A brief overview of ancient attitudes and theories regarding epilepsy from the supernatural to the scientific, including origins of the notion that excellence coincides with certain mental afflictions.
I know not and I speak of what has been.
And more, my son! for more than once when I
Sat all alone, revolving in myself
The word that is the symbol of myself,
The mortal limit of the Self was loosed,
And past into the Nameless, as a cloud
Melts into Heaven. I touch’d my limbs, the limbs
Were strange not mine—and yet no shade of doubt,
But utter clearness, and thro’ loss of Self
The gain of such large life as match’d with ours
Were Sun to spark—unshadowable in words,
Themselves but shadows of a shadow-world.
—Alfred Lord Tennyson, from "The Ancient Sage"
Introduction
It is never essential or even relevant for authors to share immutable traits with their characters—even if those traits are rare or thorny in some way (and which aren’t in the heart of their bearer, whether or not they are officially recognized as such?) I find it distasteful when authors try to capitalize on their identities or afflictions, especially in the current climate where such things are looked upon currency to trade or weapons to wield. For those of us who still have a sincere interest in the writer’s work, the writer’s identity should never be an inducement for the reader, a product for the publisher, or a device for the artist. It should certainly never become a cudgel for any party to wield.
So I have been leery of sharing any part of my own story because I don’t want it to reflect one way or another on my writing or the perception of my characters. However, the subject of epilepsy has been of personal interest to me since I began writing my trilogy. In fact, it’s indirectly the reason I started writing it. I’m hardly an authority on the subject, but I wanted to offer a little background on what has influenced the portrayal in the books.
I’ve been holding off on writing this particular piece for a while because of these complications. But a few weeks ago, Winston Malone of The Storyletter posed a question in one of his threads that prompted me to revisit this topic. (The Storyletter is a great Substack for fiction readers and writers, and I encourage anyone who hasn’t already to check it out and subscribe.) The chapter I published that week also featured “the sacred disease” prominently, so perhaps there is some synchronicity in all of this that I should acknowledge if only to help explain things to readers who may not be familiar with the term or the disorder.
For over a decade, I’ve been writing an ancient historical trilogy. In addition to the (decidedly non-woke) complexities of gender, colonialism, intercultural conflict, and religion, it also looks at epilepsy in the ancient world, as the Greeks and Scythians evidently took very different approaches to this neurological disorder, often referred to in contemporary texts as the “sacred disease.” I incorporated this for several reasons: Mircea Eliade mentions epileptic seizures as a primary initiatory experience among the world’s shamans and diviners, especially in Central Asia and Siberia, where the Scythian culture originated. Scholars like Karl Meuli and E.R. Dodds have theorized that aspects of Greek mysticism, including the mystical flight of Abaris, the journeys and shapeshifting of Aristeas, Pythagorean philosophy regarding the transmigration of souls, etc., primarily developed out of contacts with Scythians and Thracians and the diffusion of their spiritual philosophies. In contrast, as early as the 4th C. BCE, Hippocrates would write extensively “on the sacred disease,” representing an early phase of scientific thought arguing the physical origin of the disease rather than a spiritual one.
I’ve often wondered how fellow sufferers experienced this disorder in ancient times without the benefits of modern medicine, particularly when caught between these various philosophies with their divergent perspectives. What did it mean to have a sacred disease, and what was life actually like for the epileptic in ancient times?
Early Mentions: The Sacred Disease enters the historical record
Descriptions of epileptic symptoms appear in ancient Accadian medical texts as early as 2000 BCE, and the Code of Hammurabi lists seizures as a reason a defective slave may legitimately be returned for a refund. However, for the earliest surviving reference using the phrase “sacred disease” in the ancient Greek world, we turn to our old friend Herodotus:
These were the acts of madness done by Cambyses [the son of Cyrus, King of Persia] towards those of his own family, whether the madness was produced really on account of Apis or from some other cause, as many ills are wont to seize upon men; for it is said moreover that Cambyses had from his birth a certain grievous malady, that which is called by some the "sacred" disease: and it was certainly nothing strange that when the body was suffering from a grievous malady, the mind should not be sound either —Herodotus, Histories
In the accounts of Cambyses, he is described more as a volatile man with a mental illness than one suffering strictly from epileptic seizures. However, such distinctions seem highly subjective and open to interpretation for many ancient observers. In addition to the “sacred disease,” some texts refer to the “falling sickness,” “Herculean Disease,” and “diviner’s disease.” As we’ll see, the distinction between them is not necessarily straightforward—if there even was one.
What Is Meant By “Sacred”?
What we mean by the term “sacred” and what the ancient Greeks, who coined this phrase, understood by it appear to have been very different things. While they also used the word sacred in the conventional way, to speak about things associated with the gods and religious rites, they also seem to have used the term to express a range of possibilities far outside our normal usage. Medical historian Owsei Temkin explains:
What is seized by gods or demons may also be “sacred” in the sense of inspiring fear. It may be abhorred and fled from, just as the epileptic was. The “sacred disease” would then be an “awesome disease” and the epileptic an untouchable person, “taboo” particularly during his attack.
Plutarch, echoes this sentiment, but supplies it with additional shading. It might signify “great,” presumably in the sense of either size or magnitude, prominence or eminence. Or it might, as expected, refer to something reserved for the gods and therefore forbidden to humans. In his judgement, epilepsy was called “sacred” not because of its divinity but because of its strength or significance.
And that is most wonderful which is reported of the anthias [a colorful reef fish], which Homer calls the sacred fish, though some interpret sacred to signify great in that place, as we call a certain great bone os sacrum, and the epilepsy, being a great disease, the sacred disease, though others interpret that to be sacred which ought not to be touched, as being dedicated to holy use —Plutarch, Which Animals Are the Craftiest, Moralia
Then Plutarch goes on to also describe the sacred disease this way:
Then Pemptides smiling: Truly, said he, there is a certain disease of the body, which they call sacred; so that it is no wonder if some men give the appellation of sacred and divine to the most raging and vehement passion of the mind. —Plutarch, Of Love, Moralia
It seems there was no clear consensus on the meaning of “sacred” in the sacred disease, even within the individual, even in the same work, and it’s good to keep in mind that several senses of the term are possible. Generally, however, if we take our cue from Hippocrates, most would have understood the term to mean that the disease had a supernatural component and required a supernatural cure. It is this notion that Hippocrates challenges in his groundbreaking work, On the Sacred Disease:
It is thus with regard to the disease called Sacred: it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from the [sic] originates like other affections. Men regard its nature and cause as divine from ignorance and wonder, because it is not at all like to other diseases. And this notion of its divinity is kept up by their inability to comprehend it, and the simplicity of the mode by which it is cured, for men are freed from it by purifications and incantations. But if it is reckoned divine because it is wonderful, instead of one there are many diseases which would be sacred…
Mistaken Identity: Copycat conditions and the trouble with armchair diagnosis
While epilepsy remains the primary candidate for association with the sacred disease, several purported physical, mental, and spiritual maladies were referred to as “sacred” in the ancient world, and many bear a resemblance to and share symptoms with epilepsy. It is possible that ancient writers either confused or conflated these conditions into a single disease with myriad manifestations or simply considered them all manifestations of supernatural forces. Arising from unseen sources untreatable by conventional medicine, bizarre behavior would have imparted obscure infirmities with an ethereal quality—holy or demonic. A few examples of similar afflictions (mistakenly?) labeled “sacred disease”:
Nightmares, night terrors, or “attacks by incubus” could be mistaken for the convulsions of epilepsy
Lunacy, i.e. the disease of the moon, including somnambulism (sleepwalking)
Hysteria and other gynecological fluctuations were particularly apt to be linked to epilepsy
Mania in all its forms was both considered divinely inspired and likely to be mistaken for epilepsy
Melancholia, i.e. black bile
According to Heraclitus, “self-conceit is a sacred disease” (it’s not clear where on the spectrum from pride through arrogance to narcissism this is meant to land)
Vertigo (called a “little epilepsy”)
Possession (This was the preferred interpretation across the Near East, and exorcism was the prescribed cure. This would see a revival during the Christian era. Indeed, in Medieval times, under the influence of the Catholic Church, medical science would reverse itself from the position attained by Greek physicians like Hippocrates and resume attributing the symptoms of epileptics to witchcraft and demonic forces. Epileptics were segregated from healthy congregants and refused the Eucharist, and the faithful were encouraged to avoid speaking or engaging in commerce with them. Some cities exiled them outright. Cures might be attempted through exorcism, and patients were subject to unspeakable tortures at the hands of the Church, including but not limited to castration. Epileptics were obviously ineligible for the clergy due to their inherent defect. Until recently, they were also ineligible for marriage and deemed unfit to procreate.
Divine Affliction: Greek and Roman Attitudes
To the ancients the epileptic was an object of horror and disgust and not a saint or prophet as has sometimes been contended. (Temkin)
It was widely believed that the disease was inflicted by gods or demons upon sufferers for whatever reason—some claimed due to a sin against the moon, though I’m still unclear how this would occur. I suppose moon goddesses are as fickle as their ever-changing orb. In much of early medicine and magic, like cured like, and this was no different: supernatural ills demanded magical cures. Hippocrates argued that a disease inflicted by the gods should be relieved by the gods—specifically by worship in their temples—rather than sorcery. But, as objects of “horror and disgust,” would most have had access to the Greek temples?
Epilepsy was also known as “the disease which is spit upon.” The epileptic was considered unclean, and the disease was considered contagious. No one would eat with or share a dish or cup with epileptics, and they were regularly spat upon. Pliny assures us it was for a good reason:
“In cases of epilepsy we spit, that is, we throw back contagion.”
As with the Code of Hammurabi above, epileptic seizures were considered a legal basis for restitution should one be sold a defective slave, according to Plato:
If a man sell a slave who is suffering from phthisis or stone or strangury or the "sacred disease" (as it is called), or from any other complaint, mental or physical, which most men would fail to notice, although it be prolonged and hard to cure — in case the purchaser be a doctor or a trainer, it shall not be possible for him to gain restitution for such a case, nor yet if the seller warned the purchaser of the facts. But if any professional person sell any such slave to a lay person, the buyer shall claim restitution within six months, saving only in the case of epilepsy, for which disease he shall be permitted to claim within twelve months.—Plato, Laws
Word to the wise: Never buy a slave without the extended warranty.
Hippocrates: The “scientific” view
The early Greeks conceived the diaphragm (or lungs) and heart as seats of the various souls (a piece on that coming soon.) Yet, there is ample evidence for prehistoric trepanations, which some have been linked to epilepsy. The results of head injuries and brain diseases must have been observed, as trepanation was successfully employed as a remedy in some cases. By the time of Hippocrates’ writing, recognition of the brain’s role in governing the body’s functions seems to have become widespread, modernizing the archaic view that the intellect and emotions emanate from spirits residing in the body’s other organs.
And men ought to know that from nothing else but (from the brain) come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations. And by this, in an especial manner, we acquire wisdom and knowledge, and see and hear, and know what are foul and what are fair, what are bad and what are good, what are sweet, and what unsavory; some we discriminate by habit, and some we perceive by their utility. By this we distinguish objects of relish and disrelish, according to the seasons; and the same things do not always please us. And by the same organ we become mad and delirious, and fears and terrors assail us, some by night, and some by day, and dreams and untimely wanderings, and cares that are not suitable, and ignorance of present circumstances, desuetude, and unskilfulness. All these things we endure from the brain, when it is not healthy… —Hippocrates
Hippocrates also recognized an element of heritability to the disease, as there is with so many other diseases. In addition to a complicated theory of bodily humors, the condition was influenced—and treated—by careful management of diet, environment, and the elements. However, not all of his science was cutting-edge. In addition to an imbalance of the four humors, he believed winds played a pivotal role in provoking attacks, especially south winds. He did think the condition could be cured unless it persisted too long, at which point it would become chronic, with dire consequences he describes in vivid, semi-psychedelic detail:
For when the disease has prevailed for a length of time, it is no longer curable, as the brain is corroded by the phlegm, and melted, and what is melted down becomes water, and surrounds the brain externally, and overflows it…
Far out.
With their brains melting and overflowing, people apparently freak out when they feel their symptoms coming on. However, according to Hippocrates, patients aren’t freaking out because their brains are liquefying or because the gods are fucking with them for no good reason, but because they can’t abide the terrible shame of it all.
But such persons as are habituated to the disease know beforehand when they are about to be seized and flee from men; if their own house be at hand, they run home, but if not, to a deserted place, where as few persons as possible will see them falling, and they immediately cover themselves up. This they do from shame of the affection, and not from fear of the divinity, as many suppose.
Children also flee to their mothers out of “terror and dread” of the symptoms, “for being still infants they do not know yet what it is to be ashamed.” Stupid kids, all worried about their health and whatnot, will learn to prioritize shame eventually.
Hippocrates seems to take the greatest offense at the magical cures employed to treat epileptics in his day, not because they are weird, gross, and ineffective, but because they are impious. Their use implies to him that those who employ them believe two unacceptable things simultaneously: firstly, that the gods could be responsible for something as heinous as the “great” disease (as he chooses to call it), which he finds repellant:
it would appear to me that their discourse savors not of piety, as they suppose, but rather of impiety, and as if there were no gods, and that what they hold to be holy and divine, were impious and unholy.
Secondly, he’s shocked that humans could have the audacity to try through sorcery, charms, incantations, etc. to subvert the will of the gods even if they had caused such a horrific disease in humans, which they never could, because the gods only make perfect and righteous things.
How, then, are they not enemies to the gods? For if a man by magical arts and sacrifices will bring down the moon, and darken the sun, and induce storms, or fine weather, I should not believe that there was anything divine, but human, in these things, provided the power of the divine were overpowered by human knowledge and subjected to it.
Hippocrates does not make a thoroughly scientific argument, as some imply in their praise for his revolutionary text. He suggests that, contrary to earlier belief, epilepsy cannot be a spiritual or sacred disease sent by the gods because the gods only produce beautiful, virtuous, and pure things. Being an ugly, shameful, and impure disease, it cannot have come from the gods; therefore, it must derive from another source. Some have derived this pollution from demonic possession; he derives it from the imperfect physical forms of the material world. Whatever the cause, the gods cannot be blamed for anything so monstrous.
Neither truly do I count it a worthy opinion to hold that the body of man is polluted by god, the most impure by the most holy; for were it defiled, or did it suffer from any other thing, it would be like to be purified and sanctified rather than polluted by god.
He is discounting the long tradition in which gods like Apollo were said to have sent plagues and Lyssa rage, frenzy, rabies, etc. Allowing the gods to wash their hands of the “falling sickness” among all their many divine interventions requires some mental gymnastics. Hippocrates sticks the landing, saying that each body, under continual influence from divine elements, cannot claim a uniquely sacred source for its ailments.
And the disease called the Sacred arises from causes as the others, namely, those things which enter and quit the body, such as cold, the sun, and the winds, which are ever changing and are never at rest. And these things are divine, so that there is no necessity for making a distinction, and holding this disease to be more divine than the others, but all are divine, and all human.
Some Cures: Magical and Medical
As alluded to by Hippocrates, some of the cures attempted in the ancient world leaned heavily on sympathetic magic, sorcery, mysticism, and pseudoscience. They also demonstrate the desperate lengths to which patients would go to achieve relief from their symptoms. One physician called Menecrates infamously made all his patients sign a bond requiring them to become his slaves if his cures were effective. This, for some, was apparently a price worth paying for a cure. A sampling of other cures included:
Smearing the mouth with human blood.
Drinking human blood, if possible as it flowed from the wound. “While the crowd looks on,” writes Pliny, “epileptics drink the blood of gladiators, a thing horrible to see, even when wild beasts do it in the arena. Yet, by Hercules, they think it most efficacious to suck it as it foams warm from the man himself, and together with it the very soul out of the mouths of the wounds; yet it is not even human to put the mouth to the wounds of wild beasts.” (Temkin)
Eating pieces from the liver of a (Roman) gladiator (repeated nine times)
Mistletoe, if collected from the oak at the new moon without the aid of an iron instrument,
Lichen of horses (I have no idea what this is and I can’t find any info on it)
Camel’s hair/brains
The gall and rennet of the seal
The feces of the land crocodile, the heart and genitals of the hare, and the blood of the sea tortoise, or the testicles of a boar, ram, or poultry cock.
Procedures such as bleeding at the elbow and forehead, cupping, arteriotomy before and behind the ears, trephining and cauterization of the skull, application of rubefacients to the head, and purging with strong phlegmagogues
Rubbing the feet with menstrual blood
Human bones (taken internally and worn as amulets)
Medicinal herbs such as garlic, hellebore, and especially henbane which was extremely popular and remained in use even as late as 1866, gaining preference over preparations like bromide of potasium
Abstinence, some even going as far as to recommend castration
Compare with some cures advocated in the 1800s, when epileptics were often locked up in insane asylums:
For more than a century and a half masturbation figured as one of the main causes of epilepsy in medical literature…
The superstition reached its climax [as it were, tee hee] in the last third of the nineteenth century, when recourse to clitoridectomy and to castration in extreme cases was considered…
“In boys, however, circumcision, if effectually performed, is usually successful, and should be adopted in all cases in which there is reason to associate the disease with masturbation.” (Temkin)
One helpful doctor also wisely warned against reading novels. We all know the danger to our health there.
Mystical Terror: The epileptic as divine mouthpiece
Epilepsy was sometimes known as “the diviner’s disease” because of its associations with the sacred and prophecy. How prophetic powers came to the epileptic was up for debate. Some assumed that some supernatural force possessed the affected individual due to the uncontrolled convulsions that often characterized the disease. However, more often, it was assumed that the waking soul abruptly departed the body as it more commonly did in dreaming and at death and that this was the cause for the abrupt fall characteristic of the “falling sickness,” the waking body being suddenly deprived of the support of a soul.
Briefly, because I will be writing in more depth about this soon, many peoples have entertained the concept of a dual soul in which two separate spiritual elements were thought to exist within in the individual: a body or internal soul which was responsible for animating the mortal elements of the individual, and a free or external soul which was capable of exiting the body of its own will during dreams, illness, hallucinations and the like—or in the case of skilled practitioners like shamans and sorcerers, of being sent forth deliberately during trances. The ancient Greeks and other Indo-European peoples shared this belief, though their conception was far more complex than this simple duality. But that is a subject for another time.
This epileptic connection with prophetic ability resembles claims among shamans that they can invite spirits or ancestors to possess them or, more commonly, dissociate their spirits from their bodies in dreams or trance. In these altered states of consciousness, they send their souls to travel long distances, gather information, inhabit animal forms, visit spiritual realms, converse with spirits or deities, heal the sick, etc.
Daniel Sennert (16th C.), who wrote about Laplanders, defined shamans as “ecstatics” and
persons who, for a long time, lie with their minds withdrawn from their bodies as it were and after awakening relate the marvellous things which they say they have seen and heard. (Temkin)
This appropriately broad definition covers a range of potential spiritual and mental activity and could certainly include the reports of the epileptic upon rousing from an attack. And, of course, Mircea Eliade describes at length how severe illness, and in particular epileptic seizures, are a primary initiatory experience for shamans across cultures, claiming:
“The only difference between a shaman and an epileptic is that the latter cannot deliberately enter into trance.”
Eliade describes how epileptic seizures were interpreted as meetings with the gods among the Vogul. Among the Altaians, shamanism was hereditary, but if an individual had epilepsy, it was believed one of his ancestors was a shaman. The Niue shaman was likely epileptic from families in which the condition is hereditary. Traditionally, Samoan epileptics became diviners, and in the Andaman Islands, they were considered great magicians. I think we can understand why. A shaman in communion with such powerful unseen forces can’t help but gain the awe of believers in the community.
According to E.R. Dodds:
A shaman may be described as a physically unstable person who has received a call the religious life. As a result of this call he undergoes a period of training, which commonly involved solitude and fasting, and may involve a psychological change of sex. From this religious “retreat” he merges with the power, real or assumed, of passing at will into a state of mental dissociation. In that condition he is not thought, like Pythia or like a modern medium, to be possessed by an alien spirit; but his own soul is thought to leave his body and travel to distant parts, most often to the spirit world. A shaman may in fact be seen simultaneously in different places; he has the power of bilocation. From these experiences, narrated by him in extempore song, he derives the skill in divination, religious poetry, and magical medicine which makes him socially important. He becomes the repository of a supernormal wisdom.
Now, in Scythia, and probably also in Thrace, the Greeks had come into contact with peoples who, as the Swiss scholar Meuli has shown, were influenced by this shamanistic culture.
He notes several ancient Greeks who fit the description of shaman, including Epimenides, Abaris, Aristeas, and of course, Pythagoras. Dodds claims that mysterious, revered figures like Empedocles represent,
not a new but a very old type of personality, the shaman who combines the still undifferentiated functions of magician and naturalist, poet and philosopher, preacher, healer, and public counsellor. After him these functions fell apart; philosophers henceforth were neither poets nor magicians; indeed such a man was already an anachronism in the fifth century. But men like Empedocles and Pythagoras may well have exercised all the functions I have named.
Such men could hold the respect—or dread—of their communities. Though the ancients may have been leery about bestowing sacred status upon sick individuals, they also seem to have been unable to resist the enthralling visions their diseases produced, which to both the sufferer and the onlooker appear absolutely convincing as manifestations of something supernatural (see the excerpt from Dostoyevsky below).
That ambivalence resurfaces throughout history as the faithful grappled with whether to denounce or embrace the wondrous visions presented by this disease. Men of religion, including St. Thomas, were eager to draw a line between rapture brought on by mental derangements like epilepsy, demonic possession, and genuine divine inspiration. While they might all share identical signs—today, we might attribute them all to a single pathology—identifying their source—and moral value—was a genuine concern.
And yet:
The connection between true rapture and epilepsy was established by Agrippa [of Nettesheim (1486-1535)] in a chapter “On rapture, ecstasy, and divination in those who are seized by epilepsy and fainting, and in the dying.” “In some manner,” he declared, “fainting and epilepsy imitate rapture, and very often prophecies issue forth in them just as in a rapture. We read of Hercules and of very many Arabs who excelled in this kind of prophesying.” (Temkin)
Though clearly not the same, some seemed to think they were close enough. In a world woefully short on divine inspiration, seizures might not be the real thing, but they might be the next best. The alternatives generally consisted of whackos, charlatans, and stoners.
And maybe the inspiration wasn’t imitation. A particular form of epilepsy, temporal lobe epilepsy (TLE), is renowned for its mystical presentation in patients, the dreamy states it produces, its ability to provoke intense dysphoric emotions of fear or euphoria, hallucinations, and feelings of depersonalization and derealization, among other things, which often lead to extreme religiosity. Because the temporal lobe seems involved in mystical experience, TLE and mysticism have been causally linked. It has also been suggested that this form of the disorder was experienced by several important visionary religious figures throughout history, based on evidence from existing accounts of their lives, revelations, or conversions.
Throughout the ages, countless artists, philosophers, ascetics, and people of faith have struggled to connect with some higher power to tap into a source of meaning or wisdom beyond themselves and this material existence. But what that connection looks like and how it is achieved is mostly a mystery, despite the many schools of thought and worship, the harsh disciplines and methods for its attainment.
The spiritual masters of the past concluded that the wall erected between mankind and illumination was variously constructed of the conscious mind, intellect, ego, self; the active “I” impedes the dormant prophetic powers within, which need to be unshackled from the consciously aware mind to operate freely. This might become possible through meditation, sleep, trance, drugs, or some divine stimulus. What if some lucky (or unlucky) individuals are granted a shortcut, a cheat code? The trancelike state of epilepsy seemed to fulfill one or more of these criteria and was regarded by many in the ancient world as a divine gift—an open door inviting one into the realm of sacred knowledge—a gift of transcendence wrapped, as always, in bodily torment.
Madness or Genius?: Epilepsy’s influence, from politicians to poets
Why is it that all those who have become eminent in philosophy or politics or poetry or the arts are clearly of an atrabilious temperament, and some of them to such an extent as to be affected by diseases caused by black bile, as is said to have happened to Heracles among the heroes? For he appears to have been of this nature, wherefore epileptic afflictions were called by the ancients ' the sacred disease ' after him.—Aristotle, Problems
Piecing together clues to the ancient conception of these diseases is a challenge in the face of so little remaining textual evidence. Aristotle’s Problems offers such evidence and has been influential down the ages in linking epilepsy and excellence, albeit somewhat indirectly. Here, we return to the “problem” of the Herculean Disease. Aristotle (or a pseudo-Aristotle) believed that Hercules suffered from a melancholy temperament and that black bile (melancholia) had triggered his impulsive act of murderous madness, causing him to butcher his entire family. While he doesn’t directly state that Hercules suffered from epilepsy, Aristotle seems to lump melancholy and epilepsy together as diseases brought on by black bile, informing us that the epileptic term “sacred disease” is derived from association with Hercules’s atrabilious affliction and that such melancholic temperaments were characteristic of all great men in every field of excellence. It will be this generalization and conflation that encourages others down the road. After all, is it wise to argue with Aristotle?
Perhaps we also have Aristotle to thank for the moody Romantic poet, the tormented artist, and the emo rock star. If melancholy = greatness, why not lay the black bile on thick for good measure? And, of course, we don’t need to be reminded of this theory’s subsequent iterations through successive ages. The sacred disease of the past has given way to the sacrosanct diseases of today as we continue to romanticize depression, addiction, “neurodivergence,” and all manner of other afflictions as a badge of higher consciousness, creativity, or capability. We still want to see great success and genius layered with intense emotional and even physical suffering because, why should it come easily?
In recent years, we’ve seen a steep rise in the numbers of people who are not only willing to speak openly about their mental illnesses, disabilities, or other infirmities but also tout them as somehow intrinsic to their identity and a cause for celebration. While the reduction of stigma around these conditions is, of course, a net positive, and the ability of individuals to reconcile themselves to their circumstances is surely something to cheer, celebrating disease itself is a disturbing trend. Freddie DeBoer has written and spoken extensively and brilliantly about this on his Substack, but it is also helpful to recognize that it is not a new phenomenon. It has been with us since ancient times when people imagined divine causes at the root of certain mental afflictions and their sufferers to be among a sacred, artistic, or intellectual elect. Today’s medical carpetbaggers aren’t so much celebrating their diseases as they are peddling their status as members of a neurologic elite, chosen by divine forces or genetics to rise above ordinary humans with the unique vision and insight granted them by their conditions.
Thanks to the ancient notion linking the sacred disease not just to prophecy and divination but tangible greatness, the stigma had been laundered. Rather than being hindered by a handicapping infirmity, sufferers had the potential to be elevated above the crowd. During the Renaissance, when Classical texts like Aristotle’s were revived, it was contended that epilepsy was more frequent in Florence than in other regions of Italy. Utopias like Campanella’s fascinating City of the Sun were conceived in which a disproportionate number of citizens were afflicted with the sacred disease because it was believed this was a “sign of great talent.” From there, it became the basis for scientific theories.
The frequency of epilepsy among the very great suggested its wide diffusion among all men of genius, and it helped [Cesare Lombroso (1836-1909)] to form the notion of “the epileptoid nature of genius.” (Temkin)
Lombroso believed that intellectual excellence and nervous dysfunction derived from the same organic source: cerebral irritability or excitability. This irritability could elegantly explain both positive and negative results.
Lombroso broadened the biological, social, and cultural role of the epileptic by accepting Moreau de Tours’ transformation of the ancient doctrine of the great melancholic. Now cerebral irritability was the common organic cause of great original intellectual and psychic power on the one hand and of nervous disorders on the other. This theory allowed Lombroso to account for the epileptic not only as a criminal but also as a genius. All genius was epileptic as well as cognate to the criminal. One may argue whether Lombroso glorified or vilified the epileptic. However, if his thesis is stripped of its untenable assumptions, it reveals the endeavor to reduce behavior which deviates from the norm in two, socially opposite, directions to a uniform physiological explanation. (Temkin)
Was there such a thing as a uniquely “epileptic” mind? If so, what qualities did such a mind possess that set it on its course with destiny? Lombroso became interested in discerning common features shared by both epileptics and geniuses. Unfortunately, the list he came up with is not especially flattering to either group and included things like hereditary affliction, inclination to criminality, frequency of suicide, religiosity, vagabondage, absentmindedness, ruthlessness, and a loss of moral sense. It’s not much of an endorsement for either condition, frankly.
On a more encouraging note, the novelist Dostoyevsky was epileptic, and he portrayed a variety of flattering and unflattering epileptic characters in his stories. Not only were his novels the product of his undeniable intellect and talent as a writer, they are a testament to his unique perspective as a sufferer of the disorder, whose imagination could not help but be colored by his experiences with the disease. Did his genius derive from his epilepsy? Or was his epilepsy a byproduct of his overstimulated brain? It is a question impossible to answer but interesting to ponder.
Nietzsche would also ponder a similar question to that posed by Aristotle and Lombroso, wondering whether a sort of irritability or excitability of mind—an atrabilious temperament—was not responsible for driving a special kind of curiosity and propelling certain people through life.
Nietzsche speculated about “people with intellectual convulsions,” who were impatient with themselves, whose own work gave them brief burning satisfaction followed by desolation and bitterness. They thirsted for absorption in something outside themselves, in God, in images of passionate life, or in deeds. (Temkin)
Famous Sufferers: Brilliance or coincidence?:
In addition to Cambyses, some notable mythical and historical figures reputed to have suffered from “the sacred disease” include Hercules, Ajax, Bellerophon, Socrates, Plato, Empedocles, Pythagoras, and the Sybils. As mentioned above, Hercules most likely suffered from some variety of manic berserker rage, and there is no direct evidence to prove that the others had epilepsy. I, for one, am not keen on retroactively diagnosing or imposing life histories on figures from the past without clear evidence (for example, the recent trends like warping historical realities to align with one’s ideology are deeply unethical.) So, while it’s interesting to speculate, it’s not healthy to get too invested in any of these candidates.
Julius Caesar is well-documented and attested by Plutarch, Suetonius, and Appian. Caligula by Suetonius and Zeno by Evagrius Scholasticus. Alexander the Great, Hannibal, Napoleon, James Madison, Theodore Roosevelt, and Lenin are also widely believed to have been epileptic. Prophets of the Old and New Testaments, Mohammed, and numerous visionary saints have been conjectured but obviously cannot be proven.
Then there are writers and artists including Agatha Christie, Byron, Lewis Carroll, Dante, Dickens, Dostoevsky, Flaubert, Moliere, Poe, Sir Walter Scott, Tolstoy, Da Vinci, Michelangelo, Van Gogh, Beethoven, Gershwin, Handel, Tchaikovsky, and many more—some confirmed and some conjectured. Too many actors, olympians, musicians, scientists, and miscellaneous others to name, from to Danny Glover to Hugo Weaving, Elton John to Prince, Alfred Nobel to Edward Snowden fall onto this unwished list. Many more have probably kept their symptoms secret. We simply can’t know. Tennyson, for example, is alleged to have been epileptic but to have carefully concealed his symptoms because of his era’s social stigma, which falsely attributed the disease to chronic masturbation—and treated the condition even more harshly, with circumcision or castration. The vast proportion of talented people have not been epileptics, and the vast number of epileptics have not been luminaries. But the very fact that any have risen to such heights is inspiring—let alone the impressive examples history has provided.
Descriptions of attacks:
Finally, we get an intimate sense of the nature of the disorder from the vivid descriptions that begin to appear in both scientific literature and literary novels around the 19th C. These descriptions evoke just a hint of the awe-inspiring and ineffable aura-seizure events that led both sufferers and observers to deem this a “sacred disease.” Below are some quotes from Temkin’s The Falling Sickness, including the appendix featuring excerpts from the books of Dostoyevsky.
In the petit mal intellectuel the patient left his home and his work; he was absent-minded, his thought was dulled, he had fits of despair and of unprovoked anger, various impulses followed one another at brief intervals, he had a desire of destroying himself and the things that came under his hands; he was extraordinarily forgetful, had complete lapses of memory, headaches, giddiness (étourdissement); he noticed luminous sparks, visions, frightening objects. (Temkin)
“I had the impression that I was being turned around with the greatest velocity in the tremendous vortex of a sea of fire and had to fight against it with all my strength. To those around me this fight appeared as a convulsion.” —Purkynė
After the attacks have ceased, some of these patients have retained a more or less vague memory of the ideas that preoccupied them while the attacks lasted. They have declared that at the time they were under the influence of a painful dream, in a state of profound mental suffering, and dominated by a vague feeling of violent pangs of conscience or of an insurmountable, misfortune, the reason of which they were unable to penetrate. —Jules Falret
In Dostoievski’s The Possessed (Besy), the ecstatic aura [an early symptom that often precedes the onset of a seizure] is described in detail in a conversation between Kirillov and Shatov:
“There are seconds, occurring five or six at a time, and you suddenly feel you have fully attained the presence of eternal harmony. This is nothing worldly; I do not mean that it is something heavenly, but something which a man, in a worldly sense, cannot bear. One must either change physically or die. It is a clear and indisputable sensation—as if you suddenly became aware of all nature and suddenly said: yes, this is true. When God created the world he said at the end of every day of creation: ‘yes, this is true, this is good.’ This … this is not a tender emotion but simply joy. You forgive nothing because there is nothing to forgive. It is not that you love, oh—this is higher than love. What is most awful is that it is so terribly clear and such a joy. If it lasts more than five seconds, the soul will not endure it and must vanish. In these five seconds I live a lifetime, and for them I shall give away my whole life because it is worth it. To endure ten seconds one must change physically. I believe man should stop having children. To what purpose are children, to what purpose is evolution, once the goal is reached? In the Gospel it says: that they will not give birth on resurrection, that they will be like God’s angels. A hint. Does your wife bear children?”
“Kirillov, does that happen often?”
“Sometimes every three days, sometimes once a week.”
“You do not have the falling sickness?”
“No.”
“Then it will come. Take care, Kirillov. I heard that the falling sickness begins just so. An epileptic described to me in detail this warning sensation before the attack, exactly like you. He too set five seconds and said that it is impossible to endure more. Remember Mohammed’s pitcher, which had not time to empty itself while he flew on his horse all over his paradise. The pitcher—that is your five seconds; it reminds one too much of your harmony, and Mohammed was an epileptic. Take care, Kirillov, the falling sickness!”
Prince Myshkin, the hero of The Idiot, pondered the fact that in his epileptic condition there was one phase before the attack itself (provided the attack came during waking hours) when suddenly in the midst of sadness, mental darkness, oppression, his brain momentarily was as if set on fire, and all his vital forces strained themselves at once, in an unusual outburst. His consciousness and feeling of being alive became almost tenfold during these moments, which repeated themselves like lightning. His mind, his heart were illuminated with an unusual light; all excitement, all doubts, all troubles were at once as if at peace, solved in some higher calm full of clear harmonious joy and hope, full of intelligence and final reason. Yet these moments, these flashes were nothing but the presentiment of that final second (never more than a second) with which the attack itself started. This second was, of course, unbearable. (Temkin)
Conclusion
“Usually, the epileptic is avoided; on all faces he reads his sentence to isolation. Everywhere he goes, menacing and insurmountable obstacles arise to his obtaining a position, to his establishing himself, to his relationships, and to his very livelihood; he has to say good-by to his dreams of success, for the masters even refuse him work in their shops; good-by to his dreams of marriage and fatherhood, good-by to the joys of the domestic hearth. This is death to the spirit.” —Billod (Temkin)
Generally speaking, epileptics have had a pretty awful time throughout most of history, and some still do despite incredible medical advances. There are no cures for this neurological disorder, only better and worse treatments. For those who came before the modern era, there were not even those, and they suffered under the weight of the unknown, without medicine, without answers. Mostly, they lived with the internal fear of their unexplained symptoms and the external fear of the violence and scorn of their society. For most, being afflicted with the “sacred disease” meant they were taboo and untouchable.
But, in some times and places there seems to have been an exception to this certain exile. Epileptics, no doubt convinced of the spiritual nature of their affliction, could convince others to look upon it as sacred as well. For some, this was their salvation. This was the way they escaped the stigma of their disease and even became valued members of their communities.
We can poke fun at the folly of past peoples for trying to smooth over the nonsensical with the salve of the sacred, searching for divinity in hallucinations and convulsions. But it’s hard to blame sick people for wanting to believe there is purpose and meaning in their suffering, especially when the alternative is a life of misery, abuse, and exile. It must be doubly hard in a world before the advent of modern science and medicine, when gods and spirits were present in every aspect of life. I was an atheist and an empiricist long before my seizures began, and they were so profoundly alien and ominous they felt like spiritual visions, even though I knew they couldn’t be. So, I am sympathetic to those who interpreted theirs this way, especially in the days before medicine identified a cause.
I’m grateful I don’t have to live with them any longer. That’s not a choice ancient people would have had. Given a choice, would those who believed their seizures were divinely inspired have wanted them to continue, or would they have welcomed the opportunity for effective treatment, even if it meant sacrificing a divine gift? With what we know about ancient attitudes toward the sacred disease—and human nature—would most have chosen a comfortable but unremarkable life, or a punishing but exceptional one?
Aristotle. Works, Volume VII, Problemata. Translated by E.S. Forster under the editorship of W.D. Ross. Oxford Clarendon Press, 1927. Public Domain.
Dodds, E.R.. The Greeks and the Irrational. University of California Press, 1951.
Eliade, Mircea. Shamanism: Archaic Techniques of Ecstasy. Princeton University Press, 1974.
Kos, Hippocrates of. Delphi Complete Works of Hippocrates (Illustrated) (Delphi Ancient Classics Book 42). Delphi Classics, 2015. Kindle edition.
Plato. Laws, from Plato in Twelve Volumes, Vols. 10 & 11 translated by Robert Gregg Bury (1869-1951). Cambridge, MA, Harvard University Press; London, William Heinemann Ltd. (1967 & 1968). Public domain.
Plutarch. The Moralia, Which Are the Most Crafty, Water-Animals or Those Creatures That Breed Upon the Land?, translations edited by William Watson Goodwin (1831-1912), from the edition of 1878. Public domain.
Plutarch. The Moralia, Of Love, translations edited by William Watson Goodwin (1831-1912), from the edition of 1878. Public domain.
Temkin, Owsei. The Falling Sickness: A History of Epilepsy from the Greeks to the Beginnings of Modern Neurology (Softshell Books). Johns Hopkins University Press, 2010. Kindle edition.
I swear we're connected in some way. I just commented on your prior post about Dostoevsky's "The Idiot" without having read this one first. This was an interesting read and I'm going to flag it and go through it again more slowly. I read "Touched With Fire" some time ago, and although her use of statistics is questionable, the book was interesting. I also enjoyed "The Man Who Wasn't There: Investigations into the Strange New Science of the Self" by Ananthaswamy, and found his exploration of euphoric seizures in certain epileptics fascinating. Anyway, thanks for sharing your deep knowledge on this topic.
I’ve suffered from “night terrors” (sleep paralysis) for years. It’s not fun and has been particularly embarrassing when roommates or people I’ve shared hotel rooms with have had to wake me from them. Sometimes when they shake me awake they temporarily and horrifically figure into the experience. While I’m not convinced that there’s anything supernatural about these experiences (and I do believe it’s some kind of brain seizure), I’m not so bold as to reject the possibility that there’s something paranormal, trans-dimensional, and otherworldly going on, because my most unique and interesting ideas have come to me as a direct consequence of my interactions with the so-called “shadow people”. I posted a UFO story not long ago and its basically a tweaking of an actual nightmare I had.