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.

Medical Attitudes

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Isaac Ray, Asylum Superintendent

Once asylum superintendents gained a measure of respect and prestige (see last post), they used their power to secure their positions within both the medical community and their own specialty. They wanted no meddling or advice from outsiders–especially non-medical outsiders–and fought against any kind of oversight that involved community laypeople. Boards comprised of leading citizens often oversaw the running of asylums, but many times they acted as rubber stamps for whatever the superintendent decided was best. Superintendents could accept a few suggestions, of course, but they particularly resented laypeople making any kind of staff appointments. They did not want to see superintendent or assistant superintendent positions filled through committees of laypeople or appointed by the state governor. Instead, these specialized alienists wanted to establish and maintain a closed circle of “members” who controlled all aspects of asylum management.

This attitude marked their whole approach to management. Besides being very involved with the architectural details and physical construction of the asylum (superintendents were often appointed well before an asylum opened), superintendents imposed their own treatment philosophy on their institutions. “One man, one rule” defined their medical attitude–they wanted all decisions to go through them. They were usually quick to dismiss suggestions from patients’ families, even though these people undoubtedly had valuable insights to offer. This top-down, “I’m the expert” attitude was firmly entrenched by the time the Canton Asylum for Insane Indians opened, and its patients were in a particularly poor position to have their voices accepted.

Asylum Plans

Kirkbride's Plan was Used for Many Asylums

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The Superiority of Superintendents

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Medical School Class Card

In the early 1800s, physicians were not particularly respected by the public. The educational requirements to become a doctor were minimal and no licensing was required; any ambitious young man could apprentice under a doctor for a couple of years or attend three or four semesters of lectures and then launch into his own practice. Few cures for disease existed, and many doctors knew no more about illness, its prevention, or its cure than an observant mother or wise and experienced grandmother. Medicines were another matter–many families relied on herbal and other natural preparations to ease symptoms of illness, but doctors could concoct and dispense stronger remedies full of alcohol or narcotics. Even with this patient incentive to visit a physician (or to request a house call), few doctors made a good living. Competition was fierce because of the lax requirements to enter the field, and many doctors found themselves sharing too few patients with far too many physicians.

When insane asylums were built, however, a few lucky physicians found a wonderful niche for their specialized medical interest. For alienists (doctors who made a special study of mental illness), managing an asylum was a secure, well-paying position with plenty of prestige and power. Rather than competing with any number of other physicians in a family practice, alienists were regarded everywhere as experts in their field and relied upon as such. Asylum superintendents enjoyed their authority and guarded it well. Besides protecting their own turf, they were united in opposing interference in their business from non-medical officials.

Doctor with Horse and Buggy, 1894

Insane Asylum with Some Members of Staff

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Public Responsibility for the Insane

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A Painting of a circa 1625 Colonial Home in Jamestown, by Sidney King

Responsibility for helping dependent persons was largely a family affair, though some charities or benevolent individuals did step in to offer assistance. Small towns depended on nuclear farm families to meet their obligations, and authorities only stepped in for the few exceptions that occurred. However, as towns grew into cities, people without families or other support networks flocked to them for work and opportunity. If single or friendless people became insane, no individual had a legal responsibility to care for the person. Officials had to step in, and Massachusetts’ “An Act for the Relief of Idiots and Distracted Persons” in 1694 seems to be one of the earliest pieces of legislation enacted in the colonies for the care of the insane.

City officials began to pay small sums to the lowest bidder for the disabled person’s care, which tended to be dismally inadequate. Insane patients were still chained for convenience, and left to stagnate in cold, dark rooms. Their poorly paid “keepers” made no attempt to treat or cure them, and these unfortunate men and women could only mark time in what was essentially solitary confinement in a cell, until death.

Public Care for the Poor

Fairfax, Virginia Courthouse in Colonial Times

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Whose Responsibility?

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Children Working at a Textile Mill

For much of history, dependent persons–children, the sick, poor, elderly, and disabled–were considered the entire responsibility of the family. That family (or probably the head of household) could choose how it wanted to deal with that person and was usually free to act upon its  decision. Thus, officials had no reason to interfere if a family sent a six-year-old child off to work ten hours a day, ignored or neglected an elderly  parent, or allowed a blind relative to waste away emotionally and intellectually. The poor were often allowed to starve; towns were so anxious not to incur unnecessary expenses that they often banned newcomers who couldn’t prove they had work and could provide for themselves. Independent charities, religious groups, or individuals sometimes offered aid to these dependent groups, but society largely washed its hands of them. Thus, a family member who would not or could not work due to mental problems might be allowed to wander around the countryside as best he could. Violently disturbed members were often chained to prevent their wandering or interference with the rest of the family’s tasks.

This laissez faire treatment of the insane continued into relatively modern times. In Connecticut, for instance, Mary Weed, of Stratford, stated in 1786 “that for 20 years her husband had been so insane as to be kept ‘chained.'” Whether he was chained at home or in a jail is unknown, but one place was as likely as another. Even when towns did try to help dependent citizens, they often wound up in dismal environments. The poor and sick might find a place to stay at an almshouse or workhouse, while an unruly person–no matter what the cause for the behavior–would end up in jail. Eventually, towns were forced to expend more effort to help the helpless, which I will discuss in my next post.

The Empty Cupboard, courtesy Sheffield Libraries, Archives and Information

The Madman by Sir Charles Bell, 1806, courtesy of The Wellcome Library

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Early Portrait of Madness

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Self-Portrait of William Hogarth, circa 1757

William Hogarth, a British artist born in 1697, became well known for both his satirical and morality engravings and paintings. During the 1730s and 1740s, Hogarth became interested in social and moral causes. He used his considerable talents to illustrate the sorrowful lives of those in poverty or who became impoverished due to poor choices. He took on crime, gambling, prostitution, drinking, and greed, making his moral points through intricate scenes that needed little explanation.

One of Hogarth’s best-known works is a series of paintings called “A Rake’s Progress,” which follows a young man who inherits a fortune from his miserly father. He becomes a fashionable gentleman, drinks to excess and lives riotously, and eventually squanders his wealth. After various trials and tribulations of his own making, the no-longer-young Tom Rakewell ends up in the madhouse at Bedlam. Hogarth captures the misery of the institution during its days of poor treatment for patients.

In the Madhouse

Beer Street and Gin Lane, Hogarth

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Two Causes of Insanity

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Hippocrates

In ancient times, insanity was seen as a result of spiritual forces working against an individual. A god or demon could either inhabit a body and manifest in some way, or merely cause problems for the victim via spiritual power. Sometimes manifestations were considered benign or even holy, and the person who acted oddly was left alone. If the manifestations went against society’s expectations, then the spirit was deemed evil and attempts were made to get rid of it through ceremonies and incantations. Around 460 BC, the Greek physician Hippocrates argued that the brain was the actual organ of the mind and reasoning. Therefore, insanity could be treated just like any other physical problem. His ideas were generally accepted until the Middle Ages, when once again, authorities began to believe that the spiritual realm controlled the mind. During that time, ideas of witchcraft and demonic possession flourished.

Eventually, Europe once again caught up to ancient Greek thought and began to look at physical causes for mental illness. Because of their evolving beliefs about insanity, European healers stopped dismissing the insane as hopeless cases who should be locked away for life. Instead, they looked for ways to help alleviate what might be just a temporary condition. The insane began to live in asylums rather than prisons and poorhouses, and physicians tried to discover methods of caring for them that would lead to a return of sanity. The early nineteenth century became a very hopeful time in which many doctors believed almost all cases of insanity could be cured.

Demon Leaving the Body of an Epileptic Through His Mouth

Patients With Various Mental Disorders

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Coming Full Circle

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Treatment for insanity remained surprisingly consistent in many ways over hundreds of years (see last post). One great stride in treating the insane came when authorities stopped lumping “lunatics” in with criminals and the poor, either in prisons or almshouses. (Just as often, lunatics were chained or confined even in early hospitals.)

Sketch of an Inmate in Bethlem (Bedlam) Hospital

A more compassionate understanding about the special needs of the insane emerged, and from that, elaborate asylums for their care sprang up. Though asylums eventually deteriorated into little more than holding tanks and warehouses for the insane, their original purpose was founded on kindness.

During the 1960s and 1970s, funding for mental health care was diverted from asylums (which weren’t working well) and funneled into community-based services. Like the asylums before them, community services such as clinics and halfway houses were good ideas which unfortunately never received sufficient funds to work well. As mentally ill patients were turned out of asylums, they often found no help. A 2006 report from the Bureau of Justice shows that in 2005, “more than half of all prison and jail inmates had a mental health problem.” These people included 705,600 in State prisons, 78,800 in Federal prisons, and 479,900 in local jails. Mental health problems were defined by a recent history or symptoms of a mental health problem that occurred within 12 months of the time the survey was taken.

It seems that once again, prisons constitute the primary housing for the nation’s mentally ill.

The Updated Bethlem (Bedlam) Hospital

An Engraving of Bethlem (Bedlam) Hospital

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Treatments of Long Standing

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Asylum Patients With Various Disorders

Treatments for insanity were surprisingly consistent until the modern era. Bleeding, purging, forced vomiting, and other physical remedies were go-to procedures until the early 1800s. Purging (causing the bowels to evacuate) and vomiting continued into the nineteenth century. Physicians turned to opiates to sedate patients early in the seventeenth century, and they were still popular in the nineteenth.

Even “new” psychological treatments created in the nineteenth century had echoes of this earlier period. Alienists and asylum superintendents in the 1800s recommended a change of scenery and light amusements to divert the troubled mind, particularly for those who fell into depression or melancholy as it was popularly called. Robert Burton, an expert on melancholy who wrote almost 1,400 pages on the subject in 1620, called for those afflicted with the condition to “seek merry company, play at honest amusements, dress gaily, and haunt light and lovely places.” The two treatments are remarkably similar, even though the first was part of the newly emerging “moral treatment” pioneered in the early 1800s.

On a darker note, authorities in the 1600s often beat the insane in much the same way parents would discipline unruly children. Some of the beatings or other forceful remedies for “misbehavior” could be quite painful and dehumanizing. Moral treatment succeeded in reducing or stopping such punishment for the behaviors of the insane, and patients enjoyed much more humane treatment for several decades. Unfortunately, the more crowded insane asylums became, the more often attendants ended up resorting to these primitive methods for controlling behavior. Some of the worst ills of the asylum era ended up being physical abuse and the various restraining devises attendants used.

Robert Burton's Book on the Treatment of Melancholy

A German Book on Melancholy, Published in 1653

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A Few Protections

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Undated Woodcut, Chasing the Village Idiot

Americans were guided in their treatment of the insane by English law and tradition, which recognized that certain segments of the population had special needs. Children, idiots and lunatics “were siblings in the eyes of the law” says author Michael MacDonald, because they all lacked the capacity to reason. These people were put under wardship by the courts, who often sold these wardships to the highest bidder. People who became wards of idiots and children could then plunder their estates or force them into a marriage that was somehow advantageous to the guardian.

Surprisingly, lunatics often fared much better under the wardship system. Because the insane were actually expected to get well and take back their property or at least pass it on to heirs, courts demanded greater accountability from their guardians. King James told the courts that lunatics should be committed to [primarily] friends and family–“that can receive no benefit by their death.” Lunatics weren’t as attractive to unscrupulous guardians precisely because they were insane and therefore couldn’t enter into contracts, including the marriage contract. Though lunatics’ lives were never pleasant, at least they theoretically had a chance for a decent life after recovery.

King James

Anatomy Book From 1615

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Dr. Hummer’s Credentials

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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 →