Letter from Samuel A Silk to the Commissioner of Indian Affairs, October 3, l933
Dublin Core
Title
Letter from Samuel A Silk to the Commissioner of Indian Affairs, October 3, l933
Subject
Letters (Correspondence)
Memorandums
Memorandums
Description
A letter from Samuel A Silk to the Commissioner of Indian Affairs, October 3, l933 reporting on the closing of the asylum, the state of the buildings and patients, and the transfer of patients.
Creator
Samuel A Silk; Silk, Samuel A
Source
State Archives of the South Dakota State Historical Society
Publisher
Copy from The National Archives, Record Group No. 418, Records relating to the Department of the Interior, 1902-43, Record Group 418, Records of Saint Elizabeths Hospital
Date
10-03-1933
Contributor
Commissioner of Indian Affairs Department of the Interior Washington, D. C.; W. A. White, Superintendent Saint Elizabeths Hospital Washington, D. C.
Rights
government records, public domain
Text Item Type Metadata
Text
October 3, l933
Commissioner of Indian Affairs Department of the Interior Washington, D. C.
Through Dr. W. A. White, Superintendent Saint Elizabeths Hospital Washington, D. C.
SIR:
In accordance with a letter from your office dated August 25, 1933, addressed to Dr. W. A. White, I proceeded to Canton, South Dakota, for the purpose of surveying and classifying the patient personnel of Canton Asylum, and to arrange for their transfer to St. Elizabeths Hospital, Washington, D.C.
I arrived at Canton on the morning of September 6, and immediately applied myself to the task assigned to me. I tried to obtain from various sources as much information as possible concerning the mental condition, behavior, and various problems presented by the patients, and I personally examined each patient. As it turned out later, I spent much more time in Canton than I anticipated, but at the time I started this work I was to complete it within a period of 4 to 5 days, which meant the examination of 90 patients, wading through a lot of poorly kept and disarranged records, and dictating to an inexperienced stenographer an abstract on each patient. Most
of the work was completed by me about the 12th of September,
and, as I informed Dr. White in a letter of September 8, I was ready to move the patients on September 14, allowing two days for the St. Elizabeth's attendants to reach Canton. Your letter of September 9, which reached me on the morning of the 11th, suggested that I do not undertake actual moving of patients for about 10 days. I, therefore, postponed action until September 19, as per your suggestion. However, on September 16 I received another message from your office in which it was stated that you agreed to postpone until the 25th of September the actual moving of the patients, giving the South Dakota delegation time to report to Senators, etc. On the same date I received a telegram from Dr. W. A. White informing me the 25th was the final date set for moving these patients.
During my stay there I performed two special examinations of patients of the Canton Asylum - Reuben Taylor and Logan Lovejoy - at the request of your office, and submitted my reports to your office. Logan Lovejoy was subsequently discharged from the Canton hospital to the care of his relatives. The discharge of Reuben Taylor was authorized by your office in a letter which reached Dr. Humer on September 18, but for some reason he put off the actual execution of this order, and Reuben Taylor was still at the hospital at the time I left Canton on September 26, 1933. Another patient, David Zephier, was discharged to the care of his two sons in accordance with the telegram from your office, and my authorization to Dr. Hummer. A fourth patient,
by the name of Ida Roubideaux, who had been bedridden for over two years, and whose condition had reached an incurable state, was returned to the Rosebud Agency in accordance with the approval from your office, it being inadvisable to move her to Washington, D. C. So that, four patients were discharged from Canton during my brief stay there, leaving a balance of 89 patients to be moved to St. Elizabeths Hospital.
All necessary details were completed and we were in readiness for the move, when on Saturday afternoon, September 23, at about 2:30 o'clock, I was served with an injunction issued by Justice James D. Elliott, of the U. S. District Court, Sioux Falls, S.D. The court order restrained John Collier, Commissioner of Indian Affairs of the U. S., Harry R. Hummer, Superintendent of the Canton Asylum for Insane Indians, and Samuel A. Silk, their agents and employes, and all persons acting for and in their be - half, from proceeding further with the removal of Albert Blaine, Jr., and any other patients at Canton, S. D. I notified your office, and also Dr. W. A. White, Superintendent of St. Elizabeths Hospital, concerning this injunction, and requested further instructions. In the meantime I communicated with the U.S. District Attorney at Sioux Falls; and on Monday morning, September 25, I had a long conference with the District Attorney and his assistant, during which time various statutes were looked up and the line of action to be taken was discussed. These two gentlemen finally
went to the judge's chamber (while I remained in their office), their intention being to secure a prompt hearing of the case, I understand that the U. S. District Attorney requested the judge to hear the case on September 27, but the judge was not inclined to grant a hearing before October 5, providing opposing counsel did not object. I was not personally in the judge's chamber, but this information was given to me by the U. S. District Attorney. I understand that this information was also transmitted to the Attorney General. In the interim, on the morning of September 25 seven employees from St. Elizabeths Hospital, who were to assist in the transfer of the patients, arrived at Canton, S. D. The special train was held up at Mason City, Iowa, but was ready to proceed immediately to Canton. About 7:30 p.m. on September 25 I received a telegram from Dr. W. A. White that I could return with all of the other employees to St. Elizabeths, providing there was no objection on the part of the court. After being advised by the U. S. District Attorney's office that the court would have no objection, we all left Canton on the evening of September 26, arriving in Washington, D. C. on the morning of the 28th. Thus, I actually spent 21 days in connection with my detail at Canton, South Dakota. With reference to the injunction which was served upon me so unexpectedly, the following may be of interest: Rumors to that effect reached me about September l8, when the local papers
carried the news that the South Dakota delegation was unsuccessful in having the order for the patients' removal rescinded. On Monday, September 18, Mrs. Brown, the wife of John Brown, who has been a patient at Canton Asylum since March 9, 1909, visited the institution. Dr. Hummer spoke to Mr. Moen on the telephone, and told him he was sending Mrs. Brown down to his offices that she was the wife of a patient who would give him the information which he requested. About an hour or so later this woman returned to the hospital from Canton city, and stated that she wished to talk to me. She had apparently been coached by somebody, and she proceeded to act as a lawyer in behalf of the other Indians, putting a lot of questions to me, such as, why the patients were being moved, saying that the Indians were well satisfied with their treatment, that Dr. Hummer was a very good doctor, that when the patients were moved their relatives would be unable to visit them. When told that this decision was made by the Commissioner of Indian Affairs and not by me, she wanted to know why I could not write to the commissioner, telling him that this was a nice place. I told her that I could not discuss with her the medical defects of the institution, but that as far as she herself was concerned I was quite sure her husband could be discharged into her care; and I frankly told her that in my opinion this man was not insane and had not been so for many years. However, she said she did not want her husband discharged, saying that although
he might be getting along all right in the hospital, he might give her some trouble at home. Dr. Hummer at this point intervened, saying he did not agree with me, that in his opinion "Mr. Brown is now (after a residence of 24 years), slightly deteriorated and in need of the guidance which this institution gives him." It should be added that Brown is a patient who has had ground and city parole for many years, and the nurses and other employees speak of him as not insane; also, when I visited the Canton hospital in 1929 I was told that this patient could leave that institution any time he wished. On leaving Canton that day Mrs. Brown told Dr. Hummer that she would return the following day to see Mr. Moen, and it is my idea that she secured some letters from other Indians of her agency protesting against the removal of the patients, especially from the mother of Albert Blaine, Jr., for whom Mr. Moen was appointed guardian ad litem. On Friday morning, September 22, at about 10:00 o'clock Dr. Hummer received a telephone message, and he left in a great rush for Sioux Falls, remaining there most of the day. It was on that date that the petition for an injunction was presented to Judge Elliott. There is, of course, little doubt that Dr. Hummer knew all about the injunction. On Saturday morning Dr. Hummer gave the name of Albert Blaine, Jr. to someone over the outside wire, stating that Blaine was a Sioux Indian, and that he came from Yankton, South Dakota, Agency. I then anticipated some
legal action perhaps on the basis that this patient was committed to Canton and could not be moved, but examination of the patient's file failed to indicate that there had been any legal inquiry, that he had a guardian, or that anybody had complained against his removal from Canton. It may be added that very few patients are being visited by relatives at that institution; during my three weeks' stay at Canton only three patients were visited.
During my detail at Canton I had no intention to conduct an inspection of the institution, nor was I especially charged with that duty. However, during my examination of the patients, and discussions with nurses and Dr. Hummer, certain matters came to my attention which I feel may be of interest to you. As you probably know, at the request of the Indian Office during March l929 I made a thorough survey of the Canton Asylum, and submitted my report to your office on April 13, l929. During my present visit at Canton I found conditions essentially the same as during 1929 except that the wards looked somewhat cleaner, and there was apparently some improvement in the general housekeeping of the place. No improvement, however, has taken place in the psychiatric or medical care given the patients, and I was very much surprised that none of my suggestions for improvement of the place (made in my report of April 1929), were put into practice. As formerly, the records of the institution were found to be practically valueless, and most of the information contained in the abstracts which
I prepared for St. Elizabeth's Hospital was obtained from conversations with Dr. Hummer, nurses, attendants, and my examinations of patients. In the majority of instances Dr. Hummer was unable to give me any information as to the patient's behavior or other events which led to his admission to the Canton Asylum, and in many cases careful search of all records of the institution failed to disclose such information. Apparently Dr. Hummer did not consider such information necessary and he took no steps to obtain it. In the cases of a number of patients who were alleged to have assaulted others, Dr. Hummer knew nothing about the actual circumstances of such assaults, their nature, severity, etc., etc., although such patients had been in the institution 6, 8, or more years, and for a number of years had shown no abnormal behavior justifying their detention. Nor could Dr. Hummer furnish me with any information as to patients' property or the financial status of their relatives, their ability to look after such patients, etc. etc. His usual reply to such questions was "I do not know; the Indian Office may have that information." I was especially impressed with the relatively large number of patients who were free from any mental symptoms, and whose behavior in the institution over a period of years did not show anything strikingly abnormal to justify their detention there. I pointed out such patients to Dr. Hummer and he agreed with me that they did not show
any evidence of active mental disease and could take care of them
selves in any community, especially on an Indian reservation, but assumed the position that these people were below normal - mentally deficient - and they should only be discharged after they were sterilized, and as he did not have any means of doing this, there was nothing left but to keep them there. Many patients, young males and females, who have been in Canton for many years, were sent to that institution because of some difficulty at a school or agency - a fight with a white man, or a fight with a husband or wife. Almost from the first day of their admission to the asylum their behavior has been normal in every way; they have performed useful work on the farm, in the dairy, kitchens, dining rooms, sewing room, etc., with only nominal supervision or without any at all. Some of them never had any schooling, can neither read nor write. In many instances they repeatedly plead to be returned to their homes, and relatives tried to get then out, but Dr. Hummer called them mentally deficient, and reported to the Indian Office that there has been "no improvement in their mental condition." The question is, should they be judged by the standards of the upper class of cultured white people? Is it fair to keep them at Canton because some minor difficulty landed then there, while hundreds or thousands of others whose mental level is no higher are permitted to live outside? A number of patients upon admission to the institution did show mental symptoms, such as depression, mental disturbance due to alcohol, but such symptoms
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have long ago cleared up, and for long periods such patients have shown nothing abnormal. If all such patients were released it would almost empty the place. Perhaps as an illustration of this group I may cite the case of Emma Amyotte: She has been in the institution since October l5, 1923. Dr. Hummer agrees that she is not suffering from any active mental disease, but he thinks she is a moron. A review of her record indicates the following: Some time during the early part of l923 she, while residing in Canada, suffered from a stroke, and was treated at a medical hospital for the insane at Ponoka, Alberta, Canada. She being an Indian, and at the request of the Canadian government, the U. S. Commissioner of Immigration, of Montreal, endeavored to have her returned to the agency. She finally landed in Canton, S. D., on the date mentioned above. Shortly after her admission there Dr. Hummer received a copy of a letter written to the U. S. Commissioner of Immigration by the Canadian officials, as follows: "I beg to refer to your file No. 11297/456, relating to the case of Mrs. Emma Amyotte, authority for whose return to the U. S. was issued by you. I beg to state that the Medical Superintendent of the Ponoka Hospital on the date of the 9th inst. reports that Mrs. Amyotte is in excellent physical health and has been very well mentally for the past three months, and in his opinion it will not be necessary to have her committed to any institution." In spite of the above information, Dr. Hummer has continued to keep this patient confined at the Canton Asylum since October 1923.
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No serologic examinations are performed at Canton; Dr. Hummer does not know how many patients are suffering from general syphilis or syphilis of the central nervous system, and none of his patients are receiving any anti-luetic treatment. Even in cases of patients who were sent to Canton with a definite report that syphilis was present, they failed to receive any antisyphilitic treatment. (It is generally accepted that about 25% of the patients in mental hospitals are suffering from syphilis, and this is one condition which responds to treatment.) As an example, I cite the case of William Deroin, who was admitted to Canton October 15, 1931. This patient was sent there from the Winnebago Agency, Nebraska. He is blind because of an optic atrophy, is unable to walk because of a paraplegia - both of these conditions apparently due to syphilis - the physician of the Winnebago Hospital who transferred this patient to Canton reported that the patient was receiving treatment for syphilis, and although Dr. Hummer made a tentative diagnosis of locomotor ataxia (which is due to syphilis), neither the blood nor the spinal fluid was examined, and the patient has received no treatment during his residence at Canton; he just spends his time lying helpless in bed. He is frequently left alone on the ward unattended, the ward being locked from the outside with a padlock. It is evident that this patient is receiving a much inferior type of care than he was receiving at the Winnebago Agency. Mr. Deroin does not show any mental symptoms, and certainly in his
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present helpless condition he could not be a menace to anyone. The only justification for sending such a patient to a hospital would be to give him treatment for syphilis, which he has so far failed to receive although he has been at Canton nearly two years.
In the cases of suspected pulmonary tuberculosis no examinations of sputum are performed, and in no case is the diagnosis definitely established. Three patients had active coughs and loss of weight, which would point to that diagnosis. They mingled with the other patients, and no special provision was made for their care.
A minor thing may be mentioned which is characteristic of the institution. The hospital has a refrigerating plant for keeping food, but has no ice, so that when a patient has a high fever or a pulmonary hemorrhage, or some other condition requiring an ice-cap, the nurse can only obtain / some ice by going to Dr. Hummer's home and begging for a few ice cubes from Mrs. Hummer. Should a patient have a hemorrhage in the middle of the night it would be necessary to arouse the superintendent's wife to obtain some ice.
Patients continue to be padlocked in rooms; this isolation of patients is at the discretion of even untrained employes. Thus, during my visit a male attendant who had only been on duty at the hospital since August l, and who had had no previous hospital experience of any kind, looked after the male wards of the main
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building. When he went for his meals he locked certain patients into rooms, and then locked the entire ward, leaving the patients unprotected. He used his own discretion as to what patients should be placed in rooms. As he stated, he did this to prevent any fights during his absence. On Sunday, September 17, only one nurse and one male attendant were on duty for both buildings, each building having 4 wards, yet these two employes went to lunch at the same time, all the patients being locked in the wards, and some in individual rooms. Similar things go on all the time at night, and, of course, the fire hazard must be extremely great. Fortunately, the institution has so far escaped serious disaster, although during the absence of employes fights occur among the patients, and one patient lost an eye which another patient is alleged to have enucleated with his fingers. During the entire existence of the Canton Hospital there does not appear to be any case on record where the patient has been allowed to go out on parole or to his home on trial visit (as is practiced in most hospitals for mental disease), although in many instances relatives have plead to have patients discharged, and they certainly would have been willing to take them on trial visits. All the above conditions have existed in spite of the fact that, as Dr. Hummer informed me, an average of about 20 persons per year seek admission to the institution, most of them being refused because of lack of room, vacancies usually being
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created through death, and only on very few occasions through discharge of a patient as recovered. Dr. Hummer estimated the average number of discharges per year as 10, and out of the 10 nine are usually discharged through death. One is almost forced to conclude that the policy of the institution has been to keep the population stationary.
In the cases of only 9 patients do the records of the institution disclose that there have been any court inquiries. They are as follows:
Wisconsin:
John Martin
James Fishtrap
Maggie Blanchard
Maggie Blanchard was originally committed to a home for the feebleminded in Wisconsin but as there was no room for her there, the judge ordered her to the Eau Clair County Asylum, at Wisconsin. The Canton records fail to show how her transfer came about.
Nebraska:
John Brown
William Deroin
South Dakota:
Luke Standsbyhim
Abraham Hopkins
Peter Pecot
Oklahomas
George Pappon
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In several instances commitments were signed by the county judges on certification of the so-called insanity board, consisting either of two physicians, or a physician and two laymen. My own interviews with the patients were necessarily brief, my main aim being to get a certain amount of information which would be of assistance to the staff of St. Elizabeths Hospital in its future dealings with them. However, from information obtained from Dr. Hummer, nurses, attendants, and my own observations, I am of the opinion that the patient personnel may be divided into the following groups : (a) About 20 patients - Show no evidence of a psychosis, and in their present condition could make an adjustment in any community, let alone on a reservation. (b) 15 to 20 patients - Epileptic, defective, and mildly psychotic (mostly senile); they are quiet, well behaved, and could live on a reservation or with relatives under very nominal supervision. (c) 20 to 25 patients - Mentally Deficient without Psychosis, but whose deficiency is such as to require considerable care and supervision; they rather belong in an institution for feebleminded rather than in a hospital for the insane. (d) 25 to 30 - patients with various types of psychoses, requiring care and treatment in a mental hospital.
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While the above remarks concern chiefly Dr. Hummer, I do not wish to give the impression that the defects of the institution are chiefly due to Dr. Hummer's shortcomings. Although an energetic superintendent with a more modern psychiatric background could make many improvements, it must be emphasized that no institution of 100 patients, having as many different types and classes of patients as the Canton Asylum, could be operated efficiently from a medical and psychiatric standpoint without raising the per capita cost to an extraordinary and unjustifiably high point. It would be necessary to have a separate building and personnel for 5 or 6 tubercular patients, 5 or 6 wards each housing 3 or 4 patients of the epileptic class, and so on down the line of other typÓ©s now in the institution. It is generally agreed that no mental institution housing less than 500 patients can be operated on any reasonable economic basis and do justice to the patients.
Respectfully submitted,
Samuel A. Silk,
Clinical Director.
SAS-AS
Commissioner of Indian Affairs Department of the Interior Washington, D. C.
Through Dr. W. A. White, Superintendent Saint Elizabeths Hospital Washington, D. C.
SIR:
In accordance with a letter from your office dated August 25, 1933, addressed to Dr. W. A. White, I proceeded to Canton, South Dakota, for the purpose of surveying and classifying the patient personnel of Canton Asylum, and to arrange for their transfer to St. Elizabeths Hospital, Washington, D.C.
I arrived at Canton on the morning of September 6, and immediately applied myself to the task assigned to me. I tried to obtain from various sources as much information as possible concerning the mental condition, behavior, and various problems presented by the patients, and I personally examined each patient. As it turned out later, I spent much more time in Canton than I anticipated, but at the time I started this work I was to complete it within a period of 4 to 5 days, which meant the examination of 90 patients, wading through a lot of poorly kept and disarranged records, and dictating to an inexperienced stenographer an abstract on each patient. Most
of the work was completed by me about the 12th of September,
and, as I informed Dr. White in a letter of September 8, I was ready to move the patients on September 14, allowing two days for the St. Elizabeth's attendants to reach Canton. Your letter of September 9, which reached me on the morning of the 11th, suggested that I do not undertake actual moving of patients for about 10 days. I, therefore, postponed action until September 19, as per your suggestion. However, on September 16 I received another message from your office in which it was stated that you agreed to postpone until the 25th of September the actual moving of the patients, giving the South Dakota delegation time to report to Senators, etc. On the same date I received a telegram from Dr. W. A. White informing me the 25th was the final date set for moving these patients.
During my stay there I performed two special examinations of patients of the Canton Asylum - Reuben Taylor and Logan Lovejoy - at the request of your office, and submitted my reports to your office. Logan Lovejoy was subsequently discharged from the Canton hospital to the care of his relatives. The discharge of Reuben Taylor was authorized by your office in a letter which reached Dr. Humer on September 18, but for some reason he put off the actual execution of this order, and Reuben Taylor was still at the hospital at the time I left Canton on September 26, 1933. Another patient, David Zephier, was discharged to the care of his two sons in accordance with the telegram from your office, and my authorization to Dr. Hummer. A fourth patient,
by the name of Ida Roubideaux, who had been bedridden for over two years, and whose condition had reached an incurable state, was returned to the Rosebud Agency in accordance with the approval from your office, it being inadvisable to move her to Washington, D. C. So that, four patients were discharged from Canton during my brief stay there, leaving a balance of 89 patients to be moved to St. Elizabeths Hospital.
All necessary details were completed and we were in readiness for the move, when on Saturday afternoon, September 23, at about 2:30 o'clock, I was served with an injunction issued by Justice James D. Elliott, of the U. S. District Court, Sioux Falls, S.D. The court order restrained John Collier, Commissioner of Indian Affairs of the U. S., Harry R. Hummer, Superintendent of the Canton Asylum for Insane Indians, and Samuel A. Silk, their agents and employes, and all persons acting for and in their be - half, from proceeding further with the removal of Albert Blaine, Jr., and any other patients at Canton, S. D. I notified your office, and also Dr. W. A. White, Superintendent of St. Elizabeths Hospital, concerning this injunction, and requested further instructions. In the meantime I communicated with the U.S. District Attorney at Sioux Falls; and on Monday morning, September 25, I had a long conference with the District Attorney and his assistant, during which time various statutes were looked up and the line of action to be taken was discussed. These two gentlemen finally
went to the judge's chamber (while I remained in their office), their intention being to secure a prompt hearing of the case, I understand that the U. S. District Attorney requested the judge to hear the case on September 27, but the judge was not inclined to grant a hearing before October 5, providing opposing counsel did not object. I was not personally in the judge's chamber, but this information was given to me by the U. S. District Attorney. I understand that this information was also transmitted to the Attorney General. In the interim, on the morning of September 25 seven employees from St. Elizabeths Hospital, who were to assist in the transfer of the patients, arrived at Canton, S. D. The special train was held up at Mason City, Iowa, but was ready to proceed immediately to Canton. About 7:30 p.m. on September 25 I received a telegram from Dr. W. A. White that I could return with all of the other employees to St. Elizabeths, providing there was no objection on the part of the court. After being advised by the U. S. District Attorney's office that the court would have no objection, we all left Canton on the evening of September 26, arriving in Washington, D. C. on the morning of the 28th. Thus, I actually spent 21 days in connection with my detail at Canton, South Dakota. With reference to the injunction which was served upon me so unexpectedly, the following may be of interest: Rumors to that effect reached me about September l8, when the local papers
carried the news that the South Dakota delegation was unsuccessful in having the order for the patients' removal rescinded. On Monday, September 18, Mrs. Brown, the wife of John Brown, who has been a patient at Canton Asylum since March 9, 1909, visited the institution. Dr. Hummer spoke to Mr. Moen on the telephone, and told him he was sending Mrs. Brown down to his offices that she was the wife of a patient who would give him the information which he requested. About an hour or so later this woman returned to the hospital from Canton city, and stated that she wished to talk to me. She had apparently been coached by somebody, and she proceeded to act as a lawyer in behalf of the other Indians, putting a lot of questions to me, such as, why the patients were being moved, saying that the Indians were well satisfied with their treatment, that Dr. Hummer was a very good doctor, that when the patients were moved their relatives would be unable to visit them. When told that this decision was made by the Commissioner of Indian Affairs and not by me, she wanted to know why I could not write to the commissioner, telling him that this was a nice place. I told her that I could not discuss with her the medical defects of the institution, but that as far as she herself was concerned I was quite sure her husband could be discharged into her care; and I frankly told her that in my opinion this man was not insane and had not been so for many years. However, she said she did not want her husband discharged, saying that although
he might be getting along all right in the hospital, he might give her some trouble at home. Dr. Hummer at this point intervened, saying he did not agree with me, that in his opinion "Mr. Brown is now (after a residence of 24 years), slightly deteriorated and in need of the guidance which this institution gives him." It should be added that Brown is a patient who has had ground and city parole for many years, and the nurses and other employees speak of him as not insane; also, when I visited the Canton hospital in 1929 I was told that this patient could leave that institution any time he wished. On leaving Canton that day Mrs. Brown told Dr. Hummer that she would return the following day to see Mr. Moen, and it is my idea that she secured some letters from other Indians of her agency protesting against the removal of the patients, especially from the mother of Albert Blaine, Jr., for whom Mr. Moen was appointed guardian ad litem. On Friday morning, September 22, at about 10:00 o'clock Dr. Hummer received a telephone message, and he left in a great rush for Sioux Falls, remaining there most of the day. It was on that date that the petition for an injunction was presented to Judge Elliott. There is, of course, little doubt that Dr. Hummer knew all about the injunction. On Saturday morning Dr. Hummer gave the name of Albert Blaine, Jr. to someone over the outside wire, stating that Blaine was a Sioux Indian, and that he came from Yankton, South Dakota, Agency. I then anticipated some
legal action perhaps on the basis that this patient was committed to Canton and could not be moved, but examination of the patient's file failed to indicate that there had been any legal inquiry, that he had a guardian, or that anybody had complained against his removal from Canton. It may be added that very few patients are being visited by relatives at that institution; during my three weeks' stay at Canton only three patients were visited.
During my detail at Canton I had no intention to conduct an inspection of the institution, nor was I especially charged with that duty. However, during my examination of the patients, and discussions with nurses and Dr. Hummer, certain matters came to my attention which I feel may be of interest to you. As you probably know, at the request of the Indian Office during March l929 I made a thorough survey of the Canton Asylum, and submitted my report to your office on April 13, l929. During my present visit at Canton I found conditions essentially the same as during 1929 except that the wards looked somewhat cleaner, and there was apparently some improvement in the general housekeeping of the place. No improvement, however, has taken place in the psychiatric or medical care given the patients, and I was very much surprised that none of my suggestions for improvement of the place (made in my report of April 1929), were put into practice. As formerly, the records of the institution were found to be practically valueless, and most of the information contained in the abstracts which
I prepared for St. Elizabeth's Hospital was obtained from conversations with Dr. Hummer, nurses, attendants, and my examinations of patients. In the majority of instances Dr. Hummer was unable to give me any information as to the patient's behavior or other events which led to his admission to the Canton Asylum, and in many cases careful search of all records of the institution failed to disclose such information. Apparently Dr. Hummer did not consider such information necessary and he took no steps to obtain it. In the cases of a number of patients who were alleged to have assaulted others, Dr. Hummer knew nothing about the actual circumstances of such assaults, their nature, severity, etc., etc., although such patients had been in the institution 6, 8, or more years, and for a number of years had shown no abnormal behavior justifying their detention. Nor could Dr. Hummer furnish me with any information as to patients' property or the financial status of their relatives, their ability to look after such patients, etc. etc. His usual reply to such questions was "I do not know; the Indian Office may have that information." I was especially impressed with the relatively large number of patients who were free from any mental symptoms, and whose behavior in the institution over a period of years did not show anything strikingly abnormal to justify their detention there. I pointed out such patients to Dr. Hummer and he agreed with me that they did not show
any evidence of active mental disease and could take care of them
selves in any community, especially on an Indian reservation, but assumed the position that these people were below normal - mentally deficient - and they should only be discharged after they were sterilized, and as he did not have any means of doing this, there was nothing left but to keep them there. Many patients, young males and females, who have been in Canton for many years, were sent to that institution because of some difficulty at a school or agency - a fight with a white man, or a fight with a husband or wife. Almost from the first day of their admission to the asylum their behavior has been normal in every way; they have performed useful work on the farm, in the dairy, kitchens, dining rooms, sewing room, etc., with only nominal supervision or without any at all. Some of them never had any schooling, can neither read nor write. In many instances they repeatedly plead to be returned to their homes, and relatives tried to get then out, but Dr. Hummer called them mentally deficient, and reported to the Indian Office that there has been "no improvement in their mental condition." The question is, should they be judged by the standards of the upper class of cultured white people? Is it fair to keep them at Canton because some minor difficulty landed then there, while hundreds or thousands of others whose mental level is no higher are permitted to live outside? A number of patients upon admission to the institution did show mental symptoms, such as depression, mental disturbance due to alcohol, but such symptoms
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have long ago cleared up, and for long periods such patients have shown nothing abnormal. If all such patients were released it would almost empty the place. Perhaps as an illustration of this group I may cite the case of Emma Amyotte: She has been in the institution since October l5, 1923. Dr. Hummer agrees that she is not suffering from any active mental disease, but he thinks she is a moron. A review of her record indicates the following: Some time during the early part of l923 she, while residing in Canada, suffered from a stroke, and was treated at a medical hospital for the insane at Ponoka, Alberta, Canada. She being an Indian, and at the request of the Canadian government, the U. S. Commissioner of Immigration, of Montreal, endeavored to have her returned to the agency. She finally landed in Canton, S. D., on the date mentioned above. Shortly after her admission there Dr. Hummer received a copy of a letter written to the U. S. Commissioner of Immigration by the Canadian officials, as follows: "I beg to refer to your file No. 11297/456, relating to the case of Mrs. Emma Amyotte, authority for whose return to the U. S. was issued by you. I beg to state that the Medical Superintendent of the Ponoka Hospital on the date of the 9th inst. reports that Mrs. Amyotte is in excellent physical health and has been very well mentally for the past three months, and in his opinion it will not be necessary to have her committed to any institution." In spite of the above information, Dr. Hummer has continued to keep this patient confined at the Canton Asylum since October 1923.
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No serologic examinations are performed at Canton; Dr. Hummer does not know how many patients are suffering from general syphilis or syphilis of the central nervous system, and none of his patients are receiving any anti-luetic treatment. Even in cases of patients who were sent to Canton with a definite report that syphilis was present, they failed to receive any antisyphilitic treatment. (It is generally accepted that about 25% of the patients in mental hospitals are suffering from syphilis, and this is one condition which responds to treatment.) As an example, I cite the case of William Deroin, who was admitted to Canton October 15, 1931. This patient was sent there from the Winnebago Agency, Nebraska. He is blind because of an optic atrophy, is unable to walk because of a paraplegia - both of these conditions apparently due to syphilis - the physician of the Winnebago Hospital who transferred this patient to Canton reported that the patient was receiving treatment for syphilis, and although Dr. Hummer made a tentative diagnosis of locomotor ataxia (which is due to syphilis), neither the blood nor the spinal fluid was examined, and the patient has received no treatment during his residence at Canton; he just spends his time lying helpless in bed. He is frequently left alone on the ward unattended, the ward being locked from the outside with a padlock. It is evident that this patient is receiving a much inferior type of care than he was receiving at the Winnebago Agency. Mr. Deroin does not show any mental symptoms, and certainly in his
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present helpless condition he could not be a menace to anyone. The only justification for sending such a patient to a hospital would be to give him treatment for syphilis, which he has so far failed to receive although he has been at Canton nearly two years.
In the cases of suspected pulmonary tuberculosis no examinations of sputum are performed, and in no case is the diagnosis definitely established. Three patients had active coughs and loss of weight, which would point to that diagnosis. They mingled with the other patients, and no special provision was made for their care.
A minor thing may be mentioned which is characteristic of the institution. The hospital has a refrigerating plant for keeping food, but has no ice, so that when a patient has a high fever or a pulmonary hemorrhage, or some other condition requiring an ice-cap, the nurse can only obtain / some ice by going to Dr. Hummer's home and begging for a few ice cubes from Mrs. Hummer. Should a patient have a hemorrhage in the middle of the night it would be necessary to arouse the superintendent's wife to obtain some ice.
Patients continue to be padlocked in rooms; this isolation of patients is at the discretion of even untrained employes. Thus, during my visit a male attendant who had only been on duty at the hospital since August l, and who had had no previous hospital experience of any kind, looked after the male wards of the main
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building. When he went for his meals he locked certain patients into rooms, and then locked the entire ward, leaving the patients unprotected. He used his own discretion as to what patients should be placed in rooms. As he stated, he did this to prevent any fights during his absence. On Sunday, September 17, only one nurse and one male attendant were on duty for both buildings, each building having 4 wards, yet these two employes went to lunch at the same time, all the patients being locked in the wards, and some in individual rooms. Similar things go on all the time at night, and, of course, the fire hazard must be extremely great. Fortunately, the institution has so far escaped serious disaster, although during the absence of employes fights occur among the patients, and one patient lost an eye which another patient is alleged to have enucleated with his fingers. During the entire existence of the Canton Hospital there does not appear to be any case on record where the patient has been allowed to go out on parole or to his home on trial visit (as is practiced in most hospitals for mental disease), although in many instances relatives have plead to have patients discharged, and they certainly would have been willing to take them on trial visits. All the above conditions have existed in spite of the fact that, as Dr. Hummer informed me, an average of about 20 persons per year seek admission to the institution, most of them being refused because of lack of room, vacancies usually being
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created through death, and only on very few occasions through discharge of a patient as recovered. Dr. Hummer estimated the average number of discharges per year as 10, and out of the 10 nine are usually discharged through death. One is almost forced to conclude that the policy of the institution has been to keep the population stationary.
In the cases of only 9 patients do the records of the institution disclose that there have been any court inquiries. They are as follows:
Wisconsin:
John Martin
James Fishtrap
Maggie Blanchard
Maggie Blanchard was originally committed to a home for the feebleminded in Wisconsin but as there was no room for her there, the judge ordered her to the Eau Clair County Asylum, at Wisconsin. The Canton records fail to show how her transfer came about.
Nebraska:
John Brown
William Deroin
South Dakota:
Luke Standsbyhim
Abraham Hopkins
Peter Pecot
Oklahomas
George Pappon
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In several instances commitments were signed by the county judges on certification of the so-called insanity board, consisting either of two physicians, or a physician and two laymen. My own interviews with the patients were necessarily brief, my main aim being to get a certain amount of information which would be of assistance to the staff of St. Elizabeths Hospital in its future dealings with them. However, from information obtained from Dr. Hummer, nurses, attendants, and my own observations, I am of the opinion that the patient personnel may be divided into the following groups : (a) About 20 patients - Show no evidence of a psychosis, and in their present condition could make an adjustment in any community, let alone on a reservation. (b) 15 to 20 patients - Epileptic, defective, and mildly psychotic (mostly senile); they are quiet, well behaved, and could live on a reservation or with relatives under very nominal supervision. (c) 20 to 25 patients - Mentally Deficient without Psychosis, but whose deficiency is such as to require considerable care and supervision; they rather belong in an institution for feebleminded rather than in a hospital for the insane. (d) 25 to 30 - patients with various types of psychoses, requiring care and treatment in a mental hospital.
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While the above remarks concern chiefly Dr. Hummer, I do not wish to give the impression that the defects of the institution are chiefly due to Dr. Hummer's shortcomings. Although an energetic superintendent with a more modern psychiatric background could make many improvements, it must be emphasized that no institution of 100 patients, having as many different types and classes of patients as the Canton Asylum, could be operated efficiently from a medical and psychiatric standpoint without raising the per capita cost to an extraordinary and unjustifiably high point. It would be necessary to have a separate building and personnel for 5 or 6 tubercular patients, 5 or 6 wards each housing 3 or 4 patients of the epileptic class, and so on down the line of other typÓ©s now in the institution. It is generally agreed that no mental institution housing less than 500 patients can be operated on any reasonable economic basis and do justice to the patients.
Respectfully submitted,
Samuel A. Silk,
Clinical Director.
SAS-AS
Citation
Samuel A Silk; Silk, Samuel A, “Letter from Samuel A Silk to the Commissioner of Indian Affairs, October 3, l933,” Honoring the Dead: A Digital Archive of the Insane Indian Asylum, accessed May 4, 2024, https://honoringthedead.omeka.net/items/show/1.