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.

A Long Day

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Western Lunatic Asylum Medical Staff, 1896

Attendants had a difficult job in any asylum, and the ones at the Canton Asylum for Insane Indians were no exception. Besides their special duties when new patients arrived (see last post), they were in charge of general housekeeping on their wards. They were in immediate charge of the nursing of their patients, including the dispensing of medicine and changing surgical dressings. They had to make complete notes about the physical and mental condition of every patient at least once a month.

Attendants were to keep patients comfortable and clean, bathing and changing them as necessary. They had to look after bedding, sweeping, dusting, brightening the floors, hardware, plumbing, fixtures, etc. in their patients’ rooms, as well as clean the lavatories and toilets. Attendants had to accompany patients who could take outdoor exercise, and direct patients in any work tasks they were able to do. Attendants also waited table during meals, submitted a report to the superintendent each morning on any changes in their patients, and accompanied the superintendent and/or physician while he made his rounds.

In 1907, male attendants were paid $480 annually, and female attendants $420. This amounts to $11,500 and $10,100 in today’s dollars, using a Consumer Price Index calculator.

Attendants at Pennsylvania Hospital for the Insane, circa 1860s, courtesy University of Pennsylvania

Nurses at St. Elizabeths, 1917, courtesy Library of Congress

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No Job Too Small

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Oscar S. Gifford

Superintendents felt strongly that only one person could be in charge of an asylum. They wanted no interference from boards of directors or trustees, or from the public, since they felt that no one but themselves really knew their business. Superintendents also disliked sharing power–patients and staff should have no doubt as to who was in charge. Superintendents often fought a running battle with outside forces who wanted to provide oversight or help them. Superintendents frequently got their way, but that meant they were also inundated with administrative tasks that ate up their time.

Oscar S. Gifford, the first superintendent of the Canton Asylum for Insane Indians, had to personally accept and receipt for $14 and $2, the property of patients Miguel Maxcy and Arch Wolf, respectively, when they were transferred from St. Elizabeths in January, 1903. He personally took patients to church at times, escorted new patients from their reservations to the asylum, and picked up escaped patients after they were caught and detained. He wrote annual reports, corresponded with the Indian Office, and reviewed employment applications among other duties. Despite his extremely small institution, small staff, and few patients, Gifford eventually ran into trouble because he could not manage to supervise any of them effectively.

Sample Asylum Report, courtesy University of North Carolina

Patients in St. Elizabeths

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Meals at Asylums

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Dr. Harvey Black

The quality of food at asylums ranged from the piece of bread and five prunes Nelly Bly received on Blackwell’s Island to the abundance of milk and eggs sickly patients received at St. Elizabeths. Many institutions made a point of offering enticing food to patients who had problems eating; one woman at Hilltop recounted the generous breakfast of oatmeal, bacon, scrambled eggs, toast, milk and juice, and the evening pot of chocolate brought to her by staff.

Physicians generally considered it positive when patients put on weight. Notes on a woman named Katie at the Southwestern Lunatic Asylum in Virginia said that she had “fattened up some.” Of another woman there, the physician wrote that she had “gained flesh and strength.” Of others, doctors noted that patients had “improved in flesh” or had “grown stout.” There never seemed to be any attempts to help patients lose weight, even if they were described as “quite stout.”

The superintendent at Southwestern Lunatic Asylum, Harvey Black, wrote in his first report that three things were necessary to help patients recover and go home: a sufficient quantity and variety of good food, neat, comfortable clothing, and a sufficient number of efficient ward attendants. He spoke of a planned orchard of 400 apple trees, peach and pear trees, grapes, and berries, and stated that even more than that was needed. If nourishing food did have curative powers, Black seemed to want to provide it.

Southwestern Lunatic Asylum

St. Elizabeths, N-building, courtesy Library of Congress

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Insane Asylum Graveyards

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Poughkeepsie, NY Lunatic Asylum

Large public insane asylums were built primarily for people who could not afford private care. Many families, relieved at finding a place for a difficult member, left him or her at an asylum for life. And death. Asylums had to set up cemeteries for patients whose bodies weren’t claimed by families, or who had entered as paupers.

St. Elizabeths in Washington, DC was unusual in that its patients were also military veterans. The institution served as a military hospital during the Civil War, and the grounds contain a separate Civil War cemetery for military patients who died while they were hospitalized. (This time period is when St. Elizabeths got its current name. Civil War soldiers were embarrassed to write home that they were staying at the Government Hospital for the Insane, so they referred to it as St. Elizabeths, the colonial name of the land on which the hospital was located.)

Philadelphia Insane Asylum, circa 1861, where "eighteen raving maniacs were burned to death" in February, 1885

St. Elizabeths Hospital Military Cemeteries

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Canton Asylum’s Second Superintendent

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Dr. Harry R. Hummer

The Canton Asylum for Insane Indians was unusual in that it was a short-lived institution with only two superintendents. Unlike Oscar Gifford (see last post), Canton Asylum’s second superintendent was well qualified to run an insane asylum. Born in Washington, DC and educated at Georgetown University, Dr. Harry R. Hummer was an ambitious young man who desired prominence and prestige.

He worked at the Government Hospital for the Insane ( St. Elizabeths) for nine years before applying for the position of superintendent at Canton Asylum. Married with two children when he moved to Canton, South Dakota, Hummer badly wanted to run his own institution.

It must have been a difficult move for the whole family, since they had no ties whatsoever to the West. Norena Guest Hummer, cousin to the poet Edgar Guest, was used to the nice dinners and servants available as a doctor’s wife at St. Elizabeths. Hummer was used to having his orders obeyed without question, common at authoritarian eastern asylums, and certainly common at the military-style government asylum. It was a shock to both Hummers to arrive in South Dakota among a much more independent type of employee.

Poet Edgar Guest

Georgetown Medical School, circa 1900, courtesy National Library of Medicine

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The First Government Hospital for the Insane

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St. Elizabeths

St. Elizabeths

The Government Hospital for the Insane (St. Elizabeths) had been in operation about a decade when the Civil War began. Wounded soldiers were treated there, and in January, 1863, the surgeon-general of the U.S. army requested that a separate room be set aside “for the convenience of one of the manufacturers of artificial legs.” A soldier who had lost a limb through amputation could then be easily and conveniently fitted for an artificial limb. Soldiers from close-by hospitals could request a transfer to St. Elizabeths when their wounds healed, for an artificial limb-fitting.

The government hospital expanded greatly over the next two decades, and was a leader in the scientific treatment of its patients. Dr. I.W. Blackburn, its first special pathologist, was one of the first in the country assigned to a hospital. St. Elizabeths was also one of the first hospitals to use hydrotherapy to treat the insane. Dr. G.W. Foster began using this therapy around 1893, mainly in the form of cold packs to the head. The hospital purchased a complete hydrotherapeutic outfit in fiscal year 1897-1898.

A school of nursing instruction began in 1894, and became more formalized around 1899, when it was reorganized and expanded. The school began giving certificates after a two-year course, along with a promotion and raise in pay for graduates.

Private Columbus Rush, courtesy National Museum of Health and Medicine

Private Columbus Rush, courtesy National Museum of Health and Medicine

Private Rush with Prosthetic Legs, courtesy National Museum of Health and Medicine

Private Rush with Prosthetic Legs, courtesy National Museum of Health and Medicine

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Dr. W.W. Godding

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Dr. W. W. Godding, courtesy Library of Congress

Dr. W. W. Godding, courtesy Library of Congress

Dr. William Whitney Godding was the second superintendent of St. Elizabeths, still called the Government Hospital for the Insane in 1877 when he took over from Dr. Nichols. The asylum had 700 patients at the time, far more than originally planned on. Godding accommodated this large number of patients by building 18 cottages for them, where chronically ill patients could live in more homelike settings.

Godding wrote nearly two dozen articles about mental illness, and served as president of the Association of Medical Superintendents of American Institutions for the Insane (AMSAII) from 1889- 1890.

In 1897, the Department of the Interior asked Godding his opinion about building a government hospital for insane Indians. Godding said that since he had only seven Indian patients at his own hospital, he didn’t think there was any need for a separate institution for them. Though he knew there might be a number of mild cases elsewhere, he couldn’t see expending money for a separate hospital and the upkeep for it, when the entire cost for taking care of the insane Indians at the Government Hospital only totaled $2,267.00.

Senator Pettigrew from South Dakota managed to push through the Canton Asylum for Insane Indians, though, at an initial cost of $45,000.

First Pathology Lab in a Mental Hospital, St. Elizabeths, 1884, courtesy National Institutes of Health

First Pathology Lab in a Mental Hospital, St. Elizabeths, 1884, courtesy National Institutes of Health

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St. Elizabeths Superintendents

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Grand Review of the Union Army, Washington DC, courtesy Library of Congress

Grand Review of the Union Army, Washington DC, courtesy Library of Congress

Reformer Dorothea Dix was instrumental in founding St. Elizabeths in Washington DC, as a place for “enlightened curative treatment of the insane of the Army, Navy, and District of Columbia.” She recommended Charles H. Nichols for the position of superintendent. President Millard Fillmore appointed him to that position in 1852.

The hospital was constructed during Nichols’ tenure as superintendent. When the Civil War broke out, Congress authorized the unfinished east wing as a temporary hospital for Union soldiers, and the 60-bed West Lodge was used for sailors in the Potomac and Chesapeake Fleets. General Joseph Hooker was a patient at St. Elizabeths after the battle of Antietam, but was cared for in Dr. Nichols’ quarters.

Dr. Nichols and other male staff rode out to battlefields around the DC area, to treat wounded soldiers. Recuperating patients filled in for them when possible. Not all patients survived, and both Union and Confederate soldiers are buried on the grounds of St. Elizabeths.

Dr. Nichols remained as St. Elizabeths’ superintendent until 1877.

General Joe Hooker, Matthew Brady photo

General Joe Hooker, Matthew Brady photo

Civil War Ambulance Train

Civil War Ambulance Train

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Cherokee State Hospital for the Insane

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Cherokee State Hospital for the Insane

Cherokee State Hospital for the Insane

The Cherokee State Hospital for the Insane in Cherokee, Iowa was not founded by, or for, Indians. However, like the Canton Asylum for Insane Indians, it was a deeply desired institution. The towns of  Sheldon, LeMars, Fort Dodge, and Storm Lake in northwestern Iowa lobbied hard to bring the asylum to their area, since it meant jobs and economic growth. Unlike Canton Asylum, this hospital is still in operation,

In 1911, Iowa began to pass sterilization laws to prevent the procreation of undesirable or defective people. Morons, idiots, drunks, epileptics, and moral perverts were all fair targets, and if they were institutionalized, the managing staff made the determination for sterilization. Later, staff recommended candidates for sterilization to the state eugenics board, who made the final decision. By the early 1960s, nearly 2,000 people in Iowa (the majority female) were sterilized under a variety of these laws.

Dr. Walter Freeman, who had perfected the lobotomy technique, enjoyed the fame he received for his work. He was performing a public lobotomy on a patient at the Cherokee State Hospital and stepped back so a reporter could take his picture. As he did this, Freeman’s ice pick-like instrument went too deep into the patient’s brain and killed him.

In 1924, Dr. Freeman directed St. Elizabeths’ labs. He pioneered his transorbital lobotomy procedure there, but the hospital’s superintended would not allow him to use it any wide scale way.

Dr. Freeman Working

Dr. Freeman Working

Feeble-minded Subjects for Sterilization, courtesy Truman State University

Feeble-minded Subjects for Sterilization, courtesy Truman State University

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Livestock Problems at the Canton Asylum

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Hog Cholera Pamphlet

Hog Cholera Pamphlet

Dr. Hummer had one advantage at the Canton Asylum for Insane Indians that his counterpart at St. Elizabeths didn’t: acreage to raise livestock. Hummer walked into his job knowing nothing about agriculture or animal husbandry, but he soon learned the advantages of growing his own supplies.

When Hummer took over the facility in 1908, he had three dairy cows and no bull. He wanted to build up his herd so that it could supply all the facility’s milk. By 1923, he increased his holdings of dairy cattle to 17; he routinely sold or slaughtered extra calves. Hummer continually asked for more grazing land so he could increase his herd.

Hogs were a little easier to manage than cattle, and when his herd of hogs increased sufficiently, Hummer was able to cut his beef consumption in half. In the fall of 1923, however, hog cholera struck. Hummer immediately shipped four healthy hogs to the Sioux Falls market, and braced himself to lose the rest. He typically used 200 pounds of fresh pork each week, so it was a blow to lose his  home-grown supply of meat. Hummer asked for funds to buy 12-15 brood sows the next spring, to start a new herd.

Hog Buyer in the Middle of a Hog Pen, 1921, courtesy Library of Congress

Hog Buyer in the Middle of a Hog Pen, 1921, courtesy Library of Congress

USDA Scientists Examine a Pig

USDA Scientists Examine a Pig

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