As part of my new book project, Drift: Dislodging the Insane from Colonial Hong Kong, I explore how ‘lunatics’ emerged and how they were managed beyond the capacity of institutionalization in colonial Hong Kong in the second half of 19th Century and the first half of 20th Century. The story contests the conventional historiography about madmen that predominantly focuses on institutions. Unlike in Britain or in other empires’ colonies, inpatients stayed at the asylum in Hong Kong only for very short periods. Instead of psychiatric admission, they were transported via waterways either to Canton or London for further care until after World War II. While Hong Kong has long been an arena of international great powers, this story also attests the role of the former Britain’s crown colony being a nexus of the world’s commercial and political interests. I explain how such a measure was taken to maintain a ‘clean’ cityscape, as well as an instrument to ensure the smooth operation of the entrepôt.