Next to magical elements, also earthly solutions were used to cure madness. As mental illness was ascribed to evil spirits in the head, holes were drilled in the skull of the mentally ill in order to liberate these spirits.

Ritual exorcisms of the evil spirit or devil, were also a traditional solution to insanity.

Enraged spirits, the punishing hand of a god or a witch’s spell are logical explanations for something so ungraspable as mental illness. In so-called traditional cultures, whether it concerns the Congolese Twa or the ancient Belgae, these kind of external causes were often used to explain insanity.

There were many ways of curing someone from his or her madness. It nearly always went back to driving the evil spirits out of the body, preferably in a supernatural way. Herbs were used that were believed to refer to insanity because of their name or appearance. Potions with several magical ingredients and offers for the gods or ancestral invocations were also never far off in this magical world. Ritual exorcisms of the evil spirit or devil, were also a traditional solution to insanity. Song, dance and prayer were often combined with all of the above.

However, sometimes earthly solutions were sought. In cases where mental illness was attributed to an evil spirit living in the patient’s head, this spirit was given the opportunity to escape through trephination. Many trephined skulls have been found in several cultures, where new cartilage often grew around the edges of the wound. This proves that the person in question lived for quite some time after the intervention, despite the lack of anaesthesia and disinfection.

Whatever the solution to madness, the cause of the disorder was always sought outside man in those traditional cultures. Only in Ancient Greece sources appeared in which the reason for insanity was sought within the sick person him- or herself.

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