Imperial Bedlam: Institutions of Madness in Colonial Southwest Nigeria

By Jonathan Sadowsky

The colonial government of southern Nigeria began to use asylums to confine the allegedly insane in 1906. These asylums were administered by the British but confined Africans. Yet, as even many in the government recognized, insanity is a condition that shows cultural variation. Who decided the inmates were insane and how? This sophisticated historical study pursues these questions as it examines fascinating source material—writings by African patients in these institutions and the reports of officials, doctors, and others—to discuss the meaning of madness in Nigeria, the development of colonial psychiatry, and the connections between them. Jonathan Sadowsky's well-argued, concise study provides important new insights into the designation of madness across cultural and political frontiers.

Imperial Bedlam follows the development of insane asylums from their origins in the nineteenth century to innovative treatment programs developed by Nigerian physicians during the transition to independence. Special attention is given to the writings of those considered "lunatics," a perspective relatively neglected in previous studies of psychiatric institutions in Africa and most other parts of the world.

Imperial Bedlam shows how contradictions inherent in colonialism were articulated in both asylum policy and psychiatric theory. It argues that the processes of confinement, the labeling of insanity, and the symptoms of those so labeled reflected not only cultural difference but also political divides embedded in the colonial situation. Imperial Bedlam thus emphasizes not only the cultural background to madness but also its political and experiential dimensions.

This title is part of UC Press's Voices Revived program, which commemorates University of California Press's mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1999.
The colonial government of southern Nigeria began to use asylums to confine the allegedly insane in 1906. These asylums were administered by the British but confined Africans. Yet, as even many in the government recognized, insanity is a condition that sh

• Language: English
• Publisher: University of California Press
• Release date: Apr 28, 2023
• ISBN: 9780520921856

Jonathan Sadowsky

Jonathan Sadowsky is Assistant Professor of History at Case Western Reserve University.

Book preview

Imperial Bedlam

Medicine and Society

Andrew Scull, Editor

This series examines the development of medical knowledge and psychiatric practice from historical and sociological perspectives. The books contribute to a scholarly and critical reflection on the nature and role of medicine and psychiatry in modern societies.

1. The Regulation of Madness: Origins of Incarceration in France, by Robert Castel, translated by W. D. Halls.

2. Stubborn Children: Controlling Delinquency in The United States, 1640 — 1981, by John R. Sutton.

3. Social Order / Mental Disorder: Anglo-American Psychiatry in Historical Perspective, by Andrew Scull.

4. Inheriting Madness: Professionalization and Psychiatric Knowledge in Nineteenth-Century France, by Ian R. Dowbiggin.

5. Madness and Social Representations, by Denise Jodelet, translated by Tim Pownall, edited by Gerard Duveen.

6. Inventing the Feeble Mind: A History of Mental Retardation in the United States, by James W. Trent, Jr.

7. Impure Science: AIDS, Activism, and the Politics of Knowledge, by Steven G. Epstein.

8. Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century, by Joel Braslow.

9. Medicalizing the Mind: The Invention of Modern Psychotherapy, by Eric Caplan.

10. Imperial Bedlam: Institutions of Madness in Colonial Southwest Nigeria, by Jonathan Sadowsky.

Imperial Bedlam

Institutions of Madness in Colonial Southwest Nigeria

Jonathan Sadowsky

UNIVERSITY OF CALIFORNIA PRESS

Berkeley / Los Angeles / London

University of California Press

Berkeley and Los Angeles, California

University of California Press, Ltd.

London, England

© 1999 by the Regents of the University of California

Library of Congress Cataloging-in-Publication Data Sadowsky, Jonathan Hal.

Imperial bedlam: institutions of madness in colonial southwest Nigeria / Jonathan Sadowsky.

p. cm. — (Medicine and society; 10)

Originally presented as the author’s thesis (doctoral—Johns Hopkins University, 1993).

Includes bibliographical references and index.

ISBN 0-520-21616-4 (alk. paper)

i. Psychiatric hospitals—Nigeria—History. 2. Mentally ill— Care—Nigeria—History. 3. Mental illness—Treatment—Nigeria— History. 4. Psychiatry—Nigeria—History. 5. Imperialism—Health aspects—Nigeria—History. 6. Nigeria—Colonial influence— Health aspects—History. 7. Nigeria—Colonization—Health aspects—History. I. Title. II. Series.

[DNLM: i. Hospitals, Psychiatric—history—Nigeria.

2. Colonialism—Nigeria, wi ME6490 v. 10 1999 / WM 27 HN5 S126Ì 1999]

RC451.N5S23 1999

362.2'1'09669—dc2i

DNLM/DLC

for Library of Congress 99-10222

CIP

Manufactured in the United States of America

08 07 06 05 04 03 02 01 00 99 10 9 8 7 6 5 4 3 2 i

The paper used in this publication meets the minimum requirements of ANSI/NISO Z39.48-1992 (R1997) (Permanence of Paper).

Contents

Contents

Preface

Acknowledgments

CHAPTER I Introduction

CHAPTER 2 The Nineteenth Century From Pity to Alarm

CHAPTER 3 Material Conditions and the Politics of Care

CHAPTER 4 Proper Subjects for Confinement

CHAPTER 5 The Confinements of Isaac O. A Cuse of Acute Mania

CHAPTER 6 Psychiatry and Colonial Ideology

CHAPTER 7 Conclusion

Notes

Bibliography

INDEX

Preface

This project had its origins in a graduate school African history seminar in the spring of 1988, when I first read Megan Vaughan’s article on the Zomba lunatic asylum in colonial Nyasaland. I thought that the article raised so many interesting questions—about madness, and about colonialism—that more extended treatments of the subject were called for.

That summer, I discovered in Nigeria’s National Archives in Ibadan a number of documents pertaining to colonial asylums, and a central question formed: How did colonial institutions determine whom to confine? The inmates numbered in the hundreds, and although this is not a terribly large number in such a populous country, two factors did make the confinement process especially curious. One was that many in the colonial government recognized that cultural differences made the designation of insanity in Nigerians difficult for them. The second was that the government had very little interest in confining people, given that this represented an expense. They considered therapeutic goals extravagant, and whereas any government has social control needs, it was not clear why asylums were needed in addition to prisons.

The project seemed significant in three respects. First, the asylums provided a case study of a colonial institution and the formation of a colonial social policy. The second developed from the discovery of patient records, which provided a way to examine the social process of determining insanity in a context of cultural difference and political domination. Third, analysis of psychiatric writings by British alienists, as psychiatrists were then known, instantiated the role of social factors in the production of knowledge.

I conducted the majority of the research in Nigeria between January 1990 and April 1991. The data are mostly archival, drawn from Nigeria’s National Archives in Ibadan and case files from the Aro Mental Hospital in Abeokuta, to which the hospital graciously allowed me access. To get a stronger sense of the wider social field in which the asylums had been operating I, with the assistance of the Dr. Samuel Osunwole of the Institute of African Studies at the University of Ibadan, also conducted a number of interviews with traditional healers. This study, though, has not been conceived primarily as an investigation of Yoruba medicine. This is a subject that has received, and continues to receive, much deserved attention; to pursue it in its complexity and make a new contribution is beyond the scope of my main interest, the asylums. There is certainly a great deal more ethnomedical and ethnopsychiatrie work to be done, and I hope to convince future researchers in this area of the value of a historical approach.

Mental illness is a notably private matter in any society I have lived in or studied. For this reason, my desire to be a tenacious researcher sometimes conflicted with the recognition that there were borders that should be respected. I did not, for example, pursue the families or descendants of inmates in cases where that might have been possible. This, I thought, might have brought attention to the families in inappropriate ways.

One of the greatest dangers in historical research is overestimating the significance of one’s data. In this case, a particular hazard would have been to intimate that the asylum inmates in colonial Nigeria exemplify a colonial condition. I argue that their experiences cannot be understood except as part of the colonial situation but also that they were not typical or normal experiences of colonialism. I also show that in many cases these people were understood as mad by their kin and neighbors and not only by a colonial state. Arguably, asylum inmates were not even representative of the mad generally. Nigerian physician T. A. Lambo, the dean of Nigerian psychiatry, showed in the 1950s that patients treated in more traditional settings differed culturally from those in institutions and had different frames of reference. The asylums were significant in themselves but were exceptional in a number of respects.

Acknowledgments

Three advisors oversaw this study as a dissertation. Gillian Feeley-Harnik provided consistent inspiration as she stressed the intimate connections between the material and mental or spiritual. David William Cohen showed the value of examining the structure of scholarly debates and showing the assumptions common to both sides. Philip Curtin urged the value of placing specific material in comparative context. Sara Berry and Ruth Leys also provided very helpful guidance during the writing.

The research was funded by the Social Science Research Council, which also provided significant intellectual and logistical support. The SSRC also fùnded a valuable semester at the Columbia University School of Public Health, where I was a Visiting Fellow in the Psychiatric Epidemiology Training Program. At Columbia, I received valuable commentary from Bruce Dohrenwend, Bruce Link, Michael Teitelman, Inge Goldstein, Sharon Schwartz, and Ilan Meyer.

In Nigeria, the Institute for African Studies at the University of Ibadan provided a constructive working environment. Samuel Osunwole provided especially invaluable help. Bolanle Awe and Bayo Adekola also assisted me in important ways.

Many eminent figures in the Nigerian psychiatric professions welcomed and helped me more than I could have wished—I only hope I was not too much of a nuisance. In particular, I thank Tolani Asuni, Olufemi Morakinyo, A. A. Marinho, A. O. Odejide, Isaac Ekuesan, M. Olu Oyebanjo-Akinsola, and I. Dokun-Fatade. Special thanks to T. A. Lambo, the acknowledged father of psychiatry in Nigeria, who showed great patience as I pestered him for information!

For friendship and hospitality in Nigeria, thanks to Simon Heep, Ke- hinde Duze, Taiwo Duze, Dawn Davis, Dov and Dorit Shacham, Zvi and Rina Dubitsky, Laray Denzer, Debbie Klein, Kola Imasogie, Kareem Musa, David Moffat, David and Helen Williams, Carolyn Keyes Ade- naike, Pius Omole, Leon Volterre, and Femi Areola.

In England, Roy Porter, Megan Vaughan, and John Iliffe provided useful advice. Professor Iliffe shared some of his own research notes with me, and my chapter on the nineteenth century is particularly indebted to his generosity.

The writing benefited from a fellowship at the Institute for Advanced Research in the Humanities in Africa, Evanston, Illinois. In Evanston, Ivan Karp provided especially provocative commentary. My ideas were also clarified by participating in the 1995 National Endowment for the Humanities Summer Institute on the Contributions of the History of Medicine to Social History, directed by Barron Lerner and David Rothman.

Alexander Boroffka was generous in sharing his immense store of relevant documentation and provided a critical reading of the text.

Graduate students ideally learn as much from each other as from their supervisors. For support and critique of often extraordinary kinds I would like especially to thank Keith Breckenridge, Tim Burke, Catherine Burns, Garrey Dennie, Marta Elliott, Tamara Giles-Vernick, Carolyn Hamilton, Carlos Madrid, Sarah Madrid, and Rebecca Plant.

During the period when I transformed this project from a dissertation into a monograph, I profited from the advice and encouragement of my colleagues and students in the History Department at Case Western Reserve University. Catherine Kelly, Miriam Levin, Alan Rocke, Ted Steinberg, and Angela Woollacott read virtually all of the text. I was also lucky to have the support of several colleagues in the Anthropology Department expert in psychological anthropology—Thomas Csordas, Atwood Gaines, and Janis Jenkins, whose work in related areas helped me to clarify the approaches I wanted to take. Martha Woodmansee of the English Department has also been a helpful mentor to me.

Karin Barber, Chris Dole, Sander Gilman, Dieter Hollstein, Paul Landau, Philippa Levine, Shula Marks, Ugo Nwokeji, Micah Parzen, Annemarie Strassel, Mark Warren, Christina Welter, and Andrea Westcot, read all or parts of the manuscript and provided helpful criticism and advice.

Special thanks to Laura Steinberg, who was vital in too many ways to list.

A version of chapter 5 appeared in History of Psychiatry 7 (1996): 91-112, and a version of chapter 6 appeared in the Bulletin of the History of Medicine 71, i (Spring 1997): 94-in. I thank these journals for permission to republish them here.

CHAPTER I

Introduction

Despite the development of psychiatry as a scientific discipline over the lastioo years, the fundamental question of what mental illness is, still haunts the profession. … No tests have yet been developed to determine objectively the presence or absence of most mental diseases. … The criteria for medical diseases are physicochemical, while the criteria for psychiatric diseases are social and ethical.

¹

David, patient in Yaba Mental Hospital, 1987

In 1987, to celebrate its eightieth year, the Yaba Mental Hospital in Lagos published a pamphlet entitled From Asylum to Hospital. The title of the pamphlet celebrated an advance from custody to therapy that was achieved simultaneously with Nigeria’s transition to independence. A number of patients wrote contributions to the pamphlet. A patient, David, wrote a short piece entitled What Is Mental Illness? that challenged the celebratory note with this sentiment— familiar from the writings of maverick psychiatrists or radical sociologists but more remarkable coming from a hospitalized mental patient. What follows is a historical inquiry into the proposition David advanced. Though less firmly committed than he to the principle that the criteria for mental illnesses are entirely social rather than biochemical, it pursues the insight that the identification of insanity conveys important social meanings. The focus is on two institutions in southwest Nigeria, the Yaba Lunatic Asylum (later, Mental Hospital) in Lagos and Aro Mental Hospital in Abeokuta, during the colonial period.

These institutions originated in the late nineteenth century, when residents of southern Nigerian cities were troubled by an apparent swarm of lunatics on the streets. Few Nigerians had enthusiasm for asylums, and most preferred their traditional methods of care. Suspicion toward institutionalization is still strong in Nigeria, and workers in the mental hospitals concede that they are sought out only after Nigerians have brought mentally ill people to traditional or religious healers of some kind.² But colonial officials and many Africans shared a perception that a growing number of people were not being adequately taken care of by these methods. The colonial government followed British precedent and built large asylums to confine lunatics. Colonial policy, though, held that the asylums should be a last resort. The insane, most government officials felt, were better cared for in their own communities.

This preference followed from the policy of Indirect Rule, a policy associated with Nigeria’s first governor, Lord Frederick Lugard. In Nigeria, particularly the north, Lugard developed the practice of ruling via local African rulers, with the aim of preserving traditional ways of life.³ According to the dual mandate of Indirect Rule, British presence in Africa served two purposes: financial gain for Britain and the development of Africa. The goal of developing Africa was in some ways a transparent rationalization for colonial rule, but the forms that rationale took had real consequences. Asylum policy reveals with some clarity the contradictions caused by the larger policy. The African way of life did not appear to include lunatic asylums—yet the hundreds of people confined were outnumbered by those turned away due to lack of space. The asylum, introduced diffidently in the early colonial period, had become an established, even famous, feature of the Nigerian landscape by the time independence came in 1960.

Critical studies of mental pathology in Africa are not new. In fact, they form a cornerstone of the social criticism of Frantz Fanon, possibly the most famous psychiatrist to have done clinical work in Africa. Fanon’s experiences working in a colonial mental hospital in Algeria radicalized him, catalyzing one of the most searching critiques of the late colonial social order.⁴ In the section on Colonial War and Mental Disorders in The Wretched of the Earthf Fanon presented case studies of a number of psychiatric patients, both Algerian and French, who had been traumatized by experiences in the revolt.⁶ The case histories Fanon presented are extremely vivid and powerful, but there is an inconstancy in the way he interprets them. On the one hand, Fanon stressed the spec ificity of the situation. These were not just pathologies of colonialism, he showed, but problems particular to an exceedingly violent conflict. His experiences with patients were an important factor in his own politicization, as the futility of trying to produce mental health in individuals in the midst of an anticolonial war became clear to him.⁷ At the same time, though, he generalized boldly, expanding from the material into commentary about Africa and indeed the entire colonized world. For Fanon, the cases became exemplars of a colonial condition; for example, he states a number of times that colonialism produces mental pathology itself, an intriguing claim, but one which is difficult to establish and which goes beyond Fanon’s more readily persuasive argument that colonialism strongly determines the symptoms and content of the pathology.⁸ This latter insight is one I pursue in detail.

The study of insanity and psychiatric institutions in colonial Africa is now receiving renewed scrutiny from historians.⁹ Vaughan has led the way; her 1983 article in the Journal of Southern African Studies showed how the course of a lunatic’s confinement could provide a window through which to observe political and cultural conflict, between Africans and Europeans, and within the two communities.¹⁰ Her work also showed that the agenda of European psychiatric historiography cannot be imported without modification. Vaughan observed, for example, that there was no great confinement of the insane in Malawi analogous to that made notorious by Michel Foucault.¹¹

Vaughan’s work has been followed by Jock McCulloch’s wideranging study of colonial psychiatry. McCulloch has pursued and amplified the insight that colonial psychiatry had only limited insight into the psychology of Africans but provides useful sources for understanding colonial mentality. So far, though, little of the literature on African psychiatric history has given close attention to the patients’ representation of illness experience, which has been a high priority in the wider historiography of medicine in recent years.¹² This probably reflects source limitations more than the priorities of researchers but is all the more reason to pay carefùl attention to what sources are available. The perspectives of patients are elusive quarry in the history of psychiatry for any part of the world and a major concern in what follows.

Despite the development of psychiatry as a scientific discipline…

Colonial asylum policy reveals in microcosm the dynamics of the Nigerian colonial state. It also may provide a fresh look at those most spoiled terms in psychiatric history—social control and reform. The historiography of psychiatry has matured to a point where it is no longer possible to describe the history either as one of progress toward ever more benevolent reforms, or toward increasingly sinister forms of social control.¹³ The most important stimulus to the anti-hagiographie research on the history of psychiatric institutions was the publication in 1961 of Michel Foucault’s arresting study Madness and Civilization. The beginning of a remarkable career of unsettling scholarship, Madness and Civilization remains a touchstone for historians and anthropologists interested in mental illness and asylums, for whom it has become a ritual to cite Foucault’s work early on.¹⁴ Foucault’s most famous claim, that the Enlightenment inaugurated a great confinement which interrupted a dialogue of reason and madness as the mad were incarcerated, has become popular folklore as well as a subject of scholarly debate.¹⁵

The studies that followed Foucault’s adopted social control as a central concept.¹⁶ The large, custodial asylum was seen as only the most dramatic example of how psychiatry and its allied institutions served to enforce the social order. Though recent scholars have not dropped the phrase, it has come to seem at least passé, if not entirely misguided.¹⁷ Elizabeth Lunbeck, in one of the more successfill monographs using Foucaultian approaches, distinguishes social control from the point at which knowledge and power fostered the conditions conducive to the realization of both.¹⁸ And in a study of the European insane in India, Waltraud Ernst maintains that social control is overdone if used to maintain the impression that complex phenomena can be captured with a catch phrase.¹⁹

All of these reactions to social control approaches are helpful antidotes to its excesses. But psychiatry, whether caring or coercive, exists for the purpose of controlling anomalous behavior and emotion. Historians of psychiatry will only apprehend their subject by combining a sympathetic understanding of the impetus to reform with an appreciation of the drive toward social control. Description of reform need not be uncritically celebratory, and an appreciation of social control— a scapegoated term, which has often been made to carry the blame for reductionist approaches—need not posit uniformly evil institutions. I use the phrase, therefore, with the following qualifications: It should not be taken to imply that control is unidirectional, the result of the conscious intent of sinister doctors. Nor should it imply that therapy and control are mutually exclusive categories. The social pathways to asylums are complex; doctors and administrators have complex agendas and often act only at the end points of paths to treatment initiated by family members and communities.

My approach draws on the sociology of Allen Horwitz, who, instead of equating control and coercive, sees a spectrum of forms of control, ranging from the more custodial and coercive to the more supportive and therapeutic.²⁰ Horwitz attempts to predict what circumstances will produce what kind of control, arguing that cultural and social distance between the deviant and the responding community encourages a more coercive, custodial approach, as does lack of social status on the part of the deviant. Certainly Horwitz’s theory has applicability to Nigeria, where colonial lunatic asylums housed people whose status and cultural difference made them virtual nonentities in the eyes of British administrators, but where therapeutic services were developed increasingly as the institutions became the charge of Nigerians themselves.

The fundamental question of tvhat mental illness is, still haunts the profession…

What, though, is a lunatic, anyway? In most cases, I bracket the question of whether or not anyone was really afflicted with a mental illness. A trained healer has enough of a challenge diagnosing an individual in