310 Abnormal Psychology
of students going to medical school in Alexandria and the
dramatic increase in those entering the priesthood during the
early years of the spread of Christianity. After the fall of
Alexandria in 642, knowledge of Greek medicine and other
aspects of Greek learning were preserved by Byzantine and
Arab authors who translated and further elaborated them.
These writings were later translated into Latin in Europe, and
as a consequence Galen’s doctrines came to dominate med-
ical theory in the western world until well into the eighteenth
century.
The humoral theory provided a basis for understanding
individual differences in character and patterns of behavior.
Although Galen is credited with having emphasized the sig-
nificance of temperament, Leicester (1974) points out that he
did not name the temperamental types applied in the twelfth
century by Honorius of Autun who identified them as san-
guine, melancholic, choleric, and phlegmatic. By this time
temperament had come to refer to characteristic psychologi-
cal dispositions. Both bodily characteristics and personal
traits were believed to be determined within broad limits by
an individual’s characteristic balance of humors; therefore, to
assess body type was to obtain information usefully corre-
lated with character. Although the humoral theory was finally
abandoned, the concept of balance of bodily processes as an
explanation for a wide range of complex psychological and
physiological phenomena is still useful today. For example,
the concept of pneuma or animal spirits was a forerunner
of our current knowledge that the impulses of the brain are
electrical and transmitted by nerve fibers through the bio-
chemical substances known as neurohumors, most recently
called neurotransmitters. Classical ideas about melancholer
and its correlation with melancholia are precursors of current
hypotheses about the causes of serious depressive and schiz-
ophrenic disorders.
THE MIDDLE AGES TO THE
EIGHTEENTH CENTURY
Sometime in the sixth century, monks began copying and
translating available Greek manuscripts. Libraries of impor-
tant abbeys contained summaries of Galen and other Greek
physicians. Until approximately the twelfth century, monks
in some monasteries as well as local healers and itinerant
doctors provided any medical treatment in the Hippocratic-
Galenic tradition. From the eighth to the thirteenth century,
Arab and Jewish scholars were preeminent in medicine
and science. What came to be known as “Galenism,” was
based on Arabic syntheses and elaborations of his theories,
dominated Byzantine and Arabic medical theory. Many of
these treatises were translated into Latin in the twelfth cen-
tury and were used as medical texts in Western Europe uni-
versities established by the Roman Catholic Church. They
were, in fact, a major source of medical knowledge for
physicians in Western Europe through the seventeenth cen-
tury. In addition, many Middle Eastern doctors migrated to
Europe bringing knowledge of Arabic science with them.
Clark (1984) states that recent research has indicated that
by the late sixteenth century, with the tremendous increase
in literacy at the time (and, we add, by word of mouth) the
average European had at least a partial knowledge of the
accepted medical theory and practice.
A major tenet of Christianity was the importance of com-
passion and charity toward the unfortunate. Hospices were
established to provide shelter and succor for the destitute—
the orphaned, the aged, the disabled, the chronically ill
(including the mentally ill), and the destitute. Hospitals were
founded, originally attached to monasteries, where the in-
sane, who were usually regarded as sick, were accepted.
Many fundamental concepts of human nature, derived from
classical philosophy, were incorporated into the developing
Christian theology. St. Augustine (354–430), who was greatly
influenced by Neoplatonism, attempted to reconcile Plato’s
theories with Christian theology and St. Thomas Aquinas
(1225–1274), incorporated aspects of Aristotelian philosophy
into Christian theology. Christianity, gradually became a sin-
gle unifying ideology in Western Europe and its doctrines
came to have a pervasive influence on all aspects of human life.
The dualism of an immortal soul in a mortal body is cen-
tral to Christian theology. Christian doctrine held that salva-
tion of the soul requires renunciation of the pleasures of this
world, which are temptations to sin. Unpleasant and painful
experiences, including psychological suffering, could be in-
terpreted as punishment from God for sin. People with
clearly psychological disorders (“soul sickness”) were often
treated by a priest with prayers and counseling. Handbooks
were issued for priests with advice on how to deal with psy-
chological problems. They included guidelines for counsel-
ing, moral advice, recognition of responsibility.
Although faith healing and demonology increased with the
spread of Christianity, it did not replace medical treatment
among those who had access to and could afford it. The impor-
tance of demonological theories to the understanding of psy-
chopathology throughout the Middle Ages and Renaissance
has been greatly overemphasized. It was usually assumed that
demons could only cause symptoms indirectly by corrupting
the humors and animal spirits of the body. Demonology was
not invoked for most illness and deaths, including epidemic