The Drs Cox and Fishponds

In a recent post, I talked about ‘rotational therapy,’ a.k.a. ‘spinning,’ and quoted one Joseph Mason Cox, M.D. (1763-1818) as a proponent of this (long since discredited) treatment.

Dr. Cox was an English physician whose entire professional career was devoted to the evaluation and treatment of the insane (at a time when the mentally ill were largely marginalized and forgotten in Western medicine).

Originally from Bristol, he first apprenticed to a local surgeon-apothecary, and then went to further his studies in London, Edinburgh, Paris, and Leiden, receiving his medical degree from the latter in 1787. Interestingly, his thesis was psychiatric in nature, and was entitled Dissertatio Medica Inauguralis Quaedam de Mania, or An Inaugural Dissertation on One Type of Frenzy.

Though his use of spinning seems odd from our 21st century perspective, Dr. Cox was progressive in his treatment of the mentally ill for his day, stressing the respectful and humane management of patients above all else.

[sidebar: as early as 1810, individuals were misusing Cox’s rotational therapy devices for mere amusement – “the idiots belonging to the [asylum] have used it sometimes when permitted as a mode of amusement, without any inconvenience or effect whatever, [as have] others … with equal satisfaction. [All of them] … [are un]able to resist its most gentle rotation for five minutes in continuance” (Halloran). The legacy of these spinning machines can be found in amusement parks and carnivals throughout the world to this day.]

Anyway, a Dr. Mason had founded, in 1738, a private insane asylum just outside Bristol, called Fishponds, which was also then widely known as ‘Mason’s Madhouse.’ Dr Cox’s maternal grandfather, also a physician, had become the owner of Fishponds in the 1760s, and our Dr. Cox became owner and operator upon his grandfather’s death and his own return to the Bristol area in 1788.

Today, hospitals are carefully regulated and must adhere to certain standards of professional conduct, whether they are public or private. Not so in the 18th century; families could wholly own and operate their own lunatic sanatoriums in any manner they chose without the least degree of oversight. In 1804, Dr. Cox wrote a psychiatric treatise in which he described treating patients from the perspective of “a madhouse keeper” – his own descriptive term. And while extant records suggest that Dr. Cox’s tenure as madhouse keeper at Fishponds was successful, as the facility was said to be highly regarded during his administration, that wouldn’t always prove to be the case. In 1818, Dr. Cox died and the asylum passed to other owners outside the family. And by the mid-19th century, problems indeed had arisen, even though by then rudimentary government licensure requirements were in place.

The local paper, The Spectator, carried the following article under the byline The Fishponds Lunatic Case, on 6 January 1849:

“Some case occurs every now and then to remind us of the slow progress made in reforming the laws of lunacy. The Fishponds Lunatic Asylum … has been a hereditary possession [most recently of the Bompas family]. At the last quarter-session, [Dr. Bompas] applied for a renewal of his license [to run the asylum] but certain charges having been [levied] against the management… and the following facts, among others, were alleged under oath. A patient met with an accident by which two of his ribs were broken, and his case was neglected for two days, during which time the fracture escaped notice; when the accident happened he was drunk. Another patient was locked up in a cell without light or food, chair or table; he was kept in chains for some weeks. The visitors found one patient fastened in a “coercion chair,” and he was cleaned [only] three times a week. Another was found with a piece of blanket [tied] around his shoulders and one around his legs.

The [Fishponds] Asylum is divided into three departments – “the gentlemen’s department,” “the middle-class department,” and “the sick and noisy department.” In the two latter there is no provision for [even] hot water. Although falling far short in the degree of horror, these disclosures bear a painful resemblance to those made before the Parliamentary Committee of 1816, and, according to the Chairman, circumstances which have transpired prove that great negligence [still] exists in other asylums of Gloucestershire.

Pending the inquiry, Dr. Bompas withdrew his application for a license; but it was granted [instead] to Mr. Nathaniel Smith, who is related to the doctor. The Duke of Beaufort tried to extract from Mr. Smith a pledge that he should attend the Asylum daily, but Mr. Smith declined to give it.

From the proceedings of the session we draw these inferences – that although the art of treating lunatics has been thoroughly reformed, the old abuses still exist in licensed asylums; that licenses are deliberately renewed [despite] that no sufficient pledge is given for the prevention of the abuses; that a power exists to enforce the law, but is not exercised, although the object of law is to protect that class which is in every community the most helpless and most pitiable; finally, that the Magistrates, softened perhaps by indulgence for “vested interests,” flinch from their duty of protecting [the most vulnerable].”

Indeed this is a cautionary tale for those who would lessen, not bolster, governmental and professional oversight of healthcare facilities nationwide to this day.

[Post-Script: Fishponds remained a functioning asylum well into the 20th century. In 1911, one Elias Leach had his wife Eloise committed to Fishponds due to what now appears to have been a serious and unremitting post-partum depression. Their son Archie, later to be known universally as the actor Cary Grant, was told that his mother had gone on an extended vacation and then had died, and Grant didn’t know what had really happened to her until he inadvertently discovered her, still at Fishponds, in the early 1930s.]

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Rotational Therapy

“I have the pleasure of knowing that [my patient] continues well, and I am confident [that he] owes his life and reason to the swing.”
~Joseph Mason Cox, M.D. (1763-1818)

Ever watch youngsters spin themselves around in a circle to induce vertigo? What is the first thing that the kids do? I mean AFTER falling down? That’s right… they usually burst into laughter. Anyone who has had children will recognize this phenomenon and realize that it’s pretty universal.

Erasmus Darwin (1731-1802) had noted this sort of behaviour also. Though not as famous as Charles, his arguably better-known and -regarded grandson, Erasmus Darwin was a physician, philosopher, scientist, and minor celebrity in 18th century Staffordshire, England, but for less-auspicious reasons; despite having once been offered the position of personal physician to George III, he wasn’t particularly adept at any of his vocations.

He documented many of his disorganized and far-fetched ideas in bad verse. Here’s a sample prelude from one bloviation on the origins of life:

“By immutable immortal laws,
impress’d in nature by the great first cause…
say, Muse! How rose from elemental strife
organic forms, and kindled into life?”

This might be one reason his proposals weren’t always taken too seriously – being flaky could have been another.

Anyway, Darwin believed that spinning a person around not only induced slumber (?), but also laughter, and that this soporific/ mirthful combination was a great way to resolve mental illnesses and whatever else might ail you. The treatment was performed in one of two ways:

1. an ordinary chair, suspended from the ceiling by a swivel, was spun by hand, or
2. a pole with a horizontal metal arm was installed from floor to ceiling, and from the arm was suspended a chair that was spun around the pole.

rotating device (courtesy National Library of Medicine)

rotating device (courtesy National Library of Medicine)

The treatment was to be continued until the patient improved, or else promised to obey the doctor’s orders and get better, at which time he would be released from the spinning device and allowed to go back to his room and get some sleep. Contemporary sources noted that side effects of this protocol included anxiety and fear; nausea and vomiting; an ashen complexion; vertigo; sedation; and sudden bowel movements.

This would have gone nowhere except for the equally surprising fact that no less a personage than Benjamin Rush, M.D., signer of the Declaration of Independence and the man considered the Father of American Psychiatry, believed there might be some merit to the approach. Rush opined in his letters that spinning reduced brain congestion (?) and was thus therapeutic.

In actuality, all that Darwin and Rush produced were mentally ill patients who were then dizzy.

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Cabinets of Curiosities

“I like to tell people that I have the heart of a small boy, but then I add that it’s in a jar on my desk” ~Stephen King

I wasn’t kidding when I said in my online introduction that this blog would be “the attic of [my] psyche.” While I try to focus on items of a historical nature as they pertain to medicine in general, and psychiatry in particular, there are just too many interesting things ‘out there’ to thematically restrict my posts entirely.

But that’s not necessarily a sign of an attention-deficit spectrum disorder. As a matter of fact, there is a long and storied history of just such collecting (be it of objects or ideas), and before I go further with my blog, I think I should share this background with the readership.

a 17th century cabinet (courtesy of British Museum)

a 17th century cabinet (courtesy of British Museum)

The wunderkammer (“wonder-room”) was a phenomenon which arose in the courts and parlors of Europe in the early days of the Renaissance. It was an attempt (by those who had the means) to display the erudition and wealth of the owner. These encyclopedic amalgamations could be as small as those contained in a large chest of drawers (what would later evolve into modern day curio cabinets in which grandma keeps her tchotchkes). They could also be as vast as those contained in whole wings of a palace or mansion. In time, their German moniker gave way to an English term: the cabinet of curiosities (the original use of the word “cabinet” describing a room rather than a piece of furniture).

So what exactly was contained in a cabinet of curiosities? Well, just about everything and anything; it was a juxtaposition of widely disparate objects, their only unifying feature being their rarity or ability to fascinate. Such cabinets tended to focus on natural history (sometimes faked; e.g., unicorn horns, mermaid remains, dragon eggs, and phoenix tail feathers). They also stressed geology, ethnography from distant and mysterious lands, archaeology, religious or historical relics (more fakery; e.g., pieces of the True Cross and Ark of the Covenant), works of fine art, clockwork automata, and miscellaneous antiquities.

In short, they were microcosms of the known and unknown worlds, and many of the better ones formed the nuclei of present day museums – the British Museum’s ‘Enlightenment Gallery,’ the Ashmolean and Pitt Rivers Museums at Oxford, and Vienna’s Museum of Ethnology all started out this way. The concept of the cabinet of curiosities also gave rise to later 19th century hucksterism in the form of P.T. Barnum’s freak shows, and in the present, to the nationwide grotesqueries of Ripley’s Believe it or Not, and the tongue-in-cheek displays of the Museum of Jurassic Technology in Los Angeles.

Although referenced in texts far earlier, the first wunderkammer appeared in illustration in 1599, in Naples; the engraving shows a room fitted out like a studiolo, with built-in cabinets, the front panels of which could be unlocked and lowered to reveal intricate pigeonholes for display. In this 16th century print, identifiable mounted birds and reptiles, along with other strange and curious animals of uncertain provenance, are also seen suspended from the ceiling.

Both the wealthy and the learned fell under the spell of competing with each other for the best assortments of curios. Ferdinand II of Austria had a vast wunderkammer. Charles I of Great Britain also had one. The Holy Roman Emperor Rudolf II created such a space in his castle to which he retired to contemplate life when weary of the affairs of state. Others with notable collections included Gustavus Adolphus of Sweden, Sir Hans Sloane, both Augustus the Strong and Christian I of Saxony, Francesco I de Medici of Tuscany, Frederick III of Denmark, Tsar Peter the Great, Sir John Tradescant (said to possess Chief Powhatan’s deerskin mantle), the Hapsburg Dynasty (said to possess Montezuma’s headdress) … the list goes on and on.

During the Enlightenment, traveling to see these wondrous collections became the rage, so much that guide books and catalogs were published – Musaeum Tradescantianum (1656) by Ashmole, Museum Museorum (1714) by Valentini, and Schuyl’s catalog of 1727 all come to mind.

Schuyl's catalog of 1727 (courtesy of Univ of Leiden)

Schuyl’s catalog of 1727 (courtesy of Univ of Leiden)

And in a modern analogy to our era’s bloggers, both Ole Worm and Athanasius Kircher used their personal collections as starting points for published speculations on philosophy, science, and natural history. Just think what Worm and Kircher could have accomplished with the Internet!

The collecting bug finally crossed the Atlantic. Dr Thomas Mutter, a prominent surgeon in Philadelphia, gathered medical oddities and related items from his own practice and those sent to him by colleagues. When he died in 1859, he willed his collection to the American College of Surgeons; with additions gathered in the subsequent years – including Benjamin Rush’s medical chest, Florence Nightingale’s sewing kit, an early 19th century saponified corpse known as the ‘soap lady,’ the conjoined liver of Siamese Twins Chang and Eng Bunker, and President Cleveland’s resected mandibular adenocarcinoma – these holdings became today’s Mutter Museum.

Add’n, there was the Hobby Club in New York City. In 1908, it was formed as a rival to the cross-town, tangentially related, and better known Explorers’ Club. The Hobby Club was a lavish dining fraternity limited to 50 men of education and means, and was basically an opportunity for grown-up ‘show and tell.’ Selected items from each of the members’ cabinets would be brought to dinner meetings to share with the other attendees. According to its constitution, “the object of [the club] shall be to encourage the collection of literary, artistic and scientific works; to aid in the development of literary, artistic and scientific matters; to promote social and literary intercourse among its members and the discussion and consideration of various literary and economic subjects.” While the transcripts of a number of the group’s meetings from the years prior to WWI are extant, the club appears to have withered and died by the 1920s.

But NOT the desire to collect and explore.

With that background in mind, let the show begin…

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Urban Exploration

The Alienist has rec’d much inquiry re: the photo of the forsaken building that graces the header of both my Facebook page and my blog. I once thought that I was a bit odd because I’ve always been drawn to deserted and abandoned places. It seems, however, that there are others ‘out there’ like me.

As a sign that a level of respectability has been attained, in numbers if not actual pursuit, there’s a Wikipedia page explaining the hobby of Urban Exploration (UE):

Apparently, empty asylums and sanatoriums are high on the target-list of those who engage in UE. Right up my alley.

The photographer who captured the haunting image of Severalls Asylum in Colchester which I use on both of my pages goes by the nom-de-guerre ‘Nelly Urbex.’ He has produced many fascinating images of other forlorn sites, plus additional shots taken at Severalls, including at least one of the morgue. His work is excellent and well worth a look, and can be found here, along with interesting related links:

And then, from my friend and colleague Caitlin Doughty, bloggist extraordinaire at the Order of the Good Death, came this link, just today; though no mental hospitals made the list (North Brother Island is the site of a former smallpox sanitarium), it illustrates what the author calls the thirty-three most amazing deserted places in the world:


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Dr Bridges’ Phrenology Inkwell Tchotchke

Back in the day, before the morality police decided that it is bad form for physicians to consort with pharmaceutical reps, it was common practice to give practitioners small knickknacks and doodads emblazoned with the name of a drug company or product. I still see no harm in this – I’ve not yet prescribed an Rx because the pen I was holding at the time magically forced me to write a script for the same drug that was advertised on the side – but at least for those of us in the public sector, receipt of such tokens has gone the way of the Dodo.

Regardless, I thought that this sort of marketing ploy was a relatively recent invention of Madison Avenue. Apparently I was wrong.

Phrenology was a pseudoscience popularized by Viennese-trained Franz Gall in the early 19th century (about which and whom I will write more in future posts). The discipline held that facets of an individual’s psyche, behavior, and intelligence could be discerned by examining the size, bumps, dents, and general contours of that person’s skull. Long since discredited due to lack of evidence-base and subsequent misuse by racists, phrenology was all the rage in Europe until the middle 1800s, and in America even longer than that.

Apparently different flavors of phrenology evolved from Gall’s original theories. After having lost some of its luster by 1860, phrenology regained popularity in Britain by way of the new version then being espoused by the American Fowler brothers – Orson and Lorenzo. They left their lecture circuit base in New England to travel all across the United Kingdom in the late 1860s and 1870s. Men cut from the cloth of P.T. Barnum who played to the epistemological journal clubs and pretentious middle class phrenological societies that arose in their wake, they gave (paid) lectures and demonstrations to the curious public, and made a killing in the process. Lorenzo’s commercial bent is best remembered today by the porcelain phrenology busts that he designed and marketed, his name proudly embellishing the base of each; lucky collectors can still find originals of these in pricey antique shops.

The Fowlers were the most famous of the day, but there were others. One William Bally created and marketed boxed sets of small phrenological heads, each labeled with classifications such as ‘scientist,’ ‘idiot,’ and ‘criminal.’ And not to be outdone, especially on home turf, Frederick Bridges, a then-renowned English phrenologist and author of Phrenology Made Practical, attempted to counter the commercial success of the Fowlers’ phrenology busts with his own version, made smaller and in the shape of an inkwell.

Bridges Inkwell (courtesy The Alienist)

Bridges Inkwell (courtesy The Alienist)

I suppose Bridges’ thought was that a diminutive and less-expensive item that could be kept on an academic’s desk and used/ observed daily (listening, Glaxo?) might be a better selling product and advertising vector.

Whether the Bally set or the Bridges inkwell made inroads on the Fowlers’ market share is unclear. Either way, by the turn of the 20th century, phrenology was all but dead, dismissed by serious clinicians and scientists alike.

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Cradle to Grave

When I was last in London, there was a thought-provoking display at the British Museum on the pharmaceutical-centered life of those in the modern Western world. I’ll let the text of the display speak for itself:

Cradle to Grave, by Pharmacopoeia

Cradle to Grave explores our approach to health in Britain today and addresses some of the ways in which people deal with sickness and try to secure well-being. It was created by Susie Freeman, a textile artist; David Critchley, a video artist; and Dr Liz Lee, a general practitioner. The two lengths of fabric illustrate the medical stories of an average man and woman in the UK. Each stretch contains over 14,000 individual pills, tablets, and capsules, the estimated number prescribed to every person in Britain in their lifetime.

Cradle to Grave (courtesy British Museum)

Cradle to Grave (courtesy British Museum)

This does not include remedies that we might buy over the counter, which would then require about 40,000 pills total for each person over a lifetime.

Some of the treatments are common to both genders: each starts at birth with an injection of vitamin K and immunizations, and both take antibiotics and painkillers at various times. Other treatments are more specific. The woman of this display took contraceptive pills and then hormone replacement therapy in middle age. The man had asthma and hay fever when young, but enjoyed good health until his fifties. He finally stopped smoking after a bad chest infection when he was seventy. He was treated for high blood pressure over the last ten years of his life, and finally had a heart attack and died of a stroke in his mid seventies. He took as many pills in the last decade of his life as he did in the first sixty-six.

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The Martyrs of Otranto, and Tincture of Cranium

On this date in 1480, Ottomans invading Otranto, Italy, conducted a mass execution of prisoners.

Landing at the southern Italian city on July 28, the Ottoman force quickly overwhelmed Otranto (the city had rashly killed the messenger come to offer a merciful capitulation, only to find that its military garrison began deserting within days.) On August 11, the Turks took the city by storm. Thousands died on that day’s bloodbath, including the Archbishop of Otranto.

Surviving women and children were sworn into slavery. Men over age 15 had the choice of conversion — or death.

“Now it is time for us to fight to save our souls for the Lord!” a Christian shoemaker is said to have exhorted his 800 fellow prisoners. “And since he died on the cross for us, it is fitting that we should die for him.”

As you wish. The Turks had 800 faithful Christian souls dispatched to their eternal reward at the place still known as the Hill of Martyrs (when in Otranto, visit it by taking via Ottocento Martiri, just off via Antonio Primaldo — that’s the name of the militant shoemaker).

This, at least, is the most pious version of this story. The mass execution certainly did occur, but some latter-day historians like Francesco Tateo have argued that martyrdom is not attested by any of the contemporaneous sources, and the specifically religious understanding of events was only read in after the fact.

On whatever grounds one likes, Italy’s fractious city-states were deeply alarmed by the appearance on their shores of the all-conquering Turks. And in the ensuing months, they rallied together vowing to expel the invaders.

Fortunately for this coalition, the Ottoman sultan Mehmed the Conqueror died in May 1481, and a brief period of internal conflict within the empire over the succession perhaps led it to allow its Otranto outpost to wither on the vine. The Turks made peace and withdrew from their potential beachhead not long after, having held the city for just over a year. The bodies of many of the martyrs were said to have been found uncorrupted by decay. Those who had skeletonized were ensconced in the cathedral.

Cathedral of Otranto relics (courtesy

Cathedral of Otranto relics (courtesy

The Catholic church beatified the 800 martyrs in 1771, but their final elevation to sainthood occurred only in 2013, just three months ago. They were in the very first group canonized by the new Pope Francis — although the canonization was approved by his predecessor Benedict XVI on the same day that Benedict resigned his pontificate.

Considering current relations between the respective faiths, it was seen as a potentially impolitic move.

“By venerating the martyrs of Otranto, we ask God to protect the many Christians who in these times, and in many parts of the world, are still victims of violence,” Pope Francis said at the canonization Mass, diplomatically not naming any of those parts of the world.

~ ~ ~ ~ ~ ~ ~ ~

Long respected as examples of steadfast piety in the face of death and beatified in 1771, these murdered souls were not actually canonized until Pope Francis did so two years ago.

But that didn’t mean that the Otranto relics weren’t put to good use long before 2013.

the Otranto skull

the Otranto skull

There is one skull in Otranto that is peculiar. Not only does it face backwards (all of the other skulls peer out at visitors), but its occiput and parietal regions manifest sixteen partially or completely drilled holes. These holes are of different circumference and depth, with only eight of them completely penetrating the cranial vault. The holes do not seem to be peri-mortem wounds, but rather occurred by use of a trephine, semi-lunar blade, or rounded drill bit long after death. Even more oddly, the visible marks, the shapes of the holes, and the types of instrument used suggest that only ground bone powder, not large fragments or chips of skull, resulted.

The reason for the holes remained a mystery until researchers at the University of Pisa announced their conclusions this week in the Journal of Ethnopharmacology. It seems that the Otranto skull in question was being used medicinally.

apothecary jar for holding bone

apothecary jar for holding bone

It was widely believed in the Middle Ages that the bones of martyrs held curative powers, esp when used for those who suffered from diseases of the head, either epilepsy or stroke with varying degrees of hemiplegia and paralysis. Medical practitioners of the day would take ground skull powder, mix it with water and wine, and have the patient drink the suspension. Physicians believed that spiritual powers from the body remained in the skull after death; ingesting remedies made from a human head allowed a patient to gain the strength of the dead person. This practice was so pervasive from the Middle Ages until the early 18th century that apothecaries in the major cities of Europe sold entire human skulls – at very high price – as ingredients for these desired therapeutic compounds.

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Snail Water

To make Snail Water, “take garden snails, cleaned and bruised [crushed], six gallons; [then] take earthworms, washed and bruised, three gallons; of common wormwood, ground ivy, and carduruus, [mix] each one pound and a half; penniroyal, juniper berries, fennelseeds, [and] aniseeds, each half a pound; cloves and cubebs, bruised, each three ounces; spirit of wine and spring water, of each eight gallons; digest them together for the space of twenty-four hours, and then draw it off in a common alembick” ~a treatment for (non-specific) venereal disease, found in the Pharmacopoeia Paupermum, 1718, and taken originally from the well-regarded recipe of Dr Thomas Meade, St Thomas’ Hospital, Southwark, London.

Some explanation: wormwood and fennel were both used in the distillation of absinthe (the latter also being employed often for treatment of dysmenorrhea); Penny Royal, though used centuries ago to flavor soups, is a highly toxic substance more often ingested by those wishing to abort (Nirvana’s track ‘Penny Royal Tea” references this); Aniseeds taste like liquorice but were employed more commonly as a paste to kill head lice; cubebs, also known as the Java Pepper, have been used to treat infertility, but also were sprinkled on and fed to the stricken by priests during exorcisms; juniper berries, of course, are most famously known for flavoring gin; and an alembick is a vessel with a beaked cap used in distilling. Luckily, though, no one will be able to try this concoction again, since I can find nowhere the meaning of carduruus. And perhaps fortunately, it is also not known if this creation were a topical or to be ingested.

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The Baths

Recently, my elderly mother was relating memories of her nursing school training in the years after WWII at Toronto’s Western Hospital, in particular those of her psychiatric rotation. While I am not an apologist for Big Pharma, it does bear appreciating just how primitive were our collective ‘therapeutic’ interventions before Rx was widely available to address the most severe symptoms of mental illness.

There was not a psychiatric ward at the Western, so students were sent elsewhere for the rotation – across town either to the Toronto Psychiatric Hospital on Surrey Place, or to the Ontario Hospital at 999 Queen Street (aka “the 999.″) In mom’s case, it was to the latter. The cornerstone of the 999, at its opening known as the “Provincial Lunatic Asylum,” had been laid on 50 acres of an abandoned military camp in August 1846, and opened for patients four years later. Expanded over the decades, the facility had gone through several insensitive name changes by the time mom arrived, “Toronto Lunatic Asylum” and “Asylum for the Insane at Toronto” being two of the more palatable.

Mom was in nursing school in the late 1940s. Keep in mind that these were the years before Thorazine and the other antipsychotic tranquilizers were available. Benzodiazepines didn’t exist either. Lithium was known at that time to have calming effects, but would not come into widespread clinical use for another twenty years. The pharmacopoeia of the period essentially consisted of bromides, barbiturates, opiates, chloral hydrate, and paraldehyde – all indiscriminate sedatives with varying degrees of concomitant toxicity and addictive potential. All for which they were good was simple zombification of the agitated.

There were even more drastic interventions available, such as insulin coma treatments, ECT, and the lobotomy.

But surely there were therapies that were less draconian and more commonly employed on a day to day basis?

There were, and Mom remembers often being the student nurse assigned to monitor those in the hydrotherapy room. If the term ‘hydrotherapy’ evokes thoughts of Hollywood starlets lounging in scented spa waters, then you probably weren’t a mid-twentieth century psychiatric patient. In vogue starting in the late 1890s, hydrotherapy was premised on the belief that the application of hot and cold water to the disturbed could quickly produce beneficial results. Symptoms as varied as chronic insomnia, suicidality, agitation, hyperactivity, mania, and thought disorganization were all treated thus.

Though cold water immersion was used in some psychiatric wards elsewhere in North America, Mom’s experiences were with hot baths. The hydrotherapy room had soft indirect lighting and was warm and humid. Patients were restrained and placed in large stainless steel tubs, over which canvas covers were stretched and through which only the patients’ heads protruded. The afflicted were left in the baths for hours, or sometimes days, with breaks only to use the bathroom on a pre-set schedule. Falling asleep was encouraged, the goal of the baths being a diminution of restlessness and fulminate psychosis.

The bath water was typically maintained from 93°F to 99°F. Since the patients were often agitated, struggling, and yelling anyway, it was important to monitor the water temperature carefully so as not to mistake a patient screaming because of burning for one screaming merely because of mental illness.

Hydrotherapy Room (courtesy LIFE magazine)

Hydrotherapy Room (courtesy LIFE magazine)

As a student nurse, mom was assigned to sit in the hydrotherapy room and four times an hour place a thermometer under each of the canvas covers and into the water to take a reading, being careful to stay away from the protruding (and often angry) heads. Temperatures were dutifully recorded, and if they were edging out of range, an actual nurse was summoned and the hot and cold flows adjusted accordingly.

I can’t imagine many teenaged students being given such vital and yet largely unsupervised duties in this day and age.

But water temperature was not the most consequential aspect of the psychiatric rotation in the eyes of a 19 year old. At the Western, meals served to those in training were congealed, cold, and hard. But at the 999, there was a cook behind the serving line who made the food to order, hot and fresh.

Baths or no baths, the students thought they had died and gone to Heaven.

I can entirely relate to this. I don’t remember much about my medical school interviews back in the 1980s, but I can still recall which admissions committees arranged for nice meals for us. I suppose that’s human nature.

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