By: Sofia Arreguin
Social History of Epilepsy
Today, medical advancements have furthered our understanding of epilepsy, yet stigmas continue to surround persons with this condition. These individuals often face discrimination in the workplace or by society as many continue to fear or misunderstand the neurological issue. This resembles much of the thinking exhibited by communities in the past, many of which adopted a unique interpretation of epilepsy. Because there was no known cause or treatment, different eras of society attempted to make sense of epilepsy by appealing to religion, while others endeavored to understand the physiology behind it.
The First Reports
The first epilepsy report can be traced back to 2,000 B.C., inscribed on a tablet from Mesopotamia, written in the Akkadian language (Magiorkinis, et al., 2009). The author ultimately described a seizure, but, because individuals lacked knowledge of epileptic symptoms, the convulsion was diagnosed as ‘antasubbû,’ or ‘the hand of sin.’ They believed these seizures were caused by spirits and gods, especially the God of the Moon. A later report from Ancient Egypt took a more biological approach to understanding epilepsy. The case revolved around a patient’s open head wound, and when direct stimulation was applied to the brain, the body would experience convulsions. The Egyptians found that by probing the brain, the body would produce a physiological response: immense shuddering (M. Kaculini, et al., 2021). This description gave rise to the idea that focal seizures were a result of cortical irritation, or increased excitability of the brain’s cortex; it essentially expounded on the influence a severe head injury has on causing traumatic epilepsy.
The Role of Spirituality
During the Middle Ages, individuals maintained the idea of demonic possession as being the basis for epilepsy. Its literature related “demon,” “falling evil,” and “lunacy” to the display of epileptic symptoms. The Babylonians held similar views and attributed the presence of ‘evil spirits’ to the neurological condition (Magiorkinis, et al., 2009). Comparable to the account of epilepsy from Mesopotamia, the Babylonian medical text, Sakikku, referred to epilepsy as ‘antasabbû’ and ‘miqtu,’ which translates to “the falling disease.” The condition affected some aspects of their existence, even slavery. The Babylonians implemented the Hammurabi Code, which demanded that a slave who displayed symptoms of Bennu, another name for epilepsy, be returned and the money of the buyer refunded. For the Romans, epilepsy was considered an ominous sign from the gods. Often, Senatorial affairs were postponed if a Senator was affected by epilepsy during a meeting. For this reason, Romans regarded epilepsy as “morbus comitialis,” since its symptoms frequently obstructed the “day of comitia,” or the assembly of the people.
Most notable, however, for their interpretation of this condition, was Ancient Greece. Originating from the Greek word ‘epilabanein,’ meaning “to seize, possess, or afflict,” epilepsy was known by many names: “the sacred disease,” “Herculian disease,” “Seliniasmos”, and “demonism” (Magiorkinis, et al., 2009). The depiction of epilepsy as a “sacred disease” arose from the erratic behavior displayed by King Cambyses II. Men of similar high status, such as King Ceasare, or Hercules, were said to have epilepsy, and as a result, the condition came to be regarded as the “disease of geniuses.” Conversely, many Greeks regarded epilepsy to be a miasma (Greek for pollution) on the soul, cast by the Goddess of the Moon, Selene; they believed those who offended the Goddess would be afflicted with epilepsy. Selene, though, was not the sole god responsible for such affliction. A poet wrote of a young girl developing epilepsy as a result of participating in a marriage Artemis, a vengeful lunar goddess, disapproved of; it was she who many women with epilepsy were advised to bring offerings. Other Greek Gods were related to the condition, yet the attribution of these deities, such as Apollo, Hekate, Hermes, Poseidon, Mars, and Cybele, would depend on the epileptic symptoms a person would exhibit. For example, if an epileptic seizure caused the individual to “scream like a horse,” the Greeks felt Poseidon responsible; whereas the teeth grinding would lead the Greeks to blame Cybele. In Ancient Sparta, a city in Greece, newborn infants were inspected for defects by the Lesche, a council composed of elders. If the infant was determined to be unhealthy or weak, they would be placed alone in the Apothetai, a chasm within the Taygetus mountain, to perish. Many women embraced bathing their infants in wine rather than water to increase their child’s health (M. Kaculini, et al., 2021). It was believed that undiluted wine would cause ill infants to experience epileptic convulsions, whereas the healthy babies would become stronger.
The Colony
During the late 1800s, epilepsy was predominantly misinterpreted and stigmatized. Those diagnosed with epilepsy found that there were effectively no employment opportunities offered to them, so many wound up in workhouses or asylums (The History of Epilepsy Society, n.d.) Eventually, the formation of a ‘colony’ for persons, or ‘colonists,’ with epilepsy came about in 1894. Named the Chalfont Colony, this notion was based on the idea that an outdoor life with physical activities was instrumental to restoring nervous equilibrium and curing the condition. The men were tasked with plumbing, bricklaying, and carpentry, as it was believed fresh air and laborious jobs benefitted the patient’s health more than doctors and medication; however, the men were seen by a medical team. In time, a house for women was constructed, where they ironed and washed items; it wouldn’t be until later that they were allowed to assist in farming.
The Role of Eugenics
Throughout the 19th century, negative views on epilepsy began to coincide with the eugenics movement, a theory that sought to restrict the reproduction of inferior individuals, including those with epilepsy. In the early 1900s, ‘colonies’ were assembled to house those with epilepsy, offering, as many considered, rest and an escape for wealthy families to relieve themselves of the “embarrassment and discomfort of epilepsy” (L. Masia & Devinsky, 1999). As related by an American text on neurology, it was reasonable for the public to support the isolation and prevention of marriage for those with epilepsy, as it was an accepted belief that there were potential dangers that could come about from the matings between the ‘unfit.’ Similarly, a medical superintendent of Craig Colony announced there was no benefit to the marriage of epileptics; it only resulted in the creation of “diseased” offspring. During the mid-20th century, Americans regarded epilepsy as a medical and social disease. Along with being isolated, individuals with this condition faced multiplied barriers, such as laws and legislation preventing them from driving, employment, marriage, reproduction, and becoming parents (L. Masia & Devinsky, 1999). As a result, many households concealed the truth behind a relative’s connection with epilepsy; by hiding the presence of epilepsy, families hoped to increase social opportunities for their kin.
Proposed Remedies
Although modern science confirms the irrelevance of marriage as a treatment for epilepsy, Hippocrates, an ancient Greek physician, and philosopher, believed it was beneficial to engage in marriage and pregnancy to avoid seizures during puberty. This manner of thinking was also prevalent in the 19th century, as doctors would recommend marriage for women with epilepsy. The idea may have been supported by a special case involving a woman diagnosed with catamenial epilepsy, whose seizures halted once she became married and pregnant. According to Diocles, a Greek physician from the 4th century B.C., exercise, phlebotomy, and lozenges that disturbed the stomach and produced vomiting, would remedy the disorder (Magiorkinis, et al., 2009). Further recommendations come from Praxagoras of Cos, around 340 B.C., which included shaving an individual’s head, incorporating lamb, pig, young dogs, and male goats into a person’s diet, and holding one’s breath. A more intriguing treatment came from Galen, who prescribed a drink of burned human bones; he suggested the patient be unaware of the ingredient to prevent nausea (Magiorkinis, et al., 2009). Engaging in a similar course of ‘magical remedies’ was Pliny the Elder, who advised patients to ingest spring water from the skull of a deceased, unburnt man or rub their feet with menstrual blood. Other suggestions come from Aurelius Cornelius Celsus, who instructed his male patients to engage in sexual intercourse, or, if unyielding to the idea, were prescribed the blood of fallen gladiators.
Conclusion
Epilepsy is often perceived negatively by society because they either fear the condition or lack knowledge of what epilepsy encompasses. Throughout early history, seizures were thought to be the work of evil spirits possessing the body, and the only treatment available was to perform a sacred ritual to dispel the spirit. As time continued, changing attitudes toward epilepsy resulted in the separation of epileptic patients from criminals within the asylums, and the creation of hospitals, and colonies to care for epileptic patients. However, society continued to perceive them as inferior individuals who held a dangerous disease. Even as our society modernizes, many individuals continue to harbor negative stigmas toward those with epilepsy, which is something that must be changed.
References
Epilepsy Society. (n.d.) The history of Epilepsy Society. https://epilepsysociety.org.uk/what-we-do/about-epilepsy-society/history-epilepsy-society
Kaculini, C.M., et al. (2021). The History of Epilepsy: From Ancient Mystery to Modern Misconception. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC8051941/
Magiorkinis, E., et al. (2009). Hallmarks in the history of epilepsy: Epilepsy in antiquity. Epilepsy & Behavior 17, 103-108. http://dx.doi.org/10.1007/s00415-009-5433-7
Masia, S.L, & Devinsky, O. (1999). Epilepsy and Behavior: A Brief History. Epilepsy and Behavior 1, 27-36. https://doi.org/10.1006/ebeh.1999.0021
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