The first thing that needs to be addressed is that, even though there are similarities across cultures as to what madness is, there is a wide disparity as to what the definition of madness, because of language differences. Societies define insanity against their own constructs of normal behavior, which are only translatable to a limited degree across diverse cultures and ages. For instance, in English, woodiness/madness is reserved for medical conditions of mania and melancholia while folly could overlap but more often described a manifestation of irrational or sinful behavior. That being said, there was a comparative stability of medieval medicine and theological thoughts, even if that did not mean that medical theory was homogeneous.

Bartholomeus Anglicus was one of the most widely read medical authorities on madness and his ideas were mostly derived from classical texts, which highlights that rational views were not uncommon. He found that there are two distinct forms of madness: mania, a disorder of the imagination, and melancholia of the reason.[1] These were two of the most accepted forms of medical madness as accepted by those practicing medicine and taught at a university. However, in the popular imagination, there were many other types of madness outside of mania and melancholia, particularly those of decreased mental capacity, possession, extreme emotions (including drunkenness and love), and madness as caused by changes in nature. While in medicine, madness was an illness, in philosophy, theology, and literature, it was not just any illness, but one of a certain intensity with a certain amount of trauma involved. Before delving into a brief explanation of those different types of madness which most often appeared in literature, there are two very important aspects to medieval madness that need to be address: the importance of sin with respect to disease, and the importance of identity in relationship to sanity.

Since the beginning of the middle ages, didactic writers saw disease as divine punishment for sin, and very often madness was a punishment for sin in literature as often as it was in life. “In the extremely popular Salernitan medical treatise Flos medicine, the verb pecco (offend, sin) is used to describe a humoral alteration leading to disease, while in English works the names of many diseases suggest sin: epilepsy is ‘goddis wrath’ and madness and other diseases are “deofolseocnes” (devil-sickness).”[2] This widespread use of moral terminology in texts which were considered to be scientific indicates just how pervasive the religious view of disease was in the middle ages; even if medical writers used such terms in a strictly physiological sense, their readers might well feel free to pursue the moral implications of medical texts.

Madness especially was seen as the disease which was a fitting punishment for the wicked because it inflicted a misery in life that was a token of the pains of hell, and symbolized the deformity of a sinful soul in a way that worked as a powerful deterrent to others. It must be recognized that one of Jesus’ biblical features which was the most successfully employed was the of his divine power as a healer, and thus it was only through a close relationship with Jesus that madness and disease could be avoided. [3] Throughout the entire Middle Ages and the early modern age the debate continued, and resonates even today, as to the correlation between the scientific and the religious approach to the material world. Both Thomas Aquinas and Francis Bacon, Theophrastus von Hoheheim (Paracelsus) and Robert Boyle, to mention just a few significant names, strongly supported a holistic concept in the study of the physical dimension because the divine, the spiritual, or the religious can always be detected behind the material objects.[4]

The onset of madness is, at its core, a corruption of identity, a dislocation, a person outside of his or her rational faculty, because the mad present a disturbing confusion of subjecthood and objecthood. Often in medieval writing, madness is associated with a dangerous excess of individuality (erotic passion, heroic prowess).[5] Moreover, the distinction between what is animal and what is human is blurred in the mad, further confusing the presentation of identity, because madness is often configured as a crisis of boundaries and borders.[6] Views of madness in the middle ages drew heavily from antiquity, which portray madness as an illness resulting from bodily corruption and imbalance. The mentally ill, according to medieval medicine, suffer from an internal bodily disorder that seriously disturbs their status as clearly defined subjects. Insanity insists on an interpretation that pairs madness as the opposite of sanity or health, and mental or cognitive disabilities or illness are all focused on the mind. Importantly, this made the legality of madness, a legal system which was concerned with responsibility and accountability, which ultimately led, in most instances, to an understanding that madness was an inability to comprehend the world.[7] As the immediate cause of madness becomes more subject to man’s control, the cause-effect relationship of sin to madness becomes more scientifically explicable and less supernatural.

As stated above, mania and melancholia were the most recognized forms of madness in the middle ages, however in the popular imagination there are many other forms which madness took. First, let me dispel the notion that witchcraft was often associated with madness during the middle ages. Witchcraft as madness was not only rarely associated with madness during this period, but the peak for trials for witches was during the seventeenth century, not during the middle ages.[8] However, that is not to say that supernatural causes for madness did not crop up during this period. Demonic possession was often connected with madness, and very often the two were confused to the point there possession was considered to be madness. Medical writers gave little credence to possession as madness, yet it persisted in the popular imagination. I will discuss possession further, as it manifests differently in different places. Extreme emotions, especially that of love, were often considered a sign of oncoming insanity, especially if they manifested in men. While a person of decreased mental capacity could be viewed in a lens of madness, by the middle ages, and probably before, there was a clear distinction between madness and any sort of mental incapacity, specifically there was a distinction between the madman and the fool. Finally, natural surroundings could be a cause of madness, specifically the moon, giving root to the idea of lunacy. While astrology could cause madness, it was seen as the fault of the individual for being weak and prone to madness.

The first thing of interest is a literature of stories and morality tales. Its origins, no doubt, were far distant, but at the end of the Middle Ages it became a considerable mass: a long series of ‘follies’ which as in the past stigmatized vices or faults but blamed them not on pride, a lack of charity or neglect of Christian virtues but on a great unreason which could be blamed on no one in particular but which dragged everyone along in its wake in a sort of tacit agreement. The denouncing of madness became a general form of moral critique.  During this same period, literary, philosophical and moral aspects of madness were in an altogether different vein. The middle Ages had placed madness or folly in its hierarchy of vices. From the thirteenth century, onwards it was common to see Folly enlisted in the wicked soldiery of the Psychomachia. The most famous madman of the romance tradition is Chretien de Troye’s Yvain, whose madness results from a convergence of traumatic experiences (loss of love, shame of being publically denounced, despair over conflicting interests of love and duty).[9] Literature represents a window into what a wider public may be thinking about conceptions of madness, especially in differences across cultures. In order to begin an exploration of madness in medieval literature, it would work well to look first to representations of madness within the Bible, and the legacy towards madness that biblical teachings gave to the Middle Ages.

[1] Harper, Stephen. Insanity, Individuals, and Society in Late-Medieval English Literature: The Subject of Madness. Studies in Mediaeval Literature 26. Lewiston, NY: Edwin Mellen Press, 2003

[2] Doob, Penelope B. R. Nebuchadnezzar’s Children: Conventions of Madness in Middle English Literature. New Haven: Yale University Press, 1974: 2-3

[3] Forcen, Carlos Epsi and Fernando Epsi Forcen. “Demonic Possessions and Mental Illness.” Early Science and Medicine, no. 19 (2014): 261

[4] Classen, Albrecht. “Mental and Physical Health, Spirituality and Religion in the Middle Ages and Early Modern Age: Medieval Answers for Our Future? With Special Emphasis on Spiritual Healing through Narratives of Mourning.” In Mental Health, Spirituality, and Religion in the Middle Ages and Early Modern Age, edited by Albrecht Classen, 1–154. Berlin: de Gruyter, 2014.

[5] Huot, Sylvia. Madness in Medieval French Literature: Identities Found and Lost. Oxford: Oxford University Press, 2003: 1

[6] Ibid., 10

[7] Eyler, Joshua R. Disability in the Middle Ages: Reconsiderations and Reverberations. Burlington VT: Ashgate, 2010.

[8] Harper, Stephen. Insanity, Individuals, and Society in Late-Medieval English Literature: The Subject of Madness. Studies in Mediaeval Literature 26. Lewiston, NY: Edwin Mellen Press, 2003.

[9] Huot, Sylvia. Madness in Medieval French Literature: Identities Found and Lost. Oxford: Oxford University Press, 2003: 29