The Sacred Disease By Kent Perryman, Ph.D.
The History of Epilepsy and its Treatments THERE HAS BEEN AN abundance of medical literature and data published on the epilepsy disease process. In ancient times, epilepsy was referred to as a “sacred disease,” resulting from some supernatural event or power. This article will cover both the supernatural and scientific basis for understanding the nature of epilepsy, as well as their treatment approaches. No attempt will be made to explain the numerous classification schemas based on localization and seizure types. It is difficult to place an exact medical definition on epilepsy due to the range of extensive clinical phenomena associated with this disease process. Currently, the term “epilepsy” applies to an underlying paroxysmal disturbance of brain function.
Historical Perspectives of the Epileptic Process
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Over the course of history, the definition of epilepsy has been modified numerous times, depending on its reference to a fit, convulsion or seizure attributed to an abnormal behavioral state. Epileptic episodes were also associated with hysteria or emotional excesses that were exhibited as physical symptoms (somatization). The physical manifestations of seizures were believed to be more psychological than neurophysiological in origin. This lack for an appreciation of the disease was related more to the times and different cultures than to a true medical understanding. The one common feature that characterized epilepsy over the centuries was the generalized tonic-clonic seizures. The earliest known reference to epilepsy has been translated from a Babylonian cuneiform
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labeled “Sakikki” (All Diseases) dated between 1067-1046 B.C. Epileptic events in this ancient script were referred to as the “falling disease” with symptoms described as convulsing, unconsciousness and frothing of the mouth, as well as fecal incontinence. The Babylonians attributed these seizures to demonic possession. Rich Atrey, an ancient Hindu physician in the 6th century B.C, describes epilepsy as “paroxysmal loss of consciousness due to disturbances of memory and understanding of mind attended with convulsive seizures.” Hippocrates (450-370 B.C.), who refers to epilepsy in the 4th century B.C. as the “sacred disease,” did not believe this disorder to have a supernatural origin. He advocated that, like other diseases, epilepsy is primarily a hereditary trait whose origin lies in the brain due to phlegm overwhelming the brain’s blood vessels. Treatment was relegated, not by magic, but by diet. The humoral theory that predominated most of medical thought during these times was also believed responsible for epileptic seizures. Epileptogenesis was thought to be caused from an imbalance between black bile and phlegm which obstructed blood flow to the brain. Plato (427-347 B.C.) went on to suggest the imbalance could “confuse the divine circles in the head” and cause a seizure, while Aristotle (384-322 B.C.), in his “On Sleep and Waking III,” attributed seizures to gas associated with indigestion reaching the brain. Later, in 221 B.C., the Chinese described convulsions as “Dian-Kuang” (epilepsy-mania) that included tonic-clonic seizures with prodromes (partial seizures that become more generalized). Other ancient physicians, includ-