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The Madness of Love

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Sympathetic Writer Tells Anna's Story

Sympathetic Writer Tells Anna’s Story

Newspaper articles often reflect society’s view of an issue, or they can offer a view that the writer wants the public to consider. A compassionate article in the June 9, 1905 issue of the Evening World (NY, NY) was the latter type.

A woman named Anna Valentina had killed her long-time partner’s mistress under sorrowful circumstances and awaited hanging in Hackensack, NJ. Anna had fallen in love with a fellow Italian named Mike Calluel many years earlier, and he seemed by all accounts to be hard, cruel, and selfish. He used Anna relentlessly.

For ten years–always with the promise of marriage before her–Anna worked physical jobs all day (including construction), and kept house, cooked, and cleaned for Mike as well. She eventually bought a piece of land with the money she she earned, believing the purchase was one step closer to marriage. Unfortunately, she gave the property to her lover. Mike Calluel took up with a young woman named Rosa Salza and threw Anna out of the house she had bought and physically helped build for him.

Anna Carried Hods of Brick in Her Daily Work

Anna Carried Hods of Brick Like These in Her Daily Work

Mike and his new lover were evidently soul mates–Rosa simply laughed at Anna’s plight. The spurned woman held out hopes that Mike would finally return to her, so she remained in the area and frequently saw Rosa in the house she had lost to her. Rosa insulted and provoked Anna every time she saw her, and one day either spitefully called Anna in to see her or goaded Anna into coming into the house. One of Anna’s greatest tragedies was the inability to have children, and Rosa now had twins. Rosa both taunted her with the twins and mocked Anna’s worn-out face and figure until Anna finally went mad.

Anna Valentina in a December 20, 1905 Issue of the Evening World

Anna Valentina in a December 20, 1905 Issue of the Evening World

To underscore how deliberate Rosa’s behavior was, the paper reported that Rosa expected Anna to be upset and had kept a knife behind her back. Unfortunately for her, Anna was still strong from all those years of work, and wrenched the knife from Rosa and stabbed her to death.

My next post will discuss Anna’s fate.

Real Friends

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William Tuke

William Tuke

William Tuke and Philippe Pinel are generally credited with revolutionizing the care of the insane in England and France, respectively. These men substituted compassionate care for patients (at the York Retreat and the Bicêtre) for the typical imprisonment and harsh punishment the insane received before that time. But . . .

Before either of these men were even born, the Religious Society of Friends in Philadelphia were concerned about the sick and insane living in the new continent of America. Around 1709, they expressed this concern in one of their monthly meetings, and took steps to establish the Pennsylvania Hospital for both these groups in 1751, and later the Friends’ Asylum for the Relief of Persons Deprived of the Use of Their Reason solely for the insane in 1813. The asylum (which actually began to receive patients in 1817) had as one of its stated goals, to be a place where “the insane might see that they were regarded as men and brethren.” The York Retreat predated the Friends’ Asylum by a few years, but the idea for the American asylum had come much earlier and was probably delayed for many reasons, possibly including the political unrest going on in the colonies.

Friends' Asylum for the Insane

Friends’ Asylum for the Insane

When the asylum first opened, it was only for fellow Friends, but in 1834 the religious affiliation was dropped and the institution opened its doors to all patients. From its beginning, all efforts were directed toward helping patients without resorting to restraints or cruelty. The annual report from 1853 states that “a chain was never used for the confinement of a patient.” The  founders also wrote into the rules the injunction: “Come what may, the law of kindness must at all times prevail.”

Friends' Asylum History

Friends’ Asylum History

The Asylum was a far cry from the conditions Dorothea Dix met in Little Compton, Rhode Island (see last post), which were barbaric to the point of torture.

 

Another Kind of Asylum

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Certainly Not a Madhouse!

Certainly Not a Madhouse!

Words carry power, and the terminology used in psychiatric care is no exception. When asylums were first gaining popularity, the word meant a place of peace, recuperation, and sanctuary to most laypeople. The word “lunatic” or “insane” in front of it simply denoted the type of resident.

In the early years of American asylums, patients were often referred to as “unfortunates” or in other similarly sympathetic terms, but doctors soon realized that a stigma was growing around these institutions. They urged the use of words like “hospital” as more appropriate: asylums were simply places for sick minds to get well.

Going even further, sanitariums became popular as genteel places where people with nerve issues could get relief. These were many times small hospitals run by physicians . . . for the wealthy. They were private, luxurious, and generally voluntary, and patients were not burdened by the hopelessness sometimes associated with insanity. Nervousness, weak nerves, and neurasthenia were comfortable names that did not embarrass the rich.

Caregivers Outside the Adams-Nervine Asylum in Massachusetts, courtesy Historic New England

Caregivers Outside the Adams-Nervine Asylum in Massachusetts, courtesy Historic New England

One institution that bucked this trend of catering only to the wealthy was the Adams-Nervine Asylum in West Roxbury, Massachusetts. The founder, Seth Adams, provided in his will that the institution should be “for the benefit of the indigent, debilitated nervous people who are not insane, inhabitants of the Commonwealth of Massachusetts, as may be in need of the benefits of a curative institution.”  (Its charter did allow it to accept paying patients as well.)

Even a Modern Stove Required Almost 300 Pounds of Coal a Week and Produced 27 Pounds of Ash to be Sifted, courtesy Conner Prairie.org

Even a Modern Stove Required Almost 300 Pounds of Coal a Week and Produced 27 Pounds of Ash to be Sifted, courtesy Conner Prairie.org

The asylum must have been a boon to the admittedly small number of women able to go there. A Boston Globe article offered the information that “the statistics of the asylum show that of those admitted, unmarried women are in a great majority. Chiefest among the causes mentioned by the doctor as giving rise to this state of things is the fact that many of these women have worn themselves out working for and waiting upon others – daughters upon whom have devolved the weight of household cares and the nursing of invalid parents or relatives, and who have no one to fall back upon when their own strength fails.”

A Crazy Cure

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Medicine for Asthma Went Straight to the Lungs Via Cigarettes

Medicine for Asthma Went Straight to the Lungs Via Cigarettes

Many nineteenth-century theories about disease and mental illness were based on assumptions that made sense within the limited knowledge of the time. Unfortunately, quacks could pick up on ill-founded theories and make a fortune if they were good salespeople–and of course, most were excellent. Dr. Edwin Hartley Pratt’s theory about chronic disease resulting from irritation of bodily orifices (see last post) is a case in point.

Dr. Frank E. Young took on the orifice problem and created rectal dilators with exaggerated claims: they were good for anemia, constipation, sallow skin, acne, insomnia, anorexia, headaches, and on and on. These rubber plugs–shaped somewhat like a torpedo–also cured insanity. In promoting his cure, Young asserted, “three-fourths of all the howling maniacs of the world” were curable “in a few weeks’ time by the application of orificial methods.”*

Dr. Young's Rectal Dilators

Dr. Young’s Rectal Dilators

Though the medical world scoffed, Young’s devices were popular (primarily for constipation) until the FDA began to regulate and oversee medical devices in 1938. In 1940 the agency seized a shipment of Young’s dilators as misbranded (because of their claims to cure so many conditions) and Young’s company fell out of favor.

Arsenic for Beauty Typified the Errors in 1800s Medical Knowledge

Arsenic for Beauty Typified the Errors in 1800s Medical Knowledge

*Reported in The Medical News, April 29, 1893, p. 471.

Nerve-Waste and Insanity

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Dr. Edwin Pratt

Dr. Edwin Pratt

Medicine in the 1800s was not always founded on firm data; it often based cures solely on (what someone thought) were reasonable assumptions. Dr. Edwin Hartley Pratt was a homeopathic physician who eventually wrote in his 1891 book, The Philosophy of Orificial Surgery, that there was one predisposing cause for all forms of chronic diseases: “and that is a nerve-waste occasioned by orificial irritation at the lower openings of the body.”

In the September, 1893 issue of a journal called The New Way, an unattributed article presented an example of “orificial philosophy.” The author referred to an article in the Journal of Nervous and Mental Disease which discussed the abatement of insanity in cholera patients. Sixty patients were sickened by the disease at the Bonneval Asylum in France. During its peak manifestation in their bodies, “maniacs” were relieved of all symptoms of insanity, though they gradually returned as the victims got well. Melancholics were also helped, and patients who were melancholic or only slightly insane seemed to recover their sanity permanently.

Pratt's Book on the Treatment of Chronic Diseases

Pratt’s Book on the Treatment of Chronic Diseases

Though the Journal of Nervous and Mental Disease didn’t speculate about why cholera helped relieve insanity, The New Way did. “Cholera is a disease of the bowels, and results in their violent and complete evacuation and dilatation of the anal sphincter. Following this comes a compete relaxation of the whole muscular system.”

This gave the brain relief “and reason was restored while the condition lasted,” the author continued. “But as soon as the patient recovered from the cholera the relaxed condition of the muscular system disappeared and the sphincter became tight again.”

One of Pratt's Sanatoriums

One of Pratt’s Sanatoriums

The result? The inhibition of the sympathetic nervous system, “deranged circulation and a return of insanity.” The anonymous author then wrapped up his case with the declaration that “seven-tenths of the cases of insanity, irritation and derangement will be found at the outlets of the body.”*

  • September 1893, Vol 1, No. 5, p. 125

 

 

Preparing for Idiots, Lunatics, and Insane Persons

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Commericial Hospital Began Ambulance Service in 1865, courtesy National Library of Medicine

Commercial Hospital Began Ambulance Service in 1865, courtesy National Library of Medicine

Ohio became a state in 1803 and quickly realized the need for an insane asylum; its initial institution was established as The Commercial Hospital and Lunatic Asylum of Ohio in Cincinnati. Built without delay, in January, 1824, the hospital’s trustees were able to put a notice in the Liberty Hall and Cincinnati Gazette: “. . . the undersigned trustees hereby give notice . . . that they are prepared to receive idiots, lunatics and insane persons.”

Though it was a gentle enough invitation, these unprotected guests of the state may not have enjoyed their stay. Built before reformer Dorothea Dix’s campaign to treat the mentally ill with kindness and understanding, the asylum was as much a prison as a place of healing.  In 1831, the state legislature even asked the question as to “whether the cells and apartments of the lunatic asylum are sufficiently separated from each other by thick walls to prevent the inmates from communicating with each other.” Was solitary confinement their goal?

Longview Asylum, 1860

Longview Asylum, 1860

Though stumbling a bit at inception, the hospital was the starting point for an orphan asylum, the city infirmary, the Cincinnati Hospital, and Longview Asylum. A description (from 1916) of patients’ rooms at Longview shows a dramatic upswing in comfort from what must have been dismal quarters at the original Commercial Hospital:

1910 Article Shows That Asylum Was Fallible

1910 Article Shows That Asylum Was Fallible

“The walls are covered with photographs of the best pictures of the world . . . . Everywhere throughout the house are inlaid tables and unusual pieces of fancy furniture, fancy needlework, flowers, singing birds, bric-a-brac, etc. which is seldom roughly handled or destroyed by patients. In each ward is a tastily furnished cozy corner, fitted up with book shelves, easy chairs, etc., where patients who will not abuse the privilege are allowed.”

 

 

 

Brain Troubles

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School Children in the Late 1800s, courtesy Aventa Learning

School Children in the Late 1800s, courtesy Aventa Learning

Alienists in the late 1800s believed that too much mental exertion could cause insanity, whether from over-studying at school, constantly dwelling on one topic, focusing too intently on business issues, or from other situations requiring unremitting thought (without adequate rest). This was one reason for the prevailing idea that children could become insane from intense schoolwork.

Dr. Ray V. Pierce, author of The People’s Common Sense Medical Adviser in Plain English: or Medicine Simplified (1886), explained: “No mental effort can be made without waste of nervous matter. The gardener’s hoe wears by use, and so does every part of the animal organism. Otherwise, nutrition would be unnecessary for the adult.

“The production of thought wears away the gray matter of the cerebrum as surely as the digging of a canal wears away the iron particles of the spade. . . . The intellect, whether engaged in  observation, generalizations, or profound study consumes the brain and blood, hence intellectual activity implies VITAL EXPENDITURES.”

Dr. Ray V. Pierce

Dr. Ray V. Pierce

Pierce continued his explanation by saying that all the functions of the body were essential to the production of nerve-energy (including thought). Unlike exercise, which had value because it helped circulate blood, nutrition, and so on, mental labor did not have advantages of this kind. A child who studied too hard “consumes the blood, exhausts the vital forces, weakens, the organic functions . . . .”

The first result of all this expenditure would be anemia, said Pierce, because the brain “appropriated its red corpuscles” and eventually used them up. Because of this weakened state, other dire things could follow.

Image From Pierce's Book

Image From Pierce’s Book

Though an obviously incorrect explanation concerning the issue of too much schoolwork, Pierce and many others correctly noted long ago the emotional problems in over-pressured children: An uptick in anxiety, depression, and lack of joy.*

*A 2016 survey showed that nearly one in three teenagers told the American Psychological Association that stress drove them to sadness or depression — and their single biggest source of stress was school.

The American Disease

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Chart From American Nervousness, Its Causes and Consequences, 1881

Chart From American Nervousness, Its Causes and Consequences, 1881

“Nervous” diseases became prevalent toward the end of the 1800s; most manifestations were lumped under the term neurasthenia. Some public commentators believed the condition was entirely manufactured, since it seemed to affect only the wealthier people in the country. Others were convinced it was a real condition brought on by the stresses of modern life and the burdens of business. Almost all agreed that it was a peculiarly American disease.

Writers tended to mock “nervous” women who went to rest homes, sanitariums, or cruises to recover from neurasthenia, but seemed to find the condition more credible in men. “Americans who make money or achieve marked success generally have neurasthenia at some time in their lives,” said the Fort Wayne Sentinel in 1890. Nervous strain was a natural part of these successful lives, and eventually, the body succumbed to “nervous exhaustion.” Doctors often compared neurasthenia in men to the mental aberration called hysteria in women.

Nerve Medicine Aimed at Men

Nerve Medicine Aimed at Men

Symptoms of neurasthenia included fatigue, anxiety, headache, heart palpitations, and depression. Treatment in general terms emphasized rest, a change of scenery, and freedom from responsibility and care. Specifically, treatments could include massage, ocean bathing, electrical stimulation, and hypnosis. Of course, nerve tonics became popular as well. These “secret” formulas often included strychnine, morphine, cocaine, and opium among other questionable ingredients.

This Elixer Said It All

This Elixer Said It All

The term neurasthenia has faded, but its symptoms live on as chronic fatigue syndrome, “burn-out”, and similar terms that denote high stress and its effects.

 

 

For A Price

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Dr. Boris Sidis

Dr. Boris Sidis

“A good many people are beginning to realize that nervous diseases are alarmingly on the increase …. Nerves are the most ‘prominent’ complaint of the 19th century,” wrote one reporter in an 1887 issue of the Boston Globe.

As always, medical entrepreneurs found ways to accommodate the trend to everyone’s satisfaction. When a case of “nerves” became unbearable to a person or unmanageable for the family, alienists found a way to cater to wealthy patients’ need for privacy and luxury. The Sidis Psychotherapeutic Institute was an example: it was a private asylum containing “beautiful grounds, private parks, rare trees, greenhouses, sun parlors, palatial rooms, luxuriously furnished private baths, private farm products,” according to a brochure designed to appeal to Professor Boris Sidis’ expected clientele.

Images From the Sidis Psychotherapeutic Institute

Images From the Sidis Psychotherapeutic Institute

Sidis also had a reassuring message for them. “It is well known and correspondingly deplored among physicians and psychologists,” Dr. Sidis explained, “that there are fully 50pc. of mentally disturbed cases that cannot be cared for in an insane asylum. These cases are of persons who are not actually insane, but who are on the verge of that condition. Also, they are not physically ill, or if they are ill it is not so serious that they should be sent to a hospital.”

McLean Asylum for the Insane Began as a Mansion Purchased from Joseph Barrell

McLean Asylum for the Insane in Charlestown, Massachusetts Began as a Mansion Purchased from Joseph Barrell

For families wishing to avoid the stigma of insanity, a private “institute” or sanitarium was far preferable to a crowded state-run asylum manned by poorly paid and trained staff. These private asylums probably gave patients–many of whom undoubtedly had genuine mental illness–the relief they needed and served the purpose for which they were created. However, they came with a price most of the country couldn’t afford. Sidis charged today’s equivalent of $1,000 a week–out of reach for all but the wealthy. No matter how desperate they might have been to put their loved one in the best place possible, most families had to settle for state asylums.

 

Unhappily Ever After

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Charles Dickens Tried to Have His Wife Committed to an Asylum During His Affair With a Young Actress, photo circca 1850 of the Charles, Catherine, and Two of Their Children

Charles Dickens Tried to Have His Wife Committed to an Asylum During His Affair With a Young Actress, photo circa 1850 of Charles, His Wife, and Two of Their Children, courtesy Smithsonian Magazine

Most families hesitated to commit their loved ones to insane asylums until they became violent, uncontrollable, physically ill, or burdened with conditions that required constant care (hallucinations, suicidal tendencies, etc.). Unfortunately, men sometimes sent the inconvenient women in their lives to asylums, and married women were especially vulnerable.

In 1882, Mrs. Martha J. Collins suspected her husband of infidelity, and when she actually gained proof of it, he retaliated by sending her to the Kings County Lunatic Asylum in NY, and later, to Bloomingdale Asylum. Doctors released her as sane almost immediately  from each institution, but her husband pressed on and sent her to the Buffalo State Asylum for the Insane. After five weeks, she managed to get a letter delivered to her legal counsel.

Buffalo State Asylum for the Insane

Buffalo State Asylum for the Insane

Mrs. Collins’ attorneys argued that she had been committed illegally, and the asylum’s authorities considered her sane enough to be released into the care of her husband. After discussion (probably rather heated on her part) Judge Smith of the Superior Court released her unconditionally. When her husband approached her, she said, “Mr. Collins, I will shake hands with you: but that is all,” and refused to return home with him unless he agreed not to imprison her again.

A Desperate Elizabeth Packard Tries to Change Her Husband's Mind About Committing Her to Jacksonville State Hospital in Illinois

A Desperate Elizabeth Packard Tries to Change Her Husband’s Mind About Committing Her to Jacksonville State Hospital in Illinois

Refusing to return home was a courageous step for a woman of that time, who likely had little money of her own or any way of earning a living. She did keep a diary about her asylum experiences, and planned to have it printed. Hopefully, the publicity protected her from any further bullying by her husband.