From its outset, MadByz pursued three axes: forgotten categories of pre-modern psychopathology, Byzantine medical practice, and the transmission of nosological concepts into cultural arenas.
The project offered the first comprehensive study of an ancient and medieval label for “religious insanity”, enthousiasmós – literally “being inspired by a god”, but in classical texts often describing pathological ritual frenzy. While mania or melancholia had long been studied, enthusiasm had never received sustained attention. MadByz reconstructed its transformations from classical medicine and philosophy to Byzantine re-elaborations, showing how it came to be defined as a form of melancholy with delusional fears of God or illusory prophetic powers.
By editing and analysing a tenth-century compilation by the physician Romanos, the project revealed how monastic hospitals in Constantinople treated patients with psychological and spiritual distress. Far from limiting care to exorcism or spiritual direction, practitioners prescribed pharmacological remedies, dietary measures, rest, and even preventive strategies such as discouraging attendance at vigils or chants when these heightened anxiety. These findings show that Byzantine institutions could integrate mental healthcare into broader medical practice, challenging the stereotype of a purely religious approach and revealing instead a pragmatic, human-centred dimension.
The project also traced the fortunes of ancient nosological categories in unexpected arenas. The so-called “Heraclean disease” – a proverbial expression derived from Euripides’ tragedy in which Heracles is struck by madness – was reinterpreted as insanity triggered by exertion. This medicalised reading was transmitted through philosophical and medical texts and eventually crystallised in Byzantine collections of proverbs. A tragic motif thus entered medical discourse, became a clinical label, and resurfaced in everyday speech.
The early Byzantine physician Alexander of Tralles redefined melancholy as an overarching category absorbing mania and other mental disorders. This reinterpretation, long neglected, helps explain why early modern authors such as Robert Burton, in his Anatomy of Melancholy, could argue that “folly, melancholy, madness, are but one disease.” By tracing this genealogy, MadByz revealed Byzantium’s crucial role in shaping ideas that resonated into the modern period.
Results were disseminated through scholarly publications, invited lectures at leading European institutions, and an international conference in Athens (May 2025). The proceedings, to appear in two open-access special issues, will ensure long-term visibility. Public engagement activities included lectures for psychiatry trainees in Italy, postgraduate teaching in Paris, and a public talk at the Danish Institute at Athens.
