In his work Madness and Civilization, Michel Foucault dealt with the emergence of different aspects of madness in pre-modern Western Europe. His work is pioneering and one of the most important works in the field of History of Psychiatry. Curing Madness? A Social and Cultural History of Insanity in Colonial North India, 1800–1950s is a very important work to understand the colonial health structure and lunatic asylums of the period. The author has used the Foucauldian approach to discuss the asylum system in North India. This work fills the existing gap in the history of psychiatry in North India. This work closely looks at asylums in Agra, Benaras, Bareilly, Lucknow, Delhi and Lahore in North India (p. 8). The author has used a wide range of primary sources like records of Home and Jail departments, journals (both vernacular and English) and reports of committees and secondary sources and has consulted British documents in India and Britain along with private papers. This work helps us understand the condition of the infrastructure of asylums, the working process of asylums, the treatment to cure the patients and the socio-economic composition of patients and employees. Rajpal has closely analysed the development of lunatic asylums in India, and the work also brings out various socio-political features of society. Rajpal has constructed her study with various case studies, including patients from different sections of society.

In Chapter 1, Rajpal highlights the development of lunatic asylums and laws for lunacy in colonial India. Lunatic asylums, like western medicine, in India, were introduced for insane soldiers first. The infrastructures of the British government were instrumental in exerting political control on the Indian masses; lunatic asylums also maintained control over wandering faqirs, homeless and criminals. The 1849 act was significant in setting the definition of legal insanity in India, and discourses of legalism and medicalism were brought together for the first time (p. 23). The 1858 Act stated the management of lunatic asylums in India. Rajpal has shown how the ‘down to top’ approach was adopted where a local officer would inform the magistrate about any person who seemed lunatic; then, he would be sent to the asylum. The author has presented a debate over centralisation of asylums to minimise the expenditure with the help of archival documents. Several asylums were closed because of a lack of funds, and sometimes buildings constructed for other reasons were converted into asylums. Rajpal has touched on the sensitive deplorable condition of the poor who had to leave their relatives on the streets because they could not afford the processing fees of asylums.

In Chapter 2, Rajpal shifts her focus to the nature of lunatic asylums and how the lunatics were treated there. Rajpal has described the discriminatory behaviour of the colonial government towards inmates which was prejudiced by the racial superiority of British administrators. Asylums were custodial in nature and had jail-like structures. Rajpal points out that there was minimal expenditure on the comfort of lunatics, and patients were treated according to their living conditions outside the walls of asylums. The social structure of asylums is presented in this chapter. Attendants from lower castes used to work in asylums as it was supposed to provide them livelihood. Upper caste people used to hesitate to admit their family members into lunatic asylums because lower caste people worked there. Rajpal has depicted missionary activities in asylums. Franciscan nuns were considered more valuable by colonial officers than any intelligent man in treating female patients. The racial nature of officials can also be found in the taxonomies of lunatics (p. 107). Rajpal manifests the reasons which caused madness among people, such as the habit of masturbation, spirit drinking by men, loss of property of a person, unhygienic practices and unsatisfied sexual appetites and death of children in the case of women. Various ways to cure lunacy, like shock therapy and hydrotherapy, were adopted in the nineteenth–twentieth century. Rajpal has pointed out the lack of training for attendants and doctors and the lack of modernisation of asylums in the United Provinces. Lesser types of equipment were available for treating patients in the asylums of United Provinces in comparison with asylums situated in other places in colonial India.

In Chapters 3 and 4, Rajpal presents the everyday lives and case histories of insane living in lunatic asylums. Before focusing on the region of her research, Rajpal analysed the routines, daily lifestyle and works of lunatic asylums around the world and how they helped enhance authority. Capitalistic tendencies were present in the asylums of the west where private entrepreneurs used the labour of inmates of asylum for their own profit (p. 112) and capitalistic principles were also present in asylums in North India. The dangerous and the curable were considered somewhat fitter to perform labour in the asylums than the incurables (p. 113). The system of reward was begun by the administration in asylums. Those who used to perform more labour activities were given more food in the form of a reward and sometimes cash was given too. Shops were opened in the asylums, and inmates could buy items there. Rajpal mentions racial discrimination in asylums. Entertainment, food and living arrangements were crucial in treating inmates, but they varied depending on race and class. Asylums were not free from illegal activities. Rajpal has given instances where violence among inmates erupted.

Rajpal mentioned the struggles of women in getting treatment. The patriarchal nature of families usually did not allow women to be admitted to asylums, and there was one woman per three or four men. Chapter 5 discusses the cure of madness in indigenous medical traditions and the impact of western medicine on these traditions. Rajpal traces the history of madness in ancient and medieval India. Madness was linked to religion in India, and faqirs, pandits, ojhas and maulanas were used to treat the insane. However, these people were considered quacks and frauds by colonial administrators. Rajpal has given various examples of how these indigenous people used superstitious activities to cure mad persons.

The book also has ten appendices which are case notes of patients from different asylums. This book is important because it provides us with a thorough history of psychiatry in North India and explores the social positions of the insane beyond the walls of lunatic asylums, and discusses the facts from the perspectives of class, caste, race and gender. The vitality of this work lies in Rajpal’s skills to put forward a sophisticated analysis of the social history of lunatic asylums.