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The history of psychiatry as a medical specialty 

The history of psychiatry as a medical specialty
The history of psychiatry as a medical specialty

Pierre Pichot

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date: 20 May 2022

The history of psychiatry as a medical specialty has to be distinguished from the history of psychiatric medical knowledge which began in ancient Greece with the birth of medicine as a science. For more than 2000 years, only physicians observed and treated mental illnesses, and institutions were created in which the ‘lunatics’ and the ‘insane’ were received. But, as rightly pointed out by Kraepelin, the truth is that psychiatry was not really a medical specialty. One can argue about the precise date of the appearance of psychiatry as a specific field of medicine and of the psychiatrist as a specialist, devoting his professional competence exclusively to the care of the mentally ill. Denis Leigh recognizes that ‘some degree of specialization occurred [in England] among respectable physicians’ in the middle of the eighteenth century when the monopoly of Bethlem was broken and new ‘lunatic hospitals’, such as St Luke’s were opened. On the other hand, the American historian Jan Goldstein stresses that in France the language, as an exact reflection of the underlying reality, began to use expressions such as homme spécial to describe a physician specializing in a branch of medicine such as psychiatry only around 1830. This chapter charts the history of psychiatry as a medical specialty from its beginnings to the present day.

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