Tag Archives: Dr. Charles Nichols

St. Elizabeths and the Civil War

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.”

 

Early Care at St. Elizabeths

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

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

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.