“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.’
“This work is about that disease which people call “sacred”. It does not seem to me to be more divine or more sacred than any of the rest of the diseases, but it also has a natural cause and people have assumed it is sacred because of their own inexperience and their considerable wonder over how different it seems to them.”
“Those who first claimed that the disease is divinely caused seem to me to be something like the wizards, snake-oil salesmen, faith-healers, and quacks of today, those kinds of men who pretend to great piety and superior knowledge. These kinds of healers shelter themselves and use superstition as a shield against their own helplessness when they have nothing they can do to help. They claim that this affliction is sacred so it won’t be clear that they don’t know anything. They add a ready-made story and throw in a treatment in order to keep their own position strong.”
As Vivian Nutton makes clear in the overview of Mental Illness in the Ancient World (available in Brill’s New Pauly), Hippocrates Breaks from Ancient Near Eastern and Early Greek tradition here in offering physical explanations for mental illness of all kinds instead of divine explanations. Platonic and Aristotelian traditions follow with variations on somatism (the body as the cause), adding in addition to the humors, bile, and disharmony among the organs, habits (excessive consumption, actions) and environments. These approaches were refined by Hellenistic doctors and the work of Rufus and Galen where treatments also came to include psychotherapeutic as well as the physical treatments. The swing towards demonic possession as an explanation during Late Antiquity and the Christian middle ages took mental health approaches back towards the ‘sacred’ explanations of pre-rational antiquity.
Some other posts about mental health from antiquity. Oftentimes translators keep the ancient Greek term melancholy (“black bile”)
Epictetus, Treatises Collected by Arrian, 2.15: To those who cling tenaciously to any judgments they have made
“Whenever some people hear these words—that it is right to be consistent, that the moral person is free by nature and never compelled, while everything else may be hindered, forced, enslaved, subjected to others—they imagine that it is right that they maintain every judgment they have made without compromising at all.
But the first issue is that the judgment should be a good one. For, if I wish to maintain the state of my body, it should be when it is healthy, well-exercised. If you show me that you have the tones of a fevered mind and brag about it, I will say ‘Dude, look for a therapist. This is not health, but sickness.’ “
“Furthermore, for these things it is believed that their opposites are born from fear, just as in hatred of women as in the Misogunos of Atilius or that against the whole race of humankind which we have heard that Timon who is called the Misanthrope felt or even being inhospitable. All these diseases of the soul develop from a special fear of those things which people fear and then hate. They define a disease of the soul, moreover, as a vehement belief about a thing which is not desired even though it is anticipated powerfully, a belief which is constant and deeply held.”
Quae autem sunt his contraria, ea nasci putantur a metu, ut odium mulierum, quale in Μισογύνῳ Atilii1 est, ut in hominum universum genus, quod accepimus de Timone, qui μισάνθρωπος appellatur, ut inhospitalitas est: quae omnes aegrotationes animi ex quodam metu nascuntur earum rerum, quas fugiunt et oderunt. Definiunt autem animi aegrotationem opinationem vehementem de re non expetenda, tamquam valde expetenda sit, inhaerentem et penitus insitam.
“Moderation was missing from this enthusiastic person in two ways. He did not know how to take a break from work nor how to start it again. When he brought himself to write, the days used to join with nights and he was pushing himself mercilessly without a break, stopping only when he was completely worn out. But when he stopped then, he would lose himself in every kind of game and distraction. Indeed, when he entrusted himself to the forest and the mountains, he was the equal to those born to the forests and mountains, those wild men, in endurance of labor and expertise of the hunt. He was so completely engaged with the embrace of that lifestyle that he could scarcely be dragged back to his former life.
But when he did get himself under control and took himself from alluring leisure, he used to fall into his studies with such passions that he seemed not so much to have lost nothing as to have gained much.
It is clear that everyone benefits from a mental vacation—energy is gathered in leisure and all the sadness which is developed through endless pursuit of work can be dispelled though the enjoyment of distractions. But no one benefited more from a vacation than Latro. Every time he used to speak after a break, he would speak more sharply and with more force—he used to glory in how his mind was refreshed and his strength made whole. And he would squeeze as much from himself as he desired. He did not know how to portion out his powers—but he was a master of unrestrained tyranny—his eagerness had to be stopped because it was not able to be controlled…”
In utramque partem vehementi viro modus deerat: nec intermittere studium sciebat nec repetere. Cum se ad scribendum concitaverat, iungebantur noctibus dies, et sine intervallo gravius sibi instabat, nec desinebat nisi defecerat: rursus cum se remiserat, in omnes lusus, in omnes iocos se resolvebat; cum vero se silvis montibusque tradiderat, in silvis ac montibus natos, homines illos agrestis, laboris patientia et venandi sollertia provocabat, et in tantam perveniebat sic vivendi cupiditatem ut vix posset ad priorem consuetudinem retrahi. At cum sibi iniecerat manum et se blandienti otio abduxerat, tantis viribus incumbebat in studium ut non tantum nihil perdidisse sed multum adquisisse desidia videretur. Omnibus quidem prodest subinde animum relaxare; excitatur enim otio vigor, et omnis tristitia, quae continuatione pertinacis studii adducitur, feriarum hilaritate discutitur: nulli tamen intermissio manifestius proderat. Quotiens ex intervallo dicebat, multo acrius violentiusque dicebat; exultabat enim <animo>2 novato atque integro robore, et tantum a se exprimebat quantum concupierat. Nesciebat dispensare vires suas, sed inmoderati adversus se imperii fuit, ideoque studium eius prohiberi debebat quia regi non poterat…
Seneca the Younger, De Tranquillitate Animi, 5
“Our minds must be allowed a break—once rested, they will rise better and sharper. Just as fertile fields must not be overworked—for endless productivity will exhaust them soon—so too continuous work crushes the force of our minds; but rested and relaxed they restore their own powers. Weakness and weariness are born to minds from constant efforts.”
Danda est animis remissio; meliores acrioresque requieti surgent. Ut fertilibus agris non est imperandum—cito enim illos exhauriet numquam intermissa fecunditas,—ita animorum impetus adsiduus labor franget, vires recipient paulum resoluti et remissi; nascitur ex assiduitate laborum animorum hebetatio quaedam et languor.
Bonus Quotation
Fragments of Dio Chrysostom, Stob. Flor. 4, XIX
“It is right, then, to be be proper master and to permit those who want to rest sometimes. For breaks are preparation for toil—the both, the lyre and human kind become their best through resting.”
“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.’
“And the affair followed and these were my fears, leaving me with a desire for nothing but death. And my conversations with everyone nearby were about this as were my prayers to the gods. One who mentioned baths was my enemy; anyone who mentioned dinner was my enemy.
And I fled in exile from the books which contained the classical texts of my toil; I fled from writing and composition of my lectures. I lost my ability to speak even though my students were shouting for me. Whenever I tried, I was taken off track like a boat facing an opposing wind. Even though they harbored hopes of hearing me, I still went silent. My doctors were telling me to seek healing somewhere else because there were no medicines for these kinds of ills in their craft.”
“Furthermore, for these things it is believed that their opposites are born from fear, just as in hatred of women as in the Misogunos of Atilius or that against the whole race of humankind which we have heard that Timon who is called the Misanthrope felt or even being inhospitable. All these diseases of the soul develop from a special fear of those things which people fear and then hate. They define a disease of the soul, moreover, as a vehement belief about a thing which is not desired even though it is anticipated powerfully, a belief which is constant and deeply held.”
Quae autem sunt his contraria, ea nasci putantur a metu, ut odium mulierum, quale in Μισογύνῳ Atilii1 est, ut in hominum universum genus, quod accepimus de Timone, qui μισάνθρωπος appellatur, ut inhospitalitas est: quae omnes aegrotationes animi ex quodam metu nascuntur earum rerum, quas fugiunt et oderunt. Definiunt autem animi aegrotationem opinationem vehementem de re non expetenda, tamquam valde expetenda sit, inhaerentem et penitus insitam.
“Moderation was missing from this enthusiastic person in two ways. He did not know how to take a break from work nor how to start it again. When he brought himself to write, the days used to join with nights and he was pushing himself mercilessly without a break, stopping only when he was completely worn out. But when he stopped then, he would lose himself in every kind of game and distraction. Indeed, when he entrusted himself to the forest and the mountains, he was the equal to those born to the forests and mountains, those wild men, in endurance of labor and expertise of the hunt. He was so completely engaged with the embrace of that lifestyle that he could scarcely be dragged back to his former life.
But when he did get himself under control and took himself from alluring leisure, he used to fall into his studies with such passions that he seemed not so much to have lost nothing as to have gained much.
It is clear that everyone benefits from a mental vacation—energy is gathered in leisure and all the sadness which is developed through endless pursuit of work can be dispelled though the enjoyment of distractions. But no one benefited more from a vacation than Latro. Every time he used to speak after a break, he would speak more sharply and with more force—he used to glory in how his mind was refreshed and his strength made whole. And he would squeeze as much from himself as he desired. He did not know how to portion out his powers—but he was a master of unrestrained tyranny—his eagerness had to be stopped because it was not able to be controlled…”
In utramque partem vehementi viro modus deerat: nec intermittere studium sciebat nec repetere. Cum se ad scribendum concitaverat, iungebantur noctibus dies, et sine intervallo gravius sibi instabat, nec desinebat nisi defecerat: rursus cum se remiserat, in omnes lusus, in omnes iocos se resolvebat; cum vero se silvis montibusque tradiderat, in silvis ac montibus natos, homines illos agrestis, laboris patientia et venandi sollertia provocabat, et in tantam perveniebat sic vivendi cupiditatem ut vix posset ad priorem consuetudinem retrahi. At cum sibi iniecerat manum et se blandienti otio abduxerat, tantis viribus incumbebat in studium ut non tantum nihil perdidisse sed multum adquisisse desidia videretur. Omnibus quidem prodest subinde animum relaxare; excitatur enim otio vigor, et omnis tristitia, quae continuatione pertinacis studii adducitur, feriarum hilaritate discutitur: nulli tamen intermissio manifestius proderat. Quotiens ex intervallo dicebat, multo acrius violentiusque dicebat; exultabat enim <animo>2 novato atque integro robore, et tantum a se exprimebat quantum concupierat. Nesciebat dispensare vires suas, sed inmoderati adversus se imperii fuit, ideoque studium eius prohiberi debebat quia regi non poterat…
Seneca the Younger, De Tranquillitate Animi, 5
“Our minds must be allowed a break—once rested, they will rise better and sharper. Just as fertile fields must not be overworked—for endless productivity will exhaust them soon—so too continuous work crushes the force of our minds; but rested and relaxed they restore their own powers. Weakness and weariness are born to minds from constant efforts.”
Danda est animis remissio; meliores acrioresque requieti surgent. Ut fertilibus agris non est imperandum—cito enim illos exhauriet numquam intermissa fecunditas,—ita animorum impetus adsiduus labor franget, vires recipient paulum resoluti et remissi; nascitur ex assiduitate laborum animorum hebetatio quaedam et languor.
Bonus Quotation
Fragments of Dio Chrysostom, Stob. Flor. 4, XIX
“It is right, then, to be be proper master and to permit those who want to rest sometimes. For breaks are preparation for toil—the both, the lyre and human kind become their best through resting.”
“Finally, what do you prefer that she was sane or insane while she was writing? You claim sane? Therefore, she was not under the influence of occult arts. You will say she was insane? In that case, she was unconscious of what she wrote and must not be trusted. Or, more to the case, if she had been insane, she would not have known that she was insane.
For, it is like when someone is not silent because he says he is silent and by the utterance itself undermines his own claim. But saying “I’m crazy” betrays someone even more because it is not true unless he says it without understanding. The person is sane, moreover, who knows what insanity is; and, certainly, insanity cannot know itself any more than blindness can see itself.
Therefore, Prudentilla was sound in mind, if she did not think she was sound in mind. I could add more, if I wanted to, but I will leave philosopher behind now.”
Postremo quid vis: sanam an insanam fuisse, dum scriberet? Sanam dices? Nihil ergo erat magicis artibus passa. Insanam respondebis? Nesciit ergo quid scripserit, eoque ei fides non habenda est; immo etiam, si fuisset insana, insanam se esse nescisset. Nam ut absurde facit qui tacere se dicit, quod ibidem dicendo tacere sese non tacet et ipsa professione quod profitetur infirmat, ita vel magis hoc repugnant, “ego insanio,” quod verum non est, nisi sciens dicit. Porro sanus est, qui scit quid sit insania, quippe insania scire se non potest, non magis quam caecitas se videre; igitur Pudentilla compos mentis fuit, si compotem mentis se non putabat. Possum, si velim, pluribus, sed mitto dialectica
MS of Pseudo-Apuleius Platonicus, De medicaminibus herbarum liber, England 12th century. British Library, Harley 5294, fol. 43r
This and the following passage are from Plutarch’s On Whether Sickness of the Body or Mind Are Worse (Moralia 500 ff). The following (especially the last line of the first paragraph) appears to perpetuate the stigmatizing of mental illness. And it does: many behaviors we today would see as parafunctional and requiring therapy, ancient authors viewed as issues of will.
“Just as, therefore, the storm which keeps you from docking is more dangerous than the one that won’t let you sail, the storms of the soul are worse when they do not allow a person to control or put down his troubled thoughts—this person goes without a helmsman, without ballast in confusion and wandering, taking off in steep and opposite courses until suffering a harrowing shipwreck and crushing his life. This is why it is worse to suffer sickness of mind than the body: For those who are sick, merely suffer; the sick of mind suffer and harm others.
But why is it necessary to repeat the great number of afflictions? Current events remind me of them. Do you see this immense, mix up crowd which clings together and mixes around the seat of government and the market?”
