CUP (2017) h/b 503pp £105 (ISBN 9781107176010)
P.G. Wodehouse’s ‘eminent loony-doctor Sir Rodney Glossop’ has his doubts about Bertie Wooster: he thinks he has mental problems. You cannot blame him when (for example) Bertie attempts to puncture his hot water bottle with a pin in the dead of night. To put it very simply, the theme of this book is that no Hippocratic doctor of the 5th and early 4th C BC would draw such a conclusion, whatever lunacies Bertie indulged in. The theatre of mental disorder for them was observable in physical signs – bodily movements, gestures and so on. For these doctors, mental illness was an observable physical illness.
T. demonstrates her case by closely examining the way that Hippocratic texts describe mental illness. Eyes, mouth, lips, and teeth not behaving as normal, serious suffocation and congestion, strange articulations of the voice (including, for example, shouting, stammering and silences), and wild movements of the limbs—spasms, shaking, wandering about, tremors, shivering—could all be associated with insanity. Disrupted sleep, rejection of food and other disorders of eating, drinking (including drunkenness), sexual life and e.g. self-harm, leading sometimes to death, also came into the equation (but not aggressive behaviour, which affected other people, not oneself). T. points out that many of these physical signs also manifested themselves in the characters of epic and tragedy, but there they were wrapped up in the idea of the mind (phrên) or soul (psukhê) as a ‘seat of personality and identity’. The legacy of this association in the West is massive: but it is a post-Hippocratic development.
At the same time, Hippocratic doctors paid close attention to what the patients said about their state. T. describes how patients experienced their five senses (drawing on pseudo-Aristotle’s Problêmata as well) and shows how, for Hippocratic doctors, these subjective observations were related to and therefore tied in with the body’s interaction with the world and consequences for mental health. T. ends by discussing what we regard as the big issues relating to mental health—emotions, ethics, life-style, social behaviour and ‘cognitive functions’ (reasoning capacity, will-power and so on)—and demonstrates that, even where the Hippocratic doctor did engage with a patient’s personal experiences and thought processes, they continued to relate them to the patients’ physical state. Those psychological terms that later Greek doctors used (see above) were almost entirely absent from Hippocratic discussions in this general area.
T. concludes by contrasting the two ‘stories’ that emerge from her analysis: first, Hippocratic texts on mental health were ‘less perceptive and certainly more mechanical’ than those to be found in contemporary literary texts (myth and poetry in particular); at the same time, Hippocratic doctors wanted to ‘carve out a place for scientific approaches to mental well-being separate from (if not necessarily alternative to) contemporary metaphysical representations’. Such a search for reason- and observable evidence- based human intelligibility was wholly typical of 5th and 4th C thought.
This review cannot do full justice to this detailed, closely and carefully argued book that also engages with modern views of mental health and ranges widely across the whole field. T.’s work will be a major point of reference for all future research on ancient views about the subject.