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Building Psychiatric Expertise across Southeast Asia: Study Trips, Site Visits, and Therapeutic Labor in French Indochina and the Dutch East Indies, 1898–1937

Published online by Cambridge University Press:  14 July 2016

Claire Edington  and
Hans Pols
Claire Edington*
Affiliation:
University of California, San Diego
Hans Pols
Affiliation:
University of Sydney
*
cedington@ucsd.edu
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Abstract

This paper examines a series of research trips undertaken by French physicians in Indochina to the Dutch East Indies between 1898 and 1937 to study what they saw to be a successful model of a modern psychiatric service that had been developed there. Dutch experiments with forms of “open door” care and the use of patient labor as therapy, premised on earlier ideas of moral treatment, seemed to hold both therapeutic promise and the key to resolving pressing economic concerns faced by colonial psychiatric institutions. French physicians saw in neighboring Java fundamental ethnological and geographical similarities to Indochina, and Dutch successes in psychiatric assistance there raised the prospect of adapting practices the Dutch had developed to their own program in Indochina throughout the interwar years.

Type
Research Article
Information
Comparative Studies in Society and History , Volume 58 , Issue 3 , July 2016 , pp. 636 - 663
Copyright
Copyright © Society for the Comparative Study of Society and History 2016 

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References

1 Jeanselme, Edouard, “La Condition des Aliénés dans les Colonies Françaises, Anglaises et Néerlandaises d'Extrême-Orient,” La Presse Médicale (9 Aug. 1905): 497–98Google Scholar. In 1912, this article was presented to the Conference of French and Francophone Alienists and Neurologists in Tunis along with several photographs Jeanselme took on his trip.

2 Ibid.

3 For more on the French Indochina asylum system, particularly the adoption of occupational labor, see Edington, Claire, “Labor as Therapy: Agricultural Colonies and the Re-Education of the Insane in French Indochina,” Proceedings of the Western Society for French History 39 (2011): 267–77Google Scholar.

4 This story is part of a much longer history of French colonial interest in the Dutch East Indies, especially amongst academics. From 1878 to 1886, a group of scholars founded the Annales de l'Extrême-Orient, dedicated to the Indonesian archipelago and Malaysia, as well as India (“Inde trasngangétique”) and Indochina, or what we would consider today to be “South and Southeast Asia.” See Lombard, Denys, “Voyageurs Français dans l'Archipel Insulindien, XVIIe, XVIIe, XIXe Siècles,” Archipel 1 (1971): 141–68CrossRefGoogle Scholar; and Pelras, Christian, “Indonesian Studies in France: Retrospect, Situation and Prospects,” Archipel 16 (1978): 7–20CrossRefGoogle Scholar.

5 Frances Gouda, Dutch Culture Overseas: Colonial Practice in the Netherlands Indies 1900–1942 (Equinox Publishing, 2008), 45, and see note 44 on p. 253, where Gouda discusses the French Colonial Union's publication of a biweekly magazine that included a regular feature titled “The Netherlands Indies.” See also G. H. Bosquet, A French View of the Netherlands Indies (London: Oxford University Press, 1940). Even when Bosquet was critical of the Dutch perspective he praised them as a model for French efforts.

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7 Looking to other parts of the world was an important aspect of psychiatric practices at the time; the history of study trips in the history of psychiatry is well-documented. The Callan Park mental hospital near Sydney, opened in 1885, was designed by Frederick Norton Manning, who had taken two international research trips to study the architecture and design of asylums. See McDonald, D. I., “Frederick Norton Manning 1839–1903,” Journal of the Royal Australian Historical Society 58, 3 (1972): 190–201Google Scholar. The asylum was based on Thomas S. Kirkbride's On the Construction, Organization, and General Arrangements of Hospitals for the Insane (Philadelphia: s.n., 1854), which provided a template of the architecture of mental hospitals according to the principles of moral treatment. See Nancy Tomes, The Art of Asylum Keeping: Thomas Story Kirkbride and the Origins of American Psychiatry (Philadelphia: University of Pennsylvania Press, 1994).

8 This growing attention to inter-imperial and interregional encounters in the history of science and medicine is particularly striking among scholars of colonial Africa and the Caribbean. For instance, historian Deborah Neill's work on tropical medicine in colonial Africa has emphasized the importance of medical networks, travel, and conferences within the region; see Networks in Tropical Medicine: Internationalism, Colonialism, and the Rise of a Medical Specialty, 1890–1930 (Stanford: Stanford University Press, 2012). Other recent works exploring inter-imperial or interregional scientific connections include Prieto, Leida Fernandez, “Islands of Knowledge: Science and Agriculture in the History of Latin America and the Caribbean,” Isis 104 (2013): 788–97CrossRefGoogle Scholar; and Lachenal, Guillaume, “Médecine, Comparaisons et Echanges Inter-impériaux dans le Mandat Camerounais: Une Historie Croisée Franco-Allemande de la Mission Jamot,” Canadian Bulletin of Medical History 30, 2 (2013): 23–45CrossRefGoogle Scholar. In the history of psychiatry, increasing numbers of monographs and edited volumes are dedicated to comparative and global perspectives. See Sloan Mahone and Megan Vaughan, eds., Psychiatry and Empire (Basingstoke: Palgrave MacMillan, 2007); Roy Porter and David Wright, eds., The Confinement of the Insane: International Perspectives, 1800–1965 (Cambridge: Cambridge University Press, 2003); and Waltraud Ernst and Thomas Müller, eds., Transnational Psychiatries: Social and Cultural Histories of Psychiatry in Comparative Perspective c. 1800–2000 (Newcastle upon Tyne: Cambridge Scholars, 2010). While much of the focus of comparative work has been across national contexts, scholars have also begun to reach beyond the conceptual confines of single-country case studies in order to explore the transnational movements of institutions, forms, and experts. See Marijke Gijswijt-Hofstra, Harry Oosterhuis, Joost Vijselaar, and Hugh Freeman, eds., Psychiatric Cultures Compared: Psychiatry and Mental Health Care in the Twentieth Century (Amsterdam: Amsterdam University Press); and Anne Digby, Waltraud Ernst, and Projit Mukharji, eds., Crossing Colonial Historiographies: Histories of Colonial and Indigenous Medicines in Transnational Perspectives (Newcastle upon Tyne: Cambridge Scholars, 2010).

9 Many different definitions of Southeast Asia have been advanced. For some, it is best understood as a political unit that emerged in the postwar period and strengthened with the advent of Association of Southeast Asian Nations (ASEAN) in 1967. In 1933, Paul Mus used the term “Monsoon Asia” to offer an alternative definition of Southeast Asia as marked by a shared climate and geography. See Bayly, Susan, “Conceptualizing Resistance and Revolution in Vietnam: Paul Mus’ Understanding of Colonialism in Crisis,” Journal of Vietnamese Studies 4, 1 (2009): 192–205CrossRefGoogle Scholar. More recently, Anthony Reid has explored the many trade networks that tied the areas in Southeast Asia (and Asia) together, in Southeast Asia in the Age of Commerce, 1450–1680, Volume I: The Lands below the Winds (New Haven: Yale University Press, 1988); and Southeast Asia in the Age of Commerce, 1450–1680, Volume II: Expansion and Crisis (New Haven: Yale University Press, 1998). Still more recently, and of particular interest to this paper's focus on mental health, Sunil S. Amrith discusses the emergence of Southeast Asia as a region of knowledge and intervention within the twentieth-century development of transnational and international public health institutions. See Decolonizing International Health: India and Southeast Asia, 1930–1965 (Basingstoke, Hampshire: Palgrave Macmillan, 2006).

10 Arnold, David, “Tropical Governance: Managing Health in Monsoon Asia, 1908–1938,” ARI Working Paper 116 (2009), 1Google Scholar. For the role of international organizations in promoting global connections, see Akira Irye, Global Community: The Role of International Organizations in the Making of the Contemporary World (Berkeley: University of California Press, 2002). For examples of international health organizations, see Paul Weindling, ed., International Healh Organizations and Movements, 1918–1939 (New York: Cambridge University Press, 1995).

11 See Saha, Jonathan, “Madness and the Making of a Colonial Order in Burma,” Modern Asian Studies 47, 2 (2013): 406–35CrossRefGoogle Scholar; Ng Beng Yeong, Till the Break of Day: A History of Mental Health Services in Singapore: 1841–1993 (Singapore: Singapore University Press, 2001).

12 The success of the experiment owed as well to the energies of Dr. Vital Robert, who pioneered the use of agricultural colonies in Madagascar and in 1919 assumed the leadership of the Bien Hoa asylum. In West African and Caribbean colonies, psychiatric care was practically non-existent. In Algeria, it was developed under the guidance of Antoine Porot and the Algiers School, but it followed a different model and was restricted to white European patients until the 1930s. See Richard C. Keller, Colonial Madness: Psychiatry in French North Africa (Chicago: University of Chicago Press, 2007).

13 For more on histoire croisée, see Werner, Michael and Zimmerman, Bénédicte, “Beyond Comparison: Histoire Croisée and the Challenge of Reflexivity,” History and Theory 45, 1 (2006): 30–50CrossRefGoogle Scholar.

14 On asylums before the nineteenth century, see Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in Historical Perspective (Berkeley: University of California Press, 1989); Andrew Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700–1900 (New Haven: Yale University Press, 1993); and Roy Porter, Mind-Forg'd Manacles: A History of Madness in England from the Restoration to the Regency (London: Athlone, 1987). For moral treatment, see Charles L. Cherry, A Quiet Haven: Quakers, Moral Treatment, and Asylum Reform (Madison, N.J.: Fairleigh Dickinson University Press, 1989); and Jan Goldstein, Console and Classify: The French Psychiatric Profession in the Nineteenth Century (New York: Cambridge University Press, 1987), 64–119.

15 For Pinel's monograph, see Philippe Pinel, Traité Médico-Philosophique Sur l'Aliénation Mentale, ou la Manie (Paris: Richard, Caille, et Ravier, 1801). For a description of the York Retreat, the first institution in the United Kingdom to implement moral treatment, see Samuel Tuke, Description of the Retreat, an Institution near York for Insane Persons of the Society of Friends, Containing an Account of Its Origin and Progress, the Modes of Treatment, and a Statement of Cases (London: Dawsons, 1964 [1813]). The ideas on moral treatment originated among the religious group of the Quakers and only later did physicians adopt them. For a frequently used manual for the construction of asylums according to the principles of moral treatment, see Thomas Story Kirkbride, On the Construction, Organization, and General Arrangements of Hospitals for the Insane with some Remarks on Insanity and Its Treatment (Philadelphia: s.n., 1854). For a useful analysis of the regimentation of everyday life in institutions organized according to the principles of moral treatment, see Nancy Tomes, The Art of Asylum Keeping: Thomas Story Kirkbride and the Origins of American Psychiatry (Philadelphia: University of Pennsylvania Press, 1994).

16 On Schroeder van der Kolk, see Joost Vijselaar and Timo Bolt, J.L.C. Schroeder van der Kolk en het Ontstaan van de Psychiatrie in Nederland (J.L.C. Schroeder van der Kolk and the origin of psychiatry in the Netherlands) (Amsterdam: Boom, 2012). For an overview of psychiatry during this period, see Harry Oosterhuis and Marijke Gijswijt-Hofstra, Verward van Geest en Ander Ongerief: Psychiatrie en Geestelijke Gezondheidszorg in Nederland (1870–2005) (Confused of mind and other discomfort: psychiatry and mental health care in the Netherlands, 1870–2005), 3 vols. (Houten: Bohn Stafleu van Loghum, 2008), 30–56.

17 Binneveld, J.M.W. and van Lieburg, M. J., “De Eerste Psychiatrische Revolutie in Nederland: Een Revolutie die Niemand Wilde (The first psychiatric revolution in the Netherlands: a revolution nobody wanted),” Tijdschrift voor Psychiatrie 20 (1978): 517–34Google Scholar.

18 Harry Oosterhuis and Jessica Slijkhuis, Verziekte Zenuwen en Zeden: De Opkomst van de Psychiatrie in Nederland (1870–1920) (Diseased nerves and morals: the development of psychiatry in the Netherlands, 1870–1920) (Rotterdam: Erasmus, 2012).

19 F. H. Bauer and W. M. Smit, Verslag van het Onderzoek naar den Tegenwoordigen Toestand van het Krankzinnigenwezen in het Algemeen en van de Gestichten en Verblijven der Krankzinnigen in Nederlandsch Indië in het Bijzonder, met Aanwijzing der Middelen Welke tot Verbetering Kunnen Worden Aangewend, op Last der Regering Ingediend (Report on the investigation of the current state of affairs in the care for the insane in the Dutch East Indies, with recommendations) (Batavia: Landsdrukkerij, 1868).

20 See ibid. For Gheel, see 88–93; for the agricultural colonies Fitz-James and Villers, 113–25. There are passing references to Hanwell and Conolly; the authors likely assumed that the principles of non-restraint were well known.

21 The description of Meerenberg takes up a significant part of the report. See Bauer and Smit, Verslag, 97–113.

22 This ideal image contrasted with stereotypes of natives as emotional, unpredictable, duplicitous, and above all averse of working, and others of alienated, uprooted, and disgruntled educated natives living in the larger urban centers fostering social discontent and unrest and fomenting political agitation. See, for example, Hussein Syed Alatas, The Myth of the Lazy Native: A Study of the Image of the Malays, Filipinos and Javanese from the 16th to the 20th Century and Its Function in the Ideology of Colonial Capitalism (London: F. Cass, 1977); and Hans Pols, “The Nature of the Native Mind: Contested Views of Dutch Colonial Psychiatrists in the Former Dutch East Indies,” in Sloan Mahone and Megan Vaughan, eds., Psychiatry and Empire (London: Palgrave MacMillan, 2007), 172–96.

23 See Marieke Bloembergen, De Geschiedenis van de Politie in Nederlands-Indië: Uit Zorg en Angst (Leiden: KITLV/Boom, 2009); or the Indonesian translation by Marieke Bloembergen, Polisi Zaman Hindia Belanda: Dari Kepedulian dan Ketakutan (Jakarta: Kompas Gramedia Group/KITLV Press, 2011). See also Bloembergen's “The Dirty Work of Empire: Modern Policing and Public Order in Surabaya, 1911–1919,” Indonesia 83 (2007): 119–50Google Scholar; and “The Perfect Policeman: Colonial Policing, Modernity, and Conscience on Sumatra's West Coast in the Early 1930s,” Indonesia 91 (2011): 165–91Google Scholar.

24 By 1882, land acquisition and building construction had cost f 1.500.000, a considerable sum. See Swaving, C., “Het Centraal Krankzinnigengesticht te Buitenzorg (The central insane asylum at Buitenzorg),” De Indische Gids 2, 1 (1880): 337–79Google Scholar. A few comprehensive reports on the Buitenzorg asylum appeared: L.B.E. Ledeboer, Verslag omtrent het Krankzinnigengesticht te Buitenzorg over het Jaar 1892, Benevens een Korte Geschiedenis Dier Inrichting Sedert Hare Oprichting (Report of the insane Asylum at Buitenzorg for the year 1892, as well as a short history of this institution since its founding) (Batavia: Landsdrukkerij, 1894); L.B.E. Ledeboer, Verslag omtrent het Krankzinnigengesticht te Buitenzorg over het Jaar 1893 (Report on the insane asylum at Buitenzorg for the year 1893) (Batavia: Landsdrukkerij, 1894); Johan Wilhelm Hofmann, Bericht Ueber die Landesirrenanstalt in Buitenzorg (Java, Niederl.-Ostindien) Von 1894 bis Anfang Juli 1901 (Notice about the mental asylum at Buitenzorg) (Batavia: Landsdrukkerij, 1902); S. Lijkles, Verslag omtrent het Gouvernements Krankzinnigengesticht te Lawang (Residentie Pasoeroean) Vanaf de Opening op 23 Juni 1902 tot Ultimo 1905, Benevens een Overzicht van de Wordingsgeschiedenis Daarvan (Report on the government mental asylum at Lawang (Pasuruan Residency) from the opening on 23 June 1902 to 1905, as well as an overview of its development) (Batavia: Landsdrukkerij, 1906).

25 Travaglino, P.H.M., “Het Krankzinnigenwezen in Nederlandsch-Indië (Care for the insane in the Dutch East Indies),” Bulletin van den Bond van Geneesheren in Nederlands-Indië 19, 211: 2–22Google Scholar; 212: 2–24; 213: 2–35 (all 1923).

26 A report written twenty-five years later included an extensive overview of colonial hospitals for the indigenous population and a scathing critique of their deficiencies: J. Bijker, Rapport der Commissie tot Voorbereiding eener Reorganisatie van den Burgerlijken Geneeskundigen Dienst (Report of the Commission for the Preparation of a Reorganization of the Civil Health Service) (Batavia: Landsdrukkerij, 1908), 199–223.

27 A., “De Verandering van het Krankzinnigengesticht te Buitenzorg in een Centraal Militair Hospitaal (A proposal to change the Buitenzorg insane asylum into a central military hospital),” Bataviaasch Handelsblad, 30 Dec. 1881: 3.

28 Hofmann, J. W., “Krankzinnigenverpleging in Neerlandsch-Indië (Care for the insane in the Dutch Indies),” De Indische Gids 16, 2 (1894): 981–1003Google Scholar.

29 Pol, D. J. Hulshoff, “Het Bouwen van Annex-Gestichten te Lawang (Building annex institutions at Lawang),” Psychiatrische en Neurologische Bladen 21 (1917): 166–83Google Scholar.

30 Engelhard, C. F., “Psychiatrische Cijfers uit Java (Psychiatric statistics from Java),” Psychiatrische en Neurologische Bladen 29, 6 (1925): 326–40Google Scholar.

31 Pols, Hans, “The Psychiatrist as Administrator: The Career of W. F. Theunissen in the Dutch East Indies,” Health and History 14, 1 (2012): 143–64CrossRefGoogle Scholar.

32 Report of the Netherlands Indies, Intergovernmental Conference of Far-Eastern Countries on Rural Hygiene: Preparatory Papers (Geneva: League of Nations Health Organization, 1937), 199.

33 Even in Algeria, where Antoine Porot's clinic opened to much acclaim in 1911, innovations arose in the context of treating European patients. While Algeria was considered a crucible for colonial mental health reform, it would be two decades before it adopted a comprehensive system targeting indigenous communities. In the 1930s Indochina was praised by international visitors for having made the “most serious efforts” at psychiatric assistance in all the empire. For the history of psychiatry in French North Africa, see Keller, Colonial Madness. On metropolitan praise of Indochina's mental health program, see H. Aubin, L'Assistance Psychiatrique Indigène aux Colonies: Rapport de Congrès des Médecins Aliénistes et Neurologistes de France et des Pays de Langue Francaise, XLIIe session—Alger 6–11 Avril 1938 (Paris: Masson et Cie, 1938).

34 Drs. H. Réboul and E. Régis, “L'Assistance des aliénés aux colonies,” Congrès des médecins aliénistes et neurologistes de France et des pays de langue française. XXIIe session. Tunis, 1er–7 Avril 1912 (Paris: Masson et Cie, 1912), 113. Henri Réboul was Director of the Public Health Service in French Indochina at the time.

35 Ibid.

36 See, for example, Regis, E., “La Condition des Alienes dans les Colonies Néerlandaises (Legislation et Assistance),” Journal de Medecine Legale Psychiatrique 3 (1906): 97–107Google Scholar; Trung Tam Luu Tru Quoc Gia 2 (TTLT2), Goucoch, IA.8/274(4), Asile des aliénés: Documents relatifs aux asiles d'aliénés à Java (rapports—documents photographiques sur la reglèmentation et aménagement des asiles alienes de Java). The file does not contain the reports or accompanying photos, but holds a brief letter describing the mission.

37 For more on the history of Indochina's health service, see Laurence Monnais-Rousselot, Medecine et Colonisation: L'aventure Indochinoise, 1860–1939 (Paris: CNRS Editions, 1999).

38 On the innovative qualities of the 1930 law, see Pierre Dorolle, La Légilsation Indochinoise sur les Aliénés: Exposé et Commentaire des Dispositions du Décret du 18 Juillet 1930 (Saigon: Imprimerie A. Portail, 1941).

39 On issues surrounding families and patient confinement, see Edington, Claire, “Going in and Getting out of the Colonial Asylum: Families and Psychiatric Care in French Indochina,” Comparative Studies in Society and History 55, 3 (2013): 725–55CrossRefGoogle Scholar.

40 They were cared for by asylum directors chosen from French civilian or military doctors who had either served as a chief doctor at an asylum or psychiatric clinic in the metropole or had completed a “stage” or internship in psychiatry in a French asylum. They were assisted by a corps of indigenous medical doctors trained at Hanoi Medical University (where psychiatry was introduced in the curriculum in 1934), along with a large staff of indigenous nurses and wardens and an auxiliary crew of chefs, gardeners, and maintenance workers.

41 The belief that most patients had been farmers was not merely impressionistic; psychiatrists kept detailed records on every patient that entered the asylum that included their race, age, gender, home province, any criminal background, and profession. These records were compiled and analyzed in annual asylum reports. “Farmer” was by far the most common occupation. See, for example, TTLT2, Goucoch, IA.8/2912(1), “Repartition par Profession,” Rapport Annuel de Bienhoa, 1926.

42 Nguyen van Hoai would become the institution's first Vietnamese director in 1954, and the first scholar to document its organization. See his doctoral thesis: De l'Organisation de l'Hopital Psychiatrique du Sud-Vietnam (Saigon: Imprimerie Francaise d'Outre Mer, 1954).

43 See Congrès des Médecins Aliénistes et Neurologistes de France et des Pays de Langue Française: 30e Session, Genève-Lausanne, 2–7 Août 1926: Comptes-rendus (Paris: Masson et Cie, 1926).

44 A recent edited volume describes the widespread adoption of work as therapy in institutions around the world: Waltraud Ernst, Work, Psychiatry and Society, c. 1750–2010 (Manchester: Manchester University Press, 2016).

45 For a breakdown of all injections delivered at Bien Hoa in 1934, see Centre de Documentation de l'Institut de Médecine Tropicale de la Service de Santé des Armées (PHARO), 182, Rapport Annuel d'Ensemble (1934), Fonctionnement de l'Asile de Bien Hoa. Electroshock therapy was later practiced in Indochina and the Dutch East Indies. See Dorolle, Pierre, “Traitement Palliatif de l'Epilepsie Essentielle par la Convulsivothérapie Electrique (électro-choc) (Note Préliminaire),” Revue Médicale Francaise d'Extreme-Orient 20 (1942): 835Google Scholar. Asylums in both colonies undertook medical research and experiments with somatic treatment methods and analyzed culture-bound syndromes. In the Dutch case see, for example, van Loon, F. H., “Amok and Lattah,” Journal of Abnormal & Social Psychology 21, 4 (1927): 434–44CrossRefGoogle Scholar. On koro, see van Wulfften Palthe, P. M., “Koro: Eine Merkwürdige Angsthysterie (Koro: a peculiar anxiety neurosis),” Internationale Zeitschrift für Psychoanalyse 21, 2 (1935): 248–57Google Scholar.

46 On colonial labor regimes in Vietnam see, for instance, Murray, Martin J., “‘White Gold’ or ‘White Blood’? The Rubber Plantations of Colonial Indochina, 1910–1940,” Journal of Peasant Studies 19, 3–4 (1992): 41–67CrossRefGoogle Scholar. In the Dutch East Indies, the emphasis on labor and work in asylums coincided with the gradual transformation of the Indies from a trading empire into an area cultivated and made profitable by indigenous labor on plantations owned and run by Western companies. See Ann Laura Stoler, Capitalism and Confrontation in Sumatra's Plantation Belt, 1870–1979 (Ann Arbor: University of Michigan Press, 1985); Jan Breman, Taming the Coolie Beast: Plantation Society and the Colonial Order in Southeast Asia (Delhi and New York: Oxford University Press, 1989).

47 Archives Nationales d'Outre Mer (ANOM), Résidence Supérieur au Tonkin Nouveau Fonds, 3678, L'Inspecteur Général de l'Hygiène et de la Santé Publiques à Monsieur le Gouverneur Général de l'Indochine (Direction des Affaires Economiques et Administratives), 30 June 1936.

48 Ibid.

49 For more on the financial returns of the Bien Hoa asylum during the 1920s, see Roussy, Dr., “Rapport sur le Fonctionnement de l'Asile d'Aliénés de Bienhoa (Cochinchine),” Annales de Medicine et de Pharmacie Colonials 24 (1926): 34–56Google Scholar.

50 The health budget for Indochina dropped from 10,034,000 piasters in 1931 to 6,935,000 in 1935, only to rise again in 1936 with the arrival of the Popular Front government in France. Despite periodic investments in strengthening Indochina's health service, health comprised less than 1 percent of general budget for Indochina and only 10–15 percent of local budgets during the 1930s. See Monnais-Rousselot, Medecine et Colonisation, 80–82.

51 Ibid.

52 TTLT2, Goucoch, IA.8/2912(3), Rapport Annuel de Bienhoa, 1927. See also TTLT2, Goucoch, IA.8/281(2), Rapport Annuel de Bienhoa, 1925.

53 While historians mention the use of occupational labor in other colonial settings, it is typically used to illustrate the abuses of the colonial asylum system rather than analyzed in terms of a real tension in practice. See, for example, Lynette Jackson, Surfacing Up: Psychiatry and Social Order in Colonial Zimbabwe, 1908–1968 (Ithaca: Cornell University Press, 2005), 160–61.

54 TTLT2, Goucoch, IA.8/2910, Le Directeur Local de la Santé en Cochinchine à Monsieur le Gouverneur de la Cochinchine, 24 Sept. 1927. See also TTLT2, Goucoch, 3730, Procès-Verbal de la Réunion du 23 Decembre 1935 de la Commission de Surveillance et l'Asile d'Aliénés de Bienhoa, 1935.

55 Trung Tam Luu Tru Quoc Gia 1, IGHSP, 50-03, Rapport Annuel de l'Asile d'Aliénés de Bienhoa, 1933.

56 ANOM, Résidence Supérieur au Tonkin Nouveau Fonds, Le Residént Supérieur au Tonkin, Yves Chatel, à Gouveneur Général (Direction des Services Economiques et Inspection Générale de l'Hygiène et de la Santé Publique), 12 Nov. 1937.

57 Hiring these patients, or failing to discharge them, was advantageous to the asylum since they were much more reliable as workers than were inmates severely incapacitated by mental illness. TTLT2, Goucoch, 281(1), Le Médecin Directeur de l'Asile à Monsieur le Gouverneur de la Cochinchine, 13 Sept. 1924. Dutch officials in the East Indies faced similar challenges, not just in terms of who would provide the care but who would pay for it. Starting in the 1930s, the expense of care was shifted from the colonial administration to the regency (kabupaten) the patient came from. This generated endless correspondence seeking those funds, though often without success. The intent was to stimulate the regencies to take their patients back.

58 Annick Guénel, “The 1937 Bandung Conference on Rural Hygiene: Toward a New Vision of Healthcare?” in Laurence Monnais and Harold J. Cook, eds., Global Movements, Local Concerns: Medicine and Health in Southeast Asia (Singapore: Singapore University Press, 2012), 62–80. See also Litsios, Socrates, “Revisiting Bandoeng,” Social Medicine 8, 3 (2014): 113–28Google Scholar.

59 Brown, Theodore M. and Fee, Elizabeth, “The Bandoeng Conference of 1937: A Milestone in Health and Development,” American Journal of Public Health 98, 1 (2008): 40–43CrossRefGoogle Scholar. Brown and Fee note that, following the 1937 conference, and especially after World War II, international health turned to technology based approaches and vertical programs, which supplanted the older “romantic” vision for rural health. For the Alma Ata conference, see Litsios, Socrates, “The Long and Difficult Road to Alma Ata: A Personal Reflection,” International Journal of Health Services 32 (2002): 709–32CrossRefGoogle Scholar.

60 For an overview, see Laurence Monnais and Hans Pols, “Health and Disease in the Colonies: Medicine in the Age of Empire,” in Robert Aldrich and Kirsten McKenzie, eds., The Routledge History of Western Empires (New York: Routledge, 2014), 270–84.

61 The Far Eastern Association of Tropical Medicine was created through an American initiative in the Philippines. The first congress was held in Manila in 1908, followed by meetings in Hong Kong (1910), Saigon (1913), Batavia (1921), Singapore (1923), Tokyo (1925), Calcutta (1927), Bangkok (1930), Nanking (1934), and Hanoi (1938).

62 On the International Health Board, see John Farley, To Cast out Disease: A History of the International Health Division of the Rockefeller Foundation (1913–1951) (New York: Oxford University Press, 2003).

63 Sunil S. Amrith, Decolonizing International Health: India and Southeast Asia, 1930–1965 (Basingstoke: Palgrave MacMillan, 2006), 36–42.

64 van Wulfften Palthe, P. M., “Krankzinnigenverpleging in Ned.-Indië (Care for the insane in the Dutch East Indies),” Geneeskundig Tijdschrift voor Nederlandsch-Indië 73, 3 (1933): 171–81Google Scholar. The article was simultaneously published in a relatively progressive journal devoted to colonial policy—Koloniale Studiën 17 (1933): 341–69—and as a pamphlet.

65 A number of psychiatrists reacted angrily to van Wulfften Palthe's critique: van Andel, J. C., “Eenige Opmerkingen naar Aanleiding van Prof. van Wulfften Palthe's ‘Krankzinnigenverzorging in Nederlandsch-Indië,’” Geneeskundig Tijdschrift voor Nederlandsch-Indië 73 (1933): 350–59Google Scholar; Theunissen, W. F., “Enkele Opmerkingen over het Artikel ‘Krankzinnigenverzorging in Nederlandsch-Indië’ van van Wulfften Palthe,” Geneeskundig Tijdschrift voor Nederlandsch-Indië 73 (1933): 365–71Google Scholar.

66 “Krankzinnigenverzorging: Rapport over de Denkbeelden van Prof. van Wulfften Palthe (The care of the insane: report on the ideas of Prof. van Wulffthen Palthe),” Bataviaasch Nieuwsblad, 24 Jan. 1935, sec. 1, p. 3. For a more comprehensive account of the report, see “De Krankzinnigenverzorging: De Resultaten van een Commissariaal Onderzoek (The care of the insane: results of the investigation by the commission),” Het Nieuws van den Dag in Nederlandsch-Indië, 14 Feb. 1935, sec. 5, p. 2.

67 “Tehuis voor Geestelijk Invaliden: Inwijdings-Slametan (Home for mental invalids: inauguration feast meal),” Het Nieuws van den Dag voor Nederlandsch-Indië, 21 Jan. 1935, pt. 2, p. 1.

68 For an overview of the first two years of Lenteng Agung, see: van Wulfften Palthe, P. M., “Krankzinnigenverzorging in Nederlandsch-Indië (Care for the insane in the Dutch East Indies),” Geneeskundig Tijdschrift voor Nederlandsch-Indië 77 (1937): 1267–80Google Scholar.

69 Report of the Netherlands Indies, Intergovernmental Conference of Far-Eastern Countries on Rural Hygiene: Preparatory Papers (Geneva: League of Nations Health Organization, 1937), 198–203.

70 Pols, “Psychiatrist as Administrator,” 150.

71 Report of the Netherlands Indies, 201.

72 ANOM, Fonds Guernut Bb, carton 22, “Note sur la Colonie Agricole d'Aliénés de Lenteng-Agoeng (Java) par le Dr. P. M. Dorolle,” Oct. 1937.

73 Annick Guénel describes French missions to the Dutch East Indies to study anti-malarial campaigns, in “Malaria, Colonial Economics and Migrations in Vietnam,” presented at the 4th Conference of the European Association of Southeast Asian Studies in Paris, 1–4 Sept. 2004. On comparative studies of ethnological characteristics, see Colani, Madeleien, “Essai d'ethnographie compare,” Bulletin de l'Ecole française d'Extrême Orient 36 (1936): 197–280CrossRefGoogle Scholar. There was also considerable French interest in new techniques for grafting rubber trees and clones, which improved yield and were first developed in the Dutch East Endies. Aso, Michitake, “Profits or People? Rubber Plantations and Everyday Technology in Rural Indochina,” Modern Asian Studies 46, 1 (2012): 19–45CrossRefGoogle Scholar, 21.

74 ANOM, Fonds Guernut Bb, carton 22, “Note sur la Colonie Agricole d'Aliénés de Lenteng-Agoeng (Java) par le Dr. P. M. Dorolle,” Oct. 1937.

75 Ibid.

76 Ibid.

77 ANOM, Résidence Supérieur au Tonkin Nouveau Fonds, Rapport au Sujet de la Création d'un Asile Colonie sur le Terrain de l'Asile de Voi par Dr. Grinsard, 5 June 1937.

78 ANOM, Résidence Supérieur au Tonkin, 3752, Gouvernor Général à Résident Superieur du Tonkin, 13 June 1938.

79 ANOM, Résidence Supérieur au Tonkin, Lettre du Gouverneur Général de l'Indochine à Monsieur le Resident Superieur au Tonkin, 7 June 1939.

80 ANOM, Résidence Supérieur au Tonkin, 3752, Heckenroth, l'Inspecteur Général de l'Hygiène et de la Santé Publiques à Monsieur le Gouverneur Général de l'Indochine, 9 May 1938.

81 ANOM, Résidence Supérieur au Tonkin, 3752, Lettre du Gouverneur General de l'Indochine à Monsieur le Resident Superieur au Tonkin, 7 June 1939.

82 ANOM, Résidence Supérieur au Tonkin Nouveau Fonds, Rapport au Sujet de la Création d'un Asile Colonie sur le Terrain de l'Asile de Voi par Dr. Grinsard, 5 June 1937.

83 ANOM, Résidence Supérieur au Tonkin, 3752, De Raymond, le Directeur Local de la Santé à Monsieur le Résident Supérieur au Tonkin, 17 Sept. 1937 (original underlining).

84 ANOM, Résidence Supérieur au Tonkin, 3753, Réunion de la Commission de Surveillance de l'Asile d'Aliénés du Voi, 5 Dec. 1940.

85 Préface, ix, in J. Chailley Bert, Java et ses Habitants (Paris: Armand Colin et Cie, Editeurs, 1900). The book was the third in a series that also included Les Anglais à Hong Kong, and Les Anglais en Birmanie.

86 Ann Laura Stoler and Frederick Cooper, “Introduction,” in Frederick Cooper and Ann Laura Stoler, eds., Tensions of Empire: Colonial Cultures in a Bourgeois World (Berkeley: University of California Press, 1997), 1–56. See also Volker Barth and Roland Cvetkovski, eds., Imperial Cooperation and Transfer, 1870–1930: Empires and Encounters (London: Bloomsbury Academic Publishing, 2015).

87 Winckel, C.W.F., “Indonesia before the War, II: The Public Health Service in Indonesia,” Documenta Neerlandica et Indonesica de Morbis Tropicis: Quarterly Journal of Tropical Medicine and Hygiene 1, 3 (1949): 201–8Google Scholar, 207. In 1934, a 40-minute informational film, with texts in English and French, was produced to demonstrate labor therapy at the Magelang asylum. See: http://www.kirimkabar.com/site/2014/10/24/terapi-untuk-orang-yang-tidak-waras-1934 (accessed 9 Aug. 2015).