Tag Archives: Hudson River State Hospital

Tub Therapy

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Dr. Charles Pilgrim, 1908

Dr. Charles Pilgrim, 1908

Physicians used hydrotherapy (various sorts of baths and showers) extensively in the treatment of the insane. The treatments could sometimes be helpful; a nice, warm bath might relax a patient or help him sleep, or a bracing shower could stimulate a patient who felt sluggish and tired. Dr. Charles Pilgrim, however, took water treatments to an extreme with what he called “Tub Therapy.”

Dr. Pilgrim arrived at the Hudson River State Hospital from the Willard Asylum in1893. He quickly made physical improvements to the institution, installing electric lights to replace the gas lamps, and building new 50-bed cottages for patients, a new mortuary, and a lab. In 1908, Pilgrim introduced Tub Therapy, a form of the continuous bath. Patients entered the tub room and reclined on a canvas hammock in a tub of warm water, a rubber pillow behind their necks for additional comfort. Water temperature was monitored so that it remained at the proper therapeutic level.

Tub Therapy at Pilgrim State Hospital, the Former Hudson River State Hospital

Tub Therapy at Pilgrim State Hospital, the Former Hudson River State Hospital

Most patients would have enjoyed this for an hour or two, but Pilgrim’s treatment was of much longer duration. A September 17, 1908 article in The Beaver Herald (Oklahoma) stated: “You sleep for six hours . . . next morning breakfast is served to you in the tub, then dinner, then supper.” Occasionally the doctor would come in to chat or take a blood sample, and the patient grew calmer, more rested, and more cheerful all the while. After at least several days (the title of the article was “Live for Weeks in the Bathtub”), the patient finally got out of the tub with the help of a nurse and found him or herself well again.

This treatment was primarily for patients who felt madness coming on, either just fearing a breakdown or actually close to one in their own or others’ opinion. The therapy was voluntary, though it is hard to see anyone in good physical health actually enjoying the forced inactivity.

Hard Decisions

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Cato Sells, Commissioner of Indian Affairs in 1913

Cato Sells, Commissioner of Indian Affairs in 1913

Many people cared about the insane in their midst and tried to do their best by them. Though there were certainly abuses, many of the family and friends who sent their loved ones to insane asylums thought they were doing the right thing or acting in the patients’ best interests. Even after asylums began to lose their initial glow and were seen for the imperfect places they were, many people still felt mentally ill people were better off in them simply because they could receive consistent, professional care.

The Canton Asylum for Insane Indians was representative of its times in this matter. in 1913, the superintendent of the Shoshoni [sic] Indian Reservation asked the commissioner of Indian Affairs to admit Meda Ensign to the asylum. At the time, this asylum was overcrowded, as most were. The asylum’s superintendent, Dr. Hummer, still replied that he would admit her once authorization was given. Many would question this decision, since another patient would only lead to greater overcrowding.

Shoshone Encampment, Wind River Mountains, Wyoming, Photographed by W. H. Jackson in 1870

Shoshone Encampment, Wind River Mountains, Wyoming, Photographed by W. H. Jackson in 1870

Dr. Hummer did need his headcount to go up so he could supervise a bigger, more prestigious asylum, and typically did not like to discharge patients or reject new ones. However, that consideration very likely wasn’t the only thing on his mind. In his letter to the commissioner of Indian Affairs, Hummer points out the overcrowding, but adds: “If the conditions under which she is living are as bad as portrayed by Superintendent Norris, this authority (to admit Ensign) should be sent me without delay.”

Crowded Ward at Hudson River State Hospital

Crowded Ward at Hudson River State Hospital

More patients led to overcrowding, which worsened patient care but could justify more money and more buildings so that more patients could be admitted and helped. Superintendents at asylum everywhere juggled these issues, just as Dr. Hummer did. It had to be difficult not to accept patients when it was obvious they would be very poorly cared for elsewhere.

An Impossible Job?

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Superintendent Oscar Gifford

Superintendent Oscar Gifford

Though the rules and duties of each asylum position had been formulated by 1903, they were not initially given to employees at the Canton Asylum for Insane Indians. Its first superintendent, Oscar Gifford, told an inspector that he hadn’t done so because employees often had to assume whatever tasks came up, and he didn’t want to constantly make exceptions to a job description. He may have also feared that no one would want the job of attendant in particular, if they had had a chance to read the extent of their duties.

An attendant’s duties included the obvious ones of feeding, dressing, bathing, supervising exercise and manual labor for patients, preserving order at all times, taking patients to the toilet and meals, waiting on them at meals, etc.

Female Patients Farming in the early 1900s

Female Patients Farming in the early 1900s

However, they were also expected to be housekeepers extraordinaire. Attendants were to: make beds, dust, sweep, and “brighten the floors, hardware, plumbing fixtures, etc. . . . They shall have special care of the lavatories and toilet rooms, keeping them thoroughly clean.” Every portion of the ward was to be kept “well aired and of proper temperature and as free as possible for objectionable odor.” Attendants were to scrub the floors, walls, and windows when needed, and make beds. In the case of female attendants, all this work would have been done in a long, cumbersome dress and perhaps an apron.

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

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

It would have taken a large staff to do all the work properly, and Canton Asylum never had that luxury. Nurses were supposed to administer medicine (and probably change bandages, etc.), but were never hired until the last few years of the asylum’s existence. Attendants undoubtedly had those additional duties thrust on them, and it is little wonder that patient care deteriorated as the asylum filled up.

 

The Truth Not Welcome

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Tents Used for Insane Patients, courtesy National Institutes of Health

Tents Used for Insane Patients, courtesy National Institutes of Health

In January, 1931, the Board of Trustees of the American Medical Association appropriated $20,000 for the study of all institutions “caring for either the mentally ill or the mentally deficient of the United States.”

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Keeping Busy

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Clarinda State Hospital

Clarinda State Hospital

Insane asylums tried to be self-sufficient, but in our modern era it can be hard to understand just how self-sufficient they were.  The Clarinda State Hospital in Iowa was one of many similar institutions that used patient labor for the dual purpose of keeping operating costs down and giving patients something to do. The asylum employed patients (under direction) to sew nearly all the clothing they needed, and to make shoes under the direction of a shoemaker. Patients also engaged in woodworking and made brooms from broom corn raised on the asylum farm. A bit more unusual was the facility’s mattress-making department, where all the new mattresses for the asylum were made.

“Mattress hair is bought and also a good quality of material for the cover, which is made up in the sewing room and afterwards filled by patients. . . . Soiled or worn mattresses in which the hair has become packed are taken apart, thoroughly renovated by steam, dried, thoroughly picked and the hair used over again.”

The writer ended his description of the asylum with the words that: “The general spirit of the institution is to have the asylum idea as much in the background as possible and to supply surroundings and influences as much like those at home as can be made.”

It would be difficult to discover whether this aim had been achieved.

Men Working in Broom Factory at Oak Forest, IL Poorhouse, circa 1915, courtesy Library of Congress

Men Working in Broom Factory at Oak Forest, IL Poorhouse, circa 1915, courtesy Library of Congress

Patients Making Rugs, Hammocks, Baskets, etc. at Hudson River State Hospital in Poughkeepsie, NY, 1909

Patients Making Rugs, Hammocks, Baskets, etc. at Hudson River State Hospital in Poughkeepsie, NY, 1909