Lovesickness: Erasistratus Discovering the Cause of Antiochus

ART AND IMAGES IN PSYCHIATRY

SECTION EDITOR: JAMES C. HARRIS, MD Lovesickness Erasistratus Discovering the Cause of Antiochus’ Disease When the erotic appetite provokes a melancholy brooding, fires the passions, burns the humors and wastes the strengths of the body, love “is not merely behavior resembling sickness, but it is a true disease, virulent, and dangerous.” Battista Fregoso (15th century).1(p3)

ESPAIRING WHEN HIS SON the object of his love was unattainable. The terminology for lovesickness has Prince Antiochus was des- Antiochus’ love could never be grati- changed over time. Erotic melancholy perately ill, Seleucus, king fied because he was in love with Erasis- is not a subtype of mental disorder but of Syria, summoned the tratus’ very own wife. Seleucus quickly erotomania is. Erotomania is the delu- distinguishedD Greek physician Erasistra- sought to persuade Erasistratus to give sional belief that another person, gen- tus (circa 330-255 BC) to diagnose his her up to save his son. The cagey phy- erally of higher social status, is in love malady. Erasistratus and his colleague sician replied “[t]hou art his father and with you. There are primary forms, pure Herophilis from Alexandria in Egypt were yet thou wouldst not have done so if An- erotomania, and secondary forms, part renowned for their medical treatments tiochus had set his affections on [your of a broader psychiatric category (for ex- that were based on their understanding wife] Stratonice´.”3(p95) With great emo- ample, schizophrenia or bipolar disor- of human anatomy and neuroanatomy, tion, the king said that, if heaven would der). When limited to the manic phase, derived from dissecting the bodies of con- redirect his son’s passions, he most gladly it may resolve with drug treatment. demned criminals. Erasistratus is said to would give her up. Erasistratus clasped When co-occurring with schizophre- be the first physiologist, the first to ap- his hand and revealed it was Stratonice´ nia, its prognosis is poor.5 preciate that the heart is a pump, and the who inspired such passion. Antiochus Biological correlates of love are a sub- first to accurately describe the 1-way pas- had chosen to die rather than disclose ject of investigation with neuroimaging. 2 sage of blood through the heart’s valves. his disgraceful secret. Inspired by his Functional magnetic resonance imaging Centuries before William Harvey de- son’s allegiance, Seleucus agreed to give studies present photographs of romantic scribed the circulation of the blood, Eras- up his wife and split his kingdom in two, partnersorchildrentothesubjecttoevalu- istratus recognized how veins and arter- making Antiochus ruler of Upper Asia. ate brain activation. Patterns of brain ac- ies were connected to the heart. Antiochus and Stratonice´ wed in 294 BC. tivation that correlate with romantic love Herophilus, his colleague in Alexan- The painting Erasistratus Discover- differfrommaternallove.Inromanticlove, dria, Egypt, timed the pulse, linked the ing the Cause of Antiochus’ Disease (cover) the regions of the hypothalamus associ- pulse to the beating of the heart, and rec- by the American expatriate Benjamin ated with sexual arousal are activated. ognized its clinical importance. Erasis- West is a sensitive portrayal showing An- These regions are not activated in mater- tratus relied chiefly on hygiene, diet, tiochus lying prostrate in bed.4 A cloaked nallove.Inmaternallove,thefacialregions baths, and exercise (rather than purga- and melancholy King Seleucus sits cra- are specifically activated. Commonly ac- tives and bloodletting) as treatments. He dling his son’s head in his arms. Erasis- tivated regions for the 2 types of love are anticipated psychosomatic medicine in tratus is shown with his left hand on An- in the striatum, part of the reward system observations grounded in anatomy and tiochus’ heart and his right hand feeling of the human brain. In both maternal love physiology and in hypothesis testing. Antiochus’ right wrist for his pulse. While and romantic love, based on the brain re- Erasistratus used his understanding of gions activated, apprehension and social doing so he bids Stratonice´ and her reti- 6 physiology and pulse diagnosis in his di- nue of young women to enter the room. judgment are somewhat suspended! agnosis of Antiochus, who was weak, ema- The quickening of Antiochus’ heartbeat James C. Harris, MD ciated, and near death. Like other physi- and the increase in his pulse when Stra- cians who had examined him, Erasistratus tonice´ enters confirm the diagnosis. REFERENCES found nothing physically wrong with An- The most extensive early examination tiochus. Thus, he suspected a mental of love pathology is Jacques Ferrand’s cause of Antiochus’ suffering. Plutarch, in 1645 classic Erotomania or a Treatise Dis- 1. Ciavolella M. A treatise on lovesickness. Beecher his Lives, describes his diagnostic method: DA, trans. Syracuse, NY: Syracuse University Press; coursing of the Essence, Causes, Symptoms, 1990. Erasistratus perceived quite easily that [An- Prognosticks, and Cure of Love, or Erotique 2. Adler RE. Medical Firsts: From Hippocrates to the 1 tiochus] was in love...[When] any of the Melancholy. Among the preferred cures Human Genome. Hoboken, NJ: John Wiley & Sons, beauties of the court came in, male or female, were sexual intercourse, distraction, de- Inc; 2004. he would study the countenance of Antio- faming the beloved, and drug treatments. 3. Henderson J, ed. Plutarch Lives IX. Perrin B, trans. chus...Whenanyoneelse came in, Antio- Modern-day lovesickness can have Cambridge, MA: Harvard University Press; 1920. chus showed no change; but whenever [his serious consequences. John W. Hinck- 4. Stechow W. “The love of Antiochus with faire Stra- stepmother] Stratonice´ came to see him, as she ley Jr shot President Ronald Reagan to tonica” in art. Art Bull. 1945;27:221-237. doi:10 often did, either alone, or with Seleucus, lo, .2307/3047025. those tell-tale signs [of love]...stammering impress the actress Jodie Foster, hop- 5. Kennedy N, McDonough M, Kelly B, Berrios GE. speech, fiery flushes, . . . palpitations ....3(p93-97) ing to use this historical deed to gain her Erotomania revisited: clinical course and treatment. respect and love. Later, he was to pro- Compr Psychiatry. 2002;43(1):1-6. Erasistratus told the old king that his claim that this was “the greatest love of- 6. Zeki S. The neurobiology of love. FEBS Lett. 2007; son’s diagnosis was lovesickness, but that fering in the history of the world.” 581(14):2575-2579.

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