A History of Medicine with a Focus on Mental Illness – Part 2
Birth of Christ to the Middle Ages (400 AD)
Birth of Christ to AD 313 – (Edict of Milan)
Around AD 100 – AD 200
Benignus of Dijon
With the coming of Christ, new ideas were being germinated in society. The Gospels in the Bible record Christ as teaching commands for His followers to take care of the sick and parables of loving your neighbor to the point of tending to the injured (the parable of the Good Samaritan), and many such things.
Early Christians, in an attempt to follow Christ’s teaching and that of the Apostles, did things contrary to Roman custom and culture. They went so far as to break the law in their pursuit of implementing compassion for others. For example, they would take in babies who had been left in the streets to die, which was illegal.
Ever heard of the word benign? This is where the word comes from:
“Very few of the early Christians who, out of love, risked their lives as a result of tending to the contagiously sick and dying have had their names recorded in history. But one name that is known is Benignus of Dijon, a second-century Christian who was martyred in Epagny because he ‘nursed, supported, and protected a number of deformed and crippled children that had been saved from death after failed abortions and exposures’”(6).
This was of course anathema to the Romans.
“Recall the words of Seneca, the first-century Roman philosopher: ‘We drown children who at birth are weakly and abnormal’ (De Ira 1.15)”(6).
AD 130–201
Galen
Some pagans would continue to treat and care for the ill, including the mentally ill. The Greek physician, Galen, introduced an early form of psychotherapy as treatment for mental illness. Dr Daniel Amen said,
“[Galen]He is credited with the development of a tripartite theory of the soul, attempting to localize where the three parts were housed in the body: rational (brain), spiritual (heart), and appetitive (liver). In his book, On the Diagnosis and Cure of the Soul’s Passion, Galen discussed how to treat psychological problems, which some have called an early attempt at psychotherapy. He directed people with psychological issues to share their deepest passions and secrets, which can help them feel better”(3).
AD 250
Dionysius, a Christian Bishop Records Roman Reaction to a Pandemic
Again, the general thought of much of society in pagan Rome was one of lack of compassion as a rule. This was especially true regarding pandemics and, to a lesser extent, illness in general. Schmidt recorded the ancient historian Dionysius,
“During a pandemic… Dionysius, a Christian bishop of the third century, described the existing behavior of the pagans toward their fellow sick human beings in an Alexandrian plague in about A.D. 250. The pagans, he said, ‘thrust aside anyone who began to be sick, and kept aloof even from their dearest friends, and cast the sufferers out upon the public roads half dead, and left them unburied, and treated them with utter contempt when they died’ (Works of Dionysius, Epistle 12.5)’”(6).
The Western Church in Rome would not follow Roman custom and tradition in many ways. This was especially true for this particular plague. The church would spend a good deal of money taking care of widows and others in need during this plague. This act made the church more loved and hated at the same time, but the “loved” part would win out over time. Mostly, this resulted in the church growing in relevance and importance.
AD 313 – (Edict of Milan) to Middle Ages (AD 400)
AD 313
Edict of Milan
Why is this date and AD 324, significant? The Edict of Milan was declared by the Emperor Constantine in AD 313. It made Christianity legal for the first time in Roman history. Christians had been persecuted for 3 centuries. Their very existence had been illegal. For more reasons than would be appropriate in this timeline, Christians were routinely killed and otherwise put under Roman persecution. Despite this, Christianity grew.
After the Edict of Milan in AD 313 and the defeat of the Emperor of the East, Licinius, in AD 324, Christians could begin to change the way some things in society were practiced. One of the things at the top of their list was to build hospitals to take care of the sick and needy.
AD 321
First Place of Care for Mentally Ill Introduced
The morotrophium was a place of care for the mentally ill. Although Christians may have taken care of the mentally ill at an earlier point, little is known about such care. Christianity was illegal in Rome for the first three centuries after Christ was born. Thousands of Christians were put to death for practicing their religion during this time. In 313 AD, the Edict of Milan made Christianity legal, at least in the Western half of the empire. In the East, the ruler Licinius would need to be defeated by Constantine before Christianity could be legally practiced in the East (in 324 AD). Soon after the edict, Christians began to operate the morotrophium. Notice, these early Christians did not think of the mentally ill as being possessed with demons or any such notions. These were ill people, and they treated them as such.
“Compared with the service that the early Christians rendered to the physically sick and dying, we know much less about the treatment that the mentally disturbed received. This is true even though bishops and monks of the early Christian church ‘took charge of lunatics at a very early period, and gathered them together in houses specially assigned for that purpose.’ Thus, even before hospitals came into being for the physically ill and dying in the second half of the fourth century, a mental asylum (morotrophium, that is, moron = fool + trophos = nourisher) was founded as early as A.D. 321”(6).
AD 325
Council of Nicaea
Christ’s teaching of caring for the sick was now legal to implement. “For I was hungry and you gave me food, I was thirsty, and you gave me drink, I was a stranger, and you welcomed me, I was naked, and you clothed me, I was sick, and you visited me, I was in prison, and you came to me.” (Mat 25:35-36 ESV). The Council of Nicaea, in AD 325, would require Christians to have a hospital in every city where there was a cathedral. Schmidt recorded,
“…the first ecumenical council of the Christian church at Nicaea in 325 directed bishops to establish a hospice in every city that had a cathedral. Many of the early Christian hospitals or hospices were not what people understand by hospitals today. Although their most important function was to nurse and heal the sick, they also provided shelter for the poor and lodging for Christian pilgrims. These hospitals, known as xenodochia (xenos = stranger + dechesthai = to receive) were prompted by Christ’s command to care for the physically sick and by the early apostolic admonition that Christians be hospitable to strangers and travelers. With regard to the latter, the Apostle Peter told the recipients of his Epistle, ‘Offer hospitality to one another without grumbling’ (1 Peter 4:9). Similarly, Paul told the bishops (overseers) that they were to be given to hospitality (1 Timothy 3:2 and Titus 1:8)”(6).
Because the earliest Christian hospitals took care of the “strangers” and people in need, they were called xenodochia. This was an attempt to fulfil the commands in scripture to be hospitable to others.
It should be noted that the first ecumenical council in Nicaea introduced these ideas; however, sometimes certain ideas introduced were not formally adopted until later. The ideas would then be said to be part of the first council that had introduced them.
AD 369
First Hospital Built
As a part of charity, supported by voluntary contributions, Christians began to build hospitals to take care of the sick. These were not for profit, but rather charity ventures.
Christians erected the first hospital. It was built in the Eastern half of the Roman Kingdom. Hospitals were seen as more than a place to heal people of a condition and then send them off. The idea was to make sure the person could work and live, as much as is possible. In addition to having a low view of human life, the earlier view of work by the Romans, and to some extent the Greeks prior to them, was that manual labor and physical work were for the slave and lower class of society. The Bible that Christians followed taught that man was supposed to work. Work was not evil. In the Old Testament it says, “Six days shall a man work and do his labor…” (Lev. 23:3, NJKV). The New Testament follows with this: “…If anyone will not work, neither shall he eat.” (1 Thes. 3:10b, NKJV). Thus, the Christian thought was to help a person not only get better from illness, but be able to work and earn a living.
“The first hospital was built by St. Basil in Caesarea in Cappadocia about A.D. 369. It was one of ‘a large number of buildings, with houses for physicians and nurses, workshops, and industrial schools.’ Some historians believe that this hospital was not a xenodochium, but rather a nosocomium (nosus = disease + komeo = take care of) that ministered exclusively to the sick. The rehabilitation unit and workshops gave those with no occupational skills opportunity to learn a trade while recuperating”(6).
AD 375
Second Hospital Built
Another hospital was built in Edessa, in the Eastern half of the kingdom(6).
AD 390
Third Hospital Built
The early hospitals built by the Christians also acted as a place to house strangers and travelers. Thus, most nosocomia (places of healing) also acted as xenodochia (places of hospitality). Hospitals were thought to be places that would obey the Bible’s commands on caring for strangers and to show hospitality. The common term for hospital until the 12th Century was xenodochium.
“After St. Basil’s hospital was built in the East and another in Edessa in 375, Fabiola, a wealthy widow and an associate of St. Jerome, built the first hospital in the West, a nosocomium, in the city of Rome in about 390. According to Jerome, Fabiola donated all of her wealth (which was considerable) to construct this hospital, to which she brought the sick from off the streets in Rome (Letter to Oceanus 5). In 398, Fabiola, together with Pammachius, founded another hospital in Ostia, about fifty miles southwest of Rome.24 Although the nosocomium differed from the xenodochium, essentially all the hospitals were called xenodochia until the twelfth century, when ‘hospitale’ became the common term”(6).
