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Colonialism and Transnational Psychiatry

Colonialism and Transnational Psychiatry

Waltraud Ernst

(2013)

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Abstract

This book focuses on the Ranchi Indian Mental Hospital, the largest public psychiatric facility in colonial India during the 1920s and 1930s. It breaks new ground by offering unique material for a critical engagement with the phenomenon of the ‘indigenisation’ or ‘Indianisation’ of the colonial medical services and the significance of international professional networks. The work also provides a detailed assessment of the role of gender and race in this field, and of Western and culturally specific medical treatments and diagnoses. The volume offers an unprecedented look at both the local and global factors that had a strong bearing on hospital management and psychiatric treatment at this institution.


Waltraud Ernst is Professor in the History of Medicine in the Department of History, Philosophy and Religion at Oxford Brookes University, UK.


‘An in-depth account wherein individual and institutional histories coalesce, a work of honest scholarship which will be useful for medical historians, sociologists and lay readers alike.’ —Deepak Kumar, Jawaharlal Nehru University


‘Waltraud Ernst offers us a major new contribution [and] by far the most detailed and insightful account of a mental hospital for Indians produced to date. […] [Ernst is] a leading light in this field.’ —Christopher Harding, ‘Social History of Medicine’


Psychiatry in India during the nineteenth century has hitherto been represented as an essentially ‘colonial’ psychiatry, permanently and intrinsically linked with the British civilising mission and British control over India. This book is the first comprehensive case study of an early twentieth-century Indian mental hospital that was headed by an Indian rather than a British superintendent.

The work explores the ways in which the institution was run, its patient profile, the circumstances of its staff and the treatments administered, all in relation to the regional sociocultural and political context, the wider medical and colonial setting in South Asia, and contemporary global developments in psychiatry.

Themes covered in the work include gender, culture, race and plural clinical practices within the context of medical standardisation. ‘Colonialism and Transnational Psychiatry’ offers an unprecedented look at both the local and global factors that had such a strong bearing on hospital management and psychiatric treatment at this institution. This study of Ranchi sets a standard against which future scholarship will be able to judge the impact of local affairs and transnational connections on a wider range of institutions in, and exchanges between, South Asia, the West and other parts of the world.


 ‘Ernst paints a fascinating picture of a mental hospital in India where doctors and patients struggle with the problems and paradoxes of modernity during an era of dramatic political change and medical innovation on a global scale.’ —Joseph Alter, Pittsburgh University


‘A very important and original contribution to the growing literature on psychiatry and colonialism, notable for its tight focus on a single mental hospital for Indians rather than the imperial ruling class.’ —Andrew Scull, University of California, San Diego


Table of Contents

Section Title Page Action Price
Colonialism and Transnational Psychiatry_9780857280190 i
Title iii
Copyright iv
CONTENTS v
ACKNOWLEDGEMENTS ix
ABBREVIATIONS xi
TABLES AND FIGURES xiii
INTRODUCTION xvii
Chapter 1 INDIANISATION AND ITS DISCONTENTS 1
Towards Indianisation 3
Structural Inequities 5
Medical Politics and European Racial Prejudice 6
The Medical Market and Indian Competition 8
Professional Discrimination 8
Professional Closure and the Pathologisation of a Successful Community 11
The Decline of the ‘Good Parsi’ 15
Collaborators, Competitors and Ambivalence 17
Indianisation and Histories of Medicine 20
Subalterns 21
Chapter 2 THE PATIENTS: THE DEMOGRAPHICS OF GENDER AND AGE, LOCALITY, OCCUPATION, CASTE AND RELIGION 27
Gender Confined 29
‘Chronic patients’ and long-term confinement 30
‘Private’ and ‘public’ patients 33
‘Criminal Lunatics’ 35
Political prisoners 38
Petty crimes and the criminalisation of the mentally ill 39
Intellectual Disability and Patients’ Ages 41
Occupational Background and Caste 45
Religion 55
Chapter 3 INSTITUTIONAL TRENDS AND STANDARDISATION: DEATHS, DISEASES AND CURES 67
Mortality 68
Death and Illness by Gender 69
Causes of Death 74
Towards Standardisation 76
Mortality and Morbidity 78
Disease Prevalence 81
Influenza and malaria 81
Airborne diseases 84
Waterborne and parasitic diseases 87
General paralysis of the insane (GPI) and syphilis 91
Accidents and Injuries 91
Suicide, Escapes and Patients’ Freedom of Movement 94
Cures 99
Chapter 4 CLASSIFICATIONS, TYPES OF DISORDER AND AETIOLOGY 105
Standardisation and Variation of Classifications 106
Ruptures and Continuities 108
‘On the omnibus’: Dementia praecox and schizophrenia 111
Identifying mania 112
Framing melancholia and circular/manic depressive insanity 114
Delusional insanity – paranoia 120
Dementia, delirium and confusion 122
Dementia 124
Delirium 125
Confusional insanity 126
From idiocy and imbecility to mental deficiency 126
A culture-specific syndrome: Cannabis insanity 128
General paralysis of the insane (GPI): A Western culture-bound condition 137
Male and Female Maladies? 141
Confusional insanity and female reproduction-related disorders 142
Cannabis and alcohol insanity 143
Epilepsy 145
Male melancholia – female mania and schizophrenia 149
Institutions compared: Longitudinal trends in gendered diagnoses 155
Aetiology – ‘the outstanding problem of psychiatry’ 159
Chapter 5 TREATMENTS 173
Indigenous Herbs 174
‘Modern’ Drugs 178
Wonder Cures 180
The Shock Therapies 182
Sulfosin therapy 182
Insulin coma and Cardiazol shock therapy 183
Malaria shock therapy 185
Justifying the Need to Shock and Sedate 186
Psychoanalysis 188
Western and Indian Tubs: Hydrotherapy 189
Dutt’s Bratachari 191
Feasts and Religious Therapy 192
Work and Occupational Therapy – ‘useful both to the patients as well as to the State’ 193
Diet – ‘one of the most important methods of mental treatment’ 197
Sports and Entertainment – ‘helps enormously towards socialisation and rehabilitation of patients’ 199
CONCLUSION 205
NOTES 209
Introduction 209
Chapter 1 Indianisation and its Discontents 209
Chapter 2 The Patients: The Demographics of Gender and Age, Locality, Occupation, Caste and Religion 213
Chapter 3 Institutional Trends and Standardisation: Deaths, Diseases and Cures 220
Chapter 4 Classifications, Types of Disorders and Aetiology 226
Chapter 5 Treatments 238
Conclusion 245
BIBLIOGRAPHY 247
Archival Sources 247
Published Primary Sources 247
Secondary Sources 249
Index 259