Click here for more...

(ARCHIVE) VOL. XXII No. 12, October 1-15, 2012
Least leprosy, most hospital facilities
A historical survey by Dr. A. Raman

Monegar Choultry.

Leprosy was a major public health issue in India until the later decades of the 20th Century. India's National Leprosy Eradication Programme, launched in 1955, contributed to a reasonably effective management. Henry Vandyke Carter (1831-1897) of the Bombay Medical Service, particularly after his travels in Norway to study the epidemiology of leprosy, offered useful remarks on leprosy management in 19th Century India. Most medical practitioners would recall Carter as the collaborator and the artist who sketched the accurate drawings in Henry Gray's renowned Anatomy book published in 1858.

By the 1880s, approximately 120,000 patients of leprosy existed in India. This is said to have dropped to 102,000 by the 1920s. In British India, the Madras Presidency had the lowest numbers of patients of leprosy, yet the maximum government-supported treatment for the illness and asylums (hospitals) were in Madras.

A public letter dated September 26, 1816 indicates that an exclusive hospital for patients of leprosy (PoL) existed in Madras. This hospital, formally known as the Madras Leper Hospital (MLH) and, informally, the Leper Asylum, was in Washermanpet, origi-nally as a part of, and later as a separate, entity located opposite Monégar Choultry, where both male and female PoLs of all races were treated.

Monégar Choultry (MC) was a corruption of Maniakkarar Chattiram. MC commenced as a charity providing minimum food free to poor, in a rented building in Royapuram off Popham's Broadway in 1781, consequent to a severe famine. The Famine Relief Committee administered this charity, co-operating with the administrators of St Mary's Church, Fort St George, Madras. The Madras Government took over MC's administration in 1808. Because the raw materials for making kanji were supplied free to people from here, when MC grew into the Madras Native Infirmary (MNI) in 1799, it came to be called the kanji-thotti hospital. The Leper Asylum developed in conjunction with MNI. The MNI grew into Royapuram Hospital in the early 20th Century and then into Stanley Medical College and Hospital.

Before MLH, PoLs were admitted into MNI along with those not suffering from leprosy. By January 1813, the number of PoLs in MNI rose to 40. Because of the prevalent idea that leprosy was contagious, the Superintendent of MNI and the members of the Managing Committee of MNI wrote to the then Governor of Madras, Sir George Barlow, on March 20 1813 as follows: "That a separate building may be appropriated for this class of patients, in consequence of the inconveniences resulting from their intermixture with other persons in the asylum."

No response was forthcoming. A subsequent letter from the Managing Committee of MNI went on July 16, 1813. The government refused to buy the idea that leprosy was contagious. The then Chief Secretary of the Madras Government, David Hill, responded on July 27, 1813 saying that PoLs at MNI should be encouraged to return to their homes and no more of them should be admitted there. Those already admitted and hopeless of total recovery, Hill suggested, should be accommodated separately; the MNI Managing Committee should make the best and least expensive arrangement in their power to achieve that. Consequently, the number of PoLs at MNI dropped to 26 and they were shifted to a temporary building. This temporary building grew into a separate establishment, thus becoming the first hospital in Madras for treating leprosy – referred to earlier in this article as MLH.

MLH did not survive as an exclusive facility for PoLs for long. On November 30, 1813, James Dalton, Medical Officer at MNI, indicated that patients of venereal diseases at MNI be relocated "into the place lately constructed as the hospital for lepers". (James Dalton is better remembered in Madras in the context of Madras Madhouse in Purasawalkam started and supervised by Valentine Connolly in 1794. Dalton rebuilt the Purasawalkam Madhouse, which was popularly known as Dalton's Mad Hospital in 1807-1815.) Dalton's suggestion was supported by the MNI Managing Committee and the change came into effect immediately, since a public letter from the MNI Managing Committee to Hugh Elliott, the Governor of Madras, dated August 1, 1815, sought acquiring further space to accommodate PoLs.

Government responded to this request rapidly. Land was secured and a building for the hospital was erected at an overall cost of 983 star pagodas in 1815.

Although the facility was populated by PoLs, a majority of those suffering the illness preferred not to get into the hospital. They preferred to manage their lives by begging in the streets, thus becoming public nuisance. Towards the end of 1816, the MLH Managing Committee decided to bring them into MLH by force. Since police powers were weak, the managers of MC and allied charities sought the Government to introduce legislative provisions to bring those with leprosy into MLH forcibly.

No records on MLH exist between 1826 and 1840, except a letter submitted to the Government seeking approval for an expansion of the hospital in May 1832. However, a grant of Rs. 2000 came about on July 3, 1839, which seems more due to the efforts of the then medical officer James Lawder. [James Lawder, a medical officer at MNI and MLH, was keen on clamping restraints on patients of leprosy, to restrict the spread of the 'dreaded' disease. Lawder preferred constructing a 10' (c. 3 m) high wall around the asylum, whereas the government favoured a 7' (c. 2 m) high wall. Lawder's Gate bus stop in Gandareswarar Koil Street in Purasawalkam celebrates James Lawder, who probably lived somewhere near. An unverifiable Internet source indicates that Lawder lived on 'Poonamallee Road' – not mentioned as (Poonamalee 'High' Road.)

In his Surgeon's Report to the Government (1840), Lawder indicates that the expanded hospital came into existence on July 1, 1840. MLH thus became a government institution and the change – obviously – promoted its stability, efficiency, and usefulness. No record exists validating whether any magisterial intervention occurred in response to the letter sent earlier to the Government, but the Lawder report (referred to earlier) indicates that nothing changed until at least 1840:

In 1856, two new blocks of buildings were added. The MLH included 11 wards, three accommodating 31 females and eight accommodating 100 males, with an inter-bed space of 3' (c. 1 m). Not only a tall wall separated the hospital, but similar walls separated each ward. Such walls were inappropriate for reasons of cross ventilation in a hospital, making the facility similar to a prison. Between 1840 and 1856, the number of in-patients rose to more than 100, reaching 170 (the maximum) in 1854 which, in high likelihood, was due to the rising popularity of MLH as a medical facility. The number of support staff rose to 14. Recognising the value of providing healthy food to patients, MLH supplied food based on the patients' principal food habits, treating the European Anglo-Indian patients as one category and Indians as another. Patients were encouraged to carry out gardening for which "the premises furnished ample space and opportunities".

MLH remained opposite the Monégar Choultry until 1921. Freeman Freeman-Thomas (Baron Willingdon), Governor of Madras [1919-1924], closed MLH and shifted it to Chingleput in 1921. The Chingleput facility, then run and managed by a missionary organisation, came to be known as the Lady Willingdon Leper Settlement. This settlement was taken over by the Government of India (Directorate General of Health Services, Ministry of Health & Family Welfare) and re-named the Central Leprosy Teaching & Research Institute in 1955 and it continues to function.

Note: A professional article on this subject prepared for submission to a professional medical journal is available. Anyone interested please contact me for a still-to-be-published draft text. Email:

Please click here to support the Heritage Act

In this Issue

'Help the people, shift the capital'
The Bulkley Tomb resurfaces
If Bengaluru can do it, why can't we?
Shaking up the City's Councillors
The emu euphoria
A builder of Modern India
A Winter's Tale
Least leprosy, most hospital facilities
Seven women & an author
A husband, other animals and a champ

Our Regulars

Short 'N' Snappy
Our Readers Write
Quizzin' with Ram'nan
Dates for your diary

Download PDF

Back to Archives

Back to current issue...