A Disability History of the United States (8 page)

Hopkinton’s almshouse was not the only such institution in the rapidly developing Colonies. Almshouses, which began to be in regular use by the end of the colonial period, met many community needs and were a general dumping ground for all those unable to support themselves financially. They also served as correctional institutions. Connecticut’s first such institution, for example, established in 1727, was intended to house “all rogues, vagabonds and idle persons going about in town or country begging, or persons . . . feigning themselves to have knowledge in physiognomy, palmistry, or pretending that they can tell fortunes, or discover where lost or stolen goods may be found, common pipers, fidlers, runaways . . . common drunkards, common night-walkers, pilferers, wanton and lascivious persons . . . common railers or brawlers . . . as also persons under distraction and unfit to go at large, whose friends do not take care for their safe confinement.”
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A perception of the need for care or confinement, rather than diagnosis (for one could be a “fidler,” a vagabond, or “persons under distraction”), drove this early development of institutionalization.

Similar institutions developed in Rhode Island in 1725, in New York in 1736, and in Pennsylvania in 1752. The Pennsylvania Hospital was intended for “the Reception and Relief of Lunaticks: and other distemper’d and sick Poor within this Province.” The New York “Poor-House, Work-House, and House of Correction” similarly welcomed a broad spectrum of people. Virginia opened the doors of the first asylum exclusively for those with mental and cognitive disabilities—“ideots, lunatics, and other persons of unsound minds”—in 1773. The institution sought to “care . . . [for] those whose cases have not become quite desperate . . . [and restrain] others who may be dangerous to society.”
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Those with cognitive or mental disabilities may have been confined only if considered necessary, but confinement was not pleasant—either at home or in an institution. Sometimes confinement was horrific. Patrick Henry’s wife died locked in her cellar. All individuals who entered Connecticut’s institution were automatically whipped on the back “not exceeding ten lashes.” Those institutionalized as insane in the Pennsylvania Hospital were confined in the institution’s cellar and chained by the waist or ankle to the wall. Many wore a “madd-shirt”: “a close-fitting cylindrical garment of ticking, canvas, or other strong material without sleeves, which, drawn over the head, reached below the knees, and left the patient an impotent bundle or wrath, deprived of effective motion.”
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Though horrid in contemporary terms, such conditions are evidence of early efforts to provide curative treatment. The decades surrounding the American Revolution were a period of transition for those with mental and cognitive disabilities, in which some were referred to experts outside of the family and some were not. The little that physicians had to offer generally included bleeding, purging, and blistering, but turning to physicians implied that those involved considered “cure” to be possible. For James Otis Jr., cure involved a simple firming up of self-control—at least according to his father. Increasingly, however, finding a solution (which assumed an identified problem) meant seeking the assistance of individuals outside the family. Those considered available to provide assistance variably were midwives, ministers, and educators, but increasingly physicians.

This was one more manifestation of the American Enlightenment’s turn to education and reason, science, and the belief in human capacity (or at least the capacity of some people). The Revolution and the new nation itself would come to be founded on the radical argument of the Enlightenment that citizens, however limited in breadth the category might be, had rights and were capable of reasoned decision making and could be trusted with the vote. As the US Constitution, adopted in 1787, stated, “all men are created equal . . . [and] endowed by their Creator with certain unalienable rights.” Given such human potential, and trust in human reason, the new scientific method of thinking held tremendous sway. Advances and attempted advances in medicine and technology presumed that order could be found, solutions achieved, and increased enlightenment would result.

When Cotton Mather (the very same Puritan minister who had considered his stuttering a sign of sin) encouraged smallpox inoculations, and those inoculations resulted in far fewer deaths, many saw it as one more example of an enlightened society’s ability to conquer nature. Few recognized or knew that Mather had learned of the beneficial consequences of inoculation from an African-born slave. If science and reason, however, could advance technology, bring forth new political imaginings, and find medical solutions to perceived physical problems, perhaps it could be relied upon for others as well.

The most popular home medical manuals of the period also offered suggestions for the treatment of mental and cognitive disabilities. John Wesley’s 1747
Primitive Physic
suggested treating “lunacy” with a daily ounce of vinegar or applying a boiled blend of ivy, oil, and white wine to one’s shaved head every other day for three weeks. “Raging madness” could be treated by applying cold water to the head or eating only apples for a month. (Baldness would be treated by rubbing first an onion and then honey on the afflicted area twice a day.)
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The general lack of discussion and institutional acknowledgment of physical disabilities suggests that they simply were not noteworthy among communities of European colonists in the period before the Revolution. Indeed, it suggests that such bodily variations were relatively routine and expected—and accommodations were made, or simply didn’t have to be made, to integrate individuals into community labor patterns. And some people simply died. Smallpox and other epidemics routinely ran through colonial towns and villages, resulting in increased deafness, blindness, and skin disfigurements. Undoubtedly, axes occasionally caused one to lose either finger or limb, trees toppled in the wrong direction, children were burned in fires, and guns misfired.

First and foremost, families cared for individuals in the late colonial period—and could do so relatively easily in their own homes: those considered insane, for example, might need only a daily dose of vinegar. Communities of European colonists moved to provide organized care only when and if individuals came to be considered overly disruptive, and when and if families could or did not provide care.

The desire and ability to provide consistent familial or community care generally depended on some level of stability, resources, and security. European colonization in North America left few indigenous nations with the ability to provide care on a meaningful and significant scale.

Nearly half the Cherokee nation of Oklahoma died when smallpox hit in 1738, as did half the Catawbas of the southeastern coastal region in 1759. When British explorer and navigator George Vancouver first reached Puget Sound in 1792, he met members of the southern Coast Salish nation who already had been scarred and lost vision due to smallpox. In the race among European nations to best one another in gaining greater colonial control of North America, the disease had beaten the Europeans to the continent’s northwest coast.
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People of the Kiowa nation in what are now Texas, Oklahoma, and New Mexico tell a story in which a Kiowa man encounters Smallpox, riding a horse through the plain.

It’s likely that indigenous nations that highly valorized the warrior were more rigid in their bodily ideals, and thus less accepting of disability, than groups primarily agricultural or nomadic. The ever-increasing number of European settlers, and their ever-expanding geographical reach, also intensified large- and small-scale military conflicts between indigenous nations and the colonists. In those cases, and in those regions, the ability to battle became far more important for both Native and European men. A successful warrior generally required physical strength, agility, and keen eyesight, hearing, and analytical skills; and while some women excelled at war, most tribes masculinized the ideal. Some individuals simply could not live up to, or it was assumed they could not live up to, the physical and mental demands of the warrior ideal because of their bodies. In nations such as the Aztec and the Iroquois, ideals of leadership thus were more likely to exclude people whose bodies did not meet the high standard set for the community’s most esteemed positions. Such exclusion would have resulted in stigma—sometimes harsh, sometimes mild—being attached to those impairments.

At the same time indigenous peoples were dying in large numbers and being pushed from the regions of European settlement, Europeans were bringing Africans to North America by force. The first Africans arrived in North America in 1619, nineteen in number and bearing the legal status of indentured servants—not slaves. By the 1640s, however, European colonists had built slavery into the legal frameworks of colonies both north and south, and Africans landed in the New World as chattel. In 1700, twenty thousand enslaved Africans lived in North America, and by 1790 there were almost seven hundred thousand; by 1860 there were nearly four million. The transportation of slaves into the United States was abolished as of January 1808, but slavery continued legally in some parts of the United States until the Union prevailed in the Civil War in 1865.

The racist ideology of slavery held that Africans brought to North America were by definition disabled. Slaveholders and apologists for slavery used Africans’ supposed inherent mental and physical inferiority, their supposed abnormal and abhorrent bodies, to legitimize slavery. Indeed, slaveholders argued that the bodies and minds of those they enslaved were disabled to such an extent that slavery was a beneficial kindness owed to those in need of care. Disability permeated the ideology, experience, and practices of slavery in multiple and profound ways.

European slave traders built on an already existing slave trade and market within Africa. While important differences existed between the internal and transatlantic African slave trades, the two became intertwined. (Within Africa, for example, slavery did not pass from parent to child. Children born of an enslaved mother were born free.) Slave traders were in the business to make money. This meant that they sought to enslave people with bodies and minds considered fit for work, people who could command a good price.

In 1701 one slave-trading company wrote directly to the king of Whydah (Ouidah), on the coast of western Africa, characterizing the bodies and minds of those the king’s traders should seek out:

Age, height, evidence of past disease, or the state of one’s limbs thus protected some individuals from being abducted and sold into slavery but did not protect them from violence.

What happened to those whose bodies were considered too disabled for enslavement? The historian Hugh Thomas notes that in slaving raids “old men and women, as well as children, were considered valueless and often killed.” This likely included those with physical disabilities that made them ineligible for slavery. On the other hand, Africans with physical abnormalities considered extreme, whose bodies could be exhibited for money, were prized.
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Once captured or sold into the slave market, the enslaved began the deadly journey to Africa’s western coast. Historians estimate that as many as half of those pressed into slavery suffered the effects of disease, exposure, malnourishment, fatigue, or violence on the overland journey. If they reached the coast alive, they were held in wooden structures; again, with little food, subject to high disease rates, and with already traumatized bodies and minds. More died while awaiting transport.
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Sailing across the Atlantic in this period was unpleasant even for those who could afford the best of transports, and it could be deadly for anyone. Crewmembers stayed on the ships far longer than slaves did, and made repeated voyages. More than 20 percent of the crewmembers who sailed on English ships from the Bristol and Liverpool trading companies died during their labor.
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