Musical Medicine

Eric Lis

Music has been part of many, perhaps most, of the human healing traditions throughout history. Music may play an important role as an indirect factor, the way modern medicine recognizes that people with access to their favourite music tend to need less pain medication, or it can be a major part of the treatment, as in the medieval era, when common treatment regimens involved specific prayers and songs. Given the medieval setting in which many games take place, and particularly considering the religious trappings which surround healing in D&D and Pathfinder, music by all rights ought to play a bigger role in medicine than just being “what we wish the bard would stop doing.”

Since the history of music is thought to stretch back better than a hundred thousand years (the oldest known musical instrument yet discovered by archaeologists is a bone flute dated to be about 45,000 years old) it puts to shame our silly notions of things like “civilization” and “history” which go back less than a tenth of that time. It’s hard to give a decent summary of how music has influenced healing traditions, but a recent book chapter does a pretty fair job. Here are just a few salient points that might easily inform how musical healing might appear in a game.

For obvious reasons, we can know little for sure about those human societies which predate surviving written records. We don’t have texts about how they healed or descriptions of what role music played in their societies. Anthropologists have made inferences from cave paintings, carvings, and how closely instruments and other tools have been found to be buried together, but we still have little that we can say with great confidence. From surviving Native American songs, it’s thought that healing songs may have had sounds emulating human reactions – wailing to express grief, for example – or complex structures with irregular rhythms and changes. From some African traditions, it’s believed that music, like stories, may have been something uniquely learned by shamans or special figures, which may imply that music was seen to have great power and even potential for misuse. We can only speculate if music was thought to have powers of its own, or if, as in later Greek myth, it was used to petition spirits, gods, and other forces.

We know more about how music was used in the Mesopotamian era. Formal musical notation begins to appear in surviving writings about four to five thousand years ago. Egyptian medicine, as set forth by healer like Imhotep and which was probably among the most advanced in the world, made extensive use of magic and prayer in addition to herbalism and surgery. Music was inextricably linked to many remedies and music was said to be the “physic for the soul.” In Babylon, where illness was more commonly seen as divine punishment, prayer and music may have been the primary, or even the only, modality of cure. Even the Bible, in the stories of King David, describes harp music being used to alleviate mental disturbance caused by an “evil spirit.”

In Greece, where modern medicine was slowly being invented, Hippocrates and other proponents of “rational” medicine may have been among those who fought against music being used medically but historical records as recently as 500 BCE still speak of musicians using music to assuage Apollo’s wrath and end plagues. As history moved on and Rome came to prominence, healers such as Caelius Aurelianus were among the first to advocate that music, along with bed rest and healthy diet, was an essential part of healing from injury, and that music, totally independent of any magical properties, was among the most powerful pain remedies known, even as cautioned that it should be used carefully since over-exposure could cause madness.

Over the medieval and Renaissance eras, medicine became increasingly dominated by Christian philosophy, and music was seen with some ambivalence. On the one hand, as music became something to be studied by scholars, it increasingly became something that common people were somehow not worthy of, or could use only in a superficial and base fashion compared to the educated elite who “understood” music. On the other hand, the European healers of these periods made routine use of music to cure all manner of diseases… although since they told patients to sing under full moons while drinking rainwater out of exhumed skulls, we may not put too much stock into their reasoning. Music was thought to relieve suffering and melancholy and “bring harmony to the soul” but only religious music was credited with particular healing powers.

Through the fourteenth to seventeenth century, we see many writings warning that music was unhealthy and dangerous, and phenomena such as St. Vitus’ dance, wherein thousands of people could supposedly become “trapped” into a dance which they would continue until collapsing from exhaustion, became feared maladies which musicians could cause or alleviate. The fear of music and musicians continued well into the eighteenth and nineteenth centuries, and even in the relatively modern era there have been those who believed that the music of composers such as John Cage and Charles-Valentin Alkan could cause physical harm to listeners. In the twentieth century this fear of music generally evolved into concerns over its moral effects than its physical effects as our understanding of the body and its apparent vulnerabilities has evolved.

None the less, the seventeenth century saw the publication of a book entitled Phonurgia Nova, which spoke of iatromusik, music capable of causing “vibrations” in the air which could balance and purify the body and cure some illnesses (it was not recommend for, say, amputations, but it was believed to cure some spider bites).

Our games have some mechanics to reflect all of these. Clerics invoke powerful entities through song and channel their powers. Bards directly use music to heal, harm, influence, and dispel. From a certain point of view, even game concepts such as sonic damage are probably influenced by some of these earlier beliefs and legends about how music affects the body, although we certainly do know that sheer volume is capable of causing damage. Ultimately, the link between music and healing is something that’s up to each individual storyteller, but considering how powerful the link has been between them throughout history, it would seem remiss for them to have no connection at all. 

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on November 28, 2015. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system