“If only [the] mind were as easy to fix as [the] body.”
— Han Nolan
Spurred by a writing assignment and general curiosity, I recently visited the Indiana State Archives to explore the Central State Hospital Collection. Central State Hospital, originally called the Indiana Hospital for the Insane, opened on the west side of Indianapolis in 1848. In the beginning, patients were admitted from every county in the state. But eventually, space ran out, and in 1883, funding was approved for three additional mental hospitals to be built in Indiana. Even after the fourth hospital opened in 1890, crowding continued to be a problem.
In 1994, Central State Hospital closed its doors, and its records were transferred to the Archives. Most of the collection is confidential. To view a patient record, you have to be able to prove the patient is related to you. So, I dug into a piece of the collection that is open to the public: the Administrative History File. It includes information about the origins of the hospital and changes in the treatment of mental illness over the years.
One of the most interesting things I found: a table listing “probable causes of insanity” for 1753 patients admitted from 1848-1959, which included:
| Abuse from Drunken Husbands |
| Accidental Homicide |
| Adultery |
| Avarice |
| Cessation of Menses |
| Confinement in Jail |
| Constitutional |
| Coup de Soliel |
| Defective Education and Dissipation |
| Disappointed Ambition |
| Disappointment in Love |
| Dissipation |
| Domestic Bereavements |
| Domestic Dissensions |
| Dyspepsia |
| Emigration and Disappointment |
| Epilepsy |
| Erysipelas |
| Excessive Lactation |
| Excessive Use of Medicine |
| Excessive Use of Quinine |
| Excessive Use of Tobacco |
| Excessive Venery |
| Fall |
| False Accusations |
| Fatigue and Anxiety |
| Fear of Want |
| Financial Difficulties |
| Followed Fever |
| Fright |
| Gormandizing |
| Husbands in California |
| Ill Treatment from Relatives |
| Injury to the Head |
| Intemperate Drinking |
| Intense Application |
| Jealousy |
| Know Nothingism |
| Legal Difficulty |
| Loss of Property |
| Loss of Sleep and Exposure |
| Mania a Potu |
| Masturbation |
| Mesmerism |
| Mexican War Excitement |
| Millerism |
| Nephritis |
| Nostalgia |
| Opposition in Marriage |
| Paralysis |
| Physical Disease |
| Political Excitement |
| Prostitution |
| Puerperal |
| Pulmonary Disease |
| Reading Vile Books |
| Religious Excitement and Anxieties |
| Seductions |
| Spermatorrhoea |
| Spinal Irritation |
| Spiritual Rappings |
| Sterility |
| Suppression of the Menses |
| Surgical Operation |
| Unknown |
| Use of Opium |
| Use of Thompsonian Medicine |
| Violent Temper |
| Want of Occupation |
I entered all the data into a spreadsheet and came up with a few top ten lists.
Top Ten Most Common Causes of Insanity (Men and Women):
- Unknown
- Religious Excitement and Anxieties
- Physical Disease
- Domestic Bereavements
- Puerperal
- Loss of Sleep and Exposure
- Disappointment in Love
- Constitutional
- Domestic Dissensions
- Spiritual Rappings
Top Ten Most Common Causes of Insanity (Men):
- Unknown
- Religious Excitement and Anxieties
- Spiritual Rappings
- Disappointment in Love
- Epilepsy
- Domestic Bereavements
- Financial Difficulties
- Constitutional
- Physical Disease
- Masturbation
Top Ten Most Common Causes of Insanity (Women):
- Puerperal
- Domestic Bereavements
- Unknown
- Physical Disease
- Religious Excitement and Anxieties
- Domestic Dissensions
- Suppression of the Menses
- Disappointment in Love
- Constitutional
- Abuse from Drunken Husbands
Interestingly, disappointment in love made it into the top ten causes of insanity for both men and women, but there were more men admitted for this reason than women.
But I digress.
Clearly we have come a long way in understanding mental illness. We no longer hospitalize people for such odd reasons as “husbands in California,” “excessive lactation” or “reading vile books,” and we no longer consider insanity to be a synonym for depression. These are good things. This is progress.
Sadly, many of these patients probably did not require hospitalization, and we’re still struggling to find the right setting for people who are suffering with illnesses that are not easily treated with medicine. Institutionalization often does more harm than good, but trusting a suicidal and/or unpredictable patient to show up to outpatient care without hurting anyone is extremely risky. Unfortunately, treatment of the mentally ill is still largely an exercise in trial and error.
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After exploring this collection, I discovered that you can still visit the grounds of Central State Hospital. The Indiana Medical History Museum is located there in the Old Pathology Building – the oldest surviving pathology facility in the nation. I visited the museum Saturday afternoon, and nosed around the grounds as much as I could. Most of the buildings are in terrible shape, and part of the city-owned property is now home to the IMPD Mounted Patrol.
Entrance of the Old Pathology Building
But still, it is a fascinating piece of Indiana history to explore – and certainly a unique way to spend a Saturday afternoon.
The Indiana Medical History Museum is located at 3045 West Vermont Street, Indianapolis. Open Thursday-Saturday, 10-4. Guided tours only. Admission is $5.
