The biological tradition in mental health: Classical Antiquity

The biological tradition in mental health: Classical Antiquity

The biological tradition in mental health can be traced to HippocratesGreek physician and philosopher, who was the first to explain the natural origins of diseases of the soul and body. He highlighted, therefore, the physiological factor that caused them and proposed a specific treatment for each of them.

In the case of diseases of the soul, Alcmeón de Crotona, in the sixth century BC. C. was the first to relate them to the brain, because he associated it as the cradle of reasoning and the corresponding thoughts of the soul.

He also proposed the appropriate integration of opposites; that is, internal and external stimuli as health indicators. The lack of consonance between these opposites would be taken as collision or "dyscrasia".

The non-pathological condition, the hedonic state would be the equilibrium or "crassia". Other authors such as Empédocles become relevant when considering the starting point for the four mood theory, based on the interaction between the elements and qualities (fire / heat, earth / dryness, water / humidity, air / cold).

This revolutionary theory was radically against the priests, who still maintained the method of religious healing for the cause of physical and mental suffering, as seen in the article on the supernatural tradition in psychopathology.


  • 1 The beginnings of the biological tradition in psychopathology: Hippocrates
  • 2 Plato and Aristotle
  • 3 Asclepiads (1st century BC)
  • 4 Settlement of the biological tradition: Cicero (106-43 B.C.) and Plutarch (46-120 A.D.)
  • 5 The expansion of the biological tradition: Galen (130-200 AD)
  • 6 References

The beginnings of the biological tradition in psychopathology: Hippocrates

Classical Antiquity is estimated as a critical and very important period in the history of human development. In fact, here the flowering of Western medicine took place.

The first medical school on the island of Cos was founded considering Hippocrates (460 BC-370 BC). as the main promoter of this new branch of science, being recognized as the father of medicine.

He started looking for an organic cause for diseases that afflicted the mind and body, in opposition to the supernatural ideas of curse or possessions, leaving aside the term "madness" and assigning it to "disease."

Hippocrates and his followers resumed the humoral theory, which defended the idea that for there to be health in human nature there should be a balance between the four moods: blood, phlegm, black bile and yellow bile, which corresponded to a specific organ. Thus, Some kind of imbalance in its functioning would be the cause of a specific disease.

Yellow BileLiver
Black BileSpleen-Stomach

Hippocrates and psychopathology

Hippocrates believed that the gods, associated with natural laws, intervened only in healing, but considered that the physical cause of the ailment should be discovered by the doctor.

With regard to the origin of mental disorders coincided with Alcmeón, concluding that it is a imbalance of moods in the brain. In addition, he made a first classification of the disorders:

  • Phrenitis
  • Melancholia
  • Mania

Hysteria was one of the non-mental disorders, investigated by Hippocrates collecting data and by observing symptoms, where he concluded that it was due to the relocation of the uterus due to the lack of sexual relations, considering this body as changing.

His contribution in the area of ​​medicine had such an impact that it was recognized as an effective inductive knowledge and was the basis for future theories such as Galen and temperament types.

The 4 types of human temperament

Plato and Aristotle

The irruption on the scene of Plato (429-347 B.C.) and his new theses mean that, little by little, the Hippocratic idea is discarded in regard to mental illness. Plato developed the idea that an ethereal, non-material, almost magical element of each person influenced their behavior.

Thus appeared the dualistic approach, which expressed the fusion of mind and body, resulting in two souls: rational and irrational.

Plato stated that mental illness occurred when the stable connection between these two souls was lost, affecting the irrational soul.

Aristotle, disciple of Plato, supported this theory, but He pointed out that it was not possible to separate these two souls, since they work together forming a unity. He also pointed out that the irrational soul could not get sick due to its spiritual and immortal origin, returning to the importance of physical structure for the disorder to occur.

Asclepiads (1st century B.C.)

Asclepíades, although he did not accept the theory of the four moods, was the first to make the differentiation between illusions, hallucinations and delusions.

Further, classified mental illnesses as acute and chronic. The theory of this exponent is based more on the environmental influences and its position is totally against inhuman therapeutic techniques performed in order to free magical beings.

Settlement of the biological tradition: Cicero (106-43 B.C.) and Plutarch (46-120 A.D.)

Mental disorders were investigated by other Roman doctors such as Cicero and Plutarch, within the biological tradition.

Cicero gave great emphasis to the moral and philosophical component describing two emotional states:

  • Insania: Imbalance and lack of serenity
  • Fury: much more intense, it triggered negative attitudes by the collapse of mental abilities, causing the individual to act in a manner contrary to the laws

On the other hand, Plutarch showed interest in the clinical descriptions and traumas of people who had suffered a psychic imbalance. He was one of the pioneers in studying what 2000 years later would be known as PTSD or Post Traumatic Stress Disorder.

The expansion of the biological tradition: Galen (130-200 AD)

At the time of Galen's discoveries, you have to highlight doctors Areteo and Sorano They struggled to conveniently define the concept of mental illness.

  • Premorbid personalities were Areteo's initial focus of interest, who, after many observation works, stated that mental disorders are simply normal processes who had suffered a problem in their evolution, exaggerating the personality traits of a normal patient
    • Finally, he gave some references on how the same patient could oscillate between states of mania and depression, to the state of lucidity
  • Sorano stood out for his insistence on looking for ways to train specialized people for the care of the mentally ill and humanistic therapeutic development. He was also responsible for extending the classification of mental disorders previously developed by Hippocrates, adding hysteria and hypochondria

Galen and the theory of moods: The soul of the biological tradition

Galen's theses were the most prevalent among doctors of his time. I organize and summarize all the information obtained from previous authors about mental illnesses.

He also made criticisms, observations and modified the established medical system, which was used for several centuries almost as dogma. It was not very different from the hypocratic approach, although with some nuances.

His greatest contribution was the theory postulated on temperaments or personality types. He presented nine main mixtures of temperamental categories. Later he would reduce them to the four most prevalent.

Another idea of ​​Galen, who had a remarkable importance, was his conception of fear and his presence during the alterations, which further complicate the mental disorder.

Nevertheless, He disagrees with Hippocrates in relation to the idea of ​​the uterus, since he does not consider it as a changing organ. In addition, he opposes other authors such as Seneca, and his idea that reason is the only cause of disease.

Theory of moods: Relationship of temperaments with their characteristics

Temperaments characteristics
BloodyUnstable, optimistic and romantic of robust build
CholericIrritable, impatient and analytical. Slender posture of serious features.
MelancholicSensitive, pessimistic, depressive but intuitive, they are usually very thoughtful and creative, very thin texture.
PhlegmaticApathetic, calm, indifferent and very routine. Your body shape is obese.

Although there is not much information about how Galen treated psychic conditions, it is known that he provided care to people through very varied therapies that ranged from fasting to cold showers.

Further, He was one of the first to use "psychotherapy" as a method, where there was a mentor that highlighted defects and guided the patient to get emotional control based on the directed speech.


Peña-Herrera, B. (2018) General Psychopathology. Samborondón: Espiritu Santo University - Ecuador.

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