Insanity a Privileged Disease?

August 31st, 2014
The Surge in Nervous Diseases Created Interest in the Public

The Surge in Nervous Diseases Created Interest in the Public

Though insanity would never be welcomed by either victims or their families, it was perhaps a comfortable notion to think that it primarily afflicted “civilized” people and nations. Nervous diseases did not affect “savages.” Furthermore, the upper, leisured class could sometimes ascribe their whims, phobias, and “nerves” to their sensitivity and developed intellect, even when the conditions bordered on insanity.

Wealthy women could be dainty, frail, and too refined to bear anything sordid or “common.” They could afford to be highly strung, indulging in hysteria, moodiness, nervousness, and hypochondria. Men shied away from hysteria, but they could manifest both hypochondria and melancholia without losing respect. People who had these nervous disorders, or neurasthenia, as coined by Dr. George Brown (see last two posts) could go to spas, travel, or take rest cures that might include bed rest, massage, and hearty meals. Sometimes for men, treatment would be vigorous outdoor exercise.

Though all these conditions caused distress and should not be considered false or amusing in any degree, only the leisured, wealthier class could manage to indulge in them without societal disapproval. A delicate blue-blood who could eat only the daintiest food was acceptable; a factory girl would be expected to eat what she was given. A wealthy man could afford to be melancholic and withdraw from business or social obligations, whereas a working man would incur only anger or exasperation for the same behavior. Finally, the wealthy could manifest these somewhat fashionable nervous conditions without acquiring the label of insanity or suffering the trauma of  commitment to an asylum. Because they had the means to help themselves in gentler ways via the advice and services of specialists, they could perhaps cope better with their condition so that it did not become worse, the way it might for a person in poverty and with no ability to get help at the onset of the problem.

Massaging Arm in the Rest Cure, circa 1890

Massaging Arm in the Rest Cure, circa 1890

Victorian Woman Fainting of Neurasthenia

Victorian Woman Fainting of Neurasthenia

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Insanity and Physical Causes

August 28th, 2014
Charles Hamilton Hughes, Eminent Alienist, Founded and Edited The Alienist and Neurologist

Charles Hamilton Hughes, Eminent Alienist, Founded and Edited the Alienist and Neurologist

Alienists had long pondered the causes of insanity, and attributed some often-laughable (to modern sensibilities) reasons for its onset. They realized that sudden shocks, grief, worry, and other emotional traumas could at least temporarily affect a patient’s mind, but they also understood that insanity could derive from physical causes. Unfortunately for many patients, syphilis and epilepsy were two primary physical conditions behind much of the insanity found in insane asylums during this time. Sunstroke, fevers, and alcohol abuse could also damage the body enough to cause insanity.

In the 1870s, Dr. George Beard (see last post) made some important connections between stress and neurosis, attributing “American nervousness” to the sudden onslaught of a rapidly developing modern era which could overwhelm many people. However, he ultimately believed that insanity was due to physical causes.  “The central nervous system becomes dephosphorized, or perhaps, loses some of its solid constituents,” Beard wrote. In mental illness, the nervous system underwent morbid changes in its chemical structure, which diminished the patients “nervous force.” These changes could ultimately be viewed under a microscope in an autopsy, though Beard could not actually prove his theory. He was firm in his conviction, however, that all insanity was a result of some sort of diseased physical condition.

Conditions Like Anorexia Were Accepted by Physicians in the Industrial Age, photo circa 1900

Though Identified Much Earlier, Conditions Like Anorexia Became Widely Accepted by Physicians in the Industrial Age, photo circa 1900

Nerve Syrup

Nerve Syrup

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Industrialization and Mental Illness

August 24th, 2014
Americans Sought Help for Nervous Diseases

Americans Sought Help for Nervous Diseases

Americans may have enjoyed many of the new inventions and opportunities the dawning industrial age offered, but many were also thrown off balance by the increasingly fast pace of the late 1800s. Dr. George Beard noticed that Americans were having difficulty coping with life as new forms of transportation, communication, and automation made their way into society. He tried to make sense of the physical symptoms cropping up in far too many ordinary, upper and middle-class people, and determined that they were caused by an “exhaustion of the nervous system.” He termed the syndrome neurasthenia.

Though Beard’s observations were quite astute to some degree, he also perpetuated some stereotypes. He believed that “civilization” and its higher demands led to certain nervous conditions and physical complaints: “The savage can usually see well; myopia is a measure of civilization.” Likewise, American women, who were given the opportunity to socialize more easily than women in other countries, developed their “cerebral activity” more quickly. This, in turn, influenced their physical development, with the end result that American women were typically more beautiful and expressive than women in other countries.

Beard's Book on American Mental Illnes

Beard’s Chart on American Mental Illness

George Beard

George Beard

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Change in the Air

August 21st, 2014
Young Polish Boy, a Migrant Worker, Picking Berries in Maryland, courtesy National Archives

Young Polish Boy, a Migrant Worker, Picking Berries in Maryland, courtesy National Archives

Though 1903 continued in the same difficult pattern and lifestyle for most Americans (see last post), the year also saw many exciting changes. The Canton Asylum for Insane Indians, with its modern lighting and plumbing, reflected the wave of innovation and invention rippling throughout the country. From 1900 – 1903:

Henry Ford founded Ford Motor Company.

Germans invented the zeppelin airship.

Orville Wright made his first flight on the Wright Flyer.

Guglielmo Marconi completed the first two-way wireless message and got a reply.

Crayons were invented.

Owen Wister wrote The Virginian.

Industrialization had come to the country, even though the majority of the population still lived in rural areas. Men, women, and children abandoned farms and sought the factory work which mechanical innovation made available. Along with it came the ills of modern society and some new psychological problems. But, not to fear, for alienists were ready and willing to meet the challenges of the new era.

Count Ferdinand Von Zeppelin Invented His Namesake Dirigible

Count Ferdinand Von Zeppelin Invented His Namesake Dirigible

 

A Literary Reminder of a Fading West

A Literary Reminder of a Fading West

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New Century, Old Ways

August 14th, 2014
New York Street Scene, 1903

New York Street Scene, 1903

Life was difficult around the turn of the twentieth century. A simple scratch or sore throat that developed into strep could still cause death since there were no effective antibiotics, most homes had no indoor plumbing, and heating fuel was dirty and inconvenient. Though most women no longer had to weave their own cloth, many were still cutting out patterns and sewing their family’s clothes. Farming was labor-intensive, with a lot of human-power to supplement whatever farm animals were available for plowing, planting, and other tasks. Canning food for the winter was hot, exhausting, and seemingly endless when the crops came in and food had to be processed right away.

It is little wonder that the townspeople in Canton, South Dakota were so proud and impressed with the new Canton Asylum for Insane Indians,with its electric lights and indoor plumbing. (The asylum had range toilets; these flushed at intervals rather than after each individual use, but were still a great convenience.) In an age when even very young children worked hard on farms or in dangerous factory and mining jobs, the public could feel gratified that an institution existed which could provide food, shelter, and medical care to people who were struggling to get through life.

Feeding Chickens in Montana, 1908

Feeding Chickens in Montana, 1908

 

Farm House in Nebraska, 1903, courtesy Library of Congress

Farm House in Nebraska, 1903, courtesy Library of Congress

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Time Matters

August 7th, 2014
Charles Eastman, 1897, courtesy Smithsonian Institution

Charles Eastman, 1897, courtesy Smithsonian Institution

The world was truly a different place when the Canton Asylum for Insane Indians first opened on the last day of 1902. Even something as simple as clothing was remarkably different from what we typically see and wear today. Men dressed far more formally and women were tied down (and sometimes literally weighted down) with voluminous dresses and hats. It was relatively easy to tell someone’s status or wealth through clothing, since differences in the quality of cloth were easy to spot. Even people who shopped in stores for ready-to-wear clothing frequently had their outfits tailored to fit better, and one’s ability to keep clothes neat, clean, and free of wear and tear spoke loudly about his or her access to servants and/or services. Clothing also indicated modesty and morality, since there was a clear demarcation between the clothing homemakers and businessmen wore and the flashy styles of showgirls, prostitutes, gamblers, and others who did not fit into traditional roles.

These aspects of fashion and clothing are a few of the reasons that whites focused so much attention on Native American clothing–it was completely different than anything the rest of society wore. Traditional native clothing made wearers stand out, and emphasized the gap between what the country’s original inhabitants had always worn and what had become mainstream through white encroachment. To assimilate into white society–a federal goal–Native Americans had to adopt “citizen” (the white norm) clothing as an important first step. It is no wonder that the clothing issue became bigger than it perhaps should have been; in that era, clothing symbolized much more than protection from the elements or mere decorative changes in adornment.

Men's Fashions, 1903

Men’s Fashions, 1903

A Picture of What May Have Been the First American Fashion Show, Held in 1903 at the Ehrlich Bros. Dress Shop, courtesy gibsonglamor.blogspot

A Picture of What May Have Been the First American Fashion Show, Held in 1903 at the Ehrlich Bros. Dress Shop, courtesy gibsonglamor.blogspot

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How to Help

August 3rd, 2014
Occupational Therapy, Toy Making in WWI-Era Psychiatric Hospital, courtesy Otis Historical Archives, National Museum of Health and Medicine

Occupational Therapy, Toy Making in WWI-Era Psychiatric Hospital, courtesy Otis Historical Archives, National Museum of Health and Medicine

Dr. Harry Hummer, superintendent of the Canton Asylum for Insane Indians, was not inclined to an active, hands-on approach to helping his patients overcome mental illness. In addition to his own weakness in this area, he may have found it nearly impossible to apply his book knowledge to real-life situations at the asylum. His patients at St. Elizabeths in Washington, DC, had been mainly white males with a military background. In South Dakota, his patients were from another race and culture which Hummer didn’t even attempt to understand. The problem is highlighted in a letter Hummer wrote to request reimbursement for an expenditure of $118.93 that he had incurred for returning patient Lillie Chaves to her home in New Mexico.

Dr. Hummer explained: “She was reported as having been restored to ‘her normal mental condition’ under date of April 14, 1914. This was not intended to imply, however, that she was competent to make the trip from Canton to Laguna, unattended. She was a young girl of about 18 years, who understood very few English words and spoke none.”

Hummer went on to explain that there were four changes of cars during the train trip, which would have been difficult for Chavez to negotiate without an English-speaking escort. He was perfectly correct, of course, but the explanation underscores an important reason that the Canton Asylum failed in its mission. How could a psychiatrist attempt to help a patient when neither person could speak the other’s language? How could Hummer diagnose a person he couldn’t understand, and more importantly, how could he create a plan to help that person? Without interpreters assigned or available to the asylum, little could be done for non-English speakers except warehouse them. Chavez was fortunate in that her father was involved and had come up, himself, to get her.

Hydrotherapy, 1936

Hydrotherapy, 1936

Douche Bath in Pennsylvania Hospital for the Insane, 1868, courtesy cournellpsychiatry.org

Douche Bath in Pennsylvania Hospital for the Insane, 1868, courtesy cornellpsychiatry.org

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Keeping Up

July 31st, 2014
Outlines of Psychiatry

Outlines of Psychiatry

Like most people, Dr. Harry Hummer, superintendent of the Canton Asylum for Insane Indians, had a number of contradictory traits. Though he was accused of poor record-keeping on his patients and of a failure to institute any kind of mental health plan for them, he was clearly interested in maintaining expertise in his field. In January, 1913, he requested the following books for his office library:

1. Outlines of Psychiatry (William A. White)

2. Three Contributions to Sexual Theory (Sigmund Freud)

3. Mental Mechanisms (William A. White)

4. Manual of Psychiatry (J. Rogues De Fursac)

5. Treatment of Nervous and Mental Diseases (William A. White and Smith Ely Jelliffe)

Hummer was also accused of wanting to run his asylum “from a desk,” rather than from personal contact with patients and involvement with their care. That would certainly be possible through books, and studying–rather than doing–likely appealed to his natural inclinations. On a rather ironic note, three of these books were written by his former boss at St. Elizabeths, Dr. William A. White. Every time Hummer looked at the titles, he may have been reminded of the success he hadn’t, himself, attained.

An Industrious Asylum Superintendent, Thomas Kirkbride

An Industrious Asylum Superintendent, Thomas Kirkbride

Influential Psychiatrist, Sigmund Freud

Influential Psychiatrist, Sigmund Freud

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And One Step Backward

July 27th, 2014
Sioux Indian Women Receiving Rations, Pine Ridge Reservation, 1891, courtesy Library of Congress

Sioux Indian Women Receiving Rations, Pine Ridge Reservation, 1891, courtesy Library of Congress

By the early 1920s, some of the indifference to Native Americans’ cultural values had lessened (see last post). However, even if  a government official occasionally saw positive traits in native peoples or respected their need for cultural wholeness, his viewpoint could be buried in a continued avalanche of popular sentimentality and/or naivete that perpetuated stereotypes and fed unrealistic daydreams about the status of Native Americans. In 1923, a reporter for the Canton Farmers Leader wrote an article about the Canton Asylum for Insane Indians. In it, he lauded the decision to create the asylum and described a few of its patients. However, before getting to the meat of the article, the writer had this to say about current Indian affairs:

“Indians today are becoming more and more civilized. They are being educated in all sections of the country. They are given opportunities to live in much the same contentment as the white man. They have been provided with handsome reservations in appropriate portions of the nation.”

Anyone who could write this while living in proximity to a reservation was either self-deluded or determined to support a comfortable fairy-tale that allowed readers to feel good about themselves and their government.

Oraibi Girls Grinding Corn, circa 1895 - 1925, courtesy Library of Congress

Oraibi Girls Grinding Corn, circa 1895 – 1925, courtesy Library of Congress

Colville Indian Family on Reservation, circa 1900 - 1910, courtesy Library of Congress

Colville Indian Family on Reservation, circa 1900 – 1910, courtesy Library of Congress

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Tiny Steps

July 24th, 2014
ield Matron and Assistants, 1905

Field Matron and Assistants, 1905

Most Europeans settlers believed that their respective cultures were superior to Native American ones, and set about imposing their own ideas upon native peoples as soon as they were able to do so. This thinking led to many tragedies, including reservations and assimilation, with all their cascading ills. The federal government made a concerted effort to stamp out Native American culture by making job security and food dependent on compliance and forcing children to go to boarding schools, among other strategies. Not everyone supported this thinking or behavior, but it ruled.

By the 1920s, significant protest to federal policy (and field experience) caused leaders to rethink some of their practices. In a paper from 1924, “Is the Indian Susceptible to Health Education,” Dr. A. J. Chesley pointed out that many problems with Indian health had to do with the lack of health education and resources available to native peoples. After discussing a few of the problems a colleague had discovered among Chippewa families, Chesley discussed one of the doctor’s major recommendations to improve their health.

“First, that Chippewa nurses be employed to undertake public health work,” advised the colleague, Dr. S. J. Crumbine. “Experience shows that little progress has been made by white nurses, field matrons, or other workers among the Indians. Considering that the Indian nurses know the customs of the people, understand their point of view and speak their language, it is believed they might earn the confidence of the Indians and induce them to do the things which would benefit the children.”

This suggestion seems like basic common sense to anyone at all sensitive to the cultural needs of other people, but it was evidently a novel  idea. Though a better suggestion might have been to allow traditional native healing practices rather than imposing Anglo-based ones, Dr. Crumbine had been speaking specifically about tuberculosis and the close living quarters which spread the disease. In this instance, information about contagion would have been helpful in preventing the spread of the disease, and certainly would be most effective if delivered by a Chippewa nurse.

A Havasupai Indian Woman Receiving an Injection in Knee From Public Health Service Officer, courtesy National Library of Medicine

A Havasupai Indian Woman Receiving an Injection in Knee From Public Health Service Officer, courtesy National Library of Medicine

An Indian Health Service Field Nurse Demonstrates X-Rays, courtesy National Library of Medicine

An Indian Health Service Field Nurse Demonstrates X-Rays, courtesy National Library of Medicine

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