sehepunkte 26 (2026), Nr. 10

Christian Laes / Irina Metzler (eds.): 'Madness' in the Ancient World: Innate or Acquired?

The history of mental illness has been the subject of numerous publications in a variety of disciplines. By contrast, the history of intellectual disability linked to early neurodevelopmental disorders or other congenital impairments has attracted little attention from researchers. Recently, however, it has been the subject of monographs on the Modern Era (C. Goodey 2011) and the Early Middle Ages (I. Metzler 2016), as well as more localised studies. This renewed interest is underpinned in particular by the development of 'disability studies', which partly define the framework of the questions and methods through which the subject is approached. In line with this trend, a collectively edited volume with the ambiguous title, 'Madness' in the Ancient World: Innate or Acquired? (2023), aims to provide an initial comprehensive review of the sources and knowledge on the subject of intellectual disability in pre-modern societies. Alongside studies of the Eastern, Greek, Roman, Jewish and Christian ancient worlds, the volume includes explorations of the Western, Byzantine and Muslim medieval periods, complemented by a comparative perspective on ancient China, and enriched by a reflection on how observations of the present can inform the study of the past (E. Kellenberger).

The human remains of infirm or disabled bodies, studied through bioarchaeology, provide little information on congenital or early-onset disabilities linked to soft-tissue lesions or genetic configurations that do not result in skeletal changes. Under these circumstances, whilst hypotheses deserve to be tested, attributing evidence of surgical interventions or acts of brutality to the hypothesis of mentally disabled individuals (C. Bourbou) remains, by necessity, highly speculative. Iconographic sources are scarcely any easier to interpret. Ancient and medieval art may have reproduced the characteristic features of individuals with Down's syndrome to depict the Egyptian deity Bes (E. Kellenberger) or the grimacing figure of the fool in the altarpiece by the Master of Aachen (I. Metzler). But in both cases, the symbolic nature of these representations severely limits the documentary value of the works for the history of intellectual disability.

Similarly, literary fiction depicts characters and situations whose relation to reality is uncertain, posing major challenges to the historical analysis of mythological and religious literature - which by far constitutes the main body of work examined here, whether Hebrew, Christian, Talmudic or Muslim. In this literature, the figure of the 'fool' is omnipresent: it is found in the Old Testament (E. Kellenberger) and the New Testament (D. Kurek-Chomycz and E. Swai), and subsequently in Rabbinic literature (L. Lehmhaus), patristic literature (C. Laes), scholastic literature and Byzantine Christian literature (F. Vasileiou). In this context, the fool is a figure who is sometimes allegorical, and always moral, representing 'the inconvenient', whose real-life reference is difficult to pinpoint. Yet historiographical literature, populated by human figures whose existence is attested, is no less misleading, since, beyond its apparent factuality, it is shaped by literary models: whilst the attempt at a retrospective diagnosis of Korsakoff's syndrome in the Chinese Emperor Wenxuan (O. Milburn) may be appealing due to the narrative's alignment with the disease's very specific alcoholic aetiology, the attribution of the hybris of the Macedonian kings Philip II and Alexander to chronic traumatic encephalopathy (A. F. Morris), whilst based on 'clinical' arguments that merit consideration, must still be put to the test of a literary analysis of the texts recounting the tragic epic of these historical heroes. As for Christian literature, whilst it gives new visibility to the sick and disabled - the primary recipients of charity, miracles and a renewed anthropology - it must be acknowledged that intellectual disability largely falls outside the scope of this movement (F. Vasileiou).

Although more readily exploitable in theory, the medical and philosophical corpus proves disappointing. The former, because the Greco-Roman medical tradition, like its Muslim continuations (P. E. Pormann) and those in the medieval West (I. Metzler), took little interest in a category of disorders that discouraged any attempt at remediation (C. Laes notes the remarkable exception of Archigenes, to which one might add texts by Galen). Philosophy does occasionally address the subject - particularly religious philosophy, both Christian and Muslim (I. Metzler, F. Vasileiou) - and this fact is revealing: as a discipline concerned with the soul, philosophy examines intellectual disability as a psychological phenomenon.

Ultimately, it is the field of law that provides the most insight into the history of intellectual disability, both in Greece and Rome (C. Laes) and in the Byzantine (F. Vasileiou) and Western (I. Metzler) Middle Ages. As further indicated by the debates on the application of rabbinical (L. Lehmhaus) and Islamic (P. E. Pormann) prescriptions, in a pre-modern world with very limited techniques for compensating for disability, intellectual disability is first and foremost a social reality, affecting one's capacity to interact.

An examination of words and categories forms the starting point for many of the contributions. Whilst most authors emphasise the richness and apparent indeterminacy of the lexicon of mental disability (in the broadest sense) in ancient languages, a cross-cultural analysis of the terminology reveals instead that the dividing line between the concepts of 'psychological disorder' and 'mental disability' is quite clear in the cultures documented by various bodies of text. In reality, it is rather in the Middle Ages that these concepts are conflated under the term 'madman' in Western vernacular languages (Fol, Fool, Narr...), as well as in rabbinic Hebrew (shoteh, L. Lehmhaus) and in medieval Arabic (P. E. Pormann). However, the prevalence of polysemous terms does not prevent a clear distinction, in practice, between the 'loss' of reason and the original 'absence' of faculties (I. Metzler, 279-80). From this perspective, the môros, the fatuus, the natural fool or the 'mad' from birth constitute a coherent - and indeed novel - subject for historical study.

Across different cultures, a relatively coherent pattern emerges regarding the status of mental disability in 'pre-modern' societies. The silence of the sources is itself an indication that these lives unfolded primarily in the private sphere, whereas ancient sources, by their very nature, document public life. Thus, Arab hospitals, which specialised in caring for psychiatric patients, do not appear to have accommodated the mentally disabled (P. E. Pormann), and when the law breaks its silence to refer to the mentally disabled, it is most often to prescribe a guardianship or trusteeship confirming their status as 'eternal children ' (I. Metzler, 296).

Roman civil law (C. Laes), which continued in Byzantine law (F. Vasileiou) and was revived in the classical medieval West (I. Metzler), provided for them a regime of protection, legal incapacity and lack of criminal responsibility equivalent to that applicable to 'the mentally ill' under public, private and criminal law. The exceptional cases of the mentally impaired Chinese sovereigns Sima Zhong (reigned 290-307) and Andi (reigned 396-419), which gave rise to regencies (O. Milburn), confirm the relatively universal nature of the impediment posed by intellectual disability to the exercise of public office. Furthermore, judicial records from the Middle Ages confirm that it does indeed constitute a legal excuse for criminal liability, in the same way as 'insanity' (I. Metzler). Arab law confirms that illness and disability are subject to the same legal regime, by virtue of a shared inability to understand and to will - the root cause of this inability being irrelevant to legal reasoning, whether Roman or Arab (P. E. Pormann). When cross-referenced with literary accounts, the law also provides insight into the practice of 'court jesters', attested in the Roman Empire and the barbarian courts (C. Laes) before spreading to the Western kingdoms (I. Metzler).

In religious law, intellectual disability also constitutes an incapacity with multiple implications. Whether one examines Catholic (I. Metzler), Byzantine (F. Vasileiou), Rabbinic (L. Lehmhaus) or Muslim (P. E. Pormann; I. Metzler), we find, in turn, that intellectual disability prevents the exercise of the priesthood and any act of religious volition, whilst not preventing one from passively receiving graces that do not require an act of the will; that it exempts one from duties relating to piety; and that it constitutes an excuse for any religious offence. In line with civil law reasoning, these provisions also reflect a theological reflection on the spiritual nature of intellectual disability: the patristic thought of Augustine (C. Laes), the scholastic thought of Abelard, Albert the Great or Thomas Aquinas (C. Laes; I. Metzler), as well as the Christian thought of Michael Psellos (F. Vasileiou) and the Muslim thought of Ibn Khaldun (I. Metzler), all agree that it does not alter the very nature of the soul or its capacity for salvation.

Overall, this multidisciplinary and at times politically engaged exploration of intellectual disability in past cultures makes a valuable contribution to the conception of a subject that deserves to be fully defined and understood through established scientific methods.