For most of recorded history, epilepsy was treated with prayers, rituals, herbal concoctions, dietary restrictions, and sometimes outright dangerous folk remedies, because the condition was overwhelmingly understood as a spiritual affliction rather than a medical one. The first drug that reliably reduced seizures, potassium bromide, did not appear until 1857. Before that date, roughly five millennia of documented human responses to epilepsy relied on approaches that ranged from sophisticated herbal pharmacology in Asia to exorcism in medieval Europe to the drinking of gladiator blood in ancient Rome.
Spirits and the Sacred Disease
The oldest detailed accounts of epilepsy come from ancient Mesopotamia, where Babylonian medical texts catalogued seizure types with impressive clinical precision while attributing them entirely to supernatural forces. Cuneiform tablets from roughly 2000 BCE described different seizure presentations in ways that modern neurologists can still recognize, yet the prescribed response was incantation and ritual, because the seizures were believed to result from attacks by evil spirits or the displeasure of specific gods.1PubMed. Psychoses of epilepsy in Babylon: the oldest account of the disorder This supernatural framing would persist across cultures for thousands of years and remains the single most important fact about historical epilepsy treatment: the barrier to effective care was not a lack of observational skill but the assumption that seizures had spiritual rather than physical causes.
The Greeks gave epilepsy its most famous early label, calling it the “sacred disease” because its sudden, dramatic seizures seemed to indicate divine visitation. The term itself reveals the conceptual trap. If a disease is sacred, its treatment belongs to priests, not physicians.
Hippocrates and the Radical Idea That Epilepsy Was Medical
Around the fifth century BCE, a Hippocratic author wrote “On the Sacred Disease,” one of the most remarkable documents in medical history. The text was essentially a furious argument against the idea that epilepsy had divine origins. Hippocrates insisted the condition had natural causes like any other disease and identified the brain as its seat, pointing to heredity and the accumulation of bodily fluids as underlying factors.2PubMed. Hippocrates, Galen, and the patient with epilepsy. Some new perspectives on the old masters In the Hippocratic framework, seizures resulted from excess phlegm or bile disrupting the brain’s normal function, and treatments centered on diet, lifestyle changes, and correcting those imbalances.3PubMed. Epilepsy, Theories and Treatment Inside Corpus Hippocraticum
This was genuinely revolutionary thinking. The Hippocratic writers got the mechanism wrong, obviously, but they got the framing right: epilepsy was a brain disorder, not a curse. Their recommended treatments were mild by ancient standards. Dietary regulation, rest, avoidance of certain foods, and gentle exercise replaced sacrifice and prayer. The tragedy is that this naturalistic view largely failed to take hold in the broader culture. For most people living with seizures in the centuries that followed, treatment remained firmly in the spiritual domain.
Gladiator Blood and Other Folk Cures
If one theme dominates the folk treatment of epilepsy across cultures, it is the belief that consuming specific substances during or after a seizure could drive out the affliction. Some of these remedies were merely ineffective. Others were genuinely grim.
In ancient Rome, between the first and sixth centuries, multiple medical and theological authors described the practice of having people with epilepsy drink the blood of slain gladiators or consume their liver. The rationale likely traced back to Etruscan funeral rites, in which the blood of the fallen carried sacred or transformative power. Even as the religious context faded over the centuries, the magical use of gladiator blood persisted as a folk epilepsy remedy.4PubMed. Between horror and hope: gladiator’s blood as a cure for epileptics in ancient medicine After gladiatorial combat ended, similar beliefs transferred to the blood of executed criminals, and scattered reports of this practice surface in European records as late as the nineteenth century.
Trepanation, the drilling or scraping of holes in the skull, is sometimes cited as an early epilepsy intervention, though its original purpose across prehistoric cultures remains debated. Other folk remedies recorded across Europe included wearing amulets made of specific metals or animal parts, burning particular herbs to inhale the smoke, and applying poultices to the head. The common thread was the assumption that something needed to be driven out of or warded off from the body.
Ayurveda, Chinese Medicine, and Islamic Approaches
While European medicine largely abandoned the Hippocratic naturalistic view of epilepsy during the medieval period, other medical traditions continued developing systematic treatments. Indian, Chinese, and Islamic physicians all produced detailed written accounts of seizure disorders and formulated complex therapeutic approaches.
Ayurvedic Medicine
The foundational texts of Ayurveda, the Charaka Samhita and Sushruta Samhita, described epilepsy under the Sanskrit term apasmara, meaning loss of memory or consciousness. Ayurvedic physicians recognized that seizures arose from a disturbance in brain function and catalogued different seizure types based on their clinical presentation. They attributed the condition to both internal imbalances and external factors, and treatment involved detailed formulations of naturally occurring substances, compounded and administered in specific ways.5PubMed. Ancient Indian concepts about phenomenology, biology, and therapeutics of epilepsy The level of pharmacological detail in these texts is striking. While the humoral framework was wrong, the therapeutic sophistication was far beyond “take this herb.” Practitioners used combinations of plant, mineral, and animal-derived ingredients calibrated to the type of seizure and the constitution of the patient.
Traditional Chinese Medicine
In the Chinese medical tradition, epilepsy was understood as arising from wind, fire, phlegm, stasis, or deficiency. TCM prescriptions for epilepsy aimed to calm the liver, open the body’s “orifices,” reduce fever, and promote blood circulation. These formulations used bioactive components from natural drugs, and some of the plants involved have drawn modern pharmacological interest for their potential anticonvulsant properties.6PubMed Central. A narrative review on traditional Chinese medicine prescriptions and bioactive components in epilepsy treatment Acupuncture was also used as an adjunct treatment and remains part of TCM’s epilepsy management approach today.7PubMed Central. Nonpharmacological treatment of epilepsy
Ibn Sina and Islamic Medicine
During the Islamic Golden Age, the Persian physician Ibn Sina (known in the West as Avicenna) synthesized Greek, Roman, and Islamic medical knowledge in his monumental Canon of Medicine. He produced a systematic classification of epilepsy, distinguishing between forms arising directly from the brain and those caused by problems elsewhere in the body. His treatments included bloodletting, dietary adjustments, herbal remedies such as lavender and anise, and physical therapies.8PubMed. Ibn Sina’s contributions to epilepsy management: Innovations from the Islamic Golden Age Ibn Sina’s work represented a genuinely advanced pharmacological approach for its era and influenced European medicine for centuries after the Canon was translated into Latin.
Medieval Europe’s Religious Turn
In Western Europe, the medieval period saw a dramatic regression in epilepsy treatment. With a few exceptions among early Byzantine physicians, scientific views of epilepsy were overwhelmed by the dominance of the Catholic Church. People with epilepsy were widely considered possessed by demons, and treatment consisted almost entirely of religious methods: prayer, exorcism, pilgrimages, and the intercession of saints.9PubMed. Epilepsy during the Middle Ages, the Renaissance and the Enlightenment
Saint Valentine became particularly associated with epilepsy in German-speaking regions, where depictions of the saint curing people with seizures became common. Pilgrimages to sites holding his relics were a standard response to the condition, and epilepsy was widely known as “Saint Valentine’s Disease.”10PubMed Central. Saint Valentine and Epilepsy: from Medieval Devotion to Modern Global Advocacy Other saints were invoked in other regions. The underlying logic was consistent: if seizures came from demonic interference, then divine intercession was the only plausible remedy. This framework persisted for centuries and coexisted uneasily with the remnants of Hippocratic naturalism that survived in monastic libraries and university medical faculties.
Healing Practices in Africa and the Americas
Indigenous approaches to epilepsy treatment across Africa and the Americas developed independently and carried their own internal logic, combining spiritual interpretation with the use of plant and animal-derived remedies.
In parts of West Africa, traditional healing for epilepsy fell into two categories: acute interventions during a seizure and longer-term prevention. During a seizure, traditional healers in Guinea might place garlic, orange, alcohol, or grain paste into the person’s nose or mouth, sometimes while reading Koranic scripture. Preventive approaches included the use of talismans, rubbing scripture-infused preparations over the body, and having the person drink water over which religious text had been recited.11PubMed Central. Management of epilepsy through indigenous traditional and Western approaches in Africa: A systematic review These practices blended pre-Islamic spiritual traditions with Islamic religious elements.
Among indigenous groups in Central and South America, epilepsy was often attributed to specific spiritual causes. The Kamayurá people of Brazil called it teawarup and traced it to the revenge of an armadillo spirit; treatment involved kneading specific roots in water. The Chipaya people of Bolivia attributed epilepsy to a witchcraft entering through the nose and treated it with ritual animal sacrifice, dried insect infusions, and bird’s blood.12PubMed. An anthropological study about epilepsy in native tribes from Central and South America These examples are not curiosities from the distant past. Many of these practices continued into the twentieth century and, in some communities, remain part of how epilepsy is understood and addressed alongside or instead of Western medicine.
The Enlightenment and the First Effective Drug
The Enlightenment brought a slow but real shift. European physicians began systematically revisiting epilepsy as a medical rather than spiritual condition. In 1770, the Swiss physician Samuel Tissot published his Traité de l’épilepsie, a thorough account of what was then known about the condition. Tissot critically reviewed the existing literature, added his own clinical observations, and set the intellectual stage for the advances that followed over the next century. The timing was right: European medicine was increasingly abandoning its reverence for ancient authority and opening itself to empirical observation.
The true watershed moment came on May 11, 1857, when the English physician Sir Charles Locock reported in The Lancet that he had used potassium bromide to treat seizures in fifteen young women with what he described as “hysterical” epilepsy.13PubMed. Antiepileptic drug therapy the story so far This was, by broad consensus, the introduction of the first reasonably effective antiepileptic drug.14PubMed. Sir Charles Locock and potassium bromide Bromide had significant side effects, including sedation, skin problems, and cognitive dulling, but it genuinely reduced seizure frequency for many patients. For the first time in history, physicians had a pharmacological tool that worked. Bromide remained a mainstay of epilepsy treatment for decades.
Surgery, Diet, and the Electrical Brain
The late nineteenth and early twentieth centuries brought a burst of innovation in epilepsy care, driven by advances in understanding brain function.
On May 25, 1886, Sir Victor Horsley performed the first modern epilepsy surgery at the National Hospital for the Paralysed and Epileptic in London. The patient had focal seizures caused by a depressed skull fracture, and the surgery succeeded. By the end of that year, Horsley had completed nine epilepsy surgeries, firmly establishing the procedure as viable. The operation was not performed in isolation; it drew directly on the work of neurologists like Hughlings Jackson and David Ferrier, whose research on brain localization had mapped which brain regions controlled which functions.15Journal of Epilepsy. History of epilepsy surgery Without that mapping, a surgeon would have had no idea where to cut.
In the 1920s, physicians introduced the ketogenic diet as a treatment for epilepsy. The diet was designed to mimic the metabolic state of fasting, which had long been observed to reduce seizures.16PubMed. History of the ketogenic diet By drastically cutting carbohydrates and replacing them with fat, the body switches to burning ketone bodies for fuel, and something about that metabolic shift has anticonvulsant effects that researchers still do not fully understand. The ketogenic diet fell out of mainstream use when effective drugs arrived but experienced a revival in the late twentieth century, particularly for children whose seizures do not respond to medication.
Two developments in the 1930s reshaped the entire field. First, Hans Berger’s invention of electroencephalography (EEG) allowed physicians to record the brain’s electrical activity for the first time. His recordings of abnormal electrical discharges during seizures redefined epilepsy as an electrical disorder, giving clinicians a way to see what was happening in the brain during and between seizures.17PubMed. “Writing the Brain”: The birth of clinical electroencephalography This was transformative. For millennia, epilepsy had been invisible between attacks. EEG made it visible, measurable, and classifiable in ways that directly improved diagnosis and treatment selection.
Second, in 1938, Tracy Putnam and Houston Merritt discovered that phenytoin (sold as Dilantin) could stop seizures without the heavy sedation caused by bromides and phenobarbital. Their key insight, which they stated more explicitly than anyone before them, was that a drug’s anticonvulsant effect could be separated from its sedative effect.18PubMed. Putnam, Merritt, and the discovery of Dilantin This seems obvious now, but it was a conceptual breakthrough. Earlier drugs controlled seizures partly by just suppressing all brain activity. Phenytoin showed it was possible to target seizures specifically, and this principle drove the development of every subsequent antiepileptic medication.
Colonies, Marriage Bans, and the Weight of Stigma
The history of epilepsy treatment cannot be separated from the history of what society did to people with the condition. Treatments did not exist in a vacuum of pure medical concern. They were embedded in social systems that routinely stripped people with epilepsy of their freedom and basic rights.
In the late nineteenth century, specialized epilepsy colonies were established to house people with seizures who could not care for themselves or whom society did not want to accommodate. The Craig Colony for Epileptics in New York, which began admitting patients in 1896, drew most of its residents from county poorhouses and almshouses. In its first eight months, 145 people were admitted, all certified as indigent, with hundreds more identified in state asylums and poorhouses as eligible for transfer.19Journal of Mental Science. Craig Colony and Chalfont Colony for Epileptics Similar colonies operated in England and across continental Europe. These institutions were often framed as humane alternatives to asylums, and some genuinely provided better care and community than their residents had known. But they also functioned as sites of segregation, removing people with epilepsy from mainstream society.
The eugenics movement of the late nineteenth and early twentieth centuries made the situation worse. In multiple countries, laws restricted people with epilepsy from marrying, based on an overestimation of how heritable the condition was and on eugenic theories about preventing the “unfit” from reproducing.20PubMed. Epilepsy and marriage – the story of the abolition of laws that discriminated people with epilepsy in Norway In Norway, marriage restrictions for people with epilepsy persisted well into the twentieth century. Similar laws existed in parts of the United States, where some states also authorized involuntary sterilization of people with epilepsy. These were not medieval holdovers. They were modern, legislated policies enforced by twentieth-century governments.
The stigma outlived the laws. Research comparing interviews with people with epilepsy from the mid-1970s to interviews conducted in the mid-2000s found that collective memories of what epilepsy had been continued to shape how people experienced and identified with the condition decades after the worst legal discrimination had ended.21PubMed. Forgetting and remembering epilepsy: collective memory and the experience of illness The history of mistreatment became part of the illness experience itself.
Why Some Historical Treatments Worked (Sort Of)
It is tempting to dismiss everything that came before modern pharmacology as useless superstition, but the picture is more interesting than that. Fasting, which multiple cultures independently observed to reduce seizures, turned out to have a real metabolic basis that led to the ketogenic diet. Some of the plants used in traditional Chinese and Ayurvedic medicine contain compounds that modern research has identified as having genuine anticonvulsant activity. Valerian root, which appears in medieval European herbals as a remedy for convulsions, contains chemicals that interact with the same brain receptors targeted by some modern antiepileptic drugs.
The problem was never that pre-modern physicians failed to observe. Babylonian scribes described seizure semiology with a precision that modern epileptologists respect. Hippocratic writers correctly identified the brain. Ayurvedic texts catalogued seizure types. Islamic physicians distinguished between epilepsy arising in the brain and epilepsy triggered elsewhere in the body. The observations were often excellent. What was missing was a framework that could connect those observations to effective, reproducible interventions, and that framework required an understanding of electrical activity in neurons that simply did not exist until the twentieth century.
The gap between accurate observation and effective treatment is one of the most striking features of epilepsy’s long history. For roughly four thousand years, clinicians across multiple civilizations described seizures in terms that remain clinically recognizable, yet the dominant response oscillated between spiritual intervention and mild herbal sedation. The arrival of potassium bromide in 1857, EEG in the 1920s, and phenytoin in 1938 compressed more therapeutic progress into about eighty years than the preceding four millennia had produced. That compression came not from any single breakthrough but from the convergence of brain mapping, electrical recording, and systematic drug screening, a combination that turned epilepsy from a mystery into a problem that could be measured and, increasingly, managed.