Tag Archives: AMSAII

Investigations of Little Value

Dr. Carlos McDonald, circa 1915

Dr. Carlos McDonald, circa 1915

Very likely, all insane asylums were inspected on a fairly regular basis, and because of that, it would seem impossible that terrible conditions could continue to exist as they obviously did in many places. However, investigators had to care enough to make strong reports, and people in authority had to care enough to act upon them.

In 1876, Dr. Carlos McDonald became superintendent of the State Asylum for the Criminally Insane  in Auburn, New York. He stated in his first report that he had never seen the equal to the poor sanitation he found there upon arriving, that the place was a “stench in the nostrils,” that bugs crawled all over the patients’ beds, that the bread was sour and the food poor, and that patients were regularly punished, among other observations.

Believed to be Picture of Auburn Asylum for Insane Criminals

Believed to be Picture of Auburn Asylum for Insane Criminals

McDonald told an investigating committee that he had a patient who had a pistol ball in his arm “that had been shot in by my predecessor.” An attendant told him that this previous superintendent had also “blacked the eye of a patient and did not think anything of doing it himself.” Upon the orders of the assistant physician, attendants paddled patients on their bare skin with a piece of thin oak stick “about as thick as a piece of heavy sole-leather and about two and a half inches wide, with a handle.” Patients were handcuffed, chained, and shackled regularly.

Prisoners at Auburn State Prison, Not Insane, circa 1840

Prisoners at Auburn State Prison, Not Insane, circa 1840

The amazing thing that came out in McDonald’s testimony, is that the “association of the superintendents of insane asylums” (the professional organization, AMSAII) had met in the summer of that year in Auburn just before McDonald took charge. They had toured the facility and then had testified to finding the whole asylum “in the best condition.”

McDonald’s statements were made before A Special Committee of the New York State Senate, which had been appointed in May, 1880 to investigate “abuses alleged to exist in the management of insane asylums.”

Colored Asylums

West Virginia Hospital for the Insane

In comparison with whites, few African-Americans were sent to insane asylums. Some asylums did not want to accept black patients at all, while others put black patients in separate wards. Some states created separate asylums entirely for the “colored insane,” apparently subscribing to influential alienist Thomas Kirkbride’s view that “colors and classes” should not be mixed in insane asylums.

The West Virginia Hospital for the Insane was fairly typical. Its board of directors recognized the need to provide care for “colored” patients, yet didn’t feel the asylum could accept them until it had room to separate the races. The asylum did begin to accept black patients sometime in the late 1880s, placing them in separate wards from whites. In 1893, the board of directors asked for $6,000 to build a colored hospital. Shamefully, this request was made even though the asylum only had 44 colored patients. In 1900, when the asylum housed 1,001 patients, only 68 of them were African-American.

Eastern Asylum for the Colored Insane, Goldsboro, NC

Mount Vernon Hospital for the Colored Insane, courtesy Reynolds Historical Library

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Gaining Prestige for Asylum Management

Bellevue Hospital, NY, 1885, courtesy Wellcome Images

One of the immediate issues facing insane asylum superintendents was their initial lack of status. The term “mad-doctor” had little to recommend it as an indication of learning and professionalism. Even the term “alienist” did not convey to the public the intricacies of helping disabled minds. To enhance their stature, these early psychiatrists found it helpful to band together in professional groups.

The American group first communicated with each other informally through letters. Then a group of thirteen insane asylum superintendents met in 1844 to share information and exchange ideas about the treatment of the insane. They named their group the Association of Medical Superintendents of American Institutions for the Insane.

German psychiatrists united as a professional body in the Association of German Mad-doctors in 1864, though the General Journal for Psychiatry and Psychic-forensic Medicine had begun publication in 1844. The British organized the Psychological Society in 1901. They changed their name to the British Psychological Society in 1906, to avoid confusion with another organization of the same name.

These early societies were successful in gaining stature for their profession. Many alienists began to testify as expert witnesses in public trials, and the public in general felt safe in relying on their judgment.

Published June 25, 1911, courtesy sundaymagazine.org

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The Background of Asylum Superintendents

Dr. John Galt

When insane asylums were first built, there were no schools that superintendents could attend, or courses they could take, to learn how to run one. The thirteen superintendents who formed the original Association of Medical Superintendents of American Institutions for the Insane in 1844, had to forge a new profession and field of study, fight for acceptance and prestige, and defend their ground-breaking treatments to the public. They were generally up for the task.

Five of the original superintendents were from Massachusetts, two from Pennsylvania, two from Connecticut, two from New Hampshire, and two from Virginia. The oldest member, Dr.  Samuel White, was 53; the youngest, Dr. John Galt, was 22. Most of the other superintendents were in their thirties. These men shared both  a geographical background and a pioneering interest  in the study of mental disease. Though this original band certainly butted heads occasionally, they typically bonded as a body against any attack on their profession or competency. Superintendents from New England often filled the top positions in new asylums that opened in other states, ensuring at least a certain degree of orthodoxy in treating the insane.

Danvers Lunatic Asylum, Massachusetts, circa 1893

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A Growing Population of the Insane

AMSAII, courtesy National Library of Medicine

In 1844, thirteen superintendents of insane asylums met to exchange ideas about how to best run institutions for the insane. From this meeting, they formed the Association of Medical Superintendents of American Institutions for the Insane (AMSAII). As recognized experts in a very young field, they felt themselves the top authority on all matters concerning mental disease. Some of the superintendents were somewhat arrogant, but were undoubtedly sincere and enthusiastic.

In 1844, the Association proposed some ground rules for asylums. Among other propositions, they agreed that asylums should be in the country, but easily accessible from a large town. Each site should have about 50 acres of landscaped grounds besides other acreage for its needs. Superintendents felt strongly that no building should hold more than 200 patients, and only 250 at the very most. In 1866, they increased that acceptable number to 600. The original members would have been shocked to find how quickly overcrowding became one of the worst features of asylums, with sometimes thousands of patients crammed together in filth and disorder.

Crowded New York Lunatic Asylum

Unruly Patients at Blackwell's Island, from Harper's Magazine, 1860, courtesy New York Public Library

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Dr. W.W. Godding

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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