Dr. Andrew McFarland, the second superintendent of the Illinois State Hospital for the Insane and the proprietor of Jacksonville’s Oak Lawn Retreat, is a central character in the American Athena story. Women in Jacksonville shaped and reshaped his career, for better or for worse, just as his medical treatment shaped and reshaped their lives. This week finds me at the New Hampshire Historical Society in Concord, New Hampshire, where Dr.McFarland began his career.
I’m here to finish up my fellowship with the New England Regional Fellowship Consortium. Yesterday, as I sat munching on a snack below a statue of President Franklin Pierce, my phone buzzed with a message from Christian: using the census, he’s found yet another JFA alumna who had been committed to the Illinois Hospital for the Insane. There were so many, a seemingly disproportionate number compared to the general population. Clearly, education and women’s mental health are related. In addition to historical riches related to women’s education, the New Hampshire Historical Society has McFarland’s correspondence from when he served as the second superintendent of the New Hampshire Insane Asylum from 1845-1850.
McFarland was born in Concord on July 14, 1817. Educated at Dartmouth, he went on to graduate from the Jefferson Medical College in Philadelphia in 1843. In 1839, he married Annie Peaslee, whose brother, Charles, happened to be on the board of the newly established New Hampshire Insane Asylum. This did not make him a shoe-in for the job, however, because the board was wary of hiring a “green hand.” Planning began in 1830 and the state legislature approved funding in 1838, but the asylum not open until October 1842. The board hired the highly experienced Dr. George Chandler, a calculated move recommended by Dr. John Butler, head of the Boston Lunatic Hospital. In a January 1841 letter to the board, Butler believed that the New Hampshire men had an opportunity to create “the best constructed hospital in the country.” This rested entirely on their choice of an experienced superintendent who was “familiar with the advantages of all the Hospital in the country” and could improve on the best known facilities and treatments.
When McFarland took over in 1845, the institution was still struggling with maintaining a clean water system and faced an ever-growing patient population. At this point, patients were typically sponsored by individuals or communities, who paid their $1.50/week room and board. If the patient was a “pauper,” sponsors could appeal to the state for assistance. For example, in July 1848, a group of seven men from Bradford, NH made one such request on behalf of a struggling father in their community. They wrote:
“The undersigned citizens of Bradford respectfully represent that Jonathan Page, the bearer of this, is a resident of Bradford; that his son William Page is insane, and his condition is such as to render it dangerous for him to be at large and his friends are at present obliged to keep him chained, to prevent his inflicting injury upon himself and others’. We further represent that Mr. Page has a large family, who rely solely upon his daily labor for their support, and in our belief he is not able to support his said son at the Insane Hospital.” – Citizens of Bradford to Governor Jared W. Williams, July 31, 1848, N.H. Asylum Records, Series IV, Box I, folder 12, Patient Correspondence and Bills, 1843-1850, 1979-8/10/12, New Hampshire Historical Society.
The correspondence revealed how an individual’s mental illness affected entire families and communities, creating significant hardship. Though McFarland’s replies are absent from the collection, the letters from patients’ families reveal a level of intimacy with the superintendent and a willingness to forego the typical reserve of nineteenth century letters. In January 1850, a man in Portsmouth, NH indicated that McFarland had kept up a frequent correspondence with news of his wife’s illness. The man hoped a cure might still be found, offered his suggestions for care, and concluded, “I feel great confidence in your ability to treat her case properly and trust you will give me the earliest information should her case assume desided [sic] danger.”
In other cases, McFarland had to carefully navigate familial politics when members disagreed on a patient’s course of treatment. In 1850, Hiram Winnell’s brother and sister had him committed to the asylum, only to have their mother and another brother release him later, setting off a man hunt and a series of lawsuits. Even if family members agreed to have a patient committed, there would still be conflicts regarding their care. In 1845, Camillus Sanders believed his brother, James Sanders, lacked creature comforts at the asylum and asked McFarland to provide James with a little change to “indulge himself in any little thing he might fancy, and if he abused the privilege you could withdraw it.” This went against the wishes of their father, but Camillus worried about James escaping. James did just that in March 1846, writing to his father that his life was at risk in the asylum and “I could not be murdered, Sir.” He eluded the authorities for several months, showing up occasionally in the Boston area, and the correspondence does not indicate whether he was ever returned.
In all these cases, none of the letters lashed out at McFarland or blamed him for negligence. Of course this would change beginning in 1864, with the publication of Elizabeth Packard’s Three Years Imprisonment for Religious Beliefs, wherein she implicated McFarland in her wrongful commitment to the Illinois State Hospital for the Insane. Yet overall, McFarland comes across as a generally thoughtful, sensitive doctor trying to do the right thing for his patients. He fancied himself a gentleman scholar, having published writings on agriculture, as well as poetry. After stepping down from the Illinois State Hospital, he opened the Oak Lawn Retreat in Jacksonville in 1872 hoping to offer “The Better Way” to treat patients with depression. In a publication by the same name, McFarland asserted that state-run institutions, with their ornate multi-story buildings, was a calculated “repository of power” that “should be discarded.” He found that patients suffering from depression shared a perception of “personal unworthiness – of having forefited the love and confidence of others – of merited banishment, unfitness to live.” Imposing structures reinforced feelings of inadequacy, and only “serve to impair, if not altogether destroy, the hopefulness and mental elasticity that promote restoration. They all increase the idea that he is an outcast, doomed henceforth to separation from the life of the past” (“The Better Way; or Considerations Upon the Natural System of Providing For The Treatment of the Insane, by Andrew McFarland, M.D., LL.D., published as a pamphlet and Extract from the St.Louis Medical and Surgical Journal (1872) 12-17. New Hampshire Historical Society).
Speaking out against restraint and punishment (particularly the method of forcing cold baths), McFarland was strongly influenced by the community of Geel, Belgium, where the mentally ill have sought compassionate treatment since the 13th century. He advocated for the “cottage system,” or integration within the community, home care, and home-like settings within institutions. As progressive as he might seem, McFarland did not advocate for treating all patients equally. He argued that patients with greater financial means should have a “more careful regard for elegance of surroundings than is allowable in the other.”
Committed to the study of mental health since the beginning of his career, McFarland operated the Oak Lawn Retreat until his death in November 1891, at which time oversight went to his granddaughter (and JFA alum), Dr. Anne McFarland Sharpe.
Overall, the verdict is still out on Dr.McFarland and his exact role in Jacksonville. As you should know by now, I’m a firm believer in the complexity of individual stories. There’s no such thing as a true villain or hero and I’m not convinced the sources I’ve seen here tell the entire story. While there is more research in store, the New Hampshire Historical Society has yielded some significant clues.