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Psychotherapy In Egypt





Among the Egyptians the first great development of medicine came among
the priests. The two professions, the medical and priesthood, were
one, and the temples were the hospitals of the time. We have stories
of people traveling long distances to certain temples in the early
days of Egypt and also of Greece. Often the sick slept in the temples
and dreamed of ways by which they would be cured. The stories make one
feel that somehow the sleep which came over them was not entirely
natural and spontaneous, but must have been something like hypnotic
sleep. As for the dreams, the suggestions of modern time given in the
hypnotic condition seem to be the best indication that we have of what
happened in those old days. Certain it is that the persuasion of the
patient that he would get better, the influence of the diversion of
mind consequent upon his journey and the regulation of life under new
circumstances in the temple, with the repeated suggestions of the
priests and of their various remedial measures, as well as those due
to the fact that other patients around him were improving, all plainly
show the place of psychotherapy at this time.

Much of the old-time therapy was in association with dreams supposed
to have been in some way inspired. This was true at Epidaurus, at Kos,
at Rome, at Lebene, at Athens, and at every place we know of where
cures were worked in the olden times. To the modern mind it seems
impossible that dreams should come so apropos unless they were in some
way directed. The only explanation seems to be the use of suggestion,
with the probable production of sleep resembling our modern hypnotic
trance. Apparently the patient's attention was little directed to the
origin of the suggestions received, but he remembered and benefited by
them.

The most explicit testimony that we have to the antiquity of
psychotherapeutics and to the employment of the influence of the minds
of patients over their ailments in the olden time is in Pinel's
"Nosographie philosophique" and in his "Traite medico-philosophique
sur l'alienation mentale."

Pinel himself will be remembered as the great French psychiatrist who,
confident that he could control most of them by mental influence,
first dared to strike the chains from the insane in the asylums of
Paris, at the end of the eighteenth century, when for more than a
century they had been treated more barbarously than ever before in
history. The passage makes clear that the writer himself, over a
hundred years ago, was persuaded of the significance of the patient's
mental attitude and of the value of mental treatment for many nervous
and mental diseases:

An intimate acquaintance with human nature and with the character in
general of melancholics must always point out the urgent necessity of
forcibly agitating the system, of interrupting the chain of their
gloomy ideas, and of engaging their interest by powerful and
continuous impressions on their external senses. Wise regulations of
this nature are considered as having constituted in part the
celebrity and utility of the priesthood of ancient Egypt. Efforts of
industry and of art, scenes of magnificence and of grandeur, the
varied pleasures of sense, and

the imposing influences of a pompous and mysterious superstition, were
perhaps never devoted to a more laudable purpose. At both extremities
of ancient Egypt, a country which was at that time exceedingly
populous and flourishing, were temples dedicated to Saturn, whither
melancholics resorted in crowds in quest of relief. The priests,
taking advantage of their credulous confidence, ascribed to miraculous
powers the effects of natural means exclusively. Games and recreations
of all kinds were instituted in these temples. Beautiful paintings and
images were everywhere exposed to public view. The most enchanting
songs, and sounds the most melodious "took prisoner the captive
sense." Flowery gardens and groves, disposed with taste and art,
invited them to refreshment and salubrious exercise. Gaily decorated
boats sometimes transported them to breathe, amidst rural concerts,
the pure breezes of the Nile. Sometimes they were conveyed to its
verdant Isles, where, under the symbols of some guardian deity, new
and ingeniously contrived entertainments were prepared for their
reception. Every moment was devoted to some pleasurable occupation, or
rather a system of diversified amusements, enhanced and sanctioned by
superstition. An appropriate and scrupulously observed regimen,
repeated excursions to the holy places, preconcerted fetes at
different stages to excite and keep up their interest on the road,
with every other advantage of a similar nature that the experienced
priesthood could invent or command, were, in no small degree,
calculated to suspend the influence of pain, to calm the inquietudes
of a morbid mind, and to operate salutary changes in the various
functions of the system.



This gives some slight idea of the magnificent arrangement of this
famous health resort of the Greeks in which every possible care was
taken to influence the mind of the patient favorably and bring about
his cure. The buildings of the Hieron or medical institution of
Epidaurus were beautifully situated about six miles from the town of
Epidaurus in picturesque scenery and the most healthful
surroundings. There were a series of bathing houses for hydropathy.
The abatons, lofty and airy sleeping chambers with their southern
sides and open colonnade, are singularly like the open balconies of
our tuberculosis sanatoria. Every occupation of mind was provided.
There was a theatre that would seat over 10,000 people. Here the
great classic Greek plays were given with fullest effect. There was
a stadium seating about 12,000 people in which athletic events were
witnessed, finally there was a hippodrome for alt sorts of
amusements in which animals shared. Then there were the walks
through the country, sheltered paths around the grounds for
inclement weather, even tunnels for passage from one building to
another and all the influence of religion, of suggestion, of contact
with cultured priests thoroughly accustomed to dealing with all
manner of patients. No wonder the place was popular and many cures
effected.

A, South Propylaea; B, Gymnasium; C, Temple of Esculapius; DD, East
and West Abatons (temple enclosures); E, Pholos; F, Temple of
Artemis; G, Grove; H, Small Altar; I, Large Alter; J, South
Boundary; K, Square (building); L, Baths of Esculapius; M, Gymnasium
and Hostel; N, Four Quadrangles (for promenade and exercise); O,
Roman Building; P, Roman Bath; Q, Portico of Cotys; R, Northeastern
Colonnade; S, Northeastern Quadrangle; T, Temple of Aphrodite (?);
U, Northern Propylaea, on the Road to Epidaurus; V, Roman Building;
W, Northern Boundary; X, Stadium; Y, Goal or Starting Line; Z, Tunnel
between Temple and Stadium. (Caton.)




There are other phases of Egyptian medicine which serve to show us how
early many of the psychological ideas that we now are trying to adopt
and adapt in medicine had come to the thinkers in medicine of long
ago. There is, for instance, now in the Berlin museum an interesting
papyrus of the Middle Kingdom, the date of which is about 2500 B. C,
in which there are many modern ideas. It is a dialogue which attempts
the justification of suicide. The principal speaker, a man weary of
life, has made up his mind to suicide, but is hesitant. The others who
speak in the dialogue are his secondary personalities. The Egyptians
considered that there were several of these interior persons with whom
the man himself might have communication. A man could play draughts
with his ba somewhat as we play solitaire. He could talk to and
exchange gifts with his ka. He could argue and remain at variance,
but more often come to an agreement, with his khou. This last was
his luminous immortal ego, which, according to the then generally
received Egyptian conception, formed a complete and independent
personality. The whole scene thus outlined is typically modern in
certain phases of its psychology, and presents the only known
treatment for the tendency to suicide. While we have but this
instance, there seems no doubt that the same system of persuasion must
have been employed for the cure of other mental conditions than that
which predisposes to suicide.

What is described in our quotation from Pinel as the most ancient form
of psychotherapy has all down the centuries been the rule of life for
patients at institutions similar to those of Egypt. We know more of
Greece than of other countries; there the shrines of AEsculapius were
in many ways what we now call sanatoria. They were spacious buildings
pleasantly situated, the hours of rising and of rest were definitely
regulated, the patients' minds were occupied with the details of the
cure, they met pleasant companions from distant places, they had all
the advantages of diversion of mind, simple diet, long hours in the
open air and abundance of rest away from the ordinary worries of life.
Besides, there had usually been some weeks or months of
preparation during a lengthy journey and all the diversion of mind
which that implies. No wonder that these institutions acquired a
reputation for cures of symptoms which the physician had been unable
to accomplish while the patient was at home in the midst of his daily
cares and worries of life.

The temples in Egypt, in Assyria, in Greece, were much like the health
institutions--"cure houses," as the expressive German phrase calls
them--of our day. Pictures of the temple of AEsculapius at Epidaurus
show a magnificent building with beautiful grounds, ample bathing
facilities, and evidently many opportunities for a quiet, easy life
far from the worries and bustle of the world and with everything that
would suggest to the patient that he must get well. This phase of
psychotherapy in the olden time is not only interesting in itself, but
furnishes a valuable commentary on corresponding modern institutions,
since it shows that it is not so much the physical influences, which
have differed markedly at different periods, as the mental attitude so
constantly influenced at these institutions which was the real
therapeutic factor.

Now our sanatoria are nearly all founded on some special principle of
therapeutics. Some of them have dietetic fads and no food out of which
the life has been cooked is eaten. Some of them are absolutely
vegetarian. Some of them depend on wonderful springs in their
neighborhoods, others on certain forms of exercise, still others give
the rest cure. All succeed in relieving many symptoms. No one who has
analyzed the cures effected will think for a moment that it is the
special therapeutic fad of the institution that accomplishes all the
good done for patients suffering from so many different complaints.
Similar ills often are affected quite differently, and, while some are
relieved, others are not. Those who fail to be cured at one will,
however, often be relieved at another. It depends on how much
influence of mind is secured over the patient and how much diversion
from thoughts of self is provided.





Next: Mind Healing In Greece

Previous: First Physician



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