Did Julius Caesar Have Epilepsy?

The Roman general and dictator Gaius Julius Caesar (lived 100 – 44 BCE) is one of the most famous figures from all of ancient history. He been the subject of countless stage plays, films, television shows, and novels and his article on Wikipedia is consistently one of the most frequently viewed articles within WikiProject Classical Greece and Rome.

Not many people are aware, however, that, according to several ancient biographers, Julius Caesar had a chronic illness that reportedly caused him to experience headaches, sudden seizures, and vertigo. This illness is traditionally identified as epilepsy, based on descriptions of it as such by ancient writers, but the exact cause of the illness cannot really be identified, since Caesar is long dead and the descriptions of his illness in the ancient sources are far too vague for any kind of medical diagnosis.

Ploutarchos of Chaironeia on Caesar’s illness

The Greek biographer and Middle Platonist philosopher Ploutarchos of Chaironeia (lived c. 46 – after c. 119 CE) records in his biography The Life of Julius Caesar 17.2 that Julius Caesar had a sickness in his head and he suffered from epileptic seizures. He writes, as translated by Bernadotte Perrin:

“Now, at his love of danger his men were not astonished, knowing his ambition; but that he should undergo toils beyond his body’s apparent powers of endurance amazed them, because he was of a spare habit, had a soft and white skin, suffered from distemper in the head [“τὴν κεφαλὴν νοσώδης”; literally “was sickly with respect to his head”], and was subject to epileptic fits [“τοῖς ἐπὶ τοῖς ἐπιληπτικοῖς ἔνοχος”], a trouble which first attacked him, we are told, in Corduba.”

Ploutarchos mentions Caesar’s illness two more times in his biography. The second time he mentions it is in his Life of Julius Caesar 53.5–6, where he gives an alternative account of the Battle of Thapsus, which took place in 46 BCE. According to this alternative account, Caesar was not directly involved in the action of the battle because he was having an epileptic seizure at the time when the battle was taking place. Ploutarchos writes, in Perrin’s translation:

“This is the account which some give of the battle; others, however, say that Caesar himself was not in the action, but that, as he was marshalling and arraying his army, his usual sickness laid hold of him, and he, at once aware that it was beginning, before his already wavering senses were altogether confounded and overpowered by the malady, was carried to a neighbouring tower, where he stayed quietly during the battle.”

Ploutarchos makes no comment as to whether he thinks this account of the battle is more plausible than the previous one he has just given, but the fact that he only tells it afterwards and attributes the account to unnamed “others” suggests that he is trying to distance himself from it.

ABOVE: Photograph from Wikimedia Commons of a Roman marble bust from Delphoi that has been questionably identified as possibly a representation of the biographer Ploutarchos of Chaironeia

Finally, Ploutarchos recounts in his Life of Julius Caesar 60.4–7 that, probably sometime around January 44 BCE, a few months before Caesar’s assassination, there was an incident when the consuls, praetors, and the rest of the Senate approached him and he did not rise to honor them, but instead remained seated. Ploutarchos says that many people were greatly offended by this, declaring that Caesar had violated customary norms.

Ploutarchos records that Caesar himself said that the reason he hadn’t stood up was because his illness was making it hard for him to stand without feeling dizzy. Ploutarchos, however, is skeptical of this claim and instead argues that Caesar deliberately remained seated on the advice of a flatterer so that he would appear to be honored as superior to the consuls and praetors. Ploutarchos writes, in Perrin’s translation:

“This [i.e., Caesar’s refusal to stand] vexed not only the senate, but also the people, who felt that in the persons of the senators the state was insulted, and in a terrible dejection they went away at once, all who were not obliged to remain, so that Caesar too, when he was aware of his mistake, immediately turned to go home, and drawing back his toga from his neck, cried in loud tones to his friends that he was ready to offer his throat to any one who wished to kill him.”

“But afterwards he made his disease an excuse for his behaviour, saying that the senses of those who are thus afflicted do not usually remain steady when they address a multitude standing, but are speedily shaken and whirled about, bringing on giddiness and insensibility. However, what he said was not true; on the contrary, he was very desirous of rising to receive the senate; but one of his friends, as they say, or rather one of his flatterers, Cornelius Balbus, restrained him, saying: ‘Remember that thou art Caesar, and permit thyself to be courted as a superior.’”

Ploutarchos lists this incident as one of several that contributed to growing hatred against Caesar among the Senators that eventually culminated in Caesar’s assassination on 15 March 44 BCE.

ABOVE: The Assassination of Julius Caesar, painted in around 1888 by the British painter William Holmes Sullivan

Suetonius on Caesar’s illness

Ploutarchos is not, however, the only ancient biographer who mentions Caesar’s alleged epilepsy. The Roman biographer Gaius Suetonius Tranquillus (lived c. 69 – after c. 122 CE) also records that Julius Caesar experienced seizures in his Life of Julius Caesar 45.1. He writes, as translated by J. C. Rolfe:

“He is said to have been tall of stature with a fair complexion, shapely limbs, a somewhat full face, and keen black eyes; sound of health, except that towards the end he was subject to sudden fainting fits and to nightmare as well. He was twice attacked by the falling sickness​ during his campaigns.”

This is all Suetonius tells us about Caesar’s illness. Unlike Ploutarchos, Suetonius does not explicitly describe Caesar’s illness as epilepsy.

ABOVE: Illustration from the Nuremberg Chronicle, an encyclopedia printed in 1493 CE, showing what the printer imagined Suetonius might have looked like (No one knows what he really looked like.)

Appianos of Alexandria on Caesar’s illness

The Greek historian Appianos of Alexandria (lived c. 95 – c. 165 CE) also mentions that Julius Caesar suffered from epilepsy in his history The Civil Wars 2.110.1. He writes, as translated by Horace White:

“And now Caesar, either renouncing his hope, or being tired out, and wishing by this time to avoid this plot and odium, or deliberately giving up the city to certain of his enemies, or hoping to cure his bodily ailment of epilepsy and convulsions, which came upon him suddenly and especially when he was inactive, conceived the idea of a long campaign against the Getae and the Parthians.”

Notice that, like Ploutarchos, Appianos specifically says that Caesar’s illness was epilepsy. He also makes it sound like the illness bothered Caesar more when he was not actively campaigning and it therefore motivated him to go on military campaigns.

Did Caesar really have seizures?

There is widespread debate among historians over whether Julius Caesar ever really experienced seizures like the ancient biographers describe. I personally think that the arguments against him having seizures are not especially compelling, but I’ll cover them here anyway.

The first argument against the idea that Caesar had seizures is that he never mentions anything about it in any of his own writings—neither in the Commentarii de Bello Gallico nor in the Commentarii de Bello Civili. Likewise, none of the authors who are known to have been contemporaries of Caesar, such as Cicero, mention anything about him having seizures in any of their extant works. Instead, the earliest attestation of the idea that Caesar had seizures is in Ploutarchos, who was writing well over a century after Caesar’s death.

In some cases, a lack of contemporary evidence to support a claim can be a very strong indication that the claim in question is false. In this particular case, though, I don’t think that it is a very compelling objection, since Caesar specifically wrote his commentarii as accounts of his military campaigns, not as general memoirs of his everyday life. Even if we assume that Caesar was not in any way ashamed of his seizures and felt no need to hide them from the public, I don’t see any particularly strong reason why he would feel the need to tell us about them in his commentarii. We are, after all, talking about intimate details about his personal health.

Meanwhile, it’s not all that surprising that there are no works written by Caesar’s contemporaries discussing his seizures, since it is reasonable to think that most of Caesar’s contemporaries probably didn’t know about them—or at least didn’t know about them until after he allegedly had one in front of the whole Senate shortly before he was assassinated. Cicero was not, after all, Caesar’s personal physician.

The lack of contemporary sources mentioning Caesar’s seizures is especially unsurprising when you consider that only a tiny fraction of all the works that were written within Caesar’s lifetime have survived to the present day. Ploutarchos may have been writing significantly later, but he certainly had access to many records about Caesar’s life that have since been lost, so his word cannot automatically be dismissed.

ABOVE: Photograph from Wikimedia Commons of a bust in the Musei Capitolini representing the Roman orator and statesman Marcus Tullius Cicero, who was a contemporary of Caesar

The next argument holds that epilepsy was associated with divinity and biographers of Caesar might have made up that he was epileptic in order to portray him as, in some sense, more than human.

It is true that the Greeks knew epilepsy as ἠ ἱερὰ νόσος (hē hierà nósos), which means “the sacred disease.” One of the treatises included in the Hippokratic Corpus is On the Sacred Disease, which goes to great lengths to refute the belief that epilepsy is caused by a divine curse or possession, indicating that this was something that many uneducated people believed.

Having epilepsy, however, is not a common trope in ancient biographies of famous political and military leaders. In fact, as far as I can find, Julius Caesar is the only ancient political or military leader who is explicitly described in any ancient source as having been epileptic.

ABOVE: Photograph from Wikimedia Commons of a marble bust dating to the first century CE intended to represent the Greek physician Hippokrates of Kos, to whom the treatise On the Sacred Disease is traditionally attributed

People who make this argument often try to bolster it by claiming that Alexander the Great was said to have experienced seizures and the ancient biographers may have been trying to show parallels between Caesar and Alexander. For instance, in this Reddit thread from a year ago, the user “UndercoverClassicist” makes precisely this argument. The user writes:

“Plutarch is also the source of all but the most passing mentions, and has a clear agenda – he writes his biography of Caesar as a parallel to that of Alexander, and Alexander was certainly reputed to have had seizures (and you could just as well re-write this post to ask whether that was reality or literary fabrication – it would go much the same way).”

As far as I can tell, though, the claim that Alexander the Great was reported to have experienced seizures is false. “UndercoverClassicist” never cites any evidence from any ancient source to support their claim, but the passage that is normally cited to support this claim in other places online is from Ploutarchos’s own biography The Life of Alexander the Great 19.1–10, which reads as follows, as translated by Bernadotte Perrin:

“Dareios was still more encouraged by Alexander’s long delay in Kilikia, which he attributed to cowardice. The delay was due, however, to a sickness, which assailed him in consequence of fatigues, according to some,​ but according to others, because he took a bath in the river Kydnos, whose waters were icy cold.”

“Be that as it may, none of the other physicians had the courage to administer remedies, but thinking that the danger was too great to be overcome by any remedy whatever, they were afraid of the charges which would be made against them by the Makedonians in consequence of their failure.”

“But Philippos the Akarnanian, who saw that the king was in an evil plight, put confidence in his friendship, and thinking it a shameful thing not to share his peril by exhausting the resources of art in trying to help him even at great risk, prepared a medicine and persuaded him to drink it boldly, if he was anxious to regain his strength for the war.”

“Meanwhile, however, Parmenion sent a letter to Alexander from the camp, urging him to be on his guard against Philippos, for the reason that he had been persuaded by Dareios, with the promise of large gifts and a marriage with his daughter, to kill Alexander. Alexander read the letter and placed it under his pillow, without showing it to any one of his friends.”

“When the time appointed was at hand, and Philippos came in with the king’s companions, carrying the medicine in a cup, Alexander handed him the letter, while he himself took the medicine from him with readiness and no sign of suspicion. It was an amazing sight, then, and one worthy of the stage, — the one reading the letter, the other drinking the medicine, and then both together turning their eyes upon one another, but not with the same expression.”

“For Alexander, by his glad and open countenance, showed his good will towards Philippos and his trust in him, while Philippos was beside himself at the calumny, now lifting up his hands towards heaven and calling upon the gods to witness his innocence, and now falling upon the couch on which Alexander lay and beseeching him to be of good courage and obey his physician.”

“For at first the medicine mastered the patient, and as it were drove back and buried deep his bodily powers, so that his voice failed, he fell into a swoon, and became almost wholly unconscious. However, he was speedily restored to his senses by Philippos, and when he had recovered strength he showed himself to the Makedonians, who refused to be comforted until they had seen Alexander.”

In this passage, Ploutarchos does indeed describe Alexander as having an illness and fainting. The illness, however, is clearly not epilepsy, but rather a one-time, non-chronic sickness. Moreover, the fainting is not caused by the illness itself, but rather by the strong medicine that Philippos gives Alexander to treat his illness. Nothing whatsoever in this passage even remotely suggests that Ploutarchos or anyone else believed that Alexander was epileptic.

ABOVE: Photograph from Wikimedia Commons of the Alexander Mosaic from the House of the Faun in the Roman city of Pompeii, dating to the first century CE, but based on an earlier painting by Apelles of Kos dating to the fourth century BCE

The claim that people in the ancient world believed that the Carthaginian commander Hannibal Barca (lived c. 247 – between 183 and 181 BCE) was epileptic is even more complete bunk than the claim that people believed that Alexander the Great was epileptic. I cannot find any ancient source to support this claim and, in fact, I cannot even find a modern source that tries to cite an ancient source to support it. The entire claim seems to originate from modern internet lists of famous people who supposedly had epilepsy.

One final popular argument against the idea that Caesar really had epilepsy-like seizures points out that Ploutarchos only describes two incidents when these seizures supposedly occurred, both of which have them occurring at particularly dramatic moments (i.e., during a battle and in front of the entire Senate), and Ploutarchos himself seems somewhat skeptical toward both of them.

I am personally skeptical of the accounts Ploutarchos gives too. Nonetheless, even if the specific incidents Ploutarchos describes did not really happen in the way he describes them, this doesn’t necessarily mean that Caesar never experienced seizures at all. After all, it is important to note that Suetonius and Appianos both mention Caesar’s seizures as well, and they do so seemingly independent of Ploutarchos.

ABOVE: Carthaginian silver shekel dating to between 237 and 209 BCE, believed to depict Hannibal Barca as the god Melqart on the obverse and one of his famous war elephants on the reverse

The trouble with diagnosing Caesar

I’m willing to believe the ancient sources when they say that Julius Caesar had some kind of illness that sometimes caused him to experience apparent seizures of some sort, but, when it comes to what the precise identity of that illness is, I remain agnostic.

Unfortunately, the symptoms that the ancient biographers describe (e.g. headaches, apparent seizures, and vertigo) are extremely common and could have all manner of different causes. Epilepsy is certainly possible, but the same symptoms could apply to countless other illnesses.

Ploutarchos does specifically use the Greek word ἐπιληπτικοῖς (epileptikoîs) in his Life of Julius Caesar 17.2, which is the dative plural form of the Greek adjective ἐπιληπτικός (epileptikós), which is the source of the modern English word epileptic. Nonetheless, in Ploutarchos’s time, this term did not always strictly refer to the condition that we know as epilepsy today. Instead, the word was commonly used to describe any illness with epilepsy-like symptoms.

As a result of this, it seems like every year some medical expert publishes a new paper arguing that Julius Caesar’s illness was some other disease, ranging from hypoglycemia, to cerebrovascular disease, to a brain tumor, to a parasitic brain infection. The fact that so many radically different diagnoses are being offered only illustrates the sheer futility of trying to precisely identify the cause of Caesar’s illness when the only evidence we have are a few vague passages in the works of ancient biographers.