1. Genealogies of the Intimate

As a more nuanced theoretical understanding of the committal and confinement of the insane has emerged in asylum scholarship in recent years, scholars have foregrounded the relationships between families and colonial lunatic asylums. This writing of families into asylums resists the top-down social-control view of psychiatric institutions as state-controlled repositories for the ‘dangerous’, ‘deranged’, ‘deviant’ and ‘defective’, and posits instead a more porous and processual view of custodial care which involved intricate negotiations between families, doctors and asylums in the admission and release of troubled and troublesome spouses, parents, children, siblings or servants.Footnote ¹ This porous view of custodial care finds the process of committal to implicate sometimes lengthy periods of home and community-based care of mentally ill family members before committal, as a last resort, to which they may intermittently return if and when released from the asylum.Footnote ² As Catharine Coleborne has argued referring to the colonial asylums in Australia and New Zealand, families actively participated in the custodial care, asylum admission and release of the mentally ill.Footnote ³ Thus, the different colonial contexts of asylums in the extant scholarship have accounted for variations in psychiatric, social and familial practices. This writing about the work that families do alongside asylums has run along several well-worn paths, which are guided by various methodologies for exploring the available archival materials of colonial asylums.

A broad socio-historical path has examined how the size, function and legitimacy of lunatic asylums swelled exponentially within the nineteenth-century forces of colonial expansion, industrial capitalism and psychiatric professionalisation.Footnote ⁴ Andrew Scull’s pivotal argument posited that families in England in this era effectively ‘dumped’ relatives in asylums due to the pressures of their waged employment to economically sustain their households.Footnote ⁵ This view has weathered several challenges. Through exploring the criss-crossing web of writing that passed between families, patients and asylums, other paths of scholarship have explored how families shaped the medical care and treatment their relatives received in asylums,Footnote ⁶ and cared deeply about their welfare.Footnote ⁷ Coleborne’s path-breaking research on the Australasian asylums, c.1860–1918, has pushed these ideas of family engagement in at least two useful directions. First, she reads archival materials to find traces of patients’ families ‘inside’ the asylum through physicians’ case notes, letters to and from asylum doctors, patients’ letters, visitors’ logbooks, committal papers and maintenance payments. Second, she examines how various emotions, between patients and families in relation to confinement, are performed in various correspondences.

Another path of asylum scholarship – answering Roy Porter’s call for evidence of patients’ experience, to rewrite medical history ‘from below’Footnote ⁸ – has attended to the patient’s voice in archival materials. This approach is exemplified in Allan Beveridge’s analyses of patients’ letters written from various British and Scottish asylums in the late nineteenth century.Footnote ⁹ Such analyses valorise patients’ authentic perspectives which are frequently found to be oppositional to the asylum regime; and as such, are seemingly unmediated by the medical or psychiatric gaze that ‘constructs’ asylum patients in particular ways.Footnote ¹⁰ In patients’ letters that have been retained in asylum archives, or not sent to addressees for whatever reason, Beveridge’s patients were found to object to wrongful confinement, deception by relatives, brutality from attendants, coarseness of other patients, and overcrowding in the asylum. An epistemological dilemma of historical asylum scholarship in this Porter-tradition is the selection of sometimes quaint, deluded or florid bits from many patients’ letters, which are clumped together as empirical evidence of general themes reflecting real patients’ agency or states of mind. Beveridge and his collaborators have responded to the apparent loss of contexts for patients’ statements in this thematic clumping with a raft of descriptive, historical case studies of individual inmates of various asylums.Footnote ¹¹ These detailed case studies feature real patients, usually certified with mania, who have distinguished themselves as prolific producers of letters, poems, published articles and drawings that have survived in the archives.

This paper moves along these various scholarly paths, but with some theoretical and methodological differences inspired by the writing of several Foucauldian scholars. The study is anchored to one white British South African man who became mentally ill, and his settler family, as an illness narrative that is told from multiple perspectives. This is not a case study of the Beveridge ilk, but following the theoretical ideas of David Armstrong, it is a carefully contextualised analysis of a ‘patient’ as a ‘subject’, which seeks to examine particular archival scenes of his construction and reconstruction within mental health care in South Africa between 1908 and 1911.Footnote ¹² For Foucault, narratives are understood through the forces of discourse, power and history,Footnote ¹³ rather than an articulation of an authentic voice of experience that we have ready access to. The illness narrative concerns Harry Walter Wilbraham, who, after a long struggle with headaches and worsening seizures, was medically boarded from his position as Postmaster in Idutywa, in the Cape of Good Hope Colony in South Africa, with ‘a permanent disease of the brain’ and was committed to the Grahamstown Asylum in 1910, where he died the following year, aged 40 years. Harry was my great-grandfather, and this familiarity has facilitated an opportunity to reflect on a shrouded aspect of my own family history. Thus, this scholarly paper pulls between two meanings and methods of ‘genealogy’ in reconstructing patient and practitioner views, while also addressing involvement of family members in mental health care and the stigma of mental illness.

Foucauldian genealogy involves the writing of a critical history which explores the processes, procedures and conditions by which truth and knowledge are produced through the discursive regimes of the era.Footnote ¹⁴ This interrogatory lens is ‘problem-based’; and in this study, this lens produces two interwoven biographical accounts. The first examines the construction of Harry’s patient-hood, as a ‘case’ diagnosed with general paralysis of the insane (GPI). The second examines how a settler family manages the calamity of losing a partner, father and breadwinner, and the uncertainty and silences around mental illness, against a context of domestic and colonial life, c.1888–1918. For Ann Stoler, genealogies of the intimate involve tracking how relations grounded in sex, sentiment, close association with bodies, the innermost and personal, child bearing and rearing, are performed in formal records and informal traces of how a household or ‘home’ works.Footnote ¹⁵ This historical tracking involves sifting through sprawling archival documents and narrative materials about a family, about a family member’s illness, looking for significant and accidental details that connect, reiterate, interrupt, challenge or destabilise in mapping how meaning was, is and might be made in daily life.Footnote ¹⁶ This genealogical study moves among the scattered official traces of Harry’s life and illness in an archive – the physician’s reports, admission records, asylum case notes, pension and estate documents, and a letter he wrote to his mother from the asylum.

Popular genealogy involves tracing ancestors and heritage to produce a family treeFootnote ¹⁷ and, by extension, ‘family narratives’ as the auto/biographical stories we tell and are told about our own families.Footnote ¹⁸ These include formal intergenerational testimonies and heirlooms, such as diaries, letters, family photograph albums or inherited furniture; and the regaled reminiscences about the remarkable and the mundane minutiae of family living – the childhood scrapes, the hard times, the holiday at the sea, the courtship yarn. Family narratives are not always stories of closeness, safety and stability with neat beginnings and endings.Footnote ¹⁹ Complicated family narratives of trauma or illness, tough choices, secrets, disappointments, disputes, desertion and death trouble us, if not within our own histories, then permeating our awareness through pervasive representations of these experiences in other families.Footnote ²⁰ This is where this genealogical paper swerves off the established paths of scholarship and biographies on families and colonial lunatic asylums. Because Harry was my great-grandfather, I have access to further layers of his construction through the family stories, secrets and silences about his illness and death; and I want to incorporate these memory traces of experiences and feelings as inaccessibly fractured, contested and irresolutely entangled in the present.Footnote ²¹ These traces outside formal archives include a handwritten letter, family photographs, a budget-diary kept by a young widow, and interviews with Harry’s living grandsons, my father and my uncle.

The contributions to historians of these Foucauldian ways of gathering and reading source materials are various. Against calls for more first-hand personal narratives in histories of mental illness,Footnote ²² this case-study provides a microcosmic view of one patient’s and one settler family’s experiences within the discursive practices of a particular mental health care system and colonial society. The intimate arrangements of family life, the stuff of family-storytelling and memoir, are powerfully drawn into historiographical scholarship that engages with how the dynamics of family support and withdrawal, and the stigma of mental illness resonate inter-generationally. The methodology of interweaving archival sources highlights gaps and speculations within primary materials, and contradictions between them, which in turn reproduce the contingency, multiplicity, fragmentariness, silencing and unknowability of mental illness. Modern medicine’s clinical gaze works within a restitution narrative, where we have come to expect that diagnosis leads to appropriate treatment and cure, with our lives and selves restored to go on as before.Footnote ²³ But, as Maria Tamboukou, a Foucauldian scholar of genealogical life-writing, has asked: what if such narrative sequence and continuity is not possible?Footnote ²⁴ Thus, this study contributes a meaning-making process that implicates many historically and discursively located protagonists and storytellers (including the author), and a life-story that is not easily resolved, rendered or represented.

The argument about Harry’s repeated reconstruction as a mentally ill patient/subject proceeds below in five parts that examine different frames of his patient-hood and unfolding, inter-textual sets of materials as evidence. First, to broadly set the scene, Harry’s ‘case’ is situated within historiographical scholarship about British colonial asylums and psychiatric care in the Cape of Good Hope Colony in South Africa in the late nineteenth century. Second, formal state archival sources and family-storytelling are deployed to produce a biographical account of his life, and the intimate familial arrangements around him. The following parts map three archival scenes of Harry’s illness narrative. Third, various physicians’ reports are used to account for Harry’s condition, leading up to his medical boarding, pensioning and committal. Fourth, a first-hand account by Harry of his own illness is examined. This took the form of a letter he wrote from the Grahamstown Asylum to his mother. And fifth, Harry’s asylum case-notes and archived estate papers are read to reconstruct his denouement and death.

2. Colonial Psychiatry and Asylums in South Africa

One of the more political or wide-angled contexts for the narrative of Harry’s illness from 1908 and subsequent confinement in the Grahamstown Asylum in 1910–11 might be tracked through South African historical scholarship on the escalation of colonial asylums in the Cape of Good Hope Colony during the nineteenth century. The early institutions – for example the Old Somerset Hospital and the Robben Island Lunatic Asylum in Cape Town, established in 1818 and 1846 respectively – were fairly undifferentiated in their incarceration of lepers, the chronically sick, paupers and the insane.Footnote ²⁵ However, colonial expansion, and the need for specialist facilities to contain the ‘mad’, soon led to the proliferation of asylums.Footnote ²⁶ The Eastern Cape Frontier was forged at the outer geographical limits of the Cape of Good Hope Colony through contact between (white) British settlers who were funnelled into the region in waves from 1820, as professionals, trades-people and farmers, alongside and displacing indigenous communities of (black) isiXhosa-speaking people.Footnote ²⁷ The Grahamstown Asylum was opened in 1875, using a disused British military barracks known as Fort England, and quickly became overcrowded, and stretched in terms of new admissions and transfers. For example, in 1909, the year preceding Harry’s committal, there was a daily average number of resident inmates in the Grahamstown Asylum of 396, made up of 267 men and 129 women;Footnote ²⁸ and the total number of cases under care during this year was 498.Footnote ²⁹

By 1908, the Grahamstown Asylum was exclusively reserved for the “European” (white) insane, following the establishment within a 150 mile radius of the Port Alfred Asylum for the mentally handicapped and chronically infirm of all races and the Fort Beaufort Asylum for the black insane.Footnote ³⁰ Thus, the majority of cases transferred from the Grahamstown Asylum in 1909 were categorised as “Coloured” – for example, forty-seven out of fifty-four cases transferred.Footnote ³¹ The colonial policy of maintaining separate, racially segregated institutions for white and black patients was gradually phased out for practical reasons of convenience – for example, it was difficult to transfer patients to their designated asylum, miles from their homes, and black patients provided manual labour in asylums’ farms and laundries – but patients within asylums remained racially segregated until the end of the apartheid era in the 1990s.Footnote ³² With the settlement of the Union of South Africa in 1910, British colonial authority over civic services including hospitals and asylums shifted from the Cape of Good Hope Colony towards a centralised legislative system, with its headquarters in Pretoria, further away.

Recurrent themes in the South African asylum literature suggest that these political rearrangements would have infused Harry’s illness experience, diagnoses, medical boarding, committal and psychiatric care as a white settler man and civil servant in the Cape of Good Hope Colony, between the years of 1908 and 1911. First, Harry would undoubtedly have been afforded privileged asylum space,Footnote ³³ and would have been assured of a relatively smooth passage through the sticky processes of his medical boarding from his Postmaster position, and of the regulatory legalisation of asylum committal through medical, magisterial and colonial authorities.Footnote ³⁴ That there existed substantial archival traces of his ‘case’ is noteworthy here, within a colonial apparatus that governed from a distance via pervasive official chains of paper.Footnote ³⁵ Against an assertion that case records and archived documents were less readily kept for black patients, colonial asylum record-keeping was both more intricate and more nuanced. An overwhelming amount of statistical data was amassed on cases in increasingly finely calibrated categories, including race, sex, occupation, marital status, diagnosis, aetiology of illness, and so on.Footnote ³⁶ There were also thicker archival trails for mentally ill patients who could speak English, who had money/assets or owned and sold property, who were the subjects of legal scrutiny, or who were paying inmates of asylums and whose families were pursued for maintenance payments.Footnote ³⁷ Fragmentariness of archival traces was produced through transfers and readmissions of patients, and through erratic archivisation after 1910 (Union of South Africa), when many asylum records were lost or destroyed.Footnote ³⁸

Secondly, there were substantial developments in the professionalisation of psychiatry and diagnostic knowledge about psychopathology in the period 1818–1930,Footnote ³⁹ although asylums during this time were largely holding institutions providing secure and safe custody for those with severe mental illness, brain disease and mental handicap who were unable to care for themselves.Footnote ⁴⁰ Sally Swartz’s scholarship has tracked the increasingly sophisticated classificatory activity in and through the work of British colonial asylums in South Africa, with the emergence, for example, of GPI in the late nineteenth century and psychotic personality disorders in the early twentieth century.Footnote ⁴¹ Thus, Harry would have received specialised medical attention and clinical opinion on his condition, discursively contingent to this era. Genealogies of the British-trained doctors of the insane, who were imported into the Cape of Good Hope Colony, have explored their ‘styles’ or ‘schools’ of asylum doctoring expertise, noting their developing interest in neurology, with advanced neurosyphilis as a powerful aetiological factor in diagnoses of mental illness prior to the development and application of penicillin antibiotic treatment for venereal syphilis.Footnote ⁴² One of Harry’s consultant nerve-doctors and brain surgeons in Cape Town in 1909, prior to his committal in the Grahamstown Asylum, was one Dr Hugh Smith, who was reported to have been a student of Dr John Hughlings Jackson, the eminent British neurologist, at the London Hospital.Footnote ⁴³ However, this professional specialisation and clinical practice was inevitably inscribed with the discriminatory class-based, racialised and gendered norms of understandings of pathology of the colonial era, and prone to shifting aetiologies and diagnoses.Footnote ⁴⁴ These developments governed what was findable, knowable and tellable about Harry’s condition, then and now.

South African asylum historians have suggested that mental illness (GPI in particular) was on the rise in South Africa in the period 1880–90 because of the high incidence of acquired or venereal syphilis infection,Footnote ⁴⁵ but it is hard to establish firm causal associations with GPI admissions and deaths because of erratic numbers.Footnote ⁴⁶ GPI appeared in British psychiatry from the 1840s onwards, and was associated with the tertiary and fatal phase of neurosyphilis, but was also initially related to ‘the destructive influences of alcohol, tobacco and sex’.Footnote ⁴⁷ In 1909, five white men diagnosed with GPI were admitted to the Grahamstown Asylum,Footnote ⁴⁸ and two white men and one woman were reported to have venereal syphilis.Footnote ⁴⁹ Karen Jochelson’s epidemiological history of syphilis in South Africa found that although congenital forms of syphilis were endemic in indigenous populations, venereal or sexually transmitted syphilis was introduced to South Africa by European settlers, sailors and soldiers.Footnote ⁵⁰ From the mid-nineteenth century, venereal syphilitic disease was seen as the ‘settler scourge’, located initially around ports and garrison towns where migrancy and prostitution thrived, and then moved inland with the army during the South African (Anglo-Boer) War and migration towards new diamond and gold-mining towns.Footnote ⁵¹

3. Familiar and Unfamiliar Narratives

Harry Walter Wilbraham was born in 1871 in England, the fourth child of George and Mary Wilbraham. His father George was a printer compositor, and the Wilbraham household – including two older sisters (Fanny and Jane), an older brother (Alfred), and a boarder who became like a brother to Alfred and Harry (James Morrison) – was situated at 14 Tresco Road, Camberwell, Surrey.Footnote ⁵² The circumstances of Harry’s arrival in the Eastern Cape Frontier in South Africa are conjectural and somewhat heroic in family-storytelling about him.Footnote ⁵³ He was sent by his fretful parents by Settler ship to Cape Town to find a sister who had run away; but when he arrived in Cape Town, the sister had married following a shipboard romance and sailed with her new husband for Australia. As the family story goes, Harry was 17 years old in 1888, and he “trousered” (or kept) the money he had been given for his and his sister’s return sea-journey to England, and decided to stay and make a go of it in the Cape of Good Hope Colony.Footnote ⁵⁴ He was known to be clever, and had a beautiful, copperplate handwriting. Official archival records find him gainfully employed by the Cape of Good Hope Colony government as an Assistant Postmaster from 1894 in various towns in the Eastern Cape Frontier (Kokstad, Port Elizabeth, Uitenhage, Mthatha), before being appointed as Postmaster in Idutywa, now known as Dutywa, in1906.Footnote ⁵⁵

Figure 1: Harry Walter Wilbraham, c.1900. Copyright reserved, Wilbraham Family Archive. Reproduced with kind permission.

A postmaster’s work during this era of the South African or Anglo-Boer War (1899–1902) is understood to entail postal administration and delivery, and telegraphy, maintaining capillaries of communication between officials, individuals and families in far-flung peripheries and their colonial centres. As such, postal work served as a pivotal technology of effective colonial governance, and an epistolary distribution of affect and sentiment, what Ann Stoler has called ‘the colonial heart’.Footnote ⁵⁶ The speed of official correspondence about Harry’s early pensioning was noteworthy, given that letters moved by horse, cart and coaster-ship between Dutywa, Port Alfred, Port Elizabeth and Cape Town, arriving in less than five days.Footnote ⁵⁷ Thus, a postmaster’s position is read here as requiring responsibility and grit in the portability of its civic and political duties, while providing considerable social footing within the everyday habitus of colonial settler communities.Footnote ⁵⁸ The loss of this position and work due to his physical infirmity and mental illness is reflected later on by his wife, in the stigma and embarrassment of his increasingly bizarre and deluded public behaviour, and by himself, in a letter to his mother from the Grahamstown Asylum, an account of his being rendered ‘useless’ for his chosen profession in telegraphy.

Harry met Jessie May Hall in 1901 in Mthatha, and they were married in 1902, settling in Dutywa, where Harry was Assistant Postmaster at the time. Their only child, a son, my grandfather, Harry Oswald Wilbraham, known as Chick, Howie or Oswald, was born in 1903. Jessie May, known as Maysie, was born in 1882 in Port Elizabeth; an only child of working-class Eastern Cape settlers. Her father was a stonemason who built lighthouses along the Eastern Cape coast, and her mother operated an ox-cart haulage business between Frontier towns. Maysie was schooled in Butterworth, and in 1895, aged 14 years, enrolled at the Grahamstown Teachers Training College to study for a Licentiate Diploma in Music.Footnote ⁵⁹ Three years later in 1898, her first appointment as a qualified music teacher was at St Margaret’s School for Girls in Mthatha; and it was this profession as a working woman – teaching the pianoforte – that was the livelihood, creativity and passionate self-descriptionFootnote ⁶⁰ that sustained her when adversities arrived.

Figure 2: Harry Walter Wilbraham, Harry Oswald Wilbraham (‘Howie’ or ‘Chick’, aged 5 years) and Jessie May Wilbraham (Maysie), c.1908. Copyright reserved, Wilbraham Family Archive. Reproduced with kind permission.

Following disabling spells of poor health, Harry was medically boarded as ‘physically infirm’ and pensioned from his Postmaster position in December 1909, was committed to the Grahamstown Asylum in March 1910 with a ‘disease of the brain’, and died there in October 1911, aged 40 years.Footnote ⁶¹ Harry was awarded a Civil Service and Widows’ Pension of £ 70 per annum, which was paid from the outset to his wife on grounds of his disability. Maysie continued to live and give private piano lessons in Dutywa until 1918, and subsequently in Mthatha, where she lived in the house that had been built by her parents for almost 60 years. She died in Port Alfred in 1979, aged 97 years.

The family stories that are retold about Maysie celebrate her independence, her eccentricity and her doughty resilience through almost 70 years of widowhood when means were tight.Footnote ⁶² She lived alone with her young son and augmented Harry’s pension by taking in lodgers and with income she earned as a piano teacher and the church organist. Harry’s income as Postmaster was recorded as £ 268 per annum, including salary, bonus and overtime.Footnote ⁶³ The household inevitably struggled to meet the ‘heavy expenses’ of Harry’s illness and medical treatmentsFootnote ⁶⁴ prior to his committal in the Grahamstown Asylum, while using up their savings and surviving on the reduced household income of his pension of £ 70 per annum. There is mention in the certification of insanity and committal documents issued from the Resident Magistrate’s Office in Dutywa, of fees that would be deducted from this pension for Harry’s maintenance in the asylum.Footnote ⁶⁵ However, there is no surviving official or familial record that Harry was a paying inmate in the Grahamstown Asylum; or that these fees were formally appealed against or waived on grounds of the family’s penury or his status as a former civil servant of the colonial government.Footnote ⁶⁶ Harry was in possession of a Post Office Savings Bank book when he was committed,Footnote ⁶⁷ and the meagre amount of this investment was paid to Maysie according to the terms of his will in 1913.Footnote ⁶⁸ Maysie balanced every penny she spent against her monthly and annual incomes in a small budgetary notebook that remained in the family’s possession amongst her photograph albums; and she was known to be thrifty and frugal. She kept a sharp eye out for bargains at the local second-hand shop, and heated her bathwater in dozens of brown glass sherry bottles lined up in the sun. She was also notoriously preoccupied with music, and undomesticated; and whether it was due to this preoccupation, or penury, mealtimes frequently produced inadvertent surprises, such as weevils in your porridge and sour milk in your tea.

Maysie and Harry’s son, Chick, became a Magistrate in the Transkei region,Footnote ⁶⁹ married and had two sons; and Maysie was adored by her grandsons, my father and my uncle, who spent considerable amounts of their boyhood growing up in her company. They recall a head and shoulders photograph of Harry that hung above her bed in her Mthatha home, and that if really pressed, she would say that Harry had always had sharp wits about him. Beyond this, very little was said. Stories about Harry are perhaps the kind that families hold back, or carefully shroud, due to the uncertainty and stigma of mental illness. My father and my uncle recall their father, Chick, saying that Harry got headaches and beat him as a child for making a noise. The family story that ‘explains’ Harry’s condition and death, still told today with various plot embellishments, involves reference to an accident in the course of his Postmaster duties in which he fell off his horse and injured his head, precipitating a brain tumour. My archival research with patients’ case files from the Grahamstown Asylum uncovered some unexpected twists and darker corners in his illness narrative.

4. Chaos Narratives of Rupture and Loss

Harry’s troubled body moved into plane of sight in 1908, with headaches, for which he was treated by Dr Chas Armstrong Lumley, a Cambridge-trained British medical doctor stationed in Grahamstown, approximately 250 km (155 miles) from Harry’s home in Dutywa.Footnote ⁷⁰ Later in 1908 and early 1909, these headaches progressively evolved into periodic seizures resembling epileptic fits, after which Harry was left for some days with visual disturbances and without speech or use of his limbs. Dr Lumley’s various letters and clinical reports concerning his referral of Harry, in June 1909, to various medical colleagues in Cape Town who had specialised clinical interests in ‘nerve cases’ (neurology) have not been archived.Footnote ⁷¹ However, Dr Wood’s, Dr Richardson’s and Dr Smith’s extensive reports, including a technically detailed surgical account of Harry’s brain operation on the 22 June 1909, as report-backs to Dr Lumley in Grahamstown, have survived within Harry’s asylum case-notes.Footnote ⁷² It is clear from the Cape Town doctors’ five reports, spanning a two-month spell from 16 June to 11 August 1909, that Harry and his wife Maysie were in Cape Town during this time of examination, hospitalisation, surgery and recuperation; and that there was ongoing debate in the to and fro correspondence between the doctors concerning his diagnosis and prognosis. It appears from this correspondence that Lumley’s initial diagnosis involved a brain tumour – a tumour precipitated by the head injury in the horse accident, which was established to have occurred in 1897, 11 years prior to the onset of the headaches and fits – and optical neuritis. However, Lumley suspected syphilitic disease in the neurological reactivity, and had been medicating Harry with an iodide and mercury tincture to treat syphilis, prior to the Cape Town referral.

Lumley’s hypotheses were referred to the Cape Town doctors for testing; and they ruled some out and mooted others, but Dr Richardson regretted ‘that the case was not sufficiently clear to come to definite conclusions’.Footnote ⁷³ No evidence of optical neuritis was found; but the pupils of his eyes were irregularly shaped and not responsive to light. This was taken as a symptom of cerebral vascular compression, or of neurosyphilis – the so called Prostitute’s Pupil. The brain surgery revealed no tumour or cyst in the left frontal lobe, but found suspicious lesions on cortical vessels, thought to have been caused by thrombosis, Jacksonian epileptic seizures and/or tertiary syphilitic disease. The intermittent symptoms of physical paralysis, diagnosed as GPI, also causally associated with neurosyphilis, were thought to be at an early, indeterminate stage. Dr Smith’s reports strongly suggested syphilis in Harry’s case. He wrote that ‘Mr Wilbraham denies syphilis but of course in these cases one never allows a negative history of this disease to affect one’s diagnosis or treatment’; and later on, that ‘it would be interesting to know if the child [Chick] shows any signs of hereditary mischief’.Footnote ⁷⁴ It was hoped that the decompressive brain surgery would relieve intracranial vascular tension to extinguish symptoms, and it was recommended that the iodide and mercury treatment be continued ‘in the event that there is a syphilitic origin in the case’.Footnote ⁷⁵ However, remission did not materialise for Harry. The periodic seizures resumed and the left frontal lobe brain damage resulted in spells of aphasia, physical weakness and paralysis, and increasingly, confused and delusional behaviour. His medical boarding and pensioning on grounds of ‘physical infirmity’ and ‘a permanent disease of the brain’ was applied for in November 1909, effective from December 1909.Footnote ⁷⁶

Figure 3: Chick Wilbraham (aged 11 years) and Maysie Wilbraham, c.1914. Copyright reserved, Wilbraham Family Archive. Reproduced with kind permission.

5. A Patient’s Letter to Hold a Disintegrating Life and Self Together

I move now to another archival scene in Harry’s illness narrative: the letter Harry wrote to his mother (in England) from the Grahamstown Asylum on the 23 May 1910, two months after his committal on 24 March 1910.Footnote ⁷⁷ My reasons for including this letter as a first-hand account of mental deterioration, in its entirety, are various. Its form and contents resist, and augment, the ways in which patients’ letters have hitherto been represented in various historical writings about colonial asylums as descriptive themes evidenced by decontextualised snippets from many patients’ letters. Against this writing, Harry’s letter offers a sustained opportunity to engage with his particular writing, in context, in a more theoretically interpretive way via a/his strategy of suture – in both narrative and Lacanian psychoanalytic senses of this term. It is read here as an attempt, performed for the audience of a beloved and distant mother, to stitch together a coherent narrative of the chaotic illness which has unmade his self, his family and his life;Footnote ⁷⁸ and to stitch himself back into the relations of intimacy, affect and sentiment with those he loved and had lost.Footnote ⁷⁹ Harry and Maysie’s quest for diagnosis and effective treatment in Cape Town has been explored medically above. However, I point here to Harry’s own uses of a clinical gaze on his seizures, symptoms and choices, and of everyday domestic details and emotions, in this epistolary performance of suture.

The letter was written on both sides of a torn-off half-sheet of thin gauge writing paper. The appearance of a letter, and the use of a letter as a form of suture, is perhaps unsurprising in Harry’s situation. He was literally a man of letters, of beautiful copperplate handwriting, who, as a Postmaster, had made his livelihood within the ‘texture’ of colonial life. His mental and physical state was disordered at the time of this retrospective writing about his illness, and the letter mimics this desperate scrambling for order and sensibility with words omitted, illegible, scratched out, and added as marginalia. The letter was pinned to the Cape Town nerve-doctors’ reports, and archived in a different location to the patients’ casebook, a large leather-bound book in which Harry’s (and other patients’) asylum admission examination notes and weekly or monthly updates by the asylum’s medical superintendent were handwritten.Footnote ⁸⁰ There are fleeting moments of cross-reference between the sources. The superintendent’s case-note dated 19 May 1910 figured Harry as follows: ‘Remains very confused – wanders about picking up stones as diamonds, etc. Writes to his mother as Queen Mary and signs himself as King Edward Wilbraham’.Footnote ⁸¹

This case-note, and that Harry’s letter appears in the archived folder with other reports pertaining to his case, indicates that the letter was kept as clinical evidence of his confusion and delusions, and was not posted to his mother. Patients’ letters from colonial asylums were read and vetted by asylum staff, and were usually sent to addressees as communication strategies to maintain familial ties with both inmates and doctors.Footnote ⁸² But, there might have been pragmatic reasons to hold Harry’s letter back. His letter was addressed to ‘Queen Mary, Idutywa’. This is written in pencil, in a different handwriting, in the margin; and it is not clear who this referred to. It might have been addressing his mother, Mary, who lived in England and the asylum may not have known her address; or his wife and next-of-kin, Jessie May, who lived in Dutywa and to whom Harry refers in his letter as ‘Maysie’ and as ‘Queen June May’. Furthermore, contradictory archival sources suggest that Harry’s mother died in June 1909, but it is unclear whether Harry (or Maysie) knew of her death or not.Footnote ⁸³ The letter follows, with some clarifications in square brackets [thus] and Harry’s own erasures represented.

GTown Asylum

23rd May 1910

My dear Mother,

I have not seen you for 22 years, and you cannot come to the Asylum. Please ask Dr C. Armstrong Lumley to go to Idutywa GT Asylum myself. I cannot go to see you and my wife if Dr C. A. Lumley takes me out of the Asylum. My wife has not written to me for two months, but I love my Queen June May too much and my mother too. I cannot write to my brothers and Mrs Mahan and Mrs Morrison. They are awful Doctors if you I wrote ten letters. Fred and Clare lost two girls and the boy 20 years they are very sorry. After the illness for 3 years I got useless for the telegraph area. [Page 2] The first attack Dec 3. I could not take. We went to ELondon 5 weeks, 1 week Kentani. We come to Idutywa Oswald had measles very mild, May had tonsilis [sic], we was [illegible] the house [in margin: Feb 5], and I finish up the an awful attack on the left on my head and in [illegible] on the right side on head. My arm and right leg are useless. I got right again in eight or ten days. I asked the Dr should I go to Cape Town. He said “wait for a many attack”. So I had a attack May 16. Maysie birthday. [Illegible] the night but 10/30 pm May sent to the Dr, and I was too ill, I cannot talk again for 8 days. We went down by the Briton [illegible] June 12. Maysie was too ill, I was the best man. We saw 3 dressed elephants. Maysie was knocked [illegible]. We had to walk. We walk very quietly to Adderley. We waited for 9 trams and the 10 trams was the right one, Tamboers Kloof. Another man shaved on my head on Sunday morning and Doctor Richardson pencil and over my head. The operation on my head at 10.30 am on Tuesday next and it $2\frac {1}{2}$ [hours] to open my head. Maysie came to see on Thurs but I good not talk and she came on Sunday and had a nice dinner. I was a month * [in the margin: *in the asylum] want to see my girlie. In 3 weeks Dr R. had a consultation on my head and [illegible] Dr and Surgeons talked my head.

I love my mother and my wife and Oswald very much.

King Edward William Harry Walter Wilbraham

Harry’s letter finds himself in the Grahamstown Asylum, and isolated from the affective relationships that had sustained his sense of himself in the world. In the first instance, this is separation from his wife (Maysie) and young son (Oswald); but also from his mother (in England), his siblings and their families (in Australia and England), and Fred, Clare, Mrs Mahan and Mrs Morrison.Footnote ⁸⁴ This alludes to the dispersed fragmentation of kin within an era of imperial colonisation, where people moved around within and between far-flung colonial sites.Footnote ⁸⁵ Harry’s writing reasserts a feeling-connection with these significant, distant others, replacing himself within idealised intimate arrangements and familial self-object relations to establish continuity of selfhood.Footnote ⁸⁶ The warding off of chaos is most notable in his letter in the ways that he attaches the traumatic memories of his illness episodes to domestic minutiae involving his wife and son. Thus, his first seizure on 3 December 1908 was followed by a long Christmas holiday at the coast. His second seizure on 5 February 1909 coincided with Maysie’s tonsillitis and Oswald’s measles. His third seizure on 16 May 1909 happened on Maysie’s birthday. Similarly, the 1200 km (735 mile) journey to Cape Town by coaster-ship, the Briton, is represented as a shared familial experience of Maysie’s seasickness, trying to understand tram transport in a strange city, and dinners during hospital visits.

These reminiscences grapple with the longing to see Maysie (‘my queen’, ‘my girlie’), against her disappearance and absence. She had not written to him for two months. I have been unable to establish whether Maysie did write to or visit him in the asylum before his death the following year; but I suspect that she did not. Harry’s own spatial demarcation of visitation limits as ruptures of relationship – ‘you cannot come to the Asylum’ and ‘I cannot go and see you and my wife’ – and that his letter is addressed to his mother, and not to Maysie directly, are taken as clues to something or someone unfathomably altered or lost. As Harry’s letter suggests, this had been a long, trying and perplexing illness, which had inevitably disrupted their lives, used up resources, and worn down those around him. Furthermore, Maysie’s statement on his committal to the asylum on the 24 March 1910 indicates she had accompanied him to this point, but that his changed behaviour had become increasingly hard to handle, and the stigma of his condition seemed to be formalised through diagnosis and institutionalisation. The case-notes record her impressions of his ‘childish and irresponsible conduct generally’, ‘foolish petty thefts’ (stealing plants from their neighbour’s garden), and his ‘silly boasting’ (pretending to be a church minister).Footnote ⁸⁷ She had lost the familiar husband she loved and relied on; and, in family-storytelling about Harry’s illness and her subsequent widowhood, she did not seem to want to say very much about this. How might Maysie’s silence be read?

Whether Maysie ‘dumped’ Harry in the asylum in order to focus on her responsibilities as full-time breadwinner to support herself and her son – the household-economics in early capitalism hypothesis forwarded by Andrew ScullFootnote ⁸⁸ and David WrightFootnote ⁸⁹ – is perhaps imaginable and probable, but unknowable. But Grahamstown was not easily commutable from Dutywa, c. 1910, particularly when resources of money and time were tight. The Cape Town quest for medical answers had introduced the tangled intimate matter of syphilis, and the bleak indecipherability of Harry’s prognosis. One of the nerve-doctors in Cape Town, Dr Richardson’s report notes: ‘I have explained to the wife the state of affairs and she seems to be reconciled’.Footnote ⁹⁰ It is not clear what this ‘state of affairs’ was; nor what Maysie was ‘reconciled’ to. Was she told of the syphilis, and the implications of this for herself and her son? Were they tested for syphilis? Was she informed of ways to protect herself from infection? How did this remake or unravel intimacy between Harry and Maysie? These are, of course, my own contemporary questions refracted through the lens of one sexually transmitted epidemic (HIV/Aids) onto another (syphilis). Certainly, nineteenth-century colonial asylums were providing custodial care for patients committed with GPI and other neurological disorders said to be due to tertiary syphilitic disease.Footnote ⁹¹ These patients were represented in various relations with their spouses – for example, committal to the asylum as a refuge or escape from a sexually abusive husband,Footnote ⁹² or a wife’s appeal for her husband’s release from an asylum without knowledge of his syphilis and gonorrhoea.Footnote ⁹³ Mark Finnane has suggested that the asylum had physical and symbolic value in ‘separating the two parties in a domestic war’ in a rapidly changing social world.Footnote ⁹⁴

It is unclear whether Harry was similarly informed about ‘the state of affairs’ by Dr Richardson; but it is on record that he denied the possibility of syphilis during the pre-surgical clinical examination.Footnote ⁹⁵ Understandably, he does not refer to it in his letter to his mother, where his chaotic illness experience is carefully sutured to seizure-episodes as “attacks” beyond his control, comprehension or coping, and lists of bewildering and debilitating symptoms. Arthur Frank has argued that chaos narratives of illness are characterised by a rush of disjointed events that overwhelm reflective distance and the ‘voice’ (or self) that puts a coherent story together.Footnote ⁹⁶ This chaos is poignantly caught in the hurried form of Harry’s letter, scribbled quickly lest his mind escape again, and is managed through his docile surrender to the medical gaze. He does not appear to be contesting his confinement in the asylum. He recalls Dr Lumley’s and Dr Richardson’s names and the localities of their practices, and the terms, choices and procedures they prescribed. He ‘waits for another attack’ and ‘goes to Cape Town’ as advised. He describes the various medical technologies of examination of his head – shaving it, pencilling marks for the surgical operation, cutting it open and surgeons talking about it. This is the voice of a ‘patient’, constituted and wholly infused within medicalised discourse as a subject,Footnote ⁹⁷ shored up by these certainties and reassurances, but denied restitution.

6. Case 3414 – a Denouement

The last archival scene incorporates writings about Harry as Case 3414 in a patients’ casebook of the Grahamstown Asylum where he was committed on 24 March 1910, and died on 23 October 2011.Footnote ⁹⁸ Harry was noted on admission as bearing a large scar on his forehead (‘left frontal region’), the mark of his brain surgery and prior patient-hood. He was immediately recognised as insane in the admission notes by the medical superintendent, displaying the mental traces (delusional ideas about where or who he was, effusive speech and flight of ideas, impaired recent memory, inappropriate laughter) and the embodiments of insanity (dilated pupils, a ‘fatuous’ facial expression, jerky legs, slurred speech and tremor of the tongue and lips ‘like that of GPI’). He reportedly settled down fairly quickly into the daily routines of the asylum, eating and sleeping well; but was ‘of unsound mind’ as demonstrated in his mental confusion, wandering about aimlessly, picking up stones, following the attendants ‘like a child’, talking about being a doctor, and he was sometimes ‘morbidly exalted’. This peaceable being for Harry was violently ruptured by intermittent seizures, also called ‘convulsions’ and ‘epileptic-like fits’, where his ‘eyes rolled back and to the left’, which gradually increased in frequency and severity, wearing away his ability to recover his speech and mobility. He was described, from nine months after admission, as ‘incoherent’; as issuing ‘weird guttural noises’; as violent towards other patients (e.g. ‘joins in any little struggle and kicks anyone who is down’); as ‘restless and quite demented’; and as having to be restrained in the padded room.

As distressing as Harry’s denouement into madness and chaos is to read, it was disconcerting to find that the case notes shrunk in detail and frequency as his mental and physical condition deteriorated. Thus from cryptic entries detailing dementia and grimacing on 24 February 1911, and convulsions and restraint on 30 May 1911, the final entry was written, in a different handwriting, on the 23 October 1911, as follows: The patient has been going downhill steadily for the last two months, having recurring bouts of convulsive seizures almost daily. His death has been expected at any time during the past month. He died today.

If a death certificate was issued for Harry by the medical superintendent from the Grahamstown Asylum at the time of his death, a copy of this document specifying the cause of death was not archived or has been lost. A formal Death Notice, accompanied by Harry’s last will was filed with the Magistrate in Dutywa by his widow, Maysie, more than eighteen months after his death, on 19 June 1913.Footnote ⁹⁹ In terms of this official correspondence with the Master of the Supreme Court of the Union of South Africa, and as set out in Harry’s will, the full amount of Harry’s moveable property, £ 2.4.3 (two pounds, four shillings and threepence) in the Post Office Savings Bank, was paid to Maysie on the 7 August 1913. It was formally stated in this correspondence that Maysie, as the widow and applicant, had ‘discharged the funeral expenses’; although no details were given about when and where Harry was buried. In keeping with the silences Maysie maintained about Harry’s illness and death, there is no surviving Wilbraham-family record or account of his funeral. His grave, if this was indeed marked by an engraved gravestone, has not been traced in the municipal or church cemeteries of Grahamstown, Dutywa or Mthatha.

7. Conclusions: Partial Truths and Archival Fragments

This paper has mapped the intimate arrangements of familiarity through one family’s management of the calamity and chaos, the stigma and silence, of mental illness. Harry emerged through this as a patient and a subject, constituted within the medical gaze of late nineteenth- and early twentieth-century psychiatry, but ultimately as a shadowy figure. A genealogical approach holds that archival and narrative materials do not capture ‘the whole truth’ of experience of family living, debilitating illness and loss, or a self’s resilience; but construct versions of it as partial truths or truth claims.Footnote ¹⁰⁰ Each account ‘remakes history’ and ‘apprehends’ its subjects, Harry or Maysie or Chick, with the subjective lenses and discursive tools of its specific milieu and location. The critical task of representation is not to settle on one or the truth, but to map how the possibilities within singular and different truthful stories construct, jostle with, fracture and resist what is taken for granted about families and selves.

This writing of the ‘particular’, of the intimacies of illness and intricacies of death among the minutiae of a family’s lives, is cast against the sweeping generalities of claims about conditions or themes in extant colonial lunatic asylum literature. Beyond the historical description of carefully situated micro-practices, however, this paper has explored how a particular mental illness narrative is complexly entangled in an ongoing process of family storytelling, reminiscence and meaning-making in the present. This presented methodological opportunities to grapple with memory and stigma in a number of ways. Along a similar trajectory, Annette Kuhn, reflecting on her method of ‘memory work’ which used family photographs to unpack an estranged relationship with her mother, finds the value of such singular case studies thus:

for the stories they tell about a particular life, stories which will perhaps speak with a peculiar urgency to readers in whom they elicit recognition of a shared history; as a contribution towards understanding how memory works culturally; for what they offer more generally to theories of culture and methods of cultural analysis; and perhaps most important of all, as a recipe, a toolkit, even an inspiration, for further works.Footnote ¹⁰¹

As any historical researcher knows, archives are ‘black boxes’ from which anything might or might not emerge.Footnote ¹⁰² The archive’s gaps are part of the territory of partial truths; as are the risks of jumping to too-easy, too-speculative or too-critical conclusions without adequate immersion in the available materials.Footnote ¹⁰³ This paper has espoused a Foucauldian genealogical theoretical and methodological position on illness, and has used multiple genres of archival and narrative material to track this. Indeed, it was in the layering and interweaving of these materials, and in their resonances between various pasts as episodic archival scenes, and the present, that the true potential for resistance to the coherence of linear, unitary representations of selves, illness and families arose.Footnote ¹⁰⁴ Where chaos narratives of mental illness might be thought of as running wildly amok, outside discourse, as they resist the predictable coherence of clinical expertise,Footnote ¹⁰⁵ Harry’s narrative was, instead, inexorably slow, ordinary and sad in its passage. Placing the archived bits and narrative fragments side by side allowed the silences to emerge within and between stories, as further points of unfolding, becoming and listening.Footnote ¹⁰⁶

Given my familial relationship to Harry, and the secrecy woven into family storytelling about him, the engagement with the archival material was harrowing. This emotional aspect is eclipsed in the somewhat voyeuristic writing on families and colonial lunatic asylums that unpack quirks, foibles and misperceptions of the more bizarre, nineteenth-century ‘cases’ in an archive; as is the ethical dimension of accountability for representations of these ‘cases’ with the later generations of their living relatives.Footnote ¹⁰⁷ The methodology pioneered in this paper made me aware of the number of hats I wore, so to speak, on different occasions. As a historical researcher, a psychologist and family memoirist, I was positioned as a broker of meanings between the asylum’s texts and contemporary familial audiences. Some of the darker corners of Harry’s illness narrative – his diagnosis with and treatment for syphilis, his journey to Cape Town for brain surgery, his death in an asylum – were unknown to the extended family around me. These unfamiliar knowledges reverberated back and forth in contestations about ‘facts’ and in reminiscences about Maysie’s stoicism and silence.

The appearance in the asylum case notes of tertiary syphilitic disease as an aetiological factor in Harry’s neurological reactivity, and my disclosure of this status, was predictably a skeleton rattling in a family cupboard. Did he really have syphilis? Where or who could he have got syphilis from? These kinds of defensiveness introduce different ways of reading the contingency of psychiatric case-material in colonial lunatic asylum archives. On the one hand, an against-the-grain argument for Harry’s misdiagnosis might be based on the retrospective anecdotal evidence of the health and longevity of his non-symptomatic wife, Maysie, and son, Chick. Similarly, Harry’s symptoms as presented within the extant case records may be reassessed within the clinical gaze of twenty-first-century psychiatric science to produce anomalous diagnoses and treatments. But, on the other hand, extended periods of Harry’s life-narrative are without traces in formal and familial records, particularly accounts of his young manhood between the ages of 17 years, when he allegedly arrived in South Africa in 1888, and 31 years, when he married in 1902.Footnote ¹⁰⁸ Within the true-romance marriage plot recycled in family storytelling, Harry’s prior sexual desires and intimacies with other women, as inadvertent opportunities for contracting syphilis, remain uneasily hidden and difficult to talk or write about. The presence of syphilis in white settler men did not mean, of course, that they were immoral, but rather that their pre-marital sexual activity (usually with prostitutes) exposed them to the sexually transmitted diseases of the day.Footnote ¹⁰⁹ However, although venereal syphilis was initially a white settler problem in South Africa, the disease would increasingly become associated with ‘poor whites’ in the early twentieth century, and later on, almost exclusively with black people or Africans.Footnote ¹¹⁰ Thus the shame and secrecy associated with syphilis was related to its sexual transmission with black and ‘continental’ prostitutes, and fears about social hygiene and contamination of racial purity caused by venereal diseases.Footnote ¹¹¹

The psychological discursive regime of our twenty-first century informs us that a narrative grasp on the domestic dramas of our histories and presents, as genealogies of the intimate, enable us to make sense of experience, to mark milestones and rites of passage, to learn about obstacles and what values matter, and to shore up our sense of self or identity through our belonging and footing in a family, community and socio-cultural milieu.Footnote ¹¹² We moderns have also come to expect that the telling of troubling stories – finding out about and full disclosure of what really happened – is infused with powers of agency, healing, closure and moving on.Footnote ¹¹³ This has not been so in any simplistic sense of an outcome to this genealogical study. There is more at stake here than a lost grave, a sense of anguish and suffering uncovered, and uncertainty about what to do next. It is no accident that family memoirs are prefaced or followed by extensive acknowledgements of the forbearance, assistance and interest of family members, and apologies for any fictions that unwittingly or wittingly have slipped in.Footnote ¹¹⁴