At the recent sixth international conference of the Pakistan Psychiatric Society (11–14 December 1986) in Lahore, it seemed appropriate to give an account of the state of psychiatry in that city half a century ago. Such an evaluation, granted the circumstances of history, might be expected to start with a comparison with English psychiatry at the time. That association had not worked altogether to the advantage of the speciality in a city such as Lahore. Progressive ideas about the care of the mentally ill in the thirties percolated very slowly into a central administration, far removed from the local community and occupied with other urgent issues of public health.