Muhammad ibn Zakariya al-Razi and the First Psychiatric Ward

Muhammad ibn Zakariya al-Razi was one of the most well-known and respected physicians during the 9th century A.D. because of his revolutionary contributions to medicine and psychiatry. al-Razi influenced several medical fields, including pharmacology, pediatrics, neurology, psychosomatic medicine, and medical ethics. He purified alcohol (ethanol) and pioneered its use in medicine. He rejected the notion of the mind-body dichotomy and considered mental health and self-esteem as significant factors that affect a person’s health and well-being. With the idea of "sound mind in a healthy body," he was able to help many of his patients to attain complete health. He was one of the first known physicians to describe the idea of psychotherapy. He used psychotherapy in a primitive but dynamic form in his practice.

al-Razi was born in 865 A.D. in al-Rayy, which is located outside Tehran. During his youth, he moved to Baghdad where he undertook medical studies and later practiced at one of the local hospitals. The governor of Rey, Mansur ibn Ishaq, later appointed him to head the hospital in Baghdad (1). al-Razi wrote 237 books in his lifetime, 36 of which are still available today. The most popular of his writings, Liber Continens, is considered a medical encyclopedia (2). His books offered explanations for various mental illnesses that plagued society during the 10th century. These books also outlined symptoms and definitions of as well as differential diagnoses and treatments for different mental illnesses.

While working as the director of a hospital in Baghdad, al-Razi introduced the concept of psychiatric wards as a place to care for patients with mental illness. According to his views, mental disorders should be considered and treated as medical conditions. He conducted very detailed clinical observations of patients with psychiatric conditions and provided treatment with diet, medication, occupational therapy, aromatherapy, baths, and music therapy. Additionally, he practiced an early form of cognitive therapy for obsessive behavior (3). al-Razi described depression as a "melancholic obsessive-compulsive disorder," which is triggered as a result of changes of blood flow in the brain. He stated that physicians should always try to convince their patients of the possibility of improvement in their condition as well as hope in the effectiveness of treatment. As part of discharge planning, patients were given a sum of money to help with their immediate needs and their transition back into society. To our knowledge, this is the first recorded reference to psychiatric aftercare.

al-Razi believed that physicians should be modest, soft-spoken, and gentle when communicating with their patients to ease the anxiety of receiving unfavorable news. He stressed the importance of communicating with patients on a personal level rather than simply making them aware of their illness. He used a cheerful countenance and encouraging words to instill in patients the hope of recovery.

Both psychiatric residents and trainees alike can learn from al-Razi’s approach to serving patients with compassion and understanding. He is a valuable source of inspiration from the history of psychiatry, with his original work and distinct style.