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Treatment for the insane improved in the early 1900s

Published October 17. 2009 09:00AM

Before psychoanalytic techniques were introduced during the first decade of the 20th century, there was no help for the mentally challenged individuals in society.

Those without family were committed to asylums, and often confined there for life. Those with families were hidden away in attics and cellars, existing in a dark world so it wouldn't shame the family. In one case during Victorian times, one demented person was reportedly confined to an outhouse which was so narrow that "his flexor muscles permanently stiffened."

The most frightening revelation for those in asylums was that their lives would be spent in these "human rat traps." It was easy to get in but impossible to get out.

According to one investigation of a New Jersey State Asylum in 1878, authorities would pour alcohol on the epileptic patients and then set them on fire in order to weed out the pretenders.

Most doctors of the time did not believe the insane could be cured. Even Dorothy Dix, an early crusader for reform in prisons and asylums, had limited knowledge of the disease affecting the mentally ill. "They don't need any heat - they have no feeling," she once said.

Because so little was known about mental illness, there was great prejudice against the inmates. Some family members even saw their demented kin as an evidence of sin and regarded them as being possessed by some evil.

In 1872, the New York Tribune described the "devilish ignorance, brutality and lewdness" of management at a lunatic asylum in New York's Bloomingdale Hospital. And in an investigative piece, the North American Review described the institutions as having "vermin, contagious disease and food hardly less fatal than starvation."

Local almshouses had their own problems. After visiting the Schuylkill County Almshouse in September 1909, Dr. Frank Woodbury of the state committee on lunacy, and Bromley Wharton, secretary of the State Board of Charities, "strongly urged action for better care of the county's insane wards."

"Conditions in the insane department of the almshouse are so bad that the county authorities have been advised by officers of the State Board of Charities to destroy the unsafe and unsanitary structures in which the insane are now housed and to replace them with suitable buildings," the Tamaqua Courier stated.

The report said that the four-story main building, which contained patients on each floor, was condemned as "a fire trap." It said the "modern idea of insane hospital construction calls for buildings of not more than two stories, made of slow-burning material."

Woodbury was also widely known for his inspections and studies of hospitals for the insane, even traveling as far as the West Indies, where he studied the use of alcohol conditions in the tropics. In an address to the American Society for the Study of Alcohol and Other Drug Narcotics, he once stated that alcohol was the greatest active cause of insanity.

"Pennsylvania is now supporting in nearly 30 hospitals more than 16,000 indigent insane, a very large portion of whom owe their unfortunate condition directly or indirectly to the toxic effects of alcohol," he stated.

Another physician, Dr. De Lancey Carter of New York, said that 200,000 inebriates died from the effects of alcohol in the U.S. every year.

The person most responsible for changing the way medicine and society viewed the mentally ill was Sigmund Freud, who espoused psychoanalysis as a valid approach for the treatment of mental disorders. These techniques for treating the mentally ill were first introduced to the American medical community during the first decade of the 1900s.

Carl G. Jung, one of Freud's most prominent followers, was one of the first to employ psychoanalytic techniques with severely disturbed (psychotic) individuals, particularly schizophrenics. While Freud's techniques were readily adapted to "office practice, " Jung's methods were useful with more severely disturbed, hospitalized patients.

In 1900 there were only 222 psychiatrists, but thanks to the work of Freud and Jung, mental illness in America began to transform. Psychiatry became a recognized medical specialty, and a requirement in most medical schools.

Thankfully, the days of the asylum, the only "therapeutic tool" of the 19th century, were numbered in 1909 and would soon disappear.

Next: Allegheny Penitentiary

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