Indiana Medical History Quarterly

INDIANA MEDICAL HISTORY QUARTERLY INDIANA HISTORICAL SOCIETY Volume IX, Number 1 March, 1983 R131 A1 15 V9 NOI 001 The Indiana Medical History Quarterly is published by the Medical History Section of the Indiana Historical Society, 315 West Ohio Street, Indianapolis Indiana 46202. EDITORIAL STAFF CHARLES A. BONSETT, M.D., Editor 6133 East 54th Place Indianapolis, Indiana 46226 ANN G. CARMICHAEL, M.D., Ph.D., Asst. Editor 130 Goodbody Hall Indiana University Bloomington, Indiana 47401 KATHERINE MANDUSIC MCDONELL, M.A., Managing Editor Indiana Historical Society 315 West Ohio Street Indianapolis, Indiana 46202 MEDICAL HISTORY SECTION COMMITTEE CHARLES A. BONSETT, M.D., Chairman JOHN U. KEATING, M.D. KENNETH G. KOHLSTAEDT, M.D. BERNARD ROSENAK, M.D. DWIGHT SCHUSTER, M.D. WILLIAM M. SHOLTY, M.D. W. D. SNIVELY, JR., M.D. MRS. DONALD J. WHITE Manuscripts for publication in the Quarterly should be submitted to Katherine McDonell, Indiana Medical History Section, Indiana Historical Society, 315 West Ohio Street, Indianapolis, Indiana 46202. All manuscripts (including footnotes) should be typewritten, double-spaced, with wide margins and footnotes at the end. Physicians’ diaries, casebooks and letters, along with nineteenth century medical books and photographs relating to the practice of medicine in Indiana, are sought for the Indiana Historical Society Library. Please contact Robert K. O’Neill, Director, In diana Historical Society Library, 315 West Ohio Street, Indianapolis, Indiana 46202. The Indiana Medical History Museum is interested in nineteenth century medical ar tifacts for its collection. If you would like to donate any of these objects to the Museum, please write to Dr. Charles A. Bonsett, Indiana Medical History Museum, Old Pathology Building, 3000 West Washington Street, Indianapolis, Indiana 46222. Copyright 1983 by the Indiana Historical Society Pictured on the cover is an interior scene of the Women’s Department (Seven Steeples) at Central State Hospital during the 1920’s. (Photograph in the collection of the Indiana Historical Society Library.) R131 A1 15 V9 NOI 002 IN THIS ISSUE This issue of the Quarterly deals with the age-old problem of mental illness. In spite of ever-progressive knowledge and change, the problem of caring for the mentally ill will always be with us. The articles which follow represent three different, and yet equally provocative, approaches to the history of mental health care in Indiana during the late nineteenth and twentieth centuries. The first article, by Dr. Hugh C. Hendrie, describes Central State Hospital from the perspective of local twentieth century newspapers (with primary emphasis on the year 1973). Newspaper articles, particularly during this period, tend to be highly critical of the hospital. The reader of these periodic expose's is left with an indelible impression that something is grossly amiss with the system, the hospital, or its management. Dr. Hendrie’s unique and enlightening topic, if expanded to cover the hospital’s 135-year history, would make a most interesting book since controversial events, attracting the attention of the press, also have occurred from time to time during the nineteenth century. Dr. James Athon of Central State, for example, in response to the state legislature’s failure to make the necessary appropriation in 1857, returned his patients to the communities from which they were committed. This action prompted an immediate response from the press, and from the legislature. Dr. William B. Fletcher, the Hoosier Pinel who became superintendent in 1883, initiated his term by making a public bonfire using all the hospital’s mechanical restraints. Although the medical reform implicit in this act was long overdue, he was promptly rebuked on the editorial page of the local press. Later, when he exposed the graft, political corruption, and abuse taking place in the state hospital system, he was fired. In the second article, the late Carrie (White) Lively (1871-1957) reminisces about her experiences as a ward attendant, first at Central State Hospital (or more correctly, at the Indiana Hospital for the Insane as it was designated at that time), and later at East Haven in Richmond, Indiana. Mrs. Lively’s experiences within the state hospital system occupy about two years, most of which was at the Richmond hospital at the turn of the century. It is important to bear in mind that she began her work at Central Hospital with no preparation or training. She was a young widow (about twenty-nine years old with four children to support) who was suddenly confronted with the task of attending to society’s most severe examples of mental illness. However unpleasant the task, her family responsibilities made her persevere. Further, she was a sympathetic person, identifying with her patients, which made her sensitive to what she considered their abusive treatment. The following information may be useful to fully appreciate Mrs. Lively’s article. The state hospital system, then as now, was underfunded. Dr. George Edenharter, superintendent at the time that Carrie Lively worked at Central State, strove for eco nomic efficiency through a very tightly structured organization. His period of super intendency (1893-1923) was characterized by progress and growth, and the news paper coverage of his period is generally of a laudatory nature. Actually Central State’s high water mark in public esteem was achieved during the Edenharter years, and since his superintendency the hospital course has been slowly but progressively downhill. Mrs. Lively’s observations, which are critical of Edenharter, then are especially noteworthy as they describe problems existing during a more salutary 3 R131 A1 15 V9 NOI 003 4 INDIANA MEDICAL HISTORY QUARTERLY period of the hospital’s history. Dr. Ellen Dwyer provides the final article for this issue. She tells of the medical and budgetary limitations of the system which permitted the development of the symptomatology described by Hendrie and Lively. Dr. Dwyer provides a brief outline of the history and development of the mental health institutions in Indiana and why they have functioned in a less than perfect manner. Her scholarly article provides the perspective necessary to visualize the overall problem, an essential first step in comprehending this most complex subject. Charles A. Bonsett, M.D. Editor and Chairman George P. Edenharter served as superintendent of Central State from 1893 to 1923. (Photograph in the collection of the Indiana Historical Society Library.) R131 A1 15 V9 NOI 004 PRESS COVERAGE OF CENTRAL STATE HOSPITAL: ALARMS AND EXCURSIONS Hugh C. Hendrie* There is a perception held by observers and critics of the health professions that physicians are inadequately trained to practice medicine in this modern complex society. Doctors are too often puzzled and irritated by the patient’s response (or lack of it) to their well-meaning advice and bewildered and often angered by their inter actions with governments, hospitals, or insurance companies. The fault, say critics, lies not in the medical student’s mastery of medical science and technology, but in his or her ability to place the practice of medicine within its societal context. This problem, however, has not passed unnoticed among medical educators. To quote Henry Sigerist: Medical education can never reach definite forms, but is obliged to adapt itself to ever-changing conditions. Every society required of its physicians certain quali ties such as knowledge, skill, devotion to patients, conscientiousness. But the position of the physician in society and the tasks assigned to him changed and were determined primarily by the social and economic structure of a given society and by the scientific and technical means available to medicine at that time.1 The educator’s dilemma then is determining an appropriate vehicle to teach this health-societal interaction. Concentration on present-day issues is fraught with problems because educators are also integral members of their culture. It is difficult to distance oneself from society to observe objectively its effect on medicine. Sometimes it is much easier to perceive, for example, the effects of the political process on the practice of medicine in foreign cultures like the Soviet Union than it is to observe a similar process in one’s own country. There is one possible method of conveying the relationship between medicine and society in an unbiased manner. Again, to quote Sigerist discussing the teaching of medical history: It should give us a more complete picture of this development of civilization and ... should make us aware [of] where we come from in medicine, at what point we are standing today, and in what direction we are marching.2 It was with this aim in mind that I considered incorporating histories of the treatment of the mentally ill in teaching clinical psychiatry to medical students. How ever, upon inspecting these documents, one is reminded of the Japanese film Rashomon, which was devoted to the exploration of a single event as remembered in different ways by the participants. So in the history of psychiatry, one has the “insider’s” view of it being a triumphal procession to the present state of enlighten ment, contrasted with that of the social critic who perceives it as an increasingly sophisticated medium for social repression. ‘Hugh C. Hendrie is Albert E. Sterne professor and chairman of the Department of Psychiatry at Indiana University School of Medicine. This paper, originally entitled “Institutionalizing the Insane,” was delivered at the Indiana Historical Society’s annual meeting on November 7, 1981. The author wishes to thank Michele Rudnick for her research assistance during the summer of 1981. 5 R131 A1 15 V9 NOI 005 6 INDIANA MEDICAL HISTORY QUARTERLY The present study arose from the hypothesis that perhaps one could examine best the interrelationships between society and psychiatry by utilizing the Rashomon-like qualities of the various reminiscences to construct parallel views of a representative institution.

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