A Cultural History of Disability in Antiquity 9781350028555, 9781350028524

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NOTES ON CONTRIBUTORS

Ellen Adams is Senior Lecturer in Classical Art and Archaeology at King’s College, London, UK. Abi Cousins graduated from the University of Reading in 2014 with a BA (Hons) in Ancient History. She is currently training to become a solicitor in southwest England. Emma-Jayne Graham is Senior Lecturer in Classical Studies at the Open University, UK. Caroline Husquin is Associate Professor at the University of Lille, France, at the Section Histoire, Civilisation, Archéologie et Art des Mondes Anciens et Médiévaux. Edgar Kellenberger is Dr. theol. of the University of Basel, Switzerland, and is a retired pastor of the Reformed Church (Presbyterian). Peter Kruschwitz is Professor of Classics at the University of Reading, UK. Christian Laes is Professor of Ancient History at the University of Manchester, UK, and the University of Antwerp, Belgium. Jerry Toner is Fellow and Director of Studies at Churchill College and Director of Studies at Hughes Hall, Cambridge, UK. Frederik Van den Abeele is a PhD student in Law at the Institute of Contract Law (Catholic University of Leuven and University of Hasselt). Laurien Zurhake is a PhD student at the Ludwig-Maximilians University of Munich, Germany.

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As general editors of A Cultural History of Disability, we are based on either side of the Atlantic—in the Department of Disability and Education at Liverpool Hope University, United Kingdom and in the School of Social Sciences at Liverpool Hope University, United Kingdom, and in the Department of English at George Washington University, USA—but we are unified by our work and interests in disability studies, with a particular emphasis on culture and cultural production. This being so, the genesis of the project was in cultural disability studies, from which grew discussions about history that led us in many fruitful directions (e.g., Longmore 1985; Davis 1995; Garland-Thomson 1997; Mitchell and Snyder 2000; Kudlick 2003; Snyder and Mitchell 2006; Burdett 2014a; Coogan 2014; Doat 2014; Tankard 2014; Rembis 2017). The name mentioned more than any other was that of Henri-Jacques Stiker, whose work was prominent in our thoughts at the proposal stage and as such resonates here. The method in his most famous book, A History of Disability, “ranges from close readings of literary texts as exemplary of dominant myths to discussions of the etymology of disability terminology to medical taxonomies of specific conditions and test cases to an examination of current legislative initiatives” (Mitchell 1999: vii). The real interest, as Stiker states in an interview published more than thirty years after the first edition of his book, is not “History with a capital H like trained historians do,” but “grand representations, systems of thought, the structures beyond history” (Kudlick 2016: 140). The spirit if not the letter of this method is adopted in A Cultural History of Disability, our focus being how disability has been portrayed in various aspects of culture and what these representations reveal about lingering and changing social attitudes and understandings. A Cultural History of Disability is indebted to contemporary disability activism and to other movements for social justice. As David Serlin writes in the introduction to an important anthology on the intersections of disability and masculinity, Within academic culture, tectonic disciplinary and intellectual shifts of the 1960s and 1970s gave rise to the fields of ethnic studies and critical race theory, women’s and gender studies and men’s studies, LGBT studies and queer studies, and disability studies, and crip theory. Scholars in these fields have not always been in alignment, of course, but they do increasingly recognize each other as workers and activists in adjacent and overlapping fields of critical inquiry, cultural production, and social justice. (Serlin 2017: 8) Many chapters in A Cultural History of Disability are thus deeply and necessarily intersectional, attending to gender, race, sexuality, nation, and other axes of human difference. In the process, the project attends to multiple modalities of disability experience, past and present. In presenting such an interdisciplinary and theoretical project, we therefore depart from the kind of history of disability that, for example, focuses on the story of so-called special schools from the perspective of their governors

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(Burdett 2014b), or the history of major medical advances (Oshinsky 2005), in favour of one that delves into the underpinning social attitudes faced by disabled people beyond and long before such institutions or advances. We are keenly attuned as well to the many ways in which disability has been represented. A “system of representation,” according to Stuart Hall, “consists, not of individual concepts, but of different ways of organizing, clustering, arranging, and classifying concepts, and of establishing complex relations between them” (Hall 1997: 17). From this cultural studies perspective, a cultural history of disability is attuned to how disabled people have been caught up in systems of representation that, over the centuries (and with real, material effects), have variously contained, disciplined, marginalized, or normalized them. A cultural history of disability also, however, traces the ways in which disabled people themselves have authored or contested representations, shifting or altering the complex relations of power that determine the meanings of disability experience. In formal terms, A Cultural History of Disability is a six-volume work on renderings of disability from Antiquity to the twenty-first century. The set of volumes is interdisciplinary insofar as it engages scholars with interests in disability studies, education, history, literature, cultural studies, drama, art, and several other related fields and disciplines. Each volume covers one of six historical periods: Antiquity (500 BCE–800 CE); the Middle Ages (800–1450); the Renaissance (1450–1650); the long eighteenth century (1650– 1789); the long nineteenth century (1789–1914); and the modern age (1914–2000+). These individual volumes are edited by accomplished scholars who provide an outline of the major ideas and themes concerning disability in their given historical period. The internal structure of the six volumes is notable. Following the period-specific introduction, each volume comprises eight chapters whose principal titles correspond throughout the set. This means that many themes can be traced across all six volumes— and thus across all six historical periods. The overarching themes of the eight chapters in each volume are tentatively listed as atypical bodies; mobility impairment; chronic pain and illness; blindness; deafness; speech; learning difficulties; and mental health issues. All of these themes are manifestly problematic, on account of the terminology and apparent focus on impairment rather than disablement or disability, not to mention categorization that swerves from the fact that many disabled people have multiple impairments. Accordingly, many of the volume editors and chapter contributors have creatively and critically worked with and beyond these problematics. The eight-part categorization across time is ultimately extended not in a positivistic but in an analytical mode, offering not sameness but a critical difference across the historical periods under review. “Learning difficulties,” for example, materialize quite differently under modes of industrial or neoliberal capitalism (with their demands for a particular kind of productivity and speed) than they do in Antiquity or the Middle Ages, when “learning” and education were stratified more obviously according to caste or gender. Deaf people have not always conceptualized themselves as having a distinct language or inhabiting a “minority” identity; such a conceptualization clearly requires particular historical conditions that have only begun to germinate in the past three or four centuries. These two examples illustrate that, if somewhat simplistic, the overarching themes of the project assist readers who are keen to understand more about how disabled people are represented in culture and how ideas and attitudes have both resonated and changed down the centuries. Historical changes in ideas and attitudes have been at times merely adaptations of a more general pattern; they have, however, at other times been more akin to what are often understood as “paradigm shifts,” which fundamentally alter or reinvent the conditions in

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which human beings are located or rescript the underlying assumptions that give rise to how we apprehend the world. The concept of a paradigm shift comes—perhaps paradoxically for a cultural history of disability—from the history of science; Thomas S. Kuhn famously used the term to describe what happens when advocates for new scientific approaches or models (those Kuhn termed “young Turks”) overturn what they perceive as the outdated views of those who came before them (Hamilton 1997: 78). As Peter Hamilton explains, however, where other systems of representation or “aesthetic domains of painting, literature or photography differ from sciences is their essentially multi-paradigmatic as opposed to uni-paradigmatic nature” (Hamilton 1997: 80). Paradigm shifts in the history of disability have thus been about pluralizing the ways in which disabled experiences might be apprehended or have been apprehended over the centuries. For example, the activist invention of “disability identity” itself, in the twentieth century, could arguably be understood as an example of a paradigm shift that generated completely new vocabularies, multiplying the ways in which we might understand the embodied experience of disability. From this multi-paradigmatic perspective on embodiment, we can recognize that disablement on an attitudinal level involves a historical and changeable metanarrative to which people who have impairments are keyed in social encounters (Bolt 2014). Tracing these multiple paradigms across and through the cultural patterns of history, as well as noting the discontinuities between periods, can greatly enhance our critical understandings of the present. In turn, the new vocabularies of contemporary activism can enhance our critical understandings of the past. Indeed, only with the activist vocabularies of the present have we been able to conceive of disability as something that might have a cultural history worthy of being studied and debated. A Cultural History of Disability demonstrates particular interest in the etymology of disability terminology (in keeping with the method exemplified by Stiker). In English, “disability” as a term appears to date from at least the sixteenth century, according to the Oxford English Dictionary (Adams, Reiss, and Serlin 2015: 6). The political scientist Deborah A. Stone linked the term to the needs of an emergent capitalist order, which newly demanded “able-bodied” workers, but which also needed to differentiate between those who would be sorted into what she identified as a “work-based” system and those who would be placed in a “needs-based” system. For its own consolidation, the emergent capitalist order needed to prioritize the former and stigmatize the latter, and Stone argues that “the disabled state” was charged (from the time “disability” circulated widely as a term) with the sorting, prioritizing, and stigmatizing (Stone 1984). Of course, various other examples of disability terminology have circulated both before and after the period Stone surveys. Often those other terms—freak, retard, idiot, and even handicapped, which until recently in English was dominant in many locations—have served to reinforce deep stigmas against disabled people and to valorize able-bodiedness and able-mindedness. At other times, various terms for what might now be understood through a disability analytic have functioned quite differently, and the early volumes of this series provide thorough considerations of the languages of disability that were available, say, in Antiquity or the Middle Ages. Contemporary activists have put forward disability as an identity and as the preferred term in many locations, as against “handicap” and so many other discarded terms, both the negative and the seemingly positive terms Simi Linton calls “nice words” (terms activists generally perceive as patronizing, like differently abled or physically challenged) (Linton 1998: 14). For decades, in ways similar to the world-transformative reclamations in the queer movement, activists have also played with the ways in which formerly derogative words such as crip might be resignified in culturally generative ways

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(McRuer 2006; Bolt 2014). Disability terminology, although sometimes overlooked, thus reveals much about changing ideas and attitudes. Languages besides English have of course similarly been the staging grounds for vibrant conversations about disability terminology. Many Spanish speakers roundly reject minusválido (literally, less valid) or discapacitado/a; some activists and artists, particularly in Spain, have put forward the preferred term persona con diversidad funcional (person with functional diversity). Although the revision of these terms has had a more uneven reception across Latin America, the very existence of such debates testifies to ongoing and vibrant conversations about language—critical debates that resonate in Japan (Valentine 2002) and India (Rao 2001). The anthropologist Julie Livingston uses “debility” for her important work on Botswana, since no word in the languages spoken there translates easily into “disability,” even though a concept is needed for encompassing a range of “experiences of chronic illness and senescence, as well as disability per se” (Livingston 2006: 113). The international and historical scope of these debates is immense. What we begin to explain here is that A Cultural History of Disability is not meant to provide readers with the history of disability. The history of disability is in fact, from one perspective, the history of humanity, and as such too vast for any collection, no matter how extensive, illustrative, or indicative of key periods and moments. From another perspective, what we think we understand in our own moment as “disability” varies immensely across time and space, which is why this set of volumes ultimately presents multiple and variegated histories of disability. The cultural history of disability thus is not something we could or would endeavor to document, not even with the esteemed editors and authors we have gathered to conduct this research. Rather, what we offer here is a cultural history that leads readers down various and sometimes intersecting paths. The cultural history this set of volumes presents is an interdisciplinary one that is driven by an appreciation of disability studies and thus disability theory, recognizing that disability as an analytic—like a feminist or queer analytic—can be brought to bear on many different topics and cultural contexts, even if other time periods have conceptualized bodies and minds using very different language from our own. David Bolt and Robert McRuer, General Editors

REFERENCES Adams, Rachel, Benjamin Reiss, and David Serlin (2015), “Disability,” in Rachel Adams, Benjamin Reiss, and David Serlin (eds.), Keywords in Disability Studies, 5–11, New York: New York University Press. Bolt, David (2014), The Metanarrative of Blindness: A Re-Reading of Twentieth-Century Anglophone Writing, Ann Arbor: University of Michigan Press. Burdett, Emmeline (2014a), “‘Beings in Another Galaxy’: Historians, the Nazi ‘Euthanasia’ Programme, and the Question of Opposition,” in David Bolt (ed.), Changing Social Attitudes Toward Disability: Perspectives from Historical, Cultural, and Educational Studies, 38–49, Abingdon and New York: Routledge. Burdett, Emmeline (2014b), “Disability History: Voices and Sources, London Metropolitan Archives,” Journal of Literary and Cultural Disability Studies, 8 (1): 97–103. Coogan, Tom (2014), “The ‘Hunchback’: Across Cultures and Time,” in David Bolt (ed.), Changing Social Attitudes Toward Disability: Perspectives from Historical, Cultural, and Educational Studies, 71–9, Abingdon and New York: Routledge.

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Davis, Lennard J. (1995), Enforcing Normalcy: Disability, Deafness, and the Body, New York and London: Verso. Doat, David (2014), “Evolution and Human Uniqueness: Prehistory, Disability, and the Unexpected Anthropology of Charles Darwin,” in David Bolt (ed.), Changing Social Attitudes Toward Disability: Perspectives from Historical, Cultural, and Educational Studies, 15–25, Abingdon and New York: Routledge. Garland-Thomson, Rosemarie (1997), Extraordinary Bodies: Figuring Physical Disability in American Literature and Culture, New York: Columbia University Press. Hall, Stuart (1997), “The Work of Representation,” in Stuart Hall (ed.), Representation: Cultural Representation and Signifying Practices, 13–74, London: Sage Publications. Hamilton, Peter (1997), “Representing the Social: France and Frenchness in Post-War Humanist Photography,” in Stuart Hall (ed.), Representation: Cultural Representation and Signifying Practices, 75–150, London: Sage Publications. Kudlick, Catherine (2016), “An Interview with Henri-Jacques Stiker, Doyen of French Disability Studies,” Journal of Literary and Cultural Disability Studies, 10 (2): 139–54. Kudlick, Catherine (2003), “Disability History: Why We Need Another ‘Other’,” American Historical Review, 108 (3): 763–93. Linton, Simi (1998), Claiming Disability: Knowledge and Identity, New York: New York University Press. Livingston, Julie (2006), “Insights from an African History of Disability,” Radical History Review, 94: 111–26. Longmore, Paul (1985), “The Life of Randolph Bourne and the Need for a History of Disabled People,” Reviews in American History, 13 (4): 581–7. McRuer, Robert (2006), Crip Theory: Cultural Signs of Queerness and Disability, New York: New York University Press. Mitchell, David T. (1999), “Foreword,” in Henri-Jacques Stiker (ed.), A History of Disability, vii–xiv, Ann Arbor: University of Michigan Press. Mitchell, David T. and Sharon L. Snyder (2000), Narrative Prosthesis: Disability and the Dependencies of Discourse, Ann Arbor: University of Michigan Press. Oshinsky, David M. (2005), Polio: An American Story. The Crusade That Mobilized the Nation against the 20th Century’s Most Feared Disease, Oxford: Oxford University Press. Rao, Shridevi (2001), “‘A Little Inconvenience’: Perspectives of Bengali Families of Children with Disabilities on Labelling and Inclusion,” Disability and Society, 16 (4): 531–48. Rembis, Mike (2017), “A Secret Worth Knowing: Living Mad Lives in the Shadow of the Asylum,” Centre for Culture and Disability Studies YouTube Channel, May 10, https://www. youtube.com/watch?v=Ls5BgJ2x8U0 (accessed May 17, 2017). Serlin, David (2017), “Introduction,” in Kathleen M. Brian and James W. Trent, Jr. (eds.), Phallacies: Historical Intersections of Disability and Masculinity, 1–21, Oxford: Oxford University Press. Snyder, Sharon L. and David T. Mitchell (2006), Cultural Locations of Disability, Chicago: University of Chicago Press. Stone, Deborah A. (1984), The Disabled State, Philadelphia: Temple University Press. Tankard, A. (2014), “Killer Consumptive in the Wild West: the Posthumous Decline of Doc Holliday” in David Bolt (ed.), Changing Social Attitudes Toward Disability: Perspectives from Historical, Cultural, and Educational Studies, 26–37, Abingdon and New York: Routledge. Valentine, James (2002), “Naming and Narrating Disability in Japan,” in Mairian Corker and Tom Shakespeare (eds.), Disability/Postmodernity: Embodying Disability Theory, 213–27, London and New York: Continuum.

How and Whether to Say “Disability” in Latin and Ancient Greek CHRISTIAN LAES

0.1. A BOOK VOLUME AND AN INTRODUCTION ALL TOO FAMILIAR? At first sight, both the table of contents and the introduction of this volume appear comfortably familiar to a general audience of readers. After more general chapters on atypical bodies, ailments that cause the body to be immobile, and experiences of chronic pain, we proceed with a rather conventional list of impairments pertaining to the eyes, the ears, the mouth, and the head—the latter with an attempt to distinguish the mental from the intellectual. Moreover, the introduction promises an exploration of terminology and concepts regarding disability in Antiquity. To readers somewhat familiar with the topic of disability history, the appeal to familiarity probably looks rather alarming. It is indeed widely known that the holistic idea of (dis)ability came into being in the West European industrialized civilization of the late eighteenth and the nineteenth centuries.1 In their striving to have healthy citizens able to contribute to development and welfare, the rising national states distinguished categories of people who, because of their bodily or mental condition, were unable to comply with the new ideal of society as a healthy body. For such persons, the term “handicapped” came into use. The word mostly denoted an incurable condition, as well as an inability to contribute to the labor process. Such people were often kept apart and protected in specialized institutes or hospitals, while careful measurement and medical assessment of the degree of disability could entitle them and their relatives to additional financial aid. As such, one might even question the need for a volume on Antiquity in a series that deals with the history of disabilities. After all, was there any such thing as a disability in the ancient world? Far from making statements about the ancients being “just like us,” and fully aware of the necessity of carefully contextualizing the evidence, I believe that something can be added to the quite obvious statement that Greco-Roman writers could not and did not share our concept of disability. In this, historians of ancient disabilities face the same challenges as, for instance, those who study youth or homosexuality in Antiquity. For such topics, ancient historians distinguish the “etic” versus the “emic.” The former is a shorthand for an external observer of a social group, the latter for a view from the perspective of a subject within the group. In other words, in each society and in each time period, people can be observed as not children anymore, but not yet full adults either (or

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as having sex with a person of the same gender), but it remains to be seen whether within the group or society such phenomena are considered as marked differences that possibly shape the psychological makeup and even the social identity or legal status of the subjects concerned.2 However, approaching impairments in this way might be subject to criticism, as it smells strongly like a form of “ableism.” According to those who critique the focus on “able bodies,” it is offensive to insinuate that a person is less than complete, maybe even subhuman, if born with an impairment. Such assumptions generate negative implications for self-esteem and sense of identity. “Ableism” focuses on what is clinically missing (in comparison to what is considered normative) and implies that the life of the disabled person is somehow less complete (see Adams in this volume). Despite these justified concerns, I want to show that ancient writers indeed realized how certain conditions were permanently inhibiting for the general physical or mental health of human beings and/or irregular in the sense of their being less frequent (e.g., they knew that most people walk, see, and hear). Such factors possibly placed such persons at a disadvantage or caused legal problems for functioning in society. I believe that both Greek and Latin expressed such conditions by making use of “general” or “holistic” terms, which can be studied in relation to such modern concepts as disability. By a careful, close reading of the way and context in which such “vocabulary of disability” is used, one avoids the danger of universalism and essentialism, claiming that there is one single universal category of “noncompleteness” that can be simply transferred and applied to whatever society one studies. Recently, the modern concept of disability has also met with serious criticism. While the broader audience does seem to have a notion of disability (according to a recent inquiry, those in a wheelchair and people with Down’s syndrome are considered disabled by the general public; Frohne 2017: 53–4), definitions such as those of the World Health Organization are so broad and vague as to produce claims that about one billion of the world’s population is experiencing a form of disability. Advocates of the deconstruction of the term have argued that it is so intrinsically bound to concepts of health and normative bodies that any study of the terminology, by its very nature, leads to what they have labeled as “dis/ability history,” a very broad “new history” with the potential to fundamentally change our general approach to history (Waldschmidt and Bösl 2017). To this, I would respond that it remains the task of the philologist and historian to scrutinize the terms used by a civilization to holistically denote the bodily features they denote as “incomplete,” that it remains to be seen whether such categories are empty, overflowing, or devoid of transcendent meaning, and that much can be learned from the segmented field of disability history, studying the ways in which social groups have tended to be “marginalized.” In order to make this point, I approach the issue from three different angles. Firstly, I ask whether the ancients somehow drew a line of distinction between permanent and/ or incurable conditions on the one hand and diseases or illnesses on the other. Secondly, I study the label of “monster,” an obvious category of holistic ranking of persons as “different others.” Thirdly and finally, I take a closer look at the healing narratives of early Christianity, since in my view the Christian discourse on healing, miracles, and the human spirit is revealing of the way in which the topic of disability was regarded. In this chapter, I cover wide swathes of history. A critic might suggest that such an approach is to “cherry pick” from hundreds of years of texts and therefore to create a very generalized, non-historicized picture. To this objection, I answer that the texts I will be dealing with belonged to a tradition that was shared by an intellectual elite over centuries.

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In this way, Greek and Roman texts, stories, and anecdotes belonged to a shared cultural tradition, which began around 600 BCE and continued through around 800 CE. In all, my inquiry very much leads to questions about what certain Latin or Greek terms “mean.” This experiment in lexical semantics is worth investigating, given the wealth of lexicographical research and tools classicists have at their disposal. In a way, it is surprising that such an approach has not been taken before.

0.2. A DISABILITY VERSUS A DISEASE Even today, the distinction between illness and disability is not as clear cut as we would think. It is commonly said that an illness is temporary while a disability is a lasting condition. Yet, such a stance poses problems. We do not usually refer to a person with a chronic disease as being “disabled.”3 On a common level, however, we would surely label the blind or the mobility impaired as disabled rather than as ill. Now, which Ancient Greek and Latin terms denote unableness or incapacity of the whole body? Examples are ready at hand. For the Greek, ἀδύνατος, ἀνάπηρος, ἄρρωστος, and πηρός with their derived verbs and substantives come to the mind, while for the Latin, debilis, imbecillus, infirmus, and vitiosus are the most obvious examples. Yet, as any student of classical languages is told, it would be rash to simply transpose to modern usage, as if ἀσθενής /morbosus would refer to our “illness” and ἀδύνατος /vitiosus to “disability” (see Zurhake in this volume for similar challenges in the semantics of pain). The often-cited example of the Athenian examination of the adunatoi in the fifth and fourth centuries BCE—Athenian male citizens who were entitled an allowance of one to two obols per day on the basis of a yearly (!) examination as they were found unable to carry out whatever work for a living—shows that an equation between adunatoi and the present-day category of disability is impossible to make. Only those Athenian citizens with insufficient financial means got the allowance. They were not banned a priori from certain roles by collective expectation, and they were not viewed as a group to be pitied or derided (Dillon 1995; M. L. Rose 2017). However, it is worth taking a closer look at some fragments in which ancient writers themselves seem to think of categories of unabled people, somehow distinguishing them from those who were afflicted by illness. 0.2.1. The Greek dossier Some passages from Plato surely point in this direction. In the Crito, it is stated that throughout his lifetime, Socrates himself had chosen to assent to Athenian laws and legislations. Moreover, he had hardly ever left the city—he had moved around even less than “the lame and the blind and other disabled people (καὶ οἱ ἄλλοι ἀνάπηροι)” (Plato, Crit. 53a; transl. Chr. Emlyn-Jones). The term ἀνάπηρος seems to be used here in a general way and to refer to those permanently impaired (but note that it was not deemed impossible that they would move out of the city every now and then). Also, other passages point to the root πηρός as expressing permanent damage or injury. When dealing with the legislation of his perfect state, Plato refers to manslaughter as the worst crime. Next to this are the injuries and permanent mutilation caused by such injuries: Τραύματα δὴ καὶ πηρώσεις ἐκ τραυμάτων τά γε δεύτερα μετὰ θανάτους (Plato, Leg. 9.874e).4 Further on in the Laws, Plato mentions human aversion to obliged marriage, surely in cases when the partner has physical or mental illnesses or disabilities (Plato,

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Leg. 9.925e: ὁπόταν ἢ σωμάτων νοσήματα καὶ πηρώσεις ἢ διανοίας). Again, πηρώσεις seems to express a condition that is more permanent, possibly also more severe than illness. In his discussion of a “utopian” island, possibly Ceylon, Diodorus Siculus (Bibl. 2.57.5) mentions a law forcing people to bring themselves to death. Again, the use of the term πηρωθέντα points to a “holistic” condition of not being in good health, possibly aggravated by old age.5 Time and again, the root πηρός appears in combination with other words expressing illness. In such cases, it indicates a stronger gradation, in the form of a permanent and/or mutilating condition. In a comparison of things that are good by nature but may possibly be harmful to some men owing to their characters, Aristotle points to special food and equipment for the sick and the invalid: any more than an invalid would benefit from using the diet of a man in good health, or a weakling and cripple (ὁ ἀσθενὴς καὶ ἀνάπηρος) from the equipment of a healthy man and of a sound one. (Aristotle, Ethic. Eud. 8.3.6, 1248b; transl. H. Rackham) A remarkable passage in the context of “holistic” approaches toward incapacitated bodies appears with the second-century CE lexicographer, Pollux. He remarks that the word πηρός needs an addition to specify which part of the body actually was permanently damaged. So, in proper Greek, one should say πεπηρωμένος τοὺς ὀφθαλμούς (“impaired in the eyes”) to denote a blind person. However, by using the word ἀνάπηρος, the Greek language denotes an invalidity afflicting the whole body. ἀνάπηρος is used for the one who is incapacitated throughout his whole body, as Isaeus says in his speech against Aresaechmus (frg 11 Tur) “in the village he left the elder and the invalid (καὶ ἀναπήρους).” (Pollux, Onomast. 2.60) Students of Modern Greek will recognize the word ἀνάπηρος as the common term used in contemporary Greece to denote disability. Next to Pollux, other Greek lexicographers were aware of an overarching meaning of the term. Indeed, they acknowledge that: a person who is exceedingly incapacitated in one part of his body is called ἀνάπηρος. (Lexica Segueriana, Glossae rhetoricae, alphabetic entry alpha, p. 216, l. 15) One wonders whether such discussions only belonged to the sphere of subtleties and niceties within the lexicographers’ realm. At least two remarkable examples show that they did not. Here is what Dio Chrysostom (c. 40–c. 115) has to say in an oration called “Diogenes or on the Servants,” in which he has Diogenes the Cynic arguing against excessive wealth and abundance, which often consists of possessing too many domestic servants. In such matters, less is more. Indeed, the centipede has innumerable feet, yet it is the slowest of creeping things. One stomach is more than enough to fulfil men’s lust and appetite. The hands do not need more than ten fingers—hence the mention of what we now call polydactyly. Just as a hand is all the weaker for having more fingers than belong there naturally, and such a man is called a sort of cripple (ἀνάπηρος καλεῖται τρόπον τινὰ) when he has an extra finger on the outside and cannot use the other fingers properly. (Dio Chrysostomus, Or. 10.11; transl. J. W. Cohoon)

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In this passage, the phrase “a sort of a cripple” indicates Dio Chrysostom’s doubts as to whether to apply the generalizing and overarching term to the particular instance of somebody who has too many fingers. As in the older Loeb translation from Aristotle’s Eudemian Ethics (see p. 4), the term “cripple” is outdated. A modern translator would no doubt render it as “disabled,” as Emlyn-Jones did in his Plato translation from 2007 (see p. 3). When Dio Cassius (c. 155–c. 235) mentions the reluctance of the wealthy to enroll in the senatorial class and Augustus’ efforts to force them to do so, he indicates those above the age of thirty-five and the ἀνάπηροι as exempt from such obligations. With those who were over thirty-five years of age he did not concern himself, but in the case of those who were under that age and possessed the requisite rating he compelled them to become senators, unless one of them was physically disabled (χωρὶς ἢ εἴ τις ἀνάπηρος ἦν). He examined their persons himself. (Dio Cassius, Hist. Rom. 54.26; transl. E. Carey and H. Foster) So, who should we imagine as being unfit to enroll as senators? The blind, the deaf–mute, and the mute obviously come to the mind, as well as those who were more or less severely immobilized. One wonders whether also the mentally incapacitated were implied. In any case, the term ἀνάπηρος again seems to have a more general meaning, indicating conditions that would make functioning as a senator impossible anyway. 0.2.2. The Latin dossier The Latin vocabulary also reveals a sort of basic awareness of a difference between an “illness” or a temporary affliction (morbus) on the one side and more permanent defects (debilitas, imbecillitas, infirmitas, or vitium) on the other.6 For this matter, vitium was the most common term to denote a lasting effect. Thus, the jurist Modestinus in a passage on differences of terms stated: It is true that a disease (morbum) means a temporary weakness of the body, but a defect (vitium) is a perpetual corporeal hindrance; as, for instance, where one is purblind, and therefore a one-eyed man is defective (vitiosus). (Dig. 50.16.101.2; transl. S. P. Scott) Also, Cicero seemingly understood vitium as a lasting condition due to malformation of the limbs—a condition that existed even when a person was not sick or feeling bad and was linked with physical conditions: Disease (morbum) is the term applied to a breakdown of the whole body, sickness to disease attended by weakness (aegrotationem morbum cum imbecillitate), defect (vitium) when the parts of the body are not symmetrical with one another and there ensue crookedness of the limbs, distortion, ugliness. And so the first two, disease and sickness, are a result of shock and disorder to the bodily health as a whole; defect, however, is discernible of itself, though the general health is unimpaired. (Cicero, Tusc. Disp. 4.28; transl. J. E. King) Other Latin terms also connote a general condition of being weak and infirm, without really being ill. Imbecillus was an appropriate term to denote such a situation. This meaning of imbecillus is found in the legal definition of “impotence by nature”7 or in the

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fanciful etymology of imbecillus understood as “frail and fragile, as if not walking around with a stick.”8 In an edict from the November 13, 333 CE, it is stipulated that: Sons of veterans or of those persons who have been provosts or members of the imperial bodyguard or of persons who have held any other military task whatsoever, if they should be unhealthy and feeble (invalidi et inbecilli), shall be assigned to the municipal councils. In this way, you shall attach and join to the municipal councils such persons who rejoice in adequate property and yet are unsuited for military service. We also make the same regulation for those persons in Our Presence whom We have observed to be enervated by luxurious living (deliciosis nutrimentis enervatos). (Cod. Theod. 7.22.5; transl. C. Pharr) Here, imbecillis obviously refers to a general physical health condition that made participation in the army impossible once and for all. The last sentence adds character traits and mental conditions as other possible motives for such exclusion. Finally, a passage by Gellius also indicates that morbus was generally understood as an acute event, to be distinguished from a lasting condition. In the Noctes Atticae, one finds an interesting discussion on the harshness of the Law of the Twelve Tables in one specific regulation: “If disease or age (morbus aevitasve) be a hindrance, let the summoner provide a beast; if he does not wish, he need not spread a covered wagon.” At these words, the philosopher Favorinus took offence. However, the jurist Caecilius was eager to correct his interpretation. According to him, morbus in this passage did not refer to a sickness, as for instance a high fever and ague. This was in no way an inhumane law that asked for a man lying sick in bed at his home to be placed upon a beast and hurried off to court—quite the contrary. In the archaic wording of the Twelve Tables, morbus rather denoted “some defect of weakness and indisposition” (vitium aliquod inbecillitatis atque invalentiae), which did not involve danger to life. A more severe disorder (morbum vehementiorem), having the power of material injury, the writers of these laws called in another place not morbus alone, but morbus sonticus, or “a serious disease” (Gellius, Noct. Att. 20.1.24–7; transl. J. C. Rolfe). 0.2.3. Revealing legal casuistry In order to better understand the ancient discussion on acute illnesses and lasting impairing conditions, the extended discussion in Book 21 of the Digesta is a most interesting, even intriguing case. However, any discussion of it should take into account some basic facts. First, it only concerns an Edict of the Aediles on the selling of slaves and the actions to compel the vendor to take back the property where he has received more than it was worth. So, it is not a general discussion on the difference between “illness” and “disability,” but rather on the particular instance of a vendor who deliberately concealed the defects of the slaves he sold. Second, the crucial question was whether or not the slave was actually capable of performing the tasks and duties he/she was bought for (Dig. 21.1.1.8: usum ministeriumque). Third, the whole juridical discussion is pervaded by the thought that a morbus being far worse than a vitium.9 While morbus throughout was understood as a corporeal thing (illnesses, ailments, or diseases), vitium belonged to the realm of mental health and character traits (Dig. 21.1.1.9: magis etiam de corporis sanitate, quam de animi vitiis).10 Fourth, functionality took over from theoretical distinctions. Because it was realized that mental problems sometimes seriously hindered a slave’s functionality, mental traits were also occasionally adduced as a motive for annulment of the sale. The

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vendor was not required to guarantee a slave to be free from a mental defect unless he had specially stated the fact and thus concealed the defect (Dig. 21.1.4.3). When the defect was a corporeal one alone, or affected both the body and the mind, the property could be returned on this account (Dig. 21.1.4.4).11 For other instances, such as “nasty” character traits and defects, no annulment was possible, though there could be an action on purchase (Dig. 21.1.4 pr.). Table 0.1 offers a summary of the defects that affected the selling of slaves and the ways in which these defects were classified. Again, for the study of the history of disabilities, some crucial points need to be taken into account. First, this is not an extensive list of all possible defects, since it only mentions defects that were concealed at the time of sale. As such, certain afflictions including blindness or dangerous scars on the head or visible on the body are not treated (Dig. 21.1.14.10). For the same reason, the jurists do not reflect on the so-called interactional perspective, which notes that defects might change over time and space during the individual’s life course (see Graham in this volume). Second, the criterion of functionality and ability to perform tasks is crucial to the whole discussion. Only in this way can apparent contradictions, such as the assessment of a mutus (Dig. 21.1.3 and 21.1.9) be understood. It depended much on the tasks the slave had been purchased for, whether he/she was considered “disabled” or not. Third, the classification of morbus (leading to annulment) and vitium (no annulment, but only action on purchase in the best possible circumstances) is not consequently applied, hence the suspicion that the jurists were using terms that were at odds with common parlance.12 The difficulties that emerged from the casuistic use of terminology by the jurists attracted the attention of no less a lover of grammar and vocabulary than Gellius.13 To him, morbus refers to a counter-natural state that rendered the body of a slave less useful for work. An illness can affect a part of the body (as with blindness or gout) or the entire body (as with fever). Anyone suffering from a disease (morbosus) should also be regarded as suffering from a defect (vitiosus). The converse does not necessarily hold: stutterers and horses that bit were regarded as suffering from disturbing defects, but not as sick (Gellius 4.2.1–5). Casuistry emerges in this case as well. A master unknowingly purchases a eunuch. Could he have the purchase annulled because this slave is a morbosus? Yes, because infertile sows must also be returned to the seller. We may suppose that the controversy got somehow blurred because of the principle of functionality. If male slaves were indeed mainly purchased to procreate, then male infertility surely was a major defect. When the discussion proceeds with sterile female slaves, the same principle of functionality seems to interfere completely with more popular notions of health and illness. According to the lawyer Trebatius, the sale of sterile female slaves could not be canceled if they were infertile by nature, although it could be canceled if a disease had rendered them incapable of bearing children. Other writers disagreed with Trebatius, regarding every infertile slave as sick (Gellius 4.2.6–10). With a certain element of agreement about functionality as the central criterion, Gellius reports the definition provided by the lawyer Masurius Sabinus: “a deaf–mute or people with defective or injured limbs that render them less suitable for work should be regarded as ‘sick’. One who is near-sighted by nature, however, is just as healthy as one who walks somewhat more slowly than the average person” (Gellius 4.2.15; transl. J. C. Rolfe). Strangely enough, other definitions that come much nearer to the common usage of the terms and thus treat a morbus as being of a temporary nature (with a vitium being persistent) receive no support in Gellius’ view, precisely because such would imply that blindness or the sterility of a eunuch would not constitute diseases, thus eliminating the possibility that the sale could be annulled (Gellius 4.2.13–14).

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TABLE 0.1  Defects in the selling of slaves according to Dig. 21 Symptom

Entitled to annulment

No annulment

21.1.1.9: light vitium animi (e.g., temporary signs of insanity, superstitiosus, iracundus, contumax)

X

21.1.1.9: vitium animi et corporis (phreneticus with fever)

X (but: action on purchase)

21.1.1.10: run around temples and give oracular answers at the shrines (circa fana bacchatus sit et responsa dederit), but not anymore = nullum vitium

X

21.1.1.10: continuing this behavior = vitium animi

X (but: action on purchase)

21.1.1.11: features of character (praeter modum timidi, cupidi, avari, iracundi) = vitium animi

X (but: action on purchase)

21.1.2: melancholici = vitium animi

X (but: action on purchase)

21.1.3: protervi, gibberosi, curvi, pruriginosi, scabiosi, muti et surdi

X (but: action on purchase)

21.1.4.1: vitium animi ex corporis vitio (e.g., speaking disconnectedly on account of fever, making nonsense speeches in public)

X

21.1.4.2: features of character (aleatores, vinarii, gulosi, impostores, mendaces, litigiosi)

X

21.1.4.3: morio, fatuus ut in eo nullus usus sit = vitium

X (but: action on purchase)

21.1.4.6: levis lippitudo, levis dentis auriculaeve dolor, ulcus, febricula = morbus, but insignificant

X

21.1.6.1: impetiginosus = vitium (non morbus), as long as he can use the limb in which he has rabies

X

21.1.6.2: spado/qui unum testiculum habet (as long as he can generate) = neque morbosus, neque vitiosus

X

21.1.7: a slave has been castrated in such a way that any part of his body required for the purpose of generation is absolutely absent = morbosus

X

21.1.8: lingua abscisa = non sanus

X

21.1.9: mutus = morbosus

X X

21.1.9: difficult speech = non morbosus 21.1.10 pr. - 1: amputated finger or toe = non sanus, if his services are less available on this account

X X

21.1.10.2: supernumerary fingers or toes, if these are not hindrances for his functioning 21.1.10.3: myops (nearsighted) = non sanus

X

HOW AND WHETHER TO SAY “DISABILITY” IN LATIN AND ANCIENT GREEK

Symptom 21.1.10.4: partial blindness, not seeing in darkness, or only seeing when light is absent = morbosus

Entitled to annulment

9

No annulment

X

21.1.10.5: speech impairments: balbus, blaebus, atypus, tardius loquens, varus, vatius = sanus

X

21.1.11: lack of teeth = sanus

X

21.1.12 pr.: tumor (qui clavum habet) = morbosus

X X

21.1.12.1: any inequality of the cheeks, eyes, or arms, if they detract nothing from the services of the slave = sanus 21.1.12.1: one side is smaller, or one leg shorter, if it may cause some impediment

X

21.1.12.2: goiter, or prominent eyes = sanus

X

21.1.12.3: left-handed = non morbosus, non vitiosus

X

21.1.12.3: using the left hand on account of the weakness of his right = mancus

X X

21.1.12.4: bad breath, bad smell = non morbosus 21.1.12.4: bad breath, because of a bodily illness (liver or lung) = morbosus

X

21.1.13: lame (clodus) = morbosus

X

21.1.14 pr.: woman who always brought forth dead children = morbosa if this was caused by a uterine affection

X

21.1.14.1: pregnant slave = sana

X

21.1.14.3: sterile woman by nature = sana

X

21.1.14.3: sterile woman by bodily defect = non sana

X X

21.1.14.4: incontinence of urine due to sleep or wine or where this occurs through sluggishness in rising = sanus 21.1.14.4: incontinence of urine by defect of the bladder = non sanus

X X

21.1.14.5: amputated uvula when the disease has thereby disappeared 21.1.14.5: amputated uvula, but persisting illness

X

21.1.14.6: fingers that are united, if he is prevented from using his hands = non sanus

X

21.1.14.7: vagina of a female slave is so narrow that she cannot become a woman = non sana

X

21.1.14.8: enlarged tonsils that cannot be removed = vitiosus

X

21.1.15: problems with periods, twice a month or no menses at all before the right age = non sana

X

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0.3. A MONSTER Human imagination and linguistic terminology surely present other means by which to classify fellow human beings as defective others based on their bodily appearance. There might hardly be a better example of such a “holistic” approach toward bodily features than labeling another person as “a monster.” As in modern usage, the terms for “monster” in Ancient Greek and Latin cover a wide range of meanings.14 The words were applied in a loose way, always pointing to a certain transgression of moral or physical norms. All sorts of “strange” tribes and races were labeled as “monsters.” The same goes for individual ugly people, strange-looking animals, or deformed babies. As an insult, it could be used against morally ugly or vulgar people. In a religious sense, it denoted an infraction of “the normal order of things,” and as such was linked to prodigia, divination, and fortune-telling (see Husquin in this volume). In juridical texts, defining a newborn as a monstrum concerns the granting of the ius trium liberorum in the case of the birth of a deformed child. People could also become monsters, by mutilation. Contradictions in the use of the term are innate to its ambiguous meaning. While Aristotle states that monsters do not resemble their parents (De gen. an. 3.767a36–769b10), such is contradicted by the “monstrous races,” with whom congenital conditions are at stake. It is worth taking a further look at the Aristotelean theory of teratology. In the first instance, he seems to regard as a monstrosity (τέρας) people who do not take after a human being at all in their appearance (De gen. an. 4.3.767b5), thereby coming close to the concept of the monstrous shared by Roman jurists (Laes 2018: 7–8). One almost feels the scholar Aristotle struggle with the language and the terms when he states that anyone who does not resemble his parents is “really in a way a monstrosity” (4.3.767b5– 6). He understands monstrosity as a deviance from nature (4.3.767b7).15 Monsters are “necessary” by accident, since their origin is anyway located in nature, which would not produce something “against nature.” Later on, Aristotle elaborates on this point. In cases of a calf with a child’s head or a sheep with an ox’s head, or people’s faces looking like animals, we are confronted with resemblances only, since no living being can possibly be formed except in its own proper period (4.3.769b). Again, Aristotle reverts to the common parlance, stating that there are others that qualify for the name of “monstrosity”—supernumerary feet or heads come to mind. This redundancy of parts can again be explained by a wrongful mixture of the semen in the uterus, in very much the same way as is the case for deformed animals. Indeed, we read that such monstrosity is a sort of deformity (4.3.769b25–30).16 The theory of the mixture of semen drawn from each of the parts of the male and the female body is partly sustained by the observation that mutilated parents produce mutilated offspring. When one parent is deficient in some part of the body, no semen comes from that part, and the part from which no semen comes does not get formed in the offspring. Aristotle and other followers of this theory may have been inspired by the observation that blind parents produced blind offspring, though one wonders about the statement that those with scars also produced babies with the very same bodily marks (Aristotle, De gen. an. 1.17.721b18–20; Hist. an. 9.6.585b30–2). Despite the often ambivalent statements on monsters, we are left with the impression that some people were called τέρατα or monstra because of their physical appearance, which deviated from the standard expectation. Most of the time, their conditions were incurable and unchangeable. The denomination of “monster” surely was a pars pro

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toto, which characterized the whole body. Unfortunately, there are very few passages in classical literature in which “being a monster” is explicitly described as a “disabling” condition, putting people at a disadvantage. We may very well imagine such persons being integrated into society, and in a way not being disabled. Also, there are no egodocuments in which persons testify to their own condition or to the way in which they experienced being called a monster (see Husquin in this volume for rare occurrences of how those with defective bodies felt).

0.4. MIRACLES: FROM PAGAN SANCTUARIES TO CHRISTIAN HEALING As this volume deals with the period of c. 500 BCE to 500 CE, the contributors have taken great care to include Christian evidence. In this section, I explore possible changes regarding disabilities that may have been caused by the thoughts and practices of the new religion. I suggest that the miracles performed by Jesus caused certain categories of disabilities to become more established and canonized than others. Also, the category of the possessed and the “mentally deranged,” who were excluded from miraculous healing before, in Christianity received proper attention. Finally, Christianity placed greater stress on the moral responsibility and the personal belief of those receiving healing. Visitors to ancient shrines and sanctuaries assumed their conditions to be incurable for one reason or another. Therefore, they made the effort to undertake long-distance travel to consult at the shrine. On the whole, people in Antiquity most likely did not expect blindness to be healed by any natural or therapeutic means, just as they did not think about curing total deafness, muteness, or limbs that were by accident or congenitally beyond repair.17 All this is beautifully illustrated in an inscription from the Asclepion of Athens (LiDonnici 1995: 88–9). The one-eyed suppliant Ambrosia approached the testimonies (inscriptions and votive offerings) to the healing miracles that were on display at the shrine with an attitude of ridicule. In fact, she denied the possibility that “the lame and the blind” could “become well from only seeing a dream.” At the sanctuary, she was sent a dream in which Asclepius himself promised to make her well and in which he assured that he could act on such conditions. The following day, Ambrosia was healed and walked away from the shrine. Not only her eye, but also her faith in Asclepius were restored. Moreover, the god asked her to “pay a fee” by “dedicating a silver pig in the sanctuary as a memorial for her ignorance.” The donation of a pig may indeed have been an expression of humiliation for Ambrosia’s lack of belief in the healing accomplishments of the gods. As such, the healing was also a transformation of one’s mind and a confirmation of the importance of faith within one’s social network (Horn 2013: 124–8). The example shows that faith in divine providence and the necessity of rendering oneself to a deity at least sometimes was part of pagan creed (see Zurhake in this volume). Social and spiritual transformation is also witnessed in Christian healing stories. The poor manual laborer Pausikakos, who experienced cataracts and became blind because of the incompetence of his physicians, was healed by Saint Thecla. The saint not only rebalanced him as a human person, but also brought about a social transformation, since he was able to work again and was well thought of by the people surrounding him (Horn 2013: 129–31). Another miracle story shows the health of a whole city being at risk due to an infectious eye disease (Horn 2013: 135–7). In her compassion, Thecla provided a place of healing in her shrine and shared her knowledge of the remedy with one infected person. The whole community was to bathe at the shrine. This appropriate means of

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healing had to be combined with strong faith in the energy of the martyr Thecla. After attending the shrine in a holy procession, most of the people were healed as by a new fountain of baptism. Only a small group was not cured; they were excluded from further assistance, and their lack of belief served as an example for the rest of the population. In a way, those not receiving healing turned out to be the real “disabled.” Cornelia Horn has suggested that this miracle story is the “only surviving instance, in which a clear distinction was offered between disease and disability” (Horn 2013: 138). From this example, it clearly appears that one’s own moral responsibility mattered very much in order to receive healing. In all, the appeal to one’s responsibility goes back to the miracle stories of the New Testament. It is indeed stated that Jesus was not able to perform any miracle (virtus, δύναμις) in Nazareth due to the fact that the people there did not believe in him (Mc. 6:5–6 and Mt. 13:58). The only thing that was left to him in such a case of disbelief was laying hands on the infirm (infirmos) and curing them in this way (curavit). We get the impression that these infirm were distinguished from the category of people who were in need of a miracle. Who were these people? Time and again, lameness, blindness, deafness, muteness, and skin diseases turn up as the defects most often healed by the saints and in Christian sanctuaries, thereby imitating the miracles of Jesus Christ (cf. Mt. 11:5: the blind receive their sight and the lame walk, lepers are cleansed and the deaf hear). To this could be added the possessed, who had to be cleansed of evil spirits (Mc. 6:6–7; Mt. 10:8, and Lc. 9:1–2). Would such defects gradually, in the minds of the people, have developed as the incurable ailments par excellence, for which divine assistance was needed? And would failure to find divine relief have resulted in despair and in regarding such patients as really incurable, in a way even “disabled”? The emphasis on exorcism and demonic possession surely is a remarkable Christian feature, which originated in the Jewish focus on demons in cases of illness, though demonic spirits were known in Greco-Roman thought and practices as well (see Toner in this volume; Metzger 2018). Possession was a physical phenomenon (in Lc 13:10–17, an evil spirit caused a woman to be bent over and crippled for eighteen years): the malign spirit dwelled inside the intestines. Raving madness was one of the possible symptoms of possession. In any case, Christian sanctuaries were the first also to receive and cure the “mentally disturbed,” who were mostly kept away from non-Christian temples and shrines. Again, the firm belief that healing was something that happened in the mind and that it was related to a person’s personal belief and effort played a crucial role. It seems as if disability became an existential problem in early Christianity and beyond, when tolerance and equality were directly challenged in encounters with “different others,” such as the disabled. The Christian concept of equality was far removed from the pagan vision, and it established the highly demanding ethical requirement of treating all fellow Christians as children of God. Everyday practice was often different, and Christian authors went to great lengths to explain to their audience the imperfection of human society, regardless of its aspirations, in contrast with the Christian divine order.18 The miracles performed by Jesus caused certain categories of disabilities to become canonized. The category of the possessed received much more attention than it had before. Madmen attending sanctuaries was a relatively new phenomenon.19 Charity was greatly stressed in Christianity, and this gave rise to institutions such as hospitals. Finally, Christianity stressed the moral responsibility and personal belief of the healed. In fact, not being healed could be viewed as proof of a lack of personal belief, as the stories about the miracles by Saint Thecla make clear (cf. supra, p. 11). As such, the instrumental, the charitable, and the

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existential approaches have their origins in the ancient world and in early Christianity: the instrumental in pagan thoughts and practice, and the charitable and the existential in the world of Christianity.

0.5. CONCLUSIONS OR SUGGESTIONS FOR EXPLORING THIS VOLUME This volume comes at a moment when, for the first time, scholars of ancient disability of various regions and periods have gathered in collective and comparative attempts to study the “vocabulary of disability and defect.” As such, the topic has now been approached for Vedic and Sanskrit, for Hittite, for Ancient Greek, Latin, Hebrew, and Classical Arabic, as well as for a wide range of vernacular languages in the Latin West from the Middle Ages up to the Early Modern Period (discussed in about ten chapters in Laes 2017c). All of these studies point to significant differences in denoting specific disabilities—varieties that were largely culturally determined. They also mention the general lack of a clear-cut distinction in vocabulary between a temporary and a lasting condition. Also, premodern concepts seem to focus on bodies being marked or blighted by a specific physical or mental deviance, rather than resorting to more generalizing “holistic” categories of disability. In no way does this introductory chapter claim the opposite. On the contrary, the study of the vocabulary of defect as applied by the Roman jurists rather points to their very flexible use of terms such as morbus and vitium, their awareness that they sometimes run against everyday usage, and their eagerness to make things right in ad hoc situations. In his remarks on monstrosity, Aristotle reveals a similar struggle between an “academic and scholarly” everlasting definition of what constitutes a “monster” and the ways in which such monsters were commonly labeled. Pagan miracle stories sometimes reveal the importance of personal involvement by the patients. This line of thinking was much more pronounced in Christian concepts and practices of miraculous healing, paving the way for labeling those who attended the saints in vain as “the truly disabled.” However, such concepts never lead to a marked separation in vocabulary or to any clear distinction between what we would call disability, infirmity, and chronic and acute disease. Inevitably, historians approach terminology and vocabulary through the lens of fragments, which should always be understood in their context. The study of terms is always and inevitably fragmented (Frohne 2017). It needs to be supplemented by anthropological and archeological parallels. Anthropologists have time and again demonstrated how certain bodily conditions create a sense of otherness in most civilizations, even of revulsion or awe (e.g., amputation of the nose, harelip, leprosy or skin diseases, possession). Yet, when we study people affected with these afflictions in the context of burial practice, such separation mostly does not appear. So, it might very well have been the case that in their daily lives such people were treated as strangers and others, though study of the burial context alone would suggest otherwise (Dettwyler 1991; Tilley 2015). Otherness and difference were problematized throughout many cultures (Schmidt 2017). On the theme of this introduction, I suggest very much the same. Studies of medieval medical treatises have revealed how some doctors discerned between an illness (Krankheit) and a more permanent defect (Beeinträchtung) (Frohne et al. 2017: 34). The medieval concept of neutralitas, a corporeal condition in-between health and illness (Frohne 2017: 54), somehow comes close to chronic disease and/or disability and goes back to a Galenic concept of the οὐδέτερον. Occasional references in medieval law books point to the understanding of a difference between intellectual incapacity and rages

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or fury (Hiltmann 2017: 298), as well as to distinctions between treatable vulnera and lasting debilitates in cases of compensation (Metzler 2017a: 314–15). While the concept of “normality” was brought forward only in the eighteenth century, ancient Greeks and Romans were aware of “preferable conditions” and conformity of bodies. They knew that the idealized bodies as they appeared in sculpture were not an everyday occurrence (see Husquin in this volume). They expressed ideas about “preferable conditions” through terms such as holoklèros, integer, or even verbs such as debere (see Laes 2016b: 645 for many references to ancient aesthetics). So, does it make sense to search for words for disabilities in the Greek and Latin vocabulary? Is the application of the modern concept of disability to ancient categories and vocabulary a case of a misalliance? Yes, in that we do injustice to terms such as adunatos or vitium if we put them directly with our “disabled.” Yes, also, because of the fact that the modern term “disability” itself is a blurred and far from clear-cut category. But no, in that both ancient and modern societies were aware of a difference between lasting and inhibiting conditions on the one side and temporary illnesses on the other. The mere fact that we all have human bodies and share some basic feelings and perceptions justifies such a comparison. In no way does this observation lead to dogmatic essentialism or cheap assumptions about ancients “being just like us.” It rather justifies a study of how societies from the past expressed difference. This expression and description of difference ought not to lead to assessments of people of “less corporal wholesomeness” as “less abled,” let alone “less valued,” but allows for perceiving in the vocabulary both differences and similarities. After all, acknowledging some similarities between the present and the past does not need to come as a surprise. I invite the readers of this volume to go through the chapters with this last observation in mind. Antiquity definitely deserves a place in a set of volumes on the history of disability.

CHAPTER ONE

Atypical Bodies Extraordinary Body Treatment and Consideration CAROLINE HUSQUIN

1.1. INTRODUCTION He will take care to bid the drinkers beware of all those games that, with no intent of seriousness, come roistering into parties like a drunken crowd, lest unawares the members of the party introduce an insolent violence bitter as henbane in their wine as they run riot with their so-called commands, ordering stammerers to sing, or bald men to comb their hair, or the lame to dance on a greased wine-skin. Thus, by way of rudely mocking Agamestor the Academician, who had a weak and withered leg, his fellow-banqueters proposed that each man of them all drain off his cup while standing on his right foot, or pay a penalty. But when it came the turn of Agamestor to give the order, he commanded them all to drink as they saw him drink. Then he had a narrow jar brought to him, put his defective foot inside it, and drained off his cup; but all the others, since it was manifestly impossible for them to do so, though they tried, paid the penalty. Thus Agamestor showed himself an urbane gentleman; and, following his example, one should make his ripostes good-natured and merry. (Plutarch, Table-Talk 621e–f; transl. P. A. Clement, H. B. Hoffle)1 Plutarch’s discussion2 provides a fair account of the condition of individuals with striking physical characteristics in Antiquity and the various reactions these produce.3 Though victims of taunting or even cruelty, for all that they were not necessarily banished from society, as it has long been thought. Agamestor’s participation in the banquet and the facetious manner of his reaction to mockery attest to this. Even so, such a situation should not be generalized to all individuals in his position. In the Greco-Roman world, everyone stood under the permanent scrutiny of others. It was this gaze, this “eye of the beholder,” to quote R. Garland (Garland 1995; Rose 2003), that decided who should be accepted within the community and who should be excluded. It followed that everything was a matter of perception and portrayal since, with the ancients, at least in literature, the body and its aspect seem to have held particular importance, especially in the case of freedmen, for whom it had to be established whether or not they were fit to accomplish certain activities pertaining to their status (Laes 2014; 2018). Ancient sources emphasize a number of paradoxes current in Greco-Roman thought in which beauty and ugliness, health and sickness, virtue, morality, and amorality, physical integrity and corporal alteration were bound together intimately. Tackling the question of atypical bodies is not simple, as it cannot be answered by a single definition that applies

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to all places at all times. Falling into the trap of projecting contemporary concepts onto differing ancient customs, practices, and mind-sets has to be avoided. Atypical bodies in Antiquity do not inevitably match up with those of modern times. In the same way, the criteria employed to allot individuals into the category of those possessing such a body must certainly have evolved within Antiquity itself. Indeed, Republican Rome would not necessarily have considered or treated these subjects in the same manner as Imperial Rome might have done. In the Greek world, these individuals were not treated the same way in Athens or Sparta, for example. The concept of the body is in fact a truly social construct contingent on communities and based on those bodily traits focused on within the social, religious, or military context of their time. While some nineteenth- and twentieth-century researchers popularized the idea that newborns with physical defects were routinely eliminated in Antiquity, newer research has shown that this was not the case. In truth, the matter is far more complex. The present chapter proposes to deal with the problem of the definition, consideration, and treatment of persons deemed non-standard or with an “atypical” body by inquiring into the concept of normality in Antiquity and by defining its standards and deviations. To shed light on the matter, we shall first seek to define what made a body atypical in Antiquity. Then we shall observe how in Rome the perception of such persons evolved from the time of the Republic to that of the Empire. Finally, we shall look at how they were treated and what status they were accorded.

1.2. WHAT MAKES A BODY ATYPICAL? 1.2.1. The prickly question of defining the norm4 Determining what made a body atypical in Antiquity is no easy task because reference to modern categories is out of the question: ancient and current visions do not altogether overlap. Categorizing between mere variations, anomalies, and monstrosities turns out to be tricky (Dasen 2013b: 77), for our way of viewing the body in Antiquity is biased by a long historiographic tradition extolling the irreproachable form of Greek and Roman statuary. Studies on Greco-Roman art have led scholars like Johann Joachim Winckelmann (1717–68), the founding father of antique art history, to consider Greek art as the incarnation of the dream of an ideal body (Dasen 2013b: 78). The Nazis (Dasen 2013b; Van Houdt 2017) later took over the notion that the perfect body of statuary was the norm the ancient Greeks followed, which modern man should emulate if not surpass. The Oxford English Dictionary5 provides several definitions for the term “norm”: “That which is a model or a pattern; a type, a standard”; “A standard or pattern of social behaviour that is accepted in or expected of a group”; or “A value used as a reference standard for purpose of comparison.” The norm is thus a state of regularity that most closely conforms to the standard established as natural or most frequent and from which any deviation is considered abnormal. The norm can also represent a model to emulate or at least resemble as closely as possible. Contrary to modern scholars who have considered statues of ephebes as real bodies and incarnations of a norm or an objective, the ancients knew that the statues evoked an ideal never to be actually found in nature. Xenophon (Memorabilia 3.10) and later Cicero (De inventione 2.1.1–3) set out these ideas in their works. Both explain the process whereby these artistic bodies are in effect the result of the combination of the finest features to be found in different models and not the faithful replica of an actual person in real life. The ancients were fully conscious that those marble

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statues never exactly represented existing subjects and that there was a divergence between the statuary body and that of a real person. In a society in which sanitary conditions were poor, very few individuals could ever expect to approach such physical perfection (Dasen 2013b: 88–9; Trentin 2017: 234). That was not the aim, anyway. What mattered was to attain what can be qualified as having a “corps ou de beauté convenable” (seemly body or beauty) (Baroin 2015: 31–51). It is fitting to look away from the aesthetics concept of the kalokagathos, as it has been defined, toward the realia, where the notion of the ordinary citizen’s seemly good looks appears more plausible. This formulation used by C. Baroin (2015), to my mind, sheds light on an important point to take into consideration: the bodily norm, or at least what it is assumed to be, is not fixed, but rather is a shifting concept that fluctuates according to varying factors. Gender, for instance, is one such factor, since beauty criteria differ between women and men (Cicero, De officiis 1.130). Other factors vary with age and social conditions. Different traits are expected from a freedman and from a slave. Temporality has also to be taken into consideration when reflecting on the question of inborn or acquired physical characteristics, since a body evolves (Boudon-Millot 2006: 127–41), and not only due to disease and accidents that weaken or disfigure it, but also through the influence of the expectations of society. A befitting body is not solely the work of nature. Certain aspects may be put down to nature, others are acquired. The citizen’s befitting beauty is a combination of nature’s gifts and of culture; it is both inherited and acquired. Shaping the body begins early in childhood to correct or prevent defects considered shaming. A child’s body was viewed as a ductile entity; it required shaping by a whole program of manipulations, strappings, and massages, enabling it, while growing up, to obtain the appropriate form due to its gender and rank. Good manners must be instilled. To avoid being viewed as effeminate, the future male citizen must, for instance, adopt appropriate body language and an adequate gait (Gleason 2013). Hence, the corporal norm in its context of due propriety can only be defined as going beyond a healthy body in its physical integrity. The real world was far more complex because, in Greco-Roman thought, such a norm was associated with values that outstrip mere physical criteria—values such as morality, health, measure, and, of course, propriety. Deviations from the norm are not necessarily against nature, and conformity can be envisaged according to different criteria. Pseudo-Galen defines conformity according to function.6 For him, there are traits that neither comply nor go against nature, such as being too lean or too fat or having a hooked or a snub nose. He simply considers that people with these attributes fail to achieve the right balance. They cannot be taxed with going against nature because they are not handicapped in their ability to act. Conformity can thus be assessed according to a functional principle. A body may deviate from what nature is expected to produce or most usually produces, but as long as the faculties are not impaired, the deviation is not prohibitive. Other authors seem to have favored aesthetic criteria. The implication is that an atypical body cannot simply be defined as one that has suffered the loss of its faculties. Paul of Aegina presents a remedy for a man’s overly flabby chest (Medical Compendium in Seven Books 6.46). Numerous criteria are involved and can concern light transgressions. Their multiplicity is due to the fact that the body was thought to reveal moral virtues and defects. A deformed—or merely unsightly—body was supposed to harbor an evil soul, and vice versa. Hence, the body has a social role; it is an instrument of communication whereby the ancients sought indicators of the character of their fellow creatures. A body may be deemed atypical because it deviates from the norm by being too large, too slim, or too fat, or because it bears marks thought to be revelatory of moral deviance.7 These would not necessarily

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have been malformations or mutilations, but they were considered unseemly and likened to physical injury. Ultimately, the study of the perceptions and representations of bodily differences is a complex one to tackle, so broad and subjective is the notion. The field covers multiple dimensions that touch on gender, geography, temporality, aesthetics, functions, and morals. Defining a Roman bodily norm is as difficult as establishing which bodily anomalies, variations, or deficiencies were accepted, tolerated, ignored, mocked, or rejected by others. Atypical bodies would doubtless have been of many kinds and cannot be made the object of a globalizing categorization; each case needs to be assessed individually. 1.2.2. The causes of transgression are not to be neglected Given the prevailing sanitary conditions in Antiquity, anatomical variations occurred to greater or lesser extents. Each and everyone in the course of their existence could be affected by an ailment that placed them in the category of atypical bodies. N. Kelley, in a 2007 article (Kelley 2007: 31), evokes how malnutrition, diseases, consanguinity, and heredity were the main causes of congenital deformities. Acquired infirmities were due to a larger gamut of causes, some of which tie in with those already mentioned, including accidents and acts of violence (Husquin 2016: 44–56). Disease is one of the causes of congenital or acquired physical defects. It could be a syndrome contracted by a child in utero or, frequently, a pathology developed during the lifetime of a subject, leaving them with aftereffects or chronic illness. Thus, Thucydides recalls that during the “plague” of Athens, the survivors were deprived of sight and lost their memory or limbs (fingers, toes) (History of the Peloponnesian War 2.49.7–8). Avitaminosis could cause malformations in children, such as bent legs, which Galen (De sanitate tuenda 1.8) and Soranos of Ephesus (Gynaecology 2.16) ascribed to defective swaddling and to the attitude of Roman mothers. The notion of vitamin deficiency being unknown then, the two doctors struggled to find the cause of the defect. Clearly, these children suffered from rickets due to a lack of vitamin D, as attested by the remains of young girls from the fourth century CE, excavated in Lisieux (Blondiaux et al. 2002: 209–15). Pott disease, a type of tuberculosis, could also cause bodily malformations such as the gibbosity observed on an adult male from the necropolis of Towcester (UK) (Anderson 2001: 444–6). Aged thirty to forty, the incurvation of his spine almost formed a straight line. Injuries are another cause of abnormal bodily shapes. Accidents at home, at work, or elsewhere and violence with or without malevolent intent to maim are other possible causes. Galen relates an anecdote (De proprii animi cuiuslibet et affectum dignatione et curatione 4) in which the Emperor Hadrian, in a fit of rage, supposedly threw his quill at a slave and blinded him. Similar acts are recorded in the Digest, including one concerning a master who put out the eye of an apprentice by striking him with a shoe tree (Ulpian, Digest 9.2.5.3). In literature, there are often references to laborers with notable bodily characteristics without it always being possible to link the cause with their profession. Alciphron mentions a lame tailor (Letters of Farmers 24.1) and Pliny a hunchbacked fuller (Natural History 34.11–12). Certain individuals were known to have mutilated themselves or to have been mutilated in order to avoid military service (Wierschowski 1995: 205–39). He sold a Roman knight and his property at public auction, because he had cut off the thumbs of two young sons, to make them unfit for military service; but when he saw that some tax-gatherers were intent upon buying him, he knocked him down to a

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freeman of his own, with the understanding that he should be banished to the country districts, but allowed to live in freedom. (Suetonius, Augustus 24; transl. J. C. Rolfe) The ablation of thumbs rendered these young men unable to grasp, and thus unfit for combat. Valerius Maximus tells a similar tale of self-harm (Memorable Doings and Sayings 6.3.3). Ailments that today appear benign and are easily cured could have major consequences on the appearance of individuals in Antiquity. Such was the case with fractures of the bones of the lower limbs that, badly set, would result in a shortening of the leg and an irreversible limp: “But sometimes the bones unite with one another sideways, and the limb is then shorter and misshapen” (Celse, On Medicine 8.10.7). Even more explicit: “It must not be overlooked, however, that if the thigh-bone is fractured it becomes shorter, for it never returns to its former state, and that afterwards the patient treads on the tips of the toes of that leg; but the disablement is much uglier when neglect is added to misfortune” (8.10.5). A woman from the Via Lucrezia Romana I necropolis displays a fracture of the femur that, despite treatment, left one leg ten centimeters shorter than the other (Charlier 2003: 69–73; Graham 2017: 248–66). Age is another cause of bodily transformation. Numerous authors of satirical works make fun of gray hairs, baldness, wrinkles, long-sightedness, deafness, toothlessness, loss of mobility, and crippled limbs as being so many stigmas of old age and loss of bodily respectability (Parkin 2003). Acquired and congenital anomalies need, however, to be differentiated. The practice of exposing malformed babies, even though it did occur, was probably less widespread than has been written about (Evans Grubbs 2011: 21–36). Nevertheless, authors such as Seneca (De Ira 1.15.2) advised it as a pragmatic measure, reasoning similar actions were already taken in the times of Plato (Republic 5.460c) and Aristotle (Politics 7.1335b, see infra). Mutilations acquired in combat were generally an object of pride, while some pathologies were viewed as punishments for a deviant lifestyle. Painting too negative a picture of the bodies of the ancients should, however, be resisted. Anthropological examinations invariably reveal anatomical variations of greater or lesser importance from one individual to another. In the absence of soft tissues, however, it is difficult to assess at what point a condition might cause disability. Specifically, not all conditions led to deformities, so were not spectacular and did not necessarily spark off any specific reaction from the community. Other more visible deformities would, by contrast, have generated fear and rejection at the time of the Republic, as conjoined twins and hermaphrodites did. 1.2.3. Extreme cases: Prodigia Congenital malformations probably sparked the most violent reactions, in particular during Republican times. It was up to the paterfamilias to decide whether or not to expose or eliminate a child considered unfit to be raised, though in certain specific cases the State was expected to take charge of them. Such children were looked upon as the outcome of divine intervention and thus ranked among prodigia; that is, fortuitous or unusual anomalies, notable by their strange characteristics rather than being against nature (Bouché-Leclercq 1882: 75; Engels 2007). Besides malformed children, prodigia included natural phenomena such as showers of earth or earthquakes. Certain physical peculiarities were considered only prodigious and frightening. A. Allély (2004b: 74)

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identified five categories of human prodigies on the basis of lists in Livy and Julius Obsequens: hermaphrodites, malformed children, precocious children, half-human half-beast creatures, and multiple births. Only the first two are discussed here. These peculiarities were perceived as the gods’ warning to the whole city-state of their wrath. Contrary to what was current in the Greek world where such a birth was not the object of a public expiation, the anger aroused by such births seems directed against the parents and not toward the entire community. This probably explains why monstrous births are rarely mentioned in Greek sources (Garland 1995: 65). Nothing is known of the way these children were selected and transferred from the private to the public sphere, nor by which criteria they were judged to be prodigia. The pontiffs did, nevertheless, dispose of a list of identified prodigies to which they could refer. The stringent procedure observed to identify prodigia required an adequate number of trustworthy witnesses.8 Emissaries might be sent to localize and investigate the phenomenon.9 Following these inquiries, the Senate, after consulting the religious authorities (pontiffs, haruspices, et al.), would discard any untenable findings. Lexicological analysis provides no information on selection criteria.10 In Latin, other terms than prodigium were used to qualify officially recognized prodigies—omen, miraculum, signum, ostentum, portentum, and monstrum—but it is difficult to establish a clear distinction between these words. Originally, they would each have had a clearly distinct definition, but by the end of the Republic they seemed to have been used as synonyms of each other. All of them belong to the realm of divination. They are perceived as messages received through the intervention of the gods, which in most cases is borne out by their etymology. Yet, nothing in these terms indicates on what grounds a phenomenon relating to public religion qualified as prodigium, monstrum, ostentum, or portentum. The political, social, and military context also played a role in the identification of prodigia. Livy’s and Julius Obsequens’ lists reveal a rise in the number of identifications during times of crisis, particularly in wartime. Once identified, an adequate response to the prodigia was required in order to restore the pax deorum. Usually, they were expiated collectively once a year. During the Middle Republican era, human prodigia do not seem to have caused greater fear than other types of prodigia. Before the consul and praetors set out for their provinces, a supplication was held by reason of prodigies. A she-goat was reported from Picenum to have given birth to six kids at one time, and at Arretium a boy with one hand was born, at Amiternum there was a shower of earth, at Formiae the wall and gate were struck by lightning, and, a thing which caused the greatest terror, at Rome a cow belonging to the consul Gnaeus Domitius spoke, saying, “Rome, for thyself beware.” The period of prayer was held on account of the other portents; the haruspices ordered that the cow be carefully kept and fed. (Livy, History of Rome 35.21; transl. J. C. Yardley) Human monstra are listed among other prodigia of the year with no further explanation. Only the talking cow is explicitly described as the most feared prodigy and was reserved a special fate. Had the one-handed child been perceived likewise, Livy would have most probably mentioned it. But from the second Punic War onward, certain anomalies give rise to a greater fear and children manifesting these are subjected to a specific fate. Conjoined twins discovered at Rhegium in 136 BCE were cremated and their ashes thrown into the sea by order of the haruspices. The most abhorred prodigia of all, the hermaphrodite, experienced a similar fate.

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1.3. FROM PRODIGIUM TO CURIOSITY 1.3.1. Hermaphrodite as monstrum par excellence Hermaphrodites deserve special attention because of the ambiguous reactions they aroused among the ancients (Husquin 2016: 80–99). Though Hermaphroditus numbered among the gods of the pantheon, flesh and blood androgynes inspired deadly fear. A normative principle in ancient societies was the strict division of roles and functions based on sexual differentiation. Hence, an androgyne was perceived as a threat to the social order that could hinder the running of the city and put it in peril. It required expiation. Livy and Julius Obsequens list seventeen detections of androgynes, which were the subjects of a procuratio between 209 and 90 BCE. Marked by many crises that exacerbated superstitions, this period saw the gradual establishment of a ritual specifically aimed at the elimination of androgynes. The origins of these codified practices are to be found in the procuratio discovered in 207 BCE at Frusino (Champeaux 1996: 67–91; Brisson 2008: 29–32). The androgyne of Sinuessa in 209 BCE was the first known occurrence to be classified as prodigium, but it was not the subject of a particular procuratio. It was atoned for with the other prodigia of that year (Livy, History of Rome 27.11.1–6). It was from 207 BCE on that androgynes became particularly dreaded phenomena requiring individual exorcizing. Expiation ceremonies were performed with three times nine young girls singing hymns to Juno Regina and with prayers and sacrifices (27.37.5–15). The ritual must have been beneficial since it was replicated in the following procurations, such as by decemviri in 200 BCE when two new androgynes were detected. Later on, the sources do not always refer to the ritual, but it is likely that the practice that had been judged effective was continued since the androgynes invariably met the same fate: physical elimination. Androgynous infants were enclosed in a chest and thrown into the sea (more rarely into a river), where they met certain death. Only those discovered at an older age were killed directly (39.22.5), though perhaps not systematically: a sixteen-year-old found out in 200 BCE met the same fate as androgynous newborns. It is noteworthy that all of these procurations occurred between 209 and 90 BCE, a period of recurring crises of all sorts in Rome.11 This period runs almost exactly from the beginning of Rome’s Mediterranean conquest up to the Social War and the first phase of an expansion of the right to Roman citizenship. This period can be divided in two phases (Husquin 2016: 85; 2018b: 154): from 209 to 142/133 BCE and then from 142/133 BCE up to the Social War (91–88 BCE). During the first period, every procuratio of an androgyne occurs at a decisive moment when Rome is at war against a foreign power (the Other). This was the case in 207 BCE, when the ritual was initiated: the second Punic War was raging, Rome had suffered numerous defeats, and the Carthaginians were threatening to invade Roman territory, just as events turned with victories that included the Battle of the Metaurus that same year. The year 200 BCE marked the beginning of the Macedonian War. It had been necessary to invoke the risk of a war on Italian soil to obtain the vote, an opportunity seized upon by a number of clans from Gaul to attack the two main northern Roman colonies, Piacenza and Cremona. In 186 BCE, the eruption of the Bacchanalian Affair caused an internal crisis that provided an opportunity to castigate foreign cults in Rome and in the peninsula. For each threat over Italian soil, an androgyne is brought to light. During the 142 to 133 BCE period, there occurred the disputes with Numantia. Whenever a threat appeared to hang over Italian soil, an androgyne would be reported. During the second period, the discoveries of androgynes became more frequent and no longer coincided

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with Roman military operations, but with the moment when the consequences of these crises were most severely felt and required solutions. As Rome was constantly at war throughout this period, the coincidences could be insignificant, but Greek texts provide grounds for a further hypothesis. Phlegon of Tralles records the story of the androgynous child of Polycritus (Mirabilia 2; Brisson 1977: 80–122; 2008: 33). The infant was described as being different from both its father and its mother, which matches Aristotle’s definition of a monster (Generation of Animals 4.3), and more significantly, the parents belonged to different ethnic groups: he was Etolian, she was Locrian. Diodorus Siculus reports a similar case of the sex-changed child of a Macedonian father and an Arabian mother (The Library of History 32.34). In such cases, the androgyne was abhorred not only because it threatened the reproduction of the social model by its sterility and the distribution of social roles by its asexuality, but also because it gave concrete expression to the fear of the “Other”—the foreigner—and of his potentially nefarious influence over Rome. Since the conquest of the Italian peninsula, the Vrbs had been constantly at war with people whose culture was increasingly “other.” A fear of “contamination” through exotic practices grew, coinciding with the period when the diffusion of Hellenism in Rome was met with some opposition. The figure of the androgynous child could equally have been viewed as a symbolic warning of the risk of the perversion or contamination of Roman society by the “Other,” a notion that could have been used by writers and politicians a posteriori as a literary and divinatory deception to account for this period of war and its repercussions on the city of Rome. After the Social War, androgynes no longer seem to have been subjected to procurations. This change has been attributed to the diffusion of more rational ideas from Greece, the appeasement of anxieties thanks to the advent of the Augustan era, and the return to peace. Yet, procurations may have ended well before this period. Dependence on sources compels prudence. The lack of any attestation for procurations of androgynes prior to 209 BCE and their near absence after 90 BCE can reflect the nature of the sources at our disposal rather than proof that they did not occur. The ritual may have simply lost its usefulness and its performative potential in an Empire that now dominated the previously feared “Other.” 1.3.2. From fear to entertainment Under the Empire, references to procurations of human prodigia become rare and occur only in times of crisis (Husquin 2016: 99). Allély (2004b: 85–6) notes a single case of a double-headed child in 112, which the haruspices recommended throwing in the Tiber (Phlegon of Tralles, Mirabilia 25). At the same time, strangeness and disfigurement became fashionable, as noted by Quintilian: we admire things which are in some way distorted as being more sophisticated—just as some people set a higher value on human bodies which are crippled or somehow deformed than on those which have lost none of the blessings of normality. (Quintilian, The Orator’s Education 2.5.11–12; transl. D. A. Russell) Other writers confirm that misshapen creatures were reared as exhibits: In Egypt it was decided to rear a monstrosity, a human being with another pair of eyes at the back of the head, though he could not see with these. (Pliny the Elder, Natural History 11.272; transl. H. Rackham)

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Later, Augustine relates a similar anecdote, suggesting the persistence of the taste for strangeness (City of God 16.8.2). According to him, a “double person” was born in the Orient. With two heads, two chests, four hands but a single abdomen and two legs, this creature attracted many onlookers. The evolution of perception benefitted androgynes. Persons are also born of both sexes combined—what we call Hermaphrodites, formerly called androgyni and considered as portents, but now as entertainments. (Pliny the Elder, Natural History 7.34; transl. H. Rackham) The old prodigia as well as other anatomical deviations are mentioned by Pliny as mere curiosities that somewhat recall The Guinness Book of Records. The tallest person our age has seen was a man named Gabbara brought from Arabia in the principate of his late Majesty Claudius who was 9 ft. 9 in. in height. Under his late Majesty Augustus there were two persons 6 in. taller, whose bodies on account of this remarkable height were preserved in the tomb in Sallust’s Gardens; their names were Pusio and Secundilla. When the same emperor was head of the state the smallest person was a dwarf 2 ft. 5 in. high named Conopas, the pet of his granddaughter Julia, and the smallest female was Andromeda, a freedwoman of Julia Augusta. (Pliny the Elder, Natural History 7.74–5; transl. H. Rackham) Such persons could be found appealing as objects for contemplation, but also for sexual satisfaction. Pliny mentions the wealthy Gegania who bought a hunchbacked slave and put him in her bed (34.6). Individuals with atypical appearances were also sought after for their talents as entertainers to the elite. This was notably the instance with dwarfs, a certain number of whom appear to have belonged to the world of leisure and were employed as mimes, musicians, or jesters to perform before guests at banquets (Dasen 1993; 2013a: 259–78; Brunet 2003: 31–46). Lucian (The Carousal (Symposion) 18–19) describe a scene in which a dwarf amuses a party with his buffoonery by dancing absurdly and teasing guests, even provoking one guest to a pankration fight, defeating him and provoking general laughter. Dwarfs were also famous as wrestlers (Statius, Silvae 1.6.57–64). Authors have mentioned how emperors were equally fond of atypical bodies, retaining them in their entourage (Garland 1995: 45–58; Allély 2004b: 95–100; Trentin 2011: 195–208). While Suetonius describes Augustus’ disgust at malformed beings (Augustus 83), he also records that the emperor put on display a young man who was only two feet tall, weighed seventeen pounds, and had an astonishing voice (43). Suetonius also recalls how Domitian, while watching gladiator fights, would converse with a young boy with a small but monstrous head (Domitian 4). As for Elagabalus, we are told that he was fond of entertaining and humiliating individuals with disabilities or remarkable features (Gevaert and Laes 2013: 211–30): He had the custom, moreover, of asking to a dinner eight bald men, or else eight oneeyed men, or eight men who suffered from gout, or eight deaf men, or eight men of dark complexion, or eight tall men, or, again, eight fat men, his purpose being, in the case of these last, since they could not be accommodated on one couch, to call forth general laughter. (Historia Augusta, Elagabalus 29.3; transl. D. Magie) Escaping religious procuration did not necessarily mean enjoying a much better fate.

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1.3.3. Creating atypical bodies to pander to current fads? Defining the status of these banquet entertainers is no easy task, but most of them were probably slaves. Their success due to their abnormal physique, considered as it were a qualification, directly affected their price and their chances of finding a buyer on the specialized market evoked by Plutarch. Therefore just as at Rome there are some who take no account of paintings or statues or even, by Heaven, of the beauty of the boys and women for sale, but haunt the monster-market, examining those who have no calves, or are weaselarmed or have three eyes, or ostrich-heads, and searching to learn whether there has been born some Commingled shape and misformed prodigy. (Plutarch, On Being a Busybody 520c; transl. W. C. Helmbold) There is no other evidence for such markets dedicated specifically to monsters, though it is likely that slave traders kept individuals of the sort to satisfy the tastes of rich clients. The predilection of the elite for misshapen beings poses the question of availability, should demand exceed supply. Could the success of the trade have urged unscrupulous individuals into producing “artificial monsters” for profit? Longinus suggests that such a practice existed to produce dwarfs: children were supposedly locked up in cages to stunt their growth (On the Sublime 44.5). The account is recorded as hearsay, but is partly backed up by a passage in Seneca the Elder in which a man is described as purposefully maiming exposed infants with the intent to send them begging. Their pitiful condition was assumed to increase their takings (Controversiae 10.4). This case is probably fictitious in that it is recorded in a collection of case studies to train lawyers, yet it could be supposed that the example was prompted by an actual case. If such artificial monsters were far from constituting the majority of people with deformities or mutilations, it is not impossible that unscrupulous traders did produce a few to satisfy the demand for jesters and other entertainers with uncommon bodies. The thirst for amusement combined with cruelty and lucre could have led to the kind of extreme practices ascribed to Commodus: “Other men he dubbed one-eyed or one-footed, after he himself had plucked out one of their eyes or cut off one of their feet” (Historia Augusta, Commodus 10.6; transl. D. Magie).

1.4. THE PLACE OF ATYPICAL BODIES IN SOCIETY 1.4.1. A shield against the evil eye The Ancients were particularly aware of the dangers associated with the evil eye (Husquin 2016: 415), especially among the elite, who were exposed to the envy or jealousy of rivals. Protective measures were sought. When those possessed by envy to this degree let their glance fall upon a person, their eyes, which are close to the mind and draw from it the evil influence of the passion, then assail that person as if with poisoned arrows; hence, I conclude, it is not paradoxical or incredible that they should have an effect on the persons who encounter their gaze. The bite of dogs too is more dangerous when they are angry; and it is said that in human beings the sperm is more likely to lay hold and cause conception when union is accompanied by love. In general, the emotions of the mind increase the violence and

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energy of the body’s powers. What I have said shows why the so-called amulets are thought to be a protection against malice. (Plutarch, Table-Talk 681f; transl. P. A. Clement, H. B. Hoffleit) Certain individuals with deformed bodies were prized because they prompted a type of laughter associated with apotropaic and prophylactic virtues, which kept the phtonos at bay and checked fear. They were said to protect against the evil eye. Indeed, Dasen suggests that dwarfs served as live amulets for their rich owners (Dasen 2013a: 271–2). The case of Aesop suggests that the same was true for hunchbacks (Levi 1941: 220–32; Barton 1993: 167; Trentin 2009: 130–56; 2015: 51–72; 2017: 235), since it was to this aim that he had been purchased (Trentin 2015: 53–4). Crafted representations such as statues and mosaics could also be set within the home. Other objects such as small figurines were finely worked, suggesting that they were worn as amulets for permanent protection at home or while traveling. Some of these had a small ring that enabled them to be hung from or pinned to clothing. This, at least, is how some of the figures of dwarfs and hunchbacks found in Hellenistic and Roman period Asia Minor and Egypt are now interpreted (Ballet and Jeammet 2011: 50–1; Mitchell 2013: 275–97; Galbois 2014: 199– 207). These figurines associate a grotesque physique (atopia) with indecent features such as a disproportionate phallus, another essential attribute to ward off the evil eye (Trentin 2015: 6). They are found in strategic locations where individuals were particularly at risk, for instance in the public spaces of the domus or at the baths. Recent research shows that these representations had many purposes, both practical as much as aesthetic, to satisfy the urge to introspection. Perhaps the most obvious was the aesthetic function, since some of the fine pieces of serious artistic interest were produced with the greatest care with the intent of arousing viewers’ pleasure or laughter (Cèbe 1966: 345–58). Recently, researchers have put forward the notion that these images were also of major symbolic import, with resonance going well beyond the initial reaction of amusement (Masséglia 2015: 289–91; Trentin 2017: 235). Trentin argues that they were conducive to introspection in viewers, leading them to reflect on how these compared with their own bodies in terms of normality and to what extent they themselves might vary from the norm (2017: 235). As foils they had the practical function of keeping the phtonos at bay by capturing the gaze of evil enchanters and avert it from their potential victims. A good example can be found in a collection of mosaics excavated at a domus in El-Jem in Tunisia (third century CE).12 One of these represents a dancing dwarf coming forward with two crossed sticks with his back turned from a large eye, symbolizing evil, being attacked by animals13 and weapons.14 The dwarf’s outsized phallus points toward what is happening behind his back. Set above the scene is an inscription, kai su, to which is attributed the power to cast back the evil eye to whomever sent it (Dasen 2009: 226; Ballet and Jeammet 2011: 51). The same is found on a second mosaic in which another hunchback seems to execute a dance step. He too displays crossed sticks and a disproportionate phallus. On the basis of parallels with Nilotic scenes representing pygmies similarly armed, Dasen argues that the association of crossed sticks (2009: 226) with dancing dwarfs has an apotropaic function.15 These scenes were not found in any part of the house other than the entrance hall where they faced every newcomer, so protecting the residents from attack by enchanters. 1.4.2. An ambiguous status between marginalization and integration The discussion so far has revealed the ambiguity of the status of individuals bearing a physical singularity, one oscillating constantly, though never completely or definitively,

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between marginalization and integration. The consideration they received depended on the anomaly they bore. If conjoined twins and hermaphrodites were indeed radically excluded from society in Republican days, before their treatment evolved later on, it is difficult to know what happened in instances in which their anomaly was not detected at birth, as would have been the case with dwarfs. Being undetectable at birth, infanticide and exposure would have been out of the question. Slighter variations such as polydactyly seem to have caused no problem (Pliny the Elder, The Natural History 11.244). Under the Empire, the evolution of the status of abnormal individuals called for adjustments, notably to the law, not without causing certain problems for casuists, in particular regarding hermaphrodites. Roman law recognized androgynes as long as they were duly classified as male or female according to the dominant gender apparent in each subject.16 Sexual differentiation seems not to have been open to discussion, at least in the legal sphere: androgynes had to be either male or female. No allowance was made for a third gender. According to Paulus, an androgyne might be entitled to witness a will, a prerogative reserved exclusively to men, only after examination showed that the male gender was dominant (Paulus, Digest 22.5.15.1). It could be assumed that subjects affected by particularly serious malformations, which would have been classified as prodigia under the Republic, may well have died before legal proceedings in any of their aspects could be brought against them. This would explain why the matter only arises in very specific domains, such as inheritance rights. By virtue of the Julian and Papian laws, Augustus granted significant advantages to parents of at least three children. Hadrian increased these privileges by granting legitimate succession rights to freeborn mothers of three children and emancipated mothers of four (Justinian, Institutes 3.3.2; Ducos 2010: 87). A question arose as to whether or not a monstrous baby entitled a mother to the advantages of the ius trium liberorum. Ulpian answers positively (Digest 50.16.135), considering that parents cannot be held responsible for the deformity of their children, as they performed their duty of procreation; the birth of a deformed child should not preclude a mother’s rights. Paulus has a slightly different opinion (Digest 1.5.14). As the matter did not necessarily affect the rights of the main interested party, there was no question of sidelining them. In the same way, they were sometimes mocked or even humiliated. He [Commodus] displayed two misshapen hunchbacks on a silver platter after smearing them with mustard, and then straightway advanced and enriched them. (Historia Augusta, Commodus 11.2; transl. D. Magie) But there again, though they endured taunts, there was no question of any radical exclusion. They belonged fully to the entourage of the elite who could take their views into account. An ex-consul has recorded in his Annals that once at a large dinner-party, at which the writer himself was present, Tiberius was suddenly asked in a loud voice by one of the dwarfs that stood beside the table among the jesters why Paconius, who was charged with treason, remained so long alive; that the emperor at the time chided him for his saucy tongue, but a few days later wrote to the senate to decide as soon as possible about the execution of Paconius. (Suetonius, Tiberius 61; transl. J. C. Rolfe) While some belonged to the servile classes, others were freeborn, some of whom being from well-off backgrounds. Their physique does not seem to have called into question

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their affiliation to the first two orders of the Roman State. Pliny the Elder mentions Manius Maximius and M. Tullius who belonged to the equestrian order though they measured less than two cubits (7.74–5). This privileged status did not spare them from jeers, since Maximius was probably a nickname given out of mockery. Examples of figures with anomalous bodies within the elite are not uncommon. M. Sergius, Catilina’s forebear, became praetor despite his grave war injuries: he had lost one hand and his legs were severely handicapped (7.104). His colleagues did try to prevent him from officiating during religious ceremonies, but the sources do not reveal if they succeeded. This might signify that they probably did not succeed, all the more because the mutilations were gloriously acquired. Macrobius twice mentions a certain Galba, a hunchbacked lawyer and orator famous for his skills (Saturnalia 2.4.8; 2.6.3–4). Atypical bodies did not prevent assuming important offices and reaching high ranks, though they are regularly mocked in Roman literature because such mockeries were not viewed as improper. Yet, it is extremely rare to read of persons penalized because of their oddities. Obesity is one case mentioned (Laes 2016b: 606): On the custom of the censors of taking their horse from corpulent and excessively fat knights; and the question whether such action also involved degradation or left them their rank as knights. The censors used to take his horse from a man who was too fat and corpulent, evidently because they thought that so heavy a person was unfit to perform the duties of a knight. For this was not a punishment, as some think, but the knight was relieved of duty without loss of rank. Yet Cato, in the speech which he wrote On Neglecting Sacrifice, makes such an occurrence a somewhat serious charge, thus apparently indicating that it was attended with disgrace. If you understand that to have been the case, you must certainly assume that it was because a man was not looked upon as wholly free from the reproach of slothfulness, if his body had bulked and swollen to such unwieldy dimensions. (Gellius, Attic Nights 6.22.1–4; transl. J. C. Rolfe) It is not clear if the loss of their horses was experienced as a disgrace. Those concerned, whose corpulence was the cause of their horses being confiscated, cannot have endured the measure with serenity. Was it mere pragmatism, on the principle that an obese person cannot make a good horseman? Or was it a punishment for a lifestyle judged decadent? Be that as it may, if anomalous bodies were teased, railed, and occasionally discriminated against, under the Empire they were not systematically marginalized, only on occasion at the most, albeit neither does it seem that they were fully integrated. 1.4.3. How did those with defective bodies feel? How those with defective bodies perceived their own condition is particularly hard to recover, as sources seldom record their own accounts (Dettwyler 1991: 375–84; Boutin 2016: 17–28). Did they view themselves as outcasts? Clues are rare, since Roman authors did not usually belong to this category. A feeling of shame sometimes transpires in records, but it is not inherent to these persons themselves because it is generated by the judgment of others who deem that they overly deviate from the standard established by society itself. Cicero claims that people experiencing a physical anomaly did everything they could to conceal it, preferring to keep up appearances even at the cost of impairing mobility. To start with the body, do you notice how men try to hide a deformed or infirm or maimed limb? They actually take great pains and trouble to conceal, if they possibly

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can, their bodily defect, or at all events to let it be seen as little as possible; they even undergo painful courses of treatment in order to restore the natural appearance of their limbs, even though the actual use of them will not only not be improved but will even be diminished. (Cicero, De finibus bonorum et malorum 5.46; transl. H. Rackham) Some were ready to resort to surgery to end their stigma. Medical grounds for such recourse cannot be excluded, but in an age where aseptic precepts were unknown, an operation considered benign by modern standards could have been thought of as a considerable risk. The simple correction of polydactylism described by Paulus of Aegina (6.43) and Oribasius (Medical Collections 47.15) could be mortal if infection set in. No less so was the prospect of “curing” androgyny by the knife (Paulus of Aegina 6.69). There is no way of knowing if these operations were in effect practiced, and if so, how often. Nevertheless, the fact that they are mentioned in medical treatises reveals a desire to reintegrate deviant bodies into the norm, even if it only remains within the realm of literature. In theory, war injuries were proudly displayed as marks of bravery by soldiers ready to sacrifice their physical integrity for the sake of the fatherland. There are, however, clues in the literature that maimed warriors could be ashamed of their condition. For his mother’s words to Spurius Carvilius, who was sadly lame from a wound received on national service, and for that reason shy of walking abroad, “No no, my Spurius, go out! and let every step you take remind you of your gallantry,” are noble and dignified. (Cicero, De oratore 2.249; transl. E. W. Sutton, H. Rackham) Plutarch reports two similar stories. The first tells of a discussion between Alexander and Philip II on the latter’s limp, which he found embarrassing (On the Fortune or the Virtue of Alexander 331b–c). The second records three different cases of mothers urging their sons not to be ashamed of their war injuries (Sayings of Spartan Women 241e–f). More than from the circumstances in which the wounds were received, the notion of shame derives from the vocabulary used to designate the ugliness of the wounds. Celsus uses indecorus (8.10.5) and foedus (8.10.7) to qualify the shortening of a leg following a bone fracture, which caused a claudication. These epithets convey the sense of dispossession of beauty (Monteil 1964: 343) with an implication of shame and indecorum and implying moral as well as physical ugliness, beauty being assimilated into decus (i.e., what is decorous) (Arnaud-Lesot 2012: 46–51; Baroin 2015: 32–5). Physical impairment, in this case limping, casts the body beyond respectability. Lacking decus, the body no longer fits the norm, which can generate a feeling of shame. It is conceivable that self-exclusion mechanisms could lead to shunning society through fear of the potential reactions of those met. But such an attitude cannot be generalized because the opposite was also true, as sources show with the example of Sertorius who was proud to exhibit his injuries, particularly his missing eye (Gellius, Attic Nights 2.27). The consideration given to atypical bodies cannot receive a single definition. It depends on the judgment of the onlooker, which varies according to an extensive number of criteria: not only type of abnormality, gender, age, and social status, but also the period and location of the subjects in question. In essence, malformed bodies would likely have been assessed on a case-by-case basis. The treatment they received would have varied from one to another in view of the difficulty of defining what, precisely, was deemed to be a transgression. How far could a deviation extend and still be judged acceptable?

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Where did abnormality begin? It would appear impossible to give categorical answers these questions, all the more so since the way abnormal bodies were regarded appears to have evolved from Republican to Imperial times. Often, it has been shown, repulsion and taunts were not due so much to the physical aspect of the bodies themselves as to the symbolic values, the deviances, and the portents associated with them. Their social standing was ambiguous, neither entirely rejected nor really integrated. They stood midway between.

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CHAPTER TWO

Mobility Impairment Identifying Lived Experiences in Roman Italy EMMA-JAYNE GRAHAM

2.1. INTRODUCTION At an unknown moment in the second or third century CE, mourners gathered in a cemetery at Casalecchio di Reno (near modern Bologna, Italy) to bury the remains of a member of their community. The remains of the adult man they laid to rest were inhumed in a simple grave, like those of the majority of the other members of the necropolis population. In death, the man’s body was no different from those who had been interred before him. However, when his skeletal remains (T.130) were discovered by archaeologists almost two millennia later, they presented a slightly different picture, revealing evidence for severe degeneration of the bones of the right leg, especially the head of the femur and “nearly complete anchylosis [fusing] of the right hip joint,” which had fixed the leg in “a semiflexed position (about 70°–80°),” the foot unable to touch the ground (Belcastro and Mariotti 2000: 530–1). Although the cause of this condition is uncertain, the man’s response to it was clear: further skeletal degenerative changes point toward regular compressive forces affecting his upper limbs, including his wrists and hands, with slightly different osteological consequences for the right and left sides of his body, while the locations of muscle attachments in his shoulders and elbows suggested that regular weight-bearing had led to his arm muscles becoming particularly well developed (Belcastro and Mariotti 2000). In short, bioarchaeological study of the man’s remains indicated that during life he had possibly mitigated the “severe difficulties of deambulation” (Belcastro and Mariotti 2000: 530) caused by the damage to his right leg by making use of external supports, probably “two different types of crutches (such as a stick and an axillary crutch) or a different distribution pattern of the body weight on the crutches” (Belcastro and Mariotti 2000: 538). At least four centuries earlier, during the third century BCE, and approximately 375 kilometers (233 miles) further south in Italy, visitors to a popular sanctuary located on the northwest outskirts of the Latin colony of Fregellae brought offerings in the form of terracotta body parts to dedicate to the deity (or deities) whose healing powers were celebrated at the site of a spring. These so-called anatomical votives would number around 4,346 by the time that the monumentalization of the sanctuary in the midsecond century BCE effectively brought an end to the practice, with a large proportion of these objects (54 percent) taking the form of models of feet (1,654) and legs (685)

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(Ferrea and Pinna 1986). Gifts to the gods such as these are commonly interpreted as offerings intended to seek or to give thanks for divine intervention associated with vows concerning well-being, healing, or other bodily concerns (Flemming 2016; Graham and Draycott 2017; Hughes 2017). The large quantities of feet and lower limbs dedicated by suppliants at Fregellae, and indeed at similar sites (Graham 2017), suggest that in Italy during the mid-Republican period it was commonplace for large numbers of individuals to experience diseases, injuries, deformities, and other impairments connected with their lower limbs, not to mention consequent mobility limitations. These conditions and experiences evidently drove them to seek support or relief from the realm of the divine. These opening examples spotlight two (not mutually exclusive) responses to, and sources of evidence for, experiences of mobility impairment in the ancient world. Together they also raise a series of questions: What was the cause of the impairments these people experienced, how common were they, and how was the resulting non-normative ambulation exhibited by mobility-impaired individuals perceived, interpreted, and responded to by other members of their community? How did their perception of themselves compare with that of society more widely? In other words, did these impairments mean that they were considered to be socially disabled, or were their bodies merely one of many expressions of somatic difference in a world of imperfect bodies? These examples, and the questions that they raise, ultimately lead to more nuanced queries about the experience of living in Antiquity with impaired mobility. These are the questions and issues that this chapter seeks to explore. In particular, it aims to better define ancient “mobility impairment,” moving beyond problematic documentary discourses on “the lame” in order to review evidence for the causes and consequences of mobility impairment that have largely been overlooked (at least from the perspective of ancient disability studies). In doing so, it seeks to consider the ways in which an interactional approach to mobility impairment, focused upon lived experience, makes it possible to bring ancient disability studies into more productive dialogue with other aspects of ancient society, especially questions of identity. Finally, it will suggest what the consequent implications might be for understanding “disability” in the ancient world and, briefly, where the future of this area of research might lie. First, however, a disclaimer and some parameters. Evidence derived from paleopathological analysis features heavily in the discussion that follows, but it must be stressed at the outset that this chapter is not a bioarchaeological study (nor does the author claim to be a bioarchaeologist). Instead, the published results of expert analyses of human skeletal remains are presented and recontextualized in relation to a broader examination of questions concerning the social identification and consequences of mobility impairment. In line with recent work, this discussion therefore seeks to demonstrate the potential value of establishing a bridge between evidence derived from bioarchaeological studies and social theory, particularly in relation to the exploration of the lived consequences of impairments (e.g., see Graham 2013; Southwell-Wright 2013; Zakrzewski 2014; Boutin 2016; Byrnes and Muller 2017). Moreover, this chapter focuses, by choice, on forms of archaeological evidence and material culture that are sometimes sidelined in favor of historical and medical texts in studies of ancient disability (although see Southwell-Wright 2013) and, by necessity, on Roman contexts, for which these sources and questions have been more fully explored and for which the available data are more substantial.

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2.2. MOBILITY IMPAIRMENT: CATEGORIES, TERMINOLOGY, AND APPROACHES Ancient mobility impairment has been examined primarily from the perspective of textual and iconographic sources, with many studies limited to unusual or unique figures such as Macedonian King Philip II (Samama 2013), Roman emperor Claudius (Emberger 2012), and the god Hephaestus/Vulcan (Deris 2013). Others have assessed particular contexts or sources, most notably Lysias 24, On the Refusal of a Pension to the Invalid, in which the “able-ness” of an unnamed defendant is examined and debated before the Athenian Boule in the late fifth century BCE (Dillon 1995; Edwards [Rose] 1997; Bruce 2010: 257–63; Dillon 2017; M. L. Rose 2017). In addition, evidence has been sought from legal sources, such as the later Roman Digest, for ancient concepts of impairment including, but not restricted to, that affecting mobility (Toohey 2017). Unfortunately, the iconographic evidence for mobility impairment is, according to Livio Pestilli (2005: 86), especially limited: “there are no Roman artefacts that attest to a presence of lame mortals in the visual tradition.” Complementary material perspectives have been offered by studies that focus on anatomical votives and the pain caused by physical impairments affecting movement (Graham 2017; forthcoming), whereas others have united contemporary disability studies with an investigation of functional prostheses (Draycott 2014; Adams 2017). In contrast with other impairments, there remains no extended period-specific or multi-period survey devoted exclusively to impaired mobility. As a subfield, ancient disability studies has increasingly begun to move away from categorizing the impaired together with the monstrous and extremely deformed (the starting point for Robert Garland’s (1995) pioneering study). This has not been easy, however, especially when investigating physical or functional impairments such as those that might be associated with impaired mobility. There remains a propensity to categorize obvious physical deformity with forms of deviant or non-normative appearance, and to consider “human beings initial reactions towards what is ‘strange’—in the sense that they have not seen it before” (Laes 2017a: 6).1 In large part, this difficulty can be traced to the textual sources that continue to figure at the heart of discussions about ancient mobility impairment and describe it almost exclusively using (negative) terms of deformity. As Lisa Trentin (2011: 196) points out, “the words deformis, deformitatus, distortus, retortos, and informis are often used interchangeably to describe individuals with unusual (or ugly) physical features and/or obvious physical deformities.” Similarly, Livio Pestilli (2016: 13) describes “the obdurate, even contemptuous, response of ancient artists and societies to the orthopedically impaired body,” compared with that of late Antiquity and the medieval world. Nor are studies of the iconography of the “lame” god Hephaestus/Vulcan especially helpful, given that cultural attitudes toward the ways in which it was appropriate to describe or depict an impaired but nevertheless divine blacksmith were not necessarily the same as those for his mortal counterparts (Pestilli 2005; 2016; Deris 2013). Reliance on these sources makes it difficult to tease physical deformity and mobility limitation apart. While the latter can sometimes be a consequence of the former, this is not always true, or at least not to the extremes that have been supposed (Garland 1995; Vlahogiannis 1998; Kelley 2007; Bruce 2010; van Lommel 2015). The man buried at Casalecchio di Reno, for example, exhibited a visibly shortened leg, but this was hardly comparable with the types of deformity that Plutarch (Moralia 520c) describes as available in the so-called “monster markets” of Rome, where slaves could be bought who “have no calves, or who are weasel-armed or who have three eyes

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or who are ostrich-headed” (Trentin 2011: 197). Such extreme deformities may certainly not have been encountered regularly, if at all, by the Casalecchio di Reno community, but a person walking with the support of crutches may well have been a common sight.2 Furthermore, the causes of mobility impairment might be confined to the interior of the body and therefore invisible. How should these issues be resolved? Some scholars seek to avoid the ancient prejudices about deformity expressed in Greek or Latin terminology by assuming an entirely medical standpoint and by adopting modern clinical terms. This is not, however, without its own problematic by-products: while ancient medical writings are certainly obfuscated by their own “rhetorical layers,” such an approach ultimately “obscure[s] the conceptual and linguistic structures on which health itself was conceptualized” (Marx-Wolf and UpsonSaia 2015: 267). Similarly questionable are positions shaped primarily by an attempt to identify and extract “types” of physical impairment or deformity from ancient texts for self-contained study. Cutting and pasting comments and stereotypes from a number of sources means that different periods, a range of cultural contexts, and varied genres are subsequently “conflated to paint a falsely monolithic view of past practices” (SouthwellWright 2013: 71). In order to understand how mobility impairment was understood and experienced in Antiquity, alternative ways to evaluate it must therefore be sought. This chapter advocates a move away from questions based on traditional etic categorizations toward queries of an emic nature, which concern what it meant to be impaired in Antiquity. How was mobility impairment experienced in multiple ways, and how can exploring these experiences offer new perspectives on ancient society and the other identity groups (social status, gender, age) that historians use to frame their investigations?3 As Heidi Marx-Wolf and Kristi Upson-Saia (2015: 266) have pointed out for studies of disability in late Antiquity, there is a tendency in existing scholarship to ignore this type of question. However, as demonstrated below, a more complex understanding of experiences of impairment has the potential to nuance other identity categories in ways that challenge prevailing understandings of ancient society. These issues have gained ground within the wider field of disability studies, belonging to the kind of interactional approach advocated by Tom Shakespeare (2006) and Christopher Riddle (2013a; 2013b). Interactional theory seeks to understand experiences of impairment, especially those that arise as a consequence of a complex interweaving of an underlying physical impairment (such as that affecting the body of the man from Casalecchio di Reno) and the world in which a person lives (the social and cultural context in which he experienced that condition, or how it was “lived”). Acknowledging that “impairment has both physical and social dimensions” (Riddle 2013a: 32) consequently compels us to think about what the experience of a physical impairment might mean in discrete settings and in relation to discrete social contexts. Requiring a more nuanced exploration of the extent to which these experiences were significant for determining both personal identities and wider social attitudes, interactional theory demands that investigations of (ancient) impairment and disability are integrated into more longstanding studies of society, identity, and lived experience. In this way, interactional theory empowers the impaired individuals of Antiquity to contribute to the shaping of the questions that are asked about both ancient society and about disability as a social construct. With this in mind, this chapter advocates a definition of, and an approach to, mobility impairment that is distanced from concepts (ancient or modern) of deformity or “the cripple.” It focuses instead on how experiences of mobility limitations might be identified and interpreted, spotlighting both their disabling and abling aspects and intentionally

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disrupting the normative/non-normative binary (Graham 2013; Zakrzewski 2014).4 For this reason, it does not seek to establish a checklist against which an individual’s body might be assessed and the extent of any consequent mobility impairment determined, nor does it presume that certain predetermined conditions must be exhibited in order for an individual to be deemed to have experienced impaired mobility.

2.3. IDENTIFYING MOBILITY IMPAIRMENT IN THE ANCIENT WORLD This chapter focuses on archaeological sources, specifically those connected with the representation of the body in object form (votive offerings) and human skeletal remains (bioarchaeological and paleopathological evidence). Both involve interpretations that relate to retrospective diagnosis (sometimes also referred to as icono-diagnosis or retrodiagnosis), which can be defined as “the application of the diagnostic terminology of our times to historical case reports, which have been transmitted either by texts or artefacts. Retrospective diagnosis then is modern in its medical methods and results, but it is historical in the object which is diagnosed” (Leven 2004: 369–70). In other words, traditional retrospective diagnosis might infer from the recovery of votive offerings in the form of eyes the presence of individuals with visual impairments at a sanctuary, or result in the skeletal remains of an individual being “diagnosed” with Pott’s disease (spinal tuberculosis: for an example, see Piccioli et al. 2015: 133–6). However, as Karl-Heinz Leven (2004: 372–3) cautions, while it is probable that biological conditions such as Pott’s disease existed in Antiquity, ancient communities understood and interpreted the world in ways that were significantly different from those of today, including viewing it through what modern people would consider to be strictly non-biological lenses (i.e., in relation to prevailing sociocultural and religious preconceptions).5 From the perspective of an ancient individual, then, a diagnosis of Pott’s disease would have been meaningless, not only because diseases were not described, categorized, and treated in the same (comparatively) standardized way as they are today, but also because the ways in which they were experienced via the body was grounded in functional and sensory symptoms that are not necessarily perceived in universal ways. For example, an individual may not have expected that the disparate symptoms they experienced in discrete parts of their body possessed a single cause. Moreover, in the case of Pott’s disease, one of the most severe complications arising from tubercular infection of the spine can be paraplegia (loss of motor and sensory function of the lower limbs), but this may not present for “a very long period, varying from 20–30 years after the healing from TB [tuberculosis] active phase” (Piccioli et al. 2015: 135). Loss of feeling in the lower limbs might therefore occur if not spontaneously, then certainly unexpectedly, and was unlikely to be connected with the very different set of TB symptoms experienced several decades before. In short, acute trauma aside, disease and other bodily conditions that may have resulted in impaired mobility were not thought about, nor indeed experienced, in the same way as they are today, even if their fundamental biological manifestation was identical. On the one hand, then, biological data offer more direct evidence than ancient written textual descriptions of the symptoms or consequences of impairment, since they are not filtered through such complex cultural lenses. This circumvents some of the concerns outlined above but, on the other hand, the consequences of these bioarchaeological observations require careful interpretation, and bridging the gap between formal biological diagnosis and ancient experience remains challenging. It is not, however, impossible,

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and with these caveats in mind, retrospective diagnoses support the following discussion. Here, however, they are treated as a prompt for further investigation, intended to ground an impairment in somatic experience rather than to provide a definitive “answer.” After all, “without the biological component, there is no social component to disease [and impairment]. They are irreconcilably linked” (Mitchell 2011: 86). The remainder of this chapter suggests more positive ways in which this evidence might be used to better understand experiences of ancient mobility impairment.

2.4. ANATOMICAL VOTIVES AS EVIDENCE FOR MOBILITY IMPAIRMENT Despite Pestilli’s (2005) dismissal of artefactual evidence, anatomical votives such as those described above from Fregellae certainly attest to the presence of “lame mortals” at mid-Republican sanctuary sites in Italy (fourth to first centuries BCE). These objects may not have been part of a wider visual tradition of depicting functional impairments, but producing and dedicating models of the body and its constituent parts was certainly a significant aspect of prevailing religious traditions and healing practices during this period. What is more, the frequency of foot, knee, leg, and lower torso models within votive assemblages suggests that many individuals traveled to sanctuaries in order to seek or thank the divine for intervention in parts of their body that might be directly connected with mobility (Graham 2017; forthcoming). Indeed, these types are among the most common finds, with at least one example of a foot/lower limb found in over 50 percent of all known anatomical votive assemblages (Graham 2017: 254–5). Total numbers within an assemblage range from one or two examples into the thousands: excavations at Ponte di Nona (Latium) revealed 2,368 feet, or 38 percent of a total assemblage of 6,171 (the next largest group consisted of hands, at 17 percent of the total) (Potter and Wells 1985). Of the total number of reported anatomical votives from the Tiber at Rome, 58 percent were feet (402) and legs (16) (Pensabene et al. 1980); at the Ara della Regina temple at Tarquinia (Etruria) these types comprised 33 percent of the deposit (Comella 1982); while the 2,339 feet/legs (54 percent) from Fregellae have already been noted. Although these types of anatomical votive are not known from all of the sanctuaries across central Italy, and at others are outnumbered by different types (especially uteri), and while non-healing motivations such as a plea for a safe journey may be attributed to some of them, they do demonstrate that large numbers of individuals with (potentially) impaired mobility visited sanctuary sites. In this respect, they support April Pudsey’s (2017: 24) observation, based on demographic evidence for health more generally, that “in all likelihood, hundreds of thousands, if not millions, of living people in the Roman world would have been experiencing disability [impairment].”6 The location of these finds is also revealing, with their presence at both “urban” and “rural” sites confounding any notion (e.g., Potter and Wells 1985) that injuries or conditions affecting the feet and lower limbs would be experienced primarily by individuals engaged in agricultural activities. Indeed, the dedication of foot/leg votives at urban sites parallels bioarchaeological evidence from later periods of Roman history that suggests that lowerstatus individuals buried within cemeteries close to areas of intense industrial activity in the Roman suburbium demonstrate often severe physical impairment, most likely a consequence of working in tanneries, fulleries, and brickworks and engaging in other forms of manual labor (Musco et al. 2008; Graham 2013; Piccioli et al. 2015).

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Caution must be exercised when interpreting anatomical votives since the majority do not indicate what specific condition, injury, or impairment led a petitioner to seek divine support.7 Nonetheless, it is possible to speculate—as a starting point only—about the range of requests that might have been associated with these objects based on the fact that they depict parts of the body in which particular sensory or motor impairments might manifest. Although it cannot be asserted that these conditions were experienced by any of the votive dedicants, the range of hypothesized experiences is corroborated by the identification of these types of condition in paleopathological studies of cemetery populations (see below). Consequently, some might have referenced chronic conditions, such as clubfoot, fallen arches, or ingrown toenails (Potter and Wells 1985: 41–2), or “hidden” conditions, such as gout or osteoarthritis, all of which might result in painful ambulation or other mobility restrictions. Similarly, models depicting both legs may have signaled general mobility difficulties caused, perhaps, by sciatica or osteoarthritis, or possibly more substantial motor impairments brought about by spinal cord trauma, cerebral palsy, multiple sclerosis, or muscular dystrophy/atrophy (Graham 2017: 257). Acute foot or leg trauma, comprising fractures, dislocations, ruptures of the Achilles tendon, torn anterior cruciate ligaments, and other wounds, also remain possible. The extremely rare example of apparently “bandaged legs” reported for a votive deposit at Lucus Feroniae (Etruria) may indicate debilitating soft tissue injuries, ulcers, or osteomyelitis (Baggieri 1996: figs. 15–16). Regardless of the conditions themselves, what is most significant is that anatomical votives collectively suggest that “the bodies of visitors to a sanctuary might demonstrate a range of mobility impairments,” with the decision to dedicate a lower torso, leg, knee, or foot suggesting that these varied from “acute, temporarily debilitating ailments and injuries to chronic congenital anomalies or the result of more serious illness or accident. Together these objects commemorate the presence and actions of a host of differentially mobile people who engaged, in significant numbers, with religious activities within the ancient sanctuary” (Graham 2017: 257). From an interactional perspective, this evidence facilitates an investigation of the experience of mobility impairment in Republican Italy. Visiting a sanctuary to dedicate one of these objects incorporated an individual into a much wider community, not only of fellow religious petitioners, but also of people whose bodies moved (and were experienced) in disparate ways. While these living bodies animated the sanctuary, the fragmented terracotta bodies of previous visitors provided a “material attestation of the presence of [the] differentially mobile bodies” that had preceded them (Graham 2017: 260). The imagined communities that these bodies and objects produced must have reinforced to each individual their place within a community of somatic disparity. At sites such as Fregellae or Ponte di Nona, to limp, crawl, hobble, make use of crutches, wear a prosthesis, or be carried by others may well have been, if not the norm, then certainly not unusual. Such experiences might be affirming, even socially abling, as they emphasized membership within a discrete community, rather than drawing attention to individual physical and functional impairments and their potentially disabling consequences. Case study approaches to individual instances of mobility impairment have tended to close off this world of shared experience and its significance for the creation of embodied forms of collective identity. The search for historical instances of impaired mobility and society’s reaction to them (i.e., whether an impairment resulted in social disability) has also downplayed questions about how ancient individuals responded to their circumstances. Anatomical votives offer a way of evaluating these responses, suggesting that temporality played a role in

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determining what was and was not disabling. It seems unlikely that every ancient votive petitioner expected a total reversal of their symptoms, the removal of a debilitating condition, disease, or tumor, or the disappearance of an infected wound. Nevertheless, many evidently felt that it was worth a try, and worth the physical, potentially painful, effort involved in journeying to a sanctuary. Although this may imply that the experience of impairment was, for some, painful, distressing, or debilitating enough to require divine intervention, it also suggests a more positive, proactive response to it, indicating that individuals with mobility impairments did not merely withdraw or become automatically excluded from the shared practices of their social or religious communities. Indeed, the support of family, friends, and others may have been essential for completing a pilgrimage. Moreover, as Andrew Strathern and Pamela Stewart (2008: 67, emphasis added) have pointed out, “curing—the treatment of a specific isolatable disease syndrome—can usefully be distinguished from healing—the treatment of the person and their social relations as a means of dealing with the experience of illness and its resolution in recovery or otherwise.” In short, impaired petitioners may not always have expected the miraculous restoration of their former mobility, but almost certainly considered at least some forms of mobility impairment to be temporary or potentially alterable (i.e., healable). Together with an acknowledgment of the extent to which mobility impairment could shape a person’s sense of identity, this compels us to rethink any parameters that we might wish to establish concerning the ultimate consequences of mobility impairments, cautioning against assuming that impaired individuals were seen as permanently disabled, or indeed always identified themselves in relation to the perceived permanence of that aspect of their self.

2.5. PALEOPATHOLOGICAL EVIDENCE FOR MOBILITY IMPAIRMENT Bioarchaeological analyses have a major part to play in an assessment of ancient health and disease (Byrnes and Muller 2017). In the context of mobility impairment, this includes the subdiscipline of paleopathology, which can be “defined as the study of ancient disease in human remains from archaeological sites” (Roberts 2013: 79). Along with the identification of congenital and infectious diseases and levels of morbidity, paleopathology is concerned with the identification and study of trauma as it is evidenced on skeletal remains.8 As Leven (2004: 370) has pointed out, “Paleopathology applies modern methods to organic materials. It does not aim at retrospective but at modern diagnosis. There are, however, points of contact between paleopathology and retrospective diagnosis, where there is no sharp distinction between the two areas.” For this reason it must be used prudently: paleopathological data are a means to an end, and interpretation of their significance is dependent upon other aspects of bioarchaeological study (e.g., age, sex, ancestry), and upon context. Observing evidence for knee osteoarthritis need not, therefore, automatically signal the presence of pain, activity impairment, or, ultimately, social disability.9 As Charlotte Roberts (2000: 48) affirms, “conditions affecting the skeleton may be disabling, but this will depend upon their chronicity, upon the ability of the person concerned to adapt both physically and mentally, and on the attitudes, beliefs and care systems of the social group concerned.” In other words, paleopathological data must always be contextualized historically, socially, and culturally, as well as theoretically and in relation to the individual themselves (Gowland and Knüsel 2006; Zakrzewski 2014; Byrnes and Muller 2017).10

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The value of paleopathology to an interactional investigation of mobility impairment is demonstrated by the statement that “paleopathological analysis contributes an intensely personal perspective—there is little that has more immediacy than experiencing a pathology severe enough to leave markers on bone” (Tilley and Oxenham 2011: 40), as well as by the range of possible circumstances that such analysis might identify: conditions which may be identifiable include tumours (e.g., those affecting structures of the body such as the spinal cord and leading to complications); injuries, such as fractures and dislocations; congenital conditions such as cleft lip and palate, achondroplasia, osteogenesis imperfecta, myositis ossificans progressiva, and spina bifida (although the more serious disabling form—cystica—is unlikely to have been compatible with survival in the past); cerebral palsy; talipes (clubfoot); spinal deformities (which could also develop as acquired conditions through disease or trauma throughout life); diseases of the nervous system such as multiple sclerosis (which may be reflected in changes in the skeleton due to paralysis); cardiovascular system diseases (such as paralysis caused by blockage of a vessel with an embolism or thrombus); metabolic disorders such as rickets, leading to bowing deformities of the limbs; diabetes (potential damage to bones of the feet due to ulceration); osteoporosis, which can lead to fractures and disability; blood forming diseases such as anaemia (leading to general fatigue and weakness), and sickle cell (leading to death of bone tissue due to blocking of blood vessels with abnormally shaped cells) and thalassaemia (leading to associated fractures), cancers of the blood such as myeloma and leukaemia, circulatory disorders which lead to death of bone tissue at joint surfaces; endocrine disease such as a pituitary disorder, causing dwarfism or gigantism; joint disease such as osteoarthritis which may lead to joint fusion, and rheumatoid arthritis. In all these conditions, it is also necessary to be aware of the implications for involvement of associated soft tissues. (Roberts 2000: 48–51) Given the responsibility of the skeleton for the biomechanical functions of the body, it should perhaps not be surprising how many of the conditions cited by Roberts have the potential to be primary or secondary causes of mobility impairments. These range from paralysis to limping and/or pain, as well as bodily weakness that might produce balance problems or make physical movement labored and slow. Her summary also emphasizes that while different conditions might be the primary cause of impaired mobility (e.g., clubfoot), a great many more could bring about mobility difficulties as a secondary characteristic, symptom, or consequence of underlying, potentially invisible conditions (e.g., diabetes or fractures caused by osteoporosis). What is more, it serves as a reminder that an individual could experience more than one form of functional impairment, concurrently or successively. As a consequence, then, paleopathological evidence has the capacity to prompt an especially nuanced approach to mobility impairment in Antiquity, in that it requires the evidence for impairment to be assessed against different aspects of the World Health Organization (n.d.a) definition of disability. In particular, it spotlights the difference between impairment that might relate to mobility, in the sense of creating an “activity limitation” (e.g., making movement and tasks requiring balance possible but slow, painful, or otherwise difficult), and impairment that might bring about or otherwise result in “participation restrictions” that directly impact upon an individual’s ability to perform a task at all (e.g., because autonomous movement is entirely impossible or because of the consequences of a significant modification to the body or its method of locomotion). The

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first might be experienced by an individual and recognized by those with whom they interact closely, but not necessarily perceived by others, whereas the second might be much more apparent to the wider community. In turn, this raises new questions about the comparative visibility of impairment and its consequences for the production of ancient social attitudes (for more on this issue, see Laes 2018). Paleopathological evidence itself can be used to explore in more depth these observations concerning the conspicuousness, experiential, and temporal aspects of the potentially disabling consequences of impaired mobility. For example, the skeleton of a man aged forty to fifty years was excavated from an Imperial-period necropolis at Osteria del Curato in the Roman suburbium. Paleopathological analysis suggested that he may have had Type 1 Gaucher’s disease, a genetic condition characterized by “a non-specific and dull bone pain, generally periodic and chronic. … The crisis can be accompanied by fever, joint tumefaction and, in absence of treatment, rest is the only relief, thus limiting the disease duration to about 2–3 weeks” (Piccioli et al. 2015: 139). Symptoms of Type 1 Gaucher’s disease also include bruising and fatigue, with bone pain largely affecting the joints of the hips, knees, shoulders, and spine (Piccioli et al. 2015). The cemetery in which this man was buried was associated with the agricultural structures belonging to two villas, leading the excavators to posit a link with “the slave and wage worker units employed in the praedium” (Piccioli et al. 2015: 41). It is therefore likely that this man was involved in agricultural activities, although neither his upper nor lower limbs demonstrate evidence for modifications caused by heavy biomechanical stress (Piccioli et al. 2015: 137). Two things are immediately striking about this example. First is the extent to which any potential mobility impairment experienced by this individual was not distinguished by obvious or extreme physical deformity (in contrast to the emphasis placed on deformity in the studies noted above). Instead, it was largely invisible to the wider community, potentially evident to onlookers only in the manner in which he may have held or moved his body. Second, his experience was characterized by a (potentially unpredictable) combination of chronic circumstances and the periodic acute onset of short-term yet highly debilitating symptoms. At some moments this individual evidently possessed the physical ability to undertake the type of roles that his social circumstances demanded, meaning that even if his capacity was reduced in comparison with his colleagues, he was not necessarily permanently disabled in relation to those activities. Nevertheless, his condition meant that he was also intermittently immobilized and therefore became temporarily less able in relation to that context. Perhaps this accounts for the comparatively limited evidence for biomechanical stress on his bones when compared with other members of the cemetery population, indicating that his circumstances led to engagement in other activities more suited to his functional abilities. In sum, rather than his condition being disabling, it may be better described as being differently abling.11 The temporality of impairment/disability must also be borne in mind when investigating mobility impairments resulting from trauma. Evidence from the suburbs of Rome (Piccioli et al. 2015) points toward a high frequency of both well and poorly healed fractures, as well as widespread treatment for broken bones. Acute trauma, such as the fracture of foot, ankle, leg, pelvic, or vertebral bones, may have immobilized or otherwise affected the mobility of an individual in the short term, while these injuries might also have led to secondary bodily modifications that impaired a person’s subsequent mobility in comparison with their previous functionality (that is, from their experiential perspective they were more impaired than they had been before, but perhaps still less impaired than others). Accordingly, “the onset of illness or impairment

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during adulthood may be socially disabling, but the disability is a negotiation between the impairment and the pre-impairment personae of the individual” (Southwell-Wright et al. 2017: 11). Without intending to claim that individuals recovering from traumatic injuries were “disabled” or indeed long-term impaired, the prevalence of injuries, not only in Roman contexts but across the ancient world, may have been significant for determining social attitudes. Temporary forms of mobility restriction or ambulatory limitations must be interpreted in a context in which many people experienced some form of acute trauma, or knew someone who had: in Antiquity, there could be no entirely objective observer or objective experience of impairment (for an overview of the many accidents and injuries that affected ancient children, see Graumann 2017). Similarly, those who became long-term impaired may have experienced short-term mobility limitations at other points in their life course (e.g., a healed femur fracture followed by later debilitating osteoarthritis), and these experiences might have led people to expect an eventual return to near-full mobility in many instances (a hope expressed by those who deposited votive offerings). Personal experiences of short-term impairment may subsequently have impacted upon shared understandings of what impairment—and therefore disability—entailed, possibly even rendering ancient communities less quick to judge than modern scholars who seek to identify apparently “conclusive” examples of socially disabling impairments.

2.6. CASE STUDY: A MAN FROM ERCULAM In an excellent study, Nancy Lovell (2016) recounts the case of an “older adult” male, buried during the late first or early second century CE in a cemetery at Erculam (also known as Herculia), in the Campania region of Italy. His remains, buried a cappuccina in a pit covered with tiles, were treated in the same manner as the other members of the low-status local community, with its economy based on fishing, agriculture, and mercantile activities (Lovell 2016: 91). During life, the man had “sustained a fracture of the [right] femoral neck that reduced the femoral neck angle and resulted in leg shortening,” and while this hip fracture had healed, the bones of his foot underwent subsequent alterations that suggest that “the man limped whilst bearing weight on the toes of his right foot” and did not use a crutch (Lovell 2016: 91, 93). His skeleton also demonstrated evidence of other trauma, including healed and unhealed rib fractures, one of which points toward an injury “only weeks before his death,” osteoarthritis in both lower limbs that may have been linked to the original trauma as well as being subsequently exacerbated by it, and crush fractures to the vertebrae (Lovell 2016: 94). In sum, before he died, this man’s body had undergone a series of traumatic incidents, some of which had healed but all of which had lasting consequences, the most significant being the fracture of the femoral neck (hip). According to Lovell’s (2016: 92) analysis, this was most likely caused by a fall from standing height brought about by an event such as a trip, slip, or turned ankle, with the individual’s preexisting osteoarthritis rendering his bones susceptible to fracture from indirect trauma. Lovell (2016: 93) notes that “the impact of the injury on his quality of life would have been immediate and also long lasting,” before observing that even when treated surgically in the modern world “six months after sustaining a fracture, just 15% of hip fracture patients can walk across a room unaided and some 25% of those who were ambulatory before a hip fracture require long-term care afterwards.” The consequences were significant for the man from Erculam, as Lovell describes:

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It seems likely, then, that shortly after the injury this man was carried home and put to bed, and then he was assisted when he attempted to sit, stand, and, eventually to walk. … Although he was no longer a young man, it is reasonable to assume that, given his social status, he was not able to retire from wage earning or contributing to his family’s well being. Although he survived his injury by many years, he would not have been able to return to most tasks associated with a fishing or agricultural way-of-life, other than those tasks that were sedentary (e.g., mending nets, sharpening tools), and if he worked as a merchant, his activities would have been limited to those that did not require him to carry goods. (Lovell 2016: 93) Most significantly, Lovell (2016: 94) concludes that his equal treatment in death demonstrates that “while he may have been recognized as mobility impaired, he was not socially identified as disabled.” Her hypothesized account of the experiences of the man from Erculam also offers an opportunity to explore in more detail questions raised above about temporality and visibility, especially the extent to which mobility impairment might be experienced differently at particular moments and in varied contexts. Some of the potential (but far from certain) experiences of this individual are summarized in Table 2.1. The modifications to the foot of the man from Erculam attest that his body adapted to a new way of life that included continued mobility: he did not remain immobile for

TABLE 2.1  Summary of the potential experiences and consequences of impaired mobility for the man from Erculam Time frame

Experience

Visibility

Immediate post-injury

Effectively invisible to the wider Traumatic internal injury and acute, severe pain, total immobilization, focus community, but very visible focus of household community on addressing the cause of pain and treating injury

Recovery period

Continued variable degree of severe pain, movement limited to sitting/ standing and eventually walking short distances, focus on physical adjustments and recovery of functional mobility

Visible to household and periodically to wider community if able to leave the house, but restricted by travel over short distances, possibly seen receiving physical support from others

Post-recovery period

Intermittent chronic pain of varying degree due to underlying osteoarthritis and degenerative joint disease in knee/ foot linked to consequent locomotor modification, altered spatial experience and limited autonomous movement within public spaces, acceptance of new gait, new way of life, new activities, and new social identity

Visible to community when moving, visibility heightened by unusual gait, reduced speed of movement, possible use of staff/walking stick for balance (Lovell 2016: 94); if sedentary during occupational activities physical impairment may have been temporarily invisible, although possibly inferable based on gender, age, and unimpaired upper body

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Time frame

Experience

Visibility

Long term

Degenerative joint disease might not be painful but may impact upon mobility/ balance/frailty, further acute trauma (rib fracture), potentially increased dependence on others

All of the above continued but aging and further trauma might have prompted retreat to former house-bound, temporarily immobile state, increasingly visible to family and less visible to wider community

Death

Burial organized by relatives/friends, corpse treated in the same way as others

Consequences of impairment completely invisible

the remainder of his life. The implication is that he probably engaged in social and/or economic activities, even if those involved tasks or contexts that differed from those he experienced before his injury, or from what society expected of a man of his age and social status. Tilley and Oxenham (2011: 40) suggest that “where aspects of individual response to pathology can be inferred, this may provide clues to personality,” and his decision not to use a crutch, unlike the man from Casalecchio di Reno with which this chapter began, may be significant in this context. While this may have been a practical decision, connected with the extent to which it was necessary for his needs, it may also have been linked to the way in which he sought to “able” himself in new ways: freedom from a crutch may have intentionally or unintentionally enabled access to places, engagement in activities, or participation in social communities that would otherwise have been inaccessible. In many ways, then, rather than being disabled, the man from Erculam is, like many of the other individuals noted above, better described as “differently abled” at different moments, in different contexts, and in relation to different types of social role or activity. Lovell (2016: 94) reaches a similar conclusion, noting that “a fluid boundary exists between disabled and able-bodied individuals, since a disability may not be permanent or may manifest in only certain circumstances” (see also Zakrzewski 2014: 63–4). His experiences, and those of the people who cared for him, in life and in death, also challenge any uncritical assumption that people with impairments in Antiquity either were, or were not, excluded from society, complicating this picture by presenting a range of temporal and contextual experiences and possible identities existing between these rather diametrically opposed extremes. Indeed, Byrne and Muller (2017: 5) stress, with reference to recent work on the bioarchaeology of care, that “disability is both contextual and situational,” and as Table 2.1 suggests, the man from Erculam may not only have been considered more or less able at different points in his life course, but even at different moments in his daily activities. This example, together with the discussion of anatomical votives, indicates that when determining the social consequences of mobility impairment, a number of factors were at play that have consistently been overlooked by previous studies. These include the activities an impaired individual chose or was compelled to engage in, where, when, and with whom they performed those activities, and how evident their impairment was at those moments, as well as their own personal response to their circumstances.

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2.7. CONCLUSIONS Was there a difference in the social attitudes expressed toward mobility impairments that were caused by trauma, disease, lifestyle, or genetic (hidden) conditions? Current scholarship tends to assume that the loss of a limb or other catastrophic injury resulting from warfare might have been considered a marker of particular social status, whereas the restricted movement of an individual whose vertebrae had fused together and whose condition was further exacerbated by years of physical labor (severe lumbar spondyloarthritis: Piccioli et al. 2015: 93–4) would be indicative of lower social status. From here it is easy to take a short step toward the assumption that mobility impairment was a visual indicator of a person’s place in the social hierarchy. But as many of the examples cited above have demonstrated, the causes of mobility impairment were often hidden from the casual (and even from the less casual) observer, as well as from the person experiencing it. In order to make inferences about social status, occupation, or any other aspect of identity, the ancient observer required other clues: dress, the context in which they moved, the activities they performed, age, and gender. Those studying their remains from a distance of two millennia are required to contextualize their conclusions in the same terms, as well as to “interrogate the notion that the self is fixed across time and space” (Byrnes and Muller 2017: 5), in line with recent theories of (biological) personhood (Boutin 2016). With a focus on bioarchaeological and material evidence, this chapter has reiterated the importance of approaching ancient functional impairment and social disability in terms of a somatic spectrum of disparate biological bodies and diverse lived experiences. In this way, it has demonstrated the value of applying an interactional approach to the evidence from all corners and periods of the ancient world, drawing together the fragmentary evidence for both medical impairments and social identities to explore what it was like to experience, and to be seen to experience, mobility impairment. By highlighting questions of temporality and visibility, the need has been emphasized for more fluid concepts of ancient “mobility impairment” and “disability” that acknowledge the significance of nonbinary experiences. An individual may certainly have been excluded from socioeconomic activities as a result of a physical impairment that limited or altered their mobility (something that in traditional terms would render them socially “disabled”), but in the context of other socioeconomic activities that person may be better—and more positively—categorized as “differently abled.” An individual might therefore be both disabled and differently abled at the same time, their inclusion in the former category not necessarily overriding or surpassing the latter in terms of its significance to an individual or their community, since experiences of impairment and the identities that resulted from them were always situational. Nevertheless, many questions remain about mobility impairment in Antiquity, not least concerning the experiences and social identities of the long-term immobile or those with differing degrees of paraplegia or quadriplegia.12 Nor have studies begun to fully explore how identities produced in relation to physical impairment changed over time and space, or intersected with other aspects of ancient identity, such as those connected with other forms of sensory (Chapters 4, 5, and 6) or cognitive impairment (Chapters 7 and 8), or with religious identity, gender, or age (Zakrzewski 2015). For example, in both past and present contexts, frailty and physical impairments that limit or alter mobility put elderly individuals at higher risk of abuse. Was the same true for the long-term immobile of Antiquity, who were also physically dependent on others?13 Rebecca Gowland (2016;

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2017) advocates bringing these areas together, drawing attention to the underdiagnosis in paleopathological analyses of bone lesions (decubiti) that, by attesting to the presence of pressure sores, provide an indirect indicator of immobility (i.e., bed- or chair-ridden individuals). She also highlights common clinical indicators of physical abuse that, although primarily “located on the face, neck, thorax, genitals and hands,” also include multiple rib fractures: “fractures in various stages of healing are much more suggestive of abuse than a single trauma event” (Gowland 2016: 517). How might our interpretations change if the older adult man from Erculam, with his healed and unhealed rib fractures, was placed into this context? His rib may well have been fractured in a fall, perhaps due to an imbalance caused by walking on his toes, and rib fractures “are not definitive evidence of abuse” (Gowland 2017: 79), but nevertheless, an interactional approach to impairment and the life course should at least encourage more probing questions about experiences of ancient mobility impairment such as his.

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CHAPTER THREE

Chronic Pain and Illness Pain and Meaning: Interpreting Chronic Pain and Illness in Greco-Roman Antiquity LAURIEN ZURHAKE

3.1. INTRODUCTION October 144 CE When I was brought from Italy, I had contracted by ill luck many varied ailments [πολλὰ καὶ παντοῖα συνειλοχὼς τῷ σώματι] from constant sickness [οἱ συνεχεῖς κάματοι] and the stormy weather which I experienced while departing through Thrace and Macedonia, for I left home while I was still sick. The doctors were wholly at a loss not only as to how to help, but even to recognize what the whole thing was.1 (Aelius Aristides, Hieroi Logoi 2.5) Aelius Aristides was famous not only for his oratory, but above all for the constant pain and diseases that often “disabled” him from practicing his occupation. In the passage from the Hieroi Logoi quoted above, Aelius Aristides states that even doctors could not find the reason behind his illness that would enable proper treatment. He experienced a pervasive and complex phenomenon that remains poorly understood even today: chronic pain. According to current anthropologists, medical doctors, and the World Health Organization (WHO), chronic pain represents a growing epidemic in the West (Jackson 2000: 3; Driessen 2004: 151–2; National Institute of Health 2011). A quarter of Europeans are thought to experience chronic pain.2 Painkillers and other pain management methods continue to be developed at a rapid pace and are in high demand. This tendency is, as Turner points out, a consequence of changes in West European culture and mentality that took root in the nineteenth century (1980: 80–2). At that time, the incipient development of anesthetics led to an increasing desire for a higher, pain-free standard of living that, in turn, resulted in an increased “pain sensitivity.” It is in this way that Homo dolorosus, the patient (completely) controlled by pain, was born (Brena 1972: 127). One of the unintended and unwanted consequences of this “chronic pain epidemic” is that those experiencing chronic pain are often rendered “disabled” on physical, psychological, and social levels. The anthropologist Henk Driessen speaks of a process of social death (preceding and/or opposed to actual physical death), as many experience social isolation, fear, and depression due to a loss of credibility and respect that in turn lead to the alienation of friends, colleagues, and family (2004: 146). In other non-

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Western societies, however, such as the Iqwaye tribe in Papua New Guinea, chronic pain rarely occurs. The reason for this has been traced to the manner in which this tribe deals with pain: when an individual member of the tribe is ill or injured, his or her pain experience becomes the collective pain experience of the entire tribe. In this way, pain is acknowledged, shared, and given meaning (Driessen 2004: 151–3). The difference between someone who experiences chronic pain in the Western world and someone from this tribe, who may also have to cope with pain on a daily basis, is that the former is controlled and consumed by the pain, whereas the latter, through support from the tribe, is not. Cultural differences thus not only play a significant role in pain management, but may also determine whether chronic pain “exists” in a given society. What are we to do when, as in Aristides’ case, pain is no longer a symptom of perceptible tissue damage, but has developed into a disabling disease in its own right without a visible physical origin? What role did chronic pain and illness play in the Greco-Roman world? Did a concept of chronic pain or a set of chronic pain definitions exist, and if so, did they change over time? How was chronic pain perceived, experienced, and expressed? What kind of cultural pain codes existed and where can we find them? In order to answer these questions accurately and to avoid anachronism, it is first necessary to take a closer look at the modern understanding of chronic pain and its impact on theoretical and methodological approaches to chronic pain and illness in past societies. Moreover, since this chapter examines chronic pain and disease over a time span of 1,000 years, not every detail can be given equal attention (and indeed many details have been lost in transmission). A representative selection of ancient medical treatises, tragedies, letters, and memoires therefore provides the basis. The analysis is rounded off by several more detailed case studies of historical persons who recorded their symptoms and chronic pain experiences over a longer period of time. The chapter is structured thematically, with each section providing a chronological overview of a particular aspect.

3.2. CHRONIC PAIN AND ILLNESS: WORKING TOWARD A SUITABLE RESEARCH APPROACH A modern case study can help to problematize the poorly understood phenomenon called chronic pain. To this end, I would like to introduce Sebastian Brosche, a Brazilian jiu-jitsu black belt and yoga teacher, whose story paradigmatically shows how modern medical research interprets chronic pain and how complex and culturally specific chronic pain is. Brosche started practicing yoga because of chronic lower back pain. “Goddamn, it feels good not to have back pain,” he says when describing the success with yoga. “Life is full of flowers, rainbows and unicorns when your spine is healthy.”3 This amusing and intriguing statement exemplifies a problem with which people struggle today and struggled with in Antiquity: How does one deal with and express continuous pain that changes one’s sense of “normality” and impacts and impairs daily life? This question prompts one to consider the role pain plays in our “normal” lives. How do we—and people in ancient cultures—perceive pain and what role is given to this pain? Is a “healthy” life necessarily pain free, as seems to be the norm today, or is pain simply a part of life and survival? In Brosche’s case, living without pain felt like being in a fantasy world, as if such a state were abnormal; his description indicates that being in constant pain changed his sense of “normality.”4 It is therefore important for this study to establish how Greeks and Romans viewed the role(s) of pain in ordinary life and whether chronic pain challenged and changed that view.

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This brings me to a second important point, namely that Brosche also mentions having a completely degenerated spinal disk. The disk, which he had repeatedly herniated over the course of six years, would generally be interpreted in a magnetic resonance imaging (MRI) scan as a source of pain. Yet Brosche no longer experiences pain because of this— still visible—injury. What does this say about the conclusions that can possibly be drawn from such a scan? Cases like Brosche have led doctors to reassess the belief that (chronic) pain can be inferred from the appearance of bone and tissue structures. They started to examine asymptomatic volunteers from various age groups and backgrounds (Okada et al. 2011; Matsumoto et al. 2013).5 Although the findings were at times contradictory, it became clear that the degeneration of physical structures such as the spine is not necessarily accompanied by chronic pain. Indeed, they found that asymptomatic volunteers had degenerated spines, just like symptomatic patients, and that it is a normal part of aging unassociated with pain (Brinjikji et al. 2015). Up to 84 percent in most studies and in some even up to 96 percent have degenerated spines by the age of eighty (Matsumoto et al. 2013; Brinjikji et al. 2015; Crawford et al. 2016). These findings relativized the reliability of MRI scans as a diagnostic tool for locating the cause of (chronic) pain. This again points to the multifaceted nature of chronic pain: there is never just one cause. Neuroscience offers another approach by searching for the cause of chronic pain in the brain. To return briefly to Brosche as an example, it took him a year to “convince” his body that his initial injury had long since healed and that he should no longer feel pain. How is it possible that he could still experience pain even though his body was no longer damaged? Recent neurological research offers an answer: when a person experiences chronic pain, his or her pain sensitivity increases, but the ability to assess pain decreases (Butler and Mosely 2013: 70–90). The bodily sensors (nociceptors) that are triggered when something potentially damaging happens can no longer determine whether the body is in danger and whether pain sensations should be modulated or not. This “gating mechanism” in the dorsal horns of the spinal cord allows the perception of pain to be modified (Merskey and Bogduk 1994; Butler, Mosely 2013). In other words, “pain depends on the perceived stimulation level, not the actual stimulation level” (Bayer et al. 1998: 327–31).6 When the brain thinks that it is (still) in pain, even if it is no more than an insignificant scratch near the area where an injury once was, pain is felt. This means, as the neurologist Lorimer Mosely states, that “[chronic] pain is 100% real, but it no longer accurately signals damage.”7 This raises the question as to why the brain would think that the body is still damaged or in danger. Mosely argues that it is all about meaning.8 Here, social and cultural aspects of life come to the fore, aspects that used to be largely overlooked in Western medicine.9 Previous experiences, specific ideas about the body, and the contexts in which pain has been experienced all influence the meaning an individual or a body gives to pain. Since people learn through culture in a given society how and in which contexts pain ought to be understood and felt, it is challenging to retrain the brain to regain precision in evaluating bodily stimuli. But when is someone considered to have chronic pain? The prevalent pain definition, created by the taxonomy committee of the International Association for the Study of Pain (IASP), defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (1994: 8). The breadth of this definition, which incorporates social, cognitive, neurological, and emotional aspects, again points to the difficulty of defining pain. Chronic pain is defined

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as pain that persists beyond the normal time of healing (i.e., three to six months) (Bonica 1953: xi; IASP 2011). This means that when people still experience pain after six months and no tissue damage can be found, pain itself becomes the disease. Additionally, certain syndromes that result in prolonged pain are categorized under chronic pain even though normal healing could not or has not occurred, such as persistent migraines, epilepsy, phantom pain, spinal stenosis, and rheumatoid arthritis. What do these recent findings and definitions mean for our study? To be sure, “the vast majority of people’s lives in Antiquity were evidently affected by all manner of physical impairments or difficulties” (Graham 2013: 258). The incidence of fractures, inflammation, and infections was considerably higher in Antiquity than in Western countries today. At the same time, however, the average pain tolerance in Antiquity was most likely much higher than today. When scholars examine ancient skeletal remains and find signs of fractures, infections, or bone structures and joints that have been infected, inflamed, or worn down, we must therefore bear in mind that these findings do not prove that the deceased individuals experienced chronic pain and were as a result “impaired.” Granted, specific conditions such as the Klippel–Feil syndrome are usually extremely painful, but whether people in Antiquity considered such conditions as chronic is difficult to ascertain using paleopathology alone, which shows what kinds of conditions the body had endured. The emotional and psychological aspects necessary for such an assessment cannot be found in skeletal remains. That is why we have to be careful with making assumptions about chronic pain based on paleopathological data. What we can know is what people in the past wrote about their pain experiences themselves: how they thought about pain and chronic pain, how it impacted their lives, and whether it resulted in a conflict with cultural pain codes (i.e., how they were expected to cope with chronic pain and disease versus how they actually coped with it). When it comes to chronic pain, it is not necessarily the actual tissue damage that matters, but how the damage is perceived, experienced, and expressed. Secondly, although body–mind concepts in Antiquity differed from modern neuroscience, we can learn from neuroscientific studies that chronic pain is all about meaning. This ties in neatly with anthropological notions regarding pain behavior that reveals cultural pain codes. These diverse codes exist in every society and are, although often unwritten and implicit, designed to assist a person in giving his or her pain meaning. In order to find these codes, I use pain behavior as a methodological and analytical tool. Pain behavior is an anthropological term used to describe holistically (thick description) how a society or culture deals with pain. It consists of a variety of elements, including verbal (cursing, complaining, talking), vocal (screaming, groaning), motoric (biting the lips, making a fist), and social (withdrawing oneself, ignoring or concealing pain experience) components. These components can be observed in various texts, from medical treatises to letters, tragic plays, and memoirs; cultural codes constantly provide the frame of reference for a society. Thirdly, definitions can be slippery and problematic. Our modern definition of chronic pain is not the same as the definition—or definitions—of pain in Antiquity. To avoid anachronisms, I reconstruct, by studying various ancient sources and focusing on pain behavior and cultural pain codes, Greco-Roman concepts and definitions of chronic pain that shed light on how this phenomenon was perceived, experienced, and expressed in ancient society. The only points, however, at which I will use the modern definition of chronic pain is in the case studies. I present four case studies, featuring the tragic play Philoctetes and

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actual people such as Aelius Aristides, Fronto, and Gregory of Nazianzus. What they all have in common—and this corresponds with the modern definition—is that they mention recurring pain over a period of time exceeding six months. I adopt this criterion from the modern definition on the assumption that it is a human constant.

3.3. CHRONIC PAIN AND MEDICINE When looking for ancient chronic pain “definitions” or theories, medical treatises are a good place to start. Before we can focus on chronic pain, however, some preliminary remarks on pain and ancient medical theories on pain are necessary for understanding how “regular” pain was perceived. Pain was not understood as a phenomenon that stands on its own as it is today. In Greco-Roman medical sources, pain was always inextricably linked with injuries and diseases; medicine was perceived as a method to manage and control disease and its symptoms. We can see this in the way physicians write about pain, as it was interpreted as a natural symptom alerting both the patient and physician that something was wrong.10 When the disease was cured, pain disappeared with it (Villard 2006: 78). Pain also reveals clues about the location and intensity of a disease, which played an important role in diagnosis (Van der Eijk 2005). Another way to understand how ancient physicians perceived and categorized pain is to look at what words they used and in which contexts. The five most common Ancient Greek words for pain are ponos, odune, algos, pathos, and lupe. Latin has two main words for pain: dolor and cruciatus. What these two languages have in common, as Cicero complains about in his Tusculan Disputations (2.15.35), is the ambiguity of these terms: all of them can refer both to pain in general and to specific pains, such as physical pain, mental pain, and grief (Wilson 2011: 337). This ambiguity is revealing. In trying to define these terms, it becomes clear that physical and emotional aspects are inextricably linked to each other, which indicates that ancient Greeks and Romans were aware of the complex and multifarious nature of pain. As scholars, we depend just as much on context as Cicero did to determine what type of pain is meant. Notwithstanding the difficulty of clearly defining each term, scholars such as Rey, Fabrega, and Tyma have tried to show that these five words denote different aspects of pain. Thus, ponos, for instance, which originally referred to hard labor and toil, often implies long-lasting and dull pain, whereas odune signifies sharp, piercing pain (Fabrega and Tyma 1976: 349–71; Rey 1993: 21). In nominal compounds, algos, alluding to general pain, can denote a more specifically located pain (i.e., headache: kephalgia; toothache: odontalgia; or earache: ōtalgia) (Wilson 2011: 339). Dolor can mean both physical pain (especially in medical texts) and grief (often in letters and other literary genres), and cruciatus refers to torturous physical pain, but is seldom used (Wilson 2011: 347–8). Authors of various genres (including nonmedical genres) and living in different time periods had, however, divergent preferences and could use a single word for both physical and emotional conditions. Wilson also argues that, although “the semantics of pain [are] interesting in any language” and have the potential to reveal much about a given culture, when it comes to studying it in Ancient Greek and Latin, “the results are disappointing” (2011: 338). In other words, even though I generally agree with these scholars’ interpretations, it should indeed be noted that these interpretations are not fixed, and that verbal or vocal pain descriptions, metaphors, and metonyms in their

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original contexts reveal more about various pain interpretations than solely analyzing words meaning pain.11

3.4. PAIN THEORIES FROM HIPPOCRATES TO LATE ANTIQUITY In every pain theory, whether from the Corpus Hippocraticum or later medical sources, there is always an imbalance of some sort caused by specific divergent sets of elements. Healing results only when that balance is restored. In the Corpus alone, there are various different pain theories. In Places in Man 42, pain occurs when the “natural” composition of a person is disturbed. There are four elements—heat, coldness, dryness, and wetness—of which two combine to form the “natural” bodily composition of a given individual. This means that diverse combinations are possible. A disturbance is caused by the opposite of that person’s inborn nature and can only be cured by its opposite. For example, a person with a cold and dry disposition will experience pain when there is too much heat and wetness in him/her. That pain can only be remedied with the opposite: a cooling and drying treatment. This implies that the type of pain depends on the patient’s body composition, and that various types of pain—and cure—are possible. In the treatise Nature of Man 4, a different theory of the composition of the human body and, therefore, of pain is offered. According to this treatise, the body consists of a mixture of the following four humors: phlegm, blood, black bile, and yellow bile. Here, excess, deficiency, and movement cause pain and disease. This theory not only supports internal factors that can influence the humoral balance in the body, but also external factors such as weather, the seasons, and the stages of human life (Nutton 1995a: 25). Although it is clear that the proposed pain theories in Places in Man and Nature of Man differ in terms of the elements that cause pain, they function similarly. An imbalance in the body’s composition of any kind results in pain and disease, and can only be cured by restoring the initial balance. The same tendency can be observed in later pain theories in Hellenism when discoveries in vivisection and dissection began to provide an anatomical basis for medicine.12 New developments changed the way people thought about how pain worked in the body. The physician Asclepiades of Bythinia (130–40 BCE), for instance, departed from Hippocratic ideas on pain and developed a corpuscular theory. He proposed that the body was made up of molecules (μέρη, or corpuscula), which were in turn composed of atoms (ἄναρμοι ὄγκοι) and pores, or void spaces (πóροι, “poroi”).13 Free movement of the corpuscles through these gaps and pores in and around the body led to good health. Pain and disease resulted when the free movement of these particles was blocked or increased. The basic concept that pain was caused by an imbalance thus remained. Although the physician Galen also developed another pain theory, in which he understands pain as a moment of tension or pressure in the body, his main contribution to the medical discussion of pain was his pain vocabulary (Gleason 2009; Wilson 2011: 57; Roby 2015: 304–22). Galen developed one of the first systematic pain vocabularies meant to aid diagnosis in his On the Affected Parts, a treatise based on the reports both of the physician and his patients. Aretaeus of Cappadocia (c. 150–200 CE) offered a hybrid pain theory. Rather than following a particular school, he instead combined certain Hippocratic theories with Asclepiadean anatomical approaches. Aretaeus examined pain by analyzing the density

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of body parts (anatomical) with alterations in temperature (Corpus). He made lists of symptoms under the assumption (shared by his Hippocratic predecessors and Galen) that every disease had specific pain symptoms.14 Aretaeus further distinguished between general pain (πὀνος) and particular pain (ἰδἰη ὀδὐνη) for each body part (On the Causes and Symptoms of Chronic Diseases 2.12.8). His hybrid theory is, however, inconsistent: Aretaeus contradicts himself by stating in one work that dense parts are sensitive to pain and in others not (Wilson 2011: 85). This illustrates the difficulty and complexity of understanding and defining pain. Finally, in late Antiquity, Hippocratic pain theories return to popularity. Physicians like Caelius Aurelianus, Christians, and Muslims wrote commentaries and treatises on older works, such as those of Asclepiades, implying that they were aware of various pain theories, but favored the Hippocratic School (Perkins 1995; Cohen 2010; King 2013). Ultimately, however, regardless of the specifics of a given pain theory, the cause of pain was always an imbalance, and the cure was to be sought only by restoring that balance.

3.5. CHRONIC PAIN THEORIES Only a few medical chronic pain theories have been transmitted to us. Although the oldest stem from the Corpus Hippocraticum, chronic pain theories grew in importance and became more sophisticated during the Roman Imperial era as a direct result of the Second Sophistic. Albeit rarely mentioned, chronic pain surfaces in one treatise in the Corpus, namely in the Affections. There it is stated that pain from minor conditions such as a fever, if wrongly treated and diagnosed, can result in chronic pain (Affections 18, 33). It is also claimed, however, that chronic pain, although long-lasting, bothersome, and often incurable, is not fatal, whereas acute pain often is (Affections 13.29–30). In the Hippocratic treatise On Prognoses, for instance, it is made clear that pain that suddenly disappears is fatal (19.346).15 Curiously, the Corpus Hippocraticum also includes a treatise on chronic pain ascribed to a much later physician, the aforementioned Asclepiades, who did not, as we have seen, necessarily followed “Hippocratic” ideas. The corpuscular pain theory put forth by Asclepiades is not new in terms of how it functioned; what is new in the treatise Precepts, however, is that Asclepiades made a distinction between acute and chronic pain and thus between diseases. Asclepiades is thereby the first known physician to study chronic pain systematically.16 Building on Epicurean pain concepts, he observed, firstly, that acute pains are intense, whereas chronic pains are milder. Secondly, he remarks that acute diseases are of short duration and, when the physician does not act swiftly, possibly fatal, while chronic diseases last longer and are often incurable, but rarely lethal. In the case of incurable pain, contrary to common contemporary medical practice, he suggested that physicians ought to show sympathy toward their patients (Vallance 1990; Yapijakis 2009). As stated above, many other physicians and religious groups favored Hippocratic medicine, and as a result many of Asclepiades’ concepts were eventually “forgotten,” with the exception of his division of acute and chronic pain. For Galen, the real challenge is that which cannot be seen (as opposed to easily observable outward conditions such as wounds). Internal chronic diseases make themselves known through external symptoms like pain. According to Galen, every body part has its own function and, when diseased, specific pain sensations. It is here that Galen’s specific pain vocabulary comes into play: when these particular pains can be identified, the physician can

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treat his patient accordingly.17 Language, therefore, is for Galen of paramount importance, even though he shows an awareness of the limitations of language as a means for expressing pain (De locis affectis 2.7). He maintains that one can only accurately describe types of pain that one has personally experienced. Since no one can ever experience every possible form of pain, however, physicians must rely on patient accounts. The more often patients use similar descriptions, the more precise and usable the pain vocabulary is.18 Following Asclepiades’ distinction between acute and chronic pain, more attention began to be paid to chronic pain. The next physician, Aretaeus of Cappadocia, is a good example of this shift. Like Galen, Aretaeus developed his own vocabulary for describing pain and expanded the existing vocabularies of other medical authors. His innovation, however, is to show sympathy in the way he described the individual experience of pain (Wilson 2011: 83). In so doing, he is also the first to connect pain with fear and death: But this is a mighty wonder: in the discharge from the lungs alone, which is particularly dangerous, the patients do not despair of themselves, even although near the last. The insensibility of the lungs to pain appears to me to be the cause of this; for pain, even although slight, makes one to fear death, and yet, in most cases, it is more dreadful than pernicious; whereas the absence of pain, even in the great illnesses is attended with absence of the fear of death, and is more dangerous and dreadful. (Aretaeus, On the Causes and Symptoms of Acute Diseases 2.2.18) This connection between pain, fear, and death is made manifest when he deals with a specific lung condition that is dangerous, but does not cause pain. He states that when someone feels pain, he/she becomes scared: something is clearly wrong. Those who do not feel any pain are unaware that their health and, potentially, their life are in danger. He therefore implies that, although unpleasant, pain is necessary for survival. For those that experience chronic pain, having to deal with continuous pain can be life-limiting— but they live. The reason why Aretaeus emphasizes the importance of experiencing pain is reflected in his chronic pain theory. He asserts that even the subtlest of pains should be treated; if such a pain is not treated, the condition could become chronic and thus increasingly difficult or even impossible to treat: In chronic diseases, the postponement of medical treatment is a bad thing; for, by procrastination, they pass into incurable affections, being of such a nature that they do not readily go off if they once attack; and if protracted by time, they will become strong, and end only in death. Small diseases also are succeeded by greater, so that although devoid of danger at first, their progeny proves deadly. Wherefore neither should the patient conceal his complaint, from the shame of exposure, nor shrink from fear of the treatment; nor should the physician be inactive, for thus both would conspire to render the disease incurable. Some patients, from ignorance of the present and what will come at last, are content to live on with the disease. For since in most cases they do not die, so neither do they fear death, nor, for this reason, do they entrust themselves to the physician. (Aretaeus, On the Therapy of Chronic Diseases 1.1) Three details in this passage are of special interest. First is the fact that both the patient and physician are made responsible for whether or not an initially harmless condition develops into a chronic condition. Second is his advice that the patient should not be afraid of the treatment, which suggests that many were. This ties in neatly with the last

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point, namely that many who experience chronic pain prefer to experience continuous (but mild) pain as opposed to undergoing potentially painful treatments. Physicians and their cures—especially in an era in which anesthesia was at best crude—did not necessarily inspire trust and could cause more pain than the disease or injury itself. This tendency was thoroughly studied by Nobel Laureate Daniel Kahneman in his groundbreaking cold water experiment (Kahneman 1993: 401–5). In this experiment, volunteers had to put their hands in water cold enough to cause pain or discomfort (14°C) for sixty seconds. They then had to put their hands into the cold water again for the same amount of time. Without their knowledge, however, warmer water was added after sixty seconds, thus raising the temperature to 15°C. After thirty additional seconds, they were allowed to remove their hands from the water. Then came the most revealing and intriguing part of the experiment: the participants were required to put their hands in cold water for a third time, but were allowed to choose whether they wanted to repeat the first or the second, longer round. Eighty percent chose the second round. This led to the conclusion that people remember the most intense part (the peak) and the end of a (painful) sensation. When the end is less painful, they prefer that. In other words, apparently that which the experiencing self experiences—that it makes no sense to keep your hand longer in water that, although slightly warmer for thirty seconds, is still cold and painful—is not taken into consideration by the narrative self. It is the narrative self that has no sense of duration and chooses to experience a longer, less extreme bout of discomfort over a shorter, more severe one. In light of this, it is hardly surprising that people with minor pains were not always motivated to visit a physician. Is it worth experiencing more pain in order to heal? This tendency did not escape Aretaeus, as he wrote in his Proemium that healing processes could also cause pain: Of chronic diseases the pain is great, the period of wasting long, and the recovery uncertain; for either they are not dispelled at all, or the diseases relapse upon any slight error; for neither have the patients resolution to persevere to the end; or, if they do persevere, they commit blunders in a prolonged regimen. And if there also be the suffering from a painful system of cure—of thirst, of hunger, of bitter and harsh medicines, of cutting and burning—of all which there is sometimes need in protracted diseases, the patients resile as truly preferring death itself. (Aretaeus, On the Causes and Symptoms of Chronic Diseases 1.1.1) Aretaeus acknowledges that dealing with one’s pain and one’s (painful) treatments is difficult. Yet he emphasizes the importance of following a given regimen or cure in minute detail (as a slight error can worsen a patient’s condition) because it is possible, albeit not certain, to lead to healing. He encourages patients to persevere in spite of their fears or reservations. Additionally, his stress on executing a treatment properly ties in with a Hippocratic understanding of perceiving chronic pain as the result of a diagnosis that was incorrect or wrongly applied.

3.6. LATE ANTIQUITY Late Antiquity favored pain theories that remained close to the Hippocratic School. The rise of Christianity had a profound impact on concepts of pain—not necessarily directly on the pain theories themselves, but rather on the meanings given to pain and thus how

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pain was experienced. The image of chronic pain or continuous experience of pain began to change. “Established pagan” ideas about pain were transformed, as Judith Perkins termed it, into a Christian “community of suffering bodies” (1995: 191). According to Antigone Samellas, this community of co-sufferers emerged through three developments (2015: 260–96). The first was the notion that the experience of ontological pain could not be reduced to physical pain. This idea was based on the “double-pain” concept presented in the Hippocratic Aphorisms. This concept states that when there are “two pains at the same time, but not in the same place, the more violent obscures the other” (Aphorisms 2.46). Galen, for instance, referred to this concept when he commented on the pain he felt when his books were burned to ashes during a fire in Rome for which the emperor Commodus was held responsible. That pain, however, was not as great as the collective pain Commodus’ reign was causing his subjects (De indolentia 27). Clearly, contrary to what we have discussed before, Galen is here speaking of pain on a different level, and it is exactly this level that became one of the foundations of this community of suffering bodies. In so doing, it placed pain on a higher plane of consciousness and religiosity. This type of unifying pain experience evolved to have greater meaning yet could be expressed physically. The second and third developments leading to a community of co-sufferers were the transformation of pagan ritual pedagogy into ordinary martyrdom and the imitation of Christ’s passio, which placed pain in a more positive light by making it a means to salvation (Samellas 2015: 273). Continuous physical, emotional, and spiritual pain thereby took on new connotations and values. It is important to bear in mind, however, that Christian concepts of pain were built on pagan predecessors and theories. It was the experience, goal, and meaning of pain that changed, not necessarily the pain theory itself. This community of co-sufferers (or a specific part of this group) put forward a different view on and interpretation of chronic pain and made the voluntary experience of pain into a different religious and spiritual experience with specific meaning for the group.

3.7. CHRONIC PAIN NARRATIVES In the following four case studies, we will analyze the chronic pain behavior of three historical persons (Fronto, Aelius Aristides, and Gregory the Theologian) and the depiction of chronic pain in one fictional account (Sophocles’ Philoctetes). So far, we have limited our discussion to medical sources, but it was not only physicians who were concerned about their patients’ pain and disease; in some cases, the patients themselves offered personal accounts of how they grappled with pain, especially when it was longlasting. Particularly during the first centuries of Imperial Rome, an increasing interest in the body emerged. The body became an “exposed and explored interiority,” and bodily afflictions were not only endured, but were also, especially among the elite, narrated, “communicated and performed” (Holmes 2010; Brod 2016: 2). This explains why we have more sources addressing (chronic) pain from Imperial times onwards. 3.7.1. Philoctetes A telling exception, however, is Sophocles’ tragic play Philoctetes, written in the fifth century BCE. Although the dramatic depiction of Philoctetes’ pain experience is not, strictly speaking, a “patient narrative,” the way in which his pain is described must have

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mirrored and expressed to some extent contemporary ideas and attitudes toward pain behavior in order to be understandable for the audience. The tragedians might also introduce innovative or less recognizable elements, but they could not flat-out ignore cultural codes. Philoctetes, the protagonist, had been bitten on his foot by a snake. The bite resulted in excruciating pain, foul odors, and uncontrollable screams that interfered with the Greek army’s rituals for keeping the gods satisfied. Consequently, he was taken by Odysseus to the deserted island of Lemnos and abandoned there. The play begins with the return of Odysseus to the island ten years later in order to fetch Philoctetes, who, together with his bow, is needed to secure victory at Troy. From the many passages in which Philoctetes’ chronic pain behavior is depicted, I have selected two particularly representative passages. Before we analyze the first of these, it is important to point out a fundamental difference between ancient Greek tragedy and medicine regarding the origins of pain and disease. Although both genres share, in large part, their pain vocabulary (which indicates that this vocabulary was familiar to both physicians and tragedians), tragedy sees pain and disease in an individual or a community as the immediate result of divine displeasure or punishment, and not as the result of physical imbalances caused by internal and external agents (Wilson 2011: 115; Jouanna 2012). In tragedy, the gods are the agents who can give pain or take it away. This phenomenon is also known as Strafwunder (Helm and Leven 2005: c. 833–4); the epidemic that ravaged Thebes as punishment for Oedipus’ sacrilege is a well-known example. In Philoctetes’ case, this means that only his return to Troy will cure his pain. In the following two passages, we see how Philoctetes deals with recurring pain attacks: Philoctetes Child, it is killing me: I can no longer hide my distress from you—oh oh! [ἀτταταῖ]—it comes, it comes! wretch that I am! the pain, the pain! Child, it is killing me: child, it devours me! Ah oh ah oh ah oh ah oh ah oh! [ἀπαππαπαῖ, παπαππαπαππαπαππαπαῖ] Child, if you have a sword at hand, I pray you, in God’s name, take it, strike this foot of mine, now, cut it off, now—never mind my life— come child! (lines 742–50)19 Philoctetes You must not blame me, for I am distraught with tempestuous pain, and my screams are beyond my control (lines 1193–5) Firstly, we are clearly dealing with chronic pain: Philoctetes has been experiencing pain for over ten years. Every time an attack comes, however, his pain seems to be acute rather than dull. This differs from the way in which medical treatises from the same time period characterize chronic pain. The divine agency behind Philoctetes’ painful condition, which makes it a unique and unusual wound that will not heal of its own accord, could explain this divergence.

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Secondly, instead of interpreting his pain as a symptom indicating that his body is hurt, Philoctetes regards his pain as an active and living agent capable of damaging his body both internally and externally. The way in which his pain behaves is described metaphorically. As metaphors speak to the imagination and make it possible to express something intangible like pain, Philoctetes’ chronic pain can, in this way, be conveyed to others and to the audience: “it” is “killing,” “coming closer,” and “devouring.” Philoctetes’ pain is described as if it were a wild animal feasting on his foot. The idea of being killed emphasizes the power and independency of the pain, while the idea of killing expresses the severity of that pain. Being devoured also carries with it a strong sense of hopelessness and powerlessness. Such sentiments of helplessness and vulnerability are especially common among people who experience chronic pain today (Jackson 2003). Thirdly, another important aspect of pain is his vocal pain behavior. In the first passage, we encounter examples of those vocal expressions: ἀτταταῖ, παπαῖ, ἀπαππαπαῖ, and παπαππαπαππαπαππαπαῖ. The scholars Kamerbeek and Olsen, who have analyzed various cries and screams in tragedy, interpret the first two types of cries here as an “exclamation of suffering” and as an “inarticulate cry of grief,” respectively (Nordgren 2015: 108–9). In other words, these cries are strongly connected to Philoctetes’ pain descriptions (i.e., that pain is killing him and coming for him [again]): they express vocally what he also tries to articulate verbally. The prolonged vocal cries—ἀπαππαπαῖ and παπαππαπαππαπαππαπαῖ, stemming from παπαῖ—signal enduring and continued pain (Nordgren 2015: 120–7). Nordgren convincingly shows that παπαῖ functions as a cry signaling not only pain, but also surprise: Philoctetes’ pain strikes suddenly (2015: 108).20 These prolonged cries also illustrate the severity of an attack by implying that all verbal speech has been rendered useless. Philoctetes, as we can see in the second passage, is aware of this. He does not want to be made responsible for his uncontrollable screams, because the pain makes him behave irrationally. This shows the different stages one with chronic pain goes through and how such pain affects one’s mood and behavior. Lastly, on a social and verbal level, Philoctetes senses when an attack approaches and states, apologetically, that he can no longer hide his distress. His short comment indicates a cultural behavioral pain code: men should not display their distress, regardless of how severe and disabling their pain is. Philoctetes obviously fails in upholding this code, and even goes as far as begging Neoptolemus to cut off his foot with his sword, regardless of whether this leads to death. This type of irrational verbal pain behavior is common, because extreme pain highly affects the senses. Research has shown that torture is not necessarily an effective method to make people tell the truth; they usually end up saying what the torturer wants to hear in order to make the pain stop (Scarry 1985). Moreover, Philoctetes’ pain experience has also been understood as a narrative on war trauma, in which the traumatic experience of fighting in war, being injured, and then being abandoned has taken its toll and resulted in continuous agony (Rose 2000: 55–69). That said, Philoctetes’ chronic pain is particularly pernicious in that it is not only longlasting, but also acute in physical terms and especially challenging on the emotional and social planes, thus disabling him. 3.7.2. Marcus Cornelius Fronto Fronto (c. 100–166 CE) was born during the early reign of Emperor Trajan in the Numidian town of Cirta (now in Algeria). After moving to Rome, he quickly became

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known for his oratory—so much so, in fact, that Antoninus Pius hired Fronto to tutor his two sons, Marcus Aurelius and Lucius Verus. Unfortunately, Fronto’s speeches have not been handed down to us. What did survive, however, are his personal correspondences with Marcus Aurelius and friends. In these letters, Fronto shares his numerous personal experiences of pain: colds (Ad M. Caes. V.10),21 diarrhea (V.69), pains in the groin (V.33, V.65), sore eyes (Ad Amicos 1.13), neck pain (Ad M. Caes. V.27, V.29, V.30, V.31, V.32, V.44), insomnia (Ad Amicos II.2), pain in the knees (Ad M. Caes. V.21, V.59, V.61, V.71, V.73), and so on. These often form the focus of the letter, and it is clear that his pains are a source of worry for him. Indeed, his health must have limited him to a great extent, as he once decided not to become the proconsul of Asia because of it (Ellis 1903: 6–11). From his correspondence, I have selected one letter to Marcus Aurelius and two addressed to friends and family. In the first example, Fronto writes to his young student Marcus Aurelius that he has been taken by a violent pain in the neck in 145–7 CE: I have been seized, my Lord, with a most severe pain in the neck. The pain has gone from my foot. Farewell, best of Lords. Greet my Lady. (Ad M. Caes. 5.29) Marcus Aurelius responds: I cannot but be distressed that at the very time when you were writing to me your neck was so painful, nor indeed do I wish to be, nor ought I to be, other than distressed. As for me, thanks be to the gods and your prayers, I have bathed today, and taken sufficient food, and wine too I have used with relish. Farewell, my most delightful of masters. My mother greets you. (Ad M. Caes. 5.31) These passages reveal two types of pain behavior: behavior from the one experiencing pain (i.e., Fronto) and from the one witnessing someone else’s pain (i.e., Marcus Aurelius). Fronto describes his neck pain as “seizing” and “severe,” which implies the surprising and acute nature of this pain. He also mentions in passing that, although he is still in pain, the pain in his foot has at least subsided. This is a reminder of Fronto’s continuous, if various, pain experiences. His pain behavior is also expressed in social terms. By sharing and talking about his physical difficulties, Fronto avoided feeling socially isolated, as he felt listened to and found a way of receiving recognition and acknowledgment for his pain (which shows that his pain was considered by others to be real), because his student sympathized with his struggles. In other words, through sharing his painful experiences, Fronto found a way of coping with his chronic pain. The success of this method is dependent on and represented by the second passage, in which we see the other side of pain behavior, namely witnessing someone else’s pain. The young Marcus Aurelius proves himself to be a loyal and sympathetic student. He is not only alarmed by Fronto’s news, but the knowledge that Fronto wrote that very letter while being in severe pain has highly distressed him. In another letter, Marcus Aurelius wrote that he is in pain because his teacher is in pain, resulting in limiting him in eating, sleeping, and even studying (Ad M. Caes. 5.22). These responses show how pain can be shared—making it slightly easier to bear—and can even impact a person who does not experience the same pain directly.

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Apart from corresponding with Marcus, Fronto also wrote to other people to complain about his various ailments. In the next passage, he writes to Praecilius Pompeianus in 162 CE: Meanwhile, a more than usually severe attack of neuritis came on, which proved to be more persistent and troublesome than usual. And I cannot pay any attention to writing or reading letters when my limbs are racked with pain [cruciantibus]; nor have I even ventured to make such a demand upon my strength. (Ad Amicos 1.15.2) In this passage, the debilitating effects of Fronto’s chronic pain become apparent: he experiences several ailments, some of which are clearly long-lasting, causing such excruciating pain that he is unable to write or even read letters. Since these activities need not be the most tiring ones, it only emphasizes the extent to which this pain exhausts him. It is irrelevant whether Fronto actually felt all of those pains or whether he, following neurological concepts, became extremely sensitive to pain sensations and thus less able to assess the quality of those sensations. What is relevant is how he perceived and experienced his pain. His written pain behavior all the more illustrates how limiting and, in a way, “crippling” experiencing chronic pain can be in daily life. This becomes even more evident in our last example, in which he writes to his son-in-law Aufidius Victorinus in 164 CE: I have had severe pain in the eyes … No pain or lumbago in the side or back came on. The Greeks call the back bone ἱερὁν ὀστοῦν22 (the sacred bone): Suetonius Tranquillus calls it the sacred spine. For my part I would gladly not know the Greek or Latin name of a single member, if I could only live without pain in it. (Ad Amicos 1.13) Here, Fronto’s frustration and powerlessness in view of his chronic pain becomes apparent, as illustrated by the remark that he would rather be ignorant of medical terminology and pain free than know the terminology and be in pain. Here, we can observe how emotionally exhausting and consuming chronic pain can be: Fronto just wants it to stop as it becomes increasingly difficult to bear. In sum, Fronto experienced a great deal of pain in various body parts through his life. The longer it lasted, the heavier the emotional impact became. Corresponding about it with his student, friends, and family served as an apparently successful coping method. Additionally, we can also see in his correspondence how experiencing constant pain can greatly affect those in one’s immediate circle, thus making chronic pain not only a personal, but also a socially shared affair. 3.7.3. Aelius Aristides Publius Aelius Aristides Theodorus (117–81 CE), a contemporary of Fronto, was born in Hadriani in northern Mysia, now Turkey, and is considered one of the most celebrated orators of the Second Sophistic. Many of his orations as well as other works have been transmitted. One such work is the Hieroi Logoi, or Sacred Tales, in which Aristides describes how Asclepius aided him in dealing with his continuous poor health and guided him in giving meaning to it when his chronic pain oftentimes prevented him from doing what he loved most: oratory.

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As a young man, Aristides traveled to Rome to pursue a career as an orator (143 CE). His stay, however, proved to be unsuccessful due to severe pain and illness, and he had to return to Smyrna. Upon his return, he visited several physicians, with little success: “The doctors were wholly at a loss not only as to how to help, but even to recognize what the whole thing was” (Hieroi Logoi 2.5). The story of his chronic pain begins with this realization that no one understood the cause of his pain, but only that his condition was serious. The doctors accordingly sent him to the temple of Asclepius in Pergamum, a well-known healing center. In Pergamum, Aristides developed a close, long-lasting, and, in his eyes, privileged relationship with the god Asclepius. It was long-lasting because his stay at Pergamum did not heal him permanently (nor did he expect it to): “he was sick when he arrived in Pergamon and was still sick when he left two years later. He was sick upon his return” (Wilson 2011: 26–7). It is noteworthy, however, that the moments of alleviation that Aristides found through Asclepius were enough to sustain him. Throughout his life, regardless of where he was, Aristides was provided by the god with diverse cures, ranging from bathing or abstaining from bathing (Hieroi Logoi 2.53) to vomiting (1.40, 53), exercise (2.75), dietary regimens, and other prescriptions (2.43). Four passages have been selected that reveal how Aristides coped with his chronic pain over the years, how it affected his daily life, and how he gave meaning to it. There was the fiery pain, which penetrated to my brain, and all the attacks, and the impossibility of reclining at night, but I had to raise myself, and persevere bent forward, with my head on my knees. But with this and, I believe, countless other such things, there followed of necessity being wrapped in wool and other coverings, and being strictly confined, with everything shut up, so that day was equal to night, and the nights were sleepless instead of the days. (Hieroi Logoi 2.57) Aristides presents us with an extremely vivid description of how the experienced pain felt: it was a burning sensation piercing through his head. Interestingly, although we deal with chronic pain, many of Aristides’ (prolonged) attacks seem to consist of acute rather than mild pain. This nuances of the ancient medical acute–chronic pain dichotomy, as praxis (i.e., Aristides’ case, but also those of Philoctetes and Fronto), show that there is a more fluid, sometimes even overlapping, and subtle sliding scale between the two. Aristides also relates how the fiery, penetrating pain and other attacks affected him: he could not sleep at night and was hindered in his everyday movements, being able neither to lie down to rest nor to partake in daily life. In order to find any form of relief, he had to sit, bend over, and put his head on his knees. To this end, he reveals to us the method that helped him most with what seems to be something like a heavy migraine, namely wrapping himself up and thereby blocking light from his senses. Aristides also mentions that this method was frequently recommended for such conditions. In the next passage, we see a common command from Asclepius: in order to receive a particular form of healing, Aristides must travel. This time, his journey brought him to Lebedus, where his sentiments on physicians and Asclepiad medicine are revealed: When I was taken to Lebedus, and very unexpectedly and scarcely survived, then everything seemed to be of value. I needed constant help, and approached the warm springs with difficulty and sparingly. Therefore I decided to put Satyrus’ drug on

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my stomach and chest, as Satyrus had prescribed, for I thought indeed that I was not departing much from the cure, which came from the God. Straightway the first application did not please me, but it seemed to be too cold. Nevertheless I decided to persevere and to entrust to the drug, if in time it might accomplish something. And so I developed a terrible chest cold, and a constant and strong cough ensued, and I was in difficulty. And the God showed that it was consumption. And on the following day, there was a pressure in my temples and the whole of my face, and my jaws were locked together, and then, if ever, there was confusion. (Hieroi Logoi 3.10–11) The trip begins rather roughly, with Aristides being surprised that he has—barely— survived the journey. This shows his obedience toward Asclepius: although he was clearly unfit to travel, he followed the god’s recommendations and succeeded. But Aristides did not heed him at all times—and usually had to pay for it. In this passage, he mentions how he was not entirely content with the god’s cure so far, and had applied the physician Satyrus’ (father of Galen of Pergamum) drug instead. As a result, his condition worsened, and Asclepius later revealed to him what was causing him pain. This led, on the one hand, to the intensification of Aristides’ obedience toward Asclepius, and showed, on the other hand, that it was the god who knew best and not a mere mortal physician. In other passages, too, when the recommendations of the physicians conflicted with those of the god, Aristides would usually choose the latter. Throughout Aristides’ writings, it becomes apparent that healing is inextricably connected to faith in divine providence. Lack of faith could result into being unable to heal, or in lifelong deformity, even though healing in some form was available (Horn 2013: 115–43). Surely, this concept proves to be extremely advantageous for priests and other religious health care providers when they could not heal a patient: it was then the patient’s fault for not meeting certain qualifications of the divinity (e.g., purity, or neglecting to follow an instruction beforehand) (Horn 2013: 140). Most importantly, however, Aristides used several different, sometimes conflicting, health care providers at the same time, which also indicates that the ancient health care market was much more dynamic than ours today (Israelowich 2015). Regarding the extent to which his chronic pain and illness limited him, Aristides mentions that he struggled with his mobility, as he could not visit the hot springs often and was in constant need of assistance. Later in the passage, he notes that he is again in difficulty when he develops a cold, which often leads to him being immobile. In the last two passages, we see the importance of oratory for Aristides as a means for healing and for giving meaning to his chronic pain. Although Aristides had ceased from his oratorical pursuits, Asclepius motivated him to take it up again: 170/171 CE And once I happened to have a toothache, and was unable to open my mouth, and was in terrible difficulty. But he commanded me to summon a gathering of my friends and to read to them one of the speeches which I had written. Then I had in hand the third of my speeches to him. I read this through, and before I had completed all of it, I was rid of the pain. (Hieroi Logoi 4.30) The passage is extraordinary: Asclepius commands Aristides to use his voice, in the presence of others, as a means to heal himself. This concept was not new: from the

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first century CE onwards, the concept of ἀναφώνησις (anaphonesis; i.e., the use of voice training as medical treatment) had developed (Schulz 2014: 59–66). The main distinction between pure voice training and anaphonesis is that the former only trains the voice and presupposes a connection between the voice and the body, whereas the latter uses the voice to heal the body, thus positing a connection between the body, voice, and healing. The physicians Aretaios (8.13.10), Celsus (1.8.1), Caelius Aurelianus (Chron. 1.5.165, 1.1.37, 2.6.93), and Plutarch (Moral. 130B–C), for instance, recommended certain voice exercises to remedy stomachaches. Soranus (1.49, 54, 3.28) encouraged pregnant women to speak and read aloud to make them feel stronger, and Seneca (Letters 78.5) suggested the same remedy for curing colds and slight fevers. Today, the conscious act of talking about one’s issues is used as therapy. In contrast to Fronto, only writing about chronic pain was not sufficient for Aristides to find relief. He had to use his voice and his written oratory in front of his friends to cure his toothache. I call this Asclepius’ “rhetorical cure,” because Aristides, under the guidance of Asclepius, not only improved his voice—and thus his oratory—but also his health (by improving his voice). This brings us to the last passage, in which the interplay between Aristides’ chronic pain and oratory plays a substantial role in giving meaning to the pain: Pardalas, who, I would say, was the greatest expert of the Greeks of our time in the knowledge of rhetoric, dared to say and affirm to me that I had become ill through some divine good fortune, so that by my association with the God, I might make this improvement. (Hieroi Logoi 4.27) Aristides claims that the very reason he became ill, experienced intense pain, and continued to struggle with it was because it enabled him to develop a strong and special connection to the god Asclepius, who, in turn, helped him improve his oratory. In other words, if it were not for his chronic pain, he would not have been able to develop such a strong connection to the divine and improve his rhetorical skills to such an extent as to become the famous and flourishing orator he ultimately did. Aristides’ approach to his pain is a constant endeavor to make his chronic pain meaningful. 3.7.4. Gregory of Nazianzus Aelius Aristides was not the only one who connected chronic pain with the divine. In Gregory of Nazianzus’ (329–90 CE) case, however, this is done in a completely different way, revealing another face of chronic pain. Gregory, also known as Gregory the Theologian, was born on the family estate of Karbala in Arianzus, near Nazianzus in the southwest part of Cappadocia (Daley 2005). In the Eastern Orthodox Church, he is considered to be one of the “Great Church Fathers,” honored as one of the “Three Holy Hierarchs”; in the Western Church, he is regarded as one of the “Doctors of the Church” (Macdonald 2003: 124). As the respectful titles indicate, Gregory was one of the most influential bishops of the early church in establishing and shaping Christian theology. It is also important to note that he was a renowned classically trained orator and philosopher, as often becomes apparent in his writings. In Gregory’s writings, a new approach to chronic pain surfaces. As we will see in the three examples below, Gregory transforms established pagan pain theories, integrating them into his Christian ideology and theology. In the first passage, Gregory uses the familiar story of Philoctetes to symbolize and explain the complex and social components of pain:

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According to an ancient saying, when a cruel viper attacks a man with its mischievous tooth, he does not want to talk about his deadly pain to anyone but to those on whom, in a similar manner, a dismal viper has spurted its fiery venom, sowing mischief. For, indeed, only he can have knowledge of the painful evil. Thus I will, too, confess my pain to those who suffer from the same desire, the same evil, the same pain. (Carmen 2.1.4.235–41)23 In this passage, Gregory presents himself as the Christian version of Philoctetes (Samellas 2015: 273). In so doing, he builds on several key notions of (chronic) pain already analyzed above: the complex nature of pain as something hard to grasp and to communicate to others who have not experienced something similar, as well as the social ramifications of being isolated and abandoned by one’s peers. The passage becomes even more interesting when Gregory turns attention to himself and uses the aforementioned barriers as stepping-stones to place pain on a higher plane by stating that he will only share his pain with those who experience pain like him. With this statement, Gregory singles out a specific group of people: according to Gregory, only those who yearn “to carry on their shoulders the burden of the cross can have a perfect knowledge of the secrets of a downcast heart” (Carmen 2.1.4.242–4). This new usage of Philoctetes’ enduring pain formed one of the uniting foundations of an early Christian community, since it brought together those who experienced pain similarly. To what kind of enduring pain is Gregory referring? Clearly, the persistent pain in Philoctetes’ foot is only a point of reference. Yet Gregory specifically chooses a pain that is constant. According to Samellas, the viper should be taken as a symbol “for the experience of life, as a trial when one is yearning to be united with God” (2015: 275). This desire resulted in continuous pain, because it was a painful ordeal to unite two ontologically contrasting natures: “the mortal, fluid nature of man and the immortal, infinite nature of God” (Samellas 2015: 275). This idea, however, can already be found in Plotinus’ works, in which he reasserted the Hippocratic notion that, when man was one, he would not feel pain, but that the desire to become united is painful (Enneades 4.4.18). In Gregory’s view, Christians had to see themselves as suffering subjects in order to be able to put themselves in the place of the sufferer (i.e., Christ) and thus begin the path to salvation. This meant that they must willingly undergo Christ’s passion, in which continuous pain purified the person who experienced that pain. Indeed, Gregory of Nazianzus even went so far as to claim that “the nails are sweet, even though painful. For to suffer for and with Christ is more to be desired than a life of ease with others” (Oratio 45). Consequently, a new religious and much more positive concept of chronic pain was born in the form of lifelong martyrdom, which resulted in the establishment of a collective emotional community of co-sufferers.

3.8. CONCLUSION Chronic pain proves to have been just as complex and poorly understood a phenomenon, and just as physically, socially, and emotionally limiting in Antiquity as it is today. As a result, a great number of differing definitions circulate in both ancient and modern medicine. According to Greco-Roman theories, chronic pain can be caused when a condition is wrongly diagnosed, wrongly treated, or not treated at all. A painful condition is caused by an imbalance of some kind in the body. In modern medicine, the emphasis shifts from healed and thus undetectable physical damage to brain activity.

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What past and present approaches have in common is their focus on meaning. We have examined one fictive depiction and three historical accounts of how individuals gave meaning to their pain experiences. This process was anything but easy and straightforward for them. The afflicted persons could encounter difficult in articulating their pain to others (Philoctetes), could not find rest (Aelius) or perform their duties (Fronto), and had difficulties with physical mobility and emotional endurance. They could not always control their verbal, vocal, and motoric reactions. This is important, because ancient medicine presupposes a rather clear distinction between acute and chronic pain. In the case studies, however, it has become apparent that the dividing line between these two is much less clear than assumed. Fronto and Aristides often complain about their ongoing aches and ailments, but they could be both acute and mild in nature. Apart from examining how they expressed their chronic pain, we also analyzed the methods they used to find relief. There are many possibilities, although it was, at least among those who could read and write, common to communicate and share their persistent pain experience with others. We should not underestimate the importance of this, for not being able to do so, as in Philoctetes’ case, led to social isolation and an overall misère. Sympathy from others (i.e., an acknowledgment of one’s chronic condition) helped to alleviate the condition and lend it meaning. We also observed the other side of this communication process, namely the perspective of someone who witnesses another’s pain. Marcus Aurelius was at times highly affected by his tutor’s poor health, to the point that he often experienced pain as well. In the first three case studies, grappling with chronic pain was primarily considered to be a negative experience. Aristides forms a partial exception to this statement, as he found meaning in the knowledge and belief that his continuous pain was necessary for improving his oratory to almost divine levels. This changed with the rise of Christianity, where a community of suffering bodies emerged. In certain Christian circles, the meaning of long-lasting pain changed, thereby changing pain behavior as well. The development of lifelong martyrdom, of experiencing and embracing chronic pain voluntarily, shows a significantly different aspect of the chronic pain theories and especially physical–emotional experiences from those that we have witnessed so far. Instead of fearing death when in pain, as the physician Aretaeus presupposed, Christians belonging to Gregory’s group of suffering bodies welcomed it as a means of salvation. That does not mean, however, that Christian chronic pain theories were more religious in nature than their pagan counterparts. Divine agents caused Philoctetes’ pain, and the healing god Asclepius aided Aristides. The difference between these two religious groups is that pagans used the divine more as an explanatory tool or as a healing method, whereas Christians also used the divine as a goal or aim in its own right. In other words, the theory of chronic pain itself remained the same—what changed was the meaning and purpose pain received.

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CHAPTER FOUR

Blindness Visual Impairments in Antiquity FREDERIK VAN DEN ABEELE

4.1. INTRODUCTION In the fifth book of Cicero’s Tusculanae Disputationes, the discussion focuses on the sufficiency of virtue for leading a happy life. At one point in his analysis, Cicero touches upon the subject of disability: Then again, emotions of the soul, anxieties and distresses are alleviated by forgetfulness when the thoughts of the soul are diverted to pleasure. Not without reason therefore Epicurus ventured to say that the wise man always has more of good than evil because he always has pleasure; and from this he thinks there follows the conclusion we are in quest of, that the wise man is always happy. “Even if he is to be without sense of sight, of hearing?” Even then; for he despises such things in themselves. For to begin with, what pleasures, pray, does the blindness you dread so much have to go without? Seeing that some even argue that all the other pleasures reside in the actual sensations, while the perceptions of sight do not go along with any delight in the eyes, in the same way as the perceptions of taste, smell, touch, hearing are confined to the actual organ of sensation: nothing of the sort takes place with the eyes: it is the soul which receives the objects we see. Now the soul may have delight in many different ways, even without the use of sight; for I am speaking of an educated and instructed man with whom life is thought; and the thought of the wise man scarcely ever calls in the support of the eyes to aid his researches. For if night does not put a stop to happy life why should a day that resembles night stop it? For the remark of the Cyrenaic Antipater is, it is true, a bit coarse, but its purport is not pointless; when his womenfolk were bemoaning his blindness, “What is the matter?” he said: “is it that you think there is no pleasure in the night?” (Cicero, Tusculanae Disputationes 5.111–12; transl. J. E. King) Apart from Cicero, various other ancient writers have touched upon blindness, or visual impairments more generally. The diminishing or even complete loss of sight was something that intrigued philosophers, but of course other individuals such as physicians as well. When reading about visual impairments and the people who were visually disabled, one starts wondering how people experiencing a visual impairment

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were integrated in earlier societies. With regard to the medieval West, historian Jacques Le Goff depicted it as a society: full of blind people with sunken eyes and empty pupils who would come to stare out at us in the frightening picture by Breughel; the Middle Ages were full of the maimed, hunchbacks, people with goitres, the lame and the paralysed. (Le Goff 1988: 240) His depiction, fixed on the ubiquity of physical and sensory disabilities, is a rather atypical way of portraying an earlier society. Yet despite its peculiarity, one can imagine how this scene is not entirely extraordinary. After all, also in our current society a large number of people experience various forms of disability. Regarding visual impairments, for example, the World Health Organization estimates that today 1.3 billion people live with some form of visual impairment (WHO 2018). Evolutions in medical applications, such as contact lenses, and ophthalmological aid methods, such as pharmacological treatments or advanced surgical procedures, have helped to reduce - to a certain extentthe percentage of the world’s population experiencing visual impairments. Without any doubt, and certainly in the absence of these modern techniques, the proportion of people experiencing visual impairments must have been substantial in the Middle Ages. Logically, a similar conclusion can be drawn for Antiquity. In stark contrast to this (portrayed) omnipresence of disabled people stands the years of negligible attention received by this particular social group in historical research. However, due to the more recent emergence of a growing interest in disabilities, culminating in the publication of various studies, disabilities and the people who were disabled have progressively gained their place in the historical debate. Inevitably, this research on the impaired sparked off a more theoretical debate on how to tackle the methodological problems. One of the fundamental issues concerns the relative scarcity of relevant sources and their nature. Evidently, when no first-hand accounts of people with a certain disability exist, which is the case for visual impairments in Antiquity, it is impossible to understand the subjective experience of these people (Trentin 2013: 92). As secondary sources thus become more important, this raises the question as to the extent to which we can rely on the literary representation of disabled people in order to understand how these people would have experienced everyday life. Naturally, a distance between reality and representation will always remain, but—as Trentin notes—these secondary sources can offer us, to a certain extent, a reflection of social attitudes on the impairment (2013: 92). Thereafter, it is through small anecdotes and details that we, today, are able to increase our knowledge of the living conditions of the people who were disabled. A random source mentioning a visually impaired person guided by young slaves gives us, for example, insight into the ways in which these individuals did not let their disability confine their freedom of movement. Another methodological issue concerns terminology. Up until now, terms such as “disabled” and “impaired” have been used automatically to describe a particular social group of people in Antiquity. Yet, one should not forget that these concepts are relatively modern. Ancient societies did not have a similar umbrella concept to identify disabilities, and their own terminology to describe physical or mental “disability” was relatively vague (Krötzl et al. 2015: 3–5). In the context of disability studies, this methodological problem is overcome by some through the creation of an artificial distinction between “impairment” and “disability.” The former alludes to the biological nature of a condition,

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while the latter refers to the social construct attached to a somatic condition in a specified period (Metzler 2011: 45). Others have refuted this fictional dichotomy in favor of the single concept “disability,” which would then be defined as “something that is constructed by both bodily difference and social perception at the same time” (Eyler 2010: 8). In my view, as both terms are modern constructs, they can be used interchangeably when referring to somatic and cultural aspects. Naturally, the issue at hand is not confined to the use of umbrella concepts such as disability and impairment. One should equally be conscious not to instinctively transpose terminology relating to visual impairments concepts that have at first sight universal usage (Marx-Wolf and Upson-Saia 2015: 266). The answer to the question of whether someone is visually impaired will not only depend on the specified period, but also on the context. Section 4.2 will therefore provide an overview of the most commonly used terms to denote different forms of visual impairment in Antiquity. However, it should be kept in mind that despite the wide range of terms identifying different degrees of sight, the application of these terms in the ancient world was quite flexible. In Section 4.3, the focus shifts to more theoretical understandings of the eye and eye afflictions such as blindness. Apart from identifying the causes mentioned by ancient authors, this section will center on the (medical) knowledge regarding visual impairments and the availability of treatments and cures for people who were visually impaired. This closely links to Section 4.4, which will elaborate on the everyday life of visually disabled people and, more generally, on the social attitudes with regard to visual impairment. As might be expected, this will also touch upon the representation of this disability in ancient culture.

4.2. WHAT’S IN A NAME? THE VISUAL IN WRITING When speaking about blindness, everybody has more or less the same idea in mind. Based on common knowledge, blind people simply cannot see anything. Yet, speaking about blindness in a medical context often calls for further clarification. After all, the World Health Organization distinguishes between various different categories of visual impairment, including three types that are labeled “blindness.”1 Based on these categories, someone is considered “blind” if they have “a presenting visual acuity of worse than 3/60 or a corresponding visual field loss to less than 10° in the better eye” (WHO 2013: 7). This means that you can see at three meters what the average person can see at sixty meters. This example shows how context is important when referring to visual impairments. Likewise, it is good to know when a specific term is used in a certain period. In Antiquity, a terminological variety of words and groups of words exists in Ancient Hebrew, Greek, and Latin to describe the eyes and the various degrees of eye afflictions (Just 1997: 17–70). Despite this plethora of terminology, most forms of visual impairment actually receive very little attention, at least in comparison with blindness. In most cases, physical blindness is described by ‫( עִ ּוֵר‬Hebrew), τυφλός (Greek), or caecus (Latin). Apart from in exceptional or miraculous cases, these terms were only used to describe a situation of total and permanent blindness. This implies the presence of some coherency in the sources. So does Aristotle state that only the man who lacks sight in both eyes is called blind (Metaphysica 1023a). In his Origines, Isidore of Seville shares Aristotle’s conclusion, but then for the use of caecus (10.60). Although the term ‫ עִ ּוֵר‬is less clearly specified than its Greek and Latin counterparts, based on circumstantial evidence,

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it can also reasonably be assumed that the term refers in most cases to a situation of total and permanent blindness (Just 1997: 32). Just notes that the ‫ עִ ּוֵר‬word-group is never used in a context where it is clear that any residual vision is left (1997: 32). Apart from these three words, many synonymous expressions are used to denote a situation of total blindness. This is especially the case in Latin sources where word-groups revolving around the terms lumen and visum are frequently used to depict blindness. Amittere lumen oculorum, lumen amissum, and visum auferre are just some examples. Besides the words τυφλός and caecus, a study by Meulenijzer has distinguished more than 200 Greek and Latin words relating to the eyes and eye problems (2013).2 For those familiar with the ancient sources, it might come as no surprise that many different words have been found. After all, visual impairment—and especially blindness—is undoubtedly the disability that is most mentioned by ancient authors. This interest in eye problems can be attributed to various factors. Greco-Roman society is centered on performance and visual spectacle (Laes 2014: 99). Sight occupied a central position in the cultural imaginary (Squire 2015: 10) and was deemed to be of primordial importance in accessing the world (Coo 2015: 237). Undoubtedly, the profound attention paid to vision and the (partial) loss of sight in the sources is linked to this ocularcentric thinking. Moreover, the strong presence of visual impairment in ex voto and miracle stories can be explained by the special position occupied by the restoration of sight to the blind in the Christian tradition. So is the healing of the blind perceived in the Old Testament as the ultimate miracle, and it plays a central role in the New Testament as a manifestation of the divine power of Christ (Barasch 2001: 65). However, at odds with its central position stands the observation that physical blindness is rarely cured in the Old and New Testaments. It is even the exception rather than the rule (Horn 2013: 132). In exceptional cases, blindness—or better the terminology used to depict blindness—loses its permanent character and becomes a temporary condition from which a person can be redeemed (Barasch 2001: 65). In these stories, visual impairments obtain a symbolical function that has in many narratives a punitive nature. This is, for example, the case in the following anecdote in the Vita Amandi. By divine intervention, a woman was struck by blindness (caecitas) as she worshipped auguries and idols. After stating this, she led the man of God Amand to the tree where she had venerated her demons. Then he said: I am not surprised that you became blind for this stupidity, but I am amazed that the Lord’s mercy has sustained you for so long. When you should adore your Creator and Redeemer, you adore demons and dumb idols, who cannot do anything for you or for themselves. Now thus take the axe and take down this despicable tree by which you have lost your bodily sight (lumen amisisti corporis) and the redemption of your soul. I believe that if you would strongly believe, you can receive the light that you originally had obtained from the Lord. (MGH, SRM, Vita Amandi Liber 1, 24 (5.447))3 After following his instructions, the woman recovered from her impairment, as she had demonstrated her faith in God by demolishing the altar. Not surprisingly, the story does not focus on her visual impairment, but rather on her inability to believe in the Christian God. Her blindness is a physical manifestation of her inability to believe. In exchange for her confession, her sight is restored as a gift.

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Restoration of sight to the blind is certainly not a novelty in Christian sources. In various pagan traditions in Antiquity as well, like the cult of Isis and the sanctuary of Asclepius at Epidaurus, are such miraculous events known to be possible (Horn 2013). One of the Stele at the sanctuary at Epidaurus, for example, mentions the story of Aeschines who became temporarily blind as punishment for his curiosity (Błaśkiewicz 2014: 62): Aeschines, when the suppliants were already sleeping, went up a tree and peered over into the Abaton [the place inside the sanctuary of Asclepius at Epidaurus where sick and impaired people were laid to rest in the hope of meeting Asclepius in their dreams]. Then he fell out of the tree and impaled his eyes on some fencing. In a dreadful state, having been blinded, he earnestly prayed to the god, slept here, and became well. (Stele A11, transl. LiDonnici 1995: 94–5) Just as the Latin word caecus lost its permanent character in the earlier story, so does the most commonly used Greek word τυφλός lose its irreversible nature. Yet one should not forget that the stories are miraculous and, in the absence of divine intervention, the blindness would have been permanent. In this way, the use of caecus and τυφλός in the stories is in line with the permanent character generally attributed to these terms. When a person has only lost (sight in) one of his or her eyes, the visual impairment is almost never referred to as “blind in one eye.” When referring to partial loss of sight, various terms are available to ancient authors. Without the intention to be exhaustive, one can think of Greek words such as μονόφθαλμος (“having one eye”), ἑτεροφθαλμος (“deprived of one eye”) (Just 1997: 50), and ἁτερόπτιλλος (“capable of sight in one eye”) (Horn 2013: 124). In Latin, the most commonly used terms are luscus, luscinius, and cocles (Trentin 2013: 92–4).4 These words might ring a bell, as they appear in famous Roman cognomina, such as Horatius Cocles and Gaius Fabricius Luscinus. In Hebrew, Just notes, there is no separate word meaning “one-eyed” (Just 1997: 33). Apart from being one-eyed or blind, people in Antiquity were naturally also well aware of various other eye problems. In particular, medical sources are relevant in this regard as the eyes and eye problems are very often main objects of study. Eye diseases even represent a “disproportionately great part of Greek and Roman medical literature” (Jackson 1996: 2229). So does the Greek physician Galen attest over one hundred eye pathologies, as does the Roman encyclopedist Celsus devote ample attention in his De Medicina to the causes and treatments of eye problems (Jackson 1996: 2229; Trentin 2013: 95–6). The range of medical knowledge of the eye and its problems in Antiquity will be more extensively covered in Section 4.3.

4.3. BETWEEN THEORY AND PRACTICE It is not difficult to imagine situations that can lead to a visual impairment. Not paying attention to oncoming traffic or getting (forcefully) involved in a street fight are just a few examples of such events. Furthermore, ancient authors were well aware of the fact that a visual impairment could already be present at the time of birth. The Greek geographer Pausanias narrates the story of the Messenian seer Ophioneus, who was blind from birth, temporarily regained his sight, and then suddenly became blind again (Periegesis 4.10.6, 4.12.10, 4.13.3). The Roman historian Livy notes that at Ariminum “free-born children without eyes and noses had been born” (Ab urbe condita, 34.45.7, transl. J. C. Yardley). In Christian sources, one can also find many examples in the Bible and hagiography. So

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does the New Testament mention the story of Jesus healing a man who was blind from birth (John 9:1–12; see also Wheatley 2017a: 68). As might be expected, people in Antiquity also knew that at the end of one’s life a person was likely to experience a reduction of vision or even blindness (Laes 2014: 106). Many people would surely have known the stories of Isaac (Gen. 27:1), Israel (Gen. 48:10), and Eli (1 Sam. 3:2, 4:15), who all became visually impaired at a later age. Another well-known example is mentioned by Suetonius in his Divus Augustus. At a later age, Emperor Augustus’ vision in his left eye had been diminished (79.2). This observation by Suetonius stands in stark contrast with a prior physical description of the emperor (Trentin 2013: 105), where Augustus is depicted as a man with clear, bright eyes and in which he wanted it to be thought that they had some divine power (Divus Augustus 79.2). Apart from Suetonius, many other sources narrate stories of various (important) individuals experiencing a gradual loss of vison. More importantly, they shed light on the effects that the diminishing or loss of vision had, or did not have, on the capabilities of individuals. So does Trentin note that in the case of Augustus, there is no indication that his visual impairment would have diminished his auctoritas (2013: 105). Also, the Stoic Diodotus did not seem hindered by his visual impairment (blindness), as he devoted himself more strenuously to philosophy, played the lyre, and continued to teach geometry (Cicero, Tusculanae Disputationes, 5.113).5 Furthermore, it was known that heredity could be a possible cause of visual impairments (Laes 2014: 105–6). So did the Corinthian general Timoleon gradually lose his sight at an older age and even became completely blind. As Plutarch notes, he did not cause this himself, but it was due to a congenital condition that had already led some of his family members to lose their vision in a similar way (Timoleon, 37.5). Thereafter, Aristotle notes the following: There are also births of defective children from defective parents, for example lame from lame and blind from blind, and in general children who often resemble them in respect of unnatural features and possess from birth such marks as growths and scars. There has been a case of such a mark returning in the third generation: a man had a tattoo on his arm, which his son did not have but his grandson was born with it in the same place, blurred and dark. Now such features are few, and in most cases they do not occur but the children of defective parents are completely sound and there is no special rule regarding them. (Aristotle, Historia Animalium 585b–6a, transl. D. M. Balme) Probably the leading cause of visual impairment was disease (Trentin 2013: 95), with lippitudo and aspritudo being the most frequently mentioned visual problems (Jackson 1996: 2229). These terms were used to depict, as Trentin notes, “a range of eye diseases and infections characterized by inflammation and running of the eyes” (2013: 95–6).6 Although ancient eye specialists did not have access to modern medications, vaccines, and antibiotics, a comprehensive range of treatments was available to them. In particular, the collyrium stamps (signacula ocularioum)—objects used to mark eye medicines—are interesting in this regard, as they contain a lot of information. So do these stamps make reference to the name of the eye medicine and of the physician, as well as to the condition for which the drug was intended.7 Standard treatments were, among other things, baths, bloodletting, and dietary therapy, often in combination with the administration of medication (Trentin 2013: 96).

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Pliny the Younger writes in his letter to his colleague Cornutus that he is taking care of his eyes. He takes a bath, as it is good for him, and drinks wine, as it does not harm him (Epistulae 7.21.1–4). Likewise, Celsus recommends bathing and drinking of wine for a variety of (minor) eye problems (De Medicina, 6.6). In the case of proptosis, where the eyes are pushed forward due to violent inflammation, Celsus described as a treatment that blood should be let out, or otherwise a clyster and prolonged abstinence should be prescribed (De Medicina 6.8g–9c). People diagnosed with mydriasis, a condition in which one or both of the pupils are dilated and the vision becomes dimmed or even lost, are sometimes cured with hot water, while others have less luck and suddenly become blind without any apparent cause (De Medicina 6.6.37a–b). Just as today, so long as nonsurgical measures were available, surgery was not recommended, as the risks were well known by physicians. Of course, when these actions proved ineffective, surgery was used as a measure of last resort (Jackson 1996: 2248). Those who were brave enough could only hope that the eye surgeon had a steady hand, a light touch, and a lot of courage (Jackson 1996: 2247; Laes 2014: 103). Various surgical treatments are described, but the one that probably sparks one’s imagination the most is the operation used to treat cataracts, as it was the one operation performed on the interior of the eye (Jackson 1996: 2248). According to ancient practitioners, a cataract was a suffusion of diseased humor in the supposed locus vacuus between the pupil and the lens, the latter being thought to be located in the center of the eye (Rucker 1965: 338; Jackson 1996: 2248). The surgical procedure is meticulously attested. Three days before the operation, the patient was put on a diet. On the day of the surgery, the patient had to be seated facing the surgeon, who sat slightly higher. An assistant had the important task of holding the patient’s head still, as the slightest movement could cause permanent damage to the eye. After the surgeon had covered the other eye with wool and subsequently bandaged it, the operation started: [A] needle is to be taken pointed enough to penetrate, yet not too fine; and this is to be inserted straight through the two outer tunics at a spot intermediate between the pupil of the eye and the angle adjacent to the temple, away from the middle of the cataract, in such a way that no vein is wounded. The needle should not be, however, entered timidly, for it passes into the empty space; and when this is reached even a man of moderate experience cannot be mistaken, for there is then no resistance to pressure. When the spot is reached, the needle is to be sloped against the suffusion itself and should gently rotate there and little by little guide it below the region of the pupil; when the cataract has passed below the pupil it is pressed upon more firmly in order that it may settle below. If it sticks there the cure is accomplished; if it returns to some extent, it is to be cut up with the same needle and separated into several pieces, which can be the more easily stowed away singly, and form smaller obstacles to vision. (Celsus, De Medicina 7.7.14d–f, transl. W. G. Spencer) After that, the needle had to be pulled out. Lastly, the eye was covered with a woolen cloth soaked in egg white together with something to counter inflammation. After reading the surgical procedure, it might come as no surprise that there may have been eye surgeons who specifically specialized in cataracts (Figure 4.1) (De Medicina, 7.7.14; Jackson 1996: 2248).8 When reading about eye doctors and eye surgery, one must not forget that, unlike today, the Greco-Roman world did not have institutionalized training and degrees

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FIGURE 4.1  Cataract surgery in the sixteenth century (a similar setup as in Celsus’ time), Bartisch Georg, Ophtalmodouleia, Das ist Augendienst, 1583.

(Laes 2014: 101). Although there certainly were physicians specialized in the eye, there would also have been various healers with very limited medical knowledge, or even no knowledge at all. However, as Celsus notes, most eye problems could be taken care of by simple and readily procured remedies (De Medicina 6.6.39c). In most cases, people experiencing an eye problem would therefore most likely look for an eye medicine themselves. Those drugs were, known from ancient authors, widely available on the market (Laes 2014: 100). More advanced was the institutional system of care for the sick and suffering set up in the Byzantine Empire under the influence of Christianity (Efthymiadis 2017: 393). From the fourth century onwards, “hospitals” emerged in the East Roman Empire that conceptually have a lot in common with the way such institutions are perceived today, namely as a sustainable establishment where medically trained personnel offer treatment (Efthymiadis 2017: 393).9 One source even mentions a hospital for the blind (Laes 2014: 122). Moreover, various sources hint at the availability of individuals with at least some medical expertise. The Passio Leudegarri describes the unfortunate fate of a woman whose head became swollen after a spider bite. Eventually, the woman became deaf and blind due to the swelling. She requested the aid of Saint Leodegar after she had fruitlessly consulted

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medical experts (MGH, SRM, Passio Leugedarii III Auctore Frulando 33 (5.361)). Another encounter with doctors is narrated in the De Virtutibus Sanctae Geretrudis. In the region of Nivelles, there was a girl who experienced a severe chronic illness. Over the years, many doctors were consulted, yet none of them could help the child. Eventually, the girl became blind. In desperation, her parents brought her to the monastery of Nivelles, where they hoped to find a doctor who could help them (MGH, SRM, De Virtutibus Sanctae Geretrudis, 5 (2.466–7)). Although one can debate the authenticity of these stories, they offer us valuable insight into the practices and attitudes of earlier society, as they are set in everyday life and not in some mythological place. Consequently, one could ask the question as to why the parents in this last story assumed that a doctor could be found in the monastery of Nivelles. Was medical assistance at the time indeed so readily available? Further analysis of this topic falls, however, outside the scope of this chapter. Apart from natural origins, another commonly attested cause of visual impairment is accidental or intentional injury (Trentin 2013: 98–104). As already stated above, you need to use only your imagination to come up with a number of causes of eye problems, and accidents will surely be some of the first things a person thinks about. Without protective gear, work accidents would certainly not have been uncommon. In particular, in dangerous profession such as woodworking, glassblowing, and mining, the number of eye injuries would have been substantial (Trentin 2013: 98). Imagine what the eyes of a blacksmith or a glassblower had to endure without today’s protective eyewear. Furthermore, the working environment of a soldier is not the safest place for the eyes, too. Various sources mention tales of people sustaining eye injuries in battle. Well-known examples of generals experiencing visual impairment are Horatius Cocles and Hannibal, who both lost an eye in combat. Also, tragic stories of eye injuries sustained by ordinary soldiers are often described. At the Battle of Dyrrachium during the civil wars between Caesar and Pompeius, Caesar notes that no less than four centurions of the same cohort lost their eyes (De Bello Civili 3.53). The Roman epicist Lucan wrote a detailed, and more frightful, story about the soldier Tyrrhenus: Tyrrhenus was standing on the lofty bow of his ship, when Lygdamus, a wielder of the Balearic thong, aimed a bullet and slung it; and the solid lead crushed his hollow temples. The blood burst all the ligaments, and the eyes, forced from their sockets, rushed forth. Tyrrhenus stood amazed by his sudden blindness, believing that this was the darkness of death. But when he felt that his limbs retained their strength, he called to his companions: “As you are wont to place your engines, so place me too in the right position for hurling darts. Tyrrhenus must spend what remains of life in every hazard of war. This body, half dead already, can play a soldier’s part nobly: I shall be slain in place of a living man.” With these words he launched at the foe a dart which, though no eye guided it, was not launched in vain. (Lucan, Pharsalia 3.722–3; transl. J. D. Duff) Undoubtedly, a significant number of soldiers would have sustained eye injuries during their years of service. Some evidence suggests that these war scars could have been marked as symbols of honor (Trentin 2013: 100), which gives an indication of the social status of visually impaired soldiers and the assistance they were able to receive. This will be explored further in Section 4.4. On many occasions, street fights would also have resulted in (permanent) damage to a person’s eyes. A study by Nutting suggests that in personal attacks the eyes would have been deliberately targeted, often with the intent to gouge the eyeballs from their sockets

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(oculus effordere) (1922: 313). Eye injury could also be the result of punishment— something for which Roman emperors are well known (Trentin 2013: 101). Emperor Domitian once attempted to gouge out the eyes of Stephanus, a steward of Domitilla, who had tried to kill him (Suetonius, Domitianus 17.2), and Emperor Commodus was notorious for his collection of “one-eyed” men, people from whom he had plucked out an eye (Scriptores Historiae Augustae, Commodus 10.6). Blinding was also a common method of punishment in Byzantine culture. This becomes abundantly clear through the hundreds of cases of blinding in historical texts. The penalty of mutilation, such as the gouging of eyes, was carried out, among other things, in cases concerning conspiracy, magical arts, insurgency, and theft (Lascaratos and Dalla-Vorgia 1997: 51). If the penalty was blinding, an iron dagger was mainly used, yet if this was not available, any sharp tool would suffice. In some cases, the eyes were destroyed by fire using a heated iron or, more rarely, burning coals or boiling liquid. This last method was used to blind Andronicus Palaeologus and his son John (Lascaratos and Marketos 1992: 134–40). Blinding as punishment was, however, not an invention of the Byzantines. The method of destroying the eyes by fire was, for example, originally practiced by the Persians (Lascaratos and Marketos 1992: 135), and according to Herodotus, the Scythians blinded all of their prisoners (Historiae 4.2) (Figure 4.2). Similar scenes took place in the early medieval West, where the act of blinding was often used to dispose of political adversaries (Büttner 2009: 47, 50; 2017). It is also attested in early medieval legislation as a punishment for various crimes, such as murder and theft (Büttner 2009: 49, 51–2). The act of blinding as lawful action by the state can also be linked to the principle of “an eye for an eye, a tooth for a tooth.” Although this ius talionis (law of retaliation) is generally associated with the Babylonian law of Hammurabi, the principle was present in many ancient statutes (Laes 2014: 109). The Roman Law of the Twelve Tables, for example, also endorsed this principle. However, it is debated whether the rule was (often) put into practice.10 Reference to the law of retribution can also be found in the Bible (Just 1997: 81). In Leviticus, it is stated that “anyone who injures their neighbor is to be injured in the same manner: fracture for fracture, eye for eye, tooth for tooth. The one who has inflicted the injury must suffer the same injury” (24:18–20).

FIGURE 4.2  Blinding of Leo Phokas after his unsuccessful revolt (tenth century CE), Chronicle of John Skylitzes, eleventh–twelfth centuries CE.

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Blinding as punishment was also a recurrent theme in Greek and Roman mythology. The Trojan priest Laocoon was gruesomely blinded by the goddess Athena, as he had called for the destruction of the wooden horse (Quintus Smyrnaeus, Posthomerica 12.395– 415). According to the Greek Apollonius, Zeus had blinded the seer Phineus, as he had inappropriately used his prophetic powers (Argonautica 2.178–86). Likewise, the seer Tiresias was punished by the gods as he had revealed their secrets to mankind or, according to others, as he had seen the goddess Athena naked (Apollodorus, Bibliotheca 3.6.7). Also in the hagiography, one can find examples of divine intervention leading to blindness, such as the earlier attested story of the woman who was blinded as she adored idols and auguries. One could also become intentionally visually impaired by one’s own hand. In ancient culture, the act of self-blinding was linked to the well-known tale of Oedipus (Laes 2014: 108).11 In the Bible as well, the gouging out of one’s own eyes is attested. In Matthew, the following text can be found: “If your right eye causes you to stumble, gouge it out and throw it away. It is better for you to lose one part of your body than for your whole body to be thrown into hell” (5:29). This is a passage that is later repeated (Mat. 18:9) and can also be found in the gospel of Mark (9:47). Additionally, some saints, such as Brigid of Kildare (c. 451–525 CE), are known to have made themselves blind (Laes 2014: 122; Wheatley 2017b: 407). Lastly, ancient sources mention a variety of other causes of visual impairment, with one being more uncommon than the others (Laes 2014: 107). The Vita Galli attests the following gruesome disfigurement by lightning: A certain man was struck by lightning and after a long illness lost the use of his limbs and was so deformed as to appear a monster rather than a human being. He was woefully shrunk in height and was unable to walk; his face was moreover fearfully disfigured by the scars of fire and the flesh and skin had grown over his eyes till the sockets were almost obliterated, so that he was an object to inspire wonder and loathing. (MGH, SRM, Vita Galli Auctore Walahfrido Liber 2, 26 (4.329–30), transl. M. Joynt 1927: 13–140) Apart from simply mentioning the various causes of visual impairment, all of these brief anecdotes give us insight into social attitudes and perceptions concerning visually disabled people and visual impairment. After all, as Trentin correctly notes, these accounts are all embedded in a specific discourse on the visual (2013: 91). At this point, some ideas regarding visual impairments have already been highlighted. Section 4.4 will further elaborate on these, while simultaneously discussing the living conditions of the visually impaired in everyday life.

4.4. VISUALLY DISABLED PEOPLE: A COMMON SIGHT IN ANTIQUITY How many people in Antiquity were visually impaired? A comprehensive answer to this question will most likely never be formulated. Although over the years numerical comparisons between the ancient world and our current society have been conducted, the end results are always mere assumptions and never clear numbers. The reason for this is that ancient sources very rarely talk about demographic tendencies. Consequently, comparisons between then and now are, as Laes notes, “risky business” (2014: 98). What can undoubtedly be concluded, however—as was already emphasized in the introduction

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to this chapter—is that the number of people experiencing a visual impairment in Antiquity would have been substantial. As Section 4.3 made clear, the probability of becoming visually impaired during one’s lifetime was—and is still—high. For many years, blind people in Antiquity were thought to be isolated from their communities. Recently, this prevalent idea has been heavily criticized by various scholars, who have argued that it gives a distorted image of the place of the visually impaired in ancient society. Based on the extant sources, as Rose notes, “sighted people knew blind and sight-impaired people well enough to understand the abilities and limitations of failing vision” (Rose 2003: 93). The visually impaired were thus certainly not alienated or segregated, but must have been a rather common sight in everyday life. Furthermore, they would have been active members of their societies. Notwithstanding this more positive image, one should not picture the fate of blind people and those with other visual impairments too rosily. Visual impairments could, for example, also have been the subject of ridicule—a topic that will be tackled later on. 4.4.1. Getting through the day A common misconception is that children with a (visual) disability in Antiquity were not given the chance to grow up, as they were killed immediately after birth or were abandoned at a place where they would soon find death (Laes 2008: 92). Although no ancient historian would deny the existence of such practices, they would certainly not state that the practice was performed without exception. After all, many sources refer to people with congenital (visual) impairments. When referring to the practices of infanticide and child exposure in Antiquity, one should be careful not to analyze these phenomena with our current set of ideas in mind. As some authors have made clear, the act of infanticide is not the same as child exposure (Boswell 1988). Grubbs has argued that in ancient Rome, parents who abandoned their child would not see themselves as killing the infant, but in their view would be giving the child a last chance at survival (2011: 22). If the child is born without (one of his or her) eyes or if they are underdeveloped, the visual impairment is naturally observable at the time of birth. This is, however, not the case for all visual impairments. Some may only become obvious after the child has been accepted into the family. As Laes notes, in those cases, the dismissal of the child (Pädizid) would be far more exceptional than killing the child immediately after birth (Infantizid) (2008: 97). As not many extant sources refer to examples of infanticide or child exposure and reference to social attitudes regarding the practices is extremely scarce, we are left with many unanswered questions.12 Furthermore, one can only guess at the (common) reasons for parents either exposing or killing their child. The prospect of raising a disabled child without enough financial resources might have been an important reason. Fear of public opinion for having a visually disabled child could also have been a decisive argument. Furthermore, shame is undoubtedly an emotion linked to impairment, and as such might have led to infanticide or exposure. When the father of Odilia heard that his child had been born blind, he was ashamed and furious. He decided that the child had to be killed. His wife tried, however, to persuade him not to kill the girl. The father agreed, so long as his blind child was sent away (MGH, SRM, Vita Erhardi 7 (6.13); MGH, SRM, Vita Odiliae 2 (6.38); see also Thurston and Attwater 1990: 551). The fact that we are ill-informed of the reasons for dismissing or keeping a disabled child also becomes clear in the following anecdote regarding the life of Saint Sadalberga.

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When her father Gundoin had met the man of God Eustasius, he invited him to his home. There, Eustasius asked if he had any children, at which point Gundoin presented his two young sons, Leuduimus and Fulculfus, along with his wife, Saretrude. After that, Eustasius asked if there was another child. Gundoin and Saretrude admitted that there indeed was a girl, but she had lost her sight for some time (dudum luminibus orbatum) (MGH, SRM, Vita Sadalberga 4 (5.52–3)). This story has a lot in common with a modern case attested by Laes in which some villagers in Albania hid their disabled child, but at the same time took good care of them (Laes 2008: 86). It is very interesting that the parents (initially) kept the child hidden in both stories. Identifying the main reason for this anonymity is difficult. Was is shame, fear, or perhaps a sense of helplessness that led to the parents’ action? In the life of Sadalberga, her parents were undoubtedly her main caretakers. Most likely, in many families parents were only one element in the larger circle of individuals responsible for the education of a child. In Roman Antiquity, Laes notes that children were raised in a broader community of slaves, servants, family members, and older and younger brothers and sisters (2006: 87). Moreover, a nurse (nutrix) would also have played an important role in the care of the child in the early years of its life. Outsourcing the child’s care to a nurse was, according to Laes, most likely something that occurred in both the upper and the lower social classes (2006: 60). There is no indication that this would have been any different for children experiencing a (visual) impairment. In the absence of servants, slaves, and relatives, one could potentially rely on the community as, according to Trentin, “there was a strong network of interdependence that extended beyond the family to the wider community” (2013: 110). Once a (visually impaired) person had reached the proper age, he or she was integrated into the daily working process. As active members of the community, visually impaired people were certainly not excluded from this. One source gives a rare description of daily life in ancient Alexandria where, according to the text, everybody was working: They are a folk most seditious, most deceitful, most given to injury; but their city is prosperous, rich and fruitful, and in it no one is idle. Some are blowers of glass, others makers of paper, all are at least weavers of linen or seem to belong to one craft or another; the lame have their occupations, the eunuchs have theirs, the blind have theirs, and not even those whose hands are crippled are idle. (Scriptores Historiae Augustae, Firmus, Saturninus, Proculus et Bonosus 8.5–6; transl. D. Magie) Of course, not all tasks could be performed by a severe visually impaired person, yet many jobs were definitely within the range of their physical abilities. One might immediately think of simple tasks in agriculture like milking or harvesting. Likewise, work in certain crafts and industries would also be open to them. In mining, blind people were, for example, put to work in mine shafts (Laes 2014: 114–15). However, not all severely visually impaired people would have had the fortune to get a job, and many would have been reduced to beggary. As is the case today, beggars—among them people with visual impairments—would have been a common sight in major cities, where they would strategically place themselves at crowded stops and places frequently visited by the rich, hoping to receive more money. Some sources even mention intentional mutilation and the act of blinding slave children simply to evoke empathy, again in the hope of receiving more alms (Laes 2014: 113–14).

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Seneca the Elder attests the case of a man who crippled children and forced them to become beggars (Controversia 10.4). As Laes notes, this story “cannot simply be discarded as a rhetorical exaggeration” (2008: 114). A similar case is attested by John Chrysostom. As he notes, some parents blinded their children so that they became beggars (Homilia in Epistulam I ad Corinthos 21.5; PG 61.176–9). With that being said, ancient culture certainly did not automatically identify blindness with beggary and vice versa. Just notes that “such a close identification between these groups is extremely rare in antiquity” (1997: 129). One atypical example can, however, be read in the work of Diogenes Laertius. When people asked the Cynic philosopher Diogenes why people give to beggars and not philosophers, he replied: “because they know that they may one day be blind or cripple, but never think they will become a philosopher” (Vita Philosophorum 6.56). In this example, it may be noticed that Diogenes implies the existence of a correlation between beggary, blindness, and physical impairments. For more examples of visually impaired beggars, one has to look at the satirical genre. The Roman poet Martial tells the story of a Libyan who became suddenly blind (repente caecus) as he was fishing at the Baian lake that was inhabited by sacred fish. Afterwards, he still sat at the lake of Baia, but now as a beggar (Epigrammata 4.30). For the wealthier classes, being visually impaired would not have made a political career (in the Roman times the so-called cursus honorum) impossible. After all, extant sources attest visually impaired politicians in Antiquity. The former praetor Cnaeus Aufidius still spoke in front of the Senate even after he had become blind (Cicero, Tusculanae Disputationes 5.112), and the blind Appius Claudius Caecus also gave his advice in the Senate (Appian, Samnitica 10.2). Furthermore, in the earlier attested case of Augustus’ left eye, Suetonius never (indirectly) implied that his visual impairment would have affected his capacity to rule. In the case of the Byzantine Empire, blindness could have had an influence on one’s chance of claiming the throne. After all, bodily integrity was required to become emperor, according to Byzantine constitutional theory (Lascaratos and DallaVorgia 1997: 53; see also Laes 2017b: 222–5). Then again, theory and practice are not always the same. One example is Isaac II Angelus, who was blind yet ruled as co-emperor with his son Alexius IV (1203–4 CE) (Lascaratos and Dalla-Vorgia 1997: 53). Getting through the day also means getting from one place to another. A person with only a minor eye problem would not see his or her impairment as a (major) obstruction to their freedom of movement. People with a more severe visual impairment or even blindness may, however, have experienced this differently. Traveling in Antiquity was also quite different from today. Many people would (almost) never leave their hometown, and so mass tourism as we experience it today did not exist at that time. Traveling for pleasure was largely confined to the wealthier classes. Of course, if you remain in your familiar environment, a severe visual impairment would have been less of an obstacle than if you had to go to various unknown places (Laes 2014: 115). Visually impaired people of sufficient wealth were accompanied by one or more slaves. Cicero wrote that when people asked Asclepiades, a known philosopher of Eretria, what blindness had brought him, “he answered: ‘one more boy in his retinue’; for just as the most utter poverty would be endurable if we could bring ourselves to do as certain Greeks do daily, so blindness could readily be borne, should we be supplied with the aids to our infirmities” (Cicero, Tusculanae Disputationes 5.113, transl. J. E. King). Sources also mention the use of a litter for carrying important persons, a mode of transportation that would likely also have been used by wealthier visually impaired people. Others may have relied on friends or family to guide them from one place to another. Appius Claudius

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Caecus was brought to the Senate by his sons (Appian, Samnitica 10.2). The blind seer Tiresias was accompanied by his daughter Manto (Seneca, Oedipus 289–90), and Oedipus by his daughter Antigone (Seneca, Phoenissae 1–50). In most cases, however, the blind would only have had the support of a stick. Luckily, as Ovid notes, people would make way for them (Tristia 5.6.31). To date, there is no indication that guide dogs were used in Antiquity. The idea that they were used, is based on a previous incorrect interpretation of one of Martial’s epigrams (14.81). At the end of one’s life, a phase in which most people would have experienced some form of visual impairment, the range of available assistance would have depended on one’s life choices and social class. If a person was married or had children, he or she would undoubtedly have found support with these persons. The Passio Leudegarii even describes a rather odd story of marital assistance. In one particular marriage, both partners were visually impaired: the man was missing one eye and the woman missing two (vir enim uno oculo ablato, coiux vero duos). To help his wife, the man used a string (furniculo) to guide her. Later, the woman recovered from her condition, and after that, she became the one guiding her husband with the string (MGH, SRM, Passio Leugedarii II Auctore Ursino 31 (5.354–5)). As this section has demonstrated, the visually impaired were by no means social outcasts. On the contrary, they were vital members of their communities and were as such integrated into everyday life. Section 4.4.2 will focus on social attitudes regarding visually disabled people and the portrayal of this impairment in ancient culture. As one might have already noticed, the social attitudes toward the blind and, more generally, the visually impaired are frequently much more benevolent than the prevalent image of the blind as social outcasts would suggest. Consequently, one can conclude that empathy for the undeserved fate of the visually impaired was also a (common) attitude, alongside ridicule, shame, and other perceptions. Furthermore, we can detect a variety of ideas in the representation of blindness. By some, it is perceived as a sign of (divine) punishment (Just 1997: 154), while others see it as a mark of honor. Some of these ideas and perceptions will now be more extensively covered. 4.4.2. Reacting to the blind: A roller-coaster of perceptions Lured by the tales of miraculous healing, the sanctuary of Asclepios at Epidaurus might have been frequently visited by people who had sustained injury in battle (Chaniotis 2005: 1). One of the Stele narrates the story of Anticrates of Cnidos: This man had been stuck with a spear through both his eyes in some battle, and he became blind and carried around the spearhead with him, inside his face. Sleeping here, he saw a vision. It seemed to him the god pulled out the dart and fitted the socalled girls back into his eyelids. When day came he left well. (Stele B12; transl. LiDonnici 1995: 108–9) Would he have tried to hide his disability or, on the contrary, display his war scar as a symbol of bravery? Moreover, what reactions would Anticrates have had from passersby? Would his blindness have made him perhaps a focus of ridicule or would it have earned him respect? In Roman times, loss of vision as a result of warfare, and war scars in general, could have been seen as marks of honor and bravery—at least, some evidence points in that direction (Trentin 2013: 100). Sertorius, a military tribune under whose command many triumphs had been achieved, sustained several wounds, such as the loss of an eye (effosso

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oculo). However, his wounds did not make him uneasy. On the contrary, he was delighted with the disfigurement of his body, as it showed how well he had preserved the rest of his body (Sallust, Historiae 1.76). From the Declamationes Minor by Pseudo-Quintilian, we are told the odd story of a war hero who had damaged the eyes of a prostitute, resulting in her blindness. The law stated that one who blinds another should either face the same (an eye for an eye) or act as their guide. Perhaps surprisingly, the man chose the first option, as he believed that it was not done that a hero should give his hand to a prostitute to show her the way. Obliquely, one notices that his deformity would not have the same value as it would have if he had sustained it in battle. The text ends with the following quite ironic thought: “You refuse to be a prostitute’s guide, but doesn’t it occur to you that your eyes will be gouged out because of a prostitute?” (Declamationes Minor, 297, transl. D. R. S. Bailey). One final example can be found in Plautus’ Curculio, in which the main character eagerly tries to convince everyone that he had sustained his eye injury in battle (392–400). Unfortunately for him, instead of respect, he receives laughter. Lastly, it should be mentioned that war wounds could also have incited more negative reactions when they were sustained in a battle that was lost. The loss of an eye might then be seen as a punishment, rather than a mark of bravery (Trentin 2013: 100). In his Quaestiones Convivales, Plutarch makes the reader aware that jokes regarding physical features are not always appropriate. While teasing someone about his or her baldness is acceptable, laughing at blindness or a bad-smelling mouth surely is not (633c). Also, Cicero states that in physical deformity one can find ample material for joking, yet one has to know that there are limits (De Oratore 2.239). While with the upper classes this form of etiquette might have need to be taken into account, Plutarch’s text surely cannot be seen as a reflection of everyday life. Without any doubt, visual impairments would have been the subject of mockery. In Juvenal’s Satires, the blind Lucius Valerius Catullus Messalinus, two times consul, was ridiculed as follows: along with deadly Catullus, who blazed with passion for a girl he had never seen, a great and remarkable monstrosity even in our age. He should have been a beggar blowing obsequious kisses at the wheels as the carriages come down the hill at Aricia. (Juvenal, Satires 4.113–8; transl. S. M. Braund) Although ridicule might thus have been a rather typical reaction in everyday life, this does not mean that disabilities might not have sparked positive reactions. Some pitied the blind as they were unable to see beautiful things. Just notes that this reaction is stated, or at least implied, by various characters of Lucian (1997: 203–4). Others, however, would have looked down on the visually impaired. Negative attitudes toward this group of people might find their origins in the negative ways in which visual impairments are sometimes portrayed. As already mentioned, a visual disability could be seen as a punishment of the gods—a theme not only present in Greek and Roman mythology, but also in the Christian tradition. Not surprisingly, if one believes that blindness is the result of punishment, one can link this impairment to evil or misfortune. Consequently, this could potentially lead to the exclusion of the visually impaired (Husquin 2018a: 250–4). With these insights, it might not come as a surprise that academics believed that (visually) disabled people were outcasts. Furthermore, some ancient thinkers believed that one can assess a person’s personality from their outer appearance (physiognomy).13 It was believed that through the eyes you can know a person’s mind. The eyes were sometimes also perceived as weapons. In his

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Naturalis Historiae, Pliny the Elder reports that there are people “among the Triballi and the Illyrians, who also curse with their glance and kill those at whom they stare for a long time, especially if they use an angry glare, which evil of theirs adults are especially prone to suffer” (7.16; transl. Bryen and Wypustek 2009: 550). Sometimes the idea of the evil eye was linked to physical impairments (Bryen and Wypustek 2009: 550). In Karanis, a rather strange series of events was reported to the Egyptian authorities. A man named Gemellus claimed that his neighbors Iulius and Sotas had attempted to take his land, because—so he said—they looked down on him due to his weak vision (P.Mich. 6.422). Shortly after this incident, Sotas died, whereafter Iulius came to Gemellus’ land carrying a fetus in order to encircle Gemellus’ tenant farmer with the evil eye (P.Mich 6.422–3; Bryen and Wypustek 2009: 535). Could it be that Iulius believed that Gemellus’ weak vision was a sign of the evil eye and, consequently, misfortune? As anthropological studies have shown that some communities find a scapegoat in people with visual impairments in cases of death or crop failure, Laes rightfully wonders whether this is what happened in Karanis (Laes 2014: 115). However, any statement on this subject will always remain speculation.

4.5. CONCLUSION Rose notes that “the story of blind people in the ancient Greek world is neither glorious nor dismal” (2003: 79). This statement can be broadened to the entire Greco-Roman world. After all, in light of the evidence provided by the mentioned ancient sources, the earlier image of the blind being social outcasts has to be adjusted. While it cannot be excluded that there may have been some ancient communities where people with a (visual) disability would have been segregated, it would be wrong to generalize this particular attitude. People experiencing a (visual) disability would have been a common sight in Antiquity. Their appearance would surely have resulted in more than one type of reaction. Some people might have pitied the visually impaired, while others might have ridiculed them. Another person might have paid little attention to such a common sight, while others might have looked down on them. Such a variety of attitudes can also be found in our current society. In even greater contrast with the “social outcast” idea stands the fact that the visually impaired would have been rather well integrated into everyday life. People with a severe visual impairment would have been able to find work. Needless to say, one should not try to find modern equipment used to aid the visually impaired. Most persons would only have had the support of a staff, although they might occasionally have found a guide in family and friends. However, one should be careful not to picture the lives of the blind, or the visual impaired in general, too rosily. Their everyday lives would in many cases also have been rather tough. With this chapter, I hope to have demonstrated that the visually impaired were not only perceived as bringers of misfortune, and that they were, in general, far from social outcasts. As is the case today, the perceptions and attitudes regarding this impairment are much more diverse than one would at first sight believe.

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CHAPTER FIVE

Deafness Sensory Impairment as Communication Disability, Past and Present ELLEN ADAMS

The history of the senses has recently become a popular topic, but these studies usually approach it from the sole perspective of a “fully functioning,” able-bodied figure. Consideration of sensory impairments is long overdue in archaeology, classics and cognate disciplines. The disabled body is not necessarily unable to perform standard activities in life and work, but the invisible sensory and communication disability of deafness presents a particular series of challenges. There are very few references to deaf people in the ancient world (as opposed to the metaphorical use of deafness), but there are a few more on social attitudes toward the deaf, including their legal position. Other scholars have collected and reflected upon this material (notably Rose 2003; 2006; Laes 2011b). This chapter engages with this limited range of sources in a variety of innovative ways: first in order to integrate modern understandings of the condition; and second to understand how ancient views and prejudices—and their mistranslation—have influenced modernity in what may be described as “negative reception.”

5.1. TERMINOLOGY 5.1.1. What does it mean to be deaf? Modern terminology Terms affect attitudes, and attitudes shape social policy and norms. We begin by analyzing modern terminology regarding deafness, before turning to Antiquity. The wider term “disability” is critiqued elsewhere (Adams forthcoming). “Deafness” is today understood (at least by informed commentators) to be a sensory and communication disability; until recently, however, it was considered to be a cognitive or intellectual disability. This misunderstanding is partly caused by the fact that when deaf people vocalize there is often a speech impediment, which may be perceived as a learning disability. The term “deaf and dumb” was in wide circulation until relatively recently, with its more recent suggestion of a low IQ or poor cognitive processing abilities. The reading of “dumb” as “silent” is also inappropriate. A deaf person may be able to vocalize (with varying degrees of clarity), while modern sign language offers access to full communication of internal intended meaning. By extension, the term “deaf–mute” is also today considered problematic, partly because there is normally nothing wrong with the vocal cords of a deaf person, partly

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because they are not “without voice” if taught sign language, and partly because—one of the ironies of the condition—deaf people can be extremely and unintentionally noisy. The term “hearing loss” may be appropriate for deafness that arises later on in life, but it is not received well by those with congenital deafness. It is increasing realized that it is offensive to insinuate that a person is less than complete or subhuman if born with an impairment, and such assumptions generate negative implications for self-esteem and sense of identity. Hence the development of modern Deaf Pride, fueled by similar frustrations that bore Gay Pride. “Hearing loss” focuses on what is clinically missing (in terms of hearing “normality”) and implies that the life of the deaf person is of lesser value.1 In modern terms, it also fails to acknowledge the positive culture that has been built up around sign language. This difference between those who are born deaf and those who lose their hearing later on in life was also recognized in Antiquity, particularly with regard to oral communication and legal status. The modern, slightly awkward term “hard of hearing” suggests how a person may be suspended between speaking (hearing) and signing (Deaf) worlds, perhaps because they measure in audiological terms as having a mild– moderate hearing loss or because the impairment occurred later in life, after living as a hearing person. Degrees of hearing impairment were also registered in the ancient world; at least, the different implications of being partially and profoundly deaf were recognized. The modern preferred terminology is deaf or Deaf. The former indicates a clinical hearing loss, and due qualification may be helpful (e.g., whether mild, moderate, severe, or profound, and whether this was from birth). The capitalization of Deaf refers to the linguistic group that uses sign language and the community built around this. Lower-case “deaf” focuses on the medical categorization as set against the hearing “norm,” while “Deaf” celebrates the parallel culture based on sign language, which affectively erodes the communication disadvantages of deafness (within the Deaf world). The apparent lack of sign language, aids, and auditory prostheses in the ancient world renders this distinction less applicable and sharpens the contrast between Antiquity and modernity (Adams 2018). 5.1.2. Ancient terminology (Greek and Latin) References to deaf people and deafness in Greek literary and medical sources are not extensive, and they center around the terms kôphos (deaf, without hearing) and eneos (mute or speechless; this can also mean “stupid”: Samama 2017: 128). The terms appear to have been used interchangeably in the earlier Greek writings, as noted by the grammarian Ammonius, writing in the first to second centuries CE2: Deaf (κωφός) and dumb (ἐνεός) have the same meaning with the ancient writers, namely he who does not deliver speech. Thus Homer (Il. 14.16): κύματι κωφῷ about a gulf without echo. In the same way, Pythia said “I understand the deaf–mute (κωφοῦ) and I hear the one who does not speak (οὐ λαλέοντος).”3 Now, however, κωφός means “he who is hearing impaired.” (Ammonius, De adfinium vocabulorum differentia 290; transl. Laes 2011b: 462–3) Homer’s early use of kôphos reflects a bluntness, dullness, or muteness, rather than an inability to hear (for example, Iliad 11.390, 14.16, 24.54: see Rose 2003: 70)—this implies a cognitive “dumbness.” Likewise, Samama (2017: 125) argues that tuphlos (“blind” or “dark”) led to the notion of deafness, muteness, and stupidity. In Herodotus’ discussion of Croesus’ son, the focus is on his muteness rather than his inability to hear, to the extent that it has been argued that the lack of speech was due to psychological issues, rather than

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deafness; other conditions, such as autism, have been suggested in retrospective diagnoses (see Allély 2009: 18).4 It appears, therefore, that kôphos could originally have had a much wider meaning than “deaf” does today. Rose (2006: 24, fn. 30) refers to sixty-nine instances of the term kôphos in the Hippocratic Corpus. The mid-fourth century BCE Hippocratic Coan Prenotions (193) refers to the duskôphoi—the profoundly deaf—who also have other serious symptoms, such as trembling movements, paralysis (paralelumenoi) in their tongues, and being sluggish. Samama (2017: 129, 131) notes references to hypokôphos (“hard of hearing”) and heterokôphos (“deaf on one side”); this distinction indicates the recognition of different degrees of impairment. These impairments could be presented as absence of function—so anakoustos or nekoustos for “not hearing” and aphonos for “voiceless” or “not speaking” (Samama 2017: 122). This format emphasizes the weakness or inability resulting from the impairment, rather than the impairment itself or the part of the body where it is located. The Hippocratic Fleshes (18.8) refers to the congenitally deaf (oi kôphoi oi ek genees), who can utter sounds but not speak. This categorization is important; it indicates that medical professionals were alert to the communication consequences of prelingual deafness. However, Rose (2003: 70) has pointed out that the majority of Hippocratic references to kôphos consider it as a temporary condition, or as a symptom and possibly diagnostic of another issue. Furthermore, Galen, a Greek physician working in the Roman Empire from the first to early second centuries CE, used words with the kôphos root twenty-five times, and only used the word eneos (speechless) once with reference to the congenitally deaf (Laes 2011b: 461). He mainly followed the Hippocratic consideration of deafness as a temporary condition and symptom of another underlying issue. Latin also distinguished between mutus (mute) and surdus (deaf). The first-century CE Roman encyclopedist, Celsus (2.8.19–20) describes how a fever might dull the ears (aures obtunsae sunt), later referring to deafness as surditatem (from surditas). Writing from the Greek Hippocratic tradition, he provided a series of possible “treatments,” including in this reference the benefits of loose bowel motions. The class of “the deaf” is also carefully distinguished in Roman law, as those with profound congenital deafness had to further endure a series of rights being withheld (see below). Plutarch, quoting Theophrastos, states that hearing was the most important of perceptive powers, which reflects its role in communication (De audiendo 38a: Hillyard 1981: 49–52). On the word mutus, the fourth–fifth-century CE Roman grammarian, Nonius Marcellus, celebrated its onomatopoeic quality (see Lindsay 2003: 14; Laes 2011b: 463). He understood muteness not as being silent, but as being incomprehensible, bellowing like a bull (quasi mugitus). Later, in the sixth to seventh centuries, this perception of an animal bellowing continued (Isid. Etym. 10.169; Laes 2011b: 463). This definition emphasizes deafness as a communication disability rather than a sensory one, so this terminology also reflects conceptual categorization.

5.2. DEAF LIVES AND SOCIAL ATTITUDES 5.2.1. Accounts of deaf individuals The paucity of references to deaf individuals in the ancient world is striking, and is perhaps a reflection of the extent to which they were shut out of political life, and by extension elite literature. The hypothesis has been raised that deafness as an impairment may not have been that much of a hindrance in the most basic forms of labor and

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agriculture—once the instructions had been understood for repetitive, manual tasks, then a deaf person could be set to work (Laes 2011b: 46). Deaf people in the labor force are generally invisible, but then all of the masses were deprived of a voice; we do have some indications of what deaf people (particularly men) did, however. In the Hittite world, deaf men had a role to play in a number of religious festivals and could hold specific jobs, such as closing the palace gate at night (Beal 2017: 40; see also Miles 2008–9). There was a narrow range of professions open to deaf people in Mesopotamia (Kellenberger 2017: 54). The Athenian pension provided for those unable to work because of disability, but it appears to be for mobility or visual impairments; “presumably those who are deaf would not have been eligible, with the disability needing to be one which actually made one incapable of doing any work” (Dillon 2017: 173). Martial (Ep. 11.38) mentions a muleteer who fetched 20,000 sestertii as a price—so high because he was deaf, and could not hear the talk of the journey. Making a virtue of this impairment occurs today; deaf police officers monitor security cameras due to enhanced visual concentration (Bauman and Murray 2014, xxv). Laes (2011b: 469, fn. 74) notes the presence of kôphos in accounts or tax lists on papyri, but little is revealed about their lives. It is notable, however, that tax contributions were still expected from people with hearing impairments. The issue would have been much more problematic for elite figures who were expected to conduct public office; this was problematic for those with age-related deafness as well. Dio Cassius (60.12.3) relates how the Emperor Claudius allowed Lucius Sulla to sit on the praetors’ bench rather than his assigned one, as he had agerelated hearing loss. In other cases, the shame of having a (male) deaf family member may have been such that they were completely hidden away. A rare account of such a person in an elite family in the Greek and Roman (or rather Lydian) world was the unnamed son of Croesus (Herodotus 1.34, 1.38, 1.85); tellingly, the boy’s lack of speech justifies his absence of name (Allély 2009: see this work for a clear discussion of how this story was told by later authors). Herodotus refers to the son as kôphos, while later authors focus on his muteness (Laes 2011b: 454, fn. 10). The issue here is not the lack of hearing, but the absence of communication skills. In any case, Herodotus makes it clear that this son was utterly useless or ruined (diephtharto) because of his impairment, and the turning point of the story is when the son suddenly starts to speak at a moment of crisis. The relationship between deafness and muteness is unclear. Q. Pedius, a notable figure holding a consulship, had a mute grandson who became a painter (Pliny, Naturalis Historia 35.7); it is a modern interpretation that this lack of speech was due to deafness. The other few references to deaf individuals occur in early Christian sources (Laes 2011b: 455–6). The first, in Mark 7.31–7, recounts an incident in which Jesus brought hearing to a deaf person, touching both tongue and ears and declaring “Eppheta.” St. Augustine mentions a young deaf man who used gesture to communicate, and a couple with deaf and non-speaking children (De Quantitate Animae 18.31; PL 32.1052). Overall, deaf people who did not have speech also did not have a voice to leave for posterity to listen to. This is particularly true of women; there is just one mention of a deaf woman in Greek literature (Greek Anthology 11.74; Rose 2003: 73). Presumably, women had less need of a voice anyway, but see IG IV2 1, 123 for a fourth-century BCE inscription from Epidaurus recording a girl’s sudden cure of muteness. In Latin literature, female muteness might be taken as a sign of modesty, muta pudens (Lucretius 4.157).

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5.2.2. Being articulate: Deafness as a cognitive disability In Section 5.2.1, it was noted that elite deaf people were at a serious disadvantage in terms of public speaking and holding public office. It is therefore likely that deaf people were considered as different, and so were hindered from playing a part in sociopolitical life (contra Rose 2003, who argues that disabled people, in the Greek context at least, blended seamlessly into mainstream society). The Aristotelian (or Pseudo-Aristotelian) Problems (11.2.899) refers to the nasal speech that deaf people can have. Misunderstandings about deafness have long led writers, notably philosophers, to present this condition as a cognitive disability; this is one way in which the ancient world may be said to have influenced modern thought. Heraclitus, for example, compared uncomprehending people to those who are deaf—being present, while absent (B34). Plato stated that the flow of thought is articulated through speech, which is impossible for those who are congenitally profoundly deaf, so they were incapable of “right opinion” or “rational explanation” (Theaetetus 206d). Plato (Cratylus 422d–e) acknowledged other modes of communication in a reference to mime (if not actual sign language); these are clearly taken to be inferior. The slippage between deafness and cognitive impairment is therefore one way in which we might say that the ancient world has influenced the modern. It is actually Aristotle, rather than Heraclitus or Plato, to whom this ancient attitude toward deafness is ascribed. When this is examined more closely, however, the story becomes less straightforward. Aristotle noted that those deaf (kôphoi) from birth did not develop speech (eneoi), even if they could vocalize or make sounds (Historia Animalium 4.9.536b). It is perhaps telling that he makes this observation in a work about animals, and the reference to articulate people is presented as a distinction between human and nonhuman animals. This lack of articulation is considered to have cognitive implications, as noted in the statement that congenitally blind people are more intelligent than the deaf (De Sensu 1.437a16).5 However, he does not explicitly state that the deaf were incapable of obtaining rational thought, as is often claimed in modern deaf studies (see King 1996: 23 for examples from the twentieth century). McBurney (2012: 912) declares that Aristotle, “in his treatise On Sensation and the Sensible and other works, suggested that the sense of hearing was essential for the development of intelligence and reason.” But McBurney adds: “while Aristotle never asserted that deaf people could not be educated, his writings came to be interpreted as characterizing deaf individuals as ‘senseless and incapable of reason’ and ‘no better than the animals of the forest and unteachable’,” quoting Hodgson (1954: 62) as responsible for this mistranslation. Furthermore, the American National Deaf Association (n.d) website refers to Aristotle’s influence concerning the inappropriate phrase “deaf and dumb.” Gannon (1980: xxv) is responsible for this misquotation, and, according to him, Aristotle declared that those “born deaf become senseless and incapable of reason,” apparently muddling this thinker with Plato, who said something more along those lines. Mervin Garretson, in the introduction to that book (Gannon 1980: xix), takes Gannon’s translation of Aristotle, adding that this is probably the “most vicious pronouncement” concerning the implications of being deaf—strong words for a misquotation. This kind of “negative reception”—in terms of both that Antiquity influences modernity in a nonprogressive manner and that it is mistranslated and misused—was picked up on some time ago, but the confusion still remains. Werner (1932: 33) stated that it was “all the more regrettable that for centuries Aristotle’s alleged conclusion that deaf–mutes

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could not be educated should be accepted without question” (see also Peet 1851: 134, even earlier). On the whole, Enlightenment thinkers reinforced this view: language, which meant speech alone, was the only means of obtaining knowledge and self-awareness. Kant stated: “words are the means best adapted to signifying concepts. So a man who, because he was deaf from birth, must also remain dumb (without speech) can never achieve more than an analogue of reason” (Kant 1974, cited in Mirzoeff 1995: 10). Some Victorians, such as Edward B. Tylor, were interested in the thought processes behind gesture and signing, as is seen in his attention to deaf people’s gestures for counting (Tylor 1871: 168, 221, 238) or, more significantly, the role of gesture in the origins of language (Tylor 1878). This engagement was not sustained, however, throughout most of the twentieth century. That Werner’s warning from 1932 should have been ignored all this time is doubly regrettable, but this is a phenomenon often seen when ancients are used as authorities in medical and disability literature, and such a negative reception deserves further analysis. A similar view toward deafness is to be seen in the Roman world. Pliny the Elder noted the relationship between deafness and lack of speech (Pliny, Naturalis Historia 10.192); see also the early Christian philosopher, John Philoponus, who noted that the congenitally deaf could not learn to speak (De Generatione Animalium Commentaria 14.3.223.32–3; see Laes 2011b: 46, fn. 43). Writers such as Lucretius (5.1087–90) argued that speech was essential for differentiating humans from animals. This idea appears to have been adapted in the Bible: “So then faith cometh by hearing, and hearing by the word of God” (Rom: 10.17): by literal extension, the deaf were doomed to be faithless, although this may have been intended metaphorically. In the mid-seventeenth century, the deaf were essentially viewed as dumb animals (Bulwer 1648: 102, 109; see also Nelson 2014). Bulwer’s book was the first work written in English on the deaf; he developed a form of lipreading and emphasized that gesture was part of all human communication (Adams 2018). This counters the dogmatism of audism, to be explored below.

5.3. DEAFNESS AND THE LAW The Instruction of Amenemope is an Egyptian literary work by a scribe, probably of the Ramesside Period (c. 1300–1075 BCE). While it does not mention deaf people, it instructs people not to laugh at blind men or dwarfs, or generally to cause hardship for the afflicted: “Man is clay and straw, the god is his builder” (chapter 25; see Walls 2007: 14). This remarkably progressive text predates surviving literature from Greece and Rome, which is not always so kind. However, the Bible returns to a similar concept: “You shall not curse a deaf man, nor place a stumbling block before the blind, but you shall revere your God: I am the Lord” (Lev: 19.14). Greek evidence for this is poor, and clearly varied from polis to polis; the Athenian pension mentioned above appears not to have been applied for deafness. The rights of the deaf (and mute) in the Roman world were curtailed, mainly because of the inability to speak before the courts and judges (Laes 2013b: 153). This view was formalized in the sixth century CE, when the Justinian Code dictated the legal rights of deaf people as a defined class (Laes 2011b: 464 points out that this tradition went back for some time). In the Digest, “from the manner in which the debiles are distinguished from women, wards and the mad and from the fact that speech seems to be at issue with this group, it looks very much like debilis refers just to the deaf and the dumb [sic = mute]” (Toohey 2017: 299): this is the group incapacitated by its inability to communicate through speech. As

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such, the surdus (deaf) and mutus (mute) are mentioned frequently in the Digest, including in Book 45 concerning verbal contracts (Toohey 2017: 301): here, a nonverbal deaf person must make a stipulation through a slave (Digest 41.1.1). A curator was appointed for deaf people and other groups (Digest 26.5.8); as this was a legal right, this served as a distinction between Greece and Rome (Toohey 2017, 304). The deaf and mute were not allowed to take up guardianship (Digest 26.1.17): here, they are grouped with the furiosi (mad), but they were still required to pay munera (duties) where appropriate (Digest 50.2.7.1). It was stated (Codex Theod. 6.22.10) that anyone both profoundly deaf and mute could not make a will, lease a trust, or perform other such legal rights; they could, however, own property if they understood the transaction (Digest 37.3.2) or inherited it (Digest 28.5.1.2, 29.2.5). This applied specifically to those who were congenitally deaf; if someone becomes deafened after learning language and how to read and write, then they could access these legal rights (see Digest 28.1.6.1 on making a will). Deaf people could also marry (Digest 23.3.73). But deaf people could not appear before a magistrate, as they would not be able to hear and follow the praetor’s decree (Digest 3.1.1.3). The stress in these passages is notably on the ability to communicate effectively, rather than on the individual’s cognitive capacities. Toohey (2017: 302) points out that the Digest allows the son of a deaf father to manumit by his command (40.2.10), but not the son of a madman devoid of reason. However, there is slippage between the two: deaf people were considered to be “absent” and as such compared to those who were away from home (Digest 29.5.3.8; Toohey 2017: 301–2). Disability was viewed as a legal problem in the Roman world, becoming a social one during the Enlightenment, then a medical issue in the nineteenth century (Toohey 2017: 309). The Roman legal evidence focuses on deafness as a communication disability, but also at times views it as a cognitive one. Classical ideas were channeled via other cultures through the ages. For example, their influence may be detected in the Mishnah, the foundation document of rabbinic Judaism, notably in the perceived connection between hearing, speech, and intelligence (Gracer 2003). This belief was likewise applied in Jewish law. In terms of ritual law, a non-speaking deaf person was excluded from the performance of mitzvoth, although certain rabbinic sources challenged the claim that an inarticulate person was unable to learn (Belser and Lehmhaus 2017: 438–9). King (1996) has made a strong and intriguing argument: as such a large proportion of the population in Antiquity were, in some way, oppressed, being deaf did not necessarily indicate any particularly great disadvantage. However, the legal position and overall social status would indicate that this was, in fact, a problematic condition for all to deal with.

5.4. CULTURAL REPRESENTATION As deafness is an invisible disability, it is poorly represented in visual art; deafness is frequently used metaphorically, however, and to a more limited extent in comedy and satire. A metaphorical use of deafness, or kôphos, is attested in Homer and beyond, in the sense of “dullness” (see above). It is used with reference to hearing people who do not, cannot, or will not listen and understand (e.g., Aeschylus, Seven against Thebes 202, where Eteocles asks the chorus if he speaks to the deaf). In Latin literature, we find Virgil’s Eclogues (10.8): Non canimus surdis (“we sing not to deaf ears”: in the same sense as “none so deaf as those who will not hear”). It is telling that Midas is given the ears of a donkey to shame him in his stupidity (Ovid, Metamorphoses 11.146–93; note that this is

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not necessarily connected to deafness). In Christian and early Islamic discourse, spiritual blindness or deafness is a common metaphor (Laes 2017a: 14), and Israel’s prophets also used these impairments negatively in this manner (Kellenberger 2017: 52). This is a common metaphor today: for example, elites may be “deaf” to the needs of the poor, and one might “turn a blind eye” to wrongdoing. This continued reference to a sensory impairment as a character flaw (whether temporary or permanent) arguably has negative implications concerning how those groups of people are then perceived. References to such impairments may also be used for comic effect—although this does not happen in Greek literature as often as you might expect in comparison with other conditions (Garland 2017: 154). Aristophanes (Knights 43) refers to “Mr. Demos of Pnyx Hill” who is hard of hearing (upokôphon) and an easily manipulated fool. He recovers later on and recoils from his previous stupidity (Knights 1349). Likewise, Aristophanes presents kôphoi old men as doddery and easily outwitted victims (Acharnians 681). But there are few examples of such usage, given the potential for humor based on misunderstandings. One example of this is a first-century CE epigram in which a very deaf old woman is asked to bring cheeses (turoi), but brings wheat (puroi) instead; there follows a list of examples of similar sounding words that the woman mishears (Greek Anthology 11.74; see Philogelos 241). Hansen (2002: 192) has also collected stories from Antiquity that refer to deaf characters, such as the first-century CE epigram by Nikarchos, whereby two deaf men went to court because of a misunderstanding (caused by their deafness), only to discover that the judge was even deafer, resulting in a completely irrelevant verdict (Greek Anthology 11.251). Ferrari lists several examples in Latin comedy and satire of such humor based on deafness or muteness, stating (1907: 274) that, concerning examples of “malicious jest,” the “citations would be too numerous” (e.g., Terence the Eunuch 418).

5.5. THEORIES AND TREATMENTS Key debates in disability studies lie between medical professionals and pressure groups who seek to promote the views and voices of disabled people. The process of clinically fixing the body is known as the medical model, whereby the individual is rendered as able-bodied as possible, so that they can have a “normal” life. For deaf people, the aim is to use technology (such as hearing aids and cochlear implants) and other strategies (such as lipreading) to allow spoken language to be developed. The social model argues that disabled people are such because of the prejudicial beliefs and actions of the majority, which results in environmental constraints (Anderson and Carden-Coyne 2007; Thomas 2007; Schillmeier 2010). It points out that it is “normal” for any given society to have 15 percent disabled people (as calculated by the 2011 World Health Organization Report on Disability), so it should adapt to accommodate these requirements—supporting, for example, sign language use. A middle ground between the two positions may be found (see Shakespeare 2006: 43), where it is unhelpful to present these options as “either/or.” In the case of deafness, the individual may develop certain skills, such as lipreading, in addition to taking advantage of modern technology, which would fall under the medical model. However, social and environmental adjustments should facilitate communication, such as the use of quiet rooms with a user-friendly layout enabling a deaf person to follow the discussion (legally termed “reasonable adjustment” in the British 2010 Equality Act). Taking a certain degree of personal responsibility and making use of medical developments does not lessen the need for the social model.

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It has been strongly argued that the medical model is a modern concept, whereas disabled people were incorporated naturally into ancient society, today known as the social model (M. L. Rose 2003; 2017). It is notable that Roman law tended to exclude poor speakers, not include them. The considerable number of ancient medical treatises counters the suggestion that disability classifications were “foreign” to the Greeks (M. L. Rose 2017: 149); they simply did not understand the body’s mechanics as well as we do today. For example, Aristotle’s knowledge of the ear’s anatomy included the auricle, the outer acoustic ducts, the eardrum, the middle ear cavity, and the tympanic cavity, but he was not aware of the cochlea (Werner 1932: 30–1). In Antiquity, they pursued a bodily ideal in aesthetic terms, but they also sought to repair the body where necessary, to which the preserved medical tools and implements bear witness. Indeed, the cornerstone of the medical model is not the manner of classification, but the assumption that only intervening to fix the individual can solve the “problem” of disability. Elements of both the medical and social models may be detected in the ancient world, alongside a third one: the ritual, or moral, model. Here, one “deserves” good health by keeping on the right side of the gods; where the cause of a disease was unclear, divine or demonic agency could be blamed (Holmes 2010: 86; Oliver and Barnes 2012). The extensive use of sanctuaries for Asclepius and the dedication of anatomical votives demonstrate this practice (e.g., Adams 2017). There was a close relationship between philosophers and physicians in the ancient world (Holmes 2010: 93–6; Macfarlane 2010), so theories and treatments were intertwined. This link continues today; for example, the philosopher Mary Warnock was responsible for producing Britain’s 1978 Warnock Report on special educational needs. This reliance on the thought of the mind to serve the physical body and its failings is arguably another indication of classical influence. The pitfalls of relying overly on philosophical thinkers have been raised elsewhere, since such approaches tend to disregard the voices of disabled people themselves (Adams 2018). For example, Merleau-Ponty (2002: 165–6) explored the relationship between a blind man and his cane, which becomes “absorbed” into the body. This illustration has been frequently drawn from, but this case study actually ignores the voice and experience of the person with the sensory impairment (Mills 2013: 789). The blind man becomes a useful tool to think with, rather than actively contributing to our understanding of the human condition. Stated rather more bluntly: “academics who want to make comments about the impact of impairment, might do well to base their analysis on empirical evidence about how disabled people feel about their embodiment” (Shakespeare 2014: 67). This is virtually impossible to do in the case of Antiquity, where such little evidence remains. However, the following sections incorporate modern insights concerning deafness in terms of medical treatments and technology, ritual issues, and the role of gestures and sign language.

5.6. MEDICAL TREATMENTS Thompson (1931) and Scurlock and Andersen (2005) recorded numerous examples of treating ear diseases from the Assyrian library of Ashurbanipal, seventh century BCE. This included details of dressings and potions to insert into the ear canal, occasionally to deal with excessive buildup of ear wax—known literally in Akkadian as “ear shit” (Scurlock and Andersen 2005: 203). Later classical doctors generally perceived deafness as a symptom of another underlying cause. In the Hippocratic Corpus, for example, it could result from the severing near the head of the main vein, which Hippocratic doctors believed ran from

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the head to the feet (Internal Affections 18.23–5). Elsewhere, however, deafness may cause a swelling beside the ear, which could then indicate paralysis (Prorrhetic 1.159). Celsus suggests that temporary deafness caused by a fever may be set right with a nosebleed or by loose bowel motions (De Medicina 2.8.19). This latter point occurs in Hippocratic writings (Aphorisms 4.28.1): when stools are bilious, this will cease if deafness arises, and if deafness occurs, then bilious stools would mitigate this. Presumably, this connection arose from observations of a condition involving both symptoms. This is possible in Ménière’s disease—although it is not expected that one symptom would counter the other in this case (see Scurlock and Andersen 2005: 206 for a possible retrospective diagnosis of this condition in Antiquity). Elsewhere (Prorrhetic 1.129; Coan Pronotions 325) it is stated that, if deafness was a symptom after a hemorrhage and passing dark stools, then the prognosis was bad; if blood was also passed, then this was disastrous— although the deafness was alleviated in this critical situation. It is notable that deafness here is considered a symptom of a disease rather than a condition in itself. Celsus (De Medicina 6.7) devotes a lengthy section to ear maladies, including infections, pains, and the presence of maggots in the ear, as well as hearing loss. Treatments are varied, from shaving the head, anointing it with hot iris, then covering it up, to letting blood, applying poultices of various compositions, washing the ear out with wine, or inserting sponges. He warns of the buildup of wax, which requires soaking and scooping, and suggests a sneezing fit or water irrigation if an obstruction occurs. A plank could be used to deliver vibrations that may shift a foreign object. It is notable that these are solutions for temporary ear problems or deafness due to illness or blockage. Celsus (De Medicina 7.12) also operated on a patient’s tongue in order to address muteness (Ferrari 1906: 460–1 explores how the belief that muteness was due an obstacle interfering with the tongue was a “serious error” arising from ancient writings: the number of sources referred to is rather limited, however). Such beliefs appear to have influenced later Christian thought; muteness was believed to be “caused by damage to the nerves of the tongue and thus the deaf–mute was unable to move his tongue in order to articulate. To support this they quoted a saying of Aristotle in which he was supposed to have asserted this” (Werner 1932: 8); this, “because of his authoritative position, prevailed for centuries afterwards,” and, indeed, “no one dared oppose hypotheses derived from Aristotle” (Werner 1932: 29, 35). This vague incorporation of views ascribed to the ancients is surprisingly frequent in the deaf medical literature. The sign language as used, promoted, and celebrated by the Deaf community has developed alongside considerable progress in auditory technology. There is considerable tension between advocates of these different types of coping mechanisms, which are framed around different ideas of normality and identity (see Adams 2018 for a discussion of modern auditory prostheses and the varying responses to their benefits and limitations). There do not seem to have been ancient auditory prostheses of any kind, including ear trumpets (these were not invented until the second half of the seventeenth century; Jütte 2005: 115). This lack of medical technology highlights the differences between the experiences of deafness in Antiquity and modernity.

5.7. RITUAL SPHERE Historians of medicine are increasingly aware that rounded treatments look to the patient and not just the disease; otherwise, the medic is set on a pedestal and almost deified, while the patient is bound down and objectified. A comparison of the patient’s voice

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in Antiquity and modernity offers an intriguing platform for reevaluating the benefits and the limitations of the “medical model” as defined in disability studies, with its emphasis on clinically treating and fixing the body. The tension between book religions and modern disability rights’ campaigns has been well outlined in biblical studies. Avalos (2007) has explored three approaches to dealing with this clash of values and interests. The redemptionist approach attempts to realign the biblical text to fit modern sensitivities. At the other end of the scale, the rejectionist approach discards the biblical teachings on the grounds of their negative and dated portrayals of disabilities. Finally, the historicist approach focuses on the ancient context, with little or no consideration of the consequences for modern application. Our engagement with ancient Greece and Rome is necessarily different; however, the hangover of ancient views in the modern, increasingly secular and scientific Western world still poses important challenges. Such is the focus on the contrast between the clinical, medical approach and the inclusive, social model that the place of ritual or evangelical emotion concerning disability has not received as much attention. This is one area where our understanding of approaches to disability in Antiquity may inform modern studies. There existed a very different type of treatment: one involving divine intervention, rather than human. The presence of molded ears at sanctuaries among the anatomical votives suggests that problems with the ear (including earache as well as poor hearing) occurred among the ailments that visitors hoped to be treated (or these represented thanks for recovery; Figure 5.1). As deafness and muteness were considered together, models of mouths might also represent deafness (Rose 2006: 19). Figure 5.2 prominently displays the teeth, which

FIGURE 5.1  Ear votive, Roman (© Wellcome Images L0035833).

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FIGURE 5.2  Mouth and teeth votive, Roman (© Wellcome Images L0058490).

emphasizes even further the ambiguity concerning the desired treatment (possibly for toothache?). It has been argued elsewhere (Adams 2017) that such votives served as a kind of ritual prosthesis in the healing process. In biblical studies, “metaphors of physical and cognitive impairment sometimes serve as figures of moral deficiency” (Melcher 2007: 123). The Christian priest and theologian Jerome commented on the passage “faith comes by hearing” (Rom: 10.17), with the potential implication that the deaf could not follow God (but see King 1996: 4). Jerome was broadly a contemporary of St. Augustine, who is often stated as being responsible for this negative view. King (1996: 112) has made a convincing case that St. Augustine has been systematically misinterpreted by those citing the relevant reference from Contra Iulianum, including, after a series of Chinese whispers, the mainstream Encyclopedia Britannica. St. Augustine seems to have been receptive to the idea that sign and gesture could stand in for speech (McBurney 2012: 912). These comments parallel the confusion about Aristotle’s supposed pronouncement regarding the cognitive abilities of deaf people; what is important to highlight is how Antiquity has accidentally and unintentionally influenced modern thinking to reinforce a negative view of the disabled condition. Here, the influence of Antiquity stems more from a mishearing of these sources, rather than their direct voice. The Midrash on Psalm 34 embraces all bodily states, including disability, as part of the divine master plan—apart from madness, which David finds unaccountable (Avalos et al. 2007: 1). This runs counter to the approach of modern Western medicine, with its focus on fixing the body (playing God? See also miracle cures, for example, as recounted by Gregory of Tours: Laes 2011b: 457). This clash of ethical stances comes to the fore in debates over abortion and euthanasia, but it may also be seen between medics and disability groups, including the Deaf community. In Britain, the former are served by charities such as Action on Hearing Loss (AoHL; formally the Royal National Institute for Deaf People [RNID]), a large charity with close links to the medical community (much of this chapter was written in The Ear Institute and Action on Hearing Loss Library, based in the Royal National Throat, Nose and Ear Hospital in London). The latter are served by the Royal Association for Deaf People (RAD) or the much smaller—and poorer—

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member-run British Deaf Association (BDA), which focuses on the Deaf community and promotes the use of sign language: this is much more a celebration of Deaf culture rather than the pursuit of “fixes” for the broken ear. While this approach does not evoke divine forces, they are similar in the acknowledgment and acceptance that things are as they are meant to be. The occasionally hostile friction between the advocates of the AoHL and the supporters of the BDA rise from very different responses to deafness (Adams 2018). The extraordinary advances in modern medicine, which increase the ability and value of human intervention, is the single main difference between Antiquity and modernity, and inevitably has had a marked effect on the role, status, and authority of religions.

5.8. GESTURE AND SIGN Given that it is highly unlikely that a congenitally profoundly deaf person in Antiquity could have become literate and communicated using writing, all communication would be on the level of gesture (there have been several recent studies of ancient gesture; e.g., Cairns 2005; Fögen 2009; Masséglia 2015). The most famous account of gestures used by the speechless occurs in Plato (Cratylus 422e). There is also a hint from Egyptian texts of around 1200 BCE in which a magistrate admonishes an idle scribe: “Thou art one who is deaf and does not hear, to whom men make (signs) with the hand” (Miles 2008: 27). It is unlikely, however, that there was a large enough concentration of deaf people to produce sign language, and there is no proof of the presence (or absence) of full sign language in the ancient world (Rose 2003: 75; 2006: 21). Xenophon (Anabasis 4.5.33) recounts how traveling Greek soldiers used gesture to make themselves understood. Given that this communication was clearly at the level of mime, this is no indication of sign language. Likewise, the fourthcentury CE Ammianus Marcellinus (24.4.26) recounts how Emperor Julian, having sacked Maozamalcha, took as his booty a mute boy who used gesture (gesticularium) to make himself understood; this again must be mime, as sign language cannot be comprehended by those who have not themselves learned it. It is notable that the boy is described as mutum— there is no indication that he was also deaf. The Mishnah contains the statement: “A deaf– mute may communicate by signs and be communicated with by signs” (Mishnah Gittin 5.7). See also the classical Greek Ctesias, who refers to an Indian tribe who possessed dogs’ heads: they gestured as do deaf and speechless people (Indika F45 37; Nichols 2008: 113–14). Bragg (1997: 2) takes the view that classicists should not necessarily be interested in sign language, as it is highly unlikely that such a language existed in the ancient world. However, it has been argued that an understanding of the syntax and grammar of modern language can bring fresh insights into areas such as oratory, drama/pantomime, and classical art (Adams 2018). Rarely has the history of deaf communication and other visual–kinetic communication systems, such as Roman pantomime, been considered together (but see Baynton 1996: 86–7; Bragg 1997). An understanding of these visual languages provides informed suggestions as to how ancient pantomime may have been performed (Adams 2018). For example, pantomime artists could have adopted a basic form of “role shift” in sign narrative. St. Augustine makes the connection between communication as actors’ gestures and how the deaf might interact (as Harvey Peet picks up in the mid-nineteenth century; King 1996: 130). There are various elements of sign that are considerably more iconic or innate than spoken language, hence the deployment today of gestural communication programs to accompany spoken language, such as Makaton (Stokoe 2001; see also Armstrong and Wilcox 2007, which begins with a discussion of Plato’s Cratylus).

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This is also an area where we can explore classical reception and how Antiquity has been used since the Renaissance (beyond references in medical works as mentioned above). For example, John Bulwer was the first person to explore elements of sign language and deaf communication in English in the seventeenth century. By including references to Plato, Seneca, Virgil, Livy, and Plutarch, he carried the implication that gestures are universal, but he was also frustrated by the lack of evidence for ancient gesture and recognized that those of his day would differ in some ways (Bulwer 1644, Chirologia and Chironomia: 131–2). The eighteenth-century elocutionary movement drew heavily from Demosthenes and his emphasis on delivery, including gesture and action; see, for example, Reverend Gilbert Austin’s 1806 work, also called Chironomia. The dialogue between Antiquity and modernity appears to seep through all areas of this topic, including the problematic assumptions of audism.

5.9. AUDISM (THE ANCIENT WORLD AND MODERN ATTITUDES) While another chapter in this volume addresses speech impediments, it is appropriate to consider in more detail the attempt to teach deaf people to speak, or “audism” as it is known. Since the early nineteenth century, the word normal “has been used to describe how things are, as well as to prescribe how they ought to be—often both at once” (Baynton 1996: 141). Furthermore, modern medical practice takes a statistical approach toward establishing the typical body (Davis 1995; Crawford 2014; Adams 2017; Adams forthcoming). In terms of deafness, this “normally” does not just cover the ability to hear, but also the ability to communicate via speech. Here, again, modern prejudices have drawn from ancient sources. The history of the deaf in modern times centers on the audism of the hearing (and occasionally deaf) professionals and other interested bodies (e.g., Lane 1984; see also Ladd 2003; Lane 2006: 80; Leigh 2009; Scully 2009; there are some exceptions, such as Atherton 2012 on the history of the Deaf community in Britain). Tom Humphries coined the word “audism” in the mid-1970s from the Latin audire (“to hear”), although it was Lane’s 1992 book, The Mask of Benevolence: Disabling the Deaf Community, which popularized its use. Audists are people who argue that only spoken language counts (“linguistic” is based on the Latin lingua, or “tongue”) and that every attempt should be made to master this rather than learning inferior sign language. Audists attempt to control the language, identity, and history of deaf people who prefer to use sign. Parallels have therefore been drawn between colonialism and the treatment of the deaf by audists in modern times, mainly due to the nature and extent of such control (Lane 1992; Ladd 2003).6 Once again, we may detect the influence of the ancient world, notably the perceived link between spoken language and cognitive intelligence. In 1897, W. G. Jenkins (quoted in Nittrouer 2010: 8) stated that “it is customary among us to speak of the ‘sign-language’, or the ‘language of signs’, but language is that which belongs to the tongue, lingua; it is the utterance of vocal speech.” So influential has this view been that it was not until 1960 that it was first argued (by William Stokoe) that American Sign Language (or any other kind) was a language; this was widely disbelieved, including by the deaf who used it. In a recent volume on speech rehabilitation, the ancient view (ascribed to Aristotle, of course) is criticized not because of the inaccurate belief that only spoken language can shape and represent intelligent thought, but on the grounds that oral communication is or should still be possible for the deaf (Hull 2010: 6). In short, deafness as an impairment is not simply judged on the grounds

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of the impact it has on the individual’s ability to hear, but also in terms of whether they can interact with others, participate socially, and have anything to offer the world. Ancient, allegedly Aristotelian ideas were shared by the educational oralists, keen that deaf children should learn speech at any cost, so that they could enter the world of man as opposed to using sign that rendered them monkeys, apes, and dogs (Baynton 1996: 52–3). It is still possible to meet people in Britain who experienced an inappropriately orally based education, which involved having their arms bound in order to prevent them from signing, but some deaf schools (or units within mainstream schools) support British Sign Language. Greece has been relatively progressive in supporting deaf education, with a deaf school established in 1923, operating as an oral environment; this changed during the 1980s with pressure to accept Greek Sign Language, despite the general move toward mainstreaming (Lampropoulou and Hadjikakou 2010: 49). In contrast, Cyprus has been much less quick to meet the responsibility of educating deaf children, and currently is focused on the oral method, albeit with a sign language interpreter (Lampropoulou and Hadjikakou 2010: 50–2). These varying social policies reflect very different attitudes concerning how to deal with impairments and seek different ideals of “normality” (as seen with the clash of approaches between the AoHL and BDA charities). On the whole, the history of deaf education (and therefore lives) is bleak, consisting of a series of experiments made by hearing professionals with the prime aim to achieve speech—the “medicalization of cultural deafness” (Lane 1992: 120; see Adams 2018). A further influential work has been Plato’s Cratylus on names and language—and whether a name has a natural relation to that to which it refers (one might compare the iconicity of many signs) or whether it is completely conventional (as some signs are arbitrary and abstract). This has been reinterpreted through the lens of deaf studies in terms of how non-spoken modes of language are overlooked in such linguistic debates (Bauman 2008: this work assumes the existence of an ancient Greek Deaf community with full sign language; see also Armstrong 2014: 77: this explores the role of visual gesture in the origins of language). The account of signing in Plato’s Cratylus (422e) also influenced the Abbé de l’Épée, who set up the world’s first free school for the deaf in 1760s Paris (Sacks 2012: 14). His momentous contribution, not only to deaf people but also to linguistics, was to lay out the case that words are not necessary for conveying ideas—although even he did not grasp that French Sign Language is a complete language (as are other forms of sign language; Sacks 2012: 18): it would take another two hundred years for that recognition to occur.

5.10. CONCLUSION This chapter has explored the rather limited range of sources for deafness in Antiquity in a variety of ways. As always, intersectionality is relevant, particularly in terms of class, gender, and age. For example, manual workers could be set to repeated tasks without any necessary “disability,” or inability, affecting their productivity. However, elite men would be significantly disadvantaged if they were not able to articulate their thoughts and rights. Women of all classes were relatively “voiceless” anyway, and it is more difficult to assess whether class made a difference here. Deafness from birth would pose problems if this impacted on speech, whereas age-related deafness appears to have been received more sympathetically. Furthermore, we should not expect to find a single attitude toward deafness in Antiquity, but variation from culture to culture. For example, biblical texts instruct kindness toward deaf people, while there are examples of mockery in Greek

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literature (but fewer than for other impairments), and Latin literature has provided many examples of humor based on mishearings and at the expense of the deaf (Ferrari 1907). One constant throughout Antiquity, however, is the concern with the communication aspect. Whether or not this was taken to indicate a cognitive disability, it is clear that this had a negative impact on social life in an age before hearing technology and sign language. There are few mentions of deaf people in the literature, none of which is by a deaf person; writing was an elite activity, but this suggests an additional disadvantage and lowering of social status. There was a variety of theories and treatments of medical, social, and ritual natures. Medical knowledge was much less advanced in Antiquity, but that does not mean that doctors did not attempt to fix the body—they were simply less successful. It is therefore misleading to suggest that a “medical model” did not exist, but it is notable that the relationship between philosophers and physicians was much closer than it is today. It is intriguing to note that medics (mainly of the Hippocratic tradition) considered deafness as a temporary condition, and generally as a symptom of another underlying cause. Deafness was also more likely to be considered a cognitive disability in Antiquity than it is now. The legal situation makes it clear that deaf people were identified as a class and treated differently (usually with rights withheld); we should not view Antiquity as a kind of disability utopia, and the limited evidence does not suggest an era of equal opportunities. We have established some ways in which deafness was understood similarly to today; for example, recognizing the speech problems associated with prelingual deafness and that there are different degrees of deafness. However, technological advances and the development of sign language have rendered the experience of deafness very different indeed. There is a dialogue between Antiquity and modernity that has been explored over a wide range of issues. This chapter has emphasized the value of not just considering deafness in Antiquity, but also the influence of Antiquity—or, in certain cases, the influence of misinterpretations of ancient writers (particularly Aristotle and St. Augustine). At times, this appears as a “negative reception,” as regressive views have lent authority to views that disability groups may now challenge. Furthermore, a closer look reveals that these citations are not always accurate, and were presumably seized upon in order to lend further authority to the prejudices of some modern writers—Kant stated much more damaging words against deaf people than Aristotle ever did. Kant’s extreme views represent a type of audism that still exists in some quarters, if in a more toned-down form. But the modern engagement with Antiquity also can be seen in terms of rhetoric, gesture, and visual communication, and Antiquity could be drawn from as rationale to set up a deaf school. Given that our knowledge and understanding of deafness is far superior to that of Antiquity, it is astonishing to see the level of influence Antiquity still holds.

CHAPTER SIX

Speech Lack of Language, Lack of Power: Social Aspects of the Discourse about Communication Disorders in the Greco-Roman World PETER KRUSCHWITZ AND ABI COUSINS

6.1. INTRODUCTION In his satire Apocolocyntosis, the younger Seneca1 makes the recently deceased Emperor Claudius enter heaven to inquire about a potential position for him among the celestials. His arrival is met with little enthusiasm: Jupiter was notified that someone had come of decent stature, well grey; he appeared to be threatening god-knows-what, for he was constantly moving his head; he was pulling his right foot. He had been asked of what nation he was: he had responded god-knows-what with disturbed sound and confused voice; he [sc. the messenger] had not understood his language, but it was neither Greek nor Roman nor that of any other known people. Then Jupiter ordered Hercules to go, who had explored the entire world and seemed to know all nations, to find out, of which nationality he was. Subsequently, Hercules was well disturbed when he first encountered him, like someone who thought to have feared all the monsters (but had not yet). As he encountered the face of a new species, the uncommon gait, the voice of what was not a land-animal, but of the kind that sea-animals tend to have, hoarse and unstructured, he believed that a thirteenth labor had just materialized for him. On closer inspection, it then appeared to him as almost human.2 (Seneca, Apoc. 5.2–4) Claudius’ ineptitudes, in the colorful and outrageous description provided by the author of the Apocolocyntosis, characterize him as somewhat of a monstrous, hitherto unknown species (noui generis faciem), a hybrid between land and sea animal, with clear defects as regards its voice and its movements.3 In loose sequence, Claudius’ speech is described as “of disturbed sound and confused voice” (perturbato sono et uoce confusa), “incomprehensible” (and/or “opaque”: non intellegere se linguam eius), possibly “out of this world” (nec ullius gentis notae), and certainly closer to the “hoarse, resounding, yet unstructured noise of sea monsters” rather than that of land animals (vocem nullius terrestris animalis sed qualis esse marinis beluis solet, raucam et implicatam).4

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Slightly later in the same narrative, when Hercules, too, fails to make sense of Claudius, Febris appears and lets Hercules in on Claudius’ life story. Claudius, in turn, is not best pleased: At that point Claudius got filled with white rage, he got angry with the greatest possible murmur. What he said, no-one understood, but he ordered Febris to be led away, with that gesture5 of his shaky hand—barely strong enough for this one purpose, so as to decapitate people—, he had ordered her head to be cut off. (Seneca, Apoc. 6.2) Again, significant emphasis is placed on an inability to produce intelligible speech, describing Claudius’ speech as inarticulate, unstructured, and of bizarre sound. This is linked, in the first passage, to an apparent physical handicap, which has led to some speculations as regards the potential for a diagnosis of Claudius’ condition6 (which, of course, is attested in other ancient sources as well).7 Moreover, throughout the entire text, Claudius’ intellectual abilities are belittled and subject to significant levels of mockery (as either too low or over the heads of everyone else).8 This well-known description of a famous case of someone (allegedly) affected by some form of a communication disorder raises several interesting general questions. In particular, considering that this was no less than the Roman emperor, it seems important to consider the following two questions9: (i) What effect, if any, did social class have on the discourse about communication disorders? (ii) Considering that allusions are made to the decidedly dehumanizing features of Claudius’ speech, how did the discourse around speech defects and anomalies touch on aspects of physiognomy and exoticism as well as those of human physiology and psychology? The present chapter will explore these issues in some depth, based on an assessment of the broad variety of sources available and pertinent to this matter. It will focus on the Roman Empire, involving sources and a number of influential stories that were well known from the Greek sphere, however.

6.2. COMMUNICATION DISORDERS AND SOCIAL CLASS Speech-related imagery in the ancient world abounds, and it would be tedious to list all of the relevant metaphors and images that were in use. It is most telling, perhaps, to start with the observation that both the Greek and the Latin language denoted the earliest stage of childhood with words that stressed the absence of the gift of speech: νήπιος (a negative, related to ἔπος, “word” or “speech act”) and infans (again a negative, derived from fari, “to speak”), and thus English “infant”—they all describe the lack of a certain physical and mental power.10 At the same time, following the logic of these concepts, these terms would appear to define a point of departure for fully formed human life, in which the gift of speech is of quintessential importance for participation and success within an individual’s society—a fact that is celebrated in the appreciation of orators throughout the classical world, especially when coupled with proximity to political power and social influence. How and where do communication disorders, covering impairments both of speech

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(affecting articulation and speech production) and of language (affecting the processing and communication of thought processes), sit within this framework between power and societal status? Is social status an important aspect in the wider discourse, or was the focus on the individual alone? 6.2.1. The high and (sometimes not so) mighty The case of Emperor Claudius is well documented (and thus widely known), as the person affected by the communication disorder is as prominent a character as it gets. The striking contrast between factual power, as derived from Claudius’ political role, and the absence of power and control over essential aspects of his physique (with the implication of an effect on intellectual skills) is what lends this image its comedic potential.11 The height of Claudius’ fall is increased further by the narrative’s careful presentation of the character’s inability to make a strong case for his inclusion into the group of respectable members of the otherworld, thus making him end his career like an eternal sinner, unable even to negotiate a respectable punishment for himself. In turn, one must also bear in mind that the abuse hurled toward Claudius in the Apocolocyntosis only manages to unfold its comedic powers because the author is actually in a position to exploit this very height of Claudius’ fall. What is political satire in the case of Claudius would be miserable and shameful if done to a lowly, vulnerable “nobody.”12 This, of course, implies that communication disorders in a powerful (or at least prominent) figure potentially receive a rather different level of attention and treatment in sources than those of lesser-known individuals. In that regard—not so much in an effort to extend modern-day two-tiered health care treatment based on wealth to the ancient world as with the purpose to prevent comparing what cannot easily be compared—it makes sense to look at individual cases for which communication disorders are reported with a certain level of sociopolitical differentiation.13 On the other hand, it seems fair to say, almost as an a priori, that in societies in which the spoken word—oratory and rhetoric—held an almost universal power and were at the heart of the educational system, the social and political implications of communication disorders are bound to be enormous.14 It is, however, not exclusively the issue of political power that must be considered in this context—and certainly not the issue of factual, constitutional power. Rather, there is the level of an individual’s general visibility within the wider community that works as either an amplifier or a magnifying glass when it comes to speech- and languagerelated disorders. Just as a modern-day media celebrity would be more visible under the public eye and subject to a higher level of public scrutiny, thus in Antiquity, too, certain individuals were more visible than others and, just like statesmen and politicians, received special treatment. 6.2.1.1. Rulers, statesmen, and politicians (and their relatives) To begin with the cases that relate to the upper end of the spectrum of sociopolitical influence, one may start with a look at an (unnamed) son of the sixth-century Lydian king, Croesus. According to Herodotus’ account, Croesus had two sons15: Croesus, then, had two sons, one of whom had a severe disability, for he was deaf– mute, whereas the other was altogether and in every respect the first of the crop of young men: his name was Atys. (Herodotus, Hist. 1.34.2)

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The former nameless son is sidetracked and downplayed in Herodotus’ narrative by Croesus himself at first16: You happen to be my one and only child: the disabled one, as far as his hearing is concerned, I do not regard him as existing to me. (Herodotus, Hist. 1.38.2) This statement of Croesus does not prevent Herodotus from subsequently claiming: He had a child, whom I have mentioned before, decent enough in every respect, yet mute. Now, in prosperity past, Croesus had done everything within his power for him, and in addition to other things, he had sent out an embassy to Delphi to consult the oracle. (Herodotus, Hist. 1.85.1) The oracle’s response to Croesus’ inquiry is daunting: Croesus had better not asked, for he will find doom the day when he first gets to hear his son.17 And, according to Herodotus, this is precisely what happened: when the nameless son noticed an assassin sneaking up on Croesus: This child of his, the voiceless one, upon seeing the Persian sneaking up, made his voice burst out over the need and the imminent evil, and he said: “Man, do not kill Croesus.” This was the first sound he ever produced18; after that, however, he spoke for the entire time of his life. (Herodotus, Hist. 1.85.4) The report of the miraculous cure of the son’s muteness (hardly deafness, even though Herodotus had Croesus refer to his son’s ἀκοή: after all, the son must have heard the very words he managed to produce in the moment of crisis)19 in response to a perceived moment of imminent crisis is, of course, remarkable, but not without parallel.20 Equally known from other contexts is the motive of the powerless son of a powerful father. A rather similar story has been related for the son of Rome’s short-term emperor, Vitellius, with a number of interesting spins on the various motives that already existed in Herodotus21: He married Petronia, the daughter of a man of consular rank, and, from her, he had a son, Petronianus, who was one-eyed. As this son was installed as heir by his mother under the condition that he had to be released from his [sc. Vitellius’] patria potestas, he [sc. Vitellius] manumitted him and shortly thereafter, as is believed, killed him, while the incriminating story was fabricated that he intended patricide and then, driven by his conscience, drank the poison himself that was already prepared for the crime. He [sc. Vitellius] soon married Galeria Fundana from a father of praetorian rank, and he had two children from her, one of each sex: the male one, however, due to a stammer of his mouth, was virtually mute and dumb. (Suetonius, Vitellius 6) Vitellius is given a partially sighted son, whom he (according to rumors readily reported by Suetonius) kills.22 Then, when he remarries, he ends up with a son so impeded by his stammer that he can barely talk. This is the only reference to Vitellius’ son by name in Suetonius.23 While Suetonius passed over his life in silence, his eventual death is recorded

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at Suetonius (Vitellius 18), where he appears to have been killed, alongside his father and uncle, at the hands of supporters of Vespasian. At any rate, the fact that Suetonius decides not to even tell us anything further about Vitellius’ son may well suggest that even the writer could not see a legitimate reason as to why he should mention his outcome. This, in turn, could then be construed to demonstrate how people with disabilities were largely written out of history (unless serving the purpose to cause damage, if by association), simply because they were not seen as useful to the historical narrative (with a few exceptions). An interpretation along these lines may seem harsh and perhaps even unwarranted at first; one must consider, however, that both narratives—Croesus and Vitellius—independently contain explicit references to the fathers’ responses to their offspring’s respective conditions, and both narratives emphasize the tendency (explicit or implicit) to distance oneself from them, and in fact to disown or deny them as much as possible,24 showing next to no care or concern for them. The lack of transmission of a name (less difficult to reconstruct for Vitellius, of course, due to the Roman naming conventions) is but the most obvious indication of that. As Martha Rose in her discussion of “Croesus’ other son” convincingly argued, the case of Croesus raises an additional question—a question that, in the case of Vitellius, does not come into play due to the abrupt end of his career: lineage. Croesus loses his son Atys as heir-apparent, and it is quite clear that he had not had any previous inclination to leave the throne to his other son. Tragically (and deliberately presented thus in the existing narratives), as soon as the other son becomes able to step up to the task and to inherit his father’s realm, there no longer is a realm to be inherited. The Vitellius episode, if somewhat different for obvious historical reasons, does not altogether lack this component, however. The earlier (blind) son is taken out of the line of inheritance first by the mother’s stipulation, then more radically by his killing. The second one is presented as unable to perform any public duty (by Roman standards, anyway),25 and with his sibling being a girl, the father is left without an option to install an imperial dynasty—a problem that lasted no longer than Vitellius’ own life, of course. The cases described so far focus on extremes in at least two ways: first, they deal with state sovereigns (and their issue); and second, they deal with a particularly debilitating form of communication disorder.26 There is nuance, however, and another well-known case represents the middle range of the spectrum: Alcibiades, the Athenian general and statesman of the fifth century BCE. His specific condition, often referred to as a lisp, is called τραυλίζειν by Aristophanes, and it is thus mocked in his play The Wasps: SOSIAS I gathered Theoros, sitting nearby, on the ground, holding the head of a crow. Then Alcibiades spoke to me with his lisp: “Look hele, Theolos holds the head of a clow.”27 XANTHIAS Neatly lisped that, Alcibiades! (Aristophanes, Vespae 42–6) The passage demonstrates that the translation of “to lisp” is problematic: Alcibiades is not presented as struggling with the production of sibilants and fricatives, but in actual fact is represented28 as struggling to pronounce the full range of liquids, making the [r] sound like an [l].29 Parody of public figures on the comic stages inevitably involves both playful exaggeration and intent to ridicule. This does not necessitate, however, the intent to cause excessive harm. In other words, and with a focus on the present case, while

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mimesis of Alcibiades’ “lisp” could be construed as derogatory to Alcibiades, the tone of this passage seems to be more of playful joking and thus more of a means of identifying him than anything else (while still making the audience laugh).30 Equally with a view on Alcibiades’ specific disorder, Plutarch suggests that his elocution was not at all perceived to be negative, but simply as a defining feature of his language, which in actual fact made his oratory skills more pleasant: They say that his lisp befitted his voice and gave his speech a charming persuasiveness. (Plutarch, Alcibiades 1.4) This suggests that, unlike in other cases, Alcibiades’ awkward pronunciation was more of a benefit than an issue.31 It made him memorable and persuasive.32 One must note, of course, that Alcibiades’ condition was different from the aforementioned cases insofar that he, according to the sources, did have a lisp, not a stutter or stammer. The level of disruption to the production and the intelligibility of his speech is thus rather minimal. What made Alcibiades’ speech particularly charming is of course hard to determine: his elocution may have had its charming moments, whereas stuttering and stammering, both of which fundamentally disrupt the accustomed rhythm and sound of speaking, would have been rather less beneficial in speaking to large groups.33 One cannot rule out, however, that it was merely Alcibiades’ personality that outshone his irregular pronunciation.34 The absence of a comparatively glamorous personality (or, rather, the public perception thereof) in a public speaker, in conjunction with a slower wit, is of course more likely to turn against an individual in public discourse. This raises an important question: To what extent were communication disorders, by default, actually perceived as linked to intellectual abilities? Still at the ruling-class end of Greco-Roman societies, an interesting paradigm can be found in Cicero’s Philippics, where Cicero discusses Marc Antony’s family ties. In the third Philippic, Cicero briefly touches upon Marc Antony’s father-inlaw, a man called Marcus Fulvius Bambalio35: the father of your wife (who in turn a good woman, or, well, certainly a rich one), a certain Bambalio, is a man of no consequence. Nothing is more despicable than him, who, due to his hesitation of speech and his thick-wittedness, in fact took his moniker from that insult. (Cicero, Philippica 3.16) The surname of Bambalio is thought to have been derived from the Greek verb βαμβάλω, a word that Hesychus equates with βαμβαίνω, which in turn is subject to some debate with regard to its actual meaning. The most plausible solution, or so it would appear, is to see the word’s etymology in a description of an insecure, somewhat uncontrolled gait (“stumbling,” “staggering”), then transferred by comparison to the description of linguistic ability (similar to Latin titubo).36 The context of Cicero’s speech is, of course, a highly charged, polemical one, and it is plausible to assume that Cicero, as an orator, would have perhaps valued the ability to speak without fault somewhat more highly than the average Roman citizen. While this is an explanation for the discussion of Marcus Flavius’ cognomen, it is not enough of an explanation for what is actually being said. First, one must notice that the cognomen appears to be a more widely accepted, publicly recognizable one—even if it is unclear how this specific derogatory term was adopted; at any rate, it would appear to be more of an ad hoc formation, which was not in common use as a cognomen. This is testimony to the

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Roman habit of imposing cognomina related to recognizable features of an individual’s appearance, including physical peculiarities37—in this case clearly to the disadvantage of someone who could be presented as having been affected by a communication disorder. Secondly, and more importantly, however, it also seems to suggest that a communication disorder per se does not suffice to invoke ridicule and abuse: Cicero, for the purpose of his speech, does have to add that Bambalio also suffers from a stupor cordis (“thickwittedness”), which does not appear to be implied in the haesitantia linguae as such.38 6.2.1.2. Mouthpieces: Lawyers and orators While politicians and statesmen undergo constant public scrutiny, a good deal of their work potentially is done elsewhere (and in circles that are less than accurate representations of the society at large). The same cannot be said for orators and lawyers, whose success almost entirely depends on their linguistic performance and their ability to gain popular support for their causes. Pliny the Younger transmits a characterization of a man that sounds remarkably similar to that of Cicero’s Bambalio. In a letter directed to Catius Lepidus, Pliny reports how a certain Marcus Regulus performed a rather inept reading of a work commemorating his son39: Weak lungs, elocution confused, a stammer, exceptionally slow at finding the right words, no memory, nothing after all but an insane mind, and still he achieved by means of this impudence and this very frenzy that he is regarded an orator. (Pliny, Epistulae 4.7.4) Here, too, one finds a communication disorder described as haesitantia linguae paired with a description of substandard intellectual skills—again with the additional need to emphasize this specific mixture (rather than merely to assume that an audience would think that one equals the other). According to Pliny’s description, Regulus clearly was not cut out for life in the public sphere of Imperial Rome, an environment that required rhetorical skills from its upper-class members to succeed among their peers—if it had not been for his rather extraordinary ability to fuse impudence and stamina as an orator. This adds a display of stubborn perseverance to the previously detected means of counterbalancing potentially detrimental features in one’s linguistic performance—such as monarchical power (Claudius) or at least a gleaming personality (Alcibiades). By far the best-known case, however, of an orator tackling rhetorical weakness potentially related to a communication disorder is, of course, that of Demosthenes. Demosthenes has advanced to become somewhat of a paragon of the idea of overcoming a speech impediment merely by willpower and hard practice.40 In actuality, there is only rather limited evidence for Demosthenes having a stutter—past legend.41 In the ancient sources, Demosthenes’ life is characterized by a troubled upbringing: he lost his father and did not have the guidance and support one would expect of a child left with a vast inheritance.42 His prowess and success as a rhetorician early on was varied as well. Initially, he was successful in recuperating his losses: he began to sue his guardians and to write speeches against them. They explored many loopholes and countersued him who, according to Thucydides, not without danger or hard work, trained in practice, succeeded in his lawsuit. (Plutarch, Demosthenes 6.1)

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According to Plutarch, however, his early successes did not last. Eventually, Demosthenes’ efforts culminate in a presentation to the assembly—and here the evidence for the popular view that Demosthenes was a stutterer emerges in Plutarch’s account: And yet, as he first happened to address the people, he encountered many disturbances and was derided for his awkwardness, as his speech appeared to be confused in its sentences and too disagreeably, excessively strained in its thoughts. Also there was, it seemed, a certain weakness of the voice as well as an unclearness of his language as well as a shortness of breath in speaking that confused the sense of what was said as it broke up his sentences. (Plutarch, Demosthenes 6.3) The way he is described, though hardly a favorable interpretation of how he spoke, arguably makes it sound less like a physical or psychologically caused persistent speech impairment and more like the effect of nervousness of person with (hitherto) little experience in rhetorical composition and delivery. At any rate, in a society in which it is vital to be able to present oneself verbally, and where professional training and support to improve one’s ability to talk had become widely available, it was all the more important to make oneself stand out from the crowd.43 Demosthenes’ (initial) lack of training therefore appears to have placed him in a weak position socially. Therefore, the idea of him being “just” weak-voiced ultimately resulted in a perception just as damaging as having, for example, a stutter, stammer, or lisp.44 The idea of a “cultural speech impediment” due to the importance of rhetoric thus becomes an important way of analyzing speech impediments in the ancient world: while some people did indeed have stutters and stammers and so on, and were noted for that, it is important to realize that the high level of importance of a strong voice overall meant that even the smallest difficulties in speech were just as damaging as the difficulties that are associated with speech impediments in present times—to a degree that required “healing,” as is commonly believed to have occurred in the case of Demosthenes—a story so influential that it still resonated with audiences centuries (and, in fact, millennia) after the (alleged) event. 6.2.2. But what about the “voiceless masses”? The instances mentioned so far have been particularly prominent cases—prominent insofar as they revolve around prominent figures of Greco-Roman history. This observation has two important implications: on the one hand, they are an indication of a bigger, more widespread issue; and on the other hand, they may not at all be representative of the issue at large—and if they are, it is only for the fact that they actually were recorded for posterity. What about “the people,” then—the people without any particular claim to prominence, all those (largely) nameless cases that, in fact, were the vast majority? Unsurprisingly, the voiceless masses remain largely unrepresented (and thus quite literally voiceless and/or nameless) in the ancient sources45—with one notable exception: in the context of their finding their voices again (or related attempts) or their losing their voices forever.46 The same applies, grosso modo, to cases in which a communication disorder short of actual muteness can be implied.47 An interesting case is that of Zercon, who has been presented as “court jester” by the late Antiquity Greek historian Priscus of Panium when he described the situation at the court of Bleda, the brother of Attila the Hun.48 Zercon, described as a Moorish dwarf due

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to his overall appearance as well as his stammer (τραυλότης), quickly became a token gift toward the amusement of the high and mighty49: Because of his physical deformity and the laughter which his stammering and his general appearance caused (for he was rather short, hunchbacked, with distorted feet and a nose that, because of its excessive flatness, was indicated only by the nostrils) he was presented to Aspar, the son of Ardabur […]. Attila could not stand the sight of him, but Bleda was most pleased by him, not only when he was saying amusing things but even when he was not, because of the strange movements of his body as he walked. (Priscus, fragm. 13.2 (I p. 287) Blockley) The amusement caused by Zercon is described as follows50: Now, during the banquet he came forward and by his appearance, his clothing, his voice and the words which he spoke all jumbled together (for he mixed Latin, Hunnic and Gothic) he put all in a good humor and caused all to burst into uncontrollable laughter, except Attila. (Priscus, fragm. 13.3 (I p. 289) Blockley) One might be tempted, of course, simply to dismiss this episode as an expression of bad taste and a cynical display of power at the expense of people who, for some reason or other, cannot defend themselves. This would be missing the point, however, as it fails to ask the vital question: Why would anyone think that this is funny and entertaining? The answer must address two issues, namely: (i) the question of the audience; and (ii) the question as to what it is in Zercon’s performance that makes his audience laugh. Within the context of Bleda’s court (as well as with Attila present, who seems to have been styled in the fashion of a dignified Roman-style ruler in this passage), Zercon—for laughs—has been invited to perform what constitutes a profound perversion and corruption of a rhetorical showpiece. The humorous element (according to the “taste” of his audience, anyway) is derived from the crass mismatch between the task and the personality it typically requires to perform well on the one hand and the appearance and delivery skills of the chosen orator on the other. Upper-class displays of ridicule and abuse at the expense of (comparatively lowly) disabled people were not at all uncommon in the ancient world, and, what is more, it was not uncommon to stage such abuse even within the context of public spectacles.51 In that regard, Zercon represents somewhat of a comic relief-type apotropaion, staging the aristocrats’ own speech impediment-related nightmare.

6.3. THE “MONSTROUS SIDE” OF THE DISCOURSE The class implications of the Zercon episode are hard to miss, as the power relationships that already exist between the respective leading characters of this story are additionally heightened by the introduction of a counterpart who, though objectively clearly gifted in many regards, is ultimately treated as a “freak of nature” with limited, ridiculous capabilities. It is through Zercon’s confrontation with the powerful that his limitations stand out, clearly contrasted and defined. An even more disturbing and cynical level of contrast is reached in an episode related by Herodotus, in which an Egyptian king is reported deliberately to have interfered with the speech and language development of a young child—a story very similar to the famous modern tale of Caspar Hauser.52 According to Herodotus, the Egyptian king,

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Psammetichus, decided to engage in a particularly cruel form of longitudinal “research” of child language acquisition53: Prior to the reign of Psammetichus, the Egyptians believed that they were the oldest of all human populations. When Psammetichus, once he had become the king, desired to discern who had come first, from that time onward they believed that the Phrygians were born before them, but that they themselves were prior to everyone else. As Psammetichus was unable to establish any means by which to find out who had been the first human population, he devised the following: two newborn children of common people should be taken in order to be given to a shepherd, in order to be raised among his flock in an upbringing of the following kind, under the order that no one approached them speaking a single word, that they be placed in an isolated room by themselves, that she-goats be led to them in a timely manner, and that he shall arrange for them to be fed with milk and everything that was required. Psammetichus did this and ordered it as he wished to hear from the children, once their meaningless babble had been left behind, which language they would speak first. When the shepherd had done these things for a time of two years, and he opened the door and entered himself, both children fell before him and said “bekos”, stretching out their hands. At first, when he heard this, the shepherd remained quiet. As he visited them more frequently and tended to them, and as this very word was frequently used, he informed his master accordingly, and, ordered to do so, he brought the children before his face. Having heard it for himself, Psammetichus investigated who among the humans used “bekos” to denote anything, and during his investigations he found that the Phrygian used this as a term for bread. Thus, i.e. concluding from this matter, the Egyptians agreed that the Phrygians were older than they. I heard that this had thus happened from the priests of Hephaestus at Memphis. The Greeks tell, among many other inept tales, that Psammetichus also had cut out the tongues of women—and that he had thus made these women responsible for the upbringing of the children. (Herodotus, Hist. 2.2) Remarkable in many respects, this grim tale describes, most of all, the desire of a powerful ruler to find evidence for linguistic phylogeny in individuals’ ontogeny. Psammetichus’ method rests on two assumptions, namely: (i) baby language, like animal sounds, are “unarticulated” at first, but will eventually gain its “articulated,” human shape54; and (ii) from a developmental point of view, more recent languages ought to be increasingly removed from what one might think of as a natural state of the human language. Psammetichus, and in turn Herodotus as his chronicler, were by no means the only ones who clearly were fascinated by the investigation of what one might regard as primordial states of human oral communication and by deviations from perceived norms and from underlying causes that shaped communication and its related defects. There are two areas in particular that merit further investigation: (i) notions of linguistic exoticism and physiognomy; and (ii) interest in physiology and psychology. 6.3.1. Linguistic exoticism and physiognomy When Claudius enters heaven in Seneca’s Apocolocyntosis, he is not only let down by his inability to communicate intelligibly; rather, the author made a sustained effort to ridicule his protagonist by a more complex depiction of the emperor’s monstrosity, which combines elements of his physiognomy with that of linguistic impairment.55

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It is certainly possible to see this in the context of a wider discourse of monstrosity and abnormality in Rome. At the same time, it is important to consider that this discourse is not only one of deviation from a perceived or measurable norm (i.e., one about “freaks of nature”), but also one of remoteness from the city of Rome herself. A particularly interesting aspect to consider in this context is the way in which Rome’s geographers linked what they regarded as exoticism in physiognomy to linguistic behaviors. Pomponius Mela, in the third book of the De Chorographia, reports a most remarkable story about peoples inhabiting central parts of Africa, presumably Ethiopia. He writes: There are, too, beyond the deserts that we just mentioned, mute peoples and those who use nods instead of producing speech, some lack the sound of a tongue, some lack tongues altogether, others have their lips grown together, except that under their noses there is a small tube through with they are said to drink, using straws, and through which, when the desire to eat arises, they are said to absorb individual grains of the crops that grow there scattered across. (Pomponius Mela 3.91) The same story features in Pliny the Elder’s Historia Naturalis, where the author suggests that: It is little wonder that monstrous appearances of animals and humans emerge around these extreme regions, with such a level of activity of fire [sc. as available in that region], skilled in molding bodies and shaping appearances. (Pliny, Nat. Hist. 6.187) With regard to these peoples’ faces and organs of speech, Pliny adds that: others lack an upper lip, other lack tongues. Some of them, with their lips grown together and lacking nostrils, breathe through but one opening and sip their drink through reeds of grass as well as the grains of the same grass that randomly grows there, for food. Some of them use nods and movements of their limbs for their communication. (Pliny, Nat. Hist. 6.187–8) Putting the trustworthiness of these reports to one side, Pliny, rather more outspoken than Mela, leaves little doubt that he regards these types as monstrosities (monstrificas effigies), and that one ought to expect to find such monstrosities at the end of the world, especially in a climate that is dominated by extreme heat. At the same time, the unsettling or even threatening potential of the people described in these passages comes across as relatively low, as the great distance between “them” and Rome made the issue a contained and remote one. Once distance turns into proximity, the threatening potential increases significantly. When Ovid describes the sounds produced by the peoples he claims to have encountered during his exile at the Black Sea, dwelling on the exact same type of “climate racism” as a vital factor in the formation of human physiognomy and linguistic behavior, he links climate-induced shapes and distortions of the landscape to fears inspired by foreign, hostile sounds and accents56: As ordered I have come to the shapeless shores of the Euxine sea—this land lies beneath the freezing pole—and neither the climate, never free from frost, nor the soil,

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always burnt by white frost, nor the fact that the barbarian tongue does not know any Latin word and that Greek has been conquered by the sound of Getic, torture me in the same way that I am surrounded and pressed from all around me by imminent war, as well as that only a small wall scarcely grants us safety from the foe. Indeed there is peace at times, but never any trust in it: thus this place suffers and fears war in turn. (Ovid, Trist. 5.2.63–72) In another context, Ovid creates the notion of a threatening, dangerous soundscape in which unfamiliar, distorted speech is combined with wild animal noises.57 When taken together with the descriptions of Rome’s geographers and scientists, this discourse provides an interesting backdrop against which one may read Seneca’s description of Claudius’ incomprehensible speech and its likeness to unarticulated, monstrous animal sounds. 6.3.2. Physiology and psychology The tale of King Psammetichus and his “research” to establish whether Egyptian or Phrygian was the older, more original language is perhaps the earliest extensive report in Greco-Roman literature of linguistic curiosity. When it comes to communication disorders, however, scientific investigation concerns itself with two questions, namely: (i) Were they caused by a potential defect of the human vocal tract or possibly by psychological issues; and (ii) how could they be overcome? In addition to that, ancient medical records, such as the material collated in Hippocrates’ Epidemics, often note the inability to produce speech prior to a patient’s death, presumably as a way to describe fainting or a comatose state. The evidence from ancient scientific sources on communication disorders and their underlying physiological and medical causes has been collected and discussed in an excellent, comprehensive study by Jeffrey Wollock58; in that regard, there is no need to go into significant detail on the medical evidence here. With a view to the material discussed in the previous section, however, as well as with an eye on the discourse overall, one important exception must be made. In the context of “exoticism” above, the concept of “heat” as an impactful factor on the human body and its ability to develop its potential had already come to the fore. The same rationale applies in the Aristotelian treatise Problemata, where the author suggests that wine, as a supplier of heat, could be used to overcome speech impediments59: Why are stammerers more anxious, but less so when under the influence of drunkenness? Is it because the condition is similar to an affliction of an inner part which they cannot move, impeded by cooling? The wine, in turn, hot by nature, rather dissolves the cooling, whereas anxiety creates it. For anxiety is a form of fear, and fear is a form of cooling. (Aristotle, Problemata 11.36) The same author also considers and tries to explain a potential mental impact of communication disorders: Why are stammerers melancholic? Is it because being melancholic means to follow the imagination quickly, and that is what stammerers do? The urge to speak precedes their ability to do so, as their soul quickly follows the appearance. The same matter applies

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in the case of people with a lisp: but in their case the inner parts are too slow. The evidence: individuals under the influence of drunkenness turn out in such a way that they follow the appearances first and foremost, but not their intelligence. (Aristotle, Problemata 11.38) Considering the obvious and hugely debilitating impact of communication disorders on the ability to participate successfully in public but also private life in the ancient world, it is of little surprise that there is a good amount of evidence surrounding the issue of overcoming this impediment in one way or another. A particularly common theme is the narrative that immediate acute threats have the potential to help individuals to overcome their disabilities, resulting in spontaneous, lasting healings.60 In addition to the case of Croesus’ son, as discussed above, one must mention at least two further spontaneous healing narratives, viz. that of Battus and that of Echeclus. Battus I of Cyrene, whose story was already briefly mentioned above,61 according to Pausanius was cured of his stammer when he all of a sudden encountered a lion.62 Less shocking perhaps, but even more telling, is the case of Echeclus. Gellius, in his report of the story about Croesus’ son, first confirms Herodotus’ narrative, then adds the case of Echeclus, a Samian athlete.63 Echeclus, Gellius suggests, overcame his condition upon witnessing improper conduct of a sortitio (“draw”) for a competition. Like Croesus’ son, Echeclus, too, is reported as having been able to speak henceforth (oris vinculo solutus, “freed from the fetter of his mouth”) without distortions or stammer (non turbide neque adhaese). In a variant of the same story, Valerius Maximus suggests that the athlete (whom he calls Echecles) became able to speak when he witnessed an unfair allocation of a title and prize.64 What makes the case of Echeclus particularly interesting, and thus related to that of Croesus’ son from a social point of view, of course, is that the very event that triggered the man’s spontaneous cure was one of a perceived injustice in which only an active, unimpeded use of the voice was able to help. Thus, in this imagination, the need to function socially in an emergency was ultimately enough to overcome what was regarded as a physiological weakness, possibly down to a mere reluctance to function or, of course, some form of a mental block. In other words, this is the narrative of a society that numbers rhetoric among its key educational goals as a claim to authority and influence. It seems reasonable to see the healing narratives of the Christian bible and those of the JudeoChristian tradition in the Roman Empire, typically administered either to the powerless or those who then go on to become prominent supporters of the cause, in a similar light.65 Practice, therapy, or spontaneous healing were not the only ways in which the ancient sources suggest communication disorders could be addressed. An interesting question is whether already in the ancient world sign languages existed that could be used as “workarounds.” The evidence for the use of gestures and sign languages by those affected by communication disorders is scarce at best, but it is not altogether absent. One of the earliest passages appears to be the following from Plato’s Cratylus: If we had neither our voice nor a tongue, but wished to clarify matters to one another, should we not try then, as speechless people nowadays, to make use of our hands and make signs with our hands and our head and the remainder of our body? (Plato, Cratylus 422d) The use of sign languages in the Roman world is essentially unchartered territory still, and it must be stated straightaway that it is impossible to distinguish between more

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developed sign language systems (for which there is no undisputed evidence) and less specialized and sophisticated uses of gestures.66 There are a small number of interesting passages, however, that address the matter in terms of uses by those affected by voicebased communication disorders. Celsus, for example, is reported in the Digests to have claimed that: For although the intention of a speaking person is more important and preferable than their words, still no one is believed to have spoken without their voice altogether, unless it so happens that we believe that those who do not, in fact, have the capability to speak, do speak by means of their very attempt as well as a certain production of sound and an unstructured elocution, that is to say, by means of an inarticulate voice. (Dig. 33.10.7.2) Important for a number of reasons,67 this passage makes it clear that, at least in theory, forms of (non-written, oral, or quasi-oral) communication were deemed to be in use in the ancient world, even if their actual status, not least in legal terms, was subject to debate.68 Ammianus Marcellinus, in his description of the Romans’ sack of the city of Maiozamalcha under Emperor Julian the Apostate in 363 CE, relates the following episode: When the booty had been divided, with consideration given to everyone’s merits and efforts, he himself, as he was content with little, accepted a mute boy that was offered to him: trained in gestures, the boy explained the many things in which he excelled through most charming nods, worth three gold coins (?), a pleasing and welcome reward for the achieved victory. (Ammianus Marcellinus 24.4.26) In a similar vein, Augustine writes69: AUGUSTINUS Have you never seen how people are essentially having conversations with deaf people using gestures, and how those deaf people to no lesser extent ask questions, or answer, or instruct, or express either everything they wish, or certainly most of it, through gestures? When that happens, they do not express just visible things without words, but also sounds and flavors and other things along those lines. For actors, too, often express entire plots in theatres without words through their dancing and make them clear. ADEODATUS I have nothing to say in response to that except that in the case of that word ex it is not only me, but not even that dancing actor would be able to show you what it means without resorting to other words. (Augustine, Liber de Magistro 3.5) While it would seem obvious that communication without words was certainly deemed possible and even successful to an extent, much must remain unknown.70

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6.4. OUTLOOK The way in which communication disorders have been presented and were reflected upon in the discourse covered by the sources studied here is one that is inextricably linked to presence and absence of power: physical power, mental power, legal power, a power to participate in the vital context of ancient (oral) societies, a power to rule and to impose lineage, and a power to argue cases for oneself as well as for others. As language is related to human development, a less than fully developed ability to communicate orally, however caused, leaves individuals in a status of social infancy or adolescence, depending on the degree and the effects of the impediment(s)—and it is only rarely that speech that is associated with childlike patterns (such as in the case of Alcibiades) can be turned into something positive and charming (in which case personality may come into play). The power associated with a fully developed, potentially even highly trained gift of speech goes hand in hand with a set of rather serious, debilitating fears. The very fears attached to this need to function in society—a need addressed positively by ancient rhetorical treatises, but without offering much help for those who were struggling psychologically or physiologically—are palpable in sources that conceptualize communication disorders from other perspectives. They also seem to be the drivers behind comments on (what, de facto, amounts to) stage fright, from Euripides’ comment on paralyzing fear when it comes to defending oneself against the accusation of manslaughter,71 to Cicero’s vague reflection on his “being moved at the beginning of a speech” beyond what should be expected of him considering his experience and age (initio dicendi commoveri soleam vehementius quam videtur vel usus vel aetas mea postulare),72 to allusions to curses73 and witchcraft impeding on one’s proper deployment of speech (e.g., in Aelius Aristides and Libanius),74 to a Delic inscription from the third century BCE reporting an inability to speak in court when confronted with the masses.75 With the gift of speech as an essential function for social performance, it is no surprise that speech production, when anomalous, was perceived as something that needed to be understood and potentially “fixed” when “broken,” as any lasting disorder would almost automatically involve lasting exclusion, unless exceptionally an already elevated status suggested otherwise.

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CHAPTER SEVEN

Learning Difficulties Intellectual Disability in the Ancient Near East, Classical, and Late Antiquity EDGAR KELLENBERGER

7.1. METHODOLOGICAL INTRODUCTION: THE CASE OF DISABLED PRIESTS AND DISABLED DEITIES Asking about intellectual disability (ID) in Antiquity means raising a modern question, unanswerable by persons belonging to an ancient civilization, the thinking of which was structured utterly differently. Even the terminology is not compatible with our categories shaped by medicine and therapy. The difficult task of detecting ancients’ categories requires extensive research, and this research is still in its infancy. So the only way open to us is to begin with a modern question and then to be led to unknown categories offered by the seemingly unsatisfying answers of the ancient texts, or even by their strikingly notorious silence. I start with the case of disabled priests (Kellenberger 2019). I chose this example in the hope that studying the normative priestly role might reveal hidden values of the ancients concerning the human ideal. The cross-cultural idea that a priest has to be perfect is found in ancient Israel (Kellenberger 2017), Greece (Wilgaux 2009; 2018), and Rome (Morgan 1974; Baroin 2011), with analogous terminology (Greek holoklēros, Latin integer or salvus). The requested norm of being “complete” primarily concerns the body, including aesthetic appearance and lack of speech disorders. But why is intellectual perfection never mentioned, and moral perfection only rarely? And what about priests who became senile or lost their intelligence as a consequence of an accident? The sources largely remain silent, or they give inconsistent information, such as the texts by the Jewish congregation at Qumran (Dead Sea, second century BCE until first century CE). On the one hand, a mentally incompetent member (petî) is excluded from the assemblies of this congregation (as well as the lame, the crippled, the deaf, and the minor). The given justification seems strange to us: “because of the angels’ presence amidst the assembly” (Damascus Document 15). On the other hand, such a priest (petî) is authorized to make uncriticizable decisions about skin diseases, “because that duty is the priests’ alone” (Damascus Document 13; compare also in the Talmud Niddah 13b). The general emphasis on perfection of the body has led scholars to diverse explanations. Rituals did not permit the malfunctions of a priest. The analogy with perfect sacrificial animals (Feyel 2006; Georgoudi 2007) is striking, even in the use of the

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same terminology of forbidden blemishes for priests and animals (significantly in the Old Testament, Leviticus 21–2). The aesthetic aspect of a perfect body seems important for priestly authority (for Israel, Olyan 2008 emphasizes a symmetry of the two body halves). The analogy between the social and the religious etiquette was compelling regarding the priests’ respectful communication with the gods (Van der Toorn 1989); for instance, the eating of garlic, causing bad breath and flatulence, was forbidden. Likewise, a disabled priestly body would be unfavorable for a ritual. Priests and animals have to follow the qualities of divine perfection: le semblable va vers le semblable (Wilgaux 2009: 241; for continuity in Christian Middle Ages and some weighty exceptions, see Metzler 2016). Ancient Near East (ANE) and classical writers sometimes combine physical blemishes with punitive divine actions. The ideal kalos kagathos (with some ANE analogies) combines physical and moral qualities, possibly also including intelligence. In all cases, there are consequences for the understanding and assessment of disability. Though all of these explanations may contain some truth, an overarching answer is impossible to give. Deities do not follow the moral perfection demanded from humans. They commit adultery, send plagues, or induce humans to bad actions. Even the idea of a perfect divine body is not always valid. Jahwe compares himself with decay and rottenness (Hoshea 5:12). The gods Hephaistos, Dionysos, and Pan are ugly, disabled, or full of mania. The Mesopotamian deities Lillu (“idiot”) and Sukkukūtu (“deafness and dumbness”) demonstrate that even perfect intelligence is not always a divine quality (regrettably, we are not informed about the concrete activities of these deities). And in Egypt, the ugly and grotesque Bes embraces several disabilities: apochondric dwarfismus, a cretin grimace, and a protruding tongue reminiscent of Down’s syndrome (see Section 4.6). Sometimes bodily imperfection leads to positive consequences, not only in the case of Bes. See the “Suffering Servant of the Lord” (Isaiah 53), who by being crushed and disabled through Jahwe (!) causes the healing of the people (Schipper 2011); and see the future of the limping patriarch Jacob/Israel, disabled by his God after wrestling (Genesis 32). Examples from Greece are mentioned by Wilgaux (2009). In addition, there is often a distance between a requested norm and the lived practice. Pliny the Elder (Nat. Hist. 7.104–6) tells of the Roman Sergius Silus (third century BCE) who lost his right hand during battle but could still perform sacrifice (albeit after initial opposition). The diviner (mantis) Hegesistratus had an amputated leg (Herodotus, Hist. 9.37). Caecilius Metellus (approximately third century BCE), with a speech impairment, was Pontifex Maximus (Pliny, Nat. Hist. 11.174; his blindness is mentioned in 7.141 and by Seneca the Elder. Controversies 4.2), and Lev. 21 prescribes the “holy bread” also for disabled priests who were not allowed to sacrifice—presumably a sort of social security in case of later acquired impairment (Hieke 2014). Several points remain open questions (reflected on in Sections 3–5 below): (i) The predominance of physical disability versus the scarce mention of ID and the reasons for this. (ii) The relationship between a norm and lived practice. Texts more often inform us about norms that were not always realized in daily life. In contrast, information about lived practice often consists of anecdotes stressing extraordinary and extreme cases. Describing the normal course of daily life is the task of modern historians, but rarely of ancient writers. (iii) ID as deficit or as empowerment.

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7.2. TERMINOLOGY 7.2.1. Problems of diversity and range of meaning Terminology for ID is eminently rich, both in ancient and in modern languages (see Metzler 2016 for a list and summary). That is also valid for the ANE (Kellenberger 2017), for Ancient Greek (Pollux, Onomasticon 5.120–1; Clark 1993), and for Latin (Kellenberger 2011b). This richness demonstrates that the ancients, too, perceived such disabilities. The statement that less technologically advanced societies, in which the majority of people did not have formal education in the modern sense, simply did not notice IDs is obviously flawed. The rich ancient terminology is neither compatible with modern medical categories (M. L. Rose 2017) nor does it quickly reveal the ancients’ own categories. A semantic study seems to be impossible, since the limits of these somewhat cloudy lexemes remain utterly unclear. Also, we must admit that, even for our own mother tongue, we are unable to differentiate between the numerous designations that seem nearly synonymous. This general vagueness of terminology points to a deeper conceptual problem, even to the absence of any stable nature linking the people thus described (Goodey 2011). In fact, neither does today’s academic terminology, following insights of medical and educational research, get over this problem. For want of precise definition, new paraphrases and circumscriptions are invented again and again, apparently without reaching the intended aim of precision. This augmentation of terms is motivated, in addition, by interest in a respectful language excluding social attitudes of disdain and exclusion. But such well-meant coining of words hardly improves the social position or the civil rights of stigmatized groups. The meaning of innovative positive terms can be devalued by a society that retains a negative attitude, and willingly neutral terms run the risk of fostering an abstract and cold relationship with disabled persons. In Antiquity, the intellectuals did not know of such discussions. However, some writers were conscious of the semantic problems concerning differentiation and devaluation. Two examples include: (i) Aulus Gellius (4.2.1–15; second century CE) criticizes in detail the inconsistencies of lawyers differentiating between morbus (disease) and vitium (disability) in the case of disabled slaves (Text 7.1; bibliography in Laes 2018: 10). This differentiation (compare Text 7.9.3) was common in juridical contexts concerning the sale of slaves who had some defect (see also Laes 2018).

Text 7.1. Aulus Gellius, Attic Nights 4.2.13–15, transl. Rolfe: I must not omit to say that this also is stated in the works of the early jurists, that the difference between a disease (morbus) and a defect (vitium) is that the latter is lasting, while the former comes and goes. But if this be so, contrary to the opinion of Labeo, which I quoted above, neither a blind man nor a eunuch is diseased (morbosus). I have added a passage from the second book of Masurius Sabinus On Civil Law: “A madman or a mute, or one who has a broken or crippled limb, or any defect which impairs his usefulness, is diseased. But one who is by nature (naturā) nearsighted is as sound (sanus) as one who runs more slowly than others.”

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(ii) Augustine (Texts 7.2.1 and 7.2.2) uses the terms morio, fatuus, excors, obtunsus, tardicors, and others (Kellenberger 2011b). Often Augustine seems to use the lexemes interchangeably. Occasionally, he discerns degrees of handicaps (see also Text 7.18): excors designates a more serious disability than tardicors or tardissimo ingenio (“slow in learning”). In some cases, Augustine dissociates himself from the linguistic usage of the common folk. While such people use morio, Augustine, without comment, prefers fatuus. We may suppose that morio is more disdainful and fatuus less because people associate morio exclusively with jesters and entertainers.

Text 7.2.1. Augustinus, De Peccatorum Meritis 1.66, transl. Schaff: those simpletons (fatui) whom the common people call moriones are used for the amusement of the sane (cordati). Text 7.2.2. Augustinus, De Peccatorum Meritis 1.32, transl. Schaff: they are born (!) with faculties akin to brute animals,—who are (I will not say most slow in intellect [tardissimo ingenio], for this is very commonly said of others also, but) so silly (excors) as to make a show of their fatuity (delicias fatuitatis) for the amusement, even with idiotic gestures (cerriti, for text variants, see Metzler 2016: 134, note 46), and whom the vulgar call, by a name, derived from the Greek: moriones.

The future emperor Claudius had various impairments since childhood, and Suetonius designates him as animo simul et corpore hebetatus (Claudius 2.1). Maybe this was cerebral palsy (Leon 1948). His mother Antonia saw him as a monster (portentum … nec absolutum a natura, sed tantum incohatum; 3.2). His grandfather, the emperor Augustus, discussed in three letters to his wife Livia whether Claudius would be capable of future public activities (4.1–6). Strikingly, he tries to lessen these embarrassing aspects by using predominantly Greek formulations (holocleros; βεβλάφθαι καὶ εἰς τὴν τοῦ σώματος καὶ εἰς τὴν τῆς ψυχῆς ἀρτιότητα, etc.). Most ancient writers, however, show little interest in precise terms designating an ID. A striking example comes from Mesopotamia. The famous epic of Gilgamesh offers a detailed portrait of a village idiot. By comparing him to the privileged King Gilgamesh, the poet describes his sort in eight intriguing (but in part fragmentarily conserved) verses (Text 7.3). This text is not only informative about social attitudes (see Section 3), but also instructive for terminology. It is lucky that here the term lillu is used in combination with a detailed description. As with Augustine, the disabled persons are set in contrast to other humans, but this contrast relates not only to different degrees of intelligence. Having advisers and being able to give counsel is the social privilege of the mighty. In contrast, the lillu ranks among the miserable, receiving food and clothes of bad quality only and not being able to gain his bread himself. This text does not describe a concrete disability. Other occurrences of lillu point to a deficit of planning and reason (Kaǧnici 2018)—a symptom of both ID and mental illness, as well as of a certain attitude toward life. We have to accept that the ancients were not much interested in such a distinction (and admittedly today this distinction is not always crystal clear).

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Text 7.3. Gilg. 10.267–278, according to George 2003. Uncertain translations in italics, completions denoted by […]. The wise Utanapishti says to Gilgamesh seeking immortality: Why, Gilgamesh, do you constantly [chase] sorrow? You who are [built] from the flesh of gods and men, whom they [made] like your father and your mother! Did [you] ever, Gilgamesh, […] to the fool (lillu)? They placed a throne in the assembly and [told you], “Sit!” What is given to the fool is [beer] sludge instead of […] ghee, [he chews] bran and grist instead of […] He is clad in a mašhandu-garment, instead of […] instead of a belt, a cord of […] Because he has no advisers […] [because] he has no words of counsel […] have thought for him, Gilgamesh […]!

In the first half of the epic of Gilgamesh we find a further occurrence of the word lillu (Text 7.4), demonstrating its still wider range of meaning. Here, lillu is used as a swear word and a term of insult. Gilgamesh and his savage friend Enkidu want to kill the giant Humbaba. When they meet him, he welcomes them with ironic sayings. Humbaba not only vilifies Enkidu, but also reproaches Gilgamesh for going with fools like Enkidu, thereby indirectly accusing Gilgamesh himself of acting as a lillu. There is a subtle parallel to the abovementioned Text 7.3: Utanapishti indirectly designates Gilgamesh as a lillu. Who is the greater lillu—the miserably disabled person or the privileged King Gilgamesh erring in his vain search for immortality after the unexpected death of his friend Enkidu instead of fulfilling his kingly task of caring for the poor?

Text 7.4. Gilg. 5.85–8 according to George 2003: Humbaba opened his mouth to speak, saying to Gilgamesh: Let fools (lillu), Gilgamesh, take the advice of an idiot (nu’û) fellow! Why have you come [here] into my presence? Come, Enkidu, [you] spawn of a fish, who knew not his father, hatchling of terrapin and turtle who sucked not the milk of his mother!

A survey of all occurrences demonstrates that in the majority of cases lillu is used as a swear word addressed to an adversary or to the speaker himself who did something silly. One can also be an idiot by chance or by birth. This double use of lillu contradicts the modern demand for political correctness, but is crucial for understanding how the ancients perceived disability (Kellenberger 2013). The same double use is also apparent in all cultures of the ANE, of Greece, and of Rome. The instructive collection of Israelitic proverbs and epigrams often speaks of fools (mostly kesîl) as unwise persons

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with a deficient education (and, as a consequence, with a deficient moral character). But someone “being born” as a fool (Texts 7.5.1–7.5.3) is designated by the same word kesîl. Analogous formulations are Greek physei mōros (e.g., Text 7.13) and Latin naturā(liter) fatuus (e.g., Augustine, Opus Imperf. 4.123). However, this distinction is not obligatory. Many passages without this additional specification also seem to point to a congenital disability.

Text 7.5.1. Old Testament, Prov. 17.21: Fathering a fool (kesîl) brings grief, the father of an aggressive fool (nabal) has no joy. Text 7.5.2. Old Testament, Prov. 17.25: A foolish son (ben kesîl) is a vexation for his father and bitter sorrow to her who bore him. Text 7.5.3. Sirach 22.3, Greek edition: A father’s shame is in engendering an uneducable see Kellenberger 2013: 454), (such) a daughter brings him to misfortune.

son

(apaideutos;

Hebrew terminological differentiations are based on specific categories. Tentatively, we can suppose that fools were perceived by the degree of their tractability: the nabal is aggressive and hardly controllable, the petî is seducible but dirigible (Texts 7.6.1 and 7.6.2), and kesîl is the general term. Latin differentiations (furiosus/demens) are based on the visible consequences of intellectual/psychological disorders (cf. Hebrew mešugga‘/kesîl and medieval analogies in Nolte et al. 2017: 98–9, 299).

Text 7.6.1. Old Testament, Prov. 14.15: The simpleton (petî) believes everything, but the shrewd man measures his steps. Text 7.6.2. Old Testament, Prov. 22.3: The shrewd man perceives evil and hides, the simpletons go on and suffer the consequences.

A special problem, yet an unsolved riddle, is the cross-cultural phenomenon of personal names designating a foolish qualification (e.g., Mōros or Varro) (Strassi 1997; Kellenberger 2011a: 65). These observations on ancient texts demonstrate a different perception of ID in Antiquity and modern times, leading to different categorizations. We have to accept that the ancients included in one and the same term an intellectual and a mental impairment, as well as momentary foolishness (despite “normal” intelligence). In view of this broad and vague use of terms in ancient times, my present contribution renounces the sophisticated actual terminology and is content with the somewhat cloudy term “intellectual disability,” being conscious of the impossibility of capturing the strange reality of ID with a precise

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term. The term “intellectual disability” (see also Metzler 2016) is indeed equally cloudy, hiding the reality of its overlap with other impairments (in particular cognitive, psychical, and social), and this term also neglects the other sorts of intelligence we can observe in people with ID. 7.2.2. Disability as “social construct”? Present-day discussions emphasize that ID is a “social construct” (see e.g., Goodey and Rose 2013). Admittedly, since Immanuel Kant, we acknowledge the impossibility of recognizing the Ding an sich. We cannot escape our human categories, as we are all part and parcel of the culture we live in. In this sense, all of our perceptions are constructs. Research on constructs is problematic, because it will be our construct of a construct, influenced by the scholar’s own unconscious construct. A husband cannot ever study the construct of his matrimony (and during a crisis he needs an external adviser for detecting his own problematic projections). Nor can I, as a father, study the hidden social construct of my son’s ID and of my own involvement. Therefore, the present contribution abandons this actual claim. Instead, I attempt to listen to the testimonia as attentively as I listen in my pastoral work to people entrusted to my care. By this method, I hope to remain open to the complexity of human life and to avoid the oversimplifying schemes I often observe in postulated social constructs.

7.3. SOCIAL CONTEXTS The rare textual mention of ID has to be contextualized within common living conditions of malnutrition, difficult births, and diseases (e.g., meningitis), often producing some forms of ID (Pudsey 2017, and compare the anti-children Text 7.7 from the noncanonical Acts of Thomas propagating absolute sexual asceticism in the third century CE, but also Augustine in Text 7.18). The silence of the sources may be explained by the authors’ habit of setting other priorities, or due to shame or embarrassment regarding the topic of ID. The latter is especially palpable in the case of an intellectual profession handed down from father to son (compare Texts 7.5.1–7.5.3 from the milieu of scribes and administrators where a son with ID was a catastrophe for the identity and the future financial situation of the family).

Text 7.7. Acts of Thomas 12.3, transl. James: For the more part of children become useless, oppressed of devils, some openly and some invisibly, for they become either lunatic or half withered or blind or deaf or dumb or paralytic or foolish (mōroi); and if they be sound, again they will be vain, doing useless or abominable acts, for they will be caught either in adultery or murder or theft or fornication, and by all these will ye be afflicted.

All ancient texts were written by authors belonging to the cultivated elite. It is risky to transfer the views of this thin social layer to the entire population (archaeological excavations offer a partial counterbalance). Greek philosophers like Aristotle, paying particular attention to virtues such as self-control and intelligence, consider fools in

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analogy to animals (Text 7.8.1; compare Augustine Text 7.2.2 and Kellenberger 2011b: 59). This view, remaining vivid even in the era of Enlightenment (e.g., John Locke) and implying a sharp distinction between men and animals, does not conform to the ANE view in which animal qualities increased the power of deities and humans (Keel 2000: 23–9) and in which any sharp distinction between men and animals did not exist. Even lower in the scale is the valuation of the morio by Archbishop Isidore of Seville (seventh century), who associates this lexeme with “death” because of a deficient intellect (Text 7.8.2; compare Augustine Text 7.14.2).

Text 7.8.1. Aristotle, Nicomachean Ethics 1149a, transl. Rackham: So with folly (aphrōn): people irrational by nature (ek physeōs alogistoi) and living solely by sensation (aisthēsis), like certain remote tribes of barbarians, belong to the bestial class (thēriōdeis); those who lose their reason owing to some disease, such as epilepsy, or through insanity (mania). Text 7.8.2. Isidore of Sevilla, Etymologies 10.183, transl. Barney: morio: so called from “death” (mors), because such a one is not lively in intellect (non vigeat intellectu).

The vast majority of the population were farmers living in the countryside. They could easily employ their members with a slight ID in the fields and in their households (Kellenberger 2011a). Household slaves with ID are mentioned in classical times, such as Seneca’s fatua Harpaste, who does not realize her growing blindness (Text 7.9.1), but also in the Talmud (Baba Metzia 80a). Often they were despised, sometimes loved as pets or used as lovers—see Martial’s Epigrams (6.39, 12.93) and a Greek sexual wit (Text 7.9.2). Juristic regulations are collected in the Digests (Texts 7.9.3 and 7.9.4; and see 42.5.21 for the institution of a curator), with Jewish analogies in the Mishna (Abrams 1998). But psychological disorders are much more discussed in Roman law (Gardner 1993).

Text 7.9.1. Seneca Minor, Letter 50, transl. Gummere: You know Harpaste, my wife’s female clown (fatua); she has remained in my house, a burden (onus) incurred from a legacy. I particularly disapprove of these freaks (prodigia); whenever I wish to enjoy the quips of a clown, I am not compelled to hunt far; I can laugh at myself (me rideo). Now this clown (fatua) suddenly became blind. The story sounds incredible, but I assure you that it is true: she does not know that she is blind. She keeps asking her attendant to change her quarters; she says that her apartments are too dark.—You can see clearly that that which makes us smile (ridere) in the case of Harpaste happens to all the rest of us; nobody understands that he is himself greedy, or that he is covetous. Text 7.9.2. Philogelos Nr. 251, transl. Baldwin: A lady had a slave (oiketēs) who was retarded (mōros). But when she found out that his head was not the only thing about him that was thick, she got hot pants for him. So, covering her face with a mask so that she wouldn’t be recognized, she took him to bed. But in the midst of it all, he did recognize who it was. So he went to the

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gentleman of the house and said with a giggle: “Master, Master! Guess what? I just fucked the dancer, and Milady was inside the mask!” Text 7.9.3. Digests 21.4.3–4, transl. Watson: (3) Pomponius, again, says that although a vendor is not required to produce a slave of full intellect (valide sapiens), still if he sell one so silly or moronic that he is useless (ita fatuum vel morionem vendiderit, ut in eo usus nullus sit), there is a defect (vitium) under the edict. Generally, the rule which we appear to observe is that the expression “defect and disease” (vitium et morbus) applies only in respect of physical defects; a vendor is liable in respect of a defect of mind (animi vitium), not physical. It is for this reason that there are those who say that animals prone to shy or kick are not to be accounted diseased; for such defects are of the mind, not the body. (4) All in all, if the defect be only of the mind, there will be no rescission, unless the vendor has stated that such defect does not exist when, in fact, it does; an action on purchase, however, will lie, when the vendor, knowing of such defect, should not reveal it. But if the defect be wholly physical or a combination of the physical and nonphysical, there is scope for rescission. Text 7.9.4. Digests 3.1.2: Idiots male (fatuus) and female, since a curator is appointed for these persons too …

In the ANE, the royal palace and the sanctuaries had the greatest economic power in terms of providing jobs. In this context, laborers with physical impairments are mentioned much more often than those with ID (Kellenberger 2011a: 140–7; 2017: 56). Often such people were donated to a sanctuary, especially when their parents could no longer take care of them. It is reasonable to assume that Mesopotamian deities were sometimes qualified as protectors of people with ID (Kellenberger 2011a: 129–30). In Mesopotamia, we can see from the third millennium, cum grano salis, the earliest sheltered workshops (the medieval monasteries would continue this tradition). But life as a temple worker (e.g., as a weaver) was no paradise: provision lists mentioning food rations for them document many dead, sick, or fugitive workers. For Greek and Roman civilizations, the sources remain silent about such jobs. But we read about people earning their bread by sporting their ID as entertainers at the parties organized by rich people. They are called moriones (in spite of this Greek word, we know nothing about the Greek tradition). An additional physical disability could increase the amusement, certainly when dancing was involved. However, such entertainers were  competing with other moriones, professional mimes who only feigned ID. Such imposture is sometimes criticized by Martial (Texts 7.10.1 and 7.10.2; Gevaert 2012) and (more mildly) by Pliny the Younger (Letters 9.17), largely on aesthetic or financial grounds (more fundamentally Augustine, see infra). The Roman emperor Alexander Severus (third century CE; of Syrian origin) emptied his court of all moriones and other jobs he considered dubious or useless (Text 7.11; Gevaert and Laes 2013a: 225–6).

Text 7.10.1. Martial, Epigrams 14.210, transl. Shackleton: He was described as a natural (morio dictus). I bought him for twenty thousand. Give me back my money, Gargilianus. He’s no fool (sapit).

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Text 7.10.2. Martial, Epigrams 8.13: His stupidity does not lie, is not feigned by wily art. He that is witless (non sapit) to excess has his wits (sapit). Text 7.11. Aelius Lampridius (Historiae Augustae), Severus Alexander 34.2, transl. Magie: All the dwarfs, both male and female, moriones, catamites who had good voices, all kinds of entertainers at table, and actors of pantomimes he made public property; those, however, who were not of any use were assigned, each to a different town, for support, in order that no one town might be burdened by a new kind of beggars.

In classical times, aristocrats ashamed of a disabled family member tried to hide this dishonor, as Livy demonstrates in the case of Titus Manlius Torquatus (fourth century BCE), who was expelled by his father to the rustic periphery. Some parts of the description suggest ID (lingua impromptus, tarditas ingenii), but Livy’s primary interest is in the deficient pietas of a father expelling a son and so aggravating his burden (Text 7.12; Laes 2011a: 917–21). According to Livy, true pietas would foster the sparks of native talent. In contrast to this inhumane father, his son would demonstrate true pietas by drawing a knife against a noble who wanted to destroy the reputation of his father.

Text 7.12. Livius, Ab Urbe Condita 7.4.6–7, transl. Foster: But ought not his father to have healed and mended this infirmity of nature (naturae damnum)—if he had a particle of humanity about him (si quicquam in eo humani esset)—instead of chastising it and by persecution making it conspicuous? Why even the dumb brutes, if one of their young is unfortunate, do none the less cherish it and foster it. But Lucius Manlius was aggravating his son’s evil plight by evil treatment, and was doubling the burden on his heavy wits (tarditas ingenii); and any spark of native talent (naturalis vigor) that might be there he was quenching in the rustic life and boorish bringing up amongst the dumb cattle where he kept him.

In some civilizations, there was an additional incentive for shame. Mesopotamia and Republican Rome (presumably under Etruscan influence) knew a sophisticated teratology, because malformations visible after birth were assessed as being a great danger to society (Engels 2007). Mesopotamian omina collections mention humans with ID who, under the described conditions, will cause disasters for the family or for the state (Kellenberger 2013: 452); in this case, they have to be announced to the royal administration, and an expert will decide about an imminent elimination and a purification ritual. These observations raise the question of other magical practices in the context of ID. Cross-cultural phenomena include special spells used against demons in order to disable them. When they become disabled, they cannot continue their bad activities (Faraone

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1991). Some spells target both the demons’ physical disabilities and IDs (for the ANE, see Kellenberger 2013: 457; for Jewish late Antiquity, see Abusch and Schwemer 2011: 143, 186). Strikingly, spells concerning ID are addressed against demons only, and never against human adversaries. This is somewhat analogous to curses against lawbreakers; here, ID is missing, whereas some (not all!) sorts of physical disabilities are threatened (surprisingly most often blindness, almost never epilepsy, for example; see the survey in Kellenberger 2011a: 132–5). Inversely, neither therapies nor healings of ID are mentioned for people with IDs. The abundant magical and medical texts of ANE and classical times are not interested in cases of ID (Kellenberger 2013). However, there seems to have existed a sort of common knowledge or awareness about birth defects, as the formulation “since birth” is also used for disabilities that are not visible during the first months of life at least (e.g., for blindness, see Evang. John 9.2; for epilepsy, see Hippocrates, Sacred Disease 2.1–3 and Herodotus, Hist. 3.33; for women barren “since birth,” see Gellius, 4.2.9 nativa sterilitas). When a birth defect seemed to be incurable, there was no interest on the part of physicians (Goodey 2011: 212). However, Greek and Roman doctors and philosophers were confident that mental/psychological disorders were treatable (van der Eijk 2013). On the other hand, they never thought of curing a (congenitally) intellectually disabled patient. Likewise, there are neither pagan, nor Jewish, nor Christian healing narratives for ID (Metzler 2016; one possible case is discussed in Laes 2010: 50). For the special cases of epilepsy, possession by demons, and exorcism, see Section 4.5. The rise of Christianity demonstrates much continuity and also some innovation. Jesus opposed the popular opinion of his disciples about a person born blind (Evang. John 9): “Neither did this man sin, nor his parents: but that the works of God should be made manifest in him.” A direct connection between congenital disability and personal sin is seldom explicitly mentioned, from the ANE until the Christian period (Heeßel 2007; Kellenberger 2011a: 132), but this was never absent in the popular mentality (as it is even today). This appears clearly in the sermons of John Chrysostom, who demonstrates scarce interest in natural fools. That they were mocked is mentioned repeatedly in Chrysostom’s polemics against arrogant people, pagan philosophers, or heretics, in which he designates such people as more ridiculous (katagelastos) than natural fools (see Text 7.13 and also his Homilies 11.2 and 63.3 to John 1:14 and 11:40, and 58.3 to Matthew 18:6).

Text 7.13. Chrysostomos, Homily 20.4 to Romans 12:3, transl. Schaff: Why art thou confounded and disturbed, and abusest thy wisdom to foolishness, making thyself more disgraceful than one who is by nature so? For being foolish by nature (apo physeōs mōros) is no ground of complaint (egklēma). But being foolish through wisdom, is at once bereaving one’s self of excuse, and running into greater punishment. … Wherefore these [scil. the arrogant] are more miserable than the mad (mainomenoi), or than those silly by nature (physei mōroi). For like them they stir (kinousi) laughter, and like them they are ill-tempered (aēdeis). And they are out of their wits (exestēkasi) as the others are, but they are not pitied (eleountai) as they are. And they are beside themselves (paraphronousi), as are these, but they are not excused, as are these, but are hated only.

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Unlike Chrysostom, his contemporary Augustine often pays attention to people with ID (see also Laes 2018). In his statements, he appears to be a keen observer of people and their behavior. His valuations are divergent: Augustine, as an intellectual, is torn between the common negative view (Text 7.2.2) and his extraordinary theology of grace, which leads him to a more positive valuation (Kellenberger 2011b). In the latter case, he can designate a morio throwing stones against slanderers of Christ as predestinated by God to “a preference in the award of the grace of Christ over many men of the acutest intellect” (Text 7.14.1). And in spite of his general negative valuation of morio, he criticizes the institution of moriones as entertainers (a tradition apparently still alive in 400 CE) with more zeal than any other pagan or Christian author (Text 7.14.2; which is also one of the rare texts mentioning parental emotions).

Text 7.14.1. Augustinus, De Peccat. Merit. 1.32 (immediately after Text 7.1.2), transl. Schaff: And yet there was once a certain person of this class (of moriones), who was so Christian, that although he was patient to the degree of strange folly (fatuitas) with any amount of injury to himself, he was yet so impatient of any insult to the name of Christ, or, in his own person, to the religion with which he was imbued, that he could never refrain, whenever his gay and clever audience proceeded to blaspheme the sacred name, as they sometimes would in order to provoke his patience, from pelting them with stones; and on these occasions he would show no favor even to persons of rank. Well, now, such persons are predestinated and brought into being, as I suppose, in order that those who are able should understand that God’s grace and the Spirit, “which bloweth where it listeth,” does not pass over any kind of capacity in the sons of mercy, nor in like manner does it pass over any kind of capacity in the children of Gehenna, so that “he that glorieth, let him glory in the Lord.” They, however, who affirm that souls severally receive different earthly bodies, more or less gross according to the merits of their former life, and that their abilities as men vary according to the self-same merits, so that some minds are sharper and others more obtuse, and that the grace of God is also dispensed for the liberation of men from their sins according to the deserts of their former existence: what will they have to say about this man? How will they be able to attribute to him a previous life of so disgraceful a character that he deserved to be born an idiot, and at the same time of so highly meritorious a character as to entitle him? Text 7.14.2. Augustinus, De Peccat. Merit. 1.66 (immediately after Text 7.1.1), transl. Schaff: and that they fetch higher prices than the sane (cordati) when appraised for the slave market. So great, then, is the influence of mere natural feeling, even over those who are by no means simpletons (fatui), in producing amusement at another’s misfortune. Now, although a man may be amused by another man’s silliness (fatuitas), he would still dislike to be a simpleton himself; and if the father, who gladly enough looks out for, and even provokes, such things from his own prattling boy, were to foreknow that he would, when grown up, turn out a fool, he would without doubt think “him more to be grieved for than if he were dead” (compare Sirach 22.12[13]).

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7.4. PARTICULAR HANDICAPS 7.4.1. Opportunities and risks of a retrospective diagnosis Naive retrospective diagnosis—interpreting ancient texts by recourse to modern medical terminology—is especially popular in the case of diseases of famous historical persons (e.g., what was the medical cause of Mozart’s death?). Even reputable scholars (e.g., an Assyriologist together with a medical expert) have tried to match ancient descriptions with modern medical nomenclature (Scurlock and Andersen 2005). However, a lack of methodological reflection often leads to a failure to understand the deep divergences between ancient and modern categories (Leven 2005; for additional weighty caveats, see M. L. Rose 2017). Such caveats lead some scholars to the conclusion that there is no connection whatsoever between a morio and our modern experience of ID (Goodey and Rose 2013, without elucidating their view of a “household jester”). However, other scholars began to “see the danger of the pendulum swinging too far in the other direction, resulting in a lack of regard for the real, lived experiences of the sick and impaired,” so treating them “as fictions more or less untethered” to the everyday experiences of doctors, patients, “disabled and dying in antiquity” (Marx-Wolf and Upson-Saia 2015: 270–1). The present contribution attempts to establish a halfway house, being aware of the danger of imposing modern concepts on ancient culture. The following remarks on the identification of ID often remain tentative. 7.4.2. Difficulties of learning, reading, and writing Augustine wonders about the diversity of talent in different souls (Epistles 166.6.17; see Kellenberger 2011b). He distinguishes degrees of the learning process. Some acquire knowledge only slowly, while others appear utterly incapable of learning, in spite of an ardent teacher providing punishments and beatings (Opus Imperfectum 1.61, 3.161). Augustine cannot bring himself to say that God actually created such stupidity (fatuitas). Rather, he considers it a natural fault allowed by God (naturae vitium quod accidit sinente Deo 3.160). In making such a statement, he makes recourse to a rather Pelagian terminology, though he usually sharply criticizes such theories. Parental sorrows about a son with a learning difficulty are visible in a late Antiquity papyrus (Sammelbuch 5.7655), where a father writes to the teacher that he should beat his silly son (mōros kai paidion kai anoētos). “Not mastering his alphabet” is mentioned by Philostratus in an anecdote about Bradua (second century CE). Here, a surprising therapy is narrated (Text 7.15).

Text 7.15. Philostratos, Lives of the Sophists 558, transl. Wright: When he could not master his alphabet, the idea occurred to Herodes (Atticus) to bring up with him twenty-four boys of the same age named after the letters of the alphabet, so that he would be obliged to learn his letters at the same time as the names of the boys.

A special case of dyslexia is visible in a Mesopotamian exercise tablet of a pupil writing some syllables in the wrong direction (Foster 2003). However, in a society where the vast majority of the population was largely illiterate, adults without reading or writing

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skills could easily make their way in life. Hellenistic papyri demonstrate that among Egyptians who were obliged to take on administrative tasks as a village secretary, at least two persons were incapable of writing even their signature correctly and of reading the documents (Youtie 1973: 677–95 and passim). Age-related dementia is observed by Galen (Affected Parts 3.6–7) as a loss of memory and intelligence (synesis), leading to mōrōsis (Siegel 1973: 274–5; for terminological inconsistencies, see Gundert 2009: 294–5). Galen can only advise controlling the sleep of the often somnambulant patient. And in his commentary to the prorrheticon (ed. Kühn 16.696) he compares people becoming senile with natural fools (the only passage explicitly mentioning such “natural fools”—mostly such people were irrelevant to Galen since their condition was considered untreatable). That Galen was not interested in ID is also evident by his sarcastic polemic against his rivals (Text 7.16).

Text 7.16. Galenus, Affected Parts 3.7, transl. Spiegel: It is simply shameful that they pour water on the heads of all the sleepless and weakened [patients] and of those who are delirious, phrenetic and lethargic. Even Archigenes applies remedies to the heads of persons suffering from memory defects, and he will administer everything to the head in attempt to cure some moron (mōrōthenta tina).

7.4.3. ID in combination with bodily impairments Excavators have found many Hellenistic and Roman figurines, in clay or in bronze, representing humans with an impaired body and (sometimes) also faces that exhibit a degree of idiocy (illustrations in Kellenberger 2011a: 152; Mitchell 2017). Because of such an appearance, scholars chose the term “grotesques” to categorize these artefacts. Their function is uncertain and probably complex (Giuliani 1987). Often some apotropaic use can be acknowledged (e.g., for figurines with a huge phallus). Many figurines invite mockery. The high quality of some of these expressive and costly artworks (teeth of silver, etc.) suggests the possibility of representative figurines in the salons of the wealthy, demonstrating their clemency toward poor people and moriones. Ancient writers often connect physiognomic signs with “marks of stupidity” (Kellenberger 2011a: 153). In addition, Galen (Capacity of the Soul 7) follows the Aristotelian observation that large, prominent ears point to stupidity (mōrologia; Aristotle, Hist. Animal. 492b). Today, we observe a high frequency of multiple handicaps that include ID, and there is no reason to suppose a different reality in Antiquity, despite the surprisingly few mentions of this in ancient texts. At least, the Cappadocian physician Aretaeus (first century CE) describes the consequences of chronic epilepsy, sometimes damaging the patient’s dianoia and causing his madness or mōrainein (Chronic Diseases 3.4.3, and compare 3.5.6, as well as Aristotle in Text 7.8.1). Similar consequences of acute fever (possibly meningitis) are mentioned by his contemporary, Rufus of Ephesus (fragment R 3 in Pormann 1999: 58–9), and the Talmud (Baba Metzia 80a) mentions the case of a maidservant being simultaneously “foolish and epileptic and confused.” According to Pseudo-Aristotle (Problemata 30), wine makes men “silly (mōros) like the congenital epileptics.” But in most cases, ancient texts only mention noticeable bodily impairments. Such defects cause

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human beings to be difficult to integrate into a society without machines, whereas for manual work ID is less disruptive. However, we may presume that some people with bodily impairments also experienced forms of ID. A striking example is hydrocephalus. The Byzantine medic Aetius Amidensis (sixth century CE) describes its consequences: “alertness and sensations deteriorate; and I mean the visions, the hearing and the others” (Med. 6.1; see Grunert et al. 2007). ID may be subsumed under “the others” (ta loipa). The case of deaf and mute people (Laes 2011b) is especially striking. In the past, they have often been equated with the mentally retarded (see Adams and Kruschwitz and Cousins in this volume). However, it is difficult to know whether such ID was innate, a secondary consequence of the bodily impairment, or a side effect of the lack of proper education and due attention. The equation in the vocabulary begins with Mesopotamia (sakku = blocked, deaf, dumb, silly) and can be observed until the late Antiquity lexicographer Hesychios (entry eneos), citing as synonyms “deaf–mute, silly, in consequence also oblivious” (kōphos, mōros, hothen kai amnēmōn). In Herodotus’ tale (Hist. 1.34–85) about Croesus’ younger son being mute (kōphos, aphōnos, diephtharmenos) and “nonexistent” for his father (1.38), it is pointless to speculate on whether he had an ID or not (Laes 2011b: 453–5) and why he became capable of speaking in a moment of danger. In contrast, the privileged senatorial boy Quintus Pedius, congenitally mute, was allowed to learn painting and could have begun a career as a painter (Text 7.17).

Text 7.17. Plinius, Natural History 35.7.21, transl. Rackham: There was also a celebrated debate on the subject of painting held between some men of eminence which must not be omitted, when the former consul and winner of a triumph Quintus Pedius, who was appointed by the dictator Caesar at his joint heir with Augustus, had a grandson Quintus Pedius, who was born dumb (natura mutus); in this debate the orator Messala, of whose family the boy’s grandmother had been a member, gave the advice that the boy should have lessons in painting, and his late lamented Majesty Augustus also approved of the plan. The child (puer) made great progress in the art, bur died before he grew up.

A special, non-anecdotal case is provided by Augustine in his anti-Pelagian writings, where he repeatedly lists in detail all sorts of impairments and deficits observed by him. His enumerations usually run from head to toe, continuing with deficits of character and ending with deficits of intelligence in increasing order (Text 7.18). Augustine has great difficulty reconciling himself with the manifold suffering of innocent children, which he sees in connection with his problematic theology of original sin in paradise.

Text 7.18. Augustinus, Opus Imperfectum 6.16, transl. Laes et al. (2013; compare more similar passages mentioned in Kellenberger 2011b): And what shall I say about the faults of souls (vitia animarum), which make some lustful by nature, others short-tempered, others anxious, others forgetful, some slow of mind (tardicordes), and others out of their mind (excordes) and so foolish (fatui) that a human being would rather live with cattle than with that sort of human beings.

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A rare window onto the parental feelings at the death of severely disabled children (probably also with ID) is provided by the excavation of an Egyptian necropolis where artisans (not ranking among the upper class) buried their family members. The affectionate and unpretentious sepulchers and the number of funeral goods were equivalent for nondisabled and disabled children (Kellenberger 2011a: 123–4 with illustrations). Several excavations in Roman Britain similarly reveal careful burials (including grave goods) for children with severe disabilities, probably including ID; however, many prone burials demonstrate a consciousness of their otherness (Southwell-Wright 2014). Disabled adults buried without grave goods may indicate a greater social isolation (possibly because they might not have been fit for work), but their position within the cemeteries of a community excludes the possibility of any form of sacral execution or exclusion. 7.4.4. Cerebral palsy and other neurological disorders Aristotle describes men whose limbs swerve to the left when the patient wants to move them to the right (Text 7.19.1). Modern medicine has interpreted these as typical cases of cerebral palsy, as is also the case for Mesopotamian descriptions (Text 7.19.2). Moreover, the use of a specific diagnostic test seems to be identical with today’s test of the “Moro reflex” (Volk 1999): the doctor or nurse holds the infant’s head and then withdraws support, allowing the head to fall backward. Most infants quickly bow their extremities and then extend their arms wide open (see instructive videos on the Internet). The absence of this reaction points to cerebral palsy or other neurological disorders.

Text 7.19.1. Aristoteles, Nicomachean Ethics 1102b, transl. Rackham: But there also appears to be another element in the soul, which, though irrational, yet in a manner participates in rational principle. In self-restrained and unrestrained people we approve their principle, or the rational part of their souls, because it urges them in the right way and exhorts them to the best course; but their nature seems also to contain another element beside that of rational principle, which combats and resists that principle. Exactly the same thing may take place in the soul as occurs with the body in a case of paralysis: when the patient wills to move his limbs to the right they swerve to the left; and similarly in unrestrained persons their impulses run counter to their principle. But whereas in the body we see the erratic member, in the case of the soul we do not see it; nevertheless it cannot be doubted that in the soul also there is an element beside that of principle, which opposes and runs counter to principle. Text 7.19.2. Mesopotamian diagnostic treatise Sakikku (Scurlock and Andersen 2005: 331): If an infant of one (to) four years writhes in contortion so that he is unable to get up and stand, he is unable to eat bread, (and) his mouth is “seized” so that he is unable to talk, “spawn” of (the deity) Shulpaea, he will not straighten up.

Scurlock and Andersen (2005: 331–6) are keen to detect further neurological disorders that sometimes (or often) occur together with ID: spasms, floppy baby syndrome, Huntington’s disease, and spinal muscular atrophy. Very rare cases, in contrast to therapies that envisage care lasting a long period of time, are noted in

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four texts prescribing euthanasia for extremely heavy disabilities: throwing the baby into water, burying an adult alive in the earth, or burning him by fire are signs of a greatly despairing expert who will eradicate the evil, probably fearing its continuation in the next generation (the ancients’ observations and magical fears are in contrast to modern knowledge of heredity). Two of these texts mention the danger that the “house” of the family “will collapse” (“house” can mean either a building or socially the family itself). In addition, omina concerning birth anomalies and ID mention the same danger. Modern experience acknowledges the stress experienced by parents after such a birth. Greek and Latin medical texts hardly mention euthanasia, but the somewhat cryptic notice of Soranus (Gynecology 2.10; 200 CE) shifts this delicate task onto midwives, who had to observe birth anomalies and decide whether the infant was worth rearing. The practice of exposing a newborn existed, but its frequency is unknown (e.g., Gowland et al. 2014, with bibliography). In special cases, however, midwives were able to revive neonates who seemed to be bloodless and nearly dead (Aristotle, Hist. Animal. 587a). 7.4.5. Epilepsy The dramatic symptoms of epilepsy provoked explanations and engaged therapies across all epochs. Divine or demonical influence, natural origins, and possible human misconduct were discussed in all civilizations. There were many medical theories and accompanying therapies (e.g., diet in combination with the doctrine of the four humors). Hereditary factors were observed in the Hippocratic writings and in the Talmud (Jebamot 64b). The famous Hippocratic treatise On the Sacred Disease (c. 400 BCE) turns against this religious term (first mentioned by Heraclitus c. 500 BCE) and against all traditional magical rites of purification, calling them ungodly (asebeia). Arguing for a natural origin of the disease, however, does not mean that treatment itself would be without religion. And in practice, physicians also allowed for the popular magical recipes wanted and expected by their patients. The Talmud takes a sober view on epilepsy. Discussions among the rabbis about extraordinary practices in the marital bed as a cause of epilepsy and other impairments (Pesachim 112b) led to the doctrine that all forms of marital intercourse are legitimate (Nedarim 20b). The Christian Church was less liberal, forbidding intercourse during holidays in order to prevent disabled offspring (Laes 2011a: 927–8, with bibliography; regarding continuity in the Middle Ages, see Kellenberger 2011a: 132). The belief in demons causing epilepsy was common in the ANE, but also in the Christian Church (based on Mc. 9:14–29 narrating an exorcism). The great diversity of explanations for the cause of epilepsy does not demonstrate an evolution (in the direction of either more or less demonic influence), but rather reflects a difference of milieu (Kellenberger 2017: 55). The Gospels are much nearer to popular beliefs about demons, whereas the Talmud (together with Greek and Latin physicians) abstains from notions of demonical possession. But demons, causing diseases and epilepsy, play an important role in the papyri, without distinction between those of pagan, Jewish, and Christian origin. A further cross-cultural phenomenon concerns the legal waiting period after selling a slave and possibly concealing his or her epilepsy. In such a case, the seller was obliged to take back his previous slave as soon as a seizure happened. The waiting period could be fixed to between one month (Laws of Hammurabi §278) and one year (Plato, Laws 916a–b).

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7.4.6. Down’s syndrome Osteological evidence for Down’s syndrome can be detected from excavated skeletal remains, but only very few archaeological discoveries have been possible (Starbuck 2011; Rivollat 2014, with bibliography), because the age of childbearing mothers was much lower than today, and understandably archaeologists seldom pay attention to such rare phenomena. Recent ancient DNA analyses (Nolte et al. 2017) have not yet improved this situation. Since the ancient texts seem to be silent on this matter, the iconographic evidence offers another more hopeful opportunity to detect Down’s syndrome (Kellenberger 2011a; 2017). Illustrations of the Egyptian deity Bes (see Section 1 and Figure 7.1), being present across the entire Hellenistic world, provide striking reminders of phenomena that medicine perceives as disabilities. The ugly shape of Bes is in contrast to the usually idealizing character of Egyptian art, which depicts human dwarfs with dignity. The difficulty of retrospective diagnosis is apparent in the diverging identifications by scholars. They mostly posit achondroplasia (Dasen 1993), while others have proposed hypothyreosis, cretinism, polysaccharidosis, or gargoylism, which would explain Bes’ small stature with a large head and tongue, grimace, prominent brow ridges and navel, flat nose, and short neck. But no suggestion fits all of the phenomena of Bes, so that, at best, we may see a mix of various impairments in one figure. Giving attention to Bes’ noticeable tongue and his functions seems to be fruitful. It is striking that later depictions present a tongue hanging out; this seems to contradict the apotropaic character of a stuck tongue in earlier exemplars, but fits very well with the overlarge tongue of humans with Down’s syndrome (Figure 7.2). With Bes they have a lot in common, not only by their

FIGURE 7.1  Receptacle for makeup of women (Louvre, fourteenth century BCE).

FIGURE 7.2  Hellenistic period (Berlin).

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shape (stubbiness, flat nose, and other facial features): they are also charming, joyful, and friendly. Many are particularly gifted in dance, music, and theatre; Bes often is depicted as a dancer or jester across a range of ancient cultural traditions (Dasen 2013 points to Isis, Dionysos, and Roman convivia). His grotesque face led to an Alexandrian saying, cited by the Byzantine Suda lexicon (entry Bēsas): “To stand like Bēsas = to stand gaping with open mouth, in a stupid way (hypomōros).” We get the impression that the Egyptians had ambivalent feelings regarding disabilities. On the one hand, we observe a considerable amount of awe, by instrumentalizing an ugly and apotropaic Bes for chasing away malign forces (particularly during birth and pregnancy and against the perils of the night). On the other hand, we can observe, especially in Hellenistic depictions, humorous aspects allowing at least some social integration. Another surprising aspect is the function of Bes regarding the fetuses of possible miscarriages, which were laid in Bes-shaped coffins (Drilhon 1987); paradoxically, Bes was also used in birth rituals for preventing premature or difficult birth (Meeks 1992). A comparison with Israel may point to some analogies with the Hebrew petî, mentioned in Section 2.1. Late Antiquity rabbinic and Jewish magic texts cite Psalm 116:6 (“God protects the petî”) exclusively in the context of risks of birth or of premature birth. In addition, this propitious psalm verse was used for legitimating the dispensation for using a contraceptive for the sexual activities of girls who were too young and so might die during delivery because of their narrow birth canal (Kellenberger 2017: 57).

7.5. CONCLUSION The specific view on ID by the ancients shall be compared with the modern definitions offered by the World Health Organization (WHO Europe). Has there been some progress, and perhaps also some loss?

Text 7.20.1. WHO Europe’s definition of mental health: Mental health is a state of well-being in which an individual can realize his or her own potential, cope with the normal stresses of life, work productively and make a contribution to the community. Text 7.20.2. WHO Europe’s definition of intellectual disability: Intellectual disability means a significantly reduced ability to understand new or complex information and to learn and apply new skills (impaired intelligence). This results in a reduced ability to cope independently (impaired social functioning), and begins before adulthood, with a lasting effect on development. Disability depends not only on a child’s health conditions or impairments but also and crucially on the extent to which environmental factors support the child’s full participation and inclusion in society. The use of the term intellectual disability in the context of the WHO initiative “Better health, better lives” includes children with autism who have intellectual impairments. It also encompasses children who have been placed in institutions because of perceived disabilities or family rejection and who consequently acquire developmental delays and psychological problems.

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Already the term health brings a modern aspect to the perception of ID. To people in the ancient world, it was quintessential to be integrated socially within the clan and the environment. They would be astonished to hear the WHO definition emphasizing the individual person who has to realize his or her own potential (Text 7.20.1), and they would ask whether the experience of a protective community had lost its importance. However, some ANE texts foster the suspicion that only the nuclear family felt responsible for their members with ID. When they could no longer care for them, it was the central power (sanctuaries, royal administration) who had to provide at least a minimal protection through sheltered jobs (Section 3). Persons with ID need the feeling of being loved by their near environment as much as any other human being. This is, for them, more important than their individual rights and their (somewhat abstract) integration into the entire society. By this love, they are empowered to “make a contribution to the community.” Historians can hardly say how many people with ID in Antiquity were deprived of this love, being close to “social death” and forced to “make a contribution to the community” for survival, presumably also by begging. The economic value of children in ancient societies (neither to be underestimated nor overestimated) and the (rarely mentioned, but existing) emotional aspects are also to be taken into account. Some information (mocking, the institution of the moriones) give a rather dark picture. The question of whether a disabled person could be integrated into the work process was crucial for the survival of the family and depended on the occupation of their parents. But as long as their parents were able to provide care, the sources remain silent. Exceptional are Texts 7.5.1–7.5.3 describing, without any allocation of blame, parents’ sorrowful grief regarding a descendent with ID. The WHO definition of ID (Text 7.20.2) only mentions deficits, no positive qualities, in contrast to some Latin anecdotes (see Texts 7.12, 7.14.1, and 7.17) and the divine Bes in Hellenistic times. The explicit mention of ID in WHO documents, in contrast to its rarity in Antiquity, and the great effort it indicates in the area of training undoubtedly bring new chances for improvements in the modern world. However, this is no guarantee of true and full social integration. Sometimes it might also hinder such communal integration: “The modern system of diagnosing, labelling and then performing remedial actions (special education) means that a person is first and foremost ‘Johnny with Down syndrome,’ no longer ‘Johnny next door/the cobbler’s son’ ” (see Metzler 2016: 230 for the Middle Ages; for Antiquity, compare Laes 2013a: 140).

CHAPTER EIGHT

Mental Health Issues Theory and Practice in the Ancient World JERRY TONER

The ancient medical writer, Alexander of Tralles, recounts the case of a delusional patient who bound up her little finger because she was worried that the world would collapse if she bent it (Twelve Books on Medicine 1.605 and 607). Another writer, Aretaeus, describes a wealthy man who lived in constant fear that he would lose his wealth and status so his doctor arranged for fake legacies to be announced to him from time to time as a way of relieving his anxiety (On the Causes and Symptoms of Chronic Diseases 1.6). Health was a major source of concern in the ancient world, which is reflected in the size of the corpus of medical literature, and many other medical writers, such as Hippocrates, Galen, Caelius Aurelianus, Celsus, and Paul of Aegina, all include references to mental symptoms and their treatment. Many also contain clear examples of what we would call mental ill-health. But mental health is a broad term covering a wide range of mental disorders. This chapter sets out to explore the theme of mental disability in the ancient world, focusing first on problems of terminology and likely societal levels of mental health, before examining the various ways in which mental disorder was understood and treated. One recurrent difference that emerges between ancient and modern approaches to mental health was that a phenomenon that today would be conceived of in terms of illness could then be viewed in a more positive light. The chapter concludes by analyzing the ways in which the advent of a Christian empire in the fourth century CE brought significant changes in the understanding and representation of mental health in comparison with the earlier classical period.1

8.1. TERMINOLOGY As is so often the case when approaching Antiquity, basic modern terms are themselves problematic.2 The ancients understood mental disability very differently and lacked the psychological vocabulary we now possess. It is worth beginning by outlining what modern psychiatry understands as a mental disorder. The most comprehensive classification of mental disorders is the Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition and known as DSM-5, which is published by the American Psychiatric Association and contains detailed descriptions of the symptoms of all recognized mental disorders. That this “bible” of modern psychiatry is in its fifth edition should alert us to how psychiatry itself has been a rapidly evolving discipline over the past century. Whereas early psychiatrists recognized only a handful of conditions, the number now runs into the

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hundreds. This increase no doubt partly reflects the more in-depth knowledge resulting from decades of research, but it may also stem from a professionalization of what is a relatively new discipline and an attempt to legitimize it. Changes in cultural attitudes toward certain phenomena have also been reflected in the classification of mental disorder, with, for example, homosexuality being removed after its inclusion in the first DSM edition of 1952. The coverage of DSM-5 underlines how broad a concept mental health is, covering as it does conditions such as delirium and dementia, substance-related disorders such as alcoholism, schizophrenia and other psychotic disorders, mood disorders such as depression and euphoria, anxiety disorders, sexual disorders, eating disorders, personality disorders, and impulse control disorders such as kleptomania or pyromania. Mental illness, therefore, can be thought of as a broad, generic term for a range of illnesses that usually include affective or emotional instability, behavioral dysfunction, and cognitive dysfunction or impairment. Lifetime prevalence rates for various modern countries also emphasize how these categories cannot be viewed as unproblematic medical terms. Whereas in America there is a 17.1 percent lifetime prevalence rate for depression, the rate in South Korea has been only 2.9 percent. Clearly, local cultural factors play a major role in the diagnosis or recognition of certain disorders. Indeed, it is also worth emphasizing that there is no universally accepted model for the understanding of mental disorders or their treatment. There are four principal models for conceptualizing the causes of mental illness. The medical model treats mental illness as a disease with a physiological cause that can be treated by medical means. The problem with this is that while some genetic links have been established for certain conditions, for the vast majority of mental disorders it has not been possible to establish any organic pathology. The second model is the psychological model, which treats mental disorders as being caused by internal crises, such as the repression of powerful instinctive drives. Treatment consists in enabling people to understand the factors involved in the repression of these forces. The problem here is that this model sees all people in all cultures and at all times as driven by the same internal drives and overlooks cultural factors. By contrast, the anti-psychiatry model, whose most famous proponent was the French philosopher Foucault, sees mental disorder as a social construction that enforces an arbitrary set of societal norms. Mental illness in this view becomes a justification and method for society to confine those whom it sees as unacceptable. Objections to this view focus on the fact that most severe mental illnesses are found to be very similar across all societies, with very similar patterns of behavior, and are often recognized as problematic by their societies. Finally, the social stress model combines something of all the other models, seeing mental illness as partly an attribute of the individual and his or her brain, but also as a social phenomenon because its incidence is not uniformly distributed throughout society. Individuals will be exposed to different kinds of stress depending on their age, gender, and status, and these will result in different levels of mental ill-health. How a particular society responds to these disorders and the consequences for the individual experiencing them will vary considerably from one society to another. The social stress model is the one used most commonly in psychiatric practice today. Stress is therefore an important term in understanding mental health. Taken from engineering, the image relates to an external force acting upon a resistant body. In a social context, stress can be thought of as emanating from situations where the individual is threatened or where the individual’s capacity to cope is reduced. A high level of certain resources upon which an individual can call, such as family support networks, can act as

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a buffer against mental ill-health. By contrast, factors such as alcoholism or loneliness can have an amplifying effect. One key finding of modern research is that the lower down the social scale an individual sits, the higher the frequency and size of the stressors he or she is likely to face. Not only that, but the individual will have access to fewer of the resources that can act as buffers. Both of these factors generally result in significantly higher rates of mental disorder. Clearly, the capacity to cope with such stress varies considerably from person to person, with some being able to exhibit a robustness in the face of external pressure that others cannot muster.

8.2. PREVALENCE OF MENTAL HEALTH PROBLEMS What is far less clear is the degree to which such modern models can be applied to the ancient world. There is no doubt that socioeconomic inequalities were particularly marked and that many individuals, such as slaves and women, found themselves in contexts where they were often exposed to substantial levels of stress. Modern theory would lead us to expect these groups to have exhibited high degrees of mental disorder. The problem, however, is not only that ancient sources lacked a psychiatric vocabulary to express these disorders in a straightforwardly recognizable format, but also that most ancient texts, written mainly by elite males, reveal little interest in any aspect of the lives of these subordinate groups, let alone their mental health. A considerable variety of stressors undoubtedly afflicted most people. Death within the family was perhaps the most prevalent of these. Comparative evidence suggests that infant mortality rates will have been high, with approximately a quarter of children dying before their first birthday, and half before their fifth. People of all classes were therefore exposed to death from an early age. An average Roman could expect to see perhaps two siblings, one or both parents, various uncles and aunts, as well as numerous cousins and friends all die in the course of their life. This will not only have produced frequent acutely stressful experiences, but it will have robbed many of the family support networks that might otherwise have acted as buffers. We should not assume that just because death was more frequent it was therefore less affecting, although it may well be the case that Romans developed better coping mechanisms to alleviate the stress. Mothers, for example, may have limited their emotional attachment to infants until they had passed the critical one-month stage, during which the child is particularly vulnerable to disease and infection.3 This kind of approach may be alluded to in a legal opinion stating that children over ten years of age should be mourned for a year, whereas children up to the age of three years “should be mourned for one month for each year of their age at the time of their death” (Paulus, Opinions 1.21.13). This particular law does at least suggest that it was considered acceptable to grieve more for older children, presumably reflecting the far greater investment of time and resources that had been made in them. The older a child was, the more developed his or her social identity became, and so it may be that parents felt a greater degree of loss if he or she died. Infanticide, in the form of exposure, also suggests an emotional detachment from newborn infants, at least among fathers who made the decision as to whether to keep the newborn child. Seneca the Elder, however, talks of a mother pitying a beggar as she wonders whether it could be the son she exposed years before, suggesting that some mothers did develop close attachments to their infant children. Seneca does not say what the mother thought of the father who had presumably compelled her to abandon the child (Contr. 10.4.20).

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Most non-elite earned their livelihoods by means of manual work, which placed a heavy burden on the body. Modern psychiatric analysis points to a high level of comorbidity between physical and mental health. Occasional famines and more regular food crises will also have served to intensify the physical pressure on the non-elite. These pressures may all have had the effect of weakening the ability of many of the non-elite to cope with mental stress. Another group who often had to combine hard physical work with sometimes brutal treatment and a degraded status was the slaves who comprised a significant portion of the ancient population, especially in imperial cities such as fifthcentury Athens and Rome. Life was hard in both the city and the country. Urban life forced people to live in overcrowded conditions and left them vulnerable to crime. Economic migrants can be expected to have suffered more than most because they had left behind their family and wider kinship support networks at home. Financial anxieties seem to have been commonplace, with debt a frequent cause of popular complaint. Many, perhaps even a majority of people lived just above the breadline and had very few reserves to fall back on in hard times, all of which added to the overall stress levels with which the average individual in Antiquity had to cope. The physical burden of life was so great that the mental disorders more generally associated with old age were not widespread, if only because few people lived that long. Short lifespans meant that, on comparative data, only 6.7 percent of Romans lived to be over sixty, 2 percent over seventy, and just 0.25 percent over eighty.4 Some awareness of dementia did exist, however (e.g., see Juvenal, Sat. 10.232), and the medical writer Caelius Aurelianus notes that “depression is more characteristic of old age” (2.8). Disasters were also an inbuilt part of ordinary life in the Roman world that put large numbers of people in situations of extreme stress.5 This is not to say that everyone suffered repeated catastrophe, simply that extreme trauma can be expected to have occurred with a certain degree of periodic regularity given the structural deficiencies of a preindustrial society. Food crises, wars, and floods were all common. Some disasters were colossal, such as the arrival of the bubonic plague; others were small-scale, local tragedies, such as shipwrecks or fires, which will have devastated particular communities. Long, drawn-out disasters such as war or famine probably hit the poor hardest, exposing them to extreme levels of mental stress in a context where they lacked the resources to help them cope. The fact that ancient society assigned much of what can be termed “emotion work” to women also meant that disasters placed them under particular pressure because the family unit would often be badly affected by whatever crisis had occurred, be it famine or invasion.6 The most common longer-term mental disorders experienced by individuals in the aftermath of a disaster are post-traumatic stress disorder (PTSD), depression, anxiety, and panic. PTSD develops as a response to the experience of intense fear, helplessness, and horror in a crisis, with symptoms including the persistent reliving of the traumatic event in the form of recurrent dreams or intrusive flashbacks, withdrawal from society, apathy, and reduced emotional response. In the most extreme modern situations, where high mortality has been combined with numerous injuries, little rescue effort, and prolonged homelessness, as many as two-thirds of individuals exhibited the symptoms of PTSD.7 It is, of course, possible that ancient populations were simply tougher than people living today. Part of that toughness may have been reflected in the creation of coping mechanisms to alleviate the mental stress that such living conditions generated. The ancient world also valorized vigorous personality traits that, while doubtless largely developed to toughen up males for warfare, may also have increased mental robustness

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in daily life. Women probably had no alternative to keeping quiet and resolutely putting up with what life threw at them. As we have seen, significant discrepancies in reported mental disorders can exist between different societies today and reflect variations in both idealized personality types and the acceptability of reporting mental health issues. All that can be concluded with regard to Antiquity is that a large majority of the ancient population was exposed to mental stress to a degree that most Westerners would find almost unimaginable today, but that no culture existed whereby such issues could be easily articulated or brought out into the open.

8.3. THEORY AND TREATMENT However universal the impact of mental stress may be, mental illness is sufficiently affected by societal influences that it is expressed very differently from culture to culture. Modern theories about the causes of mental ill-health therefore cannot help when it comes to considering the forms that disorders take within any given society. Modern theories also bear no relation to the range of ideas that the ancients formulated to help them understand psychological problems. To begin with, it is worth emphasizing that a wide range of theories existed to explain mental disorders. These included the observations of the first men to have come close to what we call physicians—men such as Hippocrates, the “Father of Medicine.” But ancient medicine encompassed a huge array of different types of knowledge and practice. Many of these involved traditional folkloric remedies or consisted of practices that we today would understand as religion. People did not limit themselves to seeking treatment from physicians such as Hippocrates for the simple reason that few practiced outside the major cities and most of the population was rural. People also turned directly to the gods, such as the healing god Asclepius, or they visited magicians to buy various spells or amulets to ward off afflictions. A whole range of religious beliefs existed about what caused mental disorders. Explanations included both natural and supernatural causes. The actions of the stars and planets, for example, were believed by some to make those born under a particular arrangement of the constellations insane: if the Sun is in opposition to Mars in the fourth house, evils will be greater and more frequent, and those born then “will be madmen” (Firmicus Maternus 3.4.11). Secondly, even within the field of medical writers, a huge array of opinions existed. Medical writings ranged from the early Hippocratic treatises to those of later writers under the Roman Empire, such as Aretaeus, Caelius Aurelianus, Celsus, Alexander of Tralles, and Paul of Aegina. These named individuals are the exception, in that their work was copied and survives in part today. Far more had their work lost. Broadly speaking, all of these writers shared a theory that viewed the human body as a collection of liquids, not of organs. The body was thought to contain four humors—named in the most influential text of humoral medicine, the Hippocratic On the Nature of Man, as black bile, yellow bile, blood, and phlegm—as well as other fluids such as sweat, semen, urine, and spit. Illness resulted primarily from an imbalance among the body’s fluids. These theories suggested that the types of illness a patient experienced reflected different levels of heat and moisture within the body. Mania, for example, was characterized by heat, dryness, and an excess of yellow bile; melancholia by the cold dampness of black bile. But there was little upon which ancient medical writers agreed apart from the humoral basis for their ideas. They worked in a competitive marketplace and had to attract clients by formulating their own particular theories and therapies.

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What kinds of mental problems do we find in these ancient medical writers? As the opening examples show, we find various examples of patients experiencing delusions and hallucinations. The great doctor Galen, who served as the Roman emperor Marcus Aurelius’ personal physician, describes patients who plucked at loose pieces of thread on their clothes or tried to pick up nonexistent hairs. He was unsure whether such behavior resulted from the wrong association of sensory data or whether the mind had temporarily gone beyond the limits of reason. Some of these patients were able to recall why they had been acting so neurotically when they came to their senses. One said that the nap of a woolen cloth seemed to stick out, another that chaff seemed to be hanging on the walls of the sick room, and another that little animals seemed to fly near his eyes, which he tried to chase away (Commentary on the Prognostikon of Hippocrates 23; 18.2.75 K). Galen also tells us about the illness of the physician Theophilus, who was able to discuss and judge things correctly, but was under the illusion that some flute players had taken up residence in the corner of his house, where they played continually even during the night. Even when Theophilus shouted at them to go, they stayed put (On Different Symptoms 3; 7.2.60–2 K). The treatment of these kinds of mental health problems reveals how ancient ideas of mind and body were closely interconnected. This was a strongly somatic culture and all illness and anxiety was seen in purely physical terms. It therefore also seemed perfectly natural to apply physical remedies to try and solve mental problems. In cases of mental disturbance, doctors examined the shape and features of the head to see if an imbalance in temperature or fluid within the skull was affecting the brain’s function. Excessive heat or moisture would lead to madness and would be reflected in thick, black hair. Bald people, by contrast, were thought to have cool, dry brains that made the hair thin, but helped keep them sane (Galen, The Art of Medicine 7; 1.7.325–6 K). Medical treatments were concerned with maintaining humoral balance by carefully controlling the physical sensations that were working on the body, and this also applied to the brain. So music might be played to an individual experiencing madness to bring harmony back to the humoral misalignment because the sounds were thought to act on the body as a whole. Treatments would try to restore balance by physically altering the environment in which the brain was operating. The head might be shaved to allow heat to escape or strongsmelling compounds of pepper, frankincense, or oil of roses might be employed to cool the brain, thereby counteracting the inner coolness or heat of the patient (Caelius Aurelianus 1.5.167). Or for phrenitis, a hot and dry complaint, Galen preferred to drain blood from the middle vein of the forehead. The heat of mania was best treated by applying cooling remedies directly to the head. Caelius argued that the causes of mental illness could also lie in other physical factors, such as indigestion, drunkenness, sleeplessness, lovesickness, anger, grief, anxiety, superstitious fear, shock or blow, intense straining in study, business or other ambitious pursuits, love potions, the removal of long-standing hemorrhoids, or the suppression of menses in women, all of which he believed might generate a humoral imbalance (1.5). Another medical writer, Aretaeus, argued that visual imagery could cause mental illness; excessive visual stimulation encouraged people to experience delusions and hallucinations that would lead them “away from what is real.” He advised that there should be no paintings or bright colors in the rooms of patients with brain-fever (On the Treatment of Acute Diseases 1.1). Competing doctors would try and differentiate their offering by setting out alternative treatments based on a variety of physical factors. These included treatments based on diet, drink, drugs, sleeping, sweating, hydrotherapy, bloodletting, and purges. White

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hellebore was widely used to induce vomiting, while black hellebore was prescribed as a powerful laxative. Some of these treatments went to physical extremes, with Celsus advising that the insane are “best treated by certain tortures.” So whenever the patient said or did anything wrong, he was to be “coerced by starvation, fetters and flogging” (3.18.21). Caelius, by contrast, recommends far more gentle and sympathetic treatments, such as keeping the patient free from stress (1.58). Practical measures were also recommended: Caelius advises that those with phrenitis should be kept in a place where the windows are high, “for it often happens that unguarded patients in their madness jump out” (Cael. Aurel. 1.58). Caelius alone among the medical writers treats what we might term “alternative sexuality” as a mental illness, as DSM-I/II did, arguing that, “People find it hard to believe that effeminate men really exist … This condition is an affliction of a diseased mind” (4.131–2).8 Similarly, he claims that women he terms as Tribades are those who “are more eager to lie with women than men and in fact pursue women with almost masculine jealousy … they rejoice in the abuse of their sexual powers.” In Caelius’ view, such behavior constituted an affliction of the mind so severe that it was beyond the help of humoral medicine: “There exists no bodily treatment which can be applied to overcome the disease; it is rather the mind that is affected in their disgraceful vices, and it is consequently the mind that must be controlled” (1.36). Women also sought treatment from doctors for mental problems. Women were believed to experience their own gender-specific form of mental disorder, known as hysterical suffocation, which was thought to result from the womb wandering about within the body. Found mainly in virgins and widows, this represented a kind of panic attack with the symptoms including shortness of breath, chest pain, pain in the legs or groin, and seizure. The treatments prescribed involved trying to coax or coerce the womb to move back to its proper place. Strong odors were thought to be particularly effective in this task. A foul smell placed under the woman’s nose would repel a uterus that had risen high up in the body. Conversely, fragrant aromas could be applied to the patient’s vagina to try and entice the womb into returning to its proper place. Male medical writers applied their strongly somatic view of mental disorder to women whose behavior broke the bounds of what was considered normal. What caused such aberrant behavior is impossible to know, but it is certainly the case that ancient women faced an enormous burden of expectation with regard to their having children. High childhood mortality rates meant that the average woman needed to give birth to approximately 5.5 live offspring simply in order to maintain a stable population. Marriage was near universal, a semi-arranged matter organized by the girl’s father and a suitable suitor and was considered as much a family business transaction as an affair of the heart. It is reasonable to conclude that many women were trapped in unhappy relationships from which escape was legally feasible but practically impossible, condemned to an endless cycle of childbirth and child-rearing. In such conditions, it would hardly be surprising if some women exhibited signs of mental distress. But male writers medicalized these expressions of disorder according to their own preconceptions of how a woman should behave. They believed that the only permanent cure was for a woman to fulfill her core role in society: being a wife, having sex, giving birth, and child-rearing (Soranus, Gyn. 3.26). Galen also thought that dramatic seizures in women were caused by a lack of intercourse leading to the retention of “female seed,” which would then become poisonous (On Affected Places 5; 8.1.420 K). Female mental health, in other words, was understood as being reliant on reproductive activity. It may be that the “wandering womb” condition gave a recognized and quasi-acceptable means for a woman to both gain a temporary

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escape from this domestic routine and for her to express some kind of defiance toward it. But, in reality, this was probably only an option for those whose families could afford to consult a physician, families for whom it was probably not the norm for the women to work. Lower-status working women probably just had to get on with it. Even among the wealthy, it is not clear that women would always have been considered worth the expenditure incurred in consulting an expensive physician. Most of Galen’s clients, for example, seem to have been urban males, aged between twenty-five and forty, members of the leisured class who could afford to spend time exercising in the gymnasium.9 While it is certainly the case that skilled artisans and the like might also consult these physicians, other more popular forms of treatment were also available, presumably at a far lower cost. Popular ideas concerning mental illness often featured demons as the explanatory cause. That is not to say that demons were only seen as causes of mental disorder—they were also seen as divine agents who could fulfill a variety of religious purposes. Nor was there any agreement about where exactly demons came from. Often these spirits were thought to be the wandering ghosts of the restless dead, an amorphous group composed of those who had died before their time, who had died by violence, who had committed suicide, who had been denied a proper burial, and who had died before marriage.10 Such ghosts were not normally perceived by the senses and, when they did appear, looked more like corpses than living human beings.11 A corollary of this kind of belief was that these spirits could, like any divine force, exert an influence on the world of the living. This might be benign. Apuleius describes how the lemurs are souls that abandon their bodies in the grave and “these occupy the home with a propitious and peaceful attitude and are called the household gods (lares)” (De Deo Socratis 15). But many spirits seem to have been more malevolent. Bitter about being condemned to a kind of ghostly exile, and seemingly bearing a grudge against the living, these spirits could assault innocent mortals with whom they came into contact and take possession of them. It was undoubtedly easy to be afflicted by a demon. One man was simply standing outside his inn when a black dog came up and stood in front of him and yawned, which made the man yawn, and immediately the dog disappeared through his mouth and he was gripped by spasms. The great advantage of demons as a causal agent was that they were a highly flexible phenomenon that could be employed to explain the inexplicable, and in a world where the human and divine were inextricably linked, it seemed perfectly natural to understand mental phenomena in a religious context. If modern theory is right, the high level of mental disorder that we would expect to find in the ancient world also required a causal agent that was easy to catch. A variety of popular treatments existed for this kind of demonic possession. Some would try to physically force the demon out of the victim’s body by beating the victim or via the extremely risky procedure of trepanation. Bloodletting was also considered a method of allowing the hostile spirit to be drained out of the host’s body. Magical spells could be employed. One such spell, described as an “Excellent rite for driving out demons,” calls on the evil spirit to leave: “I conjure you, demon, whoever you are, by this god, SABARBARBATHIOTH SABARBARBATHIOUTH SABARBARBATHIONETH SABARBARBAPHAI. Come out, demon, whoever you are, and stay away from him.” The magic words, like abracadabra, were meant to speak directly to the demonic powers in their own language and persuade or even compel them to depart. Magic could also provide protection against demonic attack, with amulets being worn to keep them at bay. One from near Beirut, dating from the fifth century CE, reads, “Protect Alexandra from demons, spells, dizziness, and from all suffering and from insanity.” Or another from the

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Negev desert: “save Esther from evil tormentors, the evil eye, spirits, demons and night ghosts.”12 Demonic possession underlines how religion often played a core role in people’s understanding of mental disturbance and its treatment. One interesting example is the cult of Asclepius, temples to whom were found across the Mediterranean world. A common form of treatment was for patients to sleep within the temple precinct, during which the god was expected to come to them, either healing them on the spot or advising them in a dream on what they had to do to be cured. The second-century orator, Aelius Aristides, maintained a lifelong devotion to such treatments and wrote a detailed account of his numerous treatments. To the modern ear, its endless self-absorption comes across as neurotic. It is also a testament to the powerful hold these practices had over their adherents, given that they willingly carried out a whole range of strange commandments that they had received in their dreams. In one entry, Aelius explains, “I dreamed my food had not digested properly. I consulted the priest and I vomited in the evening. The god ordered us to do many strange things … when the harbor waves were swollen by the South wind and ships were in distress, I had to sail across to the opposite side, whilst eating honey and acorns, and then vomit” (Sacred Tales 1.65). Or when the god commanded him to bathe naked in the snow, he “gladly obeyed” (4.11). Perhaps the constant attention of the temple priests and attendants within a healing context delivered a placebo effect that was powerful enough to cause an improvement in many cases, particularly in relatively minor cases like that of Aristides. It would be wrong, though, to draw a hard line between these religious treatments and those of humoral medicine. Physicians often worked at the temples of Asclepius.13 The great Galen himself had decided to train as a doctor following a dream in which the god Asclepius instructed him to do so. Later on, when physician to Marcus Aurelius, he managed to avoid accompanying the emperor on a tough campaign in Germany by somewhat conveniently claiming that he had been told by Asclepius in a dream not to travel. Another easily accessible source of treatments for mental disorders was traditional folk medicine. While there was no simple coherence to these beliefs across the Mediterranean world, they do exhibit some common approaches to dealing with mental illness. People would, for example, spit on an insane person if one crossed their path, because spitting was believed to repel any mental contagion (Pliny, Natural Histories 28.7). Similarly, people put spit behind their ears to “calm mental anxiety” (Pliny, Natural Histories 28.24–7). These traditional beliefs remained widespread even once Greek humoral medicine had become more widely practiced throughout the Roman Empire. Many Romans seem to have maintained their ancestors’ early distrust of these foreign humoral theories from the East. Traditional Roman folk medicine was also a lot cheaper, positing that nature herself had provided all of the remedies people needed (Pliny, Natural Histories 2.155). Treatments were based on a relatively small number of ingredients, all of which could easily be found on an average farm, such as wool, dung, and eggs. For brain-fever, for example, Pliny advises as a treatment “wrapping a warm sheep’s lung round the patient’s head” (Pliny, Natural Histories 30.96). Exponents of traditional Roman folk medicine, such as Pliny, were keen to make a strong distinction between their own practices and magic, even though the difference is not always that obvious to the modern reader. In the case of brain-fever, Pliny mocks the various magical cures for this condition, such as having the patient drink the brain of a mouse in water or eat the ash of a weasel or the eyes of a horned owl reduced to ash. Pliny is adamant that these remedies are “the frauds with which magicians mock mankind.”

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8.4. ATTITUDES TOWARD MENTAL ILLNESS We come across those severely affected by mental disturbance in various places in the surviving ancient literature apart from medical texts. Legal texts deal with such practical matters as what should be done regarding those individuals who are unable to look after their own affairs because of mental instability, or what kind of mental disorder in a slave would allow the owner to claim his or her money back from the seller if the defect had not been declared before the sale.14 In the New Testament, we find the account of the Gerasene demoniac, who had been left to wander into the desert after he had broken the bonds that had been used to fetter him and who had lived among the tombs, naked, crying, and bruising himself with stones (Luke 8:26 and 29). Or in the book of dream interpretation by the second-century CE Artemidorus, we have dreams involving singing songs in the street or marketplace interpreted as indicating future madness since this was how madmen acted when they wandered about (Artemidorus, On. 1.76). It would be a futile task to try and diagnose these cases retrospectively. For one thing, the sources do not usually give sufficient information about the symptoms. Sometimes we do have relatively detailed descriptions, such as one from the astrologer, Firmicus Maternus, who predicts the fate of those born during an earthquake or a thunder storm: [They] will always be unstable with trembling bodies and shaking steps; through all minutes of the day they will fear the fall of threatening ruin. Their eyes will flash, they will shrink from everything; they will not be able to keep a definite order of words but the sound of their voice will be impeded, and they will hiss a tremulous murmur; or between clenched jaws their words will die on utterance. They will always think it is going to thunder or that the earth is about to move and that everything is falling. By these fears the correct order of their speech is disturbed. (Firmicus Maternus 9.17.9–10) But this is also a work of fiction in that these are the prognostications of an astrologer, not the case notes of a doctor. It is reasonable to treat this kind of text as drawing on the astrologer’s experience of abnormal behavior, but the point of his text is to create a panoply of theoretical personality types, not to describe actual individuals with any accuracy. It is possible to reconstruct something of the various attitudes that existed toward the mentally ill. The medical writer Aretaeus describes “those whose madness is associated with joy, laughter and play, who dance night and day, and sometimes go to the marketplace wearing a crown, as if they had won some contest” (On the Causes and Symptoms of Chronic Diseases 1.6). Aretaeus goes on to say that most people found this behavior “inoffensive,” suggesting a degree of tolerance. But, as previously noted, it was common to spit at the insane or to throw stones at them (Plautus, Poen. 527). It was clearly financially worthwhile for expensive physicians to pander to the mental needs of their wealthy clients, but more ordinary people with mental difficulties may have had a harder time in both being accepted and accessing treatment. They may, however, have received some help. Artemidorus claims that if a poor man dreams that he is mad it signifies he will become richer, “For a madman receives something from everyone,” suggesting that it may have been commonplace for people to help out the insane who inhabited the margins of their towns and villages (1.76). Similarly, one astrological forecast is that the retarded in mind, speech impaired, or deaf will be “wretched paupers, wanderers, or travelers, who never have a settled home,” but later it predicts that “they acquire some protection in life

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from various occupations” (Firmicus Maternus 4.14.15). This might be wishful thinking or pure invention, but it is interesting to note that the author does not, at least, find it inconceivable to imagine disabled people as being able to carry out some kind of work. The fourth-century Christian writer, John Chrysostom, describes how the mentally ill could generate donations from people in the street. He describes how men who were “empty-headed and of unsteady mind” would be forced by hunger into begging but, when their entreaties alone achieved nothing, they would perform a kind of mad act by chewing the leather of worn-out shoes or driving sharp nails into their heads. This would generate an audience, who would stand laughing and be amazed before donating what John Chrysostom calls, “a generous amount of money” (Ep. 1 ad Cor. 21.5–6). Clearly, John has a Christian agenda here, but it is noteworthy that he is attacking his flock in this sermon, suggesting it is the kind of un-Christian behavior characteristic of crowd behavior. It is also clear that the strategy worked in that the beggar did receive money. Obviously, it came at a high price, but this does suggest that some relatively widespread level of basic sympathy did exist for the mentally ill. Mental illness seems to have strong associations with social disorder. It was “monstrous attacks of madness” that made individuals turn away from the “right path of life” (Firm. Mat. 3.7.10). Mental disorders were often described in terms of the social norms of behavior they violated. Inappropriate nudity, for example, was often cited in Antiquity as a sign of madness, as was the inappropriate use of space. Those who sang in the forum, where a city’s political life was centered, or those who lived among the tombs of the dead all gave powerful indications that their mental state was abandoning the comfort zones of normality. Severe mental disorder also seems to have been associated with random violence, and people generally avoided contact with the afflicted: the Gospel of Matthew, for example, refers to a pair of madmen who were considered too violent to approach (Matt. 8:28), while Caelius describes the patient with phrenitis as one who hates everyone, “shouts, beats himself or tears his own clothing and that of his neighbor” (1.35). The practice of exorcism probably derived from the Judeo-Christian tradition and so, once the empire had become Christian, we find far greater emphasis on the role of exorcism in our sources.15 The mental illness represented by demonic possession was associated with considerable levels of disorder. When St. Antony practiced his extreme form of asceticism, spending long years alone in prayer, he faced numerous demonic assaults, which were “full of confusion, accompanied by crashing, roaring, and shouting.” The psychological impact of this attack was significant enough to cause “terror in the soul, disturbance and confusion of thoughts, dejection, hatred of ascetics, indifference, sadness, remembrance of kinsfolk, and fear of death” (Athanasius, Life of Antony 36). The fact that people understood mental disorder as being caused by an unwelcome influx of semidivine power into the human body itself reflected how dangerous and uncontrollable a force this was perceived as being. Something so threatening and destabilizing could only have been caused by a supernatural entity. In many ways, ideas about mental illness reflected the high value placed on status in the ancient world. By abandoning the settled norms of society and their position within that society, the mad rejected what most people worked hard to maintain. It was an act of such utter incomprehensibility that it required a powerful explanatory force to make it remotely understandable. These demons were often perceived in more mundane, object form in order to make them even more readily understandable. When Theodore of Sykeon, for example, drove out a host of unclean spirits that had descended upon a village, they appeared to onlookers in the form of bluebottles and dormice. Elsewhere in the Life of Theodore, we encounter

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a sea captain who is afflicted by a demon under his skin in the shape of a mouse, or else demons are described as being like beasts and reptiles breaking through walls (Life of St. Theordore of Sykeon 43.123.9.24). These were exactly the kind of pest that troubled people in their daily lives. Yet people also recognized that demons could be influenced and, in some circumstances, even be driven out, which implied that here was a supernatural force that was capable of being controlled by human intervention. This power could therefore be put to use in the form of spells designed to inflict mental ill-health on social rivals. One spell to “make mad any man or any woman” says to “take the hair of the man whom you wish together with the hair of a dead man … tie them to the body of a hawk and release it alive” (PDM 14.1182–7). We might, from a modern perspective, interpret such magic as providing a kind of basic mental health strategy, which allowed the user to offload his feelings of anger and frustration, but the ancients clearly believed that it could work. Madness was never seen as a purely negative phenomenon. Demonic possession posited mental disorder as having a supernatural cause, and so it is not surprising that the mentally disturbed were also perceived with some degree of awe. The eponymous Fake Prophet in Lucian’s tale, for example, feigns fits of madness, with foaming at the mouth caused by chewing the root of the soapwort plant, and the sight of him “filled the people with superstitious awe.” Plato talks of the four blessings of madness: that which is associated with poetic inspiration, divine prophecy, love, and religious rituals such as the frenzy of the Dionysian rites (Phaedrus 265A, 244A–B). As Caelius describes, “Some cut their limbs in a holy fantasy, as if propitiating strange gods,” but “in other respects they are sane” (1.6). Such a positive view of mental disturbance may have allowed the mentally disordered to continue to function in society, but it is more likely that such actions reflect a view that madness could serve positive functions, and so “insane” acts could be celebrated in certain circumstances by otherwise sane individuals. It also shows that mental illness did not automatically incur any social stigma. Any action that wantonly offended the gods was perceived as representing an irrational threat to the peace of the gods, the pax deorum. Christians often seemed to rejoice in the destruction of their social status in the same way as did the insane. In Lucian’s Peregrinus, for example, Peregrinus is imprisoned for being a Christian and brought before the governor, who was well aware of his “lunacy.” He even went so far as to openly insult the emperor (11–14, 18). Of course, from the Christian point of view, Roman ideas about insanity allowed them to symbolically reject the empire’s moral norms in the most conspicuous way possible. In general, the Romans left the Christians alone, seeing them as a strange, extreme sect, with only occasional acts of scapegoating and persecution. The language of madness can be seen as offering a way for the Christians to challenge the world, but in a way that did not automatically generate official suppression. Similarly, other non-Christian individuals could adopt the language of madness in order to reject society. Caelius describes how “some flee the haunts of men and going into the wilderness, live by themselves” (1.6). This may have been inexplicable to those left behind in normal society, but it did provide an avenue of escape for those who wished to take it, however tough a route that was. One of the functions of ritually exorcising the demons that were believed to have taken possession of such individuals was that it provided a way for them to be reintegrated into society if they so chose. With the accepted cause of their aberrant behavior gone, individuals could take up their previous roles without incurring any blame for their earlier abnormal actions.

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One prominent place where we find descriptions about the insane is in the histories of Roman emperors. Indeed, the uncontrolled insanity of emperors like Caligula, Nero, and Commodus has become one of the most well-known images of Rome. What characterizes the representation of these “madmen” is their excess and abuse of power. The end of the Republic had seen two generations of civil war, but the imperial system that put a stop to this involved a substantial concentration of power into the hands of one man. It is possible that such great responsibility and pressure drove some of these emperors mad, living as they did with the constant fear of assassination. But it is more profitable to see these literary representations of imperial madness as a means of safely discussing the problems inherent in the imperial system. Stories that Caligula wished to make his horse a senator highlighted the lack of checks and balances at the top of Roman government. It also served as a warning to future emperors: rule moderately, wisely, and with the support of the Senate and the Roman people or face the damning judgment of history.16

8.5. CHRISTIAN ATTITUDES TOWARD MENTAL DISORDER The Christianization of the later Roman Empire, following the conversion of the emperor Constantine, saw demonic possession acquire a more central role in mainstream literature. As Peter Brown put is, exorcism became “the Late Antique drama par excellence.”17 What caused this? It is plausible to argue that the increased focus on exorcism resulted from an increase in the appearance of mental health issues among the population. It is certainly not difficult to draw up a list of factors that may have intensified the stress widely experienced in the later empire: the inflation and chaos of the barbarian invasions of the third-century crisis; the impact of a tougher, more centralized government and bureaucracy that was designed to extract a bigger surplus out of an already oppressed peasantry; the widening gap between society’s powerful and the mass of the people; a decline in the legal status and privileges of the citizenry; an economic decline that may have set in in the west; a population decline that may have set in more generally. Clearly, the impact and indeed the existence of many of these factors is a matter of keen academic debate, and Brown may be correct when he suggests that life in the later empire may have done no more than turn “a slightly deeper shade of the ever expected grey.”18 But in a world where even small differences in income could have a major impact on quality of life, that in itself could have brought a considerable change in overall levels of mental health. What might seem minor changes to us could have been experienced as having a significant detrimental impact on life by those at the bottom of society. If the social and economic changes of the later empire did have an impact on mental health levels, the effect, as Brown also says, will not be seen in the rise of an “age of anxiety,” as Dodds put it, which was characterized by “intense and widespread feelings of guilt.”19 Rather, it would have been found among those living on the margins of subsistence, on the edge of empire, and those whose status had noticeably slipped. But it is probably better to interpret the increase in social focus put on mental phenomena as not simply reflecting any possible increase in mental health problems resulting from a rise in macro-social stressors, but rather as reflecting a significant change in the nature of the social order. The large increase in cases of possession and exorcism in the later sources can be seen as reflecting the tensions of a society that was undergoing twin processes of radical change in the form of Christianization and centralization. The tensions that this generated in a traditional, statusobsessed society found their expression in a Christian literature that looked to exorcism as the means to overcome such “disorder” and return society to good health.

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The later Roman Empire saw power and wealth concentrate into the hands of a small elite. A comparable concentration occurred in the religious sphere, with Christian bishops acquiring a powerful leadership role. Holy men represented a less authorized version of this religious elite, who had acquired special powers through their physical acts of devotion toward God, which gave them the power to adopt Jesus’ role as a miracle worker and, above all, as an exorciser of demons. Through the healing touch of the holy man, the possessed were able to have their sanity restored. The power was such that patients were able to be cured when they merely touched facecloths that had themselves touched St. Paul: “their diseases left them and the evil spirits came out of them” (Acts 19:11–12). The possessed themselves did not simply play a passive role in this drama. To be sure, their primary function was to serve as literary foils to emphasize the power of holy men and their positive effect on society. But the possessed also offered a way for controversial opinions to be publicly expressed. It is noticeable that they often appeared at times of intensified social tension when there was a need for popular leadership.20 Similarly, Paulinus of Nola observed that possessions increased in the run-up to religious festivals, since they gave an opportunity for plain speaking.21 But the holy men also often seem to have provided a focus for the straightforward expression of psychological distress. After a devastating fire in Constantinople in the autumn of 465 CE, for instance, afflicted citizens approached the holy man, Daniel the Stylite, and told him about the great personal misfortunes they had suffered. One said, “I have been stripped bare of great possessions”; another complained that, “I ran away from that terrible danger only to suffer shipwreck of my scanty belongings.” The holy man’s response was to weep with them and to emphasize that they had only themselves to blame: “you should have implored God and escaped his terrible wrath.” He also spoke “many other words of counsel” to them and thereby “turned their hopelessness into hopefulness.”22 We see the holy man acting as a focus for individual and communal distress, but we also see him turning a dreadful event into an opportunity for Christian regeneration. We can also see in such stories how mental illness acquired a powerful metaphorical role in the Christian world.23 Just as Jesus’ touch could deliver an individual from possession, so too could his church deliver the sinner from the eternal grasp of the Devil. The arrival of the bubonic plague in 541 CE provided both the ultimate stressor and the ultimate opportunity to use it as an educational metaphor for those who survived.24 We have a striking account of the physical and mental impact of the plague from John of Ephesus, who tells how total disorder soon took hold. The plague struck down all ages in what John describes as a “wine press of wrath.”25 People forgot about money and possessions, and even “selling and buying itself ceased.” A complete social dystopia was created. The survivors were psychologically devastated, having seen so many of their loved ones die in horrifying circumstances. How, asks John, could “the heart of the witness of these things not melt inside him”? People seem to have been stunned, and there was “neither crying nor mourning but only people shocked … speechless like those drowsy from wine.” Individuals were unable to function normally, and instead they “talked to his companion like men drunk with strong beer, baffled and confused. People were easily driven to insanity by the intoxicating plague.” In such a state of mental disarray, people were vulnerable to all kinds of deception. Demons sought to “mislead people and ridicule their madness,” so they made a survivor state that if earthenware pots were thrown from the windows of high buildings then the plague would leave the city. John records how foolish women even started carrying out “this madness.”

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The ultimate expression of this psychological distress occurred in the fortress city of Amida, which lay strategically on the river Tigris, in the border area with the Persian Empire. Situated between the two great regional rivals, the city had already suffered greatly from warfare before the plague arrived. In 559–60, in the face of such stress, the city experienced a collective mental breakdown. The outbreak was caused, according to John, by a band of “rebellious demons” appearing in the guise of refugees fleeing from a supposed renewed Persian attack. Alarm spread, and the people of the region “migrated all at once, and great confusion and losses occurred everywhere for many days.” This seems to have tipped some sections of society over the edge: “It was rage, madness, frenzy,” explains John. The collective disorder overturned all the normal conventions of social behavior: “people started to bark like dogs, bleat like goats, meow like cats, cuckoo like cocks, and imitate the voices of all dumb animals.” Groups of deranged individuals “gathered in groups, confused, troubled, disturbed, causing confusion, staggering about in the night on their way to the cemetery.” They sang and raged in public, bit each other, and screamed “as if with horns and trumpets.” They swore like the Devil himself. They jumped about and climbed walls, hung upside down, and rolled about naked. They were so confused that none could even recognize their home. The sane tried to treat the victims with religious ritual in churches, but even in such holy places they continued with their swearing and blasphemy. The disorder was to continue for over a year. John himself had no idea what particular sin caused the outbreak of collective diabolical possession. It is possible to speculate that the enormous pressure that military invasions and the plague generated resulted in an outbreak of mental disorder, but that would not do justice to the range of uses to which mental phenomena could be put in late Roman society. For one thing, disordered behavior was a way for the weak to critique their society in a safe manner. The dangers involved in outright rebellion meant that misery found its expression in a language of mental disorder, a language whose grammar was inversion. It allowed a suffering population an idiom through which they could complain about the extreme circumstances in which they found themselves. But John’s account serves a thoroughly Christian purpose. The mental disorder served to highlight a world that represented the very opposite of the ideal Christian society. Here was, in all its gruesome detail, a terrifying foretaste of the eternal punishment that awaited those who did not take note and repent. The narrative of the collective madness created a social dystopia to promote the ideal Christian society that was its mirror. The recovery process in Amida therefore involved a search for renewed social and religious harmony through a variety of Christian rituals, penitence, vows, and processions. Slowly, the treatment began to work, and “one by one and little by little, they started to come to their senses. They grieved, wept, groaned and kept busy in prayer and in painful supplication at all time.” Through the medium of Christian religion, therefore, the victims were able to be readmitted into normal life in a way that allowed them to publicly assert their renewed enthusiasm for Christian ideals. As a result, groups of those who had regained their senses “went to Jerusalem and to other holy places for prayers, sorrowful, clad in black, making supplication, praying and weeping.” The community, through its devotion to the Christian faith and the Church, in this way managed to recover its mental health. And with John’s narrative, mental disorder had acquired a place in Christian teleology.

NOTES

Introduction 1. S. F. Rose (2017). 2. See, for example, Aasgaard (2017: 323) on the etic versus the emic for the study of ancient childhood and youth. 3. Although, for example, in the UK, disability benefits are paid to people with some chronic conditions (e.g., osteoarthritis) that prevent them from working. This technically makes them “disabled” in legal and perhaps also social terms. See the various links to information at https://www.gov.uk/browse/disabilities. 4. Also, in other instances, the root πηρός points to permanent damage caused by mutilation. See Nicolas of Damascus (C 710.3–4) = Stobaeus, Anth. 4.2 on an Indian law referring to inability to work as the result of an afflicted injury. Also, Eustathius, Commentarii ad Homeri Iliadem (vol. 3, p. 639, l. 11) points to mutilation. Aristotle, HA 631b31 uses the term in the case of castration of children, as does Demosthenes, Or. 18.67 (De corona) on the mutilated King Philippus of Macedonia. See also Hippocrates, Art. 60 on permanent damage to the legs due to fracture; Aristotle, HA 620a1. See the excellent study of terminology by Muller (2018). 5. Also in Diodorus Siculus, Bibl. 3.13.3; Plutarch, An senibus res publica 791d; De paradox. Stoic. 1068d; 1050a; De notione Stoic. 1076b; Arrianus, Epict. 2.10.5; Pausanias, Periegesis 4.30.3. See Muller (2018: 295–6). 6. But see Synon. Cic. p. 448, 23: valetudo, vitium, morbus as synonyms. 7. Cod. Iust. 5.17.10: si maritus uxori … coire minime propter naturalem imbecillitatem valeat. See Laes (2016a) on impotence as a disability. 8. Isidorus, Orig. 10.128: imbecillus, quasi sine baculo, fragilis et inconstans. 9. Dig. 21.1.1.7: “It should be noted that disease (morbum) is defined by Sabinus to be some condition of the body which renders it less able to perform the functions for which Nature has bestowed upon us corporeal health. In some cases, disease affects the entire body, in others only a portion of the same, for instance consumption, that is to say, a wasting; a fever is a malady of the entire body; blindness, for example, is the malady of a part, although a man may be born in this condition. There is a great difference between a defect (vitium) and a disease, as where someone is a stammerer, for this is rather a blemish than a state of ill-health. I think that it is for the sake of removing all doubt on this subject, that the Aediles have made use of the term ‘the same,’ in order that no uncertainty may remain” (transl. S. P. Scott). Note that in the last line, doubt is already expressed as to how to properly maintain the distinction between morbus and vitium. 10. According to Dig. 21.1.6, morbi referred to both chronic and temporary illnesses. 11. Here, it is apparent that mental features had a corporeal basis, a basic assumption in ancient thought, which did not know of the Cartesian mind–body distinction. See Laes, Goodey, and Rose (2013b: 2). 12. See, for example, Dig. 21.1.14.8 on enlarged tonsils (antiadae). The person suffering from this is considered vitiosus, but still annulment is considered the right solution. In Dig.

NOTES

13.

14. 15.

16. 17.

18. 19.

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21.1.4.6, morbus does not lead to annulment. See also Dig. 21.1.14.5, where the terms morbus and vitium are used in a confusing way: “Pedius also says that if the uvula of anyone is amputated, it prevents rather than calls for the return of a slave, because the morbid condition (morbus) is diminished. I think that if the morbid condition disappears, there will be no ground for the return, but if the defect remains (vitium), there will be ground for it” (transl. S. P. Scott). There is extensive literature on the distinction between vitium and morbus and the selling of slaves, particularly in the works of the Roman jurists. I only cite inter alios: Lanza (2004), Hughes (2006), Gourevitch (2013), and Laes (2018: 9–10). The bibliography is vast. Gevaert and Laes (2013) deal with the question in the context of disability history. See also Dasen (2018). Note that also “the female nature” is considered “a kind of disability” (ὥσπερ ἀναπηρίαν εἶναι τὴν θηλύτητα φυσικήν (775b15–16). While such phenomena seem to be para physin (“against nature”), they are in fact kata physin (“according to nature”) (770b15–16). Note that in De gen. an. 4.772a35–b2 twins are also considered “rather to be monstrosities,” but not so much in man, who usually produces one offspring, but on occasion more. There was not any expectation that amputated or missing limbs would suddenly grow back, not even by miraculous healing. To this, there only seems to be one exception. A man had a completely empty eye socket. When he approached the sanctuary at Epidaurus for a cure, people ridiculed him for his gullibility. He was cured and left with two eyes, if we are to believe the inscription about him. I suppose that the ridiculing of the people is more revealing of the “truth” behind this story. As Jane Draycott pointed out to me, the case story might also point to eye protheses. See LiDonnici (1995: 92–3). Uhalde (2012). Laes (2019).

Chapter 1 1. Unless otherwise noted, all citations are from the Loeb Classical Library. 2. On this subject see also Meeusen (2017: 197–209). 3. Some of the arguments in the present article are developed further in my forthcoming thesis, “Penser le corps social en situation à Rome et dans le monde romain: perceptions et représentations de l’atteinte physique du Ier s. avant n. è au IVe s. n. è.” Lille-Fribourg, 2016, and in Husquin (2018b). 4. Husquin (2016: 31–56). 5. Article “Norm” in Oxford English Dictionary, http://www.oed.com.proxy.scd.univ-lille3. fr/view/Entry/128266?rskey=OoEhGq&result=1&isAdvanced=false#eid (accessed September 4, 2017). 6. Boudon-Millot (2003: 77–91; 2006); Pseudo-Galen, Medical Definitions 131. 7. According to the Anonymous Latin, Physiognomonia 85, people with spots on their skin led shameful lives. See Laes (2016b) on fatness and thinness. 8. Allély (2004b: 43–5); Livy, History of Rome 5.15. 9. Ibid. It must not have taken place in a private area or abroad. 10. Moussy (1977: 345–69); Cuny-Le Callet (2005: 46–50); Maiuri (2013: 165–77). 11. Delcourt (1938: 60); Macbain (1982: 127–35); Champeaux (1996: 67–91); Crifo (1999: 114); Brisson (2008: 32); Lentano (2010: 292–319); Graumann (2013: 190); Vallar (2013: 210–13).

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12. Levi (1941: 220–32); Dasen (2009: 226–7); Ballet and Jeammet (2011: 50–1); Masséglia (2015: 289–91); Trentin (2015: 51–9). 13. Dog, feline, bird, snake, and insect. 14. A trident and a sword. 15. On what Masséglia named the tuck-for-luck; see Masséglia (2015: 289–99); Trentin (2015: 59–61). 16. Ulpian, Digest 1.5.10; Thomas (1991: 103–58). For similar discussions, see Benkheira (2017: 421–33).

Chapter 2 1. In fairness, Laes (2017a: 6) is referring here to a “miscellaneous category” designed to capture the variety of ancient cultural responses to circumstances that might not necessarily map on to forms of disability that are recognized in the modern world, but his words are representative of the assumptions with which many less critical studies than his have traditionally begun. 2. Belcastro and Mariotti (2000: 534) suggest that at least one other skeleton (T.115) from the same necropolis may also have made use of a crutch, although the evidence is “not so clear.” Second-century CE medical writer Soranus (Gynecology 2.43–4) also famously reported the tendency for people born in Rome to walk with distorted legs, sometimes assumed to be a consequence of rickets. 3. For studies that do ask such questions, see, for example, Zakrzewski (2014) on ancient Egyptian contexts, Draycott (2015) on visual impairment in Greco-Roman Egypt, and Graham (2013) and (2017) on mobility and other physical impairments in Roman Italy. 4. Zakrzewski (2014: 63–4) calls for a “fluid continuum of ability” on which individuals might be located at different moments in the life course and that can be “viewed through the lens of the individual agent.” 5. Mitchell (2011) critically reviews retrospective diagnosis as a methodology. 6. For the Greek world, Samama (2017: 121) has also pointed toward evidence suggesting: “About 10 per cent of the skeletons found in the Greek world (Grmek 1994: 93) show at least one fracture in vitam, so that it may be said that a large part of the population suffered from a visible disability.” 7. None are inscribed with information concerning the request, and although a terracotta foot in the Science Museum, London (inv. A634921) has been described as evidencing signs of the congenital condition talipes equinovarus (clubfoot), this is difficult to verify (Graham 2017: 257). 8. Roberts (2013) offers an accessible overview. 9. Osteoarthritis is often identified as a leading cause of ancient “disability.” However, Domett et al. (2017: 762) point out that “recent bioarchaeological studies are beginning to move away from directly linking osteoarthritis with physical activity,” noting that the mechanical stress that drives it might derive from a number of complex factors. They also observe that “disability, particularly from chronic pain, is a significant consequence of osteoarthritis and reduces quality of life, but there is considerable variation in the expression of pain between individuals and it is not always linked with the severity of joint changes” (Domett et al. 2017: 770). 10. Viciano et al. (2017: 11) report the case of a juvenile male from the third–fourth-century CE necropolis of Torrenueva (Granada, Spain) who demonstrated a spinal deformity connected with Scheuermann’s disease. This had also impacted on his lower limbs, but “did not appear to interfere with the ambulation of the individual.”

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11. The phrase “differently abling” is used in this chapter in order to spotlight a potential range of situationally specific ancient bodily experiences connected with physical impairment. It does not convey any judgment concerning the relative value of those different experiences. It should be noted, however, that away from this context the phrase continues to prompt debate, and some contemporary activists have expressed concern about its euphemistic use to downplay the more difficult aspects of an individual’s experience. See, for example, Linton’s (1998) related discussion of “nice words,” in which she notes the complexities surrounding the use of similar phrases and terms, including “special,” as well as the fact that these are often not used by disabled people themselves. For the use of “differently abled” as both a term and a form of empowerment, see also Barclay (2017). 12. Tilley and Oxenham (2011) present a case of juvenile-onset quadriplegia from Neolithicperiod Vietnam that demonstrates that it is not impossible to identify these experiences. 13. The case of Peter’s young daughter in the Act of Peter (Cod. Berol. 8502.4), whose paralysis effectively saves her from sexual abuse, may be viewed as a reversal of this theme, although Solevåg (2017: 293) notes that the scenario seems “unlikely” to reflect ancient reality.

Chapter 3 1. All translations come from The Loeb Classical Library (Cambridge, MA: Harvard University Press), unless stated otherwise. I use Charles Behr’s translation for Aelius Aristides’ Hieroi Logoi. 2. Pain is recognized by the World Health Organization (WHO) as an important global, public health concern. WHO Normative Guidelines on Pain Management (2007): http:// www.who.int/medicines/areas/quality_safety/delphi_study_pain_guidelines.pdf; European Commission Health in the European Union: Special Eurobarometer 272 (2007): http:// ec.europa.eu/health/ph_publication/eb_health_en.pdf. 3. Sebastian Brosche, https://yogaforbjj.net/back-pain-week-3 at 12.00–12.08. 4. See Jackson (2003: 3–11), who shows how chronic pain affects one’s identity. 5. There are also numerous cases in which the bodies of twins, having completely different occupations yet similar bodies, have been examined. For instance, one did heavy physical work and the other deskwork. When MRI scans were obtained, orthopedists could not say which one did the heavy physical work. DNA, therefore, also seems to play a rather large role in the degeneration processes of bodies. Additionally, I want to thank Ludwig Popp for providing me with the newest articles on this topic. I also would like to take the opportunity to thank Emrys Schlatter for his support, feedback, and corrections. 6. Emphasis added. 7. See Lorimer Moseley’s seminar at “Body in mind—the role of the brain in chronic pain” at Mind & Its Potential 2011: https://www.youtube.com/watch?v=RYoGXv22G3k&t=14s at 22.00–22.17. For instance, brain scans have shown that when someone with chronic back pain sees a person picking up a heavy box, he/she experiences pain him/herself. If you think it hurts, it hurts. 8. Ibidem. Mosely used himself as an example to clarify this. Once he was walking in the woods and felt something on his leg. His brain realized that there was something there, but that the leg often received minor scratches while walking outdoors. Afterwards, he collapsed because it turned out be a venomous snakebite. After this whole ordeal, he again spent time outdoors and a twig scratched that same leg. Instead of ignoring such a triviality, the brain remembered that it was in extreme danger last time and as a consequence this scratch hurt immensely.

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9. For a long time, Western medical thought was dominated by the Cartesian duality, which represents two modes of thought: homo duplex and homo clausus. The first refers to the separation between body and mind and the second to the human being as a machine unaffected or impacted by sociocultural elements. This means that every medical condition must be physically perceivable and explained in biophysical terms otherwise the pain sensation does not exist. 10. See the medical treatise Aphorisms (4.32–3, 4.45) for discussions about pain as a symptom. 11. See Wilson’s dissertation, Depictions of Pain in the Roman Empire (2011) on pain vocabulary and my forthcoming dissertation on pain behavior. 12. See von Staden (1989), Vegetti (1998: 84–103), Majno (1975: 328–9), and Rey (1993: 31–3) on Herophilus (335–280 BCE) and Erasistratus (304–250 BCE). 13. See Keele (1957: 18–20), Rawson (1982: 369), and Vallance (1993: 702–4) for discussions about which theories Asclepiades built upon. 14. Here are his lists: On the Causes and Symptoms of Acute Diseases (CSAD), On the Causes and Symptoms of Chronic Diseases (CSCD), On the Therapy of Acute Diseases (TAD), and On the Therapy of Chronic Diseases (TCD). 15. For a full classification of fatal or long-lasting conditions, see Diseases I. 16. See Caelius Aurelianus, De Morb. Chron. (3.8). 17. However, Galen was not the only one to see the necessity of language while diagnosing pain. Slightly earlier, Archigenes (first–second century CE), living in Rome during Emperor Trajan, also developed a now lost pain vocabulary. The reason why we know about this is because Galen highly criticized the words Archigenes chose. 18. See Roby (2015), Wilson (2011), and von Staden (1995) for more on Galen’s medical language. 19. For these passages, the following translation has been used: The Women of Trachis and Philoctetes. A New Translation in Verse by Torrance (1966). 20. In Aristophanes’ play Frogs (649), ἀτταταῖ is also used to denote physical pain, as Xanthias uses the same cry when he is being beaten by Aeacus. Aeacus then asks him whether he cried out because he is in pain. This, too, supports the claim that ἀτταταῖ usually denotes physical pain. 21. M. Frontonis Epistularum ad M. Caes. et Invicem will from now on be abbreviated as Ad M. Caes. and M. Frontonis Epistularum ad Amicos as Ad Amicos. 22. Usually, when Fronto used medical terminology, he used Greek instead of Latin, hence indicating that Greek was perceived as the proper medical language. 23. For Nazianzus’ passages, I have used the translation from Samellas (2015: 273, 278).

Chapter 4 1. In its tenth revision (2016) of the International Statistical Classification of Diseases and Related Health Problems (ICD), the World Health Organization delineates the following categories in the section “visual impairment and blindness”: category 0 (mild or no visual impairment), category 1 (moderate visual impairment), category 2 (severe visual impairment), category 3 (blindness), category 4 (blindness), category 5 (blindness). Lastly, there is also category 9 for undetermined or unspecified cases (chapter VII, H54 [Visual impairment including blindness (binocular or monocular)]); see WHO (2016). On 18 June 2018 an eleventh version of ICD was released to allow Member States to prepare for implementation. ICD–11 delineates eight categories in the section “vision impairments including blindness”: category 0 (no vision impairment), category 1 (mild vision impairment), category 2 (moderate vision impairment), category 3 (severe vision impairment), category 4 (blindness), category 5

NOTES

2.

3.

4.

5. 6.

7.

8. 9. 10. 11. 12. 13.

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(blindness), category 6 (blindness) and category 9 (undetermined or unspecified) (chapter 9, 9D90 [Vision impairment including blindness]) (WHO 2019). As part of her study on visual impairments in the Roman world (200 BCE–500 CE), Meulenijzer has compiled two vocabulary lists regarding eyes and eye afflictions (a Latin vocabulary and a Greek vocabulary). The study has, however, never been finalized; see Meulenijzer (2013). All citations of hagiographical works come from the Monumenta Germaniae Historica (MGH). The hagiographical works used in this chapter can all be found in the following section of the MGH: Scriptores rerum Merovingicarum (SRM). This sourcebook is easily accessible online (http://www.dmgh.de). The references should be read as follows: [MGH], [SRM], [Title hagiography] [paragraph(s)] [book number of the SRM].[page numbers]. In his Naturalis Historia, Pliny the Elder makes a distinction between cocles and luscus. Where the former refers to persons who have been one-eyed since birth, the latter alludes to someone who only became one-eyed later in life (11.55.150). See Laes (2014: 106) and Trentin (2013: 104–6) for more examples on old age and visual impairment. According to Celsus, lippitudo is an inflammation, sometimes chronic, which often is the result of, or contributing to, trachoma (De Medicina 6.27). Jackson notes, however, that Celsus also “used the word to translate the Greek ophtalmia, while he used aspritudo for the Greek trachoma and ophtalmia, and between them they correspond also to conjunctivitis and to other eye diseases displaying the symptoms of inflamed and running eyes” (1996: 2229). Among the more than three hundred collyrium stamps that have been found, 25 percent focus on lippitudo and 20 percent on aspritudo. Followed by references to salves for clarity (claritas; 16 percent), corneal scarring (cicatrices) and suppuration (suppurationes; together accounting for 16 percent), and blurriness (caligo; 7.5 percent) (Jackson 1996: 2229–30). It should be noted that most of the discovered collyrium stamps have been found in Gaul (Baker 2011: 158–89). For more information, see Laes (2014: 102) and Trentin (2013: 96). For more information on cataracts, see Kwitko and Kelman (1998). The year in which the first hospitals were established can never be precisely determined. For an overview of the discussion with regard to dating, see Hordon (2005: 365–6). For general information on the relationship between law and visual impairments, see, among other publications, Laes (2014: 116–18) and Metzler (2017: 296–7). For more (minor) causes of visual impairment, see Laes (2014: 105–11). For more on the discussion of the complex issue of infanticide and child exposure, see, among other publications, Boswell (1988), Laes (2008), Kelley (2009), and Vuolanto (2011). For more on physiognomy, see Swain (2007).

Chapter 5 1. As those working in bioethics may argue (e.g., Camporesi 2010). The current (congenitally deaf) author disagrees. 2. This observation is repeated by the fifth-century CE lexicographer, Hesychius of Alexandria (Laes 2011b: 463). 3. The proverb is also recorded in Plutarchus, Mor. 512d. 4. Like deafness, autism is now recognized as a sensory and communication disability as opposed to a cognitive one. 5. Aristotle also thought that ears could be indicative of personality (Hist. an. 1.11.492a; Rose 2006: 19).

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6. Ladd (2003) explores four forms of such interventionism: economic, welfare, linguistic, and cultural. Lane (1992) charts five stages leading to the present situation of audism: oralism (following the 1880 Milan Conference, where signing in schools was effectively banned on an international level); day schools for deaf children rather than boarding (so causing less exposure to sign language); English dominance in schools (e.g., Sign Supported English [SSE], where signs are added to English structure); mainstreaming (where deaf children were absorbed into the norm); and finally surgery (where children are “fixed” with cochlear implants; see the medical model above).

Chapter 6 1. The authorship of the Apocolocyntosis has been disputed in the past (e.g., see Bringmann 1985: 885–9 for an overview of earlier scholarship). The debate has recently settled down somewhat, with a prevailing view that Seneca is, in fact, the author of this work. Whatever the case may be, the actual authorship is of little relevance for the present chapter. 2. The constitutio textus (and thus the translation) is problematic to say the least (cf. Lund 1996: 167–8). 3. For an interpretation of Seneca’s Claudius as an inarticulate creature (in the ancient sense), see Lund (1996). 4. Rudich (1997: 42–3) presents an interesting point when he explains this in contrast with Seneca’s (positive, or at least rather more flattering) portrayal of Claudius as an “oracle” in his speech at Polybius (Hist. 14.2). 5. On the use of gestures in the context of communication disorders (which is not what Seneca appears to imply for Claudius, however), see Section 6.3.2. 6. His disabilities, however, were not limited to a stutter, but also deafness and a limp, most recently suspected to be the effect of cerebral palsy (cf. Laes 2013b: 163–7; 2018: 140–3; but also see Gourevitch 1998: 468–70 for a cautious analysis resulting in the view that this may have been a case of Little’s disease). Of course, it is not normally a good idea to come up with a definitive diagnosis for conditions that were described in literary sources some 2,000 years ago. It thus seems wiser to abstain from proposing all too definitive solutions to this conundrum. 7. Suetonius (Claud. 30). 8. A comedic “highlight” is reached when the narrator comments on Claudius’ flatulence at the moment of his demise, suggesting that the emperor in fact found it easier to “speak” with this particular orifice than with the one more commonly used for speaking (Seneca, Apoc. 4.3). 9. It would also be reasonable to investigate the ancient medical science behind this complex question, but this would be a very different chapter altogether. For a comprehensive analysis of relevant medical sources, see Wollock (1997); for a digest of relevant sources as well as a sociohistorical approach, see Laes (2013b). 10. Cf. Golden (1995). 11. For more on this matter, see Osgood (2007). 12. It is worth noting in that respect that even the jokebook that is the Philogelos does not come up with any significant number of jokes about disabilities. Apart from the section that deals with “stinkers” (ὀζόστομοι; i.e., people with foul breath, for whatever reason), there is but one joke about a deaf person (Philog. 241): “A moron, sleeping in the same room as a deaf person, farted. When the latter noticed the stink and complained, he said: ‘Look how well you hear: you were just trying to wind me up!’” The harmless punchline of this joke is damaging to the moron, not the deaf person, as he apparently had not figured out that there are more ways than just the acoustic that allow for flatulence to be noticed. In other

NOTES

13. 14.

15.

16.

17.

18.

19.

20. 21.

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contexts, however, avoidance of abuse of lowly individuals with communication disorders was less common (cf. note 24). Note also, for example, the case of Zercon, who tends to be described as a court jester of Bleda’s (cf. Section 6.2.2). A substantial list of relevant cases has been assembled by Laes (2011b) and, subsequently, by Laes (2013b: 169–78). For an assessment of the societal impact of disabilities in ancient Greece, see, for example, Mehl (1996); for the Roman side, see Laes (2018; cf. also the contributions to Laes 2013b). For a broader focus on the ancient world (and beyond), see also Laes (2017c). This episode provided a starting point for an investigation started by Laes (2008: 85–7; cf. also Pease 1920, Rose 2003: 66–78 (“Croesus’s Other Son”); Laes 2011b: 453–5 [focusing on the importance of acknowledging ancient sources’ changing focus on deafness and/or muteness], and most recently Laes 2018: 114–17). In Xenophon (Cyr. 7.2.20), Croesus is represented as suggesting that both of his sons were no joy to him, if for varying reasons. For careful analyses with substantial anthropological parallels, see Allély (2004a; 2009). Reference to this is made in Cicero (Div. 1.121). A similarly remarkable story, involving a communication disorder and the response of the oracle at Delphi, is that of Battus I of Cyrene, as reported in Herodotus (Hist. 4.155). Battus is described as a child who is ἰσχνόφωνος and τραυλός (i.e., of weak voice and lisping), which have commonly been interpreted as “stammer” and “lisp.” The name Battus itself is a reference to the disorder, as Herodotus notices, while also pointing out that the name may in fact be a reference to the Libyan term for “ruler” or “king” rather than a Greek name. Interestingly enough, the story reported in Herodotus suggests that Battus himself went to Delphi to seek advice regarding his communication disorder (ἦλθε ἐς Δελφοὺς περὶ τῆς φωνῆς), which is also acknowledged in the Pythia’s response: ἐπὶ φωνὴν ἦλθες. Iustinus’ account of Pompeius Trogus (Iust. 13.7.1–6) has Battus’ father Grinnus consult the oracle on his son’s behalf (which would make this story even more of a double of the Croesus story). For more on Battus and his communication disorder, see Cosi (1983) and Laes (2013b: 170–1). If nothing else, this story suggests that seeking religious advice regarding a cure for communication disorders was a believable story. Battus was allegedly cured of his communication disorder by means of a sudden threat to his life; see Section 6.3.2. An alternative version is reported in Pliny the Elder (Nat. Hist. 11.270), where Croesus is in fact credited with a son who started speaking at the unusually young age of six months, which then is interpreted as a portent that hinted at the fall of Croesus’ reign and empire. Cf. Pease (1920) on this and other inconsistencies in the son of Croesus narratives. The same conundrum appears to have intrigued Valerius Maximus as well, who suggests that it was in fact pietas (filial sense of duty) that suddenly inspired the ability in Croesus’ son to speak (Val. Max. 5.4.ext.6). Lucian implies deafness in Lucian (Pr. Im. 20), and deafness has also been implied by a number of modern scholars, justified (but without watertight evidence) by the narrative of Herodotus (cf. Rose 2003: 66–78). This, as well as other minor inconsistencies, has led some scholars to believe that multiple narratives existed; see Pease (1920) for a careful analysis. For further reports of cures, see Section 6.3.2. Like Croesus, Vitellius, too, is reported to have had two sons, but both of them are described as disabled, with the non-mute one turning out to be the more problematic character of the two male offspring: whereas in Croesus’ case the son attempted to prevent the father’s death, Vitellius’ first son, who suffered from bad eyesight, is denounced for an (alleged) attempt to kill the father, and he is killed in turn.

160

NOTES

22. PIR1 V 509. 23. Laes (2013b: 177). 24. Herodotus’ statement in 1.38.2, given above, seems particularly harsh with regard to the father’s claim that the son who is affected by the condition does not in fact count for him at all. Yet, one must be careful in assessing such statements. Pliny, for example, in his Historia Naturalis, lists an individual’s voice as a “large part” of a human being’s external features (uox in homine magnam uoltus habet partem), usually recognizable before any visual feature (Pliny the Elder, Nat. Hist. 11.271; and, more generally, see Bettini 2008 on the ancient “fonosfera”). This, in turn, would justify the assumption of a significant incompleteness in a person when this key feature is absent or damaged. Similarly, Tacitus has Maternus in the Dialogus de Oratoribus compare speechlessness (mutum et elinguem) to deformitas (Tacitus, Dial. 36.8), a concept that is not altogether different from Herodotus–Croesus’ notion of διεφθαρμένον. This observation would give an explanation for an observation made by Rose (2003: 66), namely that (mute–)deafness stands out from other forms of disabling conditions in the way in which it could lead to particularly severe circumstances and repercussions for the affected. 25. Fronto, in a letter to Verus, points out the importance to an emperor of self-advertising through powerful speech, and he draws attention to the majority of emperors who came across as infantes and elingues, with their army boots as their sole mouthpiece; Fronto p. 122.22–123.2 van den Hout (= Ad Verum Imp. 2.1.9). 26. Note the ironic contrast with the idea that the presence of a powerful figure in fact inspires speechlessness in others, as mentioned in Porphyrius (Hor. sat. 1.6.56–7). A similar idea, transferred into the sphere of the (here: Christian) divine, can be seen, for example, in the late Antiquity/early medieval Akathist hymn, where one reads Ῥήτορας πολυφθόγγους ὡς ἰχθύας ἀφώνους ὁρῶμεν ἐπὶ σοὶ Θεοτόκε (“eloquent rhetors, turned mute as fish, we see, in front of you, parent of god”). 27. The Greek text derives (untranslatable) additional humor from the pronunciation of κόρακος as κόλακος, now the genitive of κόλαξ (“flatterer”). 28. There may be other explanations worth exploring: could the text potentially be taken as an indication of a certain difficulty with the production of an alveolar trill (“rolled r,” as opposed to the alveolar tap), for example? 29. This phenomenon, sometimes referred to as “lallation,” is known in modern linguistics as well, and it forms part of the stereotypical pronunciation of European languages by speakers from the Far East (cf. Borden et al. 1983 on Korean). A similar disorder is presupposed by Plutarch (Quaest. Rom. 54 = 277d), where Plutarch is trying to show how the Latin term for “meat market” is derived from the Greek term for “chef” (macellum < μάγειρος) using a mode of corruption that he explains as a “lisp” due to a “weakness of the tongue” (καὶ τὸ λάμβδα πάλιν τοῖς ἀπολισθαίνουσι τοῦ ρ δι’ ἀμβλύτητα τῆς γλώττης ὑπόκεῖται τραυλιζόμενον); for more on this (and etymology in Plutarch more generally), see Strobach (1997: 35, 80). 30. This may not be true consistently, however: Vickers (1989) has made a reasonable case for Aristophanes’ use of double entendres in the representation of Alcibiades’ “lisp” in Birds, which would take this to a different level. 31. In fact, it is reported in Archippus fr. 45 that Alcibiades’ homonymous son deliberately imitated his father’s peculiar elocution. 32. It is important, however, that such a positive perception of an awkward pronunciation was not a given; note, for example, Catull. 85, mocking the drawling speech of an individual who added an aspiration to the initial syllables of his words. 33. A similar level of prima facie charm (altogether at odds with the factual message of the poem) is implied in Priap. 7, where Priapus has been imagined to say Cum loquor, una mihi

NOTES

34.

35.

36. 37.

38.

39.

40.

41. 42. 43.

44.

161

peccatur littera; nam T/P dico semper blaesaque lingua mihi est (“When I speak, there is one letter that always makes me stumble: for I say T instead of P all the time, with a charming tongue”): of course, T P dico = te pedico. In that regard, one must wonder if Alcibiades’ “lallation” (see Note 29) was, perchance, perceived as endearing due to a potential resemblance of baby language. While generally perceived as cute (cf. Ovid, Ars 3.293–5; Minucius Felix, Oct. 2.1), its imitation (especially when deliberate and in a drawling manner) was not always well received, as the evidence from Hier. epist. 107.4.6 demonstrates (cf. Kruschwitz 2012: 209–10). Bambalio is mentioned before, in Cicero (Phil. 2.90; without further comment on the name). Dio 45.47.4, too, in passing refers to the etymology of the personal name (in what would appear a direct reference to Cicero’s Philippic; cf. also Dio 46.7.1, 46.28.1). Cf. Lochner-Hüttenbach (1962) for a useful discussion of the term and its cognates. Cf. Kajanto (1965: 240–1), who does not even list Bambalio among the more established cognomina that constitute his category of names referring to “defects of speech” (where names related to stammer and stutter are assigned to reasonably well-attested Balbus and Blaesus groups). An interesting case is CIL II 5078: L(ucius) Valerius L(uci) f(ilius) | Auctus | auium inspex | blaesus a(nnorum) | LVI s(it) t(ibi) t(erra) l(euis) | Felicio frat(ri) (“Lucius Valerius Auctus, son of Lucius, observer of birds, lisping (?), aged 61: may earth rest light on you: Felicius for his brother”). The adjective blaesus is the t. t. for the quality of lisping. Its presence in this epitaph of a diviner (discovered in Asturica) suggests a certain importance of the disability to this person and the impact it had on his (professional?) life. Or is one to assume that a constituent of the name has been displaced in the inscription, as Laes (2013b: 150), in keeping with a number of more recent editions of the text, is inclined to think? Something similar can be said for the aforementioned case of Battus I of Cyrene (see Note 17): as Laes (2013b: 170) puts it: “For Plutarch, however, the story is an illustration that even though his being ἰσχνόφωνος and τραυλός was incurable, Battus could still be an excellent leader and founder of a powerful city (De Pythiae Oraculis 405b).” Cf. the remarkable insult in Plautus (Merc. 629–30): de istac re argutus es, ut par pari respondeas/ad mandata claudus caecus mutus mancus debilis (“in that regard you are articulate to answer tit for tat, but when it comes to your duties, you are limping, blind, mute, weak, and lame”). For a range of relevant discussions, see, for example, Holst (1926), Rose (2003: 50–65; Demosthenes’ stutter), Cicurel and Shvarts (2003; Demosthenes as a case study, comparable to the biblical Moses; on the latter cf. also Tigay 1978). Laes (2013b: 173). The majority of which was stolen from him by the guardians appointed to him (Laes 2013b: 173). According to an intervention by Crassus in Cicero’s De Oratore (Cicero, De Orat. 1.115), this was not an option for everyone, however: sed sunt quidam aut ita lingua haesitantes aut ita uoce absoni aut ita uultu motuque corporis uasti atque agrestes, ut, etiam si ingeniis atque arte ualeant, tamen in oratorum numerum uenire non possint (“but there are some individuals so hesitating in their speech or so inharmonious in their voice or so unwieldy and unrefined in their facial expressions and their body movement that, even if they have the talent and the skill, they cannot become enter the league of orators”). An interesting variation on this theme is the notion that two of Socrates’ pupils, Plato and Charmides, were also “weak-voiced” (ἰσχνόφωνοι; cf. Diogenes Laertius 3.5, in addition to Socrates’ fling Alcibiades, on whom see above). These cases are significantly less prominent, however, and this may, in part, be due to these two individuals’ lack of public speaking and (active) political engagement.

162

NOTES

45. For a small number of relevant reports that have come to light (e.g., from papyri from Greco-Roman Egypt), see Laes (2018: 127–30). 46. Cf. Section 6.3.2. 47. Cf., however, aside remarks such as Martial (at 10.65) about one Carmenion, whom he ridicules with reference to what may be construed as a speech disorder: os blaesum tibi debilisque lingua est. 48. For a recent discussion of this case, see Laes (2013c). 49. To infer from Priscus’ report that Zercon himself particularly enjoyed his position would be absurd, for the same passage reports his attempts to escape Bleda’s entourage, even though it is made quite clear that Bleda very much enjoyed the man’s presence—for the purpose of his own questionable amusement. 50. On the entertainment aspect of this particular performance, cf. Halsall (2002: 17–18) and Tougher (2010: 139). On dwarfism and physical as well as mental impairments as a source of entertainment and ridicule in the ancient world, see in greater detail the excellent article by Weiler (1995); for an ancient theoretical approach to this type of humor, see Cicero (De Orat. 2.239). 51. See Weiler (1995). 52. Similarly, Holy Roman Emperor Frederick II and James IV of Scotland are reported to have conducted similar language deprivation experiments. 53. For more on this passage, see, for example, Vannicelli (1997) and Thomas (2010). A related report exists in Quintilian (Inst. Or. 10.1.10): Haec ut sciamus, atque eorum non significationem modo sed formas etiam mensurasque norimus ut ubicumque erunt posita conueniant, nisi multa lectione atque auditione adsequi nullo modo possumus, cum omnem sermonem auribus primum accipiamus. Propter quod infantes a mutis nutricibus iussu regum in solitudine educati, etiam si uerba quaedam emisisse traduntur, tamen loquendi facultate caruerunt (“We cannot possibly achieve to know all these [words], not only in terms of their meaning, but also their forms and their prosodies so that they may fit wherever they are placed, as we acquire all our language by acoustic means at first. That is why children that were brought up by mute nurses by the order of kings and were raised in isolation, even if they are reported to have uttered certain words, still lacked the power of speech”). 54. Note the parallels in terminology to the description of Claudius’ speech in Section 6.1. 55. Cf. Lowe (2015: 61; and more often). 56. Adams (2003: 105–6). 57. Cf., for example, Ovid (Trist. 3.11.7–14, 5.12.55–8). 58. Wollock (1997); cf. also Laes (2018, 120–4) and, on the lexicon of voice-related conditions, Biville (1998). 59. Similar statements at Problemata 11.54 and 11.60; cf. also ibid. 11.55 (on humans as the only living beings that stammer). This approach is, of course, at odds with the observation that consumption of alcoholic beverages has a disrupting impact on speech production, which is, in fact, noted ibid. 11.46—a theme richly explored in comedies (cf. e.g., the drunken stammer in Plaut. Most. 313). 60. This is a popular, not uncommon view even in the present day with potentially rather dangerous implications, considering that it presupposes that the real gift of producing intelligible, “normal” speech resides in everyone, and that it ultimately only requires a strong enough trigger to make individuals come to their senses. 61. See Note 17. 62. Pausanias 10.15.7. Pindar (Pyth. 5.57–62), in turn, makes Battus speak in a γλῶσσαν … ὑπερποντίαν, a “voice from over the sea” (i.e., presumably a language that sounded outlandish

NOTES

63. 64.

65.

66. 67. 68. 69.

70.

71. 72. 73.

74. 75.

163

and foreign). Where Pausanias makes Battus look weak and fearful, Pindar has Battus scare the lion, making him a rather stronger character in his narrative. Gellius 5.9. Valerius Maximus 1.8.ext.4. Valerius links this story to another one that reports the opposite effect of a shocking experience, namely the loss of one’s voice; cf. Valerius Maximus 1.8.ext.3, where the (unnamed) wife of one Nausimenes of Athens is mentioned as having lost her voice over her discovery that her son and daughter had begun an incestuous relationship. The Judeo-Christian tradition presents a number of interesting cases. In addition to the tale of Moses (cf. Note 40, and also Laes 2018: 147–8), it is in particular the presence of healing narratives in the Christian bible, as well as the role of Paul, “the fool for Christ’s sake” (cf. Welborn 2005), that have triggered subsequent narratives. The ambiguity between actual manifestations of communication disorders and spiritual imagery is not lost on the authors. Particularly interesting cases among the Christian writers include Augustine, Gregory of Tours, and the Venerable Bede (cf. Laes 2018: 130–2). An opposite case, as Christian Laes kindly pointed out to us, is that of Zacharias, the father of John the Baptist, who, according to the Gospel of Luke (Lk. 1:20), was temporarily struck mute for his unwillingness to believe in the archangel Gabriel’s words. Another matter still is the use of sign languages to communicate with foreigners (cf. e.g., Ovid, Trist. 5.10.35–42). Note, for example, the reference of “inarticulate speech,” reminding one of the way in which Claudius’ speech was characterized by Seneca (cf. Section 6.1 with Notes 3–8). In addition to, for example, Küster (1991), see Laes (2018: 124–7) on relevant legal sources. For more on the underlying semiotic discourse in Augustine’s work, see Meier-Oeser (1997: esp. 15–16). In a different context, Augustine speaks about the sign language used for the benefit of a deaf–mute boy from Milan; for more on this, cf. Laes (2018: 117). One may wish to note, however, that Herodotus in his Psammetichus story also includes the use of gestures to underline what (allegedly) was being said. In fact, even the Claudius episode in Seneca’s Apolocyntosis involves a certain level of gesturing, though not in the context of the main conversation. Euripides, frg. 67 N2 = Alcmeon 20 Jouan – van Looy (= Stobaeus 3.8). Cicero (Deiot. 1). Both actual curses and mythical imaginations (such as the Echo myth) often involve interference with an ability to speak, not least out of fear of an unwanted witness to come forward at an importune moment. Further on this, see, for example, Gager (1992: 121, 124, note 23). IG XI 1299; see also Engelmann (1975).

Chapter 8 1. 2. 3. 4.

On mental health in the Roman world, see Toner (2009: 54–91). On the terminology, see Toner (2009: 54–62). See Golden (1988). See Parkin (2003: 281) for mortality tables. As Parkin notes, “I can find hardly any reference specific to mental illness in old age, and then only of the most casual kind” (p. 170). 5. On disasters in the Roman world, see Toner (2013). 6. On gender and disaster, see Rodríguez (2007: 130–46). 7. On PTSD, see esp. Neria (2009).

164

NOTES

8. 9. 10. 11.

This cannot simply be equated to the modern concept of sexuality; see Schrijvers (1985). See Mattern (2008a). See Ogden (2009: 146). See, for example, Ovid (Met. 4.443) and Pliny’s famous ghost story (Ep. 7.27). On literary representations of ghosts, see Ogden (2009: 146–78). Quoted in Gager (1992: 234, 236) with slight alterations. See Baker (2017) on the physical healing context of Asclepia. On legal concepts of madness, see Toohey (2017). See Ogden (2009: 166–7). On the problems of retrospective diagnosis, see Karenberg and Moog (2004). Brown (1978: 25). Brown (1978: 5). Dodds (1965: 36). See also Fox (1986) and Brown (1972: 74–93). See Brown (1981). Carm. 23.58 quoted in Brown (1981: 111). Life of St Daniel the Stylite (41, 45). See Toner (2013: 108–30). On the role of disease in developments in the late empire, see Harper (2017). John’s account survives as part of The Chronicle of Zuqnīn. The major accounts are found in Pseudo-Dionysius, Incerti Auctoris Chronicon (15–16), Michael the Syrian, Chronique (9.32), and Chronicon Anonymum (1234, LXII). Pseudo-Dionysius’ account represents the primary text and is generally attributed to John of Ephesus. All translations are from Harrack’s version of The Chronicle of Zuqnīn (1999); see Toner (2013: 153–70).

12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25.

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Books and articles Aasgaard, Reidar (2017), “How Close Can We Get to Ancient Childhood?,” in Christian Laes and Ville Vuolanto (eds.), Children and Everyday Life in the Roman and Late Antique World, 318–31, London and New York: Routledge. Abrams, Judith Z. (1998), Judaism and Disability: Portrayals in Ancient Texts from the Tanach through the Bavli, Washington, DC: Gallaudet University Press. Abusch, Zvi and Daniel Schwemer (2011), Corpus of Mesopotamian Anti-witchcraft Rituals, Volume I, Leyden: Brill. Adams, Ellen (2017), “Fragmentation and the Body’s Boundaries: Reassessing the Body in Parts,” in Jane Draycott and Emma-Jayne Graham (eds.), Bodies of Evidence: Ancient Anatomical Votives Past, Present and Future, 193–213, London and New York: Routledge. Adams, Ellen (2018), “The Psychology of Prostheses: Substitution Strategies and Notions of Normality,” in Jane Draycott (ed.), Prostheses in Antiquity, 180–208, London and New York: Routledge. Adams, Ellen (forthcoming), “The Forgotten ‘Other’: Disability Studies and the Classical Body”. Adams, James Noel (2003), Bilingualism and the Latin Language, Cambridge: Cambridge University Press. Allély, Annie (2004a), “Anomalies du langage et de la parole et mutisme à Rome sous la République et le Principat. Approches religieuse, politique, sociologique et juridique,” Kentron, 20: 117–36. Allély, Annie (2004b), “Les enfants malformés et handicapés à Rome sous le principat,” Revue des Études Anciennes, 106: 73–101. Allély, Annie (2009), “La parole retrouvée du fils de Crésus à travers les sources grecques et latines : étude philologique et anthropologique,” Latomus 68: 16–34. Anderson, Julie and Ana Carden-Coyne (2007), “Enabling the Past: New Perspectives in the History of Disability,” European Review of History 14: 447–57. Anderson, Thomas (2001), “A Case of Skeletal Tuberculosis from Roman Towcester,” International Journal of Osteoarchaeology, 11: 444–6. Armstrong, David (2014), “Deaf Gain in Evolutionary Perspective,” in H-Dirksen L. Bauman and Joseph J. Murray (eds.), Deaf Gain: Raising the Stakes for Human Diversity, 77–94, Minneapolis and London: University of Minnesota Press. Armstrong, David and Sherman Wilcox (2007), The Gestural Origin of Language, Oxford: Oxford University Press. Arnaud-Lesot, Sylvie (2012), “Les aspects médicaux de la honte dans le De medicina de Celse,” in Renaud Alexandre, Charles Guérin, and Mathieu Jacotot (eds.), Rubor et Pudor. Vivre et penser la honte dans la Rome ancienne, 45–59, Paris: éditions rue d’Ulm. Atherton, Martin (2012), Deafness, Community and Culture in Britain; Leisure and Cohesion, 1945–1995, Manchester: Manchester University Press. Austin, Rev. Gilbert (1806), Chironomia: Treatise on Rhetorical Delivery, London: Bulmer and Co.

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Avalos, Hector (2007), “Redemptionism, Rejectionism, and Historicism in Emerging Approaches in Disability Studies,” Perspectives in Religious Studies, 34: 91–100. Avalos, Hector, Sarah Melcher, and Jeremy Schipper (2007), “Introduction,” in Hector Avalos, Sarah Melcher, and Jeremy Schipper (eds.), This Abled Body: Rethinking Disabilities in Biblical Studies, 1–9, Atlanta: Society of Biblical Literature. Baggieri, Gaspare (ed.) (1996), L’antica anatomia nell’arte dei donaria, Rome: Ministero per i beni e le attività culturali. Baker, Patricia A. (2011), “Collyrium Stamps: An Indicator of Regional Medical Practices in Roman Gaul,” European Journal of Archaeology, 14 (1–2), 158–89. Baker, Patricia (2017), “Viewing Health: Asclepia in Their Natural Setting,” Religion in the Roman Empire 3: 143–63. Ballet, Pascale and Violaine Jeammet (2011), “Petite plastique, grands maux. Les ‘Grotesques’ en Méditerranée aux époques hellénistique et romaine,” in Lydie Bodiou, Véronique Mehl, and Myriam Soria (eds.), Corps outragés, corps ravagés de l’Antiquité au Moyen Âge, 39–82, Turnhout: Brepols. Barasch, Moshe (2001), Blindness: The History of a Mental Image in Western Thought, New York and London: Routledge. Barclay, Jenifer L. (2017), “Differently Abled: Africanisms, Disability, and Power in the Age of Transatlantic Slavery,” in Jennifer F. Byrnes and Jennifer L. Muller (eds.), Bioarchaeology of Impairment and Disability: Theoretical, Ethnohistorical, and Methodological Perspectives, 77–94, Cham: Springer. Baroin, Catherine (2011), “Le corps du prêtre romain dans le culte public : début d’une enquête,” in Lydie Bodiou, Véronique Mehl, and Myriam Soria (eds.), Corps outragés, corps ravagés de l’Antiquité au Moyen Âge 291–315, Turnhout: Brepols. Baroin, Catherine (2015), “La beauté du corps masculin dans le monde romain : état de la recherche récente et pistes de réflexion,” Dialogues d’histoire ancienne, 14: 31–51. Barton, Carlin A. (1993), The Sorrows of the Ancient Romans, The Gladiator and the Monster, Princeton: Princeton University Press. Bauman, H-Dirksen L. (2008), “On the Disconstruction of (Sign) Language in the Western Tradition: A Deaf Reading of Plato’s Cratylus,” in H-Dirksen L. Bauman (ed.), Open Your Eyes: Deaf Studies Talking, 127–45, Minneapolis and London: University of Minnesota Press. Bauman, H-Dirksen L. and Joseph J. Murray (2014), “Deaf Gain: An Introduction,” in H-Dirksen L. Bauman and Joseph J. Murray (eds.), Deaf Gain: Raising the Stakes for Human Diversity, xv–xliii, Minneapolis and London: University of Minnesota Press. Bayer, Timothy, John Coverdale, Elizabeth Chiang, Mark Bangs, et al. (1998), “The Role of Prior Pain Experience and Expectancy in Psychologically and Physically Induced Pain,” Pain, 74 (2–3): 327–31. Baynton, Douglas (1996), Forbidden Signs: American Culture and the Campaign against Sign Language, Chicago and London: University of Chicago Press. Beal, Richard H. (2017), “Disabilities from Head to Foot in Hittite Civilization,” in Christian Laes (ed.), Disability in Antiquity, 37–46, London and New York: Routledge. Belcastro, Maria Giovanna and Mariotti Valentina (2000), “Morphological and Biomechanical Analysis of a Skeleton from Roman Imperial Necropolis of Casalecchio di Reno (Bologna, Italy, II–III c. A.D.): A Possible Case of Crutch Use,” Collegium Antropologicum, 24: 529–39. Belser, Julia Watts and Lennart Lehmhaus (2017), “Disability in Rabbinic Judaism,” in Christian Laes (ed.), Disability in Antiquity, 434–51, London and New York: Routledge.

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INDEX

As a rule, Roman names have been listed according to the nomen gentilicium, with the exception of well known names as e.g. Celsus, Cicero, and Fronto or names of emperors. ableism 1 abuse 44–5 accidents 18, 75 adunatoi 3 Aelius Aristides 47, 60–3, 145 Aeschines 71 Aeschylus 91 Aetius 131 aging 19, 72, 81, 88, 130, 140 Alcibiades 105–6 Alexander of Tralles 137 Alexander Severus 125 alternative sexuality 143 Amida 151 Ammianus Marcellinus 97, 114 Ammonius 86 amulets 25, 144–5 anaphonesis 63 anatomical votives 31–2, 36–8, 93, 95–6 androgynes 21–2, 23, 26 Anthony, Saint 147 Anticrates of Knidos 81 anti-psychiatry model 138 anxiety 137 Apuleius 144 Aretaeus 52–3, 54, 55, 130, 137, 142, 146 Aristophanes 92 Aristotle 4, 10, 72, 89, 93, 94, 112–13, 123–4, 132 art, bodies depicted in 16–17 Artemidorus 146 Asclepiades 52, 53, 80 Asclepion of Athens 11 Asclepius 93, 145 atypical bodies 15–29 audism 98–9 auditory prostheses 94 Aufidius, Cnaeus 80 Augustine, Saint 23, 96, 97, 114, 120, 128, 129, 131

Augustus 23, 26, 72, 80, 120 Austin, Gilbert 98 baldness 142 Battus I of Cyrene 113, 159 n17, 161 n38 beggars 24, 79–80, 147 bereavement 139 Bes 118, 134–5 biblical texts 71–2, 77, 88, 90, 96, 113, 118, 122, 123, 146, 147, 163 n65 bioarchaeology 31, 32, 35, 38 birth (congenital) disorders 18, 19–20, 71–2, 78, 89, 90, 126, 127, 133 blindness 67–83 bloodletting 72, 73, 94, 142, 144 body atypical 15–29 composition 52, 141 shaping 17, 24 bone fractures 19, 40, 41, 45 brain -fever 142, 145 pain perception 49 Brigid of Kildare, Saint 77 Brosche, Sebastian 48–9 bubonic plague 150–1 Bulwer, John 98 burials 132 Caecilius Metellus 118 Caelius 142, 143, 147, 148 Caligula 149 cataract surgery 73 Celsus 28, 73, 87, 94, 114, 143 cerebral palsy 132 children androgynes 21 birth (congenital) disorders 18, 19–20, 71–2, 78, 89, 90, 126, 127, 133 body shaping 17, 24

188

exposure 19, 78, 133, 139 intentional mutilation 79–80 language acquisition research 109–10 mortality 139 visual disabled 78–9 Christianity 11–13, 55–6, 63–4, 70, 71–2, 88, 92, 96, 127, 148, 149–51 Cicero 5, 27–8, 67, 80, 82, 106–7 Claudius 101–2, 103, 110, 120 Claudius, Appius Caecus 80–1 cognitive disability 89–90 cold water experiment 55 collyrium stamps 72, 157 n7 Commodus 24, 26, 76 congenital (birth) defects 18, 19–20, 71–2, 78, 89, 90, 126, 127, 133 conjoined twins 20 Croesus, sons of 86–7, 88, 103–4, 105, 131, 159 n18 crutches 31 cultural pain codes 48, 50, 58 Daniel of Stylite 150 deafness 85–100, 131 deities 118, 125, 134–5 delusions 137, 142 dementia 130, 140 demonic possession 12, 133, 144–5, 147–8, 149, 150 Demosthenes 107–8 depression 140 Diagnostic and Statistical Manual of Mental Disorders (DSM) 137–8 differently abled 40, 43, 44, 155 n11 Dio Cassius 5 Dio Chrysostom 4–5 Diodorus Siculus 22 Diogenes Laertius 80 disability groups 96–7 disasters 126, 140 Domitian 23, 76 Down’s syndrome 134–5 drug treatments 72–3, 74 dwarfs 23, 24, 25, 26, 27 dyslexia 129–30 ear disease 93–4 ear wax 93 Echeclus 113 El-Jem mosaics 25 Elagabalus 23 entertainers 22–3, 125 epilepsy 130, 133

INDEX

Erculam 41–3 evil eye 24–5, 82–3 exorcism 12, 21, 147–8, 149 exposure 19, 78, 133, 139 eye diseases 71, 72–3 eye doctors 73–5 eye injuries 75–7 Fake Prophet 148 fever 53, 87, 94, 130 Firmicus Maternus 146, 147 folk medicine 145 fools 121–2, 123–4 fractures 19, 40, 41, 45 Fronto 58–60 Fulvius, Marcus Bambalio 106–7 Galba 27 Galen 18, 52, 53–4, 56, 87, 130, 142, 143, 144, 145 gating mechanism 49 Gaucher’s disease 40 Gellius 6, 7, 27, 113, 119 Gemellus 83 gestures 97–8, 113–14 Gilgamesh 120–1 grave goods 132 Gregory of Nazianzus (the Theologian) 63–4 grief 139 grotesques 130 guide dogs 81 Gundoin 79 Hadrian 26 hair 142 hallucinations 142 handicapped 1 Harpaste 124 head-based remedies 142 healing 11–13, 62, 70–1, 81, 113, 145, 150 hearing loss 86 Hegesistratus 118 height 23 see also dwarfs Heraclitus 89 heredity 72, 133 hermaphrodites 21–2, 23, 26 Herodotus 86, 88, 103–4, 109–10, 131 Hippocratic Corpus 52, 53, 87, 93–4, 133, 141 Homer 86 hospitals 74 humors 52, 141, 142 hunchbacks 25, 26, 27

INDEX

hydrocephalus 131 hysterical suffocation 143 infanticide 78 see also exposure Instruction of Amenemope 90 intellectual disability 117–36 intentional mutilation beggars 79–80 blinding as punishment 76–7, 82 of self 18–19, 77 interactional theory 34, 37, 39 Iqwaye tribe 48 Isidore of Seville 124 Jenkins, W. G. 98 Jerome 96 Jesus 12, 72, 88, 127 John Chrysostom 127, 147 John of Ephesus 150, 151 John Philoponus 90 jokes 82, 158 n12 Julius Obsequens 20, 21 Juvenal 82 Kahneman, Daniel 55 Kant, Immanuel 90 lallation 105, 160 n29, 161 n34 Laocoon 77 learning difficulties 117–36 legal rights 6–7, 26, 90–1, 133 L’Épée, Abbé de 99 lightning strikes 77 lillu 120–1 lisping 105–6, 160 n29 Livy 20, 21, 126 Lovell, Nancy 41–2, 43 Lucan 75 Lucretius 90 magnetic resonance imaging (MRI) scans 49 mania 141, 142 Marcus Aurelius 59 Masurius Sabinus 7 medical model 92–3, 95, 138 medication 72–3, 74 melancholia 141 Ménière’s disease 94 meningitis 130 mental health 135, 137–51 metaphor 58, 91–2, 96, 150 Midas 91 Midrash 96

189

military injuries 19, 28, 75, 81–2 miracles 11–13, 70–1, 81, 96 Mishnah 91, 97 mobility impairment 31–45 mocking disability 82, 105–6, 108–9, 127, 158 n12 Modestinus 5 monsters 10–11 Moro reflex 132 Mosely, Lorimer 49 muteness 85, 86, 87, 88, 94, 131 mutilation see intentional mutilation mydriasis 73 neurological disorders 132–3 nociceptors 49 Nonius Marcellus 87 normality/norms 16–18, 48, 98, 118 obesity 27 occupational injuries 18, 75 Odilia 78 Oedipus 81 old age 19, 72, 81, 88, 130 140 Ophioneus 71 oratory 62–3, 107 Oribasius 28 osteoarthritis 41, 154 n9 Other 21, 22 Ovid 111–12 pain 47–65 behavior 50 community of sufferers 56 cultural pain codes 48, 50, 58 definition 49–50 fear and death 54 meaning 49, 50 perception 49 paleopathology 38–41, 50 Paul of Aegina 17, 26, 28 Paulinus of Nola 150 Pedius 88, 131 perception, pain 49 Peregrinus 148 Philoctetes 56–8 Phineus 77 Phlegon of Tralles 22 phrenitis 142, 143, 147 physical abuse 44–5 Plato 3–4, 89, 97, 99, 113, 148 Plautus 82 Pliny the Elder 22, 23, 27, 83, 90, 111, 118, 145

190

Pliny the Younger 73, 107 Plutarch 15, 24, 25, 28, 82, 87, 106, 107–8 Pollux 4 polydactyly 4, 28 Pomponius Mela 111 post-traumatic stress disorder (PTSD) 140 Pott’s disease 18, 35 priests 117–18 Priscus of Panium 108–9 prodigia 19–20, 22, 23 proptosis 73 Psammetichus 110 Pseudo-Aristotle 130 Pseudo-Galen 17 Pseudo-Quintilian 82 psychological model 138 punishment blinding 76–7, 82 Quintilian 22 reading ability 129–30 Regulus 107 religious treatments 145 retrospective diagnosis 35 rickets 18 ridiculing disability 82, 105–6, 108–9, 127, 158 n12 Rufus of Ephesus 130 Sadalberga, Saint 78–9 saints 11–12, 78–9, 147 Scheuermann’s disease 154 n10 self-mutilation 18–19, 77 Seneca 19, 24, 101–2, 110, 124, 139 Sergius Silus 27, 118 Sertorius 81–2 sexuality, alternative 143 shame 28, 78, 126 sign language 94, 97–8, 113–14 slaves 6–7, 24, 33–4, 124–5, 133, 140 social construction 123, 138 social death 47, 136 social disorder 147, 151 social model 92–3 social stress model 138–9, 140 Socrates 3 Sophocles (Philoctetes) 56–8 Soranus of Ephesus 18, 133 speech impairment 101–15 spells 126–7, 144, 148 spinal degeneration 49 spit 145 stammering 107–8, 109, 112 statuary 16–17

INDEX

stature 23 see also dwarfs Stephanus 76 Strafwunder 57 stress 138–9, 140 stuttering 107–8, 109, 112 Suetonius 19, 23, 26, 72, 104–5, 120 Sulla 88 surgery 28, 73 talking therapy 63 Talmud 130, 133 Thecla, Saint 11–12 Theodore of Sykeon 147–8 Theophilus 142 Thucydides 18 Tiresias 77, 81 Titus Manlius Torquatus 126 torture 58, 143 traveling 80–1 treatments drugs 72–3, 74 ear disease 93–4 eye disease 72–3, 74 folk medicine 145 mental health problems 142–3 religious 145 surgery 28, 73 Trebatius 7 trepanation 144 Tylor, Edward B. 90 Tyrrhenus 75 uterus, wandering 143 Valerius, Lucius Catullys Messalinus 82 Valerius Maximus 113, 163 n64 Virgil 91 visual imagery 142 visual impairments 67–83 vitamin deficiency 18 Vitellius 104–5 voice training 63 war injuries 19, 28, 75, 81–2 womb wandering 143 women 63, 88, 140, 141, 143–4 work participation 79, 87–8, 125, 140 writing ability 129–30 Xenophon 97 Zercon 108–9 Zeus 77