Materia Medica, Materia Moral: An Archaeology of Asylum Management and Moral Treatment in the United States, 1840-1914

Abstract

In the early 19th century, a novel approach to the treatment of the insane, known as moral treatment or management, arrived in the United States of America. With its focus on appealing to the emotional and intellectual capacities of patient, moral treatment diverged from a longstanding tradition of treating insanity as a medical condition. Its practice was further distinguished by its emphasis on removing the lunatic from their home and community and into a specialised institution: the lunatic asylum. Life at these establishments was scheduled and scripted. Patients woke, ate, slept, and took their medicines according to a regular schedule, and followed a targeted spiritual, occupational, and recreational regimen intended to instil the self-discipline and foster the self-esteem believed necessary to restore their rationality. A broad and multidisciplinary body of scholarship has grown up around moral treatment and the institutions that practised it. Yet, while many studies recognise the prominent role that buildings, furnishings, and other aspects of the material world played in effecting this reform, few researchers have engaged with these landscapes primarily through the physical objects—the materia medica and materia moral—themselves. This thesis examines how the rhetoric of moral treatment translated into the lived, material experiences associated with asylum-based treatment regimens at two case institutions: The Western Washington Hospital for the Insane near Steilacoom, Washington (1871), and the Eastern Lunatic Asylum in Williamsburg, Virginia (1773). Applying the methodologies and approaches used in historical archaeology, this thesis organises the encounters that shaped life at these institutions around the patient body. Despite its focus on the mind, moral treatment operated in, on, and around the body. Most of these treatment activities involved in treatment left a clear mark on the archaeological record. From the foods and medicines that patients ingested, to the clothes and jewellery they wore, to the structures and interior spaces that they inhabited, the material world was essential to both maintaining order in the institution and restoring order to patients’ disordered minds. While the adherents to moral treatment championed the development and construction of the ideal institution, their ideals and principles did not translate perfectly into the material world of these institutions. By juxtaposing archaeological and archival data, this thesis demonstrates that daily life in these institutions was shaped by more than the rhetoric of moral treatment alone. Rather, the practical requirements of managing of a large institution, patients’ individual ways of living and being, and the decisions of those authorities who were responsible for determining and delivering care through institutional channels coalesced, leaving a distinct mark on the archaeological record.

Date of Award	31 Dec 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Carsten Timmermann (Supervisor) & Eleanor Casella (Supervisor)