Blog #44: Epilepsy in Shakespeare's Characters

(This blog was originally posted on March 23, 2014)

My extensive study of Shakespeare’s works reveals characters that apparently had seizures and epilepsy. Based on my clinical neurological experience in the care of patients, I am certain that the great author-playwright had to have observed many seizures in its different forms.

Moving along London’s Renaissance thoroughfares, Shakespeare witnessed citizens harboring countless maladies. Epilepsy is estimated to occur in almost one percent of the population today, and there must have been at least that incidence then.  Two of the plays describe characters in the throes of a fit; others refer to altered behavior and/or responsiveness; and one makes reference to an ill-defined “epileptic” expression. 

In Othello, Othello has an actual seizure on stage following a severe emotional stress created when Iago, his trusted, but disloyal companion, famously drops Desdemona’s handkerchief for her husband, Othello, to find. This discovery causes Othello to fly into a jealous rage and an epileptic aura begins. Othello becomes confused. “It is not words that shake me thus– Pish! Noses, ears and lips? Is’t possible? – Confess? – Handkerchief? – O devil! (He falls in a trance).” (Act IV, scene 1, line 41):

Iago explains to Cassio, an observer: “…My lord is fall’n into an epilepsy. This is his second fit; he had one yesterday.” Cassio then advises: “Rub him about the temples.” Iago responds: “No, forbear. The lethargy must have his quiet course. If not, he foams at the mouth, and by and by breaks out to savage madness. Look, he stirs. Do you withdraw yourself a little while. He will recover straight.”

Anyone familiar with complex partial seizures will recognize the classical symptoms of Othello’s seizure: the aura initiated by emotional distress; the confusion and loss of awareness; and Iago’s warning to Cassio not to touch or try to restrain Othello in the midst of the seizure, which could lead to Othello reflexively assaulting Cassio, in which case he would have no recollection of doing so, afterwards.

Later in the play, Othello murders his wife in a jealous rage. In our twenty-first century, Othello’s defense lawyer could argue that his client was innocent, or at least guilty of a far less serious charge. His client, a known epileptic, was not responsible for his action because he killed in the throes of his epilepsy. This defense would be even stronger if there had been a witness who heard Desdemona crying out as she was being strangled (Act V, scene 2, line 40): “And yet I fear you; for you’re fatal then when your eyes roll so.”

 

In Julius Caesar (Act I, scene 2, line 246):    Caesar’s associates discuss Caesar’s illness. Casca says, “…for he swounded and fell down at it …He fell down in the market place and foamed at the mouth and was speechless.” Brutus says, “’Tis very like he hath the falling sickness. …What did he say when he came unto himself?” Casca replies,             “…and so he fell. When he came to himself again, he said, if he had done or said anything amiss, he desired their worships to think it was his infirmity…”

Earlier in Julius Caesar, Cassius describes Caesar in the throes of a febrile illness. Rigors of febrile chills―possibly malaria, or possibly part of another of Caesar’s convulsions―were described by Cassius in Act I, 2,119:  “…he had a fever when he was in Spain, and when the fit was on him, I did mark how he did shake. ‘Tis true, this god did shake. His coward lips did from their color fly, and that same eye whose bend doth awe the world did lose his luster. I did hear him groan…”

 

 

In Macbeth, upon hearing disturbing news, Macbeth alludes to an alteration in his well-being (Act III, 4, 21): “Then comes my fit again. I had else been perfect; whole as marble, founded as the rock…” Macbeth then experiences visual hallucinations, seeing the form of Banquo, a nobleman just murdered on his orders. Macbeth then reacts to his companions in a confused manner.  His wife makes excuses, alluding to a fit (Act II, 4, 51): Nobleman Lennox asks, “What is’t that moves your Highness?” Macbeth says, “Which of you have done this?”  Ross, a nobleman, says, “Gentlemen, rise. His Highness is not well.” Lady Macbeth says, “Sit, worthy friends. My lord is often thus, and hath been from his youth. Pray you keep seat. The fit is momentary; upon a thought he will again be well…” Macbeth’s affliction could possibly be complex partial seizures.

 

The romance comedy, The Tempest, includes Caliban, a savage and deformed slave. Shakespeare makes reference to fits, which could imply shaking chills, or possibly a seizure, in the following exchange of Stephano to Caliban; Act II, 2, 72:

• Stephano says, “He’s in his fit now and does not talk after the wisest. He shall taste of my bottle: if he have never drunk wine afore, it will go near to remove his fit….Open your mouth. This will shake your shaking, I can tell you, and that soundly (gives Caliban a drink).

 

 

The Earl of Kent, in King Lear, exclaims in anger; Act II, 2, 76: “A plague upon your epileptic visage!” This probably refers only to a face contorted in a grin but Shakespeare demonstrates his descriptive talents.

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. DINGS is his first novel. It is a mother’s dramatic story that teaches epilepsy.