Subsection 4. Mental impairment, frenzy, madness, hydrophobia, lycanthropy, St Vitus’s dance and ecstasy.

Mental impairment, fatuity or folly is, according to some, a general name for all the following kinds. Laurentius and Altomarus include madness, melancholy and the rest under this name, calling it their highest genus. If distinguished from them, it is either natural or inborn, arising from some defect in the organs and an excess of brain matter, as we see in ordinary fools; its severity generally varies from person to person, and accordingly some have more understanding than others. Or it is acquired, an accompanying condition or symptom of another disease, which comes and goes; if it persists, it is a sign of melancholy itself.

Phrenitis, which the Greeks derive from the word phrēn, is a disease of the mind involving continual madness or mental confusion accompanied by an acute fever; or it is an inflammation of the brain or its membranes, with an acute fever, that causes madness and confusion. It differs from melancholy and madness because their confusion occurs without a fever. In phrenitis it is continual, with sleeplessness, impaired memory and so on. Melancholy is generally silent; this is clamorous. Physicians identify many other such differences.

Celsus and many other writers group madness, frenzy and melancholy together. Others leave frenzy aside and make madness and melancholy a single disease—a position Jason Pratensis argues at particular length. They hold that the difference is only one of degree, of more or less, one being a stage of the other and both arising from the same cause. They differ “in a greater or lesser degree,” Gordonius says, as the humour is intensified or diminished. Aretaeus, Alexander Tertullianus, Guianerius, Savonarola and Heurnius hold the same view; Galen himself discusses the two together because of their affinity. But most modern writers treat them separately, and I shall follow them in this treatise.

Madness is therefore defined as severe mental derangement, or raving without fever, far more violent than melancholy: full of anger and clamour, with alarming looks, actions and gestures, disturbing patients much more violently in both body and mind, without fear or sorrow, and with such headlong force and boldness that sometimes three or four men cannot restrain them. It differs from frenzy only in lacking fever and in the patients’ generally having better memory.

It has the same causes as the other disorders: scorched choler, overheated blood, an inflamed brain and so on. Fracastorius adds an appropriate duration and mature age to this definition, to distinguish it from the condition of children. He requires it to be an established incapacity, to separate it from passing disturbances that arise accidentally and disappear again, as after taking henbane, nightshade, wine and the like.

This madness has several kinds. One is ecstasy, a familiar state for some people: Cardan says he could enter it whenever he pleased. In this state Indian priests deliver their oracles, and the witches of Lapland, as Olaus Magnus writes in book 3, chapter 18, “foretell everything in ecstasy,” answering whatever you ask—what your friends are doing, where they are, how they fare and so on.

Other kinds of this madness are inspired transports, revelations and visions, so often mentioned by Gregory and Bede; demonic harassment or possession; Sibylline prophecy and poetic frenzy; and states produced by eating poisonous herbs, by tarantula stings and so on, which some place in this category. The best known are lycanthropy, hydrophobia and St Vitus’s dance.

Lycanthropy, which Avicenna calls cucubuth and others “wolf-madness,” occurs when people run howling around graves and fields at night and cannot be persuaded that they are anything but wolves or similar beasts. Aetius and Paulus call it a kind of melancholy, but I would rather place it under madness, as most writers do.

Some doubt whether any such disease exists. Donatus Altomarus says that he saw two such patients in his lifetime. Wierus tells of a man at Padua in 1541 who could not be made to believe that he was anything other than a wolf. He gives another example of a Spaniard who thought himself a bear. Forestus supports this with many cases, including one he witnessed at Alkmaar in Holland: a poor farm worker who continually prowled around graves and stayed in churchyards, with a pale, dark, ugly and frightening appearance.

King Proetus’s daughters, who thought themselves cows, were probably in much the same condition. According to some interpreters, Nebuchadnezzar in Daniel suffered only from this kind of madness. This disease may have prompted Pliny’s bold assertion that some men in his time were changed into wolves and back into men again; Pausanias’s fable of a man who was a wolf for ten years before returning to his former shape; and Ovid’s story of Lycaon, among others.

Anyone wishing to learn more about this disease or read further examples should consult Augustine’s City of God, book 18, chapter 5; Mizaldus, fifth century, item 77; Schenck, book 1; Hildesheim’s second collection, on madness; Forestus, book 10, on diseases of the brain; Olaus Magnus; Vincent of Beauvais, spec. met., book 31, chapter 122; Pierius, Bodin, Zwinger, Zeilger, Peucer, Wierus, Spranger and others.

This malady, Avicenna says, troubles people most in February; according to Heurnius, it is now frequent in Bohemia and Hungary. Schernitzius says it is common in Livonia. Those affected usually hide all day and go out at night, barking and howling around graves and deserted places. They generally have sunken eyes, scabbed legs and thighs, and are very dry and pale, Altomarus says. He explains all the symptoms there and gives a brief account of their treatment.

Hydrophobia is a kind of madness well known in every village. It comes from the bite of a mad dog, or from scratching, Aurelianus says; sometimes merely from touching or smelling, as Schenck demonstrates. It affects many other creatures as well as humans. It takes its name from the sufferers’ inability to bear the sight of water or any other liquid, in which they continually imagine they see a mad dog.