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The Superintendency of Dr. John Galt, 1841 - 1862.
In 1841 the Hospital, called Eastern Lunatic Asylum and housing 125 "inmates," came under the supervision of Dr. John Galt,
an incontrovertibly brilliant physician who brought the full flower of Moral Management treatment to Williamsburg.
As Dr. Galt put it, three successive revolutions in psychiatry occured in Williamsburg.
The "First Revolution" was the Hospital's founding as a publicly supported facility exclusively for the
care of the mentally ill.
The "Second Revolution" was the introduction of Moral Management therapy. This taught,
as Dr. Galt said, that the mentally ill
"differ from us in degree, but not in kind" and are entitled to human
dignity. Dr. Galt introduced therapeutic activities and talk therapy.
He was probably alone among contemporary asylum superintendents to advocate that the psychiatric hospital
undertake in-house research and claimed to treat African-American patients
on an equal footing with whites.
Dr. Galt used restraint very sparingly (one year restraining none) and sought a calming medication to replace restraint.
He dispensed opium liberally to patients in a foreshadowing of our twentieth century neuroleptics.
The "Third Revolution in Psychiatry" became clear in 1857, when Dr. Galt was the first to advocate deinstitutionalization
and community-based mental health care. He wrote, "A large number of insane, instead of rusting out their lives in
the confines of some vast asylum, should be placed... in the neighboring community... were any other class of persons
than the insane collected together in such large numbers as is the case in some asylums, we are satisfied that
the greatest disorder would be likely to ensue." Dr. Galt's was a lone voice, over a century ahead of its
time--there were no echoes of agreement beyond his office, and the Hospital's Court of Directors three times
prevented his accomplishing these plans his disappointment and consequent depression probably contributed to his
suicide five years later.
Thus, it was that at Eastern State Hospital all the components of the modern psychiatric hospital may have first
been put into practice--human dignity for the mentally ill, therapeutic activities, talk therapy, calming medication,
in-house research, deinstitutionalization, and community-based mental health care.
Symptoms of a Dysfunctional Age: The Nineteenth Century in America was characterized by a lack of civil rights for
the majority of the people. There was slavery for African-Americans and oppression of women and children, as well as
tremendous stigma against the mentally ill. The list of servants is actually a list of slaves owned by
Eastern State Hospital around 1850. There were as many as 45 slaves working at the asylum, and they appear to have
taken a large share in the work to be done. Dr. Galt trained them, as well as white "officers" (nursing aides,
currently termed Human Services Care Workers), to provide talk therapy for the patients, although Dorothea Dix
disapproved. Eastern State had been an integrated hospital since its beginning in 1773, and in 1846 Dr. Galt
successfully submitted a bill to admit slaves as patients.
Dr. Galt claimed to treat patients equally "without regard to race." In fact, he published no records as to the
racial breakdown of the patient population. The mentally ill were another group suffering oppression at this time.
Chaining and other forms of long-term restraint were common at Eastern Lunatic Asylum until the late 1830s,
when Moral Management thinking introduced the ideals of human dignity and least restraint. In some years,
Dr. Galt used no restraints at all. However, patients that escape were sometimes cruelly treated by the surrounding
community.
The letter dated September 4, 1843 is a bill for the castration of an Eastern State patient who was captured near
Lynchburg, Virginia. Dr. Galt's reaction (he was then 23) is not known, but he did not send payment.
The Galt Papers
Today, many of The Galt Papers can be read on-line at Eastern State Hospital. Dr. Galt's Medical Library Collection
of book and some artifacts are housed in the Mental Health Library.
Graphics and history courtesy, Eastern State Hospital.
http://www.esh.dmhmrsas.virginia.gov/libservices/patlib2.htm
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