19th and 20th century psychiatry: 22 rare photos

Psychiatry has come a long way since the days when patients were shunned from society and shackled in loony bins. Psychiatrists of yore experimented with numerous techniques for treating mental disorders - some that paved the way for psychiatry and are even used today. But quite a few others would raise eyebrows today and make modern-day ethicists squirm.

In this 1930 picture, psychiatric patients stand outside their rooms in Kentucky's Hopskinsville Insane Asylum. They are wearing normal clothes and have their own rooms - but treatment wasn't always this humane.

Keep clicking to see 22 shocking photos of psychiatry in days past, from Dr. Stanley B. Burns' book, Patients & Promise: A photographic History of Mental And Mood Disorders...

Phrenology

This 1856 photograph is one of the earliest to depict a phrenologist at work. What's phrenology? It's the foundation for many of the principles that are seen in modern psychiatry and neurology today. Phrenologists believed the shape of the brain was an indicator of mental capacity, and that different portions of the brain controlled different parts of the body. Simply by feeling bumps on the skull, a phrenologist would conclude information about a person's character, intelligence, and whether or not they lacked a certain personality trait.

Civil war head injuries

Many soldiers in the American Civil War suffered head injuries that resulted in mental disorders - everything from serious dementia to personality changes. This devastation ultimately paved the way for medical advances in neurology.

This photo shows a 21-year-old corporal who was shot in the head at the Battle of Farmville in 1865, shortly before the South surrendered in the Civil War. Years after he was discharged, his physician noted, "He has many symptoms of disturbance to the brain."

An 1860s mental hospital

This 1860s photograph shows a ward for non-violent women at the West Riding Asylum in Wakefield, England. Most of these patients had terminal dementia. The bonnet these women are wearing was common for female psychiatric patients at this time.

Facial expression of emotion

Famed biologist Charles Darwin took his knowledge of facial expressions in the animal kingdom and tried to apply it to humans, examining whether visual markers could identify mental conditions.

This photo is taken from the 1872 book by Charles Darwin called "The Expression of the Emotions in Man and Animals." In his text, he described how this man's muscle contractions display terror and great mental distress.

Cranial capacity research

One of the most recognized physicians of his day, Dr. John Shaw Billings created the predecessor to the National Library of Medicine - an accomplishment that overshadowed his groundbreaking work in cranial photography.

This 1885 photograph shows Billings photographing a skull that's submerged in a tank of water to measure its cranial capacity, which was thought to influence mental conditions. Billings and his assistant had to act fast - if the skull was submerged for more than 45 seconds, it would absorb too much water and expand, providing an inaccurate measurement.

Measure the skull to measure the mind

Scientists thought they could determine intelligence, human ability, and even criminality by measuring the skull.

This image taken from German neuropsychiatrist Georg Konrad Rieger's 1885 craniology textbook illustrates how to properly measure a skull.

Dissecting the criminal brain

If scientists believed they could determine a person's criminality by measuring his head, surely the next step would be to open it up. This 1904 photograph by Argentinian physician Dr. F. Perez shows a section of an executed criminal's brain. Unfortunately, his work merited little results - he found no major differences between the brains of criminals and non-criminals.

First photograph of psychiatric patient in journal

Today, medical journals circulate to thousands of doctors in order to share findings from new studies and present unique cases. The 19th century was no different. This photograph is the first psychiatric patient to appear in the journal Revue Photographique des hopitaux de Paris, Volume 3, 1871. The journal was published through 1875.

This patient was reported to have hysterical contracture. Her problems began when she was 34 years old - at 42, she appears to have developed paralysis on one side of her body, the author wrote.

Anorexia in the 19th century

Even in the 19th century, psychiatrists saw patients with eating disorders. These images, published in Paris in 1892, depict a young woman with "visceral hysteric anorexia" who gradually gave up eating until she developed cachexia - a condition where the body is so malnourished it can't be reversed. Back then, anorexia was thought to be a teenage girl disease.

Today, researchers believe there is a strong correlation between the media's portrayal of women and teenage anorexia. But the symptoms of the disease remain relatively unchanged since the 19th century, when robust women were deemed attractive.

Mental retardation - "The Burden of the Feebleminded"

Mental retardation has been reported in literature as early as Spartan and Roman times. In the 1880s, doctors chose to isolate these patients, putting them in asylums and often neglecting them.

But in 1907, a businessman named William Pryor Letchworth donated 2000 acres of land to build a facility for the "feeble minded and epileptics." He envisioned his facility as a farm and hoped its inhabitants would learn "village life" and farming techniques in a nurturing environment. This 1912 journal article shows village-member Emma W. and a profile of her life in the village. The last resident moved out of Letchworth Village in 1996.

Utica crib

Even after chaining was deemed inhumane for psychiatric patients, restraints and other devices were used to protect patients from harming others - or themselves. Today, few photographs exist of restraining tools - but this photo of a late 1840's "Utica Crib" survived.

This crib is made out of intricately carved wood - many were made out of iron - and patients would sleep in it for extended periods of time until a regulatory crackdown curtailed restraint use for all but the most uncooperative and violent patients - a practice that's still scrutinized.

Restraint chair for violent patients

This chair was used to control violent patients at the New York State asylum in the early 20th century. An unruly patient's arms were strapped into the wooded wells, feet secured to the floor, and a belt tied around the boy - sometimes a patient's head was covered with a hood.

Outlawed restraints

This photograph shows restraints that were deemed "outmoded" by New York State in the late 1930s - iron handcuffs, muffs, wrist/body restraints, and ankle bands. New York was one of the first states to outlaw certain types of restraints. In 1933, the N.Y. State Department of Mental Hygiene created a code for restraint, which put a two hour cap on continuous restraint, and a three hour cap on seclusion time.

Sewing class for deteriorated women

This twentieth century image shows a "class of deteriorated patients" sewing at Utica State Hospital. The photograph reflects a shift in treatment as the most deteriorated, demented patients now participated in normal life activities as part of their therapy. The hope was this treatment would create a feeling of usefulness and competence within the patient.

Dancing therapy

Dancing gave patients in the asylum something to look forward to - a way to express themselves physically in an otherwise restrained environment. By the end of the 1920s, social contact like dancing was critical to psychiatric care.

To avoid outbursts among more seriously ill patients, only same sex partners were allowed to dance with each other, as seen in this 1920s photograph from the New York State Asylum.

Sound therapy from an opera singer

Psychiatrists began to use the soothing effect of music on asylum patients in the 19th century. By the end of the century, some psych wards even established bands. This 1920s photograph shows an opera singer performing at a New York City mental hospital for a sound therapy session. Psychiatrists hypothesized that certain sounds would have therapeutic effects on patients.

A press release from the event read, "An experiment that will be watched with intense interests by alienists, psychologists, and the medical profession in general took place when Miss Ethel Tamminga of Chicago, sang at the Manhattan State Hospital for the Insane on Ward's Island, New York, in an attempt to relieve some of the inmates of their obsessions."

Electricity and mental disease

In the late 1700s, Italian physician Dr. Luigi Galvani discovered that frog muscles reacted electrically when exposed to certain metals - which led to the notion that nerve pulses are electrical charges. One day, Galvani's cousin, Dr. Giovanni Aldani, convinced French asylums to let him treat hopelessly depressed patients with electricity.

By the 1850s, electricity was widely used to treat psychiatric ailments - and would eventually turn into electroconvulsive therapy nearly a century later. This photo shows a man receiving static sparks to the spine for psychosis from tabes dorsalis, a degenerative nerve condition brought on by syphilis.

Diathermia, the "laser" of its day

This photo shows a patient undergoing lateral cerebral diathermia treatment in the early 1920's. What's that? Diathermia was a precursor to electroconvulsive therapy and considered to be the "laser" of its day, using a galvanized current to jolt psychosis sufferers.

But doctors deemed it unsafe and unreliable. "As I have seen, a trouble shooter may pull out a fuse or switch at a distance and almost at once replace it, thus giving a brain case two very bad shocks, one right after the other, and possibly causing dangerous syncope," Chris M. Sampson wrote in his 1926 book "A Practice of Physiotherapy."

Electroconvulsive therapy

Electricity's role in psychosis therapy reached its pinnacle in 1938, with the development of electroconvulsive therapy, or ECT, in Italy. The shock therapy was said to cure - or at least reduce - symptoms of schizophrenia and depression. Once Italian physicians fled to the U.S. from Benito Mussolini's dictatorship, the practice took off in the States. This photograph from the mid-1940s shows a patient undergoing ECT.

Fever therapy to cure psychosis

Suffering from mental illness? Maybe you need a physical fever. In 1927, Viennese psychiatrist Dr. Julius von Wagner-Jauregg won a Nobel Prize for discovering fever therapy when he "cured" a patient with late-stage syphilis 10 years earlier, by injecting him with malaria-tainted blood to induce a fever. It was considered the first true cure that halted a psychotic disease.

Soon, all sorts of doctors were infecting their patients with malaria to cause a fever - until they realized many patients were dying from it. So they turned to other ways to heat up their patients, until the first report was published recommending ultrasound waves to therapeutically heat a person.

That led to the production of machines like this full-body fever machine (pictured) that was installed at the Fifth Avenue Hospital in New York City in the 1930s. According to a press release at the time, the machine "heats the blood stream and body tissue, much as does nature, killing off the alien germ."

Patient polygraph for examination

With all the technological advances for the field of psychiatry towards the mid-20th century, doctors started using technology to diagnose patients. Here, a patient is strapped into a polygraph machine at the government-operated Lexington Narcotic Hospital in Kentucky. Lie detectors were part of patient evaluations when this picture was taken in 1940.