Asylum Supervision

Yankton Insane Asylum, S.D.

Yankton Insane Asylum, S.D.

Almost every area of the country provided institutional care for its insane members. Any state government which created an asylum also tried to provide oversight in some way–concerning both patients’ admissions and the facility’s administration. Many counties had insanity commissions or boards whose members judged the mental status of people brought before it.

The institution at Yankton was South Dakota’s only state-run asylum. Any resident was eligible for care, and each county had a three-member board of Commissioners of Insanity. The county judge was its chairman, and the other two members were a physician and an attorney. Requests for admission went before the Commission, who were supposed to investigate the claim. A person could resist commitment; the commission would then appoint a physician to examine the person. That physician’s report resulted in freedom or commitment.

In its early days, the asylum was governed by a board which among other duties: oversaw contracts, inspected sewer lines, helped make decisions about how to slaughter the meat used at the asylum, and reported on improvements to the grounds and new systems of administration.

Main Building at the State Hospital in Yankton

Main Building at the State Hospital in Yankton

 

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Water Treatments

Continuous Bath Room, Kalamazoo Psychiatric Hospital, 1918, courtesy Kalamazoo Public Library

Continuous Bath Room, Kalamazoo Psychiatric Hospital, 1918, courtesy Kalamazoo Public Library

Patients entering an asylum were frequently given sedatives or tonics, depending upon their physical state, as well as a strong laxative to clean them out. Warm baths were thought to be calming and were frequently prescribed for agitated patients. However, what might have begun as a soothing experience could develop into something close to torture in the extreme treatment called continuous bathing, which could last for hours or days.

Cold water was generally thought to be invigorating, acting as a non-pharmaceutical tonic. Cold water might also be used to “shock” patients out of a certain behavior. Wet pack treatments were versatile in that they acted as both a shock and a sedative. Patients were wrapped in wet sheet and shocked by the cold, but the thinking was that the body would soon warm the layer of air directly beneath the sheets and create a calming effect. Attendants particularly favored wet packs, since their supposed calming influence was enhanced by the fact that the patient couldn’t move and struggle if they tied the sheet to the bed.

None of these treatments seem to have been specifically invented for asylum patients. However, there was a world of difference when a patient took a treatment willingly and in relative luxury as part of a medical cure –as the wealthy did at medical spas–or were forced to endure a treatment they did not want, as often happened in asylums. Some treatments were so uncomfortable–or could be made so–that they were viewed as punishments by patients. Since there are many instances of attendants threatening patients with these water treatments, they were obviously misused in this way.

Wet Sheet Pack, 1902

Wet Sheet Pack, 1902

Patients Were Restrained For Hours During Some Hydrotherapy Treatments

Patients Were Restrained For Hours During Some Hydrotherapy Treatments

 

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Water Therapy

Taking the Waters at the Columbian Springs

Taking the Waters at the Columbian Springs

Water therapies, known collectively as hydrotherapy, were popular forms of treatment for insanity. Most people today have relaxed under the influence of a warm, soothing soak in a tub, but it is interesting to note that bathing for health or medical reasons was popular long before bathing as a sanitation practice became nearly universal. Even after bathing for cleanliness was adopted, unless a family had running water, plenty of pots, a means to heat large quantities of water, plus a large enough container to sit in, bathing in a tub was either impossible or a huge undertaking. (Dedicated bathrooms piped for washing were not the norm in most homes until the 20th century.) Washing with a cloth from a basin would have met most people’s needs.

This may be one of the (many) reasons why asylum hydrotherapy was sometimes fearfully or passionately resisted by patients. Wealthy families were more familiar with immersion bathing at mineral spas and the like, but ordinary people from a crowded city or even a home in the country may have been more used to soaking their feet in a foot-bath each night, or scrubbing up once a week from a basin or small tub. It would have been intimidating to walk (or be forced) into an asylum’s hydrotherapy room with its strange-looking equipment and gushing streams of water.

My next post will look at the reality of various forms of hydrotherapy.

Various Forms of Water Treatment

Various Forms of Water Treatment

Spray Hydrotherapy Room, courtesy University of Western Ontario

Spray Hydrotherapy Room, courtesy University of Western Ontario

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Gender Inequality

Portrait of An Insane Woman, Hugh Welch Diamond, 1852

Portrait of An Insane Woman, by Hugh Welch Diamond, 1852

Treatment for mental disorders was generally hit-or-miss in most insane asylums, and many superintendents embarked on experimental procedures simply because there weren’t any reliable ways to help patients. Some treatments were more bizarre than others, and unfortunately, some of the treatments aimed at female patients were based on mistaken physiology-based causes of insanity.

Many doctors in the nineteenth century believed that the reproductive organs caused insanity, and removed female patients’ ovaries to abate symptoms that seemed to appear during the menses. (Hysteria was another type of female insanity attributed to physiology.) Some doctors applied electrical current to a patient’s uterus, or injected the vagina with hot water. For women who masturbated–often considered a cause of insanity–doctors ensured that the patient would find it extremely painful by cauterizing her clitoris.

Feeble-minded Subjects for Sterilization, courtesy Truman State University

Feeble-minded Subjects for Sterilization, courtesy Truman State University

At the Canton Asylum for Insane Indians, neither superintendent favored these extreme treatments. However, Dr. Harry Hummer firmly believed that female patients in their child-bearing years should not be released unless they could be sterilized.

Since he had no means to do that, he decided to keep many female patients who were otherwise candidates for discharge. Hummer was sometimes overruled in these types of decisions if a woman had a strong advocate, but his policy was most often unchallenged.

Account of A Woman Declared Insane Apparently After a Fortune-Telling

Account of A Woman Declared Insane Apparently After a Fortune-Telling

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Asylum Adjustment

Wet Sheet Pack, 1902, Used to Calm Patients

Wet Sheet Pack, 1902, Used to Calm Patients

No one could be pleased to find him or herself unexpectedly in an insane asylum (see last post) and it is remarkable that so many patients (who later wrote about their experiences) managed to stay calm enough to protect themselves. Patients able to keep their cool and observe the situation quickly saw that protests did them no good, nor did stubbornness or resistance in any form. Those who learned the rules and complied with them generally got along much better with doctors and attendants, and convinced these authority figures of their “progress” toward a cure. Asylums were one place where defiance got a person absolutely nowhere.

Attendants and Employees, Detached Building No. 4, Willard Hospital for the Insane

Attendants and Employees, Detached Building No. 4, Willard Hospital for the Insane

Attendants from both early and late periods were undoubtedly overworked and beset by unruly patients, but just as assuredly, many attendants were unkind and sometimes brutal to patients. Attendants frequently showed indifference toward their patients’ misery, confusion, and unhappiness. Attendants beat patients with their hands or with any handy object, tied them up, poured water over them and refused to let the freezing patient change into dry clothes, and forcibly restrained them for disobedience.

Attendants, Detached Building No. 1, Willard Hospital for the Insane

Attendants, Detached Building No. 1, Willard Hospital for the Insane

Patients often referred to asylums as prisons, and their attendants as jailers. Unfortunately, an insane person had an open-ended sentence rather than the definite, limited one given to most criminals.

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Few Patients Came Voluntarily

Elizabeth Packard Being Kidnapped in Broad Daylight and Taken to an Insane Asylum, courtesy National Library of Medicine

Elizabeth Packard Being Kidnapped in Broad Daylight and Taken to an Insane Asylum, courtesy National Library of Medicine

The case of Peter Thompson Good Boy (see last three posts) shows how easy it was for a Native American to lose his freedom. It would be safe to say that few or no patients at the Canton Asylum for Insane Indians actually wanted to be there. Patient Susan Wishecoby thought she was going to a hospital when she agreed to go; she apparently had epilepsy or something like it that gave her “spells” that were disruptive. She wrote plaintively that if she had known where she was going, she never would have agreed to come.

Former Patients Often Wrote Bitterly About Their Experiences in Insane Asylums

Former Patients Often Wrote Bitterly About Their Experiences in Insane Asylums

White patients also resisted commitment to an asylum. Many patients have written about the way they were tricked into asylums. Some went on carriage rides that ended at an asylum entrance; women, in particular, were sometimes arrested unexpectedly (usually at the request of a male relative or husband) and taken to an asylum; other times women or men were asked to accompany a friend or relative to a law office or some such place to help with a legal matter, only to find that the legal proceedings were loose insanity hearings against themselves!

Athens Female Ward, 1893, courtesy Athens County Historical Society and Museum

Athens Female Ward, 1893, courtesy Athens County Historical Society and Museum

Though outrageous tricks were played on men and women alike, women were particularly vulnerable to abuses of authority. Many women wrote about how easy it was for husbands to commit their wives to asylums. In her book, Behind the Scenes, or Life in an Insane Asylum* (1878), Lydia A. Smith writes: “If a man tires of his wife .  . . it is not a very difficult matter to get her in an institution of this kind. Belladonna and chloroform will give the appearance of being crazy enough . . . .”

*Available today as a reprint or free ebook.

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Dr. Hummer’s Review

Mounted Dakota Sioux Indian Police, Rosebud Agency, 1896

Mounted Dakota Sioux Indian Police, Rosebud Agency, 1896

Peter Thompson Good Boy was sent to the Government Hospital for the Insane (St. Elizabeths) even though he lived in South Dakota and should logically have been sent to the Canton Asylum for Insane Indians. (See last two posts for this case study.) Except for his accusation that a neighbor had instigated his diagnosis and deportment, Good Boy displayed no signs of psychosis, exhibited exemplary behavior at St. Elizabeths, and had received an offer of employment. Nevertheless, he was transferred to the Canton Asylum in 1916 at the age of 39.

Native American Farmer, 1889, Montana

Native American Farmer, 1889, Montana

There, Dr. Harry Hummer diagnosed Good Boy with congenital “constitutional inferiority,” a condition meaning a person was below average physically or mentally. This diagnosis also implied that the person could not quite fit in or conform to the expectations of society, and/or had little moral discipline.

Good Boy had served three years in the Army and two years as an Indian policeman, then became a farmer and married. Earlier in life, he had been arrested and sentenced to serve five years in the penitentiary, but served only two years before being pardoned by the Governor [of SD]. While he was in prison, he had been trusted and given many privileges.

 South Dakota Correctional Facility, 1912, courtesy SD Department of Corrections

South Dakota Correctional Facility, 1912, courtesy SD Department of Corrections

Patient notes at Canton Asylum state that Good Boy was clean and tidy, sociable, and friendly, but sometimes excitable and profane. He had a good memory, liked to read, liked to work, and though sometimes became very angry, “seemed good natured at heart.” Good Boy’s biggest issue at the asylum was that he talked “against the Superintendent, the attendants, and the place in general.” If Good Boy was not insane, his behavior was certainly understandable.

Fortunately, whether through the efforts of others or Hummer’s eventual decision that he could fit into reservation life, Good Boy was released from the Canton Asylum for Insane Indians in 1918. Unfortunately, his stay in jail and at the two insane asylums (May 1913 – 1918) was far longer than the two-year and three-year terms in the penitentiary that his two companions received for their part in the horse theft incident.

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More Odd Decisions

Law West of the Pecos Judged Horse Thiefs Harshly, photo taken of Langtry, Texas in 1900, courtesy National Archives

Law West of the Pecos Judged Horse Thieves Harshly, photo taken of Langtry, Texas in 1900, courtesy National Archives

After being accused of horse theft, Peter Thompson Good Boy met an Insanity Commission in South Dakota and was adjudged insane. Oddly, he was sent to the government hospital in Washington, DC instead of the much closer Canton Asylum in SD. (See last post.) Good Boy asserted that because he pleaded “not guilty” to the theft charge, he was sent to an insane asylum far away. He accused a neighbor of instigating the maneuver, because Good Boy knew something about the neighbor’s criminal behavior.

St. Elizabeths' Center Building, circa 1900, courtesy National Archives

Center Building, circa 1900, courtesy National Archives

No one in authority quite believed Good Boy, but two congressmen made inquiries on his behalf, as did a chaplain. Apparently, the authorities at St. Elizabeths had told one of the congressmen (Congressman McGuire) that if someone would take responsibility for Good Boy and give him proper attention, he could probably be released. The chaplain wrote to say that a former employer of Good Boy’s had offered him employment in Nebraska.

Patient Room at St. Elizabeths, circa 1905

Patient Room at St. Elizabeths, circa 1905

Additional inquiries were made on behalf of Good Boy, so that whoever wrote Good Boy’s case summary concluded: “In view of the various conflicting statements (some not included in this post) which we have regarding this man, it is quite impossible for us to definitely decide as to what should be done in this case. His past conduct here has been exemplary, and aside from his ideas concerning, Whipple [the neighbor], he has manifested no signs of psychosis.”

The writer said that he would write to the Commissioner of Indian Affairs about the whole matter, and urged that Good Boy at least go to an institution nearer his home.

Good Boy was transferred to the Canton Asylum for Insane Indians on May 3, 1916. My next post will discuss this asylum superintendent’s take on Good Boy’s insanity.

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Beyond Reason

Rosebud Indian Agency, courtesy South Dakota State Historical Society

Rosebud Indian Agency, courtesy South Dakota State Historical Society

Many patients at the Canton Asylum for Insane Indians did not receive a formal hearing or doctor’s examination before being sent to the asylum. Authorities at least went through the motions with Peter Thompson Good Boy. He was accused of stealing a horse on the Rosebud Reservation, and spent some time in the Deadwood, SD jail while awaiting trial. While the legal proceedings ramped up after his arraignment, Good Boy evidently developed some behaviors that his counsel (and others) said looked “as though he were mentally deranged.”

Good Boy was confined in jail from at least May 1913 to September 1913. His attorney asked the Commissioners of Insanity of Lawrence County, SD to give Good Boy a hearing to determine his mental condition, which they did. They adjudged “the said Peter Thompson Good Boy to be insane.” The state hospital would not accept him, because he was a resident of a reservation and had been brought to jail by a United States Marshal.

For some reason which isn’t clear, Good Boy was sent to the Government Hospital for the Insane (St. Elizabeths) in Washington, DC rather than the asylum in South Dakota, which was much closer.

South Dakota State Hospital, Yankton

South Dakota State Hospital, Yankton

Center Building, Government Hospital for the Insane, circa Early 20th Century

Center Building, Government Hospital for the Insane, circa Early 20th Century

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New Reasons for Insanity

Blackfoot Family

Blackfoot Family

Many (white) observers over the years believed that insanity was rare among Native Americans. Their conclusion was born out during the Indian Bureau survey that tried to assess the need for a special asylum for insane Indians; among the thousands and thousands of Indians living on reservations, fewer than a hundred could be identified with mental problems.

Though J. Lee Humfreville (see last post) had nothing to do with this survey, he backed up earlier thoughts about the prevalence of insanity with his own observations made during his Army career. In speaking about the scourge of smallpox among the Blackfeet, Humfreville told of their extreme reaction to smallpox scars.

“. . . they were so humiliated at sight of these blemishes and scars [from smallpox] that some of them committed suicide. As suicide was almost unknown . . . one may obtain from this some idea of the distress of the Blackfeet over their disfigured appearance.”

Humfreville continued, “Some of the survivors of this dreaded disease became insane; as insanity was something new to them, they believed that the anger of the Great Spirit was especially directed to those who had had the disease.”*

Clearly, mental illness among Native Americans was not common at all if even an Army captain could make that case when speaking about another matter entirely.

Manifestation of Smallpox

Manifestation of Smallpox

* Italics mine.Native American Boy in Yukon Territory Receiving Smallpox Vaccine, circa 1900

Native American Boy in Yukon Territory Receiving Smallpox Exam and Vaccine, circa 1900

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