Lunatic asylums: A business of profit during the colonial empire in India.

The knowledge about "maladies of the mind" was in the early stages of development and far from being considered as medical conditions till the mid-19th century. Around this period, the British began to establish "Native-Only" lunatic asylums in India, particularly in the Bengal Presidency of their colonial empire. These institutions were primarily meant to provide custodial care and to rehabilitate those creating nuisance, particularly the wanderers and vagrants. However, these facilities turned into forced labor houses producing goods for the British Empire in the name of treatment. As traders, the British amassed India's wealth in several ways, and the establishment of lunatic asylums for the natives was one of the profit-making businesses. Undercover of Victorian morality, the reports of medical treatment had evolved into profit margin data. This article explores some of the obscure facts of British colonial rule in regards to mental health. Copyright:

INTRODUCTION

The year 1857 witnessed the first collective revolt by Indians against the British in addition to forging a link in the chain of events, which began with the establishment of lunatic asylums during the rule of East India Company in the initial years and the British Raj later on. Before the British encroached on Indian territory, there was no practice of confinement of the mentally ill in India,[1] and the tradition of wandering, including vagrancy, was a recognized aspect of an ascetic lifestyle elaborately described in the Rig Veda.[2] This lifestyle was not considered deviant behavior.[3] After the British established their rule in India, they began to build asylums for the mentally ill; these facilities would be categorized as either “European” or “Native-Only” establishments. Maintaining their own racial, social, and cultural identity, they lived in separate localities called civil lines, had their own shopping arcades and clubs where the entry of Indians was often prohibited. T*hey built separate asylums for the lunatics of their own race. The “Native-Only” facilities expected to help the mentally ill of India were used as places to confine Indian wanderers and vagrants during the 1850s and 1860s in the Bengal Presidency.[1] To reform them, Victorian morality and a strong work ethic were imposed on these so-called “patients” to “rehabilitate and cure” them. They were used for forced labor under the garb of their treatment, and the goods produced by these “patients” in the asylums created a new significant avenue of profit for the British.

The occurrence of mental illnesses in India has been identified and recorded since ancient times. In the traditional Hindu socio-religious system, insanity was treated through Vedic prayer and Ayurvedic practices. The sacred Hindu text Atharva-Veda-Samhita mentions a specific prayer to relieve the mind from insanity.[4] Ayurveda sees insanity as a poisoning of the mind by the wrong path of life. Today, Ayurvedic practice remains popular, and the insanity treatment has remained the same. Treating insanity consists of activities that promote peaceful thinking, such as yoga and a healthy diet.[5] Apart from prayer and positive thoughts, little was done by the practitioners of Ayurveda to control insanity. On the other hand, Muslims in the Arabic world had established several hospitals for the mentally ill; the first was in Al-Qatai, Egypt, around 872 BCE.[6] The Muslim religious establishments were the places of refuge for the mentally ill, and patients were treated by a variety of procedures. In the medieval Islamic world, these hospitals came up in several places such as Baghdad, Fes, and Cairo.[78] No doubt, Muslims established several mental hospitals in the Arabic world, there were very few in India before the British arrived to rule here. Islamic mental hospitals were accepted outside of India, and they were not successful here because of obstacles in treating members of different varnas or castes, in the same institution because of the caste differences of the patients.[9]

In England, the lunatics had been receiving custodial care through their detention in asylums for centuries. Laws were enacted to define and treat them. Lunacy was legitimized through legislation than through medical evidence.

The British concept of lunacy was thus completely different from the Indian concept of mental malady. In the 18th-century treatise, Commentaries on the Laws of England defined a lunatic or non compos mentis as a person, ”who had hath his understanding, but by disease, grief, or other accident, hath lost the use of his reason.”[1] However, under the general name non compos mentis are comprised not only lunatics but also persons under frenzies, or who lose their intellects by disease as are judged by the court of chancery incapable of conducting their own affairs.[10] The persons with defective reasoning or those who have lost their reasoning power were labeled as lunatics.

A wide range of behaviors, including socially troublesome behavior, were covered under the nomenclature of lunacy. Supported by the Victorian norms, class distinction, and work ethic, the prevailing British concept of lunacy was exported to their colonies along with their own interpretations. As the British East India Company began to exercise its political power in the Indian subcontinent, they started transplanting the British model of lunatic asylums in Indian soil,[11] and the first asylum was established in the Bengal presidency in 1795 for “mad sepoys.”[10] Subsequently, a chain of lunatic asylums came up along the coastline of the Indian peninsula and other places in the country.[12]

In the following times, with new medical and scientific discoveries, there was much speculation over the causes of mental disorders though training in the diagnoses, and the treatment of mental diseases was still not part of the medical education.[13] Although the chaining and shackling of the lunatics, which was the common practice of care in Europe, began to disappear in the mid-18th century,[14] the lack of understanding regarding mental illness continued. An article published in the Journal of Medical Science of 1852 theorizing the moon and Indian climate caused seasons of insanity in India,[15] was criticized and refuted by the British Journal of Psychological Medicine and Mental Pathology as superstitious in the subsequent year.[16]

The British promoted their superiority over the native population, as they always felt that they belonged to an altogether superior breed of humankind, and Indians were much inferior to them in every respect. A report of 1856 suggested that the prevalence of insanity was lower in Indians in comparison to the British. They justified the higher prevalence among civilized populations as a greater notice is taken of those afflicted with lunacy, and thus, an apparently higher proportion of insane to the population is made to appear,[14] ignoring the Indian conditions of better family, social cohesiveness, and tolerance of mentally ill in the society as the possible reasons for low prevalence in Indians. Assumed British superiority is apparent in their justification to link Victorian morality to the care of the insane; the British considered themselves to have high moral standards, and hence felt compeled to “notice” the insane in the people of their own race.

They also felt morally responsible to “help” the Indian insane, but with certain reservations and stipulations, primarily segregating the asylums into European and Native-Only facilities. The main treatment regimens would consist of cleanliness, Victorian morality, and a work ethic;[17] morality was instead used as a mask to cover British fears of nonsedentary Indians and to justify their removal to the asylums. The detention of Indians would help correct the wanderers and vagrants that the British felt was creating trouble, thereby violating the British sense of order and civility.[1]

LUNATIC ASYLUMS: INDUSTRIES FOR PROFIT

The revolt of 1857 marked cataclysm against colonialism, which compelled the British to change their perspective of Indians. They now viewed Indians as a dangerous population that needed to be subjugated with a firmer hand. This sense of insecurity particularly aimed at wanderers and vagrants led the British to do anything from taking weapons away from them to actually removing potentially dangerous and unpredictable individuals from the community to the asylums.[18] The year 1858 witnessed the introduction of the Indian Lunatic Asylums Act which allowed the control and management of asylums by the British Government. Clauses 4 and 5 of the act empowered the British Government to herd the wanderers and vagrants presumed to be insane into the asylums with the approval of a magistrate to incarcerate there for life. These unfortunate people were not necessarily medically insane. Forced detention without a valid medical reason was legalized; wandering and vagrancy were criminalized.

Vagrancy had been a perpetual problem in England, and the first British Vagrancy Act was enacted in 1714[19] to control it. However, in India, where wandering and vagrancy were considered to be a part of the normal lifestyle, it was in no way a threat. Their detention, in most of the case, was the misuse of the law. Protection of those unable to protect themselves was a cherished concern of the medical community under the Victorian morality, particularly of the wanderers or vagrants who were the easy targets of the Government.

Wanderers at a particular stage of life, the Vanaprastha, the renouncing and living an ascetic life, was very much the part of the Hindu lifestyle. However, the Indian philosophy was not analogous with British thinking; they considered it to be deviant behavior. After the revolt of 1857, because of security reasons, the British never permitted the wanderers to choose their living arrangements as ascetics.

Forced labor and inhuman conditions of the asylums came under global admonition during the latter part of the 19th century. Asylum doctors were rarely taken seriously as their legitimacy was a topic of debate; their opinion on lunacy was never taken seriously and they lacked support from the Government.[20] The scientific study of lunacy had not been proven reliable yet, and Psychiatry was an illegitimate field of medicine.[14]

A new discovery connected mental illness with the brain replacing the accepted superstition that mental illness was caused by “phantoms.” It was also discovered that the early detection of mental illness might lead to a possible cure. The British justified their medical decisions in India on the basis of new discoveries that early detention would possibly help them to get rid of the insanity. The British was able to rationalize the removal of vagrant Indians to cure their supposed mental illnesses.

Asylums for Europeans were significantly better equipped than their Indian counterparts; the medical professionals posted that there had received better training, ensuring British superiority in every aspect of care.

The term “lunatic” in India was an ambiguous term that covered a wide range of behaviors and social improprieties. The Annual Reports from the Dullunda Asylum for 1862 shows that of 111 patients, 91 were confined for drug or alcohol intoxication who were detained for the reasons of addiction or public intoxication. Once the intoxicants were out of the patients' systems, these patients would have been coherent individuals, though the records indicate that they remained confined for an undefined period.[17]

Public nuisance rather than lunatic would better characterize most of the patients confined in Bengal asylums. The 1857 uprisings made the British fearful of the Indian population as a whole, which led to swift social regulations. While admitting them in asylums, no objective evidence of insanity was recorded, the case notes of these inmates were more preoccupied with the vagrancy than with their state of mind,[18] with the sole aim of clearing Bengal streets of wanderers and vagrants.

The actual mental disorders, which the reports reveal, included chronic mania and dementia, with the most common causes being “ganja smoking” and intemperance from alcoholic consumption.[17] Detention for alcohol or marijuana use was quite prolonged. Temperance and restraint were forced on the Indian population under the guise of an insanity cure.

In spite of the overcrowding in the asylums, the British considered it their moral and medical obligation to confine lunatics. The prevailing philosophy that morality would cure all things, including insanity; the steady work would result in a long-lasting cure for the patients in the asylums. The physical labor of patients documented throughout the asylum records included rope making, loom work, tinwork, gardening, cooking, fetching water, masonry, and any other task needed to maintain asylum grounds. Different jobs were categorized as “asylum industries,” necessary in the treatment of the insane. By 1870, the asylum industries had expanded to include new jobs such as carpentry as a viable source of income, and it was, therefore, incorporated into a financial plan rather than a treatment plan. These industries led to significant avenues of profit for the asylums and the British, an objective in full agreement with the goals of East India Company and the British Raj in India.

Some of these industries, such as the asylums' gardening, did benefit the patients. In 1862, when gardening was just 1 year old in its production, it was already feeding the Native-Only asylums, European asylums, as well as some local jails. Not only did the British see the asylum gardens as a way to give the patients an outdoor job considered as part of their treatment regimen but talso they hoped to sell the excess produce for profit. The quest for profit irrespective of medical treatment had been an ethic inherited from the East India Company, and in general, a goal agreeing with colonial profit motives.

By 1870, the gardens in Bengal's asylums were flourishing, which furnished vegetables in abundance, and produced the best kinds of fruit, both for use and sale.[21] Reports describe the gardens in details, but there is no description as to why or how laboring in the gardens helped the patients; this seemed of very little concern in the reports. Nowhere in the reports, it is mentioned that garden work was useful as a treatment, and the level of details about the patient history and diagnosis is nowhere comparable to the description of profit margins.

The Victorian British categorized human actions as either moral or immoral, and they rationalized profiting from the asylum industries as moral because it was considered to be a form of medical treatment for the inmates.

Patna Asylum Report of 1862 justifies employing lunatics as an efficient means of tranquilizing the nervous system, improving the general health, and facilitating a cure, all but the very imbecile, work, and this is effected, without any coercion, by persuasion.[17] The very next section contains the profit margins for Patna Asylum, including how to raise the profit index.

For the British, profit by any means was the motivation for housing the “insane” without a valid reason. The vagrants and wanderers could be accounted for lowering the security threats that haunted the minds of the British,[1] and ethos would justify their position that work would cure all the ills of the world. In return, they would profit off of the “remedy.” Their system of confinement, they claimed, was their moral obligation. Their method of treatment, however, resulted in profits rather than psychiatry's advancement, and India had to reap the harvest of their business tactics.

CONCLUSION

Bengal Presidency administration of East India Company began a profit-motivated move that filtered down to the management of public health facilities of lunatic asylums. In the name of the welfare of indigenous populations, the Victorian ethos was used to manipulate the diagnoses of those who were not truly mentally ill. The vagrants and wanderers of India bore the brunt of “work therapy” resulting in financial remuneration for the British Empire.

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Conflicts of interest

There are no conflicts of interest.