A hermeneutic analysis of delusion content from the casebooks of the Grahamstown Lunatic Asylum, 1890–1907

BACKGROUND AND OBJECTIVES: This study sought to investigate the content of the delusions recorded in the casebooks of the Grahamstown Lunatic Asylum as a means to explore how the colonial context shaped or influenced psychopathology. To this end, the study aimed to (1) identify the sociopolitical events of the time period that were reflected in the delusion content presented by the patients and (2) pinpoint discernible patterns in the delusion content based on the race and gender of the patient. The study was delimited to the period of Dr T.D. Greenlees’ tenure as medical superintendent, 1890–1907. METHODOLOGY: The study sampled the casebook records of 400 patients. A qualitative analysis of the casebooks was followed by adopting a Gadamerian approach to hermeneutics. The analysis drew upon the clearly articulated method and step-by-step approach for Gadamerian hermeneutics outlined by Fleming, Gaidys and Robb. RESULTS: The sociocultural and political events of South Africa during the turn of the 20th century had a marked influence on the content of the patients’ delusions. The South African War (1899–1902), the rinderpest epidemic of 1896–1898, diamond mining in Kimberley and the discovery of gold in the Witwatersrand were common features in the delusion content. Moreover, there is evidence of discernible patterns in the content of the delusions based on the race and gender of the patients. CONCLUSION: The study identified how the colonial context influenced the delusional content presented by the patients of the Grahamstown Lunatic Asylum. Of key significance is the fact that the study retrieved themes in the delusional content presented by black subjects that were silenced, omitted or censored from psychiatric texts published during colonialism.