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Conference on Medicine and Religion

Obsessional Disorders in al-Balkhi's 9th Century Treatise:  Sustenance of the Body and Soul 

Rania Awaad, M.D., Clinical Instructor in Psychiatry and Director, Stanford Muslims and Mental Health Lab, Stanford University School of Medicine

Some argue that the earliest case of Obsessive–Compulsive Disorder (OCD) was reported by Robert Burton in his compendium The Anatomy of Melancholy (1621) and that only in the 19th century did modern concepts of OCD evolve, differentiating it from other types of mental illness. In this paper, we aim to reveal an even earlier presentation of the malady we now call OCD based on the 9th century work, Sustenance of the Body and Soul, written by Abu Zayd al-Balkhi during the Islamic Golden Era. 

Discovery of this manuscript reveals that Abu Zayd al-Balkhi should be credited with differentiating OCD from other forms of mental illnesses nearly a millennium earlier than is currently claimed by anthologies documenting the history of mental illness. Particular attention is paid to al-Balkhi's classifications, 
symptom descriptions, predisposing factors, and the treatment modalities for obsessional disorders. Analysis of this manuscript in light of the DSM-5 and modern scientific discoveries reveals transcultural diagnostic consistency of OCD across many centuries. 

Al-Balkhi's discussion of obsessions, from the peak of the Islamic Golden Era, is rather similar to modern day interpretations of obsessions and curiously enough, more so than those of al-Balkhi's contemporaries. There is much to ponder in the work of al-Balkhi, including the recognition of how, in many ways, our current views of obsessions differ little from this medical forbearer. It is possible that it has taken nearly a millennia for the precocious genius of Abu Zayd al-Balkhi to be recognized and appreciated. Theoretical and clinical implications of these findings are discussed especially in light of potentially significant, yet over-looked, medical contributions during the Islamic Golden Era.