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Melancholia and Mania: the Historical Contributions of Aretaeus of Cappadocia and Emil Kraepelin

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Melancholia and Mania: the Historical Contributions of Aretaeus of Cappadocia and Emil Kraepelin University of Calgary PRISM: University of Calgary's Digital Repository Graduate Studies The Vault: Electronic Theses and Dissertations 2020-04-27 Melancholia and Mania: The Historical Contributions of Aretaeus of Cappadocia and Emil Kraepelin Marlier, Krystal Marlier, K. (2020). Melancholia and Mania: The Historical Contributions of Aretaeus of Cappadocia and Emil Kraepelin ( Unpublished master's thesis). University of Calgary, Calgary, AB. http://hdl.handle.net/1880/111923 master thesis University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. Downloaded from PRISM: https://prism.ucalgary.ca UNIVERSITY OF CALGARY Melancholia and Mania: The Historical Contributions of Aretaeus of Cappadocia and Emil Kraepelin by Krystal Marlier A THESIS SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS GRADUATE PROGRAM IN GREEK AND ROMAN STUDIES CALGARY, ALBERTA APRIL, 2020 © Krystal Marlier 2020 Abstract Two millennia ago, Aretaeus of Cappadocia, a physician from the first to second century CE, first presented a modern portrayal of the relationship between μανίη (mania) and μελαγχολίη (melancholia). His understanding is reflective of the nineteenth-century German clinician, Emil Kraepelin. I propose that Kraepelin and Aretaeus possess more similarities than differences. They were homologous in research techniques and nosology, with one significant difference in aetiology. Presently, Aretaeus’ classification remains recognized in psychiatry, though with a slight deviation in understanding and under different psychiatric labels. Likewise, Kraepelin’s classifications remain highly influential in current clinical practices. Aretaeus’ De Causis et Signis Diuturnorum Morborum (On the Causes and Symptoms of Chronic Diseases) and Kraepelin’s eighth edition of Psychiatrie: Ein Lehrbuch für Studierende und Ärzte (Psychiatry: A Manual for Students and Physicians) will be examined. By critically analyzing these writers, I intend to illustrate a remarkable continuity in the history of manic-depressive insanity. ii Acknowledgements My deepest gratitude goes first to my supervisor Dr. Peter Toohey, for his trusting guidance through both my undergraduate and graduate education. For his invaluable knowledge, and for editing multiple drafts of this thesis, scholarship applications, and conference papers. He has kept me sane in many moments of anxiousness and uncertainty. I wish to thank the faculty and staff of the Department of Classics and Religion (CLARE) for their support. Thank you to the members of my examining committee, Dr. Reyes Bertolín Cebrián and Dr. Hank Stam for their constructive feedback. Special thanks to Dr. Lesley Bolton, for lending an ear and offering sound advice; and to Professor Dr. Eric Engstrom of Humboldt- Universität for his aid through email correspondences and for meeting with me in Berlin, Germany. Many thanks also to Dr. Bertolín Cebrián, for your aid with German translations; to Mr. James Hume, for your graceful teachings of Ancient Greek; to Dr. Lindsay Driediger- Murphy for your encouragement and the invaluable treasured experiences; to Dr. Stam for your insights and honesty; to Dr. Frank Stahnisch for your encyclopedic knowledge; to Dr. Caterina Pizanias for showing me Greek culture and arts; and to Dr. Britta Leise of the Max-Planck Institut für Psychiatrie for granting access to observe the original sources of Emil Kraepelin. I would like to acknowledge the financial and institutional support for my MA research that I received from the Queen Elizabeth II Graduate Scholarship, the University of Calgary, and CLARE. Finally, I wish to thank my parents for their support in the pursuit of this passion. Mum, thank you for taking me to the library as a toddler and entertaining my wish to spend hours hidden in the stacks reading ancient civilization books. Extended thanks to Mimi and Greg for checking in, coming to visit, and for the numerous tasty treats you have fed me over the years. iii Dedication For my grandfather T.V.H, in memoriam— It is that time of year where I can completely dissolve into melancholy without regrets. iv Table of Contents Abstract .......................................................................................................................................... ii Acknowledgements ...................................................................................................................... iii Dedication ..................................................................................................................................... iv Table of Contents .......................................................................................................................... v Abbreviations, Texts Used, and Footnotes ............................................................................... vii List of Tables .............................................................................................................................. viii List of Figures ............................................................................................................................. viii Chapter 1: Introduction ............................................................................................................... 9 1.1 A Brief History of Melancholia ........................................................................................ 12 1.2 A Brief History of Mania .................................................................................................. 20 Chapter 2: Emil Kraepelin ......................................................................................................... 26 2.1 Biography ........................................................................................................................... 26 2.1.1 Dorpat, Estonia (1886-1891) ....................................................................................... 35 2.1.2 Heidelberg University (1891-1903).............................................................................. 38 2.1.3 Munich (1903-1917) ..................................................................................................... 42 2.2 Editions of Psychiatrie ....................................................................................................... 46 2.3 Manic-Depressive Insanity (MDI) ................................................................................... 52 2.3.1 Manic States ................................................................................................................. 55 2.3.2 Depressive States .......................................................................................................... 58 v 2.3.3 Mixed States .................................................................................................................. 62 2.4 Aetiology ............................................................................................................................. 64 Chapter 3: Aretaeus of Cappadocia .......................................................................................... 69 3.1 Biography ........................................................................................................................... 69 3.2 Translations and Use in Current Medical Scholarship ................................................. 73 3.3 On Causes and Symptoms of Chronic Diseases ................................................................ 75 3.3.1 Melancholia .................................................................................................................. 76 3.3.2 Transitionary Phase ..................................................................................................... 77 3.3.3 Mania ............................................................................................................................ 78 3.4 Aetiology ............................................................................................................................. 82 Chapter 4: Bringing it all Together ........................................................................................... 85 4.1 Conclusion .......................................................................................................................... 99 Bibliography .............................................................................................................................. 102 Appendices ................................................................................................................................. 110 Appendix A: Kraepelin’s Zählkarten ................................................................................... 110 Appendix B: Aretaeus’ Case Studies ................................................................................... 120 vi Abbreviations, Texts Used, and Footnotes Abbreviations Aret. Aretaeus of Cappadocia SD De Causis et Signis Diuturnorum Morborum (On Causes and Symptoms in Chronic Diseases) DSM Diagnostic and Statistical Manual(s) of Mental Disorders Aret., SD 1.5.1 (Adams, 299) Hude’s Greek of Aretaeus, SD book.chapter.section (equivalency in Adam’s translation, page number) Texts Used Aretaeus (Ancient Greek) Hude, K.,
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