Mental Disorders and Psychological Suffering in Galen's Cases

The medical treatment of 'diseases of the soul' became a subject of increasing interest during the Roman period; by contrast, Galen remains rather elusive on the topic and seems to use that phrase only in the ethical context. This study thus questions the application of the notion of 'mental disorder' to Galen and discusses its relevance to his medical thought and practice. It first examines the criteria which a condition should meet in order to be considered a proper nosological entity according to his theory; this reduces the area covered by the notion, by ruling out a number of other defective mental conditions. Then again, in our understanding of the notion, not any kind of diseases affecting the mind should be regarded as mental disorders but only psychologically harmful ones. The question is thus to find out whether Galen pays attention to that dimension of psychological pain. That last inquiry is conducted through a survey of the main case-histories illustrating his attitude as a practising physician towards what we would label neuropsychiatric conditions. In this regards two sets of nested issues are examined: the first one amounts to a technical difficulty, that is, of getting a satisfactory appraisal of the subjective state of the patient, and the second one involves finding the criteria by which such a mental state qualifies as pathological. In all this, it appears that Galen shows remarkable caution as to the power and scope of the medical gaze.