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Images in Psychiatry   |    
Saint Anthony of Qozhaya’s Cave: A Pioneering Shelter for the Mentally Ill in the Middle East
Rami Bou Khalil, M.D.
Am J Psychiatry 2013;170:476-476. doi:10.1176/appi.ajp.2012.12111465
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From Saint Joseph University, Beirut, Lebanon; and Psychiatric Hospital of the Cross, Jalledib, Lebanon.

Address correspondence to Dr. Bou Khalil (ramiboukhalil@hotmail.com).

Copyright © 2013 by the American Psychiatric Association

Accepted December , 2012.

The Monastery of Saint Anthony the Great, built in the 4th century, is 950 meters above sea level in the Qozhaya Valley of North Lebanon. In 1998, the monastery and the Qadisha Valley, of which the Qozhaya Valley is a branch, were recognized by UNESCO as a world cultural heritage site (1). According to Saint Athanasius the Great, Bishop of Alexandria, the devil fought Saint Anthony by afflicting him with boredom, laziness, and phantoms of women, but he overcame these attacks by prayer. He sequestered himself in a tomb, depending on local villagers who brought him food and water. After a second sequestering, he emerged with the help of villagers—healthy, serene, and enlightened (2).

The ancient Lebanese population believed that convents and monasteries were holy places where God works miracles. The monastery of Saint Anthony of Qozhaya had the reputation of curing patients suffering from mental disorders. At the side of the deep Qozhaya Valley, the cave has a small entrance but extends and widens inside to a great dimension (figure). Water dropped down into the cave from every side and formed stagnant pools, rendering the cave extremely humid and excessively cold in winter. Along the walls of the cave, blocks of stones were used as seats for the patients. A patient suffering from a mental disorder was attached by a chain to the wall of the cave after being delivered by his relatives to the convents’ priests. It was believed that during the third night he stayed at the cave, Saint Anthony appeared to the mentally ill, cast out the demon, released the patient from the chains, and restored the patient’s sanity. Otherwise, the treatment was extended. Although some left cured after a single treatment, many chronically mentally ill patients resided in the cave for long periods. The cave was in use until the end of the 19th century.

The Qozhaya Valley has witnessed, in the cave of St. Anthony, a particular aspect of our ancestors’ management of patients suffering from mental disorders in the Middle East until the end of the 19th century.

UNESCO World Health Center:  World Heritage List, Qadisha (Lebanon), No 850, 1998. http://whc.unesco.org/archive/advisory_body_evaluation/850.pdf
 
Gregg  RC:  Athanasius: The Life of Antony and the Letter to Marcellinus .  New York,  Paulist Press, 1980
 
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References

UNESCO World Health Center:  World Heritage List, Qadisha (Lebanon), No 850, 1998. http://whc.unesco.org/archive/advisory_body_evaluation/850.pdf
 
Gregg  RC:  Athanasius: The Life of Antony and the Letter to Marcellinus .  New York,  Paulist Press, 1980
 
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