The Miserable Life of a 19th Century Mental Patient | Human Voiced, No Ads

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[00:00:01]I don't think I need to tell you that insane asylums of yester year were not pleasant places to be. From our series in the playlists, we talked about more than a dozen notorious asylums around the world. And there's one thing that stands out, and that's the enduring misery of those poor souls confined there. From the abysmal hygiene to the frequent beatings, asylum life truly was a living nightmare.

[00:00:32]So, what we're going to do is spend some time today painting a general picture from both sides of the Atlantic, the UK and the USA, of what things were like in the 19th century, and in between that tell the stories of real people who lived through it.

[00:00:52]It's going to be as macab as it gets today, so forgive us if some of the descriptions are a little graphic.

[00:01:00]Nothing's going to be watered down.

[00:01:04]Anyway, welcome to the channel. If that didn't turn you off, I suppose we'll begin. But uh before we do, just a quick thank you to those keeping everything adree. Links to do that are in the description if you want to become a member or donate. And if you can't do that, give it a like, comment, and subscribe, and tell your friends where to find us. Anyway, enough of that.

[00:01:27]Let's begin.

[00:01:29]So, let's just set the uh scene in general. If you uh haven't watched the entire 15-hour series, we did, which I don't blame you. That's fine. Just talk about in general the uh 19th century asylum. You see, at the dawn of the 19th century, care for the mentally ill was changing somewhat as all medicine was changing. Kind of a golden age in new medical achievements, though a little bit misguided. You see, before this time, there were few dedicated hospitals for the insane. And uh that term of course is going to be used a little bit fast and loose here. Many suffering from mental illnesses were simply just locked away at home, relegated to alms houses, or even just thrown into jail cells and madouses.

[00:02:19]Conditions were often appalling in notorious mad houses like London's Bethleam Hospital, better known as Bedum, an entire story on its own.

[00:02:29]Patients in the late 18th century might be chained to the walls or kept in brutal restraints for years. And indeed an infamous case was that of James Norris. He was an American sailor confined to Bedum around 1810.

[00:02:46]He was discovered shackled by iron rings and a waist restraint to a post. And well, the worst part of it was he'd been chained to the wall for over 10 years.

[00:02:59]Such horrors once revealed spurred public outcry. Kind of hard to ignore.

[00:03:05]Only 19th century reformers argued that the mad were not wild animals to be caged and beaten, but sick human beings who could potentially be healed. Brave new ideas, I know. Influential figures on both sides of the Atlantic championed a new approach known as moral treatment.

[00:03:25]In Paris, the physician Philip Binel in the 1790s allegedly struck off the chains of the inmates at the Betra Asylum. symbolically liberating them from this medieval brutality.

[00:03:39]He and his students Jean Esol taught the patients that should be excuse me taught that patient should be treated with care and dignity not punished. Around that same time in England, the Quakers William Duke and his son Samuel Duke established the York Retreat opened in 1796.

[00:04:01]small country asylum that became an international model.

[00:04:07]The tubes, guided by their Quaker belief in the inner light of every person, banned physical abuse and chains. At the retreat, patients lived in a family-like environment, and even had gardens and workshops to occupy their minds.

[00:04:25]Samuel Tuk's 1813 book description of the retreat detailed how a peaceful environment, compassionate staff, and structured routine led many of the people to recover their reason. And that was a radical departure from the manacles and dark cells that they used to have. Inspired by such examples, the first decades of the 19th century saw a flowering of new asylums dedicated to moral treatment. In the US, Dr. Benjamin Rush, who is often called the father of American psychiatry, advocated similarly humane principles at the Pennsylvania Hospital in Philadelphia.

[00:05:06]By 1812, Rush could boast that the wards were quote, "free from the clanking of chains and the noise of the whip."

[00:05:15]Certainly an improvement.

[00:05:17]Although Rush still employed some outdated remedies. Um for example, he was found of fond of a bloodletting and invented a restraining chair for calming patients. His emphasis on treating insanity is a medical condition rather than a moral failing. That was still quite influential and of course a stepping stone to more enlightened times. Got to take it one step at a time. Soon campaigns led by activists like Dorothy Adis in the 1840s further pursued American legislatures to establish statef funed insane asylums.

[00:05:56]Now Dorothy Adis is kind of important in this story. We'll mention her again later. She visited squalid jails and alms houses where the mentally ill languished in cages or filthy pens. And in one Massachusetts report of 1843, she cataloged scenes of neglect, individuals, quote, confined in stalls, pens chained naked, beaten with rods, and lashed into obedience.

[00:06:26]Shocked into action, the states began creating large public asylums meant to rescue patients from such abuse.

[00:06:34]So by the mid-9th century, the asylum had become a central institution in both the UK and the US for handling mental illness. Britain's County Asylums Act of 1845 required each county to build an asylum for porpa patients leading to a boom.

[00:06:53]Over 60 new asylums opened in England and Wales between 1845 and 1860 alone.

[00:07:00]Similarly, the United States saw the rise of expansive state hospitals, often set in rural tranquility, according to the vision of psychiatrist Thomas Story Kirkbride.

[00:07:12]You might have heard of the Kirkbride plan. Well, these asylums were massive, ornate buildings with long staggered wings, giving patients sunlight and fresh air, surrounded by acres of fields and gardens. or looked quite nice if you didn't live there. Of course, the whole idea with this was to remove patients from the stresses of society and put them into this self-contained therapeutic community.

[00:07:42]So, on paper, everything was quite idealistic.

[00:07:47]Patients would benefit from clean air, wholesome work, regular routine, and kindly supervision.

[00:07:53]A superintendent in 1850 might proudly describe his institution as a place of refuge and rehabilitation where lunacy could be cured by science and compassion.

[00:08:06]The problem is is that reality often diverges from the ideal.

[00:08:13]This is where things go a little array.

[00:08:17]The asylum population exploded and by 1900 England's asylums held over a 100,000 patients and the US numbers were similarly swelling.

[00:08:28]Overcrowding and underfunding became chronic problems. The initial optimism that most patients could be cured through moral treatment began to fade as recovery rates stagnated.

[00:08:42]Many patients ended up living out their lives, their entire lives, that is, behind asylum walls.

[00:08:50]They just became warehouses for the chronically ill, the poor, and anyone seemed socially undesirable.

[00:08:59]Abuse and neglect which reformers thought they had vanished crept back in under the strain of overcrowded wards and weary untrained attendants.

[00:09:09]And it's within this complex context that we find our asylum patients.

[00:09:16]They lived among a mix of human intentions, rigid routine, and at times grim conditions.

[00:09:26]That's the life of a 19th century mental patient. So, let's take a look inside the general situation.

[00:09:36]So life inside an asylum was ruled by clock and bell. Inmates as they were often called, not patients, but inmates, but ought to give you a bit of an idea of uh how they were treated. They lived by a strict timetable enforced by the staff.

[00:09:54]The day was long, monotonous, regimented, intended to impose order on the minds thought to be disordered.

[00:10:01]Reconstructing a typical day requires blending various accounts, and this is kind of a blanket statement. Of course, there are exceptions, but uh keep that in mind. Nonetheless, many Victorian asylums followed a similar pattern from early morning to night, which we can trace through patient memoirs and institutional records.

[00:10:24]At first light, attendants unlocked the dormatories or single cell doors. In a large county asylum such as Liverpool Lunatic Asylum in the 1850s, bedroom doors were unlocked at 6:00 a.m. sharp.

[00:10:40]Patients were expected to rise from their beds promptly. An attendant or nurse oversaw washing and dressing. In some asylums, basic hygiene was enforced, at least until they got too crowded. Patients might line up to have their faces and hands washed. Hair was brushed or cut short.

[00:11:00]A superintendent in the 1840s advised that clean linen and neat appearance had a calming influence on the patients. So clothing was usually simple, sturdy, and uniform. In public asylums, Horer patients were often wearing institutional outfits, coarse cotton or wool dresses for women and cotton shirts for men.

[00:11:25]Well, these might be colorcoded to ward or status.

[00:11:30]For example, one English asylum issued drab brown dresses to female patients.

[00:11:36]Private patients of means, however, might be allowed to wear their own clothes or a dressing gown, but that was the exception.

[00:11:44]Well, after dressing, the morning inspection might occur. Doctors or senior nurses sometimes did early rounds briefly examining each patients condition.

[00:11:56]In Liverpool's asylum, for instance, attendants were instructed to check each patients skin for cleanliness or sores and note any changes in behavior overnight.

[00:12:07]Cleanliness was a concern because many patients suffered incontinents or neglect of hygiene.

[00:12:13]buckets or chamber pots were emptied. A pervasive smell of carbolic or lime might linger from disinfection attempts.

[00:12:22]In some accounts, patients might mention being woken early for a cold sponge bath or to have their bedding changed if it was soiled.

[00:12:31]So, you can imagine the less pleasant realities. In an overcrowded dormatory, 30 or 40 patients might share a single night staff attendant.

[00:12:42]So thorough cleanliness was hard to maintain.

[00:12:47]Some patients, especially those severely ill, wore urine soaked clothes or lay in unchanged sheets until morning staff could tend to them. More functional patients would help with the task sometimes, assisting weaker ward mates to wash and dress. A small instance of camaraderie amid the regimentation, I suppose.

[00:13:09]By 7:00 a.m., many asylums had all patients up and ready for breakfast. The first meal was usually simple and utilitarian. Accounts from English asylums describe breakfasts of porridge or grl, accompanied by bread with a smear of butter or dripping.

[00:13:28]There was typically a hot beverage, usually tea, but it' be quite weak, or coffee, sometimes cocoa.

[00:13:37]For example, in 1860s, Nottingham Asylum recorded uh that every morning patients received milk, porridge, coffee, and bread. In American institutions, cornmeal, mush, or porridge, bread, and maybe a little molasses might appear on the breakfast table.

[00:13:56]The fair was pretty bland, but at least it was filling. Designed to be economical yet stave off hunger.

[00:14:04]Protein was pretty scarce at breakfast.

[00:14:06]Eggs or bacon were luxuries seldom afforded to the rank and file patient.

[00:14:12]They ate in communal dining halls or on the ward under supervision.

[00:14:17]The atmosphere could vary. Some memoirs recall chaotic scenes of patients who were very disturbed yelling or refusing food, others sitting in a sullen and reserved silence.

[00:14:31]Table manners might be enforced in recovered wards, but in chronic wards, attendants often had to feed some patients or make sure the greedy ones didn't steal extra portions.

[00:14:42]Mary Penuly complained that the staple given to patients in her asylum was quote dark colored sour baker's bread with miserable butter every morning and evening with a bit of porridge and cheap molasses at breakfast.

[00:14:58]never heard butter been described as miserable before. I wonder what she meant by that. Well, the bread was so hard and sour that she could barely swallow it, and she noted that the oatmeal porridge upset her stomach.

[00:15:14]A few patients received a cup of thin milk porridge if they were considered delicate.

[00:15:21]Mary herself, an older woman in frail health, begged the doctor for a simple diet of biscuit and milk and beef tea, food she believed would help her regain her strength.

[00:15:34]But he refused, retorting that he didn't keep a boarding house.

[00:15:39]The message was pretty clear. Patients were going to get what they were given.

[00:15:45]Now, interestingly, asylum superintendants often doubted the adequacy of their diets in annual reports. They argued that insane asylum patients actually ate better than many poor people outside.

[00:15:59]And in fact, by the midentury, many British asylums did serve a substantial midday meal with a bit of meat in it, and allowed extra rations to those who were losing weight. But quality could be inconsistent.

[00:16:14]Nelly Bllye in her expose described rancid butter, spoiled meat broth full of fat and gristle, and a tea that tasted of dirt.

[00:16:24]Salt was withheld to bland out the food, possibly under a theory that stimulants like salt or spices could worsen lunacy, which is the most British thing I've ever heard. Don't want any flavor in the food, don't we? Well, at Blackwell's Island, patients were always hungry and thirsty. BL and others recounted how they craved clean water since even that was restricted and often unclean.

[00:16:56]Well, midday work and activities would come after this. After the morning airing and a couple of chores, the day's main occupations would begin. Victorian asylums strongly emphasized work and structured activity as a form of treatment. The sexes were strictly divided into their labors reflecting the gender norms of the era.

[00:17:19]Generally, men would work outdoors and the women would be indoors, but there were a few exceptions. For male patients, one of the most common assignments was farm and garden work.

[00:17:31]Many asylums, especially in the large rural settings, maintained extensive farms. Patients grew vegetables, raised livestock, tended orchards, both to supply the institution's kitchen, and to occupy their time usefully.

[00:17:46]In England, for example, Bucking uh excuse me, Buckinghamshire County asylum prided itself on how male inmates spent days in the fields digging, planting, harvesting, and caring for pigs and cows.

[00:17:59]Similarly, in America, institutions like the huge Udica State Hospital, excuse me, that's Udica, I've been told off about that before, or the Trans Alagany Asylum in West Virginia had working farms tilled by patient labor.

[00:18:17]One superintendent wrote, "We tried to make the institution as self-sufficient as possible, noting that able-bodied patients produce thousands of bushels of potatoes, cabbages, and other staples annually.

[00:18:31]This labor was usually unpaid, of course, but it was thought to be healthy. Physical exercise outdoors, a sense of routine, a break from brooding introspection.

[00:18:44]Well, patients might work under the direction of a steward or a farmer employed by the asylum. An expert who could tell them what to do. Some skilled patients became quasi employees.

[00:18:59]For instance, a patient who had been a tailor might be put in charge of mending clothes, or a farmer's son might drive the hay cart.

[00:19:08]Apart from farming, male patients often worked at maintenance and trades.

[00:19:14]Many asylums had workshops, carpentry shops, paint shops, shoe making or tailoring rooms. Hell, a few even had blacksmith forges.

[00:19:24]If a patient had a trade in their past life, doctors would frequently have them continue it inside.

[00:19:32]This served a practical need, you see.

[00:19:34]The asylum could use repaired furniture, freshly painted walls, handmade shoes for inmates, etc. and it was deemed therapeutic by keeping the patients mind active. At Colony Hatch Asylum in London, which by the 1880s housed over 2,000 patients, there were on-site shoe makers, tailor, carpenters, and bakers, a whole little industrial economy run with the patient help.

[00:20:01]One report noted that patients made and mended most of the institution's boots and clothing supervised by a few staff craftsmen.

[00:20:10]In New York, the Willowed State Asylum similarly trained patients in upholstery, carpentry, and farmwork, hoping some might eventually rejoin society with a a more usable skill.

[00:20:25]Female patients, on the other hand, were usually assigned to the traditional domestic spheres of work. The colossalies of the asylums were virtually powered by female patient labor, washing, drying, and ironing the mountains of linens for hundreds of inmates. That was an endless task. In an era before electric machinery, this meant hours of scrubbing on washboards, ringing sheets by hand or with crank rollers, tending huge boiling cauldrons and mangles, and standing in steamy ironing rooms. It was hard drudging work, yet many superintendants remarked that it kept the women tranquil and tired, and thus less prone to excitement.

[00:21:12]In a single year, a large asylum's laundry might process tens of thousands of items. For example, an 1880s report from an Ohio asylum noted female patients washed 60,000 pieces of laundry that year.

[00:21:28]But besides laundry, women commonly did the sewing, mending, and needle work. As soon as breakfast was over, the needles had come out.

[00:21:38]Patients might be asked with uh tasked rather with sewing new uniforms, darning stockings, repairing bedding, or making simple quilts.

[00:21:48]Many asylum annual reports proudly listed the quantities of clothing sold by female patients. For instance, there might be 500 dresses, 1,200 pillowcases, 300 pairs of socks in a year, this kind of thing.

[00:22:04]That reminds me, I need to buy new socks. Anyway, in some progressive asylums, patients also had occupational therapy in the form of crafts like basket weaving and rug making, a bit of knitting as well.

[00:22:17]Some women likely took quiet pleasure in sewing, but others of course found it monotonous. One patient sourly recalled her asylum days like this. So many hours each day sat we with our needle and thread, patching the same garments over and over. It seemed as endless as Penelope shroud.

[00:22:41]Cleaning was another duty for both sexes. Women might sweep the wards, scrub the floors, dust furniture, help in the kitchen by peeling and washing vegetables, things like that. Men might haul coal scuttles to keep the boiler and fireplaces f uh fed or cut away trash. The most unpleasant chores like emptying chamber pots and cleaning latrines often fell to the patients lowest in the unofficial pecking order or those being disciplined.

[00:23:13]There were implicit hierarchies. You see, a well- behaved patient might be rewarded with a nicer job, like helping the gardener in the conservatory, whereas a troublesome one would be on toilet duty.

[00:23:29]By late morning, the patients labor would pause for the midday meal. But before we get to that, it's worth noting that not all patients were working all the time. What about the ones that couldn't work?

[00:23:43]Indeed, a significant portion of any asylum population was comprised of severely ill, delusional, melancholic, or agitated individuals who simply couldn't participate in the routine.

[00:23:55]Good luck trying to get them to as well.

[00:23:59]Some refused, believing that they were royalty or otherwise above it. Others were physically too debilitated or were actively hallucinating and unaware of their surroundings.

[00:24:12]In many asylums, these patients would spend their morning hours sitting in the day room or if the weather was fair, in the airing court, under observation, of course, but uh unengaged.

[00:24:24]This enforced idleness could be torturous. Nelly Bllye observed women at Blackwell's Island who were forced to sit on wooden benches, silent and unmoving for hours, not allowed to converse, not allowed to move freely, nothing to occupy their minds. I'm sure that would make them less mad, right?

[00:24:45]Come on. Well, one restless woman would get up to pace around and the attendants would shove her back down and scolded that she had to sit still.

[00:24:58]Now, things like that were not universal, but they were common enough that many patient memoirs mention interminable hours of nothing to do.

[00:25:07]Inmates might stare at four blank walls or pick at the threads of their clothing or rock back and forth anything to pass the time. Few asylums tried to alleviate this by providing reading materials or organizing simple pastimes, but especially in overcrowded public wards, meaningful activity was scarce, especially for the sickest of patients.

[00:25:33]Anyway, the contrast is pretty obvious.

[00:25:35]While some of the more recovered inmates marched out to the fields ories, the more disturbed ones would languish in the day rooms, sometimes restrained or under sedatives.

[00:25:47]Their day a blur of empty time broken only by meals and medicine.

[00:25:54]This split between the active working patients and the idle chronic patients essentially created two different experiences within the same institution.

[00:26:05]The active group followed the strict daily regimen, perhaps felt time move in a structured way, while the others experienced a suffocating monotony.

[00:26:18]Days, months, years might blend into an endless stretch.

[00:26:24]So, as midday arrived, so did the main meal of the day. Dinner, which was also called lunch. I know it's a bit confusing, typically served around 12 or 100 p.m. In Victorian times, dinner was often used to refer to the principal meal at noon. Now, just like how breakfast is not really just for the morning, it's just the breaking of the fast, you know. So that means if you don't eat anything all day until 3:00 in the afternoon, that's the first thing you eat. Well, that counts as breakfast.

[00:26:56]Anyway, this was usually the most substantial food that patients would get this uh dinner/ lunchtime. It often included a bit of meat or some other protein, which the morning and evening meals lacked.

[00:27:11]According to asylum dietary schedules, a common dinner might consist of boiled or roasted meat, either beef, mutton, or pork served with potatoes and other vegetables. For instance, reco uh records from an English county asylum in the 1870s show dinners of stew or boiled beef with potatoes or carrots, which is the most British meal you can have really. I grew up on that. Just meat and three veg, that's all it was. or occasionally you'd have some salted pork or peas pudding.

[00:27:45]Bread was served on the side. In season they might get a bit of sew it pudding or rice pudding for dessert on certain days.

[00:27:56]Now the quality of the meal varied widely. In wellunded asylums the meal might be pretty decent, at least comparatively, and the portions would be ample. There are accounts of patients remarking that they ate more meat in the asylum than they ever did outside of it.

[00:28:13]One Irish porper admitted to an English asylum supposedly said the food was so good that he'd happily stay there forever.

[00:28:22]And then low standards I suppose, but this however was likely an exception or perhaps a facicious comment.

[00:28:32]In other places complaints about the food were routine. Mary Pengali wrote that at her institution they had quote plenty of meat and vegetables indifferently cooked, but we don't require food suitable for men working out of doors. We need something to temp the appetite a little.

[00:28:54]She like many patients had a poor appetite due to her depression and medications and found the coarse greasy fair to be unappetizing.

[00:29:05]She longed for a slice of homemade cake or fresh egg. Things remind her of home.

[00:29:11]Another inmate, a young woman, wisfully told Mary that at home she used to have nice cake and could make it too, showing how austere asylum food felt compared to the old family life.

[00:29:27]Now, overcrowding meant that dining was often done in shifts or in cramped conditions. At Blackwell's Island, Nelly Blind describes how 45 women were crammed at a table meant for for uh 30 rather, elbow to elbow, eating the meager soup and prunes provided, with nurses shouting at anyone who dawdled.

[00:29:49]Many weaker patients simply went hungry in that chaos, unable to compete or too frightened. By contrast, in an elite private system, a handful of convolescent patients might dine with the superintendent's family at a civilized table using china and silverware.

[00:30:09]This was the rarified end of the spectrum, though. The average patients dining experience was far more spartan and tightly controlled.

[00:30:18]After the midday dinner, a sort of rest period might occur in some asylums. In a few institutions, especially early in the century, it was common to allow patients to take a short nap or at least remain quiet after the big meal, on the theory that it aided digestion and calm.

[00:30:37]More often, however, is that the afternoon was simply a continuation of the morning's regime.

[00:30:44]If the weather was decent, there might be another supervised walk in the airing court or perhaps a more organized outdoor experience.

[00:30:53]Bit of exercise, this kind of thing. For example, there are reports of some asylums conducting group drills or calisthenics in the afternoon. A rather militaristic approach where attendants marched patients around the grounds for a bit of exercise.

[00:31:10]One 1854 report from Norfolk County Asylum in England describes nearly 300 patients assembled in the yard for drill responding to barked commands to march in formation around the acreage.

[00:31:25]Great control is gained over the patients, an inspector noted approvingly of this spectacle, as if the asylum was some kind of boot camp.

[00:31:35]Well, this was not typical everywhere, but it does show how physical exercise was sometimes regimented to maintain order.

[00:31:44]Now, supper time, often called tea in Britain, usually came in the late afternoon or early evening, about 5 or 6 p.m.

[00:31:54]This was typically a lighter repast to close the day. Commonly, it featured items similar to breakfast, more bread, often stale by now, with a bit of butter or maybe cheese, and a hot drink like tea or cocoa.

[00:32:10]Some asylums offered porridge again or a simple broth in the evening. For example, one English asylum schedule from the 1880s mentions tea with bread and margarine daily at 6 p.m. with a bit of cheese twice a week.

[00:32:26]Others might give a treat like a slice of plain cake on Sundays, probably carrot cake or one of the one of the lesser cakes.

[00:32:37]Well, but for many patients, supper was a dreary repetition of the morning meal, showing once again the tedium of asylum life.

[00:32:46]Mary Pengali wrote that at her asylum, quote, "Dark sour bread with miserable butter consists of breakfast and tea."

[00:32:56]Miserable again.

[00:32:58]Well, only occasionally did she get a little glass of milk and a soda biscuit at bedtime as a luxury, which the head nurse doled out to a few who begged hard enough.

[00:33:11]Those were the small mercies one lived for. Mary treasured that nightly glass of milk as if it were the greatest gift she ever got. Nelly Blly's account similarly described supper at Blackwell's Island as inedible stewed prunes and a cup of dirty water masquerading as tea.

[00:33:31]Many women refused to eat, either because the food was so poor or due to their illness. Blie herself stopped eating much of the food and noted how hunger and cold combined to break the spirit of even a sane person.

[00:33:46]After supper, the long day began to wind down. Patients might be herded into a common room for the evening. Evenings in the asylum could be particularly dull or eerily quiet. The patients often tired from the day's work or sedated by the effect of routine.

[00:34:04]attendance encouraged calm. Any excitement in the evening was discouraged since that could lead to trouble. Often this was the time for some mild recreation or religious exercise, depending on the day of the week and the institution's customs.

[00:34:22]For example, many asylums held daily prayers or devotions in the evening. It might be as simple as the ward nurse reading a prayer or passage from the Bible aloud with patients expected to sit quietly, perhaps join in the familiar prayers like the Lord's Prayer.

[00:34:39]More organized institutions had a chaplain who would conduct a short service.

[00:34:45]John Perl, a patient in the 1830s, recalled how on Sundays, especially the inmates were gathered for a chapel service, which he found both comforting and at times a little oppressive.

[00:34:57]Comforting and routine, but oppressive in the forced piety of it all. In smaller asylums, patients might sing a hymn together in the parlor. This injection of religiosity was based on the belief that moral and spiritual improvement went hand in hand with recovery from insanity.

[00:35:16]In lie of prayers, some places offered secular diversions in the evening. For instance, a common feature of the well-run asylum by midentury was the weekly or nightly recreation hour.

[00:35:29]Sounds really fun.

[00:35:33]Well, superintendent realized that a bit of entertainment could improve morale and even serve as a privilege to encourage good behavior.

[00:35:43]Thus, some asylums organized concerts, dancers, or lectures. The wealthy Tyurist Asylum in Sussex had regular evening amusements, billiards, card games, chess, amateur theatricals, which Meavel later acknowledged were generous, though in his state of depression they gave him a little joy. He wrote, quote, "All this bears so fair and outside that it seems difficult to quarrel with it.

[00:36:11]Yet the life that it concealed was inconceivably terrible. these parties, games, entertainments, meals, without a friend's face near me, without hope or valition. The story makes me shrink in the telling." End quote.

[00:36:28]Well, he doesn't sound too pleased, doesn't he? Nonetheless, for many inmates, the occasional dance or magic landon show was a highlight to break the monotony. Large asylums often had a hall or recreation room.

[00:36:43]However, one must remember that these entertainments were privileges. Not every patient got to enjoy them. Mary Pengui in her diary tells of a festival held at the asylum's chapel one day.

[00:36:55]Perhaps a concert or charity event for which some patients were taken out.

[00:37:00]Mary, however, was not invited. She stood in her drab gray dress, feeling humiliated that she had nothing decent to wear to a public gathering. Only when an assistant physician noticed her did he kindly say, "Do Miss Bengali. You may as well come."

[00:37:20]Still, Mary hesitated, pointing out her threadbear attire and bare neckline.

[00:37:26]He promised to have something sent for her, but instead of a dress, she eventually just brought a plate of festival food, some sweets and fruit to eat alone. She interpreted this as a sign the staff didn't trust her to be seen in public, perhaps fearing she might complain about her treatment to outsiders.

[00:37:46]Well, as night fell, bedtime approached.

[00:37:49]Asylum administrators generally believed that early to bed, early to rise was the best possible thing. Partly to maintain order, and because the night staffing was minimal, they wanted patients safely tucked away.

[00:38:04]Bedtime in many asylums was around 8:00 p.m. At Liverpool Asylum, for example, it was recorded that bedtime was 8:00 p.m. and patients slept in long rows of beds that were 2 feet and 6 in apart.

[00:38:18]Gee, 6 in. That's all. Well, attendants would methodically escort patients to their dormitories and cells.

[00:38:28]Sleeping arrangements varied. In older asylums or smaller ones, some patients had single rooms, often called cells, especially in the earlier century, small bare rooms with a bed, maybe a chamber pot. But the vast expansion of patient numbers, led to the dominance of large dormatory wards. In a dormatory, dozens of beds were arranged in rows, often very close together, as noted, sometimes barely 2 or 3 ft apart. Privacy was non-existent. One might be trying to sleep while hearing the mutterings and snores of cries of 30 people in the same hall.

[00:39:08]Within the same sex patients might be grouped roughly by their perceived condition or behavior. For instance, a noisy ward for those prone to shout at night versus a quiet ward for the melancholic or convolescent.

[00:39:23]Nonetheless, even a quiet dorm could become chaotic if one patient woke with night terrors or started screaming in hallucination.

[00:39:33]Nighttime could really be the most dangerous period. With minimal supervision, some patients tried to escape. Others got into fights or delusions. If an institution was especially understaffed, accidents would happen.

[00:39:49]Restraints were sometimes applied at night to those deemed risks. Straight jackets or restraint sheets might be used to keep a restless patient in place until morning. While Britain's asylums after the 1840s officially moved towards non-restraint policies, abolishing the routine use of manacles and straight jackets, that is. In practice, padded cells and occasional restraints at night still existed as a last resort. American asylums varied. Some were a little bit more liberalized in the use of restraining garments, especially in the post civil war years where crowding soared.

[00:40:30]By the late 19th century, another tool entered wide use to ensure a dosile night. Seditive drugs.

[00:40:38]One of the first effective sedatives was chloral hydrate introduced in the 1870s and uh later they had palahhide in the 1880s. These were given to patients in the evening to induce sleep.

[00:40:54]A patient might receive a spoonful of foultasting liquid or a powder in their tea that made them drowsy and compliant.

[00:41:01]Halaldahhide especially became a favorite of asylum doctors. As one doctor noted, it quiets them down for the night and makes them easier for the nurses to get everyone to bed. The drug's heavy, sickly, sweet odor would hang in the dormatory air. Patients could tell when others had been dosed because of the distinctive smell on their breaths.

[00:41:25]So, as 9:00 p.m. approached, most wards would be in forced darkness and silence.

[00:41:31]Attendants might carry lanterns on brief rounds to check that all were in bed.

[00:41:37]Some patients would be softly crying, perhaps missing their families or due to the voices in their heads. Probably most out of just sheer hopelessness, one might imagine.

[00:41:48]Others quickly fell asleep, exhausted by the labor of the day or uh lulled by the medication.

[00:41:56]Now and then a patient might die in the night. Sudden death was not uncommon in asylums from epileptic seizures, heart failures, or things like tuberculosis that thrived in crowded institutions.

[00:42:09]Mville chillingly noted how death would come suddenly and terribly on one of the outcasts, and the event would be hushed up and forgotten.

[00:42:20]Indeed, more doubt he was part of life in the asylum.

[00:42:25]Well, so far we followed the ordinary day under ordinary circumstance, but asylums were also places of treatment, believe it or not, or at least what passed for treatment.

[00:42:40]Well, patients with symptoms often flared when they disobeyed rules.

[00:42:46]Various interventions would come into play.

[00:42:50]The 19th century was an age before modern psychiatric therapies, but it was also an age of brave ideas, and doctors tried numerous methods to cure or at least manage insanity.

[00:43:06]These range from compassionate talking to soothing routines, the best part of moral treatment, to primitive medical procedures and brute force restraints.

[00:43:18]You see, in the early 1800s, most asylums freely used mechanical restraints, chains, handcuffs, leg irons, straight waste coats, the forerunner of the street jacket, by the way, muzzles, too, and restraining chairs. The reformers gradually curtailed most of the uh barbaric ones, but by the midentury it was a point of pride for many institutions, especially in England, to claim that they no young longer used any chains or manacles.

[00:43:49]John Connelly at Hanwell Asylum famously in 1839 removed all mechanical restraints, demonstrating that even dangerous patients could be managed with careful monitoring and the occasional padded room. Hey, it's better than nothing. His 1856 book, The Treatment of the Insane Without Mechanical Restraints, evangelized this approach.

[00:44:14]Short was flying off the shelves.

[00:44:16]Anyway, instead of trying to uh tying a man to his bed and uh subdue them like that, Connelly would put them in a padded cell, a small room with walls and a floor padded with thick cushions or canvas, so he could thrash them out as much as he wanted without injuring himself until at least his fury and energy abated. Instead of chaining a woman's hands, he would have a nurse sit with her constantly to prevent harm.

[00:44:45]This non-restraint movement spread to many asylums in Europe and the US. But not all implemented it fully. Some found it too labor intensive to watch patients constantly without any restraints. When you're short staffed where these kind of concerns come about.

[00:45:02]Therefore through the 19th century many patients did experience restraints.

[00:45:08]Straight jackets were a common tool. You know, the one the canvas coats with the long sleeves you could tie behind the back, that sort of thing.

[00:45:17]They were used to subdue those who attacked others or to protect patients from self harm. We have accounts from patients of being suddenly grabbed and thrust into these rather unforgiving outfits. One moment you might be pacing a ward in distress and the next a team of attendants might just grab you and force you into the ground and put you into the jacket. Not nice at all. But then there's also the humiliation and discomfort that was profound. Often it was used as much as a punishment for misbehavior as for genuine safety.

[00:45:54]Elizabeth Pard, for example, described women in the Jacksonville Asylum being put in straight jackets and locked in cold rooms for daring to question authority.

[00:46:06]In one instance, she recounted how a fellow patient who spoke back to an attendant was sumearily dressed up in a straight jacket for days as a lesson.

[00:46:15]Backard herself, who insisted she was sane and unjustly confined, was labeled as a troublemaker.

[00:46:23]She wrote that the threat of the straight jacket loomed over her constantly if she didn't behave to the warden's standard.

[00:46:33]Besides jackets, restraining chairs or beds were also used. Some asylums had spec uh specially designed chairs with straps where a violent patient could be fastened by the waist and limbs basically immobilized in a sitting position for hours. Others used what was called a Utica crib named after the Utica Asylum in New York. A small low boxike bed with a barred lid that could be closed over a patient, effectively a cage bed. Sure, that is the pride of the Utica inventors.

[00:47:11]Though intended to safely contain a patient without the need for hand restraints, these cribs were controversial and seen by some as inhumane.

[00:47:20]Just imagine the experience though of being slid into a narrow wooden box and hearing the lid lock above you. Now that's horrifying, especially when they put you in there when you're in a uh uncooperative state. Just say that much.

[00:47:36]Doesn't help sedate your panic.

[00:47:38]In any case, by the late 19th century, methods like that were increasingly criticized, but they did persist in some places.

[00:47:48]Seclusion in a bare room was slightly gentler in control. It used especially for those who were noisy or disruptive.

[00:47:58]Many patients write of dreaded hours in the padded room or solitary cell. Yet some doctors saw it as a necessary time out until the patient cooled down.

[00:48:10]Mid-century asylum medicine apart from restraint puts stock in various physical therapies.

[00:48:16]Water therapy i.e. hydrotherapy was especially popular. Cold and warm water were used in different ways. For hyperactic or manic patients, cold water was believed to have a subduing effect.

[00:48:31]In practice, this ranged from mild approaches, a brief cold shower to extreme dunkings.

[00:48:39]However extreme that can get. Give me the money, Labowski. Is that it? Where's the money, Labowski? That sort of thing.

[00:48:46]Maybe not that bad. We'll see. Well, one common method was the shower bath. The patient would be stripped and placed in a stall where a torrent of cold water was released from above, dousing them for several minutes.

[00:49:02]Alternatively, attendants might simply throw buckets of icy water over a restrained patient, literally attempting to shock them into calm, which, as you know, is probably not going to work. But hey, the rationalization for all this was that the shock would reduce the pulse and excite fear, thereby quilling the frenzy.

[00:49:26]Now, for melancholic or extreme anxious patients, warm water baths were employed to soothe, which sounds a hell of a lot better than what we just talked about.

[00:49:36]Doctors would seat the patient in a warm bath, often a special tub with a canvas hammock or with a cover to maintain temperature and leave them soaking for an extended period, sometimes hours on end. This was akin to a modern notion of sensory relaxation, though in some cases they seem to have overdid it. There are reports of patients being kept in continuous warm baths for days on end, taken out only briefly for, you know, necessities.

[00:50:08]Attendants would add hot water periodically to keep it at body temperature.

[00:50:13]The patient neck deep with only the head out would become languid and sometimes more manageable after such bathing marathons.

[00:50:23]Well, it's important to note that the experience of these treatments from the patients perspective was often one of trauma and intimidation.

[00:50:32]The asylum was not generally a place of kindly therapy sessions and psychological insight, at least not in the 19th century. things like that would come much later. One former patient writing in the 1890s said in effect, quote, "No sane person would have any idea how we were managed. If you screamed, they choked you. If you refused your food, they forced it down you. If you argued your sanity, they mocked you and said that it proved your madness."

[00:51:07]This captures a bit of a catch 22 that many felt. any resistance to the regime was labeled as illness and met by force.

[00:51:16]Still, not every doctor was heartless, and not every patient was cowed.

[00:51:22]Some superintendants truly embraced gentler methods, long talks, encouragement, and saw good results from some patients. They were indeed stories of recovery. A depressed soul enlivened by work in the garden. An incoherent person slowly finding clarity in the gum routine. A violent man turned peaceful after weeks without physical punishment.

[00:51:46]Mold treatment did help some people, especially in the earlier phases where asylums were smaller.

[00:51:54]But when gentler methods failed or resources were thin, force came back into play.

[00:52:01]It's telling that nearly every patient memoir mentions witnessing or experiencing abuse. Nelly Blly, though an undercover reporter, certainly did.

[00:52:10]She saw a nurse drag a woman by her hair and beat her for not sitting still.

[00:52:15]Elizabeth Packard reported attendants slapping and roughly manhandling patients during baths or when putting them to bed. Anna Agnu, who spent years in the Indiana Hospital for the Insane in the 1870s, wrote of a scene where a struggling patient was held down by multiple nurses and howls of pain echoed through the whole building as they tightened a restraint. A memory that seems to have haunted her for quite some time.

[00:52:44]But don't think of asylum inmates as simply passive victims of a machine.

[00:52:49]They were people with relationships, emotions, and coping strategies. Social dynamics within the asylum were both a source of comfort and at times additional hardship. So, let's have a look at the relationship and interactions that a patient might have.

[00:53:06]First, there was the relationship with the staff. Attendants and nurses were the everyday authority figures. Some were kind, genuinely concerned for the people in their charge. Others were not, viewing patients as less than fully human or even nuisances.

[00:53:24]It is telling that Mary Bengali consistently refers to her attendant as Miss Mills, who scolds or is unkind and lacks sympathy.

[00:53:35]But she also mentions an assistant physician, Dr. Crook Shank, who looked at me very kindly and tried to include her in a festival.

[00:53:47]Well, this indicates that experiences could vary. Many patients learned to behave for certain attendants to avoid their wrath. The power dynamic was extreme. Attendants could decide if one got a second helping of food or access to one's own belongings, or even permission to write a letter, which I'm sure were read before they were sent out. Complaining about an attendant was usually futile.

[00:54:14]Some braver souls like Elizabeth Backard would later testify publicly about abuse of attendance. But at the time of confinement, patients often felt at the mercy of these individuals.

[00:54:26]Now consider patient to patient interactions.

[00:54:29]In the rigid environment, companionship was still possible.

[00:54:34]Shared suffering often breathed empathy.

[00:54:37]In day rooms and workshops, friendships did form. Patients would look out for each other, like Mary Pengali, gently nursing a blind fellow patient, Miss Fowler, by covering her inflamed eye with a wet cloth from Mary's own handkerchief. For this small act of kindness, Mary was rebuked by the attendant, who tore the makeshift bandage away and scolded her. But Mary's instinct was to care for her friend, and it shows how patients did create these informal support networks.

[00:55:10]They would share gossip, console each other after an episode, or team up to do small favors.

[00:55:17]On the mail wards, one might see a long-term inmate informally mentoring a confused newcomer, explaining the unspoken rules of asylum life. On female wards, perhaps an older maternal figure comforted a younger woman who wept for her children at home.

[00:55:36]Yet not all patient interactions were going to be positive. Just as in any group of people under stress, there were arguments, tensions, even violence.

[00:55:47]Some patients symptoms made them aggressive or disruptive, and that could frighten the others. A normally peaceable patient might have to room next to someone who ranted and raved all night, testing their own sanity, too.

[00:56:03]Bullying could occur. Occasionally, a stronger patient might dominate or torment a weaker one if not stopped by staff. And since many patients were not actually insane in the stereotypical sense, but perhaps suffering from depression or trauma, they sometimes found it upsetting to mingle with those who fidlyly were psychotic.

[00:56:26]For example, a sane patient wrongly confined, as Herman Mirael believed himself to be at times, could be deeply distressed by being herded together with people shouting nonsense or performing strange things around him.

[00:56:42]But what about family and the outside world? For many patients, this was the most painful thing, the separation and isolation.

[00:56:52]Asylums were often built in isolated locations away from polite society.

[00:56:58]Visiting could be infrequent.

[00:57:01]In the earlier half of the century, visiting hours were sometimes heavily restricted. Perhaps family could visit on certain days for a short while and often under the eye of the staff. If a husband committed a wife, he might choose never to visit, effectively abandoning her. Elizabeth Packard's husband only came once or twice in 3 years, largely to check if she was ready to submit to him. She wasn't anyway.

[00:57:29]Well, her children were not allowed to see her until she was released. The heartbreak of mothers separated from children comes up in multiple accounts.

[00:57:38]One woman wrote that hearing children's voices, perhaps the superintendent's children playing outside, would plunge her into tears, yearning for her own little ones.

[00:57:50]Patients who did have concerned family might see them monthly or so. Mary Pengaly was fortunate that her adult sons loved her and visited her when they could, despite first believing the doctors that she needed to be there. She describes the joy of a visit from her son Lewis, who held her hand and promised to take her away for a drive when the weather improved. Mary pleaded to go home with him immediately, but he demured, trusting the doctor's judgment as she was still ill.

[00:58:23]Thus, many patients felt extremely cut off. A phrase that appears as that they felt buried alive. In fact, one of the popular asylum narratives published in the 1800s was titled A Secret Institution, 1890, where author Clarissa Lathromp likened her time in the Utica Asylum to being in tmbed where no one hears your cries.

[00:58:50]The isolation had profound effects on the mental state of patients. The daily routine we outlined was supposed to cure or at least stabilize them. But ironically, the monotony and separation could sometimes make everything worse.

[00:59:05]Doesn't take rocket science to figure that out, but you know what I mean.

[00:59:10]However, it is important to acknowledge that some patients did find ways to endure or subtly resist. Humor and creativity occasionally surfaced.

[00:59:20]In the Utica State Hospital in the 1850s, patients produced a literary magazine called the Opal, writing poems, essays, and sketches. This remarkable outlet shows that even within the walls that human imagination persisted.

[00:59:37]Religious faith was another coping mechanism. Victorian society was, of course, deeply religious, and many patients clung to this faith.

[00:59:46]Some found strength in prayer, believing that God had not abandoned them, even if their entire family had. A deeply melancholic patient might find in daily chapel services a moment of transcendence, or at least a routine that reminded them of mortality and meaning beyond the bars. Of course, religion could cut both ways. For some, it fed delusions, like those who thought they were prophets or demons, which asylums tried to suppress.

[01:00:16]But the asylum chapency was a stable and some chaplain provided genuine pastoral care that comforted individuals in those dark moments.

[01:00:27]Well, what then did a 19th century mental patient desire most?

[01:00:32]From their own words, liberty, dignity, and understanding.

[01:00:39]Elizabeth Backard, after winning her freedom in court, fought so that no married woman could ever be locked up at her husband's whim as she was. Mary Pengui published her diary as an appeal to the public to search out better methods of caring for the mentally ill.

[01:00:57]She wanted to see the inner workings of asylum of asylums rather shown to the people, the good and bad to prompt improvements.

[01:01:06]Herman Meravel wrote his pamphlet to assure future sane people who might be mistakenly confined that they were not alone and to warn society of the inconceivably terrible inner life that even a benevolently run asylum could hide.

[01:01:23]These voices once buried emerged to educate and humanize those who are labeled as no hopers, the insane.

[01:01:34]And that's where we leave it today. The daily life of a mental patient.

[01:01:42]Pretty terrible, but uh you know, it's just the way it is. Medical science and uh I suppose just a general empathy for those less fortunate.

[01:01:55]It has to um it has to improve little by little. There are a few big strides, but uh generally it's a two steps forward, one step back.

[01:02:07]Any case, thank you for joining me and uh I hope you also enjoy the playlist, the other asylum videos. There's a bit more that we have to say about this topic. Bit more we have to say about medical history indeed, but uh we'll get to that later. In any case, thank you to uh the supporters. keeping everything adfree on Patreon and YouTube memberships. You are appreciated and thank you for listening thus far. Like, comment, and subscribe. Tell your friends and we'll see you next time.

[01:02:42]Goodbye for now.