Counting Them Up

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1840 Census Map

1840 Census Map

The 1840 census was an important one in the study of insanity. In that year, a category called  “Insane and Idiots” was added to the federal population count, and this category was further divided into “white” and “colored and slaves.”

Though most historians feel the 1840 census was somewhat unreliable, probably underestimating the insane by quite a bit, it still gives the first real snapshot of the country’s assessment of these citizens.

Of the 17, 062, 566 people in the country, 14,508 whites were counted as insane, and 2,926 colored and slave were seen as insane. The number of insane and idiots in proportion to the rest of the population was 1 in 990. By 1880 the ratio had increased to 204.3 to 100,000 of population.

Phrenological View of Mental Deficiency

Phrenological View of Mental Deficiency

Concerns About Controlling the Insane

Concerns About Controlling the Insane

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Another Side to the Story

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Book by Elizabeth Packard

Book by Elizabeth Packard

Elizabeth Packard had been imprisoned in her home by her husband, who considered her insane because she did not obey him and agree with his philosophy. (See 11/12/10 post). During her sanity trial, her husband sold their home and took their children out of state.

Elizabeth, an assertive and independent woman, wrote several books about her experiences. Modern Persecution or Married Woman’s Liabilities was published in 1873.  In this work, she had the satisfaction of venting her anger about the injustices her husband had committed, while striking a blow for women’s helplessness under current laws.

Kidnapping Mrs. Packard

Kidnapping Mrs. Packard

Elizabeth became influential through her books and lectures, and was able to make an independent living. Her lobbying efforts for stricter commitment laws and rights for the insane were largely successful, though they were opposed by the psychiatric community.

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Alarming Testimony

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Elizabeth Packard

Elizabeth Packard

Several people who were committed to insane asylums wrote about their experiences. Nellie Bly’s expose as a reporter was shocking, but her stay was temporary and her release secure. Real patients who survived commitments also offered shocking testimony, which made a great impact on the public.

Elizabeth Packard, married to Reverend Theophilus Packard, did not always fall in with her husband’s way of thinking on theology. He decided to have her committed to an insane asylum in Jacksonville, Illinois. After three years he allowed her release, but then decided to confine her to their home. He locked her in a room and nailed the windows shut. Elizabeth managed to drop a letter out the window to a friend, who alerted a judge.

The Packards' Home

The Packards' Home

Judge Charles R. Starr issued a writ of habeas corpus and then interviewed Elizabeth in his chambers. He allowed her a jury trial to determine her sanity. The prosecution’s testimony centered on Elizabeth’s rebellion against her husband and his doctrine, while her defense showed that she was, nevertheless, a devout Christian. Doctors testified both for and against her, pronouncing her both insane and perfectly rational.

The jury took seven minutes to reach a verdict that Elizabeth Packard was sane.

Insane Asylum, Jacksonville, Illinois

Insane Asylum, Jacksonville, Illinois

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Amazing Space

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Bloomingdale Insane Asylum

Bloomingdale Insane Asylum

Society has always had to (somehow) accommodate the needs of the insane. In colonial America, families usually supervised members with mental problems, and the community helped as they were able, or tolerated their odd behavior. As people moved into cities and the insane mixed more closely with strangers, authorities began to house the mentally ill in poorhouses or prisons. These spaces were usually dismal and abusive, and  many people languished in them for years.

Gonzales County Jail

Gonzales County Jail

By the 1830s, society began to believe that insanity was something that could be cured, and they sought to decriminalize insanity. Doctors felt that if a person became insane in a home environment, removing that person from home and into a different environment with different routines would be very helpful. Consequently, large institutions became popular by the 1840s.

The public was grateful to have a place to send unmanageable family members, and asylums quickly filled. Eventually, they became overcrowded, and doctors realized that many patients simply could not be cured in that kind of environment.

Some critics of asylums argued that patients who were on the way to recovery were surely aggravated, or even set back, by having to associate with patients who were seriously ill. They suggested small cottages with a home-like atmosphere, as a better solution. Huge asylums remained as the only option for many people, though the quality of care declined rapidly. Today, large institutions are no longer popular.

Men's Cottages at Springfield Hospital for the Insane

Men's Cottages at Springfield Hospital for the Insane

Cottages at Iona State Hospital

Cottages at Iona State Hospital

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Another Player

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Emil Kraepelin, courtesy National Library of Medicine

Emil Kraepelin, courtesy National Library of Medicine

Emil Kraepelin (1856-1926) led the way for psychiatric research in the nineteenth century. Educated and trained in Germany, Kraepelin studied mental disorders and eventually developed a system of classifying mental illness that took into account a condition’s onset, course, and prognosis.

Kraepelin grouped conditions/illnesses by patterns of symptoms, rather than by the symptoms themselves. He called this a “clinical” rather than “symptomatic” view. Kraepelin’s distinction was important, because almost any single symptom could be seen across a broad spectrum of mental conditions. Classifying by pattern, (or syndrome) rather than symptoms led to a simpler and more uniform diagnostic system.

Kraepelin identified the pathological basis of Alzheimer’s disease,  identified schizophrenia (though he named it dementia praecox), and manic depression.

Illustration from Emil Kraepelin's Book

Illustration from Emil Kraepelin's Book, 1907

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Important Players

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30 Physicians of Lunatic Asylums, circa 1858, courtesy Library of Congress

30 Physicians of Lunatic Asylums, circa 1858, courtesy Library of Congress

Both physicians and the public became increasingly interested in the treatment of insanity as the 19th century progressed. Several people became prominent for their work and contributions to the field, and I will profile a few of them in coming blogs.

Dr. Sylvester D. Willard, born in 1825, was the son of a physician and followed in his father’s footsteps. He began an apprenticeship with his father, and graduated from Albany Medical College in 1848, after attending three semesters of lectures there.

In 1864, the secretary of the state medical society in New York was tasked with looking into the condition of the insane in state poorhouses and asylums. The secretary asked Dr. Willard to make that investigation, which he did with conscientious detail. His report on the misery within these places caught the public’s attention. Willard’s report also impressed the state’s legislature, and it passed a bill to found an asylum for the insane poor.

Dr. Willard became ill with a fever and died April 2, 1865. The asylum, which was going to be named “The Beck Asylum for the Insane” after Dr. T. Romeyn Beck (a prominent physician who studied insanity), was named “The Willard Asylum for the Insane,” instead.

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Pale Faces and Insanity

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A Klickitat Brave, 1899, couresty Library of Congress

A Klickitat Brave, 1899, courtesy Library of Congress

In 1906, Major Charles E. Woodruff, of the Army Medical Corps, wrote an article about nervous disorders and complexion. He believed that excessive exposure to light was responsible for much “nervous damage” to blonds, who didn’t have enough pigmentation to protect themselves in a sunny climate. Proof of this lay in the fact that neurasthenia was more prevalent in the South than in the North.

According to Woodruff, insanity probably followed the same rule. He asserted that “in every part of the world statistics show that the greatest number of cases occur in or near our lightest months–May, June, and July.”

Well-pigmented people, however, were much safer, and didn’t suffer from insanity to the same degree as the “less protected types.” He said that people with dark hair, brown eyes, and olive or brown skin, could “evidently stand mental and nervous strains which blonds cannot endure….”

Woodruff’s beliefs were in direct opposition to those who believed Indians had a high prevalence of insanity because of their exposure to civilization.

Hospital for the Insane of the Army and Navy and the District of Columbia, courtesy Library of Congress

Hospital for the Insane of the Army and Navy and the District of Columbia, courtesy Library of Congress

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Those Crazy Kids

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Harry Cherkos, Feeble-Minded Child, Selling Papers, 1910, courtesy Library of Congress

Harry Cherkos, Feeble-Minded Child, Selling Papers, 1910, courtesy Library of Congress

Twentieth-century psychiatry embraced many conditions as madness, including epilepsy, alcoholism, and melancholia (what we now call depression). Early psychiatrists, called alienists at the time,  did not hesitate to stick an “insanity” label on a host of conditions, nor did they excuse any member of society.

Dr. John H.W. Rhein began a 1915 article in the American Journal of Insanity by discussing insanity in children. He stated that few children were in asylums because it was easier to treat them at home. The youngest case of insanity in children (on record) was nine months, said Dr. Rhein. Of 39 cases he had personally studied, five were in 5-7 year-olds.

Neurotic and Epileptic Child, courtesy Library of Congress

Neurotic and Epileptic Child, courtesy Library of Congress

Here is a typical case: Female, age 5. “After being threatened with being shut up in a closet and having heard tales of dark places where witches live and the like, was very much frightened…and for months thereafter raved and muttered about hobgoblins. When she recovered she was very much changed.”

A Case of Paralysis in an Insane Child, 1899, courtesy National Institutes of Health

A Case of Paralysis in an Insane Child, 1899, courtesy National Institutes of Health

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Prohibiting Drinking

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Demon Rum

Demon Rum

Prohibition did not go into effect in the U.S. until 1920, but the government was concerned early on with alcohol consumption by Indians. Some Indians groups (such as the Apaches) had used alcohol ceremonially before European contact, but after being introduced to it by traders and explorers, developed a liking for rum and other distilled spirits.

Traders, especially, liked to use alcohol when they dealt with Indians. Rum was something that Indians couldn’t make, but wanted, and it impaired their judgment during the subsequent trading. Because Indians were not used to drinking and were often prodded to consume too much, they frequently overindulged.

Traders Plying Alcohol
Traders Plying Alcohol

In 1832, a law was passed against giving “ardent spirits” to Indians, but the damage had already been done. Some Indians had developed a craving for alcohol, and greedy profiteers were willing to sell it to them. In 1910, Congress appropriated $60,000 ($1,400,000 today) for the suppression of “the liquor traffic among the Indians.”

Sign from 1919

Sign from 1919

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Progress, Of Sorts

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Indian Children on Flathead Reservation, 1907, courtesy Library of Congress

Indian Children on Flathead Reservation, 1907, courtesy Library of Congress

1910, this first decade of the new century, came in the middle of the Progressive Era. Reformers fought to limit child labor, break up monopolies, and help working men earn a fair wage.

The Indian Bureau tried to make a few strides, as well. It began inspecting homes on reservations, beginning with the White Earth Reservation in Minnesota.* Two special physicians visited more than 200 homes and examined 1,266 people. Of this number, 690 had trachoma and 164 had some form of tuberculosis. This dismaying state of affairs undoubtedly played out on most other reservations.

The Indian Bureau’s medical supervisor pushed to have schools inspected for sanitation, hygiene, and ventilation. Three reservations with a high number of day schools (Cheyenne River, Pine Ridge, and Rosebud) had a physician assigned to them. He made regular visits to check on the health of pupils and inspect the schools.

Indian Schoolchildren, Mt. Pleasant, MI

Indian Schoolchildren, Mt. Pleasant, MI

*Statistics are taken from the 1910 “Report of the Commissioner of Indian Affairs to the Secretary of the Interior.” (Fiscal year ending June 30, 1910).

Indian Children, Mescalero Reservation, N.M., circa 1936, courtesty Library of Congress

Indian Children, Mescalero Reservation, N.M., circa 1936, courtesty Library of Congress

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