Historical origins of schizophrenia: two early madmen and their illness

Schizophrenia is a serious mental illness with a remarkably short recorded history. Unlike depression and mania, which are recognizable in ancient texts, schizophrenia-like disorder appeared rather suddenly in the psychiatric literature of the early nineteenth century. This could mean that the illness is a recent disease that was largely unknown in earlier times. But perhaps schizophrenia existed, embedded and disguised within more general concepts of madness and within the arcane languages and cultures of remote times. Both possibilities present major challenges to historical and psychiatric scholarship. These challenges are explored in this paper by presenting two "new" cases of schizophrenia, one from the eighteenth and one from the fourteenth century. The cases suggest that the illness may have existed as early as the medieval period. However, establishing the population prevalence of schizophrenia in earlier times--and therefore resolving the permanence-recency debate--may not be a feasible enterprise.