SCHIZOPHRENIA IN SANGAM ERA

Shakespeare's description of Tom O'Bedlam in ‘King Lear' — where Act 2, Scene 3, Line 1 goes: "Poor Tom, that eats the swimming frog, the toad...." is considered by many psychiatrists as one of the earliest descriptions of schizophrenia in literature. However, there have been descriptions of mental illness much earlier, as far back as the seventh century CE. This discovery was made by a psychiatrist from Chennai, Dr O Somasundaram, professor and director, Institute of Mental Health, Chennai, in the 1980s.
In the Sanskrit work ‘Mattavilasa Prahasana' (A Farce of Drunken Sport) by Pallava king Mahendravarman I (590-630 CE), the author describes a scene where a mad man tries to end a quarrel between a drunk man and a woman, saying: A thousand demons have entered my stomach, and they are jumping, with spears in their hands. I am vomiting hundreds of tigers and snakes. "It is evident that there is disorder of form and content of thought, persecutory and bizarre delusions, and auditory and visual hallucinations," Somasundaram wrote about the lines. "The king is familiar with the symptoms of schizophrenia."
Somasundaram alluded to the presence of a mad man in the ancient Chola port city of Puhar (Poompuhar) in the Buddhist classic ‘Manimekalai' from the second century CE. "One gets a good idea of catatonic schizophrenic's hypermotility from the lines ‘Kanavira maalaiyin kattiya thiralpuyan' (neck adorned with a garland of the foul-odoured pink alari) (canto 3, lines 104-115)." "We also notice the attitude of the public, which is one of compassion and a desire to help. There is no sense of fear, frivolity, prejudice, or stigmatisation of the mentally ill," he wrote.
In pursuit of references to psychological problems in ancient Tamil literature, Somasundaram stumbled upon epigraphs as well. "In some of the 25,000 Tamil epigraphs deciphered are references to the services to the mentally ill, by Jains," he wrote in one of his papers. One such is the Palli Sandal mental asylum, maintained by the famous Jain ascetic Naminadha, under the aegis of Kandarathitha, the medieval Chola king. Another inscription found in Tiruvarur district has a reference to the asylum for those with anxiety, then known as ‘Anjuvaan Pugalidam'. "Disasters and suffering were of considerable duration and there was no dearth of refugees and panic-stricken people. The Jain asylums were very helpful," he wrote.
By focusing his research on the intersection of literature and psychology, Dr Somasundaram became known as one of the earliest psychiatrists in the country to touch upon what is termed ‘descriptive psychopathology' today. Born in Chennai in 1926, Somasundaram was among the first in the region to study dementia pathology and demonstrate the presence of Alzheimer's disease in India through cerebral biopsy, publishing a seminal paper on the same in 1975 in the Indian Journal of Psychiatry.
Somasundaram possessed the rare knack of connecting psychological disorders in real life with their literary references and vice-versa. In an article that discusses ‘morbid jealousy', a syndrome that occurs in many psychiatric conditions, he connects Shakespeare's ‘Othello' and Tamil writer Kalki's ‘Ponniyin Selvan' with real-life murders in Tamil Nadu. Of the 500 male murderers in 1968, 71 killed their wives and 10 killed their wives' lovers. Of the six underage offenders, three killed their wives. Of the 20 female murderers, four killed their husbands, three killed the lovers, and none killed the co-wife.
Somasundaram also tried to explain in one of his articles how some psychological mechanisms such as dissociation, disturbances of consciousness, and deep religious convictions played a part in the religious experiences of Alvars, the Vaishnava poet-saints. In his study of ‘Purananooru', Somasundaram categorised various suicidal behaviours that were common in ancient Tamil civilisation. He termed king Cheraman Kanaikal Irumporai's suicide ‘optional altruistic suicide'. The king killed himself as he felt dishonoured when the prison guard delayed bringing water to him after being arrested by a Chola king. The self-immolation of the widowed Tamil queens was categorised as ‘obligatory altruistic suicide' while death by starvation by some Tamil kings and poets came under ‘acute altruistic suicide'. All these terms were coined by the French sociologist Emile Durkheim.
Dr Somasundaram ventured into modern Tamil literature as well, studying psychological disorders in popular lyricist Kannadasan's works. He suggested using the literary works of Tamil writer Jayakanthan to formulate measures on tackling stigma surrounding mental illnesses. His areas of study included Siddha and mental illness; the psychiatry of the assailants of the Tamil Nadu chief ministers; Tamil perspectives of homosexuality; and sexuality in the Thirukkural and Kama Sutra.
While the practice of using literature as a tool to understand psychological conditions is gaining importance in the West, the Indian scenario is very dim, Dr Somasundaram said. The message he tried to convey through his studies was that ancient Tamil culture was socially inclusive and didn't stigmatise the mentally ill, Dr Aravindan Sivakumar, co-founder of Thiral, said at an event held on December 7, 2024, to remember Dr Somasundaram. "At a time when psychiatry was restricted to brains and neurons, Dr Somasundaram's works showed the need for an interdisciplinary approach towards mental health and it can begin from our literature."
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