Canton Asylum Given Much Thought

Richard F. Pettigrew

Richard F. Pettigrew

Though the Canton Asylum for Insane Indians had many problems throughout its operation, the facility itself had been the subject of much consideration before its construction. When Senator Richard F. Pettigrew, Chairman of of the Committee on Indian Affairs, first proposed Senate Bill 2042 (for the purchase of land and construction thereon of an asylum for insane Indians) in 1897, he asked for “not less than one hundred acres of tillable land” and that the building should be constructed of stone or brick with a metal roof, and “shall be as nearly fire-proof as conditions will permit.”

At the time, a few Indians deemed insane had been admitted to the Government Hospital for the Insane (known as St. Elizabeths) at the rate of $91 per quarter. Payment was through the Commissioner of Indian Affairs. The hospital’s superintendent, William W. Godding, noted that he was presently treating five Indians, and that “this number has never been exceeded at any previous date.”

Center Building, St. Elizabeths, 1900

Center Building, St. Elizabeths, 1900

Godding felt that there would be only a small number of Indians who might need psychiatric care, and that to spend $150,000 to purchase land and erect an asylum (Pettigrew’s proposed figure) was unnecessary. He pointed out that even after the asylum’s construction, the government would need to add “an annual expenditure of not less than $25,000 for the equipment and maintenance of the asylum.” Currently the Government Hospital cared for insane Indians at an annual cost of $2,267.

Dr. William W. Godding, courtesy Library of Congress

Dr. William W. Godding, courtesy Library of Congress

Like many other whites of the era, Godding believed that insanity was actually rare among Indians. He continued, “the additional expenditure [that Pettigrew proposed] might be advisable if there was a prospect . . . the number of insane Indians would be very much increased.” But, Godding stated, “the records of the race do not justify any such expectation, rather the opposite.”

Obviously, Godding’s commonsense objections were ignored.

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Insanity is Lucrative

Oscar Gifford

Oscar Gifford

Early alienists tried to keep their profession closed from outsiders, both to maintain prestige and to ensure adequate salaries. They were very successful for many years, and superintendents of insane asylums were among the highest paid physicians in the field of medicine.

At a time when many family doctors earned annual salaries in the hundreds of dollars, asylum superintendents almost always earned at least two thousand.

 

Dr. John W. Givens, Idaho's First Licensed Alienist

Dr. John W. Givens, Idaho’s First Licensed Alienist

The superintendency of the Canton Asylum for Insane Indians was a plum position, particularly for the sparsely-populated area in which it was located. Its first superintendent, Oscar Gifford, was appointed strictly through political favoritism, since he was not a medical doctor. With only one or two exceptions over many decades, other asylum superintendents held medical degrees that were often from prestigious universities abroad.

Bloodletting As a Treatment for Agitation in Insanity, Essex Lunatic Asylum, 1860, courtesy Burns Archives

Bloodletting As a Treatment for Agitation in Insanity, Essex Lunatic Asylum, 1860, courtesy Burns Archives

In 1901, the Sioux Valley News triumphantly announced Gifford’s appointment while noting that it “was one of the best jobs in sight.” The position paid $2,500 annually. According to one inflation calculator, that salary would translate to $69,444.44 today. For someone without the proper education, training, or experience to hold it, the position was indeed a financial windfall. Gifford must have realized quite soon that he wasn’t qualified to run an asylum, but he held onto the job for as long as he could. His lack of medical knowledge cost at least one life, however, and the consequences of his mistakes eventually forced him out.

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Arbitrary Commitment

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

Alienists were notorious for their self-confident belief that they knew what was best for anyone with mental illness. In an essay from the July,1868 issue of the American Journal of Insanity, the (anonymous) author makes a case for doing away with legal procedures for commitment: “. . . other diseases, except those of a highly contagious type, do not call for civil interference nor court publicity.

We do not demand a commission or an inquest to decide whether a man has a fever raging into delirium, or whether he has a general paralysis, or whether a surgeon shall be permitted to amputate his limbs or trepan his skull.”

The writer went on to point out that if anyone saw a person sick or wounded in the street, “we take him forthwith to the nearest hospital, without stopping to canvass our legal right to restrain him of his liberty.”

Charles Guiteau Said He Was Temporarily Insane When He Assassinated President Garfield

Charles Guiteau Said He Was Temporarily Insane When He Assassinated President Garfield

The author lamented that a patient stricken with insanity was sometimes met with a suspicious relative who wasn’t convinced of his illness even though his other relatives were. Because of this suspicion, the patient, “against the wishes and judgment of the rest,” was then liable to the “questioning of the law and its ministers.” This then led to publicity, which might be detrimental to the patient’s recovery.

Though She Had a Trial, Mary Todd Lincoln Was Involuntarily Committed to an Asylum

Though She Had a Trial, Mary Todd Lincoln Was Involuntarily Committed to an Asylum

 

Most people, of course, would not want to be committed involuntarily to an insane asylum, and welcomed legal safeguards to prevent it. It is amazing to consider how differently alienists and laypeople considered the matter–it almost certainly boiled down to who was in control of the situation.

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Intervention in Insanity

Eliza Josolyne, Insanity Caused by Overwork, courtesy Bethlem Royal Hospital Archives

Eliza Josolyne, Insanity Caused by Overwork

Alienists (early psychiatrists) believed in actively treating insanity. Most believed that it was beneficial to a patient to completely remove him or her from familiar surroundings; the change would allow new thought patterns and behaviors to form more easily.

Many times, asylums were the change in environment alienists selected, but some recommended travel as a way to change a patient’s surroundings and get his mind focused on new things. Of course, early intervention was paramount, since all alienists believed “acute” insanity (active, new cases) were easier to cure than chronic ones of long duration.

 

Children's Dayroom at Byberry (Philadelphia State Hospital), circa 1938, courtesy Historical Society of Pennsylvania

Children’s Dayroom at Byberry (Philadelphia State Hospital), circa 1938

 

Dr. J. Parigot believed in the value of intervention to the extreme. Writing in 1864, he made the case that marriage should be avoided when undesirable traits were found in potential parents. This belief wasn’t strictly because he felt the traits would be inherited; it was additionally founded on a belief that parents with those traits couldn’t properly raise a child. He gave an example of intemperate parents who would have to be particularly careful to educate and develop their children so that they wouldn’t degenerate into intemperance themselves. Likewise, he said, “nervous and fidgety persons are incompetent to the direction and control of petulant and sometimes mischievous children.”

Children's Ward, 1927, Byberry (Philadelphis State Hospital), courtesy Historical Society of Pennsylvania

Children’s Ward, 1927, Byberry (Philadelphis State Hospital), courtesy Historical Society of Pennsylvania

To counteract the influence of tainted parents in cases of insanity, Parigot stated that: “Children who have inherited germs of mental disease should be separated from their parents, and educated under the eye of the psychiatrist. Sometimes their locality should be changed at the time of their birth. . . .”

Fortunately, such thinking was not generally accommodated by the public.

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How to Test for Insanity

Alienists Sought Help for the Insane

Alienists Sought Help for the Insane

Insanity is an elusive condition, and alienists (early psychiatrists) spent time and effort studying ways to detect it. In an article in the October, 1865 issue of the American Journal of Insanity, Dr. John Tyler admitted that “men differ so widely in their conduct and habits, that what would be manifest insanity in one man, might only be the natural and healthy and common conduct of another.” He also noted that insanity could be recognized more easily than described…one could look at deviations in a person’s normal behavior and recognize insanity. It was much more difficult to describe the person’s insanity in absolute or factual terms, however.

That did not stop Tyler from going on to give some guidelines for assessing insanity in a person:

1. Though he may not abandon friends or former occupations, the insane person begins to see the world and hold ideas only through his own inner lens or “personal laboratory.” Tyler said that these convictions were “coined by him, and not received by another.” That person will be inwardly convinced of something, rather than persuaded to it by outside facts or situations.

2. The madman is inconsistent. Tyler described a patient who insisted he was dead, yet ate, talked, and did other things inconsistent with being dead.

3. The insane person will have a “changed and peculiar expression of the countenance, of the eye, of the manner, movements, attitudes, etc.” Tyler admitted that this type of proof was hard for the layperson to recognize, but that it could be learned through “an acquaintance and domiciliation [sic] with the mentally diseased.”

There was certainly a prevalent belief at that time that a trained professional could detect an insane person just by looking at him. Eccentricity or a vibrant personality may have been a bit dangerous under the watchful eye of one of these self-confident alienists.

Isaac Ray, Asylum Superintendent and Alienist

Isaac Ray, Asylum Superintendent and Alienist

Depiction of Various Types of Insanity by J.E.D. Esquirol

Depiction of Various Types of Insanity by French alienist  J.E.D. Esquirol

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Part-Time Physicians

Doctor with Horse and Buggy, 1894

Doctor with Horse and Buggy, 1894

Early physicians were prepared to handle a variety of medical cases, and rural practitioners often took on mental illness as well, if their territories were too far away from asylums for treatment. They had a difficult and uncertain occupation, however, that didn’t necessarily provide a good living. We may be used to seeing doctors earning comfortable salaries today, but that wasn’t always the case.

 

View of Taunton State Hospital, Interior

View of Taunton State Hospital, Interior

Rural doctors could not set extraordinarily high fees for their work or they wouldn’t have been able to find and keep patients. But, the time-consuming trips they made to see patients (during the age of house calls) prevented them from seeing many patients on any given day. Few patients, of course, meant meager salaries. Earnings were all too often along the lines of the doctor in 1849 who billed a patient $12 for services–but then deducted two dollars in exchange for two bushels of buckwheat.

Because it was so difficult to earn a living as a full-time physician, many doctors took on second jobs. During the early 1800s in Burke County, North Carolina, doctors held second jobs ranging from Superior Court clerk, to school teacher, to hotel operator, to farmer, in order to supplement their wages as physicians.

Doctor's Parlor, Willard Asylum for the Chronic Insane

Doctor’s Parlor, Willard Asylum for the Chronic Insane

It is no wonder that a position as an asylum superintendent would be so attractive to medical men, and so jealously guarded by physicians who were alienists. Because they could squeeze out competition, asylum superintendents enjoyed decent salaries and pleasant places to live. Though they didn’t own the homes or living areas they received on the asylum’s grounds, the buildings were grand and elegant (at least at first), and the grounds beautifully landscaped. Such a situation was much better than the salaries and living arrangements available to many other physicians outside the field.

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Interesting Cases

Alienists Could Be Prominent Public Figures

Alienists Could Be Prominent Public Figures

Alienists (psychiatrists) wanted to provide good care for the insane in their midst, and in the early years offered assistance primarily¬† through therapeutic stays at insane asylums. These doctors’ favored regimens of rest, occupational therapy, and structured time probably served many patients well, but such programs could not help everyone. Alienists were still exploring the causes and treatments of insanity, and some of their thoughts missed the mark widely.

In an 1871 paper on mental disease (reported in the Transactions of the Medical Society of the State of North Carolina), the author described a “case of violent cerebral excitement” in a 5-year-old, which had been relieved by an oral dose of bromide of potassium. This case of “mental disease” seems to be clearly a case of epilepsy, and we can only wonder if the child was tagged for life as insane.

Another paper in the same publication discussed “Mania Transitoria,” or insanity of very short duration. During this type of mania, people could be fully aware of their surroundings (or not) and actions. It was brought on by such things as physical disease or the “accumulation of harbored feelings over a number of years.” The author seems to be describing explosions of temper or momentary passionate outbursts, but he attributed this type of insanity’s cause–or attributed it at least in part–to masturbation and petit mal epilepsy.

Craig Colony for Epileptics, courtesy museumofdisability.org

Craig Colony for Epileptics, courtesy museumofdisability.org

Cures For Epilepsy Were Plentiful

Cures For Epilepsy Were Plentiful

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Early Problems Providing Mental Health Care

Civil War Soldier Angelo Crapsey, 1861, Who Committed Suicide in 1864 After a Period of Mental Illness, courtesy Kutztown University of Pennsylvania

Civil War Soldier Angelo Crapsey, 1861, Who Committed Suicide in 1864 After a Period of Mental Illness, courtesy Kutztown University of Pennsylvania

Leaders in many states recognized early on that they needed to provide treatment for mental illness at public expense. The North Carolina Hospital (Raleigh) opened in 1856, but an influx of patients after the Civil War forced the state to find other places for care, such as in private homes. It is likely that this increased need for care occurred just as families were hurting for cash: Fraud became so widespread that the state  had to pass laws requiring counties to care for the insane, instead.

Early care in North Carolina’s asylum consisted primarily of rest, occupational therapy, and treatment for physical problems. Cure rates during this period were in the neighborhood of 30 – 40 percent. Though high, these cure rates may be accurate. After the trauma of fighting during the Civil War, patients who were former soldiers may have been truly helped by a stay in a calm, well-regulated environment where not much was demanded of them.

North Carolina’s constitution mandated that the state care for all of its “insane, blind, and deaf-mute persons.” However, there was still a great deal of stigma attached to insanity and public acknowledgement of it by families. By 1884, the general population–though it recognized the need for care–wanted it provided at home. Consequently, many family physicians found it necessary to study insanity so they could at least recognize and provide some sort of treatment for it among their patients.

Peaceful Scene at North Carolina Hospital, 1924

Peaceful Scene at North Carolina Hospital, 1924

 

Drug Room at North Carolina Hospital, 1924

Drug Room at North Carolina Hospital, 1924

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Building Plans

Epileptic Cottage in Abilene, Texas

Epileptic Cottage in Abilene, Texas

In 1915, the 47 patients at the Canton Asylum for Insane Indians filled the building to capacity. Both the present superintendent, Dr. Harry Hummer, and the previous one, Oscar Gifford, had made requests for additional buildings. The buildings were not only for the purpose of expansion, but also to separate types of patients. Dr. Hummer was extremely happy to see his capacity almost double when a requested hospital was approved; he mentioned that he would initially use it to separate epileptics from the rest of Canton Asylum’s patients.

Hummer was also delighted when he gained approval for a residential cottage. He, his wife, and two sons could live separately from the patients and gain a bit of privacy and respite from the constant activity inherent in an asylum. Hummer received two bids for the project and recommended accepting the bid from Martin Granos:

“He agrees to give us three coats of plaster, a larger basement [than the other bidder], a larger cistern, beamed ceiling in the living-room, stained shingles, a $58.00 range, a $31.00 ice-box built in, oak finish throughout the interior, fireproofed fireplace and three kinds of water in the bath-room.”

Later inspectors found this cottage very nice, indeed, especially in contrast to the living quarters of the rest of the asylum’s employees.

From a Bathroom Catalog, 1915

From a Bathroom Catalog, 1915

1915 Kitchen Range

1915 Kitchen Range

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Exercising Care

Patients and Staff Playing Croquet at Willard Asylum, circa 1880, courtesy Robert Bogdan Collection, disabilitymuseum.org

Patients and Staff Playing Croquet at Willard Asylum, circa 1880, courtesy Robert Bogdan Collection, disabilitymuseum.org

Inspections are simply written and verbal snapshots of an investigator’s particular visit. That visit may have occurred during an exceptionally good or bad time, or during a relatively normal period. Inspections at the Canton Asylum for Insane Indians are somewhat erratic in content, but it does seem clear that it was a better-run place during its earlier years. When it was inspected in 1916, the patient population was small enough that the staff could engage with them in a positive way:

“Calisthentics, [sic] breathing exercises, and marching are provided for such patients as are able to receive physical training. The play-ground equipment consists of outfits for baseball, basket ball, quoits, tennis, and one giant stride [slide], six swings, one portable see-saw, one teeter, tennis and a sixteen pound shot, all of which are popular especially the swings and shot. The play-ground exercises are supervised by the attendants.” The inspector added that instruction in hygiene and sanitation “with especial reference to personal cleanliness is given by the attendants.”

At the time, there were 47 patients in the asylum, mainly in their 20s – 40s. Many would have had some physical problems, but in general, they represented a relatively vigorous age group. Attendants and laborers may well have had a little more time than they did later, to interact with patients who were not otherwise taking up a great deal of their time with nursing duties.

Patient Picnic at Ancora Psychiatric Hospital, late 1950s

Patient Picnic at Ancora Psychiatric Hospital, late 1950s

Metropolitan Lunatic Asylum, Kew: female patients exercising Credit: Wellcome Library, London.

Female Patients Exercising at the Metropolitan Lunatic Asylum, Kew, Australia, courtesy, Wellcome Library, London

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