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Saturday, December 2, 2023

How People With Mental Illnesses Were Treated in the Middle Ages

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A mental illness can be caused by a lot of factors, be it environmental, psychological, or genetic. These disorders influence the cognitive ability of the one who is affected, and in dangerous cases they know how to take over. It is no secret that these illnesses test the foundation, and the core of the family that is affected, and that it can bring out the best from it, as well as the worst.

In this article we want to give you an idea of what it would be like to be the host of such a illness. In this article there are going to be cruel acts that you may not agree with, but before any negative feeling starts building up do understand that those were different times, and people were doing what we are trying to do today… Survive.

Underneath these negative remarks do know that there were also acts of good deed, after all one is capable of doing as much good as he did bad. To help you digest the information that is to come understand that people in these times were massively influenced by religion, which more times than not saw mental Illnesses as a punishment by god.

To give you the full picture of why people were doing what they were doing, we are going to need to start from the very “beginning”, which is the Ancient period.

Ancient Times

The first evidence of people attempting to treat mental illness dates back as far as 5000 BCE. Evidence which includes trephined skulls which were found near the regions where the ancient civilizations were located. In those times there were a lot of things that the people did not understand, and why somebody is behaving differently then everybody else is one of them. With not enough knowledge on human health they demonized the mentally ill claiming that they were possessed and/or cursed. Mystic treatments where used to aid the “cursed” but most of the time these treatments were brutal.

One of those brutal procedures was called “Trephining”, where one would be treated by receiving a hole in their skull (or trephine) so that the evil spirits can leave their head. This was done with stone tools. The skulls that have shown us this have also shown us that the patients healed from these. Later on down the road of time these trephining methods were used to relieve migraines as well as skull fractures.

Trephining in the middle ages as depicted in the painting Cutting the Stone by Hieronymus Bosch

In ancient Mesopotamia more non skull fracturing methods were used. What would happen was priests would perform rituals and exorcisms to make the evil spirits leave. On some occasions the priest-doctors would treat the “evil spirit” as a human being and attempt to bribe it, threaten it, punish it, and even put it into submission, and yes you guessed it, all of this was done to the ill patient, not the “spirit”.

The Hebrews as well as the ancient Persians believed that illnesses were inflicted by God as a punishment, a punishment for your or your ancestor’s sins. The Persians in particular thought that the way to cure these illnesses was to have a pure mind, body and soul. To do that you would need to commit good deeds and have good thoughts all the while you keep your hygiene adequate.

The ancient Egyptians were the ones with the best treatments for this given time period. They attempted to aid the mentally ill by engaging them in society. This includes dances, concerts, and other various social activities that might end up “normalizing” them. This civilization was truly ahead of it’s time, an argument for this would be the medical breakthroughs that they had. They treated wounds, performed surgical operations effectively, and they also assumed that the brain was the source of all mental functions. All of this can be found on the Edwin Smith papyrus and the Ebers papyrus.

But no matter how good their treatments were they also assumed spirits and unearthly forces to be the culprits behind the mental illnesses. Music, chants, and songs were sang in an attempt to ease the patient’s brain, but we can all take a guess on how that worked out.

We can say that in terms of challenging the belief system of the time the ancient Greeks were doing a fairly good job. Famous physician Hippocrates denied the belief that mental illnesses were caused by supernatural forces. Instead he stated that they came from natural occurrences within the human body. The Roman physician Galen later  claimed that there were four essential fluids of which the human body was composed. The fluids being: blood, phlegm, bile, and black bile, where the different combinations of these fluids would bring out the personality of an individual.

Trephining was used to cure multiple things, in most cases it was to let the evil spirits out of your head

Now you might be saying to yourself that all of this is informative stuff, but how were the mentally ill treated in this time period? To be honest, it depended on the illness. There are different types of illnesses and in those days (as well as in the medieval ages) people did not have a name for them so we can’t really know how people specifically reacted to each illness. But what they did have were supervisors.

Depending on how harmful you were to yourself and to the ones around you, you would have divergent supervisors (family pride comes into play as well). If you could not function in society, but not cause damage to yourself or the ones around you, you would most likely be supervised by a family member, a maid, or a close friend at home. But if you had destructive tendencies or your family was too ashamed of you, you would be left in the supervision of God, alone to wander the world.


During the ancient times people had a lack of knowledge in the field of mental health, and most assumed that it was the work of a being of higher power. We can’t judge them for that because they were trying to help by using the information presented to them at that time. If it wasn’t for these attempts we would not be where we are today, both medically and technologically.

Medieval Times

Medieval Europe, along with it’s medicinal practices was overtaken by Christianity. That means more exorcisms, more chants, more torturing. During the Early Medieval Ages people still believed that the fluids (mentioned above) were the ones that caused mental illness, and in order to bring balance back to the body, patients were given laxatives, emetics, and were bled using cupping or leeches. A combination of black hellebore, clocynth and aloes was believed to cleanse one of melancholy, this concoction was called Hiera Logadii. Extracting blood was a common medical treatment, and any form of bleeding was used… this included extracting it from the forehead, tapping the hemorroidal veins or the head. The tobacco that was later imported from America was used to induce vomiting. A unique form of shock treatment was used during the medieval ages where the mentally ill would be thrown into cold waters so that the shock would “bring them to their senses”.

A look inside Bedlam asylum

Care of the mentally ill was generally left to the family of the individual, although some outside intervention occurred (Church). Interesting fact: Baghdad was the home of the first mental hospital which dates back to 792. Soon after Baghdad came the now ruined cities of Syria, Aleppo and Damascus.

Even though the mentally ill were left in the custody of their family, they were widely abused, particularly in the territories where Christianity ruled. Abuse such as beatings, torture and exile were common, this was due to the stigma and shame attached to these types of illnesses. Many locked away their struggling family members in cellars, or locked them away in a cage under the control of servants. Others were left to find their way in the world alone.

The way the ill were treated varied from place to place, but most would lean towards abusive behaviour, mostly because of family pride. We don’t expect you to agree with what the people were doing in this time period, but we want you to understand why they did it. Family marriages to create alliances and relieve families were heavily relied upon in this time period, and by one seeing a “dent” in the bloodline, one would back out of any agreement. In China it was believed that the affliction was the result of immoral behavior by the individual or by their relatives. It was also believed that the ill carried “bad fate” and that it was contagious the same way as most non mental illnesses are. Beatings were commonly administered in hopes that the physical punishment would “teach” one out of his illness.

The ones who were considered a nuisance were wiped out of town or pointed in the nearest neighboring village, but not everyone treated the ill this way. In Flanders, the citizens of Geel developed a shrine to Saint Dympha that became a hospice to house the mentally ill. Where the building was overcrowded, the villagers took the ill in. This formed a special family colony that exists to this day in Geel. Monasteries were also a welcome haven for the ill.

Some towns had madmen towers which were used to incarcerate the one who are “deprived of reason”. In those towers the ill would be placed in special chambers called “narrenturme”. Interesting fact: The word lunatic comes from the superstitious belief in medieval Europe that changes in the moon’s phases could cause madness or insanity in certain people.  The ill were deemed moon-sick, or lunatic (from Latin Luna for Moon).

Bloodletting being used as a cure for mental illness

One of the more infamous medieval mental hospitals is “Saint Mary of Bethlehem”. Later, this hospital would receive the name Bedlam and after receiving more and more people it became more and more notorious for it’s hellish conditions. Also during the period of the bubonic plague the Church was trying to find it’s scapegoat, and there was no better scapegoat than the ones who were possessed by the devil and the evil forces. In 1484 the then Pope Innocent VIII declared a massive witch hunt which reportedly led to the death and torture of 50,000 people (of whom were mostly female).

The eventual improvement in the field of mental illness eventually came in the nineteenth century, where doctors began to deny the belief that an individual could be ill because of a manifestation of evil spirits.


Inquiries Journal


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  1. Your generalisations are rather sweeping, The implication that people accused of witchcraft were mentally ill is dubious, some may have been, but many seem to have been perfectly rational, moreover, the witch hunts were not ‘medieval’, they went on into the 18th century, with the 1580s-1620s being the peak period. Nor do you make any attempt to distinguish between mental handicaps and mental illness – these are not the same thing at all.

    • Excuse our writing, our mother tongue is not English, but that is no excuse. We fixed the text where it said “Handicapped” rather than “ill”. We don’t claim the witch hunts stopped in the medieval period, and we don’t claim that everyone who was labeled as a witch was mentally ill. These are your personal assumptions.

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