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Sakikku is organized into six chapters and tablet 26 is the first in the chapter about epilepsy.          Tablet BM47753. Neo-Babylonian Period. Courtesy of the British Museum, London. 

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Neurological diseases and conditions are often thought of as discoveries of modern medicine and modern healthcare. However, many of the ailments of the brain have been recorded all throughout human history. And in the case of epilepsy, as far back as the Neo-Babylonian period and beyond.

Shown in the provided image is tablet 26 of a 40 tablet diagnostic collection named the Sakikku, written around 1000 BC. When translated, this title means "all diseases". This tablet succeeds an almost 1000-year older Akkadian tablet that describes the symptoms of an epileptic seizure. The Sakikku, however, identifies these symptoms as linked to a condition rather than a single instance of seizure. Of course, the condition was not named epilepsy by the ancient Babylonians, but their recognition of these symptoms provides insight into their advanced understanding of neurological conditions and their symptoms. The tablet records all known symptoms of the seizure-inducing condition, as well as stimuli that had proven to cause said symptoms. The first believe historical account of epilepsy being identified as its own neurological condition is attributed to Cao Yuan Fang and his medical investigation accounts in 610 AD.

Source:

Kaculini, C. M., Tate-Looney, A. J., & Seifi, A. (2021). The History of Epilepsy: From Ancient Mystery to Modern Misconception. Cureus, 13(3), e13953. https://doi.org/10.7759/cureus.13953

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The Medieval Period and Epilepsy: A Sacred Affliction

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The Medieval Period and Epilepsy: A Sacred Affliction

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During the medieval period (5th–15th centuries), epilepsy was predominantly viewed through a religious and supernatural lens. Known widely as the "Sacred Disease," epilepsy was thought to result from divine punishment, demonic possession, or the influence of evil spirits. This perspective shaped societal attitudes and treatment approaches, leading to reliance on spiritual interventions rather than medical solutions.

Epileptic seizures were often seen as manifestations of otherworldly forces. Those who suffered from epilepsy were sometimes ostracized or regarded with fear, as their condition was misunderstood and linked to malevolent influences. Religious institutions played a central role in addressing epilepsy, with treatments ranging from prayers and exorcisms to the use of relics believed to possess healing properties.

Artifacts and Examples Referenced

In the video "Origin and Meaning of Epilepsy, Seizures, and Fits," specific artifacts and historical practices highlight this era's perspective:

1. Relics of Saints: Holy relics, such as bones or clothing of saints, were used to "cure" epilepsy. For instance, relics associated with Saint Valentine were believed to have healing powers for individuals suffering from seizures.

2. Liturgical Texts and Exorcisms: Manuscripts from the period detail prayers and rituals aimed at expelling evil spirits from those afflicted with epilepsy. These texts served as both spiritual guidance and practical tools for clergy.

3. Amulets and Charms: In addition to Christian relics, amulets inscribed with protective prayers or symbols were used as talismans to ward off seizures, blending Christian and folkloric traditions.

The medieval approach to epilepsy reflects the deep entanglement of medical beliefs with spiritual and cultural practices. While limited by the absence of scientific understanding, these practices underscore humanity's ongoing attempt to interpret and address neurological disorders within the framework of their time.

Source:

Neurophysiology. (2017, October 22). Origin and meaning of Epilepsy Seizures and Fits [Video]. YouTube. https://www.youtube.com/watch?v=yhPOoaTNtBA

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Origin and meaning of Epilepsy Seizures and Fits

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The Renaissance and Early Modern Period: Advances in Understanding Epilepsy

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The Renaissance and Early Modern Period: Advances in Understanding Epilepsy

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During the Renaissance and Early Modern period (15th–17th centuries), the understanding of epilepsy began to shift from supernatural explanations to naturalistic and anatomical interpretations. Influenced by the revival of classical knowledge and advancements in medicine and science, scholars and physicians started exploring the brain's role in epilepsy and developing early scientific hypotheses about its causes.

The article "The Evolution of the Concepts of Seizures and Epilepsy" highlights several pivotal developments from this era. Andreas Vesalius (1514–1564), often considered the father of modern anatomy, rejected medieval ideas about epilepsy being caused by demons or divine intervention. His groundbreaking anatomical text, De Humani Corporis Fabrica, emphasized studying the brain and nervous system to understand disorders like epilepsy. Paracelsus (1493–1541), a revolutionary physician, suggested that epilepsy could be caused by internal imbalances rather than external forces. His emphasis on chemistry and the role of bodily humors marked a significant departure from earlier mystical views. Thomas Willis (1621–1675) made one of the most significant contributions to the study of epilepsy in the 17th century. He identified the brain as the central organ responsible for seizures, describing abnormal electrical activity as the underlying cause. His work, Cerebri Anatome, laid the foundation for modern neurology.

This era marked a pivotal transition in how epilepsy was viewed and treated. By linking seizures to natural causes, Renaissance physicians began dismantling centuries of stigma. Their focus on empirical observation and scientific reasoning provided the groundwork for the modern understanding of epilepsy as a neurological condition. The Renaissance and Early Modern period reflect a profound shift toward evidence-based medicine, setting the stage for future breakthroughs in neuroscience.

Source:

Patel, P., & Moshé, S. L. (2020). The evolution of the concepts of seizures and epilepsy: What's in a name?. Epilepsia open, 5(1), 22–35. https://doi.org/10.1002/epi4.12375

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The evolution of the concepts of seizures and epilepsy: What’s in a name?

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This review aims to highlight the historical hallmarks in the development of the concepts of seizures and epilepsy. It begins with a discussion of seizure semiology and terminology, followed by the pathophysiology of seizures. We then discuss the…

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Thomas Willis (1621–1675) was a pioneering English physician and anatomist whose work significantly advanced the understanding of epilepsy and laid the foundation for modern neurology. In his seminal work, Cerebri Anatome (1664), Willis provided groundbreaking insights into the structure and function of the brain and nervous system, introducing ideas that redefined the medical understanding of epilepsy.

Willis challenged prevailing supernatural explanations of epilepsy, which often attributed seizures to demonic possession or divine punishment. Instead, he proposed that epilepsy was a physical disorder originating in the brain. He identified abnormal electrical activity and disruptions in the brain's natural functions as the primary causes of seizures. His emphasis on the brain's role in epilepsy marked a pivotal shift from mystical to scientific explanations of the condition.

Cerebri Anatome included detailed illustrations and descriptions of the brain's anatomy, highlighting the centrality of the cerebral cortex and its connections to the nervous system. Willis also coined the term "neurology," establishing it as a distinct field of study. His systematic approach to studying the brain and its disorders encouraged future physicians to view epilepsy and similar conditions as treatable medical issues rather than moral or spiritual afflictions.

Thomas Willis's work not only deepened scientific understanding of epilepsy but also helped dismantle centuries of stigma surrounding the condition. By emphasizing the physiological basis of seizures, he provided a framework for evidence-based treatment and inspired generations of neurologists to continue studying the brain's intricate functions. His contributions remain a cornerstone in the history of neuroscience and epilepsy research.

Source:

Teive, H. A. G., Coutinho, L., Camargo, C. H. F., Munhoz, R. P., & Walusinski, O. (2022). Thomas Willis' legacy on the 400th anniversary of his birth. O legado de Thomas Willis no 400° aniversário de seu nascimento. Arquivos de neuro-psiquiatria, 80(7), 759–762. https://doi.org/10.1055/s-0042-1755278

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Illustration to Understanding: Jean Cruveilhier's Contributions to Epilepsy

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Illustration to Understanding: Jean Cruveilhier's Contributions to Epilepsy

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Jean Cruveilhier (1791–1874), a French anatomist, made significant contributions to the understanding of neurological disorders, including epilepsy, through his detailed anatomical illustrations and descriptions in his work Anatomie pathologique du corps humain (1829–1842). His influential atlas, known for its over 200 hand-colored lithographed plates, provided invaluable insights into the brain and nervous system, helping to shape the field of neurology in the 19th century.

Cruveilhier’s work advanced the understanding of epilepsy by illustrating and documenting the pathological changes in the brain associated with neurological disorders. While the scientific community had already begun to view epilepsy as a medical condition rather than a supernatural phenomenon, Cruveilhier’s anatomical illustrations provided further evidence of the brain’s direct involvement in the disorder. His detailed depictions of the brain’s structures and how they were affected by disease helped establish a clearer understanding of the underlying causes of conditions like epilepsy.

Through Anatomie pathologique, Cruveilhier helped identify the pathological features that could be linked to epilepsy, including abnormalities in the brain’s tissues and blood vessels. His illustrations gave physicians and researchers a more precise way to examine how epileptic seizures might result from physical changes in the brain, building on the anatomical foundation laid by earlier figures like Thomas Willis.

Cruveilhier’s contributions were crucial in moving the study of epilepsy from a theoretical, often mystical realm into the domain of clinical neurology, where it could be better understood and treated. By providing the first comprehensive visual documentation of neurological pathology, he helped shape future research into the brain’s role in epilepsy and other disorders, bridging the gap between anatomy and functional neurology. His work continues to be a significant reference in the field of neuroscience, particularly in the study of neurological diseases.

Source:

Flamm, E. S. (1973). THE NEUROLOGY OF JEAN CRUVEILHIER. Medical History, 17(4), 343–355. https://doi.org/10.1017/s0025727300018950

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Stanford Medicine researchers and their colleagues found that removing or inhibiting the fasciola cinereum may help epilepsy patients who aren't helped by surgery.

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Continuing to Uncover Secrets in Epilepsy

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Continuing to Uncover Secrets in Epilepsy

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A recent breakthrough in epilepsy research, conducted by researchers at Stanford Medicine, has led to the discovery of a previously overlooked region of the brain that plays a significant role in epilepsy. The study identified the fasciola cinereum, a region in the hippocampus, as crucial in initiating and propagating seizures. This discovery could pave the way for new treatment options for patients with epilepsy, particularly those whose seizures are not responsive to current therapies.

The Stanford team’s research builds upon centuries of neurological research, including the foundational work of figures like Thomas Willis, who first linked epilepsy to brain function, and Jean Cruveilhier, who provided detailed anatomical descriptions of the brain. Their historical contributions laid the groundwork for understanding the brain’s involvement in seizures, and modern research continues to refine this understanding.

The identification of the fasciola cinereum as a key player in epilepsy provides new avenues for intervention. By targeting this specific region, it may be possible to develop more effective treatments for epilepsy, particularly for patients who do not respond to traditional methods such as medication or surgery. This discovery highlights the ongoing progress in epilepsy research, where advancements in neuroanatomy and physiology are leading to better, more targeted therapies.

The work at Stanford Medicine exemplifies how centuries of research have culminated in this cutting-edge discovery, illustrating the importance of continued exploration into the brain’s complex structures to improve treatment outcomes for individuals with epilepsy.

Source:

D’Ardenne, K. (n.d.). Stanford Medicine-led study identifies novel target for epilepsy treatment. News Center. https://med.stanford.edu/news/all-news/2024/04/epilepsy-treatment.html

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William Gowers (1845–1915) would be an ideal guide through a museum exploring the historical journey of understanding epilepsy, given his pioneering contributions to the clinical study and classification of neurological disorders. As one of the foremost experts on epilepsy during the late 19th and early 20th centuries, Gowers’ comprehensive work, Epilepsy and Other Convulsive Diseases (1881), helped shape the modern medical understanding of epilepsy.

Gowers was a trailblazer in the systematic study of epilepsy, approaching it with a clinical mindset that was revolutionary for his time. Prior to Gowers, much of the understanding of epilepsy had been rooted in mystical or inaccurate theories, but Gowers contributed significantly to treating epilepsy as a neurological condition with identifiable causes, patterns, and potential treatments. His detailed classification of seizure types, including generalized and focal seizures, laid the groundwork for the diagnosis and treatment of epilepsy that we use today. He also emphasized the importance of observing the onset, progression, and cessation of seizures to understand their origins, an approach that informed future research into the disorder.

His contributions extended beyond classification to the development of treatment methods, where he stressed the significance of pharmacological interventions for controlling seizures. This insight was crucial in the eventual development of antiepileptic drugs. Gowers' work provided a clinical framework that balanced both practical care and theoretical understanding, making him an invaluable figure for explaining the practical aspects of treating epilepsy through the ages.

Gowers’ impact on the understanding of epilepsy is still felt today in the fields of neurology and epilepsy research. As a docent through the museum, Gowers would provide visitors with a rich, detailed view of how epilepsy was classified, diagnosed, and treated during his era, offering a bridge between the early mystical views of epilepsy and the modern, evidence-based medical approaches that define current research. His approach would highlight the importance of observation, classification, and treatment, offering a comprehensive perspective on the evolution of epilepsy research and care.

Source:

Eadie, M. J. (2011). William Gowers’ interpretation of epileptogenic mechanisms: 1880-1906. Epilepsia, 52(6), 1045–1051. https://doi.org/10.1111/j.1528-1167.2011.02983.x