Sacred Disease

Photo: Peter Paul Rubens, 1638. From The Conversation

Hippocrates, Rationalism, and the Sacred Disease

By Ezra Chan


In the Hippocratic work “On the Sacred Disease,” the author uses a wide breadth of knowledge and logical reasoning to develop his theories on the sacred disease, also known as epilepsy,[1] expanding his ideas with Hippocratic philosophies of the natural world and the concept of a divine origin. Although the sacred disease was widely believed at the time to have a divine cause, Hippocrates proposed that all human diseases have natural explanations. The author, staying true to Hippocratic dogma, uses the case of epilepsy as a way to showcase the rationalist philosophy of studying and filling gaps in human understanding. His ultimate goal in this work is not to refute the idea that a disease might be ‘sacred’ but rather to convey alternate explanations, demonstrating the value of both rationalist thinking and the study of diverse subject matters.[2]

Concepts of religion and the magical dominated pre-Hippocratic medical thinking; they  were the foundation for diseases that were otherwise unexplainable. Medical practitioners of the ancient world commonly attributed seizure disorders and others to a supernatural etiology, such as the possession by evil spirits.[3] The oldest known description of epilepsy can be traced back to around 1050 BCE in an Akkadian medical text, the Sakikku, which translated in English means “all diseases.”[4] Hippocrates’ teachings introduced and popularized a more scientific explanation for diseases, opposing the common attribution of illness to supernatural influence.

Hippocrates was highly educated, studying subjects beyond medicine, such as philosophy and the science of the natural world. The Hippocratic author used such knowledge to propose his own explanation for the seemingly high proportion of epileptic attacks during a change in the wind: he combined his knowledge of nature with that of human physiology. He found that certain cardinal winds had significant attributes, such as the north and the south being “the strongest of the winds.”[5] These two winds also seemed to have an effect on their environments– the north wind “precipitates the moisture in the air so that the cloudy and damp elements are separated out,” but the south wind seemed to have an opposite effect and make things become “dark instead of bright, warm instead of cold and moist instead of dry.”[6] As these effects seemed to extend to even the “large and powerful bodies,” like the sun, sea, and stars, the author deduced that it might also affect the human brain.[7] He then proposed a medically based theory on the specific reaction of the mind to a change in the wind. His hypothesized conclusion states that the south wind causes the brain to be “flabby, relaxing the blood vessels at the same time,” whereas the north wind “solidif[ies] the healthy part of the brain while any morbid part is separated out and forms a fluid layer around the outside.”[8] This is, essentially, the author’s demonstration of the importance of physicians studying non-medical subject areas, specifically natural science and philosophy.

The Hippocratic author’s study of the wind and the mind reveal his process of developing theories. His writing and recount of his journey to coming to a conclusion open up the logical progression of his reasoning. In the excerpt, he first describes the facts that he knows from his study of nature: the effects of the wind on the environment. He then makes a connection between that and his understanding of human brain biology, and comes up with a proposition for the mechanisms that the wind triggers. The sacred disease is an example of the greater philosophy that Hippocrates emphasizes, in that one can use rationalist thinking to expand on already existing knowledge and generate new ideas and theories, adding more knowledge to the human collection.

Hippocrates rejected the notion that the disease had a supernatural origin, as it did not follow his line of reasoning. The way he explains it, the presence or intervention of a god, something divine, in a human, should not logically cause the severe symptoms of epilepsy. Rather, it would most likely “purify or sanctify” an individual.[9] His emphasis on logical reasoning and rationalist philosophy is revealed in this text, and highlighted in his belief that “[the sacred disease] is no more difficult to understand, nor is it any more divine than any other malady.”[10] He acknowledges that nature is of divine origin, and so diseases that are caused by nature are indirectly caused by this divine origin following his reasoning. That being said, the author holds that the disease of epilepsy is not unique in its divine causation or incomprehensibility, but rather an attempt of others to “conceal their ignorance.”[11]

Hippocrates pioneered the philosophy that all human diseases have natural causes and can be explained, and, because of his contributions, he is recognized as the father of modern medicine.[12] The medical community of the ancient world adopted his teachings, as seen in the literature of the Hippocratic Corpus, and the Hippocratic method became the standard for medical practice. The ethical principles of medical practitioners today are still being shaped by the teachings of Hippocrates, as seen in the reverence for the Hippocratic Oath.[13] While explanations for the sacred disease have advanced since his era, the rationalism championed by Hippocrates continues to form the foundation of modern practice, clinical observations, and logical reasoning in medicine.[14]


Ezra Chan (College ‘24) is a student at the University of Pennsylvania majoring in History and Health and Societies.



[1] I refer to epilepsy, seizure disorders, and the sacred disease interchangeably in my writing.

[2]Hippocrates. “The Sacred Disease.” (Penguin, 1983), 237.

[3] Eadie M. “Epilepsy-from the Sakikku to hughlings Jackson.” J Clin Neurosci. 1995, 156-62.

[4] Patel P, Moshé SL. “The evolution of the concepts of seizures and epilepsy: What’s in a name?” (Epilepsia Open, 2020), 22-35.

[5] Hippocrates. “The Sacred Disease.” (Penguin, 1983), 247.

[6] Hippocrates. “The Sacred Disease.” (Penguin, 1983), 248.

[7] Hippocrates. “The Sacred Disease.” (Penguin, 1983), 248.

[8] Hippocrates. “The Sacred Disease.” (Penguin, 1983), 248.

[9] Hippocrates. “The Sacred Disease.” (Penguin, 1983), 240.

[10] Hippocrates. “The Sacred Disease.” (Penguin, 1983), 248.

[11] Hippocrates. “The Sacred Disease.” (Penguin, 1983), 238

[12] Yapijakis C. “Hippocrates of Kos, the father of clinical medicine, and Asclepiades of Bithynia, the father of molecular medicine. Review.” (In Vivo, 2009) 507-14.

[13] Marketos SG, Skiadas PK. “The modern hippocratic tradition. Some messages for contemporary medicine.” (Spine, 1999), 1159-63.

[14]  Yapijakis C. “Hippocrates of Kos, the father of clinical medicine, and Asclepiades of Bithynia, the father of molecular medicine. Review.” (In Vivo, 2009) 507-14.