Classical Medicine & Mental Health

DISCLAIMER: NONE OF THIS IS MEDICAL ADVICE – IT’S TO BE TAKEN AS IS. DO NOT DO ANYTHING WITHOUT TALKING TO A MEDICAL PROFESSIONAL FIRST.

Just a few weeks ago I was trying to refute the idea that those who have mental health issues should be discouraged from Stoic philosophy – which I saw as an interpretation – turns out that this was largely due to this author’s biased interpretation of ideas – you can adapt philosophy. Arguing about one correct interpretation of philosophy is a terrible concept anyway – you can make it meaningful to you.

Sometimes the internet takes to you weird places…

I came across a name – Caelius Aurelianus (believed to be of African descent) – a 5th Century physician and writer on medical topics who wrote a book called ‘On Acute Diseases, On Chronic Diseases’. The book itself contains what is thought to be a translation of previous works by the Greek physician Soranus of Ephesus – who was alive during the 1st/2nd Century AD. It was translated in 1950 by someone called Israel Edward Drabkin.

Some things were discovered earlier…

The book contains a number of amazing things that are not acknowledged in most medical history. I want to first take a look at two conditions that are ascribed to being discovered by physicians far later in life – Asthma and Sleep Paralysis.

Asthma

Most people believe that Sir William Osler considered by many to be the the ‘father of modern medicine’ to have been the first to describe Asthma with clinical accuracy – I’d like to point out – this is wrong.

Men are more subject to attacks of asthma than are women; old men and boys more so than young men, and soft bodies more so than those of a hardy nature. The attacks come more often in the winter and at night than in the summer and during the day. In some cases asthma arises spontaneously, in others it supervenes upon a previous disease, often coming after a severe chill.

In asthma there is difficulty in breathing, frequently of short rather than long duration, and a choking sensation in the chest together with a feeling of heaviness and burning heat.

The disease is marked by alternate periods of attack and remission. The latter intervals are sometimes completely free and clear of symptoms of disease, but at other times are marred by the presence of traces of the ailment. That is, even in the intervals of remission the patient may still suffer from shortness of breath, a condition which becomes quite obvious when he does any climbing or hurrying or is distressed by indigestion, fatigued by venery, or troubled by cold, dust, or smoke.

Asthma is a disease involving a state of stricture.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

Compare this description to the one given by Sir William Osler.

Spasm of the bronchial muscles

Swelling of the bronchial mucous membrane

A special form of inflammation of the smaller bronchioles

Having many resemblances to hay fever

The affection running in families.

Often beginning in childhood and sometimes lasting into old age.

Bizarre and extraordinary variety of circumstances which at times induce a paroxysm:

Sputum is distinctive: rounded gelatinous masses (“perles“) and Curschmann spirals & octahedral crystals of Leyden

A Brief History of Asthma and Its Mechanisms to Modern Concepts of Disease Pathogenesis

The language used to identify the organs is more precise but the mechanism of action is exactly the same.

Incubus (Sleep Paralysis)

Again this is attributed to someone in the 16th Century for clinical presentation – but it’s described here in perfect clinical accuracy.

The condition cannot be called a disease unless it occurs continually and with bodily discomfort. But nightmare when it is a disease is a forerunner of epilepsy and Soranus in his work On Causes, which he calls Aetiologumena has shown abundantly that the incubus is not a god or a demigod or Cupid.

Those who suffer from the disease of nightmare show extreme sluggishness of bodily movement and stiffness. And particularly during the dream there is a feeling of heaviness and oppression and a sort of choking. They imagine that someone has suddenly attacked them and stunned their senses, exhausting them and preventing outcry.

From the feeling of heaviness we gather that the disease involves a state of stricture; from the length of time it lasts we consider it a chronic disease.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

I’ve had sleep paralysis – it’s terrifying. I do not have a visual mind’s eye (aphantasia) – so I wonder if this is the reason why I never see visions of a demon, but I can understand the concept of feeling like something is standing on your chest.

There’s nothing more terrifying than waking and you do not know how to tell your lungs to take in air – it’s absolutely indescribable. The brief amount of time it usually takes you are in pure terror – how do you turn on an automatic process? One you never think about.

On My Autism…

I think my Autism is described here across two separate conditions – Epilepsy and Mania. I’ll explain…

Sensory Sensitivity and Epilepsy

I have extremely high sensitive sensitivity – when I lived in cold housing I was affected by dust, asthma, tinnitus, sometimes I get visual hallucinations as described here when extremely sleep deprived – as do most people. Here it’s described someone who is on the verge of an epileptic attack – what’s interesting to me is that these have been the conditions that preceded my sleep paralysis in a few cases.

Those who are on the verge of an attack of epilepsy show symptoms in common with those of other diseases originating in the membrane of the brain, e.g., heaviness of the head and dizziness, head noises, sympathetic pain in the back of the head, eyes staring, ringing in the ears or impairment of hearing, and blurring of vision accompanied by dizziness. Certain objects may appear as if dangling before the eyes, like the sparkling points in marble (Greek amarygmata or marmarygae) or spiders’ webs or thin clouds or small winged animals, such as gnats. And patients see sparks flashing or rings of fire spinning before their eyes. The tongue feels rigid, the muscles quiver, and there is pain in the back between the shoulder blades. And patients see sparks flashing or rings of fire spinning before their eyes.

There are also the following symptoms: stiffness of the throat, constant precordial distention, yawning, sneezing, flow of saliva, distaste for food or else an uncontrolled desire for it, continued wakefulness or else excessive and unprofitable sleep, troubled dreams, difficulty in digesting food, … mind unsettled and troubled, a tendency to become angry for no good reason, forgetfulness of what has just recently taken place, and a susceptibility to anything that blurs the vision.

As the disease emerges and takes hold of the body, the patient is bereft of his senses. As the attack gains full sway, in some cases the patient remains completely immobile; his face is pale and lowered, respiration slow, and pulse large; he is overcome as if by a deep sleep.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

This is almost text book signs also that I am about to have an Autistic meltdown and this is what happens to me a lot of the time – I literally shut down.

Epilepsy is one of the highest co-occurring diagnoses for Autistic people, it’s very hard for me not to believe that epilepsy is the more advanced form of my sensory sensitivity – when the brain is overly connected between regions things can overload me. I actually do have mini-seizures for certain things – sometimes my mind wipes if a noise is too loud – I do not collapse or seize but my mind goes completely blank as if I have been briefly concussed.

What also points this out to me is this particular thing they mention for making sure you do not trigger a further attack:

Thereafter many of the previously mentioned symptoms which indicate the onset of the disease, e.g., dizziness and dimness of vision, may occur when the patient does something while bending forward, or watches a ship or a swiftly rotating potter’s wheel, gazes at flowing water, looks up a great height or a cliff, hears a loud noise or shout, suffers a severe chill, takes too hot a bath, or smells strong odors whether pleasant or unpleasant, such as that of burning storax, frankincense, bdellium, lignite, bitumen, or stag’s horn.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

Mania

Sometimes it arises from hidden causes, at other times from observable causes, such as exposure to intense heat, the taking of severe cold, indigestion, frequent and uncontrolled drunkenness (Greek craepalè), continual sleeplessness, excesses of venery, anger, grief, anxiety, or superstitious fear, a shock or blow, intense straining of the senses and the mind in study, business, or other ambitious pursuits, the drinking of drugs, especially those intended to excite love (Greek philtropota), the removal of long-standing hemorrhoids or varices, and, finally, the suppression of the menses in women.

Before the disease emerges, those who are not attacked suddenly by it have the same symptoms as persons on the verge of epilepsy or of apoplexy. These signs may be found, then, in what has already been said. But some seek to distinguish the antecedent signs of these diseases by listing specific signs for each of them in addition to the general signs common to all. Thus deep sleep, they say, is indicative of the coming of epilepsy; light and short sleep, on the other hand, of mania. So, too, they take it as an indication that mania is imminent when a person in a state of anger suffers congestion of the head and believes that he has gone mad or, again, when such a person is overcome by speechlessness resulting from groundless fear.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

I… These are the things that cause my Autistic meltdowns. These are the things I am constantly balancing. Here Caelius Aurelianus talks about how ‘Mania’ presents – I want you to think about modern descriptions of Autism, Schizophrenia, and Autistic Burnout.

Now when the disease of mania emerges into the open, there is impairment of reason unaccompanied by fever; this impairment of reason in some cases is severe, in others mild; it differs in the various cases its outward form and appearance, though its nature and character are the same. For, when mania lays hold to the mind, it manifests itself now in anger, now in merriment, now in sadness or futility, and now, as some relate, in an overpowering fear of things which are quite harmless. Thus the patient will be afraid of caves or will be obsessed by the fear of a falling into a ditch or will dread other things which may for some reason inspire fear.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

So these are things that are described to treat this condition…

As for the treatment, we hold that measures should be taken similar to those employed in epilepsy. Thus, to begin with, have the patient lie in a moderately light and warm room. The room should be perfectly quiet, unadorned by paintings, not lighted by low windows, and on the ground floor rather than on the upper stories, for victims of mania have often jumped out of windows. And the bed should be firmly fastened down. It should face away from the entrance to the room so that the patient will not see those who enter. In this way the danger of exciting and aggravating his madness by letting him see many different faces will be avoided. And the bedclothes should be soft.

Do not permit many people, especially strangers, to enter the room. And instruct the servants to correct the patient’s aberrations while giving them a sympathetic hearing. That is, have the servants, on the one hand, avoid the mistake of agreeing with everything the patient says, corroborating all his fantasies, and thus increasing his mania; and, on the other hand, have them avoid the mistake of objecting to everything he says and thus aggravating the severity of the attack. Let them rather at times lead the patient on by yielding to him and agreeing with him, and at other times indirectly correct his illusions by pointing out the truth. And if the patient begins to get out of bed and cannot easily be restrained, or is distressed especially because of loneliness, use a large number of servants and have them covertly restrain him by massaging his limbs; in this way they will avoid upsetting him.

If the patient is wakeful, prescribe passive exercise, first in a hammock and then in a sedan chair. The rapid dripping of water may be employed to induce sleep, for under the influence of its sound patients often fall asleep. And heat should then be applied to the eyes with warm sponges, and the stiffness of the lids relaxed; for the beneficial effects of this treatment will pass through the eyes to the membranes of the brain.

And then prescribe passive exercise, first in a sedan chair and then in a cart drawn by hand. When the patient’s body has gained strength, prescribe walking and also vocal exercise, as required by the case. Thus have the patient read aloud even from texts that are marred by false statements. In this way he will exercise his mind more thoroughly. And for the same reason he should also be kept busy answering questions. This will enable us both to detect malingering and to obtain the information we require.

Then let him relax, giving him reading that is easy to understand; injury due to overexertion will thus be avoided. For if these mental exercises overtax the patient’s strength, they are no less harmful than passive exercise carried to excess.

And so after the reading let him see a stage performance. A mime is suitable if the patient’s madness has manifested itself in dejection; on the other hand, a composition depicting sadness or tragic terror is suitable in cases of madness which involve playful childishness. For the particular characteristic of a case of mental disturbance must be corrected by emphasizing the opposite quality, so that the mental condition, too, may attain the balanced state of health.

And as the treatment proceeds, have the patient deliver discourses or speeches, as far as his ability and strength permit. And in this case the speeches should all be arranged in the same way, the introduction to be delivered with a gentle voice, the narrative portions and proof more loudly and intensely, and the conclusion, again, in a subdued and kindly manner. This is in accordance with the precepts of those who have written on vocal exercise (Greek anaphótièsis). An audience should be present, consisting of persons familiar to the patient; by according the speech favorable attention and praise, they will help relax the speaker’s mind. And, in fact, any pleasant bodily exercise promotes the general health.

Now if he is unacquainted with literature, give him problems appropriate to his particular craft, e.g., agricultural problems if he is a farmer, problems in navigation if he is a pilot. And if he is without any skill whatever, give him questions on commonplace matters, or let him play checkers. Such a game can exercise his mind, particularly if he plays with a more experienced opponent.

When the patient has had his walk and rest, he should be carefully anointed. At first, massage him only slightly and simply. But when his recovery has become more obvious, massage him behind the shoulders and the neck with a downward motion, using a stronger stroke than before; this is the moderate rubdown which the Greeks call cataspasmos. In the final stage also massage the head; and when the head is relieved, prescribe bathing.

Then, if the patient shows no new symptoms and has accustomed himself to the various parts of his regimen, change of climate should be prescribed. And if he is willing to hear discussions of philosophers, he should be afforded the opportunity. For by their words philosophers help to banish fear, sorrow , and wrath, and in so doing make no small contribution to the health of the body.

But if the disease persists and becomes chronic, being marked by attacks alternating with intervals of remission, relieve the attacks, using the same remedies as those prescribed above for the initial attack of mania. But in the intervals of remission, prescribe, first, the restorative series of treatments including various types of passive exercise, vocal exercise arranged under the supervision of a musician, walking, passive exercise, varied food, and the like.

Again, in restoring the patient’s health, the services of a trainer should be employed. Use should also be made of natural waters, such as alkaline springs, particularly those free from any pungent odor which might injure the membranes o f the brain. A trip abroad by land or sea and various mental diversions are helpful in affording relaxation of the mind.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

I don’t know how to tell you that all of these things help me with my Autistic difficulties… but they do – every one of these things is beneficial.

One of the assertions is that ‘Mania’ is caused by stricture of the body – massage is recommended to help with this – it’s been shown in widespread scientific trials to be beneficial in reducing anxiety and depression.

Acupuncture is also recommended and has some reasonable evidence in science in meta-analyses to be beneficial for anxiety, depression, and a number of auto-immune diseases.

Maybe the answers I was looking for are not in pharmaceuticals for me. Maybe they’ve been here all along – but people want to be known as the ones who discover stuff and most of these things have been frowned upon by the modern medical establishment.

Published by roryreckons

I am an ADHD/Autism/OCD advocate and independent ADHD/Autism researcher. I am training in 2021 to become an ICF Accredited ADHD coach. I write mainly about ADHD/Autism/OCD/Mental health issues, but will also discuss morality, abolition, and current affairs occasionally.

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