Hippocrates is credited with having written or at least inspired the Hippocratic Corpus, which gathered more than 70 medical texts together.
It was in this work that he first advanced his theory of the four humors to explain the main causes of illnesses in humans. His work was later widely disseminated by the Roman physician Galen CE. This strengthened the role it played in the treatment of illnesses, both physical and mental. These humors represented different aspects of a human, connected to the four elements wind, air, earth and fire and the four seasons spring, summer, fall and winter. While these four humors could be used to describe physical illnesses, they could also be used to describe mental conditions.
Black bile was associated with someone who was melancholic, yellow bile with a choleric temperament, blood with someone who was sanguine and phlegm with a person who was phlegmatic.
If someone was too melancholic, this meant they had too much black bile in their body. A manic person could have either too much blood or too much yellow bile.
Ultimately, the way to restore emotional well-being was to find a way to balance the four humors. Hippocrates also believed body parts played a role in mental illness. Sadly, this was to become a curse for women for two millennium.
The Greek word for uterus is hyster. This idea was to be used against women who might or might not have been suffering from mental illness until the early part of the 20th century. As a medical philosophy, humoralism remained the primary way to treat mental illness until the middle of the 19th century — almost 2, years after Hippocrates first proposed it.
Great writers like Shakespeare and Ben Johnson frequently refer to humors in relation to character. Shakespeare used the word many times in sonnets and plays. Hamlet, for instance, was thought to have too much black bile, which played a role in his melancholic attitude towards the world.
Yet in the Middle Ages, parts of Europe slid back toward superstition. Beginning in the 13th century, mentally ill individuals, especially women, were thought to have been possessed by the devil.
This belief remained strong until the middle of the 17th century, when humoralism regained its predominant position during the Enlightenment. Humoral theory continued in some form until the midth century.
More modern treatment of mental illness began in the 16th century with the establishment of hospitals and sanatoriums like Bedlam in England.
While we look upon these things in modern times as horrific, in the 16th century these institutions were seen as a more humane way to treat the mentally ill. In the mid- to late 19th century, men like Joseph Breuer and Sigmund Freud started to articulate psychological explanations for mental illness rather than physical ones. These were the first steps of psychoanalysis, which dominated much of the first half of the 20th century.
On this account. The physician should make every effort that all the sick, and all the healthy, should be most cheerful of soul at all times, and that they should be relieved of the passions of the psyche that cause anxiety. Gregor Reisch d. Gregor Reisch included an often-reproduced woodcut profile of the head in his book Margarita Philosophica.
The figure locates various faculties of the soul cogitation, memory, etc. Note that Imaginativa imagination is located directly over the eyes. Ideas about the "balance of the passions" were popular in the Renaissance and early modern periods. One famous work showing how influential these ideas would become is Robert Burton's The Anatomy of Melancholy which included the following observations about the possibly disastrous role of unchecked emotions: "the mind most effectually works upon the body, producing by his passions and perturbations miraculous alterations.
Some authors suggested that the imagination affected the body directly by its immaterial agency, others that it operated indirectly by first arousing the emotions which, in turn, "are greatly alterative with respect to the body.
Speculation about the influence of the "imagination" was intense during the Renaissance period. It was widely believed that vivid ideas could lead to various bodily consequences, including diseases and monstrous births. The mother, advised by her neighbor to hold a live frog in her hand as a means to cure her fever, was still holding the frog that evening, when she and her husband conceived a child.
Intellectuals and lay people alike were strongly committed to these ideas in the seventeenth and eighteenth centuries. While certain philosophical fashions within the medical community changed to reflect the Scientific Revolution going on around it, much medical practice remained traditional and fundamentally unaltered.
Consideration of the role of the imagination and of strong emotions in the onset and course of illnesses continued into the nineteenth century. Medical literature included extensive essays and specialized monographs on emotional states and their impact on somatic health and disease. The husband is attempting to lead his pregnant wife away from the cage of the great apes at the zoo.
He is afraid that by looking at the ape in her condition, she might give birth to a deformed baby. The longstanding belief that the vividly stimulated imagination of pregnant women could lead to "monstrous" births persisted in popular culture well into the nineteenth century. In many ways, however, the close of the eighteenth century marked a new era. As part of the Scientific Revolution, anatomical investigation once undertaken in antiquity had revived and became a hotly pursued field of study.
Andreas Vesalius in sixteenth century Padua and Thomas Willis in seventeenth century Oxford were just two of the many bold explorers who cut into the body, probed its structure, and displayed their findings in beautifully illustrated works. In the eighteenth century, physicians increasingly turned to anatomy as a foundation for pathology.
As a result, disease processes were progressively "localized," that is, said to reside primarily in the disruptions or "lesions" of the solid parts of the body rather than in the imbalance of humors. Post mortem dissection became an increasingly common medical practice. The De Fabrica, the first modern work of anatomy, was initially published in This plate is enlarged from the Venice edition. Andreas Vesalius Edouard Hamman What is particularly notable about this scene of Vesalius about to perform an autopsy is his gaze, directed away from the cadaver, and his hand resting on the left arm, almost as if taking a pulse.
An outstanding example of seventeenth-century anatomical achievement was Thomas Willis's Cerebri Anatome On the Anatomy of the Brain , first published in Shown here are Willis's engravings of the human brain left page and of the sheep brain right page. At the turn of the nineteenth century, diagnostic breakthroughs swiftly succeeded the maturation of gross pathological anatomy.
This stands in sharp contrast to the scene typically depicted at the medieval bedside. The physician placed one end of the instrument on the patient's chest and his ear to the other, so he could listen to the sounds of disrupted anatomy within.
The stethoscope is illustrated here in a fold-out plate with parts of the lung shown at the right. The further development of microscopic anatomy by Rudolf Virchow and others in the nineteenth century led to greater knowledge of tissues and cells.
This development, unfortunately, also fragmented the notion of organismic unity implicit in classical and early modern medical theory. In Virchow's most influential book, Die Cellularpathologie , he described and depicted the precise microscopic structure of cells--including nerve cells--but seemed to leave no place in the body's operation for the influence of the emotions.
Rudolph Virchow is regarded as perhaps the greatest medical scientist of the nineteenth century. He was a pioneer in the field of cellular pathology and pursued pathological anatomy at the tissue and cell level. By the mid-nineteenth century, however, a place was secured for emotions in connection with disease even as post mortem anatomy and cellular pathology advanced. Already in the eighteenth century William Cullen had noted that patients with certain major disorders--"insanity", for example--did not always show the expected organic lesions upon post mortem dissection.
He reasoned that, instead, such patients may have developed "a considerable and unusual excess in the excitement of the brain" and that this excitement could in turn have derived from "violent emotions or passions of the mind.
These physicians hoped to find in nervous system physiology a compromise of sorts between traditional ideas linking emotions and disease and the new desire to extend the reach of localistic pathology.
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