Holiday Fun

Northern Hospital for the Insane

Though patients were not usually happy to be at an insane asylum, many could still enjoy themselves and have fun under the right circumstances. The Daily Northwestern in Oshkosh, Wisconsin wrote that during one Christmas party, patients enjoyed seeing one of the doctors receive a good-natured gag gift. The patients were delighted with their own gifts, which had been distributed amid festive decorations and a beautiful Christmas tree. However . . .

“Another present worthy of mention was an elegant box of cobwebs received by Dr. Pember who was made the victim of a good joke which many of the patients as well as attendants enjoyed. It appears that the doctor has a great habit of going around the building and upsetting chairs, tables, etc., in search of cobwebs for which it is alleged he has a great abhorrence. As a sort of a take off on his pet pleasure the attendants gathered some cobwebs and gave the doctor a carefully packed box of them,” the paper reported in 1885.

Nurses From Northern Hospital for the Insane, 1890s, courtesy Oshkosh Public Museum

The Daily Northwestern continued: “Messrs. Brightrall, Roberts and Anderson, the gentlemen supervisors, and Misses Mitchell, Schultz and Casey, the lady supervisors, Harry Baum, the druggist, T.J. Vaughn, the steward, Mr. Neville, the warden, Miss Hale, the matron, Dr. Wiggington and his amiable wife and every officer and attendant connected with the institution deserve a deal of credit for the work which they certainly must have done to make the entertainment a success.” The paper added, “One thing is noticeable at the hospital and that is the kindly feeling which all of the patients have for Dr. and Mrs. Wigginton.”

Christmas Decorations at Taunton State Hospital, circa 1900

Though some of this commentary may or may not have been typical hyperbole, various patient memoirs show that patients and staff could indeed develop respect, love, and camaraderie for each other.

Holidays are Hard

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Most asylum superintendents, especially at the beginning of the asylum era, wanted to recreate a home atmosphere for patients. They often arranged outings, dances, and other activities that tried to normalize life for patients. Holidays, of course, can bring sadness to anyone remembering the past and asylum patients undoubtedly had an especially rough time during any festive season.

Photos 1923_0010 — Christmas at Morningside Hospital in Portland, Oregon

At Christmas, asylum staff and the surrounding communities tried to remember these forgotten people. Many civic organizations donated food and clothing to insane asylums, or sought to make the patients more comfortable. Churches, school bands, and choral groups would visit asylums to sing and entertain patients, and money was usually set aside in some way for improved meals. The Milwaukee Sentinel wrote on December 25, 1903 that:

“Inmates of the county insane asylum will enjoy rabbit stew, oysters, and plum pudding for dinner today. The Christmas tree entertainment was held last evening, and the program of music and recitations was followed by dancing and bags of candy and fruit were distributed.

Christmas Decorations in Ward of Bellevue Hospital, 1920

“The usual Christmas festival for the patients of the Milwaukee Hospital for Insane was given on last evening. A Christmas tree, illuminated by colored electric lamps and laden with presents, a concert by the hospital orchestra, and dancing, comprised the entertainment. Every patient received a present and refreshments were served. A special breakfast and dinner will be served today, and skating on the lake will be indulged in.”

Christmas Turkeys Displayed Outside Spencer State Hospital, formerly Second Hospital for the Insane, circa 1924, courtesy WVU Libraries

These and similar festivities elsewhere were aimed at patients, but very likely heartened the staff as well.

St. Elizabeths and the Civil War

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General Joseph Hooker Received Care at St. Elizabeths, courtesy NARA RG 418-P-717

Before the Civil War began, Dr. Nichols (see last two posts) and his oversight committee decided to open up the unfinished east wing of the asylum to the army’s use for sick soldiers. The space was officially called St. Elizabeth Army General Hospital, but soldiers called it St. Elizabeths when they wrote home. Nichols also opened a building called the West Lodge to the navy.

Nichols was hard pressed to run the asylum and help the military side of the operation as well. For the most part, only the military’s sick came to the hospital, though a few hundred (out of about 1,900) patients were treated for war wounds. In April 1863, however, military hospitals began to send their patients with amputated legs to St. Elizabeths because it had opened up a prosthetic limb shop. Soldiers with leg amputations received surgical treatment there, were fitted for legs, and remained until healed. The patient also learned how to clean and oil his new leg and care for it under the supervision of R. W. Jewett, who had patented the artificial limb shop.

St. Elizabeths’ Civil War Cemetery, circa 1897

Many inconveniences resulted from the asylum’s accommodation of the military, including prime agricultural land being taken from service for ordnance training. Nichols also found it hard to collect from paying patients whose families lived in the South. (Out of compassion, he did not discharge these patients.) Foraging soldiers stole food from the hospital’s garden, and numerous other trespasses–like stealing coal–frustrated Nichols repeatedly.

The Army Maintained Many Hospitals During the Civil War. This is Ward K of Armory Square Hospital, Washington, DC, 1862, Located Aproximately Where the National Air and Space Museum Stands Today, courtesy Library of Congress

The Army Maintained Many Hospitals During the Civil War. This is Ward K of Armory Square Hospital, Washington, DC, 1862, Located Approximately Where the National Air and Space Museum Stands Today, courtesy Library of Congress

As the war went on, 85 percent of the total number of admissions to the asylum came from the army. The rate of navy admissions was much lower because in Nichols’ words: “. . . the seaman has a more hardy and unsusceptible [sic] constitution than the landsman.”

Early Care at St. Elizabeths

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A Four-Horse Carriage Used to Take Male Patients to Town at St. Elizabeths

A Four-Horse Carriage Used at St. Elizabeths to Take Male Patients to Town

The Government Hospital for the Insane–better known as St. Elizabeths–accepted the insane of the District of Columbia but had a special patient population of veterans from the nation’s army and navy. Like most institutions of its kind, the asylum was beautifully landscaped and had pleasing views for the patients.

St. Elizabeths’ first superintendent, Dr. Charles Nichols, did not run to extreme treatments. If a patient were not overtly disturbed, he prescribed tonics and a nourishing diet, warm baths, and treatments for “regularity of all the alimentary functions.” Provided patients could be induced to eat (the first step on the alimentary journey), alimentary treatment consisted primarily of ensuring the bowel excreted waste properly. Physicians sometimes induced vomiting to “clean out” the system, but it was far more likely that they would administer purgatives (very strong laxatives) to make sure the bowel was completely evacuated.

Dr. Charles Nichols

As in most asylums, patients were offered work to occupy their time and distract their minds from their troubles. Patients were allowed visitors, could walk on the grounds, and enjoyed (especially early on) individual treatment plans. Theories of the time supposed that most insanity was caused by environment and habits, so every effort was made to provide “things rational, agreeable, and foreign to the subject of delusion.”

Nurses on the Lawn Across From Building E, St. Elizabeths, courtesy NARA

Whether a patient’s environment had become contaminated by overwork, marital problems, or the many pressures of life, doctors hoped that taking people away from the environment which had created their mental distress would allow them to recover. For at least the initial period of asylum growth, this belief was an overwhelmingly valid reason for insisting patients be committed to an institution rather than receive treatment at home.

A Special Veterans Hospital

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An Early View of the Government Hospital for the Insane

Though Armistice Day (November 11) was renamed Veterans Day only in 1954, veterans with mental health issues did have a special facility to meet their needs quite early on. Though crusader Dorothea Dix had pushed unsuccessfully for federal funding to help pay for America’s (civilian) mentally ill, she and other supporters did manage to get approval for a hospital for the insane of the army, navy, and District of Columbia. On January 15, 1855, the Government Hospital for the Insane received its first patient, Thomas Sessford.

Dr. Charles Nichols was the facility’s first superintendent, and he helped design one of the campus’s earliest buildings, the Center Building. One interesting feature was that the wards used different species of wood for their interiors: the Beech Ward installed woodwork from beeches, and the Cherry and Poplar Wards installed their interior woodwork from like-named trees. The patients had lovely views of the Anacostia River and farmland, and the grounds had extensive trees, shrubs, and flowers to give it a rural feeling of peace.

St. Elizabeths, 1917, courtesy Library of Congress

Allison Building’s Sleeping Porches, 1910, courtesy National Archives and Records Administration

The Government Hospital for the Insane became known during the Civil War as St. Elizabeths. Sick soldiers quartered in the hospital were embarrassed to write home from an insane asylum and simply substituted the historic name of the land patent on which the hospital stood. The name was made official in 1916.

My next two posts will discuss early care at St. Elizabeths, and its Civil War operation.

Any Problems With This?

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Kansas Pioneers Struggled Constantly

As pioneers pushed westward, mental health issues went with them or developed once settled (see last post). Kansas established its first insane asylum in 1863, which opened in 1866 and was known as the Kansas State Insane Asylum and later as Osawatomie State Hospital. Three trustees managed it until 1873, when a six-member board of trustees appointed by the governor took over. Trustees were paid three dollars a day (about $62 today) and mileage, as was a separate citizen committee which visited the institution at least twice a year.

Image result for early osawatomie Originally, patients were admitted on a reimbursement plan, either through the county where they lived if impoverished, or through a bond given by their guardians. Private patients paid their own way. Some admissions were voluntary, but otherwise, someone who had been judged incompetent and had an appointed guardian, could be admitted via a jury of six people. One of the six had to be a physician with a regular practice and in good standing. A probate court would determine payment arrangements.

Osawatomie State Hospital’s Old Main Building, Constructed in 1869

Comprehensive legislation relating to the asylum in 1870 introduced another way of admission. This method did not inquire into a person’s insanity. Instead, a doctor could certify that he believed a patient was insane–and that certification along with a bond for maintenance signed by any individual and approved under a probate court–was enough to admit someone to the asylum. This sort of involuntary commitment could be made only at private expense, so indigent citizens were relatively safe from it.

Not so for patients whose absence may have benefited an unscrupulous relative or guardian in some way. We can certainly speculate about the number of inconvenient spouses, wayward children, and other undesirable relatives who resided in this Kansas asylum.

Loneliness Too Much to Bear

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The Vast Plains Could Be Lonely and Unsettling, photo of Kansas Plains courtesy of U.S. Department of the Interior, Geological Survey

Traumatic events could lead to madness (see last post) for vulnerable individuals, but other, more passive conditions could also affect mental health. Isolation and loneliness caused great distress in even the hardiest pioneers, as seen in cases of prairie madness encountered by homesteaders during the mid to late 1800s.

Away from familiar surroundings and without social support because of the distance between other settlers, victims could fall prey to great despair and hopelessness.This particular syndrome was not an official one, and had a loose set of behaviors that included depression, crying, apathy, and withdrawal, as well as violence and anger. The condition wasn’t even terribly uncommon: E.V. Smalley, the editor of Northwest Illustrated Monthly Magazine, said in 1893, “An alarming amount of insanity occurs in the new prairie States among farmers and their wives.”

Homesteaders Faced Different Conditions Than They Had in the East

Top issues for many settlers was the move away from home and everything familiar–this issue was even greater for immigrants who came from small, tight-knit villages and spoke a language other than English. The intense hardship of living on the prairie exhausted people physically and made it hard to visualize success. The landscape could be bleak and stretched for miles with no trees to break up the magnitude of isolation, while the wind itself blew constantly and irritated raw nerves beyond coping. Only when the Great Plains became more populated, transportation and communication improved, and towns sprang up, did the condition start to disappear.

A Sod House Was a Far Cry From Most Settlers’ Former Homes, courtesy Library of Congress

The Forces of Nature

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Scene From an 1886 Issue of Harper’s Weekly Depicting Charleston’s Massive Earthquake

We know today that traumatic events can create mental health issues, and encourage victims to seek help after disasters of all kinds. Even a hundred years ago, medical professionals recognized that people could experience profound reactions to disaster–they just couldn’t offer preventative assistance.

In August, 1866, a massive earthquake centered around Charleston, South Carolina created havoc from Maine to Florida. Of course, people were physically hurt as a result, but many also experienced what we would now term post-traumatic stress disorder. At least three women seem to have literally died of it–the newspapers reported they were “frightened to death”–and others suffered nervous conditions that required sedation. They consumed medicines containing morphine, laudanum, valerian, and/or alcohol for relief, or simply went straight to bars for comfort.

Destruction in South Carolina

The Savannah Morning News reported that at least a dozen people went insane and had to be sent to lunatic asylums, though it didn’t mention whether or not the stays were short or long-term. Continued aftershocks kept people anxious–and presumably on medication–for several months afterward.

Photograph Taken After the 1906 Earthquake, courtesy Sonoma County Library

Similar cases of “earthquake madness” have been reported elsewhere. The 1906 Santa Rosa (California) earthquake also left a number of victims insane. Mrs. L. W. Stebbins died in 1907: “Her awful experiences in those April days racked and wrecked her mind and body, ” reported the Press Democrat. “Her reason failed, and she was taken to the state hospital for treatment, but steadily declined in health…” At least six others from Sonoma County went into an asylum and three died there. Jacob H. Schlotterback of Santa Rosa was one of them, and his cause of death was listed as: “earthquake of April 18, 1906.”

Another Kind of Hell

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This Undated Postcard Shows the County Poorhouse Which Later Became the Strafford County Asylum

Most people would consider living in an insane asylum to be a sort of hell in and of itself, but when conditions in these institutions were unsanitary, unkind, or unsafe, life took on an especially hellish aspect. Though most asylums were–at least originally–built to be safe, they did not always stay that way and staff were not always as protective as they might have been. Disaster could result.

The Strafford County Asylum in New Hampshire came into being when the county decided to move its pauper insane from its poorhouse into a separate asylum where patients could be better accommodated. All went well for twenty years, until a personality clash of some kind occurred between superintendent Charles E. Demeritt and his assistant manager, William P. Driscoll. Demeritt gave up control of the asylum to Driscoll.

Though the building was not that old, almost all repairs and renovations had been made using pine. This wood had dried over the years and shrunk to the point that patients could see each other between the floors and cells. The windows had bars in them and the patients’ rooms were locked up at night.

Account of Asylum Fire

On February 9, 1893 the night watchman saw a fire in the room of a patient named Mary La Fontaine. Wilbur Chesley, the watchman, immediately ran into the building and awakened Driscoll, who began to unlock the patients’ doors. The building material was so combustible that Driscoll could only get to some of the first floor rooms before the building was engulfed in flames. He, his family, and only three patients escaped.The rest , some forty or forty-one, were burned alive.

Investigation showed inexcusable ineptness: dangerous conditions had been allowed to exist for years, and the watchman had not even known that a fire hose and fire buckets were available in the building. Even worse, the fire was so small–no bigger than a bushel basket–when Chesley and Driscoll had rushed to the patient’s room, that they could easily have extinguished it. Instead, Chesley ran for help and Driscoll began unlocking rooms. And finally, the matches which probably started the fire, had been given to the patient (who smoked) by Driscoll himself.

Another Dreadful Fire Had Previously Occurred January 7, 1881 at the Strafford County Almshouse

As a result of this disaster the state’s legislature abolished county asylums and placed the care of the insane under the state.

Cures are Insane

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Brattleboro Retreat in Vermont, Which Opened for Occupancy in 1836

To modern sensibilities, much of what has been believed in the past about insanity sounds silly and unbelievable. Though we can often follow the logic behind even outlandish ideas, given the lack of research available at the time, the logic behind certain treatments can be a little more difficult to grasp.

In Vermont somewhere around 1800, a man named Richard Whitney became “mentally deranged” and a council of physicians tried its best to help him. They concluded that a temporary “suspension of consciousness” was just what was needed, the theory being that if the patient could be rendered unconscious in a fairly dramatic way, his mind would be diverted from unhappy associations and so remove the cause of his affliction.

As Late as the 1930s, Patients Were Induced Into Low Blood Sugar Comas to Rewire the Brain

As Late as the 1930s, Psychiatric Patients Were Induced Into Low Blood Sugar Comas to Rewire the Brain

The physicians first completely submerged him in water until he “became insensible” and then resuscitated him. This experimental treatment failed, but undaunted, the doctors tried again. The second effort involved opium, selected as “the proper agent for the stupefaction of the life forces.” Unfortunately, this trial killed the patient.*

Thought this extreme example is outrageous, alienists (the first mental health specialists) frequently experimented with new treatments on patients–most probably without consent or oversight. Records will never show how many died or suffered catastrophic harm from them, but researchers can rest assured that much suffering was involved.

The Utica Crib Was a Notorious Restraining Device

*Information about this case came from a work called the History of Brattleboro, published in 1806 and retold in a history of asylums in 1916..

Healing, Hell, and the History of American Insane Asylums

The History of Insane Asylums

Holiday Fun

Holidays are Hard

St. Elizabeths and the Civil War

Early Care at St. Elizabeths

A Special Veterans Hospital

Any Problems With This?

Loneliness Too Much to Bear

The Forces of Nature

Another Kind of Hell

Cures are Insane