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Images in PsychiatryFull Access

The Foundation of the First Western Mental Asylum

On the morning of Feb. 24, 1409, while Friar Jofré (1350–1417) was heading to the Cathedral of Valencia to preach the sermon on the first Sunday of Lent, he saw a crowd mistreating and making fun of a mentally ill man. Outraged, he spoke in his sermon about the need for an institution for the mentally ill (1, 2). Ten merchants offered to provide the necessary funds to carry out Friar Jofré's request, and on March 15, 1410, the building of a hospital, Spital Dels Folls, Orats, e Ignocents (Hospital of the Lunatics, Insane, and Innocents), began (2).

Friar Jofré rescued Christian captives as a Mercedarian friar in North Africa. In his missions he may have heard about hospitals for the mentally ill that already existed in the Arab world (3). He may also have met Christians admitted to such hospitals suffering from pellagra (2). Although some hospitals in England and Germany admitted mentally ill patients, this hospital was the first one built only for that purpose (4). The Spanish humanistic tradition regarding the mentally ill spread throughout Iberia and then to the Hispanic Americas (5, 6). Philippe Pinel would later praise the occupational therapy used for treatment in this institution (7). For over six centuries, the Spital Dels Folls, Orats, e Ignocents of Valencia has been a beacon institution for the treatment of mental illness.

Address correspondence and reprint requests to Dr. Sierra, Psychiatry Service, Hospital la Fe, Avda. de Campanar 21, Valencia 46009, Spain; (e-mail). Painting reproduced with the permission of the Diputación de Valencia, Valencia, Spain (Fray Gilabert Jofré amparando a un loco [Father Gilabert Jofré protecting an insane person], by Joaquin Sorolla Bastida, 1887, oil on canvas, 202×150 cm). Image accepted for publication May 2009.
References

1 Ramajo Alista F : Vida y Obra del Padre Juan Gilabert Jofré. Valencia, Spain, Diputación de Valencia, 1998 Google Scholar

2 Tropé H : Del Hospital de los Inocentes (1409–1512) a la Casa de los Locos del Hospital General (1512–1699), in El Manicomio de Valencia del Siglo XV al XX. Edited by Livianos L. Madrid, Paradox, 2006, pp 15–117 Google Scholar

3 Ackernecht EH : A Short History of Medicine. Montreal, Maxwell Macmillan, 1970 Google Scholar

4 Rumbaut RD : The first psychiatry hospital of the western world. Am J Psychiatry 1972; 128:1305–1309 LinkGoogle Scholar

5 López-Ibor JL : La fundación en Valencia del primer hospital psiquiátrico del mundo. Actas Esp Psiquiatr 2008; 36:1–9 MedlineGoogle Scholar

6 Delgado Roig J : Fundaciones Psiquiátricas en Sevilla y Nuevo Mundo. Madrid, Paz Montalvo, 1945 Google Scholar

7 Pinel P : Traité médico-philosophique sur l'aliénation mentale, ou la Manie (an IX). Paris, Richard, Caille & Ravier, 1801 Google Scholar