Category Archives: St. Elizabeths Hospital

St. Elizabeths Hospital in Washington, DC was officially known as the Government Hospital for the Insane. It was founded by Dorothea Dix before the Civil War. It was turned into a hospital for the wounded during the Civil War. Soldiers didn’t want to write home from an insane asylum, so they used the name (St. Elizabeths) from the land grant on which the hospital served.

Another Canton Patient History

Front View of Canton Asylum, courtesy National Institutes of Health

Front View of Canton Asylum, courtesy National Institutes of Health

Some of the only Canton Asylum for Insane Indians’ patient histories available come from assessments St. Elizabeths staff made when patients were transferred in 1933 (see last two posts). Here is one more sample patient history:

Meda Ensign (Tribe Shoshone)

This patient had been admitted to Canton Asylum in 1913 at age 24, at the request of the Superintendent of Shoshone Agency, Wyoming. Medical certificate states, “Patient was crippled, deaf and dumb and of unsound mind and should be sent to the Insane Asylum for Indians. This girl has no one to look after and care for her and very often runs about in winter weather scantily dressed. She suffers very much from cold and hunger.”

During her residence in Canton she was said to have been quiet, well-behaved, apparently comprehended many things said to her but was unable to articulate words and her actions were those of a young child, showed periods of irritability, times of depression, tried to do some ward work but accomplished very little, was no problem in that she was tidy and clean.

The assessment went on to relate that Ensign had fractured her left leg at one time, and then sustained a second fracture near the first one after slipping on the walk. She also had trachoma (a debilitating eye disease that often led to blindness). Her mental diagnosis was “mental deficiency” or imbecility.

Staff assessment at the time of admission showed that “the patient is quiet, apathetic, disinterested. She appeared quite dully mentally, understood almost nothing that was said to her, could not talk. She was quiet and well-behaved on the ward, neat and tidy in her habits, did not aggravate the other patients or get into fights or show irritability.” St. Elizabeths’ staff also diagnosed Ensign with “imbecility.”

Three Photos of a Hysterical Woman Screaming, courtesy Wellcome Library

Three Photos of a Hysterical Woman Screaming, courtesy Wellcome Library

Asylum Patients With Various Disorders

Asylum Patients With Various Disorders

Canton’s Patients

Canton Asylum with Swing Sets

Canton Asylum with Swing Sets

Few patient records from the Canton Asylum for Insane Indians are intact or complete. This is not unusual–many asylums destroyed their records over the years, since early administrators did not see any potentially historical value in them. The Canton Asylum’s records are especially problematic, though, since its superintendent, Dr. Harry Hummer, was faulted several times for a failure to even keep good records. What never existed cannot very well be found, in many cases. There are a few records that remain, and when patients were transferred to St. Elizabeths after the Canton Asylum closed, staff observed them for a period of time and then summarized the patient’s history and current behavior (see last post). Here is an example of their summation of a patient:

Nesba (Tribe – Navajo)

She was admitted to the Canton Asylum . . . at the request of the Superintendent of Southern Navajo Agency, Fort Defiance, Arizona. The medical certificate at the time stated, “The patient has been in present condition for past two years. Present symptoms, feeblemindedness, dementia.” The patient is a congenital defective suffering with cerebral palsies. . . . During her stay in the Canton Asylum she was infantile in her reaction, subject to tantrums during which she cried and yelled, sang, etc. These periods seemed to coincide with her menstrual periods. At one time during her stay there she was quite destructive to clothing . . . she mimicked people and seemed to delight in teasing other patients.

On her admission here the patient was passively cooperative but unable to stand alone due to her physical handicap. She is mute except for guttural noises which she makes in her throat. No definitive mental content can be elicited. She smiles at any attention received, is quite highly pleased at any effort of others to associate with her.

Other remarks continued to assess the patient’s physical condition and mental status, but staff said it was “impossible to determine whether she is oriented or if her memory is better.” She had been admitted to Canton Asylum in 1924 when she was about 20 years old, so would have been around 30 when she came to St. Elizabeths. Her physical condition probably brought her to and kept her in an asylum.

My next post will give one more patient history.

Group of Female Patients, Eastern Hospital for the Insane, courtesy National Institutes of Health

Group of Female Patients, Eastern Hospital for the Insane, courtesy National Institutes of Health

 

Acute Insanity as Cause of Death

Acute Insanity as Cause of Death

Patient Histories

Many Physicians Believed Insanity Stemmed from Physical Causes

Many Physicians Believed Insanity Stemmed from Physical Causes

An important innovation in the treatment of the insane was to obtain a history of patients’ past life and behavior. This allowed doctors to see how much the patient was deviating from previous behavior that was “normal” for that person; it also allowed them to see if anything important might have happened to cause the patient’s decline in mental health. Illnesses, shocks, losses, and so on could be precipitating events, as could lifestyle practices such as alcohol or opiate use. All mental illness wasn’t connected to outside factors, of course, but alienists began to realize that for them to understand and help patients, they had to understand what they had been like before they became insane.

Most patient records are missing from the existing files on the Canton Asylum for Insane Indians. Medical files seemed to have been fairly up-to-date when the asylum first opened, since the asylum’s assistant superintendent, Dr. John Turner, could ascertain the date of a patient’s pregnancy by the menstrual records he kept. When Dr. Harry Hummer took over as superintendent, one report mentioned that his record-keeping was modeled after that of St. Elizabeths, where he had been a physician. However, the doctor was criticized in later reports for poor record-keeping. The reports on patients that he sent to relatives varied little from month to month, and Hummer put a stop to even this slight gesture after a number of years.

When patients were transferred to St. Elizabeths after the Canton Asylum closed, staff reviewed what was known about them and then wrote their own assessments after a short period of observation. Sometimes these short notes are the only ones available, and they at least give a glimpse as to why a patient came to the asylum.

In my next couple of posts, I will share a few of these patients notes.

Psychoanalysis Is News, courtesy National Archives

Psychoanalysis Is News, courtesy National Archives

Group of Prominent German Alienists

Group of Prominent German Alienists

Make it Pretty

Exhibition of Fancy Work, 1908, courtesy Willard

Exhibition of Fancy Work, 1908, courtesy inmatesofwillard.com

Occupational therapy was an important part of patient care in nearly all asylums. Patients were encouraged to do skilled work that got their minds off their problems/issues and produced a tangible object in which they could take pride. Genteel ladies might do fancy sewing while men engaged in woodwork, even in an elite asylum such as the McLean Asylum for the Insane in Massachusetts.

Indian patients at the Canton Asylum for Insane Indians were also encouraged to do crafts like beadwork and basket weaving if they so desired, to help pass time. (Peter Thompson Good Boy spent time “beading” at St. Elizabeths during his stay there beginning in 1913.) Occasionally, patients like Lizzie Vipont earned a little bit of money with their beadwork by selling items to visitors. Necklaces and handbags seemed to be most popular–or at least are mentioned most often. One report mentions that men whittled wooden objects, but went on to say that women were the primarily crafters. The asylum’s second superintendent, Dr. Harry Hummer, also allowed these kinds of occupations, but apparently stopped encouraging it so that the practice fell by the wayside.

This photo appeared in USA Today. Artifacts left over from the Hiawatha Insane Asylum for Indians in Canton, S.D. are displayed at the Canton Public Library on April 23, 2013. Photo: Elisha Page, Sioux Falls, S.D. Argus Leader

This photo appeared in USA Today. Artifacts left over from the Hiawatha Insane Asylum for Indians in Canton, S.D. are displayed at the Canton Public Library on April 23, 2013. Photo: Elisha Page, Sioux Falls, S.D. Argus Leader

 

Occupational Therapy, Toy Making in WWI-Era Psychiatric Hospital, courtesy Otis Historical Archives, National Museum of Health and Medicine

Occupational Therapy, Toy Making in WWI-Era Psychiatric Hospital, courtesy Otis Historical Archives, National Museum of Health and Medicine

Matters of Size

Bryan Hall, a Patient at St. Elizabeths Admitted in 1874 and Spent at Least 47 Years There

Bryan Hall, a Patient at the Government Hospital for the Insane, Admitted in 1874 and Spent at Least 47 Years There

In 1903, the Canton Asylum for Insane Indians‘ first year of operation, the American Medico-Psychological Association (the main U.S. organization for psychologists) met in Washington, DC.

During opening remarks, visitors were reminded of the city’s many interesting sights and activities available to them, including a association-sponsored general smoker in the Willard Hotel (a smoker was an informal meeting or a recruiting meeting used by men’s organizations) and a luncheon at the Government Hospital for the Insane (later known as St. Elizabeths). Continue reading

Useful Visitors

Photos Showed What Words Could Not

Photos Showed What Words Could Not

Though many patients felt they didn’t get enough visitors, and others didn’t like being treated as entertainment for the thrill-seeking public (see last blog), certain visitors were supposed to help asylum patients. Most states set up a Lunacy Commission whose job it was to visit and inspect the state’s insane asylums. These appointed personnel were supposed to go through the facilities and ensure that patients were being treated humanely. They were also charged with reviewing the superintendent’s management and suggesting changes for the benefit of the institution; this oversight could include reviewing the asylum’s financial records and expenditures. The Government Hospital for the Insane, later St. Elizabeths, was an exception in that it was overseen by a Board of Visitors who performed much the same function.

Most asylums were not at all afraid or ashamed to have their finances reviewed. Many superintendents were proud of their fiscal management and also grateful for numerous charitable contributions such as newspaper subscriptions, special entertainments, gifts of furniture, and the like. They enjoyed showing off the productivity of their patients in terms of food raised, garments sewed, etc. However, superintendents realized that all patients did not present well, and usually took pains to ensure that visiting officials saw their institutions at their best. Most asylums kept the calmer, better-behaved patients in wards closer to the administrative offices. Recovering patients often moved from ward to ward as they got better, and eventually ended up in one of these more public wards. When visitors saw such patients, who were often nearly recovered or had minor illnesses to begin with, they were reassured. Any cruel treatment, confinement, and restraint generally occurred on wards which were not shown to the public. This is one reason that patient abuse could thrive despite the oversight built into the asylum system.

Montevue Asylum, African-American Ward

Montevue Asylum, African-American Ward

Montevue Asylum in Maryland, 1909, Photographed by the State's Lunacy Commission

Montevue Asylum in Maryland, 1909, Photographed by the State’s Lunacy Commission

Not Just Patients Suffered

For most of his tenure, Dr. Harry Hummer ran the Canton Asylum for Insane Indians as the only medical person on staff. He resisted trained nurses (probably because they could challenge his own expertise) and immediately undermined and harassed the nurses forced on him by the Indian Service. Grace Fillius reported to the asylum in September, 1928, and her strong personality immediately clashed with Hummer’s.

Fillius had worked as a nurse with the Army during the Great War, and suffered a breakdown in 1918 which apparently required a short stay at St. Elizabeths. When Hummer began his work against her, he brought up this breakdown as a weakness inherent in her character. Though this “cause for concern” was probably produced out of spite, it also fit in with Hummer’s philosophy that a person could never truly be cured of mental illness (see last post).

St. Elizabeths, East and North Facade, courtesy Library of Congress

______________________________________________________________________________________

Dr. Hummer’s Credentials

Dr. Harry Hummer

Dr. William A. White was an undisputed leader in the field of psychiatry (see last post). He was St. Elizabeths’ superintendent for over twenty years, and implemented many innovations. St. Elizabeths endured its own cycles of overcrowding, scandals, and investigations, but it was generally considered  one of the leading institutions of its kind. It attracted some of the country’s best psychiatrists and researchers, who wanted to be affiliated with the asylum and its good reputation. Continue reading

An Important Alienist

Alienists Were Considered Experts

Alienists became more important as experts to draw on after psychiatry became more established.

Dr. William A. White, for many years the superintendent of the federal government’s first hospital for the insane, St. Elizabeths, was an especially important figure.

His book, Outlines of Psychiatry, became a classic in its field and was used as a textbook for many years. Continue reading

Compassionate Doctors

Dr. William A. White, Superintendent at St. Elizabeths, courtesy National Institutes of Health

Dr. William A. White, Superintendent at St. Elizabeths

Though many abuses toward patients  were either condoned or ignored by senior staff, some doctors cared very much about patient abuse.

When Dr. William A. White took over as superintendent of St. Elizabeths (the federal government’s hospital for insane soldiers, sailors, and citizens of Washington, D.C.), he immediately issued a terse letter absolutely revoking use of the saddle (a harness fashioned around a patient in bed and tied so that he/she could not raise up) as a restraining device. Continue reading