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Nothing makes you feel more like potted meat than a good ol’ mental hospital.  I visited the Indiana Medical History Museum last week on the outskirts of Indianapolis, the grounds and history of the former — and notorious — Central State Hospital asylum.  The museum holds all the relics and settings of a restored, turn-of-the-century pathology department at a teaching facility on the grounds of the asylum.

The pathology department was remarkably efficient.  The corpse refrigerator, for example, is next to the autopsy room and the auditorium, where students could watch the bodies being dissected.  A small brick morgue was situated immediately next to the autopsy room, and above the autopsy room was the records room with its custom-build ledger table. 

The records room pictured above, where all notes were made about the autopsy, has a 19th-century intercom on the wall.  The pipe ran down to the room below and amplified the conversation taking place in the autopsy room about the bodies, so the doctor could transcribe the discoveries being made on the table.  (The beige machine in the autopsy room is a child’s iron lung from several decades later.) Up to 40% of the patients in the early 20th century suffered from syphilis, so several areas of the ledger allowed for notes on that disease.

Another notable feature of the records room is the garden that’s barely visible outside the window, surrounding the old morgue building.

The garden is interesting, not only because it was installed in 2003 and maintained by Marion County Master Gardeners, but because it raises some questions about how we think nostalgically about old treatments.

The grounds of the facility are expansive, and they used to house massive dormitories for male and female patients that were built in a staggered fashion called a Kirkbride plan to allow as much light as possible in the rooms.  Fresh air and light were considered a radical way of treating the mentally ill, and they were encouraged to be outside on the grounds as much as possible.

Unfortunately, this did not mean patients were allowed to roam in a medicinal herb garden, or even in the beautiful manicured gardens that once graced the facility. No, they were there to work.  As part of a regime of “moral therapy” that asserted that the middle-class value of hard work and industry would realign skewed minds, the more sentient patients were made to cultivate the land and work in the facilities of the asylum, including a cannery that produced an astonishing amount of food.  The Indiana Public Records Commission has a short essay on this common treatment at the Central State Hospital, including a picture of the canning facility:

To prove their commitment to the new middle class values, CSH physicians attempted to engender in their patients a certain discipline and value system that fostered an industrial work ethic. Healthier patients were required, not encouraged, to follow strict work schedules, that included producing garment piece work and other products that could be sold to outside factories. In the early twentieth century, CSH instituted an “occupational therapy” program that entailed patients working with hand/foot operated machines to create products for no compensation. A few decades later, CSH built a cannery for patients, indicating that the hospital’s full integration into the industrial world had been achieved. Importantly, the work therapy program served another equally imperative function: it provided additional moneys to supplement unreliable state funding that ebbed and flowed with the changing political tides.

Regulated work, however, was not enough. A “well-regulated” diet, a highly “regimented” morning and evening schedule, the reading of wholesome books from the hospital’s “selected library”, and the partaking in “mild and innocent amusements” were sure cures for mental illness and a sure way of inculcating white middle-class mores. In retrospect, the living conditions at CSH may seem overly oppressive and the motives of the physicians questionable, but this highly structured environment did offer solace to many patients, particularly in a period when few other cures existed.

In some respects, patients and medicinal plants were alike.  Both were judged by their visible characteristics according to old theories of medical science.  Plants were tested by the Doctrine of Signatures, a concept from the 17th century that asserted one could “read” a plant by its characteristics, shape, and color to determine how it might be used to heal someone.  Spotted leaves, for example, could indicate a plant could heal a rash or hives on the body. (Click on the thumbnails below to see how some of the individual plants in the Medicinal Healing Garden were read.)

But where this sounds almost charming with plants, its extensions into human science weren’t so terrific. This diagram from the museum’s photo stream shows how 19th-century doctors used the quack science of phrenology — reading someone’s skull for imperfections that indicated mental illness — to diagnose patients.

A picture of good health!  Must be all that wholesome canned food.  Or maybe not.  Unfortunately, phrenology was used to determine all kinds of race- and gender-biased “degeneracies” that ignored social factors and all kinds of contributing factors.

Ultimately, the CSH was a bit too focused on cool new science and not enough on adequate staffing and maintenance of its facilities, so it had become notorious for patient abuse and vermin-ridden kitchens by the 1920s, when it housed up to 3,000 patients.  It’s not a coincidence that the pathology building survived intact and the rest of the hospital buildings on the 100-acre plot fell into decline and were razed.  We still have hundreds of patients’ brains pickled in jars available for viewing in the pathology lab. I’ll spare you the pictures, but the vintage canning equipment is divine.

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