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himself with superstitious ideas, he hates life ... he is terror-stricken, he mistakes his fantasies for the truth ... he complains of imaginary diseases, he curses life and wishes for death. ’
    At the opposite pole lay mania. A condition marked by excess and uncontrollability, it found vent, for Aretaeus, in ‘fury, excitement and cheerfulness’. In acute forms, the sick person ‘sometimes slaughters the servants’; or he might become grandiose: ‘without being cultivated he says he is a philosopher.’ Mania often included euphoria: the sufferer ‘has deliriums, he studies astronomy, philosophy ... he feels great and inspired’.
    Displaying the rationalist temper of Classical medicine, Aretaeus deplored those collective outbursts of frenzied cultic Dionysian activity which, to his mind, had disgraced Greek civilization and were still all too present in the Roman Empire, diagnosing these religious outbursts medically. He pinpointed the kinds of superstitious mania which involved possession by a god (divine furor), especially amongst those following the cult of Cybele (Juno). In ‘enthusiastic and ecstatic states’, devotees would stage wild processions, and, as with the Corybantics, believers ‘would castrate themselves and then offer their penis to the goddess’. Zealots fell into trances supposedly derived from divine inspiration, feeling deliriously euphoric and worshipping the gods of ecstasy and the dance. All this, in his view, betrayed ‘insanity ... in an ill, drunken and confused soul’.
    Aretaeus has been credited with identifying what were much later to be called bipolar disorders. ‘Some patients after being melancholic have fits of mania’, he observed, ‘so that mania is like a variety of melancholy.’ A person previously euphoric suddenly ‘has a tendency to melancholy; he becomes, at the end of the attack, languid, sad, taciturn, he complains that he is worried about his future, he feels ashamed.’ After the down phase, they might swing back to hyperactivity: ‘they show off in public with crowned heads as if they were returning victorious from the games; sometimes they laugh and dance all day and all night.’
    Aretaeus’ very recognizable picture of wild mood-swings would have seemed perfectly familiar to the nineteenth-century French psychiatrists, Jean-Pierre Falret and Jules Baillarger, whose work on circular or double insanity pointed towards the modern category of manic-depressive psychosis (see Chapter 6). Yet we must beware the temptations of hindsight.
    Graeco-Roman medicine offered a welter of therapies for the mad, sometimes at odds with each other. The physician Soranus recommended talking to the deranged; Celsus by contrast believed in shock treatment, suggesting isolating patients in total darkness and administering cathartics in hopes of frightening them back into health.
     
    A continuing tradition
    Medieval Islamic and Christian medicine honoured and followed the medical traditions begun by Hippocrates and systematized by Galen, Aretaeus, and others, and the accounts of madness advanced by medieval learned doctors essentially repeated them. In the herbals and leechbooks produced by early medieval monks, simplified Classical learning was intermingled with folk beliefs and magical remedies. Melancholia and mania dominated the diagnoses. Among the medi-evals, Bartholomaeus Anglicus, who taught in thirteenth-century Paris, in the Aretaean manner included under ‘melancholia’ such states as anxiety, hypochondriasis, depression, and delusion.
    Greek-derived thinking retained its validity and vitality in the Renaissance. Denis Fontanon, a mid-sixteenth-century professor at Montpellier, then a major medical university, stated, apropos mania, that it ‘occurs sometimes solely from the warmer temper of the brain without a harmful humour, and this is like what happens in drunkenness. It occasionally arises from stinging and warm humours, such as yellow bile, attacking the