image: Les Très Riches Heures du Duc de Berry, Folio 108r
As early as 490 in Jerusalem, there was a hospital devoted to the treatment of mentally ill patients. In the Islamic world, the maristans were described by European travelers, who wrote on their wonder at the care and kindness shown to lunatics. In 872, Ahmad ibn Tulun built a hospital in Cairo that provided care to the insane. Nonetheless, Roy Porter cautions against idealising the role of hospitals generally in medieval Islam stating that “They were a drop in the ocean for the vast population that they had to serve, and their true function lay in highlighting ideals of compassion and bringing together the activities of the medical profession.”
In Europe during the medieval era, a variety of settings were employed to house the small subsection of the population of the mad who were housed in institutional settings. Porter gives examples of such locales where some of the insane were cared for, such as in monasteries. A few towns had towers where madmen were kept (called Narrentürme or fools’ tower). The ancient Parisian hospital Hôtel-Dieualso had a small number of cells set aside for lunatics, whilst the town of Elbing boasted a madhouse, Tollhaus, attached to the Teutonic Knights’ hospital. Other such institutions for the insane were established after the Christian Reconquista, including hospitals in Valencia (1407), Zaragoza (1425), Seville (1436), Barcelona (1481), and Toledo (1483). The Priory of Saint Mary of Bethlehem, which later became known more notoriously as Bedlam, was founded in 1247. At the start of the fifteenth century it housed just six insane men.