“We do not have to visit a madhouse to find disordered minds; our planet is the mental institution of the universe.”
― Johann Wolfgang von Goethe
It has often been said that the compassion by which we treat the incarcerated is indicative of the state of our society as a whole. A logical extension of this sentiment would be to bring under scrutiny the conditions by which we care for those whose minds are shaken and broken; the insane, the mad, the traumatized, the disturbed. In my opinion, the definition of ‘insanity’ is as loose-weave as the intellects of those who try to define it – I would know, having been accused of madness more times than the average Englishman drinks tea.
When mediocre medical minds exhaust their limited and unimaginative reservoir of knowledge in treating the insane, what is left to them, but to incarcerate the sick and label it ‘treatment‘? Consequently, methods by which one might restrain a patient are numerous – some designed with the intention of preventing harm to an otherwise violent patient, others seemingly intended to cause the precise opposite – often damaging the already fragile intellects of the afflicted and pushing them far beyond conceivable help.
This week we shall be studying one such device: the infamous Utica Crib, a device that is to mental health what politicians are to society – detrimental to positive development and likely extremely dangerous.
Although used throughout the world in the mid 19th century, the Utica Crib found its most ardent supporters – and detractors – in the United States. First developed in France by Dr. M.H. Aubanel of the Marseilles Lunatic Asylum in 1845, it was then introduced into America by Dr. Brigham in 1846 and utilized almost immediately in several state institutions, including New York State Asylum.
The design was simple – described as coffin shaped, a bed with barred sides and a hinged roof, 3 feet wide, 6 feet long and 18 inches deep, although with the addition of a hospital grade mattress, this space was reduced to a mere 12 inches. Into this wood or iron cage, patients deemed too unruly for free mobility were placed for periods ranging from a few hours to several days.
This highly inhibitive form of restraint was considered by many to be an upgrade from previous methods such as shackles, small windowless rooms or the straitjacket (known at the time as the camisole de force – not to be confused with the delicate undergarment). Needless to say, almost complete ignorance of the nature of mental disorders had led physicians and alienists (the predecessor to the psychologist) to resort to such extreme measures as a means to prevent harm to the patients and others. Yet with common scientific opinion being that of essentially viewing patients as animals and ‘wretches’, negligence and bizarre medical ‘solutions’ such as the Utica Crib were commonplace.
Additionally it should not be ignored the ‘symptoms’ identified as reason enough to subject a person to residence within an asylum, such as epilepsy, over-working, masturbation, sexual fervor, impropriety, nervous shaking, war-trauma and the ever-vague catch-all, ‘women issues’. To resist ones plight within such an institution was to be considered ‘disruptive’ and liable to have oneself locked within the tiny enclosure.
Understandably, patients were less than enthusiastic at their imprisonment. Dr. William Hammond, an avid protester of the treatment describes in The International Review in 1880:
“It is a matter of experience that patients who were […] in the crib, dashing themselves with violence against the bars like a wild lion in its cage when confined…”
Hammond goes on to describe that patients had died while contained in the cribs. Frequently those who were suffering epileptic seizures or similar afflictions and then placed into the cages died within them in short order. Those already severely distraught would be so panicked that they would suffer heart-attacks and also perish. A British physician alienist Daniel H. Tuke, in his book on insanity in the United States, mentions that, while a proponent of the use of the crib-bed was beneficial to prevent suicidal harm:
“It is so temptingly facile a mode of restraint, and is on that account so certain to be abused, that I hope it will not be introduced into this country.”
Defense of the ‘Utica Crib’ was as fervent as it was devoid of scientific credibility. A most lucid inmate of the Utica Asylum, so eloquently told a reporter how much he liked it:
“When I occupy this bed I rest easily, for I know where to find myself in the morning. Without such restraint, I might do myself some harm during the night.”
… leaving one to wonder why in the case of this patient, a hinged, locking lid was even needed. Comfortingly termed by defenders as a ‘covered bed’, excuses for utilization ranged from how ‘getting in and out of bed at frequent periods’ would exhaust the patient and expose them to cold, to:
“So simple and harmless is the contrivance that parents, after seeing them, inquire, “Why would not this be a good plan to prevent our babies from falling out of their cradles?” It certainly would.”
Despite these reassuring yet ridiculous statements, specific cases of abuse were common. One such was the sad story of Sara Halverson, who in 1867 had seen fit to escape her institutional circumstances, and upon re-capture had been imprisoned in the coffin-crib. So spirited was her opposition to this cruelty, she soon found herself locked in almost all the time. A record from 1873 reads:
“Noisy as ever – lower limbs flexed so that knees are drawn up to the chin. Crawls about on buttocks feet & hands – fierce & noisy.”
Two years later, her confinement remained the same while her physical conditions worsened. June 1874 and March 1875 entries read:
Finally in March 1876, the last known entry reads:
“Can’t walk, but is much quieter.”
Unfortunately neither Sara’s mental ailment nor her ultimate fate is known. Perhaps due to victims of restraint like Sara and patients like her, or perhaps even to the mental health institution finally coming to its senses, several years later use of the Utica Crib was gradually phased out and dispensed with. However, as only one option in a portfolio of strange and harmful treatments available to physicians, the poor care and mistreatment suffered by mental health patients was far from over.