MEDICAL DEVELOPMENTS AND PATIENT UNREST 63 slight percentage of leprosy patients actually develop deformities). These are the people who are branded as "lepers" or "burnt out cases" even though they are cured. They press for the same assistance that the state offers to other handicapped citizens. The more visible and organized displays of protest by leprosy patients date from the 1930s and early 1940s, with a series of revolts in some leprosy asylums across the country, which marked a shift from the long pre-history of more muted resistance by patients within the asylums. This article discusses the evolution of the leprosy asylum in India from its inception in the mid-nineteenth century, and the extent to which this institution was moulded by the medical perception of leprosy; then within this context I examine the various forms of protest adopted by patients within asylums. It will be argued that the medical discoveries of the 1920s produced a transformed medical perception of leprosy, which paved the way for a more militant patient protest. At this stage some statistical data is necessary. Of the estimated 120,000 leprosy patients in India in 1881, only about 1% received any kind of organized relief.3 In 1911 there were some 73 asylums, catering to about 5000 patients, or 4.7% of the total.4 By 1916 there were computed 81 asylums in India with 7.056 inmates.5 The 1921 Census estimated the total number of patients at 102,000.6 Some provincial data may also be considered; in the case of Bengal the 1921 Census estimated 15,000 leprosy patients, of which about 500 were housed in 3 settlements; some few out-patient clinics also existed.7 The vast majority of patients, then, were outside of organized support. Many of them were left to their own devices, often at the mercy of local communities who practiced harsh forms of discrim/ination, including eviction from the village and forfeiture of rights.8 Outside intervention into leprosy in the nineteenth century, whether official, medical, or missionary sponsored, evaded intrusion at the village level, and came to focus instead on the leprosy asylum, which received the support also of elite indigenous groups The study of leprosy in colonial India offers a new entry point into the on-going debates on public health in colonial India. Existing scholarship has focused on areas of direct state intervention, on wider public health matters and preventive medicine, and on epidemic diseases, where the offitial intervention is seen as central.9 In the case of leprosy non-official bodies were most active, especially missionaries, and the role of the colonial state was far smaller than for epidemic diseases like smallpox, cholera or plague.10 This study seeks also to open up for to scholarship the vast role of voluntary bodies in the dissemination of western medicine in India. Some of the wider conclusions drawn about western medicine in India or indigenous responses to western medicine and its institutions, derived from areas where state power was overtly coercive, as in the charged atmosphere