Tag Archives: St. Elizabeths

Social Interests

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Railroad Depot in Canton, South Dakota

Railroad Depot in Canton, South Dakota

Throughout history, social ties have been important. Citizens in small towns certainly kept tabs on their neighbors, but even in large cities, prominent people were reported on in the “society pages.” Many small-town newspapers kept tabs on the comings and goings of the locals, and reported on visits from their relatives and friends. On September 30, 1910, the Sioux Valley News reported that:

— Ed L. Wendt took a trip up to Lake Preston Tuesday to attend to some business matters

— Col. Arthur Linn went to Hot Springs last Saturday to attend a meeting of the Soldiers’ Home board

Soldiers' Home in Hot Springs, South Dakota

Soldiers’ Home in Hot Springs, South Dakota

— Mrs. C. F. Neighbors came up from Sioux City Monday to spend a few days with her friend Miss Grace Hanson

— Miss Ethel McClanahan arrived in Canton a few days ago and has been a guest of Dr. Hummer and family at the Indian Asylum. Miss McClanahan was for a number of years chief nurse in St. Elizabeth’s hospital in Washington, D. C. . . .

Unidentified Asylum Nurses

Unidentified Asylum Nurses

McClanahan was working on a special case in the west at the time, and presumably stopped in to see Dr. Hummer on her way to  “visit friends further east” as the paper reported. Still, despite Dr. Hummer’s reputation for temper and haughtiness at the asylum, he could evidently be quite cordial to those he felt were his social or professional equals.

Inspection Details

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In A Rake's Progress, Tom Rakewell Loses His Fortune to Drink, Gambling, and Women, and Ends Up in an Insane Asylum

In A Rake’s Progress, Tom Rakewell Loses His Fortune to Drink, Gambling, and Women, and Ends Up in an Insane Asylum

When insane asylums were inspected, nearly anything going on was fair game for examination. During St. Elizabeths’ 1906 investigation, Dr. Harry Hummer, who later became superintendent at the Canton Asylum for Insane Indians gave testimony concerning gambling at the asylum.

Hummer was asked if he had heard of any case where “cards were played for money by the attendants and patients.” Hummer replied that he had heard of cases, though he did not believe attendants had been present. A police officer had informed Hummer that there was a game going on in the asylum’s smoke room under the bakery; Hummer called in the two patients and threatened to revoke their parole privileges (free time without attendants) if they did not stop. They said they would, but apparently shifted their game to an outdoor area. Hummer again threatened to revoke their parole privileges, but they swore they would not gamble again and he let them continue with their relative freedom.

Hummer was then asked if he had ever played cards at St. Elizabeths. Hummer said he had, generally about 3:00 p.m. with two of the night watchmen and perhaps a patient or two. They played a game called pedro. When asked if he ever played seven-up, Hummer replied, “I don’t believe so, sir–not as severe a game as that.”

Pedro (pronounced peedro) actually seems to be the more complicated game; it is difficult to understand why Dr. Hummer pronounced seven-up a “severe” game. The rules to both games can be found on the internet.

Men Playing All Fours, Also Known as Seven Up, Civil War Era

Men Playing All Fours, Also Known as Seven Up, Civil War Era

Men Playing Seven Up at a Boarding House

Men Playing Seven Up at a Boarding House

Inspection Results

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State Lunatic Asylum in Lincoln, Nebraska

State Lunatic Asylum in Lincoln, Nebraska

The two federal institutions for the insane (St. Elizabeths and the Canton Asylum for Insane Indians) were investigated several times. In 1926, the comptroller general of the United States listed his findings concerning the investigation into St. Elizabeths. They included the following:

— The laws under which persons …are committed to the hospital are not adequate or sufficiently definite.

— There are too many patients in some of the wards, resulting in a crowded and unhealthy condition.

— Dining rooms, sitting rooms, toilets, baths, and other facilities of some of the wards are quite inadequate and most unsatisfactory.

— The fire hazard in certain wards is too great, and there does not appear to be sufficient fire fighting equipment.

— Several findings concerned the proper accounting of patients’ monies and valuables, including the need for a place to safeguard them.

Some of these 1926 findings were similar to those at Canton Asylum (overcrowding, inadequate facilities, and fire hazards). However, St. Elizabeths had 4,340 patients in June 1926, well over 50 times the number of patients at the Canton Asylum. The facility was not perfect, but by no means did it have 50 times the problems of its sister asylum. Undoubtedly St. Elizabeths’ leadership had something to do with its better performance.

Asylums were frequently inspected and investigated, and most had similar problems. Appropriations were generally set for a certain time period and included set numbers of personnel positions. Because funding wasn’t based on actual patient populations or patient to staff ratios, overcrowding could set off a cascade of problems. Facilities became inadequate and attendants became overburdened. In turn, stressed attendants probably lost patience or reacted less professionally with difficult patients. A new (and possibly sufficient) cycle of funding may have given an institution a chance to catch its figurative breath, but a new cycle of overcrowding was almost certain to begin shortly thereafter. As the public became more comfortable using insane asylums, their demands on these institutions created perpetual overcrowding. Insane asylums were often victims of their own success.

Overcrowding at Byberry (Philadelphia State Hospital) from a 1946 Department of Welfare Report

Overcrowding at Byberry (Philadelphia State Hospital) from a 1946 Department of Welfare Report

Patients Had to Sleep in Chairs at the Camarillo Mental Hospital

Patients Had to Sleep in Chairs at the Camarillo Mental Hospital, courtesy Camarillo State Hospital Historical Society

 

 

Asylum Comparisons

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St. Elizabeths Hospital for the Insane of the Army, Navy, and District of Columbia

St. Elizabeths Hospital for the Insane of the Army, Navy, and District of Columbia

St. Elizabeths and the Canton Asylum for Insane Indians were investigated a number of times during the early twentieth century. Both were federal insane asylums, but they were also quite different. St. Elizabeths was very much a medical facility, while the Canton Asylum was run along Indian boarding school lines. In 1927:

— St. Elizabeths had an amusement hall (Hitchcock Hall) for patients; Canton Asylum did not.

— St. Elizabeths had specialized buildings like cottages for tubercular patients and quarantine buildings; Canton Asylum did not.

St. Elizabeths had a 10,000 volume library and subscribed to 35 periodicals; in 1925 the Congressional Library began to send its surplus magazines to the asylum (about 1,000 a month); Canton Asylum received subscriptions to about half a dozen magazines.

St. Elizabeths had a furlough program which allowed patients to go home on trial visits; a social worker followed up on patients during these short visits; Canton Asylum actively discouraged furloughs for any reason. St. Elizabeths created an out-patient department for veterans who had been discharged from the military shortly after commitment. This department helped some patients find employment and tried to help them find a home so that they would not be overwhelmed when they were released. Canton Asylum did not help its patients this way.

A typical menu for a Tuesday midday meal at St. Elizabeths showed: bean soup, beef pot roast, gravy, browned potatoes, cucumbers, bread, oleo, and tapioca cream pudding. A menu for Canton Asylum (from the 1928 Meriam Report) showed: a stew of meat and carrots, with more fat and bones than anything else, thin apple sauce, bread, and coffee.

St. Elizabeths was significantly larger than the Canton Asylum, which gave it justification for some of its specialized facilities. However, its placement in Washington, DC and its patient population (veterans and citizens of the District of Columbia) also mattered. The American Red Cross, veterans’ groups, and the Knights of Columbus, as well as other civic organizations had easy access for volunteer work and aid of various kinds; the Canton Asylum had to depend on the kindness of small-town organizations like volunteer ministers and the Canton Band to help its patients.

However, both organizations had areas of weakness that investigations brought to light.

Dining Room at McLean Asylum for the Insane

Dining Room at McLean Asylum for the Insane

Bear Cubs at St. Elizabeths' Zoological Gardens

Bear Cubs at St. Elizabeths’ Zoological Gardens

Investigations Elsewhere

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Government Hospital for the Insane Administration Building

Government Hospital for the Insane Administration Building

The Canton Asylum for Insane Indians had its share of investigations, which often were a result of staff complaints. It was not unique in this respect–other asylums were also investigated with regularity, sometimes because of staff complaints, but often through outside intervention. In 1906, the Medico-Legal Society of the District of Columbia made a number of spectacular charges against the Government Hospital for the Insane (St. Elizabeths). The charges included allegations of brutal restraint through the use of “toweling” and the “saddle,” as well as “kicking and cuffing by attendants.”

Toweling involved placing dry towels around a patient’s neck and twisting from behind, to physically subdue a patient who was out of control. The allegations included a charge that the towels were twisted until the patient fell over semi-conscious. The saddle was a device which held patients in a reclining position, bound hand, foot, and neck, so that they couldn’t move at all; many were supposedly left for hours in this condition.

Patients were abused this way for their failure to obey orders or to do work properly, or for “taking an extra spoonful of beans” at table. Additionally, attendants were charged with using the feeding tube (which was pushed down through to nostril to feed patients who would not willingly eat on their own) as a punishment.

The charges were sensational, but were they true? St. Elizabeths’s board of visitors (its oversight group) asked the Medico-Legal society to help them investigate the charges they had made, but the group refused to appear before them or to submit its records concerning the abuse.

My next few posts will continue to discuss this investigation.

Utica Crib, Another Notorious Restraining Device

Utica Crib, Another Notorious Restraining Device

Force Feeding

Force Feeding

A Cost Analysis

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Lincoln County Courthouse, circa 1902, located in Canton

Lincoln County Courthouse, circa 1902, located in Canton

Interested parties (mainly in South Dakota) wanted an asylum established exclusively for insane Indians, and tried to make a case for it. They met with a complete lack of support from the superintendent (William W. Godding) of the only other federal institution for the insane, St. Elizabeths. Godding pointed out that the costs to maintain the few insane Indians at St. Elizabeths was less than $3,000 a year, while the proposed asylum in South Dakota would cost $150,000 and need an annual expenditure of at least $25,000 to run it. (See last post.)

However, the Indian Office supported the idea of an asylum, and began to gather figures to show how badly it was needed. St. Elizabeths reported that it had seven Indians in care in 1897 (two had been there close to ten years) for a total cost of $9,506.50 for their entire time as patients. The acting Commissioner of Indian Affairs had no figures as to how many insane Indians might actually need a new asylum’s services, but thought that “an asylum that would accommodate fifty patients would be ample.”

Government Hospital for the Insane of the Army, Navy, and District of Columbia, known commonly as St. Elizabeths

Government Hospital for the Insane of the Army, Navy, and District of Columbia, known commonly as St. Elizabeths

When the Commissioner, William Jones, later canvassed the various reservations to ascertain the number of insane Indians on them, most had none. Of the reservation agents who responded, only 58 Indians were found to be insane, with 7 of that number already in asylums. Agents mentioned other Indians as being “idiotic,” but tellingly, not needing help. One agent said that “a few” on his reservation were slightly insane but not requiring restraint in an asylum. (His estimate is not included in the preceding figure.) Of the 51 potential patients actually on reservations, the agents felt only 34 might need asylum care.

Even if all 58 patients had been taken to St. Elizabeths at a cost of $91/quarter ($364 annually), the total annual cost would have been only slightly over $21,000 a year. That was still under the figure Dr. Godding suggested would be needed to run an asylum in South Dakota each year. Clearly, anyone who did the math could see that even with the added transportation costs to St. Elizabeths, a new asylum really wasn’t worth the money for the few patients that might make use of it. Even paying extra at local state asylums (to offset transporting patients to Washington, DC where St. Elizabeths was located) would have been cheaper.

Yet, the asylum was built, staffed, and infrastructure put in place to support it. A later inspector called the Canton Asylum for Insane Indians a “magnificent political gesture” that had done little good for the recipients it had promised to help.

Canton Asylum Given Much Thought

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Richard F. Pettigrew

Richard F. Pettigrew

Though the Canton Asylum for Insane Indians had many problems throughout its operation, the facility itself had been the subject of much consideration before its construction. When Senator Richard F. Pettigrew, Chairman of of the Committee on Indian Affairs, first proposed Senate Bill 2042 (for the purchase of land and construction thereon of an asylum for insane Indians) in 1897, he asked for “not less than one hundred acres of tillable land” and that the building should be constructed of stone or brick with a metal roof, and “shall be as nearly fire-proof as conditions will permit.”

At the time, a few Indians deemed insane had been admitted to the Government Hospital for the Insane (known as St. Elizabeths) at the rate of $91 per quarter. Payment was through the Commissioner of Indian Affairs. The hospital’s superintendent, William W. Godding, noted that he was presently treating five Indians, and that “this number has never been exceeded at any previous date.”

Center Building, St. Elizabeths, 1900

Center Building, St. Elizabeths, 1900

Godding felt that there would be only a small number of Indians who might need psychiatric care, and that to spend $150,000 to purchase land and erect an asylum (Pettigrew’s proposed figure) was unnecessary. He pointed out that even after the asylum’s construction, the government would need to add “an annual expenditure of not less than $25,000 for the equipment and maintenance of the asylum.” Currently the Government Hospital cared for insane Indians at an annual cost of $2,267.

Dr. William W. Godding, courtesy Library of Congress

Dr. William W. Godding, courtesy Library of Congress

Like many other whites of the era, Godding believed that insanity was actually rare among Indians. He continued, “the additional expenditure [that Pettigrew proposed] might be advisable if there was a prospect . . . the number of insane Indians would be very much increased.” But, Godding stated, “the records of the race do not justify any such expectation, rather the opposite.”

Obviously, Godding’s commonsense objections were ignored.

Grimes Was Not Impressed

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Morningside Hospital Patient Ward, circa 1935

When Dr. John Maurice Grimes inspected mental institutions in the U.S. (see last two posts), he discovered that the federal asylum in Washington, DC, (St. Elizabeths) was overcrowded. Continue reading →

Where Do You Go?

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Living Quarters in an Insane Asylum

Living Quarters in an Insane Asylum

Nearly every patient in an insane asylum wanted out. Asylum superintendents often put up roadblocks to this when they didn’t feel a patient was well enough to go home; there are many accounts of clashes between the asylum’s medical staff advising against removal, and patients’ families who thought they looked or seemed well enough to come home. Continue reading →

Dr. Hummer’s Review

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Mounted Dakota Sioux Indian Police, Rosebud Agency, 1896

Mounted Dakota Sioux Indian Police, Rosebud Agency, 1896

Peter Thompson Good Boy was sent to the Government Hospital for the Insane (St. Elizabeths) even though he lived in South Dakota and should logically have been sent to the Canton Asylum for Insane Indians.  Except for his accusation that a neighbor had instigated his diagnosis and deportment, Good Boy displayed no signs of psychosis, exhibited exemplary behavior at St. Elizabeths, and had received an offer of employment. Continue reading →