Author Archives: Carla Joinson

Fourth of July

Sioux Indians Hitting a Dime at 100 Yards, July 4, 1891, courtesy Library of Congress

The Indian Bureau was never culturally sensitive, especially when it came to Native American celebrations. It actively discouraged or forbade ceremonial dances, feasts, and other gatherings, fearing that they might unite tribes or keep them from assimilating into white culture. Most gatherings required written permission. One explanation for the Indian Bureau allowing celebrations at all was offered in Sunday Magazine (July 2, 1911): “Shut off on reservations and compelled to do without any extraneous amusements, the Indian grows morose and is much more inclined to give trouble than when occasionally permitted to enjoy himself.”

The Bureau didn’t pay as much attention to Fourth of July celebrations, and Native Americans soon discovered that they could get together on that day without written permission. They began to use the Fourth of July as an excuse to gather and perform the dances and ceremonies they enjoyed. Some tribes had a practice of giving away assets during celebrations, often through a formal ceremony called a potlatch. Native Americans considered it an honor to give their possessions to others, and often gave to the poorest members of the tribe, first. Sioux Indians apparently ramped up this gift-giving practice on the Fourth of July, and the Indian Bureau began calling this “Give-Away Day.” Tribal members celebrated the Fourth with games of skill and strength, feasting, and dancing. They also incorporated their practice of honoring individuals with important gifts, with no thought of reciprocation. Gifts were substantial–horses, fancy bead work, saddles, and other valuable items. Whites seemed to be amazed by the practice, since it often left the giver without any resources.

Fourth of July Celebration, 1891, South Dakota, courtesy Library of Congress

Nez Perce Fourth of July Parade, Spaulding, Idaho, 1902, courtesy Library of Congress

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Treating Morbid Impusles

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Surgeon General William Hammond

In A Treatise on Insanity (1883), author William Hammond (former surgeon-general of the Army) described various cases of intellectual objective morbid impulses and how he had treated them. In one case, a young man developed an overwhelming desire to throw vitriolic acid over women’s beautiful gowns. He considered his actions “immoral and degrading,” but told Dr. Hammond that “a handsome dress acts upon me very much as I suppose a piece of red cloth does on an infuriated bull: I must attack it.” The young man had managed to throw vitriol on three women’s dresses without being caught, but wanted desperately to stop doing it. He could not determine where the impulse came from, but simply found it impossible to control.

Tilden’s Bromide of Calcium

Dr. Hammond examined the man, and could find no disease other than “wakefulness.” Hammond prescribed a bromide of calcium (a sedative) and “insisted on his removing himself from further temptation by taking a sea voyage on a sailing vessel upon which there were no women passengers.” The young man did so, and came back after three or four month free of his impulse to ruin women’s dresses with vitriol.

According to Hammond, an intellectual objective morbid impulse is an idea that occurs to a person which is contrary to his sense of right and wrong, urging the person to do something “repugnant to his conscience and wishes.” As in the case of the young man just described, such an impulse “if yielded to . . . is often of a character as to demand the serious consideration of society.” In his case, the man would probably have ended up in an asylum if he had not had his condition nipped in the bud.

Dr. Hammond’s Book

Trauma Care for the Insane

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How to Care for the Insane

Many asylum patients were ill with various chronic conditions, but accidents and self-inflicted injuries also kept doctors busy. In How to Care for the Insane by Dr. William Granger (1886), the author discusses some particular issues that nurses might confront:

A cut throat: Patients may cut their throats from ear to ear and do really little injury, or they may make a small stabbing wound and divide a large blood-vessel and die almost immediately, or they may cut the windpipe and not cut the blood-vessels. Little can be done by the attendants to stop the flow of blood, even if the great blood-vessels are not cut. The head should be kept bent forward and the chin pressed against the chest.

Injury from Eating Glass: Patients sometimes eat glass . . . In the treatment do not give an emetic or a cathartic. Such food as has a tendency to constipate the bowels, and such as will also enclose the glass and coat its sharp edges, is to be given. Potatoes, especially sweet, oatmeal, or thick indian-meal pudding, are appropriate. Cotton, which is generally at hand, will, if swallowed, engage the glass in its fibres, and so protect from injury.

Patients and Nurses in Female Ward B, Weston State Hospital, 1924, courtesy West Virginia & Regional History Collection

State Hospital Nurses, circa 1914, courtesy Missouri State Archives

Injury with Needles: This is a self-injury, but it may be severe and require immediate attention. Patients may open a vein or an artery with a needle, or plunge it into the eye. But the more common way is for a patient to stick many needles under the skin, sometimes to the number of several hundred. Sometimes patients introduce them near the heart or lungs, and as a needle will often “travel” when in the flesh, it may work its way into a deeper part, and so a number get into the lungs or the heart, causing death . . . An attempt or desire to so injure one’s self should be guarded against by the attendants, and if accomplished should be at once reported to the physician, that efforts may be made to extract the needle.

Common Sense

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Annie Payson Call

Laypeople were interested in mental health, and by the early 1900s had recognized that their lives might be happier if they could overcome and control some of the mental distress which seemed rampant in their complex and hurried world. Annie Payson Call wrote articles for the Ladies’ Home Journal in which she offered advice to women who suffered various nervous afflictions. In her book Nerves and Common Sense (1909), she gave a case study of a woman’s problem and cure in her relationship with an irritable husband.

A brokenhearted woman complained to a friend about her husband’s unkindness and hard heart; after hearing her out, the friend helped her understand that the situation was essentially her own fault. Because she had been trying to please her husband and he didn’t notice her efforts, she had become emotionally distressed. “Now it is perfectly true that this husband was irritable and brutal,” said Call. However, because the woman was “demanding from her husband what he really ought to have given her as a matter of course,” she was wearing herself out and suffering to no avail.

Ladies’ Home Journal Offered Women Advice

“She was a plucky little woman and very intelligent once her eyes were opened,” said Call. “She recognized the fact that her suffering was resistance to her husband’s irritable selfishness, and she stopped resisting.

“As his wife stopped demanding, he began to give,” Call related. “As his wife’s nerves became calm and quiet his nerves quieted and calmed.” It turned out that business worries had been at the root of his brutishness; once his wife stabilized her emotions he suddenly turned to her and confided his troubles. After that, all was well.

Patent Medicines Helped Nerve

Call’s advice must at times have been trying in the extreme to her readers, but since she wrote many articles of this sort, they were obviously well-received enough that Ladies’ Home Journal continued to publish them. Many of her suggestions urged changes in attitude and thought, which probably worked well for readers who could not visit alienists (experts in mental health) or find sympathy at home.

The Front Line

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Clifford Beers

Though administrators and superintendents get most of the recognition for asylum care, attendants were the really critical employees. Their skills and strengths, their attitudes and moods, affected patients profoundly. Clifford Beers, a Yale graduate who suffered a mental breakdown in the early 1900s and later wrote about it in A Mind That Found Itself, described his treatment at the hands of the attendants at his well-regarded institution.

Attendants Could Often Be Violent With Patients

Beers had been at odds with his attendants because they were so indifferent and deliberately cruel to him: refusing to give him a glass of water when he requested one, neglecting to bathe him, and the like. Beers retaliated with small acts of defiance, mainly verbal, which goaded his attendants into telling him they were just waiting for a chance to beat him.

Man Being Restrained in West Riding Lunatic Asylum

Beers recorded that on November 25, 1902, he politely asked an attendant for a drink, was refused with curses, and then answered in kind. This was the opportunity his attendants had been waiting for; one held a lantern in Beers’ dark room while the other knocked him down, kicked him, and choked him. They stopped when he pretended to be unconscious, and left him “to live or die for all they cared,” Beers wrote. Beers showed the attending physician his bruises the next day, but neither attendant was fired for his actions.

Madness in a Modern World Part Two

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Crowded Train Platform in Victorian Era

Life has always been stressful, so what was it about the nineteenth-century world that increased stress so much that alienists thought it contributed to a rising rate of madness (see last post)? Change itself brings stress, of course, and nineteenth-century humans were experiencing a great deal of change.

As telegraphs, telephones, locomotives, trolleys, and the like infiltrated daily living, it meant that the pace of life picked up for most people. Additionally, the noise level of society rose considerably as machines became more prevalent (even simple changes like clattering typewriters replacing writing by hand in offices). Studies show that constant noise increases levels of cortisol and adrenaline, which then have their own negative consequences on the body.

Interior of Magnolia Cotton Mills Spinning Room, Mississippi, circa 1912, courtesy NARA

Not everyone embraced and trusted all the new inventions, either. Doctors diagnosed “elevator sickness” and “railway neurosis” brought on when people experienced the physical novelty and/or stress of using these new technologies. “Dyspepsia,” a term used to describe intestinal troubles of various kinds, was rampant in the nineteenth century–probably as a reaction to stress. Nervousness with life in general sometimes led to “neurasthenia,” a term encompassing feelings of anxiety, depression, irritability, and other symptoms of mental distress.

Noisy, Crowded Life in a New York Tenement, circa1890

One of the positive beliefs alienists embraced was that insanity was not an inevitable hereditary condition, as had been previously believed. Instead, they began to believe that certain people were perhaps disposed toward insanity, but that it would only manifest if conditions were right. In the nineteenth century, it appeared that conditions were right for troubling symptoms to appear in many people.

Madness in a Modern World

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Edison and Light Bulb

Politicians who supported an asylum exclusively for Indians often justified the need by parroting the claims of alienists. These specialists in mental illness maintained that the pressures of the modern world led to an increase in insanity. The fact that reservation agents couldn’t even find a hundred “insane Indians” at the end of the nineteenth century did little to support that notion. However, the rate of insanity was increasing among the rest of the population. And, alienists may not have been completely off-track in their thinking.

From the earliest times, people had lived in much the same way: they walked or used animals and boats for transportation, wrote messages to one another by hand, and planned their daily activities by the rising and setting of the sun. Suddenly, around 1830, tremendous changes occurred.

The Tom Thumb, courtesy Bureau of Public Roads, Department of Commerce

In 1827, the Baltimore & Ohio Railroad began transporting people and goods mechanically with a little steam engine called the Tom Thumb. In 1869, workers completed the first transcontinental railroad, which reduced a difficult wagon or stagecoach ride of several weeks or months to one week. Samuel Morse patented the telegraph in 1840, Bell patented the telephone in 1876, and Edison introduced the light bulb in 1879. These changes absolutely revolutionized daily living, especially in cities.

Horse-drawn Ambulance in Front of Fire Station on Race Street in Philadelphia, 1865

Even though these new inventions were embraced by the public, they also created distrust, stress, and fear as people began to accommodate and use them. An “Age of Anxiety” began in which there were new dangers everywhere–and the stress did indeed lead to mental breakdowns. (The prevalence of these inventions in cities is probably why alienists considered rural areas better for asylums.) My next post will examine this modern phenomenon further.

You Get What You Pay For

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Female Patients Farming in the early 1900s

The superintendents at most asylums had the best of intentions when it came to patient care. They understood (for that era) what kind of help patients needed and what kind of attendants could best provide it. Most asylums had rules of conduct for staff and lists of optimal behaviors they expected to see in them; if these desires had been met, most asylums would have been better places. However, superintendents were at the mercy of legislatures, which often underfunded public asylums. Except for the wealthiest private institutions, attendant staffing was never high enough to provide good–or sometimes even adequate–care.

Tennessee Central Hospital for the Insane

Staffing issues were especially tough during WWI, when many doctors and nurses left private employment for military service. In 1918 the superintendent of Tennessee’s Central Hospital wrote about the problem he (and all asylums had) in attracting good workers: “We have from forty to sixty beds soiled each night, and the patients who soil the beds at night soil themselves often during the day and have to be dressed and attended to…and the great State of Tennessee says to our attendants, ‘We will allow you from twenty to thirty-five dollars a month for this.'”

Laundry Room at Fulton State Hospital, 1910

This was not much money for what was typically a 14-hour workday full of exhausting physical (and sometimes dangerous) labor. Workers in manufacturing earned around $48 weekly in 1914, unionized bricklayers in New York earned nearly $31 a week in 1913, and even notoriously underpaid female mill workers earned between $5 and $7 a week. The typical asylum attendant’s poor pay almost guaranteed that good workers would go elsewhere. Asylums were often left with attendants who for one reason or another could find work nowhere else.

Off to the Poorhouse

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Bradyville and Readyville Poorhouse Residents, circa 1903, courtesy http://cannonccp.weebly.com

Though early American society embraced self-sufficiency, people in authority did recognize that some people could not provide for themselves (widows/orphans/disabled) and that a person could fall upon hard times despite their best efforts. Churches and municipalities usually provided short-term relief in a person’s home, but a long-term situation was another matter.

Early on, the poor were simply auctioned off to the lowest bidder. The auction’s winner provided food, shelter, clothing, etc. to the pauper (and perhaps to his family) in exchange for the pauper’s labor. The arrangement was more like being an indentured servant than a slave, but it was definitely not anyone’s preferred way of life. As can be imagined, this system led to many abuses, and some auctioned paupers were badly treated, overworked, and nearly starved.

Peabody Poor Farm, Kansas

Poorhouses were set up (usually by counties) to be more efficient than this auctioning system. Authorities also hoped that the poor who resided in them could learn discipline and good habits so that they could get out and become useful citizens. They were not meant to be pleasant, but rather, to discourage residence by anyone who was at all capable of working. Children would be separated from parents, and wives from husbands. Many poorhouse inmates had to wear a dreary uniform that further shamed them. Residents were required to work, if able, often at the accompanying “poor farm.”

Fulton Country, Illinois, Poor Farm Residents

Going to the poorhouse was so dreadful that mournful poems and songs were written about the experience. One such effort by Will Carleton was called “Over the Hill to the Poorhouse” and ended with this stanza:

Over the hill to the poorhouse—my child’rn dear, goodbye!
Many a night I’ve watched you when only God was nigh:
And God’ll judge between us; but I will always pray
That you shall never suffer the half I do today. (1882)

A Rational Solution

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Almshouse Occupants at Meal Time, circa 1911

Wealthy families with an insane member could usually afford to pay someone to care for their unfortunate relative; they also had accommodations for him or her. It was an entirely different matter for the poor or even the middle class, whose homes were often small and cramped by today’s standards. A working family found it almost impossible to spare an able-bodied member to care full-time for someone who was sick, whether physically or mentally. Consequently, illness of any kind sometimes drove a family into poverty, or into the dreaded poorhouse.

Residents of an Almshouse Making Shoes, courtesy Library of Congress

Poorhouses were set up to care for people who had no one else to support them. Mentally ill people with no support also wound up in poorhouses, and nobody benefited when that happened. The insane person disrupted the routine of the poorhouse and very likely frightened the other people in it. That person could get no real help, either, because a poorhouse wasn’t set up to help people with mental illness. Consequently, no one benefited from the arrangement, and the victim of insanity often suffered terribly when the poorhouse caretaker simply confined him or her to a room or an outbuilding (see last post).

Kings County Almshouse, Brooklyn, NY, circa 1900, courtesy the Museum of the City of New York

One of the arguments for asylums was that jailers and poorhouse managers didn’t have the accommodations to adequately care for the insane, or the expertise to do it even if they had the space. Asylums, where trained personnel in buildings constructed specifically for keeping the insane comfortable, were supposed to be an enlightened solution to an age-old problem.

Indians, Insanity, and American History Blog

Asylums And Insanity Treatments 1800 – 1935

Author Archives: Carla Joinson

Fourth of July

Treating Morbid Impusles

Trauma Care for the Insane

Common Sense

The Front Line

Madness in a Modern World Part Two

Madness in a Modern World

You Get What You Pay For

Off to the Poorhouse

A Rational Solution