| Article Access Statistics|
| Viewed||3220 |
| Printed||40 |
| Emailed||0 |
| PDF Downloaded||203 |
| Comments ||[Add] |
Click on image for details.
|Year : 2018
: 60 | Issue : 6 | Page
|History of psychiatry in Bengal
Gautam Kumar Bandyopadhyay1, Malay Ghoshal2, Gautam Saha3, Om Prakash Singh4
1 Department of Psychiatry, Sagar Dutta Medical College, Kolkata, India
2 Department of Psychiatry, Medical College, Kolkata, India
3 Consultant Psychiatrist, CLINIC BRAIN, 19/C, Pioneer Park, Dist North 24 Parganas, Kolkata, India
4 Department of Psychiatry, NRS Medical College, Kolkata, India
Click here for correspondence address and
|Date of Web Publication||5-Feb-2018|
| Abstract|| |
The history of psychiatry in Bengal mirrors the history of psychiatry in India. With Bengal being an important location for the East India Company, it became the locus for much infrastructure development, including the setting up of lunatic asylums. This article traces the development of psychiatric care in Bengal, from the early time of private asylums exclusively for Europeans, to psychiatric care in the present time.
|How to cite this article:|
Bandyopadhyay GK, Ghoshal M, Saha G, Singh OP. History of psychiatry in Bengal. Indian J Psychiatry 2018;60, Suppl S1:192-7
| Introduction|| |
Although the Portuguese introduced 'European' medicine in India during the 16-17th century in Goa, segregation of lunatics in mental asylums was entirely a British concept. So, the history of psychiatry in Bengal is actually the history of establishment of mental hospitals. The history of development of mental hospitals in Bengal and its gradual transition towards humanitarian dimension is a fascinating story of over a century and more.
| Eighteenth Century|| |
The journey of lunatic asylums in India was started in Bombay (1746) when backyard of a hospital was planned to be converted into a place specified for the lunatics. But little is known about establishment of like attempts in Bengal before 1780s. After the battle of Buxar (1764) the diwani of Bengal, Bihar and Orissa was conferred on British East India Company and centre of British power was shifted from Madras to Calcutta. Bengal turns in to one of the important place for East India Company in matters of power, revenue and diplomacy. In the early British period, mental asylums were primarily built to protect the community, not the mental patients and were established to segregate European soldiers and some desi sepoyees (native soldiers) employed in the East India Company. English people had to adapt themselves in a totally new environment and a typical hot Indian climate. In addition to that life and property were also insecure for them out of the political situation, which contributed to their mental health. In this critical period of time need to establish asylums was felt, and possibly there were few private madhouses, however no definite evidences regarding those are available today.
During Warren Hasting's time (1773-1785), The Pitt's India Act (1784) was introduced and the activities of East India Company came under a board of control. By this Act, British Govt. was given the supreme control over Company's affair and its administration in India. Systematic reforms and measures were undertaken during Lord Cornwallis's time (1786-1793). It was during this period, reference to the first mental asylum of Calcutta was recorded in the proceedings of Calcutta Medical Board as:
“The proceedings of the Calcutta Medical Board of 3rd April 1787, contain a memorial from surgeon G. M. Kenderdine, in charge of the insane asylum”
The same proceedings of 24th May 1787 recorded death of this surgeon on 19th May mentioning him as in charge of insane Europeans. It is evident from these records that definitely there was an existing asylum which catered the need of the European patients. In the previous proceedings, it was further mentioned that Mr. Kenderdine wanted to build a new house to keep his patients. Medical board recommended the foundation of a regular asylum and nominated one Asst. surgeon William Dick as in charge of that asylum, in a letter dated 7th May 1787. Within two weeks Govt. approved this. Dick was appointed on a salary of Rs.200 per month. Later on, Dick proposed the erection of a lunatic asylum at his own cost. Company agreed to pay him Rs.400 per month as rent. Another building for female patients was sanctioned at a rent of Rs.200 per month.
| Dick's Asylum|| |
Dick continued his asylum service until 1818 and after his death in 1821, the Court of Directors of East India Company ordered to close this asylum. Today, it is difficult to locate area of Dick's asylum, possibly it was located one thousand feet south-west to the present location of Seth Sukhlal Karnani Memorial Hospital, Kolkata. Despite the court of director's intention of discontinuation of asylum service and sending European patients back to their cool homeland, medical board proposed the establishment of another asylum near central hospital immediately, it was their felt need.
| Beardsmore's Hospital|| |
Incidentally there was one Mr. I. Beardsmore, who was also the head-keeper of an asylum (? Dick's Asylum) had already erected one private asylum at Bhowanipore just behind the Presidency General Hospital in 1817. Beardsmore proposed a medical board to keep the Company's patients at the rate of Rs.100 per month for higher class and Rs.50 per month for lower class. Board readily accepted his proposal, as it was cheaper than their apprehended cost. On 15th June 1821 five European patients were transferred to Beardsmore's hospital.
This asylum was meant for European patients only. Along with poor patients there were private patients also. Initially, the number of patients was hardly a dozen, soon it crossed 50-60. The hospital had a central house with a beautiful garden. Patients seemed to be happy. Among the staff, there was a superintendent, apothecary, matron etc. With this service everybody was happy except Mr. Beardsmore, as the cost of such humane care was so much that he was unable to bear this. For the next thirty years or more the story around the hospital was full of hot exchanges and requests from part of Beardsmore to raise the sanctioned money for the asylum.
| Lunacy Policy of Bengal|| |
During 1850s, at least three important socio-political decisions generated a reform in the system of asylum management in India. Firstly, Lord Dalhousie passed the Lunacy Policy of Bengal (1856), secondly, the Indian Lunatic Asylum Act was passed in 1858 and thirdly, the rising overcrowding, mismanagement, inferior conditions, uncaring treatment and misuse of public funds in the private asylums alarmed the government to work in favour of nationalization of asylums. So, after forty years of private management European Lunatic Asylum of Bhowanipore was taken over from Beardsmore family in 1856 by the Government and surgeon Dr. j. Cantor was put in charge of this.
| Other Asylums|| |
During almost the same time period which parallels the development of Bhowanipore asylum, another lunatic asylum was opened on 17th April 1795 at Monghyr in Bihar, about 400-500 miles north to Calcutta. This hospital was meant for insane soldiers. This asylum was situated at the south of Monghyr Fort on the banks of river Ganges. Structurally, it was like barracks and this asylum was closed on the 1st November 1831. But before this closure, another asylum was opened at Patna in 1821.
In 1815 (?1819), a new asylum was opened at Dacca (currently Dhaka, Bangladesh). It was situated in Muralibazar at the back of the central jail. The asylum consisted of two tile sheds and three single story buildings. It had an accommodation for 278 males and 45 females thus making a total of 323 inmates. Dacca and Chittagong divisions and districts of Rangpur and Pabna were allotted to Dacca lunatic asylum .
In 1874, as districts constituting the province of Assam were separated from Bengal in 1876 Tezpur Lunatic Asylum was established.
During 1874, there were at least six lunatic asylums in the Presidency of Bengal, which were, Bhowanipore, Dacca, Patna, Maidapur, Cuttack and Dullanda. But in the report on the Lunatic Asylums In Bengal by the Committee appointed to inquire into medical expenditure in Bengal in the year 1879 reveals that there were at least two more asylums in addition to those mentioned asylums. These two were, Berhampore and Hazaribagh . Almost all the asylums were in a deplorable state and these asylums were meant for native insanes, partially or totally.
| Asylum for the Natives|| |
During the early 19th century, company directors had decided to build separate shelters for native criminal insane and wandering lunatics. Initial attempts to put native Indian lunatics include the establishment of “Bengal Presidency Native Insane Hospital” near Russapaglah area of 24 parganas (currently Tollygunj area of Kolkata) adjacent to the district jail in 1816. One native doctor, one jamader, eight peons, two cooks, two matores and two bhisties were sanctioned at a very low budget. It was built to cater 50-60 patients, but a report in 1834 showed that there were at least 267 patients with a nominal increase in financial sanction. Another report in 1842 depicts condition of the hospital buildings was 'filthy, crowded, defaced and broken .
Considering the deplorable condition of the native asylum, establishment of a new hospital for insane natives was planned. This new asylum was Dullanda Lunatic Asylum. Location of this hospital was where today's police training school is situated at lower circular road, near SSKM Hospital. In September 1847 native insane of Russapaglah hospital were shifted to the new place of Dullanda. In the pen picture of a very famous psychiatrist, Dr. L P Varma, 'it was a circular building which had a courtyard within it. All round the courtyard were small rooms, each of which accommodated four lunatics. This building had a single entrance which had a big iron gate, guarded by a sentry.' This native asylum was made for 150 patients, but had to accommodate almost double number of patients. Upto the middle of 19th century, the civil surgeon of a district under the supervision of district magistrate used to look after asylum affair. It was a difficult job for the civil surgeon as he has to look after so many medical-administrative problems of a district. For Dullanda asylum civil surgeon of 24 parganas, Dr. Francis Pemble Strong had tried as best as he could, but even for him it was hard to find adequate time for a lunatic asylum. In 1855 the medical board suggested to appoint a full time medical superintendent for all the asylums. But the Government only permitted the appointment of a full time officer to look after on both Bhowanipore asylum and Dullanda asylum as a 'test case'. Dr. J Cantor was recruited in this post. Another important change that was made during this period (1857) was erection of a separate house within the premise of Dullanda asylum to accommodate 80 female patients .
| Post Revolt (1857) Changes|| |
On 1st November 1858 came the Queen's proclamation and administration of the country passed to the crown from the East India Company's hands. Act no.36 of 1858 authorized the establishment of asylums “for the reception and detention of lunatics at such places within the limits of the said Government as may be deemed proper”. At this juncture we may revisit the history of Bhowanipore asylum at the hands of Dr. J Cantor who is the newly appointed full time superintendent for both Bhowanipore and Dullanda asylum, as 'the seal of medical supremacy in the treatment of the lunatics in Brtitish India's main centre was set'. Dr. Cantor had some experience in the scientific management of lunatics and with his administration discipline, internal control and financial economy came to pervade Bhowanipore European Asylum's all permissive atmosphere. He strongly believed that medical persons should be in charge of mental hospitals and was of the opinion that, “kindness is the real substitute for mechanical restraint”.
In 1868, Sir James Clerk, by the order of Secretary of state of India prepared a questionnaire on the status of asylums in India. Responses from the Bengal Presidency revealed overcrowding and poor data keeping. From 1863 to 1867, out of a total of 2274 patients admitted in asylums of Bengal, 514 died and 858 declared cured. The common modes of treatment were, using morphia, tincture digitalis, bromides of potassium, anodynes etc. along with occupational therapy, gardening, pleasurable, amusements, good sanitation, exercise, cold bathing and so on. Arthur Payne (1862), then Superintendent of Asylums of Presidency was of the opinion that, “the fatality among non-working men is beyond all proportions, greater than among the working class.” So, the inmates were forced to work, but their work was said to be 'voluntary'! These form of work was known as 'lunatic labor', which included garden production, castor oil manufacturing, mustard oil manufacturing, soorki manufacturing, gunny weaving, coir weaving, wheat grinding, road making, building compounds and so many productive business generating lots of money as profit for the asylums .
The lunatic asylum of Maidapur had accommodation of 75 patients. This asylum was situated at a distance of 3 miles from Berhampore and was looked after by the civil surgeon of the district, one hospital assistant doctor, one daroga and other staff .
| Berhampore Lunatic Asylum|| |
Accommodation at the Dullanda asylum was for both criminal and non-criminal lunatics. Both the Superintendents, Dr. Cantor and Dr. Payne felt the problem of mixing these two groups of patients, it was more relevant in cases of long stay patients. So, the question of strengthening the number of staff and separating those two groups arose. As a long term solution, establishing separate cells for criminal lunatics in all the prisons was suggested. However, the Lieutenant Governor then wished to open a new hospital as a solution and it was decided to open this at Berhampore. Shortly after the battle of Plassey, Berhampore was selected as a site for station troops to prevent revolts. After the revolt of 1857, European troops were again stationed here, but they were finally withdrawn in 1870, and these barracks were now lying empty. It was easy to erect an enclosure around those barracks and convert it into an asylum , 3, 1!
The Maidapur asylum was closed down in 1876. All the patients along with the total staff of Maidapur were transferred to Berhampore. The Government of Bengal issued a notice on 8th June 1886 to allot separate areas under different lunatic asylums. The new asylum of Berhampore was required to deal with patients from Murshidabad, Rajshahi, Nadia, Jessore, Khulna, Bhagalpore, Malda, Purnea, Burdwan, Birbhum and Balasore. In 1905, the Berhampore lunatic asylum was enlarged at the cost of Rs. 3 lacs and named as Central Lunatic Asylum, Berhampore (Verma,1953). All the patients of Dullanda asylum and Cuttack asylum were shifted to the Berhampore asylum. For the first time there was an uproar from the intellectual section of Bengal, as at that time Berhampore was not considered as a very healthy place. It was considered as a den of malaria and after this resistance it was decided that after the establishment of central asylum of Ranchi, which is a healthy place in comparison to Berhampore, all the patients of Dullanda will be shifted to Ranchi and their staying at Berhampore central asylum is only a temporary measure .
| Central Lunatic Asylum, Ranchi|| |
The Central lunatic asylum of Ranchi was opened on 17th May 1918 and all the European and Anglo-Indian patients of Berhampore and Bhowanipore asylum were transferred there. Bhowanipore asylum was ceased to exist as a regular asylum from 16th September 1918 and it was opened on the same day as a temporary ward for observation cases. The buildings at Bhowanipore Mental Observation Ward were completed in June 1923 and it was opened on the 1st May 1924,. In the year 1922, the names of all the 'lunatic asylum' were changed into 'mental hospital'.
In his autobiography 'All too human' (1939), Berkeley Hill  wrote, “Ranchi European Asylum as it was first called was the product of a panic on the part of Government of Bengal. About thirty years ago the people of Calcutta were beginning to realize that the old Bhowanipore asylum was a disgrace to their fair city. I know as a fact that round about 1880 Indian lunatics in Bhowanipore were employed in dragging scavenger carts through the streets. Guilty consciences in Calcutta grew so numerous that at least it was decided that 'something should be done about it”....... In the end it was decided to build two large asylums, one for the Indians and the other for Europeans and Anglo-Indians”.
Initially the first site was selected at Namkum, Ranchi, which created much opposition among the European inhabitants of Ranchi. Following this, an almost barren land of Kanke, at least 10 miles away from Ranchi railway station was selected as the ideal place for lunatics ! The first Medical Superintendent was Major A S M Peebles (who left after 18 months) and Deputy Superintendent was Dr. Joytirmoy Roy. Berkeley Hill joined as medical superintendent on 19th October 1919, under whose able leadership European Lunatic Asylum became a symbol of excellence, but that was a different story.
| Indian Mental Hospital, Ranchi|| |
The hospital for Indian mental patients at Ranchi was actually opened in 1925 and the first superintendent of this hospital was Capt. J E Dhunjibhoy. The hospital received it's first set of 110 male patients from Patna on 4th September 1925, followed by a set of 53 female patients from Patna asylum on 19th September 1925. A series of patients from Patna, Berhampore and Dacca mental hospitals came in batches and by 31st December 1925 the hospital had a population of a 1226 patients, soon it crossed the limits of accommodation there .
It was to the credit of Capt. Dhunjibhoy and his assistants, that such a large number of mental patients were transferred to such a distant place without any mishap. In the writings of Capt. Dhunjibhoy this journey was narrated as, “ patients were taken from hospital to the steamer in motor cars. All the excited cases were securely accommodated in specially constructed cubicles on the boat...and they were looked after by the accompanying hospital and police staff. A contract was made with the Eastern Bengal Railway to furnish five bogies fitted with prison bars and with sitting accommodation to suit my requirements under my instruction, all latrine doors being removed and a continuous corridor was constructed running throughout the entire length of the five bogies..etc”.
In 1929, overcrowding and congestion was tackled adding 50 emergency beds and attempts were made to discharge more chronic patients. Magistrates were instructed to be more careful in sending patients to this hospital .
Bhore committee reports
In 1944, Col. M Taylor, the superintendent of European Mental Hospital at Ranchi as a member of Health Survey and Development Committee (popularly known as Bhore Committee, 1946) was asked to survey mental hospitals. According to this report there were at least 19 mental hospitals. Col. Taylor visited six places in Calcutta on 30th December 1944 in order to meet Dr. G Bose as Dr. Bose intended to leave the city on 1st January 1945. The visited hospitals were : Lumbini Park Mental Hospital, Mental Hospital for Male Patients at Mankundu, The Mental Hospital for Females, The Observation Ward, Bhowanipore, the outdoor Neuropsychiatric clinic of Carmichael Medical college and Medical college hospital, Calcutta .
| Lumbini Park Mental Hospital|| |
Located at Bediadanga Road, Tiljala area in the Ballygunj locality, this private mental hospital was started by the efforts of Indian Psycho-Analytical Society on 5th February 1940. The house of this hospital was a gift to the Psycho analytical Society from the famous author Rajsekhar Bose, who was the elder brother of 'father of psychoanalysis in India' Dr. G S Bose. This hospital was started with three beds only, but was soon raised to 48 beds, it finally expanded to a 200-bed hospital .
| Mankundu Mental Hospital|| |
Another private enterprise, this was opened in 1933 by the efforts of a person, Dr. K K Das, who was the founder secretary of this hospital. The male section of the Mankundu Mental Hospital was situated at Mankundu, about 22 miles from Calcutta. It gained recognition as a hospital under the Lunacy Act in 1940. According to Col. Taylor of Bhore Committee, “ the buildings are good, but in a very bad state of repair, and the compound is an absolute jungle. I found patients under poor control, and the whole atmosphere of the hospital was most depressing.”
The female section of Mankundu hospital was located in a rented house at 75, Circular Road, Calcutta. According to Taylor that place was not very suitable for the purpose, but the patients appeared to be happier and better cared for, although he had mentioned about the inadequacy and poor quality of Nursing Personnel.
A few other hospitals were also providing psychiatric care during the pre-independence period in Bengal.
| The Insane Ward of Gobra Leper Asylum|| |
Once Leprosy was a comorbidity among mental patients. To segregate those patients having Leprosy, an insane ward was opened at the Albert Victor Leper Asylum at Gobra on 26th September 1916. All cases of leprosy among mental patients were sent here from Bengal, Bihar and Orissa. This hospital was closed in 1934. It was converted in to a full strength 250 bedded mental hospital for Mental Diseases in 1967. Later it was renamed as Calcutta Pavlov Hospital ,.
| Bangyia Unmad Ashram|| |
This was an Ayurvedic hospital with indoor facilities, started in 1935 by the famous Kaviraj A B Dutta. It was converted into a 100 bedded modern hospital in the sixties .
| General Hospital Psychiatry Units|| |
Transformation of asylum based, autocratic, seclusive mental hospital system of 'closed' psychiatric care to the flexible 'open' system of psychiatric care was primarily initiated by Dr. G S Bose, supported by Indian Association for Mental Hygiene. On 1st May 1933, the Psychiatry OPD of Carmichael Medical College (current R G Kar Medical College, Kolkata) was opened and it was the first Psychiatric Outpatient dept. of India. Every week this OPD remained open on Tuesdays and Monday from 8am to 10 am. Total number of patients attended OPD in the first year was 174. Dr. Bose was the medical officer in charge. Dr. Bhupati Mohan Ghosh and Dr. Kamakkhya Charan Mukherjee were there to assist him. Dr. Nagendranath De and Dr. S Banerjee joined this clinic later on . The Psychiatry OPD of Medical College Hospital, Calcutta was started in 1939.
From Col. Taylor's report it is evident that the scope for learning Psychiatry was minimal during these early attempts of introduction of psychiatric care in general hospitals. In Bhore Committee report (1946), Taylor wrote, “I left Calcutta, having formed the opinion that the mental hospitals and clinics which I visited there cannot be considered satisfactory, and far below the standard which one would expect to find in a University city. There is a crying need for a modern mental hospital for Indians in Calcutta of at least 250 beds—both in the interests of community and the University. The bulk of clinical material passes to the Indian Mental Hospital, Ranchi, and it is not feasible either to send large number of patients from Ranchi to Calcutta, or to send Medical students to Ranchi”.
All medical colleges acquired Psychiatric Units between 1962-1965, these are now Psychiatry Departments with indoor facilities and post graduate trainees in most of them. The University of Calcutta started DPM Course in 1959 and MD in Psychiatry in 1967.
Post-independence psychiatry in Bengal: Other developments
From 1960s onwards, psychiatry took a great stride in Bengal. Mental observation ward at Bhowanipore had gained mental hospital status in 1952 and from 1962 onwards it started functioning as the Psychiatry unit of IPGMER Calcutta, with 30 beds and OPD facilities. Later, it was converted into Institute of Psychiatry in 1992. Lumbini Park Mental Hospital was upgraded and taken over by the Government. All the District General Hospitals have psychiatry OPDs now. In addition to the existing government hospitals, there are now three more state run mental hospitals, these are—350 bedded Berhampur mental hospital, 190 bedded Institute of Mental Care, Purulia and 30 bedded Toofangaunj Mental Hospital, Coochbehar.
Today, private sector Psychiatry is also strong in Bengal. In addition to that, many NGOs, clinical psychologists, counseling psychologists and psychiatric social workers are also serving their job well. The fascinating journey of Psychiatry in Bengal is a never-ending story. Hope it will be continued through the Community psychiatric phase and thereafter.
| Commentary|| |
The truism of what Bengal does today, India does tomorrow, seems particularly apt. The article provides a fairly detailed account of the developments of Asylums in Bengal, on the background of the East India Company's efforts to provide health care for the people living in its territories, and the constant arguments about private/public arrangements. After 1857, things changed somewhat, but as Bengal was where it (the Revolt) all started, progress was tardy. Since health had been placed under Provincial control, there was constant preoccupation with costs and locations. As the authors point out, many sites where the asylums were located were observed to be unsuitable. Finally, the Govt of Bengal paid several lakhs towards the construction of the Indian Mental Hospital, Ranchi, after a heated debate about why the Asylum was being situated in Bihar. The separation of Assam, the partition, and subsequent reunification of Bengal also had their impact. Calcutta was also where the first Medical College was begun in 1835. Calcutta was where William O'Shaughnessy experimented on the use of cannabis on the mentally ill in the 1840's, James Esdaille practiced hypnosis in the 1850's, and many local Bengali newspapers and pamphlets commented on psychological issues and hysteria. It was here that GS Bose began his work, though his work was viewed by considerable skepticism by the more orthodox psychiatrists like Mapother and Moore- Taylor. The final partition of Bengal in 1947, to a fraction of what the Bengal Presidency once was, and the frequent administrative mergers and moves of the various Asylums, makes it quite unlike the other big Presidency asylum of Madras. The impact of regional history on the provision of health services, in independent India needs a closer scrutiny.
| References|| |
Sengupta C, Monochikitsa: Ancholik Etihaser Ek Addhyay; Ekshan (1987) vol. 18, pp 91-130.
History of Mental Hospitals in Indian Sub-continents, Shridhar Sharma, Indian Journal of Psychiatry(1984) 24(4),295-300.
Varma L P, History of Psychiatry In India and Pakistan, Indian Journal Of Neurology & Psychiatry, 1953, Vol. 4 No. 1 & 2, pp26-53.
Report on the Lunatic Asylums in Bengal, by the Committee appointed to inquire into medical expenditure in Bengal, printed at the Bengal Secretariat Press, Calcutta,1879.
Ernst W (1991) Mad Tales From The Raj :The European Insane in British India,1800-1858, Routledge, London
Basu A R, A New Knowledge of Madness—Nineteenth Century Asylum Psychiatry in Bengal, Indian Journal of History of Science,39.3(2004) 247-277.
Chowdhury A N; 180 Years of Institute of Psychiatry; Commemorative Brochure; 180 years celebration of Institute of Psychiatry, Calcutta, 1997, pp 42-50.
Owen Berkeley Hill ;ALL TOO HUMAN An Unconventional Autobiography, London; Peter Davies, 1939.
Mental Hospital Reports; The British Journal of Psychiatry, 1927,73(302),485-487.
Report of The Survey And Development Committee, 1946, vol 3, published by the Manager of Publications, Delhi.
Bandyopadhyay G, Anonyo Girindrasekhar, A Life sketch on Dr. G S Bose, published by DANA, Kolkata,2011.
Chakraborty A, Mental Health and Psychiatry in West Bengal, Mental Health : An Indian Perspective 1946-2003, Director General of Health Services, Ministry of Health & FW, New Delhi, 2004.
Dr. Om Prakash Singh
Department of Psychiatry, NRS Medical College, Kolkata, West Bengal
Source of Support: None, Conflict of Interest: None