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Epilepsy in Ancient Greek Medicine---The Vital Step

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Epilepsy in Ancient Greek Medicine---The Vital Step View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Seizure 2000; 9: 12–21 doi: 10.1053/seiz.1999.0332, available online at http://www.idealibrary.com on Epilepsy in ancient Greek medicine—the vital step JAMES LONGRIGG Formerly Reader in Ancient Philosophy & Science, University of Newcastle, UK Correspondence to: Linden Lodge, High Hamsterley Road, Hamsterley Mill, Rowlands Gill, Tyne & Wear, NE39 1HD, UK EPILEPSY IN ANCIENT GREEK MEDICINE: ‘possessed’ the sick man’s body. To do so he employed THE VITAL STEP prayers, supplications, spells and incantations. Surviv- ing Egyptial medical papyri, like the Hearst and Ebers In the opening paragraph of his book, The Falling Sick- Papyrus, consist largely of prescriptions of drugs in- ness: A History of Epilepsy from the Greeks to the Be- terspersed with magical spells which were believed to ginnings of Modern Neurology1, Temkin writes as fol- impart efficacy to the prescriptions they follow. Many lows: of the remedies prescribed contain noxious or offen- sive ingredients to make them as unpalatable as pos- Diseases can be considered as acts or sible to the possessing spirit and so give it no induce- invasions by the gods, demons, or evil ment to linger in the patient’s body. spirits, and treated by the invocation of The ancient Babylonians, too, lived in a world supposedly supernatural powers. Or they haunted by evil spirits. Whenever they fell ill they be- were considered the effects of natural lieved that they had been seized by one of these spirits. causes and are consequently treated by Those afflicted sought for aid to bring about a return to natural means. In the struggle between the their previous condition. The healer’s function was to magic and the scientific conception the help them achieve this end by removing the cause of latter has gradually emerged victorious their illness. Patients were required to atone for their in the western world. The fight has been sins and the angry god has to be placated. The treat- long and eventful, and in it epilepsy held ment involved the employment of ritual involving sac- one of the key positions. Showing both rifice and incantations. physical and psychic symptoms, epilepsy A recently translated cuneiform text preserves in- more than any other disease was open to valuable evidence of Babylonian views regarding the interpretation both as a physiological pro- nature of epilepsy. Here we are presented with an ac- cess and as the effect of spiritual influ- curate and comprehensive description of many famil- ences. iar features of an epileptic seizure2: In this paper I propose to concentrate upon the struggle mentioned here by Temkin and shall en- 12. [If at the time] of his fit [the deavour to describe the social and intellectual influ- patient] loses consciousness and foam ences that brought about the vital step-forward that led comes from his mouth, it is miqtu [diur- some medical authors in fifth century Greece to regard nal epilepsy]. epilepsy, notwithstanding its striking and alarming 13. [If at the time] of his fit he loses con- symptoms, as a disease due to purely natural causes. sciousness and his arms and legs bend Although our evidence of early medicine in ancient round to the same side as his neck, it is Egypt and Mesopotamia is in an incomplete and frag- miqtu. mentary state, it is nevertheless possible to draw some general conclusions from it. It is clear that the physi- 14. If at the time of his fit. takes hold of cian in these societies considered diseases to be signs him and foam comes from his mouth, an of divine displeasure and caused by the intrusion of [unfulfilled] vow made by his father has a demon. The primary purpose of the physician was seized him. He [the child] will die. to appease the god or drive out the demon which had 15. If at the time of his fit after it has 1059–1311/00/010012 + 10 $35.00/0 c 2000 BEA Trading Ltd Epilepsy in ancient Greek medicine—the vital step 13 taken hold of him foam comes from his the Heroic Age regarding disease and the operation of mouth,—hand of Lilu.¨ remedies employed to effect a cure, were, like those 16. If at the end of his fit when his of their ancient Egyptian and Mesopotamian counter- limbs become relaxed again his bowels parts, permeated with belief in magic and the supernat- are sometimes seized and he has a motion, ural. As the Roman encyclopaedist Cornelius Celsus it is ‘hand of ghost’ [nocturnal epilepsy]. later declared, ‘morbos. ad iram deorum immortal- ium relatos esse’. (On medicine, Proem, 4), diseases 17–18. If at the end of his fit his limbs were attributed to the wrath of the gods—although become paralysed, he is dazed [or dizzy], here the gods, for the most part, act directly and not his abdomen is ‘wasted’ [sc. as of one in through the intermediary of demons or evil spirits. In need of food] and he returns everything the first book of the Iliad, for example, the plague which is put into his mouth. - hand of a which attacks the Greek army besieging Troy is sent ghost who has died in a mass killing. He by Apollo in punishment for Agamemnon’s arrogant will die. treatment of his priest Chryses, who had come to the 19–22. If at the end of his fit his limbs Greek camp to try to ransom his captured daughter: become paralysed, [the demon] ‘pouring The arrows rattled on the shoulders of out’ upon him so much that he loses con- the angry god when he moved and his trol [of his functions]; if when he thus coming was like the night. Then he sat ‘pours out’ upon him his eyes are red down apart from the ships and let fly a and his face expressionless; if his ser’anu- shaft. Terrible was the twang of the silver vessels pulsate at a quickened rate and he bow. He attacked the mules first and the cries although the tips of his fingers and swift dogs, but then he loosed his pierc- toes remain cold; if when the exorcist asks ing shafts upon the men themselves and the sick person to repeat [a prayer] he re- shot them down and continually the pyres peats what he says to him, but after [the of the dead thickly burned. For nine days demon] has let him go he does not know the missiles of the god ranged throughout what he said, - hand of Lilu-la’bi.¨ the host. 3 23. If before his fit a half of his body is ‘heavy’ for him and pricks him, and after- The same superstitious attitude towards epilepsy is wards he has a fit with loss of conscious- also to be found in Classical Greece. Our best evidence ness and he loses control [of his func- of this is afforded by the Hippocratic treatise, On the tions], it is miqtu. At midday it will be Sacred Disease, whose author mounts a vigorous at- most serious for him. tack upon witch-doctors, faith-healers, charlatans and quacks who claim that epilepsy has a sacred charac- 24–25. If before his fit he suffers from ter and who regard manifestations of mental disease frontal headaches and is emotionally up- generally as due to supernatural causation4: set, and afterwards he. [..] his hands and feet, [and] rolls from side to side [on the In my opinion those who first attributed ground] without deviation [of the eyes] or a sacred character to this disease were foam[ing at the mouth], it is a fall due to the sort of people we nowadays call emotional shock, or ‘hand of Ishtar’. He witch-doctors, faith-healers, charlatans will recover. and quacks. These people also pretend to 26. If when he has his fit [the fallen per- be very pious and to have superior knowl- son] is looking sideways or the whites of edge. Shielding themselves by citing the his eyes deviate to the side, and blood divine as an excuse for their own per- flows from his mouth, for female [pa- plexity in not knowing what beneficial tients] it is Lilu,¨ and for male, Lilˆıtu. treatment to apply, they held this condi- tion to be sacred so that their ignorance Sakikku 12–26. might not be manifest. By choosing suit- able terms they established a mode of Our unknown Babylonian, however, unequivocally treatment that safeguarded their own po- maintains elsewhere: ‘if epilepsy falls once upon a per- sitions. They prescribed purifications and son [or falls many times], [it is (as a result of) posses- incantations. sion] by a demon or a departed spirit.’ Our earliest literary sources for the history of Greek Our author also attacks as charlatans those who di- medicine are the epic works of Homer and Hesiod agnose manifestations of mental disease as due to su- which clearly reveal that the views of the Greeks of pernatural causation5: 14 J. Longrigg Men in need of a livelihood contrive and This so-called ‘Sacred Disease’ is due embroider many fictions of all sorts with to the same causes as other diseases, to regard to this disease and many other mat- the things that come to and go from the ters, putting the blame for each kind of body, to cold and sun and changing rest- complaint upon a particular god. If the pa- less winds. These things are divine so that tient acts like a goat, if he roars, or has there is no need to put the disease in a spe- convulsions on his right side, they say that cial class and to consider it more divine the Mother of the Gods is responsible.
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