Pictured Above: Collier C. Harris, “For Persons of Insane and Disordered Minds: The Treatment of Mental Deficiency in Colonial Virginia,” Virginia Cavalcade, 21, no. 1 (1971): 34.
“chained to the floor with his hands tied across his breast – clothes torn off, except the shirt – his feet and elbows bruised considerably – and his countenance, grimaces, and incoherent language, truly descriptive of his unhappy condition. As he was free from fever, and his pulse not tense or preternaturally full, I deemed this is a fair case for the application of cold water…” (1).
This quote from a doctor in the early 1800's is a good representation of what it was like in the Williamsburg Eastern State Hospital. The inhumane practices of this early metal institution helped facilitate the medical innovation that we use today.
A General Overview
The Eastern State Public Hospital for persons of Insane and Disordered minds was the first public hospital to devote their time money and care to the mentally ill in America (2). The institution was once known as the “Public Hospital for Idiots, Lunatics, and Other Persons of Unsound Minds” (3). The hospital admitted its first patient on October the 12th of 1773 (4). This hospital was located in Williamsburg Virginia (5). The facility had been originally built with twenty-four cells along with a small apartment for the live-in keeper to stay in (6). The patients rooms or cells were only eleven feet and nine inches by ten feet and nine inches in size (7). Looking back on the start of this hospital, one can see that it changed a lot in its medical practices, size, and appearance as it grew throughout time. This hospital set the ground work for treating mentally unstable people all around the country. Between the 1800-1860’s in the antebellum period of America, there was many important transitions and advances in psychiatry that can be seen through the growth of public asylums around the country (8). During this time, early psychiatrists in the United States demonstrated the prevalence of mental health, giving insanity a coherent definition, and garnering respect for the mental health field (9). These medical advances could not have been possible without the start of The Eastern State Hospital.
Pictured Above: Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 12.
The Opening of the Asylum
Francis Fauquier was a royal governor who was the first to propose having a public hospital for the mentally ill in 1766 (10). He proposed this idea to the Virginia House of Burgess in 1766 and again in 1767 (11) pushing them on multiple occasions saying the hospital would insure “the ease and comfort of the whole community… and preform acts of charity to the unhappy objects” (12). Around this time period, people had conflicting ideas on mental health. Some believed that being mentally ill was in fact a curable disease, were others believed that these people were just sinners. Yet, everyone seemed to agree on the fact that it was dangerous to have individuals like this wandering about at their own free will (13) so the House finally agreed on the hospital and laid down the groundwork for the Eastern State Public Hospital of Williamsburg to be opened (14). When it first opened its doors, it was quite small. The hospital was staffed with a keeper or a superintendent, a matron for female patients, slaves to work as servants, and a physician who would visit the hospital (15). A man by the name of James Galt was the first in keeper who had the responsibility of running the establishment (16). His wife, Mary Galt, was the matron and the first physician went by the name Jon de Sequerya. The hospital did keep on growing. By 1833 the hospital had four main buildings and housed 55 patients (17). There were changes in staff around this time period as well. After Sequerya died, three new doctors, one being the son of James Galt, came to the establishment.
Picture on Left: Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 12.
Picture on Right: Ibid., 2.
Established Rules
The administration of the hospital was given two important rules by the government to follow when first opening the facility. The first was that the hospital was not allowed to accept any person into the hospital who was considered “un-curable” (18). The establishment was trying to only “intervene when a crisis existed and provide-short term care” (19) and for this reason, they were not originally established to help long term patients. The second was, if a friend of a mentally ill patient offered to take care of them, the hospital must allow the patient to be released into their care. (20) Another important policy that was put into place in the beginning was the rules on the admissions to the hospital. A magistrate would bring a concern for a mentally unstable person to the sheriff or constable in order to have that man or woman be brought before three local justices (21). If a majority of the justices rule this person to be insane, he or she would be sent to the Williamsburg hospital (22). This set precedence or the procedures that are still in place to this day in the state of Virginia. Although they are more elaborate, the same general rules apply today through Virginian’s ECO policy (23).
How did they Diagnose?
The physicians of this time typically broke down the diagnosis of an insane person into two categories, Mania or Melancholia. Mania was considered “a condition indicated by violet restless and frenzied behaviors” (24). Melancholia was considered “a disposition in which the person tended to be inordinately depressed, listless, and grief stricken” (25). Physicians assumed that with either diagnosis, the patients had a physical disease that causes lesions on the brain making them insane (26).
Common Treatments
Lord Dunmore believed that “perhaps no country in the British Dominions treated its insane with more humanity then Virginia” (27) but when looking back on the common treatments it seems absurd. It was not uncommon for the physicians of this time to use “treatments” that seem inhumane in today’s society but back in this time were believed to be just the opposite and in fact helping them. For example, doctors would submerge patients in cold water for extended periods of time to try and intimidate them (28). They believed this “re-focused” the patients. Another common practice would be to blister and bled patients. The doctors of this time believed that this drained the patient’s system of the toxins and harmful liquids that were in their bodies (29). Doctors put restraints, strait jackets or manacles on their patients some which were created by the local Williamsburg Blacksmith who could only take them off when necessary (30). The main idea behind all the treatments was to have the patient reconsider their behaviors in order for them to try and restore their body back to a normal state. These practices were not only found in the Williamsburg Hospital but in fact were also found in other countries hospitals and in the other American hospitals, once there were more established. In the Spring of 1828 South Carolina Lunatic Asylum opened its doors (31). This was around the same time period when other parts of America were beginning to realize the importance of these institutions and when citizens started realizing that people actually could have an uncontrollable mental disorder. The South Carolina Asylum utilized many of the same treatment tactics as the Williamsburg institution, including drugging the patients and causing them to bleed (32).
Pictured Above: Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 16.
Pictured on Left: Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 13.
Pictured on Right: Ibid., 13.
Effects of the Hospital
In 1835 the Virginia House of Delegates had a committee to come and review the hospital (33). They found that the hospital was being run too much like a prison. Therefore, the public hospital started to make changes in the way the hospital was run. For example, patients were now able to work in a vegetable garden and eat at a dinner table all together (34). John Galt II believed that “life inside the asylum should be as sane, orderly, and pleasant as possible with comfortable beds, furniture, and pictures on the walls” (35). The transformation of this hospital helped the place have more of a sense of hope than doom. The changes made to the Williamsburg hospital helped advance the mental institutions around the country to become more humane and ultimately effecting positively the psychiatric wards we have today. The hospital did have some set backs along the journey to today though. The Eastern State Hospital effected some of the staff in a negative way. For example, Dr. John Galt II committed suicide in 1862 due to depression leaving 300 patients without medical supervision (36). It may have been too much for some of the early doctors to handle because all of the medical procedures practiced were new and they were only discovering what it means to have mental health issues. Later that same month in which Dr. Galt II committed suicide, union troops during the civil war captured the asylum and in the following few years the hospital suffered in different ways including when the original hospital building was burnt to the ground on the night of Jun 7th, 1885 (37). Through all of these negative and discouraging circumstances the hospital still kept growing in many aspects. This asylum marks the beginning of psychology in America. The trials and errors of the Eastern State Public Hospital of Williamsburg greatly aided the advancement of the mental health services we offer today, serving as an integral component of the history of psychological practices utilized in the mental health field.
Footnotes
1- Norman Dain, Concepts of Insanity in the United States (Rutgers University Press, 1964), 24.
2- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 1.
3- George Tucker, "Williamsburg Once Known for Its Mental Hospital," Virginian - Pilot, Sep 26, 1999, B3.
4- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 1.
5- Ibid., 1.
6- Ibid., 1.
7- Granville L. Joness, “The History of the Founding of the Eastern State Hospital of Virginia,” The American Journal of Psychiatry, 110, no. 9 (1954): 647.
8- JE Moran, “Asylum in the Community: Managing the Insane in Antebellum America,” History of Psychiatry 9, no. 34 (1998) 218.
9- Norman Dain, Concepts of Insanity in the United States (Rutgers University Press, 1964), 204.
10- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 2.
11- Granville L. Joness, “The History of the Founding of the Eastern State Hospital of Virginia,” The American Journal of Psychiatry, 110, no. 9 (1954): 644.
12- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 8.
13- Collier C. Harris, “For Persons of Insane and Disordered Minds: The Treatment of Mental Deficiency in Colonial Virginia,” Virginia Cavalcade, 21, no. 1 (1971): 38.
14- Ibid., 38.
15- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 9.
16- Ibid., 9.
17- Ibid., 21.
18- Ibid., 10.
19- Ibid., 11
20- Ibid., 11.
21- Ibid., 10.
22- Ibid., 10.
23- "State Emergency Medical Services Advisory Board." Virginia Decoded. Accessed April 24, 2017. https://vacode.org/32.1-111.4:1/?q= Emergency Custody Order.
24- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 13.
25- Ibid., 13.
26- Ibid., 14.
27- Collier C. Harris, “For Persons of Insane and Disordered Minds: The Treatment of Mental Deficiency in Colonial Virginia,” Virginia Cavalcade, 21, no. 1 (1971): 38.
28- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 14.
29- Ibid., 15.
30- Ibid., 15.
31- Peter McCandless, Moonlight, Magnolias, and Madness: Insanity in South Carolina from the Colonial Period to the Progressive Era (University of North Carolina Press: 1996), 63.
32- Ibid., 186.
33- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 25.
34- Ibid., 27.
35- Ibid., 34.
36- "Additional from the North," The Daily Dispatch (1852-1865), Nov 06, 1863, 1.
37- Shomer S. Zwelling, Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. (Williamsburg, VA: The Colonial Williamsburg Foundation, 1985), 59.
Bibliography
"Additional from the North." The Daily Dispatch (1852-1865), Nov 06, 1863, 1.
Dain, Norman. Concepts of Insanity in the United States. Rutgers University Press, 1964.
Gay, Peter. The Enlightenment: A Comprehensive Anthology. New York: Simon and Schuster Inc., 1973.
Harris, Collier C. “For Persons of Insane and Disordered Minds: The Treatment of Mental Deficiency in Colonial Virginia.” Virginia Cavalcade, 21, no. 1 (1971): 34-41.
"Independence Day." The New York Herald (1840-1865), Jul 07, 1855, 2.
Jones, Granville L. “The History of the Founding of the Eastern State Hospital of Virginia.” The American Journal of Psychiatry, 110, no. 9 (1954): 644-650.
McCandless, Peter. Moonlight, Magnolias, and Madness: Insanity in South Carolina from the Colonial Period to the Progressive Era. University of North Carolina Press: 1996.
Moran, JE. “Asylum in the Community: Managing the Insane in Antebellum America.” History of Psychiatry 9, no. 34 (1998) 217-40.
"State Emergency Medical Services Advisory Board." Virginia Decoded. Accessed April 24, 2017. https://vacode.org/32.1-111.4:1/?q= Emergency Custody Order.
Tucker, George. "Williamsburg Once Known for Its Mental Hospital." Virginian - Pilot, Sep 26, 1999, B3.
Zwelling, Shomer S. Quest for a Cure: The Public Hospital in Williamsburg, 1773-1883. Williamsburg, VA: The Colonial Williamsburg Foundation, 1985.