BENGALURU:Bengaluru’s first mental health hospital was set up in 1838, when a section was opened for the mentally ill in the Hospital for Soldiers, Peons and Paupers, started by the The East India Company for the benefit of soldiers in the Cantonment area.
The hospital, which is now the National Institute of Mental Health and Neurosciences, NIMHANS, was the result of the effort put in by Dr Charles Irving Smith. He was born in Bangalore to a family that worked in the East India Company in 1831. Dr Smith studied in the UK before being appointed as Surgeon to the Mysore Commission in 1836.
In a commonplace book (in which people used to note down observations and copied extracts into, a diary of sorts), Dr Smith kept a record of his medical work. His writing reveals that Dr Smith had documented several cases of mental illnesses in the Hospital for Soldiers, Peons and Paupers.
“I had personally treated 20 to 30 patients of all castes and ages. The form of mania most common and the least amenable to treatment, appeared to be result of a previous and low inflammation state of brain and not infrequently combined with a partial paralysis,” he writes in the commonplace book, with the reference to the ward opened in 1838 for treating the mentally ill. It also says that first a ward was opened for men, while during the following year another ward was opened for women.
The Lunatic Asylum
Based on his experience, he recognised a requirement for a separate hospital. Thereafter, with the permission granted by Sir Mark Cubbon, the Lunatic Asylum of Bangalore was started on Avenue Road in 1850. Now, a State Bank of India branch occupies this spot.
A coffee-table book penned by the faculty of the Department of Psychiatry, Mindscape and Landscape, released during the President’s visit to the campus this year, says, “The Asylum was at an elevation, close to the lake, adequate water supply and dry earth conservancy was provided.”
Cost of food was the biggest operational expenditure. The coffee-table book says,”The diet cost around 66% of the hospital expenditure.” In the year 1863-64, 3643 rupees 1 anna and 1 paise was the annual expenditure.
Co-author of the book, Prof Sanjeev Jain, says, “Hospitals of Bengaluru were clean and had a healthy environment. They were well designed, by British standards. The Dharmabodhi lake could be seen from the hospital.”
A copy of the Mysore gazette, put together by Benjamin Lewis Rice (epigraphist), also published in the Mindscape and Landscape, highlights how patients were treated back then, while drawing a comparison to the present. “For the latter two years, the males and females have been allowed to mix together freely in the garden without any bad results; on the contrary it is noticed that they hardly take notice of each other.”
According to Prof Pratima Murthy, co-author of Mindscape and Landscape, the wards for men and women are more segrated today and the sexes do come into contact, but not often. A practice continued today is the practice of recreational activities such as candle-making and stitching.
During the Mysore Famine in 1876-1878, the mentally ill suffered the most due to scarcity of food during a famine says a 1901 Census report. But those in the Asylum fared better, with lesser mortality rates, than the mentally-ill outside.
Change of time
Mindscape and Landscape also highlights how the institution changed in the next era. In 1881, after the transfer of administration to Wodeyar Kings, Surgeon Major J Houston came up with a memorandum for future medical arrangements. The need for bigger mental hospital was emphasised as the population of Bangalore was increasing.
By 1914, a limit had been reached. The asylum had 200 patients, 27 Europeans and Eurasians. By the 1920, number of patients increased by 100 every year. During the same time, the emphasis on providing a diagnosis and prognosis was laid, along with the requirement of a proper medical degree. This replaced “moral therapy”, the practice of using baths and sedatives as recovery methods. Therefore, there was a need for a qualified medical practitioner.
Dr Francis Xavier Noronha, whose father was a personal assistant to Sir Mark Cubbon, joined the Mysore Medical Service. He spent a short time studying the methods of Institute of Psychiatry in London. On his return, he became the first qualified Indian Psychiatrist to head the Asylum, says the book.
Prior to the Indian Lunacy Act of 1922, Noronha referred to a mental diseases act in South Africa to replace the term ‘lunatic asylum’ with ‘hospital’. It led to renaming of the hospital to ‘Mysore Government Mental Hospital’.
The building suffered from bad lighting and ventilation, and poor safety measures. An updation was necessary. A site in Hulikal in Mysore City was first considered, but, the government finalised on a site between Lalbagh and Basvanagudi, due to proximity to Victoria and Minto Hospitals. It was modeled after The Bethlem Hospital at Lambeth.
In 1939, while status of mental health facilities in the country was on decline, NIMHANS stood out with state-of-the art facilities.
Back Through Time
The Oldest Building
Mindscape and Landscape has a picture of the foundation stone being laid by Krishnaraja Wodeyar IV in 1936 in the present day NIMHANS Campus. “The teaching of psychiatry in India as a formal discipline, started in this building. Professor NN Wig, currently heading Post Graduate Institute in Chandigarh prayed to the building and touched the steps in reverence when he came for a visit,” says Prof Jain. The department of psychiatry, next to the convention centre has a Ram temple inside. “We could not trace the owners of the temple lands that are located between Lakasandra and Byrasandra villages. Wilson of Wilson Gardens, the Health Inspector, during the time, wanted these buildings to serve the mentally Ill and the poor,” adds Jain.
Lobotomy
In 1942, the first lobotomy surgery was conducted. The frontal lobe was cut to ensure smooth intellectual functioning. It was conducted by Dr M V Govindaswamy and Dr B N Balakrishna in AIIMH. “Patients who were violent are subdued, the bellicose are more modest,” said the two doctors in the Indian Medical Gazette, 1944. “It was the Nobel Prize-winning idea and reflects the practices of the times. In 1972, the proceedure was stopped. Today, the proceedure is being considered for epilepsy,” said Jain.
The Book
A coffee-table book, Mindscape and Landscape – an Illustrated History
of Nimhans, written by the faculty of the institution, was released when President Pranab Mukherjee visited early this year. The authors are Prof Pratima Murthy, Prof Sanjeev Jain and post doctoral fellow P Radhika. “While the actual book took one year, the statistical information related to patients was collected over ten years. The book captures the growth of mental health in the Mysore state. Dr Sanjeev even researched at the Welcome Library in London,” says Prof Pratima Murthy.