A Psychiatric Milestone by Various

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[Illustration: THE NEW YORK HOSPITAL, DUANE STREET AND BROADWAY

The building to the left was erected in 1808 for the exclusive use of
patients suffering from mental disorders.]

A PSYCHIATRIC MILESTONE

BLOOMINGDALE HOSPITAL CENTENARY

1821-1921

"Cum corpore ut una
Crescere sentimus, pariterque senescere mentem."
--LUCRETIUS

PRIVATELY PRINTED

BY THE SOCIETY OF THE NEW YORK HOSPITAL

1921

ANNIVERSARY COMMITTEE

HOWARD TOWNSEND
BRONSON WINTHROP
R. HORACE GALLATIN

PREFACE

The opening of Bloomingdale Asylum on June 1, 1821, was an important
event in the treatment of mental disorders and in the progress of
humanitarian and scientific work in America. Hospital treatment for
persons suffering from mental disorders had been furnished by the New
York Hospital since its opening in 1792, and the Governors had given
much thought and effort to securing the facilities needed. The treatment
consisted, however, principally in the administration of drugs and the
employment of such other physical measures as were in vogue at that
time. Little attempt was made to study the minds of the patients or to
treat them by measures directed specifically to influencing their
thoughts, feelings, and behavior, and what treatment of this character
there was had for its object little more than the repression of
excitement and disordered activity. The value and importance of
treatment directed to the mind had, indeed, been long recognized, but in
practice it had been subordinated to treatment of the actual and assumed
physical disorders to which the mental state of the patient was
attributed, and, in the few hospitals where persons suffering from
mental disorders were received, means for its application were almost or
quite entirely lacking. The establishment of Bloomingdale Asylum for the
purpose of ascertaining to what extent the recovery of the patients
might be accomplished by moral as well as by purely medical treatment
marked, therefore, the very earliest stages of the development in
America of the system of study and treatment of mental disorders which
with increasing amplification and precision is now universally employed.

A hundred years of growth and activity in the work thus established have
now been accomplished, and it seemed fitting to the Governors of the
Hospital that the event should be commemorated in a way that would be
appropriate to its significance and importance. It was decided that the
principal place in the celebration should be given to the purely medical
and scientific aspects of the work, with special reference to the
progress which had been made in the direction of the practical
usefulness of psychiatry in the treatment of illness generally, and in
the management of problems of human behavior and welfare. Arrangements
were made for four addresses by physicians of conspicuous eminence in
their particular fields, and invitations to attend the exercises were
sent to the leading psychiatrists, psychologists, and neurologists of
America, and to others who were known to be specially interested in the
field of study and practice in which the Hospital is engaged. It was
felt that, in view of the place which France and England had held in the
movement in which Bloomingdale Asylum had its origin, it would add
greatly to the interest and value of the celebration if representatives
of these countries were present and made addresses. How fortunate it
was, then, that it became possible to welcome from France Dr. Pierre
Janet, who stands pre-eminent in the field of psychopathology, and from
England Dr. Richard G. Rows, whose contributions to the study and
treatment of the war neuroses and to the relation between psychic and
physical reactions marked him as especially qualified to present the
more advanced view-point of British psychiatry. The other two principal
addresses were made by Dr. Adolf Meyer, who, by reason of his scientific
contributions and his wonderfully productive practical work in clinical
and organized psychiatry and in mental hygiene, is the acknowledged
leader of psychiatry in America, and by Dr. Lewellys F. Barker, who,
because of his eminence as an internist and of the extent to which he
has advocated and employed psychiatric knowledge and methods in his
practice, has contributed greatly to interesting and informing
physicians concerning the value and importance of psychiatry in general
medical practice. The addresses given by these distinguished physicians,
representing advanced views in psychiatry held in Europe and America,
were peculiarly appropriate to the occasion and to the object of the
celebration. They were supplemented by an historical review of the
origin and development of the Hospital and of its work by Mr. Edward W.
Sheldon, President of the Society of the New York Hospital, and by a
statement concerning the medical development, made by Dr. William L.
Russell, the Medical Superintendent. The greetings of the New York
Academy of Medicine were presented in an interesting address by Dr.
George D. Stewart, President of the Academy.

Of scarcely less significance and interest than the addresses was the
pageant presented on the lawn during the intermission between the
sessions, depicting scenes and incidents illustrating the origin and
development of the Hospital, and of psychiatry and mental hygiene. The
text and the scenes displayed were prepared by Dr. Charles I. Lambert,
First Assistant Physician of the Hospital, and by Mrs. Adelyn Wesley,
who directed the performance and acted as narrator. The performers were
persons who were connected with the Hospital, twenty-two of whom were
patients.

The celebration was held on May 26, 1921. The weather was exceptionally
clear, with bright sunshine and moderate temperature. The grounds, in
their Spring dress of fresh leaves and flowers, were especially
beautiful. This added much to the attractiveness of the occasion and the
pleasure of those who attended. Luncheon was served on the lawn in front
of the Brown Villa and the pageant was presented on the adjoining
recreation grounds. The beauty of the day and the surroundings, the
character of the addresses and of the speakers, the remarkable felicity
and grace with which they were introduced by the President, the dignity
and noble idealism of his closing words, and the distinguished character
of the audience, all contributed to make the celebration one of
exceptional interest and value to those who were present, and a notable
event in the history of the Hospital.

For the purpose of preserving, and of perhaps extending to some who were
not present, the spirit of the occasion, and of placing in permanent
form an account of the proceedings and the addresses which were made,
this volume has been published by the Society of the New York Hospital.

WILLIAM L. RUSSELL.

CONTENTS

Page
PREFACE vii

INVOCATION 3
REV. FRANK H. SIMMONDS

HISTORICAL REVIEW 7
EDWARD W. SHELDON, ESQ.
President of the Society of the New York Hospital

"THE CONTRIBUTIONS OF PSYCHIATRY TO THE UNDERSTANDING OF LIFE PROBLEMS" 17
ADOLF MEYER, M.D.
Director of the Henry Phipps Psychiatric Clinic, Johns Hopkins
Hospital, and Professor of Psychiatry, Johns Hopkins University,
Baltimore, Maryland

"THE IMPORTANCE OF PSYCHIATRY IN GENERAL MEDICAL PRACTICE" 55
LEWELLYS F. BARKER, M.D.
Professor of Clinical Medicine, Johns Hopkins Medical School,
Baltimore, Maryland

GREETINGS FROM THE NEW YORK ACADEMY OF MEDICINE 79
GEORGE D. STEWART, M.D.
President of the Academy

"THE BIOLOGICAL SIGNIFICANCE OF MENTAL ILLNESS" 89
RICHARD G. ROWS, M.D.
Director of the Section on Mental Illnesses of the Special
Neurological Hospital, Tooting, London, England

"THE RELATION OF THE NEUROSES TO THE PSYCHOSES" 115
PIERRE JANET, M.D.
Professor of Psychology, College de France

"THE MEDICAL DEVELOPMENT OF BLOOMINGDALE HOSPITAL" 147
WILLIAM L. RUSSELL, M.D.
Medical Superintendent

THE TABLEAU-PAGEANT 171

NAMES OF THOSE WHO ATTENDED THE EXERCISES 177

APPENDIX I 191
COMMUNICATIONS FROM DR. BEDFORD PIERCE
Medical Superintendent of The Retreat, York, England
EXTRACT FROM MINUTES OF BOARD OF DIRECTORS OF THE RETREAT,
APRIL 30, 1921.
TRANSCRIPT FROM THE VISITORS BOOK OF THE RETREAT, 1803-17.

APPENDIX II 195
A LETTER ON PAUPER LUNATIC ASYLUMS FROM SAMUEL TUKE TO
THOMAS EDDY, 1815.

APPENDIX III 200
THOMAS EDDY'S COMMUNICATION TO THE BOARD OF GOVERNORS, APRIL, 1815.

APPENDIX IV 209
EXTRACTS FROM THE MINUTES OF THE BOARD OF GOVERNORS IN RELATION TO
ACTION TAKEN RESPECTING THOS. EDDY'S COMMUNICATION DATED
APRIL, 1815.

APPENDIX V 212
ADDRESS TO THE PUBLIC BY THE GOVERNORS, 1821.

APPENDIX VI 216
BOARD OF GOVERNORS OF THE SOCIETY OF THE NEW YORK HOSPITAL, 1821
AND 1921.

APPENDIX VII 218
ORGANIZATION OF BLOOMINGDALE HOSPITAL, 1821 AND 1921.

ILLUSTRATIONS

New York Hospital and Lunatic Asylum, 1808 _Frontispiece_
FACING PAGE
Bloomingdale Asylum, 1821 2
Bloomingdale Asylum, 1894 80
Bloomingdale Hospital, 1921 148
The Tableau-Pageant 172
Thomas Eddy 195

THE SOCIETY OF THE NEW YORK HOSPITAL

[Illustration: BLOOMINGDALE ASYLUM

As it appeared when it was opened in 1821. It was located near the seven
mile stone on the Bloomingdale Road, now 116th Street and Broadway.]

BLOOMINGDALE HOSPITAL CENTENARY

The One Hundredth Anniversary of the establishment of Bloomingdale
Hospital as a separate department for mental diseases of The Society of
the New York Hospital was celebrated at the Hospital at White Plains on
Thursday, May 26, 1921. The addresses were given in the Assembly Hall.

Mr. Edward W. Sheldon, the President of the Society, acted as Chairman.

MORNING SESSION

The exercises opened with an invocation by the Reverend Frank H.
Simmonds, rector of Grace Episcopal Church at White Plains:

Oh, most mighty and all-merciful God, whose power is over all Thy works,
who willest that all men shall glorify Thee in the constant bringing to
perfection those powers of Thine which shall more and more make perfect
the beings of Thy creation, we glorify Thee in the gift of Thy Divine
Son Jesus Christ, the Great Physician of our souls, the Sun of
Righteousness arising with healing in His wings, who disposeth every
great and little incident to the glory of God the Father, and to the
comfort of them that love and serve him, we render thanks to Thee and
glorify Thy Name, this day, which brings to completion the hundredth
anniversary of this noble institution's birthday. Oh, Thou, who didst
put it into the hearts and minds of men to dedicate their lives and
fortunes to the advancement of science and medicine for the sick and
afflicted, we render Thee most high praise and hearty thanks for the
grace and virtue of the founders of this institution--men whose names
are written in the Golden Book of life as those who loved their fellow
men.

We praise Thee for such men as Thomas Eddy, James Macdonald, Pliny
Earle, and these endless others, who from age to age have held high the
torch of knowledge and have kept before them the golden rule of service.
Inasmuch as ye have done it unto one of the least of these my brethren,
ye have done it unto me.

Be pleased, oh merciful Father, to bless this day and gathering. Lift up
and enlighten our hearts and minds to a higher perception of all that is
noble, all that is true, all that is merciful. Awaken our dull senses to
the full knowledge of light in Thee, and may all that is said and done
be with the guiding of Thy Holy Spirit.

We pray for the continued blessing of this institution and hospital, and
on all those who are striving to bring out of darkness those unhappy
souls, into the pure light of understanding.

Bless the Governors, physicians, and nurses, direct their judgments,
prosper their undertakings, and dispose their ministry that the world
may feel the blessing and comfort of life in the prevention of disease
and the preservation of health. And may we all be gathered in this
nation to a more perfect unity of life and purpose in the desire to
spend and be spent in the service of our fellow men.

We ask it all in the name and through the mediation of Thy Son Jesus
Christ, our Lord. Amen.

ADDRESS BY
MR. EDWARD W. SHELDON

MR. SHELDON

It is with profound gratification that the Governors welcome your
generous presence to-day on an occasion which means so much to us and
which has perhaps some general significance. For we are met in honor of
what is almost a unique event in our national history, the centennial
anniversary celebration of an exclusively psychopathic hospital. A
summary of its origin and development may be appropriate.

A hundred and fifty years ago the only institutions on this side of the
Atlantic which cared for mental diseases were the Pennsylvania Hospital,
chartered in 1751, a private general hospital which had accommodations
for a few mental cases, and the Eastern State Hospital for the insane,
at Williamsburg, Virginia, a public institution incorporated in 1768. No
other one of the thirteen Colonies had a hospital of any kind, general
or special. With a view of remedying this deplorable lack in New York,
steps were taken in 1769 to establish an adequate general hospital in
the City of New York. This resulted in the grant, on June 11, 1771, of
the Royal Charter of The Society of the New York Hospital. Soon
afterward the construction of the Hospital buildings began on a spacious
tract on lower Broadway opposite Pearl Street, in which provision was
also to be made for mental cases; but before any patients could be
admitted, an accidental fire, in February, 1775, consumed the interior
of the buildings. Reconstruction was immediately undertaken and
completed early in the spring of 1776. But by that time the
Revolutionary War was in full course, and the buildings were taken over
by the Continental authorities as barracks for troops, and were
surrounded by fortifications. When the British captured the city in
September, 1776, they made the same use of the buildings for their own
troops, who remained there until 1783. A long period of readjustment
then ensued, and it was not until January, 1791, that the Hospital was
at last opened to patients. In September, 1792, the Governors directed
the admission of the first mental case, and for the hundred and
twenty-nine years since that time the Society has continuously devoted a
part of its effort to the care of the mentally diseased. After a few
years a separate building for them was deemed desirable, and was
constructed. The State assisted this expansion of the Hospital by
appropriating to the Society $12,500 a year for fifty years. This new
building housed comfortably seventy-five patients, but ten years later
even this proved inadequate in size and undesirable in surroundings. In
the meanwhile a wave of reform in the care of the insane was rising in
Europe under the influence of such benefactors as Philippe Pinel in
France, and William and Samuel Tuke in England. Thomas Eddy, a
philanthropic Quaker Governor of the Society, who was then its Treasurer
and afterward in succession its Vice-President and President, becoming
aware of this movement, and having made a special study of the care and
cure of mental affections, presented a communication to the Governors in
which he advocated a change in the medical treatment, and in particular
the adoption of the so-called moral management similar to that pursued
by the Tukes at The Retreat, in Yorkshire, England. This memorable
communication was printed by the Governors, and constitutes one of the
first of the systematic attempts made in the United States to put this
important medical subject on a humane and scientific basis. To carry out
his plan, Mr. Eddy urged the purchase of a large tract of land near the
city and the erection of suitable buildings. He ventured the moderate
estimate that the population of the city, then about 110,000, might be
doubled by 1836, and quadrupled by 1856. In fact, it was more than
doubled in those first twenty years, and sextupled in the second
twenty. He was justified, therefore, in believing that the hospital
site on lower Broadway would soon be surrounded by a dense population,
and quite unsuited for the efficient care of mental diseases. The
Governors gave these recommendations immediate and favorable
consideration. Various tracts of land, containing in all about
seventy-seven acres, and lying on the historic Harlem Heights between
what are now Riverside Drive and Columbus Avenue, and 107th and 120th
Streets, were subsequently bought by the Society for about $31,000. To
aid in the construction and maintenance of the necessary hospital
buildings, the Legislature, by an act reciting that there was no other
institution in the State where insane patients could be accommodated,
and that humanity and the interest of the State required that provision
should be made for their care and cure, granted an additional annual
appropriation of $10,000 to the Society from 1816 until 1857. The main
Hospital, built of brownstone, stood where the massive library of
Columbia University now is, and the brick building still standing at the
northeast corner of Broadway and 116th Street was the residence of the
Medical Superintendent. The only access to this site by land was over
what was known as the Bloomingdale Road, running from Broadway and 23d
Street through the Bloomingdale district on the North River to 116th
Street, and from that fact our institution assumed the name of
Bloomingdale Asylum, or, as it is now called, Bloomingdale Hospital.
This beautiful elevated site overlooking the Hudson River and the Harlem
River was admirably fitted for its purpose. The spacious tract of land,
laid out in walks and gardens, an extensive grove of trees, generous
playgrounds and ample greenhouses, combined to give the spot unusual
beauty and efficiency. This notable work finished, the Governors of the
Society issued on May 10, 1821, an "Address to the Public"[1] which
marks so great an advance in psychiatry in our country that it deserves
study. The national character of the institution was indicated in the
opening paragraph, where it announced that the Asylum would be open for
the reception of patients from any part of the United States on the
first of the following June. Accommodation for 200 patients was
provided, and to these new surroundings were removed on that day all the
mental cases then under treatment at the New York Hospital on lower
Broadway.

In this retired and ideal spot the work of Bloomingdale Hospital was
successfully prosecuted for three-quarters of a century. But the seven
miles that separated it from the old hospital was steadily built over,
and before fifty years had gone the growth of the city had passed the
asylum grounds. Foreseeing that they could not maintain that verdant
oasis intact for many years longer, the Governors, in 1868, bought this
300-acre tract on the outskirts of the Village of White Plains. After
prolonged consideration of the time and method of development of the
property, final plans were adopted in December, 1891, construction was
begun May 1, 1892, and two years later, under the direction of our
Medical Superintendent, Dr. Samuel B. Lyon, all the patients were moved
from the old to this new Bloomingdale. The cost of the new buildings was
about $1,500,000. From time to time the original Bloomingdale site was
sold and now supplies room, among other structures, for Columbia
University, Barnard College, the Cathedral of St. John the Divine, St.
Luke's Hospital, the Woman's Hospital, and the National Academy of
Design. With the proceeds of those sales of the old Bloomingdale, not
only was the cost of the new Bloomingdale met, but the permanent
endowment of the Society was substantially increased, and Thomas Eddy
was proved to have been both a wise humanitarian and a far-sighted
steward of charitable funds.

In their "Address to the Public" to which I have referred, issued when
Bloomingdale Hospital was opened in 1821, the Governors of the Society
spoke of the new conception of moral treatment of the mentally afflicted
which had been established in several European hospitals and which was
supplanting the harsh and cruel usage of former days, as "one of the
noblest triumphs of pure and enlightened benevolence." In that same
spirit those founders dedicated themselves to the conduct of this
institution. Their devotion to the work was impressive. Looking back on
those early days we see a constant personal attention to the details of
institutional life that commands admiration. The standards then set have
become a tradition that has been preserved unbroken for a hundred years.
Humane methods of care, the progressively best that medical science can
devise, the utilization of a growingly productive pursuit of research,
have consistently marked the administration of this great trust. The
Governors of to-day are as determined as any of their predecessors to
maintain that ideal of "pure and enlightened benevolence." New paths are
opening and larger resources are becoming available. Under the guidance
of our distinguished Medical Superintendent, with his able and devoted
staff of physicians, a broader and more intensive development is
already under way. Animated by that resolve and cheered by that
prospect, we may thus confidently hope, as we begin the second century
of Bloomingdale's career, for results not less fruitful and gratifying
than those which we celebrate to-day.

FOOTNOTES:

[Footnote 1: Address of the Governors of the New York Hospital, to the
Public, relative to the Asylum for the Insane at Bloomingdale, New York,
May 10th, 1821. Reprinted by Bloomingdale Hospital Press, White Plains,
May 26, 1921. See Appendix V, p. 212.]

ADDRESS BY
DR. ADOLF MEYER

_The Chairman_: In celebrating our centenary we are naturally dealing
also with the larger subject of general psychiatry. Our success in this
discussion should be materially promoted by the presence with us of Dr.
Adolf Meyer, Professor of Psychiatry in the Medical School of Johns
Hopkins University, and Director of the Phipps Psychiatric Clinic, of
Baltimore. Before taking up this important work in that famous medical
centre, Dr. Meyer was actively engaged for several years in psychopathic
work in New York. He will speak to us on "THE CONTRIBUTIONS OF
PSYCHIATRY TO THE UNDERSTANDING OF LIFE PROBLEMS."

DR. MEYER

When Dr. Russell honored me with the invitation to speak at this
centenary celebration of the renowned Bloomingdale Hospital, my
immediate impulse was to choose as my topic a phase of psychiatric
development to which this Hospital has especially contributed through
our greatly missed August Hoch and his deeply appreciated coworker
Amsden. I have in mind the great gain in concreteness of the physician's
work with mind and the resulting contribution of psychiatry to a better
knowledge of human life and its problems. The great gain this passing
century is able to hand on to its successor is the clearer recognition
of just what the psychiatrist actually works with and works on.

Of all the divisions of medicine, psychiatry has suffered longest from
man's groping for a conception of his own nature. Psychiatry means,
literally, the healing of souls. What then do we actually mean by soul
or by psyche? This question has too long been treated as a disturbing
puzzle.

To-day we feel that modern psychiatry has found itself--through the
discovery that, after all, the uncritical common-sense view of mind and
soul is not so far remote from a critical common-sense view of the
individual and its life activity, freed from the forbidding and
confusing assumptions through which the concept of mind and soul has
been held in bewildering awe.

Strange to say, good old Aristotle was nearer an understanding than most
of the wise men and women that have succeeded him for these more than
two thousand years. He saw in the psyche what he called the form and
realization or fulfilment of the human organism; he would probably now
say with us, the activity and function as an individual or person.

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