the hero as madman

19
THE HERO AS MADMAN L. D. HANKOFF Episodes of malingering of mental illness are ascribed to five individuals in history before 500 B.C.-Odysseus, David, Solon, Kai Khosrau, and Brutus. The five ancient accounts follow a general pattern. All five heroes were early in their careers, before achieving anything like their ultimate renown, were confronted by life threatening situations? and malingered mental disorder to escape the death threat. Following the incident all five went on to extraor- dinary careers, in no way deterred by their past aberrant public behavior. The malingering of mental disorder stands as a nodal point in their careers presaging brilliant accomplishments and functioning as a self-renewal, perhaps symbolizing the hero’s rebirth. The malingering or feigning of illness dates back to antiquity as a subject of medical interest. Medical writings, however, are much predated by nonmedical descriptions of feigned and factitious illness. As one of the forms of ruses, malingering appears throughout world literature and folklore. Accounts of malingered illness are to be found in the Bible and other ancient writings.‘ It has even been surmised that the Assyrian king Esarhaddon (ruled 680-667 B.C.) malingered somatic complaints, based on his correspondence with his physicians.2 Ambroise Pare (1510-1590) wrote on “the cozenages and crafty tricks of beggars” exposing simu- lated and factitious surgical conditions as well as other malingered conditions such as “counterfeit falling sickne~s.”~ The medico-legal writings of the Roman physician Paolo Zacchias (1584-1659) provided a systematic and classic work on the subject. I n discussing feigned madness (simulata insania), Zacchias cited a number of cases from the ancient nonmedical literat~re.~ From the medical writings of antiquity only scant mention remains of ma- lingering and, to my knowledge, no mention at all of the malingering of mental illness. Not until the sixteenth century did the subject begin to be delineated by medical authorities. Johann Weyer (1515-1588) in his humane approach to witch- craft distinguished between the work of Satan, genuine mental illness, and ma- lingering when diagnosing aberrant behavi~r.~ ‘Jones, A. Bassett and Llewellyn, Llewellyn J. Malingering or the Simulation of Disease. Phila- delphia: Blakiston, 1918, pp. 4-8. Xinnier Wilson, J. V. An Introduction to Babylonian Psychiat,ry, in Festschrift to Professor B. Landsberger, Chicago: Chicago University Press 1965, p. 289-298. The remarkable correspondence between king Esarhaddon and his physicians in which Re dramatizes his symptoms, chiding them for their poor level of care, and they respond with reassurance and support can be found in Pfeiffer, Robert H. State Letters of Assyria, New Haven, Conn.: American Oriental Society, 1935, pp. 197-203. Ambroise, The Collected Works of Ambroise Pare, translated by Thomas Johnson, Pound Ridge, N. Y.: Milford House, 1968, pp. 992-995. ‘Zacchias, Paolo (Zacchie, Pauli), Quaestionum Media-Legalium. Lugdani (Lyons): Anisson and Joannis Posuel, 1701, Vol. I, Bk, 111, Tit. 11, Question V, p. 251. 6Weyer, Johann, De praestigiis daemonum, et Incantationibm ac Venefiiis, Cited in Veith, Ilza, Hysteria: The History of a Disease, Chicago: University of Chicago Press, 1965, p. 109. L. D. HANKOFF, M.D. is currentlp Professor of Psychiatry, New York Medical College, and Chairman of Psychiatry, Misericoria and Fordham Hospitals, Bronx, New York; Previously di- rected and developed programs in psychiatry at Queens Hospital Center, Brooklyn, New York City; Author of book Emergency Psychiatric Treatment: The Handbook of Secondary Prevention, as well as 66 publications in psychopharmacology,cnmmunity psychiatry, crisis internedon, history of psychiatry, suicide, and military psychiatry. 315

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Page 1: The hero as madman

THE HERO AS MADMAN L. D. HANKOFF

Episodes of malingering of mental illness are ascribed to five individuals in history before 500 B.C.-Odysseus, David, Solon, Kai Khosrau, and Brutus. The five ancient accounts follow a general pattern. All five heroes were early in their careers, before achieving anything like their ultimate renown, were confronted by life threatening situations? and malingered mental disorder to escape the death threat. Following the incident all five went on to extraor- dinary careers, in no way deterred by their past aberrant public behavior. The malingering of mental disorder stands as a nodal point in their careers presaging brilliant accomplishments and functioning as a self-renewal, perhaps symbolizing the hero’s rebirth.

The malingering or feigning of illness dates back to antiquity as a subject of medical interest. Medical writings, however, are much predated by nonmedical descriptions of feigned and factitious illness. As one of the forms of ruses, malingering appears throughout world literature and folklore. Accounts of malingered illness are to be found in the Bible and other ancient writings.‘ It has even been surmised that the Assyrian king Esarhaddon (ruled 680-667 B.C.) malingered somatic complaints, based on his correspondence with his physicians.2 Ambroise Pare (1510-1590) wrote on “the cozenages and crafty tricks of beggars” exposing simu- lated and factitious surgical conditions as well as other malingered conditions such as “counterfeit falling sickne~s.”~ The medico-legal writings of the Roman physician Paolo Zacchias (1584-1659) provided a systematic and classic work on the subject. In discussing feigned madness (simulata insania), Zacchias cited a number of cases from the ancient nonmedical l i t e ra t~re .~

From the medical writings of antiquity only scant mention remains of ma- lingering and, to my knowledge, no mention at all of the malingering of mental illness. Not until the sixteenth century did the subject begin to be delineated by medical authorities. Johann Weyer (1515-1588) in his humane approach to witch- craft distinguished between the work of Satan, genuine mental illness, and ma- lingering when diagnosing aberrant b e h a v i ~ r . ~

‘Jones, A. Bassett and Llewellyn, Llewellyn J. Malingering or the Simulation of Disease. Phila- delphia: Blakiston, 1918, pp. 4-8.

Xinnier Wilson, J. V. An Introduction to Babylonian Psychiat,ry, in Festschrift to Professor B. Landsberger, Chicago: Chicago University Press 1965, p. 289-298. The remarkable correspondence between king Esarhaddon and his physicians in which Re dramatizes his symptoms, chiding them for their poor level of care, and they respond with reassurance and support can be found in Pfeiffer, Robert H. State Letters of Assyria, New Haven, Conn.: American Oriental Society, 1935, pp. 197-203.

Ambroise, The Collected Works of Ambroise Pare, translated by Thomas Johnson, Pound Ridge, N. Y.: Milford House, 1968, pp. 992-995.

‘Zacchias, Paolo (Zacchie, Pauli), Quaestionum Media-Legalium. Lugdani (Lyons): Anisson and Joannis Posuel, 1701, Vol. I, Bk, 111, Tit. 11, Question V, p. 251.

6Weyer, Johann, De praestigiis daemonum, et Incantationibm ac Venefiiis, Cited in Veith, Ilza, Hysteria: The History of a Disease, Chicago: University of Chicago Press, 1965, p. 109.

L. D. HANKOFF, M.D. is currentlp Professor of Psychiatry, New York Medical College, and Chairman of Psychiatry, Misericoria and Fordham Hospitals, Bronx, New York; Previously di- rected and developed programs in psychiatry at Queens Hospital Center, Brooklyn, New York City; Author of book Emergency Psychiatric Treatment: The Handbook of Secondary Prevention, as well as 66 publications in psychopharmacology, cnmmunity psychiatry, crisis internedon, history of psychiatry, suicide, and military psychiatry.

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316 L. D. HANKOFF

This paper is a study of those accounts of malingering of mental illness of the most ancient origin, attributed to individuals or legendary figures before 500 B.C. The basis for this date will become clearer as the findings are presented and con- trasted with later alleged malingerers. The study has involved a review of litera- ture and history, inscriptions and artifacts related to episodes of malingering of mental illness in the ancient world. The primary data for the present study, it must be emphasized, are the reconstructed accounts, i.e., the work of the authors or reporters, and not the episodes themselves, and my inferences are limited accord- ingly. For this reason it will be necessary to weigh closely the sources, particularly the eras from which they are drawn.

In focusing on accounts of malingering I also hope to gain insights into the more general concept among the ancients of mental disorder. The writer who describes a convincing malingerer, I have reasoned, is reflecting a concept and description of mental illness of his own or the malingerer’s era. Furthermore, the account indicates the response to a public display of madness that might have been expected in that era.

THE ANCIENT ACCOUNTS The malingering accounts which follow are ascribed to five ancient figures,

the most ancient alleged to have feigned mental disorder, and are as far as I can determine all of the examples down to approximately the midpoint of the milienium before Christ. In effect, I have tried to sum up the most ancient writings on feigned mental disorder prior to 500 B.C. As will be seen, the characters were significant figures with established traditional dates and histories. The primary data, i.e., the descriptions of their malingered mental disorders, are drawn from varying sources and eras and it will be important in making comparisons to do as little violence as possible to the context of the accounts.

David and the King of Gath. The Biblical account of David’s feigning madness covers a few lines of the First Book of Samuel.6 David, fleeing the murderous rage of King Saul, goes to the Philistine King Achish of Gath. Reminding their king that David is a former enemy, Achish’s servants greet his arrival with the pro- verbial “Saul hath slain his thousands, and David his ten thousands.” In fear David disguises his character, makes himself appear insane, drums and writes on the gates, and drools onto his unattended beard. Achish reacts angrily and asks his servants why they have brought a madman before him. David flees to safety.

In addition to I Samuel, the Psalms make reference to the incident. Psalm 56 mentions David being taken or seized by the Philistines in Gath, suggesting he was a prisoner during the episode but maintained his trust in God despite his great fear.? In Psalm 34 there is mention of David’s deliberate change of demeanor or understanding (using the same Hebrew phrase found in I Samuel) and his being driven away by Abimelech.8 The name Abimelech has been explained as a generic

61 Samuel 21:ll-16. Wxdm 56:1, Ewald, Heinrich.

*Psalm 34:l.

The History of Israel. London: Longmans, Green, 1869-86, Vol. 111, p. 83.

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THE HERO AS MADMAN 317

or dynastic title of A ~ h i s h . ~ The remainder of the Psalm may relate to the incident in that it extols the power of God to deliver the righteous from their straits. The Midrashic literature relates Psalm 104 t o the incident, the reference being to the wisdom of God in creating all things, even madness which can serve God's pur- poses.1° Madness became the means of rescue just as the lowly spider saved David on another occasion.l'

When David flees Saul he stops at the Tabernacle maintained in the town of Nob to obtain food and weapons as well as to receive oracular insight.I2 The priest Ahimelech tells him he has only the sword of Goliath which David takes and thus conspicuously armed goes to the court of Achish in Gath, Goliath's home town. It has been suggested that it would be "an insane thing" inviting retaliation to carry the sword of Goliath into the midst of the Philistines and therefore this cannot be a factual account.13 On the other hand, it might be reasoned that the proverbial greeting by the servants of Achish was prompted by this very evidence of David's having slain their champion, Goliath.'4 The aroused Philistines thus become a danger leading to the malingering.

Later after a brief reconciliation with Saul, David again flees and comes to Achi~h.'~ This time, however, he achieves an alliance, presumably after adequate negotiations.'e Would not the past performance of David have prejudiced the possibility of Achish's acceptance of David as an ally? This has plausibly been explained by the fact that David was accompanied in the second encounter by 600 of his respected fighters and had gained a reputation as Saul's rival.'? It has also been suggested that the king of Gath in the latter flight may have been a suc- cessor to the first, both named Achish.'?

The antiquity of this account of malingering is well-established. Historically, David's involvement with Saul and his fleeing from Saul's jealous anger occurred not many years before Saul's suicide in battle around 1020 B.C.l8 The malingering episode in the mind of the author of I Samuel is attached to this critical phase of Jewish history. A good deal of textual criticism has been amassed by both Jewish and Christian scholars who agree on an authorship before the fall of the Northern kingdom (Samaria) in 722 B.C. for all of the Books of Samuel, with some portions based on contemporary sources.1g

OCohen, A. The Psalms (Soncino Books of the Bible), London: The Soncino Press, 1968, p. 99; Ginaberg, Louis, The Legends of the. Jews, PkiladelpFa: Jewish Pub. SOC. of America, 1913, Vol. IV, p. 89; Goldman, S., Samuel (Soncino Books of the Bible) London: The Soncino Press, 1967, p. 132.

'OPsalm 104:24; Braude, William G., tr. The Midrash on Psalms, New Haven: Yale University Press, 1959, Vol. I, pp. 408-410; Preuss, Julius, Biblisch-talmudisch Medizin, Berlin: Verlag von S Karger, 1923, p. 359.

"Ginaberg, op cit. (n. 9), Vol. IV, p. 90. 121 Samuel 22:lO; Goldman op. Cit. (n. 91, p. 130. 13Smith, Henry P. A Critical and Exegetical Commentary on the Books of Samuel (The International

Critical Commentary), Edinburgh: Clark, 1951, p. 201. '4Braude, op cil. (n. lo), Vol. 1, p. 409; Ewald, op cit., (n. 7), Vol. 111, p. 83; Yalkut ha-Makiri,

Jenlsalem: Shlomo Buber, 1900, p. 212 (Hebrew). 161 Samuel 27:2-3. '6Goldman, o p cit. (n. 9)' p. 163. l'Ewald, o p cit. (n. 7), VOl. 111, p. 84. 18Free&nan, David N. (Section A) and Campbell, Edward F., Jr. (Section B). The chronology

of Israel and the ancient Near East, in Wright, G. Ernest, ed., The Bible and the Ancient Near East. Garden City, N.Y.: Doubleday, 1965, pp. 265-299.

'Qoldman, op. cd., (n. 9), p. ix; Segal, N. H., The Pentateuch, Its Composition and its Authorship, and Other Biblical Studies, .Jerusalem: Magnes Press, 1967, p. 219; Smith, op cit., (n. 13), p. 405.

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318 L. D. HANKOFF

Odysseus and Palamedes. Odysseus, the legendary Greek hero who devised the Trojan horse, is described as having feigned madness in order to escape induction into the army that was being assembled to sail for Troy.2O When the messengers arrive, Odysseus, pretending to be mad, yokes a horse and ox to a plough, puts a cap or bandages on his head, and sows salt as he plows. Palamedes who had been sent to enlist him perceives the ruse and places Telemachus in the path of the team, saying “Lay aside your sham and join the league.’’ Odysseus stops the team and picks up the child and thereafter goes on to fulfill his military obligation with the Greek expedition. In a variation, Palamedes draws his sword threateningly on the infant Telemachus.21

The episode is very briefly stated in the remains of an 8th Century B.C. poem, the Cypria, which, as part of the Trojan Cycle of epic poetry, presented events occurring before the Iliad and Odyssey.22 The Cypria may have been written as their in t roduct i~n .~~ Neither of the latter describe the malingering24 but the Odyssey does mention the balkiness of Odysseus in joining the expedition, ;I month being required to win him Reference is also made of the prophesy known to Od- ysseus that the expedition would take him away from his bride and newborn son for 20 years.26 The Cypria also mentions the aftermath of the malingering when Odysseus obtains his revenge on Palamedes by causing him to be drowned or stoned.27

While of ancient origin the theme of Odysseus’ feigned madness seems to have become a popular one for many ancient writers.28 It was the subject of a tragedy, now lost, “The Mad Odysseus” by Sophocles (496-406 B.C.) .29 Euripides, Aeschylus, and Sophocles all have lost works entitled “Palamedes” which may have touched on the episode.30

Solon and the Megarian Campaign. Solon (c. 638-559 B.C.), the great Greek lawgiver, was a private citizen up to the time of the incident of bis feigned mad- ness.31 The background was an exhausting war between his native Athens and Megaris over the ownership of the island of Salamis. In weariness the Athenians

20Grant, Mary, The Myths of Hyginus, Lawrence, Kans.: Univenity of Kansas Press, 1960, Fab. XCV, p. 84; Kerenyi, C., The Heros of the Greeks, New York: Grove Press, 1960, p. 328; Rose, H. J., A Handbook of Greek Mythology, London: Methuen, 1933, p. 238.

21Rose, op. eit. (n. 20), p. 238. ezEvelyn-White, Hugh G., Hesoid, the Homeric Hymns and Homeram, (Loeb Classical Library)

London: Heinemann, 1964, p. 493; Lesky, Albin, A History of Greek Literature, London: Methuen, 1966, p. 81; Whibley, Leonard, ed., A Companion to Greek Studies, New York: Hafner, 1963, 4th Ed., p. 126.

3Vhadwick, H. Munro and Chadwick, N. Kershaw, The Growth of Literature, Cambridge: University Press; 1932-1940, Vol. 1, p. 535.

Z‘Kerenyi, op. cit. (n. 20), p. 328; Pearson, A.C., The Fragments of Sophocles, Cambridge: Uni- versity Press, 1917, Vol. 11, p. 115.

260dyssey 24.115; Kerenyi, op. cit. (n. 20), p. 328. 260dyssey 2.170. z’fEvelyn-White, op. cit. (n. 22), p. 505. 2*Rose, op. cit. (n. 20), p. 238; Scherer, Margaret R. The Legends of Troy in Art and Literalure,

BPearson, op. cit. (n. 24), p. 115. 34Touan, Francois, EuripicEe el Les Legendes Des Chanks Cypriens: Des origines de la gwrre de

Troie a l’Iliade, Paris: Societ,e d’Edition“Leu Belle Lettres,” 1966, p. 6; Scherer, op. cit. (n. 28), p. 142. ZlFreernan, Kathleen, The Work and Life of Solon, London: University of Wales Press; 1926,

p. 168.

London: Phaidon, 1963, p. 142.

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THE HERO AS MADMAN 319

withdrew from the contest and passed a law that gave the death penalty to anyone advocating the cause. Aware of the intense commitment by many as well as him- self, Solon had his family announce that he had become insane. Sometime after- ward he ran into the marketplace, like Odysseus with a cap on his head, and de- livered a 100 line elegy or martial hymn which he had composed and memorized.32 Under the guise of his feigned madness he was able to deliver this poem which advocated an expedition against the Megarians for Salamis. This performance, along with efforts by his confederates in the crowd, particularly Pisistratus, had the desired effect of arousing support for the cause, repeal of the law, and under- taking of the war in which Solon is said to have played a key role. He was elected an archon in 594 B.C.33

While the war with the Megarians and Solon’s greatness are established his- torical facts, the account of Solon’s malingering rests on shaky ground.34 Fragments remain of Solon’s verse which may be considered part of the marketplace recitation but give no proof of his malingering.36 There are no contemporary references to the episode, the earliest possibly being a scholiast on Homer noting that Aristotle (384-322 B.C.) referred to the Many later writers refer to the episode,37 Plutarch (45-120 A.D.) giving perhaps the most detail.38

Earlier histories make no mention of Solon’s malingering. For example, the great historian Herodotus (b. 485) who had a ready pen for curiosities as well as madness mentions Solon and his mental agility but makes no reference to his ma- lingering. Interestingly, Herodotus describes a later episode involving Pisistratus, the confederate of Solon in the market place, in which Pisistratus wounds himself and his mules, claiming to have been attacked by his enemies.39

From the available sources it seems likely that the account of Solon’s feigned madness was an accretion some few generations or centuries after his lifetime as the legend of his life was spun out.

Brutus and Tarquin. The malingering of Brutus was not of madness but of imbecility or stupidity. The king of Rome, Tarquinius Superbus, in extending his power and wealth put to death the older brother and father of his nephew Lucius Junius (Brutus). In order to escape the same fate, Lucius feigned imbecility and received the nickname Dullard (Brutus). He permitted his uncle to take his property and allayed any fears on the king’s part that he was capable of vigorous action. During the course of Brutus’ ruse Tarquinius sent Brutus with his own sons, Titus

32Edmonds, J.M. Elegg and Iambus, Cambridge, Mass.: Harvard University Press (Loeb Clas- sical Library), 1954, Vol. 1, p. 115.

aaWill, Frederic, Solon’s Consciousness of Himself, Transadions and Proceedings of the American

84Freeman, op . cit. (n. 31), p. 170. S5Edmonds, op. cit. (n. 32), pp. 104-155. ?Freeman, op. cil. (n. 31), p. 168. a7Migginbotham, John, tr., Cieero: On Moral Obligation, Berkeley and Los Angela: University

of California Press, 1967, p. 77; Diogenes Laertius, Lives of Eminent Philosophers. trans. by Et. D. Hicks. London: Heinemann (Loeb Classical Library), 1925, p. 49; Demosthenes. DeFalsa Legatione. trans. by C . A. Vince and J. H. Vince, New York: Putnam (Loeb Classical Library), 1926, p. 407.

**Plutarch, Licfes, tram. by B. Perrin, Cambridge, Mass. : Harvard University Press (Loeb Classical Library), 1948, Vol. I, pp. 421-3, 573.

3SHerodotus, The Histories, trans. by A. DeSelincourt, Edinburgh: Penguin, 1959, p. 34.

PhiloZogicuZ Association. Vol. LXXXIX, 1958 (Transaction XXVI), pp. 301-311.

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320 L. D. HANKOFF

and Aruns, to the Delphic oracle, Lucius going as a kind of butt for the others.40 A t the oracle they heard the prediction that the first one to kiss his mother would become king. As they left, the two sons were anxious to seek out their mother, but Brutus pretended to trip and let his lips touch the earth, giving a symbolic meaning to the oracular statement and fulfilling it thusly. After the rape and suicide of Lucretia, Brutus dropped his mask of stupidity and led a rebellion against Tarquin.

Dionysius of Halicarnassus (c. 54-c. 7 B.C.) in his history of Rome gives con- siderable detail from the life of Brutus and has him delivering a fine oration to the patricians when he rouses them to rebelli~n.~‘ I n the speech Brutus explains that he contrived the appearance of a fool to save his life, maintaining the disguise for 25 years until he was at last ready and able to reveal himself. Following the over- throw of Tarquin, Brutus became one of the first consuls of Rome in 509 B.C.

While there is no question that a Brutus who was a first consul lived, there is much question about the specific details of his heroic career. Many early Latin writers have some reference to Brutus,42 perhaps the earliest reference to Brutus’ feigned stupidity being by Postumius Albinus, consul in 151 B.C., which is cited in The Saturnalia of Macrobius Ambro~ius .~~ Modern scholarship suggests that most of the legendary features of the life of Brutus were elaborated by his putative descendents in the late fourth century B.C.44 and we may only surmise that the malingering anecdote took form at that time.

Kai-Khosrau and Afrasiyab. Kai-Khosrau (Key Khosrow, Kae-Khusru, Kai-Khoshro) is one of the great legendary kings of the national mythology of Iran. Kai-Khosrau is identified with the epic past of Iran in the royal Kayanian (Rayanid, Kavayan) dynasty which eventually ushered in Zoroastriani~rn.~~ The account of Kai-Khosrau’s malingered mental derangement is given in the Shanamah (Epic of Kings) of Ferdowsi (c. 932-c. 1005).46 Kai-Khosrau was the son of Siyavosh, the Kayanian heir, and Ferangis, daughter of Afrasiyab, ruler of the rival Turanians. Afrasiyab ordered the newborn Kai-Khosrau killed because

PoLivy, trans, by B. 0. Foster (Loeb Classical Library). Cambridge, Mass. : Harvard University Press (Loeb Classical Library), 1957, Vol. I, p. 195.

41Dionysius of Halicarnassus, The Roman Antiquities, trans. by E. Cary. Cambridge, Mass. : Harvard University Press (Loeb Classical Library), 1950, Vol. 11, p. 505.

42In addition to Livy (n. 40) and Dionysius of Halicarnassus (n. 41) mention of Brutus’ feigned stupidity is to be found in Dio (Cassius Dio Cocceianus), Roman History, trans. by E. Cay, Cam- bridge, Mass.: Harvard University Press (Loeb Classical Library), 1961, Vol 1, p. 79; Diodorus of Sicily (Diodorus Siculus), trans. by G. H. Oldfather, London : Heinemann (Loeb Classical Library), 1933, Vol. IV, p. 91; Cicero, Brutus and Orator, trans. by G. L. Hendrickson and €1. M. Hubbell, Cambridge, Mass.: Harvard University Press (Loeb Classical Library), 1962, p. 53; Ovid, Fmti trans by J. G. Frazer, Cambridge, Mass. : Harvard University Press (Loeb Classical Library), 1959,

‘3Macrobius, The Saturmlia, trans. by P. V. Davies, New York: Columbia University Press, 1969, p. 252.

440gilvie, R. M., A Commentary on Livy: Books 1-6, Oxford: Clarendon Press, 1965, p. 216; Walsh, P. G., Livy: His Historical Aims and Methods. Cambridge: University Press, 1961, p. 277.

46B0de, Dastur Framroze Ardmhir and Nanavuthy, Piloo, Songs of Zarathushtra: The Guthrm, London: George Allen and Unwin Ltd., 1952, pp. 61, 85; Carnoy, A. J., Iranian Mythology, In The Mythology of All Races, Boston: Marshal Jones, 1917, Vol. VI, .p. 336; The Encyclopaedia of Islam, Leyden: Brill, 1927, Vol. 11, pp. 636-8; West, E. W., Pahlavz Texts, Part 11, The Dadistan-i Dini and the Epistles of Manuskihar (Muller, F. Max, ed., The Sacred Books of the East, Vol. XVIII). Delhi: Motilal Banarsidasa, 1965, p. 258; Part V. Marvels of Zoroastriaizism (Muller, Vol. XLVII), p. xxviii.

dBFerdowsi, The Epic of Kings, trand. by R. Levy, Chicago: University of Chicago Press, 1967,

p. 109.

pp. 100-102.

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THE HERO AS MADMAN 321

of a prophesy that evil would come from the offspring. He is allowed, however, to be raised by shepherds. When summoned later to Afrasiyab, Kai-Khosrau is carefully tutored by an ally to appear insane. In the presence of his suspicious grandfather Kai-Khosrau replies to questions in an irrelevant, incoherent manner with marked loosening of associations. Ferdowsi, writing perhaps two millennia after the legend's origins, gives a remarkable verbatim question and answer inter- view4' worthy of a Kraepelin or Bleuler to demonstrate the brilliance of Kai-Khos- rau's sham of madness. The ruse works and the boy is sent from the royal court unharmed to grow up and eventually become the greatest of the Kayanian dynasty.

The Kai-Khosrau of Ferdowsi is clearly his modern Persian presentation of the Kayanian hero who appears in the Pahlavi literature of the Sasanian period, 226-652 A D . , in turn traceable to the A v e ~ t a ~ ~ (under the names of Husravah, Haosravah, Husravangh, etc.) .49 Utilizing the traditional points in the life of Zoroaster and this chronology the accession of Kai-Khosrau may be fixed a t 840 B.C.50 While the connection between Ferdowsi's hero and the Avestan one is ~ell-established,~~ the specific incident of malingering is not to be found in the precursor literature. Some of the Kayanian heroes of the Avestan literature are found to have their counterparts on the Vedic literature51 and Hindu myth0logy5~ as well as the later Mithraic mythology.53 Husravah of the Avesta is thought to correspond to a Vedic character Susravas or S u ~ r a v a s . ~ ~ Again, however, no anec- dote of feigned madness can be found in reference to these counterparts to my knowl- edge.

The portrayal of Kai-Khosrau by Ferdowsi is that of a fabulous hero con- sistent with the Avestan and Pahlavi glimpses of him. Ferdowsi, however, presents a complete tapestry of legend and poetic description with many details not found in the extant precursor literature. It is reasonable to assume that the feigned madness episode of the Shahnamah was based on an earlier source available to Ferdowsi now lost. It would seem unlikely that Ferdowsi would have synthesized this entire episode without some traditional base. There is, however, no proof of a more ancient account than the 10th century version of Ferdowsi.

Sources. The five characters portrayed as feigning madness fall historically between the siege of Troy (traditionally, 1192-1183 B.C.) and the expulsion of the Tarquins from Rome, 509 B.C. The earliest extant mention of each episode

p71bid, pp. 101-2. 48Carnoy, op. cit. (n. 45), p. 337; Encyclopaedia, op. tit. (n. 45), Vol. 11, p. 635; Sanjana, Peshotun

Dustoor Behramjee, The Dinkard, Bombay: Duftur Ashkara Press, 1874-1917, Vol. X, p. VII,

4gBartholomae, Christian, Altiranishes Worterbuch, Strassburg : Trubner, 1904, col. 1738 ; Encyclo-

60West, op. cit. (n. 45), Part, V, p. xxviii. 61Carnoy, op . cit. (n. 45), p. 336; Keith, Arthur Berriedale, The Religion and Philosophy of the

Veda and Upanishads, Cambridge, Mass. : Harvard University Press (Harvard Oriental Series), 1925, Vol. 31, p. 227.

VOl. XIII, p. XIV.

paediu, op . cit. (n. 45), vol. 11, p. 638.

62Carnoy, op. cQ. (n. 45), p. 337. 63Campbel1, Leroy A., MilhraiC Iconography a d I h l o g y , Leyden: Brill, 1968, pp. 113-115,

"Carney, op. cit. (n. 45), p. 337; Macdonell, A. A., Vedic Mythology (Grundiss der Indo-Arischen Phiologie und Altertum skunde I11 Band, I Heft A), Strmsburg: Trubner, 1897, p. 64; Macdonell, Arthur A. and Keith, Arthur Berriedale, Vedic Index of Names and Subjects, Delhi: Motilal Banarsi- dam, 1967, Vol. IT, p. 460.

119-120, 220.

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covers a much wider chronological period. The Book of Samuel for David and the Cypria for Odysseus are the most ancient. Solon and Brutus may have had their alleged episodes recorded one or two centuries after they lived. The most un- fortunate gap in the sources is in relation to Kai-Khosrau. A pre-Zoroaster epic hero, Kai-Khosrau figures prominently in the Avestan and Pahlavi literature, but the malingering account is not to be found, to my knowledge, before the 10th century work of Ferdowsi.

It is not surprising that the literature of antiquity has given us no eyewitness account of feigned madness. However, the considerable time gap between the ascribed era of the hero and the first records of his ruse is more than enough for the work of legend building.55 As Eliade has put it, “the historical character of the persons celebrated in epic poetry is not in question. But their historicity does not long resist the corrosive action of mythicization. . . the recollection of a historical event or a real personage survives in popular memory for two or three centuries a t the utmost.”66

Despite the diversity of sources, I believe some generalizations on the entire series are possible without doing violence to the context of the separate episode. The earliest literary accounts of the feigned madness appear to have been serious in their intent and written as reflecting historical events for a general readership. The accounts were not written by or for mental health specialists, i.e., physicians, priest-healers, or philosophers, but rather seem to be entirely within the layman’s province.

The antiquity of the topic of feigned madness is of interest since it appears as ancient as the topic of insanity. The Bible, for example, mentions madness in the oldest books, the Pentateuch (Deut. 28:28; Leviticus 26:36) but the first case history of frank mental aberration is contemporaneous with David, that of S a ~ l . 6 ~ Sophocles who wrote the play of Odysseus’ malingering also wrote a play por- traying the madness of Ajax, both plays being based on the Trojan Cycle of poetry.58 The school of Hippocrates (460-357 B.C.) which gave the earliest systematic descrip- tions of mental derangement59 dates much after feigned madness had appeared in legend and myth.

The dearth of ancient medical literature on malingering contrasts with the lively interest shown by some ancient nonmedical writers. Plutarch in particular discusses malingering in a t least seven different places in his works, giving accounts of feigned mental illness by Solon and Meton, the self-injuries of Pisistratus and Sosis, and the feigned poor eyesight of the flatterers of Dionysius of Syracuse.60

55Eliade, Mircea, Cosmos and History: The Myth of the Eternal Return, New York: Harper and Row, 1959, p. 42; Ogilvie, op. cit. (n. 44), p. 216; Chadwick and Chadwick, op. cit. (n. 23), Vol. 111, p. 761-2. In relation to the story of David, Chadwick and Chadwick estimate it may have been committed to writing within two centuries of his life, Vol. 111, p. 755.

GeEliade, Cosmos, op. cit. (n. 55), p. 42. Waul’s madness is described in I Samuel 16:14, 18:10, 20:9, 24. G*Jouan, op. cit. (n. 30), p. 6 ; Scherer, op. eii. (n. 2811, p. 220. @O’Brien-Moore, Ainsworth. Madness in Ancient Literature, Weimar : R. Wagner Sohn, 1924,

p. 20; Hippocrates, trans. by W. H. S. Jones, Cambridge, Mass.: Harvard University Press, (Loeb Classical Library), 1972, Vol. I, p. lix-lx.

6oPlutarch, op. cit. (n. 38), Vol. I, pp. 421-423, 489-491, 573, Vol. 111, p. 257, Vol. IV, pp. 45-47, Vol. VI, pp. 73-75 ; Moralin, trans. by Frank Cole Babbltt, London: Heinemann (Loeb Classical Library), 1927, Vol. I, p. 289.

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Plutarch seems to have undertaken the compilation of malingering syndromes long before the subject was defined and classified in medical terms.

AN ANCIENT VIEW OF MENTAL DISORDER The Heroes. The five individuals described are the only ones in the ancient

world before 500 B.C. to whom feigned mental disorder is ascribed. All are extraor- dinarily distinguished men in their own eras. David and Kai-Khosrau were the outstanding kings of their dynasties. Odysseus, also a king, was the key figure in a war which was a turning point in Greek history.61 Solon and Brutus each were “firsts,” the Law Giver and Pro-Consul, respectively.

A number of interesting similarities exist between David and Kai-Khosrau.62 Both were shepherds and encountered lions in their youth, united their nations during lengthy reigns,63 advanced their religions, and are connected with messianic traditions. The parallelisms between Old Testament and Avestan writings are well known64 and an influence of Judaism on the later Zoroastrianism has been theorized. Do the similarities in the two careers represent shared or borrowed legendary roles occupied by David and Kai-Khosrau of which feigned madness is an integral part?

Similarities also exist between the accounts of Brutus and Kai-Khosrau. Both are of the royal family and potential ascendants to power based on their lineage. The tyrant in both cases was related to them through the maternal line. King Tarquinius was the brother of Tarquinia, mother of B r u t ~ s . ~ ~ Afrasiyab was the father of Ferangis, the mother of Kai-Khosrau.66 In both cases the tyrants had killed the fathers of the two her0es.6~ Both heroes were in danger of being killed by the tyrant while still in their youth. The ruling power seeking to destroy them is put off by the ruse. Both heroes go on to revenge themselves. Kai-Khosrau kills AfrasiyabG’ and Brutus engineers the revolt which overthrows Targuinius. 68

Finally, both become great national heroes. In terms of the malingering, both featured dullness and simplicity meant t o impress the viewer with their harmless- ness. Furthermore, both maintained their retreat for many years. They contrast with the other examples of feigned mental illness in which there was some quality of agitation, floridness, or even theatricality and in which the duration was short- lived centering around a fairly circumscribed situation.

GIAllen, Thomas W, !f‘h Homeric Catalogue of Ships, Oxford: Clarendon Press, 1921, pp. 117, 178; Graves, Robert, The Greek Myths, New York: Braziller, 1957, Vol. 11, p. 302; Lesky, op . cif. (n. 22), p. 41 ; Owgan, Henry, Miscellanea Homerica, Dublin: William Curry, 1850, p. 125; Simpson, R. Hope and Lazenby, J. F., The Catalogue of the ships in Homer’s “Illiad,” Oxford: Clarendon Press, 1970, p. 169; Vico, Giambattista, The New Bnence, trans. by T. G. Bergin and M. H. Fisch, Garden City, N.Y.: Doubleday, 1961, p. 153.

82Ewald, op . czt. (n. 7), Vol. 111, p. 83. 63David reigned 40 years according to I1 Samuel 5:4, I Kings 2:11, I Chronicles 29:27; Kai-

Khosrau, 60 years, West, op. cit. (n. 45), Part I, p. 150, Part 111. p. 15, Part V, p. xuviii. Warmesteter, J., The Zencl-Avesla: Part I , The Vendidad, Delhi: Motilal Banamidass, 1969,

p. lviii; Jastrow, Morris, Aspects of Religious Belief and Practice in Babylonia and Assyria, New York: Putnam, 1911, p. 60.

65Livy, op. cit. (n. 40), Vol. I, p. 195. “Darmesteter, J. ,The ZencdAvesta: Part 11, The Sirozans, Yasts, and Nyayzk, Oxford: Clarendon

67Sanjana, op. cit. (n. 48), Vol. 111, p. 138, Vol. XIII, p. 16, Vol. XIV, p. 94; West, op. eit. (n. 45),

68Dionysius of Halicarnassus, op. cd. (n. 41), Vol. 11, pp. 487, 505, Vol. 111, p. 3; Livy, op . cit.

Press, 1883, p. 64; Ferdowsi, op . cit. (n. 46), p. 99.

Part 111, p. 64.

(n. 40), Vol. 1, p. 207; Ovid, op. cit. (n. 42), p. 119.

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The maternal lineage of Brutus and Kai-Khosrau in relation to the kings who threatened them may be of considerable importance. There is much evidence that a maternal line of succession to the throne prevailed in many ancient kingships.69 Brutus’ father, older brother, and himself in that order were heirs to the throne of Tarquin. In executing the first two, Tarquin set in motion his plan to shift suc- cession to the male line and pass the throne on to one of his sons.7o The overthrow of Tarquin led to the installation of Brutus and a co-consul, both of whom were of royal blood, and a continuation of a hereditary monarchy but in much modified form.71 It has been shown that the patricians in overthrowing the Tarquins es- tablished their own form of annual kingship.72 The role of Brutus as a king of Rome is of significance in the present context of the malingering episode because of the religious nature of the Roman kingship. Fraxer has demonstrated “that the old Roman kingship was essentially a religious and as will be shown below there is an important connection between mental disorder and a religious office. Afrasi- yab in wanting t o destroy Kai-Khosrau was guilty of the same impulse as Tarquin in threatening the female line of succession to the throne.

By modern standards, perhaps, the picture of an outstanding national hero resorting to feigned madness is incongruous and ludicrous. The ancient hero is cast in a demeaning, even laughable disguise and furthermore uses deceit to achieve his ends. While our modern sense of fair play or propriety might be offended, Huszinga has shown that “archaic culture” completely accepted such cunning.74 The use of a ruse or trickery to triumph over one’s enemies was a common feature of ancient myth and fable. Both David and Odysseus repeatedly use guile in their careers to achieve their ends. The beggar disguise of Odysseus is the key to his eventual triumph over Penelope’s lovers. The Bible presents an almost continuous series of ruses and deceptions: Jacob as Esau, Joseph as a vizier to the Pharoah deceiving his brothers, Abraham passing Sarah off as his sister, Tamar as a prostitute, etc.

I n feigning madness the hero is meeting his challenge with stratagem. The disguise he uses, moreover, is of his true ability and personality, and not his identity. In resorting to this disguise, the hero accomplishes a major change in the nature of the contest or challenge facing him. The hero in all of these situations is faced with a physical force or governmental structure which he cannot defeat. In feigning mental disorder, the hero has changed the contest from one of power to one of wit. In the arena of wit our wily hero is a t his best. As Huszinga puts it, “the act of fraudulently outwitting somebody else has itself become a subject for competi- tion.”74

In the present series the only failure of the ruse occurs when Odysseus is challenged by the sagacious Palamedes. Palamedes, the man who outwits him, was

GOFraser, James G., The Golden Bough, Part I, The Magic Art and the Evolution of Kings. New York: Macmillan, 1951, Vol. 11, pp. 266-323.

TOIbid., Vol. 11, p. 291. 71Livy, op . cit. (n. 40), Vol. I, p. 209; Frazer, op. cit. (n. 69), Vol. 11, p. 290; Vico, op. cit. (n. 61),

72Frazer, op. cit. (n. 69), Vol. 11, p. 290;Vico, op. cd. (n. 61), p. 201. 73Frazer, op. cit. (n. 69), Vol. 11, p. 289. 74Huizinga, Johan, Homo Ludens: A Study of the Play Element in Culture. Boston: Beacon Press,

p. 12.

1964, p. 52.

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also known for his intellectual accomplishments. It falls to Palamedes to outwit the disguised Odysseus; and his means is through the testing of the malingerer’s emotional functioning in the face of his obviously disordered cognitive functioning. Palamedes goes to the heart of most intense emotional attachment, the newborn first son of the raving Odysseus. Unmasked, Odysseus goes to war and fights well but the blow to his most treasured personal quality is not forgotten and he sub- sequently takes murderous revenge.

Some light on the meaning of the disguise of feigned madness may be shed by considering the choice of disguises used by ancient heros. For example, during the assembling of the Greek forces bound for Troy, another hero in addition to Odys- seus attempts to escape enlistment. Achilles goes away to live with a group of young women dressed as one of them.76 Odysseus, among the Greeks most noted as one who lived by his wits, i.e., used intellectual approaches for emotional or physical challenge^,?^ chose madness to disguise his most notable asset. Achilles noted for his physical prowess in battle7’ is disguised as a young woman, thus negating his outstanding qualities. His disguise is also uncovered and by Odysseus who disguised as a merchant observes one of the girls attracted to a sword among his wares.

Can the ancient malingerer of mental disorder be viewed in terms of contemporary psychopathological formulations? Since modern formula- tions are derived from clinical case studies and our primary data is ancient non- medical literature, any inferences must be made with the greatest caution. Sigerist has cautioned us on the use of nonmedical writings as sources for the descriptions of diseases and treatments, particularly when the literature is mythology or legend.78 In the present series, the accounts of Odysseus and Kai-Khosrau most clearly fall into the category of legend.

There are a few features common to the series of malingerers as a whole which suggest some tentative inferences relative to modern psychiatry. One such feature is the portrayal of the madman by the malingerer as a person heedless of danger and lacking in appropriate social responses. David and Kai-Khosrau show no awe for the royal courts in which they babble. Solon defies capital punishment to recite a poem in the agora. As noted above, Odysseus is unmasked when his heedless- ness for the safety of his newborn son is tested by Palamedes. Brutus, in less dra- matic circumstances, demonstrates his misjudgment of authority when he accom- panies Tarquin’s sons to the Delphic oracle carrying a stick as his inelegant offering to the His inappropriate offering earned him the further derision of Titus and Aruns but proved to be simply an extension of his own disguise since the stick contained in it a rod of gold.

The disregard for danger and external authority of our pre-500 B.C. malingerers suggests the perceptual defect of acute organic brain syndrome. Organic delirium,

Psychopathology.

76Grant, op. cit. (n. 20), Fab. XCVI, p. 85; Statius, trans. by J. H. Modey, Cambridge, Mass.:

'Vice, op. cit. (n. 61), pp, 256-257. 771bid., p. 256. 7sSigerist Henry E., A History of Medicine, Vol. II: Early Greek, Hindu, and Persian Medicine,

New York: &ford University Press, 1961, p. 19. 7gLivy, op. c i f . (n. 40), Vol. I, pp. 195-196.

Harvard University Press (Loeb Classical Library), 1957, Vol. 11, pp. 200, 573, 575.

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the phrenitis of the Hippocratic and post-Hippocratic writers,s0 was perhaps the most clearly defined mental syndrome of the ancients. It would be natural for the lay writers describing malingering at some distance to use the most well-rec- ognized form of mental disturbance as a model for their descriptions.

Our contemporary studies of malingered mental illness have stressed under- lying or associated psychopathology. Genuine and simulated mental illness may be impossible to distinguish and may often coexist.81 The pure malingering of mental disorder is extremely rare and its detection most difficult.82 The malingerer of mental disorder may be defending himself against psychotic breakdown by actively sim- ulating a disorder.83 The claim of malingering may be made by a recovered patient in order to remove the onus of mental illness.83 Such a maneuver may very well apply to one or another of our ancient heroes where he or his biographers were desirous of tidying up past history.

Which of our heroes might have been falsely portrayed as malingering after having suffered a genuine mental disorder? The presence of accomplices in the cases of Solon and Kai-Khosrau argues against this in their cases. In the case of Odysseus, the exposing of his disguise indicates that true malingering was intended by the writers. The responsiveness of Odysseus to the danger to Telemachus does not completely rule out genuine mental disorder since we know that even the acutely disturbed patient often retains some responsiveness to social cues and intense emotional influences.

In the cases of David and Brutus we have only the word of the heroes that they were malingering. Might they have suffered real disorders and upon recovery offered as explanations that they had resorted to disguises? The possibility of a reactive disorder, psychotic or neurotic in nature, appears very unlikely in the case of Brutus in view of the long duration and imbecilic quality of his facade. David, on the other hand, presented the picture of an acute, apparently transitory disorder with some agitation. Ganser’s Syndrome, the rare hysterical dissociative reaction seen in prisoners, is characterized by nonsensical replies and behavior which may have been features of David’s description. David was, in effect, a prisoner of the Philistines and had been under considerable stress as a fugitive. Might David as a prisoner of the Philistines been given a description of a prison psychosis by the author of I Samuel? David lacked the premorbid hysterical personality features associated with Ganser’s Syndrome; but, more importantly, a case has never been reported in a person of superior intelligence.% Ganser’s

SOHippocrates, op. cit. (n. 59), Vol. I, pp. lvii, lix-lx, 165, 245-7, 265, Vol. 11, p. 15, 67, Vol. IV, p. 195; Hankoff, L.D., Ancient Descriptions of Organic Brain Syndrome: The “Kordiakos” of the Talmud, h e r . J. Psychiatry, 1972, 129, 233-236; Jackson, Stanley W., Galen-On Mental Disorders, Journal of the History of the Behavioral Sciences, 1969, 6, 365-384; O’Brien-Moore, op. cit. (n. 68), p. 20.

81Davidson, Henry A., Forensic Psychiatry, New York: Ronald PrRss, 1965, 2nd ed, p. 214; Eissler, E. R., Malingering, in G. B. Wilbur and W. Muensterberger, eds., Psychoanalysis a d CuG ture, New York: Wiley, 1967, pp. 218-253; Jones, op. cit. (n. l), pp. 20-24; Freedman, Alfred M. and Kaplan, Harold I., eds. Comprehensive Textbook of Psychiatry, Baltimore: Williams and Williams, 1967, pp. 758, 1121; Myerson, Abraham, Malingering, in Harry C. Solomon and P. I. Yakovlev, eds., Manual of Military Neuropsychiatry, Philadelphia: Saunders, 1944, pp. 189-194; Spiro, Herd. R., Chronic Factitious Illness: Munchausen’s Syndrome. Archives of General Psychiatry, 1968, 18, 569-579.

82Freedman and Kaplan, op. cit. (n. 81 ); Myerson, op. cit. (n. 81). 83Eissler, op. cit. (n. 81). 84Freedman and Kaplan, op. cif., (n. 81), p. 1151.

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Syndrome appears an unlikely diagnosis and the language of I Samuel and Psalm 34 points to a deliberate simulation. The possibility remains, however, that tran- sient reactive psychotic states were seen in the ancient world and were the basis for the descriptions of David’s malingering.

Another feature common to the group pertains to the motivation or ostensible goal of the ruse. The feigning of madness is used as a last resort t o preserve the life of the hero. David, Brutus, and Kai-Khosrau were in the power of the rulers they faced and might easily have been executed. Solon was eluding capital punish- ment. Odysseus was not in mortal danger, but was living under a prophesy of a 20-year separation from his new family and a loss of the world as he knew it.

The ostensible motivation for malingering down through its history has very much reflected specific cultural settings, particularly when malingering has existed in “epidemic” form. Pare reported malingering as part of the beggar’s approach to sympathy and alms.86 Widespread malingering has been encountered during un- popular military campaigns, practices being reported among the Greeks and Ro- mans.86 Following the battle of Waterloo (1815), youth with feigned injuries attributed to the battle were frequently seen in public in England.87 In our cen- tury the tedium and hardship of forced labor have been associated with a high rate of malingering.88 In the present series the combination of mortal peril and a gifted, wily hero seem to be the necessary and sufficient causes for feigned madness in accounts set in the ancient world.

The Spectator. The behavior of the ancient malingerer appears to have trans- mitted a message to the observer with considerable accuracy. The communication to the observer was that the madman malingerer was harmless, incapable of aggres- sion or self-assertion, defenseless, and lacking in any potential for injury to au- thority. This display had the effect of shifting the role of the viewer from that of punitive authority to that of passive spectator. The shifting of roles is particularly dramatic in the case of David. The men of king Achish proclaim David as the war- rior who has “slain ten thousands” (of their Philistine kinsmen), but the appearance of the slobbering madman prevents all thought of revenge and Achish can only register annoyance a t his own men for bringing a madman before him.

The ancient writers have presented the malingering of mental illness as a relatively convincing form of ruse, only one out of five being detected. In por- traying malingering of mental illness as so difficult of detection, the ancient author seems to imply that a shared concept of mental illness existed which could be convincingly counterfeited. Thus, the features of the feigned mental illness given in the accounts might well be some of our most ancient reflections on mental ill- ness, considerably predating the observations of Hippocrates.

SSPare, op. cit. (n. 3), p. 995, felt, that the counterfeiting of disease by beggars had much increased in his time.

86GaVin, Hector, On Feigned and Factitious Diseases, chiefly of Soldiers and Seamen, on th.e Means Used to Simulate or Produce them and on the Best Modes of Discovering Impostors, London: Churchill, 1843; Jones, op. cit. (n. l), p. 5; Idoersch, Frederick P. “Malingering; with Reference to its Neuro sy chiatric Aspects in Civil and in Military Practice.” The Medical Clinics of North America. day: Clinic Number, Philadelphia: Saunders, 1944, pp. 928-944; Myerson, op. cit., (n. 81).

8’Blatchford, Thomas W., An Inaugural Dissertation of Feignad Diseases, New York: Forbes, 1817, p. 13.

SEField, Mark G., Some problems of Soviet medical practice: A Sociological approach. New England Journal of Medicine, 1953, 948, 919-926.

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The choice by the hero of the disguise of mental illness and its successful use in delivering him from danger have usually been attributed to ancient nian’s sacred awe of madness. It has usually been theorized that ancient or primitive man attributed mental illness to the work of the gods or possession by an invading spirit.89 The madman, therefore, was to be avoided since injury to him may in- advertently affect the spiritual forces causing the madness or otherwise offend the gods. In the case of the five, various scholars and commentators have invoked the sacred status theory as the explanation for the immunity experienced by the ma- lingerer.gO The theory of the sacred origins of madness has wide ramifications and has been given much credence as a major ancient explanation of mental illness.gi While the ancient theories of mental illness may not be fully discussed here, it is important to note that a variety of causes were considered by the ancients and that a multi- factorial approach was considered by some ancient au thor i t ie~ .~~ Interpersonal factors, excessive wine drinking, meteorological and astrological influences among others were all seen as affecting the mental state along with the wishes of the gods. I do not think, therefore, that we need limit the explanation of the immunity of the madman to any hypothetical sacred status. Nor is there a single detail in any of the accounts of the five to indicate that a sacred status was influential in staying the hand of a ~ t h o r i t y . ~ ~

I believe another factor may be at work, though seldom recognized, in some- times protecting the mentally disturbed, both genuine and counterfeit, from vio- lent attack. The general appearance of the madman may contain powerful in- hibiting stimuli to the spectator. The posture, speech, sounds, gestures, and even odors of the grossly mentally disordered may be cues which prevent action by the mature aggressive male. The aggressor may experience inhibition at a biologically determined level when confronted by the totally defenseless madman. The por- trayal of gross mental disorder may thus be acting as a stimulus of an ethological nature to protect the mentally disordered one. I suggest that part of the explana- tion of the use and success of the malingering of mental illness may be in the exist- ence of a biological response to the appearance of madness.

BgMeir, C. A., Dynamic psychology and the Classical World, in G. Mora and Jeanne L. Brand, eds., Psychiatry and its History. Springfield,Ill. : Thomas, 1970, pp. 163-167.

goGuillaume, Alfred, Prophecy and Diz~ination Among the Hebrews and Other Semiles, New York: Harper, 1938, pp. 197, 206; Nicholson, Reynold A., Selected Poems f rom the Divan Shamsi Tubriz”, Cambridge: University Press, 1952, pp. 3, 198; Preuss, o p . cil. (n. lo), p. 359, all mention the sacred awe of the insane in the Near East. Goldman, op. cit. (n. 9), p. 133; Hardie, J. B., Medicine and the Biblical World, Canadian Medical Association Journnl, 1966, 94, 32-36; Bosch, Juan, David: The Biography of a King, trans. by J. Marks. New York: Hawthorn, 1966. p. 84, all relate David’s ruse to the same fear. Niebuhr, G. B., The History of Rome, trans. by J. C. Hare and C. Thirlwall, Phila- delphia: Wardie, 1835, Vol. 1, p. 375, in the context of Brutus’ ruse, states that the Romans regarded madmen as sacred.

QlDodds, Eric R., The Greeks and the Irralional, Berkeley and Los Angeles: University of Cali- fornia Press, 1951, p. 64; Galdston, Iago, ed., Historic Derivations of Modern Psychiatry, New York: McGraw-Hill, 1967, p. 12.

VZDodds, op. cit. (n. 91), pe,“5, 69: O’Brien-Moore, op. cit. (n. 59), pp. 11, 20; Herodotus, op . cit. (n. 39), pp. 383-389, gives attitude toward causative fact,ors in mental aberration in his dis- cussion of Cleomenes, Spartan king, who engaged in unscrupulous behavior and committed suicide by mincing himself with a dagger. Herodotus weighs the effronteries of the gods perpetrated by Cleomenes as well as his excessive wine drinking, offering finally the opinion that his corrupting of the Delphic oracle was the last straw bringing about his downfall.

gZSmith, op. cit. (n. 13), p. 147, observes that the Arab idea of possession of the insane by a spirit or jinn is nowhere to be found in the Old Testament.

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Aftermath. Resorting to feigned mental disturbance is not without its price. To begin with, there is the possibility that the ruse might not have succeeded, as was the case with Odysseus. In addition, feigning mental illness might well carry with it the stigma which mental illness has carried in modern times: a loss of social prestige, limitations on one’s future career, and public humiliation. In our cases the opposite follows. The bout of mental illness, albeit feigned, was fol- lowed by greater career accomplishments. The individuals were not branded as potential security risks or considered prone to future breakdowns and therefore denied leadership roles. David’s case is particularly interesting since he comes again to King Achish in a later chapter, is accepted, sheltered, and given a respon- sible warrior role in Achish’s battles.15 The writers describing these cases of feigned madness saw no inconsistency in a once mad man assuming future positions of great responsibility. The author in the Book of Samuel apparently viewed the sequence of David’s two encounters with Achish and the latter’s differing reactions as a plausible history requiring no particular explanation.

Following the feigning of mental illness, each hero enters a new phase of his career. Not long after the ruse, David becomes king; Solon becomes the leader of the expedition against the Megarans; Odysseus, although exposed, goes on to his military and seafaring exploits; Brutus leads a successful revolt; and Kai- Bhosrau eventually becomes the greatest Kayanid ruler. The accounts of feigned madness stand as nodal points in the heroes’ careers, ushering in new phases of great accomplishments. Might the accounts relate to the cultural phenomena and symbolism of rebirth or regeneration?

Rebirth ritual and symbol has been found to be a basic element in the initiatory practices of primitive cultures.94 It has been shown that these initiatory practices- puberty, secret society, and mystic vocation ritesg5-reflect a universaI human need and process.96 This need pertains to the induction of the adult into the life of spirit and the necessary preliminary ritual death of the child with his asexual, ignorant, and profane status. Eliade in tracing the history of initiatory rites sees them as all but disappearing as rituals by time of the historic religions,g7 those of our malingerers’ writers. Following the disappearance of initiatory rituals, vestiges, memories, and civic initiatory ceremonies remained in the ancient world.g7 My- thology broadly reflects initiatory motifs.98

Of particular interest to us here is that initiatory process regularly associated with mental illness, shamanic induction. The shaman enters his mystical vocation by way of a bout of mental illness.99 The strange behavior and sometimes total disintegration of the personality of the initiate follows in the wake of a selection process. The individual who eventually becomes a shaman may be started on his path in a variety of ways. He may be hereditarily designated, receive a “call,”

”Eliade, Mircea, Rites and Symbols of Initiation: The Mysteries of Birth and Rebirth, New Yo&:

OsIbid., p . 2.

ellbid., p . 108.

ggEliade, Rites, op. cit. (n. 94), pp. 88, 91; Ackerknecht, Erwin H. Psychopathology, Primitive Medicine and Primitive Culture, Bulletin of the History of Medicine, 1943, 16, 30-67; Sigerist, op. cit. (n. 78), Vol. I, Primitiue and Archaic Medi&e, p . 176.

Harper and Row, 1965.

¶elbid., pp. 135-6.

QsIbid., pp. 125-128.

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or have an unusual or very stressful experience.lo0 Mental disturbance then follows but this must be cured before he can become a shaman.lo1 The shaman integrates into his new personality organization the conscious awareness of his past irrational condition.lo2 His past mental illness is just one of a variety of nonrational processes and religious experiences which the shaman possesses and utilizes in his daily prac- tices as a spiritual mediator for his tribesmen.lo2 Eliade states, “the psychopathology of the shamanic vocation is not profane; it does not belong to ordinary symptom- atology.

Might our accounts of the pre-500 B.C. malingerers be the literary expres- sions of initiatory symbolism or past initiatory rituals of shamanic types in the respective cultures? The similarities to the career of the shaman of our five heroes include: (a) the “call” experienced by the heroes (Odysseus tried to ignore his), (b) a stressful precipitating situation, (c) a self-limited mental disturbance, and (d) a recovery with heightened capabilities. Do our accounts point to past eras when heroes and leaders such as ours underwent an initiatory ritual in order to achieve the mental capacity to serve as leaders? The Scandinavian warrior had to pass through a stage as a frenzied berserker t o achieve full fighting status.lo4 The initiatory process also accounts for the preadult’s temporary descent into chaos and death.lo5 The childlike behavior of Brutus may have represented the retrogression of the hero to embryonal chaos before his rebirth as a king, i.e., a spiritual leader. Another retrogression is that of the disguise of Achilles living among the girls, an arrangement described in some primitive puberty initiations. Eliade points t o this and other features in the story of Achilles which are initiatory ordea1s.lo6

The confrontation of Palamedes and Odysseus is of deep significance and consistent with the symbolism of initiatory rituals. Palamedes whose name means “ancient wisdom” was the inventor of part of the alphabet, the discus, dice, meas- uring implements, the posting of sentinels, and lightho~ses.~07 He was a definer and setter&of limits, the epitomy of the civilizer and bearer of culture to man emerging from protohistory. Graves has pointed out the kinship between Palamedes, Pro- metheus, Hermes, and Thoth.los The civilizer Palamedes confronts the young newlywed Odysseus and deprives him of his position a t the hearth and as the rearer of his newborn son until he has completed his ordeal of strife and travel. The Palamedes-Odysseus confrontation is a restatement of the initiatory rite which dictates that the youth must be reborn-Odysseus is put off 20 years, a full cycle of manhood-before the gifts of culture, genitality, and fatherhood are fully granted to him.

op. cit. (n. lll), p. 87.

It has an initiatory structure and signification.”’”

loODodds, op. cit. (n. 91), p. 140; Sigerist, op. cit. (n. 78), Vol. 1, pp. 172-173; Eliade, Rites,

‘OlAckerknecht, op. cit., (n. 99), p. 46; Eliade, Rites, op. cit. (n. 94), p. 88. l”Eliade, Rites, op. d. (n. 94), p. 102; Sigerist, op. eit. (n. 78), Vol. I, p. 177. 103Eliade, Rites, op. cit. (n. 94), p. 89. 104Zbid., p. 81.

laGIbid., p. 109. lOTGraves, op. cit. (n. 61), Vol. I, p. 65, Vol. 11, p. 300. 10*Zbid., Vol. I, p. 188, Vol. 11, p. 303.

1061bid., pp. 18-19.

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The specific function of madness in the initiatory ritual is clear. In order for the initiand to be reborn, he must die in symbolic terms.loS Madness stood for death of the mind as well as the return to primordial chaos and disorganization. In the case of our heroes it is particularly apt since their mental gifts were so out- standing and their surrender of their mental abilities a total surrender of self.

Another feature of initiatory rituals is that of the initiand's terror during such rituals.l1° Immersed in a cosmic experience the initiand fears being killed by divine beings surrounding him."' David, Brutus, and Kai-Khosrau were all menaced by divine beings, i.e., kings.

By comparison, the accounts of feigned madness ascribed to characters after 500 B.C. do not involve heroic figures nor do they suggest initiatory or rebirth motifs.'12 The contrast between the heroic pre-500 B.C. malingerer and the un- distinguished or ludicrous post-500 B.C. malingerer might be explained by the changing role of religion and initiation ritual in the first millennium B.C. The year 500 B.C. stands as a convenient dividing line for massive changes which occurred in the known world beginning in the 6th and 7th ~enturies."~ The 6th century saw the rise of Zoroaster, Buddha, and Confucius as well as "the self-realization of Classical Gree~e.""~ Perhaps the sweeping changes of that time are related to a change in the experiencing of irrational phenomena and the way in which they were regarded. Before 500 B.C. the religious and secular experience of the individual were inseparable, and irrational experiences, such as mental illness, were integrated

'M'Eliade, Rites, op. cit. (n. 94), p. 91. IlOZbid., p. 35. "'Zbid., p. 24. "ZMalingerers after 500 B.C. are decidedly less heroic in stature and the events less dramatic

and serious Meton, an astronomer and city planner, was opposed to a naval expedition by Athens against Sicily in 415 B.C. On the eve of the expedition, in feigned madness he burned his house down. The next day he pleaded for his son, a captain in the ill-fated fleet and obtained the son's release, Plutarch, op. cit. (n. 38), Vol. 111, p. 257, Vol. IV, pp. 45-47; Aelianus, Claudius, A Registre of Hystories (Varia Historia), trans. by Abraham Fleming, London: Woodcocke, 1576, p. 150. The malingering of mental disorder as amusement appears in one of the slapstick comedies of Plautus (c. 254184 B.C.), Manaechmi (The Two Menaechmuses). Presented sometime after 215 B.C., this mistaken identity farce contains a scene in which one of the identical twins tries to capitalize on the confusion by feign- ing madness and was most likely taken from an original by Poseidippus produced about 275-270 B.C., Plautus, trans by P. Nixon, Cambridge, Mass. : University Press (Loeb Classical Library), 1959, Vol. 11; O'Brien-Moore, op. cit. (n. 59). p. 36, 53. The undignified and foolish public behavior of the Emperor Claudius (10 B.C.-54 A.D.) f ed him to claim that he had feigned stupidity during the reign of his predecessor, Caligula, in order tofurvive. His subjects were unconvinced by the claim and a book was published shortly thereafter, The Elevation of Fools," the thesis of which was that no one feigns folly, Suetonius, trans. by J.C. Rolfe, Cambridge, Mass.: Harvard University Press (Loeb Classical Library), 1951, Vol. 11, p. 71; Dio, op. cd. (n. 42), Vol. VII, p. 371. During the reign of the Emperor Tiberius (14-37 A.D.) a praetor, Plautius Silvanus, threw his wife out of a window and subsequently claimed to have been asleep during the episode. Tiberius inspected the bed chamber, found marks of a struggle, and Silvanus was eventually executed, Tacitus, trans. by John Jackson, Cambridge, Mass. : Harvard University Press (Loeb Classical Library), 1951, Vol. 111, p. 41.

11ZGouldner, Alvin W., Ente~ Plato, New York: Basic Books, 1965, p. 79; Murray, Gilbert, Five Stages of Greek Religion, Garden City, N.Y.: Doubleday, 1951, p. 38.

114Murr~y, Five, op. cit. (n. 113), p. 41. The overlap of world changing events in the 6th cent. B.C. is extraordinary. Not only do Zoroaster (660-583 B.C.) Buddha (563483 B.C.) and Confuciw (551-479 B.C.) have contemporaneous beginnings for their respective influences but the only modern religion in existence at that time, Judaism, underwent a cataclysmic change with the destruction of the Temple in 587 B.C. and the creation of the Dias ora which was to characterize Judaism through the 20th century. The destruction of the Temple, w&le perhaps serving as the death of$m era, may have provided a stunning and revivifying challenge to an entrenched torpid state initiating the viable condition which followed.

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nto the total personality. After 500 B.C. secular and religious experiences are compartmentalized; medical writers have begun to describe and classify mental syndromes and “causes” are ascribed to behavior. Irrational experiences for the later period have lost some of their value as enlarging experiences. Irrational experiences for the post-500 B.C. man were a matter to be avoided, denigrated, or “treated.” For the pre-500 B.C. man they might be utilized to advance his leadership stat us.

Since I have suggested that the accounts of feigned madness pertaining to the more archaic period, i.e., before 500 B.C., may reflect initiatory symbolism, we must ask the question as to the possible initiatory symbolism of accounts of genuine mental disorder alleged in the archaic period. Might the ancient accounts of gen- uine madness reflect this symbolism as well as does feigned madness? If it can be demonstrated that some ancient allegations of madness reflected initiatory sym- bolism, why has one hero been accounted genuine and another counterfeit? These questions cannot be answered here but do warrant further study.

SUMMARY AND CONCLUSIONS 1. Episodes of malingering of mental illness are ascribed to five individuals

in history before 500 B.C.-Odysseus, David, Solon, Kai-Khosrau, and Brutus. The earliest written accounts describing these episodes are found in epic or his- torical literary forms and were presented as serious accounts to be read by a non- professional general audience. The accounts of malingering appear to have taken form two hundred or more years after the heroes’ eras, a passage of time allowing for the mythicization of the heroes.

The five ancient accounts follow a pattern. All five heroes early in their careers, before achieving anything like their ultimate renown, were confronted by life-threatening situations, and malingered mental disorder to escape the death threat. The ruse of feigned mental disorder was successful in all cases except Odys- seus. Following the incident all five went on to extraordinary careers, in no way deterred by their past aberrant public behavior. The malingering of mental dis- order stands as a nodal point in the hero’s career presaging brilliant accomplish- ments and perhaps symbolizing the hero’s rebirth through self-renewal. Their subsequent deeds marked them among the most outstanding individuals in their eras or dynasties.

3. By contrast, individuals accounted malingerers of mental disorder in post- 500 B.C. antiquity present a much more varied set of motivations and nonheroic or even ludicrous personal qualifications. The post-500 B.C. malingerers are a t various points in their careers and do not experience self-renewal through their malingering episodes.

4. By resorting to the disguise of malingering the hero has changed the nature of the challenging situation in which he was placed from physical power to mental agility. The choice of the disguise of mental disorder serves to mask the most out- standing asset of the hero, his great mental ability. The facade of gross mental disturbance may have been a successful means of avoiding extermination because

2.

Four became kings and Solon, the archon of Athens.

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it functioned in an ethological fashion as an inhibitor of aggression in the adult male authority.

5. The ancient hero’s descent into the chaos of feigned mental disorder followed by the full blossoming of his career suggests the form and symbolism of an initiatory ritual. The shaman undergoes an episode of mental illness before achieving full status in his mystic vocation. Madness, as a death of the mind, in the career of the shaman and our heroes symbolizes the death of the profane, uninitiated self which makes way for (re-) birth of the sacred, initiated mature religious figure. The royal status achieved by four of the heroes was in ancient times a religious office.