Culture remains an ambiguous concept for psychiatry: deprecated by the assumption that it is secondary to biomedical reality, yet at the same time some notion of 'culture' has served to represent the modern against the primitive. Contemporary clinical understandings of culture derive from imperial medicine which had applied the accepted distinction between the biological form and the cultural content of psychopathology to local illnesses which could not easily be fitted into the European nosology. The later concept of culture-bound pathology, like the psychoanalysts' 'modal personality', only imperfectly escaped from evaluative assumptions of 'development', but it is difficult to argue that psychiatry provided British colonial administrations with any significant ideological justification.