Kilpauk Mental Hospital: The Bethlem of South Asia - A recall of its history prior to 1970.

PERIOD OF CUSTODIAL CARE ONLY: The magnificent "Institute of Mental Health" has its history almost from 1795 when the East India company appointed Surgeon Valentine Conolly to be in charge of a "House for accommodating persons of unsound mind." After a few transitions, backed by a government order for the construction of a lunatic asylum in a 66 1/2 acre site, the asylum started functioning from 1871. The period of about six decades from its inception could be referred to as "the period of custodial care." However, the quality of care for the general medical problems gradually improved with the creation of separate facilities for some common ailments and also one for seriously ill. Separate wards were also conceptualized for criminal patients and female inmates. TOWARDS MODERN COMPREHENSIVE PATIENT CARE: Thanks to Government sanctions, the staff strength gradually increased with regularization of bed strength to 1800, and by 1948-1957, the hospital had 14 medical officers and a host of other staff. The period from 1939 to 1948 witnessed the introduction of electroconvulsive therapy and insulin coma therapy including the modified one and also insulin histamine therapy. During the prephenothiazine era, the drugs used were barbiturates, paraldehyde, opiates, and Rauwolfia serpentina, which were discontinued after the use of Chlorpromazine from 1954. Psychosurgery was also undertaken in selected cases from 1948, but the procedure went out of vogue soon due to the quality of outcome being poor and development of complications. Rehabilitation of patients got a fillip with the introduction of occupation therapy in 1949 and industrial therapy center in 1970. Extension of psychiatric services to general hospitals began from 1949. ADVANCES IN ACADEMIC SPHERES AND RESEARCH ACTIVITIES: Regular training was imparted to paramedical and undergraduate medical students from 1948. The institute had the privilege of hosting the Annual National Conference of Indian Psychiatric Society - 1957. The institute also spearheaded in several pioneering researches such as insulin coma therapy, syphilis, and Alzheimer's dementia, to name a few. The pivotal role played by the State Psychiatric Institutes in patient care, training, and research, should speak for adequate empowerment of these government institutes.

Battered baby syndrome: a review of eight cases.

A review of eight cases of the Battered Baby Syndrome, diagnosed in the Orthopaedic Department of a large childrens' hospital in India during a three year period is presented. Majority of the cases had major fractures due to repetitive child abuse. Most of the children were undernourished and psychoanalysis of the parents revealed that with regard to child abuse, conditions in India do not differ materially from the Western World. This review does not include minor injuries to the children or solitary fractures in children as a results of child abuse. This may indicate that many cases have been missed. The importance of early detection of this condition and multidisciplinary approach in the management have been stressed. This condition has yet to gain wide recognition in Indian.

Treatment of the mentally ill in the Chola Empire in 11(th) -12(th) centuries AD: A study of epigraphs.

The paper deals with the epigraphs of the Chola emperors Veera Rajendra Deva (1063-1069 AD) and Raja Raja III (1216-1256 AD), found at the temples of Thirumukkudal and Vedaranyam, with emphasis on the treatment given to the residents of the attached hospitals with special reference to treatment of mental disorders.

Literary destigmatisation of mental illness: A study of the writings of Jayakanthan.

National and international associations of psychiatry are busy formulating and executing anti-stigma measures and activities. Literary works of creative artists could be utilised for this purpose. This article based on the writings of a popular Tamil writer Jayakanthan discusses some of his works in relation to this.

Poet Bharathi, touched with fire.

Substance use among creative artists is very common. In this paper, such use by the great Tamil poet, Subramani Bharathi, is considered.

The seeds of creativity and the soil of poet Kannadasan.

The links betweencreative genius and insanity have been studied by numerous experts and famous writers. Recent studies by several psychiatrists have revealed an increase in psychopathology in creative artists, especially writers and poets. The cyclothymic temperamental traits of a Tamil poet, Kannadasan, are studied here.

Facets of morbid jealousy: With an anecdote from a historical Tamil romance.

Morbid jealousy is a symptom which occurs in many psychiatric conditions. The complex emotional aspects of jealousy have been discussed by earlier authors. The clinical, cultural, social, and forensic aspects, are touched upon. Morbid jealousy is a favourite topic among novelists and dramatists. "Othello" is a classic example. This topic is covered in one of the famous historical romances of the Tamil author, Kalki.

Neuro syphilis: Portrayals by Sir Arthur Conan Doyle.

The developments in neuro syphilis in the 19 th century are integral parts of the history of psychiatry. The delineation of various aspects of neuro syphilis by Sir Arthur Conan Doyle in three of his stories is discussed in brief.

Private psychiatric care in the past: With special reference to Chennai.

The 'madhouse' managed by Connolly and Dalton, situated in Chennai, prior to the opening of the Madras Lunatic Asylum in 1871 is described. The status of the private madhouses of England that existed before the county asylums were established in 1845 is briefly touched upon. A legitimate criticism of the shortcomings of this system along with the need for reorganization was forcibly brought by writers such as Defoe and others. Their suggestions find a place in subsequent mental health legislations. The legislation covering these aspects incorporated in the Mental Health Act 1987 form the basis for the licensing of our private mental health care centres.

Psychiatric thoughts in the Tamil culture.

THE SIGNIFICANCE OF PSYCHIATRIC THOUGHTS IN TAMIL CULTURE IS BROUGHT FORTH WITH RELEVANT HISTORICAL AND LITERARY EVIDENCES: psycho-physiological aspects of emotions, descriptions of severely disturbed individuals, attitude of the society towards the mentally ill and epigraphic material describing hospital care of psychiatric patients in the first millennium are alluded. These references unravel the advanced psychiatric medical knowledge in the Ancient Tamil system of Medicine namely the Siddha system. The mythical origin of Siddha Medicine, attributes of the Siddhars (knowledgeable persons) and short biographical notes of eminent siddhars like Agathiyar, Bogar, Therayar and Thirumoolar are cited. Ancient theories of etiopathogenesis, namely the Panchaboothas and Tridoshas are detailed. Agathiyar's deschptions, classification and treatment of mental illnesses and Yogi Siddhar's contribution to psychiatry require significant mentioning. Siddha system has proved its potential effect by displaying promising results in treating HIV and Hepatitis-B. Likewise the author encourages similar discoveries in Siddha Medicine with relevance to psychiatry.

Seizure disorders-views of the Indian medical systems.

The deschptions, etio-pathology and some aspects of treatment of the seizure disorders in the three Indian Systems of Medicine, namely The Siddha, The Ayurveda and The Unani are briefly mentioned. "If more or less, three humors cause disease, The learned count the wind is the first of these."Medicine, Thirukkural.

The malleus maleficarum and its psychopathology of sex.

A historical background to the writing of the Malleus Maleficarum is given. The psychosexual dysfunctions classified in the D. S. M. Ill are compared with those described by the Malleus.A brief mention is made of the Koro-like syndrome described in the Malleus.

MURDER IN TAMIL NADU(A Study of Murder Trials of 1968).

The murder trials of 1968 in Tamil Nadu totalling 526 are studied and assessed on the pattern of the U. K. Home Office study. The results showed that there were six psychotic murderers, 16 murderers who attempted suicide, 483 'normal' male murderers, 20 female murderers and 6 youthful murderers. Age, sex, method of killing and motives of the murderers are discussed. The implications of the study with reference to the penal institutions and prevention of crime are dealt with.