Late medieval philosophical and theological discussions of mental disorders: Witelo,Oresme,Gerson

Abstract

No matter from which perspective Witelo, Oresme and Gerson approach mental disorders, they think that madness usually has a bodily, such as a humoral or organic, origin. They do, however, consider divine or demonic causes as possibly being behind immediate causes. According to Witelo and the Parisians, because of a change in the body, madmen’s sensory fantasy is disturbed and in this situation their intellect does not act normally, and their will lacks freedom. It is important to realize that, according to the medieval writers, mentally-disordered people have not lost any parts of their soul or their basic potencies. If this were the case, they would not be human beings by definition.

Keywords

Fantasy madness mental disorder Middle Ages will

Introduction

It has often been thought that medieval discussions on mental disorders were dominated by witchcraft and demonology. This belief has been persistent, especially in general histories of medicine,¹ despite the fact that there has been a lengthy series of studies which concentrate on various medieval theories of mental disorders and present a much more balanced view of them. Among medieval philosophical and theological madness theories, in addition to Thomas Aquinas’s theory, which has been investigated in several monographs and articles, certain articles have also studied the theories of others.² The madness theories of medieval philosophers and theologians have also been discussed in larger monographs which give an overall view of the medieval theories.³ There are also studies of particular theological questions linked with madness, such as investigations into demonic possession (Kemp, 1989, 1990: 135–46; Kemp and Williams, 1987) and sacred folly (Kinsman, 1974: esp. 277–8; Pfnür, 1987: esp. 800–4; Saward, 1980: esp. 31–103).⁴ Various theological and philosophical questions have also been dealt with in studies of medieval juridical madness theories,⁵ and in studies of medieval medical theories of madness.⁶ It is often impossible and unnecessary to draw a strict distinction between philosophical, theological, juridical and medical madness theories in the Middle Ages; all the theories are, in many ways, based on classical medical theories.

Most of the studies dealing with medieval discussions of mental disorders concentrate on the early or high Middle Ages. This is particularly true in the case of philosophical and theological discussions. A reason for this is that most of the late medieval philosophers and theologians do not seem to have written systematically about mental disorders. Many, however, comment on them in various contexts. Despite the lack of scholarly work concerning late medieval madness-conceptions, there have been rather curt interpretations of them. Sometimes, even those who have defended the rational character of the early or high medieval approaches to madness have claimed that, after Thomas Aquinas, the rational attitude changed. Thomas F. Graham wrote in his book Medieval Minds: Mental Health in the Middle Ages that philosophers after Aquinas had ‘resistance to progress in learning’, and since they

failed to grasp the objective spirit of Aristotle and Aquinas, circular arguments and fruitless discussions prevailed which, in turn, antagonized generations of scientists, so that the schism between philosophy and mental science seemed irreparable, a break that accelerated the decline of medieval wisdom. (Graham, 1967: 73)

In this article, I aim to present and analyse philosophical and theological mental disorder texts by two late medieval Parisian thinkers, Nicole Oresme (c. 1323–82) and Jean Gerson (1363–1429). To set them in context, I also discuss the mental disorder thinking of the thirteenth-century Polish thinker Witelo (c. 1237–78/later). All were writers on a wide range of subjects who, among other things, were interested in mental disorders and wrote quite a lot about them. Nicole Oresme was a philosopher and theologian, natural scientist, counsellor to the French King, and finally the Bishop of Lisieux. Jean Gerson was a theologian, philosopher, and Chancellor of the University of Paris, as well as being a mystic. Witelo was a Polish (Silesian) natural philosopher and theologian, who also lived for some time in Italy. In my analysis I will consider in detail what these three thinkers say about mental disorders in various contexts. Demonological treatises certainly belonged to the contexts in which Witelo, Oresme and Gerson discussed mental disorders. I shall therefore pay special attention to the question of whether they ultimately considered mental disorders to be caused by demons or linked with them. Oresme’s considerations of madness are the most comprehensive, so I will discuss his texts in greater detail.

By ‘mental disorder’, I mean states of mind that were considered as serious and abnormal; more serious, for example, than passing problems caused by harmful passions or habits. The most common traditional terms used for mental disorders in the late medieval theological and philosophical texts were ‘amentia’ (Latin: amentia), ‘dementia’ (dementia), ‘epilepsy’ (epilepsia), ‘foolishness’ (fatuitas), ‘frenzy’ (phrenesis), ‘fury’ (furia, furor), ‘insanity’ (insania), ‘lovesickness’ (amor hereos), ‘lunacy’ (lunatia), ‘mania’ (mania), ‘melancholy’ (melancholia) and ‘stupidity’ (stultitia). According to Fritz (1992: 6–7), following an antique tradition, the medieval writers divided madness into two types. The first consisted of such states as amentia, dementia, insanity, foolishness and stupidity. These states often, but not always, referred to negative, passive madness – an absence of reason. The second consisted of such states as frenzy, fury, lethargy, mania and melancholy, which referred to positive, active madness, causing something harmful. On the basis of Greek and Islamic medicine, medieval physicians supposed the cause of a mental disorder was usually a humoral imbalance.⁷ Despite the ancient Graeco-Arabic tradition, it was not easy to define various mental disorders. Melancholy was traditionally associated with an imbalance or excess of black bile with no fever. Constantine the African defined melancholy either as being a belief in some imaginary evil or as a suspicion from which arose fear and sorrow. The distinction between mania and melancholy was difficult to make. Fritz explains that mania included excitation, and melancholy included feeling low. Many medieval writers discussed them side-by-side, and Bartholomaeus Anglicus (thirteenth century), for example, made no distinction between them in recommending remedies. Frenzy was believed to result from the action of yellow bile on the brain, and it was thought to be accompanied by fever and erratic behaviour, such as weeping, raging and laughing.⁸ Fury was favoured by the lawyers in referring to those evincing active, raging madness (Fritz, 1992: 7, 157–9; Neaman, 1975: 74, 89–90). Epilepsy was held to arise from the movement of phlegm or black bile or blood to the brain. The phases of the moon were believed to affect the changes in humours in epileptics, and lunacy was sometimes identified with epilepsy (Fritz, 1992: 209–13; Kemp, 1990: 120). Medieval theologians and philosophers sketched their views of madness by more or less applying these characteristics.

Witelo

One of the medieval philosophers interested in mental disorders is Witelo (c. 1230/35–75/later), who considers them in his De causa primaria paenitentiae in hominibus et de natura daemonum (probably 1268; Burchardt, 1979: 209).⁹ Witelo’s demonological work was forgotten until the beginning of the twentieth century; according to Birkenmajer (1972: 256), researchers became interested in Witelo’s work only after reading Oresme’s references to it in his works. Witelo deals mainly with the mental disorders of mania, melancholia, frenzy, epilepsy and lovesickness. According to Birkenmajer, Witelo seeks to deal with the subject of demonology solely based on natural reason, and he hopes to be able to do so without conflicting with the Christian faith. He distinguishes between two types of demons: those which simply appear without doing anything, and those which do something but which are only rarely seen. Witelo calls the first type apparitiones, which have natural reasons in human beings, that is, in the perturbations of brain and in the illusions of the senses, and which have no supernatural connections. They may therefore be called ‘pseudodemons’, as Birkenmajer and Burchardt label them. The second type are real demons (Birkenmajer, 1918: 5; 1972: 108, 256; Burchardt, 1986: 4–5). When dealing with these apparitiones, Witelo also deals with mental disturbances.

Witelo’s debt to Graeco-Arabic medicine is obvious, but Burchardt has shown that the principal source of his psychopathology is Constantine the African’s Viaticum peregrinantis, the Latin adaptation of Ibn al-Djassar’s medical handbook Zad al-Musafir (tenth century). In the Viaticum, the causes, symptoms and remedies of mental disorders such as lovesickness, melancholy and frenzy play an important role. Burchardt considers that Witelo has, however, combined the aetiological theories of the Viaticum with al-Ghazali’s theory of the interior senses. Burchardt states that Witelo has paid special attention to the role of fantasy in madmen’s confused cognition in his treatise, creating a new synthesis in the area of psychopathology (Burchardt, 1979: 143–6, 214).

Witelo considers various bodily and mental states and also situations in life in which people may have special apparitions. Maniacs, melancholics, frenetics and epileptics may have them, but also those suffering from stroke (apoplexia) or fever. In principle, even healthy people may sometimes have them: while sleeping or in a dark place, for example.

Maniacs and melancholics

Let us begin with the treatise of the mental disorders of maniacs and melancholics. Witelo’s solution of combining mania and melancholy seems to Burchardt (1986: 10) an anticipation of the modern concept of manic-depressive psychosis. Indeed, this combination was quite common in the Middle Ages. Although Witelo combines mania and melancholy, he is mostly interested in the phenomena that were traditionally linked with melancholy. Witelo thinks that the mental disorders of this group are caused by melancholic fumes ascending to their brains. Because of these fumes, the fantasy powers of the people in question judge some things they see as black, and then they say they have seen demons. In the traditional manner Witelo says that these people have a constant fear of demons, since they carry the reasons for their fears with them.¹⁰

Constant fear and thoughts about demons may, according to Witelo, lead to a dramatic chain of dangerous psycho-physical reactions. In explaining these reactions, Witelo sheds interesting light on the question of what exactly may happen in the cognitive capacities when people suffer a mental disorder. He suggests that fear can change the temperature of the body by making it cold on the exterior and hot in the interior. If, Witelo says, in this situation the fantasy sometimes descends to the common sense, where the actual sensations of the outside are collected, people believe that they actually see the demon of which they are afraid.¹¹ So if, in the interior senses, fantasy happens to get mixed up with the common sense, people think they see something that is only in their imagination.

But more follows. In addition to cognitive disorders, the disproportionate heat caused by the fear of demons may lead to changes in the appearance of the human being, especially if the heat has reached the heart. It may lead to a dramatic, visible phenomenon, in which the whole body seems to be destroyed by fire: it seems to burn on the inside and even becomes black and burnt on the outside. People to whom this happens are said to have seen demons burning in the fire of hell.¹² Witelo adds that sometimes the interior heat cannot burn the body, but it melts the glue that connects the flesh and the bones, and the person swells.¹³ Furthermore, too much exterior coldness, which is caused by fear, can cause dangerous phenomena: it hinders the working of the nerves and arteries; the spirits of people are not free; there is no sense or movement and people are as if they were dead.¹⁴ Might one even say that Witelo is afraid of fear? At least he does not underestimate the effect of fear.

Frenetics, epileptics and the lovesick

According to Witelo, frenetics may also have special apparitions. Their brains become corrupted because of, for example, the heat of yellow bile or because of the boiling of the blood close to the heart. Sometimes they have a disease of the diaphragm or stomach or womb or other members that suffer from smouldering, and these diseases affect the brain because of the connection of the nerves of those members with them. Since in this situation the rational power is impeded from intellectual operations, the sensory powers no longer have the dominion of the rational power, saying, for instance, that what people think they see is not real. People may say they have seen somebody burning and red; this redness originates from the redness of the yellow bile or the blood.¹⁵

Witelo thinks that the visions peculiar to epileptics are also the product of a natural cause: the fume ascending to their brains, no matter which humours and organs are in disorder and causing trouble. He holds that the disturbance in the brains of epileptics involves the front part of the brain, which is the place of common sense. When the functions of common sense, which rouses all the senses, are impeded, the whole body collapses as if it were dead. In this situation, rational power does not judge rationally but fantastically, from intrinsic phantasms. Here Witelo presents an interesting, culturally-based view of how epileptics interpret their coloured visions: if, for example, phlegm causes the brain and the phantasms to become white, northern people believe they see white heavenly angels, while the southern Moors believe they see demons. Conversely, if the effect comes from the black bile, the northern people think they see demons, but the Moors think they see angels. Epileptics may also see something quite different: if the effect is caused by thick humidity in the brain, epileptics may see trees and mountains, linking them either with paradise or with hell, according to the qualities of the humidity. Witelo remarks that since epileptics’ back part of the brain is unharmed, their memory catches their visions, and afterwards tells them that they have seen something marvellous. They therefore remember what they have seen during their seizure.¹⁶ Witelo remarks that epilepsy (as well as strokes) varies according to the phases of the moon, but he does not explain why.¹⁷

Epileptics may, according to Witelo, have illusory visions, but on the other hand, he thinks they may have special cognitive capabilities that healthy people do not have. Since the movements of the spirits are quietened in epilepsy, and the rational soul does not reach the exterior sensible objects, the soul can change from its usual state and join substances which are separate from matter and, because of this, see the future and prophesy.¹⁸ Unfortunately, Witelo does not develop this idea. Elsewhere, he says that epileptics and melancholics (and sleeping persons) may see future things – because of the effect from separate intelligences (angels) – when there is no impeding imagination.¹⁹

In the Middle Ages, those suffering from lovesickness (amor hereos) comprised an interesting group of somewhat mentally-disturbed people with whom illusory visions were often associated. Lovesickness was a disease to which the Arabic doctors, such as Ibn al-Djassar, paid much attention. Witelo states that lovesick people may not say they have seen a demon; quite the opposite, they may say they have seen their loved ones when they were not present, but this is because of a demon. According to Witelo, such people have repeatedly imprinted the forms of their loved ones onto their imagination; sometimes these strong forms fall into the common senses where actual sensations are collected, and the people concerned think they see their loved ones. Demons do not, therefore, have a role in these visions.²⁰

Let us now examine Witelo’s explanation of people who sleepwalk. Sometimes people who wake up can find themselves far from the place where they went to sleep, saying that they have been carried off by demons. What has happened is this: in sleep, the common sense of these people is bound, but their particular senses are loosened through something hot, possibly the hotness of fever. Sometimes these people indeed wake up somewhere other than where they went to sleep, but what has happened is that they have moved by themselves and have not been carried by a demon. Witelo seems to think that the activation of the particular senses has made these people walk, even though their common sense is not working.²¹ Thus, he provides a natural explanation for sleepwalking.

Summary

Witelo deals with maniacs, melancholics, frenetic, epileptics and other mentally-disturbed people when considering various bodily-mental states and situations in life where people may have apparitions. In such people the functions of the sensory fantasy powers are infected, and the powers judge wrongly. The problems in fantasy powers are caused because of the infections in the brains, which, in turn, may be caused by an imbalance of fumes or temperature. Sometimes the fantasy, with its images, and common sense, with its actual sensations, get confused, and then people may think they actually see something that they only imagine. Since the rational power is, in this situation, impeded from intellectual operations, it cannot say that what people think they see is not real. On the other hand, some mentally-disturbed people may have special cognitive abilities that healthy people do not have. Witelo thinks that at least epileptics and melancholics may see future things – because of the effect of angels – when there is no impeding imagination in them.

Nicole Oresme

Nicole Oresme (c. 1323–82) gives more consideration to mental disorders than many other philosophers and theologians in the late Middle Ages. Among others, he was familiar with Witelo’s conceptions of mental disorders and he made references to his texts (Birkenmajer, 1972: 256). The main source for Oresme’s conceptions of this theme is his De causis mirabilium, in which he deals with marvels involving various sensations and the activity of the soul and the body. Another central source for Oresme’s thoughts on mental disorders is his Tractatus de configurationibus qualitatum et motuum, where, in considering mental disorders, he attempts to show that various marvellous phenomena can have natural explanations. The mental disorders that mostly interest Oresme are mania, melancholy, lunacy, epilepsy, lovesickness and foolishness.

In the first chapter of De causis mirabilium, Oresme says, referring to Witelo (Huot, 2003: 177, 178),²² that marvels appear to those who are in a frenzy, to those who are melancholic, and to those who have epilepsy or other diseases. The experience of a marvel is not necessarily constant, but it is possible, according to Oresme, that a human being experiences a marvel at one moment, and at another it is over, as in the case of epilepsy. What causes the marvels concerned? Oresme says that people experience marvels because of various fumes, humours and similar things, and because of a strong effect (of the moon?), as in the case of lunatics. Even a small humour or fume or effect, especially in the cognitive capacities, may cause marvellous appearances. Oresme emphasizes that marvels are only rarely experienced by those who are prudent and in good complexion; usually they are experienced by the infirm, children, women or similar people.²³

Huot (2003: 177, 178) sees misogyny in this. She remarks that ‘[t]he misogynistic view of women as naturally irrational, in fact, suggests that they are not even susceptible to the journey through madness and back to sanity that can be traced by a male character’, and continues: ‘If a woman’s very nature predisposes her to melancholic delusions, then clearly her irrational symptoms have a meaning very different from those of men, whose madness is a fall from nature, an aberration.’²⁴ It is clear that according to most if not all the medieval thinkers, Oresme among them, women are less rational than men. However, they do not appear to say that women’s weakness lies on the substantial level or that their souls are different from those of men. The question seems rather to be about the qualitative level that is considered weaker in women; women’s dispositions were thought either to be weaker or not in the best possible order.

Maniacs

The disorders Oresme mostly discusses are mania and melancholy. Sometimes he combines them; sometimes he talks about them separately. Let us first see what Oresme says about mania. In De causis mirabilium he writes that maniacs (and melancholics) have many fumes which ascend particularly around the brains and the instruments of the soul ‘as it is known’. These fumes have an effect on the fantasies of the people concerned, their behaviour directly following what occurs in their fantasies: they cannot control themselves, be quiet or calm down.²⁵ Maniacs are constantly in motion, both in relation to their limbs and their thoughts.²⁶ They do not stay settled with one objective, but continually, rapidly change from one objective to another.²⁷ They do not speak of perfect, long propositions but of truncated ones, and they are unable to repeat what they have said.²⁸ Oresme reminds us that according to Galen, the emotions of maniacs vary from extremes: sometimes laughing, crying, being brave, being timid, believing that the sky is falling, raising their arms to sustain it and so on.²⁹ On the other hand, Oresme says that, because of black melancholic fumes, in most cases maniacs think bad things.³⁰ He also refers to the traditional physicians who say that lepers and those infected by bad, melancholic and burnt humours think bad and ugly things, especially when bad fumes ascend to their cognitive faculties.³¹ The fear that follows causes thoughts of the devil, sins, torments, etc., in maniacs’ minds.³² When they speak, they typically speak about bad things.³³ Oresme’s language might lead one to suppose that he is speaking rather about melancholy. The explanation is probably that he does not, in fact, make a sharp distinction between mania and melancholy.

In referring to mania in De causis mirabilium, Oresme scarcely mentions the visions of demons, but in Tractatus de configurationibus he does. It appears that, like other mentally-disturbed people, those having mania may see and hear demons and other things that have no exterior counterpart. In dealing with these phenomena, he develops the aetiology of maniacs’ (and perhaps also other madmen’s) problems. According to Oresme, the visions and hearings concerned arise as follows: people’s imaginative or estimative capacity is corrupted because there is something wrong with the organs of their interior senses. This defect is, in turn, due to an abscess on the brain or some other cause, often originating in the heart.³⁴ It is very interesting to see that Oresme says that some problems in the brain or elsewhere affect the interior senses (imaginative and estimative capacities) through the organs of those senses. Thus, the chain of causation is very physical. Here he does not mention the humours or fumes at all, although he may take for granted that, in the organic problems concerned, humours and fumes are in imbalance.

Melancholics

Let us now turn to melancholy. According to Oresme, fear is a typical feature of it; he remarks that Avicenna and Galen did not think it surprising that melancholics are afraid, since they have the cause of fear in them, that is, the black melancholic humour.³⁵ How does it make people afraid? As seen in connection with mania, Oresme thinks that black melancholic fumes make people think bad things. Because of the fear that follows, thoughts of the devil, sins, torments, etc., occur in their minds.³⁶ Oresme also holds to the traditional view that because a melancholic person’s spirit is thick and cold, the person is like a fool and is not bright.³⁷ Similarly to what he says about mania, Oresme adds that melancholics (and women) belong to a group of people who act immediately, without deliberation, when something comes to mind or when something occurs to them.³⁸

In the traditional medical interpretation of melancholics as fools and unintelligent, Oresme recognizes a possible contradiction with what Aristotle said about them: in Problems, (Pseudo-)Aristotle remarked that all men, such as Socrates who were wise and able, were also melancholic. Oresme does not attempt to deny that the wise men to whom Aristotle referred were melancholics. He specifies that the troubles in their exterior parts had made them cold and dry and therefore melancholic. However, wisdom was able to survive in these men. Oresme explains this as follows: because of their repeatedly good (interior) acts, such men have good inclinations in some of their (interior) organs and potencies, and they think about good deeds. Oresme also adds that since melancholics are cold and thick, something impressed in them, such as good disposition, also remains.³⁹ Elsewhere, he admits that there are melancholics who have the use of reason, and he even talks about prudent or wise melancholics. According to Oresme, the tragedy of some melancholics is that they understand well that there is no reason to be afraid, but they are still just as afraid as some maniacs.⁴⁰ In their case too, in some acts they are melancholic while in others they are healthy. It becomes clear that Oresme thinks melancholy does not always envelop the whole personality. Perhaps some new light is thrown on the connection between mania and melancholy: in maniacs the problems of melancholics may become very strong.

Frenetics, lunatics, epileptics and the lovesick

According to Oresme, there is also natural causation in what happens to frenetics, lunatics, epileptics and those suffering from lovesickness. Frenetics do not really interest Oresme, and he only mentions them with others suffering from naturally caused mental disorders; but he pays more attention to lunatics, epileptics and the lovesick. Where lunatics are concerned, Oresme states that it is already clear from the term that their humours have been shifted naturally, that is, by the moon, not by a demon.⁴¹ He talks about lunacy and epilepsy separately, but he probably accepts the traditional view that the moon can affect epileptics through affecting their humours. Together with epileptics, he talks about the possessed (arrepticius). It remains unclear whether he really means demoniacs here. Anyway, Oresme says that in the possessed and epileptics there is a revoking or reclusion of the soul to the inside, and a retraction of the sensitive spirits into the interior capacities. In epileptics this happens at the time of a seizure.⁴² Oresme seems to mean that in the case of those who are possessed, and also of epileptics, the soul is not in contact with the outside world and is unable to receive information from it through the spirits which normally move around the body. In epileptics, the reason for this is probably the moon shifting the humours. As we shall see later, such an inward turn may have interesting consequences.

Oresme thinks that people who have lovesickness (amor ereus) see their beloved strongly in their imagination, believing that they see him/her when they actually do not. According to Oresme, similar things happen to many other melancholics – even those having the use of reason. This is because of the melancholic humours ascending to their brains.⁴³ Thus, Oresme combines even lovesickness with melancholy. He knows several cures for this disease and, referring to Witelo, he states that the best cure for this kind of melancholy is to be joyful and consoled in a remote place, and not to think of bad things.⁴⁴ Elsewhere, Oresme suggests music as a cure.⁴⁵

Demonic causation is an error

Oresme is well aware that his contemporaries often thought that mental disorders came from demons or from God. He considers that it is really ignorance of natural causes that makes people think this. He says that those who are not physicians easily attribute such diseases as a stroke, epilepsy and mania either to God or to demons, since they may occur suddenly and even to healthy people, and the people in question do not know their causes.⁴⁶ With the help of medicine, he continues, we know, for example, that melancholy causes various symptoms in the human being; those who look most wise suddenly look most stupid, and those who look healthy suddenly have their head or neck twisted back. Certain humours may run to the tongue, the brain, the stomach, the arm, or to other places, and then there can be astonishing changes in the person. All this can, however, be explained by natural causes.⁴⁷ In holding this opinion, Oresme must face the objection that many traditional authorities, such as Avicenna and even Christ, have considered madmen (maniacs) to be demoniacs.⁴⁸ To this Oresme says, as above, that those who do not know immediate and natural causes for a madman’s experiences refer to demons, heaven or God as a cause; they are wrong.⁴⁹

Oresme questions whether mental disorders are always sufficiently explained by bodily causes. Perhaps not always. He thinks that there are grades of madness: some people are always completely mad, some temporarily, some in respect to some things but not others.⁵⁰ He admits that bodily complexions do not always suffice to explain this variation. Some people are mad, although they seem to be healthy and to have an optimal complexion of natural capacities: they see, hear and can speak well, they are strong, eat, act and sleep well, etc. Why is this?⁵¹ At least in Tabula in De causis mirabilium, this question remains unanswered, as does the question of why animals such as horses and cows, unlike human beings, do not become mad.⁵² There should be nothing in principle to stop them becoming mad, since Oresme certainly thinks they have both the body and the interior senses which might be disturbed.

Indirect demonic and magical causation are possible

It appears that Oresme consistently gives natural explanations to mental disorders. It is, however, possible that demons or witches may cause them. Oresme does not wish to maintain that all the strange phenomena in the world have natural explanations, but he suggests that many of them have, including those which happen to madmen.⁵³ Where melancholy is concerned, Oresme refers to Avicenna, who thinks that even if melancholy results from a demon, it is sufficient for us to understand that in it the bodily complexion is dominated by black bile. The proximate cause of melancholy is therefore black bile, whether the cause of the black bile is a demon or not.⁵⁴

According to Oresme, in addition to demons, magicians or necromancers are indirectly able to cause mental disorders. He admits that magical art can cause human beings to be shaken into such a state of terror and imagination that they are out of their senses and become like (velut) demented beings or those having a species of mania. Such people then believe that they see or hear things that they do not see or hear.⁵⁵ Oresme does not appear to say that in this case the person is really in a state of dementia or mania, but rather in a state that recalls them. However, is real madness possible in such a case? Does Oresme think that a great fright may cast a person into a real mental disorder? He refers to Hippocrates, who thinks that long-lasting fear (timor) and timidity (pusillanimitas) produce a melancholic person. If people are afraid and sad for a long time, such a habit is generated in their soul so that they become maniac or melancholic.⁵⁶ Thus, Oresme seems to agree that at least prolonged fear – probably also caused by a magician – may lead to a kind of mental disorder.

In writing about necromancers, Oresme admits that such magicians may be able to produce fumes out of certain materials that can make human beings so demented that some terrible or fantastic things appear to them. Such artificial fumes are called suffumigations (suffumigatio).⁵⁷ Such activities, Oresme remarks, must be most dangerous to the necromancers themselves. In making their invocations they may not only be changed in body, but also become totally mentally disturbed. They look like idiots (ydeot) or persons in a fury, and become totally alien, not only to other people but somehow even to themselves. Moreover, it is possible that they may not return soon, if ever, to their pristine state.⁵⁸

Madmen’s special or supernatural capacities

Even if the causes of the mental disorders are at least mostly natural, Oresme considers that mentally-disordered people can have extraordinary or even supernatural capacities, such as revealing hidden things or foretelling the future. In Oresme’s texts, this question especially concerns maniacs, perhaps because they are usually thought to be the active kind of madmen. He thinks that madmen may not always be able to foretell the future, but some maniacs may temporarily see some things more clearly than healthy people. Oresme does not seem completely sure why this is so, but thinks it may be because the spirits in maniacs’ bodies run quickly and become subtler due to the sudden changes (antiperistasis) in their bodies.⁵⁹

The state in which maniacs have subtle spirits and humours does not, however, last long, since thick spirits and humours come and darken them.⁶⁰ In saying this, Oresme once again seems to combine melancholic humours with mania. He thinks that even healthy people may have such very subtle spirits and humours, but this may also be temporary: they lose their line of thought, get headaches and sometimes even become fools.⁶¹ Oresme continues that one can sometimes be bright and at other times a total fool. Indeed, many of the brightest people become dull, and this may be because the brighter the spirits, the more darkened or corrupted they may become.⁶² Oresme may mean that a talented person has the capacity for good and bad.

In addition to seeing clearly, maniacs were sometimes thought to reveal hidden things and foretell the future. Oresme ponders possible explanations for such phenomena. One of them is the Platonic idea that in the human memory, from the beginning, there are all the species of knowable things that would be known if not hindered. Oresme admits that this theory might explain phenomena such as maniacs’ ability to foretell, but he clearly rejects it.⁶³

Another explanation is quite trivial: it is possible, Oresme suggests, that a maniac who talks all the time may sometimes say something true about the future, just as it could happen that Socrates, wandering around the streets of Paris like a fool, could chance upon his friend’s home.⁶⁴ Oresme remarks that maniacs speaking the truth by chance at one moment may be in connection with their previous thinking of the same thing. What kind of thinking is possible for them? His answer is vague (in confuso) thinking, since in most cases maniacs’ thoughts are disturbed because of the black melancholic fumes within them.⁶⁵ Here again mania is combined with melancholic fumes.

As a possible natural explanation of maniacs’ disputed capacities to reveal hidden things or foretell the future, Oresme ponders the influence of the audience in situations when maniacs’ capacities are said to be active. For example, he thinks that fear or murmuring among listeners may alter the medium, the air, and this in turn may alter the organs of maniacs, which may then alter their cognitive capacities.⁶⁶ By this, Oresme really seems to mean that maniacs could, through the air and organs, read other people’s thoughts. Although he seems to accept that something like this is possible, he criticizes people’s credulity: he remarks that people take maniacs’ stories too seriously, and too readily think that maniacs speak only about their life.⁶⁷

It is somewhat surprising that in the case of epileptics, Oresme accepts without hesitation their foretelling of the future. As already mentioned, he thinks that in epileptics and those possessed there can be a revoking or reclusion of the soul to the inside and the sensitive spirits retract into the interior capacities. The exterior senses of these people are then deadened so that they neither see nor hear, but their interior capacity functions. Oresme considers that in this condition such people have a marvellous power. Some of them, in their ecstasy, have marvellous visions. Later (e.g. epileptics after their seizure) they say that they have seen much; sometimes, according to Oresme, they foretell the future and reveal hidden things.⁶⁸ Unfortunately, he does not attempt to specify these ecstasies and visions and explain whether the secrets revealed to these people are in some way from outside.

It appears that Oresme believes that mentally-disordered people may be able to reveal hidden things and even foretell the future. He presents this opinion especially in his Tractatus de configurationibus. In his Livre de divinacions, however, Oresme maintains that those who can prophesy lead sober and peaceful lives, have mirror-clear souls and are free from worldly thoughts. In saying this, he refers to Moses Maimonides, who maintains that concupiscence and sadness hinder prophesying.⁶⁹ Should we think, like Thorndike (1934, III: 420), that Oresme is not entirely consistent in his interpretations? Not necessarily. First, Oresme may think that real prophesying is a divine effect that requires a positive state of mind, while a natural ability to reveal hidden things does not. Even if he thought that prophesying could be compared with the natural revealing of hidden things, it would still be possible to think that, according to Oresme, a person might be, in very different states of mind, free to receive knowledge of hidden things.⁷⁰

Besides special capacities of the mind, some mentally-disturbed people were traditionally thought to have some special bodily strengths. Oresme accepts the traditional view that some frenetics may become extraordinarily strong and quick, much stronger and quicker than they were before their frenzy.⁷¹

Summary

Oresme deals mostly with mental disorders, often mania and melancholy, in trying to show that various marvels can have natural explanations. He thinks that in most cases mental disorders are caused by various physical problems in the brain or other parts of the body which affect the organs or the interior senses. Madmen have lost their use of reason, but not always totally. Oresme considers that the thinking and behaviour of mentally-disturbed people is in many ways irrelevant. However, some of them, whose souls are turned inwards, may also have some special capacities, such as clear thinking and foretelling the future. Oresme takes great pains to prove that all the phenomena around madmen usually have natural explanations. An indirect demonical explanation is still also possible.

Jean Gerson

The mental disorders that Jean Gerson (1363–1429) mainly deals with are the common ones: mania, melancholy, frenzy and foolishness. He presents somewhat colourful examples of the behaviour of people suffering from them (especially melancholy), but several of them are, or resemble, classical examples of madness originating in Greek and Arabic medicine. Gerson knew Nicole Oresme’s considerations of mental disorders and sometimes refers to them in his discussions (Hansen, 1985: 116–17).⁷² Nowhere does Gerson make clear distinctions between mental disorders; on the contrary, he often combines them. Instead, he gives a general clarification of the dispersion of the mind. He makes it clear that in this life any dispersion only concerns the ‘second acts’ of the mind, that is its operations, not its first act, its essence.⁷³ Thus, according to Gerson, the soul of mentally-disordered people cannot be damaged, but its operations are out of order. This is also probably the view of Witelo and Oresme, although I have not found this clearly expressed by either. According to Gerson, the state of the soul is then so serious that its possible evil acts are not considered culpable.⁷⁴ Some medieval writers, such as Henry of Ghent (c. 1217–93), specified that madmen do sin in the bad acts they commit because of their madness, if it is their own fault that they are mad.⁷⁵

Gerson discusses the lack of rational thinking in the case of mentally-disordered people in his interesting De consolatione theologiae, which is built on a dialogue between Volucer and Monicus. They discuss rational judgement and liberum arbitrium. Volucer says that there are those who lack all rational judgement, such as babies and fools, those whose judgement is imperfect, such as children, and those whose judgement is weak, such as women.⁷⁶ Volucer also states that the use of liberum arbitrium, which is dependent on a harmonious bodily disposition, can be blocked in countless ways. In babies, fools, drunkards and many madmen, the use of liberum arbitrium is totally impeded; in children it is imperfect, and in women and people affected by various passions it is unstable and variable. Gerson is not very interested in the underlying bodily states in those with mental disorders, but uses Volucer to refer to the corrupted humours which generate melancholic fantasies.⁷⁷ Some writers, such as William Ockham (c. 1285–1347), went even further and pondered whether (some) madmen performed any higher acts, that is, acts in the intellect and the will (Hirvonen, 2006: 182–3).

Conversely, people whose rational thinking is limited or non-existent may sometimes be able to speak the truth about things better than adult healthy men. In his short work for students, Livret-Proverbes pour Écoliers, Gerson says: ‘If you wish to know the truth about things, listen to a drunkard, a child, one who is stupid (sot), or a woman.’⁷⁸ Unfortunately Gerson does not elaborate on this statement, but he may have thought that the limitations of these people’s cognition result in space for very clear sensations about some things. Another explanation might be that such people may not be able to censor what they say.

Maniacs, melancholics and frenetics

Gerson’s most expansive comments on mental disorders occur in his text De passionibus animae, in which he deals mainly with maniacs and melancholics, combining them in the same way as many other late medieval writers did. Gerson’s discussion of mental disorders emphasizes the role of the human being’s imaginative power. A mentally-disordered person imagines something that does not really exist. However, it does not always seem to be only a question of a problem in the imagining part of the sensory capacity. Interestingly, Gerson appears to think that madmen’s exterior sensations may also be out of order. According to him, it may happen that – because of darkened (melancholic) spirits in human beings – there is a sensation in their exterior senses as if an exterior object had caused it. Gerson says that some say this is a cause of maniacs’ and some melancholics’ belief that they have seen or sensed outside themselves something that is only inside them. Even a normal person, when in a dark place and afraid, may sometimes see or hear horrifying things that do not really exist, but the melancholics see or hear them in daylight because of the darkness of the spirits. Gerson, like many before him, remarks that melancholics cannot get rid of their sadness because they carry its cause within themselves.⁷⁹

Like Oresme, for example, Gerson notes that a madman is not necessarily totally mad. Gerson says he himself has known such a mentally-disordered person who, despite being brilliant and familiar with medicine, was so terrified that he hid himself in a forest and never came out. Gerson also mentions some other cases of this kind. Most are classic examples of mental disorders (melancholy) in ancient and medieval literature. He tells us there was once someone who thought he was a cockerel, and sang like a cockerel. Another man thought he was a cat, and searched for mice under a bed. Another, imagining himself to have a horn on his forehead, was always ashamed when he saw someone looking at him, and covered his forehead. A man imagining himself infected with leprosy or epilepsy escaped from everyone and was afraid of seeing and talking with them. Another person, imagining himself as having feet of iron, stepped most firmly on the earth, while someone else did not dare to walk, fancying that his feet were made of glass.⁸⁰ Gerson remarks that according to some interpreters, Nebuchadnezzar’s case also belongs to this series: he ate hay like a bull and lived with beasts, fancying that he was a bull.⁸¹

Gerson also deals with mental disorders in his De distinctione verarum revelationum a falsis, when he ponders how, in various cases, it is possible to make a distinction between truth and falsehood. He speaks about a learned man who first thought himself to be the Pope, then the Antichrist, then if not the Antichrist, at least his precursor. Finally, he was tempted to kill himself in order not to harm Christian people. Through God’s mercy, he came to a saner state of mind and, to warn people, wrote about his mistakes.⁸² If extraordinary revelations seem to happen to some people, they should not, according to Gerson, immediately trust these revelations. First, one should consider that such things result from a lesion of the fantasy and be worried about being ill, like frenetics, maniacs and melancholics.⁸³ Here Gerson does not make a distinction between mania, melancholy and frenzy. All seem to cause the problems concerned. In De probatione spirituum, he says that there should first be an investigation to determine whether the people having visions are of sound judgement. The judgement of their intellect may be affected by a lesion in the brain, as it is in frenetics and other sick people who think they see, hear and taste things which other people experience when they are asleep.⁸⁴ Gerson also mentions frenetics in his De consolatione theologiae. Volucer and Monicus discuss people who are awake but speak as if they are dreaming, and who say almost nothing coherent. Like maniacs and melancholics, frenetic people take phantasms of something which occurs internally to refer to real things outside the mind.⁸⁵

A person’s own role in causing madness

Unlike Witelo and Oresme, Gerson pays attention to the role that human beings themselves may have in causing their mental disorders. Even the way of thinking that a person chooses may lead to mental disorder. Gerson warns that it is obviously dangerous for a human being to surrender to imaginings or fantasies. Bad habits generated by acts of the imagination can harm the imaginative power and consequently the whole human being, in such a way that the person becomes like a beast.⁸⁶ According to Gerson, every freely flowing imagination has its insanity or drunkenness and something like a demonic passion, as Origen puts it. Such an imagination can totally pervert a person’s judgement of reason. This is evident, Gerson states, in the case of the impatient in whom ‘patience, when too often outraged, is converted into fury’, as the proverb says.⁸⁷

On the other hand, Gerson refers to the dangers of excessive abstinence. It may lead to lesions of the brain, perturbation of reason, and even to mania, fury, melancholy or frenzy. When this happens, the phantasms reserved in the brain are so intensive that people think they see, hear and touch things that they have not actually sensed with their exterior senses. Gerson states that this effect sometimes strengthens, until it reaches such insanity that people believe themselves to be something other than what they are: a cat, a cockerel, an ass, even a dead person.⁸⁸ Here Gerson again refers to the case of Nebuchadnezzar: many authorities have thought that he suffered from this kind of disease when he considered himself to be a brute animal.⁸⁹ Gerson continues that medical books are full of such monstrous apparitions and disturbances in the power of judgement. People having them need medical care.⁹⁰ Gerson himself has seen and even examined some who are damaged in this way.⁹¹

In his letter to a hermit called Antoine, Gerson says that a person’s abstinence should not be so excessive that it destroys the body and impedes the use of reason by debilitating and evacuating the brain and triggering melancholic insanities. Gerson warns Antoine that it is less likely that sanity will be restored after the power of reason has been upset.⁹² He says that, even in cases where magicians seem to cause mental disorders, abstinence may be the explanation. He thinks that in the case of magical art, many of its practices require excessive fasting and other acts which disturb the senses and reason, and people who dedicate themselves to such arts often become insane.⁹³

Even the contemplative life, according to Gerson, may sometimes be connected with mental disorders. Huizinga (1935: 278), however, appears to exaggerate when he straightforwardly interprets Gerson as thinking that the contemplative life has great dangers, and has made many people mad. Gerson indeed thinks that there are people who may end up with frenzy or melancholy if they try to live a contemplative life.⁹⁴ However, in answer to the claim that many people have been disappointed with the contemplative life and have become fools or melancholic, Gerson answers that many have also been disappointed with an active life, and not all people have been given the grace to live a contemplative life. As to the possible mental disorders of contemplative people, worldly people easily think contemplatives are fools and melancholics, because their life is different.⁹⁵ Indeed, contemplatives are not, according to Gerson, as wise and prudent in worldly matters as those who live an active life, because their primary interest is not in such things.⁹⁶

In Jean Gerson’s texts, mental disorders appear almost always as naturally caused. However, Gerson also thinks that demons can do a lot of harm to human beings, such as causing various illusions and other troubles related to fantasy. Sometimes the devil may indirectly cause mental disorders, for example by tempting people to practise excessive fasting, which may lead to mental disorders such as melancholy, as we have already seen.⁹⁷ Whatever may cause mental disorders, Gerson appears to think that such states are quite common. He says that the kinds of states that Horace calls furies or insanities are infinite, according to physicians. Gerson remarks that, from this, Horace deduces that all people are in some way stupid and adds that also in the Bible, in Ecclesiastes, it is said that the number of stupid people is infinite.⁹⁸ Brian Patrick McGuire (2005) thinks that Gerson himself ‘may have been on the verge of mental illness’.⁹⁹

Summary

Gerson starts from the belief that the soul of mentally-disordered people cannot be damaged, but its operations are out of order. The imagination of mentally-disordered people is confused, but according to Gerson, their exterior sensations may also be out of order. Because of darkened (melancholic) spirits, such a sensation may happen to be felt in their exterior senses, as if an exterior object had caused it. Gerson is not very interested in the bodily causes of madness, but refers to corrupted fumes and lesions in brains. Madmen have neither rational judgement nor liberum arbitrium, and therefore their bad acts are not considered to be culpable. Gerson is interested in inappropriate asceticism’s (and even contemplation’s) connection to mental disorders. He thinks that excessive abstinence may generate lesions of the brain and in this way cause madness.

Conclusion

My aim in this article was to analyse the philosophical and theological discussions of mental disorders by two late medieval Parisian thinkers: Oresme and Gerson. To put them in context, I first discussed Witelo’s texts. Witelo, Oresme and Gerson make observations on mental disorders in various contexts, including those of demonology and marvels. On the basis of this consideration, it seems clear that, no matter from which perspective Witelo and the Parisians approach mental disorders, they think that madness usually has a bodily, such as a humoral or organic, origin. They do, however, consider divine or demonic causes as possibly being behind immediate causes. Oresme and Gerson, at least, stress that demons can only affect the lower parts of the human being, the body and sensations, not the intellect directly. According to Witelo, Oresme and Gerson, because of a change in the body, the sensory fantasy of madmen is disturbed, and in this situation their intellect does not act normally, and their will lacks freedom.

According to the medieval thinkers, there can be both negative and positive phenomena in mentally-disordered people. Concerning negative symptoms, reference is often made to the classical lists of symptoms. As far as the postitive phenomena are concerned, Witelo, Oresme and Gerson agree that mentally-disordered people may have special capacities, even the ability to tell the future. These can have natural explanations. Witelo refers to angels in explaining the foretelling of things, while Oresme refers only to the inner capacities of the human being, but both think that such a special capability becomes possible when there are no ordinary acts of cognition in the mind.

Witelo, Oresme and Gerson write mainly about mania and melancholy, which they often combine, as well as frenzy and epilepsy. None of them tries to present proper definitions or typologies of various mental disorders. Exact differences or nuances between various mental disorders are not of primary interest to them, and they do not often use the terms referring to these disturbances with great precision. They consider that what the disorders actually do to the mind is most important, and whether a mentally-disordered person’s reason can function or not; all forms of madness seem to cause similar problems with respect to cognition and will.

It is important to realize that, according to the medieval writers, mentally-disordered people have not lost any parts of their soul or their basic potencies. If this were the case, they would not, by definition, be human beings.¹⁰⁰ Instead, they have lost the use of some parts of the soul and their functions. Generally, the late medieval philosophers and theologians investigated in this study consider mental disorders as part of their rational philosophical and theological theories, and one cannot see anything in their texts that would have ‘antagonized generations of scientists, so that the schism between philosophy and mental science seemed irreparable’ (Graham, 1967: 73). The rational approach to mental disorders also survived in the late Middle Ages.

Footnotes

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Notes

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