In the spring of 1858, Dr. Lewis Quier Bowerbank applied for the position of consulting surgeon at the Kingston Public Hospital. The son of a Jamaican parish rector, Bowerbank had received his medical education from the University of Edinburgh, with additional training in London. Upon returning to Jamaica later in 1836, he practiced medicine in the capital of Spanish Town before moving in 1853 to Kingston, the island's major port city, where he established a medical practice with his brother-in-law. He also served as a member of the island's Central Board of Health. But when he applied to become consulting surgeon at the Public Hospital, the commissioners rejected Bowerbank and left the post vacant. Just two days later, Bowerbank published a scathing exposé of endemic neglect and malpractice within the hospital and adjoining lunatic asylum. Bowerbank's Letter to the Commissioners of the Public Hospital and Lunatic Asylum of Kingston, Jamaica Relative to the Present State and Management of these Institutions sparked a years-long controversy over the general conditions in the hospital and asylum.Footnote 1 Within that broader controversy, one particular aspect of institutional practice emerged as the subject of intense focus and eventually became the source of imperial scandal: the cruel and abusive treatment of women patients in the lunatic asylum.Footnote 2
Medicine was not usually the stuff of imperial scandal. Like political scandals in Britain, imperial scandals often started with salacious charges of sexual impropriety that gradually shifted toward more weighty accusations of corruption.Footnote 3 But if medicine was not a frequent generator of scandal, torture—and especially the torture of women—was.Footnote 4 The most important revelations of the Kingston lunatic asylum scandal concerned the torture and abuse of vulnerable black women and shone light on administrative misconduct. Moreover, its ramifications mushroomed far beyond the island. As scholars have noted, scandals allowed the boundaries of appropriate behavior to be delineated in a public setting. The issue of respectability was especially salient in colonial contexts, where morality was seen as a key distinction between metropolitan and colonial life. It was widely accepted that many British colonies—and Jamaica in particular—were hotbeds of corruption and vice. The supposed purity of British social life was protected by the oceans that separated the metropole from the corrupting colonies. Scandals—whether about imposters, sexual impropriety, or torture—disrupted this status quo. Acceptance of looser standards and regulations could only be tacit, whereas scandals of this sort pressed these issues publicly and so required firm rebukes. Furthermore, scandal legitimized empire by shifting attention to individual misdeeds rather than the crime of imperialism itself.Footnote 5
Scandals were also well documented, and because of the voluminous archival records produced about the Kingston scandal, a spate of historians have outlined the lineaments of this scandal in a series of recent works. Bowerbank spent over two years trying to convince authorities that conditions within the asylum—and the adjoining hospital—required immediate intervention. His crusade divided Kingston's elite, pitting the Jamaican government—whose inadequacies Bowerbank blamed for the institution's failures—against members of the city's medical community. It also led to the discovery of physical abuse in the asylum, with the worst violence against asylum patients coming to light years into the scandal. Once confirmed, these revelations forced reluctant imperial officials to intervene. Following a local commission's exhaustive examination of both institutions, the Colonial Office sent questionnaires to the governors of more than thirty colonies, asking about abuses within their local asylums.Footnote 6 This was a remarkable, though temporary, result, one at odds with the hardening racial ideologies and narrowing liberalism of the late 1850s and early 1860s. For this reason, some scholars see these events as a foundational moment in the development of a rudimentary imperial public health policy that also injects the historiographies of colonial medicine and psychiatry with an evocative case study from the British Caribbean, a region these fields have too often ignored in favor of India, Africa, and the dominions.Footnote 7
Yet the way the scandal unfolded, and the terms on which its debates rested, belie these conclusions. For at stake was a disagreement about the standard of care that colonial institutions had to provide and the question whether these facilities had an obligation to apply the latest models emanating from the metropole. Attempts to export medical standards from the metropole to the colonies were inherently flawed. In the case of Kingston, while there was widespread approval of the new standards for asylum management developed in Britain, commentators fiercely disagreed about whether it was possible or even desirable to reform Jamaica's asylums to match British guidelines. That there was so much disagreement on this point was not simply a product of the colonial context, however, for the training of local authorities and doctors in British methods was not always controversial.Footnote 8 Yet even in Britain, asylum practices remained the subject of significant debate and often haphazard execution. They were not the monolithic and stable pillars of knowledge, tested and refined in the metropole, that Jamaican commentators and imperial bureaucrats implied. Thus the debate about whether British models were applicable to colonial contexts was not simply about the differences between metropole and colony or about the changing views of freedpeople; it also reflected the instability of those ideas themselves.
Crucially, the scandal crystallized debates over what postemancipation imperial governance was supposed to accomplish. Bowerbank's crusade assigned the task of overseeing asylum conditions and practices—and making them conform to metropolitan models—to colonial administrators at a moment of heightened debate about the kind of imperial rule and philanthropic help the freedpeople of the Caribbean should receive. Moreover, Bowerbank identified the ways in which the constitutional status quo left patients vulnerable, a breach of the governing ethos. In theory, Jamaica's constitutional structure limited direct intervention from London, instead granting significant power to the Jamaican legislature, a longstanding source of frustration for imperial administrators. In the late 1850s, the Jamaican House of Assembly largely determined island affairs. While the governor could veto measures, as could the Colonial Office, the metropolitan government could neither mandate particular courses of action nor conduct its own investigations. Moreover, the lunatic asylum and public hospital came under the direct authority of the legislature.Footnote 9 The Colonial Office saw these constitutional constraints as justification for an initially neutral stance in the early years of the scandal.
Ultimately, the scandal was so explosive because, within it, two contradictory political impulses about postemancipation imperial governance collided. On the one hand, by the late 1850s––after two decades in which black Jamaicans prioritized their autonomy over the needs of the plantation system––there was growing cynicism about whether freedpeople would ever conform to European moral codes and work practices. In the wake of severe economic decline, white observers registered their disappointment by criticizing the work ethic and morality of freedpeople; out of the accumulation of these criticisms emerged new versions of racist ideology.Footnote 10 On the other hand, imperial actors still claimed to operate under principles of benevolent governance, ideas that stemmed from the abolitionists’ insistence that black subjects required protection from the predations of plantation owners and their allies. The asylum scandal was caught in the nexus of these two narratives. If black subjects were owed protection—and most asylum patients were black or brown and had been born into enslavement, making them precisely those whom abolitionists had rallied British politicians to protect—then they deserved the same standards of care as their white British counterparts. But those who believed in the inherent inferiority of freedpeople questioned whether British models were in fact suitable for this population. Thus, as the scandal grew into a transatlantic debate over which treatment methods ought to be used in the colonies, it did so at a moment in which black subjects were increasingly seen as undeserving of the benevolence they were supposedly receiving.
The Model
In the mid-nineteenth century, the British model of lunacy treatment was itself new, in flux, and only partially implemented across the United Kingdom. For most of the eighteenth century, insanity treatments had emphasized the physical control and domination of patients in order to break through their mental defenses. Such domination took the form of violent corporal punishment or, even for those who wanted whippings and beatings to end, restraints. The lunacy reform movement, which began in the late eighteenth century, significantly rethought the basic premises of insanity treatment by moving away from domination and physical control. Lunacy reforms admired the York Retreat, a Quaker institution built in 1792 that pioneered “moral treatment,” an ideology that viewed patients as rational subjects who could recover from their temporary state of madness only if their moral character was primarily attended to. Since physical brutality could not transform character, it had no place within moral treatment.Footnote 11
Inspired by the ideology of moral treatment, also known as “moral management,” British reformers campaigned for a state system of public asylums that applied its tenets. As part of their campaign, reformers needed to convince families to choose state-run asylums for their mentally ill relatives instead of other private arrangements. They did so by popularizing the image of an ideal asylum. Underpinned by moral management precepts, these proposed state asylums would offer flexible, individualized care practiced by kind staff. The superintendents of these facilities would be a visible presence, visiting patients daily and modeling methods to their staff. The institutions would be small, as would individual wards, with patients classified by the severity of their ailments. They would be located in rural settings, where patients would breathe fresh air and be soothed by beautiful landscapes. Each asylum would have ample grounds on which patients could participate in games, recreation, and physical labor. Finally, following the path of Hanwell County Asylum, the first large asylum to introduce a non-restraint system, the model asylum would banish restraints entirely. Parliament passed lunacy reform in 1845 on the strength of this image, creating a national Lunacy Commission and requiring counties and boroughs to build pauper lunatic asylums.Footnote 12 Moral management was now the official metropolitan ideology.
Yet parliamentary sanction was merely that: approval from London. It did not mean swift and even implementation of the desired national system across the United Kingdom. To be sure, by the late 1850s, most English and Welsh counties had state asylums operating in accordance with moral management principles, although northern English border counties and southern Welsh counties, among others, lagged behind.Footnote 13 In Scotland, however, the London-based Lunacy Commission had no authority—Scotland had its own Lunacy Commission, created more than a decade after its English counterpart—and the geographical and cultural isolation of the Highlands meant that folk practices and in-home care remained standard approaches to caring for the insane there until the late 1850s. State asylums were only completed in the Highlands in the mid-1860s, and it would take at least a decade before these institutions were reliably running on moral management.Footnote 14 Thus, the colonies were not the only peripheries where metropolitan ideas had uneven purchase; regions of the British Isles were also slower to implement standards dictated by the metropole.Footnote 15
Even where moral management was in place in state asylums, its application was haphazard, insecure, and ineffective. One of non-restraint's early proponents, John Conolly, the superintendent who oversaw Hanwell's transition to non-restraint, worried that state asylums might revert to restraint methods.Footnote 16 Moreover, moral management never led to better outcomes for patients, even as it remained the core ideology behind lunacy treatment into the twentieth century. Instead, state asylums became semipermanent dumping grounds for patients who would almost certainly never leave, which led to a cycle of overcrowding that could only be fixed through the construction of new buildings or wings.Footnote 17 Nevertheless, the various commentators in this scandal—both in Jamaica and in Britain—clung to the fixed ideology behind this model, seemingly taking little note of its imperfect implementation in Britain.
The Crusader
If known, these subtleties mattered little to Bowerbank, whose exposé—while condemning virtually every aspect of the hospital and asylum—was especially critical of the asylum. The Kingston Asylum in some ways had predated the turn to state asylums in the United Kingdom. Its origins lay in the public hospital, built in the bustling port city in the 1770s to serve European patients. Though not intended to be a facility for the insane, it gradually became the primary place to send the mentally ill, beginning in the 1790s. The need for a separate but nearby institution grew, and a separate asylum was built in the early 1820s. Conditions within declined rapidly and, as one scholar notes, likely did so as the patient population increasingly included black subjects.Footnote 18 While the abominations of slavery, the convulsions of emancipation, and indeed the injustices of imperialism itself had a baleful influence on the mental health of many black subjects, colonial doctors and bureaucrats frequently labeled those unwilling to conform to European behavioral codes as insane.Footnote 19 According to Bowerbank, the asylum suffered from overcrowding, which led to violence: “In each [cell], three, four, or even fourteen lunatics are locked up at night, to fight and murder each other; for there is no one to keep the peace; no one to tell of the awful tragedy till morning, when the cells are opened, and the lifeless corpse proclaims the truth in all its terrors.” Even worse, in his eyes, was a more sensational crime—“among the males crowded into these cells, there is reason to apprehend that sodomy has been committed!!”Footnote 20 He insisted that the medical community and the Jamaican government had known about these faults for years. The annual reports from hospital doctors and a letter from former head physician Edward Bancroft, all from the 1840s, testified to that fact. So, too, did long excerpts of letters and reports from prominent Jamaican and British medical experts. Legislation from 1843 to build a new asylum in response to these criticisms was further proof, even though the structure remained unfinished. Bowerbank also pointed to criticisms from the 1850s as commentators and government bodies deplored the state of these facilities. Jamaica's Central Board of Health described the threat of both institutions becoming “the birth-place and cradle of pestilence and death.”Footnote 21 By the time of Bowerbank's writing in 1858, little had changed.
At the core of Bowerbank's criticisms was his belief that British standards must be implemented in Jamaican institutions, which he supported by drawing upon the writings of British experts like William Farr and John Conolly, instrumental figures in the campaign to make moral management official asylum policy, even borrowing their language. Farr, superintendent of the General Register Office's statistics department, had praised the non-restraint system in an 1841 article. Bowerbank had evidently studied this article quite closely, for some of his comments were unattributed quotations from it. Beyond this borrowing, Bowerbank noted that an asylum “intended to be conducted on the modern, or so-called non-restraint system” required special attention to construction and division of space, so that patients could be physically separated by symptoms and severity of illness, eliminating the need for restraints. Hanwell superintendent John Conolly's work also influenced Bowerbank, who noted that “modern” asylums took special care to ease conditions for their patients.Footnote 22
The immediate target of Bowerbank's attacks was Dr. James Scott, head physician of the asylum and hospital. Their debate was not about how well the asylum followed the English blueprint, but instead about whether the standard was at all appropriate for the Jamaican facility. In examining this scandal, some scholars have suggested that while Caribbean medical personnel largely agreed to use moral management as their guide, asylums failed to meet British standards because of the difficulty adapting them to colonial contexts.Footnote 23 Yet the writings of Bowerbank and Scott demonstrate that they fundamentally disagreed about the standard's usefulness in Jamaica. These competing narratives established the ideological contours of the asylum controversy, which would expand into a colonial—and eventually imperial—scandal.
While Scott admired British establishments, he did not see moral management as a realistic ideology for Jamaican facilities. “It would be well if the Hospital in Jamaica, as well as other Institutions in the island, could be assimilated more and more to a European standard,” he wrote to Bowerbank, “but, however fervent your aspirations may be on this point, I very much fear that the prospect of their realization is rather remote.” Indeed, he went further and asked, “Is there a single institution in this country, that will bear favorable comparison with analogous establishments in Great Britain?”Footnote 24 Moreover, Scott pinpointed the imperfections of the British model as he noted that murders were also “committed in the best regulated Asylums in England and America.”Footnote 25
Scott offered another rubric, one that lowered aspirations for what colonial medicine could accomplish. It would be better to compare the asylum to its previous condition, not to British or European asylums, a standard his institutions would struggle to meet. As Scott described, when he first visited the asylum in 1839, “A more ill regulated place I never entered; all was confusion, disorder, filth, and coercion.” Little had changed by the time he became head surgeon in 1844. Judged by this measure, the asylum showed marked improvement, allowing Scott to present a narrative of progress in which the facility moved out of its previous squalor under his aegis.Footnote 26 In this narrative, Scott was savior.
Among the strongest supporters for the asylum's status quo was Jamaica's governor, Sir Charles Henry Darling. Unlike most governors, Darling had spent considerable time in Jamaica and was intimately familiar with the island's political life. In the 1830s, he had completed a stint of military service in the island, and, after retiring from the army in 1841, he moved back to Jamaica, where he spent the next six years holding government positions and serving on the legislative council. He was the only Jamaican governor who had previously served in the Jamaica Assembly.Footnote 27 Darling was unusually familiar with the asylum as well. As an assemblyman, Darling had served on the board that oversaw the initial stages of the new asylum building project. That committee singled out two designs: a submission from James Harris, the architect who designed Hanwell, and a design created by Dr. Luther Bell, the physician in charge of Boston's McLean Asylum. Darling and his colleagues selected Harris's design, which was cheaper and more suited to the tropical climate. It also required less space and a smaller staff.Footnote 28 In choosing Harris's design, the commissioners had selected someone who had made the “ideal type” a structural reality.
Darling's familiarity with the asylum likely primed him to support Scott. The governor largely adhered to Scott's view: even with its failure to adhere to British standards, the asylum was better than anything else Jamaica had to offer. And if the asylum did fail, its worst features were likely symptoms of Kingston's poor infrastructure. “[T]he City of Kingston itself,” he noted, “is without a system of Drainage and Sewerage and the nuisance of Cess-Pools is one to which the best Residences in it are exposed.” In focusing on Kingston's infrastructure—which was notoriously poor at the time—Darling rejected Bowerbank's claim that facilities of care should aim for higher standards of cleanliness.Footnote 29
There is no doubt that some of the Buildings on the Old Hospital Premises must be utterly condemned, when compared with the Modern Hospitals of Europe and America and even of some young and flourishing Colonies, but bad as they may be, they are nevertheless Abodes very superior to the wretched Hovels to which some of the Patients admitted into the Hospital have been accustomed.Footnote 30
This was an even lower standard than Scott had espoused. Though he was motivated by a desire to provide some level of medical care to the sick and suffering, Darling saw no value in trying to match practices in other colonies, let alone in Britain. Conditions only had to be better than “wretched Hovels,” a low bar indeed.Footnote 31
Yet even as Darling set his own criteria for evaluating these institutions, his comments and subsequent actions betrayed the degree to which he had nonetheless absorbed a basic belief in moral management. In describing a recent inspection of the asylum, he noted proudly the “clean and comfortable aspect of the place,” especially since no patients were restrained.Footnote 32 He later agreed that the asylum buildings were “very unfavorable to the success of curative systems,” but cited financial constraints from the legislature, which controlled the purse.Footnote 33 Still, by early 1859, Darling signed into law a bill that placed the asylum more directly under the governor's authority. It transferred the responsibilities of the board of commissioners to one person who held the newly created position of inspector and director of the hospital and asylum and reported directly to the governor.Footnote 34
The Mediators
For the men of the Colonial Office, the disputes over conditions in the asylum were a local matter, one that the governor should investigate himself. Yet Darling did not share this understanding of his responsibility as governor. His was a role of arbitration and executive power, not of judicial investigation or direct oversight over incarcerating facilities. Nevertheless, the Colonial Office asked Darling to investigate Bowerbank's claims himself.Footnote 35 He did so, albeit reluctantly. “[I]t did not occur to me that I could be expected to undertake the duties of enquiry in person,” he complained, noting that he had never done so during thirty years of colonial service “in Six Colonies situated in various Quarters of the Globe.”Footnote 36 His investigation was cursory, gathering reports from his new inspector, Daniel Trench, and from a civil engineer who confirmed the drainage and ventilation problems that plagued most, but not all, of the hospital and asylum facilities.Footnote 37
London bureaucrats noted Darling's reluctance. Internal memoranda and penciled marginalia reveal a growing interest among Colonial Office staffers in the hostile exchanges between the two men. For example, in a late 1858 dispatch, when Darling claimed he had no power over the commissioners, “except the power to dismiss those of the Commissions who are not of the Executive committee,” the distinction rang false. Not only did someone pencil in “What further power can he want?” they also noted that the executive committee, over which the governor claimed to have no control, “consist[ed] of his own officers & is bound to assist him according to his own views.” Comments like these were mere marginal scribbling, not official pronouncements, but they nevertheless show an internal skepticism even as the Colonial Office maintained a publicly neutral position.Footnote 38
Colonial Office bureaucrats found it increasingly difficult to sort through the onslaught of correspondence on the matter. In particular, they struggled to determine what was political animus between Darling and Bowerbank and what was urgent. Senior clerk Henry Taylor warned that the animosity between the two men was obscuring potentially important questions. “[A]s the correspondence already before us shows,” he wrote, “it will be very easy … to lose all the facts of public importance in a labyrinth of personal controversy.”Footnote 39 Moreover, battle lines were forming between segments of the Kingston political and professional elite, all driven by the personality clashes among Bowerbank, Scott, and Darling. After several local physicians publicly allied with Bowerbank,Footnote 40 senior clerk Henry Taylor remarked, “The truth is that so many of the medical men in Jamaica have got themselves involved in the controversy about the management of the Hospital & Lunatic Asylum that the Gov. might well find some difficulty in [appointing] any one to cooperate with Dr. Scott who was not at variance with him.”Footnote 41 Still, the London bureaucrats had only encountered Bowerbank through their reading of his acrimonious correspondence. They did not know him, and many internalized the governor's overwhelming suspicions of the doctor.
Convinced that no “justice” could be found in Jamaica, Bowerbank traveled to London to meet the secretary of state for the colonies, novelist Sir Edward Bulwer-Lytton.Footnote 42 He arrived in early March 1859, but the Colonial Office rejected his request. Any investigation had to happen “in Jamaica & not in England,” they insisted.Footnote 43 The response was the same when a Cornish MP requested an imperial commission investigate.Footnote 44 Desperate, Bowerbank turned to Anthony Ashley-Cooper, 7th Earl of Shaftesbury, a philanthropist, evangelical politician, and lunacy reformer. As chair of the Lunacy Commission, Shaftesbury oversaw the rolling out of moral management across England and Wales.Footnote 45 Well versed in Bowerbank's arguments, Shaftesbury called for the imperial government to investigate the Jamaican doctor's charges.Footnote 46 His involvement was not welcomed.Footnote 47
Jamaica's constitutional configuration—with so much power resting in the Assembly—prevented imperial investigations even in matters of humanitarian concern, and officials highlighted these limits when they responded to Shaftesbury. Taylor described the earl's recommendations as “inexpedient, if not impracticable,” likely to offend “the Legislature & the local Authorities in Jamaica.”Footnote 48 Since “Jamaica is a Colony engaging in the forms of responsible Govt,” another staffer wrote, the Colonial Office could not mandate directions about even the structural layout of the asylum. To be sure, there was confusion, even within the Colonial Office, as to the precise nature of the constitutional arrangement. An early draft originally described Jamaica as “a self-governed Colony,” before that phrase was crossed out and replaced in the margins with “engaging in the forms of responsible Govt.”Footnote 49 Still, these bureaucrats characterized the Jamaican legislature as “jealous of its authority” and likely to “refuse anything which might be demanded of it in a spirit of dictation & reproach.”Footnote 50 Accordingly, neither the Colonial Office nor the Lunacy Commission could send investigators.Footnote 51
While by many measures, Bowerbank's trip seemed a failure—he never met with secretary of state Bulwer-Lytton or his successor, the Duke of Newcastle, nor had the Colonial Office intervened in the controversy—his trip expanded the scope of the scandal, which now had a metropolitan dimension. By calling on Shaftesbury for help, he inserted the Lunacy Commission into the scandal, an organization deeply invested in the principles of moral management. Their presence validated the argument that British standards were the only suitable model for colonial institutions. Furthermore, after his visit, Colonial Office staffers began to send copies of most asylum-related dispatches from Jamaica to the Commissioners, frequently with questions about standard asylum practice, another tacit promotion of the British model.Footnote 52
Bowerbank's visit also sparked an airing of his concerns in the British press, as articles spoke pointedly toward the broader ideals of British humanitarianism that Jamaican officials were abandoning. In an August 1859 editorial in the Times written by someone called “B,” likely Bowerbank, the author praised the reformed asylums in Britain. Moral management's success should have inspired British colonial administrators, he wrote. Instead, “[l]ocal divisions, local bickerings, and party politics are seen to becloud the mental vision of the colonial administrators when the interests of the insane are put forward.” Moreover, the author insisted, the conditions within the asylum were a stain on the empire more broadly. “[O]ne would hesitate to credit its existence in an English settlement, and still more so in one so long administered under the British crown,” he wrote. “It is a disgrace, a blot upon the civilization of the people of Jamaica, allied as they are to the British nation.” In other words, by not implementing moral management, the colonial administration was failing to uphold British precepts of humanitarianism and philanthropy.Footnote 53 Articles of this kind functioned in two ways.Footnote 54 Not only did they bring the Kingston asylum case to the attention of a larger public, they also identified “moral management” as the epitome of English—at times, British—imperial values, making colonies that chose not to import this standard insufficiently English.
The Proofs
One thing was clear after Bowerbank's trip: only a certain kind of evidence—incontrovertible proof of patients clearly harmed by treatment regimens that went against both moral management and imperial ideas of good governance—could push the Colonial Office to disrupt the constitutional arrangement. Reports of this kind were most valuable, moreover, if they had clear human stakes. Two such revelations emerged in 1860, and together they convinced the Colonial Office to intervene. The first was the testimony presented to the Jamaica Assembly that mortality rates were, at 27 percent a year, higher than they should have been.Footnote 55 Even accounting for patients suffering from poverty, old age, or other ailments, Colonial Office clerks still felt the death toll was too high, especially after the Lunacy Commission reported that “a well conducted County Asylum in England” usually had mortality rates between 11 and 12 percent.Footnote 56 Once again, both the commissioners and the Colonial Office affirmed the British institution as the guide for best practices, appropriate conditions, and acceptable death rates.
The second revelation—that asylum staff were not merely failing to implement moral management but were instead actively abusing women patients—was even more significant and truly galvanized metropolitan action. It also came from a surprising source. Ann Pratt, a mixed-race Jamaican woman in her late twenties, was admitted to the asylum in January 1860, after legal proceedings against the men she accused of raping her turned against her instead. She left the asylum in July 1860, and days later sent Darling a copy of a pamphlet she had written, along with a request that he send a copy to the “Colonial Minister.” In Seven Months in the Kingston Lunatic Asylum, and What I saw There, published, and perhaps written, with the help of Bowerbank, Pratt recounted numerous incidents of staff violence toward patients, abuses she had either experienced herself or witnessed. Nurses and attendants dragged patients around the grounds, punched and hit them repeatedly, and teased and mocked patients who asked for food or assistance. At times, they enlisted other patients to help them carry or drag patients around. Women were most frequently subjected to this abuse, and the pregnant, ill, and elderly were not spared.Footnote 57
Especially damning were Pratt's descriptions of a practice she called “tanking,” whereby asylum staff dunked patients in bathing tanks and held them underwater. Tankings frequently functioned as punishment and, according to Pratt, they could be lethal. One elderly woman, Margaret Reed, died days after a tanking. Louise Cochran also died a few days after her mother had discharged her from the asylum. Overseeing all of this violence, including tanking, was the asylum's matron, Judith Ryan, who routinely beat patients, stole their food, and coerced them into providing labor in her home. Pratt's writing made clear that the asylum was, at best, a place of incarceration rather than care. At worst, it brought patients more torment and potentially death.Footnote 58
Seven Months marked the major turning point in this scandal. First, the pamphlet sharpened the focus on the asylum specifically, for while the physical conditions within the hospital were poor, it was only in the asylum where patients were viciously punished for being ill. More importantly, Pratt's narrative injected real stakes into what had previously been an abstract debate over asylum standards. Bowerbank had never mentioned tanking or staff violence toward patients in his original pamphlets—given his thoroughness, he must have been unaware of tanking—and the violence he did mention was that between patients. To be sure, he had insisted that patients were suffering due to the poor conditions, but now London officials were reading about the severe beatings of the most vulnerable of women. It was no longer the abstract conditions that were harming patients, but the people tasked to take care of them. This was a problem that could no longer be fixed by relying on Jamaican officials, especially not now that prominent metropolitan observers were paying attention to the case's developments.
Moreover, tanking swiftly came to represent all asylum violence. Colonial Office bureaucrats considered tanking unusual and unacceptable, proof that the Kingston facility was not operating under moral management. After the pamphlet's arrival in London, officials began to ask serious questions about asylum practices. Moreover, Seven Months may have also inspired other patients to fight against their tormentors. In a September 1860 letter, head physician Scott claimed that patients believed they could invoke Bowerbank's name to block further abuse. “It is remarkable,” he complained, “that the name of Doctor Bowerbank is constantly introduced by them, especially when they are directed to do anything in the Institution. … [T]hey then threaten to make complaints to that person, and express their determination to see him so soon as they leave the Asylum.”Footnote 59 Pratt had met Bowerbank soon after she was released from the asylum, and so the specifics of her experience must have become common knowledge, as patients used Bowerbank's name as a weapon to stave off violence.Footnote 60
The new focus on tanking continued during the spring 1861 trial of Matron Ryan and three asylum nurses for an assault on Harriett Jarrett, a patient who had died in the asylum in either late May or early June 1860. Jarrett had reportedly entered the asylum in decent physical health but was then battered and tanked repeatedly by Ryan and the nurses. Pratt and another patient, Henrietta Dawson, both described Ryan hitting Jarrett with her hands and other implements. Jarrett was also tanked and submerged underwater. Yet the defense successfully argued that Jarrett had entered the asylum in poor physical condition. An array of witnesses, including nurses, washerwomen, and medical staff, including Scott, testified that she was feeble, riddled with venereal diseases, and “deranged.” After no more than five minutes’ deliberation, the jury found the women innocent.Footnote 61 Darling chose not to reinstate them.Footnote 62
Their acquittal only amplified metropolitan concerns about tanking, and the Duke of Newcastle's skeptical response to the news demonstrated the Colonial Office's deep engagement with the problems in Jamaica.Footnote 63 Newcastle and his colleagues now believed Bowerbank, and with this new conviction came a drive to seek the truth about the asylum, regardless of what Darling, Scott, or trial verdicts might say. Not only did the Colonial Office demand a more detailed account of trial proceedings—Darling's initial dispatch was sparse, with no accompanying documents to explain the trial or the verdict—but Newcastle pressed specifically for information about whether “‘tanking’ has been resorted to in the Lunatic Asylum … for purposes of punishment, discipline or intimidation.”Footnote 64 He was not easily mollified by Darling's insistence that tanking was an unavoidable accident, caused primarily by the mental defects and volatility of black Jamaicans. Darling explained,
[t]here are few people for whom so much allowance should be made in respect to occasional loss of temper and exhibition of force, as those whose natural passions have not been moderated by civilizing influences, and who being themselves of what may be called an African temperament are charged as subordinate Servants with the duty of handling and restraining violent lunatics for the most part of the same excitable Race.Footnote 65
Here, Darling was tapping into common ideas about black intelligence and laziness that were circulating throughout postemancipation imperial networks, including the Colonial Office. Yet while well known in the Colonial Office—senior West India Office clerk Henry Taylor had expressed some sympathy with these views—the horror of tanking surmounted these beliefs.Footnote 66
The Verdicts
In 1861, under continued imperial pressure, the Jamaican legislature created a local commission that conducted “a searching enquiry” into conditions in the hospital and asylum. The five-person panel included members of the legislative council, a Supreme Court assistant judge, and deputy inspector-generals of the army and naval hospitals.Footnote 67 Each commissioner was granted the powers of judges and could jail those who refused to appear before the panel.Footnote 68 The commission held meetings at the Kingston courthouse for several months. The first witness was Bowerbank, who spent two days repeating his exhaustive criticisms of both facilities. “[T]he present Lunatic Asylum will never allow the moral or modern treatment to be pursued,” he insisted.Footnote 69 The commissioners then interviewed an impressive array of witnesses: doctors (including head physician James Scott), nurses, other staff members and some of their lovers, Inspector Trench, patients, friends and relatives of patients, and other visitors. Ann Pratt's case came up repeatedly: not only did she appear before the committee several times but witnesses, including the wife of the ship's captain, also testified to her sanity before her admission to the asylum and the dreadful condition she was in after she left.Footnote 70 By November 1861, the commission finished its investigation and submitted its report to the governor.
The commission's findings vindicated Bowerbank completely. At no point “ha[d] anything like systematic curative treatment” been the main goal, they wrote. Instead, medical staff focused more on physical ailments than mental ones, and indeed the institution more likely worsened the condition of patients than cured them.Footnote 71 Tanking was the most evocative symbol of widespread neglect. The commissioners gave it “the first and most prominent place” in their report, for it had occasionally hastened the death of the women who experienced it. Tanking “was the established punishment and means of coercion,” they explained. Moreover, “[t]hat the dread of it might sink as deeply as possible into the insane mind, it was the frequent practice to threaten it one day, and not carry out the threat till the following.” The practice did not end until after Matron Ryan's dismissal in summer 1860.Footnote 72 While the doctors may not have known the full extent of the violence in the asylum, the commissioners acknowledged, they likely suspected and chose not to investigate. That these physicians would have turned a blind eye was “a dereliction of the gravest character.”Footnote 73 Yet, the commission found, Scott was compromised. He had owed money to Matron Ryan and her husband, a former superintendent of the men's asylum. He “left the control of the asylum almost entirely in her hands,” they noted, and he could not “too strictly [enquire] into [her] management.” His financial entanglements were thus directly responsible for the neglect of patients.Footnote 74
In their recommendations, the commissioners echoed the received wisdom from the Lunacy Commission. First, they praised the plans for the new asylum, which they believed was better suited for curing patients. “Lunatics are to find regular and systematic employment” in the asylum's garden. Work mitigated the cruelty of confining patients while giving them nothing to do. They also requested that other handicrafts and games be introduced, since “[i]n the better managed European asylums these resources are provided.” Second, the commissioners suggested an independent inspection system, in which knowledgeable physicians oversaw the asylums, not local politicians. These would be the men who would frequently inspect the facilities and conduct any required inspections. This new system would be more “accordant to the European model” than the previous system.Footnote 75
In the wake of this report, the Jamaican government took up several of the commission's recommendations. Although the legislature did not approve the recommended £16,000 grant, they did pass bills for two grants of £1,250 each to improve the sewers. An additional £2,000 was designated for the new asylum's completion. Darling charged Scott “with culpable neglect” and suspended him from his position. In Scott's place, Darling installed Dr. Andrew Dunn as temporary consulting surgeon, a man chosen for his seniority among Kingston physicians.Footnote 76
The commission's report inspired more universal pronouncements from the Colonial Office about the role colonial officials had in directly overseeing colonial asylums. Even as Newcastle criticized the Jamaican individuals responsible, he used broad prescriptive language to send a message beyond Jamaica. In response to Trench's claim that his job did not include inspecting the asylum at night, Newcastle insisted that “[t]here ought to have been no hour of the day or night nor corner of the Hospl. or Asylum in which the Attendants cd. have assured themselves that the Inspector might not make his appearance.”Footnote 77 Similarly, Newcastle had prescriptions for Governor Edward Eyre, Darling's replacement after taking a leave of absence in March 1862.Footnote 78 The governor's duty was to make unannounced inspections to all incarcerating facilities—hospitals, prisons, lepers’ asylums, workhouses, and “all public institutions of the same nature over which he has a controuling [sic] power.” On such visits, governors needed to inspect every corner of these premises thoroughly, “not merely to those portions to which the persons in charge of them may propose to conduct him.” They also needed to interview privately facility residents.Footnote 79
Newcastle's pronouncements were universal in tone because his audience was broader than Jamaica's governors. Indeed, the revelation that such crimes had been endemic in the Kingston asylum cast suspicion on similar institutions in other colonies, and the Colonial Office wondered whether Darling's approach was typical of governors, not an unfortunate exception. Henry Taylor noted that colonial governors might have assumed that these institutions were not their responsibility, since in England, “Hospls. are generally supported by voluntary contributions & supervised by those who support them.” This had certainly been Darling's view as well. But this assumption, if it was widely held among governors, was now firmly rejected by metropolitan bureaucrats: overseeing these institutions was now one of the governor's responsibilities.Footnote 80
Conclusion
In the end, Bowerbank won. Despite its limits, the Colonial Office upheld moral management as the British approach to asylum treatment against which colonial institutions were to be judged; tanking stood out as the most potent symbol of a colony's grievous departure from metropolitan practice. The lessons from Jamaica were applied widely across the empire, at least at first. Since the Colonial Office believed the Kingston asylum was symptomatic of a broader imperial problem, the senior West Indies clerk, Henry Taylor, sent a questionnaire to each colonial governor. The Colonial Office received thirty-three reports, which officials used to produce a final document that ordered colonial asylums to implement moral management throughout their facilities.Footnote 81 Moral management was now doubly confirmed: its elevation to official guiding standard for colonial asylums also reasserted it as the sanctioned protocol for British asylums. Furthermore, with governors now in charge of enforcing moral management in the colonies, the Colonial Office was manifestly pursuing bureaucratic as well as medical solutions to public health problems.
The asylum scandal demonstrates the value of a more capacious approach within British historiography to the postemancipation period in the Caribbean. Currently, the literature conceives of the period quite narrowly, both in temporal and thematic terms. Scholars often implicitly treat this phase as lasting about three decades, from 1834 or 1838 to 1865, during which time the economic underpinning of the plantation economies collapsed and the official mind shifted away from the Americas to the more promising African, subcontinental, and Pacific colonies. To be sure, this shift had cultural dimensions as well, as the civilizing mission gave way to a more pessimistic and cynical view of black subjects, one intimately bound up in emerging theories of biological racial difference that reached its apogee in 1865 and 1866, when Crown Colony rule was imposed and black subjects were stripped of political power.Footnote 82 Yet even this cultural shift was very much tied to labor concerns, a predominant theme within postemancipation scholarship.
The asylum scandal provides a path to thinking about broader conceptions of postemancipation rule. First, this was not a crisis primarily about labor but instead about the imperial government's responsibility to the chronically ill, who were at the constant whim of the state. Public institutions like asylums, hospitals, and prisons were intimate points of contact between freedpeople and the state––places where tonal shifts in imperial rule had swift and brutal impact on the daily lives of black subjects. Second, the scandal tested the humanitarian commitments of the British Empire. Decades after abolition, the plight of black subjects could still animate limited forms of humanitarian politics. Limited, because the question at the heart of this debate was the following: with humanitarian concerns still dictating the politics of care in nineteenth-century Britain, were the black imperial subjects of the Caribbean owed the same standards of care as their white counterparts in the metropole? And if they were, was the imperial state responsible for ensuring that metropolitan standards were met? Such questions reflected the previous two decades of postemancipation conflicts between freedpeople and white Britons. As white commentators grew more cynical about emancipation, they began to depart from the early abolitionist ethos that blacks were in theory due the same treatment as white subjects. And as these debates grew more heated, asylum patients––and other freedpeople––were caught between clashing ideologies of rule.
The scandal occurred toward the end of the postemancipation period (as conventionally understood), but its aftermath was shaped by the turmoil of the 1860s. If that decade marked the enshrining in law of the cynical, racist pessimism about the capacity of black subjects, then the true measure of what freedom from slavery accomplished is best assessed after that legal marker, not before. The state of the asylum before the scandal proved to be a prescient indicator: the conditions in which patients suffered before Bowerbank's intervention—and the racism toward freedpeople that allowed such neglect to set in—prefigured post-1860s attitudes to black subjects. The scandal's immediate aftermath may have reasserted the rights of black subjects to the same standards of care as afforded white Britons. But in practice, the results were much less salutary, as Darling's racism more accurately reflected daily conditions in the asylum, where any improvements were limited and temporary. While the new asylum was eventually finished, and an English physician was sent to Jamaica to oversee it, the legislature never fully funded refurbishment plans, nor did the hospital ever receive the promised drainage improvements. Within decades of the scandal, the asylum was once again notorious for its abominable conditions.Footnote 83
