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St. Elizabeths and the Civil War

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

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.

Civil War Cemetery, circa 1897

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.”

 

A Special Veterans Hospital

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An Early View of the Government Hospital for the Insane

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

St. Elizabeths, 1917, courtesy Library of Congress

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

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.

 

 

 

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

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

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

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

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

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

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

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

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.

Anti-Insane Asylum Society

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Elizabeth Packard

Elizabeth Packard

Elizabeth Packard, who had been committed to an insane asylum by her husband for disagreeing with his religious views, was a fortunate woman–she was actually released from the institution. Afterward she pushed for a jury trial to plead her sanity and won, another uncommon victory for a woman who had been declared insane!

Packard later campaigned tirelessly on behalf of the insane, advocating particularly for laws that made commitment more difficult and writing books informing the public about the reality of treatment in an asylum. She also advocated for an Anti-Insane Asylum Society. Though it never became a popular movement, Packard’s simple Constitution for it would have made life easier for many others if it had been widely adopted. After an explanatory preamble, Packard asked members to pledge the following:

Asylum Where Elizabeth Packard Was Committed

Asylum Where Elizabeth Packard Was Committed

— To never consent to enter an asylum as a patient

— To never consent to have any relative or friend entered into an asylum as a patient

— That if [members] or anyone in their family became insane, they would be taken care of in their own homes

— That these people would be kindly and patiently cared for

— That if relatives of the unfortunates could not provide for their care, the Society would “furnish them the means for doing so”

— That the fund for helping unfortunates should be bestowed by a committee of the Society after investigation of the case.

One of Packard's Books

One of Packard’s Books

Though Packard’s Society never achieved national distinction, it became the forerunner of other ex-patient groups that have persistently arisen to help members who have received care at mental hospitals.

 

Authority Always Wins

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Investigative Reporter Nellie Bly Being Committed to an Asylum

Investigative Reporter Nellie Bly Being Committed to an Asylum

Whether a supposedly “insane” patient really was or was not, the odds were not in his favor when it came to putting up a defense against commitment and treatment. One potent factor against patients was the almost automatic presumption that the diagnosis they suffered was correct. (See last post.) Another factor was the very real authority and influence of an asylum’s superintendent.

Superintendents almost never initiated a diagnosis of insanity unless a person were sent directly to an asylum because of dangerous or noteworthy actions that seemed to put the patient or society at risk. In that case, a superintendent or one of his staff might examine the person and decide whether or not he was insane. Otherwise, some sort of panel or set of doctors/judges made the diagnosis and sent the patient to the (usually) nearest asylum. This certainly gave an appearance of impartiality to the superintendent, who might then be presumed to have only the patient’s best interests at heart.

Reverend Hiram Chase (mentioned in my last post) noted that he had once spoken with a man whose wife had been in an asylum for a long time. Chase asked the man what he thought about “the propriety of keeping one so many years in an asylum.” The man essentially replied that the doctors were wise and skillful, the nurses and attendants well skilled, that “great care and patience were exercised over the patient, and that no stone was left unturned to soothe and comfort these unfortunate victims of insanity.”

Attendants Were Not Nearly So Patient and Skilled as the Public Supposed

Attendants Were Not Nearly So Patient and Skilled as the Public Supposed

Dr. John Gray was Superintendent of the Lunatic Asylum in Utica During Chase's Commitment There

Dr. John Gray was Superintendent of the Lunatic Asylum in Utica During Chase’s Commitment There

Chase cheerfully accepted this husband’s words on the topic. Later, he unfortunately found them to be patently untrue once he was, himself, committed to the Lunatic Asylum in Utica [New York]. Chase stayed there for a little over two years and afterward wrote a measured but unsparing account of his stay that should have made others fearful of too innocent a trust.

 

Laws Against Insanity

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Society Believed in Better Breeding

Society Believed in Better Breeding

Even early societies realized that traits could be passed from parents to children. This belief, though based in fact, presented a problem because people did not–or more probably could not–differentiate between conditions that were actually inherited and traits that cropped up in offspring because of upbringing and environment.

Parents who had a genuine mental illness could model behavior that their children picked up and displayed, for example, though the children were not themselves mentally ill. The community, unfortunately, would believe that the mentally ill parent(s) had passed the condition to their offspring–with the children’s behavior as proof. Men and women who saw mental illness in their immediate families were often afraid to marry because they believed their children might inherit insanity–and potential mates were just as often scared off by the prospect. Families of the mentally ill became wary of letting the community know about their loved ones’ condition because all relatives might be stigmatized.

Eugenics Advocacy Poster From the Philadelphia Sesqui-Centennial Exhibition, 1926

Eugenics Advocacy Poster From the Philadelphia Sesqui-Centennial Exhibition, 1926

As time went on, these ideas were upheld by law. An important immigration law which went into effect in 1882 prohibited entry into the U.S. of any “lunatic, idiot, or any person unable to take care of himself or herself without becoming a public charge.” Not satisfied with preventing undesirable people from entering the country from other lands, the U.S. began to adopt a mindset that felt it acceptable to prevent the reproduction of “undesirables” who were actually citizens. Eugenics* laws made it legal to forcibly sterilize people who were “insane, idiotic, imbecile, feebleminded or epileptic”–all in the public interest.

Immigration Laws Stopped Undesirables From Entering the U.S., courtesy Cold Spring Harbor Laboratory

Immigration Laws Stopped Undesirables From Entering the U.S., courtesy Cold Spring Harbor Laboratory

*Eugenics is the the science of improving a human population by controlled breeding.

Maternity as a Cause of Insanity

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Dr. John P. Gray

Dr. John P. Gray

Mothers today know they have a difficult job, but in the late 1800s some alienists believed maternity could cause insanity. They based this belief on the surprisingly sympathetic premise that the overwork, anxiety, and loss of sleep associated with caring for children could weaken the body–and consequently the mind–enough that a woman could no longer cope sanely with life. Dr. John P. Gray, superintendent of the State Lunatic Asylum in Utica, New York gave an example:

In 1885, a woman with five children came to the asylum with symptoms Gray diagnosed as mania; she had lost her mental balance a few weeks after the youngest was born. The new mother “was incoherent, laughed to herself, expressed no interest or anxiety in her children, [and] wandered from one subject to another.” Her history showed that she had been vigorous and strong, but that she began doing her normal work two weeks after the birth of her last child.

Careworn Mother During the Great Depression, 1936, courtesy Library of Congress Photograph by Dorothea Lange

Careworn Mother During the Great Depression, 1936, courtesy Library of Congress Photograph by Dorothea Lange

Unfortunately, four of her children got whooping-cough and then the baby, and this mother was kept awake and was up often at night, “and then for six weeks she was deprived largely of sleep, was anxious, worked constantly, and took little food . . .'” One day she felt strange in her heart and head, then her mind wandered, and “from that time lost self-direction and passed into insanity.”

Money Made a Difference in the Ability to Care for Children

Money Made a Difference in the Ability to Care for Children

Gray then vigorously took up the cause of mothers. “In all the range of human affairs there is no neglect, no wrong, no cruelty, that compares with the neglect and ignorance associated with motherhood.” He said that this neglect was both a direct cause, and sometimes an indirect cause, of insanity. ” Husbands, he said, must protect their wives and make some sacrifices, themselves, “to shield their wives from undue labor under any circumstances, and especially under such [impending motherhood] and with such a possible outcome.

Strong words for an era in which women could not even vote!

Asylums Indeed

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A History of Rhode Island

A History of Rhode Island

Though insane asylums faced abuse charges after they became overcrowded, they were sanctuaries of peace measured against the care many insane patients had received in city-provided institutions. Cases written about in the book, State of Rhode Island and Providence Plantations at the End of the Century: A History (edited by Edward Field) is probably typical of treatment during the middle-1700s:

Rebecca Gibbs had been under the care of “the Towne of Newport” for 30 years and, “She seemed to be in a sense folded together, her lower limbs being drawn up to her breast so that her knees and her chin met and from this position there was never a change.” A physical deformity would have been bad enough, but Rebecca’s condition was caused by “her having been for several winters shut up in a cell without fire and without clothes, where she had drawn herself as compactly as possible together as a protection against the cold and had so continued till sinew and muscle were unable to relax.”

Thomas R. Hazard Wrote a Ground-Breaking Report on the Treatment of Rhode Island's Insane in 1851, courtsy Rhode Island Historical Society Library

Thomas R. Hazard Wrote a Ground-Breaking Report on the Treatment of Rhode Island’s Insane in 1851, courtesy Rhode Island Historical Society Library

In a different town, a man was chained and “so wrapped in bagging that when an apple was placed within his reach he could only gnaw it like an animal as it rolled about the floor and he rolled after it.”

Though some towns did treat the insane more kindly, that may have been the exception rather than the rule. Until the new idea of “moral treatment” based on kindness and retraining made its way to America in the 1830s, the insane could not expect comfort or help from society.

Rhode Island State Hospital for the Insane, Stone Hall, courtesy Rhode Island Department of State

Rhode Island State Hospital for the Insane, Stone Hall, courtesy Rhode Island Department of State