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A hospital for the mentally ill in the Middle Ages

Published online by Cambridge University Press:  02 January 2018

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Abstract

Type
Editorials
Copyright
Copyright © Royal College of Psychiatrists, 2016 

The Hospital de Folls de Santa María dels Pobres Innocents (Hospital for the Mad of Saint Mary of the Poor Innocents) was founded by Father Joan Gilabert Jofre in May 1409 and opened in June 1410 with the financial support of Lorenzo Saloni and the approval of King Martin I of Aragon and Pope Benedictinus XIII. At that time, ‘innocents’ was a term used to describe children, people with intellectual disability and people with severe mental illness.

The hospital was conceived as a safe place for people with mental illness. Months before its foundation, Father Jofre had publicly preached against the irrational persecution of the mentally ill and in favour of creation of a special hospital, having seen how both mentally ill men and women were physically and sexually abused and left freezing and starving in the streets. Through the centuries the hospital advocated for the mentally ill and became a pioneer in occupational therapy: men carried out activities in agriculture and women in sewing and knitting. The hospital also became a shelter for orphaned children who lived in the streets. After severe damage by fire in 1547 the building was reconstructed and went through several restorations over the centuries. Since 1963 it has housed the Valencia Public Library.

The gate of the hospital's main entrance from the original 1409 structure has surprisingly survived through the centuries. In the image we can see a characteristic Gothic framed pointed arch with two responds on the sides congruent with the characteristic architectural style in Valencia during the early 15th century. The former tympanum contains today a sculpture of Saint Mary of the Innocents holding baby Jesus.

It is believed that Father Jofre found inspiration in the way mentally ill people received care at the Maristan of Sidi Frej in Fez, Morocco, as he had taken several trips to Muslim territories and was probably exposed to the way mentally ill people received care in the Islamic world. Following the opening of the hospital in Valencia, a similar hospital was founded a few years later in Saragossa, Spain. It was praised by Philippe Pinel at the time of the foundation of moral treatment.

At a time in which a religious approach was often taken to explain mental illness, the Hospital of Valencia is proof of early advocacy and treatment for the mentally ill in the Middle Ages.

Published with the kind permission of Carlos Espi Forcén.

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