Читать книгу Asylum on the Hill - Katherine Ziff - Страница 12

TWO

PATIENTS

“Each Admission Represented a Poor, Helpless, Hopeless Sufferer”

On a cold day in the middle of winter, a little girl from Athens County became the Athens Lunatic Asylum’s first patient. Her older brother accompanied her as, likely traveling by horse and wagon, they drove down the earthen road from town, across the Hockhocking River, and then up the great hill to the imposing Victorian structure. Eleven-year-old Alice had spent that Friday morning with her brother in commitment proceedings in the office of Athens County probate judge Leonidas Jewitt. Athens physician Dr. H. M. Lash and her brother provided witness and testimony as to her insanity.¹ After arriving at the asylum, they climbed its steps and entered the brick building—with its sixteen-foot ceilings, tile and marble floors, and oak woodwork—walked past the carpeted parlors ornamented with potted palms, and entered the west wing. There she was left by her brother with her clothing and little else.

Alice had a seizure disorder. Known at the time simply as epilepsy, seizure disorders were a great puzzle to American asylum physicians. Generally physicians resisted admitting patients with epilepsy, though by 1877 the Athens Asylum was caring, perhaps reluctantly, for patients with this diagnosis.² Superintendent Rutter in 1877 wrote to the hospital’s trustees, “The hospital at this time contains forty (40) epileptics, all of whom are, by reason of their unfortunate complication, utterly unfit to be associated with any other class of patients.”³

Effective treatment for epilepsy was not developed until the twentieth century, and nineteenth-century asylum physicians were at a loss in their efforts to care for patients with the disorder. Superintendent Holden of the Athens asylum in 1879 recommended to Ohio’s governor a separate institution for Ohio’s “epileptics,” with the idea of isolating them so as not to disturb other patients. Holden noted: “This class of unfortunate beings should claim the attention of the State, and be provided for in a separate institution. The idea of their being associated with the insane is wrong. The fall, with the piercing cry of the epileptic, is shocking even to the sane person, but to those whose nervous constitutions are shattered, or about gone, it is excruciating and greatly detrimental. . . . [T]he epileptics are often dangerous and homicidal.”⁴

When Alice arrived on January 16, 1874, her pulse and temperature were noted and a case file opened. The asylum physician who examined her described her as intelligent, kind, and cheerful. Her temperament was noted as “excitable” and her health apparently good. The admitting physician wrote that she “has swallowed pins and cut herself with glass as attempts at suicide. The attacks vary in duration and occur from two days or a week, at times more mild than at others. She appears to have warning of an approaching paroxysm.”⁵

One can only imagine Alice’s life as a young girl with a seizure disorder among three hundred or more women of all ages with a variety of mental illnesses. The medical notes documenting her progress describe the seizures and her recovery from them.

1/21[/74]: Had one paroxysm. Not very severe, stretched and tossed herself about in bed, jaws firmly closed. She did strike and scratch her nurse and remained partly conscious during the whole paroxysm. Was as well as usual the next morning except a slight soreness in muscles of limb and some headache.

1/27/74: Had slight paroxysm last night similar in form to preceding much shorter in duration and less recovery after. Symptoms are much the same as previous.

1/28/74: Had a mild attack at going to bed 8 pm, no symptoms remaining the following morning.

1/29/74: Had one other mild paroxysm last night, no remaining symptoms this morning.

2/15/74: Has had no attacks since the above date and is doing very well at present.⁶

The casebook does not note what became of Alice or how long she lived at the asylum. Genealogical records, though, suggest that she married in Michigan in 1879 and died in Los Angeles at the age of eighty in 1943.

The asylum accepted and cared for a diversity of patients. The elderly with dementia, women in need of care after childbirth, persons who had attempted suicide or harmed others, those committing crimes while mentally ill, persons with drug and alcohol addictions, and persons with what would be diagnosed today as schizophrenia, depression, or bipolar disorder are examples of the wide variety of the patients treated for conditions considered to be mental illness in late Victorian America.

Three documents were required to commit a person to an asylum in Ohio: a medical certificate from a physician certifying insanity; a request for commitment from the probate court with the names of witnesses; and a paper prepared by the asylum accepting the patient and noting the date, number assigned, age, and county of residence. Nearly a century’s worth of these documents—many thousands of them—are archived with Ohio University Libraries. Folded, packed in letter-sized folios, layered with a fine sifting of dust accumulated over 135 years, and tied with faded red ribbons, the commitment papers reveal many details about asylum patients: age, health, family situation, symptoms, and the medical witness’s best guess as to the cause of the bout of insanity.⁷ Each of Ohio’s eighty-eight counties had its own medical certificate and request for commitment; thus, the documents vary according to the originating county. The forms for each county evolved over time as to the kinds of details recorded. Some, filed away and undisturbed since 1874, display elaborate wax seals in still-brilliant golds and cadmium reds, and all bear the individual handwriting of physicians and probate judges with notes sometimes attached or written in the margins in ink or pencil. Officials wrote their notes with fountain pens and ink; one learns, as one reads through hundreds of these papers, to decipher the peculiarities of individual handwriting and the conventions of nineteenth-century penmanship. The documents contain the official legal and medical narratives of each of the 4,511 persons admitted between 1874 and 1893. Behind each official story couched in clinical language lie the struggles, pain, and sometimes the death of patients.⁸ The narratives presented here are constructed from the stark facts offered in the medical evaluations; from the occasional departures from the measured clinical and judicial language in the commitment papers by officials explaining extraordinary medical events or pleading for swift action; and from notes and letters written by patients that were confiscated and preserved in files by asylum staff.

Two casebooks (one for men and one for women) maintained by asylum medical staff are kept under lock and key at the library of the Ohio Historical Society in Columbus, Ohio. Measuring eighteen inches tall by twelve inches wide, the casebooks, labeled with gold letters, are bound in oxblood leather and tan suede, with endpapers of marbled maroon, cream, teal, burgundy, royal blue, and yellow, and contain entries handwritten in ink on preprinted forms. Because the creamy white forms with light blue lines are printed on thick paper with a high cotton rag content, they are sturdy and beautifully preserved today, nearly 150 years later. The men’s casebook is rich in details about the condition of patients at admission, though records cease in the spring of 1874 with Male Patient 179. Updates in the form of Progress of Case notes for these original 179 male patients were made every few months until mid-1875, at which time the effort was either abandoned or a new method of tracking patient progress (now lost to history) was instituted. One wonders whether by 1875, when the average daily number of patients stood at 597, the asylum’s two assistant physicians were overwhelmed by the volume of work and simply ceased taking notes. The women’s casebook contrasts with the men’s. Details for female patients upon admission contain much less detail, and Progress of Case notes ceased altogether in January 1874, with the admission of the tenth female to the asylum.

Though the asylum was designed for only 572 patients, by 1876 the asylum’s average daily count had reached 646. Superintendent Gundry advised the hospital’s trustees in 1876 of crowded conditions: “One fact which these (statistical) tables will fail to show as vividly as your frequent visits to the Hospital during the past year must have impressed upon your consideration is the crowded condition of the Hospital. It is not yet three years since the first patient was admitted within these walls, and the wards are now over-crowded. There are more than seventy (70) patients in excess of the number this house was designed to accommodate.”⁹

In 1886, the asylum’s staff was caring for 672 patients each day, exceeding its intended capacity by a hundred patients. Even with the 1887 addition of space for 36 men and as many women, bringing the asylum’s capacity to 644, in 1893 the asylum remained crowded, with an average daily occupancy of 813, or 169 patients over capacity.

When it opened, the asylum at Athens served twenty-eight of Ohio’s eighty-eight counties. (Using today’s mental health care language, the asylum’s catchment area comprised twenty-eight counties in the rural south and southeast quadrant of Ohio.) State asylums in Columbus, Cincinnati, Cleveland, and Dayton served the rest of the state, and patients were sometimes sent from there to the asylum at Athens to relieve crowded wards. Athens received a hundred or more patients during the nineteenth century from sister institutions in Ohio; these patients arrived without case records and came usually in groups of a dozen or more, accompanied only by a list of their names, addresses, and age. Likely the patients transferring from Ohio’s urban centers arrived by train, as transport by road to Athens was difficult in the nineteenth century, with axle-deep mud in the winter and spring making wagon and coach passage travel to the asylum nearly impossible at times.¹⁰

FIGURE 2.1 Service area of the Athens Lunatic Asylum in southeastern Ohio, 1874. Originally published in The New People’s Universal Cyclopedia of Universal Knowledge (New York: Phillips and Hunt, 1885).

The asylum’s commitment documents reveal that the admissions process dealt with every possible category of patient. Nineteenth-century mental illness diagnostic systems were based on the work of the French asylum physician Philippe Pinel.¹¹ Ohio asylum physicians practicing during the moral treatment era classified patients into eight categories: mania, mania with epilepsy, monomania (an obsession causing mental disarray), paresis (neurosyphilis eventually ending in dementia and death), melancholia (depression), five subcategories of dementia, imbecility, and finally not insane. These categories and the number of patients fitting each description were listed each year in the asylum’s annual report.

Much more diverse were the causes ascribed to mental illness, their relationships to mental illness sometimes inscrutable.¹² Sixty-nine possible “physical” causes were tallied annually, including fevers, head and spinal injuries, sunstroke, apoplectic attack, dysentery, pneumonia and asthma, menstrual derangements, change of life, lactation, pregnancy, syphilis, masturbation,¹³ intemperance, inhalation of nitrous oxide, lead poisoning, opium eating, bathing while overheated, excessive use of tobacco, exposure, loss of sight, and excessive heat. Twenty-seven possible “moral” causes were thought to underlie mental illness in the taxonomy of causation of nineteenth-century asylum medicine. Chief among them were business and financial troubles, domestic troubles, grief at loss of friends or family, and poverty and loss of money. Other moral causes tallied at Ohio’s asylums each year were disappointment, fright, religious excitement, abuse by relatives, prison life, slander, spiritualism, attempted rape, unmarried life, and repression by parents. Community physicians speculated about an even broader array of causation as they filled out patients’ commitment papers, including reasons such as fording a cold creek while menstruating, uterine troubles, typhoid fever, cannonading, the shock of enduring a great storm at sea while immigrating to America from Germany, physical prostration from overexertion, unwise disposition of property, hard drinking, and disease of the stomach and bowel. The accounts of the lives of the patients in this chapter are based on the observations and descriptions of community physicians and probate judges, surviving case notes from asylum physicians, testimony and descriptions from family and friends, and in some instances the writings of patients themselves.

Male Patient 1, a merchant from an eastern Ohio county bordering the Ohio River, was admitted to the asylum on Sunday, January 11, 1874. The case notes relate that he was sixty-two years old, married, Methodist, and possessed of a “good education.” His parents had immigrated to America from Ireland and died before his admission. In describing the patient’s disposition and health, the admitting asylum physician noted that he was a quick-tempered, kind, sober, and industrious man with light brown hair. Depressed and in poor health for three months, he feared financial ruin. He had good reason to be worried about his business: at that time, Americans were living through the Long Depression. We learn that the “exciting cause of his mental illness” was judged to be “business perplexity and general ill health” and that he was depressed “respecting his future condition and fear of pecuniary loss.” By the time of admission, he was weak in body with “paroxysmal attacks of jumping and noise,” had made an attempt to hang himself, and was thought to be dangerous and “apt to strike people suddenly.” He had lucid moments in which his mind functioned well, but at other times he was “sometimes excited and tries to fight and bite.” He slept poorly. We learn that his “vegetative functioning” was poor, he possessed a craving appetite, his bowels were constipated, his eyes were blue, his vision was good, and his hearing, smell, and taste were unremarkable. Six entries describing his condition appear in the casebook:

January 11: 98 1/2 temperature, pulse 64, weight 100 pounds. Strength 60 on the Dynamometer.¹⁴ Feeling almost normal. Seems to be much better and in good spirits.

January 20: temperature 98 1/4, pulse 64, weight 102 pounds. Seems to be some better. Had a bad day on the 18th, confined mostly to the forenoon and was about as bad as when brought here.

February 7: Pulse 60, strength 70, weight 104 pounds. Improving slowly. Does not have those spells of mania as when he came except some and then not so bad.

May 2: About the same as when first admitted mentally but much stronger physically. Tried to but [sic] his head against the wall about a week ago.

May 8: Has become jaundiced in the conjunctival some and in the skin a little.

May 16: Still continues considerably yellow. Was given a pill containing 1/2 gr. Potassium & 1 gr. Aloes.

May 17: Has taken meat within the last 18 hours. Remains weak and is rather drowsy most of the time.

May 28: Taken away (by his brother who was a physician).¹⁵

The last entry notes that Male Patient 1 died at home six weeks later.

The asylum records contain many other instances of men, especially older men, hospitalized for depression and worry surrounding financial circumstances. Male Patient 150, a sixty-year-old farmer, is another example. He entered the asylum for an illness “one year of duration, the exciting cause of which is Financial Embarassment.” Some remained preoccupied with finances while in the asylum, writing for money to purchase clothes or as repayment of debt. Families of men who were depressed, violent, and out of work brought them to the asylum as a last resort. A thirty-year-old man from Chillicothe was hospitalized with “melancholia with incipient dementia (caused by) failure in business.”¹⁶ A sixty-year-old man was hospitalized after having been “thrown out of employment” and having attempted “violence upon himself and others.”¹⁷ A farmer, age twenty-six and married, fell into a depression after the death of his father, complicated by financial worries and his responsibilities as executor of his father’s estate. The medical witness described the history of his case as “one month, for the first two weeks slight mental disturbance followed by violent fits of insanity. The cause is depression of mind from the recent death of his father, of whom he is Executor and anxiety relative to pecuniary matters.” The physician and the asylum also cited a “blow to the head” occasioned by a fall and injury to the right side of the head. The young farmer remained hospitalized at the asylum for a month, after which he was sent home “seemingly almost well.” Presumably the asylum’s regimen of rest and purposeful activity was more curative than the home treatment he received: “blistering the nape of the neck.”¹⁸ A fifty-year-old farmer from the Ohio River town of Portsmouth was committed by his wife in 1874 because he had attempted suicide by shooting himself. This man had been hospitalized twenty years earlier at the asylum in Columbus, Ohio, but was at home on his farm in 1874 when he attempted suicide.¹⁹ During the previous three weeks, he had “acted strangely, avoiding the society of friends and imagines there are men on the roof of his own house and sometimes that of his neighbors.” The medical witness and the asylum’s admission notes describe him as a man “with all sorts of delusions about his wife and children being in the fires at the boilerhouse” and who “sometimes imagines he is being robbed at night and goes about the house naked.” Hospitalized in February 1874, he arrived “at times very much depressed and thinks all his friends have deserted him.” Three months later he was “still very much discontented with being kept here,” and though his general health was good, he “did not eat much.” In July 1874, his condition was much the same. The casebook records that in July he “got outside one day and ran to the hill but did not attempt to go farther.” In September, he was taken home by his family.²⁰

FIGURE 2.2 Letter and note from patient, 1880. Courtesy of the Mahn Center for Archives and Special Collections, Ohio University Libraries.

The new asylum provided a place for southern Ohio’s poorhouses (also known as county homes or infirmaries) to relocate their residents thought to be mentally ill.²¹ Among the first patients admitted to the asylum at Athens were four women from the Ross County Home: Female Patients 3, 4, 5, and 6. Their cases for insanity, brought before the probate court in Chillicothe on the afternoon of January 16, 1874, had been prepared that morning by the physician attending the county home. The court determined that the women were unable to attend the probate hearing in the judge’s chambers, and they were represented, with no other witnesses, by the physician attending the county home. At the proceedings, they were all found to be insane and eligible for commitment to a state asylum. Two days later, the four women, one of them in a straitjacket, traveled together to Athens (accompanied by the Ross County sheriff) and were admitted to the asylum on January 19. The reports of the medical witness and the asylum casebook provide a glimpse into the lives and conditions of these four women from the poorhouse.

Female Patient 3, age thirty-two, was determined to have been mentally ill for five years. The physician serving as medical witness summarized the grim facts of her condition: “The cause of her illness is exposure after confinement (childbirth) with her last child, want, and a brutal husband. She appeared entirely recovered at the end of her first year (at the Infirmary) and was sent home but relapsed. Medical treatment has consisted of nourishing food and cold baths.”²²

Female Patient 4, a forty-year-old widow, traveled to the asylum wearing “sleeves,” the Victorian name for a straitjacket. The physician determined that she had been insane for five years and wrote only of her history, “Cause unknown—was in Asylum at Columbus Ohio for three years past, then confined in the County Infirmary.” From the casebook we learn that she “was brought in sleeves by sheriff,” that she had been treated previously at the Central Asylum at Columbus for “paroxysms of excitement,” and that her health was “tolerable good” but her sight and hearing were failing. The casebook holds one note about her progress, written a few weeks later on February 2, 1874: “[She] remains much the same as when admitted—general health tolerable good, at times violent, destructive and dangerous.”

The medical witness physician made one note in regard to Female Patient 5, who was thirty-eight: “I found her at the Infirmary five years ago, insane—she has failed in her speech and articulation, in the last six months very much. The cause is unknown except her father was a drunkard and abusive. There have been no attempts of violence.” An asylum physician noted a few weeks after her admission that she “remains the same as when admitted both physically and mentally. She is very noisy at times.”²³

We learn from the Ross County certificate of insanity that Female Patient 6 was age fifty-nine and “she has been insane for over five years—was in Asylum at Columbus two years and the last time in the infirmary. Cause: unhappy family relations with her husband.” After she was admitted to the asylum at Athens, one case note was entered for her, on February 2, 1874: “Failing sight and deficient hearing. [She] has not improved since her admission into the Asylum. She is very excitable at times.”

Difficulty following childbirth—exhaustion, depression, illness, lack of proper care—brought many women to the asylum. Ill with mastitis and depressed following the birth of her third child, the wife of a Civil War veteran was hospitalized in 1874 by her doctor and her husband, becoming Female Patient 36.²⁴ Her doctor wrote,

Duration of her illness is about six months, the exciting cause of which is probably childbirth or the puerperal state.²⁵ [She] has attempted violence upon herself. She has taken remedies to quiet her nervous system, such as Chloral Bromides and Morphine, but not regularly nor in large enough doses to have much effect. . . . About three months after confinement and while suffering with repeated mammary abscesses & much pain & loss of sleep she first began to exhibit symptoms of Insanity[.] [S]he has been very melancholy—has several times attempted suicide & says she is fearful she may kill her child. Does not eat or sleep enough[;] requires constant watching.

The casebook noted that she had been brought by her husband to the asylum suffering from an abscess of both breasts and talking of suicide by hanging, poison, or drowning. She recovered and returned home, and a few years later she visited Boston and wrote a memoir of her visit there to Henry Wadsworth Longfellow’s garden, where he presented her with a rose. The son whose birth precipitated her illness went on to work for the Internal Revenue Service and lived to the age of eighty-one.

Another mother and her child did not fare so well. A probate judge in Zanesville, Ohio, added this note to the asylum superintendent to the standard commitment form for Female Patient 62, emphasizing the desperate situation of his charge, an unmarried woman who had killed her child:

March 3, 1874

Dr. R. Gundry:

Athens, O.

Dear Sir:

In the case of ______, I copy the following from the Medical Certificate. The exciting cause of her Insanity “is trouble growing out of a bastard child. She murdered her child with an ax and does not attempt to conceal it. She has been worse during her menstrual period. She imagines spirits present and talking with her.”

Any information that I can give you regarding any of the patients sent from here will be cheerfully given.

Very Respectfully

L. R. Landfear

Probate Judge

Commitment for insanity in circumstances of unwed motherhood was not unheard of. Female Patient 192, a twenty-eight-year-old woman from Zanesville, Ohio, was hospitalized ostensibly for guilt over having disgraced her family in this manner. Explained the medical witness,

The exciting cause of disease: compunction for having disgraced herself and family. Has not attempted violence. Her mind was devoted as much as possible by all who knew her. Chloral & bromide & Potassia were given to procure sleep, other remidees we used as tonics etc. . . . I would say there are other circumstances which would have tendency to throw further light upon the subject. Last Spring she had an Illegitimate child, and from that time never left the house. During Aug. and Sept. she nursed a Sister who had Typhoid Fever and during that time the first symptoms of Insanity were detected.

Women were also declared insane because of the strain of bearing many children. A twenty-six-year-old mother from the Columbus area was sent to the Athens asylum because of “over-anxiety about her children. The primary cause is over-child bearing, having had five children in six years.” Her doctor suggested that she might be soon cured at the asylum and could perhaps “make a rappid recovery if she can have proper care, treatment and rest.”²⁶

In Victorian America, sexually transmitted disease, especially syphilis, was of medical, moral, and social concern. In part because of the association of the disease with prostitution, women were thought to be responsible for spreading the disease and were urged to keep themselves clean. A medical treatise on the treatment of syphilis from 1842 notes, “If, in general, women were more cleanly and careful of themselves, the venereal disease would be far less common.”²⁷ Both women and men were encouraged by their physicians not to marry if they had syphilis, to prevent spreading the disease.

Female Patient 277, a new bride twenty years of age, had contracted syphilis while visiting Wheeling, West Virginia, when she was nineteen.²⁸ She visited a doctor in Mount Vernon, Ohio, and he treated her, though he urged her not to follow through with plans to marry. Despite this advice, marry she did. Following the wedding, she and her husband visited another physician regarded as a “quack” by her Mount Vernon physician. The “quack,” without examining her, told her she was pregnant and infected with syphilis and sent her back to her father’s home. Here unfolded a drama involving suicide attempts, which led to her commitment to the asylum at Athens on June 5, 1874.²⁹ Her Mount Vernon physician prepared her commitment papers with no mention of syphilis, saving that for a private letter to the asylum superintendent.

Statement of Medical Witness to the Probate Court:

I hereby certify that I have examined Mrs. ______, State of Ohio and find her insane. I believe her now to be free from any infectious disease or vermin.

She is twenty years of age. On Wednesday May 28th 1874 I was called upon to see the aforesaid lady found her at the Commercial House in Mt. Vernon, Ohio in bed[.] [H]er voice was husky, pupils contracted, she acknowledged to having taken morphine with a view of destroying her life[:] under a threat from me that her trunk should be examined she gave me a bottle containing 10 1/2 grains of Sulphate of Morphine. Strong Coffee was ordered and a close watch kept. On Thursday evening following upon hearing her Father’s voice, she shot herself in the thorax, the ball entered at the middle and near the left side of the Sternum, and passed in an outward direction and now lies in the soft parts covering the left side of the Thorax. None of the parties were ever in an Asylum. Mrs. ______ has never had Epilepsy. This person has made two attempts to take her life, and of which I have knowledge. The treatment has been good nutritious diet and a sedative. She now says that she does not want to recover, has attempted to probe the wound with her fingers.

Her physician attached a letter describing the year-long unfolding of the situation, which included the diagnosis of syphilis and follow-up treatment by the “quack,” details that he wished to spare the patient’s parents. His notes, down to the blue silk dress purchased by the bride, give an unusually vivid picture of the difficulties of this young woman.

June 1st, 1874

To the Superintendent of the Lunatic Asylum at Athens, Ohio

Dear doctor,

I take this opportunity to give you some more information in regard to ______ than I felt called upon to make in the Certificate. I write you expecting that what I now reveal will be kept a secret for the sake of the father and mother of this unfortunate woman. She first consulted me for a private disease about the middle of last January. Said she contracted it 2 months prior in Wheeling Va. I made an examination and found a chancre and multiple bubers in both groins. I regarded the case one of true Syphilis and so treated it. In a few weeks she had sore throat & an eruption. Under the use of Hyd. Bichloride & Tinct. Ferri internally and applications of nitrate of silver the chancre healed, eruptions & sore throat disappeared. She remained under my care 2 1/2 months when I regarded her cured. She told me that she was engaged to be married, time had been set—I told her the danger of getting married in that condition and advised her to postpone the day indefinitely[.] [T]his she said [she] could not do and was married since [that] time in April[.] [O]n her way to the home of her husband they stopped in Zanesville and consulted a quack doctor by the name of ______. Without any vaginal examination he pronounced her badly diseased and pregnant—and sent her back to her father. On Wednesday May 20th she started from her father’s with the view of joining her husband. She stopped in Zanesville and consulted the Quack[;] prior to leaving home she tried to poison herself with strychnine. She purchased in Zanesville a beautiful blue silk dress, with kid slippers and other articles of dress to match and returned to this city on Saturday May 23rd. She came to my office (after an absence of some 8 weeks). I made an examination and could not find any evidence of disease. Tried hard to satisfy her . . . and told her to seek the advice of some regular physician. She took that . . . advice and again chose a quack. After this she proceeded at once to the carrying out of her plan. First on Tuesday at 10 and 10 1/2 PM and [again] Wednesday 4 AM she took a dose of morphine in all 45 grains. I saw her on Wednesday 11 AM, found her pupils contracted, voice husky, said she had vomited after each dose. Under threat that her trunk should be examined she gave me up what Morphine she had left & said she would go on with her husband. Her father came before she got started and the moment she heard his voice she shot herself. . . . The cause of her insanity is very plain I think. I expect that under your professional care & skill she will be returned entirely cured both in body and mind.

Yours,

______, MD

The new bride entered the asylum at Athens four days later on June 5 as Female Patient 277.

In 1874, another bride was found to be insane and was hospitalized with witness provided by two female friends. Distraught that she had married the wrong man, Female Patient 242 was suicidal and had to be watched constantly by friends. The physician explained, “The exciting cause is as I learn Matrimonial disappointment. She is sane on some subjects and has perfect lucid intervals in which she is sane on all. She has attempted violence upon herself. I am of [the] opinion that if confined for a few weeks under kind treatment, that she will entirely recover as suicide is her only Mania.” The probate judge added a separate letter explaining the situation to the superintendent:

Dr. Gundry

Dear Sir:

Inclosed please find papers in case of ______[,] a married lady[;] it appears that she is sensible of having disappointed someone else by Marrying her present husband and for that reason she ought to put herself out of the way of all. She finds no fault with her husband[.] She has repeatedly attempted Suicide by different means. Her friends are compelled to guard her continually, she seems to be reasonable in other matters. Please reply at your earliest convenience, as she is being kept here to wait the reply.

Respectfully etc.

J. C. Evans

PJ [Probate Judge]

The sights, sounds, and injuries of the battlefields of the American Civil War induced trauma and illness that, for some, resulted in commitment to the asylum. Male Patient 216, from a farm along the Ohio River, was hospitalized because of a mental illness dating from 1865. His physician wrote that the cause of his illness was “Typhoid fever, from which he suffered while in the Army during the year of 1864. [He] has made attempts of violence upon his family and others.” This veteran had been a private in the 91st Regiment of the Ohio Infantry. Before his illness, he participated in the West Virginia war theater, including a raid up the Kanawha River and pursuit of Morgan’s Raiders.

Male Patient 231, a private in the 188th Ohio Infantry, was admitted to the Athens asylum in 1874 following ten years of mental illness attributed to the trauma of the sounds of battle. His physician describes his case, which dated from 1864, as a “case of chronic mania, he was in an asylum about five years ago. The cause is nervous derangement, probably acquired while in the Army. He received a sudden shock from cannonading.”

Male Patient 3 enlisted in the Ohio 77th Infantry Regiment at the age of fifteen and endured near-constant battle conditions until the war’s end, when he had his first “attack” of mental illness. The medical report committing him in 1874 noted, “About seven years ago [he] had an attack lasting two or three months, has had three or four attacks since. He has made threats of violence upon himself and also upon others.” The teenager fought with his regiment in the spring of 1862 at Shiloh, the bloodiest battle in U.S. history at that time. Descriptions of the battlefield at Shiloh note the corpse-littered ground, creating a deadly psychological effect. The young soldier pressed on with his unit to the siege of Corinth, then to Chickamauga, and finally to the siege of Atlanta before falling psychologically ill.

Some Civil War veterans were sent to asylums because their violent behavior could not be controlled at home. Male Patient 243, a private in the Ohio Infantry, was hospitalized at Athens in 1874, according to the medical witness because of a blow on the head received while in the U.S. Army in 1863, when he was fifteen years old. He was soon hospitalized in the state asylum at Columbus, Ohio, which burned in 1868, no doubt creating further trauma for this veteran. Since then he had been confined at home, in Marietta, Ohio, “subject to paroxysms of violent mania.” His father initiated his second hospitalization when the Athens asylum opened in 1874.

Families of soldiers who were killed suffered as well. Some were unable to recover and required hospitalization. An Ohio mother, age sixty-four, remained stricken with grief over the death of her son in the war, and her family brought her for commitment to the asylum, where she became Female Patient 286. The medical witness noted,

This is to certify that I have this day examined Mrs. ______, a Widow Lady about 64 years of age, and find her labouring under that species of Insanity known by the name of Monia Mania, arriseing from the distress caused by her son, being killed in the late War[.] [S]he has been three times to the Asylum, and discharged each time cured[;] she has been home from the Asylum this last time two years and four months, continued Well and undisturbed in her mind until the first day of Last March, when she began to show symptoms of mental aberration—Since which time she has been more or less noisy and troublesome, being more so whenever the subject matter of her son is brought to her mind[.] [T]he Physical health is good, [and she] has been under no medical treatment, I therefore feel confident that removal to some asylum where she can get a proper Treatment will soon restore her Mind.

Another mother, Female Patient 749, was hospitalized in 1874 because of “grief of the death of her son in the Army.”

Male Patient 819, age twenty-eight, was admitted to the asylum by way of special legislation passed by the Ohio General Assembly. He had been sent to Athens from his family home in Philadelphia to live with an uncle. Because he was not a resident of Ohio, an act of the Ohio General Assembly was required for his admission to the asylum. His admission papers consist of a small certificate with a two-and-a-half-inch red wax seal signed by the Ohio secretary of state. Once in the asylum, he penned a series of plaintive notes to family members and to asylum physicians asking for help in going home. Written in purple ink, some in English and others in German, the letters were never sent but kept instead in asylum files. The undated letters repeatedly inquire about coming home; one letter directs his uncle in Athens to send him a drum over at the asylum.

To Emil S., N. 6th Street Philadelphia

Dear brother Emil

I am wanting to wait to get home. I will inform you how I am getting along which to let you know about my coming home, since 10 years away from home . . . telegraph immediately and want to know whether farther is well nothing more at present hoping to see you soon.

Leon S.

Atlanta

Dear brother Leon S.

I would like to know how soon you will be in Philadelphia or you could send me a telegraph that you are well about my traveling home myself alone I was going to ask you about coming home telegraph to send me home.

This is all at present

Solomon S.

Marshall, Missouri

Dear brother Solomon,

Hoping to see you soon I will let you know how soon. I will be at home and hoping that you are well and all I which to now [sic] whether you are going home. This it would be better at home so good bye at present.

Nothing more.

Mr. Abraham ______.

Please Telegraph to Mr. Isaac ______. to bring his son home.

Mr. Abraham S., Athens

Bring over one drum at for ______.

Mr. Abraham S.

Please send over one drum for ______.

Dr. Rutter

Dr. Kelly

Dr. Rutter & Dr. Kelly

Please leave me know whether I can leave after dinner for my home my farther will pay for the time that I stayed in Athens and what it cost my farther will pay what it cost to travel home to Philadelphia.³⁰

FIGURE 2.3 Note from Male Patient 819 to Superintendent Rutter and Dr. Kelly, 1880. Courtesy of the Mahn Center for Archives and Special Collections, Ohio University Libraries.

Some patients resisted hospitalization by taking matters into their own hands and escaping or making plans to leave.³¹ Their strong feelings and inventive plans are recorded in their own letters as well as in the asylum’s casebook. Male Patient 1060, a Captain C. of the Ohio River town of Marietta,³² was hospitalized by family and friends, who inquired by letter as to his well-being.

Marietta, Ohio July 8, 1880.

The Surgeon In Charge of the Asylum Athens O.

Dear Sir

Will you please keep us informed of Capt. C. and how he is getting along and what prospects there is of his recovery. His sister sent his clothes but did not here whether he rec’d them hope he did, please give us your Opinion and oblige.

Yours Respectfully,

Capt. Ben F. Hall³³

Captain C., meanwhile, was making plans to escape from the asylum, which he documented in a note written in pencil on a scrap of paper that was confiscated and filed by asylum staff.

To John Smart:

Friend John, as I have become convinced that my imprisonment has turned into persecution you are all I have left to depend on now I want you to go and hunt up a saw blade new or old it will be better if fine and hand it up to me at the third windo from the angle don’t fail to get me something this evening for I want to start for home to night also get me a good stout heavy club to defend myself with don’t fail me in the name of the God we both serve and worship. I will be waiting for you.³⁴

He did not escape; he died there two years later and was buried in the asylum cemetery, where his remains rest today.