One of the finest books that narrate the history of Lahore of the late Sikh era can be found in an excellent description by Dr. Honigberger. This physician of Maharajah Ranjit Singh from 1812 on wards was present when he died in 1839. He remained in Lahore till the British took over in 1849.

Every time I pass by the Punjab Institute of Cardiology on Jail Road, hidden just behind it is the Punjab Institute of Mental Health. The reason I think of Dr Johann Martin Honigberger, the author of “Thirty Five Years in the East”, is because the very first mental health hospital in Lahore was set up by this amazing doctor. The very first ward for psychiatric care was set up just behind the Sikh-era gunpowder factory he had set up outside Delhi Gate on the edge of Landa Bazaar. The Sikh rulers after Ranjit Singh called it ‘Paggal Khana’, but once the British took over in 1849 they renamed it Central Lunatic Asylum. This was part of a hospital then named ‘Al-Shifa’.

It was in its day a very modern hospital. It was in this place where Dr Honigberger introduced homeopathy to the Indian sub-continent. As Honigberger was a favourite student of the German doctor Samuel Hahnemann who founded homeopathy in the 1790s, he brought along a cartload of medicines. One account tells us of Maharajah Ranjit Singh trying out allopathy, homeopathy, Unani medicines, and herbal concoctions of hakeems as well as Hindu Vedic medicines. Dr Honigberger’s opinion is that the Sikh ruler was highly suspicious of most ‘medicine men’ which led him to try five different cures all at the same time, which, he felt, led to his death.

The treatment of psychiatric patients in Punjab starts with the setting up of this ‘Al-Shifa’ ward. Initially, patients from the rich and influential families of Lahore were admitted, and they were made to pay a reasonable amount to the hospital for treatment. The ward was in a horse stable to one side of Raja Suchet Singh’s palace. Word soon got out that a few ‘chronic epileptic cases’ had been cured. One account states that (this is a direct translation): “the foreign doctor can cure the mad”. It was then that for the first time a certain respectability came to the science of psychiatry in Lahore.

The maharajah passed away in 1839 and for 10 years confusion followed. It was during this period that the number of patients increased. We learn that initially beds were doubled and then by the time the British arrived in 1849, it was full. Amazingly, we also see that with the British taking over a lot of the patients were removed by their families.

The British introduced a new scientific title to the term ‘paggal khana’ when they renamed it the Central Lunatic Asylum, not that any respectability to psychiatry could be seen in the renaming. The new British District Civil Surgeon, a Dr C M. Smith, took over from Dr Honigberger, who left for Hungary and Europe. It was there that he wrote his famous book, which can be read in any good library anywhere in the world. But the contribution of Dr. Honigberger lives on in Lahore, just as that of another great Hungarian, Dr. Gottlieb Wilhelm Leitner, the founder of Government College, Lahore, the Punjab University, Lahore, and the Oriental College of Lahore. Sadly, it seems we have not dedicated any road or street, let alone a crossing or even a building after these two great Hungarians who served Lahore and its people more than most.

But the story of psychiatric care in Lahore never stopped. Once the East India Board of Administrators took over power in 1849, the judicial commissioner Robert Montgomery decided that a much bigger and secluded place was needed. So it was in 1854 that in the place where once stood the small fort-cum-residence of Suba Singh of the Sikh Triumvirate a new ‘Lunatic Asylum’ was purpose-built. In the reign of Ranjit Singh this place was used as a relaxing place for those indulging in ‘bhang’ and strong drinks, known among British observers as ‘horse-kick wine’.

It took about two decades for the new hospital to come up and it was handed over to Col Dr George Ewan, a psychiatrist who was appointed its first medical superintendent. Dr Ewans was a dedicated professional and had done considerable research on the phenomenon of ‘Shah Daula’ children. Soon numbers swelled. Sadly, he died in 1914 and for the next eight years this place did not have any trained psychiatrist. The reason given by the colonial rulers was that no professionally-trained psychiatrist could be found.

But then Lt Col C J Lodge Patch was made medical superintendent of what was once again renamed Lahore Mental Hospital. His initial joining report states: “In cages I found naked men handcuffed, most crawling on their knees like dogs lest they be punished and deprived of food”. His 1939 report makes absolutely gruesome reading.

Come Pakistan and the amazing psychiatric specialist by the name of Dr M A A Aziz took over and his services are well-known in Lahore in the 1970s and before. Under him the hospital was expanded and a much more humane approach was put into force. The hospital was once again renamed ‘Government Hospital for Psychiatric Diseases’. As a better understanding of psychiatry took root yet again the hospital was, for the fourth time, renamed the Punjab Institute of Mental Health, Lahore. That is the name as it stands today, surely a quantum leap from the days it was called the ‘Paggal Khana’.

Last year in the company of my dear friend Saifullah Khalid I visited this historic hospital. One had read stories of patients during the 1947 partition, especially those by Sadaat Hasan Manto. So one walked along the caged wards with caution. To our delight it was not very different from any other hospital. The humane touch of the greats of the past could be seen on the faces of the lost souls who end up there. It makes me sad that these human beings who dwell on the undesirable side of the spectrum do not elicit the support that all of us owe them. In a way if we fail them we really are failing ourselves.

Published in Dawn, July 29th, 2018