What did the ancients think about depression, and how to cure it? We will look at the views of Celsus, who wrote the most complete medical guide that has survived from Roman times (excluding the writings of Galen).
We know almost nothing about the life of Aulus Cornelius Celsus. Even the dates of his birth and death are uncertain; most estimates place them between 25 B.C. and 50 A.D. He is important to history for the medical treatise he left behind. This book, called De Medicina, was originally part of a larger encyclopedia that covered a vast number of topics. For me it is a fascinating window into how people of his era thought about the body and its ailments.
His recommendations for the treatment of depression, melancholia, and insanity are still of historical value for those studying the progress of medical science. The human body has not changed since his day, even though our environment and technology have. My hope is that someone reading this article may find this information to be of some use. Even obsolete knowledge can have utility. I have read that some of Celsus’s recommendations on the amputation of limbs were actually used in the First World War.
However, I want to make it clear that I am not endorsing, approving, or recommending anything that Celsus wrote on this subject, or on any other medical subject. The information in this article is presented for historical purposes only, and is not intended as any specific medical treatment for depression or melancholia, or any other healthcare regimen. Readers looking for medical advice for their situation should consult with their physician.
The points below appear in book III, chapter 18 of De Medicina.
1. Sufferers of melancholia respond differently to light or dark rooms. Some prefer to be kept in dark rooms; others prefer well-lit spaces. It all depends on the patient, and the care-giver should be sensitive to his needs. As he says, Neutrum autem perpetuum est: alium enim lux, alium tenebrae magis turbant. And this means, “Neither way is always right: light upsets some, and darkness upsets another.”
2. The head can be shaved, and then rubbed with water infused with “vervains” (verbenae). Rose oil can also be poured over the head and into the nostrils. The patient can also inhale rue mixed with vinegar. Another remedy is saffron ointment with “orris” rubbed on the head (crocinum unguentum cum irino in caput additum).
Other medicaments also provide some relief for the sufferer. Celsus advises that the juice of the herbs “bitter-sweet” (solanum) and “pellitory” (muralis) can be rubbed on a shaved head to alleviate delusions and sadness.
Also good for “composing the mind” are preparations of “decoction of poppy” or “hyoscyamus” (papaver aut hyoscyamos) mixed with water. Some physicians recommend smearing the forehead with cardamomum balsam or sycamine tears (amomum vel sycamini lacrmam fronti inducunt).
However, not all physicians agree with these herbal remedies, Celsus says. Asclepiades, a Greek doctor whose writings Celsus draws on for reference, says that herbal remedies for melancholia are of no use in the long term. Instead, he recommended that the patient that he should for a day abstain from food, drink, and sleep. And in the evenings, he should be rubbed gently about the body. This kind of massaging was very effective; but too much rubbing can produce lethargy.
3. Rubbing of the body and even immersions in water can work in some cases; but here again, we must realize that depression is very specific to each sufferer.
4. If people are suffering from deep anxieties, you should try to relieve their fears by explaining how the fears are baseless. Random laughter should be stopped by stern counsel and even threats. For some depressed people, music, cymbals, and certain noises also work well. Story-telling and games are great remedies for depression.
5. It is often better to agree with the patient than to try to contradict or correct him. In this way, the mind can be gradually moved from the irrational to the rational.
6. It is also good to revive the patient’s interests. You can read to him or play games with them. The intention here is to try to divert them from the fears that torment their minds. Try to get the patient to recite things he can remember. The mind has to be made to “let go” of one thing and focus on something else.
7. Sleep can be induced by the sound of gently falling water, or by the suspended feeling of being in a hammock.
8. Sometimes purgatives work. The patient can be given hellebore and then be induced to vomit.
9. Madness is generally less serious when the insane person is laughing, than when he is overly grave and somber.
10. The most controversial part of Celsus’s recommendations involve the administration of “tortures.” He advises that the insane person can sometimes be treated by starvation, physical restraints, and “flogging.” The idea here was to shock the insane person’s body and mind and force him to take new mental directions. Celsus says, “It is good to be suddenly terrified and completely scared; so is anything that powerfully excites the mind.” When the mind is suddenly “snapped out” of one state, new possibilities open up. Terror, in other words, works well.
11. Depressed or insane people should also be made to exercise vigorously. This also causes the spirit to become animated.
All in all, these remedies were probably the best that science could offer at the time. Of course pharmaceutical science since Celsus’s day has advanced. But we must remember that in his era, the only medicines that were available were the ones that could be found naturally in plants, or extracted from animals or minerals.
But if we look at these suggestions closely, we at least find a recognition that depression was a mental condition. Celsus tells us to distract or divert the mind; to “shock” our systems with new stimuli; and to seek out nurturing environments. Celsus apparently believed that sometimes the mind and body needed to be jolted into new patterns and behaviors. He seems to have been aware that the mind can become caught in its own ruts. Although his advice on “tortures” is not accepted today, there is at least an attempt at a theory behind it. By administering the body sudden and violent stimuli, the mind may be diverted from its depressive state.
The information in this article is presented for historical purposes and is not intended as any specific medical treatment for depression or melancholia, or any other healthcare regimen. It is not intended as an endorsement of Celsus’s medical opinions or treatments. Readers looking for medical advice for their situation should consult with their physician.
Learn more about this and other related topics in my translation of On Duties.