Yasmin Shafei explores the language of nineteenth-century Egyptian citizens’ petitions and points to its significance for the development culturally sensitive mental health interventions today.
What happens when the intimate spiritual language that a community uses to understand mental illnesses is replaced by the cold and diagnostic language of a modernizing state? Using the poignant language of ordinary Egyptians in the late nineteenth century, this piece explores that pivotal collision, addressing a fundamental question with contemporary relevance to wider and enduring discussions about power, language, and care systems. The sources examined here capture a society in transition, one in which medical practitioners were beginning to inscribe individuals with newly developed diagnostic language. The tensions were more than just linguistic, however; they embodied a struggle over meaning, authority, and care.
Why do we study mental illnesses?
Perceptions of sanity and insanity are dynamic, evolving regularly as functions of time and culture. Constructions of mental illnesses have historically intersected with both state policies and public attitudes towards the mentally ill. To study mental illnesses, therefore, is to understand the ideas, beliefs, and norms that pervaded society at any given time. Practices of asylum confinement highlight class, gender, religious, and national differences, revealing the manner in which these differences were viewed and constructed both within and beyond the walls of the asylum. As such, studying the asylum and its patients enables a wider understanding of society and, ultimately, of a nation’s social history (see Porter 1987; Dols 1992; Scull 2015). As historian Eugene Rogan aptly explains, “[t]o some degree, we study the mad to better understand the sane” (Rogan 2002, 106).
Language and power
Language is also a product of time and culture, reflecting perceptions of the people and places it emanates from. Historic language relating to illnesses is not only indicative of perceptions of society’s ill and vulnerable, it also sheds light on the fluidity of language and its implications over time. Perceptions of the mentally ill, in particular, are often intertwined with cultural and religious ideas surrounding normality, race, and gender. Analyzing the language of nineteenth-century citizen petitions alongside official medical memoranda enables an understanding of the manner in which madness was being reinterpreted in Egypt, from a phenomenon integrated into spiritual and community life to one managed by the state’s emerging medical institutions.
Moreover, language is an instrument of power. French philosopher Michel Foucault notably argued that discourse, the structured language of a field, is inextricably linked to the production of knowledge and relations of power (Foucault 1972, 49). In colonial settings, language is further complicated by its use as a marker of native culture and practices against an intrusive colonial state. In nineteenth-century Egypt, the practice of psychiatry itself was both a reflection of British power and a contested practice whose history reflects broader tensions between state and society.
Nineteenth-century citizen petitions
Citizen petitions are the subject of growing scholarly work and were common tools of interaction between the state and the people in the Ottoman world. As foundational mechanisms of Ottoman administration, they served as direct channels for subjects to seek justice, report grievances, or request intervention from local officials and senior administrators. Historian Suraiya Faroqhi (2010) further argues that petitions constituted political acts, aimed at influencing government decisions.
Nineteenth-century citizen petitions, or ‘arḍaḥāls, held at the Dār al-Wathā’iq al-Qawmiyya [National Archives] in Cairo, belong to this historic tradition. This specific corpus provides valuable insights into the ways in which Egyptians engaged with the institution of the asylum during the first decades of its management by British authorities. These documents were widely used by family members to petition for the discharge of mentally ill relatives from the only state asylum in Egypt during this period, the ‘Abbāsiyya Asylum. Following the British occupation of Egypt in 1882, the asylum came under control of British administrators, who adopted British psychiatric practices to manage the asylum and treat its patients. Not only do these petitions reveal the means through which family members requested the immediate discharge of their relatives from the asylum, they further shed light on the language they used to define their ailments and conditions.
Analyzing citizen petitions also works to center the lived experiences of patient’s families within the historical inquiry on colonial asylums. Not only does it demonstrate the multi-faceted and inter-dependent nature of the psychiatric encounter, it also highlights the negotiation and resistance strategies deployed by the actors in this encounter. Contrary to the narrative perpetuated by the British authorities about the nature of their psychiatric “reforms,” citizen petitions reveal that members of the public sought to discharge their relatives from the ‘Abbāsiyya Asylum, preferring instead to treat them at home through a combination of family care and traditional treatments. These archival documents thus provide a unique historical understanding of the ways in which members of the population deployed their own agency in interpreting and negotiating legal practices and systems enforced by the colonial state.
Wellcome Collection. Source: Wellcome Collection.
The language of “lunacy”
Citizen petitions contain a wealth of information on the language used to refer to mental illnesses and the mentally ill in late nineteenth-century Egypt, providing historians with invaluable insights into the manner in which mental illnesses were defined and labelled by Egyptian families. Studying the language used in citizen petitions thus enables greater historical understanding both of cultural attitudes towards mental illnesses and of the emotions surrounding confinement in turn-of-the-century Egypt. It also enables historians to tell the story of mental health and psychiatry in Egypt from the perspective of patients’ families, as opposed to traditional historiographic narratives that focus on the state, its institutions, and its doctors. This institutional bias was intrinsic to a colonial psychiatric project designed to highlight authoritative, professional, and often foreign medical voices, thereby systematically marginalizing and silencing the perspectives of patients and their families.
A number of specific terms were used by petitioning family members to identify mental illnesses affecting their relatives, most of which are no longer in use today. One of the common references used by Egyptian families in citizen petitions was the term ’i‘tarāhu Luṭf min ’Allāh [graced by God]. This was one of the most common references to mental illnesses used by lay people during the late nineteenth century. The term reflects public perceptions of mental illnesses as divine blessings which distance the mentally ill from worldly problems and challenges. This type of language does not appear in official documents of the ‘Abbāsiyya Asylum, nor those of the Lunacy Division (a body established by the British in 1884 to oversee the ‘Abbāsiyya Asylum, and which controlled mental health policy, licensing, and patient petitions).
This language did more than describe a condition, however, it performed a social function. By framing mental illness within a shared cosmology of grace, it asserted a form of social worth for the afflicted person, preserving their dignity and insulating them from shame. This difference underscores a fundamental dichotomy between a communal and spiritual understanding of mental illness, on the one hand, and the colonial state’s project to medicalize, standardize, and control it, on the other. Medical officers were guided by uniform, scientific terminologies used to identify and diagnose mental illnesses in official government documents. The complete separation of these linguistic realms is significant because it highlights two coexisting but incompatible systems of meaning, one that situated “madness” within a framework of divine and communal care and another that framed it as a medical defect requiring institutional separation.
Another common reference used to identify mental illnesses in petitions is the generic word ‘ayā [illness]. It refers to a person who is tired, ill, or disabled, and is used to refer to a wide range of physical and mental illnesses in Egypt. Despite its general meaning, it was commonly used in petitions by family members during the late nineteenth century. In some cases, petitions simply referred to the patient as someone affected by an ‘ayā. In other cases, they employed a more detailed reference to an ‘ayā fī ‘aqlahu [illness of the mind]. Use of the term ‘ayā reflects the manner in which mental illnesses were believed to be similar to physical illnesses. These ideas date back to Greco-Roman perceptions which continued until the Arab conquest of Egypt, and which conceived of mental illnesses as treatable diseases centred in the brain (Ahonen 2014).
Use of the word ‘injidhāb [attraction] to refer to mental illnesses also appears in citizen petitions submitted by families. Stemming from Sufi notions and practices, the reference suggests that the mind of a mentally ill person is “attracted” to a higher power and, thus, that their senses are not entirely grounded in the material world. In Sufi psychology, the state of jadhb refers to a divine “drawing” of the spirit (rūh) towards God, an overwhelming spiritual attraction that can temporarily suspend a person’s sensory engagement with the physical world (Chittick 1989, 323–26). This state often resembles symptoms of mental illnesses. The appearance of this Sufi-derived term is significant because it preserves a non-stigmatizing and spiritual epistemology of mental experience that understood it not as a pathological defect, but rather as a transcendent connection. That this language existed only in family petitions and not in official documents underscores how families used their own cultural frameworks to resist a colonial psychiatry that reduced their relatives’ experiences to mere symptoms.
The road to medical terminologies
In contrast to the language used by lay people in citizen petitions during the late nineteenth century, the language employed by psychiatrists and medical officers was remarkably different. The juxtaposition between lay references and medical terms enables historians to examine differences between perceptions of insanity that existed among members of Egypt’s working classes, on the one hand, and its psychiatric institutions, on the other. The language of families in citizen petitions is emotional, spiritual, and personal. The language employed by institutions of power, however, reflects the narrative they seek to perpetuate, one that medicalizes mental illnesses and places them physically and linguistically inside the asylum. It was both unified and scientific.
The gap between these linguistic worlds signifies more than evolving knowledge. It marks a shift in the very site of authority over a person’s mind and body, from the narrative authority of the family and community to the diagnostic authority of the medical expert and the state. Not only does this alter the relationship between the sufferer, their family, and the source of authority over their condition, it also reframes the historical analysis in terms of power and authority, bearing relevance for scholars of sociology, political science, critical theory, and bioethics.
Within this context, the most common reference employed by medical officers in referral memoranda (tadhkaras) in the decade between 1884 and 1895 is the term khalal fī al-quwwā al-‘aqliyya [defect in mental faculties]. The widespread use of this term in referral memoranda points to a common understanding of the medical terminologies that were being developed during this period, and which were subsequently used by asylum psychiatrists and medical officers to refer to a range of mental illnesses and disturbances.
Between the spiritual and the medical
The contrast between the language used to identify mental illnesses by lay people and that which was employed by medical officers in Egypt is a reflection of the different meanings ascribed to mental illnesses, whether it be a manifestation of God’s grace, a divine attraction, or an illness of the mind, much like any other physical illness. The references used in citizen petitions reveal nineteenth-century perceptions of mental illnesses as divine blessings or attractions, perceptions that were gradually lost to the medicalization of mental illnesses in the twentieth century.
The range of lay terms used in citizen petitions uncovers the richness of the language used by Egyptian men and women from rural and urban backgrounds to refer to mental illnesses in the late nineteenth century. This language ultimately reveals a lost world of spiritual and cultural ideas which neither stigmatized nor ostracized the mentally ill, opting instead to understand their illnesses as manifestations of the divine and to treat them communally rather than institutionally.
This lost linguistic world does more than illuminate the past, however, it poses a provocative question for our present. It challenges us to reflect on the legacy of this shift in vocabulary and the transfer of power that it mirrors. While this shift underpinned undeniable advances in modern psychiatry, it also reinforced new tensions that resonate in contemporary debates. These include the tensions between clinical objectivity and personal meaning, between institutional efficiency and communal care, and between standardized diagnosis and cultural understanding.
Today, as global mental health initiatives strive to be culturally relevant, and as patient advocacy emphasizes lived experiences over purely clinical narratives, the voices in these nineteenth century petitions serve to remind us that every system of care is built upon a language of power. Recovering the words of these petitions prompts us to question the forms of understanding, dignity, and social connection that might be marginalized when one powerful language of mental distress replaces another. In the end, studying this historical moment asks us to consider how, in our pursuit of modern medical and institutional care, we can preserve space for the meaning and humanity that older languages of distress sought to express.
About the author
Yasmin Shafei is a Postdoctoral fellow at The Center for Economic, Legal, and Social Studies and Documentation (CEDEJ) in Cairo. She holds a PhD in Middle Eastern history from the American University of Beirut and an MA and BA in International Relations from the American University in Cairo. Her research focuses on the intersections of colonial studies and the histories of medicine. Specifically, her thesis explored documents at the National Archives in Egypt and the UK to investigate the impact of British colonial rule on the development of medicine and Egypt’s asylums, interrogating intersections of race, class, and gender. Her work also examines the lived experiences of patients and their families. She has written articles in several journals including the Journal of Middle East Women’s Studies and an upcoming book chapter in the edited volume entitled Disability History in the Modern Middle East, to be published by Bloomsbury in August 2026.
References
Ahonen, Marke. 2014. Mental Disorders in Ancient Philosophy. Springer.
Chittick, William C. 1989. The Sufi Path of Knowledge: Ibn al-‘Arabi’s Metaphysics of Imagination. State University of New York Press.
Dols, Michael W. 1992. Majnūn: The Madman in Medieval Islamic Society. Clarendon Press.
Faroqhi, Suraiya. 2010. Coping with the State: Political Conflict and Crime in the Ottoman Empire, 1550-1720. Gorgias Press.
Foucault, Michel. 1972. The Archaeology of Knowledge and the Discourse on Language. Translated by A. M. Sheridan Smith. Pantheon Books.
Porter, Roy. 1987. A Social History of Madness: Stories of the Insane. Weidenfeld and Nicolson.
Rogan, Eugene. 2002. “Madness and Marginality: The Advent of the Psychiatric Asylum in Egypt and Lebanon.” In Outside In: On the Margins of the Modern Middle East, edited by Eugene Rogan, 104–25. I.B. Tauris.
Scull, Andrew. 2015. Madness in Civilization: A Cultural History of Insanity, from the Bible to Freud, from the Madhouse to Modern Medicine. Thames and Hudson.
