Taking the Cure in Isolation

Apuleius, Metamorphoses 4.1

“Around noon, when the sun’s flame was already hot, we turned off in some village to the home of some old men known well to the thieves. This was easy to understand for even a donkey thanks to the prolonged conversation and shared kisses. They also gave some gifts to them which I had carried on my back and seemed to relate that they were obtained through theft with secret whispers. Once we were unburdened of every bag, they left us to amble and eat in a field next to the home.

But I was not really drawn to a pastoral communion with either the ass or my old horse and I was also not quite used to eating grass. I could see a garden on the other side of the stable, so I broke into it, already wracked by hunger. I filled my stomach immediately with those vegetables, even though they were raw, and I was saying a little prayer to all the gods as I looked around the place, hoping I might find the light of rose bushes in the nearby gardens.

This isolation was providing me confidence I did not have before, if once I was away from the road and hidden by bushes, I could eat the medicine and rise from the curved-hoof of four-footed pack animal to stand straight like a man, while no one was looking.”

Diem ferme circa medium, cum iam flagrantia solis caleretur, in pago quodam apud notos ac familiares latronibus senes devertimus. Sic enim primus aditus et sermo prolixus et oscula mutua quamvis asino sentire praestabant. Nam et rebus eos quibusdam dorso meo depromptis munerabantur, et secretis gannitibus quod essent latrocinio partae videbantur indicare. Iamque nos omni sarcina levatos in pratum proximum passim libero pastui tradidere. Nec me cum asino vel equo meo compascuus coetus attinere potuit, adhuc insolitum alioquin prandere faenum; sed plane pone stabulum prospectum hortulum iam fame perditus fidenter invado, et quamvis crudis holeribus affatim tamen ventrem sagino, deosque comprecatus omnes cuncta prospectabam loca, sicubi forte conterminis in hortulis candens reperirem rosarium. Nam et ipsa solitudo iam mihi bonam fiduciam tribuebat, si devius et frutectis absconditus, sumpto remedio, de iumenti quadripedis incurvo gradu rursum erectus in hominem inspectante nullo resurgerem.

Nicolai Abildgaard – Fotis sees her Lover Lucius Transformed into an Ass. Motif from Apeleius’ The Golden Ass

Know-nothings, Faith-healers, and Quacks: Mystifying and Abusing Mental Illness

Hippocrates of Cos, The Sacred Disease 1 and 2

“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.”

[…]

Περὶ τῆς ίερῆς νούσου καλεομένης ὧδ᾿ ἔχει. οὐδέν τί μοι δοκεῖ τῶν ἄλλων θειοτέρη εἶναι νούσων οὐδὲ ἱερωτέρη, ἀλλὰ φύσιν μὲν ἔχει καὶ πρόφασιν, οἱ δ᾿ ἄνθρωποι ἐνόμισαν θεῖόν τι πρῆγμα εἶναι ὑπὸ ἀπειρίης καὶ θαυμασιότητος, ὅτι οὐδὲν ἔοικεν ἑτέροισι·

“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.”

Ἐμοὶ δὲ δοκέουσιν οἱ πρῶτοι τοῦτο τὸ νόσημα ἱερώσαντες τοιοῦτοι εἶναι ἄνθρωποι οἷοι καὶ νῦν εἰσι μάγοι τε καὶ καθάρται καὶ ἀγύρται καὶ ἀλαζόνες, οὗτοι δὲ καὶ προσποιέονται σφόδρα θεοσεβέες εἶναι καὶ πλέον τι εἰδέναι. οὗτοι τοίνυν παραμπεχόμενοι καὶ προβαλλόμενοι τὸ θεῖον τῆς ἀμηχανίης τοῦ μὴ ἔχειν ὅ τι προσενέγκαντες ὠφελήσουσι, καὶ ὡς μὴ κατάδηλοι ἔωσιν οὐδὲν ἐπιστάμενοι, ἱερὸν ἐνόμισαν τοῦτο τὸ πάθος εἶναι· καὶ λόγους ἐπιλέξαντες ἐπιτηδείους τὴν ἴησιν κατεστήσαντο ἐς τὸ ἀσφαλὲς σφίσιν αὐτοῖσι,

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”)

Galen says loss of speech is not melancholy

Women, misogyny, and suicide

Lykanthropy as a type of melancholy

Hippocrates on melancholic desire for isolation

Hippocrates and Galen on hallucination and depression

The positive side of delusion

Aristotle on Mind-body connection

Music for healing mental affliction

Galen on the use of narcotics

Celsus on abusive treatments for mental illness

Seneca and Epictetus on Sick Days for Mental Health

Seneca and Plutarch on Whether Peace of Mind Helps

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.’ “

ιε′. Πρὸς τοὺς σκληρῶς τισιν ὧν ἔκριναν ἐμμένοντας.

῞Οταν ἀκούσωσί τινες τούτων τῶν λόγων, ὅτι βέβαιον εἶναι δεῖ καὶ ἡ μὲν προαίρεσις ἐλεύθερον φύσει καὶ ἀνανάγκαστον, τὰ δ’ ἄλλα κωλυτά, ἀναγκαστά, δοῦλα, ἀλλότρια, φαντάζονται ὅτι δεῖ παντὶ τῷ κριθέντι ὑπ’ αὐτῶν ἀπαραβάτως ἐμμένειν. ἀλλὰ πρῶτον ὑγιὲς εἶναι δεῖ τὸ κεκριμένον. θέλω γὰρ εἶναι τόνους ἐν σώματι, ἀλλ’ ὡς ὑγιαίνοντι, ὡς ἀθλοῦντι· ἂν δέ μοι φρενιτικοῦ τόνους ἔχων ἐνδεικνύῃ[ς] καὶ ἀλαζονεύῃ ἐπ’ αὐτοῖς, ἐρῶ σοι ὅτι ‘ἄνθρωπε, ζήτει τὸν θεραπεύσοντα. τοῦτο οὐκ εἰσὶ τόνοι, ἀλλ’ ἀτονία’.

 

Image result for ancient greek asclepius relief
Hygeia [“Health”] and her father Asklepios Taken from Pinterest

The Need for a Serious Friend or a Committed Enemy

Plutarch, Progress in Virtue 81f-82b

“When they need healing, people who have tooth pain or a stubbed toe go to doctors while those who have a fever ask them to come to their homes and help them. But people who fall into melancholy or a frenzy or hallucinations often cannot handle doctors visiting them and either urge them to leave or chase them off because they do not perceive that they are sick thanks to the severity of their sickness.

This is true as well of those who seriously fuck up. The people who cannot be cured are those who behave hatefully and cruelly and turn mean to those who try to correct them or help them. Those who endure and even welcome help do better. It is no small sign of progress when someone who is screwing up listens to those who try to correct them, to explain what the problem is, to reveal weakness and not to take pleasure in hiding mistakes or in them not being known but to admit them and the need to be held and advised by someone else. 

That’s why Diogenes says somewhere that for the sake of safety a person should be concerned about finding either a serious friend or a committed enemy, to escape wickedness either through direct critique or kind assistance.”

Τῶν τοίνυν δεομένων ἰατρείας οἱ μὲν ὀδόντα πονοῦντες ἢ δακτυλον αὐτόθεν βαδίζουσι παρὰ τοὺς θεραπεύοντας, οἱ δὲ πυρέττοντες οἴκαδε καλοῦσι καὶ δέονται βοηθεῖν, οἱ δ᾿ εἰς μελαγχολίαν ἢ φρενῖτιν ἢ παρακοπὴν ἥκοντες οὐδὲ φοιτῶντας ἐνιαχοῦ πρὸς αὐτοὺς ἀνέχονται, ἀλλ᾿ ἐξελαύνουσιν ἢ φεύγουσιν, μηδ᾿ ὅτι νοσοῦσιν ὑπὸ τοῦ σφόδρα νοσεῖν αἰσθανόμενοι. οὕτω δὴ καὶ τῶν ἁμαρτανόντων ἀνήκεστοι μέν εἰσιν οἱ πρὸς τοὺς ἐλέγχοντας καὶ νουθετοῦντας ἐχθρῶς καὶ ἀγρίως διατιθέμενοι καὶ χαλεπαίνοντες· οἱ δ᾿ ὑπομένοντες καὶ προσιέμενοι πραότερον ἔχουσι. τὸ δ᾿ ἑαυτὸν ἁμαρτάνοντα παρέχειν τοῖς ἐλέγχουσι καὶ τὸ πάθος λέγειν καὶ τὴν μοχθηρίαν ἀποκαλύπτειν καὶ μὴ χαίρειν λανθάνοντα μηδ᾿ ἀγαπᾶν ἀγνοούμενον ἀλλ᾿ ὁμολογεῖν καὶ δεῖσθαι τοῦ ἁπτομένου καὶ νουθετοῦντος οὐ φαῦλον ἂν εἴη προκοπῆς σημεῖον. ὥς που Διογένης ἔλεγε τῷ σωτηρίας δεομένῳ ζητεῖν προσήκειν ἢ φίλον σπουδαῖον ἢ διάπυρον ἐχθρόν, ὅπως ἐλεγχόμενος ἢ θεραπευόμενος ἐκφεύγοι τὴν κακίαν. 

Joseph Stevens, “Enemies” 1854

The Weakness of Bodies and the Strength to Be Better

Basil, Letter 195

“Please understand that our own situation is no more endurable than it usually is. It is enough to say this and point to the weakness of our bodies. When it comes to the overwhelming sickness that dominates us, it is not easier to illustrate it with words or to be persuaded by fact whether or not I have suffered any kind of sickness greater than what you have known yourself. Ah, it is God’s job to provide us with the ability to endure the hits to our body sent by the Lord to make us better.”

Τὰ δὲ ἡμέτερα μηδὲν ἀνεκτότερα γίνωσκε τῆς συνηθείας εἶναι. ἀρκεῖ δὲ τοσοῦτον εἰπεῖν, καὶ ἐνδείξασθαί σοι τοῦ σώματος ἡμῶν τὴν ἀσθένειαν. τὴν γὰρ νῦν κατέχουσαν ἡμᾶς εἰς τὸ ἀρρωστεῖν ὑπερβολήν, οὔτε λόγῳ ἐνδείξασθαι ῥᾷδιον, οὔτε ἔργῳ πεισθῆναι, εἴπερ ἐκείνων, ὧν αὐτὸς ᾔδεις, εὑρέθη τι πλεῖον παρ᾿ ἡμῖν1 εἰς ἀρρωστίαν. Θεοῦ δὲ τοῦ ἀγαθοῦ ἔργον δοῦναι ἡμῖν δύναμιν, πρὸς τὸ ἐν ὑπομονῇ φέρειν τὰς ἐπὶ συμφέροντι ἡμῖν ἐπαγομένας εἰς τὸ σῶμα πληγὰς παρὰ τοῦ εὐεργετοῦντος ἡμᾶς Κυρίου.

Two Years and then Some More: A Plague’s Retreat and Return

Thucydides, Peloponnesian War 3.87

“As winter started coming on, the disease afflicted the Athenians a second time—even though it hadn’t totally disappeared before, there was still a period of relief. Then it lingered no less than a year when the first encounter was two. The overall result was that nothing overwhelmed the Athenians and sapped their power more than this.

No fewer than 4400 hoplites died from the ranks along with three hundred cavalry. And the number of the rest of the masses that died was never discovered.”

Τοῦ δ’ ἐπιγιγνομένου χειμῶνος ἡ νόσος τὸ δεύτερον ἐπέπεσε τοῖς ᾿Αθηναίοις, ἐκλιποῦσα μὲν οὐδένα χρόνον τὸ παντάπασιν, ἐγένετο δέ τις ὅμως διοκωχή. παρέμεινε δὲ τὸ μὲν ὕστερον οὐκ ἔλασσον ἐνιαυτοῦ, τὸ δὲ πρότερον καὶ δύο ἔτη, ὥστε ᾿Αθηναίους γε μὴ εἶναι ὅτι μᾶλλον τούτου ἐπίεσε καὶ ἐκάκωσε τὴν δύναμιν· τετρακοσίων γὰρ ὁπλιτῶν καὶ τετρακισχιλίων οὐκ ἐλάσσους ἀπέθανον ἐκ τῶν τάξεων καὶ τριακοσίων ἱππέων, τοῦ δὲ ἄλλου ὄχλου ἀνεξεύρετος ἀριθμός.

The famous plague is described at 2.47-55 and first fell on the Athenians in 430 BCE. Three years later, after a respite, it returned.

The tenth plague: the death of the first-born including Pharaoh’s son. From the Haggadah for Passover (the ‘Sister Haggadah’). 2nd or 3rd quarter of the 14th century. British Library

Just Think Your Way Out of Sickness!

For more on plagues and leadership, see this post.

Aelian, Varia Historia 13.27

“Remember that Socrates’ body was thought to be orderly and in control of wisdom for this reason too. When the Athenians were suffering a pandemic and some were dying and others were near death, Socrates was the only one who was not sick. What mind do we think shared space with such a body?”

Ὅτι τὸ Σωκράτους σῶμα πεπίστευτο κόσμιον καὶ σωφροσύνης ἐγκρατὲς γεγονέναι καὶ ταύτῃ. ἐνόσουν Ἀθηναῖοι πανδημεί, καὶ οἱ μὲν ἀπέθνῃσκον, οἱ δὲ ἐπιθανατίως εἶχον, Σωκράτης δὲ μόνος οὐκ ἐνόσησε τὴν ἀρχήν. ὁ τοίνυν τοιούτῳ συνὼν σώματι τίνα ἡγούμεθα ἐσχηκέναι ψυχήν;

Apollonius of Tyana, 8.28

“Do these practices merely make a refinement of the senses or establish power over the greatest and most amazing forces? You need to see what I mean from different things, not the least of which were done during that epidemic in Ephesus.

When the disease was in the shape of an old beggar, I saw it and once I saw it I tackled it. I did not stop the disease but instead I destroyed it. The one I prayed to is clear as day in the temple which I built in thanks. It was for Herakles the Defender, the one I chose as a helper—because he is wise and brave, he once cleansed Elis of a plague and wiped away the waves of filth which the earth released when Augeas was tyrant.”

“Ἆρ᾿ οὖν τὸ οὕτως διαιτᾶσθαι λεπτότητα μόνον ἐργάζεται τῶν αἰσθήσεων ἢ ἰσχὺν ἐπὶ τὰ μέγιστά τε καὶ θαυμασιώτατα; θεωρεῖν δ᾿ ἔξεστιν ὃ λέγω καὶ ἀπ᾿ ἄλλων μέν, οὐχ ἥκιστα δὲ κἀκ τῶν ἐν Ἐφέσῳ περὶ τὴν νόσον ἐκείνην πραχθέντων· τὸ γὰρ τοῦ λοιμοῦ εἶδος, πτωχῷ δὲ γέροντι εἴκαστο, καὶ εἶδον καὶ ἰδὼν εἷλον, οὐ παύσας νόσον, ἀλλ᾿ ἐξελών, ὅτῳ δ᾿ εὐξάμενος, δηλοῖ τὸ ἱερόν, ὃ ἐν Ἐφέσῳ ὑπὲρ τούτου ἱδρυσάμην, Ἡρακλέους μὲν γὰρ Ἀποτροπαίου ἐστί, ξυνεργὸν δ᾿ αὐτὸν εἱλόμην, ἐπειδὴ σοφός τε καὶ ἀνδρεῖος ὢν ἐκάθηρέ ποτε λοιμοῦ τὴν Ἦλιν, τὰς ἀναθυμιάσεις ἀποκλύσας, ἃς παρεῖχεν ἡ γῆ κατ᾿ Αὐγέαν τυραννεύοντα.

File:Philosopher probably Apollonius of Tyana Heraklion museum original.jpg
Statue of a philosopher, probably Apollonius of Tyana. Late 2nd – 3rd century AD.

The Poor are Always Sick

Sophocles, fr. 354 [perhaps from the Creusa]

“Don’t be at all surprised that I hold on to my money,
Lord, Even mortals who have immense wealth
Still clutch to profits when humans put everything
In second place after money.
Some people envy the person who isn’t sick.
But no poor person seems healthy to me—the poor are always sick.”

καὶ μή τι θαυμάσῃς με τοῦ κέρδους, ἄναξ,
ὧδ᾿ ἀντέχεσθαι. καὶ γὰρ οἳ πλοῦτον μακρὸν
θνητῶν ἔχουσι, τοῦ γε κερδαίνειν ὅμως
ἀπρὶξ ἔχονται, κἄστι πρὸς τὰ χρήματα
θνητοῖσι τἆλλα δεύτερ᾿. εἰσὶ δ᾿ οἵτινες
αἰνοῦσιν ἄνοσον ἄνδρ᾿· ἐμοὶ δ᾿ οὐδεὶς δοκεῖ
εἶναι πένης ὢν ἄνοσος, ἀλλ᾿ ἀεὶ νοσεῖν.

Fr. 256

“The most noble thing is to be just.
The best thing is to live without sickness.
But the most pleasurable is to have the power
To take what you want every day.”

κάλλιστόν ἐστι τοὔνδικον πεφυκέναι,
λῷστον δὲ τὸ ζῆν ἄνοσον, ἥδιστον δ᾿ ὅτῳ
πάρεστι λῆψις ὧν ἐρᾷ καθ᾿ ἡμέραν

Asclepius arrives in Kos, Greeted by Hippocrates

Take Care of Yourself, For Me!

Cicero, Lettters 16.14

Tully Greets Tiro,

Andricus got here a day later than I was anticipating so I had a night full of fear and worry. I am not even a little bit clearer from your letters about how you’re doing, but I am still relieved. I have no bit of pleasure, nothing to read I can really touch before I see you.

Command that the doctor receive however much he demands! I have written as much to Ummius. I gather that your mind is exhausted and that this is why you’re sick. If you care anything about me, resurrect your love of literature and the life of the mind that makes me love you. You need a strong mind to help your body heal and I beg you to get it back as much as for me as for you. Keep Acastus there to look after you. Save yourself for me! The day of my promise is almost here. If you come, I will be there in person.

Again, and again, take care of yourself.

TULLIUS TIRONI S.

Andricus postridie ad me venit quam exspectaram; itaque habui noctem plenam timoris ac miseriae. tuis litteris nihilo sum factus certior quo modo te haberes, sed tamen sum recreatus. ego omni delectatione litterisque omnibus careo, quas ante quam te videro attingere non possum.

Medico mercedis quantum poscet promitti iubeto. id scripsi ad Ummium. audio te animo angi et medicum dicere ex eo te laborare. si me diligis, excita ex somno tuas litteras humanitatemque, propter quam mihi es carissimus. nunc opus est te animo valere ut corpore possis. id cum tua tum mea causa facias a te peto. Acastum retine, quo commodius tibi ministretur. conserva te mihi. dies promissorum adest, quem1 etiam repraesentabo si adveneris.

Etiam atque etiam vale.

Comfort in Literature in the Face of Disease and Death

Pliny, Letters 8.19

“I have so much joy and comfort in literature that there’s nothing that can’t be made happier because of it and there’s nothing sad enough to detract from its effect. I am so troubled by the sickness of my wife and the danger to my household, even the threat of death, that I have fled to my study as the only distraction from pain. I may sense my troubles more in this way but I yet bear them more easily. 

It is my custom, however, to test on my friends’ judgment–especially yours– anything I intend to circulate publicly. So, if you have ever before done so, please examine the book which you are receiving with this letter, since I fear that have focused too poorly because of my sorrow. I was able to overcome my grief enough to write, but I could not do it with a light and happy spirit. For happiness to come from study, study must arise from joy.  Goodbye”

Et gaudium mihi et solacium in litteris, nihilque tam laetum quod his laetius, tam triste quod non per has minus triste. Itaque et infirmitate uxoris et meorum periculo, quorundam vero etiam morte turbatus, ad unicum doloris levamentum studia confugi, quae praestant ut adversa magis intellegam sed patientius feram. Est autem mihi moris, quod sum daturus in manus hominum, ante amicorum iudicio examinare, in primis tuo. Proinde si quando, nunc intende libro quem cum hac epistula accipies, quia vereor ne ipse ut tristis parum intenderim. Imperare enim dolori ut scriberem potui; ut vacuo animo laetoque, non potui. Porro ut ex studiis gaudium sic studia hilaritate proveniunt. Vale.

Rattenberg (Tyrol). Augustine museum – Memento-mori-painting ( 1694 ) from Kitzbühl – detail with inscription: “All skulls are signed but one; write your name on it, it is yours.”

Two Years and then Some More: A Plague’s Retreat and Return

Thucydides, Peloponnesian War 3.87

“As winter started coming on, the disease afflicted the Athenians a second time—even though it hadn’t totally disappeared before, there was still a period of relief. Then it lingered no less than a year when the first encounter was two. The overall result was that nothing overwhelmed the Athenians and sapped their power more than this.

No fewer than 4400 hoplites died from the ranks along with three hundred cavalry. And the number of the rest of the masses that died was never discovered.”

Τοῦ δ’ ἐπιγιγνομένου χειμῶνος ἡ νόσος τὸ δεύτερον ἐπέπεσε τοῖς ᾿Αθηναίοις, ἐκλιποῦσα μὲν οὐδένα χρόνον τὸ παντάπασιν, ἐγένετο δέ τις ὅμως διοκωχή. παρέμεινε δὲ τὸ μὲν ὕστερον οὐκ ἔλασσον ἐνιαυτοῦ, τὸ δὲ πρότερον καὶ δύο ἔτη, ὥστε ᾿Αθηναίους γε μὴ εἶναι ὅτι μᾶλλον τούτου ἐπίεσε καὶ ἐκάκωσε τὴν δύναμιν· τετρακοσίων γὰρ ὁπλιτῶν καὶ τετρακισχιλίων οὐκ ἐλάσσους ἀπέθανον ἐκ τῶν τάξεων καὶ τριακοσίων ἱππέων, τοῦ δὲ ἄλλου ὄχλου ἀνεξεύρετος ἀριθμός.

The famous plague is described at 2.47-55 and first fell on the Athenians in 430 BCE. Three years later, after a respite, it returned.

The tenth plague: the death of the first-born including Pharaoh’s son. From the Haggadah for Passover (the ‘Sister Haggadah’). 2nd or 3rd quarter of the 14th century. British Library