471E4--Week 4 Questions/Comments--Tuesday

I appreciate this book following Tomes’ Kirkbride piece because it truly shows the flipside of the perfect Kirkbride institution. I found myself chuckling when Trezvant asked Kirkbride if he can steal his attendants. It makes me believe that Kirkbride was truly a successful pioneer in moral treatments. I like McCandless’ easy read which counterbalances the perfection of Kirbride’s system. –Kasey Moore

In regards to the comparison between the Kirkbride system and the South Carolina Asylum, I was proud of the depth in which McCandless describes the conflicts of visitors. I felt that the argument he presented, Trezvant’s struggles, were similar to the ones we had in our class discussion about allowing visitors. I felt that the book justified my thoughts and feelings on the complex situation. –Kasey Moore

In class we discussed the potential neglect and abuse that Tomes might have left out in her glorified painting of Kirkbride. I was wondering, after reading the reports of neglect and abuse in South Carolina Asylum, if we feel differently about Kirkbride. It seems that Tomes’ glorified painting might not have been so off as McCandless similarly paints him as the model superintendent. –Kasey Moore

Finally, I was wondering the implication of having a “visiting” physician and a superintendent as two personages. – Kasey Moore

It seemed to me that a real setback to the South Carolina Insane Asylum early on was the lack of government subsidy needed to provide for amusements necessary to attract the wealthier patients that would pay to take the burden off the state. I know the government deplored the idea of giving money upfront for “extravagances,” such as gardens, carriages, and indoor plumbing, but without them the asylum suffered from a poor image (whereas Kirkbride understood the need for such amusements as a selling point). –Scott Campbell

I was shocked how South Carolina law required two doctors to examine a prospective asylum patient and the okay of a justice of the peace, in contrast to Pennsylvania that only required one doctor. This certainly hurt the South Carolina asylum’s admission numbers, but had to have protected individuals that were likely to be put away because of social/economical/family control. –Scott Campbell

A common thread, I see nationally, between asylum officers curing their patients appears to be how the officers blamed society at large for undermining their efforts. Whether by not having enough attendants or the right facilities, or getting patients too late to truly help, the officers rarely looked at themselves and their regimen as the problem. Instead they wrote off the so called chronic cases as beyond their control. –Scott Campbell

McCandless begins his writings with a discussion of James Petigru's quote describing South Carolina in itself being one large insane asylum. As one studies the antebellum and Civil War periods, this seems like a pretty logical argument. How did that affect the creation of the South Carolina Lunatic Asylum? ~Emily Barry

Was the use of restraints and solitary confinement harmful or helpful? It seems to me that whilst the staff may think it helps because it keeps the patient from having an episode so they can move about their day, but for the patient it seems hurtful because after weeks or months of solitude, one may go even "crazier" than they already are. ~ Emily Barry

I was so excited that this book contains a section about insanity within slavery. Previous readings hinted at racial differences in the care of the insane, but had not discussed it in depth. McCandless answered a lot of my questions. What I'm still curious about is why institutions in SC opened their doors to blacks in about 1850 as opposed to any other time. -Joanna Jourdan

McCandless says that "While in the building, visitors had to be accompanied by one of the officers or attendants and were prohibited from remaining long or conversing with the patients" (109). Did this apply to family members, or just people unassociated with the asylum? -Joanna Jourdan

I wasn't surprised by the issues the asylum and regents had with filling staff positions due to the negativity that constantly surrounded the South Carolina Insane Asylum, but I was shocked that they had the mother of a patient be the matron in the hospital. This seems like it would be ineffective to the curing of the patient. Was it common for family members of the insane to work within the asylum or is this only the case because of South Carolina's difficult case? -Carly W.

I found that McCandless was a great contrast to Tomes. I saw many different observations. One that surprised and stuck out to me was that the mentally- ill women were more prone to be cared for at home. This was due to the fact that women are easily restrained. But also McCandless gives another side of the story by telling the story of the man who cared for his wife at home day and night. Gender actually had a great deal to do with whether men and women were cared for at home or at the asylum. Apparently men would feel less masculine if they were being cared for at home with the wife and children taking care of them. – Courtney Collier

Going off of my last point, gender roles also happened within the asylums as far as activities that were planned for the patients. Some women complained that they even wanted more to do instead of the simple needlework. The men also did not have much land to do outdoor activities. I feel that this also hurt the South Carolina asylum because the northern asylums did not have as much of the patriarchal values as the southern region did. –Courtney Collier

The quote on page 108 just kills me! The committee of regents said that visitors saw them “not as idiots or brutes, but as members of the great family of intelligent creatures.” That statement just sounds so untrue to me because society did not view them as intelligent at all. –Courtney Collier

On page 104, I understand that they may have had to restrain a patient to get medicine in them but why did they leave the patient in a chair till the next morning? Was is really violence or was it just laziness? I do not see how that could help anyone recover. –Courtney Collier

Like others stated above, I thought that McCandless’ book provided supplementary information for understanding the Kirkbride plan and other methods for dealing with insanity. McCandless addressed issues within the institution, from abuse of the patients to racial tensions within the asylum. I was particularly struck by McCandless’ argument that South Carolina asylums were really no different than “newer” and “better” asylums in the North. Tomes may have portrayed Kirkbride with beyond admirable intentions, but I thought that Trezvant and Parker had an actual interest in the welfare of their institution and their patients as well. I also found it interesting that while McCandless appeared to have a surplus of information for actual cases, he lacked evidence in other areas. -- Chelsea Chin

After reading these various accounts on mental institutions and how they became to be, I figured that at least one author’s version of the beginning would be different. However everyone seems to be in agreement of what basically happened in the time period before asylums were created and asylums mainly got their start. What happened to asylums after they were built also seem to follow a similar pattern (but I may just be overthinking the similarities, since everyone else has commented on the differences between this Book and Tomes’ account). Both the South Carolina institute and Kirkbride’s experienced an overflow of people, South Carolina wanted to move to the county in order to have more room and to be away from the citizens of the Columbia (this was never achieved however), and both asylums faced a steady decline towards the end of their lives. There were differences between the two as well, I was just surprised at the number of similarities between the two. - Morgan H.

On page 67 McCandless states that “Occasionally a convalescing patient was hired to act as a temporary keeper during the early years.” This statement struck me as odd that they would allow patients to take care of other patients. How beneficial was this to their health? Did it inspire some to want to get better and move on in life or did it upset the patients to be governed by someone who was once one of them? - Morgan H.

Like Morgan, I too was struck by the idea of convalescing patients taking care of others. Was this only an early year thing, did it happen in other places? I can see where this could fit in to what we talked about last week about rewarding patients in good behavior. --Carly W.

McCandless was a great follow up read to Tomes which provides the similarities and differences that the South and North had in reference to mental illness. Finally, the issue of race appeared and the different housing accommodations and treatment that blacks received. While their treatment was more harsh and drastic than the lower classes, I saw many similarities between the blacks of South Carolina and the poor classes of Pennsylvania. In the respect that both were basically ignored within the asylum. Another huge point was the use of sedatives and stimulants and the shift away from powerful drugs such as morphine. I'd like to think this signified a medical advancement made within terms to the addictive nature of morphine but I'm not convinced of that. Either way, I was excited to see new and different medicines to be used within the hospital.- Maggie Nunn

I am not surprised by the amount of people who did not want to put their loved ones in the asylum. In the proper southern culture, it was probably less frowned upon to take care of your loved one in the privacy of your own home than to acknowledge to your community that a family member was suffering from mental illness. I'm sure families who did acknowledge these problems suffered severe social consequences. -Maggie Nunn

McCandless discussed how many citizens did not want to put their loved ones in an asylum based off of ridicule. They were quoted as saying they did not want to become a burden to society. Did this ideal hinder the process of building a public asylum? Was it because people were embarrassed they could not afford the care of their loved one or was it the fact that someone in their family was insane? –Jack Hylan

Besides fiscal responsibility why do you think there was such a significant difference in support for the asylum in South Carolina versus the North.? Was it just about budget control or was there a general mentality that it was the responsibility of ones own to take care of family members who were ill? –Jack Hylan

Like Mr. Campbell, I wonder just how varied the laws were between the states regarding the examination & admission of patients to the asylums? Another question that arises from this one is how do you balance the public good & it's rights with the rights of the individual and their good? Also, I wonder if the asylum officers ever considered that their actions or regimen as the problem? ~Alex Young

South Carolina’s first “Mad House” was connected to a poorhouse. What are the pro’s and con’s to this placement in the eyes of someone in the 19th century? – Katie Tryon

McCandless says that people in the backcountry of South Carolina were more tolerant of strange behavior. This made me immediately think of our discussion in class to what is normal and what is not normal? – Katie Tryon

Through our previous readings I had not thought of the architecture of a mental hospital based on location but after reading about Trezevant’s fight to build a hospital that was single room in width makes complete sense for the extremely hot summers in the south. – Katie Tryon

Regarding the intersection of medical care and psychiatric care: p90. A patient's illness did not show improvement over a prolonged period, then he had an "apoplectic fit." Davis responded by bleeding and purging, and the patient died that same day. I have to wonder, if this patient did not have a mental illness, how would this apoplectic (a word meaning rage or stroke) fit have been treated?--Stef L.

--- GROUP WORK

Break into 3 groups of 5 (focused on 2 chapters each) and address the following questions:

Time span (with key ranges where possible) and note any years of significance (why are they important?).

Two-three key points about the South Carolina Asylum discussed within the chapters.

Whose voices do we hear? Whose viewpoints do we see? Public? Families? Practitioners? Mentally ill? (Consider the sources used by McCandless, are they sufficient enough to support his interpretation, if not why?)

What was something that surprised you in these chapters? Perhaps a favorite quote/phrase or interesting story?

https://docs.google.com/document/d/1AM-uaXBf73dnLyx3RReTP8jwFPaNW67P1eoo3A_SmtY/edit?usp=sharing