history of psychiatry history of psychiatry ancient specialty in psychiatry can be traced in ancient india. the oldest texts on psychiatry include the ayurvedic text, charaka samhita. some of the first hospitals for curing mental illness were established during the 3rd century bce. during the 5th century bce, mental disorders, especially those with psychotic traits, were considered supernatural in origin, a view which existed throughout ancient greece and rome. the beginning of psychiatry as a medical specialty is dated to the middle of the nineteenth century, although one may trace its germination to the late eighteenth century. some of the early manuals about mental disorders were created by the greeks. in the 4th century bce, hippocrates theorized that physiological abnormalities may be the root of mental disorders. in 4th- to 5th-century bce greece, hippocrates wrote that he visited democritus and found him in his garden cutting open animals. democritus explained that he was attempting to discover the cause of madness and melancholy. hippocrates praised his work. democritus had with him a book on madness and melancholy. religious leaders often turned to versions of exorcism to treat mental disorders, often utilizing methods that many consider to be cruel and/or barbaric. middle ages a number of hospitals known as bimaristans were built throughout arab countries beginning around the early 9th century, with the first in baghdad. they sometimes contained wards for mentally ill patients, typically those who exhibited violence or had debilitating chronic illness. physicians who wrote on mental disorders and their treatment in the medieval islamic period included muhammad ibn zakariya al-razi (rhazes), the arab physician najab ud-din muhammad, and abu ali al-hussain ibn abdallah ibn sina, known in the west as avicenna. specialist hospitals were built in medieval europe from the 13th century to treat mental disorders but were utilized only as custodial institutions and did not provide any type of treatment. early modern period plan of the bethlem royal hospital, an early public asylum for the mentally ill. during the early modern period, mentally ill people were often held captive in cages or kept up within the city walls, or they were compelled to amuse members of courtly society. from the 13th century onwards, sick and poor people were kept in newly founded ecclesiastical hospitals, such as the "spittal sente jorgen" erected in 1212 in leipzig, in saxony, germany. here, those with serious mental problems were isolated from the rest of the community in accordance with contemporary european practice. also founded in the 13th century, bethlem royal hospital in london was one of the oldest lunatic asylums. in the late 17th century, privately run asylums for the insane began to proliferate and expand in size. already in 1632 it was recorded that bethlem royal hospital, london had "below stairs a parlor, a kitchen, two larders, a long entry throughout the house, and 21 rooms wherein the poor distracted people lie, and above the stairs eight rooms more for servants and the poor to lie in". inmates who were deemed dangerous or disturbing were chained, but bethlem was an otherwise open building for its inhabitants to roam around its confines and possibly throughout the general neighborhood in which the hospital was situated. in 1676, bethlem expanded into newly built premises at moorfields with a capacity for 100 inmates.: 155 : 27 in 1621, oxford university mathematician, astrologer, and scholar robert burton published one of the earliest treatises on mental illness, the anatomy of melancholy, what it is: with all the kinds, causes, symptomes, prognostickes, and several cures of it. in three maine partitions with their several sections, members, and subsections. philosophically, medicinally, historically, opened and cut up. burton thought that there was "no greater cause of melancholy than idleness, no better cure than business." unlike english philosopher of science francis bacon, burton argued that knowledge of the mind, not natural science, is humankind's greatest need. in 1656, louis xiv of france created a public system of hospitals for those with mental disorders, but as in england, no real treatment was applied. in 1713 the bethel hospital norwich was opened, the first purpose-built asylum in england, founded by mary chapman. humanitarian reform main article: moral treatmentin saxony, a new social policy was implemented at the beginning of the 18th century in which criminals, prostitutes, vagrants, orphans, and the mentally ill were incarcerated and re-educated in the concepts of the enlightenment. as a result, a variety of jails, approved schools, and insane asylums were constructed, including the hospital "chur-sachisches zucht-waysen und armen-haus" in waldheim in 1716, which was the first governmental institution dedicated to the care of the mentally ill on the german territory.dr. philippe pinel at the salpêtrière, 1795 by tony robert-fleury. pinel ordering the removal of chains from patients at the paris asylum for insane women. attitudes towards the mentally ill began to change. it came to be viewed as a disorder that required compassionate treatment that would aid in the rehabilitation of the victim. in 1758 english physician william battie wrote his treatise on madness on the management of mental disorder. it was a critique aimed particularly at the bethlem hospital, where a conservative regime continued to use barbaric custodial treatment. battie argued for a tailored management of patients entailing cleanliness, good food, fresh air, and distraction from friends and family. he argued that mental disorder originated from dysfunction of the material brain and body rather than the internal workings of the mind. exorcisms and other methods such as trephining weren't common thirty years later, then ruling monarch in england george iii was known to have a mental disorder. following the king's remission in 1789, mental illness came to be seen as something which could be treated and cured. the introduction of moral treatment was initiated independently by the french doctor philippe pinel and the english quaker william tuke. in 1792 pinel became the chief physician at the bicêtre hospital. in 1797, jean-baptiste pussin first freed patients of their chains and banned physical punishment, although straitjackets could be used instead. patients were allowed to move freely about the hospital grounds, and eventually dark dungeons were replaced with sunny, well-ventilated rooms. pussin and pinel's approach was seen as remarkably successful and they later brought similar reforms to a mental hospital in paris for female patients, la salpetrière. pinel's student and successor, jean esquirol (1772–1840), went on to help establish 10 new mental hospitals that operated on the same principles. there was an emphasis on the selection and supervision of attendants in order to establish a suitable setting to facilitate psychological work, and particularly on the employment of ex-patients as they were thought most likely to refrain from inhumane treatment while being able to stand up to pleading, menaces, or complaining. the york retreat (c.1796) was built by william tuke, a pioneer of moral treatment for the insane. william tuke led the development of a radical new type of institution in northern england, following the death of a fellow quaker in a local asylum in 1790.: 84–85 : 30 in 1796, with the help of fellow quakers and others, he founded the york retreat, where eventually about 30 patients lived as part of a small community in a quiet country house and engaged in a combination of rest, talk, and manual work. rejecting medical theories and techniques, the efforts of the york retreat centered around minimizing restraints and cultivating rationality and moral strength. the entire tuke family became known as founders of moral treatment. william tuke's grandson, samuel tuke, published an influential work in the early 19th century on the methods of the retreat; pinel's treatise on insanity had by then been published, and samuel tuke translated his term as "moral treatment". tuke's retreat became a model throughout the world for humane and moral treatment of patients with mental disorders. the york retreat inspired similar institutions in the united states, most notably the brattleboro retreat and the hartford retreat (now the institute of living). although tuke, pinel and others had tried to do away with physical restraint, it remained widespread into the 19th century. at the lincoln asylum in england, robert gardiner hill, with the support of edward parker charlesworth, pioneered a mode of treatment that suited "all types" of patients, so that mechanical restraints and coercion could be dispensed with — a situation he finally achieved in 1838. in 1839 sergeant john adams and dr. john conolly were impressed by the work of hill, and introduced the method into their hanwell asylum, by then the largest in the country. hill's system was adapted, since conolly was unable to supervise each attendant as closely as hill had done. by september 1839, mechanical restraint was no longer required for any patient. phrenology william a. f. browne was an influential reformer of the lunatic asylum in the mid-19th century, and an advocate of the new 'science' of phrenology. scotland's edinburgh medical school of the eighteenth century developed an interest in mental illness, with influential teachers including william cullen (1710–1790) and robert whytt (1714–1766) emphasising the clinical importance of psychiatric disorders. in 1816, the phrenologist johann spurzheim (1776–1832) visited edinburgh and lectured on his craniological and phrenological concepts; the central concepts of the system were that the brain is the organ of the mind and that human behaviour can be usefully understood in neurological rather than philosophical or religious terms. phrenologists also laid stress on the modularity of mind. some of the medical students, including william a. f. browne (1805–1885), responded very positively to this materialist conception of the nervous system and, by implication, of mental disorder. george combe (1788–1858), an edinburgh solicitor, became an unrivaled exponent of phrenological thinking, and his brother, andrew combe (1797–1847), who was later appointed a physician to queen victoria, wrote a phrenological treatise entitled observations on mental derangement (1831). they also founded the edinburgh phrenological society in 1820. institutionalization the modern era of providing care for the mentally ill began in the early 19th century with a large state-led effort. public mental asylums were established in britain after the passing of the 1808 county asylums act. this empowered magistrates to build rate-supported asylums in every county to house the many 'pauper lunatics'. nine counties first applied, and the first public asylum opened in 1812 in nottinghamshire. parliamentary committees were established to investigate abuses at private madhouses like bethlem hospital - its officers were eventually dismissed and national attention was focused on the routine use of bars, chains and handcuffs and the filthy conditions the inmates lived in. however, it was not until 1828 that the newly appointed commissioners in lunacy were empowered to license and supervise private asylums. lord shaftesbury, a vigorous campaigner for the reform of lunacy law in england, and the head of the lunacy commission for 40 years. the lunacy act 1845 was an important landmark in the treatment of the mentally ill, as it explicitly changed the status of mentally ill people to patients who required treatment. the act created the lunacy commission, headed by lord shaftesbury, to focus on lunacy legislation reform. the commission was made up of eleven metropolitan commissioners who were required to carry out the provisions of the act; the compulsory construction of asylums in every county, with regular inspections on behalf of the home secretary. all asylums were required to have written regulations and to have a resident qualified physician. a national body for asylum superintendents - the medico-psychological association - was established in 1866 under the presidency of william a. f. browne, although the body appeared in an earlier form in 1841. in 1838, france enacted a law to regulate both the admissions into asylums and asylum services across the country. édouard séguin developed a systematic approach for training individuals with mental deficiencies, and, in 1839, he opened the first school for the severely "retarded". his method of treatment was based on the assumption that the mentally deficient did not experience disease. in the united states, the erection of state asylums began with the first law for the creation of one in new york, passed in 1842. the utica state hospital was opened approximately in 1850. the creation of this hospital, as of many others, was largely the work of dorothea lynde dix, whose philanthropic efforts extended over many states, and in europe as far as