Tuesday, February 5, 2019


Chiara Thumiger, P. N. Singer (ed.), Mental Illness in Ancient Medicine: from Celsus to Paul of Aegina. Studies in Ancient Medicine, 50. Leiden; Boston: Brill, 2018. Pp. xv, 479. ISBN 9789004362727. €143,00.

Reviewed by Michaela Senkova, University of Leicester (m.senkova422@gmail.com)

Version at BMCR home site

[The Table of Contents is listed below.]

Mental Illness in Ancient Medicine is volume 50 in Brill's series 'Studies in Ancient Medicine'.1 It is a collection of 14 papers,2 which aim to map and problematize the different conceptualizations of the mind and its pathology offered by ancient medical authors. With the earliest taxonomy of the genera insaniae being found in the first-century-AD text De Medicina (3.18) by Aulus Cornelius Celsus,3 the contributions primarily focus on the period from the early Principate to the seventh century AD, and discuss less studied authors such as Athenaeus of Attalia and Rufus of Ephesus, but also famous figures, notably Galen of Pergamum.

The editors set the scene in their compact, but clear and thorough Introduction (1-32), in which they address the socio- historical background of the subject, while foregrounding some of the crucial methodological issues. They explain that the notion of disease is a socio-cultural construct and offer a brief survey of approaches to mental health by ancient writers. A significant part of the Introduction is dedicated to contextualizing the theories of Celsus, whose text De Medicina the editors rightly stress is "the first organic, extended account of mental suffering from a medical perspective" (14). Following the Introduction, individual contributions are grouped into three thematic sections, each exploring the history of mental illness from a different viewpoint. A complete list of authors and titles is given at the end of this review, and below I list some of the highlights of the volume's three sections.

Part One comprises two papers, which discuss the interaction of practical medicine with wider intellectual and cultural views of Graeco-Roman antiquity. This may be the shortest of the three sections in the book (33-106), but it is nonetheless interesting. Metzger's contribution is particularly refreshing: it investigates views on demonic aetiology through the juxtaposition of medical opinions (esp. those of Oribasius and Posidonius) and theological ones (esp. those of Origen), and demonstrates that, far from limiting himself strictly to natural explanations, the scientific doctor of late antiquity was more open-minded about supernatural causation than previously assumed.

The nine papers in Part Two focus on the conceptualization of mental illness and its treatment by specific medical authors (107-340). Not surprisingly, the ways in which the authors under consideration theorize about the topic are distinct. While some show clear influence from earlier medical models, others display innovative approaches: Athenaeus of Attalia understands exercise and education as appropriate means for a mental health regimen (Coughlin), Archigenes of Apamea sees no clear difference between the therapy for mental and non-mental disorders (Lewis), and Rufus of Ephesus advances his diagnostic method by highlighting the importance of patients' voices (Letts). Two papers in Part Two concentrate solely on Galen. Firstly, Devinant argues that the lack of treatises dedicated specifically to mental health within the Galenic corpus may indicate Galen's doubts about the relevance of mental illness to his medical theory. Secondly, Julião addresses Galen's psychological and physiological conceptualizations of memory disorders.

Exceptionally invigorating in Part Two are the two thematically linked contributions by Thumiger because of their relevance to modern day society. She considers the works of multiple authors (e.g. Aretaeus of Cappadocia and Caelius Aurelianus) and addresses the link between food and sexual desires on the one hand and medical pathologies on the other, arguing that ethical and social standards modify our understanding of illness.

The final part of the book comprises three papers, which examine the interaction between medicine and philosophy and shed light in particular on the practical value of philosophical discourse in the treatment of mental illness (341-420). Ahonen demonstrates that some kinds of madness were "healable" by philosophy, with "the Stoics promot[ing] themselves as effective therapists" (364). Gill bluntly asks whether philosophers could have offered clinical consultations for patients with mental disturbances. While it seems to him that they did not, the distinction between the fields of medicine and philosophy is not so clear-cut. Both doctors and philosophers raised concerns about mental health, and both saw it as a vital element of overall physical well-being. Last but not least, Singer closes the book with a novel approach to the study of Galen's "therapy of the soul" by analyzing Galen's models of psychological explanations in relation to their genre and context. The scarcity of treatment records and the repetition of case histories lead Singer to conclude that Galen's interests lie in demonstrating not his therapeutic achievement, but rather his diagnostic skill.

Overall, the individual contributions are well researched and the editors must be praised for their conscientious work. The book contains a generous bibliography (421-449), a list of primary text abbreviations and editions (VII-XV), and, alongside the obligatory general index (470-479), also a much appreciated index locorum (450-469), all of which allow for easier orientation in the book and further research. Each quoted Greek and Latin passage is given both in the original language and in punctilious English translation, with careful referencing throughout. This meticulous presentation suggests that the editors expect the book to be read more widely than by expert classicists only.

Although errors are kept to a minimum, it would have been helpful if the editors had been consistent in editing the titles of ancient works – citations of the same source appear interchangeably in English and in Latin throughout the book (e.g. while the work of Pseudo-Aristotle is cited as Problems on page 25, it appears as Problemata Physica on page 35 and as Problemata on page 274; to add to the confusion, an abbreviated form Pr. can also be found in the text, e.g. page 281). This inconsistency may perplex readers unfamiliar with such sources, but the list of abbreviations of primary texts and of editions and the index locorum set the matter straight. Thus the editors succeed in every way in presenting a thought-provoking and at the same time approachable volume, which will surely appeal to a readership of both experts and enthusiasts.

Table of Contents

Introduction. Disease Classification and Mental illness: Ancient and Modern Perspectives, Chiara Thumiger and P. N. Singer
PART 1: Broader Reflections on Mental Illness: Medical Theories in their Socio-intellectual Context
1. Between Insanity and Wisdom: Perceptions of Melancholy in the Ps.-Hippocratic Letters 10-17, George Kazantzidis
2. "Not a Daimōn, but a Severe Illness": Oribasius, Posidonius and Later Ancient Perspectives on Superhuman Agents Causing Disease, Nadine Metzger
PART 2: Individual Authors and Themes
3. Athenaeus of Attalia on the Psychological Causes of Bodily Health, Sean Coughlin
4. Archigenes of Apamea's Treatment of Mental Diseases, Orly Lewis
5. Mental Perceptions and Pathology in the Work of Rufus of Ephesus, Melinda Letts
6. Mental Disorders and Psychological Suffering in Galen's Cases, Julien Devinant
7. Galen on Memory, Forgetting and Memory Loss, Ricardo Julião
8. Stomachikon, Hydrophobia and Other Eating Disturbances: Volition and Taste in Late-Antique Medical Discussions, Chiara Thumiger
9. "A Most Acute, Disgusting and Indecent Disease": Satyriasis and Sexual Disorders in Ancient Medicine, Chiara Thumiger
10. Mental Derangement in Methodist Nosography: What Caelius Aurelianus Had to Say, Anna Maria Urso
11. Mental Illness in the Medical Compilations of Late Antiquity: The Case of Aëtius of Amida, Ricarda Gäbel
PART 3: Philosophy and Mental Illness
12. Making the Distinction: The Stoic View of Mental Illness, Marke Ahonen
13. Philosophical Psychological Therapy: Did It Have Any Impact on Medical Practice?, Christopher Gill
14. Galen's Pathological Soul: Diagnosis and Therapy in Ethical and Medical Texts and Contexts, P. N. Singer


1.   Previous titles are listed at Brill.com.
2.   Most contributions derive from presentations at the conference "Mental Diseases in Ancient Medicine" held at the Humboldt- Universität zu Berlin in October 2014.
3.   Except perhaps for a few references in philosophy (e.g. Plato Phaedrus 265a9-10 and Timaeus 86b1-7), the lack of a well-defined model of mental disease in earlier periods is well recognized and acknowledged in the volume.

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