In 1910, an article about the 16th-century biographical dictionary Al-Kawakib Al-Sa'ira by Najm al-Din al-Ghazzi appeared in the Damascene monthly Al-Muqtabas. The article is an indictment of al-Ghazzi's work, which is therein characterized as the product of an era of Islamic cultural and intellectual decline, as evidenced by al-Ghazzi's inclusion of the biographies of majadhib (holy fools). The author found it shameful that such men, whom he labels "imbecile fools" and "worthless individuals" should appear on the same pages alongside the luminaries of the 16th century, for they "trespassed the boundaries of Islamic law with their pretensions that violated mores, and manipulated the minds of the populace." His outrage against holy fools was by no means a voice in the wilderness. In 1929, for example, the influential reformer Muhammad Rashid Rida published a fatwa entitled "Is the majdhub a saint or a madman " in the periodical Al-Manar, in response to a request by a reader who was seeking clarification of the distinction between holy fools and madmen. Rida's fatwa harshly condemns the worship of holy fools, who, he declared, were anything but saints. Instead, he pronounces such individuals either unfortunates afflicted by innate mental defects, or, worse still, impostors whose personal appearance and habits - including the lack of physical hygiene, the practice of public nudity, and the use of foul or incomprehensible language - more likely indicate, if anything, a relationship with Satan rather than with the Divine. Yet, as recent research has shown, less than a century earlier members of the same urban, literate strata of society to whom Rida belonged had openly expressed their belief in and veneration of majadhib. This paper explores the confluence of factors that caused this dramatic shift in perceptions of holy fools in Syria and Lebanon in the late 19th and early 20th century. I analyze sources such as the press (including scientific journals), court records, and the records of select medical schools and hospitals, and suggest that the change was part and parcel of the emergence of new conceptualizations of embodied difference and of the appearance of the "the disabled" as a social category. I further attempt to explain why and how this shift, while undoubtedly leading to new educational and employment opportunities for some people with certain physical impairments, also increased the stigmatization and marginalization of others.