Scope note: This article covers exorcistic healing within the Western medical tradition, from Mesopotamian and Levantine origins through early Christianity, medieval Europe, and the early modern period. Chinese and other non-Western exorcistic traditions appear only as comparative reference.
Summary
Exorcism is a ritual procedure for expelling a spirit, demon, or malign force believed to have entered and afflicted a person. In Western medical history it functioned as a primary therapeutic modality whenever illness was attributed to demonic agency rather than humoral disorder or natural cause. The practice originated in Mesopotamian medicine, entered Jewish tradition, and was prominent in early Christian healing ministry before becoming institutionalized in medieval Catholic care for the mentally disturbed. Throughout the early modern period, physicians and clergy negotiated the boundary between natural and supernatural diagnosis, using exorcism as a foil against which medical jurisdiction over madness was progressively expanded. It was never simply displaced by natural medicine; for centuries the two explanatory frameworks coexisted, competed, and informed each other.
Mesopotamian Origins
The earliest documented exorcistic medicine comes from ancient Mesopotamia, where evil spirits were understood to cause illness in three main ways: lack of caution (the dominant Sumerian view), sin against the gods (the dominant Semitic position), and sorcery or black magic.(Sigerist, Henry E., 1951) Mesopotamian evil spirits fell into three distinct classes: ghosts of the unburied dead roaming in search of a body, spirits born from human-demon unions, and pure devils whose function was to perform evil deeds on earth.(Sigerist, Henry E., 1951)
Treatment was strictly etiological: the healer aimed to remove the cause of illness by propitiating offended gods, expelling demons, and destroying witchcraft, combining prayer, sacrifice, and elaborate ritual.(Sigerist, Henry E., 1951) The Maqlu and Shurpu incantation series, two of the principal texts of Babylonian magical medicine, dealt extensively with the destruction of witchcraft through fire, using imitative magic in which images of wizard and witch were burned while spells were recited over them.(Sigerist, Henry E., 1951)
As the Semitic element grew stronger within Mesopotamian civilization, the concept of sin as the cause of disease became more prominent, and incantations gradually shifted from demon-expelling spells toward prayer-type texts addressed directly to gods.(Sigerist, Henry E., 1951)
Exorcism in the Greco-Roman World
Ancient medicine lacked any legal criterion defining who could be called a doctor; the lawyer Ulpian allowed specialists and midwives but drew the line at those using incantations, even if patients claimed benefit.(Nutton, 2023)
The Levantine tradition of attributing illness to demonic possession, requiring exorcism for recovery, was distinct from Graeco-Roman naturalism; tablets from the camp at Carnuntum show this demonological tradition spreading into the Roman army.(Nutton, 2023) The demon Barsaphael was believed to give migraine headaches to those residing “in my hour.”(Nutton, 2023) Lucian’s second-century dialogue records the perspective of an educated pagan skeptic toward exorcism of epileptics, showing that before Christianity the educated class was not inclined to conflate epilepsy and possession.(Temkin, Owsei, 1971) The dialogue describes a Syrian exorcist from Palestine who treats those who “fall down in the light of the moon.”(Temkin, Owsei, 1971)
The result was a medical pluralism, a mixture of many competing types of healing, with a range as broad as the social status of their practitioners and as the variety of doctrines that they held.(Nutton, 2023)
Jewish Antecedents and New Testament Healing
No instance of exorcism appears in the Old Testament.(Ferngren, 2009) Josephus attributes exorcistic techniques to Solomon, reflecting the Jewish tradition that linked exorcism to Solomonic wisdom.(Ferngren, 2009)
The healing ministry described in the New Testament made exorcism prominent in early Christian practice, though not all illness in the New Testament is attributed to demons; the tradition presents a more varied disease etiology than is commonly assumed.(Ferngren, 2009) The healing miracles of Jesus and his followers served not merely as acts of compassion but as demonstrations of divine authority that attracted converts, constituting a major element of Christianity’s missionary appeal.(Nutton, 2023) The New Testament account of Jesus healing a boy who foamed, gnashed his teeth, and fell into convulsion (Mark 9:14-29) became one of the most debated passages in the history of exorcism and falling-sickness; the symptoms were identical to those ancient physicians recognized as epileptic.(Temkin, Owsei, 1971)
Exorcism in Early Christian Medicine
Tertullian articulated an influential theory of demonic etiology: demons first make people ill, then command novel or contrary remedies to produce apparent cures, thereby receiving credit for the healing they themselves caused.(Ferngren, 2009)
In the key interpretive dispute about epilepsy, Origen argued for a fully demonological account of the lunatic boy in Matthew 17, against physicians who diagnosed it as a physical condition.(Ferngren, 2009) His position was influential, and Temkin notes that following Origen many Greek and Latin Fathers interpreted the biblical account as genuine demonic possession rather than natural disease, representing a decisive break with the naturalism of pagan antiquity.(Temkin, Owsei, 1971) However, several Greek and Latin Fathers did accept physiological explanations of epilepsy, including Clement of Alexandria and Tertullian himself on other occasions, making Origen’s position contested rather than universal.(Ferngren, 2009)
Byzantine medical glosses of the early medieval period distinguished two clinical presentations: those with full convulsions and unconsciousness (understood as natural disease) and those with foaming and trembling without convulsion, whom popular speech called “demoniacs.”(Temkin, Owsei, 1971) Latin texts from the seventh century explicitly identified the epileptic (caducus) with the demoniac (demoniacus) and prescribed remedies “for epileptics, i.e., demoniacs.”(Temkin, Owsei, 1971)
Within monastic medicine, the diagnostic practice of diakrisis (“discernment”) served as the method for distinguishing demonic affliction from natural illness, a skill reserved for senior monastics and requiring divine illumination beyond ordinary medical knowledge.(Ferngren, 2009) The therapeutic response to demonic and non-demonic illness in monastic contexts was not always different in kind; blessed oil, the sign of the cross, prayer, and exorcism could treat both categories.(Ferngren, 2009) Cases of contested diagnosis are documented from late antiquity: Theodoret of Cyrrhus records a delirious woman whose condition “some called the action of a demon, while the doctors named it a disease of the brain.”(Ferngren, 2009)
Despite popular assumptions to the contrary, a naturalistic understanding of mental illness was not fully replaced by supernatural causation in late antiquity or the Middle Ages; naturalistic etiology was more common in both periods than modern surveys often assume.(Ferngren, 2009)
Medieval European Practice
Christian saints’ shrines became primary sites for healing the mad in medieval Europe, with pilgrims bringing mentally disturbed relatives to the tombs of martyrs seeking miraculous cure.(Andrew Scull, 2015) The most documented example is the shrine of St. Dymphna at Gheel in Belgium, where lunatics were chained in the church by the ankle for eighteen days of exorcism; if madness persisted, many of the afflicted moved in with local peasant families, making Gheel a prototypical model of community care for the insane.(Andrew Scull, 2015) By 1532 the shrine was administered by ten clerics who supervised an elaborate ritual of prayers, penances, and ceremonial offerings.
Hellebore (Veratrum album) was employed in exorcisms during this period: one of William Turner’s Italian contemporaries, writing in the mid-sixteenth century, offered serious reservations about the widespread use of helleborism in exorcisms practiced on men.(Francia, 2014) The drug’s powerful emetic and purgative effects made it instrumentally attractive for expulsion rituals; whether it was conceptualized as pharmacological or magical depended on the practitioner.
Throughout the medieval period, most mentally disturbed individuals remained the responsibility of their families rather than institutions; confinement was the exception.(Andrew Scull, 2015) Madness was seen primarily as a social and spiritual rather than a medical problem.(Andrew Scull, 2015)
The Early Modern Boundary Dispute
By the Renaissance, madness-as-strategy was Christianized: God permits madness not only to punish but to redeem and sanctify.(Garson, 2022) In practice, a pragmatic division operated between natural and supernatural forms of madness, with physicians handling the natural and priests the supernatural, and this division was recognized by both sides without dispute.(Garson, 2022)
Between 50,000 and 100,000 people were executed as witches across Europe in the early modern period; witchcraft and possession were believed by educated contemporaries as well as common people, and to reject them was widely understood as a threat to Christian truth.(Andrew Scull, 2015) Physicians and Protestant and Catholic clergy alike conceded that some forms of madness were spiritual affliction, while others were bodily illness: Andrew Boorde wrote that “another kinde of madnesse” existed in which the afflicted “be ever possessed of the devyl.”(Andrew Scull, 2015)
Robert Burton’s Anatomy of Melancholy (1621) went so far as to catalog demonic possession as one subtype of madness alongside natural types such as lycanthropia, hydrophobia, and St. Vitus dance, treating it within a medical taxonomy.(Garson, 2022)
The Harsnett–Jorden Controversy
The most significant English contest over exorcistic jurisdiction involved the physician Edward Jorden, who in 1602 attempted to defend Elizabeth Jackson from witchcraft charges by attributing her alleged victim Mary Glover’s symptoms to “suffocation of the mother” (hysteria) rather than demonic possession.(Garson, 2022) Jorden deployed two strategies: he argued that even demon-caused disease might be mediated through humoral disorder and thus amenable to medical treatment; and he claimed meta-jurisdiction over the diagnostic question of which cases were genuinely demonic.(Garson, 2022) The presiding judge, Sir Edmund Anderson, rejected Jorden’s testimony on grounds that Garson finds compelling: Jorden had offered no specific natural cause but only a vacuous form of natural explanation, and Anderson rightly concluded that “if you tell me neither a natural cause of it, nor a natural remedy, I will tell you that it is not natural.”(Garson, 2022)
Shakespeare’s King Lear, written in the same years, naturalizes madness by depicting it arising from betrayal and psychological suffering rather than supernatural causes; Scull notes that Shakespeare drew on Samuel Harsnett’s debunking of Jesuit exorcisms for the play’s demonic imagery.(Andrew Scull, 2015)
Significantly, Jorden did not reject charms, exorcisms, amulets, and incantations as such; he redeployed them as theater (psychological interventions that worked on the patient’s imagination rather than supernatural entities).(Garson, 2022) This move, stripping exorcistic forms of their supernatural referent while retaining their therapeutic function, anticipated later psychological frameworks for understanding suggestion and placebo.
The Eighteenth Century: Anatomical Challenge and Charismatic Persistence
Thomas Willis, whose anatomical research on the nervous system in the mid-seventeenth century laid the groundwork for neurology, explicitly claimed that anatomy of the nervous system had revealed “the hidden causes of diseases and symptoms, which are commonly ascribed to the incantation of witches.”(Andrew Scull, 2015) This formulation is significant: Willis did not simply add a new framework but claimed it rendered exorcistic explanation redundant.
John Wesley and the Methodist revival maintained belief in demonic possession as a plausible account of mental disturbance, and Wesley himself was a firm believer in demonomania and a forceful advocate of spiritual healing through fasting and prayer.(Andrew Scull, 2015)
The most spectacular late exorcist was the Austrian Catholic priest Johann Joseph Gassner (1727-1779), who drew crowds of thousands in 1760s-70s Germany to his performances of exorcism for ailments including blindness, epilepsy, St. Vitus dance, and hysteria.(Andrew Scull, 2015) Gassner’s exorcisms directly provoked Franz Anton Mesmer, who argued that the same phenomena Gassner attributed to demons could be explained by his theory of animal magnetism, a subtle physical fluid whose disruption caused disease.(Haller, 2010) Mesmer thus displaced demonic agency with a naturalistic (if scientifically unvalidated) mechanism, consciously positioning himself against what he saw as religious exorcism. In building his theory, Mesmer drew on Paracelsus’s magnetic philosophy, Athanasius Kircher’s theology of magnetism, and Gassner’s practices; animal magnetism was more a reformulation of older exorcistic traditions than a rupture from them.(Haller, 2010) The 1775 silencing of Gassner by Pope and secular authorities removed the most visible Catholic exorcist just as the secular framing of “animal magnetism” was establishing itself.(Andrew Scull, 2015)
Social Function and the Exorcism-Adorcism Continuum
Exorcism rarely operated as an isolated technique; it existed within a broader system of responses to possession illness. Possession typically begins as traumatic illness, and where exorcism proves ineffective, the response shifts to accommodation: placating the spirit and domesticating it through cult (adorcism).(Lewis, I. M., 2003) In male-dominated religious contexts, repeated exorcistic rituals can paradoxically stimulate possession trance, functioning covertly as ecstatic cults.(Lewis, I. M., 2003) The Catholic Church progressively narrowed its official recognition of possession to a small residuum that psychiatrists could not explain otherwise, with all other cases reclassified as “pseudo-possessions” explicable by modern science.(Lewis, I. M., 2003) Tarantism in medieval Italy illustrates the cultural variability of diagnostic attribution: the same epidemic dance disorder that was treated by exorcism in the Low Countries was understood in Italy as spider-bite poisoning rather than possession.(Lewis, I. M., 2003)
The evil eye tradition throughout the Mediterranean engaged exorcism as one element of a broader system of countermagic; the evil eye offered a structured explanation for mental illness, disaster, and death, and the patterned responses it generated (including exorcism) functioned as social-psychological mechanisms for conflict resolution without direct personal confrontation.(Maloney, Clarence (ed.), 1976)
Scholarly Assessment
The historiography of exorcism in Western medicine has moved away from a simple narrative of rational medicine displacing superstition. Ferngren, Kroll, and Bachrach have shown that naturalistic etiology was more persistent across late antiquity and the Middle Ages than earlier scholarship assumed, and that demonic and natural explanations coexisted rather than succeeded each other in strict sequence.(Ferngren, 2009) The early modern boundary dispute between physicians and exorcists was not primarily about the existence of demons but about who held diagnostic authority, a jurisdictional contest as much as an epistemological one.(Garson, 2022)
The evidence for Mesopotamian origins is substantial, and the transmission from Levantine demonological medicine into Jewish Second Temple literature and then early Christianity is well documented. Where the record is thinner is in connecting the formal Mesopotamian exorcistic corpus directly to specific early Christian ritual practice; the chain passes through Second Temple Judaism at a point where the documentary record is fragmentary.
The tendency to treat exorcism as exclusively a response to spirit-possession misses its relationship to somatic illness: in Mesopotamia, epilepsy, headache, and leg pain were all addressed through exorcistic means. In medieval Europe, the diagnostic question of whether a given patient’s illness was demonic or humoral was a genuine clinical question requiring skilled discernment, not simply a category error. Historians who focus only on the possession cases risk losing the broader picture of exorcism as part of an integrated etiological system in which natural and supernatural causes were both real, both potentially present, and both in need of differential assessment.