WHAT IF THEY built an asylum and nobody showed up? By asking this question, I mean to forefront the problem of what sort of a structure it is to which people are committed or present themselves. In the extensive literature on asylums that has developed over the course of the last three decades, most authors assume a needy or dominated population to exist around such buildings who eventually give over their unfortunates to fill them up. Few theorists, moreover, look seriously at those who staff these structures, who are, at least in the rank-and-filejobs, generally locals. Thus, while we can find an ample literature about asylums as tokens of a type, we find much less on the actual local existence of any particular institution. 1 This essay developed out of a project investigating the cultural and historical relationships between a (recently) large mental hospital, St. Columba's Hospital in Sligo town, serving the counties of Sligo and Leitrim in the northwest of Ireland, and a market town and its environs, containing about 1,600 people, that for the purposes of this study I am calling Kilronan. In this paper I am interested in the local presence of a bureaucratic structure, examining how this institution is locally constituted as well as looking at some of the historical changes that it has effected at this locality. By proceeding in this fashion, the argument both echoes and reinforces recent calls in the discipline to treat together local, colonial, and national histories, insisting that understanding historical change in culture and understanding how culture conditions historical change are equally necessary parts of a comprehensive anthropological analysis