Investigations Elsewhere

Government Hospital for the Insane Administration Building

The Canton Asylum for Insane Indians had its share of investigations, which often were a result of staff complaints. It was not unique in this respect–other asylums were also investigated with regularity, sometimes because of staff complaints, but often through outside intervention. In 1906, the Medico-Legal Society of the District of Columbia made a number of spectacular charges against the Government Hospital for the Insane (St. Elizabeths). The charges included allegations of brutal restraint through the use of “toweling” and the “saddle,” as well as “kicking and cuffing by attendants.”

Toweling involved placing dry towels around a patient’s neck and twisting from behind, to physically subdue a patient who was out of control. The allegations included a charge that the towels were twisted until the patient fell over semi-conscious. The saddle was a device which held patients in a reclining position, bound hand, foot, and neck, so that they couldn’t move at all; many were supposedly left for hours in this condition.

Patients were abused this way for their failure to obey orders or to do work properly, or for “taking an extra spoonful of beans” at table. Additionally, attendants were charged with using the feeding tube (which was pushed down through to nostril to feed patients who would not willingly eat on their own) as a punishment.

The charges were sensational, but were they true? St. Elizabeths’s board of visitors (its oversight group) asked the Medico-Legal society to help them investigate the charges they had made, but the group refused to appear before them or to submit its records concerning the abuse.

My next few posts will continue to discuss this investigation.

Utica Crib, Another Notorious Restraining Device

Force Feeding

Local News

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1904 Sioux Valley News

The Sioux Valley News, Canton’s weekly newspaper, delivered both national and local news. It kept its readers abreast of world affairs, and also reported the goings-on of Canton citizens in detail, going far beyond important events like births and deaths. On February 10, 1913, the paper reported:

— A blue card on the A. B. Carlson residence notifies the passing public that “Laddie” has the measles.

— I. O. Steensland and John Marston on last Monday shipped sixty head of extra fine cattle to Chicago.

— Rev. F. G. Wood pastor of the Baptist church held a religious service at the Indian Asylum on last Sunday afternoon, which was very much enjoyed and appreciated by the Asylum management and inmates as well.

— E. D. Warner has been entertaining LaGrippe [the flu] for a week. So attentive has he been to his guest that he has not been out of the house during his guest’s stay.

— The Misses Marguerite Brethorst, Susanna Avery, Tena Gedstad and Grace Lewison, of Lennox, were in Canton Monday, and took in “A Comedy of Errors” at the Kennedy opera house.

East Side of Main Street, Canton, SD circa 1912

5th Street, looking east, Canton, SD 1907

Canton in the News

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East Side of Main Street, Canton, SD around 1912

Canton, SD was a bustling town at the turn of the twentieth century (see last post), and its newspaper, the Sioux Valley News reported its activities in depth. Very little negative reporting went on; instead, the paper discussed the daily activities of its residents, cheered on business enterprises, and pushed an agenda to present Canton as a wonderful place for both working and living. A prominent grocery story created “Chraft & Hansen’s Canton Coffee,” which the proprietors said was a line of coffee “as good as any in the land.” They took out an ad in the March 4, 1904 edition to invite townspeople to partake of complimentary servings of Canton No. 25 in its line.

The coffee was probably needed, since a month later that same year, the paper raged that “after eighteen years of existence without open saloons Canton has opened her door and invited the saloon to enter.” The columnist was not ready to assert “that all who voted for license, did so because they were evil minded,” but it was clear that the paper’s position was solidly opposed to the move.

Arbuckles’ Was a Famous Brand of Coffee

Saloon, early 1900s

A Nice Place to Visit

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The city of Canton, SD was proud of its asylum, and it was certainly a building that looked good. With electric lights, indoor plumbing, and coal heat, the building was probably a step up from what many residents enjoyed themselves. The town itself already had an impressive courthouse building, a railway depot, a college, hotels, a large Chautauqua auditorium for lectures and public programs, and an expansive fairgrounds.

The town was a popular tourist destination, and a relocated shipbuilder named M. M. Hanson built passenger boats that allowed pleasure-seekers to take excursions down the Sioux River. His first boat (The City of Canton) held 100 passengers, and his second (Sioux Queen) held 200. Hanson also owned 30 row boats he hired out.

Canton’s population of around 2,000 (in 1900) could not have supported all the activities and institutions it hosted, and the city relied on tourists to help bring in dollars. The Canton Asylum for Insane Indians was itself a tourist attraction, and visitors to the area were urged to stop and tour it while they were in town. Spoons, plates, postcards, and small cloth items were a few of the souvenirs tourists could pick up in town; they could also buy bead work and other craft items at the asylum from patients who earned money by creating and selling their handiwork.

It would have been an economic blow, indeed, for the town to lose the institution. This was especially true during the Depression (it closed in 1933), when many people depended heavily on the wages that the asylum generated.

Hiawatha Fence from Advertisement

Canton, S.D. Masonic Temple, 1912

A Cost Analysis

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Lincoln County Courthouse, circa 1902, located in Canton

Interested parties (mainly in South Dakota) wanted an asylum established exclusively for insane Indians, and tried to make a case for it. They met with a complete lack of support from the superintendent (William W. Godding) of the only other federal institution for the insane, St. Elizabeths. Godding pointed out that the costs to maintain the few insane Indians at St. Elizabeths was less than $3,000 a year, while the proposed asylum in South Dakota would cost $150,000 and need an annual expenditure of at least $25,000 to run it. (See last post.)

However, the Indian Office supported the idea of an asylum, and began to gather figures to show how badly it was needed. St. Elizabeths reported that it had seven Indians in care in 1897 (two had been there close to ten years) for a total cost of $9,506.50 for their entire time as patients. The acting Commissioner of Indian Affairs had no figures as to how many insane Indians might actually need a new asylum’s services, but thought that “an asylum that would accommodate fifty patients would be ample.”

Government Hospital for the Insane of the Army, Navy, and District of Columbia, known commonly as St. Elizabeths

When the Commissioner, William Jones, later canvassed the various reservations to ascertain the number of insane Indians on them, most had none. Of the reservation agents who responded, only 58 Indians were found to be insane, with 7 of that number already in asylums. Agents mentioned other Indians as being “idiotic,” but tellingly, not needing help. One agent said that “a few” on his reservation were slightly insane but not requiring restraint in an asylum. (His estimate is not included in the preceding figure.) Of the 51 potential patients actually on reservations, the agents felt only 34 might need asylum care.

Even if all 58 patients had been taken to St. Elizabeths at a cost of $91/quarter ($364 annually), the total annual cost would have been only slightly over $21,000 a year. That was still under the figure Dr. Godding suggested would be needed to run an asylum in South Dakota each year. Clearly, anyone who did the math could see that even with the added transportation costs to St. Elizabeths, a new asylum really wasn’t worth the money for the few patients that might make use of it. Even paying extra at local state asylums (to offset transporting patients to Washington, DC where St. Elizabeths was located) would have been cheaper.

Yet, the asylum was built, staffed, and infrastructure put in place to support it. A later inspector called the Canton Asylum for Insane Indians a “magnificent political gesture” that had done little good for the recipients it had promised to help.

Canton Asylum Given Much Thought

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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

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

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.

Insanity is Lucrative

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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

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

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.

Arbitrary Commitment

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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

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

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.

Intervention in Insanity

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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

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

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.

How to Test for Insanity

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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

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

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

Indians, Insanity, and American History Blog

Asylums And Insanity Treatments 1800 – 1935

Investigations Elsewhere

Local News

Canton in the News

A Nice Place to Visit

A Cost Analysis

Canton Asylum Given Much Thought

Insanity is Lucrative

Arbitrary Commitment

Intervention in Insanity

How to Test for Insanity