Limitations of Inspections

Living Quarters in an Insane Asylum

Living Quarters in an Insane Asylum

Many researchers have wondered how inspectors failed to note the shortcomings of the Canton Asylum for Insane Indians, since it was inspected many times over the course of its existence. Most asylums were inspected regularly, yet like visitors to the Canton Asylum, most outsiders failed to uncover problems that made life miserable for patients.

Moses Swan, a patient at the Troy Marshall Infirmary and Lunatic Asylum (New York) from 1860-71, offers a partial explanation. “You know but little how patients are treated by attendants and others. I have seen gentlemen and ladies visit this main house . . . and remark how nice it looked, and so it did.”

Attendants Could Be Quite Cruel to Patients

Attendants Could Be Quite Cruel to Patients

Swan explained that a nicely dressed visitor looked in on him once, saw the “nice white spread” on Swan’s bed and the presumably soft mattress under it, and said that Swan’s accommodations looked very nice. However, what the visitor couldn’t see were Swan’s sleepless nights as he listened to the cries and wails of disturbed patients, how frightened he was when he was locked in a room with an uncontrollable patient, or how cruelly the attendants treated him when they desired. Swan was kept continually locked in a cell for many months after arriving at the institution, had no liberty to leave the building, and received only a few visitors over the years.

Doctors Visit Patients Who Are Kept in Restraints

Doctors Visit Patients Who Are Kept in Restraints

In his writings after recovery, Swan tried to warn the relatives of those who considered sending a loved one to an asylum: “O Fathers! O, Mothers! keep your unfortunate sons and daughters from these places until a reform has been brought about . . . . I would say to one and all, know you are right before you transport any to an earthly hell.”

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

Empty Yourself

Bloodletting As a Treatment for Agitation in Insanity, courtesy Burns Archives

Bloodletting As a Treatment for Agitation in Insanity, courtesy Burns Archives

Early alienists typically believed that an insane person needed to eliminate something from the body in order to get well. Copious bleeding and/or purging were popular ways to deplete a maniac’s excessive energy or excitement, but many alienists soon came to believe the procedure was too extreme. Instead, they turned their attention to the bowels.

Samuel Woodward, former superintendent of the Massachusetts State Lunatic Hospital, wrote in 1846 that it was “common for the bowels to be constipated in mania,” and advised a round of laxatives to help solve the problem. He also urged that these laxatives be gentle, but unfortunately turned to poisonous mercurial compounds to do the job. A popular concoction was “blue pill” which was generally a mixture of about one-third mercury, one-third rose oil, and small proportions of licorice, milk sugar, and possibly another quarter portion of hollyhock or marshmallow derivative. Two or three of these pills might represent close to a hundred times the level of exposure that the EPA considers safe today.

Calomel Preparation, Flavored

Calomel Preparation, Flavored

Benjamin Rush's Bilious Pills

Benjamin Rush’s Bilious Pills

Mercury poisoning usually shows up first with headache, nausea, stomach pain, and later, with sore gums and loose teeth. Eventually, symptoms move on to the brain and cause loss of memory and insomnia, and often irritability, depression, and paranoia as well. Since the alienist’s goal for his patient was a daily evacuation of the bowels, patients could take something like calomel or blue pill for quite some time. And, the psychological type of symptoms as a result of mercury poisoning might well keep the sufferer both in an asylum and taking the medicine indefinitely.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

How to Commit

Elizabeth Packard Being Taken to an Asylum Against Her Will, courtesy National Library of Medicine

Elizabeth Packard Being Taken to an Asylum Against Her Will, courtesy National Library of Medicine

Few patients went to insane asylums voluntarily; most were committed by physicians called in once concerned family members decided a patient’s behavior had reached some sort of tipping point. Committing a patient to an asylum should have been a very serious affair, but it is evident that it was not always done with professionalism and discernment. In an article* published by the American Journal of Insanity (1876), Dr. A. E. MacDonald gave medical students some sound advice about how to examine a patient and determine whether or not to propose commitment.

Dr. Abraham Myerson, Dr. I Veron Brigg, and Dr. Earl K. Holt Examine Defendants, 1934

Dr. Abraham Myerson, Dr. I Veron Brigg, and Dr. Earl K. Holt Examine Defendants, 1934

Many states required the concurrence of two or more physicians to commit a person to an asylum. MacDonald noted that many times a physician–perhaps at the invitation of the family’s physician–was asked to commit a patient to an asylum, rather than to examine a patient. He likened the situation to that of a physician called in to prescribe medicine to a patient without examining him first to see if the medicine were needed. Families would seldom do such a thing, yet with a presumably insane patient, the verdict was often presupposed and the physician essentially called in to rubber-stamp the decision. MacDonald cautioned students to be careful, though, and to examine such a patient thoroughly with an eye to defending himself in a court of law should the patient later sue.

MacDonald went on to say that physicians often encountered two groups within the family: those who wanted the patient committed, and those who didn’t. He also emphasized that much of what he would hear concerning the patient from these family members would be either useless or untrue. He tried to give students a road map of pertinent questions to ask and a systematic way to approach the situation so they could assess a patient objectively.

He also had this bit of advice: “I advise you to make sure of being able at once to recognize your patient from those who may surround him, by learning before you enter the room, some particulars as to his dress or appearance. It is not a little awkward and embarrassing to address yourself to a bystander, under the impression that he is the patient, but it is a mistake that has happened, and might happen again.”

Ambulance Outside Bellevue Psychiatric Hospital, 1895

Ambulance Outside Bellevue Psychiatric Hospital, 1895

*From a lecture delivered before the students of the University of the City of New York, Medical Department, March 10, 1876.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

Dance Therapy

Dance Therapy in New York State Asylum, 1920

Dance Therapy in New York State Asylum, 1920

Physical exercise was seen as therapeutic for mental illness, and the staff at insane asylums employed it in many ways. Patients often labored in asylum gardens and farms, took walks, joined in exercise programs, or otherwise used their bodies in healthful ways. Dancing was one type of movement that asylum managers used for entertainment, reward, and healing. Dancing not only released pent-up energy in an enjoyable way, but it also allowed patients a measure of self-expression. Some who participated in group dances were also able to form social bonds that helped them endure their stay in an asylum.

Edward Elgar

Edward Elgar

Composer Edward Elgar began his career at the Worcester County and City Lunatic Asylum in Powick, England in 1879, at age 21. As bandmaster, he composed many polkas, quadrilles, and minuets for the asylum’s 22-piece (asylum-staff) band; his music was “cheerful, charming, and appropriate to its setting.” Additionally, he and the band gave concerts that also brought the patients enjoyment. Later in his career, Elgar liked to shock listeners by referring to “when I was at the lunatic asylum.”

Music Recovered From Elgar's Early Career

Music Recovered From Elgar’s Early Career

Though he wrote no masterpieces during the five years he composed pieces at the Worcester Asylum, he later went on to write the Enigma Variations and the Pomp and Circumstances Marches.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

Dancing in the New Year

Lunatics Dancing at Blackwell's Island, New York in 1865

Lunatics Dancing at Blackwell’s Island, New York in 1865

Most asylums tried to incorporate decorations and festive activities into their patients’ lives during the Christmas season; the cheerfulness helped many patients and also brightened the morale of staff. Dances were popular entertainments at asylums, and many undoubtedly held special New Year’s Eve dances as an end to the holiday season.

Article About a Dance

Article About a Dance

A reporter attending a New Year’s Eve dance at Middlesex Madhouse in Hanwell (1842) described the participants as looking and behaving like “a crowd of children.” He described the dancing as being of the kind one saw at village fairs, and that the patients didn’t wear uniforms or “workhouse” dresses. Many of the patients definitely enjoyed the activity and talked avidly and gaily, but others seemed anxious, disturbed, melancholy, or uneasy.

There had evidently been a change of management or policy, because the reporter described a girl who had formerly been restrained a great deal of the time and had just recently been released from that treatment. “Her wrists were deformed by the hard leather cases in which they had been confined; and so habituated had she been to wear them at night, that for some time after they had been removed she held up her hands to be bound whenever she went to bed.”

A Twelfth Night Party at Hanwell Lunatic Asylum

A Twelfth Night Party at Hanwell Lunatic Asylum

Though his article was laudatory, the sad picture he painted at the end was the reality many patients at asylums faced. One night of comparative fun and freedom could scarcely make up for it.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

Christmas Festivities

Christmas Tree in Wisconsin State Hospital, 1895

Christmas Tree in Wisconsin State Hospital, 1895

Though attendants at times ignored, and the public itself often forgot about patients in insane asylums, the Christmas season brought out a desire to remember even the most removed members of society. Many civic organizations donated food and clothing to insane asylums, or sought to make the patients more comfortable. Churches, school bands, and choral groups would visit asylums to sing and entertain patients, and money was usually set aside in some way for improved meals. The Milwaukee Sentinel wrote on December 25, 1903 that:

“Inmates of the county insane asylum will enjoy rabbit stew, oysters, and plum pudding for dinner today. The Christmas tree entertainment was held last evening, and the program of music and recitations was followed by dancing and bags of candy and fruit were distributed.

Christmas Decorations in Ward of Bellevue Hospital, 1920

Christmas Decorations in Ward of Bellevue Hospital, 1920

“The usual Christmas festival for the patients of the Milwaukee Hospital for Insane was given on last evening. A Christmas tree, illuminated by colored electric lamps and laden with presents, a concert by the hospital orchestra, and dancing, comprised the entertainment. Every patient received a present and refreshments were served. A special breakfast and dinner will be served today, and skating on the lake will be indulged in.”

Christmas Turkeys Displayed Outside Spencer State Hospital, formerly Second Hospital for the Insane, circa 1924, courtesy WVU Libraries

Christmas Turkeys Displayed Outside Spencer State Hospital, formerly Second Hospital for the Insane, circa 1924, courtesy WVU Libraries

These and similar festivities elsewhere were aimed at patients, but very likely heartened the staff as well.

 

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

A Case of Insanity

Dr. Isaac Ray, courtesy National Library of Medicine

Dr. Isaac Ray, courtesy National Library of Medicine

Alienists had many interesting theories about insanity and what caused it, and frequently had to explain their views to the public. Court cases involving an insanity defense could create heated debate on the topic, and an article in the October, 1866, issue of the American Journal of Insanity provided a platform for such a discussion.

The case involved Mary Harris, a citizen of the District of Columbia, who shot her former lover dead. She was acquitted and released because of her insanity at the time she committed the crime. Dr. Nichols, superintendent of the Government Hospital for the Insane (St. Elizabeths), testified to her insanity, but did not mean to imply that she was cured of it. There may have been no legal way to keep her confined, however, so she was “let loose upon the community” in the words of the article’s author, Dr. Isaac Ray.

A Gender-Based Cause of Insanity

A Gender-Based Cause of Insanity

Dr. Ray did not discuss the particulars of that case, but instead went on to discuss a “class” of similar cases, where women committed heinous crimes. Because of the “peculiar influence of those organs which play so large a part in the female economy,” said Ray, these criminal acts may have been prompted not so much by motive as by the woman’s physiology. Ray went on to say, “With woman it is but a step from extreme susceptibility to downright hysteria, and from that to overt insanity.” In his opinion, many women who committed crimes like murder (as revenge), had experienced “a strong moral shock and an irritable condition of the nervous system.” He asked, “Is it strange that a person thus situated, should become insane?” (In Harris’s case, he referenced her “uterine derangement.”)

Alice Mitchell Tried to Murder Freda Ward Due to the Exciting Cause of Thwarted Love and Jealousy; She Was Found Insane

Alice Mitchell Tried to Murder Freda Ward Due to the Exciting Cause of Thwarted Love and Jealousy; She Was Found Insane and Committed to the Tennessee State Insane Asylum

Though Ray’s views seem to be compassionate, they were bad news, indeed, for females accused of insanity who might come before him for assessment. Ray was too ready to believe that their gender made them susceptible to insanity, and that it took so little to push them over the edge.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

Anyone Could Be Insane

Alsa Thompson, Age 4

Alsa Thompson, Age 4

Early alienists did not spare many conditions when it came to assessing insanity. Alcohol abuse, syphilis, and epilepsy, were often considered forms of insanity, as were the physical manifestations of a severe form of niacin deficiency called pellagra. Women with severe PMS or menopausal symptoms, or even too much interest in sex, could also be considered insane. Children did not escape that label, either.

Publicity Surrounded This Unusual Case

Publicity Surrounded This Unusual Case

In 1925, seven-year-old Alsa Thompson confessed to poisoning her family by putting sulphuric acid and ant paste in their evening meal. Fortunately, her intended victims found the taste so awful that they didn’t eat more than a bite or two of the meal, but the child’s troubled psyche had been exposed. Further investigation found that she had slashed her five-year-old sister’s wrists with a safety razor (which didn’t kill her), and had poisoned two canaries and a cat.

Judge Walter Gates dismissed the insanity complaint that had been brought against Alsa, but he did feel she needed to be under observation. He remanded Alsa into the custody of parole officer Jean McCracken of the local lunacy commission until she could be transferred to a state institution.

Some Contemporaries Obviously Doubted Alsa's Confession

Some Contemporaries Obviously Doubted Alsa’s Confession

Newspaper accounts of the time mentioned that she did not seem bothered by the accusation and simply stated, “I like to see them die,” when questioned about her motives. Her father vigorously defended her, and others thought she was simply impressionable and confessed to a crime she did not commit.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

Early Thoughts on Insanity

Insane Asylum at Raleigh, North Carolina

Insane Asylum at Raleigh, North Carolina

The more settled eastern states generated most of the research and theory concerning insanity in the 1800s. Most asylum superintendents were both born and educated in the east, and the region produced and trained most asylum superintendents for many years. North Carolina, for example, did not even see a published paper on the topic of insanity from its state medical society until 1871. That paper, “Report of a Case of Violent Cerebral Excitement Relieved by Bromide of Potassium” involved a five-year-old boy. Only the standards of the time could have considered the child insane.

Death by Childbirth Insanity

Death by Childbirth Insanity

The next paper was entitled, “Mania Transitoria” and described momentary insanity that befell people who were otherwise aware of their surroundings and actions. The doctor believed that this transitory state of insanity was related to heredity and certain physical diseases. That theory makes the condition sound like epilepsy, but the author seemed to think that it was something else.

Hysterical Epilepsy, circa 1876

Hysterical Epilepsy, circa 1876

Dr. Grissom attributed the condition to masturbation and petit mal epilepsy as well as the former factors, so it is difficult to know what he is describing. Since many people suffering epilepsy were considered insane during this era, it is quite possible that these episodes of transitory mania sent many otherwise capable men and women to an insane asylum.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians

Lucid Lunatics

 

Life In An Insane Asylum Was Dangerous

Life In An Insane Asylum Was Dangerous

One of the most heartbreaking–and frightening–aspects of treatment in an insane asylum was that so many patients probably were not insane. Native American patients at the Canton Asylum for Insane Indians were rarely evaluated by any competent medical person before they were committed. Powerless and misunderstood, they were often railroaded into the asylum for convenience or spite.

Many white patients undoubtedly suffered the same fate. Women were also politically and financially powerless, and many inconvenient women may have been committed to asylums at the pleasure of their spouses, fathers, or other legal guardians. Diaries and letters that women wrote spoke passionately about how terrible asylums were, and how the rigid routines, loss of freedom, and frightening environment, were enough to make any sane person lose her mind. A woman who had little experience of the world, or who perhaps had never left her home without an escort, would be terrified in an asylum. One can only imagine the stress levels these wronged patients endured.

Patient at Surrey County Asylum, circa 1855, courtesy the Royal Photographic Society Collection, National Media Museum

Patient at Surrey County Asylum, circa 1855, courtesy the Royal Photographic Society Collection, National Media Museum

Diagnoses were also at fault. Medical conditions like epilepsy were considered a part of insanity, and patients who could be effectively treated today, would have spent their lives in insane asylums. Other reasons for commitment were just as tragic. Commitment papers for patients admitted to the Western North Carolina Insane Asylum in Morganton, North Carolina during the two years ending November 30, 1908 included reasons like:

— cigarette smoking

— desire to marry

— cocaine habit

— hard work and nose bleed

Western North Carolina Insane Asylum

Western North Carolina Insane Asylum

Though these diagnoses cannot tell the whole story, modern researchers have to wonder how much mental illness actually accompanied the patients’ conditions.

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GRIM SHADOWS:
The Story of the Canton Asylum for Insane Indians
by Carla Joinson
AVAILABLE FOR PRE-ORDER
Publication Date: June 1, 2016

GRIM SHADOWS: The Story of the Canton Asylum for Insane Indians