Tag Archives: Willard Asylum

Impossible Tasks?

Supervisor-in-Chief, Attendants & Employees, Detached Building No. 4, Willard Asylum

Supervisor-in-Chief, Attendants & Employees, Detached Building No. 4, Willard Asylum

Though superintendents and other professional staff were inherently in charge of insane asylums, attendants were the true backbones of them. What attendants did or did not do, the way they treated patients, and their attitudes in general could provide some sort of therapeutic benefit or make a patient’s stay as miserable as possible.

At the Canton Asylum for Insane Indians, attendants were never trained. They likely watched what other attendants did and followed suit, also bringing in their own attitudes and experience to patient care. There were guidelines for attendants–provided after inspectors discovered that the asylum’s first superintendent (Oscar Gifford) had never disseminated them to staff–but they would have been difficult to follow due to the asylum’s perpetual short-staffing. In fact, any number of subsequent inspections showed that most guidelines obviously were not followed. The government did make its priorities clear, however:

A Group of the Asylum Staff, Willard Asylum

A Group of the Asylum Staff, Willard Asylum

“In the event of a fire, your first duty is to save the lives of all the patients under your charge. Your second duty is to save government property. Your third duty is to yourself. These duties are always to be considered in this order.”

Attendants at Pennsylvania Hospital for the Insane

Attendants at Pennsylvania Hospital for the Insane

Clearly, human staff were of least value to the Bureau of Indian Affairs. It is little wonder that the agency allowed its one asylum to fall into neglect simply because it would not provide enough people to adequately care for their charges.

My next post will discuss the enormity of attendants’ responsibilities.

 

Tub Therapy

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.

More Rules

Patients Demonstrate Hand Restraints, 1915, courtesy The Burns Archive

Patients Demonstrate Hand Restraints, 1915, courtesy The Burns Archive

The Indian Office provided rules for attendants working at the Canton Asylum for Insane Indians which were thorough and explicit; similar instructions were most likely the case in all other insane asylums. Patients were supposed to “preserve order” but only by using the mildest means possible. Rule 20 stated: “No kicking, striking, shaking, or choking of a patient will be permitted under any circumstances. Patients must not be thrown violently to the floor in controlling them, but the attendant shall call such assistance as will enable him to control the patient without injury.”

This rule was broken any number of times, and at least one male attendant was fired for committing unwarranted violence against patients. Mechanical restraints like cuffs and camisoles (straitjacket) were to be used only with the consent of the physician or superintendent, but employees did not follow this rule. Instead, they got restraints from the financial clerk simply by asking for them. Dr. Hummer, who later received very harsh criticism for the asylum’s excessive use of restraints, either permitted their use (though he often said restraints weren’t used) or he abdicated his responsibilities to the financial clerk. Either way, he had to know that employees were using restraints quite freely . . . unless he wasn’t making rounds often enough to catch it. Whatever the reason for all the restraints, Dr. Hummer was responsible for the situation.

Medical Staff at Willard Asylum

Medical Staff at Willard Asylum

Staff of Arizona State Asylum, 1914

Staff of Arizona State Asylum, 1914