"Mad Doctors" : American Psychiatrists, 1800-1860
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University of Massachusetts Amherst ScholarWorks@UMass Amherst Doctoral Dissertations 1896 - February 2014 1-1-1976 "Mad doctors" : American psychiatrists, 1800-1860. Constance M. McGovern University of Massachusetts Amherst Follow this and additional works at: https://scholarworks.umass.edu/dissertations_1 Recommended Citation McGovern, Constance M., ""Mad doctors" : American psychiatrists, 1800-1860." (1976). Doctoral Dissertations 1896 - February 2014. 1350. https://scholarworks.umass.edu/dissertations_1/1350 This Open Access Dissertation is brought to you for free and open access by ScholarWorks@UMass Amherst. It has been accepted for inclusion in Doctoral Dissertations 1896 - February 2014 by an authorized administrator of ScholarWorks@UMass Amherst. For more information, please contact [email protected]. "MAD DOCTORS:" AMERICAN PSYCHIATRISTS, l500-ie60 A Dissertation Presented By Constance Madeline McGovern Submitted to the Graduate School of^he University of Massachusetts in partial of fulfillment of the requirements for the decree DOCTOR OF PHILOSOPHY April !976 History 1 @ Constance Madeline McGovern 1976 All Rights Reserved "MAD DOCTORS:" AMERICAN PSYCHIATRISTS, 1800-1860 A Dissertation Presented By Constance Madeline McGovern Approved as to style and content by: Leonard L. Richards, Chairman of Committee Mario S. De Pillis, Member / Paul S. Boyer, Member Eric T. Carlson, Member JL<u w. mdJ^ Gerald W. McFarland, Department Head History- April 1976 ACKNOWLEDGMENTS At every stago of researching and writing this dissertation I have received invaluable assistance. T am indebted especially to the staff of the Interlibrary Loan Department of the University of Massachusetts at Amherst, especially Marie Clark, Ute Bargmann, and Judy Schaefer. Their expertise in locating rare and obscure sources was superb, as was their willingness to help. The consultants at the University's Computer Center were equally expert at guiding a novice through the initial "maze" of computer programing. I am also grateful to Caroline Morris and Bonnie Blustein of the Pennsylvania Hospital, Patricia Gatherum of the Ohio Historical Society, William Joyce of the American Antiquarian Society, and Dr. Hobart Hansen, Director of the Western State Hospital in Staunton, Virginia. Each of making these people went far beyond the bounds of ordinary assistance in available to me the manuscript collections of their institutions. But by far my greatest debt is tc the members of my dissertation the priceless committee. Professor Leonard Richards, the director, has student's thinking. talent for asking just the right questions to sharpen a Mario De Pillis Furthermore, he spent hours honing my prose. Professor and has been a has guided me through many years of graduate school that cannot be repaid. perceptive critic of this work. To him I owe a debt found the loopholes in Professor Paul Boyer, an astute reader, invariably suggestions. Dr. Eric Carlson interrupted my arguments and made invaluable School, the New York Hospital, and his his work at the Cornell Medical reading and discussing my dissertation psychiatric practice to spend time in . V Without their guidance this dissertation would have been a hard task, with their help it has been a rewarding experience Special thanks go to my sister-in-law, Carol McGovern, who has sat through rrany an hour of my rambling on about antebellum psychiatrists and still has had the patience to type draft after draft. Finally, this dissertation is dedicated to the memory of my father. Without his early encouragement and faith in me, this would not have been. ABSTRACT "Mad Doctcrs:" American Psychiatrists, 1800-lCSO (April 1976) Constance M. McGovern, B.A., College of Our Lady of the Elms M.A., University of Massachusetts, Ph.D., University of Massachusetts Directed by: Professor Leonard L. Richards In 1800 the idea of pursuing a career of caring for the insane was virtually unknown. Yet, by i860, 115 physicians chose to enter this nascent field. The traditional thesis that the spirit of reform and belief in egalitarianism inspired these men seems to hold true for a few. But sympathy for the down-trodden and unfortunate does not fully explain all motivation, others may have been seeking personal fulfillment. My computer study of 2li0£ graduates, 1800-18^0, of six Mew England colleges illustrates that men entering professional fields after 1820 had was especially a different experience from those entering before 1820. This whicn true for doctors and my study verifies the general medical histories assume increasing difficulties for doctors in the antebellum period. Antebellum physicians were looking for opportunities in stable and the commer- lucrative practices, but with the waning of public confidence, multiplication of medical cialization of the patent medicine industry, the sects, their goals were school graduates, and the onslaught of irregular frequently unrealized. conservatism, Grounded in religious, political, and educational disrupted, first by the general rest- the lives of future alienists were by specific communal and familial lessness of Jacksonian society, and then vii instability. And with seemingly little opportunity to gain success in practicing general medicine, they were willing to take a chance in the unproven field of treating mental illness. In the antebellum years, psychiatric medicine was practiced only within asylum walls. Thus, these doctors turned to asylum administration. Americans, of course, did not "discover" the asylum, Europeans did. American psychiatrists learned the lessons of institutionalization and therapeutic treatment especially from their British colleagues. British psychiatrists, who viewed social change and cleavage in much the same way as Americans, founded their professi^ rial organization in l8hl, and within three years, the English Association had its duplicate in the United States, The movement toward professionalization in America culminated when a number of psychiatrists — specifically Francis Stribling of Staunton, Virginia, William Awl of Columbus, Ohio, Samuel Woodward of Worcester, Massachusetts, and Thomas Kirkbride of Philadelphia, Pennsylvania — felt the need of a concerted effort to control professional behavior, further publicize and justify their profession's work, and establish professional independence. A recognizable, official, national body which could synchro- each of nize action and thought became a necessity. By the early l8U0s, situation these "mad doctors" (as they called themselves) faced a critical was resolute in that threatened his professional standing, and so each through a formal organization. his efforts to attain professional autonomy founded, in These four men and nine other early psychiatrists, Superintendents of American Institutions 18UU, the Association of Medical Psychiatric Association). for the Insane (later renamed the American Association grew. Striving somewhat Year by year, the membership of the VX11• • • unsuccessfully to maintain a national representation, the Association, nevertheless, matured into a self-conscious, elite, and powerful profes- sional organization. It dictated policies for organization, administration, and treatment of the insane to state legislatures and charitable organiza- tions which supported asylums. No other policies were tolerated. Consequently, in the last half of the nineteenth century, the Association and many of its members became inflexible, clingin b to the early dictates of the Association and failing to incorporate the discoveries of advancing science. ix TABLE OF CONTENTS ACKNOWLEDGMENTS iv CHAPTER 1. REFORMERS OR REGULATORS? 1 2. AN UNCERTAIN PROFESSION Hi 3. AMERICAN ALIENISTS 51 lu THE ATLANTIC VJORLD 79 ORGANIZERS * H3 6. MASTERS OF MADNESS 1^2 191 7. A UNIQUE RESPONSE 201 APPENDIX A. THE STATE OF THE PROFESSIONS, METHODOLOGY 216 APPENDIX B. LIST OF AMERICAN ALIENISTS X LIST OF GRAPHS Graph 1. Comparison of Selected Professional Experiences of Older and Younger Professionals 17 2. Comparison of Professional Experience in the 1820s and 1850s 18 3. Attainment of a Long-term Practice (10+ years) for Doctors, Lawyers, and Ministers, 1830-1860 22 U. I 'ore than Two Practices for Doctors, Lawyers, and Ministers, 1830-1860 23 5>. Percentage of Long-term Practices (10+ years) for "Unsuc- cessful Doctors" h$ 6. Percentage of Alienists Beginning Practices in Difficult Communities 61 7. Comparison of First Practices of Older and Younger Doctors . 63 8. Percent of Delegates to the Association from the Northeast, 18UU-1860 . 163 9. Professional Men Who Abandoned Their Practices within Ten Years 2 °3 10. Professional Men Who Left Their Professions Temporarily before Normal Retirement Age 20li 11. Professional Men Who Failed to Establish a Long-term Practice in a Single Locality 205 12. Professional Men Who Failed to Establish a Lon^-term Practice on Their First, Second, and Third Attempts .... 206 Times 13. Professional Men Who Moved Three or More Practiced Other Professions 111. Professional Men Who Had at Some Time More than One Year .... 211 15. Professional Men "Unemployed" for xi LIST OF TABLES Table 1. Availability of Medical Schools with Clinical Facilities . 32 2. Average Marriage Ages of Lawyers, Ministers, Doctors, and Alienists 66 and 3 # Years between Start of Professional Practices Marri age 67 U. Length of Service in Psychiatry 7h 5. Regional Participation in Discussion at the Association . 16U 6. Average Time Spent in Preparation for Professional Careers . 212 212 7. Lapse of Time