Psychological symptoms and medical responses in nineteenthcentury India

History of Psychiatry2015, Vol. 26(1) 88 –97© The Author(s) 2014

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DOI: 10.1177/0957154X14530815hpy.sagepub.com

Psychological symptoms and medical responses in nineteenth-century India

P RadhikaNational Institute of Mental Health and Neuro Sciences, Bangalore, India

Pratima MurthyNational Institute of Mental Health and Neuro Sciences, Bangalore, India

Alok SarinSitaram Bhartia Institute of Science and Research, New Delhi, India

Sanjeev JainNational Institute of Mental Health and Neuro Sciences, Bangalore, India

AbstractThe article documents medical approaches to mental illness in mid- to late-nineteenth-century India through examining the Indian Medical Gazette and other medical accounts. By the late nineteenth century, psychiatry in Europe moved from discussions around asylum-based care to a nuanced and informed debate about the nature of mental symptoms. This included ideas on phrenology and craniometry, biological and psycho-social causes, physical and drug treatments, many of which travelled to India. Simultaneously, indigenous socio-medical ideas were being debated. From the early to the mid-nineteenth century, not much distinction was made between the Western and the native ‘mind’, and consequently the diagnosis and investigation of mental symptoms did not differ. However, by the late nineteenth century Western medicine considered the ‘Western mind’ as more civilized and sophisticated than the ‘native mind.

KeywordsBiomedical approach, colonial medicine, history, India, psychological ideas, 19th century

Corresponding author:Sanjeev Jain, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Hosur Road, Post Bag 2900, Bangalore-560029, India. Email: [email protected]

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Radhika et al. 89

Introduction

An organized European medical service, run by the East India Company, was in place in India by

the late eighteenth century. Subsequently, descriptions and discussions about diseases and their

correlates were recorded in detail (Arnold, 1993; Pati and Harrison, 2001, 2009). Formal academic

interest was further enhanced with the publication of the Indian Medical Gazette (started in 1866),

which described itself as ‘A Monthly Record of Medicine, Surgery, Obstetrics, Jurisprudence, and

the Collateral Sciences; and of General Medical Intelligence, Indian and European’. It had been

preceded by a number of ‘local’ medical journals in Bombay and Madras, but the Gazette attempted

to cover health-related issues on an all-India perspective. In the mid-1870s, the Gazette’s subtitle

further included ‘hygiene’ and in the mid-1880s, ‘public health’, while jurisprudence and obstetrics

were removed.

The purpose of the Indian Medical Gazette was to document the breadth of medical science and

practice – specialized and general – across the vast continent of India. The medical reports pub-

lished in the journal came from dispensaries in far corners of British India, e.g. Fort Lockhart,

Samana (North West India on the border with Afghanistan); Jhang (Pakistan Punjab); Arrah

(Bihar); Bhuggocool in Dacca district (Bangladesh); and Noakhilah in Bogra district (Bangladesh).

Reports were submitted by both Indian and European doctors, including officers of the Indian

Medical Services (IMS) and civilian employees of the Government.

In an early issue, editors C. Macnamara and K. McLeod (1873) put out a call to medical officers

to report local socio-medical practices. Their concern was the reluctance of the Indian populace to

access ‘Western’ medicine, and their preference for ‘primitive’ medicine that was locally available.

The editors reflect that it would be useful to know ‘why a dispensary is not well attended ...

because of a kobiraj, pir, fukeer or other pretender’, and record two such dispensary reports, one

from Noakhilah dispensary (present-day Bangladesh) where a ‘godman’ (religious guru) Shumboo

Thakur conducted what they called an Adalut (court) where he promised to remove all kinds of

ailments and, when he died, many more Shumboo Thakurs arose from among his followers. The

second report was from Bhuggocool dispensary, Dacca district, where a man called Kally Coomer

Chuckerbutty administered the dust of his feet as a panacea for all illnesses. Such documentation

was important for British administration and the medical establishment, to ensure the spread of

‘scientific’ medicine, a process not merely occurring in the colonies but also ‘back home’ in Britain.

The journal editors condemn native superstition, wherein dengue fever is chased away from a

South Indian village through drumming, but also add that England itself is ‘not foreign to similar

cults’ (Macnamara and McLeod, 1873: 299). This suggests that at least in the mid-nineteenth cen-

tury, there were no assumptions being made about essential differences between Indian and British

society in the credulousness of the populace, or public acceptance of ‘Western’ medicine.

In this paper, we focus on descriptions of and discussions about psychological symptoms in

medical accounts in nineteenth-century India. By this time, doctors seeking employment in the

East India Company were expected to familiarize themselves with the principles of mental health

care by working in one of the asylums in the UK for at least three months (Crawford, 1914). These

medical accounts help us understand the travel of ideas about mental syndromes between Europe

and India.

Phenomenology of psychological medicine: investigation and treatment

Many papers in the Indian Medical Gazette present detailed clinical descriptions of mental illness

and its treatment. One of the earliest descriptions of hysteria is provided by Pandurang and


90 History of Psychiatry 26(1)

colleagues in a note on ‘Hysteria’; this discusses a 12-year-old girl H. who suffered from loss of

speech and twitching of lower and upper extremities after seeing a reptile. The doctor concludes

that she is afflicted with hysteria based on the abrupt onset of choreiform movement, and its disap-

pearance after the use of chlorodyne mixture, within three days (Pandurang et al., 1869).

An article by a civil surgeon from the Dacca asylum, now in Bangladesh, lists the various delu-

sions and provides a fascinating and detailed description of phenomenology. The delusions

recorded include the following: one patient described being gifted a tea garden by Queen Victoria,

another of possessing three lakhs (300,000) rupees in England and trading in goods, a third deify-

ing herself as the daughter of agni (fire), and a fourth feeling persecuted by those who ‘blew his

body with wind’ (Smith, 1875: 207–8). Patients in India were thus incorporating British institu-

tions into their delusions.

P.W. O’Gorman from the sub-medical department presents ‘A case of acute mania’ in a 29-year-

old European soldier admitted to the Agra station hospital for 14 days in December 1881. The

author reports the patient’s symptoms and treatment, and detailed descriptions of his behaviour –

staring eyes, clenching teeth, tearing clothes and sheets, his delusions of being ‘Jesus Christ’ and

‘Blessed Virgin’. The patient’s food intake, sleep, urine and stool patterns, grasping and response

ability, and people’s attitude towards him, are also discussed by O’Gorman (1882).

There are also reports of effective treatments. Indian doctors were publishing their findings as

early as 1867, a year after the Indian Medical Gazette began. Ram Chunder Mitter, of the Arrah

charitable dispensary, discusses ‘A case of mania treated successfully’. R., a 14-year-old married

girl who suddenly showed signs of illness, is described as being quiet, not listening to relatives,

singing and talking nonsense all day, and not eating well since the beginning of her illness. She is

successfully treated over a week by the application of a blister over the top of her head, along with

purgatives, cold bath, tartar emetic and morphia (Mitter, 1867).

JN and MM (1867) – who preferred these abbreviated names – present details about their use of

‘Bromide of potassium in insanity’. They show its effectiveness in inducing sleep and calming a

person through two case studies: a father and son with incipient and confirmed insanity, respec-

tively. They list favourable effects of the salt, along with other substances that they have adminis-

tered: kamila troches (kamila rubbed up with confection of roses), painting the lumbar region of

the spine with the linimentum cantharides of the British Pharmacopoeia, a dose of laxative of

rhubarb, aloes and taraxacum, and a dose of ‘potassii bromidi, ammon: carb:, extract: chirett fluid

and aquae ad’ (JN and MM, 1867). The doctors mention having later learnt of potassium bromide

being endorsed by ‘high authority’ in the Edinburgh Monthly Journal.This coincides with the introduction of bromides in the 1860s in Britain and Europe. As Healy

(2000: 396) points out: ‘their use was initially in hospital settings where, combined with henbane,

digitalis or cannabis, they proved effective sedatives. By the turn of the century bromides had

migrated into private care.’ JN and MM’s study appeared within a decade of Charles Locock (1857:

528) describing the use of potassium bromide in hysterical epilepsy and hysteria.

We also find elaborate descriptions of psychopathology in the asylum reports of the mid- to late-

nineteenth century. The 1871–72 report of the Punjab asylum records:

The common form of insanity from Indian hemp is dementia, with or without melancholia, where the

patient is totally indifferent to persons and things, and to what is passing around him. He seems to hold no

intercourse with the world, has a stupid stare, is very quiet, sleeps well, and has a voracious appetite … A

less frequent form from the incautious use of hemp shows itself in excitement and paroxysms of violence

with intervals of quiet. They talk loudly, are authoritative and commanding, and most irritable. This state

will last for a day or two, and the patient becomes more tractable; but he is never safe. (Punjab Lunatic

Asylum, 1872: 5)


Radhika et al. 91

In the Delhi report for 1875, the following is recorded for Ashraff Khan, a criminal lunatic:

On one occasion, in the hot weather, he refused to leave his sleeping ward until he had seen me, and I found

the reason was that he thought he had been cheated of his proper quantity of food by the jamadar [junior

official], whom he still looks upon as his enemy, and who he believes wishes to kill him. He first asked me

the weight of the bread and dal which he ought to get, and on being told this he brought out the whole of

his previous day’s rations, which he had hidden away in a corner untouched, and he requested that it might

be weighed there and then. Fortunately both the bread and the dal, although they had been kept so long,

were rather over the prescribed weight. He was a little crestfallen at the result, but apparently satisfied, and

I have heard no more complaints since. I mention the circumstance to show what unfounded suspicions

occasionally come across the man’s mind; and during these there can be no doubt that he is prepared for

any deed of violence, for, while questioning me about his rations, his whole manner was most excited.

(Delhi Lunatic Asylum, 1876: 18)

There are other reports in the Delhi asylum records: an Irish soldier converting to Islam and mobi-

lizing all Muslims to help the Russians fight the English (Delhi Lunatic Asylum, 1877) and a Sikh

‘sirbhangi’ (‘head full of cannabis’) guerrilla soldier being discharged as not insane, though he was

admitted for eating the body of a dead child in 1883 (Jain, 2003: 279).

The asylum reports during the mid- to late-nineteenth century were debating diagnoses and also

presenting psychological reasons for insanity. The 1872 Punjab report states:

The classification of the forms of madness as manifested in natives is, in my opinion susceptible of a

more simple arrangement than that laid down in Return 12, in which we have acute and chronic mania,

and also acute and chronic dementia. Instead of these four heads, I would make two great forms of

mental derangement, one characterised by visible excitement, the other by depression. Melancholia,

when the mind is engrossed in some painful sentiment, with perhaps propensity to suicide or homicidal

impulse, may complicate almost every form of derangement of mind, but it is always dependent on

delusion expressed or not, and, therefore, is correctly made a separate disorder. (Punjab Lunatic Asylum,

1872: 3)

Psychological causes for mental illness were being acknowledged in many patients. Grief is cited

as one of ‘the chief causes for insanity’ (Delhi Lunatic Asylum, 1874: 3; 1875: 10). It was a pre-

dominant cause among 23 physical causes and 18 moral causes, as it was found in 13 cases vis-à-

vis 8 cases caused by ganja, i.e. hemp/cannabis (Delhi Lunatic Asylum, 1875: 10).

Thus, the following are all evident in reports from India: concepts of hysteria, classification

of insanity into few or several categories, content and nature of delusions, and hereditary and

exogenous causes of mental illness (biological, such as cannabis, or psychological such as grief).

These issues are congruent with preoccupations in Britain, Europe and the USA at that period, and

do not seem to suggest any attempt at using a different framework for defining psychological

symptoms in India (Altschule, 1976; Berrios, 1999; Shorter, 1996). Clearly, similar issues are still

being discussed: somatic symptoms (hysteria) in the Third World/LAMIC countries; the use of

DSM-5 vs. ICD-11; the role of drugs of abuse; and social adversity in mental illness.

Biomedical or physiological approaches

Advances in anatomical and physiological understanding of brain function, and attempts to corre-

late it with various diseases through phrenology, impulse theories, degeneration theories, etc., were

evident throughout the nineteenth century in Europe, and were used in discussions about mental

illness in India too.



McLeod (1883) discusses the limitations of phrenology in mapping mental functions to local-

ized parts of the brain, but emphasizes its strengths in attempting to build an ‘objective method of

observation’ and making a necessary connection between the brain and mind, thus making the

study of mind a study of biology (p. 4). By this time phrenology had become discredited in Britain

and Europe after the initial popularity it enjoyed between 1810 and 1840 (Shorter, 1996), though

many have suggested that the current preoccupation with imaging and its correlates with mental

phenomena may be an extension of this anatomical inquiry (Uttal, 2001).

Another lecture given by R.J. Macnamara, at the 1894 annual session of the Indian Medical

Congress, presents a study of head measurements of the insane in comparison with the sane, and

also discusses how a given personality trait could be determined by measuring the area of the skull

that overlies the corresponding area of the brain. The lecture, later reproduced in the Indian Medical Gazette (Macnamara, 1896), asserts that the mentally ill and lunatics have a smaller brain size than

normal people. It suggests that their deficient intelligence is the cause for criminal behaviour and

their inability to assess right and wrong. Macnamara thus argues for the law to be liberal with

criminal lunatics. Macnamara’s study followed Samuel George Morton’s major monographs on

craniometry, Crania Americana (1839) and An Inquiry into the Distinctive Characteristics of the Aboriginal Race of America and Crania Aegyptiaca (1844), which claimed that intellectual capac-

ity is directly proportional to cranial capacity (Shorter, 1996). The topic of racial and temperamen-

tal differences in cranium size had again been made popular by Morton and others (Le Bon, 1879),

and Macnamara’s paper suggests considerable familiarity with these ideas. The work of McLeod

and Macnamara is indicative of the biomedical gaze in mental science at the end of nineteenth

century in India.

Indian doctors were also reporting on ‘bio-markers’ of mental illness. A note on melancholia

points out: ‘From my experience of this disease I find that in several cases the urine of melancholic

persons is loaded with a dark substance, and is strongly acidic in reaction’ (Shah, 1882). Urine

changes during melancholia had been described in traditional Ayurvedic and Unani medicine, as

well as European medicine (Broumand, 2011; Glas, 2003; Klibansky, Panofsky and Saxl, 1964).

This shared semiology makes it difficult to determine whether Shah’s ideas were derived from

adherence to prevalent traditions in India, or by what he would have learned at British medical

school (which in any case derived their knowledge from similar sources: Galen and Avicenna).

Debates on genetic causes and family histories that started in the eighteenth century continued

into the nineteenth. In his report on mania, Mitter (1867) opines that the patient has ‘no family his-

tory’. JN and MM (1867), looking at mania across three generations of patients (son, father and

grandfather), assert that ‘there could be no doubt of the hereditary tendency’. The clustering of

mental illness in families was thus well recognized.

Treatments included experiments with drugs, both native and European. W.B. O’Shaughnessy

of Calcutta presented the first evidence of the medical use of cannabis indica in treating illnesses

such as rheumatism, cholera and delirium tremens in 1839 (O’Shaughnessy, 1838–40).

Subsequently, during the annual meeting of the Association of Medical Superintendents of

American Institutions for the Insane, Dr John P. Gray, Superintendent, New York State Lunatic

Asylum, Utica, read a paper ‘On the use of cannabis indica in the treatment of insanity’, which is

recorded in the proceedings of the meeting. Gray states that there had been a renewed interest in

the last three to four years in the use of cannabis indica in treating insanity. Its most marked effect

was in acute mania and was least effective in melancholia. Other doctors present at the meeting

concurred with Gray on hemp’s usefulness in reducing delusions, controlling hysterical disposi-

tions and producing a soporific effect in the treatment of mania. If the substance had failed at all,

they attributed it to the preparation used rather than to the qualities of hemp (Shrady, 1859: 83–9).

This shows that ideas about treatment were not merely travelling from the West to India, but also


Radhika et al. 93

in the other direction. The Indian Medical Gazette also recorded the use of drugs. A report on some

effects of Indian hemp documents the cases of two young European women who fainted after being

given hemp for menstrual problems (Bensley, 1866); the author asks whether other doctors have

observed similar effects.

As discussed earlier, JN and MM record the successful use of potassium bromide in insanity.

Shah (1882: 265), in his note on melancholia, suggests that ‘patients derive great benefit from the

acetate of potash and nitric ether treatment’.

Through the mid- to late-nineteenth-century Indian Medical Gazette reports, we thus see a

growing interest in biomedical approaches to mental illness and treatment. In Britain and Europe,

the work of Hughlings Jackson, Gustav Fritsch and Eduard Hitzig, and David Ferrier led to the

development of ‘a structurally oriented neurology’ (Bynum, 1985: 95), and by the twentieth cen-

tury in Britain and Europe, explanations for trance and hypnotic states were seen to reside in physi-

ology rather than psychology (Williams, 1985: 242). As Meynert was to say in 1890, ‘The more

that psychiatry seeks, and finds, its scientific basis in a deep and finely grained understanding of

the anatomical structure [of the brain], the more it elevates itself to the status of science that deals

with causes’ (Shorter, 1996: 77).

Healy (2000) and Shorter (1996) have shown the extensive use of physical therapies during the

nineteenth century: opiates during the first half of the century; henbane alkaloids, hyoscine and

hyoscyamine in the mid-nineteenth century; bromides, barbiturates and chloral in the 1860s; and

the use of lithium salts for manic depressive disorders between 1800 and 1900. Moreover, this use

of ‘organic’ treatments for mental illness suggests a gradual transition, as plant-based medicines,

usually sourced from the colonies (and based on awareness of the use in the particular culture),

were replaced by products from industrial chemistry. The use of plant-based medicine was now

relegated to ‘folk’ (pre-scientific) medicine, though this did not prevent, for example, its rapid use

to develop anti-hypertensive and anti-psychotic drugs in the twentieth century based upon reser-

pine and related alkaloids derived from Rauwolfia (Jain and Murthy, 2009).

Psychological and psycho-social approaches

Psychological and psycho-social approaches to understanding mental illness were prevalent, and

we find one of the earliest descriptions of hysteria in the mid-nineteenth century by Pandurang and

colleagues (1869). They describe the case as ‘a nervous disorder simulating chorea’ whose aetiol-

ogy is not entirely organic:

The sudden development of choreaic movements after evident fright, the inability of speech and the

extraordinary recovery in the space of three days seem to me rather unusual features in the history of

chorea … the patient did not evince any marked deficiency in the general state of nutrition, and bore no

evidence whatever of a hyper fibrinated condition of blood … The short duration of the disease, the

absence of its connection with some particular dyscrasia, and its reappearance, appear to me related more

to a mental peculiarity of the patient, similar to hysteria, than to a true morbid condition, or diseased

condition of the corpus striatum (which more generally happens to be the cause) …

Subsequently, Murray (1890) records a case of hystero-epilepsy explicitly stating that the illness is

psychological, not entirely organic. He reports the case of a German sailor T. Dahucke, admitted at

the Calcutta general hospital in 1885, who showed signs of epileptic seizure and subsequently

became mentally deranged. He concludes that the seizure is hysterical in character because of its

‘suspicious regularity at a stated time, morning and evening’ and that the patient ‘premeditated his

attack by systematically making his bed and lying down to have a fit’. The surgeon diagnoses the

illness as hystero-epilepsy since it has features of both paroxysmal attacks.



Both these reports understand hysteria as a nervous disorder and not as having its origins in the

female uterus or genitalia (Altschule, 1976: 296). Pandurang and his colleagues attribute the cause

to ‘evident fright’, and Murray to ‘loss of nervous equilibrium’. Murray (1890: 322) says, ‘These

nerve storms are a result of nerve exhaustion by debilitating influences of all kinds, whether the

enervation be due to prolonged pyrexia, to tropical heat, or other allied causes, operating pathologi-

cally on the nerve centres.’ This understanding began with Laycock in A Treatise on the Nervous Diseases of Women (1840) and was taken forward by Briquet in Traité clinique et thérapeutique de l’hystérie (1859). Murray pays direct allegiance to Laycock while remarking on a case of hysterical

hemiplegia, ‘I recollect a very singular case that came under my observation a good many years

ago when resident physician in the clinical wards of the Edinburgh Royal Infirmary under Professor

Laycock’ (Murray, 1890: 323).

Pandurang and his colleagues were drawing on ideas circulating in the nineteenth century but

were also making independent observations. Unlike Briquet (Altschule, 1976: 299), they do not

see hysteria as a brain disorder (Pandurang et al., 1869). Nor do they, like Breuer or Freud, consider

the possibility of the snake symbolizing repressed sexuality (Breuer and Freud, 1955; Freud, 1913:

132). Also, unlike Laycock, Pandurang et al. do not emphasize the gender-specificity of the syn-

drome, although the patient they happen to be describing is a young woman. Murray (1890) on the

other hand remarks, ‘Hysteria is generally rare among the male sex but when it does occur it is of

a very severe and pronounced type (hysteria masculine).’

By this time, Charcot was conducting extensive experiments at the Salpêtrière School and he

included a chapter on hystero-epilepsy in his Leçons sur les Maladies du Système Nerveux (Charcot,

1872–73). Also, Charcot’s lectures that included case histories of male patients had become well

known by 1890 (Charcot, 1887a, 1887b, 1889). The ideas about hysteria advanced by Pandurang

and his colleagues, and by Murray, their use of the diagnosis for both sexes, and discussions about

its wider implications were recorded well before Freud made his contributions. They reflect an

awareness and acceptance of the ‘interior’ of the mind of the patient, both Indian and European.

At the same time, hypnotism was used as an effective therapy in the nineteenth century. In

‘Hypnotic therapeutics in natives of India’, Delany (1899: 445) reports on gunner K.S. whom he

cures of partial deafness and blindness that he finds has no organic cause. The second case is of a

Pathan border policeman who is addicted to opium. Delany remarks on the particular success of

this case because of the multiple translations involved, with Delany knowing only English and the

policeman only Pushtu; despite this, an adequate and effective doctor-patient communication had

worked. The use of hypnotism needs to be seen as drawing on a long Western tradition but also in

the context of medical hypnotism practised in India. James Esdaile, for example, who set up a

Mesmeric Hospital in Calcutta in the 1840s, was widely acknowledged during his time (Ernst,

2004; Jain and Sarin, 2000).

‘Native’ psychology

Was the psychological aetiology of mental illness in India or the success of psychological tech-

niques like hypnotism founded on an understanding of a native mind that was ‘primitive’? Such an

understanding did exist in the early and mid-nineteenth century. The incidence of mental illness,

for example, was seen as increasing with ‘progress’ and ‘civilisation’ (Burrows, 1820; Halliday and

Seymour, 1829) or seen as rare in a ‘country where the mental faculties were so less cultivated’

(Wise, 1852). But others disputed the ‘primitiveness’ of the native mind. Winslow Forbes, editor of

Psychological Medicine and Mental Pathology, caustically responded to Wise’s opinion as ‘inter-

esting’ but full of ‘error’ and ‘unsubstantiated’. He disagreed with Wise’s opinion that ‘Hindoos

[sic] are perhaps in a lower state of mental development than even the rudest savages’ given the

literary and architectural achievements in India (Forbes, 1853: 356–7).


Radhika et al. 95

However, by the late nineteenth century, the idea of the native mind as ‘primitive’, ‘gullible’ and

superstitious became dominant. The Agra asylum report for 1878 pronounces that moral causes

were not very significant among the Indian insane because natives are ‘little prone to emotional

excitement, while at the same time the requirement necessary to impart contentment to their lives

are few and simple’ (Hilson, 1879). Another report suggests that the primitive psychological state

of the native was the basis for the predominance of certain disease forms. General paralysis in

mental illness was seen as rare among Indians because it was ‘associated with highly civilised

states, and most common among men who live in cities and do brain work’; the general Indian

masses were instead more prone to syphilis (McLeod, 1899: 373).

Likewise, the ‘simplicity’ of the native mind was seen as the reason for its susceptibility to

hypnotism. The Indian mind was seen as ‘saturated with … superstition’, ‘highly imaginative and

credulous’, ‘less analytical’ and ‘less enlightened’ than his Western counterpart; the native ‘readily

obeys a suggestion, especially under the influence of a Sahib’ (Delany, 1899: 446). Thus, the

native’s mind was not only seen as ‘primitive’ but also as acknowledging the mind of the sahib

(European, master) as ‘civilized’ and ‘superior’.

Conclusion

The mid- to late-nineteenth-century medical reports show that provision of services for the men-

tally ill was accompanied by descriptive and analytical efforts to understand insanity. Basic tenets

of psychiatry that included classification, descriptive accounts, somatic and psychological thera-

pies were incorporated easily. A caveat that remains is that there are few descriptive accounts of

patients’ experiences. Hence, we cannot accurately map the public acceptance of Western medi-

cine. Nevertheless, the vast number of people accessing hospitals and dispensaries perhaps tell the

tale. In the Hospital for Peons, Paupers and Soldiers, Bangalore (South India), for instance, 23,406

consultations were documented between 1836 and 1849, and there were 4,336 admissions in 1849

alone, from an overall population of 100,000 (Jain, 2003: 296).

Theories prevalent in the ‘West’ were applied, but since they in turn derived from Galenic/

Islamic medicine, there was considerable overlap: urine changes in depression; bazaar medicine;

blistering; morphia/cannabis use, etc. By the mid-nineteenth century, as Indian doctors trained in

Western medicine emerged, they used ‘Western’ concepts readily, and incorporated prevailing

conditions into these theories. Western doctors, too, saw no inherent difference between the

Western and native mind. However, by the late nineteenth century, a more biological approach

(craniometry, infections), accompanied by imperialist notions of the mind, made the technology

and science of ‘western’ medicine demarcate the native mind as ‘less civilized’ and ‘inferior’ to

the Western mind.

Funding

This work was supported by the Wellcome Trust (grant number WT096493MA) for the project ‘Turning the

Pages: Exploring the History of Psychiatry in India’.

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Psychological symptoms and medical responses in nineteenthcentury India

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