Lovecraft was schizophrenic

Medicine and madness at Cthulhu

What we would perhaps call the first hospital was a Greek temple, a good half a millennium before the Christian era. This temple was dedicated to the god Asclepios, a healing god who, according to Greek mythology, belongs to the Chtonian gods. The healing process or the Asclepius cult is described in such a way that the sick go to sleep outside the cities in a temple. Strict attention is paid to rest, and during sleep, in the dream of Asklepios, the sufferer himself is imposed on diets and cures that alleviate the disease. The cult of Asklepios is probably related to the Imhotep cult.

Imhotep was a scholar of the 3rd millennium BC in Egypt. As a universal scholar, he is also ascribed a special knowledge of medicine. In the Greco-Roman world, Imhotep and Asklepios partially merged into one mythical figure.

Hyppocrates: beginning of medicine as a science

The transition from a supernatural, divine-magical concept of illness to a rational concept of medicine is associated with the name of one man: Hippocrates of Kos. He puts the observation of the body at the center of his medical diagnosis. Hippocrates sees himself as a descendant of Asclepius.

The Asklepios cult actually had an effect. One can compare it on the one hand with a cure and the associated getting out of everyday life, on the other hand the so-called healing sleep is a well-known remedy for various diseases and injuries. To what extent the priesthood actively influenced dreams and treatment, one can at best speculate. However, some reports from the patients are extremely plastic and could be an indication of manipulation. Similar to the oracle of Delphi, hallucinations could also have been caused here by gases.

What is exciting is a cult of dream healers, which can be very easily incorporated into lovecraft adventures. In principle, this cult would have no bad intentions, but individual members could have dissenting opinions about boundaries that could not be crossed. Aslepios himself was killed by Zeus because he used his healing art to bring a dead person back to life.


Medicine in the Middle Ages

Medicine in the European Middle Ages is largely uninspired. The knowledge from antiquity is hardly used and the clergy takes care of the sick. As a result, illnesses are increasingly seen as God's punishment for a dishonest life. In the Islamic world, but also in the Orthodox Eastern Roman Empire, the knowledge of the Greeks is built upon.

The new world

With the discovery and colonization of the New World, slaves in particular from West Africa are deported to the West Indies and the French areas of the new continent. They bring their own religion, voodoo, with them. Through the mixing of beliefs and the search for one's own religious home, directions of belief develop that have moved away from their African origins. In particular, the cult of the voodoo doll was originally used by priests in Haiti. This is not about a harmful spell, at least not primarily, but an analogy spell that is supposed to help the sick.

The doll is the representative body. The illness or injury is localized and healed with a ritual. Similarities with the European medieval Atzmann probably lead to the fact that the puppet magic is basically dismissed as evil.

Voodoo also assumes that health problems are caused by a higher power. The difference, however, is that suffering is not of divine but of demonic or ghostly origin.

Voodoo followers also believe in that one, good god, but it is too powerful to be called directly. As in Catholicism, a priesthood is therefore necessary, and ancestral cult and belief in spirits and demons are mandatory, these are everywhere and help and harm people. Healing is therefore achieved by invoking deceased relatives or spirits or by driving out demons. Sometimes rituals with animal sacrifices are necessary. Here the life of the animal is given to the spirit or the ancestor, while the meat of the animal is eaten by the sufferer or the participants in the ritual. Strictly speaking, it is therefore ritualized slaughter, as it occurs in many religions. People are not offered as sacrifices, such cases are not part of the voodoo ritual.

The old medicine lives on in Africa in particular, but natural medicine and spiritual healing in connection with ceremonies and intoxicating substances are also used more or less successfully in Haiti and parts of South and Central America. In conventional medicine, one can speak of charlatanism up to verifiable results, such as the effect of some jungle plants on rheumatism or to disinfect wounds.

Marie Laveau is considered the most important voodoo priestess and most influential person in New Orleans towards the end of the 19th century. After her death in 1881, her eldest daughter, who is also called Marie Laveau, continues her mother's practices. Marie Laveau the Younger but soon disappears without a trace The call of the Cthulhu Lovecraft describes how carved figures that are probably images of the Cthulhu are found during a raid on an alleged voodoo ceremony. What if these swamp priests of Louisiana had corrupted voodoo in a disgusting way?

One point that has not been considered a disease in either Europe or the New World is mental illness or insanity. If someone is mentally not up to date in the Middle Ages, he will at best be mocked, but was able to survive in the mostly village community. Only in the case of aggressive disturbances is the person excluded and banished from a need for protection.

Nervous ailments and madness

Ailments like epilepsy, holy disease or simply called epilepsy are considered to be signs of obsession. Delusions, personality disorders and extreme psychoses are treated with an exorcism. It should be noted that psychosis can also be caused by religious devotion. In the Middle Ages, the existence of demons, spirits, the devil and God was not a question of belief, but a fact. Stepping into this world, encouraged by the affirmation of society, can lead to a delusion or obsession that cannot be primarily cured or alleviated psychiatrically, but only in the way that religious practice provides.

Exorcisms are more the rule than the exception in church history, but to what extent there is a helping approach behind them is unknown after the many horror films of the present day. The expulsion is supposed to help the victim, this has always been the goal. That this goal could not always be achieved (numbers of failed exorcisms of the Middle Ages and the present are unfortunately not available to me) should be clear, the medical discipline and the knowledge of body and mind, in general, have rarely been as low as in human history during the Middle Ages in Europe, which is why little help with illnesses could generally be expected. One case that has achieved notoriety is the death of Anneliese Michel in 1976. Although the exorcism was not the cause of death here, the priests and parents were sentenced for the lack of medical care during the ritual.

Trance and states of obsession are clinically documented and show their own clinical picture. However, other disorders such as schizophrenia, delusions or mental changes such as depression as a result of mental or physical trauma or illnesses may not be diagnosed; they are always considered to be an exclusion criterion. This may be because of the need to ensure priority medical care. In the case of Anneliese Michel, it is certain that she suffered from epilepsy. An expulsion never helped, and whether there were other mental illnesses could never be diagnosed.

Followers of a cult, as Lovecraft describes it, are mad or firmly convinced of their belief. The mix here is exciting, some are religious zealots while others have gone mad. Because delusional people, psychopaths or schizophrenics are hardly able to create sustainable structures to build, maintain or expand an organization like a cult. Zealots are necessary for this. In addition, it is questionable whether the members are basically treatable.


The beginning of modern medicine

A new era begins at the beginning of the 20th century. In the mid-19th century, epilepsy was studied more closely and than right one Disease recognized. In 1908 the term schizophrenia was established and after the First World War the tremor of war or the war neurosis led to the state taking an interest in the diagnosis and treatment of psychological and neurological diseases. The doctor Sigmund Freund also gave psychiatry new impulses. Sickness and illness are now seen in a psychosocial setting. There is still an old approach to therapy, which consists of hot baths, pain and immersion in water. The repertoire was later expanded to include electroshock therapy and surgical interventions on the brain.
One innovation is drug treatment. Not least through the development of pharmaceutical products and the synthesis of naturally occurring active ingredients such as barbiturates, heroin and caffeine and institutional treatment in clinics are exemplary in the German Reich.
The third approach about behavioral therapy, if one would like to designate the form of this therapy that was not yet systematically recorded at the time, as well as psychoanalysis is viewed extremely skeptically and is only enjoying a lively popularity overseas.


The new approaches end abruptly as if inhuman. Not only were Freud's books burned, any attempt at serious confrontation with mental illnesses was suppressed by the National Socialists. As part of the annihilation of unworthy life, around 100,000 people are murdered.

There were tendencies towards euthanasia even before the end of the 19th century. But it wasn't until this time that the approach changed. These were theoretical considerations that no longer had anything to do with euthanasia of suffering and terminally ill people, but internalized popular or racial hygiene and the spirit of social Darwinism.
Eugenics is a widespread theory in the industrialized countries of the time. However, I consider it very complex and difficult to go into it explicitly in terms of playing technique, because on the one hand it serves as a catchphrase for social progress in the beginning of the century, on the other hand the player is familiar with the consequences of a corresponding practice.

I find the history of medicine for the atomic age or the present less exciting, which is why I will not continue with it here. In particular, the spirit of the 20s with its belief in progress and an omnipresent war trauma make characters easily susceptible to pill and alcohol abuse, at least addiction and dependence are an issue with city dwellers, even if this is not generally seen as a problem.


Medical history on Wikipedia
Medicine in the Middle Ages via planet knowledge
Very good article on schizophrenia on Wikipedia