Enduring Institutions and the Lingering Stench of Corruption

Enduring Institutions and the Lingering Stench of Corruption

Written for DSAB 620

Reaction Paper 3

Keith Murfee-DeConcini

Insane asylums after 1850 became much more custodial in their nature of operation and that’s when the real trouble began. Curing patients was no longer the aim. The new aim was containment. Because of the new focus, overcrowding was a persistent issue, as the final chapter in The Discovery of the Asylum (Chapter 11, The Enduring Institution) alludes to. “The Worcester state hospital, for example, had a total of 285 rooms for sleeping, feeding and employing about 250 inmates. Between 1845 and i860 as many as 532 and never less than 301 patients filled them Conditions were little better elsewhere. In 1871, the New Jersey asylum at Trenton squeezed 700 inmates into buildings intended to hold 500.”  

It was problems like these that led disenchanted superintendent Pliny Earle in the 1870s to publish an article entitled “The Curability of Insanity,’’ which he turned into a book nearly ten years later. In the article, Earle tore down the asylums’ claim to fame: their success rates. By “...a careful attention to the mechanics of record-keeping, Earle disclosed that the antebellum figures on the number of cures were grossly exaggerated. The annual reports had estimated percentages of recoveries not on the basis of patients admitted but on those discharged; they had counted the same patient as cured many times over, with each release after a relapse put down as another recovery.”  

Earle also took aim at contemporary asylums, stating that he believed that, “The institutions of the 1830’s and 1840’s had offered patients better care with a greater likelihood of recovery than existing ones.” He blamed the rise of chronic cases in the asylums in part because of the downgrade in care. Earle also claimed that insanity “as a whole, is really becoming more and more an incurable disease. . . . All estimates based upon the assumption that either seventy-five, or seventy, or sixty, or even fifty percent of the persons attacked with insanity can ... be cured and returned to the class of permanent producers . . . are necessarily false, and consequently both ‘a delusion and a snare.’ ”

Even with these concerns raised by superintendents like Pliny Earle, or the fundamental objections of neurologists like William Hammond, nothing was done to shutter the asylums. What ended up happening was that eventually the asylums took over the purpose of the local almshouses and jails, because, “The population of the poorhouse itself became compelling evidence of the need for institutionalization. Its corridors were filled with first- and second-generation immigrants along with the broken, aged, diseased, crippled, and dissolute. In northeastern states especially, ‘immigrant’ and ‘poor’ became synonymous terms...The poor took their place alongside the criminal, the insane, and the delinquent, as fit subjects for a custodial operation.”   

            What came alongside the later asylums was another institution known as The School for the Feebleminded (i.e. people with intellectual disabilities). These schools sprang up around the country and their aim was noble, at least in the beginning. From what we have learned in the Discovery of the Asylum, it did not take long for the asylums’ to veer off course from their original goal either. While it did take slightly longer for the Schools to veer off course, eventually they followed the way of the asylum.

In his book, “Inventing the Feeble Mind: A History of Intellectual Disability in the United States,” author James W. Treat weaves together the history of the various state schools created with the purpose of educating those deemed by society to be intellectually disabled. To borrow from his introduction: “Intellectual disability is a construction whose changing meaning is shaped both by individuals who initiate and administer policies, programs, and practices and by the social context to which these individuals are responding.”

Let’s look at how that term has evolved, for the construction of the term has been viewed in a variety of different forms: “Since it emerged as a social problem in the second quarter of the nineteenth century, educators, social reformers, physicians, psychologists, sociologists, and social workers have viewed intellectual disability in diverse ways: as a disorder of the senses, a moral flaw, a medical disease, a mental deficiency, a menace to the social fabric, mental retardation, and finally a disability.”

Before, during and after the 1870s, the Feebleminded and the like were viewed as a burden to society. Superintendents of the mental wards and the schools, “believed that phenotypical damage caused by alcoholism in one generation could be passed on; a disabled child was the result of the poor ‘genetic environment’ of the parent compounded by the poor home environment into which the child was born.” They had studies to back this up (see Dugdale’s The Jukes, 1877). Their conclusions stated that, “degeneracy among generations could take on markedly different forms—a drunk in one generation, a prostitute in another, and an idiot in yet another.” Although “Disability itself was not easily predicted across generations,” they found that “intergenerational patterns were more predictable than previously thought.”

We have seen where the state schools for the Feebleminded eventually went off the rails like the asylums before them. We need no clearer examples than Willowbrook and Pennhurst. Are we really past them as much as we think we are? In the concluding pages of The Discovery of the Asylum, David Rothman thinks we are: “In fact, since the Progressive era, we have been gradually escaping from institutional responses, and one can foresee the period when incarceration will be used still more rarely than it is today. In this sense the story of the origins of the asylum is liberating. We need not remain trapped in inherited answers. An awareness of the causes and implications of past choices should encourage us to a greater experimentation with our own solutions.”

Have we really learned that much from the past of almshouses, poorhouses, asylums and state-run schools for the Feebleminded, to successfully fend off a reemergence of the horrors done to those deemed different enough from the norm by society, to warrant those horrors? As with the Eugenics movement, whose aim was the “betterment” of human society, we must remember that heinous acts can start from seemingly “good intentions.”

  

References:

Dugdale, Richard Louis. 1887. "The Jukes": A Study in Crime, Pauperism, Disease and Heredity; Also Further Studies of Criminals by Richard Louis Dugdale. New York: G.P. Putnam's Sons

Earle, Pliny.1887.  The Curability of Insanity by Pliny Earle. Philadelphia: J.B. Lippincott Company

Rothman, David J. 1990. “The Enduring Institution." Chap. 11 in The Discovery of the Asylum (Revised Edition), by David J. Rothman, 265-295. New Brunswick: Aldine Transaction.

Trent, James W. 2017 “Introduction.” In Inventing the Feeble Mind: A History of Intellectual Disability in the United States, by James W. Trent, xvii. New York: Oxford University Press

Trent, James W. 2017 “The Burden of the Feebleminded” Chap 3 in Inventing the Feeble Mind: A History of Intellectual Disability in the United States, by James W. Trent, 55-92. New York: Oxford University Press