain is Like a Colony of Ants.” Harper’sSeptember 2014, 49-52.

“The self does not exist as a paranormal being living on its own within the brain. It is, instead, the central dramatic character of the confabulated scenarios. In these stories, it is always on center stage—if not as participant, then as observer and commentator—because that is where all of the sensory information arrives and is integrated.”

For a good overview of issues of brain, mind and consciousness from multiple disciplinary perspectives, see Dennett, Dale C. 2017. From Bacteria to Bach and Back: The Evolution of Minds. New York.

Keep an Open Door: Galen on Living Honestly

Galen, Affections [De propriorum animi cuiuslibet affectuum dignotione et curatione] 5.25–26

“Always be on guard against the matter which is greatest in this, once you choose to honor yourself. For it is possible always to keep at hand the memory of the hideousness of the soul of those who get angry and the beauty of those who are untroubled by rage.

For whoever, thanks to being accustomed to a mistaken behavior over time, has developed a stain of emotions which cannot be washed away,  must for as great an amount of time attend to each of those beliefs by which a man might become noble and good, should he heed them. We lose sight of a thing that falls easily from our minds because they have been previously filled by these emotions.

Therefore this must be pursued by each of those who want to be saved as if there were no proper season for taking it easy; and all of us must turn toward accusing ourselves, and we must listen to [others] gently, not for the sake of castigating them but for shaping them in turn.

Keep the door of your home open all the time and permit those who understand to enter at every opportune moment. If you are prepared in this way, be bold enough to be discovered as overcome by any of the major mistakes by none of those who enter. Just as it is possible to banish a bad feeling for one who is unwilling, it is easy to banish great ones for one who has made this decision.

When your door is open all the time, as I said, then let there be plenty of time for people who understand to enter. As all the other people who enter a public space attempt to act properly, so too act in the same way in your private home. But those who are ashamed before others only because they might be caught, do not feel shame before themselves alone: but you, feel shame before yourself especially, if you follow this precept.”

ὃ δ’ ἐϲτὶ μέγιϲτον ἐν τούτῳ, ἀεὶ φύλαττε, προῃρημένοϲ γε τιμᾶν ϲεαυτόν. ἔϲτι δὲ τοῦτο διὰ μνήμηϲ ἔχειν πρόχειρα τό τε τῶν ὀργιζομένων τῆϲ ψυχῆϲ αἶϲχοϲ τό τε τῶν ἀοργήτων κάλλοϲ. ὃϲ γὰρ ἁμαρτάνειν ἐθιϲθεὶϲ χρόνῳ πολλῷ δυϲέκνιπτον ἔϲχε τὴν κηλῖδα τῶν παθῶν, τούτῳ καὶ τῶν δογμάτων, οἷϲ πειθόμενοϲ ἀνὴρ γενήϲῃ καλὸϲ κἀγαθόϲ, ἐν πολλῷ χρόνῳ προϲήκει μελετᾶν ἕκαϲτον. ἐπιλανθανόμεθα γὰρ αὐτοῦ ῥᾳδίωϲ ἐκπίπτοντοϲ τῆϲ ψυχῆϲ ἡμῶν διὰ τὸ φθάϲαι πεπληρῶϲθαι τοῖϲ πάθεϲιν αὐτήν.

τοιγαροῦν παρακολουθητέον ἐϲτὶν ἑκάϲτῳ τῶν ϲωθῆναι βουλομένων, ὡϲ <δεῖ> μηδεμίαν ὥραν ἀπορρᾳθυμεῖν, ἐπι-τρεπτέον τε πᾶϲι κατηγορεῖν ἡμῶν <παρ>ακουϲτέον | τε πράωϲ αὐτῶν καὶ χάριν <ἰϲτέον> οὐ τοῖϲ κολακεύουϲιν, ἀλλὰ τοῖϲ ἐπιπλήττουϲιν.

ἀνεῴχθω ϲου ἡ θύρα διὰ παντὸϲ τῆϲ οἰκήϲεωϲ <καὶ> ἐξέϲτω τοῖϲ ϲυνήθεϲιν εἰϲιέναι πάντα καιρόν, ἢν οὕτωϲ ᾖϲ παρεϲκευαϲμένοϲ, ὡϲ θαρρεῖν ὑπὸ τῶν εἰϲιόντων εὑρίϲκεϲθαι μηδενὶ τῶν μεγάλων ἁμαρτημάτων ἰϲχυρῶϲ κατειλημμένον. ἔϲτι δ’ ὥϲπερ τῷ <ἄκοντι> πᾶν ἐκκόψαι δύϲκολον, οὕτω τὰ μεγάλα τῷ βουληθέντι ῥᾷϲτον.

τῆϲ θύραϲ οὖν ἀνεῳγμένηϲ ϲου διὰ παντόϲ, ὡϲ εἶπον, ἐξουϲία τοῖϲ ϲυνήθεϲιν ἔϲτω κατὰ πάντα καιρὸν εἰϲιέναι. ὡϲ δ’ οἱ ἄλλοι πάντεϲ ἄνθρωποι προελθόντεϲ εἰϲ τὸ δημόϲιον ἅπαντα πειρῶνται πράττειν κοϲμίωϲ, οὕτω ϲὺ κατὰ τὴν ἰδίαν οἰκίαν πρᾶττε. ἀλλ’ ἐκεῖνοι μὲν αἰδούμενοι τοὺϲ ἄλλουϲ ἁμαρτόντεϲ τι φωραθῆναι μόνουϲ ἑαυτοὺϲ οὐκ αἰδοῦνται, ϲὺ δὲ ϲαυτὸν αἰδοῦ μάλιϲτα πειθόμενοϲ τῷ φάντι·

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Also…

Diagnose Thyself: Why Be a Doctor?

Galen, On the Opinions of Hippocrates and Plato 9.5.5-7

“For some  practice the art of medicine for the money, and some do it for exemption from taxes. But some pursue medicine because of their love for humanity [philanthrôpia] just as there are those who do it for the fame or honor medicine attracts. Therefore doctors are named by the fact that they are all craftsmen of health in common, inasmuch as they perform their craft for different reasons—one will be called a lover of humanity [philanthrôpos], another titled a lover of honor [philotimos], while another is considered a lover of reputation [philodoxos] and another is a money maker.

The aim of a doctor for doctors, then, is not fame or wealth, as Mênodotos the Empiricist wrote. This is a goal for Mênodotus but not for Diocles or Hippocrates or Empedocles nor even a few others of those ancient doctors—however so many ministered to people because of their love of humanity [philanthrôpia]. Left bare among these kind of examples—and they are abundant in Hippocrates and Plato—the particular features and the common traits of each craft may be examined.”

τινὲς μὲν γὰρ ἕνεκα χρηματισμοῦ τὴν ἰατρικὴν τέχνην ἐργάζονται, τινὲς δὲ διὰ τὴν ἐκ τῶν νόμων αὐτοῖς διδομένην ἀλειτουργησίαν, ἔνιοι δὲ διὰ φιλανθρωπίαν, ὥσπερ ἄλλοι διὰ τὴν ἐπὶ ταύτῃ δόξαν ἢ τιμήν.  ὀνομασθήσονται τοιγαροῦν ᾗ μὲν ὑγιείας εἰσὶ δημιουργοὶ κοινῇ πάντες ἰατροί, καθόσον δὲ τὰς πράξεις ἐπὶ διαφόροις ποιοῦνται σκοποῖς, ὁ μέν τις φιλάνθρωπος, ὁ δὲ φιλότιμος, ὁ δὲ φιλόδοξος, ὁ δὲ χρηματιστής.

οὔκουν τοῖς ἰατροῖς τὸ τέλος ἐστὶν ὡς ἰατροῖς ἔνδοξον ἢ πόριμον, ὡς Μηνόδοτος <ὁ> ἐμπειρικὸς ἔγραψεν, ἀλλὰ Μηνοδότῳ μὲν τοῦτο, Διοκλεῖ δ’ οὐ τοῦτο, καθάπερ οὐδὲ ῾Ιπποκράτει καὶ ᾿Εμπεδοκλεῖ οὐδ’ ἄλλοις τῶν παλαιῶν οὐκ ὀλίγοις ὅσοι διὰ φιλανθρωπίαν ἐθεράπευον τοὺς ἀνθρώπους. γυμνασάμενος οὖν ἐν τοῖς τοιούτοις τις παραδείγμασι, πάμπολλα δ’ ἐστὶ παρ’ ῾Ιπποκράτει καὶ Πλάτωνι, ῥᾳδίως κατόψεται τά τε ἴδια τέχνης ἑκάστης καὶ τὰ κοινά.

 

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From medievalists.net

Ancient Greek Depression and the Brain: Galen and Hippocrates

Galen, De Locis Affectis 8.190-191

“Fear always plagues people with melancholy but they don’t always have the same kind of abnormal (para phusin) thoughts. For example, one person believes that he has grown a shell and because of this he avoids everyone who nears him so that he might not break it. When another hears the roosters singing, just as if the birds strike their wings before their song, he also slaps his arms against his sides and imitates the animals’ voice. Fear comes to another that Atlas who is supporting the universe might drop it because he is worn out and for this reason he will be crushed and he will destroy us with him.

But there are ten thousand other fantasies. The melancholic differ from one another, but even though they all exhibit fear, despair, blaming of life and hatred for people, they do not all want to die. For some, fear of death is the principle source of their depression. Some will seem paradoxical to you because they fear death and desire death at the same time.

For this reason it seems right that Hippocrates divided all of these symptoms into two groups: fear (phobos) and despair (dusthumia). Because of this sort of despair, they hate everyone they see and are always gloomy and they are afraid like children are frightened in deep darkness and uneducated adults too. As external darkness makes nearly all people afraid, except for those who are bold by nature or have been well-educated for it, so too the color of the black bile overshadows places of thought with darkness and makes people afraid.

The fact that the humors and altogether the equilibrium (krâsis) of the body may alter the reality of the mind is agreed upon by the best doctors and philosophers and I have shown already in one publication in which, by pursuing the body’s balances, I demonstrated the abilities of the mind. For this reason, those who are ignorant about the power of humors do not dare to write anything about melancholy. Of these, there are also those of the school of Erasistratos. It is right to be amazed at him for people’s common thoughts, as with many other beliefs about which not a few philosophers and doctors are ignorant. Therefore, nearly everyone calls melancholy a sickness, indicating through this name that its cause is bile.”

ἀεὶ μὲν οὖν  οἱ φόβοι συνεδρεύουσι τοῖς μελαγχολικοῖς, οὐκ ἀεὶ δὲ ταὐτὸν εἶδος τῶν παρὰ φύσιν αὐτοῖς γίγνεται φαντασιῶν, εἴγε ὁ μέν τις ὀστρακοῦς ᾤετο γεγονέναι, καὶ διὰ τοῦτ’ ἐξίστατο τοῖς ἀπαντῶσιν, ὅπως μὴ συντριβείη· θεώμενος δέ τις ἄλλος ἀλεκτρυόνας ᾄδοντας, ὥσπερ ἐκεῖνοι τὰς πτέρυγας προσέκρουον πρὸ ᾠδῆς, οὕτω καὶ αὐτὸς τοὺς βραχίονας προσκρούων ταῖς πλευραῖς ἐμιμεῖτο τὴν φωνὴν τῶν ζώων. φόβος δ’ ἦν ἄλλῳ, μή πως ὁ βαστάζων τὸν κόσμον ῎Ατλας ἀποσείσηται κεκμηκὼς αὐτὸν, οὕτως τε καὶ αὐτὸς συντριβείη καὶ ἡμᾶς αὐτῷ συναπολέσειεν·

ἄλλα τε μυρία τοιαῦτα φαντασιοῦνται. διαφέρονται δὲ ἀλλήλων οἱ μελαγχολικοὶ, τὸ μὲν φοβεῖσθαι καὶ δυσθυμεῖν καὶ μέμφεσθαι τῇ ζωῇ καὶ μισεῖν τοὺς ἀνθρώπους ἅπαντες ἔχοντες, ἀποθανεῖν δ’ ἐπιθυμοῦντες οὐ πάντες, ἀλλ’ ἔστιν ἐνίοις αὐτῶν αὐτὸ δὴ τοῦτο κεφάλαιον τῆς μελαγχολίας, τὸ περὶ τοῦ θανάτου δέος· ἔνιοι δὲ ἀλλόκοτοί σοι δόξουσιν, ἅμα τε καὶ δεδιέναι τὸν θάνατον καὶ θανατᾷν. ὥστε ὀρθῶς ἔοικεν ὁ ῾Ιπποκράτης εἰς δύο ταῦτα ἀναγαγεῖν τὰ συμπτώματα αὐτῶν πάντα, φόβον καὶ δυσθυμίαν· ἐπί γέ τοι τῇ τοιαύτῃ δυσθυμίᾳ  μισοῦσιν πάντας, οὓς ἂν βλέπωσιν, καὶ σκυθρωποὶ διὰ παντός εἰσι, δειμαίνοντες, ὥσπερ ἐν σκότῳ βαθεῖ τά τε παιδία φοβεῖται καὶ τῶν τελείων οἱ ἀπαίδευτοι. καθάπερ γὰρ καὶ τὸ ἔξωθεν σκότος εἰς φόβον ἄγει σχεδὸν ἅπαντας ἀνθρώπους, πλὴν τῶν ἤτοι πάνυ φύσει τολμηρῶν, ἢ πεπαιδευμένων, οὕτως καὶ τῆς μελαίνης χολῆς τὸ χρῶμα παραπλησίως σκότῳ τὸν φρονοῦντα τόπον ἐπισκιάζον ἐργάζεται τοὺς φόβους.

ὅτι γὰρ οἵ τε χυμοὶ καὶ ὅλως ἡ τοῦ σώματος κρᾶσις ἀλλοιοῖ τὰς ἐνεργείας τῆς ψυχῆς, ὡμολόγηται τοῖς ἀρίστοις ἰατροῖς τε καὶ φιλοσόφοις, ἐμοί τε δι’ ἑνὸς ὑπομνήματος ἀποδέδεικται, καθ’ ὃ ταῖς τοῦ σώματος κράσεσιν ἀκολουθούσας ἀπέδειξα τὰς τῆς ψυχῆς δυνάμεις· ὅθεν οὐδὲ γράψαι τι περὶ μελαγχολίας ἐτόλμησαν οἱ τὴν τῶν χυμῶν δύναμιν ἀγνοήσαντες, ἐξ ὧν εἰσι καὶ οἱ περὶ τὸν ᾿Ερασίστρατον.  ἄξιον δέ ἐστι κᾀν τούτῳ θαυμάσαι τὰς κοινὰς ἐννοίας τῶν ἀνθρώπων, ὥσπερ καὶ τἄλλα πολλὰ δόγματα, περὶ ὧν ἠγνόησαν οὐκ ὀλίγοι φιλοσόφων τε καὶ ἰατρῶν· ἅπαντες γοῦν ὀνομάζουσιν τὸ πάθος τοῦτο μελαγχολίαν, ἐνδεικνύμενοι διὰ  τῆς προσηγορίας τὸν αἴτιον αὐτοῦ χυμόν.

 

*Erasistratos was a doctor and author during the Hellenistic period.

I found this passage from reading: Patricia A. Clark and M. Lynn Rose. 2016. “Psychiatric Disability in the Galenic Medical Matrix.” In Christian Laes, Chris Goodey, and M. Lynn Rose (eds.). Disabilities in Roman Antiquity: Disparate Bodies a Capite Ad Calcem. Leiden: 45-72.

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A relief from Ephesus

The modern debate about “mind” verses “brain” has its origins in antiquity and notions of the “soul” and the “body”. Hippocrates presents one of the earliest arguments that everything is physical and biological.

Hippocrates of Cos, On the Sacred Disease 14

 “People should know that our pleasures, happiness, laughter, and jokes from nowhere else [but the brain] and that our griefs, pains, sorrows, depressions and mourning come from the same place. And through it we think especially, and ponder, and see and hear and come to perceive both shameful things and noble things and wicked things and good things as well as sweet and bitter, at times judging them so by custom, at others by understanding what is advantageous based on distinguishing what is pleasurable and not in the right time and [that] these things are not the same to us.

By this very organ we become both sane and delirious and fears and horrors attend us sometimes at night and sometimes at day. This brings us bouts of sleeplessness and makes us mistake-prone at terrible times,  bringing thoughts we cannot follow, and deeds which are unknown, unaccustomed or untried.

Yes, we suffer all these things from or brain when it is not health but is hotter than natural, too cold or too wet or too dry or suffers any other kind of thing contrary to its custom. We go insane because of its moistness. For whenever it is wetter than natural, it is forced to move. And when it moves, neither sight can be still nor hearing. Instead, we hear and see different things at different times and the tongue talks about the kinds of things it sees and hears each time. But a person can think as long as the brain remains still.”

 Εἰδέναι δὲ χρὴ τοὺς ἀνθρώπους, ὅτι ἐξ οὐδενὸς ἡμῖν αἱ ἡδοναὶ γίνονται καὶ αἱ εὐφροσύναι καὶ γέλωτες καὶ παιδιαὶ ἢ ἐντεῦθεν καὶ λῦπαι καὶ ἀνίαι καὶ δυσφροσύναι καὶ κλαυθμοί. Καὶ τούτῳ φρονεῦμεν μάλιστα καὶ νοεῦμεν καὶ βλέπομεν καὶ ἀκούομεν καὶ γινώσκομεν τά τε αἰσχρὰ καὶ τὰ καλὰ καὶ τὰ κακὰ καὶ ἀγαθὰ καὶ ἡδέα καὶ ἀηδέα, τὰ μὲν νόμῳ διακρίνοντες, τὰ δὲ τῷ ξυμφέροντι αἰσθανόμενοι, τῷ δὲ καὶ τὰς ἡδονὰς καὶ τὰς ἀηδίας τοῖσι καιροῖσι διαγινώσκοντες, καὶ οὐ ταὐτὰ ἀρέσκει ἡμῖν. Τῷ δὲ αὐτῷ τούτῳ καὶ μαινόμεθα καὶ παραφρονέομεν, καὶ δείματα καὶ φόβοι παρίστανται ἡμῖν τὰ μὲν νύκτωρ, τὰ δὲ μεθ’ ἡμέρην, καὶ ἐνύπνια καὶ πλάνοι ἄκαιροι, καὶ φροντίδες οὐχ ἱκνεύμεναι, καὶ ἀγνωσίη τῶν καθεστεώτων καὶ ἀηθίη καὶ ἀπειρίη. Καὶ ταῦτα πάσχομεν ἀπὸ τοῦ ἐγκεφάλου πάντα, ὅταν οὗτος μὴ ὑγιαίνῃ, ἀλλ’ ἢ θερμότερος τῆς φύσιος γένηται ἢ ψυχρότερος ἢ ὑγρότερος ἢ ξηρότερος, ἤ τι ἄλλο πεπόνθῃ πάθος παρὰ τὴν φύσιν ὃ μὴ ἐώθει. Καὶ μαινόμεθα μὲν ὑπὸ ὑγρότητος· ὅταν γὰρ ὑγρότερος τῆς φύσιος ᾖ, ἀνάγκη κινεῖσθαι, κινευμένου δὲ μήτε τὴν ὄψιν ἀτρεμίζειν μήτε τὴν ἀκοήν, ἀλλ᾿ ἄλλοτε ἄλλα ὁρᾶν καὶ ἀκούειν, τήν τε γλῶσσαν τοιαῦτα διαλέγεσθαι οἷα ἂν βλέπῃ τε καὶ ἀκούῃ ἑκάστοτε· ὅσον δ᾿ ἂν ἀτρεμήσῃ ὁ ἐγκέφαλος χρόνον, τοσοῦτον καὶ φρονεῖ ὁ ἄνθρωπος.

On the Sacred Disease, 9

“For these reasons I think that the brain has the most power in the human being. For when it happens to be healthy, it is our interpreter of all the things that happen from the air. And air furnishes intelligence. The eyes, and ears, and tongue and hands and feet do the kinds of things the brain decides. Indeed, the portion of intelligence distributed throughout the body comes from the air. The brain is the emissary to understanding. For whenever a person draws breath inside it rushes first to the brain and then it spreads through the rest of the body once it leaves its distilled form in the brain, that very thing which is thought and has judgment. If it were to enter the body first and the rain later, it would leave understanding in the flesh and the arteries and then go hot and impure into the brain, all mixed up with the bile from flesh and blood, with the result that it would uncertain.”

Κατὰ ταῦτα νομίζω τὸν ἐγκέφαλον δυναμιν ἔχειν πλείστην ἐν τῷ ἀνθρώπῳ· οὗτος γὰρ ἡμῖν ἐστι τῶν ἀπὸ τοῦ ἠέρος γινομένων ἑρμηνεύς, ἢν ὑγιαίνων τυγχάνῃ· τὴν δὲ φρόνησιν ὁ ἀὴρ παρέχεται. οἱ δὲ ὀφθαλμοὶ καὶ τὰ ὦτα καὶ ἡ γλῶσσα καὶ αἱ χεῖρες καὶ οἱ πόδες οἷα ἂν ὁ ἐγκέφαλος γινώσκῃ, τοιαῦτα πρήσσουσι·† γίνεται γὰρ ἐν ἅπαντι τῷ σώματι τῆς φρονήσιος, ὡςἂν μετέχῃ τοῦ ἠέρος.† ἐς δὲ τὴν σύνεσιν ὁ ἐγκέφαλός ἐστιν ὁ διαγγέλλων· ὅταν γὰρ σπάσῃ τὸ πνεῦμα ὥνθρωπος ἐς ἑωυτόν, ἐς τὸν ἐγκέφαλον πρῶτον ἀφικνεῖται, καὶ οὕτως ἐς τὸ λοιπὸν σῶμα σκίδναται ὁ ἀήρ, καταλελοιπὼς ἐν τῷ ἐγκεφάλῳ ἑωυτοῦ τὴν ἀκμὴν καὶ ὅ τι ἂν ᾖ φρόνιμόν τε καὶ γνώμην ἔχον· εἰ γὰρ ἐς τὸ σῶμα πρῶτον ἀφικνεῖτο καὶ ὕστερον ἐς τὸν ἐγκέφαλον, ἐν τῇσι σαρξὶ καὶ ἐν τῇσι φλεψὶ καταλελοιπὼς τὴν διάγνωσιν ἐς τὸν ἐγκέφαλον ἂν ἴοιθερμὸς ἐὼν καὶ οὐκ ἀκραιφνής, ἀλλ᾿ ἐπιμεμιγμένος τῇ ἰκμάδι τῇ ἀπό τε τῶν σαρκῶν καὶ τοῦ αἵματος, ὥστε μηκέτι εἶναι ἀκριβής.

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Edmund Wilson. “On Free Will and How the Brain is Like a Colony of Ants.” Harper’sSeptember 2014, 49-52.

“The self does not exist as a paranormal being living on its own within the brain. It is, instead, the central dramatic character of the confabulated scenarios. In these stories, it is always on center stage—if not as participant, then as observer and commentator—because that is where all of the sensory information arrives and is integrated.”

For a good overview of issues of brain, mind and consciousness from multiple disciplinary perspectives, see Dennett, Dale C. 2017. From Bacteria to Bach and Back: The Evolution of Minds. New York.

Keep an Open Door: Galen on Living Honestly

Galen, Affections [De propriorum animi cuiuslibet affectuum dignotione et curatione] 5.25–26

“Always be on guard against the matter which is greatest in this, once you choose to honor yourself. For it is possible always to keep at hand the memory of the hideousness of the soul of those who get angry and the beauty of those who are untroubled by rage.

For whoever, thanks to being accustomed to a mistaken behavior over time, has developed a stain of emotions which cannot be washed away,  must for as great an amount of time attend to each of those beliefs by which a man might become noble and good, should he heed them. For we lose sight of a thing that falls easily from our minds because they have been previously filled by these emotions.

Therefore this must be pursued by each of those who want to be saved as if there were no proper season for taking it easy; and all of us must turn toward accusing ourselves, and we must listen to [others] gently, not for the sake of castigating them but for shaping them in turn.

Keep the door of your home open all the time and permit those who understand to enter at every opportune moment. If you are prepared in this way, be bold enough to be discovered as overcome by any of the major mistakes by none of those who enter. Just as it is possible to banish a bad feeling for one who is unwilling, it is easy to banish great ones for one who has made this decision.

When your door is open all the time, as I said, then let there be plenty of time for people who understand to enter. As all the other people who enter a public space attempt to act properly, so too act in the same way in your private home. But those who are ashamed before others only because they might be caught, do not feel shame before themselves alone: but you, feel shame before yourself especially, if you follow this precept.”

ὃ δ’ ἐϲτὶ μέγιϲτον ἐν τούτῳ, ἀεὶ φύλαττε, προῃρημένοϲ γε τιμᾶν ϲεαυτόν. ἔϲτι δὲ τοῦτο διὰ μνήμηϲ ἔχειν πρόχειρα τό τε τῶν ὀργιζομένων τῆϲ ψυχῆϲ αἶϲχοϲ τό τε τῶν ἀοργήτων κάλλοϲ. ὃϲ γὰρ ἁμαρτάνειν ἐθιϲθεὶϲ χρόνῳ πολλῷ δυϲέκνιπτον ἔϲχε τὴν κηλῖδα τῶν παθῶν, τούτῳ καὶ τῶν δογμάτων, οἷϲ πειθόμενοϲ ἀνὴρ γενήϲῃ καλὸϲ κἀγαθόϲ, ἐν πολλῷ χρόνῳ προϲήκει μελετᾶν ἕκαϲτον. ἐπιλανθανόμεθα γὰρ αὐτοῦ ῥᾳδίωϲ ἐκπίπτοντοϲ τῆϲ ψυχῆϲ ἡμῶν διὰ τὸ φθάϲαι πεπληρῶϲθαι τοῖϲ πάθεϲιν αὐτήν.

τοιγαροῦν παρακολουθητέον ἐϲτὶν ἑκάϲτῳ τῶν ϲωθῆναι βουλομένων, ὡϲ <δεῖ> μηδεμίαν ὥραν ἀπορρᾳθυμεῖν, ἐπι-τρεπτέον τε πᾶϲι κατηγορεῖν ἡμῶν <παρ>ακουϲτέον | τε πράωϲ αὐτῶν καὶ χάριν <ἰϲτέον> οὐ τοῖϲ κολακεύουϲιν, ἀλλὰ τοῖϲ ἐπιπλήττουϲιν.

ἀνεῴχθω ϲου ἡ θύρα διὰ παντὸϲ τῆϲ οἰκήϲεωϲ <καὶ> ἐξέϲτω τοῖϲ ϲυνήθεϲιν εἰϲιέναι πάντα καιρόν, ἢν οὕτωϲ ᾖϲ παρεϲκευαϲμένοϲ, ὡϲ θαρρεῖν ὑπὸ τῶν εἰϲιόντων εὑρίϲκεϲθαι μηδενὶ τῶν μεγάλων ἁμαρτημάτων ἰϲχυρῶϲ κατειλημμένον. ἔϲτι δ’ ὥϲπερ τῷ <ἄκοντι> πᾶν ἐκκόψαι δύϲκολον, οὕτω τὰ μεγάλα τῷ βουληθέντι ῥᾷϲτον.

τῆϲ θύραϲ οὖν ἀνεῳγμένηϲ ϲου διὰ παντόϲ, ὡϲ εἶπον, ἐξουϲία τοῖϲ ϲυνήθεϲιν ἔϲτω κατὰ πάντα καιρὸν εἰϲιέναι. ὡϲ δ’ οἱ ἄλλοι πάντεϲ ἄνθρωποι προελθόντεϲ εἰϲ τὸ δημόϲιον ἅπαντα πειρῶνται πράττειν κοϲμίωϲ, οὕτω ϲὺ κατὰ τὴν ἰδίαν οἰκίαν πρᾶττε. ἀλλ’ ἐκεῖνοι μὲν αἰδούμενοι τοὺϲ ἄλλουϲ ἁμαρτόντεϲ τι φωραθῆναι μόνουϲ ἑαυτοὺϲ οὐκ αἰδοῦνται, ϲὺ δὲ ϲαυτὸν αἰδοῦ μάλιϲτα πειθόμενοϲ τῷ φάντι·

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Also…

Diagnose Thyself: Why Be a Doctor?

Galen, On the Opinions of Hippocrates and Plato 9.5.5-7

“For some men practice the art of medicine for the money, and some do it because of the exemption from taxes. But some pursue medicine because of their love for humanity [philanthrôpia] just as there are those who do it for the fame or honor medicine attracts. Therefore doctors are named by the fact that they are all craftsmen of health in common, inasmanuch as they perform their craft for different reasons—one will be called a lover of humanity [philanthrôpos], another titled a lover of honor [philotimos], while another is considered a lover of reputation [philodoxos] and another is a money maker.

The aim of a doctor for doctors, then, is not fame or wealth, as Mênodotos the Empiricist wrote. This is a goal for Mênodotus but not for Diocles or Hippocrates or Empedocles nor even a few others of those ancient doctors—however so many ministered to people because of their love of humanity [philanthrôpia]. Left bare among these kind of examples—and they are abundant in Hippocrates and Plato—the particular features and the common traits of each craft may be examined.”

τινὲς μὲν γὰρ ἕνεκα χρηματισμοῦ τὴν ἰατρικὴν τέχνην ἐργάζονται, τινὲς δὲ διὰ τὴν ἐκ τῶν νόμων αὐτοῖς διδομένην ἀλειτουργησίαν, ἔνιοι δὲ διὰ φιλανθρωπίαν, ὥσπερ ἄλλοι διὰ τὴν ἐπὶ ταύτῃ δόξαν ἢ τιμήν.  ὀνομασθήσονται τοιγαροῦν ᾗ μὲν ὑγιείας εἰσὶ δημιουργοὶ κοινῇ πάντες ἰατροί, καθόσον δὲ τὰς πράξεις ἐπὶ διαφόροις ποιοῦνται σκοποῖς, ὁ μέν τις φιλάνθρωπος, ὁ δὲ φιλότιμος, ὁ δὲ φιλόδοξος, ὁ δὲ χρηματιστής.

οὔκουν τοῖς ἰατροῖς τὸ τέλος ἐστὶν ὡς ἰατροῖς ἔνδοξον ἢ πόριμον, ὡς Μηνόδοτος <ὁ> ἐμπειρικὸς ἔγραψεν, ἀλλὰ Μηνοδότῳ μὲν τοῦτο, Διοκλεῖ δ’ οὐ τοῦτο, καθάπερ οὐδὲ ῾Ιπποκράτει καὶ ᾿Εμπεδοκλεῖ οὐδ’ ἄλλοις τῶν παλαιῶν οὐκ ὀλίγοις ὅσοι διὰ φιλανθρωπίαν ἐθεράπευον τοὺς ἀνθρώπους. γυμνασάμενος οὖν ἐν τοῖς τοιούτοις τις παραδείγμασι, πάμπολλα δ’ ἐστὶ παρ’ ῾Ιπποκράτει καὶ Πλάτωνι, ῥᾳδίως κατόψεται τά τε ἴδια τέχνης ἑκάστης καὶ τὰ κοινά.

 

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From medievalists.net

Ancient Greek Depression: Galen on Fear and Loathing

Galen, De Locis Affectis 8.190-191

“Fear always plagues people with melancholy but they don’t always have the same kind of abnormal (para phusin) thoughts. For example, one person believes that he has grown a shell and because of this he avoids everyone who nears him so that he might not break it. When another hears the roosters singing, just as if the birds strike their wings before their song, he also slaps his arms against his sides and imitates the animals’ voice. Fear comes to another that Atlas who is supporting the universe might drop it because he is worn out and for this reason he will be crushed and he will destroy us with him.

But there are ten thousand other fantasies. The melancholic differ from one another, but even though they all exhibit fear, despair, blaming of life and hatred for people, they do not all want to die. For some, fear of death is the principle source of their depression. Some will seem paradoxical to you because they fear death and desire death at the same time.

For this reason it seems right that Hippocrates divided all of these symptoms into two groups: fear (phobos) and despair (dusthumia). Because of this sort of despair, they hate everyone they see and are always gloomy and they are afraid like children are frightened in deep darkness and uneducated adults too. As external darkness makes nearly all people afraid, except for those who are bold by nature or have been well-educated for it, so too the color of the black bile overshadows places of thought with darkness and makes people afraid.

The fact that the humors and altogether the equilibrium (krâsis) of the body may alter the reality of the mind is agreed upon by the best doctors and philosophers and I have shown in already in one publication in which by pursuing the body’s balances I demonstrated the abilities of the mind. For this reason, those who are ignorant about the power of humors do not dare to write anything about melancholy. Of these, there are also those of the school of Erasistratos. It is right to be amazed at him for people’s common thoughts, as with many other beliefs about which not a few philosophers and doctors are ignorant. Therefore, nearly everyone calls melancholy a sickness, indicating through this name that its cause is bile.”

ἀεὶ μὲν οὖν  οἱ φόβοι συνεδρεύουσι τοῖς μελαγχολικοῖς, οὐκ ἀεὶ δὲ ταὐτὸν εἶδος τῶν παρὰ φύσιν αὐτοῖς γίγνεται φαντασιῶν, εἴγε ὁ μέν τις ὀστρακοῦς ᾤετο γεγονέναι, καὶ διὰ τοῦτ’ ἐξίστατο τοῖς ἀπαντῶσιν, ὅπως μὴ συντριβείη· θεώμενος δέ τις ἄλλος ἀλεκτρυόνας ᾄδοντας, ὥσπερ ἐκεῖνοι τὰς πτέρυγας προσέκρουον πρὸ ᾠδῆς, οὕτω καὶ αὐτὸς τοὺς βραχίονας προσκρούων ταῖς πλευραῖς ἐμιμεῖτο τὴν φωνὴν τῶν ζώων. φόβος δ’ ἦν ἄλλῳ, μή πως ὁ βαστάζων τὸν κόσμον ῎Ατλας ἀποσείσηται κεκμηκὼς αὐτὸν, οὕτως τε καὶ αὐτὸς συντριβείη καὶ ἡμᾶς αὐτῷ συναπολέσειεν·

ἄλλα τε μυρία τοιαῦτα φαντασιοῦνται. διαφέρονται δὲ ἀλλήλων οἱ μελαγχολικοὶ, τὸ μὲν φοβεῖσθαι καὶ δυσθυμεῖν καὶ μέμφεσθαι τῇ ζωῇ καὶ μισεῖν τοὺς ἀνθρώπους ἅπαντες ἔχοντες, ἀποθανεῖν δ’ ἐπιθυμοῦντες οὐ πάντες, ἀλλ’ ἔστιν ἐνίοις αὐτῶν αὐτὸ δὴ τοῦτο κεφάλαιον τῆς μελαγχολίας, τὸ περὶ τοῦ θανάτου δέος· ἔνιοι δὲ ἀλλόκοτοί σοι δόξουσιν, ἅμα τε καὶ δεδιέναι τὸν θάνατον καὶ θανατᾷν. ὥστε ὀρθῶς ἔοικεν ὁ ῾Ιπποκράτης εἰς δύο ταῦτα ἀναγαγεῖν τὰ συμπτώματα αὐτῶν πάντα, φόβον καὶ δυσθυμίαν· ἐπί γέ τοι τῇ τοιαύτῃ δυσθυμίᾳ  μισοῦσιν πάντας, οὓς ἂν βλέπωσιν, καὶ σκυθρωποὶ διὰ παντός εἰσι, δειμαίνοντες, ὥσπερ ἐν σκότῳ βαθεῖ τά τε παιδία φοβεῖται καὶ τῶν τελείων οἱ ἀπαίδευτοι. καθάπερ γὰρ καὶ τὸ ἔξωθεν σκότος εἰς φόβον ἄγει σχεδὸν ἅπαντας ἀνθρώπους, πλὴν τῶν ἤτοι πάνυ φύσει τολμηρῶν, ἢ πεπαιδευμένων, οὕτως καὶ τῆς μελαίνης χολῆς τὸ χρῶμα παραπλησίως σκότῳ τὸν φρονοῦντα τόπον ἐπισκιάζον ἐργάζεται τοὺς φόβους.

ὅτι γὰρ οἵ τε χυμοὶ καὶ ὅλως ἡ τοῦ σώματος κρᾶσις ἀλλοιοῖ τὰς ἐνεργείας τῆς ψυχῆς, ὡμολόγηται τοῖς ἀρίστοις ἰατροῖς τε καὶ φιλοσόφοις, ἐμοί τε δι’ ἑνὸς ὑπομνήματος ἀποδέδεικται, καθ’ ὃ ταῖς τοῦ σώματος κράσεσιν ἀκολουθούσας ἀπέδειξα τὰς τῆς ψυχῆς δυνάμεις· ὅθεν οὐδὲ γράψαι τι περὶ μελαγχολίας ἐτόλμησαν οἱ τὴν τῶν χυμῶν δύναμιν ἀγνοήσαντες, ἐξ ὧν εἰσι καὶ οἱ περὶ τὸν ᾿Ερασίστρατον.  ἄξιον δέ ἐστι κᾀν τούτῳ θαυμάσαι τὰς κοινὰς ἐννοίας τῶν ἀνθρώπων, ὥσπερ καὶ τἄλλα πολλὰ δόγματα, περὶ ὧν ἠγνόησαν οὐκ ὀλίγοι φιλοσόφων τε καὶ ἰατρῶν· ἅπαντες γοῦν ὀνομάζουσιν τὸ πάθος τοῦτο μελαγχολίαν, ἐνδεικνύμενοι διὰ  τῆς προσηγορίας τὸν αἴτιον αὐτοῦ χυμόν.

 

*Erasistratos was a doctor and author during the Hellenistic period.

I found this passage from reading: Patricia A. Clark and M. Lynn Rose. 2016. “Psychiatric Disability in the Galenic Medical Matrix.” In Christian Laes, Chris Goodey, and M. Lynn Rose (eds.). Disabilities in Roman Antiquity: Disparate Bodies a Capite Ad Calcem. Leiden: 45-72.

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A relief from Ephesus

The Consumption of Metis, Birth of Athena, and Creation of the Aegis (Hes. frag. 343)

The following fragment of Hesiod (343 MW) is preserved by Galen and appears to come out of a tradition presenting a catalog of Zeus’ wives.  In this is overlaps in content with Hesiod’s Theogony (806-901 and following) which has a similar order.  Some of the details, however, are a bit different.  Of special notice is the description of Metis’ hanging out in Zeus’ entrails or the creation of the Aegis.

“Because of that rivalry, [Hera] bore a famous son,
Hephaistos, on her own without aegis-bearing Zeus,
A son who surpassed all of the gods with his hands.
But [Zeus] stretched out next to the daughter of
Ocean and well-tressed Tethys apart from fair-cheeked Hera,
As he surprised Metis, even though she knows much.
He grabbed her with his hands and put her in his belly,
Because he feared that she might bear something stronger than lightning.
This is the reason that Kronos’ royal son who lives in the sky
Suddenly swallowed her whole. She was immediately pregnant
With Pallas Athena, whom the father of men and gods produced
Through his head near the banks of the river Tritôn.
Mêtis sat hidden beneath Zeus’ entrails,
That mother of Athena, creator of just affairs,
The one who knows most of gods and mortal men.
Then the goddess Themis stretched out beside him,
She surpassed all gods who have Olympian homes with her skilled handsl
She made the aegis, that army-routing armor of Athena,
Alongside the one who bore her, Athena dressed in warrior’s arms.”

Galenus, De placitis Hippocr. et Plat. iii. 8 p. 318 Müller
(=Chrysippus fr. 908, Stoic. Vet. Fr. 11. 256 v. Arnim)

ἐκ ταύτης ἔριδος ἣ μὲν τέκε φαίδιμον υἱὸν
῞Ηφαιστον †τέχνηισιν ἄνευ Διὸς αἰγιόχοιο
ἐκ πάντων παλάμηισι κεκασμένον Οὐρανιώνων·
αὐτὰρ ὅ γ’ ᾿Ωκεανοῦ καὶ Τηθύος ἠυκόμοιο
κούρηι νόσφ’ ῞Ηρης παρελέξατο καλλιπαρήου
ἐξαπαφὼν Μῆτιν καίπερ πολύιδριν ἐοῦσαν·
συμμάρψας δ’ ὅ γε χερσὶν ἑὴν ἐγκάτθετο νηδύν,
δείσας μὴ τέξηι κρατερώτερον ἄλλο κεραυνοῦ·
τούνεκά μιν Κρονίδης ὑψίζυγος αἰθέρι ναίων
κάππιεν ἐξαπίνης. ἣ δ’ αὐτίκα Παλλάδ’ ᾿Αθήνην
κύσατο· τὴν μὲν ἔτικτε πατὴρ ἀνδρῶν τε θεῶν τε
πὰρ κορυφήν, Τρίτωνος ἐπ’ ὄχθηισιν ποταμοῖο.
Μῆτις δ’ αὖτε Ζηνὸς ὑπὸ σπλάγχνοις λελαθυῖα
ἧστο, ᾿Αθηναίης μήτηρ, τέκταινα δικαίων,
πλεῖστα θεῶν εἰδυῖα καταθνητῶν τ’ ἀνθρώπων.
†ἔνθα θεὰ παρέλεκτο Θέμις† παλάμαις περὶ πάντων
ἀθανάτων ἐκέκασθ’ οἳ ᾿Ολύμπια δώματ’ ἔχουσιν,
αἰγίδα ποιήσασα φοβέστρατον ἔντος ᾿Αθήνης·
σὺν τῆι ἐγείνατό μιν, πολεμήϊα τεύχε’ ἔχουσαν.