After her admission to Norwich State Hospital, my great-grandmother, Graziella, was sent to North B. The patient population around the time she was admitted was 434, which may not seem like much now, but the existing buildings were only designed to hold 400. Over the years, although more wards were built, Norwich State Hospital was always said to be overcrowded. They just couldn’t keep up with the growing number of mentally ill patients.
When Graziella was first admitted, in June 1908, she was disheveled and confused and unable to answer simple questions such as What is your name? and Where do you live? According to her patient record, it was impossible to get a response from her because of her hallucinations and delusions. Graziella was diagnosed with manic-depressive psychosis. In the weeks that followed her admission, she was depressed and said she wanted to commit suicide.
But after several weeks there, she seemed to pull out of it a bit. Here are a few of the entries in the late summer and early fall of 1908:
- 8/23/08 Is up half the day, is anxious to help with the ward work, much more cheerful.
- 9/2/08 Much brighter. Asked the doctor to send and have clothes brought from home for her, she wants clean clothes to put on if she is to be here much longer.
- 9/11/08 Much more cheerful, improving. Helps considerably with the ward work.
After that last note, however, there was a gap of over a month before the next notation, and it was grim:
- 10/18/08 About three weeks ago patient became disturbed. She threw away her teeth … and they have not been found.
When I first read the patient records, the word “teeth” caught my eye. I remember thinking, didn’t Mom once say that some doctor thought it was a good idea to pull out all Graziella’s teeth?
I went back to the part of Graziella’s patient record where her physical attributes at the time of admission had been enumerated: height, weight, sex, race, even the dimensions of her head. Her complexion was “dark,” her expression “worried,” and her teeth were “fair.” Aha! Graziella still had her own teeth when she came to the hospital. I suspect that some time between the note on September 11 (when she was said to be improving) and September 27 (the day she threw her dentures down the toilet), all her teeth must have been removed. My next question was, why would they do something like that?
The early twentieth century was a time when general medicine was making great strides, identifying the specific organisms which caused diseases such as typhus or measles. However, there was no similar consensus among psychiatrists as to the causes of schizophrenia or manic-depressive disorder. Psychiatrists were driven to find cures for mental illness partly because of the alarming rise in the number of patients pouring into the state hospitals. But they were also driven by a sense that their medical specialty wasn’t as highly regarded as others, because couldn’t come up with a cure. They speculated on the possible causes of mental illness which ranged from environmental factors (urbanization, the industrial boom, and immigration) to biological factors (brain lesions and hidden infections).
It seemed to me, when reading about psychiatry during this period, that whenever a new idea for curing insanity cropped up in the medical literature or the news, state hospital superintendents were sometimes too eager to try it on their own patients. As the numbers of the mentally ill in state hospitals rose, psychiatrists looked for solutions that could be administered across the board to likely patients. Problems arose when they couldn’t reproduce the results found in the journal articles. Many of these methods were rushed into clinical use before there was adequate experimentation on their effectiveness. Another way of putting it was that the experimentation was done directly on patients who didn’t appear to have much choice.
At the time that Graziella had been a patient, teeth were thought to be the most common place for hidden infections which were thought (by some) to cause insanity. Articles appeared the medical journals with titles such as “Nervous Disorders Due to the Teeth” and newspaper articles such as “Expert – After 11 Years’ Study – Says Bad Teeth Cause Insanity.”
This second article was written about the work of Dr. Henry Cotton of Trenton State Hospital. Dr. Cotton became famous (or infamous) because he took the theory of hidden infections to a unreasonable extreme. If pulling teeth didn’t work, he would remove tonsils, spleens, appendixes, and even the colon. Worse than that, he faked his statistics. Investigations into his work showed that the mortality rate for his abdominal surgeries may have been as high as 44%. Dr. Cotton was eventually forced to retire in 1930. That was too late to prevent his dubious methods from being performed on Graziella and thousands of other mental patients.
Coming next: “Graziella’s Demise.”
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Scull, Andrew. Madhouse: A Tragic Tale of Megalomania and Modern Medicine. New Haven, Conn.: Yale University Press, 2005.
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