HISTORY OF PSYCHIATRY
A recent article in G7: Beyond 2015 quotes two leading Oxford medical researchers in the rearguard of several East African disease outbreaks. Dr Adrian Hill, director of the Jenner Institute on vaccine research, points out, “We know there will be more outbreaks. . . . Many viruses are lurking, and then there are going to be new viruses.” The views of his colleague, Professor Peter Horby, director of the Epidemic Diseases Research Group Oxford, are summed up: “The lessons from vaccines and therapeutics for Ebola . . . include our understanding of how outbreaks occur and spread . . . the effects of supportive clinical care and public health interventions, and understanding the impact of different human behavior and customs.”1
These two researchers would seemingly accelerate history. But playing helpless witness to growing and burgeoning epidemics with no cure is as common as warfare. Historical lessons are plentiful, especially with regard to “understanding the impact of different human behavior and customs.” With the vagueness of “madness,” the term “plague” has described catastrophic outbreaks of disease since the invention of writing, not far removed from the biblically inspired quarantine—from the Italian quaranta, forty, the number of days ships’ crew members were required to remain isolated in Venetian ports during the time of the black plague in Europe, the number of days Jesus fasted in the desert before beginning his ministry.
Indeed, an early physician’s greatest insight could be that disease was not curable, at least not through any physical machinations. Comfort, education, fortuitously placed and skillfully manipulated placebo (literally, in Latin, “I shall placate”) were the best that could be done in most cases, with perhaps, as the Greeks and later Arabs were wont to do, some empirical documentation as to the natural course of disease. This sounds a lot like psychiatry. The Hippocratics called it the “art” of medicine. It does not take a psychiatrist, however, to see that this “artful” approach frequently fails.
Witness the following early medical text, written not by a physician but by a disgraced general, a statesman-turned-journalist, as objective an eyewitness to disease as there ever has been. Here is Thucydides’ account of the unidentified, rapidly fatal plague that befell a besieged Athens in the second year of the first historical “30 years’ war.” This was the so-called Peloponnesian War (431-404 bc) for which Thucydides remains the definitive historian. This brutal civil war pitted the two lead-ing Greek city-states of the time—Athens and Sparta—against each other and hastened the end of the brief democratic experiment that had uniquely marked Athenian government for less than 100 years—the “Golden Age” of Greece.
The most famed statesman of the period, Pericles, succumbed to the fatal disease soon after his own glorified admonition, or funeral oration, to the citizenry to hold strong and steady through the crisis. Thucydides survived the disease.
(I offer my own interpretation here because Thucydides was, to borrow a recent reincarnation from Maureen Dowd, an “odd duck.” He has flummoxed translators since the second century bc with his idiosyncratic style, and he continues to defy definitive translation. The gist of the story is clear; the details are any-thing but. Like a good psychiatrist, in such cases, I prefer to lay my own eyes on the primary material.2 Or, as one of my weight-lifting patients once said to me, “Why travel light when you’re strong?”)
Dr Martin is currently an adult and pediatric consultation-liaison psychiatrist at Newton-Wellesley Hospital in Newton, Mass, and a Clinical Assistant Professor of Psychiatry at Tufts University School of Medicine in Boston. He has a Master’s degree in Near Eastern Languages and Cultures from UCLA, and was a high school Latin and Greek teacher before returning to medical school. He is the founder of the Yale Philosophy and Psychiatry Group, and has published several articles on historical, philological, and philosophical issues in psychiatry and medicine. He reports no conflicts of interest concerning the subject matter of this article.
1. The Authorized G7 Publication. Ebola: global health threats need a global research and development solution. G7: Beyond 2015. 2015:90-91.
2. Martin EB Jr. The virtuous physician: a new translation of a pseudo-Hippocratic text and its implications for the history of moral inquiry; or, the significance of an insignificant text. J Interdisciplin Hist Ideas. 2012;1(2):1-41.
3. Thucydides. The History of the Peloponnesian War. Crawley R, trans. 2009. http://www.gutenberg.org/files/7142/7142-h/7142-h.htm. Accessed June 15, 2015.