When the Civil War ended, Southern White health professionals believed they were facing a potential wave of Black patients. The contemporary racist thinking held that, without slavery, Black people would fall into illness and insanity. “Under the compulsive power of the white man,” influential physician Samuel A. Cartwright wrote in a 1851 article, “Report on the Diseases and Physical Peculiarities of the Negro Race,” “they are made to labor or exercise, which makes the lungs perform the duty of vitalizing the blood more perfectly than is done when they are left free to indulge in idleness.”
Virginia’s push to create an all-Black state asylum came out of this fear of Black madness, as well as the segregationist desire to house Black patients separately from White ones. Officially founded in 1869, the asylum at its inception committed 123 supposedly mentally ill patients and 100 who were poor or homeless and had nowhere else to go, many of them transferred from other state institutions.
There’s very little record of what it was truly like to be a patient at Central Lunatic Asylum. Many of the patients were illiterate — an outgrowth of the prohibition on reading among enslaved people — and the archives don’t include their writing anyway. And until recently, few of the records were available to researchers at all. The hospital — which exists today under the name Central State Hospital, in the town of Petersburg, about 25 miles south of Richmond — has been chronically underfunded and unable to protect its century-old files from deterioration. One historian who visited in 2003 describes watching in horror as a staff worker nearly tossed out a sheaf of papers in a cleanup effort.
In 2007, hospital administrators reached out to King Davis, a former mental health commissioner for Virginia and a professor of mental health policy at the University of Texas at Austin, with a plea to protect the archives. Davis quickly secured funding from the university and the National Association of State Mental Health Program Directors to begin what has become a more than decade-long project to preserve Central’s files. Since then, his team has digitized approximately 800,000 pages of documents, 10,000 photographs and hundreds of pages of negatives and slides about the hospital, among other records.
The documents and photos shed light on a painful history. Patients at Central in its first few decades lived in crowded and unsanitary conditions, subject to treatments that were anything but therapeutic, including experimental surgeries and forced sterilization. Because doctors believed that Black sanity depended on hard labor — and because that labor was free — patients were required to work at the hospital, tending its large farm or doing domestic chores such as laundry and cleaning. “Central really worked just to re-enslave the people who were there,” says Kirby Randolph, a professor of history and bioethics at the Kansas City University medical school who has studied the hospital’s early years.