Night Terrors and Anxiety Attacks in Hippocrates

Hippocrates of Cos, Critical Days  302

“And whenever the liver swells more against his lungs, someone goes mad. He thinks he sees before his eyes creeping things and all kinds of beasts, fighting soldiers even as he believes that he is fighting with them. He speaks as if he is seeing these things and lashes out and threatens if someone forbids him from going out. If he stands, he may not be able to raise his legs and falls. His feet are always cold and whenever he sleeps, he jumps up from slumber and has witnessed frightening dreams.

We know that this fitfulness and fearing comes from dreams: whenever he calms down, he describes the kinds of dreams that he shaped out with his body and was describing with his tongue. He suffers these things in this way. And there are times when he is speechless for a whole day and night, gasping deeply for breath. When he stops this mad episode, he is immediately sensible again and if someone asks him a question, he responds right away and understands everything which was said. But, then later again, he falls under the same symptoms. This malady strikes most often when someone is abroad, especially if someone is walking on a deserted road. But it does happen other times too.’

καὶ ὁκόταν τὸ ἧπαρ μᾶλλον ἀναπτυχθῇ πρὸς τὰς φρένας, παραφρονέει· καὶ προφαίνεσθαί οἱ δοκέει πρὸ τῶν ὀφθαλμῶν ἑρπετὰ καὶ ἄλλα παντοδαπὰ θηρία, καὶ ὁπλίτας μαχομένους, καὶ αὐτὸς αὐτοῖς δοκέει μάχεσθαι· καὶ τοιαῦτα λέγει ὡς ὁρέων, καὶ ἐξέρχεται, καὶ ἀπειλεῖ, ἢν μή τις αὐτὸν ἐῴη διεξιέναι· καὶ ἢν ἀναστῇ, οὐ δύναται αἴρειν τὰ σκέλεα, ἀλλὰ πίπτει. οἱ δὲ πόδες αἰεὶ ψυχροί γίνονται· καὶ ὁκόταν καθεύδῃ, ἀναΐσσει ἐκ τοῦ ὕπνου, καὶ ἐνύπνια ὁρῇ φοβερά. τῷδε δὲ γινώσκομεν ὅτι ἀπὸ ἐνυπνίων ἀναΐσσει καὶ φοβέεται· ὅταν ἔννοος γένηται, ἀφηγεῖται τὰ ἐνύπνια τοιαῦτα ὁκοῖα καὶ τῷ σώματι ἐποίεέ τε καὶ τῇ γλώσσῃ ἔλεγε. ταῦτα μὲν οὖν ὧδε πάσχει. ἔστι δ᾿ ὅτε καὶ ἄφωνος γίνεται ὅλην τὴν ἡμέρην καὶ τὴν νύκτα, ἀναπνέων πολὺ ἀθρόον πνεῦμα. ὅταν δὲ παύσηται παραφρονέων, εὐθὺς ἔννοος γίνεται, καὶ ἢν ἐρωτᾷ τις αὐτόν, ὀρθῶς ἀποκρίνεται, καὶ γινώσκει πάντα τὰ λεγόμενα· εἶτ᾿ αὖθις ὀλίγῳ ὕστερον ἐν τοῖσιν αὐτοῖσιν ἄλγεσι κεῖται. αὕτη ἡ νοῦσος προσπίπτει μάλιστα ἐν ἀποδημίῃ, καὶ ἤν πῃ ἐρήμην ὁδὸν βαδίσῃ· λαμβάνει δὲ καὶ ἄλλως.

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Image from the British Library

Medically Mad or Just Thinking Bad? Early Greek on Being Crazy

An ancient distinction between mental maladies with absolutely no relevance to the modern day.

Assemblywomen, 248-253

[First Woman]: But what if Kephalos attacks you with abuse—
How will you response to him in the assembly?

[Praksagora]: I will say he’s out of his mind [paraphronein]

[First Woman]: but everyone knows this!

[Praksagora]: then I will also call him psychopathic [lit. ‘black-biled’=melancholic].

[First Woman]: They know this too.

[Praksagora]: But I will add that he produces terrible ceramics and will then do a fine job of doing the same to the city.

ἀτὰρ ἢν Κέφαλός σοι λοιδορῆται προσφθαρείς,
πῶς ἀντερεῖς πρὸς αὐτὸν ἐν τἠκκλησίᾳ;
ΠΡΑΞΑΓΟΡΑ φήσω παραφρονεῖν αὐτόν.
ΓΥΝΗ Α …ἀλλὰ τοῦτό γε
ἴσασι πάντες.
ΠΡΑΞΑΓΟΡΑ ἀλλὰ καὶ μελαγχολᾶν.
ΓΥΝΗ Α καὶ τοῦτ᾿ ἴσασιν.
ΠΡΑΞΑΓΟΡΑἀλλὰ καὶ τὰ τρύβλια
κακῶς κεραμεύειν, τὴν δὲ πόλιν εὖ καὶ καλῶς.

Melancholy here contrasts with “thinking -wrongly” (paraphronein). A scholion to another play by Aristophanes glosses the realms of these types of mental maladies (Schol. ad Plut. 11a ex 20-28)

“He seems to say this because he harmed or helped his master through his own virtue more—and while he disturbed him through prophecy, he made him crazy [melankholan] through medicine and took away his ability to think [phronein] through wisdom, which is the art of thinking. The servant lies. For he does not speak the truth….”

…τοῦτο οὖν
ἔοικε λέγειν, ὅτι διὰ τῶν ἑαυτοῦ
μᾶλλον ἀρετῶν ἔβλαψε τὸν δεσπότην
ἤπερ ὠφέλησε, καὶ διὰ μὲν τῆς
μαντείας ἐτάραξε, διὰ δὲ τῆς ἰατρι-
κῆς μελαγχολᾶν ἐποίησε, διὰ δὲ
τῆς σοφίας, ὅ ἐστι τῆς φρονήσεως,
τοῦ φρονεῖν αὐτὸν ἀφείλατο. ψεύδεται
ὁ δοῦλος· οὐ γὰρ ἀλήθειαν λέγει

Where melancholy denotes a physical ailment [i.e. biologically caused and treated], paraphrosunê indicates parafunctionality which may be treated without medicine.

μελαγχολάω: to be atrabilious, melancholy-mad.

μελαγχολία: atrabiliousness, melancholy, a disease [atual LSJ definition]

παραφροσύνη, ἡ:  wandering of mind, derangment, delirium

παραφρονέω: to be beside oneself, be deranged, or mad.

Lyrica Adespota, fr. 3.9-10

“Lust–that magician–takes me. It descends upon my mind
And makes me crazy!”

῎Ερως μ’ ἔλα]β’ ὁ γόης· εἰς τὴν ψυχήν μου εἰσπε-
σὼν [ποιεῖ μ]ε παραφρονεῖν.

Aristotle, Metaphysics 4.1009b

“In the same way, ‘truth’ concerning the way things appear has come to some people from their senses. They believe that it is right that truth should be judged neither by the multitude or the scarcity [of those who believe it]; and they believe that the same thing seems sweet to some who taste it and bitter to others with the result that if all men were sick or if they were all insane and two or three were healthy or in their right mind, wouldn’t it seem that these few were sick and crazy and not the rest?”

[1] —ὅμοιως δὲ καὶ ἡ περὶ τὰ φαινόμενα ἀλήθεια ἐνίοις ἐκ τῶν αἰσθητῶν ἐλήλυθεν. τὸ μὲν γὰρ ἀληθὲς οὐ πλήθει κρίνεσθαι οἴονται προσήκειν οὐδὲ ὀλιγότητι, τὸ δ᾽ αὐτὸ τοῖς μὲν γλυκὺ γευομένοις δοκεῖν εἶναι τοῖς δὲ πικρόν, ὥστ᾽ εἰ πάντες ἔκαμνον [5] ἢ πάντες παρεφρόνουν, δύο δ᾽ ἢ τρεῖς ὑγίαινον ἢ νοῦν εἶχον, δοκεῖν ἂν τούτους κάμνειν καὶ παραφρονεῖν τοὺς δ᾽ ἄλλους οὔ:

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How Many Drinks?

Because Tuesday is the New Thursday….

Athenaeus, Deipnosophists Book 2 36a-d (=Adesp. com. fr. 101 and Eubulus fr. 93)

Mnêsitheos used to say, “the gods taught mortals
About wine because it is the greatest good
For those who use it correctly, and the opposite for those who don’t.
It gives sustenance to those who use it well,
Strength to their minds and their bodies.
It is also extremely useful for medicine,
Since it is mixed in with other drugs
And provides relief to those who have been wounded.
It also helps in daily gatherings it brings joy
To those who mix it and drink it wisely.
But to those who are excessive it brings outrage.
If you mix it evenly with water, it makes you crazy.
Unmixed, it paralyzes bodies.

“For this reason, Dionysus is called a doctor everywhere. The Pythia told some people to call Dionysus the “Healer”. Euboulos (fr. 93) has Dionysus saying this:

“I prescribe only three bowls of wine
For people of good sense. One is for health,
to drink first. The second is for
Sex and pleasure, and the third is for sleep—
Those who are wise drain that bowl and then
Go home. The fourth isn’t mine any more,
But it belongs to Hubris. And a fifth bowl leads to shouting;
A sixth bowl to street-parties; a seventh for brawls;
An eighth’s for getting arrested; the ninth makes dark bile.
And the tenth is madness to make you hurl […]
A lot of wine poured into a little bottle
Easily throws drunks down on their asses.”

Terracotta kylix (drinking cup), Attributed to the Amasis Painter,Vases
Kylix attributed to the Amasis Painter, ca. 540 BC

<ὁ> Μνησίθεος δ᾿ ἔφη ǁ τὸν οἶνον τοὺς θεοὺς
θνητοῖς καταδεῖξαι τοῖς μὲν ὀρθῶς χρωμένοις
ἀγαθὸν μέγιστον, τοῖς δ᾿ ἀτάκτως τοὔμπαλιν.
τροφήν τε γὰρ δίδωσι τοῖς <εὖ> χρωμένοις
ἰσχύν τε ταῖς ψυχαῖσι καὶ τοῖς σώμασιν.
εἰς τὴν ἰατρικήν τε χρησιμώτατον·
καὶ τοῖς ποτοῖς γὰρ φαρμάκοις κεράννυται,
καὶ τοῖσιν ἑλκωθεῖσιν ὠφελίαν ἔχει.
ἐν ταῖς συνουσίαις τε ταῖς καθ᾿ ἡμέραν
τοῖς μὲν μέτριον πίνουσι καὶ κεκραμένον |
εὐθυμίαν, ἐὰν δ᾿ ὑπερβάλῃς, ὕβριν,
ἐὰν δ᾿ ἴσον ἴσῳ προσφέρῃ, μανίαν ποεῖ·
ἐὰν δ᾿ ἄκρατον, παράλυσιν τῶν σωμάτων.

διὸ καὶ καλεῖσθαι τὸν Διόνυσον πανταχοῦ ἰατρόν. ἡ δὲ Πυθία εἴρηκέ τισι Διόνυσον ὑγιάτην καλεῖν. Εὔβουλος δὲ ποιεῖ τὸν Διόνυσον λέγοντα·

τρεῖς γὰρ μόνους κρατῆρας ἐγκεραννύω
τοῖς εὖ φρονοῦσι· τὸν μὲν ὑγιείας ἕνα,
ὃν πρῶτον ἐκπίνουσι, τὸν δὲ δεύτερον |
ἔρωτος ἡδονῆς τε, τὸν τρίτον δ᾿ ὕπνου,
ὃν ἐκπιόντες οἱ σοφοὶ κεκλημένοι
οἴκαδε βαδίζουσ᾿. ὁ δὲ τέταρτος οὐκέτι ἡμέτερός ἐστ᾿, ἀλλ᾿
ὕβρεος· ὁ δὲ πέμπτος βοῆς·
ἕκτος δὲ κώμων· ἕβδομος δ᾿ ὑπωπίων·
<ὁ δ᾿> ὄγδοος κλητῆρος· ὁ δ᾿ ἔνατος χολῆς·
δέκατος δὲ μανίας, ὥστε καὶ βάλλειν ποεῖ
πολὺς γὰρ εἰς ἓν μικρὸν ἀγγεῖον χυθεὶς
ὑποσκελίζει ῥᾷστα τοὺς πεπωκότας.

 

An eternal question:

 

 

Also, this is a possibility. Look, three drinks! (true story: a friend once ‘invented’ a drinking game which entailed a shot every time the chorus repeated. Not. A. Good. Idea.)

Presocratic Healthcare Plan: Everyone a Doctor, Everyone a Sage

A Letter to Hippocrates: Ps.-Hipp. Epist. 23 (9.392–93 Littré)

“Democritus writes to Hippocrates on the nature of human beings:

“Hippocrates, all people should know the art of medicine, since it it is noble and also advantageous for life and it is a special possession of those people who have deep experience in education and argumentation. I think that the pursuit of wisdom is the sibling and roommate of medicine since wisdom frees the soul of suffering, and medicine rids the body of illnesses.”

Δημόκριτος Ἱπποκράτει περὶ φύσιος ἀνθρώπου.

χρὴ πάντας ἀνθρώπους ἰητρικὴν τέχνην ἐπίστασθαι, ὦ Ἱππόκρατες, καλὸν γὰρ ἅμα καὶ ξυμφέρον ἐς τὸν βίον, τουτέων δὲ μάλιστα τοὺς παιδείας καὶ λόγων ἴδριας γεγενημένους. ἱστορίην σοφίης γὰρ δοκέω ἰητρικῆς ἀδελφὴν καὶ ξύνοικον· σοφίη μὲν γὰρ ψυχὴν ἀναρύεται παθέων, ἰητρικὴ δὲ νούσους σωμάτων ἀφαιρέεται [. . .].

Image from Wikipedia

The Key to a Long Life: Magic (Or Maybe Climate and Diet)

Lucian, Octogenarians 3-5

“Homer claims that Nestor, obviously, the wisest of the Achaians, lived more than three generations, a man the poet explains to us was best trained in both mind and body. And the prophet Teiresis, well tragedy has him living through six generations. It might be credible that a man dedicated to the gods and who followed a reverent diet might live as long as possible.

It is recorded that whole clans of people are very long-lived thanks to their way of life—for example, the people of the Egyptians called holy-authors, the exegetes of myth in Assyria and Arabia, and the people the Indians call Brahmans, men who pursue philosophy with precision. There are also the people called the magoi, that prophetic clan dedicated to the gods among the Persians, Parthians, Bactrians, Khoasmians, Arians, Sacae, Medes, and among many other barbarian people. The magoi are strong and live many years because they learn to use magic and eat with considerable discipline.

There are, in addition, entire peoples who are long-lived: for example, some people record that the Sêres live up to 300 years. According to some authors, this is because of the weather; others claim that it is their soul or their diet that is responsible for the length of their lives—for, they claim that the whole nation drinks only water. It is reported that the people of Athos live 130 years or that the Chaldeans live over a hundred and that they rely on barley bread as a medicine to keep their vision sharp.”

Νέστορα μὲν οὖν τὸν σοφώτατον τῶν Ἀχαιῶν ἐπὶ τρεῖς παρατεῖναι γενεὰς Ὅμηρος λέγει, ὃν συνίστησιν ἡμῖν γεγυμνασμένον ἄριστα καὶ ψυχῇ καὶ σώματι. καὶ Τειρεσίαν δὲ τὸν μάντιν ἡ τραγῳδία μέχρις ἓξ γενεῶν παρατεῖναι λέγει. πιθανὸν δ᾿ ἂν εἴη ἄνδρα θεοῖς ἀνακείμενον καθαρωτέρᾳ διαίτῃ χρώμενον ἐπὶ μήκιστον βιῶναι. καὶ γένη δὲ ὅλα μακρόβια ἱστορεῖται διὰ τὴν δίαιταν, ὥσπερ Αἰγυπτίων οἱ καλούμενοι ἱερογραμματεῖς, Ἀσσυρίων δὲ καὶ Ἀράβων οἱ ἐξηγηταὶ τῶν μύθων, Ἰνδῶν δὲ οἱ καλούμενοι Βραχμᾶνες, ἄνδρες ἀκριβῶς φιλοσοφίᾳ σχολάζοντες, καὶ οἱ καλούμενοι δὲ μάγοι, γένος τοῦτο μαντικὸν καὶ θεοῖς ἀνακείμενον παρά τε Πέρσαις καὶ Πάρθοις καὶ Βάκτροις καὶ Χωρασμίοις καὶ Ἀρείοις καὶ Σάκαις καὶ Μήδοις καὶ παρὰ πολλοῖς ἄλλοις βαρβάροις, ἐρρωμένοι τέ εἰσι καὶ πολυχρόνιοι διὰ τὸ μαγεύειν διαιτώμενοι καὶ αὐτοὶ ἀκριβέστερον. ἤδη δὲ καὶ ἔθνη ὅλα μακροβιώτατα, ὥσπερ Σῆρας μὲν ἱστοροῦσι μέχρι τριακοσίων ζῆν ἐτῶν, οἱ μὲν τῷ ἀέρι, οἱ δὲ τῇ γῇ τὴν αἰτίαν τοῦ μακροῦ γήρως προστιθέντες, οἱ δὲ καὶ τῇ διαίτῃ· ὑδροποτεῖν γάρ φασι τὸ ἔθνος τοῦτο σύμπαν. καὶ Ἀθῴτας δὲ μέχρι τριάκοντα καὶ ἑκατὸν ἐτῶν βιοῦν ἱστορεῖται, καὶ τοὺς Χαλδαίους ὑπὲρ τὰ ἑκατὸν ἔτη βιοῦν λόγος, τούτους μὲν καὶ κριθίνῳ ἄρτῳ χρωμένους, ὡς ὀξυδορκίας τοῦτο φάρμακον·

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The Witch of Endor, by the Master of Otto van Moerdrecht, 15th century

Laughing at Babies

Pseudo-Hippocrates, Letter 9.360 

 “I [Hippocrates] said, “Know that you should explain the reason for your laughter.” And [Democritus], after glaring at me for a bit, said, “you believe that there are two reasons for my laughter, good things and bad things. But I laugh for one reason: the human being. Humans are full of ignorance but empty of correct affairs, acting like babies in their little plots, and also laboring over endless toil without winning any profit.

Humans travel to the ends of the earth and over the uncharted wilds with unchecked desires, minting silver and gold and never stopping in the pursuit of possession, but always throwing a fit for more, so that there’s never one bit less than others have. And then, they are not at all ashamed to call themselves happy.”

[ΙΠ.] “ἴσθι δὲ νῦν περὶ σέο γέλωτος τῷ βίῳ λόγον δώσων.”

ὁ δὲ μάλα τρανὸν ἐπιδών μοι, “δύο,” φησὶ, “τοῦ ἐμοῦ γέλωτος αἰτίας δοκέεις, ἀγαθὰ καὶ φαῦλα· ἐγὼ δὲ ἕνα γελῶ τὸν ἄνθρωπον, ἀνοίης μὲν γέμοντα, κενεὸν δὲ πρηγμάτων ὀρθῶν, πάσῃσιν ἐπιβουλῇσι νηπιάζοντα, καὶ μηδεμιῆς ἕνεκεν ὠφελείης ἀλγέοντα τοὺς ἀνηνύτους μόχθους, πείρατα γῆς καὶ ἀορίστους μυχοὺς ἀμέτροισιν ἐπιθυμίῃσιν ὁδεύοντα, ἄργυρον τήκοντα καὶ χρυσὸν, καὶ μὴ παυόμενον τῆς κτήσιος ταύτης, αἰεὶ δὲ θορυβεύμενον περὶ τὸ πλέον, ὅκως αὐτοῦ ἐλάσσων μὴ γένηται· καὶ οὐδὲν αἰσχύνεται λεγόμενος εὐδαίμων [. . .].”

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Hippocrates: Unmarried Women are Sad Because of Periods

Hippocrates of Cos, On Girls [Peri Parthenôn] 1

“Let’s talk first concerning the disease which is called sacred and paralyzed people and the many anxieties which frighten people seriously enough that they lose their minds and believe that they see evil spirits by night or even at times by die or sometimes on all hours. Many have hanged themselves before because of this kind of vision, more often women than men.

For a woman’s nature is more depressed and sorrowful. And young women, when they are at the age of marriage and without a husband, suffer terribly at the time of their menstruation, which they did not suffer earlier in life. For blood collects later in their uterus so that it may flow out. When, then, the mouth of the exit does not create an opening, the blood pools up more because of food and the body’s growth. When the blood has nowhere to flow, it rises up toward the heart and the diaphragm. When these organs are filled, the heart is desensitized and from this transformation it becomes numb. Madness overtakes women because of this numbness.”

Πρῶτον περὶ τῆς ἱερῆς νούσου καλεομένης, καὶ περὶ τῶν ἀποπληκτικῶν, καὶ περὶ τῶν δειμάτων, ὁκόσα φοβεῦνται ἰσχυρῶς ἄνθρωποι, ὥστε παραφρονέειν καὶ ὁρῆν δοκέειν δαίμονάς τινας ἐφ᾿ ἑωυτῶν δυσμενέας, ὁκότε μὲν νυκτός, ὁκότε δὲ ἡμέρης, ὁκότε δὲ ἀμφοτέρῃσι τῇσιν ὥρῃσιν. ἔπειτα ἀπὸ τῆς τοιαύτης ὄψιος πολλοὶ ἤδη ἀπηγχονίσθησαν, πλέονες δὲ γυναῖκες ἢ ἄνδρες· ἀθυμοτέρη γὰρ καὶ λυπηροτέρη ἡ φύσις ἡ γυναικείη. αἱ δὲ παρθένοι, ὁκόσῃσιν ὥρη γάμου, παρανδρούμεναι, τοῦτο μᾶλλον πάσχουσιν ἅμα τῇ καθόδῳ τῶν ἐπιμηνίων, πρότερον οὐ μάλα ταῦτα κακοπαθέουσαι. ὕστερον γὰρ τὸ αἷμα ξυλλείβεται ἐς τὰς μήτρας, ὡς ἀπορρευσόμενον· ὁκόταν οὖν τὸ στόμα τῆς ἐξόδου μὴ ᾖ ἀνεστομωμένον, τὸ δὲ αἷμα πλέον ἐπιρρέῃ διά τε σιτία καὶ τὴν αὔξησιν τοῦ σώματος, τηνικαῦτα οὐκ ἔχον τὸ αἷμα ἔκρουν ἀναΐσσει ὑπὸ πλήθους ἐς τὴν καρδίην καὶ ἐς τὴν διάφραξιν. ὁκόταν οὖν ταῦτα πληρωθέωσιν, ἐμωρώθη ἡ καρδίη, εἶτ᾿ ἐκ τῆς μωρώσιος νάρκη, εἶτ᾿ ἐκ τῆς νάρκης παράνοια ἔλαβεν.

Hippocrates should have consulted a woman physician like Trotula