Beyond the asylum: Colonial psychiatry in French Indochina, 1880-1940 Claire Ellen Edington Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy under the Executive Committee of the Graduate School of Arts and Sciences COLUMBIA UNIVERSITY 2013 2013 Claire Ellen Edington All rights reserved ABSTRACT Beyond the asylum: Colonial psychiatry in French Indochina, 1880-1940 Claire Ellen Edington This dissertation looks beyond the asylum to consider the development of psychiatry in French Indochina as the product of everyday exchanges between lay people and experts. Drawing on archival research conducted over two years in Vietnam and France - including hundreds of patient case files - I trace the movements of patients in and out of asylums and between prisons, poor houses, youth reformatories, hospitals and family homes. Together, these individual patient itineraries challenge our notion of the colonial asylum as a closed setting where patients rarely left, run by experts who enjoyed broad and unquestioned authority. Instead, they reveal how ideas about what it meant to be abnormal, as well as normal enough to return to social life, were debated between psychiatrists, colonial authorities and the public throughout the early decades of twentieth century. By examining the dynamics of patient movements in and out of psychiatric care, this study shifts our perspective from the asylum itself to its relationship with the world beyond its walls. Colonial scholars have focused on the way psychiatry provided a new scientific discourse of racial difference and how it figured within a wider biopolitics of colonial rule. However the social histories of the asylums themselves, and how they functioned within colonial political systems, remain little explored. I argue that by situating the history of psychiatry within the local dynamics of colonial rule, the asylum emerges as less of a blunt instrument for the control and medicalization of colonial society than as a valuable historical site for reframing narratives of colonial repression and resistance. Table of Contents Chapter 1: Getting out of the asylum: 1 writing the social history of psychiatry in French Indochina Chapter 2: The legal category of the ‘insane’ person in French Indochina: 28 a background to confinement Chapter 3: Patients, staff and the everyday challenges of asylum administration 83 Chapter 4: Going in and getting out of the colonial asylum: 135 families and the politics of caregiving Chapter 5: Labor as therapy: agricultural colonies and the re-education of the ‘insane’ 183 Chapter 6: Psychiatric expertise and Indochina's crime problem 227 Conclusion 266 Annex 273 Bibliography 295 i Annex list Map of French Indochina (1887-1954) List of Figures: Figure 1: Table of Patient Numbers and Days of Hospitalization at the Bien Hoa Asylum (1919- 1934) Figure 2: Chart of annual patient admittances at the Bien Hoa asylum (1919-1934) Figure 3: Map of the Bien Hoa Asylum, Cochinchina, 1927 Figure 4: Drawing of Pavilion for "Calm Patients," Bien Hoa Asylum, 1927 Figure 5: Plans for a "U" shape Pavilion, to be installed at the Voi Asylum in Tonkin, 1927 Figure 6: Model of the typical cell for patients in the "agitated wing" at Bien Hoa, 1927 Figure 7: European Pavilion, Bien Hoa, 1931 Figure 8: Graphic of Staff Mutations at the Bien Hoa asylum, from 1919 to 1933 Figure 9: Graphic of Patient Movements at the Neuropsychiatric Service, Chôquan Hospital, 1934 Figure 10: Entrance to Bien Hoa, 1934 Figure 11: Photo of Admission Building at the Voi Asylum, Tonkin Figure 12: Photo of a model of Bien Hoa that was handmade by patients and asylum guards that was included as part of a colonial exhibition in France in the 1930s Figure 13: Photo of the inside courtyard of the Voi Asylum, Tonkin Figure 14: Photo from the "Park" at the Bien Hoa Asylum, Cochinchna, 1931 Figure 15: Photo of the inside of one of pavilions for "calm" Vietnamese patients. Figure 16: Photo of patients tending to a vegetable garden at the Voi Asylum Figure 17: Patients help with the preparation of meals at the Voi asylum Figure 18: Photo of animal stables, Voi Asylum Figure 19: Photo of patients at Voi preparing the fields for rice cultivation Figure 20: Newly arrived patients at the asile colonie of Lengteng-Agoeng in 1934 ii Acknowledgments This dissertation would not have been possible without the support of many people. I would first like to thank my committee: Ronald Bayer, Susan Pedersen, Emmanuelle Saada, Kavita Sivarakrishnan and Kim Hopper. Their unique, and complementary, expertise on questions ranging from medical ethics to the history of empire was instrumental in shaping this dissertation into a much richer and more interesting story. I would especially like to thank Ronald Bayer for his years of patient support and Susan Pedersen who first taught me to trust my instincts as a historian. A special thank you is also owed to Emmanuelle Saada who challenged me every step of the way while also encouraging me to aim high. Eric Jennings was a source of important encouragement from the very start. He first introduced me to the archives in Aix-en-Provence and during this project's development has helped me to see the bigger picture. I am also indebted to Laurence Monnais and David Wright whose work on the history of colonial medicine in Indochina and the history of psychiatry respectively served as major inspirations for this dissertation and who I have since come to consider as valued colleagues and friends. I am eternally grateful to Jennifer Hirsch who, learning of my interest in French colonial history, asked me to join the then nascent partnership between the Mailman School of Public Health at Columbia University and Hanoi Medical University as a second year graduate student. Without her initial support I would not have found my passion for Vietnamese history and met those who have since become dear friends and colleagues. Among those scholars of Vietnam, I would like to extend special thanks to Michael Vann, Erik Harms, Mitch Aso, Caroline Herbelin, Stéphanie Ponsavady, David Deltesta and Christina Firpo for welcoming me into their world with open arms. iii In particular, Haydon Cherry who held my hand through the last year of graduate school and who has taught me so much about the craft of history, and of friendship. This project would not have been possible without the generous support provided by the National Institutes of Health pre-doctoral training program in Gender, Sexuality and Health, the Weatherhead East Asian Institute at Columbia University, the Alliance Program for Doctoral Mobility at Columbia University (with special thanks to Henri Bergeron at Sciences Po), the NIH- sponsored Social Science Training and Research Partnership and various travel awards made possible by the Mailman School of Public Health, the Vietnamese Studies Group and the French Colonial Historical Society. I am also grateful for the invaluable assistance provided by librarians and archivists across three continents. I would like to thank the staffs of the New York Academy of Medicine, the Archives Nationales de France in Aix-en-Provence, especially Olivia Pelletier for her knowledge of the Indochina collection, those at the Bibliothèque Interuniversitaire de Médecine in Paris and the Centre de Documentation de l’Institut de Médecine Tropicale de la Service de Santé des Armées in Marseille (PHARO), particularly Aline Pueyo who made doing research there so easy and enjoyable. In Vietnam, I would like to thank the staffs of the archives at National Archives Center No. 1 (Hanoi) and National Archives Center No. 2 (Ho Chi Minh City) and the National Archives of Cambodia in Phnom Penh. For providing essential logistical support during my research trips, I would also like to thank in Hanoi, the Ecole Française d'Extrême Orient and the Hanoi Medical University, and in Aix-en- Provence, the Association Février. In my travels, I have had the opportunity to extend my family circle for which I am profoundly grateful. In Vietnam, an especially heartfelt thank you is owed to Le Minh Giang, Asia Nguyen Cooper and Giles Cooper, Jenny and Lasse Melgaard, Jason Picard, and Phong Nguyen and iv his family, all of whom offered me a home away from home. And in France, Charlotte Legg, Francesca Hansen, Sarah Ghabrial and Cindy Ermus who, through their companionship and sense of adventure, made time working in faraway archives a real pleasure. At Columbia University, I am deeply appreciative for the occasion to have met such a brilliant group of friends and future colleagues: Anne Montgomery, Brendan Hart, Kirk Fiereck, Sara Lewis, Ronna Popkin, Mari Webel, Alison Bateman-House, Matthew Spooner, Elizabeth Hinton, Aimee Genell, Toby Harper, and Daniel Asen. At different points and in different ways, they have all lent critical support to this project's development over the years. I would also like to thank William McAllister, for his mentorship, and the other fellows of the Mellon Interdisciplinary Graduates Program who gently pushed the bounds of my thinking. I am also grateful to the women of the Columbia-NYU Colonial Public Health Workshop - Sarah Cook, Elisa Gonzalez, Maria John, Charlotte Legg and Jessica Pearson-Patel - who provided a real intellectual home for me in New York City. Exchanging our work and learning from you counts among the more fulfilling experiences I have had as a graduate student. I am especially grateful to Jessica Pearson-Patel who has been by my side for the last five years. I would not have wanted to go through this experience with anyone else. To my friends and family, no words can express my gratitude. In particular, I would like to thank Rachel Rosenberg and Rachel Barker for their compassionate and loyal friendship since long before I decided to attend graduate school.