Amit Ranjan Basu
The arrival of psychiatry in India was a disjuncture from the practices that already existed for mental healing. Not only were these practices based on concepts that did not follow the Cartesian mind/body binary, but I also consider it inappropriate to call those practices psychiatry though many historians of Indian medicine do. It is one thing to use ’mental health’ or ’psychiatry’ or ’psychology’ interchangeably as a rhetoric while elaborating on indigenous systems in English, but to reduce different culturally saturated practices with their own terminologies to an all-engulfing western word psychiatry, is another. For, it tends to produce a narrative that simplistically brings psychiatry in a line where pre-colonial systems at once lose their characteristics and any autonomous domain.
It is not true that mad persons were not confined in houses before the colonialists came. A brief historical overview on the Indian Lunacy Act, 1912 mentioned Mahmud Khilji (1436-69), who established a ’mental hospital’ at Dhar, near Mandu in Madhya Pradesh with Maulana Fazular Lah Hakim as the appointed physician.’[1] In fact, the concept of hospitals was first conceived and practised in Arabian medicine in all the countries ruled by Muslims, and served as a model for the European hospitals. The first such hospital was founded by Walid b. Abdal Malik in AD 707.
Two types of hospitals emerged. One was the ’fixed hospital’ located in particular places and the other, the ’mobile’ one that used to move from place to place and stopped at one place as long as it was necessary. Insane persons were kept locked up and chained in hospitals specified for them under regular supervision. Firuz Shah, successor of Mohmmad Bin Tuglak, added several hospitals to a list of 70 hospitals run by his predecessor in Delhi. Firuz Shah had ordered that everyone suffering from insanity should be captured, chained and kept in the hospital and treated with medicine ’prescribed by him’ which was found ’useful’. Moreover, he also provided a ’special diet’ for them.[2] In any case, it is not very difficult to imagine that wandering and violent people were kept in custody and not many hospitals for the insane came up as it happened with British colonialists, who brought in a rational system of western medicine, which saw a growth of many institutions by the mid-eighteenth century.
Arrangements for keeping lunatics under private care but with the East India Company’s patronage had started by the late-eighteenth century in Calcutta. The first recorded evidence for it can be dated to 1787. D.G. Crawford, who wrote A History of the Indian Medical Service, 1600-1913 in two volumes, gave a brief account of the establishment of this lunatic asylum in Calcutta:
“The proceeding of the Calcutta Medical Board of 3rd April 1887, contain a memorial from surgeon G. M. Kenderdine in charge of the Insane Asylum …[t]he Board recommended to Government, in a letter dated 7th May 1787 the foundation of a regular asylum and nominated Assistant Surgeon William Dick to its charge … Dick was appointed on a salary of Rs. 200 per month. A Bengal Military letter dated 16th August 1787, reports in para 108-’Lunatic Hospital. Have accepted the proposals of Mr. Dick, an Asstt. Surgeon for the erection of one. The House (sic) is to be built at his Expense (sic) and rented by the company at Rs. 400 per month’ . A General letter from Bengal dated 6th November 1788, reports in para 98 that sanction has been given to the erection of a Lunatic Hospital for females, for which a rent of 200 rupees a month will be paid.”[3]
During the late eighteenth and early nineteenth centuries, the ’trade in lunacy’ became a lucrative business for England and India. In Calcutta, a surgeon, Mr Beardsmore entered into a contract with the Government of Bengal, which lasted for 30 years, and the government provided from about Rs. 20,000-40,000 per year for taking care of, on an average, 20-40 lunatics. Compared to the Hanwell Asylum of England, the average cost per patient was seven to eight times more here![4] The asylum came up in Calcutta in 1817 exclusively for Europeans. Unlike the previous one, which had to close down, this asylum still exists in the city as the Institute of Psychiatry. Let us look at its emergence narrated by an Indian psychiatrist 50 years ago:
” [I]n 1817, Surgeon Mr. Beardsmore who was superintendent of a Government Lunatic Asylum found that the conditions in the lunatic hospital were not congenial for the patients and so he decided to erect the lunatic asylum at the outskirts of Calcutta immediately behind the Presidency Jail. This was solely due to the enterprise and enthusiasm of Mr. Beardsmore and the hospital was a private property. It was meant exclusively for Europeans. Govt. contributed five-sixth of its expenses while one-sixth was met by the contributions of the private patients themselves. When the hospital was started Mr. Beardsmore had hardly half a dozen patients but soon they increased to 50-60 in number. The asylum had a central house surrounded by several ranges of barracks, which were thrown together in no very definite plan but were added from time to time to suit the needs of the public. Every visitor was pleased with the cleanliness of the apartments and ventilation of the rooms. The gardens were beautiful and had a pleasing and refreshing appearance. Patients looked happy, cheerful and comfortable. The asylum was managed by a European superintendent and a steward. There was an Apothecary to look after the male patients and a Matron to watch the female patients. Restraint was in use but it was in extreme moderation. Excited patients were treated with morphia, opium and hot baths. Sometimes leeches had to be applied to such patients in order to alloy their excitements but venesection was never done. Blisters were found useful in chronic patients as it helped them to shorten the duration of their periodic excitements.”[5]
By early nineteenth century, the Court of Directors of East India Company decided to build lunatic asylums for native criminal and freely wandering insane persons in Bengal. Government records show that in 24 Parganas near the jail at Russapuglah, a plan was being sanctioned in 1804 to build an asylum for receiving 50-60 insane natives within a budget of Rs 7,500. One native doctor, one jamadar, eight peons, two cooks, two matores and two bhisties totalling a cost of Rs 84 per month manned it.[6] However, within two decades, the situation at Russapuglah asylum deteriorated and patients started dying frequently. A member of the Medical Board, Mr Gillman, visited the place and reported:
“The site of it is very bad being surrounded by jungle, swamps, jeels, pools from earth has been excavated for making bricks etc. etc. In short, I believe a worse situation could not be found. The buildings are low and damp and not half-large enough for the number of patients, to which must be attributed the numerous deaths that occur there.”[7]
The Russapuglah asylum continued to be crowded and a report in 1834 showed 267 patients with an expense of Rs 8,011, anna 0 and paisa 9. Though the number of staff was increased to 44, there still remained only one native doctor and one jamadar!’[8]
Till the mid-nineteenth century, most of the official records did not reflect any discussion on medical observations apart from nominal counts of patients and their occupations. Most of it was related to the issue of establishment and expenses. But the population distribution of the patients admitted shows that they were also coming from the adjacent districts apart from the city, and that these admissions were influenced by the policing of wandering lunatics in the streets. However, the large number of patients from poorer classes also indicates that the marker of insanity and its treatment promoted by the colonialists was also gaining ground. After the revolt of 1857, when the colonial power was transferred from the East India Company to the Queen in 1858, and with the Penal and Criminal Procedure Code, came the Act No. 36 of 1858, which provided for better control and management of lunatics. Actually three Acts came together with the Queen’s proclamation. First, the Lunacy (Supreme Courts) Act of 1858; second, the Lunacy (Districts Courts) Act of 1858; and third, the Indian Lunatic Asylums Act of 1858. The racial and class prejudice that was the hallmark of colonial governance took effect in the colonial policy where people from lower class and caste were provided uneven service compared to the white, rich men. While reviewing the reports on lunatic asylums in Bengal Presidency, T. Hastings records:
“Cruel as the natives of India naturally are both to man and to beast, cruelty to lunatics is not one of their characteristics; and in a subsequent page we shall propose to use the feeling of compassion which possesses them, in a plan we have to offer for the future advantage of the Hindustan [emphasis mine].”[9]
Hastings seems to be quite amazed as to how a ’naturally’ cruel people could have such compassion for lunatics, which Europeans did not have! The new law provided power to the Magistrates to detain any person suffering from insanity after proper certification by a medical practitioner. More than dealing with the subject, the law provided in detail for both regulating the reception of the patients as well as their administrative management. Patched up with phrases borrowed from the European asylum reformers, it claimed to further the concept of non-restraint in the Indian asylums, using chains and straitjackets in only exceptional cases. However, it also created new administrative problems when superintendents of the asylums started complaining against the Magistrates about not only the latter’s incapacity to judge insanity, but also about remaining open to any certification of lunacy, and dumping individuals in the asylum. Interestingly enough, superintendents complained, in rhetoric of human rights, that they were being forced to illegally detain persons who were not insane!
Amit Ranjan Basu is an independent researcher in social psychiatry.
[1] O. Somasundram, ’The Indian Lunacy Act, 1912: A Historic Background’, Indian Journal of Psychiatry, Vol. 29(1), 1987, p. 5.
[2] Muhammad Zubayr Siddiqi, Studies in Arabic and Persian Medical Literature, Calcutta, 1959, pp. xiii-xxxvi. Compared to studies in Ayurveda, history of Islamic medicine or Unani in India is much less in number despite having existed for 700 years! In medieval India, there are ample pieces of evidence of free exchange between these two systems. For Unani (Greco-Arab) medicine in India, also see M.Z. Siddiqi, ’The Unani Tibb (Greek Medicine) in India’, Islamic Culture, Vol. XLII(3), 1968, pp. 161-72; S.A. Hosseini, ‘An Elementary Study of the Principles of Individual and Group Psychotherapy and Mental Health in Islam’, Indian J Psychiatry, Vol. 25(4), 1983, pp. 335- 37 ; M.S. Khan, ’Arabic and Persian Source Materials for the History of Science in Medieval India’, Islamic Culture, Vol. LXII(2-3), 1988, pp. 113-39; Byron Good and Mary Jo Del Veechio Good, ’The Comparative Study of Greco-Islamic Medicine: The Integration of Medical Knowledge into Local Symbolic Contexts’, in Charles Leslie and Allan Young, eds, Paths to Asian Medical Knowledge, Delhi, 1993, pp. 255-71; Kristin L. Bright, The Travelling Tonic: Tradition, Commodity and the Body in Unani (Greco-Arab) Medicine in India, Ann Arbor, 2000; and Neshat Quaiser, ’Politics, Culture and Colonialism: Unani’s Debate with Doctory’, in Biswamoy Pati and Mark Harrison, eds, Health, Medicine and Empire: Perspectives on Colonial India, 2001, pp. 317-55.
[3] D.G. Crawford, History of Indian Medical Service, Vol. 2, London, 1914, p. 395.
[4] Waltraud Ernst, ’The Rise of the European Lunatic Asylum in Colonial India (1750-1858)’, Bulletin of the Indian Institute of History of Medicine, Vol. XVII, 1987, pp. 95-96; ’Asylum Provision and the East India Company in the Nineteenth Century’, Medical History, Vol. 42, 1998, pp. 478-81; and ’The Madras Lunatic Asylum in the Early Nineteenth Century’, Bulletin of the Indian Institute of History of Medicine, Vol. XXVIII, 1998,pp. 15-18.
[5] L.P. Varma, ’History of Psychiatry in India and Pakistan’, Indian J Psychiatry, Vol. 4(1-4), 1953, p. 33.
[6] West Bengal State Archives (WBSA), Judicial Department, Criminal Branch Proceedings (JCP), Nos 17-20, 1804, Police Office, Calcutta, to George Dowdeswell, Secretary to the Government of Bengal, 5 Aug. 1804.
[7] WBSA, JCP, No. 3, 1818, W.B. Bayley, Acting Chief Secretary to the Government of Bengal to the Secretary to the Medical Board, 17 Mar. 1818.
[8] WBSA, JCP, Nos 1-15, 1835, I.H. Patton, Magistrate of the 24 Pergunnahs, to W.H. Macnaughten, Secretary to the Government of Bengal, Judicial Department, 17 Mar. 1835.
[9] T. Hastings, ’Lunatic Asylums in Bengal’, Calcutta Review, Vol. 26(52), 1856, p. 592.
[1o] WBSA, General Department, Medical Branch Proceedings, Nos 39-45, May 1860, F.J. Mouat, Inspector General of Jails, Lower Provinces, to E.H. Lushington, Officiating Secretary to the Government of Bengal, 20 Aug. 1859.