Canton Asylum

Cato Sells, Commissioner of Indian Affairs in 1921

Admissions to the Canton Asylum for Insane Indians were routed through reservation Indian agents (later superintendents), who performed much of the administrative and supervisory functions concerned with running these population centers. The asylum usually had several dozen applications on file, and tried to fill vacancies with patients who had been waiting the longest. Sometimes urgent or acute cases took precedence, but there were always more applications than room at the asylum. Dr. Harry Hummer was often accused of poor record-keeping, but he was apparently required to take a “census” of patients at the end of each fiscal year (June 30). Not all of these survive, but those that do at least give a snapshot of the asylum population. In 1921:

There were 45 male and 45 female patients. Since opening, there had been 146 male and 114 female patients, so the patient population tended to skew male.

There were 28 tribes represented. Since opening, 50 tribes were represented. The greatest numbers of patients came from the Chippewa, Menominee, and Sioux, with the latter being highest. This undoubtedly resulted because the asylum was located near Sioux reservations; studies had always shown that asylums served more people in close geographic range than farther out. States that tried to locate asylums centrally to be fair to an entire region were frustrated in these attempts because of this natural pattern.

Since opening, 62 patients had died of respiratory diseases, mainly tuberculosis (45) and croupous pneumonia (9). From 1903 to 1921, 115 patients had died.

TB Sanitorium Buildings, Phoenix Indian School circa 1890 to 1910, courtesy National Archives

Alaskan TB Patients, courtesy Indian Health Service

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Music Was Popular with Patients

Though Dr. Harry Hummer failed in many important areas when it came to providing care to his patients, he did try to provide occupations for the patients who wanted to be active. Some letters from patients to the Commissioner of Indian Affairs speak of being grateful for chores because being busy helped pass the time. Some also make reference to trips to town in the asylum automobile, going to the movies, and other pleasurable experiences.

In an inspector’s report from 1916, the asylum obviously had outdoor amusements. Other visitors often spoke of seeing patients strolling on the lawns or sitting in chairs when the weather was pleasant. However, the inspector also noted: “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, 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.”

One of the primary pictures of the Canton Asylum for Insane Indians shows some swings in the foreground.

Trolley to an Asylum

Patients Putting on a Play, Long Island State Hospital

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Male Ward at Athens Lunatic Asylum, courtesy Ohio University Libraries University Archives

There are only two or three pictures available of the Canton Asylum; since they are only of the outside, it’s difficult to get a good idea about the physical layout of the rooms or what it might have been like to live there. In 1910, there were eighteen buildings associated with the asylum. These included barns, sheds, granaries, and similar structures. The main building was two stories high, with jasper granite stone foundations. Underneath, a basement ran underneath the entire building. The basement was divided into several compartments by brick partition walls. The first and second stories had eleven foot ceilings, which should have made the inside look spacious.

The main building held four wards. Two were on the first and second floor of the east wing (males) and two on the first and second floor of the west wing (females). Each ward had an attendant’s room, plus three private rooms where patients could be secluded if necessary. The superintendent (Dr. Harry Hummer) and eighteen employees lived in the main building, though Dr. Hummer eventually got a detached cottage for his family. The asylum had electricity which came from a small electric plant about two miles away. The facility was heated via radiators and used hard well water, along with rainwater collected in two cisterns.

Physician's Bedroom at One of Willard Insane Asylum's Buildings (The Branch)

Cisterns Held Precious Rainwater Runoff

A nicely maintained lawn surrounded the building, and patients often sat outside during nice weather. Inside, the building was often stuffy and smelly. The hard water made it difficult to launder clothing and sheets and keep them really clean, and eventually the entire facility began to look shabby and rundown.

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Boys Working at an Indian Boarding School, location unknown, courtesy Minnesota Historical Society

The Indian Office liked to hire Native Americans who had been educated in its boarding school system, figuring that graduates would be more familiar with white American culture than people who had stayed on reservations. Unfortunately, many boarding school educations prepared students for entry level work rather than supervisory positions. Students frequently spent half their school day in manual labor rather than academics, and then worked as servants in white homes during vacations.

Charles Eastman (1858-1939) was an exception to this typical educational path. He attended mission schools and later Beloit (a private college), before graduating from Dartmouth in 1887. He then attended Boston University, graduated in 1889, and became the first Native American with a certified European-type medical degree. Eastman worked in the Indian Health Service within the Bureau of Indian Affairs (known at that time as the Indian Office) and was able to minister to Native Americans casualties at Wounded Knee.

Charles Eastman, 1897, courtesy Smithsonian Institution

Charles Eastman, 1913, courtesy Smithsonian Institution

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Pueblo Indians Working in the Indian Service School, Taos, New Mexico, courtesy Library of Congress

When Dr. Harry Hummer found himself understaffed as a result of the manpower shortage created by WWI, he asked the Indian Office to approve higher wages to help him fill positions. (See last post.) Otherwise, he would have to look at hiring Indian workers. For him, Indian staff was a last resort; for the Indian Service, hiring Native American workers was becoming much more commonplace. One of the most important reasons for hiring Native Americans was the hope that it would make the process of assimilation (submerging Indians into white culture as a way of “killing the Indian” without actual bloodshed) quicker and easier. Indians’ employment within the Indian Service itself seemed a perfect way to give Native Americans a stake in white culture and for them to serve as role models for others on their reservations.

Before the Civil War, not many positions were filled by Native Americans, but the government pushed employment for them after the war. Employment within the Indian Service’s education department went from 15 percent in 1888 to 45 percent in 1899. By 1912, Native American employees made up nearly 30 percent of all regular employees in the Indian Service, not just in its education department. (There aren’t statistics that break down employment in every job category for this period.) Teachers were still mainly white, but the number of Native American teachers had risen from 0 in 1888 to 50 in 1905.

Yakama Indian Employees and School Children, Fort Simcoe, Washington, circa 1888, courtesy Library of Congress

Hospital Staff, Tulalip Indian School, circa 1910, courtesy University of Washington Libraries, Special Collection Division

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Everyone Helped the War Effort, courtesy baylor.edu

The Bureau of Indian Affair’s efforts to provide health care to Indians was always hit or miss (see last post). One of the obstacles to providing quality–and timely–care resulted from the vast expanses of land out West. Reservation lands could include acreage that rivaled that of some states, but often only one or two doctors were assigned to cover these huge areas. Even if the Indian population had been in comparatively superb health, doctors’ travel time would have prevented them from seeing many patients. Officials knew that many Indians suffered from serious health problems, but didn’t have the personnel to minister to them effectively.

World War I created more problems. Physicians throughout the Indian Service bailed out to work instead for the U.S. Army or to work in the civilian sector; both venues usually meant better pay. The government concentrated most of its construction and supply effort on the army rather than civilian organizations, and there was little done in the way of new construction or even repairs, stateside. Even if the government had wanted to ramp up its efforts to build hospitals and clinics, or provide better health care, it faced the same manpower shortages affecting the rest of the country. Most young, healthy men were overseas or in war-critical positions stateside, and unavailable for more ordinary concerns. Dr. Harry Hummer had such a problem finding and keeping staff at the Canton Asylum for Insane Indians that he implored the Indian Office to raise wages so he could fill positions.

Base Hospital 21, Organized in One Week

Nurse Helen Grace McClelland, Who Served at Base #10 Hospital in France, courtesy University of Pennsylvania

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President Taft Speaking at Manassas Court House, Virginia in 1911, courtesy Library of Congress

The Bureau of Indian Affairs tried to address the many health issues developing among tribes who had lost their traditional lands, lifestyles, and occupations. However, funds were always far too short to do much good, and healthcare was not provided with any kind of continuity. As time went on and the country began to use  surveys and statistics as a basis for action, the government surveyed reservations and schools to discover the extent of the sanitation and health issues which were being reported. When President Taft received the information, which showed a high incidence of tuberculosis and trachoma (an eye disease which often led to blindness), along with a scarcity of medical care, he was shocked.

“The death rate of the Indian country is 35 per thousand as compared with 15 per thousand–the average death rate of the United States as a whole . . .,” he told Congress in 1911. “Last year, of 42,000 Indians examined for disease, over 16 percent of them had trachoma . . . . Of the 40,000 Indians examined, 6,000 had tuberculosis.” Taft asked Congress for more money to go toward Indian health care. . . . “It is our immediate duty to give the race a fair chance for an unmaimed birth, healthy childhood, and a physically efficient maturity.”

Appropriations for Indian medical service rose from $40,000 in 1911 to $350,000 in 1918.

A Grandfather and Two of His Grandchildren Infected With Trachoma, Rincon Reservation, Californina in 1912, courtesy National Library of Medicine

Group Picture at the Phoenix Indian School Tuberculosis Sanitorium Phoenix, AZ, circa 1890-1910, courtesy National Institutes of Health

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Dr. Harry Hummer

Though the Canton Asylum for Insane Indians did not receive visits and inspections as regularly as most other asylums (see last post), some of the inspectors who visited had a strong sense that something was wrong. When Charles L. Davis inspected the asylum, he found it practically roiling with anger and rebellion, with almost all its employees ready to quit. In a report written in late 1909, Davis determined that Dr. Harry Hummer was not a good choice as superintendent for the asylum. Though quite a number of charges had been made against Hummer by the staff and his own assistant superintendent, Davis did not feel that any one of them quite warranted Hummer’s dismissal from the Indian Service. Instead, he advised the Indian Office that Hummer was simply temperamentally unsuited for his position. “In view of the facts developed through my investigation . . . there is nothing left but to recommend another man be placed in charge of the Asylum,” Davis wrote.

Twenty years later, in April, 1929, the facing sheet (a government form) of Dr. Emil Krulish’s latest report on the asylum said in the subject block: Reports on unsatisfactory conditions brought about by conduct of the supt. Dr. Hummer.” Dr. Emil Krulish ended this short follow-up to a prior inspection with: “. . . I desire to state that my last visit has more fully convinced me that a change in the management of this institution is imperative for the sake of harmony and efficient service.”

Dr. Hummer stayed on.

Advertisement for an Asylum

Staff of Arizona State Asylum, 1914

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William A. Jones was Commissioner of Indian Affairs When the Canton Asylum Opened

Few people ever wanted to enter an insane asylum, no matter how well run or up-to-date it was. And, like all institutions run by fallible human beings, asylums were not immune to mistakes and misjudgments on the part of their staffs. One problem the Canton Asylum for Insane Indians faced that St. Elizabeths and McLean didn’t (see last few posts) came as direct consequence of its long-distance oversight.

The Canton Asylum for Insane Indians was not under a trustee or board of visitors system like the other two asylums, though it is certainly untrue that this establishment was never inspected or investigated. However, the asylum was managed for the most part from thousands of miles away. The asylum’s superintendent in Canton reported directly to the commissioner of Indian Affairs in Washington, DC, and the seven commissioners who held the position during the time the asylum was open very seldom, if ever, actually visited the place.

Agents or inspectors from the Indian Office did come by fairly regularly, but none of these men were psychiatrists. They found it difficult to determine how well the patients were being treated  for mental health issues, and usually confined themselves to commenting on the state of the buildings and how efficiently the superintendent ran his farming operation. Medical staff from the Indian Office eventually began visiting much more often as the asylum grew in size and came to the notice of the commissioner through complaints. Dr. Emil Krulish became a frequent visitor and made numerous criticisms that honed in on treatment and the way the superintendent, Dr. Harry Hummer, managed his personnel and patients. However, his voice was ignored and Hummer continued to thrive in his position.

House of Indian Agent Will Hayes, circa 1920-1940, courtesy Library of Congress

Home of Indian Agent William Shelton, circa 1910, courtesy Denver Public Library

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A Typical Report from an Asylum's Board of Directors

McLean Asylum for the Insane and St. Elizabeths were two very different, yet for the most part, well-regulated insane asylums (see last two posts). And though they differed from each other in terms of funding and client base, they contrasted even more sharply with the Canton Asylum for Insane Indians. The Canton asylum was a government-funded asylum like St. Elizabeths, and both of these institutions focused on either indigent patients or those of moderate income. What really set the Canton asylum apart from McLean and St. Elizabeths, though, was the difference in oversight.

At McLean, trustees watched over the management of the asylum and a Visiting Committee “made it a point to see personally each patient in the asylum once a week, checking his name off a prepared list,” according to the editors of The Institutional Care of the Insane in the U.S.A. and Canada, published in 1916. This extraordinary degree of oversight took place well before 1900, when the facility had one nurse for every four patients. As the asylum grew, trustees could not keep to the same schedule, but they were still intensely involved with the asylum. Even at the turn of the twentieth century, trustees hired eminent architects for additional buildings, and doctors knew their patients and kept detailed histories on them.

The government hospital, St. Elizabeths, first fell under the scrutiny of a five-member board of charities, appointed by the President of the United States for terms of three years. Additionally, the President appointed a nine-member Board of Visitors. This board included representatives of the military and clergy, and many times included an acting or retired surgeon-general. In 1914, Brigadier General George M. Sternberg, a pioneer in battlefield wound treatment during the Civil War, was President of the Board, and the surgeon generals of the Navy and Army were also represented. The latter surgeon-general was William C. Gorgas, who had been responsible for wiping out yellow fever in Havana after Walter Reed’s discovery of the mosquito vector for it. Though St. Elizabeths had its share of detractors and investigations, that asylum and McLean were typically watched over by prominent locals who took their duties seriously and felt responsible for providing area patients with quality care.

In my next post, I will discuss oversight for the Canton Asylum for Insane Indians.

William C. Gorgas at the Time of the Panama Canal Construction, courtesy National Library of Medicine

General George M. Sternberg

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