Wednesday, May 03, 2006

Early MH Tx

Not everyone will have an interest in a museum of early mental health treatment. But for those few…The Public Hospital in Colonial Williamsburg in Virginia is a restored replica of the first mental health hospital in America, built in 1773. I was in school in Williamsburg when the museum was still just a room at Eastern State with evil-looking tools for various reworkings of your skull, so the restored building is of some interest to me.

There had been a sharp increase in the number of asylums in England from 1650 onward (especially after the Great Fire of London), but the idea came later to the colonies. Depending on the prevailing culture of each colony the mentally ill were classified with either the poor or the criminals and treated accordingly.

The historical record can be stretched to prove whatever point you like. If you wish to emphasize how enlightened early treatment was compared to treatment from 1850-1950, you can emphasize the spacious gardens and good food required by law in most places, and the frequent mention in official records of the need for quiet and reflection. “…officials such as be charged with the maintenance of the hospital shall endeavor to find congenial work for those in their care” is not far different from the current growing emphasis on creative vocational services. Legislatures and magistrates insisted on kindly treatment.

But if you want to show how barbaric were the times and how deep the aversion to the mentally ill, there is ample evidence for that as well. Bloodletting and purging were common treatments for any illness; most medicines in use were either without effect or mildly poisonous; food could be sparse or ruined; shackling was common and confinement lengthy. Lawmakers might insist, but towns and counties often ignored the law.

You can also find echoes of your favorite modern theory among the ideas in vogue from 1600-1800. Some insisted that all problems were the result of brain and nervous disorders, others saw lack of contemplation or piety as disordering. Eating the wrong foods, insufficient herbs, or having neglectful parents were identified by others as primary causes. Galen’s theories of Four Humours enjoyed a number of incarnations and revivals. Few doctors admitted a variety of causes for illness, lumping epilepsy, postpartum depression, and advanced syphilis together, each explained by a single encompassing theory. It was an age of extremes, in which people either believed that the mentally ill had no control over their actions or were acting entirely with free will.

Trepanning, or drilling holes in your head, was still popular.

For relief of "Lunacy":

Give a decoction of Agrimony four times a day
Or - rub the head several times a day with vinegar, in which ground ivy leaves have been infused
Or - an ounce of distilled vinegar daily
Or - boil the juice of ground ivy with sweet oil and white wine into an oinment. Shave the head, anoint it therewith and chafe it in juice warm every other day for three weeks
Bruise also the leaves and bind them on the head, and give three spoonfuls of juice warm every morning. This will also cure melancholy

For the relief of "Raging Madness"

Apply to the head, cloths dipt in cold water.
Or - set the patient with his head under a great water-fall, as long as his strength will bear: or pour water on his head from a tea-kettle
Or - let him eat nothing but apples for a month.
Or - nothing but bread and milk.

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