CPP Curiosities: Mental Health and “Moral Treatment”

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Greetings and salutations, fellow historico-medico afficionados, and welcome to another installment of CPP Curiosities, our semi-regular segment on the unusual and interesting aspects of medical history. Past articles have covered a variety of topics, from historic treatments for syphilis to the preservation of Lenin’s remains to the Greek and Roman god of medicine.

Today’s issue is the first in a three-part series of guest articles written by students in the Karabots Junior Fellows Program. The KJF Program is a three-year after-school and summer internship for Philadelphia high school students from underserved communities who have an interest in careers in healthcare and medicine. These two wrote these articles as part of a two-week summer internship wherein they worked closely with staff in the Historical Medical Library of the College of Physicians of Philadelphia and conducted original research on a topic of their choice. First up is Yazmeen Robinson, who chose to research “moral treatment,” a 19th century mental health practice.

Take it away, Yazmeen!  –KI

Seven female patients in the "Insane Department" at Philadelphia General Hospital sit around a small table.

“Patients in insane department,” Philadelphia General Hospital Photograph Collection, Historical Medical Library of The College of Physicians of Philadelphia, box 2, photo no. 7

Psychiatric hospitals were built for those who were suffering from mental illness and could somehow recover from it. During the nineteenth-century in the United States, there were new European ideas about the treatment of people who were mentally ill. These ideas were called “moral treatment” which promised treatment for those with mental illness in an asylum. During the 19th century, they thought that by treating the patients more like children rather than an animal, patients would have a better chance at recovering. Treating the patients as individuals and helping them to gain control of themselves was very important. Moral treatment at the asylum was connected with occupational therapy, religion, and their community. Moral treatment usually didn’t include traditional treatments like physical restraints.

The moral treatment of the insane refused to associate with the disruptive behavior of mentally ill individuals. Some people with mental illness were too violent or disruptive to stay at their homes or in their communities. Some people with mental illness received treatment at home other than a hospital.

Friends Asylum was established by Philadelphia’s Quaker community in 1814, which was the first institute designed to perform the full program of moral treatment. The Friends Asylum wasn’t run by physicians. It was run by lay staff, which made it unique. Private hospitals were more available to wealthier families to care for their mentally ill family member.

At Taunton Hospital in Massachusetts, there was a lower story that was built and designed for patients that were uncontrollable or considered “filthy.” The Taunton Lunatic Asylum Casebook (1854-1868) has 240 entries with patients’ names, mental states, family histories, and financial status. These records contained information about patients’ profession, lineage, time in America, ships sailed on, and whether their taxes had been paid.

Page from Taunton Lunatic Asylum casebook (1854 - 1868), MSS 6/011, Historical Medical Library of The College of Physicians of Philadelphia.

Page from Taunton Lunatic Asylum casebook (1854 – 1868), MSS 6/011, Historical Medical Library of The College of Physicians of Philadelphia.

Here are two patient records that I found interesting:

pg. 101:

Weigandt, Louis, 41, admitted April 3,1860, Boston
Hopeless and quiet
German in Boston, 12 years, wife lives at 70 Crystal Palace, Luicida St.
Mr. Nash reports Weigandt born in Germany, landed in New York how long ago unknown. Parents never in U.S.; Weigandt had lived mostly in Boston.
Wife Jane born in Marblehead, no doubt has a set[?] there
Is cousins with cashier of Marblehead Bank
Mr. Locke says wife [?] care of [?] Crystal Palace

pg. 96:

Copeland, John, 29, admitted Feburary 24, 1860 North Bedford
Doubtful and troublesome; now has been very [?]; fugitive slave; can go as far as health is concerned
Mr. Locke says [Copeland] born in Newburn, North Carolina
Feb 23rd 1863: He [Copeland] says does not know where he was born first found himself in Newburn. Then to Duplin County, there 4 years, came to Philadelphia in 1855 from Wilmington, thence to New York and Albany. 2 years in Albany, then to Wilton County, 9 months there, then to North Bedford, 2 months there. Send to Philadelphia.

Today there are only a few psychiatric hospitals that exist. Psychiatric care is now delivered through other services, such as crisis service. Doctors today gives patients psychiatric medications, such as, antidepressants, anti-anxiety medications, and mood-stabilizing medications, which help treat, but do not completely cure, mental illness. Depending on how severe the patient’s mental illness is, the treatment that will be given could be a mixed treatment. Today there is a treatment team that helps with a patient’s unique recovery plan, which includes educational programs, support groups, and counseling.

Thanks, Yazmeen! Be sure to check back, dear reader, for our second installment soon. Until next time. Catch you on the strange side!

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The Karabots Junior Fellows Challenge Banned Books

Students in the Karabots Junior Fellows Program examine a set of challenged books on display at the Historical Medical Library

September 24-30, 2017, marked the most recent installment of Banned Books Week. Created in 1982 by the American Library Association (ALA), Banned Books Week calls attention to books that have been challenged or banned by local, state, or federal organizations (particularly libraries and schools), emphasizing the importance of free speech and expression. Described by the ALA as the ”annual celebration of the freedom to read,” Banned Books Week is held every year during the last week of September.

In celebration of Banned Books Week, the new cohort of the Karabots Junior Fellows took their first trip to the Historical Medical Library of the College of Physicians of Philadelphia. There they met with Beth Lander and Caitlin Angelone, the Library’s College Librarian and Reference Librarian, respectively, who introduced them to the diverse materials the Historical Medical Library has to offer. During their visit, the students entered the library stacks, the climate-controlled space in which the College of Physicians’ vast collection of medical-related books and manuscripts are stored. In the spirit of Banned Books Week, they also viewed several books in the collection that have been challenged for various reasons, including books related to witchcraft and sexual health.

Students in the Karabots Junior Fellows Program meet with College Librarian Beth Lander during a tour of the Historical Medical Library

Following their trip to the Library, the students returned to the classroom to discuss the tenets of Banned Books Week. Youth Program Coordinator Kevin Impellizeri challenged them to consider the definitions of “censorship” and “obscenity” and critically examine why individuals or groups would attempt to challenge access to a particular book. They came to the conclusion that “objectionable material” is largely in the eye of the beholder, shaped by a wide variety of factors, including taste, cultural norms, and religious beliefs; as a result, there is no one shared standard for obscenity. They then applied what they learned by going through numerous influential books that have been challenged or banned, including the ALA’s 100 most challenged books of 2000-2009 and selected readings from the 2012 Library of Congress exhibit Books that Shaped America.

 

 

Philly Youth Browse Banned Books

Three students from the Karabots Junior Fellows program stand in front of books on display in the Historical Medical Library for the Banned Books Week exhibit

Last week, students in the Karabots Junior Fellows and Teva Pharmaceuticals Internship Programs tackled some controversial reading material. September 25-October 1 marked the celebration of Banned Books Week. Started in 1982, Banned Books Week raises awareness of books that have been challenged or outright banned in order to raise awareness of risks raised by censorship and encourage freedom of expression. Every year there are calls to restrict access to books held in bookstores and school and public libraries; the American Library Association (ALA) reports that since 1982 over 11,300 books have been challenged. Reasons for a challenge on a given book often stem from objections to content or subject matter, especially when it comes to access to minors. Some famous novels that have been challenged or banned include John Steinbeck’s  The Grapes of Wrath (for language and sexual references), Upton Sinclair’s The Jungle (for its political message), Ralph Ellison’s Invisible Man (for its depictions of race) and even Dr. Seuss’ Hop on Pop (for encouraging violence against fathers!).

In the spirit of the season, the Historical Medical Library of the College of Physicians of Philadelphia displayed an exhibit of challenged books from their collection. CEPI also contributed, selecting books for the exhibit on behalf of our three Youth Programs. Their selections were:

The students visited the Library and talked with Library Assistant Caitlin Angelone, who introduced them to the entries in the exhibit and discussed the reasons people attempt to restrict access to certain books. As they explored the exhibit, our students shared their thoughts on intellectual freedom and censorship, and our instructors encouraged them to read a banned or challenged book for themselves.

Students from the Teva Pharmaceuticals Internship Program stand in front of books on display for the Historical medical Library's exhibit for Banned Books Week. They are speaking with Library Assistant Caitlin Angelone.

If you would like to learn more about challenged books, the American Library Association maintains a list of the most frequently challenged books. The official page of Banned Books Week has curated a a selection of challenged books from the Library of Congress’ exhibit: Books that Shaped AmericaFeel free to read over the lists to see which ones you’ve read or may add to your reading list.

Exquisite Corpses Etching Workshop: Drypoint Edition

A few weekends ago, a number of students crowded around a display of books in our historical medical library as Historical Medical Librarian Beth Lander spoke. The books ranged from the Renaissance to the 1850’s, and were all filled with astoundingly beautiful medical illustrations. Beth went from book to book, elucidating the various manuscripts and placing them in context of their history and importance to medicine. The students were there to cut them apart. Well, not the actual books, but photocopies of the illustrations in them. This was all part of a class in tandem with Second State Press called Exquisite Corpses Etching Workshop: Drypoint.

After we had spent an hour poring over the minute details of the illustrations in these antique books, students ventured into the classroom, where a spread of the photocopies lay across two 6 foot tables. Students chose a handful of images and went to work cutting them apart and gluing them onto paper, reassembling, abstracting, and creating inspired collages.

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Printmaker Lauren Pakradooni from Second State then passed out sheets of plexiglass. Students placed the plexi plates on top of their collages and traced them, digging and etching into the plates with a sharp pointed tool called a scribe. Lauren described the techniques one could use to create marks and make tonal value, including cross-hatching, stippling, and scratching with sandpaper.

On Sunday, students came to Second State Press where they inked their incomplete plates and did test prints to see how their initial etchings were coming out. After reviewing how the various techniques looked once printed, students worked back into their plates, completing their etchings and running them through the press, with terrific results!

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Be sure to check our Events page for upcoming arts events – we are holding another session of our 8-week specimen drawing course, Drawing Anatomical Anomalies in September and October, as well as an interactive performance of Edgar Allen Poe’s Masque of the Red Death, followed by cocktails and a conversation about tuberculosis in Poe’s life and works on October 4th.

Happy Birthday, Dr. Laënnec: The Karabots Junior Fellows Commemorate 200 Years of the Stethoscope

Two students from the Karabots Junior Fellows Program experiment with a Laënnec stethoscope

Today is the 235th birthday of Rene Laënnec, the inventor of one of the mainstays of the medical professional’s toolkit: the stethoscope. As it turns out, 2016 also marks the 200th anniversary of the stethoscope.

In honor of the device’s bicentennial, the Historical Medical Library of the College of Physicians of Philadelphia hosted an exhibition of some of the stethoscopes in the College of Physicians of Philadelphia’s vast collection. There were also stethoscopes on loan from Thomas Jefferson University Archives and three private collections. On display were stethoscopes past and present, including one owned by William Osler and both an original and a more modern facsimile of Laënnec’s original design.

Students in the Karabots Junior Fellows Program were on hand to examine the collection, learning facts about the stethoscope from our very own CEPI Director Jacqui Bowman who organized the exhibition in collaboration with George Davis, MD.

The Karabots Junior Fellows meet with CEPI Director Jacqui Bowman to learn about the history of the stethoscope

After exploring the exhibit, the Fellows broke into groups to try their hand at conducting their own auscultations (the technical term for an examination with a stethoscope). They also compared past and present technology by experimenting with a recreation of a Civil War stethoscope in an attempt to learn which was more efficient at detecting a heartbeat.

Karabots Junior Fellows experiment with giving each other auscultations

In March 2016, look out for a mini exhibit on monaural stethoscopes in our CEPI display case near the Koop Education Center here at the College of Physicians.