By Adrian Sparrow
Throughout most of history, epilepsy has been regarded as a spiritual condition. Descriptions of epileptic seizures date back as old as 2000 BC from Mesopotamian and Homeric period texts. The oldest known detailed record of the disease is in the Sakikku, a Babylonian cuneiform text from 1067-1046 BC, and offers lists of signs and symptoms, treatments, outcomes, and different seizure types. Seizures were thought to be caused by the possession of evil spirits and thus called for spiritual treatment. Because of its strong spiritual distinction, epilepsy was regarded in ancient Greece as the ‘Sacred Disease’.
Hippocrates, who distanced himself from myths and tales, believed that nature was the “teacher of all teachers”. He instead attributed this ‘sacred disease’ to having a natural cause, declaring it not “any more divine or sacred than other diseases”. He continues to say that even the most mysterious disease was still due to natural causes, not because of an angry god or evil spirits.
“Men regard its nature and cause as divine from ignorance and wonder because it is not at all like other diseases…Men being in want of the means of life, invent many and various things, and devise many contrivances for all other things and for this disease, in every phase of the disease, assigning the cause to a god…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,” – Hippocrates (putative), On the Sacred Disease
Continuing on, the text describes the known anatomy of the brain and its major veins, and Hippocrates argues that epilepsy begins with the accumulation of phlegm (one of his defined four humors), beginning in utero. Children who had the disease mostly died, due to their small veins and inability to accommodate the increased buildup of cold phlegm. The phlegm would block air to the brain, he argued, and according to him elderly patients mostly survived due to their larger veins and hotter blood. Hippocrates concluded that the sacred disease (Hippocrates instead referred to epilepsy as the great disease, which gave rise to the term grand mal for tonic-clonic seizures) was proof that the brain governed over man, and believed that the buildup of phlegm and air blockage was the reason behind patients’ symptoms.
The first effective anti-seizure medication, bromide, was introduced in the mid-1800s, and later phenobarbital and phenytoin in the early 1900s, which encouraged the notion that seizures are a medical problem, not a spiritual one.
Regarding its social impact, Hippocrates noted that the reason for peoples’ tendency to flee and hide when they anticipate an episode was due to social stigma, and not out of fear of the divines. Unfortunately, his views on modern medicine weren’t accepted, and evil spirits continued to be blamed as the cause until even in the 20th century where Tanzania and other parts of Africa believed epilepsy was contagious and was associated with witchcraft, poisoning, and possession by evil spirits. In the UK, epilepsy was even considered grounds for annulment of marriage until 1971. International Epilepsy Day was begun in 2015 to increase awareness and support for the disease, and reduce social stigma.