Tag Archives: poor record-keeping at the Canton Asylum for Insane Indians

Suggested Changes From The Problem With Indian Administration

Patients Seated in Dining Room at Pennhurst, circa 1915, the Former Eastern Pennsylvania Institution for the Feeble Minded and Epileptic

Patients Seated in Dining Room at Pennhurst, circa 1915, the Former Eastern Pennsylvania Institution for the Feeble Minded and Epileptic

When The Problem With Indian Administration was delivered to the Secretary of the Interior by Lewis Meriam’s team (see last post), the report made many recommendations for the hundreds of schools, reservations, and hospitals the team had visited. These included increasing salaries of personnel who had direct contact with Indians (to attract better people to the Indian Service), more cubic feet per child at boarding schools, and adopting the standards established by the American College of Surgeons for accredited hospitals to all Indian Service hospitals.

The team recommended several specific improvements for the Canton Asylum for Insane Indians: Increase the personnel; put a graduate nurse in charge of each building with patients; provide additional laborers for the farm and dairy; segregate epileptics, children, and the tuberculous into three groups apart from the other patients; and improve equipment in the hospital, kitchen, and bakery. The team included a call for installing “a system of records conforming to accepted psychiatric practice in hospitals for the insane.”

Cottages 6 and 5, Epileptic Colony, Abilene, Texas

Cottages 6 and 5, Epileptic Colony, Abilene, Texas

Children's Dayroom at Byberry Mental Institution, circa 1938, courtesy Historical Society of Pennsylvania

Children’s Dayroom at Byberry,  Later the Philadelphia State Hospital,, circa 1938, courtesy Historical Society of Pennsylvania

Dr. Harry Hummer, superintendent at the Canton Asylum, did try many times to get a separate cottage for epileptic patients, but was never successful. However, a later inspector who was a psychiatrist–which no one on Meriam team had been–believed that most of the patients with convulsions were not even epileptic. Meriam’s team likely had to go by Dr. Hummer’s diagnoses, in which he had identified any patient with convulsions as epileptic.

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Another Canton Patient History

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

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Patient Histories

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

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