Volume 19, 2007 - Brown University

The Hippocratic View of Epilepsy
and Brain Function
Eleanor Thomas
The Sacred Disease by Hippocrates is a fifth century treatise which attempts to
explain the symptoms, causes, and prognosis of a person suffering from epilepsy.
It also seeks to debunk claims by magicians and other sources considered
disreputable that epilepsy is a “sacred disease,” ordained by the gods and
curable through religious and magical expiation. In proposing a model of brain
function, it asserts that epilepsy is a legitimate physical disease, like any other,
and that it originates in the brain, when specific pathophysiological processes
disrupt normal functioning.
One can learn much about the cultural environment and prevailing attitudes
towards illness from The Sacred Disease. Prognosis, and not treatment, is the
primary focus of the text. Hippocrates makes powerful arguments about the usefulness
of accurate prognosis to a physician, as it gives him credibility. However
in the modern sense the utility of The Sacred Disease is very limited, since treatment
is neglected in favor of prognosis. Though the author at times appears
overly preoccupied with arguments against superstitious explanations for epilepsy,
Hippocrates’ treatise on epilepsy is notable as an ancient model for how
the brain works and consequences of disruption of function; he provides a logical
and consistent system of cognition.
Since Hippocrates argues so vehemently against the sacred origin of epilepsy,
the meaning he ascribes to the term the “sacred disease” is a logical starting
point in an analysis of this treatise. Is in fact epilepsy what ancient authors
have in mind when they describe the “sacred disease?” There is much evidence
that most did, and Hippocrates’ description of the disease is certainly very consistent
with the modern conception of epilepsy. When Herodotus describes
Cambyses, a Persian monarch, he states that “from his birth he was afflicted
with a dreadful disease. . . which some call the sacred sickness” and also
comments that “it would be by no means strange, therefore, if his mind were
affected in some degree, seeing that his body labored under so sore a malady”
(Rawlinson, 1942: 227). Herodotus’ use of the term “sacred sickness” does not
conclusively refer to epilepsy, as it merely identifies the “sacred sickness” as an
illness seated in the brain, not definitely distinguishing it from other mental
illnesses, such as mania.
One of Hippocrates’ most convincing arguments for a biological origin of
epilepsy is that although a number of different diseases can cause mental illness,
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