One of the seminal events in the history of diagnosis and treatment of severe psychiatric illnesswas the understanding of psychotic symptoms such as hallucinations, delusions, and paranoid ideas as resulting from “sickness” rather than from supernatural causes. With this realization, patients were treated with medications, not tortured or killed or jailed. Among the earliest psychiatric hospitals in theworldwas one in northern Africa. The word “maristan” is a contraction of a Persian word (bimarstan) meaning “the locus of sick people.” Maristans were medical institutions with four specialties: internal medicine, ophthalmology, traumatology, andpsychiatry.Over the centuries, they progressively restricted their work to mental patients only. As far as we know, the first historically known maristan in the Arab-Islamic region is the one in Baghdad during the reign of Harun Al Rashid. In Morocco, the first was built inMarrakech during the Almohad dynasty in the 12th century. It was described by Abdelwahad Al Murrakushi, a contemporary historian, as an exceptional medical institution, supported personally by the sultans. In Fez, during the Merinid dynasty another maristan, called “Sidi Fredj,”was built in the 13th century by the sultan AbuYaqub (1286–1307). LeoAfricanus (hisoriginal namewas Hassan Al Wazzan) worked in this maristan for 2 years as a secretary at the end of the 15th century. Adjacent to the Sidi Fredj maristan, herb shops allowed the preparation of many kinds of medications for centuries, and they still exist today. Medicine at that time was completely Hippocratic and never mentioned irrational causes of diseases, as is evident in medical books of famous physicians such as Ibn Rushd (Averroes) or Ibn Zohr (Avenzoar), who lived inMarrakech during the 12th and 13th centuries. Father Galaberto Jofre, a Spanish priest, came to “Africa” twice at the beginning of the 15th century to pay ransoms for Christian war prisoners and bring them back to Spain. He most probably visited Fez, which was the capital of Morocco
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