Keywords:
Epilepsy - Mythology - Neurosciences - History of Medicine
Palabras clave:
Epilepsia - Mitología - Neurociencias - Historia de la medicina
Epilepsy has been seen through many different standpoints since its inception. During
the first periods of humankind, it was surrounded by an aura of mysticism and divinity,
but as scientific knowledge evolved, the concept of epilepsy has changed. Although
historical records of epilepsy date back to 2000 BCE (Assyrian and Babylonian texts),
the origin of the word is considered to come from the ancient Greek verb “epilambanein,”
which means “to seize possess or afflict”[1]. Epilepsy had different names during the Greek era, such as seliniasmos, sacred
disease, and demonism[1]. One of the denominations for the condition is “Herculian disease,” as many authors
believe that the demigod suffered from epilepsy[1]. Euripides, the Greek tragic poet, attributes Heracles’ madness to epilepsy in his
renowned play “Herakles”[2]. The Romans also worshipped Heracles as a hero-god, and differences between Latin
and Greek changed the name Heracles to “Hercules”[3]. Roman physicians started calling epilepsy “Morbus Herculi” as well as to explain Hercules’ madness[4]. Aëtius also used this expression to represent the physical strength manifested
by a person in a convulsion[4].
The demigod was the son of Zeus and Alcmena, queen of Mycenae[5]. Amphitryon (real husband of Alcmena) was assembling an army to reconquer Mycenae
and avenge the death of his wife’s brothers[5]. During this period, Zeus took advantage of Amphytrion’s absence, impersonating
him to lay with her for one night[5]. When Amphytrion arrived, he consulted a seer, who told him that he had been cuckolded
by Zeus[5]. A few months later, Zeus boasted to the other gods in Olympus that he had begotten
his greatest creation so far, whom he called Heracles (Glory of Hera)[5]. Hera hated Heracles because he was the fruit of Zeus’ infidelity and perpetrated
multiple attempts to kill him or make his life miserable[5]. Abandoned by his mother, who feared Hera’s threats, Zeus’ son was found by the
goddess herself, during a casual stroll with Athena. Ignoring the identity of the
child, Athena convinced Hera of breastfeeding him[5]. The child bit Hera’s nipple with such immense force that it made her fling him
down in pain[6]. The resulting spurt of milk flew across the sky and became the milky way ([Figure 1])[7].
Figure 1 The origin of the milky way by Peter Paul Rubens (1636)[7].
In Euripides’ play “Herakles,” this brave man is in Hades’ domains for the last of
his Labors; meanwhile, the uprising tyrant Lykos, who had killed Creon, king of Thebes,
threatens Heracles’ family[8]. The hero returns before Lykos can go through with the murder and slays him in Zeus’
Soter Altar[8]. Hera took advantage of this situation and sent her servants Iris and Lyssa to madden
Heracles, making him believe that he had to kill king Eurystheus[8]. Heracles’ madness is clearly depicted in the following fragment:
“Messenger: …he was no longer himself; his features were distorted. His pupils were
rolling around in his eyes that were suddenly bloodshot, and foam was dripping onto
his bushy beard.”[8]
The demigod, driven into madness, mistook his wife and children for Eurystheus’ family,
ending up killing them, oblivious of his actions ([Figure 2])[9]:
“Herakles: War? Who did this? Who-destroyed them?…
Herakles: And my wife-was I the one- responsible?
Amphitryon: All of this… by one hand. Yours.”[8]
Figure 2 Hercules firing arrows at his children by Antonio Canova De Agostini (1799)[9].
The Roman counterpart of “Herakles” was “Hercules Furens,” a play by Seneca the younger[10]. In this play, the author attributes the demigod’s madness to physical exhaustion,
as it transmuted to psychological exhaustion leading to temporary insanity[10]. Epilepsy was considered a “sacred disease” since ancient Greek medicine[10]. Depending on the symptoms of the epileptic seizure, it was attributed to several
deities, including Hera, Cybele, Poseidon, Mars, Hekate, Hermes, and Apollo[11]. Hippocrates of Kos was the first author to argue against the divine origin of the
sacred disease on his “Corpus Hippocraticum”[12]:
“Le cervau est l’origine de l’épilepsie comme de toutes les autres très-grandes maladies…”
(“The brain is the origin of epilepsy, as any of the other great diseases.”)[13]
“L’altération du cervau se fait pour la pituite ou par la bile.” (“Depravement of the
brain arises from phlegm and bile.”)[13]
Regardless of the source, the madness of Heracles could represent what has been described
as “les états crépusculaires” (crepuscular states) in the French literature[14]. Postictal psychosis (PP) is the most frequent of the psychoses in epilepsy (25%)[15]. These are characterized by having a lucid interval (between the end of the seizure
and the onset of psychotic symptoms), religious delusions, violent behavior, aggression,
and visual hallucinations, following a complex partial seizure usually located in
the temporal lobe[15]. Both verbal and physical violence can occur, and suicide has been associated with
PP[15].
Aggression is a complex behavior governed by neuroanatomic structures such as the
temporal lobe and the amygdala[16]. Violent acts in epileptic patients have been described in the literature for over
a century[17]. Patients are on a confusional state and exhibit resistive violence during postictal
acts[17]. This has been described by Pandya et al., who performed a review of no less than
50 cases of epileptic patients committing murder and being placed on trial[17].
Epilepsy was believed to be an instrument of punishment sent by the gods. Euripides
and Seneca conveyed through their plays that this was not a divine act; instead, it
had a biological cause, supporting the Hippocratic thought of the era. Heracles is
a clear depiction of how fiction could link to reality, as epileptic citizens in the
real world can commit crimes because of this illness, just as this brave man. Interestingly,
epilepsy has always been associated with prominent political and cultural leaders,
as Campanella stated in “The city of the sun”:
“This is a sign of great talent, wherefore Hercules, Socrates, Mohammed, Scotus, and
Callimachus suffered from it.”[18]
Despite the fact that it has been more than 2500 years since Greek mythology was at
its peak, it is worth remembering its historical contribution to epilepsy, based on
one of the greatest fictional heroes: Heracles.
