During the British Occupation mental patients were detained in the old Slave Lodge, the old Somerset Hospital and on Robben Island. In 1846 the first mental hospital was formally established on Robben Island, and was finally closed down in 1920. The history of our early lunacy laws is described.S. Afr. Med. J., 48, 1629 (1974)

Minde, M

English

In the days of the Dutch East India Company mental illness was relatively common, owing to the harsh living conditions, poor food and excessive consumption of alcohol. Mental patients were detained in the general hospital, in the slave lodge, and on Robben Island. Examples of such cases, taken from the records, are described.S. Afr. Med. J., 48, 1270 (1974

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-----------------------1270Hislol'Y 01 MedicineS -A. MEDIESE TYDSKRIF 15 Junie 1974The History of Mental Health Servicesin South MricaPART I. IN THE DAYS OF THE DUTCH EAST INDIA COMPANYM.MINDE'i"".SUMMARYIn the days of the Dutch East India Company mental illnesswas relatively common, owing to the harsh living condi-ti<rns, poor food and excessive consumption of alcohol.Mental patients were detained in the general hospital, inthe slave lodge, and on Robben Island. Examples ofsuch cases, taken from the records, are described.S. Air. Med. J., 48, 1270 (1974).Unless certain important facts are kept in mind, one mayeasily get a distorted picture of the actual state of affairsas regards mental illness during the early days at theCape. These include the small population, the tryingconditions under which the early settlers lived, and theprevailing knowledge and approach to mental disease.It is often forgotten how small the numbers of theoriginal White settlers at the Cape were. Van Riebeecklanded in 1652 with 100 men and 25 women and children.By 1661 they numbered 144, and 289 by 1679. In 1701the White population was 1 334 and there were 891 slaves.In 1795 the population was only 14927 Whites and16839 slaves.'"The early settlers lived in ill-built shacks, often wentshort of food and were exposed to inclement weatherconditions in winter. Ill-health was a serious problem.Of the 126 persons who made up the whole settlementin June 1652, 30 were ill with dysentery or fever.During May and June 13 deaths occurred from scurvy~nd dysentery. On 19 June only 15 out of 98 persons!lvmg ashore could work. The illnesses they sufferedmcluded oedema due to malnutrition and beri-beri. C. L.Leipoldt' sugg.ests that they also suffered from pellagra.This I~ very likely, and it still not infrequently causes aconfusIOnal state among patients in mental hospitals.The mId-seventeenth century was a time when thegeneral population drank heavily, and there are manyreferences to excessive indulgence in alcohol among theearly settlers. Van Riebeeck was constantly requestingthe Company to replenish his stock of arrack, the favouritealcoholic drink of the period. In 1656 he requested theClaremont, CapeM. M1 IDE, M.B. CH.B., PsychiatristDate received: 25 February 1974.Company to send an arrack distiller. Almost every shiparriving at the Cape had several 'leggers arracq' in itscargo.Beer was considered to be part of the daily diet andits yeast content no doubt provided some much-neededvitamins. It was not long before the Company sent outsome hop plants and numerous canteens soon arose inthe vicinity of the fort of Goede Hoop. When viticulturewas established the distillation of wine and brandy began.Drunkenness was a great problem to the authorities andin 1657 the Company's servants were forbidden credit ofmore than 2 pence farthing at any inn, nor were theyallowed to buy drink after nine in the evening. Drunkenbrawling often resulted in stabbings, even murders, andthe inn-keepers at the Cape had an evil reputation, asrecorded by many travellers.~The hard conditions of life no doubt contributed to thegeneral atmosphere of the times, producing a mentalclimate very different from that of the present day.Religion of a severe Calvinistic type, combined withflourishing superstition, affected all aspects of Efe.Justice was harsh and punishment severe. Torture wasan everyday part of the judicial procedure, and sentenceslike whipping, branding, beheading and breaking on thewheel were common events, often carried out in public.Other instances of what we now consider barbarity werefrequent. Thus a female slave who strangled her half-castinfant was tied up in a sack and thrown into the icywaters of Table Bay.' On 18 December 1671 'a certainHottentot girl, about 24 years old who had since herearly childhood been respectably educated here bycivilized burghers, carefully taught the Dutch languageand trained in burgher manners, had, without our beingable to discover any reason, hanged herself in a sheep-penby means of her "cabay band".' An inquest was heldand 'according to the resolution of the Council 'the bodywas towards evening dragged by a donkey to the gallows,and there as a loathing of such abominableness, placedwith the head in a fork, and hanged between heaven andearth.'January 10th 1672. Discovered this morning that thefork on which the female Rottentoo had been han<>ed hadbeen taken down and fallen over. Careful inquir;; failedto discover the author.'January 11th. Towards evening in order to carry outthe sentence, the above-mentioned female Hottentoo wasagain lifted on the fork."'· At other times suicides were-15 June 1974 S.A. MEDICAL JOURNAL 1271•dragged to the scaffold and suspended by the legs, orelse the bodies were placed in a porcupine hole.'The outlook on homosexuality is illustrated by thefollowing extracts from the Cape Archives:"'July 12th 1674. The captain of the Helena, CorneliusJansen Frooy, charged with 1:he most abominable crimecommitted with some young sailors.'July 17th 1674. The two boys of the Helena examined,and though not confessing to having complied with theskipper's designs, nevertheless acknowledged that he hadendeavoured to induce them to do so. Several Commis-sioners from the Council proceeded on board to informthe delinquents of their death sentence. N.B. The sentenceis that they be drowned in the bay.'December 16, 1725. A soldier, a sailor, and a field-guard to be smothered for the crime of sodomy.'February 15, 1725. Two men sentenced for sodomy.Sentenced to be taken on board and with weights attachedto them to be drowned in the bay.'People were, therefore, by our standards, insensitive tonuelties which would be considered abominable today.This approach was intensified by the fact that the smallWhite population was completely outnumbered by thenatives as well as by the large numbers of slaves who wereregarded as inferior beings, on whom aggressive orsadistic instincts could be vented with little fear ofreprisal.It is thus to be expected that the public attitude tolunacy would also share this insensitive outlook, whilemedieval beliefs of demoniac possession as a cause ofmental disease were still rife. It was only with the adventof the French Revolution, towards the end of the 18thcentury, that the modern concept of lunacy as a diseasewas initiated by the French physician Pinel.The situation during the Dutch East India Company'srule was that the European population was so small thatspecial facilities for the treatment of lunatics, in thenature of mental hospitals, were hardly to be expected.Nor did the general attitude then make it likely thatanyone would bother over-much to provide such facilities.On the other hand, hypovitaminosis, alcoholism.infection, exhaustion and venereal disease were all rifeand tended to make mental disease more common.These facts also held good for the large sailor populationwhich regularly called at the Cape to and from the East,and thus contributed their quota of mentally ill. As forlunacy laws-there were none.The foregoing makes it clear that in studying thehistory of this period one cannot expect to find detaileddescriptions of methods of handling lunatics, or of in-stitutions in which they were confined. One only meetsisolated, casual mention of cases of mental disease, andone has to infer a good deal, owing to lack of detail.A consideration of all available facts shows that in thedays of the Dutch East India Company mental caseswere confined in one of the following places at the Cape:I. The ordinary hospital.2. The slave lodge.3. The convict station on Robben Island.THE HOSPITALSA hospital was one of the earliest necessities of the firstsettlers when they landed in 1652, both for themselves andfor sick members of the crews of passing ships. The firsthospital formed part of the fort of Goede Hoop erectedby Van Riebeeck soon after he landed, and was openedin 1656. It was very roughly constructed of planks thatchedwith reeds, and was situated in the 'hornwork' of thefort with the blacksmith's shop on one side and thestable on the other.s The beds were stuffed with grass.and the place naturally soon became infested with vermin.In winter it was buffeted by the fierce north-westerly gales,and in summer the odour of rotting sea-weed made lifealmost unbearable for the patients.Van Riebeeck himself was a surgeon, though he is onlyrecorded as having practised his art once, when the seniorsurgeon was absent and the assistant taken ilLS And onthat occasion he appears to have done it with ill grace,suggesting that he felt it below his dignity in his exaltedrank as Commander.Among the surgeons whose names are mentioned duringthe very early days of the settlement are Cornelis, accusedof occult practices on one occasion, Pieter Van Meerhof.who married a Hottentot maid, Vetteman, who left theCompany's service and became the first civil surgeon andprivate practitioner at the Cape, and Dr William Robert-son from Dundee who performed the first legal postmortemexamination on 14 December 1658.'When the fort was replaced by the stone castle anotherhospital was erected during Simon Van der Stel's governor-ship on a site just below the Company's garden betweenthe upper ends of the present Adderley and St George'sStreets. It was begun in 1697 and opened on 24 October1699.'It was a large building which held 500 patients andcould take 750 in an emergency. A plan of this hospitalcan be found in the book of the German traveller O. F.Mentzel.·o It was a large two-storied building of a cruciformshape and intended only for the soldiers and sailors ofthe Company. Six to 10 slaves attended the patients inrelays both day and nightSTo this hospital was later added a ward for mentalpatients, as described in this extract from the Archives:'It was moreover decided as a useful and orderly measureto build on to one of the wings as soon as possible a smallenclosed apartment for locking up the mad who are nowand then found in the hospital, and with whom at presentwe are embarrassed.'April 12th 1711. Decided that the chief surgeon's houseand an apartment for the mentally diseased be built.'It was common occurrence for officers and crew ofpassing ships to go insane and be set ashore at the Cape.Thus H. Swellengrebel wrote to Governor Ryk van Tulbaghon 21 July 1742, informing him that the captain of hisship, Jacob Popta, had gone out of his mind in Simon'sBay. Another letter from the Governor to the Governor-General of the Indies states that a ship's captain, Adriaanvan der Graaf, had become insane and had to be relievedof his command on 1 February 1734.The third and last hospital to be built under theCompany's regime was situated not far from the castle,1272 S.-A. MEDIESE TYDSKRIF 15 Junie 1974-near the site of the present magistrate's court in CaledonSquare. The foundation stone was laid by Governor VanPlettenberg on 2 November 1772. There were delays inthe building operations, and it had barely been completedwhen Holland found itself at war with England duringthe American War of Independence. It was feared thatthe British might try to seize the Cape, so the allied FrenchPondicherry Regiment was sent to help defend the Capeagainst a possible attack. As no other quarters wereavailable, a part of the newly-built hospital was turnedinto barracks for this regiment. It was henceforth indis-criminately known as the Barracks, Kaserne or Hospital.THE SLAVE LODGEVan Riebeeck only had a few household slaves during thefirst years of the settlement, though he would have likedmany more, and he frequently asked the Company tosend him some. The first large batch of slaves arrivedat the Cape on board the Amersfoort on 28 March 1658.This ship had left Amsterdam on 14 October 1657 witha crew of 323, of whom 29 died on the voyage whileanother 30 lay ill with scurvy." While at sea the Amersfoortmet a Portuguese slaver, and as Holland was at war withPortugal, took 250 of her best slaves and landed them atthe Cape for the use of the Company.In order to accomodate this large addition to the slavepopulation, a lodge was built just below the Company'sgarden, on the site of the present Old Supreme Courtbuilding at the top of Adderley Street. The slave populationcontinued to increase so rapidly---rhat by 1670 the lodgehad to be enlarged and rebuilt. By 1751 it had becomeso dilapidated and overcrowded that it was again rebuiltand extended to house 600 slaves.In the lodge the sexes were separated, while the childrenalso had a section of their own. There was, however,considerable promiscuity among the slaves, and visitingsoldiers and sailors frequel.1tly found their way to the lodgeat night for convivial entertainment. There was a directorin charge of the lodge, as well as surgeons, overseers andteachers on the staff.An attic in the building housed convicts, while mentallyill persons were at times given small rooms within theslave lodge. This is illustrated by a resolution of the Gover-nor and Council on 11 December 1725: 'Martha Nantas'husband, the burgher Nicholas Mieker, is a dangerouslunatic. She begs the Council to take steps to confine himand he is placed in a small room in the slave lodge.His wife and friends to pay for his keep and to prov:dehim with food.'-signed by Jan de la Fontairie, Governor,and Ryk van Tulbagh, Secretary.ROBBEN ISLANDThe use of this island as a convict settlement was begun byVan Riebeeck very soon after he came to the Cape.Slaves were sent there for punishment, Hottentots whohad come in conflict with the authorities were exiled there,and occasionally Whites who had committed crimes weresent across to the island. The first overseer appointed byVan Riebeeck was Jan Wouters, but in 1658 he was founjto be incompetent and was replaced by Ryk Overhagen,who drew the princely salary of 14 gulden (about 190cents) per month.There are a number of references to the detention ofmental patients on Robben Island in the old Cape records.However, no attempt was made to conduct a lunatic asylumon the island until much later, during the Britishoccupation.An interesting extract from the Cape Archives bearingon the use of Robben Island as a place of detention forlunatics reads as follows: 'June 4th, 1718. A patient inthe hospital was seized with an attack of madness duringthe night and in that state killed a sick man lying nextto him. He wounded ten or eleven more before he wasoverpowered'. This had a sequel: 'June 19th, 1723. Newsfrom Robben Island that Willem Wilkens . . . had hadanother attack on the island, and wounded a person,but not fatally.'REFERENCESI. Laidler, P. W.: A Tavern of the Ocean, p. 204. Cape Town: MaskewMiller.2. De Kock, V. (1950): Those in Bondage, appendix p. 237. Cape Town:Howard T.mmins.3. Leibbrandt, H. C. V.: Precis of the Cape Archives, Letters andDocuments received. No. 24, p. 270.4. Carmichael, Capt. (1832): Good Hope Lirerary Gazelle, I September1832.5. Leibbrandt, H. C. V.: Precis of the Cape of Good Hope ArchivesJournal 1671 - 1674 and 1676, p. 35.6. Minde, M. (1937): /n Search of Happiness, p. 235. London: F.Muller.7. Leibbrandt, H. C. V.: Precis of the Archives of the Cape of GoodHope Journal 1671·1674, p. 208, 1699 - 1732. p. 299.8. Laidler, P. W. (1937): S. Air. Med. J., 11,202.9. Leipoldt, C. L. (1936): Jan van Riebeeck, p. 137 London: LongmansGreen.10. Mentzel, O. F. (1921): A Geographical and Topographical Descrip-tion of the Cape of Good Hope. Translated by H. Mandelbrote, VanRiebeeck Society, Cape Town, p. 109.•

The History of Mental Health Services in South Africa