Rural psychiatry on the nineteenth-century frontier: the career of Jacob Bowers.

Abstract

RURAL PSYCHIATRY ON THE NINETEENTH-CENTURY FRONTIER: THE CAREER OFJACOB BOWERS LLOYD ALLAN WELLS* On its opening in 1879, the Rochester State Hospital in Rochester, Minnesota, effected a policy of keeping a complete record of every patient treated in that hospital. While such a policy is virtually mandated today, it was unusual for that time. Examination of the early records of the Rochester State Hospital provides some interesting information about the demography of psychiatric illness in nineteenth-century Minnesota . In addition, it provides a fascinating glimpse into the personality and clinical acumen of the writer of the early notes, Dr. Jacob Bowers, the first superintendent of the Rochester State Hospital. From the records of the first 40 patients admitted to the hospital, one can gain an idea of the types of problems which Bowers saw, as well as the methods of treatment which he used. The information available about Bowers's life is rather sketchy. He was born in 1841 in Berlin, Ontario, the son of a large landowner in Berlin who had moved to Canada from Pennsylvania. Bowers received the degree ofBachelor ofArts from the University ofToronto, where he subsequently received the degree of Master of Arts in modern languages . The year after his receipt of the master's degree, while supporting himself as a teacher of French and German at the London Collegiate Institute in London, Ontario, he also began his study of medicine in a preceptorship setting. He then enrolled in the Toronto College of Medicine for 1 year. Although this fundamental education in medicine was sufficient for the times, he proceeded to transfer to the University of Michigan Medical School, from which he received the M.D. degree in 1868 at age 27. Apparently, Bowers had no doubt about becoming what was then called an "alienist," because immediately after graduation he moved to St. Peter, Minnesota, arriving at the first Minnesota Hospital for the ?Assistant professor of psychiatry, Mayo Medical School, Rochester, Minnesota 55901.© 1981 by The University of Chicago. 0031-5982/81/2402-0216$01.00 270 I Lloyd Allan Wells ¦ Rural Psychiatry Insane just 21A years after its opening, at the invitation of its medical director and first superintendent, Dr. Samuel Schantz. The hospital setting into which Bowers went was of some interest. There was no public hospital for psychiatric disorder in Minnesota until 1866. In fact, the only care for the indigent insane in Minnesota until 1862 was in nonmedical settings, such as poorhouses and houses of correction, with no treatment as such provided. In 1862, a man was found to be insane by a court and was ordered to be committed to a public hospital—although there was none. Perhaps this is an early example of sub rosa legislation by the judiciary. Since no hospital was available, arrangements were made with the state of Iowa to treat the patient. Not unexpectedly, there was soon an onslaught of mentally ill Minnesotans en route to Iowa, and the authorities there became rather unhappy. An agreement was reached that all Minnesota patients would be hospitalized in Minnesota by 1866. Perhaps the legislators entertained the hope that mental illness would have disappeared by 1866; in any event, they made no provisions for a hospital, and, when 1866 came, there was none. During that year, a bill was introduced into the state senate which would establish an insane asylum. A crisis was perceived, and a ready-made hospital in St. Peter was purchased rather than built. Schantz was appointed superintendent. It was this man alone who handled the influx of patients into the mental hospital when it opened in December 1866; and it was he who hired Bowers as his first and only assistant physician. Bowers began his work there in June 1868 with no clinical training other than his work at the University of Michigan. He came to a hospital rich in clinical and teaching material, with an able but overworked supervisor for whom he felt affection. Unexpectedly, 2 months after Bowers's arrival, Schantz died, and Bowers became acting superintendent by default. The work and its responsibility were undoubtedly arduous for a man 3 months out of medical school. In addition to caring for all...