Category Archives: Canton Asylum for Insane Indians

Canton Asylum for Insane Indians in South Dakota was also known as Hiawatha. It opened in December 1902 and closed in 1934 after charges of neglect and abuse were validated. Dr. Harry Reid Hummer and Oscar Sherman Gifford were its only two superintendents. Its only patients were Native Americans, typically called Indians. It was the only federal insane asylum created solely for an ethnic group and served only Indians.

More Rules

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Patients Demonstrate Hand Restraints, 1915, courtesy The Burns Archive

Patients Demonstrate Hand Restraints, 1915, courtesy The Burns Archive

The Indian Office provided rules for attendants working at the Canton Asylum for Insane Indians which were thorough and explicit; similar instructions were most likely the case in all other insane asylums. Patients were supposed to “preserve order” but only by using the mildest means possible. Rule 20 stated: “No kicking, striking, shaking, or choking of a patient will be permitted under any circumstances. Patients must not be thrown violently to the floor in controlling them, but the attendant shall call such assistance as will enable him to control the patient without injury.”

This rule was broken any number of times, and at least one male attendant was fired for committing unwarranted violence against patients. Mechanical restraints like cuffs and camisoles (straitjacket) were to be used only with the consent of the physician or superintendent, but employees did not follow this rule. Instead, they got restraints from the financial clerk simply by asking for them. Dr. Hummer, who later received very harsh criticism for the asylum’s excessive use of restraints, either permitted their use (though he often said restraints weren’t used) or he abdicated his responsibilities to the financial clerk. Either way, he had to know that employees were using restraints quite freely . . . unless he wasn’t making rounds often enough to catch it. Whatever the reason for all the restraints, Dr. Hummer was responsible for the situation.

Medical Staff at Willard Asylum

Medical Staff at Willard Asylum

Staff of Arizona State Asylum, 1914

Staff of Arizona State Asylum, 1914

And the Patients’ Side

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Patient Dining Room at West Virginia Hospital for the Insane, 1912

Patient Dining Room at West Virginia Hospital for the Insane, 1912

Employees at the Canton Asylum for Insane Indians had clear instructions concerning their duties, including the all-important attendants who were at the heart of patient care. (See last post.) They were charged with keeping rooms neat and clean, attending to their patients’ needs in terms of clothing and personal care–basically what anyone would expect of an institution set up to care for the insane. The reality was often different, and the conditions many patients lived under would have been disheartening.

Though foreign to their own experience on or off a reservation, patients arriving at Canton Asylum when it first opened would have walked into a spacious, light-filled building. Electricity and running water might have been exciting to use, and regular meals supplemented by garden produce would have been tasty and welcome. As the asylum deteriorated over the years, however, patient comfort declined. The early structure had been pretty and airy, with pictures on the walls and nice furniture. As time went on, the pictures disappeared; the floors, clothes, and bedding became dingy and worn; and the nourishing food evolved into a monotonous diet of starches and vegetables. Patients used chamber pots instead of toilets, which allowed human waste to create a stench and promote disease in the midst of crowded rooms.

By the time the asylum closed, one inspector likened patient care at the asylum to that of a prison. Patients who had been sent to the institution for mental problems received no mental health care at all–the whole purpose for the asylum. Ultimately, authorities concluded that almost no amount of money could make the asylum function  as it should and decided to shut it down.

Female Ward at Athens Lunatic Asylum, 1893

Female Ward at Athens Lunatic Asylum, 1893

Women's Sewing Room at Spring Grove, 1910s

Women’s Sewing Room at Spring Grove, 1910s

A Difficult Life for All

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People Seated on a Bench Near Van Deusen Cottage, Kalamazoo State Mental Hospital

People Seated on a Bench Near Van Deusen Cottage, Kalamazoo State Mental Hospital

Though patients undoubtedly had wretched experiences at most asylums, the life of an attendant was also difficult. Even in the first decades of the twentieth century, it was usual for attendants and other staff (including physicians) to reside at the asylum where they worked. Continue reading →

A Patient’s Work is Never Done

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Gardner State Colony for the Insane

Gardner State Colony for the Insane

Insane asylums used patient labor for both occupational therapy and cost-containment (see last post). However, that labor didn’t always start after the facility had been completed and simply needed to be maintained. Asylum administrators often brought in patients after only a limited space was ready for occupancy, and then used them to help build the rest of the asylum.

In October of 1902, Governor Crane of Massachusetts declared its newest asylum, the Gardner State Colony, ready to receive patients and admitted five men from the Taunton Insane Hospital. Five more men were transferred from Westborough two months later, and over the winter these male patients worked in the woods to cut down 46,000 feet of lumber. That summer, they worked on the farm and excavated for the asylum’s water supply; in 1904 the institution received 111 patients.

A case can surely be made that patients enjoyed certain types of occupational therapy such as fancy needle-work or light gardening, but tasks such as building roads, chopping down trees, clearing fields, working in hot laundry rooms, etc. were not for their benefit. Though some administrators (and the public) may have seen the practice as simply expecting able-bodied men and women to work for their room and board, there is really no way to know what kind of coercive measures were used to get some of the more difficult and undesirable tasks completed.

Photo of Patients Collecting Maple Syrup from Trees on the Grounds of the London Asylum for the Insane

Photo of Patients Collecting Maple Syrup from Trees on the Grounds of the London Asylum for the Insane

Male Patients at Spring Grove Hospital

Male Patients at Spring Grove Hospital

Another Canton Patient History

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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

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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

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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

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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

Precedent for Asylum Care

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Smallpox Prevention Poster Distributed by the Minnesota Department of Health, circa 1924

Smallpox Prevention Poster Distributed by the Minnesota Department of Health, circa 1924

In its treaties, the federal government routinely promised many material goods to Native Americans, as well as less tangible goods such as health care and education. Much of the government’s early health care consisted more of record-keeping than anything else: what illnesses were striking Indians in what regions, how many had died, and from what causes? Often, the precipitating factor for providing even minimal health care stemmed from concern for whites: when epidemics (like smallpox) among Indians threatened to spill over into white settlements, federal doctors often gave vaccines and provided what preventative care was available to native populations. Civilian physicians and missionaries sometimes took up the slack, but health care was primarily a federal obligation.

Though that medical care was inadequate in the extreme, the moral obligation to provide it was clear. In 1831, the Supreme Court had described the federal government’s responsibility to Indians when Chief Justice John Marshall wrote: “Their (Native American) relation to the United States resembles that of a ward to his guardian.”

Though many argued over it at the time, the Canton Asylum for Insane Indians did not represent anything outside the bounds of what the government might have been expected to provide. Clearly, provision for mental health fell under a guardian/ward relationship just as physical care did. The problem lay in whether or not a separate facility only for Indians was the answer. For the patients who traveled hundreds of miles to the asylum when they might otherwise have been admitted to a closer state hospital, the answer would probably be a resounding “No!”

Medicine Man Outside His Tepee, 19th Century, courtesy National Institutes of Health

Medicine Man Outside His Tepee, 19th Century, courtesy National Institutes of Health

 

Medicine Lodge on the White Earth Reservation, Date Unknown

Medicine Lodge on the White Earth Reservation, Date Unknown

Appropriate Care

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Native American Known as Shields Who Served as a Healer or Medicine Man, Crow Creek Reservation, courtesy Blue Cloud Abbey Native American Photograph Collection

Native American Known as Shields Who Served as a Healer or Medicine Man, Crow Creek Reservation, courtesy Blue Cloud Abbey Native American Photograph Collection

Though some patients may have considered their stay at an asylum as a period of respite from the cares of the world, most patients just wanted out. Some understood that they needed help and could agree with the commitment decision, but even these patients wanted to get well and go home. Native American patients would have had these same feelings, but their stay in a facility like the Canton Asylum for Insane Indians probably helped them less than asylums helped Anglo patients. Unless their mental symptoms resulted from physical  ailments–which would benefit from nutritious food, rest, and mild medications–asylum medicine was so different from Native American practices that it was not likely to help them.

Both native peoples and newcomers relied on herbs and nature-based tonics to help them get well, but except for certain very well-known ingredients, the herbal preparations of either group could be hit or miss when it came to curing ailments. However, Native Americans derived a great deal of benefit from their culture’s method of treatment as well as from any herbal concoction they might take in conjunction with it. Native peoples were community oriented, and relied heavily on ceremonies, chants, music, dancing, and so on that required many participants. This sort of community medicine varied greatly from the much more private doctor/patient practice of Europeans. When Native Americans went to a non-native hospital (or asylum), they had to step out of their culture and away from all the comfort, security, and faith that it held. Without their customary practices in place, particularly with mental issues, there would be little hope of gaining a cure.

Sand Painting in Sacred Kiva, circa 1890 to 1900

Sand Painting in Sacred Kiva, circa 1890 to 1900

 

A Navajo Man in Ceremonail Dress, Including Mask and Body Paint, 1904, Edward S. Curtis

A Navajo Man in Ceremonial Dress, Including Mask and Body Paint, 1904, Edward S. Curtis