One of the most difficult questions in the history of psychiatry, and in historical psychology generally, when it comes to ideas having to do with norm and deviation, sanity and disorder, is the distinction – and its historical situatedness – between innate, ingrained, congenital ‘madness’ and madness that is pathological and acquired through disease, accident, an experience of some kind or simple physiological growth.
The question is not only one of further individuating the object of study. It is nothing less than the distinction of illness and disorder from moral deviation and responsibility, and the establishment, more generally, of an idea of a ‘norm’ when it comes to mental capacities, legitimising (or not) medical or spiritual intervention, granting sense and validity to legal procedures, and tracing ontological distinctions between human individuals perceived as categorically different and as ‘less’, or ‘less properly’, human than others.
In terms of scholarship, these questions bring together the insights and explorations of disability studies, ancient medicine, socio-economic history and history in general, both material and literary, as well as the associated theoretical methodologies. Laes and Metzler, the editors of the volume, and the former the organiser of the conference that generated it, are experts in these areas of inquiry, which focuses on disability and the history of madness in the Graeco-Roman and medieval periods, and are well equipped to address these difficult questions. Both are aware of the complications and, in some cases, unavoidable aporia of the enterprise, especially in connection with the pitfalls of anachronism. They have nonetheless managed to offer a stimulating, state-of-the art take on sources and questions, taking into consideration the road travelled so far in ancient disability studies and the history of medicine (Laes, in the first chapter), and not shying away from an ethical and personal engagement with history and our own position as historians and human beings (Metzler, in the penultimate chapter, and E. Kellenberger's second study, the final chapter in the volume). In addition, the editors have succeeded, across these eleven studies, in bringing together methodologies and voices various in focus, theme, period and angle, making the ancient Mediterranean more than just Greece and Rome (although ‘ancient world’ in the title is still meant in the restricted sense).
One important theme that opens and underlies the discussion is anachronism as a pitfall, but also as a controlled risk that must be run for the sake of engaged scholarship. Disability, mental disorder and innateness are modern constructs in the sense we intend them. To look for them in antiquity requires care and a leap of faith in human intelligibility across periods and contexts. In ‘Hidden in Plain Sight or Simply Untraceable’, Laes summarises the problems and methodologies, striking in my view a proper middle point between the extremes of aporia on the one hand and simplistic parallelism on the other. He combines the data offered by ancient medical writings and literary texts with the results of inquiries into the semantics of ancient vocabulary, with ancient biology and with what legal sources say about the judicial ‘value’ of the intellectually different. In a fascinating chapter on incapacitas mentis at the end of the volume Metzler returns to these questions in an important methodological ecphrasis entitled ‘Do words change the world or vice versa?’ (pp. 284–8), in my view one of the most instructive parts of the volume. There are ‘factual’ questions of disability history and attempts to answer them. But there is also the deeper purpose and sense – one might say, the ethical value – of tackling such, partially existential, questions in historical sources, their relation to contemporary reality and to subjective experiences, past or present. When studying the terminology through which stories of varying (mental) ability have been transmitted, scholars have a chance to renegotiate or at least to call into question the solidity and reality of the categories in a more universal sense.
The volume contributes greatly to this awareness. A good example that puts this reflection into practice is the contribution by Kellenberger in his first chapter. ‘The Quest for Down Syndrome (and Other Symptoms) in Antiquity’ offers a thorough analysis of manifestations compatible with Down syndrome in ancient sources, literary and iconographic, persuasively focusing on the Egyptian deity Bes. In his second chapter, ‘Living Creatively with Intellectual Disabilities: a Father's Observations as an Opportunity for Historical Research’, Kellenberger starts from an element of personal biography – the experience of his son, Bernhard, who was born with cerebral palsy – and takes it as an occasion for a practical historia. He explores categories we take for granted as cornerstones of European but also human identity (community, a sense of individuality, the value of learning and religious experience, creativity) and explores them against the concrete instance of one individual's (Bernhard's) experience of ‘creative life’ and the expectations of our culture, historically intended.
If theoretical reflection is the indispensable backbone for the difficult, elusive topic of the volume, the selection of chapters is also rich in terms of data and factual information. The range of geographies and periods is not exhaustive – this would have been impossible –, but rich nonetheless. C. Bourbou, in ‘“Mad Bones”: Tracing Mental Disability in the Bioarchaeological Record and its Possible Socio-Economic Implications in Past Societies’, looks at the bioarchaeological evidence for mental disability, a difficult but not impossible task: it is not only bone damage and lasting health issues that preserve social and personal information, but also burial style and the positioning of corpses. From this perspective she offers an exemplary analysis of four cases and sketches some hypotheses and interpretations, along with offering a convincing call for the inclusion of the discipline in disability studies (E.-J. Graham has a chapter on relevant topics in Laes's 2013 Disabilities in Roman Antiquity). A.F. Morris's ‘Dagger of the Mind: Macedonian Kings and Chronic Traumatic Encephalopathy’ is an intriguing attempt at retrospective diagnosis, hard to prove for this famous patient, but surely concrete for a multitude of military men in ancient society (and others); this is an instructive addition to existing literature on Alexander. P. Pormann's ‘Fools in Arabic Medicine and Hospitals: Medical, Social and Economic Studies’, despite concluding with a Socratic admission to ‘not (having being able) to know’ precise details about institutional and economic aspects of intellectual disorder in Arabic contexts, offers a fresh, instructive look at the melancholic as a natural state and at the terminology of mental impairment in Arabic translations. Other scholars consider rabbinic texts (L. Lehmhaus, ‘The Shoteh in Rabbinic Sources: Intellectual Disability or Mental Illness?’), New Testament writings (D. Kurek-Chomycz and E. Swai, ‘Excluded from the Kingdom or Leading the Revolution? Môroi and the Question of Intellectual Disability in New Testament Writings’), Byzantium (F. Vasileiou, ‘Searching for Intellectual Disability in Byzantium’) and China (O. Milburn, ‘Brain Injury and Intellectual Disabilities in Early and Medieval China: Two Case Studies’), analysing kuang, brain damage in a variety of examples, focusing, with cautious retrospection, on two case studies: the alcohol-related Korsakoff syndrome and ‘intellectual disability’. The latter is the only chapter to venture outside the realm of Mediterranean antiquity. More comparative breadth remains an objective for a future enterprise.
The book is rich in information on particular cases the ancient historian is unlikely to be familiar with, and it is an inspiring example of an interdisciplinary approach. It poses a clear question and frames it ethically as well as epistemologically. If the answer is, in part, revealed to be impossible to discover, the itineraries of inquiry and methodological probing are themselves valuable.
