Author Archives: Carla Joinson

Many Thanks

Corn Dance, Taos Pueblo, circa 1920s

Though the majority of the U.S. population celebrates an official day of gratitude called Thanksgiving, Native Americans have always had a deep tradition of routinely giving thanks. They have particularly given attention and gratitude to the animals and plants which gave their lives to provide sustenance or medicine.

Planting ceremonies were also important, as were dances and feasts to celebrate good crops. Among others, the Creek, Cherokee, Seminole, Yuchi, and Iroquois tribes celebrated the Green Corn Festival, which marked the beginning of the first corn harvest. It was a time to thank Mother Earth and all living things for providing food and other usable items that made life good. The Maple Syrup Ceremony (late spring), Strawberry Ceremony (early summer), Bean Dance and Buffalo Dance (winter), are only a few of the times that Native Americans set aside to acknowledge their dependence upon the bounty of the earth.

Buffalo Dance at Hano, courtesy www.firstpeoples.us

Qahatika Women Resting in Harvest Field, courtesy Library of Congress

The Iroquois particularly formalized times of thanksgiving, which would include a special Thanksgiving Address. A speaker was chosen to give thanks on behalf of all the people. The thanksgiving prayer then offered gratitude to the Creator for the earth and the living things upon it. The prayer could be quite long, encompassing specific things the speaker wanted to call special attention to, like birds, rivers, medicinal grasses and herbs, wind, rain, sunshine, the moon and stars, and so on. Thanksgiving festivals provided opportunities to feast, express gratitude, and enjoy good things, and also provided times of cleansing, healing, forgiveness, and reconciliation.

A Remarkable Woman

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Susan La Flesche Picotte, courtesy Smithsonian Institution

Susan La Flesche Picotte was born in 1865 to the last recognized chief of the Omaha Indian tribe, Chief Joseph La Flesche (Iron Eye). She went to the Elizabeth Institute for Young Ladies in New Jersey and then returned to her reservation to teach at a Quaker school. She became interested in medicine and returned east to attend the Hampton Institute, and later, the Women’s Medical College of Pennsylvania. She graduated at the top of her class in 1889 and became the first Native American woman to receive a medical degree.

After an internship in Philadelphia, Picotte returned to her reservation where she provided health care at its boarding school. She was the only doctor on the reservation and served at least 1,244 patients while covering 1,350 square miles of territory to do so. She was also the nation’s first Indian medical missionary, and taught Sunday School, led hymn singing, and presided at funerals, amid her many other duties.

Left to Right, Nattie Fremont?, Mary Tyndall, Susan La Flesche, and Susan’s Sister, Marguerite, 1880, courtesy Nebraska State Historical Society

Front Entrance, Dr. Susan La Flesche Picotte Memorial Hospital, Omaha Indian Reservation, National Historic Landmark Photogragh

Front Entrance, Dr. Susan La Flesche Picotte Memorial Hospital, Omaha Indian Reservation, National Historic Landmark Photograph

La Flesche resigned from her duties in 1893 due to her own poor health, andmarried Henry Picotte in 1894. They moved to Bancroft, Nebraska, where she set up a private practice. Picotte was passionate about improving the health of Native Americans; she was especially passionate about the evil effects of alcohol on her people and did everything in her power to prevent alcohol abuse on reservations. La Flesche eventually built a privately-funded hospital on the Omaha Reservation at Walthill, Nebraska. She died two years later at only fifty years of age, of bone cancer.

Far Instead of Near

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Quapaw Agency Office Near Wyandotte, Oklahoma, courtesy Columbia University

Though Congress had tried to site the Canton Asylum for Insane Indians as centrally to the majority of Indian reservations out West as possible, it was still a difficult place for families to visit. Many reservations were hundreds of miles away, and few relatives had the funds to visit regularly.

The family of Robert Thompson was probably typical. Thompson had been admitted to the Canton Asylum in 1907 at age 30, with a diagnosis of hemiplegia–meaning that he had paralysis on one (more typical) or both sides of his body. The condition could be due to several reasons, but because of his age, may have been from cerebral palsy or a tumor rather than a stroke. His diagnosis was later revised to epileptic psychosis.

Epilepsy Was a Feared Condition

In 1921, the superintendent of Quapaw Indian Agency in Oklahoma wrote to Canton Asylum’s superintendent, Dr. Harry Hummer, asking that he consider transferring Thompson to a facility closer to his family. Thompson’s sister and aunt had visited him within the year, and had offered to care for him at home. Hummer would not approve of this plan, so the women had contacted the state asylum at Vinita, Oklahoma, which was less than 30 miles away rather than Canton’s 500 miles.

Eastern State Hospital in Vinita, Oklahoma, courtesy Oklahoman Archive

The state asylum was willing to accept Thompson as a patient if the family could get a commitment for him from the county, but Hummer was apparently not so anxious to let him go. Thompson was not released from the Canton Asylum until more than two years later.

Horror Abounds

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Danvers State Hospital

Many people enjoy the frights and chills of a good Halloween “haunted house” . . . but some thrill-seekers zero in on former insane asylums. The suffering and fear hanging over these structures offer an atmosphere attractive to a variety of people: the simply curious, paranormal investigators–and unfortunately–vandals and occultists who want to tap into the sites’ evil reputations. A few former asylums conduct ghost tours which are extremely popular, and much of it has to do with the dark atmosphere these places inspire. Could there really be anything to the emotional pull these places seem to have?

One particular asylum is steeped in eerie history. The Danvers State Lunatic Asylum was built on property which was part of the former Salem Village, where the original witchcraft attacks on Reverend Samuel Parris’s family took place. The family’s slave, Tituba, was one of the first accused of witchcraft by the Parris children. and her confession led to the accusation of many others. Trials were later moved to what is now modern Salem. John Proctor (the first male to be accused of being a witch during the trials) George Burroughs, John Willard, George Jacobs Sr., and Martha Carrier were hung on Gallows Hill in 1692–also on the Danvers Asylum property.

Images of Salem During Witchcraft Trials

One of the Salem witch trial judges, John Hathorne–an ancestor of famed writer Nathaniel Hawthorne*–lived in a house at the top of the hill (called both Hawthorne and Hathorne Hill) where the asylum would later be sited. He was both quick to pass sentence and defiantly against reconsidering it even if witnesses recanted; some historians speculate that he may have been making money off his victims’ property.

Two Homes of Villagers Accused of Witchcraft

Two Homes of Villagers Involved in the Witchcraft Trials

Whether the property where this asylum (now a residential space) once stood is haunted or not is up to individual experience, but it is safe to say that it’s history might lead to it.**

*Nathaniel added the “w” to his name.

** Illustrations are from a book, Chronicles of Danvers, 1923

Bon Appétit

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Dr. William Whittington Herbert Force Feeding a Patient, 1894, courtesy Wellcome Images

Force was used far too often in U.S. insane asylums (see last post), but one of the worst acts of coercion had to be forced alimentation, or force-feeding. Some patients simply would not eat, either because they feared being poisoned, were too sick or stressed to have an appetite, or simply didn’t want to cooperate with attendants. Many superintendents did allow a certain amount of patient freedom in this area, but when they feared patients were going to actually hurt themselves by refusing to eat, they acted. Doctors had several ways to force food upon their patients.

— In cases of “great physical weakness,” they injected “nutritive substances” into the rectum

— One recommended practice was to force open the mouth, close the nostrils, and pour liquid food down the throat.

Tools That Could Be Used for Force Feeding

This practice was dangerous and resulted in more than one death by strangulation/drowning, and was terrifying for patients

— Another procedure involved securing the patient “so that resistance is impossible” and forcing his mouth open with screw wedge. The patient’s head would be thrown back and kept fixed in order to “introduce the gag, made of smooth wood”, which had a hole in the center. The doctor inserted a stomach-tube, and then liquid or semi-liquid food would be poured into the funnel shaped entrance of the tube to let it “readily pass into the stomach.”

— Finally, doctors could insert a tube through the nostril and down the throat into the stomach. In these cases, they could give the patient only very thin liquids.

Force Feeding a Suffragette in Prison, 1912

Doctors often did try to simply persuade patients to eat, allow a patient to have a favorite attendant assist at meals, or just give in to little quirks patients insisted upon before they would eat. However, when they made the decision to force-feed, it was traumatic for patients. Even worse, some attendants force-fed patients as a punishment, or threatened them with it to make them behave.

The Mechanical Treatment of Insanity

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Kings County Lunatic Asylum in Flatbush, NY

Dr. William Hammond (who was not a fan of insane asylums) was appalled at the widespread use of restraints in U.S. facilities, comparing these institutions unfavorably with those in England which had just about abandoned the practice. He wrote: “At present [1883] ignorant and brutal attendants, some of them selected from the very lowest class, can, at their option, from whim, caprice, anger, or any other inadequate cause, order or place a lunatic in the camisole, crib, or other mechanical restraint.”

Hammond did not necessarily argue that all restraints be abolished, but his suggestions followed the course that British alienists used when they began to eliminate restraints. For patients who always took off their clothes, for instance, attendants could use “strong dresses which were secured around the waist with a leathern belt, fastened by a small lock.” Patients who were violent toward themselves or others, could wear “a dress, of which the sleeves terminated in a stuffed glove without divisions for the fingers and thumb.

Athens Female Ward, 1893, courtesy Athens County Historical Society and Museum

One of Hammond’s suggestions to the state of New York, which asked his advice as it investigated the management of its insane asylums, was to keep the decision to use restraints out of the hands of attendants. Only the medical officer should decide to use mechanical means of control, and Hammond said that even with that safeguard in place, every order for restraint should be documented in a record book. That book, in turn, should be open to inspection.

Postcard of the Athens Lunatic Asylum

The only two asylums in the U.S. which did not use restraints at all at the time of Hammond’s writing were the Kings County Asylum at Flatbush, Long Island and one in Athens, Ohio (Athens Asylum for the Insane) which he did not specifically name.

The Need for Treatment

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Professional Nurses Would Have Looked Reassuring

Before the advent of insane asylums, most families by necessity had to simply accommodate a person’s mental health problems as best they could, and then wait to see what the future held. Once asylums became both established and accepted, medical intervention became much more the norm. Though some doctors believed strongly that many patients might not benefit at all from a stay in an asylum (one said that forcible confinement in an institution “would tend strongly to cause the disease to pass into some more intense form”), most saw institutional care as far superior to home care.

Probable Causes of Insanity, Missouri State Lunatic Asylum, 1954, courtesy Missouri State Archives

Alienists had several reasons for feeling this way. Most believed that the home environment was almost always at least partly to blame for an individual’s problem. Either something was going on that directly fed the mental problem, or associations the patient couldn’t get away from wouldn’t allow recovery. Doctors believed that simply getting a patient away from the situation and into a calm environment that didn’t make demands on him, would go a long way toward nipping the problem in the bud. They also felt that patients’ families didn’t have the knowledge or skill to handle mental illnesses, and certainly couldn’t make instant judgments concerning medicine, restraints, and the like.

Patients in Kalamazoo, Michigan Asylum, circa 1870s

Alienists, themselves, had four basic forms of treatment: mechanical, moral, hygienic, and medicinal. My next few posts will explore these types of treatment.

An Old Standby Treatment

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Florence Nightingale Suffered from Crimean Fever, Taking to Her Bed at Age 38 But Not Dying Until 90

Many of us refer casually to hypochondria as a condition in which a person thinks he’s ill when he’s not. Though the victim’s friends or family may see perfect health, the hypochondriac constantly fears or suffers feelings of illness. Hypochondria has afflicted people through the ages, but alienists in the twentieth century differentiated its degrees of seriousness.

The first stage of hypochondria was entirely mental: the person thought he was ill when he was not. The second stage began when he started to act ill and displayed symptoms consistent with the particular problem he believed he had. The third stage occurred when the person started to suffer from the actual condition; as one alienist noted, “Real disease, is, therefore, induced.”

Jacobus Schroeder van der Kolk

Dr. William A. Hammond recalled a woman who believed she had suffered a disease of the tongue which caused it to fall off. Of course,the tongue was still there, but Hammond could not persuade her that it really was. Eventually, he decided to treat her with an aloetic purge, which he had seen recommended by a European alienist, Jacobus Schroeder van der Kolk. This purge consisted of a succotorine aloe (a medicinal aloe from Africa), castile soap, and a simple syrup, along with whatever else a doctor might choose to mix in. It was essentially a harmless concoction, but fell right in with the era’s belief that a good purge could do a world of good.

Aloe Succotrina

The purge dislodged “large quantities of hardened fecal matter” and restored the woman’s menstrual cycle, and within a month, “she was entirely free from all perceptional, intellectual, or emotional derangement,” said Hammond. To his credit, Hammond didn’t clash wills with the patient, but instead worked in a way that accommodated her illness and caused her the least harm.

Worse Than Waterlogged

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Ladislas Meduna, courtesy University of Illinois Archive

Much of the therapy for insanity was experimental, and a number of treatments likely inflicted a great deal of harm and discomfort on patients. Something like Pilgrim’s Tub Therapy (see last post) may have resulted in a waterlogged and weakened patient, but would not have otherwise imposed great trauma, particularly since the treatment was almost always voluntary. On the other hand, shock treatments could be both violent and frightening.

In the 1930s, psychiatrists began experimenting with various kinds of treatments that threw the body into convulsions. For some reason–and they did not know why–convulsions often helped patients with depression and other problems. In 1933, Ladislaus (also Ladislas) von Meduna began inducing convulsions through intravenous drugs. He had noticed that schizophrenia and epilepsy could not seem to co-exist, and believed that controllable convulsions would cure schizophrenics.

Preparation for Shock Therapy

Meduna began experimenting with camphor, but didn’t get reliable results. He moved on to strychnine, thebain, pilocarpin, and pentilenetetrazol, the latter also referred to as metrazol or cardiazol. He injected these substances intramuscularly, but only got reliable results with metrazol. This substance induced quick, violent convulsions that Meduna reported “cured” 50 percent of his subjects. Unfortunately, the convulsions that metrazol induced were so violent that they also caused spinal fractures in 41 percent of Meduna’s patients. Many patients also reported feelings of “impending death and sudden annihilation” before the convulsions started.

Shock Treatments Could be Violent and Frightening

Eventually another psychiatrist (A. E. Bennett) combined metrazol with curare (a muscle paralyzing agent) to make the convulsions less violent. Later practitioners also sedated patients so they didn’t go through this treatment while conscious–such an obvious step that it should not have taken nearly a decade to hit upon. Eventually, insulin shock therapy won out over the metrazol injections, and they in turn gave way to electroconvulsive shock therapy.

Tub Therapy

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Dr. Charles Pilgrim, 1908

Physicians used hydrotherapy (various sorts of baths and showers) extensively in the treatment of the insane. The treatments could sometimes be helpful; a nice, warm bath might relax a patient or help him sleep, or a bracing shower could stimulate a patient who felt sluggish and tired. Dr. Charles Pilgrim, however, took water treatments to an extreme with what he called “Tub Therapy.”

Dr. Pilgrim arrived at the Hudson River State Hospital from the Willard Asylum in1893. He quickly made physical improvements to the institution, installing electric lights to replace the gas lamps, and building new 50-bed cottages for patients, a new mortuary, and a lab. In 1908, Pilgrim introduced Tub Therapy, a form of the continuous bath. Patients entered the tub room and reclined on a canvas hammock in a tub of warm water, a rubber pillow behind their necks for additional comfort. Water temperature was monitored so that it remained at the proper therapeutic level.

Tub Therapy at Pilgrim State Hospital, the Former Hudson River State Hospital

Most patients would have enjoyed this for an hour or two, but Pilgrim’s treatment was of much longer duration. A September 17, 1908 article in The Beaver Herald (Oklahoma) stated: “You sleep for six hours . . . next morning breakfast is served to you in the tub, then dinner, then supper.” Occasionally the doctor would come in to chat or take a blood sample, and the patient grew calmer, more rested, and more cheerful all the while. After at least several days (the title of the article was “Live for Weeks in the Bathtub”), the patient finally got out of the tub with the help of a nurse and found him or herself well again.

This treatment was primarily for patients who felt madness coming on, either just fearing a breakdown or actually close to one in their own or others’ opinion. The therapy was voluntary, though it is hard to see anyone in good physical health actually enjoying the forced inactivity.

Indians, Insanity, and American History Blog

Asylums And Insanity Treatments 1800 – 1935

Author Archives: Carla Joinson

Many Thanks

A Remarkable Woman

Far Instead of Near

Horror Abounds

Bon Appétit

The Mechanical Treatment of Insanity

The Need for Treatment

An Old Standby Treatment

Worse Than Waterlogged

Tub Therapy