Damn it feels good to be back. Sorry for the hiatus - life gets busy and unfortunately, the blog had to take a back seat. As I wrote this, I remembered how much I hate how this site formats posts & photos. So apologies if some of the spacing is off. Anyway, I've got a lot of interesting interviews and topics in the pipeline I think you guys will love. So let's get back into it shall we?
One of the things that certainly piqued my curiosity of asylums were the patient treatments.
By today's standards, most of these would seem inhumane and barbaric, but at the time ... this was all they had.
I want to give just a few examples of treatments I find to be interesting, but I'm always curious to know what you guys think.
More and more asylums are being demolished for land development or perhaps worse, demo by neglect. With Fergus Falls being the most recent asylum on the chopping block, it truly breaks my heart to know that the beautiful architecture and history will soon be forgotten. This is one of the last remaining Kirkbride asylums left standing, and to lose it would be a real shame.
Side note: check out Friends of the Kirkbride to keep up with all things Fergus Falls related.
When these structures are erased from existence, not only do we lose architectural beauty, we lose
rich history – good and bad – of what happened behind these walls. Most
important of all, we lose the history and progression of understanding and
treating mental illness.
As I explained in a prior post, before formal psychiatric institutions were built, people
suffering from mental illness were often shackled to walls and floors in attics
and basements. “Modern
medicine” as we know it today includes psychotropic medications and outpatient therapy;
however this term once referred to barbaric
treatments such as a tranquilizer chair, hydrotherapy, insulin coma therapy,
electric shock therapy, or a trans-orbital lobotomy.
TREPANATION
Many people thought the early cause of mental illness were demons lurking inside the skull. To fix this, a procedure known as
“trepanation” was done: putting a hole in the patient’s head to create a door
in which the demons can escape.
This procedure was done from the Neolithic era
all the way to the early 20th century by cultures all over the
world. This procedure bled over into the early days of the lobotomy (known as the leucotomy). After a hole as drilled into the skull, a leucotome was inserted to sever neural connections.
TRANQUILIZER CHAIR
In the late 18th century, Dr. Benjamin Rush, the “Father of American Psychiatry”, built the tranquilizer chair as a way to slow
blood flow to the brain, lessen muscle and motor activity, and inhibit sensory
awareness. Many times, these patients would be left in the chair for up to 6
months.
Common practices included bloodletting with knives and leeches,
scalding hot water poured on the feet, and ice-cold water doused on the head.
LUNATIC BOX
In the 18th & 19th centuries, the
lunatic box was used to calm down violent or out of control patients. The box
was totally dark inside with one small hole in the front.Once inside the box, the person would stand with barely any room to move, in their own urine and feces, until whoever put them inside decided they were calm enough to be released.
FEVER CABINETS
In the early 20th
century, fever cabinets were used for the “cure” of venereal diseases, like
syphilis. These hot boxes were lined with high-wattage bulbs to elevate the
patient’s body temperature near 105 degrees. It was believed the sweat and high
temperature would kill the virus and cause the patient to sweat out the
syphilis. The patient was often given doses of arsenic, as it was believed this
would help rid the syphilis. More “humane” doctors provided water and ice caps
to patients during this treatment.
HYDROTHERAPY
There are many different forms of
this early 20th century therapy. Generally, hyperactive patients
were given warm, tiring baths, while lethargic patients were given stimulating
sprays of water.
One form of hydrotherapy was
wrapping the patient in a towel soaked in ice-cold water.
Patients would also
be submerged in a bath with their head
above water for hours or days. They were strapped in and could not get out;
only to use the restroom.
Hydrotherapy also included taking
patients into an area with high-pressure jets and straying them with extremely
hot or cold water.
ELECTROSHOCK THERAPY
As early as the 16th century,
seizures have been used to treat psychosis in patients. A modern practice of
electroshock therapy developed in 1938, and is now commonly known as
“electroconvulsive therapy” or “ECT”. ECT is still used today, generally under
anesthesia, but was at its peak in the 1940s and 1950s. During ECT, electrodes
are placed on the patient’s scalp to cause seizures that are electrically
induced to provide temporary relief from major depression, schizophrenia, mania,
and catatonia.
INSULIN COMA THERAPY
Used heavily in the 1940s and 1950s
for schizophrenic patients, insulin coma therapy involved a patient being
injected with high doses of insulin, causing them to go into a coma for up to
an hour. Many times these patients would experience seizures during the coma.
These comas were usually
administered 6 days a week for about 2 months. Over the course of 50 or 60
comas, the insulin dosage would increase and then level out. Once the doctor
believed the ICT to be beneficial, the dosage would decrease and the treatment
would eventually be stopped.
When the patients were not
undergoing ICT, the nurses were instructed to highly supervise them in case of
major hypoglycemia. This supervision was not always a bad time for the
patients; it often included walking, playing games, flower-picking, and map-reading.
LOBOTOMY
The frontal lobe of the brain was
the main focus for lobotomies because this area houses behavior and
personality. Patients suffering from schizophrenia, manic/depressive disorder,
and bipolar disorder were the likeliest to receive a lobotomy.
In the 1940s, early lobotomies
involved cutting a hole in the skull and injecting ethanol into the brain to
destroy fibers that connected the frontal lobe. Portuguese neurologist Antonio
Moniz (who created the lobotomy) introduced the leucotome: a loop wire that,
when rotated, created a circular lesion in the brain.
American neurosurgeons
Walter Freeman and James Watt adopted Moniz’s technique, later becoming the
“Freeman-Watts Technique”. (Yes, I'll be doing an entire future post dedicated to Freeman).
Italian psychiatrist Amarro
Fiamberti first developed a procedure accessing frontal lobes through the eye
sockets. This was Freeman’s inspiration to develop the trans orbital lobotomy
in 1945.
The trans orbital lobotomy involved
a modified ice pick called an “orbitoclast” and a small hammer. The orbitoclast
would be inserted by lifting the upper eyelid and go through the top of the
eyesocket. The idea was to sever the connection between the frontal lobe and
the thalamus (this area receives/relays sensory input). In the US alone, from the 1930s to 1970s, about 40,000 lobotomies were performed. Freeman himself performed about 3,500.
I'm curious to know what your favorite treatments were or what you find the most interesting. I'm always looking for new topics to cover/people to interview - feel free to shoot an email to asylumhistory@gmail.com
-JM
-JM
