Asylum for the Insane
Photo courtesy Mike Slate
TENNESSEE LUNATIC ASYLUM
The movement for an asylum in Tennessee arose in the context of the nationwide reforming furor associated with the Second Great Awakening. The asylum movement in America built its ideological arguments upon the theories of a group of European physicians including Phillipe Pinel of France, Daniel Hawke Tuke of England, and Vincenzo Chiarugi of Italy. These thinkers advocated a system known as “Moral Treatment.” The heart of this system consisted of the theory that insanity often arose in the context of a disordered environment. Treatment involved removing the patients from harmful surroundings and immersing them in a carefully controlled milieu in which they could develop the habits and modes of thought conducive to health.
The Tennessee General Assembly established the asylum in 1832, and it opened its doors to patients in 1840. The physicians and staff of the institution quickly attempted to apply the principles of moral treatment in combination with somatic therapies such as venesection and purging commonly used during the era. In 1845 a book titled A Secret Worth Knowing, purportedly written by an asylum patient named Green Grimes, appeared praising the asylum’s success. The book was followed the next year by a sequel, Lily of the West.
Despite Grimes’s praise, however, the institution quickly faced a set of interlocking, intractable problems. The legislature had been quite generous with its appropriations, at least as measured by the total size of the state budget. For most years during the antebellum era, asylum appropriations far exceeded those for the state penitentiary, the other public institution founded during this era of reform, and in fact the asylum budget often surpassed that of the entire executive payroll. But the money was never enough. Despite the fact that the staff of the asylum emphasized the crucial role of prompt treatment (within a year of the onset of symptoms) in curing mental disease, families and local governments unburdened themselves of relatives or citizens with long-standing problems. The asylum also found itself overwhelmed with pauper cases, which required state financial assistance. The latter problem was compounded by an early underestimation of the costs of caring for paupers in the asylum. Actual costs per patient for pauper care amounted to more than twice the original estimate. Finally, the assumptions of antebellum medical science may well have worked against the asylum. The institution treated persons with a wide variety of illnesses including alcoholism, depressive disorders, mania, seizure disorders, and frank psychosis. While some of these conditions might have responded to an environment structured according to the ideas of moral treatment, others did not. Indeed, many of these conditions only found effective treatment with the development of modern drug therapies, and many others still cannot be treated effectively.
The asylum lurched along, chronically over budget (sometimes by as much as 200 percent) and understaffed. Its original quarters, at the corner of the present Twelfth Avenue South and Division Street in Nashville, proved woefully inadequate. A visit by Dorothea Dix, the itinerant champion of asylum and penitentiary reform, combined with the pleas of asylum staff, prompted the legislature to approve the construction of another facility. This building, located on Murfreesboro Pike to the southeast of Nashville, remained the home of the asylum from 1851 to 1995. During that period it underwent several changes of name, becoming first the Tennessee Hospital for the Insane, then, upon incorporation with the developing system of state mental hospitals, Central Hospital for the Insane, and finally Middle Tennessee Mental Health Institute. Its institutional history, however, stretches back unbroken to the first lunatic asylum founded by the legislature in 1837.
By 1865 even the superintendent of the asylum flatly admitted that the asylum could not hope, under existing conditions, to strive for the goals of moral treatment. Instead, the institution had become a custodial facility, harboring the chronically and irredeemably ill. Yet the institution’s continued existence, albeit with a long checkered history, into the present day attests to the power and nobility of the original vision.
Nashville, TN Insane Asylum Blaze, Aug 1863
From www3.gendisasters.com
Posted January 9th, 2009 by Stu Beitler
AN INSANE ASYLUM ON FIRE.
EIGHT OF THE INMATES OF A TENNESSEE INSTITUTION BURNED TO DEATH.
Nashville, Tenn., March 14. — This morning the Central Insane Asylum, situated seven miles from this city, is almost a mass of ruins, and beneath it are the charred bodies of half a dozen of the unfortunate inmates. At 10:15 last night Watchman FITZHUGH discovered an ugly tongue of flame breaking through the roof of the western main wing of the building. How it caught none could learn, but it reached from the ground through the second and third stories, and cut off the few rooms that were behind it. In a moment the alarm was given, and the 400 inmates of the institution were thrown into wild commotion. There were twenty-eight men in the wing when the fire caught, and twenty of them were quickly removed to the main hall, the other eight being left to their fate behind the impassable wall of flames. The city was telephoned to for aid, but Chief CARREL of the Fire Department could not be found, and his subordinates refused to move without instructions. Finally, after two hours delay, the Chief was found, ahd he, with two engines, left for the scene of the disaster. In the meantime the west wing had collapsed, the fire had spread, and the inmates made frantic by their danger, were beginning to break from the guard and scatter like frightened animals over the surrounding country. The fire engines arrived on the scene at 2:15, and in a few moments a stream of water was playing on the main building. Previously, the inmates of the asylum, the servants, and the guards had rendered fire service with buckets and succeeded in holding the fire in check to some extent. The doomed inmates were in the west wing. They were all males and white.
The New York Times New York 1863-08-17
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Researched and Transcribed by Stu Beitler. Thank you, Stu!
SIX FALL VICTIMS OF THE TENNESSEE INSANE HOSPITAL FIRE.
Nashville, Tenn., March 16. — The beautiful Central insane asylum, situated seven miles from this city, is almost a mass of ruins. Beneath it are the charred bodies of half a dozen of the unfortunate inmates. In the outhouses near by are huddled the poor, demented creatures who found an asylum in the grand old structure now laid in ashes.
The fire was discovered at 10:15 p.m. in the west wing, in which there were twenty-eight patients. Twenty-two of these were saved before escape was cut off. The other six met a fearful fate in the flames. The city was telephoned for aid, but Chief CARROLL, of the fire department, could not be found, and his subordinates refused to move without orders. Finally after two hours delay, the chief was found, and started for the scene of the disaster with two engines. In the meantime the west wing had collapsed. The fire had caught in the main building, and the inmates, made frantic, by their danger, were beginning to break from the guard and scatter like frightened animals over the surrounding country.
At 3:15 the inmates who had been huddled for several hours in the yard in front of the main building, were returned to the east wing. About twenty-five had escaped, the majority of whom were harmless. At this moment the west wing had become entirely demolished and about one half of the main building. The dangerous lunatics were kept locked all the time in the East wing and none of them were subjected to exposure or danger during the progress of the flames. It was reported at 3:30 a.m. that one of the women, an inmate of the asylum, had been drowned in the late on the lawn, but her name could not be leared. The fire was at the same time reported fully under control, and the inmates were comfortably housed and all was quiet. It is impossible as yet to give any estimates of the loss, though it will be heavy. The building was fully insured.
Waterloo Daily Courier Iowa 1891-03-16
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“The Asylum for the Insane was known as Central State(in 1950’s & 60’s) on Murfreesboro Road.”
-Harrison Fisher
The Insane Hospital is actually located on the street I live on. County Hospital Road was Asylum Road
because it deadended into what is now Bordeaux Hospital but was then the County Asylum for the
Insane. The name was changed for obvious reasons as the community of Bordeaux grew.
-R. Craig Harper
Historic Nashville 
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