Tag Archives: Amariah Brigham

Reasonable Rehabilitation

Amariah Brigham was Utica Asylum's First Superintendent

Amariah Brigham was Utica Asylum’s First Superintendent

The change in attitude between the old-style treatment of the insane and the new moral treatment’s philosophy (introduced by Pinel and Tuke) cannot be emphasized enough. Though some of the worst cruelties and neglect had fallen out of favor by Benjamin Rush’s time (December 24, 1745 – April 19, 1813), the man considered the “Father of American Psychiatry” believed that any physician treating an insane person had to first dominate that individual–usually through fear. Hence, threats and coercion were considered perfectly acceptable ways to gain the necessary control and authority.

One of the pioneers in American psychiatry, Dr. Amariah Brigham (December 26, 1798 – September 8, 1849) urged a completely different style of treatment. He and others of like mind developed the (then) modern insane asylum, which was capable of putting their ideas into action. For instance, Brigham believed that mental occupation was useful in effecting a cure, and suggested engaging patients’ minds in learning. He urged every institution to have something of a school within it, containing books, maps, scientific apparatus, and so on. Patients could learn reading, writing, drawing, music, arithmetic, history, philosophy, etc. The instructors in these schools would engage with patients constantly: they would teach, of course, but would also eat with patients, join them in recreational activities, and generally become their comrades. This type of engagement was for patients who were curable.

Interior of Shoe Shop, Willard Asylum for the Insane

Interior of Shoe Shop, Willard Asylum for the Insane

Patients Making Rugs, Hammocks, etc. at Hudson River State Hospital, 1909

Patients Making Rugs, Hammocks, etc. at Hudson River State Hospital, 1909

For those who weren’t (the chronic insane), manual tasks such as farm work, basket-weaving, sewing and embroidery, painting, printing, shoe-making, etc. would go a long way toward engaging patients’ attention and re-directing their thoughts in a positive manner. The physical work would also preserve their health by keeping them active.

In either type of patient, this kind of moral management, with its regular schedule, mental diversions, and lack of coercion, could be expected to help patients much more than the fear-based management of preceding philosophies. If the public had provided enough money to implement these programs effectively, the early hopes of the new psychiatric profession might have been realized.

Pursuing an Agenda

American Journal of Insanity

Asylum superintendents tended to support each other and their profession, and presented a united front to the public. Though they published studies and treatment-oriented articles in the American Journal of Insanity (AJA) and other medical organs, the AJA in particular reflected much of their philosophy.

In a July, 1868 article, “Admission to Hospitals for the Insane,” the author contended that it was especially unkind to make the insane endure a public hearing on their sanity. “If we find a man sick or wounded in the street, we take him forthwith to the nearest hospital, without stopping to canvass our legal right to restrain him of his liberty,” the author stated.

With the insane, however, relatives force publicity by requiring “an inquisition to establish the delirium or the lunacy,” the article continued. He said that there was no more reason why a magistrate or civil authority should inquire into treatment [for an insane person] than there was to “rescue a patient from the hands of a skillful surgeon who is binding him to an operating table to perform an amputation.”

This article is only one instance of an ongoing disagreement between the psychiatric profession and private citizens about the value of admitting (or coercing) patients into asylums without due process.

Amariah Brigham, founder of the AJA

Mary Todd Lincoln (Judged Insane by a Jury After a 10-Minute Deliberation)

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Psychiatry in 1903

Dr. Amariah Brigham

By 1903, American psychiatrists had held formal meetings for many years, first as a select group of insane asylum superintendents, then as the more inclusive American Medico-Psychological Association. One striking characteristic of psychiatrists at that time was a confidence in their ability to understand the causes of insanity and the best treatments for it.

One very prominent psychiatrist, Dr. Amariah Brigham, testified in court that he could recognize insanity on sight. He had been called as an expert witness in the case of a murderer whom the defense characterized as idiotic and demented. Brigham had not been allowed to speak to the prisoner or examine him in order to make an informed diagnosis, so the prosecution tried to shake Brigham concerning his ability to diagnose insanity by sight.

As “proof” that he could indeed make this kind of diagnosis, Brigham, at the direction of the court, scanned the crowd attending the trial  so that he could pick out  a lunatic. Eventually, he pointed to a man in the audience and pronounced him insane. The man reacted with wild gestures, shouting and cursing  Brigham for calling him insane–which was taken as proof that he was. Brigham followed through with his testimony concerning the defendant, and though the man was found guilty, he was sentenced to prison instead of being executed.

An account of this episode is found in the “Proceedings of the American-Medico Association,” 1903.

State Insane Asylum, Utica, New York (Brigham was its first superintendent)

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Tell Us All About It

Amariah Brigham, courtesy National Library of Medicine

Amariah Brigham, courtesy National Library of Medicine

After the Association of Medical Superintendents of American Institutions for the Insane formed, they needed a format in which to discuss emerging ideas, treatments, and work experiences within the mental health field.

The superintendent of Utica (N.Y.) State Hospital, Amariah Brigham (1798-1849), created the American Journal of Insanity as a forum for this exchange of information, and probably wrote all the articles for its first issue. Though it was the mouthpiece of the association, Utica State Hospital owned the AJI until the Association of Medical Superintendents bought it in 1892. Its name was changed to the American Journal of Psychiatry in 1921.

AJI’s first issue (July 1844) discussed “Insanity Illustrated by Cases.” One such case began: “Mr. ___, aged 48, had uniformly enjoyed good health until the summer of 1842, when he complained some of not feeling well, was weak and dyspeptic, and in November had what was supposed to be a slight paralytic attack. For this and severe pain of the head he was bled seven or eight times, took cathartic medicines and was blistered largely. He remained dull and disinclined to exercise for five or six weeks, when he became suddenly deranged…”

American Journal of Insanity, courtesy National Library of Medicine

American Journal of Insanity, courtesy National Library of Medicine

Ad from American Journal of Insanity

Ad from American Journal of Insanity

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