In
1880 the Vermont institution known as the Brattleboro “Asylum”
provided care to insane peoples, primarily those native to the state and
employed in the laboring and agricultural businesses. Increasingly over
the next decade, the Asylum would consciously and actively discharge out-of-state
patients in an effort to make the Asylum’s services available chiefly
to Vermont’s poor. These efforts were intended to transform the
Asylum into a state institution, a pragmatic shift because much of the
funding for the treatment of the poor came from the state of Vermont’s
treasury. Even before these efforts began in earnest, though, the largest
in-hospital population was comprised of state-funded patients, outnumbering
town patients, which in turn outnumbered the private, self-paying insane.
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In
the Supervisors of the Insane biennial report, legal insanity was defined
as “anything otherwise than normal,” and the majority of patients
were classified as having a maniacal disease (137 out of 177 resident patients
in June, 1880). 25 patients were termed melancholiacs, 17 considered to
have a “decided suicidal disposition,” and 16 were deemed “homicidal
in tendency.” All patients were classified as pauper, poor person,
transient, convict, or criminal, a classification system which carried strong
negative connotations about what type of person the majority of insane people
were. Despite these negative connotations, however, psychiatric physicians were starting to attribute insanity and mental disorders to innate and hereditary causes even as early as 1880. Many believed that insanity must be analyzed and interpreted from the perspective of family history. “Constitutional predispositions” were considered an increasingly potent cause of insanity, and it was widely believed that while insanity could be hereditary or due to accident (post-natal), it frequently arose from dormant tendencies at a time when the patient was forced to confront some exciting stimulus. |
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Early commitments were encouraged in the late 19th century in hopes of preventing diseases from becoming chronic. Despite these efforts, however, only 4 patients were discharged between 1878 and 1880. One doctor and two assistants, “humane” men of “ability and integrity” provided care for all of Brattleboro’s patients. Modern treatments consisted of determining pathology of the disease, prescribing appropriate medical treatment, and diverting the patient’s mind. These diversions, termed a “mental hygiene curriculum,” included putting the patients to work around the asylum, attending chapel, exercising at the gymnasium, reading at the library, playing games at the amusement hall (including bowling, billiards, croquet, etc.), or attending the events that were organized on the Asylum’s campus or for the public 1-2 times per week (such as poultry shows and musical performances). During the years surrounding 1880, the patients complained chiefly about illegal confinement and the lack of specific comforts associated with home. | |