In 1881 J. M. Machado de Assis published a short novel entitled The Psychiatrist. The main character, Simao Bacamarte, “a physician of noble birth”, devoted himself to “the health of the soul” (as he defined psychopathology) and conceived a new, revolutionary (for the times) hypothesis: “The number of persons suffering from insanity, he believed, was far greater than commonly supposed”. Dr Bacamarte explains: “Till now, madness has been thought a small island in an ocean of sanity. I am beginning to suspect that it is not an island at all but a continent”.
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