• Thảo Mac

Spain: The Cradle of Psychiatry

Throughout history, the region where Spain is now located has witnessed many power and cultural exchanges. This has created a unique opportunity for the modern-day country to accumulate various innovative approaches to mental issues.

(Source: Alamy)

Since ancient times, humans have tried to decode the mysteries of the human brain. When Hippocrates — the famous Greek physician — established the science of humourism, he theorized that mental disorders were a natural phenomenon and could potentially be explained and healed. According to Hippocrates, the imbalance of four bodily fluids — the blood, the phlegm, the yellow bile, and the black bile — was the main cause of “dyscrasia,” the mentally unstable state of a human being. His theory was supported and further developed by Galen of Pergamon. Their study later categorized different types of “dyscrasia” accordingly to the causative bodily fluid: “mania” (problems with the yellow bile), “melancholy” (problems with the black bile), or “frenesis” (mania with fever).

After the fall of Ancient Greece, the Hippocratic approach to mental health was adopted by the Arabic. From the ninth to the fourteenth century, people with mental disorders were treated like regular patients in Arabic hospitals, called “bimaristans”. In 1025, Avicenna, a Persian physician, documented the most advanced and compassionate medical treatments of the time, including those for mental disorders in the book Canon of Medicine. It later became the standard treatment guideline in this region.

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The following expansion of Christianity in the Middle Age led to the fall of the Arabic era, but various heritages were preserved, among which was the Canon of Medicine. Realizing the value of the book, the Spaniards translated it to Latin, the most prestigious language in Europe at the time. Yet, even the holy language of the church could not lift the superstitious prejudices against mental illness that were plaguing Europe during the Middle Age.

Europe in the Middle Age era was allegedly merciless for people with mental illness. In contrast to the Hippocratic approach to mental health, Middle Age Europeans believed that mental disorders were signs of the moral downfall of a person, who voluntarily let demons take hold of them. For a long time, the common cure for mental illness in Europe was to “scare sanity back to them.” Should that method fail, the patient would be “exorcised,” since the demonic grip on them was too strong for mortal treatments to be effective. Needless to say, very few patients survived, and even fewer of them regained their sanity.

However, in Southern Europe, the attitude toward mentally ill patients was less extreme. From the Ancient Greeks and Arabics to the Roman Empire, this constant shift in power had left Spain relatively lenient toward new cultures. Thus, instead of ignoring the teaching of Canon of Medicine, the Spaniards changed it so that the approach mentioned in the book would fit their current Christian belief. While it was different from the original version, the new approach in Spain was still far more compassionate than the contemporary French or English one. Upon the Age of Enlightenment in Europe, it was thanks to this that Spain quickly became the cradle of psychiatry.

(Source: Valencia Actua)

While the Englishmen were busy throwing "lunatics" in Bedlam, in 1409, Father Jofre constructed the “Hospital de los Inocentes” in Valencia, Spain. The work was sponsored by Lorenzo Salom — a silk manufacturer who shared the same belief with Father Jofre, that less unfortunate folks should be treated with kindness. While Hospital de los Inocentes was technically categorized as an asylum, it was different from Bedlam. For one, it was in Spain that occupational and recreational therapy was born, before it was brought to England by William Tuke. Soon, other hospitals appeared around the Iberian Peninsula region. Together, they formed an early nucleus of humanitarian psychiatric care. Juan Luis Vives, the father of empirical psychology, further advanced the Spanish landscape of mental health. In 1512, at the beginning of Valencia’s Golden Age, all hospitals in Valencia were united under the name “Hospital General,” forming a humanitarian system to treat mentally ill members of the society.

As imperialism expanded, the Spaniards started to explore unknown parts of the world, bringing their psychiatry studies with them. It is quite certain that it was Spain who introduced Western psychiatric care to South America and Southeast Asia. Meanwhile, in their homeland, physicians in Europe were drawn to Spain to study their modern approach to mental health. Among them was Philippe Pinel, who made it his mission to bring the Spanish treatments back to France and the world.

Spain eventually fell behind in the studies of mental health issues and has not had any big achievements for a while. But we should not forget that it was in Spain that psychiatry as we know it began.


Speaking Plainly:

  • Hippocrates believed that mental disorders were the result of the imbalance of bodily fluids, not due to demonic possession as previously believed.

  • In 1025, the book “Canon of Medicine” was published in Persia. It later became the standard guild in Islamic hospitals and was translated to Latin.

  • In 1404, “Hospital de los Inocentes” were built in Valencia, Spain. It was considered the first official psychiatry hospital in the world.

  • The sixteenth century was the golden age of psychiatry in Spain. Spanish Colonialism brought the current psychiatric care of Spain to different parts of the world.

  • Spain is considered the cradle of psychiatry.