Tag Archives: trachoma

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

Pettigrew Was Right

Richard F. Pettigrew, courtesy University of Minnesota Law Library

Senator Richard Pettigrew wanted a federal  insane asylum for Indians placed in South Dakota, the state he represented. Via the Committee on Indian Affairs, he pushed for information that would justify his project. The committee sent a query to Indian agents on reservations, asking among other things, how many insane Indians were in their jurisdiction, and what facilities or programs they had for dealing with insanity if it occurred. The forty agents who responded were somewhat disheartening (see last post), since most had only one or two insane Indians–if any–on the reservations they supervised, and most did not seem to require any special care. However, Pettigrew could make his point with the next part of the questionnaire, concerning facilities for helping or caring for insane Indians on reservations. Most replies were similar:

“We have no special course of treatment for mentally diseased Indians. When they become violent we place them in charge of the Indian police until such time as they can be transferred to an asylum for treatment.” Chas. E.McChesny

“We have no special course of treatment for mentally diseased Indians.” John W. Cramer

“As we have no hospital to keep insane in, we are unable to give any special treatment to this class of cases.” J. R. Finney, agency physician on behalf of agent Thomas Richards

“They are cared for by their relatives.” Robert M. Allen

One agent’s reply is representative of several others: “Have never known of an insane Indian. There is no necessity for such (special course of treatment for insane Indians) on this reservation.” H. B. Freeman

Senator Pettigrew at least had the satisfaction of proving that reservations had no facilities or programs to care for Indians who became insane. His real challenge was to convince Congress to build an asylum for the exclusive use of the fifty to sixty Indians who might need its services.

Dr. W. P. Whitted Examines the Eyes of a Trachoma Patient, 1941, courtesy National Archives

Members of the Three Affiliated Tribes on the Banks of the Missouri River

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Indian Health Programs

President Taft Speaking at Manassas Court House, Virginia in 1911, courtesy Library of Congress

The Bureau of Indian Affairs tried to address the many health issues developing among tribes who had lost their traditional lands, lifestyles, and occupations. However, funds were always far too short to do much good, and healthcare was not provided with any kind of continuity. As time went on and the country began to use  surveys and statistics as a basis for action, the government surveyed reservations and schools to discover the extent of the sanitation and health issues which were being reported. When President Taft received the information, which showed a high incidence of tuberculosis and trachoma (an eye disease which often led to blindness), along with a scarcity of medical care, he was shocked.

“The death rate of the Indian country is 35 per thousand as compared with 15 per thousand–the average death rate of the United States as a whole . . .,” he told Congress in 1911. “Last year, of 42,000 Indians examined for disease, over 16 percent of them had trachoma . . . . Of the 40,000 Indians examined, 6,000 had tuberculosis.” Taft asked Congress for more money to go toward Indian health care. . . . “It is our immediate duty to give the race a fair chance for an unmaimed birth, healthy childhood, and a physically efficient maturity.”

Appropriations for Indian medical service rose from $40,000 in 1911 to $350,000 in 1918.

A Grandfather and Two of His Grandchildren Infected With Trachoma, Rincon Reservation, Californina in 1912, courtesy National Library of Medicine

Group Picture at the Phoenix Indian School Tuberculosis Sanitorium Phoenix, AZ, circa 1890-1910, courtesy National Institutes of Health

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Progress, Of Sorts

Indian Children on Flathead Reservation, 1907, courtesy Library of Congress

Indian Children on Flathead Reservation, 1907, courtesy Library of Congress

1910, this first decade of the new century, came in the middle of the Progressive Era. Reformers fought to limit child labor, break up monopolies, and help working men earn a fair wage.

The Indian Bureau tried to make a few strides, as well. It began inspecting homes on reservations, beginning with the White Earth Reservation in Minnesota.* Two special physicians visited more than 200 homes and examined 1,266 people. Of this number, 690 had trachoma and 164 had some form of tuberculosis. This dismaying state of affairs undoubtedly played out on most other reservations.

The Indian Bureau’s medical supervisor pushed to have schools inspected for sanitation, hygiene, and ventilation. Three reservations with a high number of day schools (Cheyenne River, Pine Ridge, and Rosebud) had a physician assigned to them. He made regular visits to check on the health of pupils and inspect the schools.

Indian Schoolchildren, Mt. Pleasant, MI

Indian Schoolchildren, Mt. Pleasant, MI

*Statistics are taken from the 1910 “Report of the Commissioner of Indian Affairs to the Secretary of the Interior.” (Fiscal year ending June 30, 1910).

Indian Children, Mescalero Reservation, N.M., circa 1936, courtesty Library of Congress

Indian Children, Mescalero Reservation, N.M., circa 1936, courtesty Library of Congress

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Another Pill to Swallow

William A. Jones, Commissioner of Indian Affairs (1897-1905)

William A. Jones, Commissioner of Indian Affairs (1897-1905)

When Native Americans were forced to live on reservations, their health declined. Poor food quality led to malnutrition and put them at risk for disease and ill health. Two diseases in particular, trachoma and tuberculosis, devastated Indian populations.

Government Doctor Giving Trachoma Examination on Stillwater Indian Reservation

Government Doctor Giving Trachoma Examination on Stillwater Indian Reservation

Trachoma is an easily transmitted virus that infects the eyes, and is usually picked up in childhood. It thrives in congested, unsanitary conditions, which developed when tribes were crowded together and prevented from moving around and relocating camps. Children would be re-infected so often that scars made the eyelids turn inward, causing the eyelashes to scratch the cornea. Victims said the pain nearly drove them wild, “as though cinders were in both eyes.”  Permanent blindness often resulted.

Tuberculosis is a bacterial lung infection that causes  death by suffocation from excess fluid (blood or phlegm) or by respiratory failure. Tissue in the lung is killed by TB and eventually the patient simply cannot absorb enough oxygen. By the mid-1800s, the Navajo death rate was ten times the national average. Prior to 1935, most adult TB patients were left to fend for themselves, while children attending boarding schools were either segregated or institutionalized. In 1904, Commissioner of Indian Affairs, William Jones, ordered all infected children out of the schools. Most returned to their reservations and died a slow death.

Group Picture at the Tuberculosis Sanitorium, Phoenix Indian School circa 1890-1910, courtesy National Archives

Group Picture at the Tuberculosis Sanitorium, Phoenix Indian School circa 1890-1910, courtesy National Archives

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