Canton Asylum

Insane Asylum at Kankakee

Along with solid advances in science, the late 1800s and early 1900s saw plenty of faddish cures for ailments. In 1899, the New York Times reported on a young man, Irwin Fuller Bush, considered hopelessly insane, who had been restored to health through an operation. “Today, through the treatment with lymph from glands of goats, Bush is at home and declared to be completely restored in mind.” Dr. Roberts, a physician in Greene City, Missouri, had discovered the miraculous properties of goat glands and treated young Bush. The glands were also said to “arrest senility.” Roberts was enthusiastic enough about his treatment to go to Europe and try to convince alienists there to adopt the treatment in their own insane asylums.

Bush had been committed to the Insane Asylum at Kankakee (Illinois). In that same asylum, that same year, Dr. J. B. Murphy planned to remove a tumor from the brain of another patient held there. This man, “the son of wealthy parents, has been confined in that institution for six years and has been regarded as incurable.” The tumor had shown up on an X-ray, and Murphy and his assistant were convinced their operation would be successful. “There is no doubt that this discovery [of tumors on the brain] will lead to the removal of the causes of insanity in many cases,” said Murphy.

The Kankakee asylum appears to have been especially proactive in searching out new treatments for insanity. Undoubtedly they had permission to perform these two treatments, but one wonders how many friendless patients they may have experimented on, as well.

Meeting of Medical Staff, Kankakee Mental Hospital, circa 1910

Another Proponent of Goat Glands, Dr. Brinkley Used Them to Invigorate Aging Men

______________________________________________________________________________________

Many Physicians Believed Insanity Stemmed from Physical Causes

Some of the new ideas about insanity and ways to prevent it helped doctors believe in cures after a long period in which they had resigned themselves to believing that most insanity was chronic. An article from the November 12, 1922 edition of The Washington Post quoted Dr. Toulouse, a renowned French alienist, who had founded the League for Mental Hygiene and Prophylaxis. He believed that “half the occupants of the world’s insane asylums are not mad, but diseased.” Like most other alienists, Toulouse also believed that early intervention was critical; he set up a clinic where people could go when they felt their “nerves giving way.”

Toulouse believed the three great causes of insanity were sorrow, thyroid deficiency, and vice. Patients at his clinic would be questioned at length so that Toulouse could arrive at a life history for the individual. A physical exam would then determine whether they “were born with an excess of thyroid matter” or whether they had become addicts to vice–including drugs. Though all three (main) causes of insanity could be cured, Toulouse felt that madness caused by sorrow was the most difficult to resolve successfully.

Sorrow caused by bereavement or crosses in love could be healed after time, but sorrow caused by loss of money was the hardest to cure. “Practically the only sedative for a person who has once been wealthy and who finds himself suddenly poverty-stricken is to provide him again with wealth,” said Toulouse. This was obviously an impractical course of treatment.

______________________________________________________________________________________

Dr. Isaac Ray, courtesy National Institutes of Health

The nineteenth century saw many medical breakthroughs (see last post), and the public and doctors alike began to think that science could solve all human ailments. Doctors saw that better sanitation and hygiene during the Civil War helped prevent disease,and alienists began to hope that the same strides could be achieved through mental hygiene. Dr. Isaac Ray, a very powerful and prominent insane asylum superintendent, defined mental hygiene (in part) as “preserving the mind against all incidents and influences calculated to deteriorate its qualities.”

Isaac and others involved in the mental hygiene movement believed that if people could live in a situation and atmosphere that promoted mental health, they would either not fall ill in the first place, or the symptoms might not be as severe. Stress, urbanization, poverty, and industrialization were considered major players in undermining mental health, and these mental health hygienists emphasized the importance of proper rest, diet, exercise, education, self-discipline, and proper surroundings to promote mental health. (The latter is one reason that asylums were built to be magnificent and beautiful.) Though almost everyone could see benefits to these important elements of living, not all alienists agreed that they would prevent or resolve mental problems. Some thought that all mental illness sprang from biological, rather than social, causes. Early hygienists did not institute scientific studies or use methodologies that could support their beliefs, so mental hygiene remained only on the fringes of medicine for decades.

The Principles of Mental Hygiene Had Wide Acceptance, courtesy Johns Hopkins Public Health Magazine

______________________________________________________________________________________

Lister's New Disinfectant Method in Use

Important medical breakthroughs occurred during the 1800s. Especially important was the idea that disinfectants could help prevent the spread of disease in hospitals. Joseph Lister used carbolic acid to clean wounds and surgical instruments in hospitals, which brought deaths from infection down from 60% to about 4%. Many doctors scoffed at his ideas, but his success forced them to adopt his methods. Just a few years later, Louis Pasteur and Robert Koch developed the germ theory of disease. This was also revolutionary, since many doctors until then had no idea whatsoever about the mechanism of disease. Some thought illness generated spontaneously, while others thought the atmosphere could contain the elements of ill health or that certain personalities and physical attributes predisposed people to certain diseases.

In 1879, researchers developed a vaccine for cholera. Before the turn of the century, vaccines were developed for anthrax, rabies, tetanus, diphtheria, typhoid, and plague. It must have seemed that science had conquered–or would soon conquer–all the ills of mankind. It was a hopeful time, which led both medical doctors and alienists (specialists in treating diseases of the mind) to believe that few conditions were beyond treatment and cure.

Joseph Lister

Robert Koch, courtesy National Library of Medicine

______________________________________________________________________________________

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

______________________________________________________________________________________

usan 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 more than 1,000 people; she resigned in 1893 due to her own poor health. She married Henry Picotte in 1894 and moved to Bancroft, Nebraska, where she set up a private practice. Picotte was passionate about improving the health of Native Americans. She taught them ways to improve health, lobbied to prohibit alcohol on reservations, and eventually built a privately-funded hospital on the Omaha Reservation at Walthill, Nebraska. She died two years later at only fifty years of age.

Picotte's Father, Joseph La Flesche (Iron Eye)

Picotte's Hospital

______________________________________________________________________________________

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

______________________________________________________________________________________

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

______________________________________________________________________________________

Front View of Canton Asylum, courtesy National Library of Medicine

For non-wealthy patients entering an insane asylum, both admitting procedures and accommodations were much different than for the wealthy (see last post). Alienists did not have as much time to spend with new patients, and often took short personal histories  solely from family members’ who were often biased. Patients may then have been taken straight to their rooms and left by themselves to sort out their new, distressing situation. Some patients would first face a bath and delousing–neither of which would have been done with delicacy.

At the Canton Asylum for Insane Indians, language barriers would complicate the process for many patients. They, too, were frequently deloused and/or bathed. Their clothes were inventoried, and any money they had brought with them was taken for safekeeping. In many insane asylums, patients with similar behaviors were grouped together, and as patients recuperated, they would be moved to appropriate wards or floors. Canton Asylum never took that approach, partly because they never had a high concentration of single-gender patients who could be combined that way. Therefore, quiet patients might room with violent ones, or well-oriented patients be shut in with people who raved or hallucinated. This mismatch could only serve to make the experience worse for patients who were aware of their surroundings.

Committal Document from Ireland

A List of Patients in St. Louis Asylum

______________________________________________________________________________________

East House Dining Room, circa 1903, courtesy harvardmuseums.org

The wealthy at McLean Asylum for the Insane enjoyed many amenities that less affluent patients did not (see last post). Some patients lived in single-dwelling cottages with several bedrooms, a dining and living room, modern bathrooms, and sometimes even servants’ quarters. Typically, these cottages were paid for by the patient’s family and later deeded to McLean, in exchange for the relative’s care. Though many patients appreciated their surroundings, what they and their families benefited most from was the time that their alienists and physicians could give them.

Doctors caring for a wealthy patient had the time to give detailed instructions on how a particular person was to be treated; for instance, one patient’s entry stated that she could come and go from her cottage as she pleased, read whenever she wanted, and shampoo her own hair when it suited her. Alienists at McLean could take their time with patients’ histories, noting what pleased and displeased them, what might have caused the onset of their disorder, how they reacted to certain situations, etc. More than that, the nursing and attendant staff were not so hurried and harried. They could accompany patients on leisurely walks, talk to them and assist them in numerous ways, and retain the patience and kindness that other hospitals drove out of its staff by overwork. Many of McLean’s patients undoubtedly were helped simply by the respectful treatment they received.

First Graduating Class of McLean Nursing School, 1886, courtesy McLean Hospital

Hope Cottage at McLean Hospital, 1903, courtesy Harvard Art Museum

______________________________________________________________________________________