The epilepsy of Emperor Michael IV, Paphlagon (1034-1041 A.D.): accounts of Byzantine historians and physicians.
OBJECTIVE
Presentation of epilepsy suffered by Byzantine Emperor Michael IV, Paphlagon (who reigned from 1034 to 1041 A.D.) and the attitude of his contemporary society to his disorder.


METHODS
Research into the accounts of Byzantine historians and chroniclers referring to the case of the emperor and Byzantine medical texts revealing the opinion of official medicine about the disorder.


RESULTS
Byzantine historians and chroniclers provide detailed clinical descriptions of the seizures of Emperor Michael IV. Nearly all, expressing popular opinion, considered his disease to be demonic possession that constituted a form of divine punishment for the emperor's adultery and act of murder; his royal entourage continually attempted euphemistically to present this condition as a psychic disease. On the contrary, research into Byzantine medical texts reveals that the physicians, already from the 4th century, following Hippocratic tradition, believed that epilepsy was primarily a brain-related disorder and based their treatment on this etiological principle.


CONCLUSIONS
From the study of the Byzantine histories and chronicles, it can be deduced that Emperor Michael IV, Paphlagon, suffered from generalized tonic-clonic epileptic seizures. Despite the concept then held by well-educated Byzantine doctors, who considered epilepsy a brain disorder, information indicates the deep prejudices of his social environment.
Lascaratos
J
J
Department of History of Medicine, Medical School, National Athens University, Athens, Greece.
Zis
P V
PV
D018612:Byzantium; D004827:Epilepsy / Q000266:history*; D005197:Famous Persons; D049691:History, Medieval; D006801:Humans