Recreation as Treatment at the Hamilton Asylum for the Insane

Dr. James Russell

In 1887, Dr. James Russell was appointed the third Medical Superintendent of the Hamilton Asylum for the Insane. In addition to being a staunch devotee of “Moral Treatment” of the insane and a vociferous critic of the use of gynecological surgeries on insane women, Dr. Russell was a fierce advocate for incorporating recreation and sports into the treatment of his patients.

In 1893, Russell tried an “experiment” and formed the Asylum Curling Club.  The Club was a huge success, travelling for matches as far away as Toronto. Russell reported that, “In every rink there were at least two patients, and it was not easy to distinguish who was who on the ice. Our club won the Walker Trophy one year, which was open to all clubs in the Hamilton district.” (By 1904, a proper skating rink was constructed on Hamilton’s grounds. In 1905, the Asylum Lawn Bowling Club was formed, another success under the leadership of Dr. Russell.)

Recreation at the Asylum (photos courtesy of the Hamilton Museum of Mental Health Care)

In his 1900 annual report to the Inspector of Asylums, Dr. Russell, included a section titled “Methods of Treatment”. In the first paragraph, Russell humbly admits that, “(t)he public have the idea that asylum physicians have some specific remedy for the cure of insanity, which is of course nonsense”. (Emphasis added.) (Full text is transcribed at the end of this post for easier reading.)

1900 Annual Report to the Inspector of Aylums (via Google Books)

It was Dr. Russell who integrated recreation and sport into the system of “moral treatment” used at the Hamilton Asylum for the Insane. In this report, he makes the case that these activities, combined with “a busy workshop of industry”, are the best methods to cure the insane. Russell argues that “a large proportion of insanity is due to unnatural and perverted methods of living, which include secret vices, excessive use of alcohol, imperfect nutrition, mental worry over real or imaginary trouble, the struggle for existence, unfavorable social environment, hereditary weakness, etc. All or any of these conditions reacting on a mind feebly endowed naturally, will in time unhinge the mental equilibrium and prepare the unhappy victim for asylum treatment.”

Russell goes on to argue that his introduction of sports to the Asylum had indeed improved the outcomes for his patients. “The various sports which we have encouraged here have done a marvelous work in improving the morale of the institution and in establishing a splendid esprit de corps between patients, officers and attendants. In looking over our large list of recoveries during the past year, I am glad to record the fact that we have drawn most largely from the devotees of our various sporting clubs. This is exactly in accordance with the theory which I have laid down, and should encourage us to still greater effort in the future.” (Emphasis added)

The full text of this report follows:

“METHODS OF TREATMENT”

“I do not presume to offer any panacea or even any new method of treating the insane. The literature of the subject by authors well skilled in science and ripe in experience is so extensive and so widely diffused that little new can be written on the subject. I desire simply to emphasize some of the well known methods of treatment in light of personal experience and subsequent results. The treatment of the insane may be divided under three heads: the moral, the social and the medical. I put the medical last for I consider it the least important, at least that part which includes the administration of drugs. The public have the idea that asylum physicians have some specific remedy for the cure of insanity, which is of course nonsense.

The last year has convinced me more strongly than ever of the immense advantage of systematized labor and recreation as a remedial agent. A large proportion of insanity is due to unnatural and perverted methods of living, which include secret vices, excessive use of alcohol, imperfect nutrition, mental worry over real or imaginary trouble, the struggle for existence, unfavorable social environment, hereditary weakness, etc. All or any of these conditions reacting on a mind feebly endowed naturally, will in time unhinge the mental equilibrium and prepare the unhappy victim for asylum treatment.

All rational methods of treatment must consist in a complete reversal of the above perverted methods of living, and our whole asylum equipment and practice must be specially arranged with that end in view. The asylum in all its appointments should be a busy workshop of industry, for mental growth will only react to well directed and persistent exercise, and sloth and indolence are the sure forerunners of mental and physical decay.

Not less important is the necessity for alternating labor with recreation. Healthful and invigorating sports should be practiced in great variety of form to suit the varied tastes of a heterogeneous population. The various sports which we have encouraged here have done a marvelous work in improving the morale of the institution and in establishing a splendid esprit de corps between patients, officers and attendants. In looking over our large list of recoveries during the past year, I am glad to record the fact that we have drawn most largely from the devotees of our various sporting clubs. This is exactly in accordance with the theory which I have laid down, and should encourage us to still greater effort in the future. The curative idea has been too long underestimated in the treatment of the insane, and that is one of the reasons why all our asylums are loaded up with such large armies of chronic cases.

They are allowed to dawdle away their time in interminable idleness, and drag out their weary days in mental and physical inertia; lost to the world, and a burden upon their friends or perchance the generosity of the State. From an economic point of view, not to speak of its social importance to the individual and the community at large, the Government would do well to encourage in every possible way the efforts of the superintendents to provide a diversity of labor, as well as an alternating system of recreation and sports, for statistics as well as experience prove beyond doubt these to be the sheet anchor methods of treating the insane.

Shakespeare with that superhuman insight to human character, has so correctly portrayed this condition that I may be excused for quoting him in this connection.

Macbeth –           “Canst thou not minister to a mind diseas’d,

                              Pluck from the memory a rooted sorrow,

                              Raze out the written troubles of the brain,

                              And with some sweet oblivious antidote

                              Cleanse the stuff’d bosom of that perilous stuff,

                              Which weighs upon the heart?”

Doctor –               “Therein the patient must minister to himself.”

Macbeth –           “Throw physic to the dogs; I’ll none of it.”

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