Blog: Profesor Manuel Gurpegui – Catedrático y Director del Departamento de Psiquiatría de la Universidad de Granada.
Jesús Pérez, M.D., PH.D.
Fernando Girón-Irueste, M.D., PH.D.
Manuel Gurpegui, M.D.
Ross J. Baldessarinir, M.D.
José de León, M.D.
Images in Psychiatry
The Lions of Granada Maristan
This statue of a lion is one of two that sprayed water jets into the pool of Granada Maristan (1365). Lions were traditional Islamic symbols of power and were commonly used in fountains in medieval Moorish southern Spain (Al-Andalus). Image courtesy of the Alhambra Museum, Granada, Spain.
The people of Fez prefer to take care of themselves at home. The only people from the city in the maristan are madmen for whom several rooms are set aside (1, p. 177).
—Leo Africanus (1507)
Leo Africanus (Hasan al-Wazzan, c.1485–1554) was famous for his geography of North Africa. Following reconquest of his native Granada, Spain, by the Catholic Monarchs, his family moved to Fez, Morocco, where he worked 1 year in a maristan, which means “place for the sick” in Persian (1). Another travel writer, the Austrian physician Hieronymus Münzer (c.1437–1508), described the maristan of Granada as a “house for lunatics, built by the Moors” (2). Maristans had spread widely in the 9th and 10th centuries into North Africa and reached Moorish southern Spain (Al-Andalus) in the 14th century.Mostwere founded by sultans and upported by donations and patient fees, and they were typically supervised by physicians. Many were teaching hospitals. Their clinical units usually were organized by type of disease, and some evolved to care for specific disorders, including mental illnesses. The maristan of Cairo, Egypt (872), was the earliest identified as primarily psychiatric (3, 4).
In 1365, Granada’s Sultan Muhammed V (1338–1391) initiated construction of a maristan at the foot of his palace, the Alhambra.
This two-story rectangular brick structure covered in plaster had a central courtyard surrounded by clinical living spaces accommodating 200 patients in individual rooms measuring 6 by 6 meters and connected by galleries (3). Statues of lions (figure) that served as fountains for a central pool can still be found in the Alhambra Museum.
The Granada Maristan was one of the earliest European hospitals that included care for the mentally ill, and the maristan tradition probably influenced other early European hospitals (3, 4). Many Moorish and Christian mental asylums in Europe, including Bethlem Hospital in London, began as hospices for foreigners and homeless persons, later becoming hospitals for general medical conditions and eventually more specialized for care of the mentally ill (4). The Fez Maristan (1286), where Leo Africanus worked, probably was a model for psychiatrically oriented institutions in Spain (5). The Christian Hospital for Lunatics, the Insane, and Innocents in Valencia, Spain (1409), founded by Friar Juan Gilabert Jofré (1350–1417), who had visited maristans in North Africa, is considered the first purely psychiatric asylum in Europe (6).
1. Maalouf A: Leo Africanus. Chicago, Ivan R Dee, 1986
2. Münzer H: Viaje por España y Portugal (1494–1495). Madrid, Polifemo, 2002
3. García Granados JA, Girón-Irueste F, Salvatierra Cuenca V: El Maristán de Granada: un hospital islámico. Madrid, Asociación Española de Neuropsiquiatría, 1989
4. Pérez J, Baldessarini RJ, Undurraga J, Sánchez-Moreno J: Origins of psychiatric hospitalization in medieval Spain. Psychiatr Q 2012; 83:419–430
5. Chakib A, Battas O, Moussaoui D: Le Maristane Sidi-Frej à Fès. Hist Sci Med 1991; 28:171–175
6. Livianos Aldana L, Sierra San Miguel P, Rojo Moreno L: The foundation of the first Western mental asylum (images in psychiatry). Am J Psychiatry 2010; 167:260
From Cambridgeshire and Peterborough NHS Foundation Trust and the University of Cambridge, Cambridge, U.K.; the University of Granada, Granada, Spain; Harvard Medical School, Boston; and the University of Kentucky, Lexington. Address correspondence to Dr. Pérez (email@example.com). Image accepted for publication September 2012 (doi: 10.1176/appi.ajp.2012.12081066).
This article was supported in part by a grant from the Bruce J. Anderson Foundation to Dr. Baldessarini.
The authors thank Lorraine Maw, M.A., for editorial assistance.
* Estimado lector, este es un blog de divulgación científica dirigido al profesional, estudiante, y en general, a toda persona interesada en el campo de la psiquiatría. La información aquí expuesta, no constituye una recomendación para que usted realice ningún tipo de tratamiento médico o psiquiátrico, ni sustituye la visita a un especialista. Ante cualquier patología, consulte siempre a un profesional de la medicina o de la psiquiatría.