308 Abnormal Psychology
drinks to augment depleted humors. It was generally believed
that opposites are cures for opposites, hence cold packs
and cooling drinks for fever, hot drinks and warm blankets
for chills, herbal extracts with narcotic properties (such as
opium) for agitation and excitement, and extracts with stimu-
lating properties for lethargy. If a disease is caused by a
morbid agent, the process of coction normally expels the
morbid agent in the feces, urine, and sweat, and the physician
helped by administering appropriate laxatives, diuretics, or
sudorifics. Diet, exercise, and adequate sleep, subsumed
under the concept of “regimen,” was considered of paramount
importance both in managing disease and maintaining both
mental and physical health (Lloyd, 1978).
Theories that attributed psychopathology to the failure to
use reason to control emotion, restrain impulse, and regulate
conduct date back at least as far as Plato (428–348 B.C.). He
is credited with having introduced the concept of the tripartite
soul, which, elaborated by Aristotle, persisted for centuries.
The function of the rational soul is to seek knowledge and
truth; it is intended to govern the spirited soul (mediating
sensation and movement), which in turn is intended to govern
the appetitive soul (the nutritive and reproductive functions).
Eros is the energetic force for all activity and, at its lowest
level, is sexual desire. The rational soul can seek knowledge
only if Eros is sublimated to higher ends (Plato, 1894a).
The soul, in this line of thinking, can become diseased as
a result of bodily disease: “For where the acid and briny
phlegm and other bitter and bilious humours wander about in
the body, and...mingle their own vapours with the motions
of the soul...they produce all sorts of diseases, and being
carried to the three places of the soul, whichever they may
severally assail, they create infinite varieties of ill-temper and
melancholy... .” In Plato’s view “excessive pains and plea-
sures are justly to be regarded as the greatest disease to which
the soul is liable.. .” and can cause madness (Plato, 1894b).
The intensity of sexual drive can cause mental disorder in
both men and women. The idea that sexual deprivation in
females is the cause of “all varieties of disease” served down
through the centuries to explain hysteria, accompanied by the
assumption that hysteria can be cured by sexual intercourse.
The view that the passions, or affective excitement (particu-
larly that arising from the sexual passion), are a significant
cause of psychopathology first described by Plato, was held
until the nineteenth century and appears in Studies on Hyste-
riaby Breuer and Freud (1895/1955).
As Rome became the center of power in the Mediter-
ranean world, the various schools of Greek medicine gradu-
ally transferred there from Alexandria. By the time the
Roman empire had been established, Greek physicians dom-
inated Roman medicine. Physicians separated into various
sects, each basing its system of treatment on a different
aspect of Greek medical philosophy. Some physicians re-
tained the theory of humors. The pneumatists believed that
disturbed pneuma flow in the body caused disease. The
methodists, who based their theory on atomism, attributed
disease to an abnormal constriction or relaxation of the solid
particles of the body. The empirical school renounced theory
in favor of devising treatments based on observation. The
eclectics took whatever seemed useful to them from the other
schools.
Aulus Cornelius Celsus, a first century Roman writer,
compiled an encyclopedia of which De Medicina,the portion
on medicine, survives. The work largely derived from the
HippocraticCorpus.It was printed in 1478, translated into
English in 1756, and was used by physicians as a medical text
into the eighteenth century (Celsus, 1935).
Celsus made the usual distinction between insanity and
the delirium of patients suffering from high fever. Some
insane persons are sad, others hilarious; some are more read-
ily controlled and rave in words only; others are rebellious
and act with violence. Of the latter, some do harm only by
impulse whereas others, although appearing sane, seize the
occasion for mischief, and their insanity must be detected by
the result of their acts. Patients should have pleasant sur-
roundings, be provided with interesting but not overstimulat-
ing diversions, and should not be left alone or among people
whom they do not know. They should be agreed with, rather
than opposed, with the object of turning their mind slowly
and imperceptibly from irrational talk to something better.
For insane persons duped by phantoms, Celsus recommended
purging with black hellebore, a poisonous herb believed to
purge black choler. Those who are hilarious should be given
white hellebore (another poisonous herb) as an emetic. Mas-
sage should be used sparingly with patients who are over-
cheerful. Insane persons who are deceived by the mind may
benefit if forced by fear to consider what they are doing; for
example starvation or flogging might force the patient, little
by little, to fix his or her attention and learn. (Such treatments,
we note, suggest modern methods of aversive conditioning
and attempts to train attentional focusing.)
Galen of Pergamon (ca. A.D. 130–201) was considered
the greatest of the eclecticist physicians. (We note that
Hippocrates’ reputation is largely based on Galen’s frequent
citations as the authority of his own views.) He integrated the
doctrine of pneuma into an elaboration of the theory of four
humors in which different diseases are caused by different
imbalances of the normal equilibrium of the humors and their
specific qualities (“dyscrasia”). Galen emphasized that be-
cause individuals have characteristic patterns for metaboliz-
ing the elements of food, they differ in temperament, which