As the various causes of madness generally carry moral connotations that brand the madman as a sinner responsible for his own disease, so too the usual symptoms often point to moral fault in at least two ways. First, the actions of many madmen are grotesque, mechanical, absurd: as such, they naturally indicated a certain deformity of soul, a lack of the image of God, that is associated with moral depravity. Second, literary madmen suffer from a sort of guilt by association, and are quite often based upon biblical madmen, in the West. As stated before, it was commonly believed that the Original Sin disposed all men to madness and disease and caused mental derangement by altering man’s psychology, so all men were born predisposed for madness. According to Stephen Harper in Insanity, Individuals, and Society in Late-Medieval English Literature, the connection between sin and madness is made clear in the Old Testament, giving the example of Zechariah predicting that the people who attack Jerusalem will be punished with madness. [1].

There are three purposes for which disease and madness are afflicted, according to a view of disease that derives from sin: punishment, purgation, and test. Punishment in literature usually appears in the form of a vain pagan king who denies the true god (the mad sinner). Purgation in literature appears in order to remake a once holy person (the unholy wild man). Test in literature is usually voluntary (the holy wild man). Herod would be the best example of the mad sinner in medieval literature. However cruel and tyrannical he may have been, though, he was not actually a mad sinner. This image was a creation of the middle ages. Outside of these three purposes for madness, there were also levels to what was considered a crime and a sin as committed by someone on the cusp of being deemed insane. A totally involuntary act (e.g. a murder committed by a man maddened by a blow to the head) is not sinful; a partly voluntary act (a murder committed by a man maddened by passion so strong it could have been resisted only with the greatest difficulty) is a sin, but its seriousness is somewhat diminished; and a technically voluntary act (a murder committed by a drunk) is completely sinful.[2] Also, to the extent that disease is seen in moral terms as a punishment for sin or a test from God, the cure too usually has a moral component.

The final, and most important, aspect of biblical madness as it pertains to medieval conceptions of madness in literature is that of the concept of spirit possession. William Menzies Alexander was one of the first to note that even within the Bible, the concept of spirit possession as a form of madness is relatively new. Outside of the New Testament, there are no cases of demoniacal possession, but there are explicit cases of lunacy and epilepsy; within the New Testament, there are no cases of lunacy and epilepsy proper, but many cases of demoniacal possession. From this, it would seem that there is something interesting about the appearance of Christ within the text in relationship to discussions of madness. In the Gospels, those looked upon as the seat of demonic possession would have been seen as sick persons in the Old Testament, suffering from peculiar diseases (mania, epilepsy, delirium, hypochondria, paralysis, temporary dumbness).[3] The main spiritual basis for the discernment of spirits are Mark 13:22, Matthew 24:24, II Corinthians 11:13-15, I Timothy 3:1-2, II Timothy 3:2, II Timothy 3:5-7, and I John 4:1. They provide a basic set of linguistic idioms that medieval authors drew upon when discussing the issue.[4]

It would seem that Christianity has a long tradition of spirit possession, probably due to the fact that spirit possession confers miraculous powers onto Jesus. However, it must be noted as well that there is a link between the rise of monotheism in general and the rise of reported cases of spirit possession.[5] Jesus’ experience of spirit possession was to say the least a form of positive spirit possession.[6] It gave him power to heal those who believed his spirit was holy and it gave him power to cast out demons and those spirits that caused disease. Jesus’ method of casting out demons became the paradigm for exorcism rituals in the Christian tradition. [7] When medieval people attempted to decide whether an individual was divinely or demonically possessed, they were responding to a congeries of ambiguous behaviors that could signify either state. That is to say, the cultural categories of the divinely and the demonically possessed were constructed in similar ways as regards exterior behaviors, even though in terms of interior status the two categories were dichotomous: one involved the penetration of the Holy Spirit, and the other, an evil spirit. The most important aspect of the entire concept of spirit possession, whether positive or demonic, is that possession is always associated with win, so man must consent, by sinning or accepting salvation, in order to be possessed by the devil or the holy spirit. Consent is paramount to a biblical interpretation of possession as madness, connecting back to the complicated issue of identity. Perhaps it is simply a fact of human nature that we are loathe to acknowledge that misfortune comes by chance rather than by desert; but whatever the reason, medical theory from pagan antiquity through the Renaissance assigned moral as well as physical causes to disease, and religious remedies were proposed in conjunction with purely physiological ones. What is more is that saintliness could sometimes clothe itself in the disguise of madness, so madness could take on the form of a parodic or perverted saintliness.

While most scholars studying medieval forms of madness as portrayed in literature agree that possession and madness were often seen as the same illness, Peter Dendle in his book Demonic Possession in Anglo-Saxon England, disagrees on the extent that possession and madness were distinct illnesses. According to Dendle, demon possession is not just an early misunderstanding of mental illness, though mental illness was sometimes interpreted as possession. A wide range of aberrant behaviors, from muscle control disorders to political and theological heterodoxy, were periodically regarded as the work of demons (sometimes described as indwelling, sometimes not)-and nondemonic muscle control and mental disorders.[8] To Dendle, there is a much more delicate relationship between sin and illness through the middle ages than some other authors are willing to admit, an association which at times finds expression in passages implying that all illness was at some root level attributed to prior guilt or sin. He sees that more often than not, possession was considered distinct from insanity throughout the medieval era, though he does concede that it is rarely clear how precisely any given author envisions this distinction.[9]

[1] Harper: 31

[2] Doob, Penelope B. R. Nebuchadnezzar’s Children: Conventions of Madness in Middle English Literature. New Haven: Yale University Press, 1974: 35

[3] Alexander, William Menzies. Demonic Possession in the New Testament: Its Relations Historical, Medical, and Theological. Edinburgh: T & T Clark, 1902: 2

[4] Caciola, Nancy Mandeville. Discerning Spirits: Divine and Demonic Possession in the Middle Ages. Ithaca, NY: Cornell University Press, 2003: 4

[5] McNamara, Patrick. Spirit Possession and Exorcism: History, Psychology, and Neurobiology. Santa Barbara, CA: Praeger, 2011: 133

[6] Positive spirit possession needs to be briefly address. While it is true that positive spirit possession protects against demonic possession, it, like demonic possession, was seen as a form of madness. However, positive spirit possession was a crucial step towards achieving salvation.

[7] McNamara., 133

[8] Dendle, Peter. Demonic Possession in Anglo-Saxon England. Kalamazoo, Michigan: Medieval Institute Publications, 2014: 3

[9] Dendle, Peter. Demonic Possession in Anglo-Saxon England. Kalamazoo, Michigan: Medieval Institute Publications, 2014: 4