`Cure, comfort and safe custody': public lunatic asylums in early nineteenth-century England

This is a slightly unsatisfying book on an excellent subject. The treatment of mental illness in southwestern Nigeria is widely known from the Aro Mental Hospital, opened during the Second World War and conducted between 1954 and 1963 by Dr T A Lambo as an experiment in combining current Western therapies with indigenous practices in a village setting. Dr Sadowsky has had access to the Aro Hospital records, including case files, as well as the archival sources referring both to Aro and to its more conventional predecessor, the Yaba Lunatic Asylum of 1906. Sadowsky engages with a series of controversies in the history of mental illness, especially in Africa. In a rather slender account of mental care in precolonial southwestern Nigeria, he argues that Africans and Europeans of the time shared common views of madness, although not of appropriate institutions for treating it. Turning to the colonial period, he sees psychiatry as both a method of social control and a means of social reform, the tendency towards coercive control being strongest where patients were of low social status and culturally distanced from their doctors, as generally in colonial Africa. He then examines how colonial authorities decided whom to confine, finding that most were men who caused distress and confusion to those around them, but that-contrary to conventional wisdom at the time-African families were extremely reluctant to consign their relatives to dreaded custodial institutions, instead pressing eagerly for the release even of those who remained ill. Sadowsky's chief interest, however, is to elicit historical insights from patients' statements contained in the Aro Hospital case files, although he insists that such evidence is too exceptional to form the basis for generalizations, as colonial doctors were often tempted to do. Many of the statements quoted are extremely interesting and Sadowsky claims convincingly that they show how the content of insanity was specific to the time and place, but beyond this they give little more than an impression of incoherence. The problem with the book is that in pursuing these intriguing questions, Sadowsky has neglected to provide a consecutive history either of the Yaba and Aro institutions or of the colonial authorities' approach to the treatment of mental illness. If the Aro records are to be available to other historians, this failure can be remedied. If not, an important opportunity may have been lost.