Psychiatry

Interpersonal and Biological Processes

ISSN: 0033-2747 (Print) 1943-281X (Online) Journal homepage: http://www.tandfonline.com/loi/upsy20

A Study of Mental Disorder in Ancient Greek

Culture

George W. Kisker

To cite this article: George W. Kisker (1941) A Study of Mental Disorder in Ancient Greek Culture,
Psychiatry, 4:4, 535-545, DOI: 10.1080/00332747.1941.11022366

To link to this article: http://dx.doi.org/10.1080/00332747.1941.11022366

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 A Study of Mental Disorder in Ancient Greek
Culture
George W. Kisker*

M ODERN psychiatry and the study of psychopathological manifestations of

behavior represent the third period of a series which began with pre-historic
man and which followed a tortuous, and stormy, path to our present age of relative
enlightenment. The first of these periods may be considered to have had its beginnings
in the primitive beliefs of archaic man, reaching its culmination with the medical
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teachings of Hippocrates and, as an epicrisis, with the theories and practices of Galen.l
The second era includes the many centuries following the influence of Galen and his
students, and is brought to a close at the end of the eighteenth century with the
appearance of Pinel and Esquirol in France, and Tuke in England. 2 It is to these
men that the credit for the dawn of modern psychiatry is due. The unchaining of the
insane wretches from the filthy, disease ridden cribs of the Salpetriere and the
Bicetre will forever represent, in medical psychology, the triumph of rationalism over
superstitions and prejudices born of fear and ignorance.
The present discussion will concern itself with the first of these three periods,
directing the major portion of its attention to mental diseases with reference to
ancient Greek civilization, but making occasional excursions into temporally and
spatially related cultures. Little reference is made to madness in the ancient Egyptian
works and the knowledge which we have of the Hebrews comes to us by way of the
Sacred Scriptures. Nothing is known of the subject with reference to the early
Chinese cultures, although the Vagadasastir of the Brahmins is laden with demono-
logical concepts which have a direct bearing upon our problem. s

A consideration of the possible sources the prevalence of insanity among the

of material, particularly with reference to Greeks of the pre-Christian era. The work
systematic studies of mental disease in is characterized by a lack of classification
ancient cultures, reveals that, in the past and organization, finding its chief value in
century, only five significant studies have its primacy more than in its actual con-
been made, none of which were instituted tribution. Thomee points out that mad-
or carried out by investigators in medi- ness in the ancient Greek world was more
cine or in psychology. The first of these
common than had been supposed, basing
studies was published in 1830 by Thomee
his conclusion on the numerous accounts
as a dissertation at the University of
of feigned insanity. He suggests that
Bonn. 4 This quasi-medical work devotes
approximately one-fifth of its content to melancholia was more common than
either mania or amentia, and emphasizes
• Thomee, .Johann Heinrich, Historia Insanorum the importance of the unstable economic
apud Grrecos; University of Bonn Dissertation, 1830
(113 and vi pp.). conditions and the climatic conditions of
* B.A. Ohio State University 39; M.A. Ohio State University 40; Rsc. Asst. Psychology Longview State
Hospital 32; Headmaster, Miami Beach Private Day School 33·38; Rsc. Psychologist Columbus State HospItal
38-40; In~tl'. 01110 Stut" UHlv"l'~ll.Y 4041. Ful.' hIlJlill/5I'('l.hy, Il':,(, Reference List~ ~ecti()n of thil!l it;~ue.
1 Conklin, E. S., Principles of Abnormal Psychology; New York, Henry Holt, 1927 (xiv and 627 pp.);
pp. 495·500.
• Tuke, D. H., Chapters on the History of the Insane in the British Isles; London, Kegan Paul, Trench,
1882 (x and 548 pp.) •
• Park, Roswell, An Epitome of the History of Medicine; New York, F. H. Davis, 1901 (xiv and 370 pp.);
p.4.
[535 ]
 536
Greece in the retiology of these mental
states. In this connection, he attributes
Hesiod's morose disposition to the un-
favorable climate of Breotia. Thomee
mentions both lycanthropy and boan-
thropy, the latter of which includes the
tales of the Bacchantes, of Orpheus and
of Pentheus. Reference is made to the
frenzy of Heracles, of Athamas, of Ajax
and to the delusion of Thrasyllus, in addi-
tion to the recounting of the story of
Dionysus being driven mad by Hera.
Cleomenes and Apollodorus are cited as
being instances of pathological intoxi-
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cation.
The second work worthy of mention is
that of Semelaigne, published in 1869. 5
The volume consists of six chapters, the
first five of which deal with the period of
Hippocrates, the age of the Alexandrine
physicians, and the Grreco-Roman period.
The sixth chapter deals with the legisla-
tive aspect of the problem.
The next important work on the subject
is that of Tambornino which appeared in
1909. 6 The volume is confined almost en-
tirely to the theory of possession, most
of which deals with the Christian theory.
A part of the work, however, bears di-
rectly on the Greek period. Tambornino
tells us that, in the Greek mind, madness
was to be expected in those in whom
"subitus pavor," attributed to Pan, was
aroused; participants in the orgiastic cele-
brations of Dionysus, Sabazus, the Great
Mother, and others; prophets, who were
considered to be filled with divine afflatus;
poets; all those who deviated in any pro-
nounced way from the normal course of
life. Tambornino considers the most im-
portant divinities of possession to be the
diseases themselves. In this connection,
he mentions Mania, Lyssa and Febris as
being personified diseases.
In 1919, a dissertation by Vaughan 1 ap-
peared in which a comprehensive account
of the popular beliefs concerning madness
is given along with an analysis of mad-
5 Semelaigne, Rene, Etudes Historiques sur l'Alie-
nation Mentale dans l'Antiquite; Paris, Asselin, 1869
(000 pp.).
• Tambornino, J., De Antiquorum Dromonismo;
Giessen, Topelmann, 1909 (112 pp.).
• Vaughan, Agnes C., Madness in Greek Thought
and Custom; Baltimore, J. H. Furst, 1919 (14 pp.).
GEORGE W. KISKER
ness in its relation to Greek religion and
society. This work was followed in 1924
by that of O'Brien-Moore,8 a study of un-
usual scholarliness which makes a de-
tailed investigation into references to
madness as they occur in Greek literature.
This author points out that the actual
historical cases of insanity are extremely
limited. The madness of Cambyses, 9 Cle-
omenes,lO Cotys of Thrace,ll Dionysus of
Syracuse, 12 the young man spoken of by
Horace,ls Thrasyllus, the Athenian who
regarded all the ships of the Pirreus as
his own,14 the matricide mentioned in a
rescript of Marcus Antonius,15 Phemonoe,
the priestess at Delphi,16 a person men-
tioned by Aretreus who imagined himself
a brick,11 the case of persistent delirium
mentioned by Hippocrates, and also the
phobia mentioned by the same writer,18
and an actor who went temporarily insane
while enacting Ajax,19 account for almost
the entire list of direct references to men-
tal disease in the historical persons of the
period. It becomes necessary, then to
investigate our subject through indirect
channels.
Without adequate case history, it is
quite futile to attempt to describe mental
maladies of more than two millenniums
past in terms of present day syndromes.
It must be recognized that mental dis-
eases, to a far greater extent than somatic
diseases, are overlapping in their symp-
tomatologies. None of the reports of
mental illness in ancient peoples are
sufficiently detailed to allow us to make
even the most tentative diagnoses, despite
the fact that such hypothetical diagnoses
are tempting and have appeared in the
literature from time to time. This implicit
difficulty in no way invalidates the study
but necessarily operates as a restraining
factor.
8 O'Brien-Moore, Ainsworth, Madness in Ancient
Literature; Weimar, Wagner Sohn, 1924 (228 pp.).
1.• Herodotus,
11
III, 30.
Herodotus, VI, 15.
Athenreus, XII, 42.
1. Diodorus Siculus, XV, 73.
" Horace, Epistulae; II, 2, 128.
H Mlian, Varia Historia; IV, 25.
10 Digest I, 18, 14.
16 Lucan, Pharsalia; V, 123.
I f Aretreus, De Causis et Signis Morborum Din-
t-wrnOTUm; I. S.
18 Hippocrates, De Affectionibus Internis; 48.
19 Lucian, De Saltatione; 83-84.
 PERSONALITY DISORDER AND HISTORY
Abnormality is a concept of broad and
often confusing implications. By its very
nature, since normality implies abnor-
mality, unusual behavior is a correlative
of the life of every organism and of every
natural process. Perfect regularity of be-
havior is unthinkable, and if attained,
would paradoxically become irregular.
The task of determining what is normal
and what is abnormal becomes increas-
ingly difficult when viewed in this light.
The problem presents a certain circularity
which is at once disconcerting and stimu-
lating. That many aspects of abnormal
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behavior are culturally defined, is unques-
tionable. The prederastic practices of the
Classical Period, while never achieving
full societal sanction, nevertheless were
implicitly condoned and appeared less ab-
normal than similar practices in our con-
temporary culture. Cultural organization
may determine both the direction and the
extent of abnormality.
The early historical periods, in virtually
all cultures, were characterized by the
concept of supernatural possession. Per-
sons exhibiting unusual behavior patterns
were considered to be the victims of the
fury of the gods. The anthropomorphism
of primitive man, which led him to read
spirits and divinities into the inanimate
world in order to explain it, also operated
to explain unusual behavior by allowing
him to recognize the possibility of angry
spirits lodging themselves in man himself.
This most primitive mechanism existed
in a relatively pure form from early man
down through the historical period. Its
tremendous hold on the popular mind is
att.ested to by the fact that this same
mechanism, after having been attacked
vigorously by Hippocrates and Galen, re-
appeared with increased vigor in the
witch crazes of the sixteenth and seven-
teenth centuries and exists endemically to
this day in a wide range of contemporary
cultural organizations.
The earliest references to personality
deviations are to be found in biblical
literature, in the social, artistic and politi-
cal history of Greece, and finally, in the
cuneiform writings of Chaldeans, in
primitive statuary, and in the bas-reliefs
amI lira wIngs of other anc1ent peoples.
3
537
Through the Bible we know that the
ancient Semitic tribes considered madness
to be a direct visitation from heaven and
more specifically, the possession of an
individual by an evil spirit or demon.
Mark 1-32 tells us that, "They brought
unto him all that were diseased and them
that were possessed with devils." In
Matthew 10-18 we find, "Heal the sick,
cleanse the lepers, raise the dead, cast
out the devils." Similarly, Matthew 8-16
states, "They brought unto him many
that were possessed with devils; and he
cast out the spirits with his word, and
healed all that were sick." Saul-1097-
1058 B.C.-was troubled by such an evil
spirit. After he failed to carry out fully
a divine injunction to slay every living
thing of a neighboring tribe, an evil spirit
from the Lord troubled him. It is inter-
esting to note that before his death by
suicide, Saul's condition was alleviated by
the music of David's harp. Saul's disorder
seems to have been of a recurrent type.
At times he exhibited melancholia, sus-
piciousness and mutism while at other
times he was apparently in a highly ex-
cited state, with a violent, impulsive tem-
per and homicidal urges. At such times
he indulged in ecstatic logorrhcea. Job,
like Saul, was troubled with a demon
while Nebuchadrezzar-601-561 B.C.-
was the victim of a mental malady closely
resembling the Greek lycanthropy, in
which the affected persons were described
as being hollow eyed, dry tongued, and
extremely pale. Supposedly, they fancied
themselves wolves and went about at
night, howling and digging at graves. The
first reports of this condition are said to
have originated in Argos from whence it
spread throughout Europe and endured
for many centuries.
From the cuneiform writings, bas-re-
liefs, and statuary of other early peoples,
we obtain an occasional glimpse of ancient
psychopathology. Most important is the
fact that trephining the skull was an
established practice from the earliest
times. The significance of this fact proba-
bly lies in the same direction as that of
trephining in present day primitive tribes
where the operation is performed to allow
the evil spirit to escape from the body.
 538
Turning to the continental Greek cul-
ture, we find that any understanding of
the period with which we are concerned
is based necessarily upon some knowledge
of the development and extension of philo-
sophical thought from the time of Thales
down to the time of Hippocrates. Many
important concepts concerning the abnor-
mal are implicit in the doctrines of the
period. Thales of Miletus is usually re-
ferred to as the first of the true philoso-
phers for it was he who first sought to
explain nature in terms of nature itself.
Prior to his time, explanations of man,
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nature, and the universe, were made in
terms of mythology and race traditions.
Such a condition has an analogy in certain
contemporary primitive cultures where
all natural phenomena are explained on
a restricted, ethnocentric basis. In such
cultures, traditional explanations are sel-
dom challenged. Thales, who has left no
written works, departed from the tradi-
tional approach in concluding that the
ultimate reality in nature is water, thus
turning men's minds to nature itself
rather than to mythological dicta. Closely
following Thales was Pythagoras of
Samos-580-497 B.C.-who introduced a
more formal, mystic doctrine. While none
of his writings are extant, it was he who
describes the ultimate reality in terms of
a harmony of numbers or a number rela-
tionship. His belief in the significance of
such relationships was consuming and he
succeeded in firing a large school of fol-
lowers with his basic conceptions. With
the Pythagorean school we find also an
extension of the doctrine of metempsy-
chosis, or the transmigration of souls from
man to other men or to animals. Pythag-
oras himself claimed to remember his
earlier incarnations. This doctrine, pro-
mulgated throughout the world in the
Hindu idea of Rebirth, in the Jewish
Cabbala, and in the Shiite sect of the
Moslems, was destined to play an impor-
tant role in later conceptions of abnormal
behavior.
The next person of major importance in
Greek thought is Heraclitus of Ephesus-
536-470 B.C.-who denied the reality of
permanence and contended that the one
reality is change, as exemplified in fire.
GEORGE W. KISKER
He considered the Soul to be a fiery vapor
and in so doing, was in complete accord
with the Patristic philosophers of the
early church. They, too, thought of the
Soul as a fiery vapor and declared this
vapor to be the breath of God. In states
of intense religious ecstacy, these church
fathers declared they could see their own
souls as well as the souls of others. Here
we see the mechanics of visual hallucina-
tion, a condition which, considering the
number of references to visions, was not
uncommon.
About this time, there loomed an im-
posing figure on the Greek horizon in the
form of Herodotus of Halicarnassus-480-
425 B.C. Herodotus has been referred to
as the father of history, and in many
respects such a position is justified despite
the fact that he considered his history as
a branch of literature, and in so doing,
was more concerned with the artistic
arrangement of his material than with its
exactness and directness. His conception
of history was a dramatic conception and
his energies were directed towards the
entertainment and amusement of his
audience. His contributions, however, are
no less valuable because of this direction
of his own interests, for the roots of re-
corded history are to be found in his
work.
We are now brought to the period of
Anaxagorus and Empedocles, both of
whom were, in part, contemporaries of
Hippocrates. The principles of these men
were, however, laid down before the
works of Hippocrates and thus might be
considered as belonging to the pre-Hippo-
cratic period. Anaxagorus maintained
that there was a vast number of elements,
in fact, one for every sense quality. Thus,
there was considered to be an element of
wetness, an element of heat, an element
of density, of each color, and of every
other known sense quality. Anaxagorus
proceeded to explain the nature of various
objects on the basis of differences in the
combinations of the prindprll elements.
This interpretation was modified by
Empedocles who narrowed the infinite
number of elements postulated by Anax-
agorus to the four fundamental elements
of fire, air, ertrt.h, rtnrl w::Jter. Different
 PERSONALITY DISORDER AND HISTORY
objects consisted of combinations of these
four basic elements in different propor-
tions. This conception was still further
elaborated and modified in the more ex-
tensive works of Hippocrates.
The medical conception of madness, as
opposed to the popular and literary con-
ceptions, was an outgrowth of this early
philosophical thinking, on the one hand,
and biological tendencies of such men as
Anaximander of Miletus and others.
Anaximander suggested that living crea-
tures arose from the moist element as it
was evaporated by the sun. Man, in turn,
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was born from animals of another species,
probably of the fishes in which human
beings developed until they reached a
stage where they were able to take care
of themselves. When this time arrived,
man was cast upon the shore. 20 Taylor has
pointed out that this early biology was
free from superstition, admitting neither
magic nor supernatural power and allow-
ing but a minimum of religious awe. 21 It
was this trend which persevered through
the more philosophical writings of Anax-
agorus, Democritus and others who al-
lowed biological considerations and medi-
cal doctrines to find their way into their
work.
It is to Hippocrates that we must turn
if we are to understand the processes by
which the naturalistic conception of mad-
ness arose. The physiology of Hippocrates
is too well known to warrant elaboration
at this point. For him, the organism was
composed of the four humours-phlegm,
yellow bile, black bile, and blood. 22 Dis-
ease and sickness was thought of in terms
of an imbalance or a disturbance of these
four humours which in turn were c9m-
posed of the four qualities of hot, cold,
dry and moist. Later, during the time of
Galen, more subtle differentiations were
made in the humours with the concomi-
tant development of a theory of tempera-
ments. While Hippocrates did not ex-
plicitly expound a theory of tempera-
ments, such a system is implied through
his work.
20 Burnet, John, Early Greelc Philosophy; London,
Black, 1920 (Ix and 375 pp.).
"-' Taylor, Henry Osborn, Greek Biology and M edi-
c'lno; Hoston, Mm'8hal! Jonou, 1022 (xv and 151 pp.).
•• Hippocratci3, Dc Nattwa IIominis; 4.
539
During this same period, physicians
outside of Greece, particularly those of
Egypt and Babylonia, were unable to
divorce themselves from religion and
astrology. Natural causation was neither
welcomed nor accepted by them. Disease
was considered a demoniacal manifesta-
tion as we have already seen with refer-
ence to the Semitic tribes. In this con-
nection, it is worth noting that, while
physical disease was readily accepted
by the early Greek physicians as being
due to natural causes, the same attitude
towards mental disorder was slower in
gaining a foothold. It was not until Hip-
pocrates' tract, On the Sacred Disease ap-
peared that a vigorous attempt was made
to show that the convulsive, epileptoid
disorder was no different from other dis-
eases. 23 This work marks the peak of the
effort to explain mental abnormality in
terms of material elements operating in
accordance with natural laws. It also
represents the culmination of the humour
theories of the Hippocratics and the
atomistic doctrines of the Methodici.
In the Hippocratic corpus, the book on
Epilepsy is the most important from the
standpoint of mental disease. It contains
many interesting observations, case his-
tories, and sound diagnoses. In the pre-
Hippocratic books of the Hippocratic
corpus-those which are thought to have
antedated the actual writings of Hippoc-
rates but which evidently belonged to
the same school-there is reference, in
several of the medical propositions, to
word-deafness and word-blindness follow-
ing cerebral hemorrhage, and also refer-
ence is made to a psychotic state associ-
ated with the menses. Oliver 24 suggests
that this condition resembled the halluzi-
natorische Verworrenheit of Meynert and
the Irresein bei Absuten Krankheiten of
Kraepelin. Kempf 25 would call the condi-
tion one of catatonic or hebephrenic
dis sociation.
Of the more generally accepted Hippo-
23 Adams, Francis, Genuine Works of IIippocrates;
Baltimore. WilliamR and WilkinR, 1fl!'lfl (x and 384
pp.).
.. Oliver, J. R., The P~ychiatI'Y of Hippocrates.
Amer. J. l'sychtatry (UJ:l5) 5:107-115.
." ICempf, I!ldward J., r~ychopathology; ::H. Loui~,
C. V. Mu~by, 1928 (.l<..l<.111 amI 762 pp.) .
 540
cratic books-those which bear the im-
print of a single man's personality-the
Prognostic contains a description of the
teeth grinding which is so common in pro-
longed manic-depressions and paranoid
states. In the Sacred Disease, Hippoc-
rates emphasizes the point that the con-
dition, which presumably was epilepsy, is
based upon a humoral pathology. In this
case, the disease is caused by a faulty
circulation of the humours within the
brain. In this statement we find the first
inclination to localize mental disease
within the brain. While Hippocrates has
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given an excellent description of the
clinical manifestations of epilepsy, espe-
cially with regard to convulsive behavior,
his systematic treatment of the subject
was hampered by a lack of anatomical
and physiological information. General-
izing with reference to the period, it may
be said that while clinical descriptions
and observations were excellent, the ana-
tomical knowledge of the time was highly
superficial and the physiological concepts
were almost entirely fanciful. While
Hippocrates, in contra-distinction to the
anti-Hippocratics, localized intelligence in
the brain, his functional interpretations
are valuable only in a historical light.
The brain was thought to execute a con-
trol over the excretion of superfluous
fluids and to distribute these fluids to
other portions of the body. The retention
of fluids in the brain was considered to
be related to apoplexy, epilepsy and
delirium.
In the seven books of The Epidemics,
there are a number of case histories with
reference to psychasthenic states. There
is, in Book III, a case of a woman of
Thasos who, in a state of melancholia,
developed an aversion to food, and ex-
hibited loss of sleep, fears, depression and
a slight fever. In Book VII, we are intro-
duced to Nicanor who was terrified by a
woman who had played a flute at the time
he had taken his first drink. Thereafter,
Nicanor was unable to listen to the notes
of a flute without being engulfed in a host
of vague fears. III thIs same book, the
case of Demokles is recorded. This man,
when walking near a precipice or bridge,
or when crossing even a shallow ditch,
GEORGE W. KISKER
was seized with anxiety, would become
dizzy, and would begin to tremble. This
same man could, without evil conse-
quences, walk in the ditch. Such cases as
these are typical of many psychoneurotic
conditions which confront the medical
psychologist of today.
The therapeutics of the early Greek
physicians were, as would be expected,
directed by the humoral pathology which
was assumed to underlie the abnormal
mental states. It was thought that each
humour was attracted by some drug
towards which it maintained a particular
affinity. As a result, purgatives were
given, not only to empty the stomach of
its contents, but for the purpose of with-
drawing the detrimental humours from
the body. Hellebore was probably the
most widely used of the therapeutic
drugs. The white hellebore was an emetic
and the black hellebore was a purgative.
There is also ample scattered evidence to
indicate that psychotherapeutic methods
were recognized and used in many cases.
A rich source of material with reference
to the problem of psychopathology in
Greece is the elevated literature of the
period with which we are concerned.
References to madness in the Homeric
works are extremely limited. No person
suffering from mental disorder is ever
directly introduced, making it necessary
to obtain any knowledge of Homer's
beliefs from inference. Just as the gods
were able to send death, it was evident
that they could send folly.26 Through a
logical extension of the concept, it is rea-
sonable to suppose that they could also
send madness. There is some question as
to whether Bellerophon was considered as
being mentally deranged. In later times,
we know that he was listed among the
ancient madmen. Aristotle 27 mentions
Bellerophon, along with Ajax and Hera-
cles, as suffering from black bile. In the
Epic mind, however, we are not certain
that a clear distinction was made between
madness and sanity. Neither Cassandra
nor Ajax, in Homer, are indicated as being
mentally unbalanced. If there are any
indications of madness in Homer's works,
.. Odyssey; IX, 350.
27 Aristotle, Problemata; XXX, 1, 3.
 PERSONALITY DISORDER AND HISTORY 541

it is the doctrine that mental disease is a Argus and the sting of a gadfly. The
disease sent, like any other sickness, by symptoms in Io's case were entirely
an angry god and cured by the inter- physical, consisting of convulsive shud-
vention of another god, or by the ap- dering, intense excitement, fluttering
peased sender of the illness. heart, rolling eyes, panting, wild words,
Madness in JE::schylus is complicated and wild leapings. O'Brien-Moore 30 tends
by the introduction of the Erinyes and to minimize the actual madness in this
mantic possession, concepts which are case, suggesting that the terror and ex-
further complicated by the supernatural citement were not without actual cause,
trend of JE::schylus' own thinking. The thus making it appear that any human
Erinyes, described by Harrison 28 as being being, under the same influences, would
a part of an ancient primitive religion react fh much the same way. The ulti-
which was ignored by Homer, are the mate source of Io's action is the goddess,
half-materialized spirits of the slain who Hera, who makes possible the events
return to appear before the slayer and, as which cause 10 to act as an insane person.
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in the case of Orestes, to drive them mad. In otder to gain a comprehension of

This mechanism, found in the Chrephori, Sophocles' conception of madness we must
is altered in the Septem, where the turn our attention to the Ajax. In his
Erinyes become both a curse and the lost plays it is possible that he may have
means by which the curse will be brought described an Athamas maddened by Hera,
to fulfillment. The whole concept is char- and in his Alcmreon he may have treated
acterized by its primitive nature and by the problem of the Erinyes. The Odysseus
the confusion involved in its use. During Mainomenos concerned itself with the
JE::schylus' career, these Erinyes were feigned madness of Odysseus, who, in
developed into the actual goddess of order to avoid going to Troy, yoked an
madness for in the last play, Xantriae, ox and a horse together to indicate that
the character of Lyssa is introduced he was bereft of his senses. It is also
by JE::schylus during the destruction of possible that the Tympanistae dealt with
Pentheus by the Bacchanals. 29 Lyssa is a the Bacchic frenzy.31 In the Ajax, Sopho-
single personality possessed with super- cles reveals a new development in the
natural powers, namely, the power to conception of the disordered mind. For
affect the minds of mortals. Thus, in him, psychological mechanisms play an
JE::schylus, we see a transition of the important role. He recognizes that the
Erinyes from a vague ghost-like concep- mental functioning of the madman is dif-
tion to a goddess personifying madness. ferent from that of the sane person.
A second character of importance who Unlike madness in JE::schylus, Sophocles
is portrayed in JE::schylus as being men- shows that the mentally disordered per-
tally unbalanced is Cassandra in the son lives, not in a super-natural world,
Agamemnon. The cause of Cassandra's but in an unreal world. The influence of
frenzy is ultimately Apollo, although the the goddess of madness becomes manifest
mechanism is that of mantic possession in in the institution of the process which
which the god, in some form, actually makes it possible for one to live in this
enters the body of the victim. JE::schylus, world of unreality. The underlying cause
however, does not describe Cassandra's of Ajax' madness is Athena who tells
condition either in terms of Apolline pos- Odysseus that she caused it.32 Athena is
session or in terms of Dionysiac posses-
motivated by anger arising out of Ajax'
sion, of which he was doubtlessly aware.
insolence. Athena herself tells us that
The third character in JE::schylus' extant when Ajax had come in the night to
plays who was mentally disordered is 10
slaughter the Greek chiefs, she disordered
in the Prometheus. In her case, the mad-
his sense perceptions and caused him to
ness is accounted for by the ghost of
turn his fury on the flocks of sheep. Later,
~OXJII~·.d~QlI. ,)'1I11ff lJ:jllllu, l'rQI~QQ'I'rlllrlfJ to thll !i1tud'l,l
of the Greek Religion; Cambridge, University Press, 00 Reference footnote 8; pp. 90-91.
1!)()R (xxII and fiRO pp.). !J. Heference footnote 8; pp. 101-102.
.. Reference footnote 8; p. 80. 3.:l Ajax, 51.
 542
when he is restored to his senses, he has
a complete amnesia for all of the events
during the fateful interim.
The insight of Sophocles into delusional
insanity is profound. He clearly recog-
nized the difference between the world of
the person suffering from a delusion and
the world of that same person during
moments of sanity. While lEschylus' con-
ception of madness is external, character-
ized by physical manifestations, Sopho-
cles conception deals with psychological
phenomena and, in so doing, foreshadows
the psychological dramas of Euripides.
Closely related to the work of Sophocles
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is that of Bacchylides whose epinician ode
for Alexidamus of Metapontion gives us
the story of the daughters of Proteus who
enter the temenos of Hera and boast that
the wealth of their father is greater than
hers. Hera is angered and drives them
into the mountains where they wander in
madness. Herodotus 33 tells us that all the
Argive women were maddened and, in
another variation, Vergil 34 states that
they fancied themselves cows. Bacchyl-
ides, however, speaks only of the Prce-
tides and considers their wanderings as
indicative of the madness. Reference to
Mclampus, who is usually connected with
the myth, is omitted. The cure is brought
about by Hera who has been influenced
by Artemis to whom Proteus appealed
after his daughters had been wandering
for thirteen months. The entire treatment
seems to be of a highly superficial nature,
especially with reference to the mecha-
nism of the madness.
The treatment of madness in Euripides
is complicated by the fact that, in addition
to his efforts to establish new beliefs, he
is attempting, through the medium of his
plays, to destroy old beliefs. His work
brings to us several characters who are
depicted in states of mental abnormality.
The first of these characters is Orestes.
O'Brien-Moore 35 suggests that Euripides'
conception of the mad Orestes is a protest
against the earlier representation of
lEschylus in which Orestes sees, in his
madness, real existent creatures as the
"" Hpronotll", rx:, 34,
M Vergil, Ducolics; VI, 48.
"Reference foot.note Rj p, 116,
GEORGE W. KISKER
result of the machinations of a moral law.
In Euripides' treatment, Orestes suffers
from a troubled conscience. At the begin-
ning of the play, Orestes is represented as
being exhausted and unkempt, and sud-
denly, while talking to Elektra, he sees
the Erinyes coming to attack him.36 His
eyes roll wildly and he is seized with
maniacal strength. Elektra futilely at-
tempts to restrain him in the bed from
which he leaps and calls for weapons with
which to fight his tormentors. Then, as
suddenly as the attack appeared, it is
over and Orestes is once again himself. sT •
In the Hercules Furens, Euripides pic-
tures for us, in the last half of the play,
the madness of Heracles and the conse-
quent murdering of his children. The
goddess Lyssa is the agent of the mad-
ness, and causes Heracles to foam at the
mouth, roll his eyes, laugh insanely, pant,
bellow, shake his head, and finally, to fall
senseless to the floor.3s Concomitant with
these physical symptoms which, like those
of Orestes in the Iphigeneia in Tauris are
symptomatic of epilepsy,39 the madness of
Heracles is complicated by the fact of an
elaborate delusion which eventually leads
to the slaying of his children. To bring
his bloody orgy of slaughter to an end,
Athena descends and, by casting a stone,
knocks him to the ground where he is tied
securely to the pillars of his house. 4o In
the Bacchae, Euripides describes the mad-
ness of Argave who, being possessed by
Dionysus, mistakes her own son, Pen-
theus, for a lion and falls upon him with
the aid of other bacchanals, tearing him
apart. During the earlier phases of her
madness, Argave expresses physical
symptoms similar to those of Heracles.
As the body of her son is torn apart, she
possesses herself of his head and desires
to nail it to the triglyphs of the palace.
The delusion is complete and it is only
through a slow, systematic process that
Cadmus is enabled to bring her back to a
point where she recognizes the severed
head as that of her son, and not that of a
lion. When this point is reached, Argave
.. Euripides, Orestes; 257.
M Rerel'leHce fuuLuuLe 36; 1l1l. 275-271.
3R Euripidoo, Horoulo8 Furono; 1006.
3D HlppOC.rates, De Morbo Sa.cro; VIII.
4P ReIenmce footnote SSi pp. lOO!H012.
 PERSONALITY DISORDER AND HISTORY
shows a comparable amnesia for the
events which took place during her career
as a bacchanal.
In the Troades, Euripides portrays
Cassandra as being possessed by Apollo
in a manner similar to the possession of
a worshipper of Dionysus. Just as lEschy-
Ius thought of madness in terms of
Erinyes, Euripides thinks of it in terms
of Bacchic frenzy to which other abnor-
mal states are to be compared. In the
case of Cassandra, the mental condition is
not particularly stressed and is character-
ized primarily by her supernaturally ac-
quired knowledge of the future with
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reference to the death of Agamemnon and
the wanderings of Odysseus.
The popular conception of madness in
Greek culture was an outgrowth of the
influence of both the literary and bio-
logical conceptions, coupled with a liberal
amount of superstition and folk-lore. The
popular Greek mind, not unlike the
popular contemporary mind, placed a
great faith in portents and signs. Artemi-
dorus 41 stated that for a poor man to
dream of repeating a song on the streets
or in the market place, was a sign of
insanity since such behavior is that of a
madman. Galen indicated that an in-
creased beating of the vein in the inner
side of the arm could be relied upon as
a sign of madness. 42 Similarly, there is
evidence which indicates that mental dis-
order was considered to be more frequent
in certain seasons of the year than in
others. Hippocrates 43 tells us that phre-
nitis is especially rampant during that
period from the time of the equinox until
the setting of Pleiades. He tells us also
that the beginning of winter is a very
dangerous time for the development of
mental conditions. Aretreus 44 mentions
that relapses are to be feared in the
spring. Manetho,45 in an astronomical
poem, says that people are more prone
to attacks of madness when the heavenly
bodies are in certain positions. Epilepsy
is to be feared when the moon is in con-
junction with Mars, while frenzy and
41 Artemidorus, I, 76, 26-30.
.. Reference footnote 7; p. 18.
.. Hippocrates, Epidemics; I, 9.
.. Aretreus, I, 6, 59.
.. Manetho, I, 5, 229-232.
543
madness are indicated when Mars and
Saturn are descending, and the moon and
sun are in opposition. The lunar influence
is explicit in these conceptions.
Vaughan 46 suggests that the inhabi-
tants of ancient Greece did not seem to
have the same horror of insanity that is
apparent today, nor were the affiicted
hidden from the public. While Rome may
have had provision for the pauper in-
sane, such was not the case in Greece
where the mentally diseased were the
objects, in many instances, of public
derision and ridicule. At times these un-
fortunate persons were followed in the
streets where they were stoned and
abused in a variety of ways. This atti-
tude, however, was not a general one. As
might be expected, a great fear of the
violently insane was apparent in Greece
just as it is in every other culture. It
is generally agreed that Greece made no
provision for the mentally ill. Plato 47
recommended keeping madmen at home
by any possible means. This may be in-
terpreted as advocating imprisonment and
personal restraint such as was described
by Aristophanes 48 in connection with the
character, Philocleon.
Herodotus 49 informs us that Cambyses
was affiicted with the Sacred Disease from
birth. That he was mentally disordered
is evident, to a degree, by the violence of
his actions. A list of his actions, which
are suggestive of the epileptoid person-
ality, would include his ill-usage of the
Egyptian priests and the god, Apis, which
the Egyptians said was responsible for
his madness; the murder of his brother,
Smerdis; the murder of his sister whom
he had married; the murder of Prexaspes'
son; the burial alive of twelve Persian
nobles; his mockery of holy rites, and a
prolonged series of wild outrages against
his family, his nobles, and his political
and military allies.
Herodotus 50 also describes Cleomenes
as being insane. He tells us that he mani-
fested mental disorder upon his return
to Sparta at which time he struck his
... Reference footnote 7; p. 37.
., Plnto, Laws; II, 934 C·D .
.. Aristophanes, Wasps; 112 .
.. Herodotus, III, 33 .
GO Herodotus, VI, 75, 84 .
 544
countrymen in the face with his sceptre.
As a result of his activities, his relatives
found it necessary to imprison him by
placing his feet in stocks. While he was
secured in this manner, he prevailed upon
a helot to give him a knife with which he
mutilated his legs, his thighs and hips,
and finally, his abdomen. His death was
the result of these self-inflicted wounds.
The Argives said that Cleomenes lost his
senses because of his misdeeds, but the
Spartans maintained that his madness
was the result of his habit of drinking his
wine unmixed with water, a custom he
had learned from the Scythians. It is
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interesting to note that the idea of super-
natural cause was rejected.
With regard to the cure of madness,
popular and legendary techniques are
numerous. Medically, we have already
seen that the greatest emphasis was
placed upon drug therapy, proper regime,
diet, and similar physical considerations.
To a limited degree, psychotherapeutics
were also recognized and made use of.
Popularly, other means were resorted to
by the more superstitious and the less
informed. Since madness was attributed
to supernatural powers, the cure would
have to be in terms of appeasing and gain-
ing the favor of those powers. As a result,
sacrifices and offerings were common.
Cures have been attributed to Zeus, who
cured Io's madness by his touch 51; to
Hera, who cured the Prcetides; to Apollo,
who purified Orestes at Delphi 52; to
Athena, who cured Ajax 53; to Cybele, who
cured Dionysus; to Medea; and to the
Corybantes. The cures were effected in
most cases through purification, propitia-
tory rites, and through the participation
in the mysteries of Hecate at lEgina, of
Sabazius, Cybele, and the Corybantes.
Other cures were ascribed to various
animal substances, plants, cathartic
stones, whipping, music and motion and
miscellaneous beliefs. Dioscorides 54 men-
tions the animal and plant cures in great
detail. With reference to the former, such
suggestions were made as to take, for
three weeks, the liver of a vulture cooked
"lEschylus, P'rometheus; 848.
50lEschylus, Choephori; begin p. 1021.
"Reference footnote 38; pp. 1012-1018.
50 Dio~corW,ljii, De Simpli,oibllll; HI,
GEORGE W. KISKER
in blood and administered in honey.
Other remedies suggested putting the gall
of a sea tortoise up the nostrils or drink-
ing the blood of a sea tortoise. Plants,
too, were considered highly efficacious in
the cure of mental disease. The leaves of
the black poplar, the flower of the wild
violet, and the roots of the horse-fennel
were common ingredients in medications
prepared for the afflicted.
The Greeks also availed themselves of
the use of cathartic stones which, when
burned, or when worn as an amulet were
believed to have some curative effect on
the mental condition. In some instances,
the stone was used to precipitate the con-
dition, as in the belief that the odor of
burning jet would cause a grand mal,
while in other cases, the wearing of the
stone was looked upon as a prophylactic
measure.
Vaughan 55 concludes, with regard to
whipping as a therapeutic measure, that
while whipping may have existed in the
late Greek period, there is no evidence in
the entire Greek literature to indicate its
existence before or during the Classical
period. The use of music and rhythm as
a psychotherapeutic measure was not un-
common to the Greeks, nor to any of the
other ancient peoples. The sedative na-
ture, or on the other hand, the exciting
influence of certain types of music was
widely recognized. We have already seen
how Saul was soothed by David's harp.
In contrast, the Phrygian flutes, used in
the various orgiastic rites, were highly
stimulating. Plato recommended a combi-
nation of motion and sound as a cure for
madness,56 while Aristotle 57 also mentions
the efficacy of music in cases of mental
illness. In certain variations of the story
of the Prretides, it is said that their cure
was accomplished, in part, by music pre-
scribed by Melampus. 58
In light of the foregoing material, it
becomes quite apparent that man's in-
terest in the problem of mental disorder
is by no means of recent origin. It must
be pointed out, however, that we have
•• Reference footnote 7; pp. 53-55.
56 Plato, Laws; VII, 790 E.
51 Aristotle, Politica; 8, 7.
'" ApnllndQrl1~, II, 29.
 PERSONALITY DISORDER AND HISTORY
been examining into the conditions exist-
ing during the classical Greek period.
While it would be possible to cite refer-
ences to mental disease in other cultures
and at other periods in history, the atti-
tudes taken towards the mentally dis-
eased would vary considerably from cul-
ture to culture and from time to time. It
is of the utmost significance that in no
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545
other culture or period in histQry, other
than our own, has a more tolerant attitude
been taken towards the mentally ill. As
in so many other fields, the ancient
Greeks anticipated many of the ideas
which we like to believe are products of
our own age and culture.
COLUMBUS STATE HOSPITAL,
COLUMBUS, OHIO.