Ep. 55: History of Taunton State Hospital, Part 1 (1854-1886)

This week's episode explores the history of the first three decades of Taunton State Hospital in Taunton, Massachusetts. Find out why people were sent to this hospital and what major world events led to a dramatic increase of patient admissions at asylums around the state. Learn what a "magic lantern show" was and why the asylum had to have a wall built around it to protect patients.

My main source for this episode is A Brief History of Taunton Lunatic Hospital 1854 to 2016 by Joseph Langlois. All other sources are listed at the end of the episode transcript.

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Transcript

Hello, hello, hello, and welcome back to another episode of Behind the Walls of the World’s Psychiatric Hospitals! I’m your host, Dr. Sarah Gallup, and today we’re going to dive in to a new hospital history, but we aren’t going very far – we’re staying in Massachusetts but heading an hour south of Danvers to Taunton. 

I will be relying heavily on the book A Brief History of the Taunton Lunatic Hospital 1854-2016 by Joseph Langlois throughout this episode and series. All other sources will be listed at the end of the episode transcript. 

So come on in and get comfortable as we go behind the walls of Taunton State Hospital…

In our last series on Danvers State Hospital, I had mentioned that it was the fourth lunatic asylum to be built in Massachusetts but the first built in the Kirkbride style. I’d gotten that information from the Danvers State Hospital website, but – whoops! – turns out it wasn’t 100% accurate. Thank you to Lisa for pointing out that the three previous hospitals were constructed (or reconstructed) into Kirkbrides before Danvers. As always, I don’t claim to be an expert on these hospitals, but I do my best to be as accurate as I can be. And I always invite folks to send me more information or personal stories or what-have-you about these hospitals because there is always so much to know. And even in a multi-part series, I’m going to overlook so much for the sake of time.

But anyway, I wanted to back up just a bit for those of you who are new to the show and just listening for the first time. At the beginning of the 1800s, folks who were deemed “lunatics” or “mad” were housed in jails or almhouses. And when they referred to lunatics, their definition was quite broad: it meant anyone who had symptoms of mental illness, anyone who struggled with alcohol or substance use addiction, anyone who had a physical defect of some kind, or anyone who was poor. Picture the Cratchit family from Charles Dickens’ story A Christmas Carol, which was written in 1843. These weren’t necessarily folks who would be considered insane by today’s standards, but they were working class and had a son with a physical disability who begged for change in the streets. These were the types of folks who could potentially end up in an almshouse or jail for being socially unacceptable.

The conditions these folks endured, especially in local jails, was abysmal. They were chained to posts, sometimes poorly-clad or naked, in cold and damp cells. They weren’t given much care, if they were given any, and reformers worked hard to get their conditions changed. 

In 1833, the first lunatic asylum was built in Worcester, Massachusetts, to house the “pauper poor” from Boston (Langlois 10). Just a few years later, in 1839, the Boston Lunatic Hospital opened. But even with the efforts of these two new facilities, there were simply too many people admitted, and the sites quickly became overcrowded.

On March 28, 1841, Dorothea Dix went to teach a Sunday School class at the East Cambridge Jail. The things she witnessed there forever changed her – and the treatment of mental illness. After seeing the horrifying conditions inmates were forced to live in, Dorothea Dix traveled up and down the East Coast, visiting jails, poorhouses, and asylums and documenting how people were treated there. She wrote a “memorial” to the Massachusetts legislature, appealing for change. And her petition was granted. Funds were later set aside for building insane asylums to humanely treat folks with mental illness. This set off a domino effect of asylums being built to house and treat folks who had previously been incarcerated.

We also have to remember, as we’d mentioned during the series on the Provincial Lunatic Asylum in Toronto, that there was an influx of immigration during the 1840s, particularly from Ireland. The Irish Potato Famine had started in 1845, which displaced many folks who immigrated to the east coast of the United States. As we discussed in those episodes on the Toronto asylum, anyone perceived as different risked ending up in an asylum because they didn’t adhere to social norms.

By the late 1840s, with the asylums in Worcester and Boston already over capacity, it became clear that a new asylum would need to be built. In 1851, a site for the new asylum was proposed in Taunton. Two years later, in 1853, construction began on what would end up being an elaborate Kirkbride style building. It was designed by the Boyden and Ball architectural firm from Boston – Eldridge Boyden (of Boyden and Ball) would end up being considered one of the finest architects of the mid-19th century and would go on to design many notable university and civic buildings as well as churches (Langlois 17). 

In typical Kirkbride fashion, the new asylum would be built in the countryside on a large piece of land. The citizens of Taunton contributed $13,000 to purchase the 134 acre parcel the asylum would be built on (Langlois 17). This area was specifically chosen because it bordered the Mill River, which would provide a natural barrier to the city creeping up on the asylum. It was described as follows: 

The grounds of the 134 acres extend in a southerly direction to within a half-mile of the center of the town. With an exceedingly varied surface, a beautiful grove of more than sixty acres, and bounded by a river for nearly half its extent, the site has natural advantages that are rarely met with. As nearly all the land lies between the hospital and the town, and as its position is furthermore strengthened by having the river for a natural barrier, the institution will probably be able to hold at bay for many years the encroachments of an increasing population, and will avoid the difficulty into which many similar institutions have fallen – of being gradually drawn, in consequence of the increase of a flourishing town, into the heart of a city. (Qtd. in Langlois 18)

Once they had the location picked out, it was time to start building. Construction of the new hospital began in 1853 (Langlois 18). The building itself was designed in the Neo-Classical style (“Taunton State Hospital”) and constructed in the shape of an E, with one wing for women and one wing for men. The front entrance was impressive and imposing; it rose three stories high and had a large dome on top (Langlois 17), sorta similar to the dome on Saint Peter’s Basilica in the Vatican, if you’re familiar with that.

The first floor had office space, reception rooms, and living quarters for the superintendent (Langlois 17), so this was primarily an administrative area. There was a large hall that was used as an assembly room, chapel, and auditorium. It would later be known as the finest hall remaining in the United States from the pre-Civil War era (17).

The first superintendent of Taunton, Dr. George C.S. Choate, added this information about the central block:

The center building has a frontage of fifty-five feet toward the town, and projects from the main front about fifty feet. In this are the office, dispensary, apartments for the officers, and rooms for the reception of visitors and social intercourse of patients. It is surmounted by a dome, which rises seventy feet above the roof, and from which there is a panoramic view of great beauty, embracing the neighboring town, with its many tokens of busy life, several flourishing villages, the numerous ponds and streams with which the surrounding country abounds, and reaching in the far distance even to the blue hills of Norfolk County. (Qtd. in Langlois 19)

Now, interestingly, the lower story of the main block included what were called “strong rooms.” Joseph Langlois notes that there were 42 of these strong rooms that were originally designed to contain violent or “filthy” patients. They were built with stone, brick, and iron with walls 16 inches thick. The floors were made of wood and were sloped toward a stone. Langlois said that when he ventured down to the strong rooms, they were dark like a dungeon. And, even better, there was only one narrow passageway leading to them from the central administration block (18). Emergency exits were clearly not a consideration back then. Now, fortunately, the one saving grace to come out of the construction of these strong rooms is that they were never used for their intended purpose. Dr. Choate later said the following about the strong rooms:

…We urge upon all, who have the care of the insane, to abandon what we regard as the barbarous relics of an ancient and mistaken policy, and at least try the experiment of that system, which is based upon the enduring principals of human kindness and love. (Qtd. in Langlois 22)

I appreciate that most, if not all, of these asylums did practice using kindness and love. At least for a while till it all got out of hand. I’m really surprised the strong rooms weren’t used later, to be honest. If I had to guess, they probably ended up as storage spaces over the years.

By early 1854, construction had completed, and the asylum was ready to begin accepting patients. On April 7, 1854, the first patients were transferred from Worcester Asylum to Taunton (Langlois 20). Most of these patients were described as demented, medically infirmed, and of a chronically disabled nature. Most of the new patients were between 25 and 45 years old, but the youngest was a boy only 6 years old (20). Langlois wasn’t able to find why he was admitted so young.

Most of the new admits were farmers, laborers, and seamen who had been born in the U.S. (Langlois 21). The most frequent causes of insanity for men included intemperance, ill health, masturbation, religious excitement, and trouble about property (21). For women, the most common causes of insanity were ill health and religious excitement (21). Most of these reasons would definitely not be causes of admission to a state hospital today, except perhaps if the intemperance were linked to a mood disorder or religious excitement were delusional in nature.

During the first year the new asylum was open, a total of 330 patients were admitted – 211 from Worcester alone (Langlois 20). And you have to remember that Kirkbride hospitals were designed for a capacity of about 250 patients. This doesn’t mean that all 330 were there at the same time, though. Throughout the first year it was open, 64 patients were discharged, 24 died, and 3 eloped (20). Langlois points out that the most frequent causes of death were phthisis (which was also known as tuberculosis and consumption), dysentery, apoplexy (or stroke), and manic exhaustion (20). 

It’s been a while since I’ve discussed manic exhaustion, but if you’ve ever seen someone in a true manic episode, it can be exhausting just watching them. Of course, mania looks different in different people. I worked with a patient a few years ago who was struggling through an obvious manic episode. It was like he could not be turned off. He was yelling nonstop, constantly moving and pacing and hitting the walls. He wasn’t sleeping, wasn’t stopping to rest, didn’t want to eat – you get the picture. And medications were only doing so much for him at the very beginning of treatment. I remember thinking that it’s no wonder people just dropped dead before mood stabilizers came along – the body has to slow itself down somehow.

Anyway, you may also be wondering how those three patients escaped. They were working outside, probably on construction of part of the hospital or nearby road, and ran off while they were out (Langlois 20).

Strangely, and almost inconceivably today, there were only 22 staff members to care for the 330 patients who came through the hospital that year (Langlois 20). Even if we round down and estimate that only 250 patients were there at any given time, that would still be over a 11:1 ratio of patients to staff.

The staff at the hospital included Dr. Choate, the superintendent; and Dr. Z. B. Adams, assistant physician. There was a clerk of records, a housekeeper in charge of kitchen stores, a cook, a seamstress, an engineer, a farmer, seven attendants for the male wing, and seven attendants for the female wing (Langlois 20).

Dr. Choate had way too much responsibility on his shoulders as the superintendent. Somehow, he was expected to see each patient on a daily basis. He was responsible for insuring “the medical, moral, and physical well-being and treatment of his patients” (Langlois 20). I don’t know that I’d want to be responsible for my patients’ moral well-being for many reasons. Dr. Choate was also in charge of hiring all employees and managing the budget (20). That’s just way too much work for one person to assume. I would have a hard time checking in with my 40 patients in a day.

The hospital as a whole practiced the tenets of moral therapy, which included a good diet, exercise, lack of stress, good ventilation, amusements, and the opportunity to work (Langlois 21).

Langlois adds that there were many different types of recreational opportunities, including singing classes, reading, bowling (for men), and something called a magic lantern show, which he says were an early form of slide projector and a popular form of entertainment at the time (Langlois 15). I had to look this up, and it’s really quite fascinating. There was a projector, which looks somewhat similar to a movie projector, and glass slides that had still images painted on them. But the “magic” part of the show was that there were two other projectors running at the same time that also had slides. These other images projected onto the screen, so it could give the illusion of movement. It was all fairly simple, but I’m sure patients and staff alike enjoyed these shows.

As for work opportunities, these developed over the years, but would go on to include the farm and garden (even though apparently the land was known for its sandy soil that was not good for planting). Later, when a road was added that connected the asylum to a public road, it was patients who staffed its labor (Langlois 22). What I found particularly disturbing about the addition of this road was that it seemed to (unintentionally) invite members of the public to drive out to the asylum on Sundays and peek in the windows, especially at women patients (22). I find this so disturbing for so many reasons, but it just highlights how vulnerable patients were.

The second year of the hospital’s operation began in 1855. The overall population rose to 262 patients, including five prisoners who had allegedly gone insane while in prison. One inmate had been convicted of murder and made several attempts to escape while at the hospital, making him an inherently high-risk patient (Langlois 22-23). And you gotta remember that most of the patients at the asylum hadn’t committed a crime. They were just regular people with mental illness or seizures or problems with their spouse or neighbor. So mixing the criminally insane with everyone else posed serious problems. 

One of the issues staff faced is something that continues to be an issue today, although we manage it better. Patients who are at imminent risk of harm to themselves or others need to be watched by a 1:1 staff member. In Taunton, this essentially took away one of the seven attendants on that side of the hospital, leaving fewer people to care for the 100-and-something patients in that wing. Today when we have a staff who is on a 1:1 observation for a patient, we’re allowed to get an extra staff member to make up the difference so we don’t “lose” a set of eyes on the patients.

A number of improvements were also made during the second year of operation. According to Joseph Langlois, a separate laundry building was added, as well as the bowling alley, improved steam delivery system, library expansion, and the development of a singing school. Local newspapers gave free subscriptions to the hospital, a concert was given by the Beethoven Society of Taunton, a chapel was established, as well as reading and sewing rooms. A horse and carriage were purchased, a fence was placed around the farm, and over 50 trees were planted (23-24).

By 1856, the patient population had gone up to 298 with an average of 15 admissions per month (Langlois 24). There were now 37 employees at the hospital. This was the same year that Northampton 

We also have to remember, similar to what I mentioned in the episodes on Danvers State Hospital, that running in the background of all of this is a huge influx of immigrants from Ireland. The Irish Potato Famine of the late 1840s and early 1850s had essentially forced many people to flee Ireland. Many of them came to Massachusetts. And any time there’s a large group of people who are different from the majority, there are going to be misunderstandings and prejudice. And, among Irish immigrants, there was a fair amount of disappointment. Many had left for the U.S. in search of prosperity and a new start, only to struggle once they arrived. Dr. Choate made a particularly icky remark about Irish immigrants who ended up at the asylum:

They [are] peculiarly apt to fall into a state of hopelessness and dementia…They leave their own country with the most exalted and highly colored notions of prosperity…this disappointment is too much for their minds, uncultivated and narrow as they are by education and religion. (Qtd in Langlois 21)

Today most (but hopefully all) mental health professionals look at the multiple stressors that influence someone’s diagnostic picture. Someone who has just survived a famine in their home country and made the probably heart wrenching decision to take their family and move to a completely new country only to not be able to find work and struggle to feed their family there would – or should – be met with a clinician who understands the layers of stressful situations the person has endured.

But instead, doctors in the 19th century just ascribed immigrants’ very real traumas to them being “uncultivated.” That’s…great. And, as we’ve mentioned, people who weren’t able to fit into society were at higher risk of being sent to an asylum. So by 1856, 43% of admissions were foreign-born individuals, most of whom were Irish (Langlois 24). A law was passed that stated all “lunatics” needed to be sent to state hospitals. But the “American insane” could be kept at the Boston Lunatic Hospital (24). So there was some sort of segregation happening that kept U.S.-born patients predominately in one facility, but foreign-born patients predominately at another facility.

In 1858, the number of admissions around Massachusetts had increased substantially, so the Lunatic Hospital in Northampton was opened to relieve overcrowding at all the existing facilities. Within two months of it opening, Northampton had already exceeded its capacity after taking transfers from other asylums around the state (“Northampton State Hospital”).

In only a few short years, in 1862, the hospital population at Taunton had largely increased to 425. Finally – finally – construction began on a stone wall that would encircle the hospital and curb all those creepers who traveled out on Sundays to peer at the patients (Langlois 25). It’s really something that they were less concerned about patients getting out than they were of the public looking in, like patients were spectacles on display.

Just as an aside because I find it interesting, the salaries of employees were listed. Here is what staff earned in 1862:

Superintendent | $1,800/year |   | $55,663/year today
Assistant Physician | $600/year |   | $18,554
Treasurer | $225/year |   | $9,369
Assistant Seamstress | $14/month | $168/year |  
Engineer | $40/month | $480/year |  
Baker | $30/month | $360/year |  
Male Attendants | $20/month | $240/year |  
Female Attendants | $14/month | $168/year |  
Laundress | $3/week | $156/year |  
Cook | $2/week | $104/year |  

(adapted from Langlois 25)

And just to give a sort of an equivalent, medical directors’ salaries with the CA Dept of State Hospitals start at $300k/year. And, to be fair, they work incredibly hard. It’s a job I don’t think I’d want to have.

Also in 1862, the asylum was continuing to expand and offer more amenities and services to patients. They added a new billiard room, more books to the library, added stables, and new furnishings (Langlois 26). I’m actually surprised that they added new furnishings only eight years after the asylum opened, especially given the historical context of what was going on at the time.

The American Civil War had started the previous year, in 1861. Massachusetts was a Northern state, so several of their male employees left to join the Union Army (Langlois 26). And we have to remember that the asylum didn’t have many employees to begin with, so any loss of staffing must have been really difficult. Impressively, though, the staff seemed to recognize the toll that this war would have upon troops and citizens alike. In the 1862 annual report, Dr. Choate predicted that the war would lead to a corresponding increase in cases of “mental disturbance” (26). Today we would recognize this as symptoms of trauma, with some cases likely meeting criteria for PTSD.

Admissions during the Civil War slowed somewhat, and the total patient population in 1863 was 421 (Langlois 26). Patients still participated in work assignments that included road and wall construction. This would be physically demanding and potentially dangerous work conditions, and we need to remember that patients weren’t compensated for their work (26). It was considered a necessary component of their treatment. And while I see a lot of value in having patients work, not paying them just leads to exploitation. Today, at least in California, patients at state hospitals who have jobs earn federal minimum wage and are subject to taxes just like anyone else. 

In 1870, Dr. Choate retired after 16 years as superintendent of Taunton Lunatic Asylum (Langlois 26). He was succeeded by Dr. William W. Godding who, according to Joseph Langlois, was considered one of the eminent physicians of his time (26-27).

Dr. Godding approved a number of improvements for the asylum, including a new ventilation system, new windows, and adding family visiting rooms and an expanded menu (Langlois 27). They added more private patients rooms, as well, which makes me wonder if this was to increase revenue to the hospital itself. There was a new drainage system installed, as well as a carpenter’s shop and new laundry room (27). 

Notably, Dr. Godding was able to facilitate getting $125,000 to expand the hospital. He had pleaded before the state legislature about the inadequate conditions of the asylum, noting that there were only four wards for men and four wards for women. One of the wards, he said, was quite small, whereas the others contained 60-70 patients each. By securing additional funds, he hoped to expand to having 10 wards for men and 10 wards for women (Langlois 27). This would also hopefully improve safety and patient care.

In 1877, after only seven years as superintendent, Dr. Godding resigned to become the governor of the Hospital for the Insane in Washington, D.C. This is what would later become St. Elizabeth’s Hospital (Langlois 27-28).

Also in 1877, the second asylum in Worcester opened (“The Second Worcester State Hospital”). This one was built in the Kirkbride style and was called the Hospital for the Chronically Insane (Langlois 27). If you recall from our series on the Provincial Lunatic Asylum in Toronto, there were two types of insane asylums at this time: one for acutely ill patients, who had a reasonable chance of improvement and discharge within a year or two, and one for chronically ill patients – those who had less hope for a full recovery because of their mental illness or what we’d consider today a developmental disorder.

So once the second asylum in Worcester opened, Taunton was able to send over some of its more chronically ill patients. As a result, there was a drop in the patient population over the following year – from 782 in 1877 to 579 in 1878 (Langlois 27).

And you may also remember from our previous series that Danvers State Hospital opened in 1878, which further relieved overcrowding – at least, for a moment.

Dr. John Peaslee Brown became the third superintendent of Taunton Lunatic Asylum in 1878 (Langlois 28). He had been working at the New Hampshire Asylum for the previous 12 years, so he came with some experience. By this time, the superintendent earned $2,500/year (or the equivalent of about $78,000/year today). The lowest-paid employee was a female cook, who earned $3/week, or the equivalent of about $4800/year today (28).

Patients were expected to work, of course, in addition to reading, exercising, attending chapel, and going to Friday night entertainments. The latter would include games of various sorts, being read to by the Assistant Physician (which I think is cute), magic lantern shows, and a series of lectures and concerts (Langlois 28). In order to encourage more physical activity, two wards were left unlocked so patients could come and go to get exercise. Turned out, this proved to be effective in reducing aggressive behavior toward others as well as reducing self-injurious behavior (29).

Dr. Brown was very proud of the diet the hospital offered its patients. He said:

Most of our patients are poorly fed and badly nourished before coming to the hospital. In the beginning of treatment in those cases, we depend more on good nourishing food than the material medica: milk and eggs with wine and other stimulants, being more freely dispensed than any form of drugs, though the latter are frequently called to our aid. (Qtd. in Langlois 29)

And I just have to giggle here. Yeah, I bet the patients are doing just fine with their regimen of wine and stimulants! That’s the front-line of defense, but they also have other drugs at their disposal when needed. I assume he’s referring to laudanum, ipecac, opium, and other similar treatments. I mean, my patients would probably be happy, too, if we fed them booze and drugs all day long. It probably helps after the long days of building roads.

By 1881, there were 556 patients and 102 employees at Taunton (Langlois 29). That same year, 27 inmates were transferred from nearby prisons; this required special arrangements to keep the inmates and other patients safe (29). Restraints were used sparingly – about 2% of the time with male patients and 4% of the time with female patients. Langlois says the most common restraint device was a belt with “wristers” that restricted hand movements and the individual’s reach (30). We have something similar that we use today, though infrequently at my hospital. Walking wrist restraints allow a patient who is struggling with aggression to be able to move somewhat freely around the unit but restricts their arm movement, so they can’t hit anyone. They’re still able to eat and write – they just can’t forcefully extend a fist.

There were more elderly and medically compromised patients being admitted to Taunton, which led to a corresponding increase in the number of patient deaths – most of whom died from dementia but others, sadly, died from what turned out to be an unusually hot and dry summer (30). Today we have to be extra careful during the summer with patients who are taking certain psychotropic medications, as some can increase their body temperature during warm months. So to prevent hyperthermia, we have to be mindful of the weather outside and not take patients out if it’s above a certain temperature.

Men worked on the farm, in the laundry, piggery, kitchen, bakery, and carpenter’s shop, as well as in groundskeeping and food distribution (Langlois 30). Women were tasked with knitting, sewing, kitchen and laundry work. In one year, they made 460 dresses, 959 sheets, 253 suspenders, 1,183 bath towels, and hemmed 76 rugs (31).

In 1883, there were 674 patients – 124 over capacity. Most patients were admitted with a diagnosis of paresis, most likely caused by late stage syphilis (Langlois 31). There were so many people being admitted with communicable diseases that Dr. Brown decided there needed to be an infirmary in the attic. The hospital also recommended adding a training school for nurses of the insane (31).

As Joseph Langlois points out, 1884 was an important year for women (30). Two women, Ruth S. Murray and Grace S. Barlett were appointed to the Board of Trustees. The state’s first female assistant physician, Dr. Alice Rogers, was appointed (30). This is pretty progressive for the late 19th century.

And lastly, in 1886, the wall surrounding the asylum was finally completed (Langlois 32). Thirty-two years after it was started, the wall would finally keep members of the public from peering into windows and gawking at patients like some sort of side show. For the sake of their privacy, I’m so sorry it took that long to complete.

And that’s where I’m going to end part one of the history of Taunton State Hospital. Tune in next time to find out what my favorite part of the old hospital was – and why I was drawn to cover it on the show.

As always, thank you so much for listening! If you’re a new listener, thank you for joining us! Feel free to check out the Facebook and Instagram pages for pictures, updates, and random things I find interesting about these old hospitals.

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I appreciate you all! I know I say this often, but I really had no idea that so many people would listen to my little show. I really thought it would be me talking to myself and my mom, but it’s been so nice to connect with other people who are interested in learning more about these old hospitals and about the people who lived there.

But as always, remember the words of Maya Angelou: “Do the best you can until you know better. Then, when you know better, do better.” Until next time…

Langlois, Joseph. A Brief History of the Taunton Lunatic Hospital 1854 to 2016. Otherwords Press, 2020.

“Northampton State Hospital.” Northampton State Hospital, 2023.  https://northamptonstatehospital.org

“Taunton State Hospital.” Wikipedia. https://en.wikipedia.org/wiki/Taunton_State_Hospital

“The Second Worcester State Hospital.” Worcester Historical Museum. https://worcesterhistorical.com/worcester-state-hospital/the-second-worcester-state-hospital/