The distinction between ‘Passion’ and ‘Emotion’. Vincenzo Chiarugi: a case study

‘Passioni’ and ‘Emozioni’

Different versions of the distinction between ‘passion’ and ‘emotion’ can be found in the work of medical thinkers such as Sir Alexander Crichton (Charland, 2008), Philippe Pinel (Charland, 2010a), Jean-Etienne Esquirol (Charland, 2010b) and Théodule Ribot (Charland, 2011). In Della pazzia, the Florentine physician Vincenzo Chiarugi introduces an interesting variant of that distinction. He writes:

Every idea (idea), which, under the action of the external or internal senses (sensi) is presented to the soul (Anima) and received by the same, is always accompanied by a positive (bene) or negative (male) feeling (sentimento) or, so to say, of pleasure (piacere) or discomfort (molestia). Therefore, under these circumstances, the soul, in a certain sense, receives more or less violent impacts, from which is derived a vivid internal sentiment (sentimento interno) for the object (l’ogetto) which has caused them, that the soul keeps almost constantly present in the mind (mente) the same object either with a feeling (sentimento) of pleasure (bene) or of pain (molesto), even when there is no reason for it. To those basic effects, which the sensation (sensazione), or imagination (immagianazio), or memory (memoria) awakes in man, we shall give the name of emotions (Emozioni), actually representing ‘first motions’ (Primi moti). To the group of phenomena, then, and to the persistence of those effects caused by the emotions, and which become sensitive in nearly all the functions of the body, will be given the name of passions (Passioni) or ‘affections of the soul’ (Affezioni dell’ Animo). (Chiarugi, 1987: 66; Chiarugi, 1793–4, Tome 1: 36. Capitalization present in the original Italian)

To begin to understand the assumptions at play in this statement of the distinction between ‘passion’ and ‘emotion’, it is helpful to consider the full Italian title of Chiarugi’s work, since it bears its methodological commitments on its sleeve. It reads: Della pazzia, in genere, e in specie. Trattato medico-analitico, con un centuria de osservazioni. The full English translation of that Italian title reads: On Insanity and its Classification (Chiarugi, 1987). The omissions in the English title are worth pondering. First, the English translation makes no mention of the allusion to ‘species’ and ‘genera’ as modes of classification in the original title. This is an editorial simplification of some historical consequence, since the qualification squarely places Chiarugi’s work in the nosological tradition of figures like Boissier de Sauvages and William Cullen, particularly the latter (Chiarugi, 1987: 4, 23, 27, 207–10). A second qualification in the original title that is omitted in the English translation is the reference to ‘one hundred observations’. This editorial decision is also worth stressing, since the qualification reflects Chiarugi’s theoretical commitment to the Hippocratic tradition – undergoing a revival at the time – and its focus on gathering detailed clinical observations from case histories: the ‘natural history’ of disease (Chiarugi, 1987: 3). Finally, there is the reference to ‘medico-analytic’ method, which is also omitted in the English title. It reflects a methodological commitment to the work of Locke and his successors, the French Idéologistes, who urge us to analyse complex ideas into their simplest empirical constituents by a process known as ‘abstraction’ (abstraction) on the grounds that all genuine scientific knowledge should initially be derived from empirical, that is, sensory, observation (Chiarugi, 1987: 4).

Context of ‘Emozioni’

René Descartes is sometimes said to have been the first major Western thinker to officially use the term ‘emotion’ (émotion) in something like its modern psychological sense (Dixon, 2003: 76, but see also 104). The reference that is usually provided in defence of this claim is taken from Descartes’ famous but still much neglected monograph on the passions, Les passions de l’âme (Descartes, 1650). In that book, he suggests that, under some circumstances, we might refer to the ‘passions’ (passions) of the soul as ‘emotions’ (émotions):

After having considered in what respects the passions (passions) of the soul differ from all its other thoughts (pensées), it seems that we may (peut) define them generally as those perceptions (perceptions), sensations (sensations), or emotions (émotions), of the soul (âme) which we refer particularly to it, and which are caused, maintained, and strengthened by some movement of the animal spirits. (Cottingham, Stoothoff and Murdoch, 1985: 339)

It would, however, be a mistake to assume, without further proof and argument, that the inspiration for Chiarugi’s theory of the passions lies only, or primarily, with Descartes and that they both mean the same by the term ‘emotion’ (Fr. émotion, It. emozioni). Perhaps the only inference we can safely make, based on the textual evidence adumbrated so far, is that ‘emotion’ appears to be a psychological term of art for both Descartes and Chiarugi. The ‘motions’ that are the emotions not only emanate from the soul, but are also motions of the soul that are felt by the soul. The point is not trivial, since this usage departs from other more traditional uses of the term ‘emotion’, according to which ‘emotions’ are primarily physical in nature. Such physical uses of the term are noted in the famous 1751–72 Encyclopédie, ou dictionnaire raisonné des sciences, des arts et des métiers, edited by Diderot and D’Alembert, with which Chiarugi would have been familiar (Chiarugi, 1987: xiii, xl–xlvi, xcvvi). In this popular and very comprehensive reference work, physical (physique) and psychological (moral) uses of the term ‘emotion’ (émotion) are distinguished. One common usage of the term in the physical sense occurs in reference to movements of the pulse. This does not appear to be the manner in which Chiarugi understands the term ‘emozioni’ and why, perhaps, he takes the time to explicitly define and distinguish that term from ‘passioni’ as carefully as he does.

Chiarugi states that ‘emozioni’ are internal feelings (sentimento interno) we have towards objects. They are, in his words, ‘first motions’ (Primi moti) of the soul, that may or may not lead to passions (passioni). Note that on this account, ‘emozioni’ appear to have what contemporary philo-sophers call ‘intentionality’, that is, they are about objects in the world; they are feelings we have towards objects. ‘Emozioni’, moreover, are simpler in their constitution than ‘passioni’, which are said to be effects (effeti) of ‘emozioni’ that persist beyond the initial ‘first movement’ that is the emotion, and are diffused throughout the body. These bodily manifestations of the passions not only outlast the initial short-term emotions that cause them, they can also acquire a chronic character, which can be inimical to health and even lead to insanity (Chiarugi, 1987: 18). In addition to complexity, then, duration appears to be another important distinguishing feature of Chiarugi’s distinction between ‘passioni’ and ‘emozioni’. While ‘passioni’ appear to have bodily manifestations and characteristics that accompany and underlie them, ‘emozioni’ appear to be more exclusively psychological in nature, feelings of the soul that occur in the soul. Finally, ‘emozioni’ on this account also have a ‘valence’. That is, they have an associated positive (bene) or negative (male) charge, reflected in the hedonistic character they exhibit, which is either pleasurable (piacere) or painful (molesta).

Thus, Chiarugi appears to endorse a psychological sense of the term ‘emotion’. In this he appears to be consistent with Descartes, but slightly at odds with the relevant entry in the Encyclopédie, which mentions both psychological (moral) and physical (physique) senses of the term and defines ‘emotion’ (émotion) as a light movement: ‘movement leger’. At this point, it is interesting to ask why Descartes might have opted for this psychological sense of the term. One possibility – a speculation at this point – is that the inspiration may have come from the writings of Michael de Montaigne. In his 1580 Essais, Montaigne refers several times to both ‘émotion’ and ‘émotions’ in what seems to be a psychological sense. For example, at one point he refers to ‘une emotion de plaisir extraordinaire’ (Montaigne, 1580: 424). In another case, there is a reference to feeling an emotion in relation to a son bidding farewell to his mother: ‘sentit toutefois l’emotion de cette adieu maternel’ (p. 235). However, there are also instances where ‘émotion’ and ‘émotions’ appear to have more physical connotations, such as when one is said to feel emotions in relation to one’s pulse: ‘pendant que le pouls nous bats et que nous sentons de l’émotion’ (p. 715). A purely physical example of the term occurs in the context of a remark on emotions of air and wind: ‘une émotion d’air et de vent’ (p. 914). This evidence is suggestive of an emerging psychological sense of the term ‘emotion’ in the French vernacular that may have inspired Descartes to follow suit. However, in Montaigne there are still clear cases where the term ‘emotion’ is used in a primarily physical sense, as is also the case with Descartes.

Montaigne’s writings, however, do not settle the question why Descartes introduces the French term ‘émotion’ into his theoretical lexicon, even if they may provide a plausible scholarly inspiration and precedent for that strategy. A complication that deserves mention here is that, in Les passions de l’âme, Descartes also employs the term ‘émotion’ in relation to movements of the will. In this text, he tells us that we may also call (nommer) our willings (volontés) ‘emotions of the soul’ (émotions de l’ésprit). However, at the same time, he emphasizes that we must recognize that, unlike ‘passions’ (passions), these ‘emotions’ (émotions) are not caused, maintained or fortified by animal spirits, but rather caused by the soul itself (Descartes, 1650/1990: 58, Art. 29). From this it follows that it is misleading to identify and treat ‘passions’ (passions) as ‘emotions’ (émotions) without qualification in Descartes’ corpus, since there are also willings (volontés) which are ‘emotions’ (émotions) but not ‘passions’ (passions). This is not a problem for Chiarugi, for whom ‘passioni’ and ‘emozioni’ represent different theoretical posits altogether.

Context of ‘Passioni’

We have seen that Descartes tells us that we can redefine the ‘passions’ as ‘emotions’ – if we wish. However, he does not tell us that we must, though he does say it would be better (encore mieux) if we did, because of the strength with which they agitate (agiter) and disturb (ébranler) the soul compared with other mental states (pensées). It is puzzling that after this he sometimes uses the term to refer to ‘passions’ proper, for example, love and hate, while at other times he uses it to refer to movements of the heart and blood (Descartes, 1650/1990: 69, Art. 46; 89, Art. 79). In Chiarugi’s case, we have a different explanation for why we should introduce the term ‘emotion’ (emozioni). The clue is a reference to the Stoic doctrine of ‘first movements’ (Primi moti) of the soul, which Chiarugi calls ‘emozioni’. His view is that these first movements, namely emozioni, precede the onset of full-fledged ‘passions’, namely passioni. Chiarugi’s direct citations to Cicero’s Tusculan Disputations acquire special significance in this context and suggest another line of influence in his choice to employ the terminology of ‘emotions’ (emozioni) as affective theoretical posits that are complementary to, but also distinct from, ‘passions’ (passioni). Indeed, Chiarugi seems to have been very much influenced by the manner in which Cicero links excessive and extreme passions to the onset of insanity (Chiarugi, 1987: 207, 221, 237). Given the importance that he accords to Cicero in this domain, it would not be surprising if Chiarugi were influenced by other aspects of the Roman orators’ writings on the passions, as well as additional related writings in the Stoic tradition, such as those of Seneca.

The original Latin formulation of Chiarugi’s ‘emozioni’, which he refers to as ‘Primi moti’, is ‘primus motus’ (Sorabji, 2000: 343; see also 66 n.2). These first movements of the soul were known by the early Stoics as ‘pre-passions’ (propatheia, antetheia). A key figure in this development was Seneca (Sorabji, 2000: 66–9), who is said to have insisted that ‘pre-passions are not yet emotion’ (Sorabji, 2000: 344). Note that ‘emotion’ in this last passage is meant to be understood in something like the modern sense, as involving judgement of a sort that involves an assent of the mind (adsensus menti), and the voluntary choice and admission that a certain emotional response is appropriate (Sorabji, 2000: 67, 73). Commentators like Richard Sorabji argue that it is this independence between the initial first movements that precede full-fledged emotions and the sub-sequent judgements that follow – that is, the full-fledged emotions themselves – which make Stoic cognitive therapy for the emotions possible. For while reason may be largely unable to prevent us feeling and experiencing the initial shocks and first movements that precede full-fledged emotional responses, reason and judgement can play a part in preventing us from assenting to those feelings and experiences as if they were appropriate. As Seneca puts it, there is: ‘… the initial and mental shock produced by the appearance of good or bad; secondly, the assent to that appearance and to the appearance that it is appropriate to react; thirdly, the movement of being carried away and judging that one must react, come what may’ (Sorabji, 2000: 73). It is admittedly speculative to link Chiarugi’s allusion to ‘first movements’ to this specific view of Seneca and its alleged basis in Cicero. But as a first line of interpretation the hypothesis is worth considering.

According to Sorabji, it is possible to identify a variety of the doctrine of first movements in Cicero’s thought as well. These are the initial, largely involuntary, bites and little contractions of the mind (morsus et contractiunulae animi) that precede full-fledged passions and can occur independently of them (Sorabji, 2000: 67). The fact that Cicero does not define what the early Stoic philosophers called ‘passions’ (pathe) in Latin as ‘passio’, but instead opts for the innovative and more idiosyncratic ‘perturbations’ (perturbatio) adds an extra degree of complexity to this situation (Lang, 1972: 425). Cicero’s perturbations of the mind may be likened to what are now called ‘emotional disturbance’, a kind of ‘temporary insanity’, different from more permanent and serious ailments of the mind, like ‘mental illness’ (morbus), which includes insanity (insania) and fury (furor), and different still from forms of psychotic illness or ‘mental disease’ (aegrotatio) which represent a ‘total destruction of the human personality’ (Lang, 1972: 421, 434; but see also Graver, 2002: xxxviii–xxxix). Chiarugi does not endorse this scheme from the Tusculan Disputations, although he does discuss some of its elements. He refers to these terminological and conceptual issues in his struggle with the terminology and definition of ‘insanity’ (pazzia), which he ultimately defines as a ‘true, chronic, permanent delirium (delirio)’ that reflects a ‘disease of the brain’ (Chiarugi, 1987: 207, 18). ‘It is evident,’ he writes, ‘that the transition from a strong passion, sustained for a long time, to true insanity, may be very short’ (Chiarugi, 1987: 71). The problem is that, in trying to link all these authors, there is not one but probably several overlapping terminological and conceptual threads in the discussion. Cicero’s ‘perturbatio’ are normally referred to as ‘emotions’ by modern commentators, and not ‘passions’ (Graver, 2000; Lang, 1972; Sorabji, 2000). On the other hand, according to Chiarugi’s scheme, they are best interpreted as ‘passions’ (passioni) rather than ‘emotions’ (emozioni).

It is now time to summarize the upshot of this brief, rather speculative, exegetical excursion. It is that Chiarugi’s first movements, which he calls ‘emozioni’, are not full-fledged passions, that is, ‘passioni’. Instead, ‘emozioni’ are very much like the ‘first movements’ of the sort discussed by Seneca. He, in turn, is arguably influenced by Cicero’s doctrine of ‘little bites and contractions’ as distinct and independent from full-fledged perturbatio, which we now commonly refer to as ‘emotions’, but which Chiarugi refers to as ‘passioni’. In other words, in Chiarugi’s scheme, the emozioni precede the passions, the passioni, but are not themselves passions, that is, passioni. Thus, in this scheme, emozioni might be called ‘pre-passions’. The two terms – ‘emozioni’ and ‘passioni’ – and their associated concepts are therefore categorically different in Chiarugi’s theory. In his scheme, emozioni are the initial involuntary first movements of the soul that do not yet involve full judgement or assent and precede the passioni. On their side, passioni do involve judgement and assent. This last point is crucial. Philosophically, it is the reason why ‘passions’ (passioni) on this largely cognitivist view are susceptible to reason and amenable to therapy. Herein lies the essence and rationale for so-called ‘moral treatment’, what Chiarugi (1987: 139; 1793–4, Tome 2: 75) refers to as the ‘cura morale’.

Perhaps influenced by the writings of Rousseau, Chiarugi stresses the importance of a good education in the development of a character that can resist and fight the more noxious temptations and excesses associated with the passions (Chiarugi, 1987: 78–9). On the question of general remedies for disorders of passion, or disorders that are due to passions, he does have general moral recommendations for treatment, even if these do not reflect an explicit application of the distinction between ‘passion’ and ‘emotion’. Melancholia, for example, is said to require moral treatment in which new, sometimes contrary, passions like hope, love and even fright, are awakened or elicited in order to diffuse or displace the dominating passions of fear and sadness that help support the ‘… wrong idea which has become habitual’ (Chiarugi, 1987: 136–9). Significantly, Chiarugi does not refer to these intervening affective states as ‘emotions’ (emozioni) in this discussion, but instead implies that they are ‘passions’ (passioni) (Chiarugi, 1793–4, Tome 2: 70). Kindness and trust are said to be essential to this kind of moral treatment. Sudden psychological shocks may also sometimes be helpful in dislodging the pathological fixed ideas in melancholia. Electro-shock treatment (ellittricismo) administered using a Leyden jar (boccia de Leida) is mentioned in this context, as it is for epilepsy (Chiarugi, 1987: 309; Chiarugi, 1793–4, Tome 3: 237). Finally, diverse forms of training and activity, diet, weather and even ‘the use of legitimate sex’ also play an important role in treatment of this sort (Chiarugi, 1987: 142–3).

It is both interesting and surprising that there do not appear to be any explicit allusions to the distinction between ‘passioni’ and ‘emozioni’ in Chiarugi’s 100 clinical observations. There, blood-letting and other physical therapies are the treatments of choice and the discussion is framed in anatomical and physical terms, rather than psychological (morale) ones (Chiarugi, 1987: 145; on this see also Gerard, 1997: 382). Why then does he insist on that distinction in the opening pages of his treatise? Admittedly, there are two explicit references to ‘emotional’ conflict in the 100 cases. But this is not the clue it appears to be. In the original Italian, the reference is to ‘passions’ (passioni) and not ‘emotions’ (emozioni) (Chiarugi, 1987: 246, 267; Chiarugi, 1793–4, Tome 3: 95, 141–2). In general, it is puzzling that, while Chiarugi praises the benefits of moral treatment, and while he clearly proposes a specific version of the distinction between ‘passions’ (passioni) and ‘emotions’ (emozioni), he does not substantially allude to that distinction in his clinical discussions. He does state that ‘the influence of one emotion in controlling an opposite one is undoubtable’ (Chiarugi, 1987: 267). However, there is apparently no detailed application of this venerable principle to be found in the 100 cases. Moreover, this English statement of the principle is again a mistranslation. In the original Italian the point is framed in terms of ‘passions’ and not ‘emotions’: L’influenza d’una passione per domarne un altra contraria è indubitata (Chiarugi, 1793–4, Tome 3: 142). Indeed, readers of the English translation of Della Pazzia must be warned that there are some serious lapses in this translation of Chiarugi’s Italian text. The term ‘passioni’ is often unilaterally – and without warning – replaced by the English ‘emotion’, which of course contradicts Chiarugi’s concerted efforts to make and respect that very distinction (for example, compare Chiarugi, 1987: 157–67 with Chiarugi 1793–4, Tome 3: 103–10; see also 1987: lxv).

‘Passioni’

Now that we have some elements of an interpretive framework in place in order to provide a context for Chiarugi’s motivation for making a distinction between ‘passions’ (passioni) and ‘emotions’ (emozioni), we can examine Chiarugi’s more direct pronouncements on ‘passioni’. He begins with the claim that the passions (passioni) are often called ‘affections of the soul’ (Affezioni dell’ anima). However, soon after, he claims that maybe they should rather be called ‘affections of the body’ (Affezioni del corpo). His reasoning is that ‘… every different passion corresponds to a different state of the soul through which it reacts on the body’ (Chiarugi, 1987: 67). In a theoretical allusion that harks back to the work of William Cullen and Thomas Willis, these sensitive changes are said to be ‘caused by the direct action of the soul through the sensorium commune (sensorio comune) and the nerves (nervi)’. Therefore, passions have an important bodily dimension – their sensitive manifestation – which Chiarugi likens to an external (esteriore) ‘silent language’ (mutto linguaggio). Those external bodily manifestations consist in ‘… the physiognomy, gesticulation, and in many other functions of the body’ (p. 67). The physiognomy (fisonomia) of the passions is extremely important in this account, since it plays a crucial role in identifying and individuating the different passions by referring to their corresponding paradigmatic facial expressions. Indeed, at one point Chiarugi writes that the so-called ‘language of passions’ is ‘… expressed particularly by certain movements and changes in the mimicry of the face, which consist of the physiognomy, [… so that …] in correspondence to a different passion prevailing in an insane person, different traits appear in his face’ (p. 88). This is an allusion to popular physiognomic doctrines of the time which can be found in many other medical writers on insanity, including Pinel and later Esquirol.

According to Chiarugi, what is even more ‘remarkable’ (rimarcabili) than these physiognomic characteristics are the vital movements (moti vitali) that underlie and accompany them. Those bodily changes play an essential role in Chiarugi’s account of the manner in which passions are implicated in insanity and health and illness generally. The vital forces in question (forze vitali) include the circulation (circolazione) and the nerves (nervi).The nature and configuration of these vital forces correspond with Chiarugi’s tripartite classification of the passions. In his words:

… whenever a certain passion arises, an increase in the nervous and the vasculatory system takes place. Consequently, I shall include them under a distinct class called exciting passions. On the other hand, sedative passions will be called those which more or less free the nervous system of its activity to the point of hindering and even stopping life. Finally, certain passions which are the result of the combination of many others have been called mixed passions because in view of expression they could not have been placed in any of the two previous classes. (Chiarugi, 1987: 69)

In the original Italian version of Chiarugi’s text, these three classes of passions are referred to as ‘Passioni eccitante’, ‘Passioni sedative’, ‘Passioni miste’ (Chiarugi 1793–4, Tome 1: 141). The introduction of that classification is followed by a brief account of where diverse individual passions are located in the classification. Thus, happiness (Allegressa), love (Amore) and anger (Collera) are examples of exciting passions. These kinds of passions can lead to delirium when they are chronic and excessive. Sadness (Tristezza), fear (Timore) and hatred (Odio) are examples of sedative passions. They can lead to atrophy and slow death when they are chronic and excessive. Mixed passions include jealousy (Gelosia), shame (Vergogna), piety (Misericordia) and despair (Disperazione). Chiarugi hesitates about whether or not to include despair as a distinct passion, even though he notes that it is sometimes considered a mixture of sadness and anger. This suggests that there are aspects of this classification which are not his own, though it is apparently not borrowed from any of the authors he cites that have relevant views in the area, notably Cicero, François Boissier de Sauvages and Simon André Tissot.

It is important to note that the passions are not necessarily always morbid in Chiarugi’s account. It is only when they are sustained for too long and carried to excess (eccesso) and lead to ‘… considerable increase or decrease in the activity of the nervous system and the circulation …’ that they cause delirium (delirio) and other morbid consequences (Chiarugi, 1987: 70). When the passions become chronic and excessive in this way they degenerate and become impaired to the point where they have effects contrary (contrari) and even opposite (oposto) to those inscribed in their original design. For example, ‘… an unresponsive love of long standing can produce languor, chlorosis, consumption, and other diseases of similar nature’ (p. 70). Moreover, happiness, terror and anger can ‘… go so far as to take the life instantaneously’ (p. 70). Thus, it is in virtue of their underlying physiological characteristics that the passions can lead to delirium, insanity and other forms of mental and physical derangement.

The term ‘moral’ (morale) in this context refers to mental, or psychological, aspects of mental illness and its treatment, and includes features of ‘mental hygiene’ such as personal temperament, diet, climate, geography, as well as lifestyle and occupation. In general, and by default, the intended contrast here is between what is physical and what is mental: in Chiarugi’s native Italian, ‘fisica, e morale’ (Chiarugi 1793–4, Tome 2: 25). In Chiarugi’s view, passions are partly moral, that is, psychological, phenomena, which means that they are understandable in such terms and susceptible to rational assessment and management. At the same time, the passions also exercise a causal influence on behaviour and the course and onset of insanity, by virtue of their impact on the brain through the sensorium commune. Against this backdrop, Chiarugi appears to be convinced that the ‘soul itself remains intrinsically unchanged in mental illness’ (Chiarugi, 1987: lxi, 11, 17–18). It is instead the sensorium commune that is impaired (pp. 14–15). These impairments result in the faulty reasoning (raziocinio erroneo) and false principles (falso principio) that are the characteristic hallmarks of delirium (delirio), which on this scheme is ultimately a defect in intellectual functioning (funzioni intellettuali) (Chiarugi, 1987: 23; Chiarugi, 1793–4, Tome 1: 35).

In this last respect, it is worth emphasizing that the passions and emotions do not constitute a separate uniform faculty (facolta) of their own, alongside the Will (Volonta) and the Understanding (Intelleto) (Chiarugi, 1987: 10–11). This is despite the fact that on some occasions Chiarugi does refer to ‘feeling’ (sentimento) as a ‘faculty’ on the same level as ‘distinguishing’ and ‘moving’ (p. 10). In general, Chiarugi’s division of the faculties is consistent with the account of these provided in the Encyclopédie and elsewhere. Affective states and processes are important in the organization of thinking and behaviour, but there is no separate faculty of these to stand alongside the faculties of the Will and Understanding.

Conclusion

Vincenzo Chiarugi introduces a variant of the distinction between ‘passion’ and ‘emotion’ that seems to be modelled along the lines of the Stoic doctrine of first movements. Yet despite his professed interest in moral treatment and the psychopathology of affectivity, he makes no clear use of that distinction in his clinical reports and ultimately ‘… we know little about his psychological methods’ (Grange, 1963: 372, see also 377). At the same time, his general analysis of how the passions figure in mental illness and its treatment is consonant with similar approaches in other major thinkers of the period, like Pinel.