The Extended Eastern State Hospital
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Galt was adamant that separate institutions for the insane were necessary. While he was not opposed in principle to almshouses-locally funded refuges for the poor and needy-he didn't think they were suitable in his region given the relative sparseness of its population and maintained that independent asylums were best for the welfare of the insane.

Perhaps in countries possessing a dense population, the chronic insane might in a measure be tolerably well provided for in almshouses, but this does not appear practicable in Virginia. And although I have not had an opportunity of examining into the matter personally, yet from the accounts of others, I fear that the insane, so situated, are not usually comfortable. (48; 8-9)

His concern is perhaps unsurprising. As David Rothman notes "State investigations of the almshouses consistently returned a dismal verdict. Visiting committees found poor-relief institutions in the Jacksonian period in bad condition. After 1850 the situation continued to deteriorate." (288) Rothman quotes one report, which describes the buildings as "inconvenient, poorly constructed and without any adaptation to the object to which it is appropriated. They mixed the old and the young, the sane and the insane, the sick and the well ... diseased, dirty men, and squalid women and children." (288) It is not difficult to see how the removal of the insane from this environment could be seen as a helpful move.

That Galt was instrumental in removing the insane to separate institutions did not mean that he was determined to force them out of society and to mark the mad out as a separate caste of people. As the following statement of his frequently repeated beliefs shows, his philosophy was very different.

I cannot omit to say here, as having been a guide to our present action, that in amusements as in other matters, the policy seems best, to treat the insane as though they were sane, and moreover, not as children, but as men and women. And as a general rule, we have observed that the patients preferred an engagement in the pursuits of the sane, in the community around them, to other means of recreation of unusual nature. (59; 30)

This view was clearly informed by the wider realization that the insane were not a separate class, made up of demons or sinners, but simply people who were afflicted with an illness. As Galt's comments show, this shift in viewpoint had a massive impact on the willingness of the now "enlightened" public to recognize their responsibilities to the insane and to support the funding of institutional care. The division between the insane and the rest of the population was no longer as clear as it once was.

Each one of us stands as it were on the brink of a precipice, and forever liable to be cast down, by the force of circumstances, into the whelming waters below. Hence, the general interest, with a corresponding action, should be even greater than it is, considering the growing demand on the part of an enlightened public, for additional and still more comfortable accommodations for those of their friends who languish under the dread calamity of a "mind diseased." (55; 18)

Under John M. Galt's direction, the Eastern State Hospital admitted both free blacks and slaves as patients, claiming to be the first institution of its type to do so. The following extended extract from Galt's writings on "The Coloured Insane" shows that these patients had a complicated status in relation to their white counterparts.

It not being deemed feasible or requisite to establish separate institutions for insane coloured persons, it is suggested that provision be made for them in ordinary asylums. This may be done either by the erection of a building for the purpose in the vicinity of an asylum, not within the some enclosure, but under the same directory and superintendent; or by appropriating an out-building or wing to this end; or simply by their admission into the wards of the white patients, care being taken in selecting the wards in which they are placed and distributed. No particular difficulty is anticipated in carrying into execution either of these three plans; they might be severally adopted, according to the extent of the prejudice relative to this subject in any community, to the number of coloured insane requiring accommodations, and other collateral circumstances.

In the Eastern asylum no particular strictness is observed in isolating the white from the coloured patients; nor under the arrangement adopted in this respect, is there the slightest difference in management originating from the presence of the two races in the same asylum. There happens to be at this institution an out-building, devoted many years ago to the separation of convalescent patients from the more insane; in this are now placed the coloured females, who are thus never in contact, necessarily, with the white patients. The male coloured are few, being ordinarily only half the number of the females belonging to this class. No special arrangement is adopted with regard to them. The mode of treatment in the asylum and the climate conjointly, prevent any disadvantage from occurring here, even if there should be otherwise a tendency in that direction; for very few of the male patients are in the wards but a short time during the day, so that, except in rare instances, there is little or no necessary direct communication between the two classes. But this is not found to be a matter of any consequence; for the servants of the institution are all of them slaves; and the white patients are familiar, of course, with these, and generally look upon the coloured patients pretty much in the same light as they do the servants. (48; 27)

It is not clear when Galt says with relation to the presence of black males in the main building that the "mode of treatment in the asylum and the climate conjointly, prevent any disadvantage from occurring here, even if there should be otherwise a tendency in that direction"; we cannot be sure whether these patients were subjected to special forms of treatment or restraint. As Galt observes, unlike their masters, slaves were necessarily more acquiescent to treatment.

It is in the early stage of mental derangement that medical or perturbing measures are most valuable and efficient; but the very fact that it is to the interest of his owner that a slave should recover from insanity, apart from feelings of kindness and a sense of duty, induces him to send for a physician in the acute of incubative stage of the disease; hence we have as an almost invariable circumstance, the application of medical aid in the early period of the derangement ... With regard to free persons, in private, there are two serious obstacles to putting in force these valuable means. In the first place, many patients being unused to control, it is difficult to make them do otherwise than as they please, and hence there is uncertainty about the whole matter. (48; 26)

Galt's analysis of why fewer slaves became insane in comparison to their free counterparts provides insight into both the perceived causes of insanity in mainstream American life and the ways that Southerners justified their treatment of slaves. 

The proportionate number of slaves who become deranged, is less than that of free colored persons, and less than that of the whites. From many of the causes affecting the other classes of our inhabitants, they are somewhat exempt; for example, they are removed from much of the mental excitement to which the free population of the Union is necessarily exposed in the daily routine of life; not to mention the liability of the latter to the influence of the agitating novelties in religion, the intensity of political discussion, and other elements of the excessive mental action which is the result of our republican form of government. Again, they have not the anxious cares and anxieties relative to property, which tend to depress some of our free citizens. The future, which to some of our white population may seem dark and gloomy, to them presents no cloud on the horizon. Moreover, not only are they less exposed to causative influences of a moral character, but the mode of life which they lead tends to strengthen the constitution, and enable it to resist physical agents, calculated to induce insanity. (48; 25)

Sounding like a precursor of critics of postmodernism such as Fredric Jameson, Galt argued that modern life was plagued by spatial and social confusion and that the "safe-guards" against insanity were being gradually eroded as the world apparently developed.

[N]ow, it may be said, almost without a metaphor, that we have annihilated space and time, through steam and the telegraph ... and forthwith the whole country vibrates to the same potent energy.

Again-At a former period there were manly pastimes-pastimes which, often as in the cricket of "merrie England," were serviceable as a wholesome recreation, and also in developing the muscular over the nervous system. But amusement now either appeals to the imagination, as in the theatre, or to the intellect, as in public lectures; or, as is but too frequently the case, we form our recreation out of the very excitement to which we have referred. (55; 21)

In the following section from the same document, it is unclear when Galt refers to “the young America” being released from “parental control” whether he refers to the youthful members of the American population, or the young nation itself, being released from the control of “merrie England.” Whatever the case, he clearly talks in terms of a problem on a national scale.

[I]n connection with the early release of the young America from parental control, there is consequently at the same time a nervous diathesis, and a decided deficiency in habits of self-restraint. And hence also there is the absence of moderation, perhaps of all safe-guards, one of the most effectual against physical disturbance.

Even, too, with our provision for early and continuous cultivation of the understanding, there certainly seems to be a want of that holy worship of the true that ought to be invariably inculcated. So that partisan zeal is permitted to close the avenues of real knowledge, and its deluded followers surrender their judgment to the sway of any popular agitation, even though proved to be of an entirely erroneous nature. (55; 21)

Galt cites particular examples of this tendency to delusion, such as Millerism, a religious movement that believed the Second Coming would take place on October 22, 1844 (it didn’t). Galt concludes however that all such instances are part of wider currents in American life, pointing out that “if there be not one mind-destroying agitation before the view of the country, there is another; and what we should chiefly blame and seek to correct, therefore, is not so much any special falsity, but general proclivities which are ready to admit and foster delusions of the kind-as the seed is nourished in the hot-bed of the gardener.” (55; 20) Galt described his time as "excitable."

“This is an excitable age, an age of excitement-a period in which there are multitudinous sources of mental stimulation-a period when there is an eager craving for these stimuli-a passionate disposition to eagerly drink them in, as after a parching drought, the thirsty earth absorbs the tumultuous rain-a period when there is not only this manifold excitement, and a strong inclination as it were to quaff it as a sparkling, intoxicating draught, but where there is too a mental constitution of very ordinary occurrence, in which this desire and facility to receive are likewise attended by an extreme physical pliability, so that the mental powers from such sources are "easily warped and wrung." (55; 19)

It is not clear what proportion of the population Galt believes is in danger of this kind of transformation, although he does describe such constitutions as being "of very ordinary occurrence." Similarly, when Galt writes that "there is in reality, as a sort of compensation for the blessings of civilization, amongst other drawbacks, some increase of nervous and mental diseases" (55; 22), it is not clear whether he is hinting that the "blessings" in question may not be as great as they seem, once the “drawbacks” he gestures toward are considered. We can identify the same tension in the following observation:

[W]hilst the indomitable energy of the American is fast making him the greatest nation that the skies have ever looked upon, we have, as indeed might be reasonably anticipated, evils of a counterbalancing character. ... we trace the results of excessive or misdirected mental excitement, in the wrecked mind which seeks a refuge and resting place in our institutions for the insane. (55; 20)

The question of whether or not the "blessings of civilization" are eventually outweighed by the associated “evils” is left unanswered.

See the Complete Report for 1857.
See the Bibliography.