ARISTOTLE (384-322 B.C.)

Little is known of the life of this great physician other than the fact that he was bom in the small kingdom of Cappadocia in Asia Minor, and practiced medicine in Imperial Rome. We do know, however, that he was a penetrating and accurate observer of mental disorders and anticipated a number of the basic concepts of modem psychiatry.Aretaeus’ clinical accounts of mania and melancholia indicate that the disorder we now know as manic-depressive psychosis existed in essentially the same form in antiquity. His picture of the manic’s overconfident, hyperactive behavior, and the melancholic’s preoccupation with guilt feelings, self-sacrifice, and religious ideas would stand up well today. He recognized that there was a connection between these two states, and correctly observed that melancholia is not always followed by mania. He also noted that young people are more susceptible to mania and older people to melancholia, and that spontaneous recovery from these conditions is rarely lasting.Aretaeus gave accurate descriptions of a number of other clinical entities and apparently followed up his cases inorder to establish a prognosis for each type. He contributed to what would now be called differential diagnosis by presenting a clinical picture of agitated depression, senile disorders, and mental deterioration. He also distinguished between patients who were manic and melancholic and those who appeared “stupid, absent, and musing,” a condition we now recognize as one type of schizophrenic reaction.So far as we know, Aretaeus did not propose any new methods of treatment, but some of his ideas on etiology were distinctly in advance of his time. He apparently rejected the notion that mental illness is a sign of divine inspiration, and recognized both physical and psychological determinants. He attributed mania to hot, dry blood, and the “absent, musing condition” to refrigeration. Although these ideas are understandably crude, he adumbrated Galen’s concept of “consensus,” as well as the modern idea of the organism as a unitary system, by suggesting that a mental disease may originate in the abdomen and spread secondarily to the head.Aretaeus’ comments on the psychological factors underlying mental illness are even more impressive. He reported a severe case of melancholia in which the individual recovered fully after falling in love. He analyzed the ravings of manic patients and showed that they were not suddenly possessed of new, divinely inspired knowledge of poetry or geometry, but confined themselves to matters which they had already studied. And, more important, Aretaeus discovered that psychotic behavior of this kind is not a sudden metamorphosis but an extension of pre-existing tendencies-—for example, he observed that people who develop mania are “naturally irritable, violent, easily given to joy, of a facile spirit for pleasant and childish things.” Here was a clear and cogent anticipation of the modem concept of the premorbid personality.ARISTOTLE (384-322 B.C.). Aristotle, whose work De Anima is considered the first treatise on psychology, was born in Stagira, Greece. As the son of a physician he acquired an early interest in zoology and physiology. Between the ages of seventeen and thirty- seven he studied at the philosophical school of Plato, the Academy, and probably remained to teach rhetoric and scientific subjects. Although chosen as Plato’s successor, he refused this post and set up a small Platonic group on the island of Lesbos instead. From 343- 336 he served as tutor to Alexander the Great, and from 335-323 he headed the Peripatetic School in Athens. When Alexander suddenly died in 323, he fled under political pressure to Chalcis on the island of Euboea, where he died the following year.The scope of Aristotle’s work is so immense that we can only indicate the major areas in which he influenced psychological thinking. One of the most important is the fact that he conceived of the psyche as part of the natural rather than the supernatural world: “The soul’s study falls within the science of nature.” For this reason his De Anima, though a work on the soul, was included among his physical rather than his metaphysical writings. In contrast to Plato, who viewed the soul only in its relation to the “Good” and “ideas,” Aristotle considered it in some sense the “principle of animal life,” and claimed that matter and form— the physical and mental—are always found together. He even described form as the actualization of matter. More specifically, he believed that the soul or psyche is the activity or functioning of the body: “The soul is to the body as cutting is to the axe.” This concept was of great significance in later psychology, since it was based on an essential and functional relationship between mind and body.Aristotle studied many of the activities of the soul, including the senses,learning, memory, emotion, imagination, and reasoning. He believed that these processes occupy positions on a single scale of nature in which plants are characterized by nutritive functions, animals by sensitive functions, and man by rational functions. In keeping with his view that matter is potentiality and form actuality, he claimed that the qualities inherent in objects became actualized as sensations of color, taste, smell, etc. There is therefore an integral relationship between the object’s potential and the power of the sense organ. The sensory process itself was explained in somewhat mechanical terms, since he claimed that qualities are carried or communicated by the blood. Perception, too, was conceived as an activity of the soul carried out through the agency of the body. It consists in the communication of the form of the perceived object to the perceiving subject.In addition to the particular qualities conveyed by the individual sense organs, Aristotle also claimed that certain qualities—unity, number, size, shape, time, rest, motion—are perceived through a “common sense” in which images produced by the individual sense organs are united. The organ of the common sense is the heart, and the medium through which the “motions” of the sense organs reach it is “pneuma” or breath. If the motion of the sense organ continues beyond the actual perception, it is called memory. Beyond these functions, man, and man alone, possesses “nous” or reason which enables him to apprehend the highest truths. The connection between this activity and the animal soul, however, is not described.In the light of the history of thought, Aristotle’s account of the relation between body and soul has a double significance. First, he implied that the soul or psyche cannot be understood except by studying the physical functions, the body. And second, even though he did not actually perform experiments, his view that number, size, unity, etc., are “sensibles” made them at least theoretically amenable to experimental as well as physiological study. But it was not until the nineteenth century that men like Gustav Fechner and Ernst Weber actually engaged in this type of scientific research.