Mind and Madness in Classical Antiquity

  • Bennett Simon


The history of psychiatry in Greek and Roman antiquity is the frame story for the history of psychiatry in the Western world as well as the history of that topic in a particular era and in particular places. That is, it is not only one current in the stream that becomes modern psychiatry, but it is also the caput Nili, “the head of the Nile.” The terminology, categories, and core ways of thinking about mind and its derangements that evolved in ancient Greece have left an indelible stamp on all subsequent thinking about these topics. The distinction between rational and irrational, the notion of an internal mental life, and the notion of psychic conflict and that psychic conflicts can be categorized, classified, studied, and systematically influenced are all legacies from classical Greece. The notion of the body as a system, as a balance, as a mechanism, as a hierarchy of organs, or as a parliament of organs—these underlie the medical models that arose from the fifth century B.C.E. onwards. Furthermore, the Greeks developed the idea that it is possible to understand how balances and imbalances among organs and body constituents influence mind and madness, how one central organ (at first believed to be the heart, but later the brain) is the organ of mental operations, and that that organ mediates influences from the outside world and from the internal world of the body. The articulation of a concept of body and a concept of mind and the realization that if the person is thus divided there is a need to find a way of conceptualizing the unity are Greek “discoveries” or presuppositions that have left a permanent mark on our thinking about thinking.1


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Annotated Bibliography

  1. Albutt, T. C., Greek Medicine in Rome, London, 1921. [A standard work on the assimilation of Greek medicine in the Roman Empire.]Google Scholar
  2. Bourgey, L., Observation et expérience chez les médicins de la Collection hippocratique, Paris, 1953. [A perceptive and powerful discussion of the problem of “science” and “fantasy” in Hippocratic medicine.]Google Scholar
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  5. Dover, K. J., Greek Homosexuality, Cambridge, MA, 1978 [This is now far and away the best work on this most controversial topic and supercedes many previous works.]Google Scholar
  6. Drabkin, I. F., “Remarks on ancient psychopathology,” Isis, 46:223–234, 1955. [This is a germinal paper, frequently cited in the field, which lays out an—alas—as yet unfulfilled program for the comprehensive study of the history of psychiatry.]Google Scholar
  7. Edelstein, L., Ancient Medicine, Selected Papers, ed. O. Temkin and C. L. Temkin, Baltimore, 1967. [A useful and accessible collection on a variety of topics in the history of ancient medicine by a prominent scholar and “gadfly” in the field.]Google Scholar
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  9. Howells, J. G., ed., World History of Psychiatry, New York, 1975. [This work contains a number of survey articles, in addition to C. P. Ducey and B. Simon, “Ancient Greece and Rome,” pp. 1–38, relevant to antiquity and the ancient Middle East.]Google Scholar
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  17. Scarborough, J., ed., Symposium on Byzantine Medicine (Dumbarton Oaks Papers, No. 38), Washington, DC, 1985. [A compendium of scholarship in the field; important for understanding the fate of classical teaching and for seeing how those teachings were understood in an era closer to them than our own. See in particular M. Dols, “Insanity in Byzantine and Islamic Medicine,” pp. 135–148.]Google Scholar
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Notes and References

  1. 1.
    Some of the reference items mentioned in the text are presented here followed by a brief annotation in square brackets about the significance and value of the work. Some of these works are noteworthy for their accessibility and summary value, some because of the extent and depth of their scholarship, and, unfortunately, only a few for both. A few important annotated items not mentioned specifically in the text are included. For a brief, useful, and scholarly overview of the history of psychiatry in antiquity, see the relevant sections, with bibliography, in the article by George Mora, “Historical and Theoretical Trends in Psychiatry,” in H. I. Kaplan, A. M. Freedman, B. J. Sadock, eds., Comprehensive Textbook of Psychiatry, 3rd ed., Vol. I, pp. 4–94 (Baltimore, 1980). C. P. Ducey and B. Simon, “Ancient Greece and Rome,” in J. G. Howells, ed., World History of Psychiatry (New York, 1975), pp. 1–38, is also a useful overview, but is more selective. G. Rosen, Madness in Society (Chicago, 1968) is quite interesting and gracefully written but focuses on a relatively small number of topics. An excellent short overview is in Porter, Roy, Madness: A Brief History Oxford, Oxford University Press, 2002. B. Simon, Mind and Madness in Ancient Greece: The Classical Roots of Modern Psychiatry (Ithaca, NY, 1978) covers “classical” Greek antiquity (from the eighth to the early fourth centuries B.C.E.) but again only selected topics are covered in depth. It is written not exclusively from an historical perspective, but also from the viewpoint of delineating certain models of mind and mental illness that are hypothesized to run through the history of psychiatry. E. R. Dodds, The Greeks and the Irrational (Berkeley, CA, 1951) is one of the most exciting books written on a variety of topics relevant to the history of psychiatry and must be read and studied, even though it is not a systematic treatise. His mixture of detailed imaginative scholarship, judicious use of psychoanalytic and anthropological approaches, and a deep sympathy for the anxieties of the classical Greek world make this book unique and uniquely useful. See R. S. Peters, ed., Brett’s History of Psychology, rev. ed. (Cambridge, MA, 1965) for a useful overview of the more philosophic thinkers of antiquity, especially Aristotle. These works, for those who do not read French and German, constitute a good survey with coverage in depth of a number of specific topics. Jackie Pigeaud, La Maladie de l’âme: Étude sur la relation de l’âme et du corps dans la tradition médicophilosophique antique (Paris, 1981) is indispensable for the history of mental illness in Hellenistic and Roman antiquity; its focus is on the interplay of philosophy and medicine. The French is not difficult or convoluted and is accessible to those who are much less than fluent in the language. The textbooks of history of psychiatry per se are problematic: F. G. Alexander and S. T. Selesnick, The History of Psychiatry (New York, 1966) and G. Zilboorg and G. W. Henry, A History of Medical Psychology (New York, 1941) are most accessible, but there are frequent errors of fact and generalization; they should be used as armchair guide books. Giuseppe Roccatagliata, A History of Ancient Psychiatry (Westport, CT, 1986) is also a place to start but suffers from the same problems as the preceding histories of psychiatry. W. Leibbrand and A. Wettley, Der Wahnsinn: Geschichte der Abendländischen Psychopathologie (Freiburg/Munich, 1961) is superb, but it has not been translated into English, is in difficult German, and deals little with folk belief and folk healing. Access to primary sources is frequently difficult and a bit forbidding. Overall, the Loeb Classical Library of Greek and Roman authors—original texts and facing translations—is still the most scholarly source that is accessible to the interested nonspecialist. The medical works are represented spottily in the Loeb series, but more editions of Hippocrates and of Galen are being prepared. On particular authors, if there is a better edition, often the only way for the nonspecialist to learn about it is to consult a specialist in the history of psychiatry and medicine in antiquity and/or a classicist. The works of Hippocrates are most abundantly represented in the great series by Littré (in French) with Greek text, French translation, and introductions and notes. The works of Galen are most abundantly represented in the series edited by D. C. G. Kühn, with German translation. These are both nineteenth century editions, and are gradually being superseded by more modern versions, a few in English, some in French, and most in German. For the best available texts, consult the series, Corpus Medicorum Graecorum, which now consists of individual volumes of works attributed to Hippocrates of Galen (plus a few others) and different volumes may be translated into English (a few), German, or French. A search under that title in major libraries will provide the complete current list of available texts. Caelius Aurelianus (date controversial, could be fifth century C.E.), On Acute Diseases and On Chronic Diseases is found in an excellent edition and translation by I. F. Drabkin (Chicago, 1950). [A fine edition, in Latin and English, of this important medical thinker of late antiquity, with much material on acute and chronic mental illness. A source of many ideas and information for later centuries.] Aretaeus (of uncertain date; could be first century B.C.E. or second century C.E.) can be found in English in an outdated edition (1856), and a good Greek text is available. Consult the bibliography in Pigeaud, op. cit., and in W. Smith, The Hippocratic Tradition (Ithaca, NY, 1978). [A detailed discussion of the origins of the traditions about Hippocrates in the centuries just before Galen and in Galen’s lifetime. Difficult reading, but a good glimpse of what the modern historiography of ancient medicine is like at its best.] The newsletters of the Society for Ancient Medicine and Pharmacy are the richest and most scholarly, detailed, and up-to-date source of bibliography and reviews in the area of ancient medicine and related fields. They make available work being done in Europe that is often quite relevant to the history of psychiatry. The standard journals of medical history (e.g., Bulletin of the History of Medicine, Clio Medica) and the Journal of the History of the Behavioral Sciences frequently contain useful articles and book reviews in this area.Google Scholar
  2. 2.
    Simon, op. cit.; Ducey and Simon, op. cit.; Russo, J., and Simon, B. Homeric Psychology and the Oral Epic Tradition. Journal of the History of Ideas. 1968; 29:484–494. (Reprinted in Wright J., ed., Modern Essays on the Iliad, Bloomington: Univ. of Indiana Press, 1977.) Simon, B., and Weiner, H. Models of Mind and Mental Illness in Ancient Greece. I. The Homeric Model of Mind. J. Hist. Behav. Sci. 1966; 2:303–314.Google Scholar
  3. 3.
    The literature on Aristotle is immense and, unfortunately, cannot be reviewed in this chapter. An excellent treatment of mental functioning and malfunctioning in Aristotle is Daniel Robinson, Aristotle’s Psychology (New York, 1990).Google Scholar
  4. 4.
    For the problem of how much continuity and how much discontinuity there is between ancient and modern diagnostic terms, see Stanley Jackson, Melancholia and Depression: From Hippocratic Times to Modern Times (New Haven, CT, 1985). [An excellent survey and critical essay on the history of melancholia, with much useful material presented in the early chapters (and scattered throughout) on antiquity. Notes and references, including to Jackson’s articles on Galen and mental illness, are especially useful.] On hysteria, see Mark S. Micale, “Hysteria and Its Historiography: A Review of Past and Present Writings (I) and (II),” History of Science 27:223–255, 319–351 (1989) (also this volume) and especially the work of H. King, “Once upon a Text: Hysteria from Hippocrates,” in S. L. Gilman, H. King, R. Porter, G. S. Rousseau, and E. Showalter, eds., Hysteria: Beyond Freud (Berkeley, CA., 1993) pp. 3–90, and “Once upon a Text: The Hippocratic Origins of Hysteria,” in G. S. Rousseau and Roy Porter, eds., Hysteria in Western Civilization (Berkeley, CA, forthcoming) and the entry “Hysteria” Oxford Classical Dictionary. [An important “revisionist” view of Hippocratic “hysteria”; she argues for a striking discontinuity between classical Greek and later conceptions of hysteria; I would argue that the “glass is half-full” and the degree of continuity is astonishing.]Google Scholar
  5. 5.
    Simon, op. cit.; see also P. Slater, The Glory of Hera (Boston, 1968). [A psychoanalytic and sociocultural analysis of the representation and significance of the madnesses in Greek tragedy, with an illuminating analysis of strains in male-female relationships in classical Greek culture. Problematic in a number of ways; to be read with a grain of salt; it is nevertheless an invaluable and pioneering work.]Google Scholar
  6. 6.
  7. 7.
  8. 8.
  9. 9.
    E. R. Dodds, Pagan and Christian in an Age of Anxiety: Some Aspects of Religious Experience from Marcus Aurelius to Constantine (Cambridge, 1965). [A good introduction to the frame of mind in late antiquity and to source material of some important thinkers, as well sources on popular beliefs.]Google Scholar
  10. 10.
    See, for example, Isaac Ray, A Treatise on the Medical Jurisprudence of Insanity, ed. W. Overholser (Cambridge, MA 1962 [1838]), a “modern work” that does not presuppose the great authority of the ancient writers but still makes references and allusions to the study of antiquity. The main nineteenth century history of psychiatry in antiquity is Armand Semelaigne, Études historiques sur l’alienation mentale dans l’antiquité (Paris, 1869).Google Scholar
  11. 11.
    Eagleton, Terry, Literary theory: an introduction/Terry Eagleton. 2nd ed., Oxford, U.K.; Cambridgs, Mass.: Blackwell, 1996.Google Scholar
  12. 12.
    M. C. Nussbaum, The Therapy of Desire: Theory and Practice in Hellenistic Ethics (Princeton, NJ, 1994).Google Scholar
  13. 13.
    Call. Comed. 28, reference in H. G. Liddell, R. Scott, and H. S. Jones, Greek-English Lexicon (Oxford), under elleboriao.Google Scholar
  14. 14.
    Histories, III, 32.Google Scholar
  15. 15.
    M. Grant, The Jews in the Roman World (New York, 1973), pp. 284–285 and endnote.Google Scholar
  16. 16.
    Cambridge, 1979.Google Scholar
  17. 17.
    Cambridge, 1982.Google Scholar
  18. 18.
    Sudhir Kakar, Shamans, Mystics, and Doctors: A Psychological Inquiry into India and its Healing Traditions (Boston, 1984); also G. Obeyesekere, “Psychocultural Exegesis of a Case of Spirit Possession in Sri Lanka,” in V. Crapanzano and V. Gattison, eds., Case Studies in Spirit Possession, (New York, 1977), pp. 235–294.Google Scholar
  19. 19.
    See, for example, W. D. Smith, “The so-called possession in pre-Christian Greece,” Transactions of the American Philological Association 96: 403–436 (1965); for the nonliteralness of Greek ideas of possession, see Peter Brown, The Cult of the Saints (Chicago, 1981), who makes a strong case for the uniqueness in the pagan world of the Christian worship at the shrines of the saints; and Yoram Bilu, “The Taming of the Deviants and Beyond: An Analysis of Dybbuk Possession and Exorcism in Judaism,” in Psychoanalytic Study of Society, Vol. 11 (Hillsdale, NJ, 1985), pp. 1–32, on the specifics and relatively recent history of Dybbuk possession in Judaism: Hebrew magic amulets had to be phrased as charms to prevent illness and were forbidden to purport to “cure.” (cf. Theodore Schrire, Hebrew Magic Amulets: Their Decipherment and Interpretation (New York, 1982).CrossRefGoogle Scholar
  20. 20.
    Arthur Kleinman, Patients and Healers in the Context of Culture (Berkeley, CA, 1980).; Fabrega, Horacio, Disease and Social Behavior: An Interdisciplinary Perspective. Cambridge, MA., MIT Press, 1974.Google Scholar
  21. 21.
    A. Cameron and A. Kuhrt, eds., Images of Women in Antiquity (Detroit, 1983). [Several articles, especially the ones by R. Padel, “Women: Model for Possession by Greek Daemons,” pp. 2–19, and Pomeroy, “Infanticide in Hellenistic Greece,” 207–222, are important for bringing issues about women into the history of psychiatry. Good bibliography.]Google Scholar
  22. 22.
    W. Smith, The Hippocratic Tradition (Ithaca, NY, 1978).Google Scholar
  23. 23.
    Op. cit., p. 50.Google Scholar
  24. 24.
    For example, H. Flashar, Melancholie und Melancholiker in den medizinischen Theorien der Antike (Berlin, 1966). [One of several excellent modern works on melancholy in antiquity, its cultural and historical setting, and the history of transmission of ideas about melancholy.] F. Kudlien, Der Beginn des Medizinischen Denkens bei den Griechens von Homer bis Hippocrates (Zurich; 1967). [A superb short work on early Greek medical and psychological thought.] Summarized by W. Smith, The Hippocratic Tradition (Ithaca, NY, 1978), pp. 234–236.Google Scholar
  25. 25.
    For example, W. Burkert, Greek Religion, trans. J. Raffan (Cambridge, MA, 1985); see index. [A magisterial work, containing much of interest for the history of psychiatry, especially folk-belief and folk-healing, e.g., healing oracles, possession, healing shrines, beliefs in immortality of the soul.]Google Scholar
  26. 26.
    Brown, op. cit., esp. pp. 50–68.Google Scholar
  27. 27.
    For example, Erwin Rohde, Psyche: The Cult of Souls and Belief in Immortality among the Greeks, trans. from 8th German ed. by W. B. Hillis (London, 1925). [A monumental and still indispensable work on the history of beliefs in immortality, possession, bewitchments and kindred topics.] Also see Dodds, Greeks and the Irrational.Google Scholar
  28. 28.
    See discussion in Ducey and Simon, op. cit., pp. 22–23.Google Scholar
  29. 29.
    Princeton, NJ, 1995. [This is the most thorough and theoretically sophisticated study of madness in Greek tragedy and related topics.]Google Scholar
  30. 30.
    David Grene and R. Lattimore, trans., The Complete Greek Tragedies, Vol. 1 (Chicago, 1960), pp. 141–150.Google Scholar
  31. 31.
    Burkert, op. cit., see index under Korybantes and Pan.Google Scholar
  32. 32.
    Loeb edition, IV, 29–30. The relation of this condition to what the physicians (and Plato) called husterikai, “hysterical” states, has been briefly discussed by Simon, op cit.Google Scholar
  33. 33.
    Mark 5:1–14; Luke 8:26–37. A phrase from this story, that the possessed man, now cured was “clothed and sane,” imatismenon kai s-ophronounta, in Greek, was used on a 19th century seal of the Asylum Superintendents Association that later became the American Psychiatric Association.Google Scholar
  34. 34.
    G. Luck, Arcana Mundi: Magic and the Occult in the Greek and Roman Worlds (A collection of Ancient Texts, Translated, Annotated, and Introduced) (Baltimore, 1985), especially pp. 163–226. [The first work I know of that gives some access to material that formed so much of the day-to-day mental life on the ancient world.]Google Scholar
  35. 35.
    Hans Dieter Betz, ed., The Greek Magical Papyri in Translation: Including the Demotic Spells. Volume One: Text (Chicago, 1986).Google Scholar
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    J. C. Lawson, Modern Greek Folklore and Ancient Greek Religion: A Study in Survivals, intro. Al. N. Oikonomides (New Hyde Park, NY, 1909), p.23. [The genus is late nineteenth century traveller’s anecdotal survey of folklore in Greece, but the material is very rich for folk healing and folk theories of illness; the collocation with antiquity is quite important. Useful introduction to this edition.]Google Scholar
  37. 37.
    Luck, op. cit., pp. 190–192.Google Scholar
  38. 38.
    In post-World War II Alaska, shamans began to wrestle with “Communist demons,” an addition to the traditional Eskimo catalogue of possessing agencies (Jane Murphy, “Psychotherapeutic Aspects of Shamanism on St. Lawrence Island, Alaska,” in A. Kiev, ed., Magic, Faith and Healing (Glencoe, IL, 1964), pp. 53–83, esp. p. 77.Google Scholar
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    R. Blum and E. Blum, The Dangerous Hour: The Lore and Culture of Crisis and Mystery in Rural Greece (New York, 1970), on twentieth century rural Greece.Google Scholar
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    Cf. Jacob’s blessing at Genesis 49:12.Google Scholar
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    Rohde, op. cit.Google Scholar
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    See discussion by Bernard Knox, The Heroic Temper (Berkeley, CA, 1964), pp. 56–57.Google Scholar
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    Pausanias, Guide to Greece, trans., intro. Peter Levi (Harmondsworth, UK, 1984), VI, 9, 6–8.Google Scholar
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    See brief account and bibliography in Mora, A. M. Freedman, B. J. Sadock, eds., Comprehensive Textbook of Psychiatry, 3rd ed., Vol. I, pp. 4–94 (Baltimore, 1980) op. cit.; E. J. Edelstein and L. Edelstein, Aesclepius: A Collection and Interpretation of the Testimonies (Baltimore, 1945) [the classic work on the healing shrines of Aesclepius and the use of dreams and incubation in diagnosis and cure]; and Burkert, op. cit.Google Scholar
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    Charles Behr, Aelius Aristides and the Sacred Tales (Amsterdam, 1968).Google Scholar
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    P. C. Miller, Dreams in Late Antiquity: Studies in the Imagination of a Culture (Princeton, NJ, 1994). [An outstanding survey and analysis of the multiple uses of dreaming and methods of dream interpretation in the Graeco-Roman and Judaeo-Christian world of late antiquity.]Google Scholar
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    Dodds, Pagans and Christians, pp. 41–52; L. Deubner, De Incubatione (1900).Google Scholar
  52. 52.
    F. Kudlien, “Der Artzt des Körpers und der Arzt der Seele,” Clio Medica 3:1–20 (1968). [Still the best short summary of the state of medical, philosophical, and Christian theological debates on who heals whom, and with what means, in early Christian antiquity.]Google Scholar
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    Dodds, Pagans and Christians.Google Scholar
  54. 54.
    The literature on mystical and gnostic movements in the early Christian centuries is vast, perplexing, and often difficult of access. Several encyclopedia articles are useful, especially “Neoplatonism,” Encyclopedia Britannica, 16th ed. (Chicago); “Kabbalah,” “Merkabah Mysticism,” and “Neoplatonism,” in Encyclopedia Judaica (Jerusalem, 1972); Dodds, Pagans and Christians; Peters, op. cit.; and Walter Scott, Hermetica: The Ancient Greek and Latin Writings which Contain Religious or Philosophical Teachings Ascribed to Hermes Trismegistus (Boulder, CO, 1982); Also see J. M. Rist, Plotinus: The Road to Reality (Cambridge, 1977) and bibliography.Google Scholar
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    Dodds, Pagans and Christians.Google Scholar
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    P. Lain-Entralgo, The Therapy of the Word in Classical Antiquity, trans. L. J. Rather and J. M. Sharp (New Haven, CT, 1970). [A pioneering text on medicine as a dialogic enterprise in antiquity. Many useful references to classical sources.] Also see Simon, op. cit., for fuller discussions of earlier philosophies as therapy.Google Scholar
  57. 57.
    For example, Anthony Preuss, Unpublished manuscript, SUNY, Department of Philosophy (Binghamton, NY, 1983), who cites the following passage.Google Scholar
  58. 58.
    Chrysippus, Therapeia tes psuches [Therapy of the psyche], quoted by Galen, On the Doctrines of Hippocrates and Plato, Part I (Berlin, 1978), Part II (Berlin, 1980), p. 299. [A detailed and thorough edition of an important work of Galen (part of Corpus Medicorum Graecorum) that gives access in English to some of the best scholarly work about medicine and philosophy in antiquity.]Google Scholar
  59. 59.
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  61. 61.
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  64. 66.
    The anatomical functional distinction between motor and sensory nerves had been established by Galen’s time. See Simon, op. cit., pp. 267–268 and endnotes for references.Google Scholar
  65. 67.
    Some relationship between depression and elation is suggested in Aristotle’s (or pseudo-Aristotle’s) Problemata (late fourth century B.C.E.), but by the time of the writings of Aretaeus (probably second century, C.E.—date uncertain) a clearer relationship had been spelled out. See Jackson, op. cit., especially pp. 25–49 and 250–254 and endnotes.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Bennett Simon
    • 1
  1. 1.PsychiatryHarvard UniversityUSA

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