Hippocratic Precept: Don’t Blackmail Sick People for Money

Corpus Hippocratica, Precepts 4.10

“The way you address a patient requires some kind of a theory too. For, if you begin talking about payment, then something else occurs in every situation. You will leave the sick person with the kind of impression that you will abandon him and leave if there is no agreement and that you don’t care and you will not apply any relief in the present.

Therefore, you should not make an issue about payment. For we believe that this kind of thought is harmful when someone is sick, and even more so if the sickness is intense. For the swiftness of a sickness which does not provide ample time for changing your mind urges the one who practices medicine well not to seek profit but to think more of reputation. It is, therefore, better to rebuke patients who have been saved rather than to blackmail those who are facing ruin.”

παραινέσιος δ’ ἂν καὶ τοῦτ’ ἐπιδεηθείη τῆς θεωρίης· εἰ γὰρ ἄρξαιο περὶ μισθαρίων· ξυμβάλλει γάρ τι καὶ τῷ ξύμπαντι· τῷ μὲν ἀλγέοντι τοιαύτην διανόησιν ἐμποιήσεις τὴν, ὅτι [οὐκ] ἀπολιπὼν αὐτὸν πορεύσῃ μὴ ξυνθέμενος, καὶ ὅτι ἀμελήσεις, καὶ οὐχ ὑποθήσῃ τινὰ τῷ παρεόντι. ἐπιμελεῖσθαι οὖν οὐ δεῖ περὶ στάσιος μισθοῦ· ἄχρηστον γὰρ ἡγεύμεθα ἐνθύμησιν ὀχλεομένου τὴν τοιαύτην, πουλὺ δὲ μᾶλλον, ἢν ὀξὺ νόσημά τι· νούσου γὰρ ταχυτὴς καιρὸν μὴ διδοῦσα ἐς ἀναστροφὴν οὐκ ἐποτρύνει τὸν καλῶς ἰητρεύοντα ζητεῖν τὸ λυσιτελές, ἔχεσθαι δὲ δόξης μᾶλλον· κρέσσον οὖν σωζομένοισιν ὀνειδίζειν ἢ ὀλεθρίως ἔχοντας προμύσσειν.

Image result for medieval manuscript doctor seeing patient

Loss of Speech Is Not Melancholy

from Galen, In Hippocratis Aphorismo

‘We call dumb [akratê] the tongue which is unstable because it cannot articulate the voice clearly or which is immoveable and paralyzed in every way. And some part of the body which is paralyzed is called apoplectic.

I do not know what the reason is that people say that these things are melancholic. For the sorts of things are rightly the signs of melancholy, which indeed all of the Greeks together agree, are fear or despair which lasts for a long time, this sort of thing is melancholic. Otherwise we say that melancholic maladies also include sores and boils, both rough and itchy, dark and white.

But loss of control of the tongue does not seem to be believed to be one of any of these kinds of afflictions nor of that called melancholy by everyone, just as apoplexy is not of this kind.”

 ᾿Ακρατῆ μὲν ὀνομάζει γλῶσσαν ἤτοι τὴν ἀστήρικτον ὡς μὴ διαθροῦσαν ἀκριβῶς τὴν φωνὴν ἢ τὴν ἀκίνητόν τε καὶ παραλελυμένην παντάπασιν. ἀπόπληκτον δέ τι τοῦ σώματος τὸ παραλελυμένον. διὰ τί δὲ ἐξαίφνης γινόμενα ταῦτα μελαγχολικὰ ὑπάρχειν φησὶν οὐκ οἶδα. μελαγχολίας μὲν γὰρ, ἣν δὴ καὶ συνήθως ἅπαντες ῞Ελληνες ὁμολογοῦσιν, ὀρθῶς εἴρηται πρὸς αὐτοῦ τὰ τοιαῦτα γνωρίσματα, ἢν φόβος ἢ δυσθυμία πολὺν χρόνον ἔχουσα διατελέῃ, μελαγχολικὸν τὸ τοιοῦτον. ἄλλως δὲ μελαγχολικὰ λέγομεν εἶναι πάθη τούς τε καρκίνους καὶ τοὺς ἰλέφαντας, ἔτι τε λέπρας καὶ ψώρας καὶ μέλανας ἀλφούς. ἀλλ’ οὐδὲ τῶν τοιούτων παθῶν τινος οὔτε τῆς ὑπὸ πάντων ὀνομαζομένης μελαγχολίας ὁρᾶται προηγουμένη γλώσσης ἀκράτεια, καθά-περ οὐδὲ μορίου τινὸς ἀποπληξία.


Intestinal Fortitude: Adventures in Ancient Medical Treatments

Galen, Method of Medicine 14: 10, 856

“The man was forty years old, as you know. While he was believed to be colic, he not only failed to profit from fomentations, heat treatments, ointments, and enemas—those kinds of things which doctors typically apply—but his condition was exacerbated by most of them. When rue-oil was applied rectally, he got worse; and he was worse still after the application of castor oil. When honey which had been prepared with pepper was inserted, he felt the worst find of pain. And he also suffered when he took the juice of fenugreek finished with honey.* For these reasons, I surmised that the biting fluids had worked themselves into the intestinal walls to begin with and that these were causing infection along with the treatments that had been inserted through his rectum, with the additional complication of the substances that had been ingested orally.

I gave him some food that would not cause problems. Then when I saw him in more pain, I realized that it was critical to purse the kakokhumia [bad-bile]. Although the medicine which is best for this sort of bile-issue is mad from aloe which people now call bitter, I did not date have this man purged right away because he was in pain and without proper nutrition for two months. Once I purged him in stages and moderately over a period of fifteen days I healed him and did not have to provide any other treatment. This man was at that time not afflicted for the first time, and he no longer had stomach pains.”

ὁ μέν γε τεσσαρακοντούτης ἦν, ὡς οἶσθα, | κωλικὸς εἶναι νομιζόμενος, οὐ μόνον οὐδὲν ὀνινάμενος ὑπὸ καταντλήσεων καὶ πυρίας καὶ καταπλασμάτων καὶ κλυσμάτων, οἷς συνήθως εἰώθασιν ἐπὶ τῶν τοιούτων χρῆσθαι διαθέσεων, ἀλλὰ καὶ παροξυνόμενος ὑπὸ τῶν πλείστων. ἐπὶ γοῦν ἐλαίῳ πηγανίνῳ διὰ τῆς ἕδρας ἐνεθέντι χείρων ἐγένετο καὶ αὖθις ἐπὶ καστορίῳ· καὶ μέντοι καὶ μέλι ποτὲ προσενεγκάμενος ἑφθὸν ἔχον πέπερι ἐσχάτως ὠδυνήθη· καὶ τὸν χυλὸν δὲ τῆς ἑφθῆς τήλεως ἅμα μέλιτι λαβὼν ἱκανῶς παρωξύνθη. στοχασάμενος οὖν ἐγὼ χυμοὺς δακνώδεις ἐν αὐτοῖς τοῖς χιτῶσι τῶν ἐντέρων ἀναπεπόσθαι, συνδιαφθείροντας ἑαυτοῖς τά τε κάτωθεν ἐνιέμενα καὶ τὰ διὰ τοῦ στόματος λαμβανόμενα, δύσφθαρτον αὐτῷ τροφὴν δούς.

εἶτ᾿ ἰδὼν ὀδυνώμενον ἔγνων χρῆναι τὴν κακοχυμίαν ἐκκαθαίρειν. ὄντος δ᾿ ἀρίστου πρὸς τὰς τοιαύτας κακοχυμίας φαρμάκου τοῦ διὰ τῆς ἀλόης, ὃ καλοῦσιν ἤδη συνήθως πικράν, ἀθρόως μὲν οὐκ ἐτόλμησα καθαίρειν αὐτὸν τὸν ἄνθρωπον, ὑπό τε τῆς ὀδύνης καὶ τῆς ἐνδείας καθῃρημένον ἤδη που δυοῖν μηνῶν. ἐκ διαστημάτων δέ τινων σύμμετρον | τοῦτ᾿ ἐργαζόμενος ἡμέρας ὡς οἶσθά που πεντεκαίδεκα τελέως ἰασάμην αὐτὸν οὐδὲν οὐκέτι αὐτῷ προσαγαγὼν ἄλλο βοήθημα. οὗτος μὲν οὖν ἐν ἐκείνῳ τῷ χρόνῳ πρῶτον οὕτως ἠνωχλεῖτο, μηδέπω πρότερον ἀλγήσας ἔντερα.

*In case the reader is uncertain, it does in fact seem that all of these substances were applied to the intestines rectally. 

Pour Some Pepper on Me….

Theophrastus, Inquiry in Plants, 9.20.1

“Pepper is in fact a fruit and there are two kinds of it. One is rounded just like orobos [bitter vetch], it has a husk and flesh just like bay-berries [daphnides]. The other is long and has black seeds just like poppies [mekônika]. This is far stronger than the former one. Both are warming [thermantika]. In addition to frankincense [libanôtos] these help against hemlock.”

XX. Τὸ δὴ πέπερι καρπὸς μέν ἐστι διττὸν δὲ αὐτοῦ τὸ γένος· τὸ μὲν γὰρ στρογγύλον ὥσπερ ὄροβος, κέλυφος ἔχον καὶ σάρκα καθάπερ αἱ δαφνίδες, ὑπέρυθρον· τὸ δὲ πρόμηκες μέλαν σπερμάτια μηκωνικὰ ἔχον· ἰσχυρότερον δὲ πολὺ τοῦτο θατέρου· θερμαντικὰ δὲ ἄμφω· δι᾿ ὃ καὶ πρὸς τὸ κώνειον βοηθεῖ ταῦτά τε καὶ ὁ λιβανωτός.

Orobos: vicia ervilia
Mêkônika: papaver somniferum

Pepper is carminative, causing increased flow of gastric juices

Dioscorides, De materia medica 2.159:2-3

“Both kinds of pepper commonly have the following effects:, digestive, uretic, absorbent [antidiarrheal], pro-perspirant and a purgative for things which overshadow girls. It also treats those who drink it and rub it on for periodic shakes and helps those bitten by wild beasts and also compels [out?] fetuses. It seems to make someone not pregnant when applied after sex.

It helps with coughs and aids with all kinds of ailments in the chest cavity, when it is taken in lozenges and suspensions, and it helps with sore throats when rubbed in with honey. It also treats constricted bowels when drunk with young laurel leaves. When it is crushed with stavesacre, it helps to produces phlegm, which is both painless and healthy to do. It stimulates your libido and helps as well in a soup mixed over heat. When it is prepared with pitch it helps neck swelling, and it darkens white spots with washing. Like lentils, pepper jumps in a pan right on the coals when it is roasting.”

δύναμιν δὲ ἔχει κοινῶς θερμαντικήν, πεπτικήν, οὐρητικήν, ἐπισπαστικήν, διαφορητικήν, σμηκτικὴν τῶν ταῖς κόραις ἐπισκοτούντων· ἁρμόζει καὶ ῥίγεσι περιοδικοῖς πινόμενον καὶ συγχριόμενον, καὶ θηριοδήκτοις ἀρήγει, ἄγει καὶ ἔμβρυα. ἀτόκιον δὲ εἶναι δοκεῖ μετὰ συνουσίαν προστιθέμενον, βηξί τε καὶ πᾶσι τοῖς περὶ θώρακα πάθεσιν ἁρμόζει, ἔν τε ἐκλεικτοῖς καὶ ποτήμασι λαμβανόμενον, καὶ συνάγχαις ἁρμόζει διαχριόμενον σὺν μέλιτι, καὶ στρόφους λύει πινόμενον μετὰ δάφνης φύλλων ἁπαλῶν. ἀποφλεγματίζει δὲ σὺν σταφίδι διαμασηθέν, ἀνώδυνόν τέ ἐστι καὶ ὑγιεινόν, καὶ ὄρεξιν κινεῖ καὶ πέψει συνεργεῖ μειγνύμενον ἐμβάμμασιν. ἀναλημφθὲν δὲ πίσσῃ χοιράδας διαφορεῖ, σμήχει δὲ ἀλφοὺς σὺν νίτρῳ. φώγνυται δὲ ἐν ὀστράκῳ καινῷ ἐπ’ ἀνθράκων κινούμενον ὡς φακοί.

Image result for long black pepper ancient Greek

Ignorant in a Special Kind of Ignorance

Hippocrates of Cos, The Art 8

 “There are some who find fault with medicine because of doctors who are not willing to attempt cases completely overpowered by diseases, saying that while doctors will try to heal patients whose diseases would heal themselves, they do not touch cases for which there is a great need of help—and, if [medicine] were truly an art, it would be necessary to treat all diseases equally.

The people who say these things, if they are really criticizing doctors because they do not care about the people who say these kinds of things as if they were delirious, perhaps they might make a more pointed critique than the one they offer. For, if someone believes that a skill can do something it cannot do or a exhibit a character which it does not have by nature, he is ignorant with the kind of ignorance that is closer to madness than a lack of education. For it is possible for us to master some fields by a natural disposition and with the tools of the art and then to become practitioners of these fields, but it is not possible for others.”

VIII. Εἰσὶ δέ τινες οἳ καὶ διὰ τοὺς μὴ θέλοντας ἐγχειρεῖν τοῖσι κεκρατημένοις ὑπὸ τῶν νοσημάτων μέμφονται τὴν ἰητρικήν, λέγοντες ὡς ταῦτα μὲν καὶ αὐτὰ ὑφ᾿ ἑωυτῶν ἂν ἐξυγιάζοιτο ἃ ἐγχειρέουσιν ἰῆσθαι, ἃ δ᾿ ἐπικουρίης δεῖται μεγάλης οὐχ ἅπτονται, δεῖν δέ, εἴπερ ἦν ἡ τέχνη, πάνθ᾿ ὁμοίως ἰῆσθαι. οἱ μὲν οὖν ταῦτα λέγοντες, εἰ ἐμέμφοντο τοῖς ἰητροῖς, ὅτι αὐτῶν τοιαῦτα λεγόντων οὐκ ἐπιμέλονται ὡς παραφρονεύντων, εἰκότως ἂν ἐμεμφοντο μᾶλλον ἢ ἐκεῖνα μεμφόμενοι. εἰ γάρ τις ἢ τέχνην ἐς ἃ μὴ τέχνη, ἢ φύσιν ἐς ἃ μὴ φύσις πέφυκεν, ἀξιώσειε δύνασθαι, ἀγνοεῖ ἄγνοιαν ἁρμόζουσαν μανίῃ μᾶλλον ἢ ἀμαθίῃ. ὧν γὰρ ἔστιν ἡμῖν τοῖσί τε τῶν φυσίων τοῖσι τε τῶν τεχνέων ὀργάνοις ἐπικρατεῖν, τούτων ἔστιν ἡμῖν δημιουργοῖς εἶναι, ἄλλων δὲ οὐκ ἔστιν.

This has no relation to the last statement but I needed to share it to remember it. Also, anything like this sticks with me because (1) I grind my teeth and (2) my spouse is a dentist.

Hippocrates, Prognostica 3

“To grind the teeth during a fever—if it is not a lifelong habit—is sign of insanity and mortal danger. And if this is done while delirious, it is especially deadly.”

ὀδόντας δὲ πρίειν ἐν πυρετῷ, ὁκόσοισι μὴ σύνηθές ἐστιν ἀπὸ παίδων, μανικὸν καὶ θανατῶδες·6 ἢν δὲ καὶ παραφρονέων τοῦτο ποιῇ, ὀλέθριον κάρτα ἤδη γίνεται.

Everything Comes from the Brain

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’s September 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: 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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