Psychiatry

Psychiatry is the branch of medicine that refers to the prevention, diagnosis, assessment and treatment of mental disorders in people. It comes from the two Greek words which refer to “mind healing,” from the Greek psyche (“soul”) and iatros (“doctor”). It differs from psychology which studies the everyday mental processes in both humans and animals.

In the ancient world there were clearly many people who suffered from mental disorders and there are records of physicians in Ancient Egypt and Ancient Greece who tried to explain mental disturbances. Some of their ideas were that people suffering from mental problems had been possessed by demons or other supernatural spirits. The Greeks had stories involving Ajax, when unwell, slaughtering a flock of sheep, and Oestes hallucinating.

By contrast Plato (427–347 b.c.e.) felt that mental disorders could be of divine origin. However he gradually came to see that part of the treatment could involve a dialogue with a physician. Building on Plato's work, Aristotle (384–322 b.c.e.) felt that psychological problems must result from physical ones. Aristotle also claimed that great thinkers had a “melancholic temperament.”

Early thinking of people being taken over by spirits, especially evil spirits, led to the proscription [Page 1434]of harsh punishments, with a reference appearing in the Bible: “a man also or a woman that hath familiar spirits, or that is a wizard, shall surely be put to death” (Leviticus xix 31). These ideas were also prevalent in parts of Asia, especially South-east Asia where many folk dances involved trying to hold back the will of spirits which took over humans. The concept of the “shaman” (medicine man) or his equivalent, who can expel these spirits still exists in many parts of the world.

However the ideas of the Egyptians and the Greeks were considerably refined in Roman times by Galen of Pergamum (in modern-day Turkey)—Galen was actually Greek, who lived during the height of the Roman Empire. Galen viewed the body as consisting of four main bodily humors: blood, yellow bile, black bile, and phlegm. As a result, Galen saw many problems, including mental ones, as resulting from an imbalance between these as a scientific way of explaining what had previously been seen as supernatural.

Throughout the medieval period in Europe, the development of some of the ways of dealing with mental disorders varied from an attempt to explain them scientifically, to spiritual and supernatural explanations which continued to see an interplay of the spirit world with that of the humans. The earliest known hospital wards for people with mental disorders appear to have been in Baghdad (in modern-day Iraq) where the Persian physician Rhazes (865–925) set aside rooms for sufferers to rest and be rehabilitated.

A number of purpose-built asylums started appearing in medieval times, with England leading the way. The Bethlehem Royal Hospital (known colloquially as Bedlam) was founded just outside the walls of the City of London in 1247. There were certainly permanent patients at Bedlam in 1403, at which time some asylums were known to exist in Egypt and Spain, a trend gradually spreading to the rest of Europe. To demonstrate the contrary view, mention should also be made of the alchemist and physician Paracelsus (Phillipus Aureolus Theiophratus Bombastus von Hohenheim, 1493–1541) who felt that mental disorders had natural causes, but then urged that insane people should be burned at the stake.

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