Saying Goodbye

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Bloomingdale Asylum

Bloomingdale Asylum

Patients were often kept in insane asylums far too long because they were friendless or without family to take them in, even after improvement. Wealthier patients could fare better since it was easier for their families to hire attendants for home care, but wealth did not guarantee their welcome back into the family circle.

Millionaire John Armstrong Chanler’s family (part of the wealthy Astor clan) committed him to an asylum probably to prevent him carrying out business plans they thought were risky. He was a resident of Virginia, but was tricked by a friend into going to New York City. There, he was subsequently committed to New York Hospital, also called Bloomingdale Asylum. His family promptly cut him out of their lives.

Chanler seated on a horse, 1912, courtesy Holsinger Studio Collection and U.Va. Digitization Services

Chanler seated on a horse, 1912, courtesy Holsinger Studio Collection and U.Va. Digitization Services

Unfortunately for them, Chanler managed to write an impassioned plea for help and smuggle it out of Bloomingdale via a discharged journalist who had been committed for morphine addiction. The reporter didn’t get the letter to Chanler’s lawyer, but instead wrote a sensational story. Though the story publicized his plight, little help resulted.

Chanler's Scathing Report on His Stay at Bloomingdale

Chanler’s Scathing Report on His Stay at Bloomingdale

Chanler trained himself to walk far and fast, and on Thanksgiving Eve, 1900, he slipped out the gates of Bloomingdale, perhaps with the help of a loyal friend. Chanler made it back to Virginia where his friends helped him pursue a trial to determine his state of mind. The ultimate result: Chanler was declared legally sane in that state. Years later, the New York courts also found him sane.

This is one instance–a rarity indeed–of triumph for someone whose family had been determined to keep him in an asylum.

 

 

Happy Holidays

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Christmas Tree in Wisconsin State Hospital, 1895

Christmas Tree in Wisconsin State Hospital, 1895

Asylum patients were often lonely and neglected by their families during the holidays, though a few superintendents, like Dr. E.H. Williams, the assistant physician at Matteawan State Hospital (1897), didn’t think the holidays mattered much to them. He believed that the insane couldn’t handle changes in routine and wouldn’t appreciate celebrations, anyway.

Most asylum superintendents didn’t believe this, and tried hard to make holidays like Christmas special. Public charities and organizations often helped them. They donated food and clothing, and churches brought groups to visit and sing. Usually, meals were also festive and special. The Milwaukee Sentinel described a dinner meal in 1903 that included rabbit stew, oysters, and plum pudding. The evening before, staff had distributed bags of candy and fruit as patients enjoyed music and danced. Festivities like these undoubtedly meant a great deal to patients burdened by the monotonous regimen that was such a large part of their treatment.

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

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

Very often, asylums would decorate Christmas trees and their public areas; superintendents also made sure that every patient received a gift, using money that had been set aside for that purpose or relying on donations from charities.

Patients and Staff at Christmas Party at State Hospital, Jamestown, courtesy Historical Society of North Dakota

Patients and Staff at Christmas Party at State Hospital, Jamestown, courtesy Historical Society of North Dakota

It  was important that no one be forgotten, and all these efforts to provide a bit of cheer and comfort undoubtedly helped patients through an especially difficult time. Likewise, the staff enjoyed the break in routine, and received the psychic boost that comes from helping others.

Was There Any Way Out?

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Force Feeding a Patient at the Willard, Asylum for the Insane, llate 1800s, courtesy The Inmates of Willard

Force Feeding a Patient at the Willard Asylum for the Insane, late 1800s, courtesy The Inmates of Willard

Horror stories abound about the cruelty and sadness of life in an asylum. Especially as asylums became overcrowded and less well-run, it was hard for patients to recover from whatever condition had sent them there. Even worse, the patients’ relatives often had no desire or incentive to bring them home–whether they did get better or not. Sometimes, patients simply had no relatives or friends to return to.

Physicians at asylums had more incentive to discharge patients so that their “cure rates” could go up, but if they had nowhere to send an “improved” or “cured” patient, they might feel they had no choice but to keep them in the asylum. Additionally, many physicians were too busy–or didn’t care enough–to spend much time with patients and couldn’t determine whether or not they had improved. All these factors could lead to a lifetime of treatment for what had been a temporary problem.

Doctors and Administrators at the Florida State Hospital, circa 1920s, courtesy State Archives of Florida

Doctors and Administrators at the Florida State Hospital, circa 1920s, courtesy State Archives of Florida

An 1880 report from the Insane Asylum of California summed up the facility’s overall cure rate (since its creation) as just under 47%. This was certainly an admirable rate, but the superintendent also pointed out that very sadly, some patients were being sent to the asylum who more properly belonged to a state hospital or infirmary. He was speaking specifically about patients who were senile or had chronic diseases, but he also mentioned a state law against sending “cases of “idiocy or imbecility, or simple feebleness of mind” to asylums. The law was obviously being ignored.

An Advocate Went a Long Way Toward a Patient's Release, courtesy Portraits of Eloise blog

An Advocate Went a Long Way Toward a Patient’s Release, courtesy Portraits of Eloise blog

Some patients did manage to get out of asylums even though the odds were stacked against them, and I will discuss these cases in an upcoming post(s).

Dangerous Confinement

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Harper's New Monthly Magazine, 1866, Showed A Doctor Making His Rounds at Blackwell's Island Lunatic Asylum

Harper’s New Monthly Magazine, 1866, Showed A Doctor Making His Rounds at Blackwell’s Island Lunatic Asylum

The attendants working in insane asylums often had deservedly poor reputations. However, many were dedicated and capable, and performed their duties admirably. We can only imagine the outcome of any number of harrowing situations if attendants had not remained calm and committed to the people who depended on them.

An article in an 1879 issue of the New York Times reported on a fire that had broken out in a large building beside the main asylum on Blackwell’s Island. The building held about 100 female patients, who were locked in rows of cells on each floor. Smoke began pouring out of the cellar late in the evening and attendants gave the alarm. The Medical Superintendent had them unlock each cell and release the patients, but getting them outside to safety could have been quite a task given the unusual circumstances and mental state of the patients.

An Asylum Dance at Blackwell's Island

An Asylum Dance at Blackwell’s Island

However, to calm patients’ fear and excitement, the attendants told the women “there was to be a dance in the Amusement Hall, a building in which concerts and balls were given to the inmates of the asylum,” the paper reported.

The patients exited via fire escapes, and to keep up the pretense that all was well, someone played “a merry air” on the piano in the Amusement Hall. Some of the patients began to dance on the lawn as employees and others fought the fire, and every life was saved.

New York City Asylum for the Insane on Blackwell's Island

New York City Asylum for the Insane on Blackwell’s Island

The Insane in Territories

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Main Street in Norman, OK, 1889, courtesy Emma Coleman Photography Collection, University of Oklahoma

Main Street in Norman, OK, 1889, courtesy Emma Coleman Photography Collection, University of Oklahoma

Several states had created insane asylums while they were still part of a Territory; Oklahoma was one of these. The Cherokee Nation actually established the first asylum in the area when they erected the Cherokee Home for the Insane, Deaf, Dumb, and Blind outside the city of Tahlequah in 1873.

The Territory’s non-native insane were sent to Jacksonville, Illinois for treatment until two physicians created a private company called the Oklahoma Sanitarium Company. The Territorial Legislation awarded them a three-year contract to care for the insane, hoping to cut down on transportation costs for patients going to Illinois. The company constructed a hospital (the Oklahoma State Hospital) at Norman, OK in 1895. The Territory also approved a second asylum (Oklahoma Hospital for the Insane) in Supply, OK in 1905.

Dr. Griffin Was Hired from North Carolina in 1899

Dr. Griffin Was Hired from North Carolina in 1899 and Became Superintendent in 1902

Because Oklahoma’s institutions were created later on in the asylum era (a third one opened in 1913), care was relatively modern: the State Hospital’s staff consisted of both attendants and nurses, as well as a physician-superintendent and assistant physicians. By 1910, it had even adopted the practice of employing women nurses in male wards. Within twenty years of its creation, the hospital had a training school for nurses and a laboratory.

Oklahoma Sanitarium Building, 1897, courtesy Emma Coleman Photography Collection, Oklahoma University

Oklahoma Sanitarium Building, 1897, courtesy Emma Coleman Photography Collection, Oklahoma University

A 1909 report from the institution shows that 94 patients were either released or “restored” and 48 released as “improved.” A number of other patients (71) were paroled, that is, given the opportunity to go home to see how they would do, while 15 managed to escape.

For those in the asylum at the time, a majority diagnosis was hereditary insanity. Other causes for insanity included: ill health; syphilis; inebriates; old age; drugs; child birth; mental worry; privation; injury to brain; epilepsy; sunstroke; pellagra; and self abuse.

Paying the Bills

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Many Eager Dreamers Rushed to California in 1849

Many Eager Dreamers Rushed to California in 1849

The idea that asylums were necessary had been widely accepted in America by the middle of the nineteenth century. Even far-flung regions like California provided for the care of the insane; it established an asylum at Stockton in 1853, only a few years after the 1849 gold rush.

Creating an asylum called for relevant legislation, and California’s first general law regarding the insane gave the responsibility for proper commitment to county judges:

“. . . [the judge shall] upon the application of any person under oath, setting forth that any person by reason of insanity was unsafe to be at large, or was suffering from mental derangement, forthwith cause the said person to be brought before him and cause to appear two reputable physicians, to examine the alleged insane person . . . .”

Though it seems that just about anyone prepared to swear to another’s insanity could begin the application process for commitment, this young state (created just three years earlier in1850) commendably included some practical safeguards. First, the initiator’s desire was not enough to force a commitment, and that person had to go through government channels to continue the process–surely a deterrent to some cases of spite or malice.

Second, not only did the two required physicians have to examine the proposed patient and declare him/her insane, they had to certify under oath that the diagnosis was correct. Then, it was still the judge’s decision to commit the person, based largely on the premise that the suspected person was not safe to be at large. The expenses incurred by any person so committed would be born by the state–and that even included expenses for the patient’s travel to the asylum. The latter may not have been an extremely powerful deterrent against frivolous commitments, but presumably judges in a newly functioning state would be careful about committing people to Stockton without considering the drain on public funds.

Most state institutions were designed primarily to help the poor, though many did take paying patients. California followed this pattern and allowed the non-indigent into its state asylums. However, the State Commission in Lunacy was to collect any appropriate charges for these latter patients, and could “bring action to recover such charges.”

Building at Stockton State Hospital

Building at Stockton State Hospital

Old Photo of Stockton State Hospital

Old Photo of Stockton State Hospital

Schools for Insanity

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Alienist Dr. Isaac Ray

Alienist Dr. Isaac Ray

People today wonder how physicians and other educated people could have believed excessive smoking, masturbation, or reading novels might lead to insanity. Though anything in excess is probably not as healthy for a person as that same thing in moderation, how could something like “excessive study” cause insanity? An extremely prominent alienist, Dr. Isaac Ray, explained:

“Though hard study at school is rarely the immediate cause of insanity, it is the most frequent of its ulterior causes, except hereditary tendencies.” Ray further declared that the chances of recovery [from insanity] were far fewer in the “studious, intellectual child” than in the opposite type. The reason for this, Ray explained, was that “though the immediate mischief may have seemed slight, but the brain is left in a condition of peculiar impressibility, which renders it morbidly sensitive to every adverse influence.”

irls From Glen Eden Boarding School for Girls, circa 1911

Students From Glen Eden Boarding School for Girls, circa 1911

Ray’s remarks appeared in a September, 1859 issue of the The Atlantic Monthly, within an article strongly admonishing the then-present system of excessive schoolwork for children. A typical schedule in a well-run girls’ boarding school could be something like this: Rise at 5:00 a.m., study for two hours, eat breakfast, spend six more hours in the schoolroom, eat lunch, then spend two hours sewing, writing letters, completing other small tasks, and perhaps walking if weather permitted. Afterward there would be another hour of study, supper, and then two more hours of study–eleven in all. The author later mentioned popular Sunday School contests throughout the country, in which winners memorized up to 5,000 Bible verses.

An 1854 Math Book by Joseph Ray

An 1854 Math Book by Joseph Ray

It’s no wonder that many children fell into ill health, whether or not the excessive study actually led to insanity. However, with this kind of tasking in mind, it’s a bit easier to believe the (unnamed) author’s statement that he had recently heard of “a child’s dying insane, from sheer overwork, and raving of algebra.”

 

Podcast About Vanished in Hiawatha

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I hope that some visitors are aware that I have written a book about a unique asylum: Vanished in Hiawatha: The Story of the Canton Asylum for Insane Indians, which was published last year by the University of Nebraska Press. I recently had the pleasure of being interviewed about it for a podcast available on the New Books Network:

Carla Joinson, “Vanished in Hiawatha: The Story of the Canton Asylum for Insane Indians” (U. Nebraska, 2016)

You can download the podcast at the bottom left of the page. If you care to listen to it, I hope the interview (by a wonderful host from the University of California, Santa Cruz) will give you a feel for what this book is about.

When Johnny Came Marching Home

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Soldiers Could Never Escape the Suffering Imposed by the Civil War, courtesy Library of Congress

Soldiers Could Never Escape the Suffering Imposed by the Civil War, courtesy Library of Congress

People today understand the after-effects of war on veterans better than previous generations did (though that doesn’t diminish its trauma). Soldiers in previous eras were much more on their own, since medical personnel didn’t recognize the emotional damage and scarring they often suffered. Civil War soldiers in particular faced a changed war environment that greatly contributed to their later trauma.

These young men suffered death and injury on the grandest scale experienced in American history. They endured horrific wounds inflicted by new weapons and then went on to suffer just as intently afterward from assembly-line-style amputations. Many soldiers saw the ground seem to crawl and shift with wounded, struggling bodies after a great battle, or heard cries for help they could never forget. They often carried this trauma back to the battlefield and then home.

ivil War Soldier Angelo Crapsey, 1861, Who Committed Suicide in 1864 After a Period of Mental Illness, courtesy Kutztown University of Pennsylvania

Civil War Soldier Angelo Crapsey, 1861, Who Committed Suicide in 1864 After a Period of Mental Illness, courtesy Kutztown University of Pennsylvania

Physicians did recognize that some symptoms occurred specifically to soldiers they saw: heart palpitations, sweating, and/or rapid breathing, and other symptoms of panic attacks. These manifestations were identified by Jacob Mendes Da Costa and called “Da Costa’s Syndrome” or more commonly, “soldier’s heart” or “irritable heart.” Some physicians sympathized with men suffering from it, while others thought they were merely shirking their duty. At home, men who suffered from the after-effects of war trauma were similarly misunderstood.

The Government Hospital for the Insane (later known as St. Elizabeths) had been built specifically for soldiers, sailors, and the indigent of Washington, DC, but many other asylums also saw an influx of veterans who could not cope with their post-war trauma. Most did not get much help beyond the security of three meals a day and a bed to sleep in, along with occupational therapy–usually in the form of work–to help them pass their days.

Brevet Brigadier General Newell Gleason Was Committed to the Indiana State Hospital for the Insane in 1874 andCommitted Suicide in 1886 Some Time After His Release, courtesy Library of Congress

Brevet Brigadier General Newell Gleason Was Admitted to the Indiana State Hospital for the Insane in 1874 and Committed Suicide in 1886 Some Time After His Release, courtesy Library of Congress

These veterans were often traumatized one last time by family members and a society ashamed by the idea of mental illness and the “weakness” of the man suffering from it.

Confusion About Insanity

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This Delusional Woman Believed Her Friends Wanted to Hurt Her

This Delusional Woman Believed Her Friends Wanted to Hurt Her

Though many alienists (a term for early psychiatrists) felt perfectly competent to treat insanity, few felt that they could actually define it. In his book, A Treatise on Insanity in its Medical Relations (1883), Dr. William Hammond demonstrated the difficult of defining insanity by citing various experts:

“According to Hoffbauer, an individual is insane when the understanding is diverted . . . when he is powerless to avail himself of  his intellectual facilities, or to make known his wishes in a suitable manner.” However, Hammond pointed out, this definition would include conditions like “apoplexy and concussion and compression of the brain.”

“The late Professor Gilman . . . declared that ‘insanity is a disease of the brain by which the freedom of the will is impaired.'” As with the previous definition, however, Hammond declared that “this definition neither covers the subject nor excludes other diseases.”

Insanity Could Lead to Unthinkable Crimes

Insanity Could Lead to Unthinkable Crimes

Several alienists Hammond quoted declined to define insanity at all, saying that no definition in any kind of general terms would be useful. Even common manifestations of insanity such as illusions, hallucinations, and delusions could not definitively diagnose it, since there were reasons why these conditions might occur whether a person was insane or not.

Alienists Did Not Necessarily Believe Insanity Caused All or Most Crime

Alienists Did Not Necessarily Believe Insanity Caused All or Most Crime (January 19, 1919 Issue of the Chicago Tribune)

One of the issues surrounding the diagnosis of insanity through the ages is that the condition can’t really be defined the way a case of measles or a broken leg can be. Culture, custom, expectations, and so on constantly refine what is acceptable behavior or what will be tolerated through the ages and across cultures.

That leaves the question: What is insanity?