Tag Archives: New York State Lunatic Asylum

Predicting Insanity

An Article from the Trenton Evening New, Nove 7, 1898, Showing a Change in Behavior Leading to an Insanity Diagnosis

An Article from the Trenton Evening New, Nov. 7, 1898, Showing a Change in Behavior Leading to an Insanity Diagnosis

Toward the latter part of the nineteenth century, mental health specialists (alienists) began to alter their approach to diagnosing insanity. Instead of looking at specific behaviors in patients and making a diagnosis from them, doctors thought it made more sense to look at changes in patients’ ordinary behaviors. To paraphrase one expert: Performing a dangerous tightrope stunt would not be considered insanity in a circus performer, but might be in someone who had never done such a thing and suddenly decided to try it.

Of course, neither alienists nor families wanted to wait until someone actually became insane before they intervened. Could there possibly be ways to predict the development of insanity? An article in the April, 1879 issue of the American Journal of Insanity gave some tips for family physicians to use in monitoring the possible development of insanity in their patients. In the words of the article’s author, Dr. Judson Andrews, early indications that might be considered precursors of insanity included:

Front Entrance, New York State Lunatic Asylum Where Dr. Andrews was Assistant Physician

Front Entrance, New York State Lunatic Asylum Where Dr. Andrews was Assistant Physician

— morbid dreams

— impairment of sleep

— a symptom cluster that included loss of appetite and indigestion, with pain, belching, flatulence, heartburn, and offensive breath

— a symptom cluster that included an increased action of the heart, full and strong pulse, a flushed face and slightly elevated temperature of the skin; the appetite might remain the same or even increase, but there would almost always be weight loss

— diseases which might cause the heart to “fail to supply the amount of blood necessary for the nutrition of the brain” or the lungs to “supply the purifying and exhilarating oxygen”

— headache [descriptions of the types of headache people might experience are similar to migraines]

— restlessness in either the extremities or “in the general movement of the whole body”

American Journal of Insanity

American Journal of Insanity

Though it might be alarming to consider any of these physical symptoms an indication of impending insanity, the emotional tips–discussed in my next post–actually could have been red flags.

 

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Understanding Insanity

Alienist Dr. Allen McLane Hamilton, 1910

Alienist Dr. Allen McLane Hamilton, 1910

Even though alienists (the term for early psychiatrists) treated insanity with vigor and resolution, they usually could not say with any certainty what had caused the condition.

An 1879 article, “Early Indications of Insanity,” in The American Journal of Insanity stated that in general, the cause of all insanity could be found in the neglect of, or an infraction of, the “established laws of physical or mental health.”

Since this could encompass almost anything, the writer went on to the core of his article, which was how to determine that someone was going insane. Continue reading

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Power at an Insane Asylum

Dr. John Gray

Dr. John Gray

Superintendents were responsible for almost everything at an asylum. Though their responsibility might bog them down with administrative details, it also made their word law in the asylum. John Gray, superintendent of the New York State Lunatic Asylum at Utica, was arguably one of the most powerful of these powerful men.

Gray fired anyone on his staff who disagreed with him, and carried on ill-natured vendettas against fellow doctors and superintendents whose policies he disliked. Gray enjoyed the limelight and was criticized for spending too much time testifying in trials as an expert witness. He edited the American Journal of Insanity for many years, but was often accused of refusing to publish articles about insanity and its treatment when they differed from his own.

Gray spent 34 years at Utica. In 1886, after testifying as an expert witness, Gray returned to his office in the evening. Henry Remshaw, who may have been temporarily insane, walked into Gray’s office and shot him in the face. Gray never fully recovered from the attack and spent his remaining four years of life in poor health.

New York State Lunatic Asylum at Utica

New York State Lunatic Asylum at Utica

Utica Crib, used for disruptive patients

Utica Crib, used for disruptive patients

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