Elmer Ernest Southard.

The kingdom of evils; psychiatric social work presented in one hundred case histories, together with a classification of social divisions of evil online

. (page 1 of 63)
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THE KINGDOM OF EVILS



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THE MACMILLAN COMPANY

NEW YORK • BOSTON' • CHICAGO • DALLAS
ATLANTA • SAN FRANCISCO

MACMILLAN & CO., Limited

LONDON • BOMBAY • CALCUTTA
MELBOURNE

THE MACMILLAN CO. OF CANADA, Ltd.

TORONTO






THE KINGDOM OF EVILS

Psychiatric Social JVork Presented in One Hundred Case Histories To-
gether with a Classification of Social Divisions of Evil



BY

E. E. SOUTHARD, M.D.

Late Bullard Professor of Neuropathology, Harvard Medical School; Pathologist

Massachusetts Commission on Mental Diseases; Director, Boston Psychopathic

Hospital; President, American Medico-Psychological Association



MARY C. JARRETT

Associate Director, Smith College Training School for Social Work; formerly Chiei
of Social Service, Boston Psychopathic Hospital



WITH AN INTRODUCTION BY

RICHARD C. CABOT, M.D.

Professor of Social Ethics, Harvard University
AND

A NOTE UPON LEGAL ENTANGLEMENT
AS A DIVISION OF EVIL BY

ROSCOE POUND

Dean of the Harvard Law School



BOSTON COLLEGE LI BRAKY
CHESTNUT HILL, MASS.

THE MACMILLAN COMPANY
1922

All rights reserved



PRINTED IN THE UNITED STATES OF AMERICA



Copyright, 1922,
By the MACMILLAN COMPANY.



Set up and printed. Published October, 1932.



Press of
J. J. Little & Ives Company
New York. U. S. A.



14



To

The Memory of

JOSIAH ROYCE

WHOSE WORK ON

THE SOCIAL CONSCIOUSNESS

THE PROBLEM OF EVIL AND

THE PRINCIPLES OF ORDER

HELD OUR OWN WORK

IN SOLUTION.



PREFACE

The writing of this book had been completed, with the excep-
tion of a few passages, and the form of it had been planned
before Dr. Southard's sudden death from pneumonia in Feb-
ruary, 1920. He had said that he would do no more work
upon it after February first, for one might continue indefi-
nitely to elaborate a book such as this. We felt that its chief
value would lie in the suggestiveness of the ideas presented and
not in their completeness. It was not intended that the book
should be either a treatise or a text-book, but a record of ex-
perience with comment. Such a work might serve several
purposes, — to suggest ideas to social workers, to reveal to other
professional persons the nature of social work, and to throw
light upon the problems of mental hygiene for all persons inter-
ested in human life. Mr. Pound has said that "it is a book
to quarry in."

Among the passages that Dr. Southard had not written were
some on medical subjects, which his friend. Dr. Harry C.
Solomon, was kind enough to write in accordance with views
held by Dr. Southard.

The cases were not chosen as examples of successful social
work, but were selected because they were believed to be in-
structive, whether by reason of success or failure.

The work of the social service of the Psychopathic Hospital
during the period that this book records was the sum of much
earnest and thoughtful effort on the part of many workers,
assistants, students, and volunteers, to whom I wish that I
might make personal acknowledgment at this time. Among
the assistant social workers who had most to do with the de-
velopment of the work were Mrs. Helen Anderson Young,
Mrs. Maida H. Solomon, Miss Helen Wright, and Miss



viii PREFACE

Dorothy Q. Hale. Among the physicians who helped most to
develop the social work of the hospital were Dr. Herman M.
Adler, Dr. A. Warren Stearns, Dr. Abraham Myerson, Dr.
Frankwood E. Williams, and Dr. Harry C. Solomon.

Mary C. Jarrett.
Boston,

July 22,, 1922.



INTRODUCTION

This book should appeal to a very wide pubhc because it is
a vivid transcript of poignant human experience — a record of
human misfortunes and their healing. But this record should
be especially illuminating because it is written by a man who
was many men at once. He gathered these human documents
as a student of mental disease and mental suffering; but he
saw them also with the sympathies of a social worker and the
insight of a philosopher. Philosophers do not often go to
psychiatric hospitals. Psychiatrists are rarely of a philosophic
turn of mind. Neither philosophers nor psychiatrists have
until lately been concerned with concrete, moral, educational, or
juristic problems, with which the authors here deal.

But Dr. Southard has in this book given us the mirror image
of his many-sided mind, incurably interested in all human suf-
fering, no matter where it led or whence it came, unwilling to
confine his interest within any boundaries, — scientific, profes-
sional, or temperamental, — until he had understood a sufferer's
troubles to the bottom. He has given us, therefore, a book
full of cross-lights. He lights education from the side of medi-
cine, law, and economics. He shows the doctor how he looks
to the educator, to the lawyer, and to the social worker. He
brings medical habits of thought into jurisprudence, economics,
and education.

The book is full of technical terms not all of which are
translated. But their meaning is soon clear from the context
and their inclusion, — unexplained, — gives one a stimulating
sense of looking straight into a busy workshop and gathering
there the unexpurgated details of the situation. A heightened
sense of reality and frankness results. Meantime, we get a sat-
isfactory familiarity with the psychiatric jargon with which
ere long pretty much all professions must be familiar. Army
men will have to know it — since so many malingerers are psy-
chopaths and so many mental tests (psychologic) are sure to
be incorporated in the army routine of the future.

Judges and lawyers have for some years past been getting



X INTRODUCTION

inoculated with the terms, the mental habits, and concepts of
the psychiatrist, since defective delinquents, epileptics, and the
feeble-minded, as well as the insane, so often are before the
courts.

Politicians and lawmakers must be familiar with the
methods and concepts employed in this book. For our laws
on sedition, our problems of free speech, the purposes and per-
formances of our prison officials, almshouse superintendents,
and asylum attendants can be judged only in the light of psy-
chiatric tests and psychiatric results.

* * * *

The book is written in part to illustrate how doctor and
social worker can co-operate in the care of the mentally
deranged. It also illustrates, I think, how fruitful such co-
operation can be, because the doctor, whose long suit is diag-
nosis, gets the aid of one much stronger than he on treatment,
— namely, the social worker. After the diagnosis there is
often little that the doctor, unaided, can do. The social worker
comes to the front just there. Provided she can get a diagnosis
and prognosis to start from, she mobilizes for the patient's
good resources altogether out of the doctor's reach.

This has been part of Miss Jarrett's contribution to the book.
She has been co-author of the text throughout. But her in-
fluence and her point of view as well as her diagnostic and
therapeutic efforts have been active in the daily dealings witli
the patients here pictured, as well as in the printed pictures
themselves.

I think, myself, that if the psychiatrist were yet a little more
broad-minded, he would call the clergyman as well as the
social worker to his aid and would find his patients thanking
him for a new sort of help now given by neither doctor nor
social worker. But that is for the Utopian future when the
clergy get their rights and come to earn almost the wages of

hodcarriers.

* * * *

One fact certified to in this book is alone and of itself worth'
reading the whole for, — the fact that more than one man who
was too crazy to get along at all in the community outside an
asylum did perfectly well in the army! The army, apparently,
is sometimes wiser than the doctors and social workers in its
environmental guidance of certain poor chaps, who, as soon



INTRODUCTION XI

as demobilized, must again be clapped into an insane asylum.
Surely this sheds light both on the army and on the asylum.
Even though such cases are admittedly rare, even though many
more are driven into asylums by army life, it is surely an
arresting bit of information, that army life is good for the
wits of some. Does this mean that the army provides more
discipline or less than the non-military life, more work or less,
more interest or less, more variety or less? All these possi-
bilities are open. Indeed, I have seen them all fulfilled. But
in any case a new remedy is added to the therapeutic accoutre-
ment of the average psychiatrist when he learns (and if he
believes) that army life did really suit some of the mentally
diseased patients studied by the authors.

^ ^jc ^ ^

Dr. Southard saw his profession as others see it. That is
a rare and valuable power. He did not "claim everything" for
psychiatry. Yet he claimed more, perhaps, than anyone else
ever did, up to his time. For since he included "mental hy-
giene" in the domain of his art and believed that labor dis-
putes, family rows, and international ambitions, as well as
crime, alcoholism, and school-backwardness, belong in the field
of mental hygiene, — it might at first sight appear that he set
no limits to his profession or its scope. But in point of fact,
limits, definitions, clear dividing-lines between adjacent fields
of professional work, were almost a hobby of his, — as this
book abundantly proves. He divides the science of psychology
from the art of psychiatry, and the alienist from the psychia-
trist. He refuses to confound (as psychiatrists and psycholo-
gists often do) the sphere of immorality with the sphere of
disease. Not all sinners are sick — in his view, nor all criminals
psychopaths.

This admirable clearness of definition is one of the out-
standing merits of the book. He ranges everywhere through
the emotions, struggles, diseases, weaknesses, delusions of
humanity. We are beside him in the courtroom, in the labora-
tory, and in the homes of some very queer people. But he
always keeps a clear head. He is never swept into a panic nor
into a wide glittering generalization, never tempted into mer-
gers that obliterate valuable differences. He has nothing of
the fanatic or the doctrinaire except their energy, nothing of
the imperialist except his sweep of vision.



Xll INTRODUCTION

I Wish he could have lived to compress this book some-
what. It is perhaps too literal a transcript from his daily life
and work. Yet there is an advantage in his very copiousness
and reiteration. It is like life and teaches like experience. Its
faithfulness to fact is in some ways more impressive than it
would have been had he cut and selected his material more
rigidly. Who reads this book will learn, — as the writer him-
self learned, — a body of balanced and cautious doctrine, docile
under the "bludgeonings of chance." We can hardly forget
teachings reiterated from so many points of view — just as real
life reiterates them. In the end we are landed square in the
middle of a moving train of thought, orderly and progressive,
but by no means at the end of its run. We are abreast of the
same difficulties, equipped with the same solutions that Dr.
Southard and Miss Jarrett were daily presenting to the current
army of workers, — doctors, judges, social workers, parents, —
who weave themselves in and out of these pages.

That is what he would have wished.

Richard C. Cabot.



CONTENTS



BOOK I— THE THREE MAJOR SPHERES OF SOCIAL
WORK (Cases i to 7)

Public, Social^ Individual

NojE — The literal formulas (P, S, I; P, S; etc.) stand for Public, Social,

Individual.

PAGE

5



Agnes Jackson, pathetic nuisance (P, S, I)

Richard Sully, morbid altruist (P, S) 8

Jennie Walton, peculiar thievery (P, I) 17

Henry Loyal, "black sheep" ; devoted, irresponsible

father (S, I) 22

Nora Campbell, ladylike adventuress (P) 29"

Alfred Mack, industrial disabilitj^ due to alcoholism

(S) 35

James Bailey, "shell-shock" analogue (I) 42



BOOK n— THE FIVE MAJOR FORMS OF EVIL IN

THE REGNUM MALORUM (Cases 8 to 38)

Six Complex Cases {One Pentadic, Five Tetradic) Analyzed
by Forms of Evil

Note — The literal formulas (M, E, V, L, P; M, E, V, L; etc) stand for
Morbi, Errores, Vitia, Litigia, Penuriae.

8. Rose Talbot, highly intelligent sex delinquent

(M, E, V, L, P) 51

9. Thomas Fuller, moron who set a fire (M, E, V, L) 65

10. Bertha Greenwood, hysterical sex delinquent (M,

E, V, P) 69

11. Lewis Goldstein, illiterate, industrially disabled

(M, E, L, P) 83



XIV CONTENTS



PAGE



12. Elsa Albrecht, mother of illegitimate children

(M, V, L, P) ■ 87

13. Agnes O'Brien, moron, divorcee, devoted mother

(E, V, L, P) 95

Ten Less Complex Cases ( Triadic Combinations of Evil)

14. Margaret Hersey, deaf, suspicious (M, E, V) 98

15. Bessie Polski, "mystery girl," hysterical (M, E, L) 103

16. Mark White, grown-up "spoiled child," psycho-

pathic (M, E, P) 107

17. Eva Collins, weak-willed, alcoholic, syphilitic

(M, V, L) 109

■ 18. Hamilton Green, "ej-e case," alcoholic, spoiled child

(M, V, P) 113

19. John Flynn, industrial traumatic neurosis (M, L,

P) . . . "5

20. Dora Hadley, intelligent sex delinquent (E, V, L) 121

21. Bessie Silverman, ambitious for an education (E,

V, P) 126

22. Elliot Calderwood, so-called "little fiend," quite

amenable (E, L, P) 128

23. Julia Brown, who lived as a man (V, L, P) 133



Ten Binary Combinations of Evil

24. David Stone, who feared open spaces (M, E) 137

25. Alfred Stevens, pilferer (M, V) 142

26. Kevork Ardinian, "work or fight" problem (M, L) 146

27. Herman Simonson, psychoneurotic clothes-presser

(M, P) 151

28. Aimee Prevost, suicidal psychopath (E, V) 154

29. John Manaos, technical deserter (E, L) 158

30. Emma Marburg, poor housekeeper with scolding

husband (E, P) 161

31. Alice Nardini, married to a "black sheep" (V, L) 167



CONTENTS XV

PAGE

32. Catherine O'Connor, quarrelsome wife (V, P) 172

33. Ignatz Simanski, forger (L, P) 177

Five Simple Cases of Evil

34. Daniel Griffin, afraid to go out alone (M) 178

35. John Henry, lad kept a prisoner by his mother (E) 182

36. Clara Perkins, fabricator, mother of illegitimate

children (V) 189

37. Nathan Blumberg, frugality or non-support (L) 192

38. Margaret Dolan, poor, old, overworked (P) 195



BOOK III— ELEVEN MAJOR GROUPS OF MEN-
TAL DISEASES (Cases 39 to 100)

/. Syphilopsychoses

39. Greeley Harrison, costly delay of diagnosis in gen-

eral paresis 203

40. Greta Meyer, widow with syphilis, depressed 205

41. Walter Heinmas, familial syphilis, revealed by

routine examination 207

42. David Collins, foreman in machine shop with gen-

eral paresis 211

"43. Carl Spindler, paretic soldier 215

44. Thomas Scannell, steady young soldier began to

sing, dance, and fight 215

45. Archibald Sherry, twelve-year-old victim of con-

genital locomotor ataxia 2 16

46. Harold Gordon, industrial disability caused by

syphilis 218

//. Hypophrenoses

47. Florence Warner, high-grade moron "football of

environment" 219

48. Bessie Newman, psychopathic family of ten mem-

bers, each an individual problem 223



XVI CONTENTS

PAdE

49. Nathan Rosenthal, imbecile kept at work 229

50. Bernard Bomstein, moron street-car conductor in

the navy 232

51. Howard Driscoll, recidivist with honorable dis-

charge from the army 233

52. Beatrice Cellini, subnormal girl called "vain, idle,

lazy, selfish, untruthful, immoral" 234

///. Epileptoses

53. Luigi Silva, alcoholic epileptic once a reliable

workman 236

54. Patrick Donovan, epileptic who killed his mother 238

55. Charles Lovell, drafted but discharged 240

56. Frank Wayne, enlisted man with seizures after In-

oculation 241

57. John Bristol, policeman, enlisted, had night attacks

following inoculation 242

IV. Pharmacopsychoses

58. John Logan, alcoholic, expert physicist; valuable

employee 244

59. Patrick Nolan, delirium tremens during wife's ab-

sence ■ 250

60. John Sullivan, discouraged real-estate agent with

alcoholic hallucinosis 252

61. Margaret Murray, the root of family dissension,

alcoholic hallucinosis 257

62. Michael Piso, jealous, feeble-minded teamster with

family in need 262

63. Marian Spring, psychopathic woman with drug

habit 267

F. Encephalopsychoses

64. Thomas Warren, salesman with moments when he

"lost himself" 270



CONTENTS XVll

PAGE

65. Helen Fitzpatrick, choreic girl with illegitimate

child 273



VI. Somatopsychoses

66. Ethel Murphy, unmarried mother with mild men-

tal disease 276

67. Joseph O'Brien, mind affected after influenza 277

VII. Geriopsychoses

68. Jeanette Burroughs, widow who saw her dead son 279

69. Catherine Cudahy, enraged by the vindictive tick-

ing of the clock 283

VIII. Schizophrenoses

70. Dana Scott, a chore-man in the country suffering

from dementia simplex 284

71. Ralph Johnson, compensated schizophrenic, once a

vagrant 29 1

72. Manual Rizzo, litigious vagrant and counterfeiter 294

73. Paul Ernst, salesman who lost his position through

an acute attack 295

74. Nora McCarthy, spoiled child who made attempts

at suicide 299

75. Clara Goldberg, girl committed after three years'

observation. 301

76. George Stone, soldier with croix de guerre who

developed paranoid conditions after discharge 306

77. George Mullen, left a state hospital and enlisted 308

78. Paul Dawson, soldier who claimed to be faking

mental disease 308

79. Howard Lancaster, corporal with dementia praecox 310

80. James Hill, army captain with dual personality 310



XVlli CONTENTS

IX. Cyclothymoses

PAGE

8i. Winifred Reed, young woman with wandering

spells 312

82. William Donahue, came as an out-patient because

he "lacked initiative" 317

83. Marie Dubois, governess who needs hospital care

occasionally 319

84. Joe Marino, mischievous boy on probation 321

85. Robert MacPherson, sailor given to "excited

actions" 323

86. Clarence Adams, discharged soldier restless and

over-talkative 326

X. Psychoneuroses

87. Maurice Eastman, psychoneurotic cigar-maker with

financial worries 328

88. Sadie Strauss, hysterical convulsions in a young girl 335

89. Joseph Fangillo, periodic voluntary^ patient 337

90. Dennis O'Donnell, industrial accident case 339

91. Walter Nelson, naval machinist with traumatic

hysteria 341

92. Martin O'Hara, feeble-minded soldier discharged

for hysteria 342

93. Joseph Levenson, drafted soldier discharged for

physical incapacity, is case of psychasthenia 344

XI. Psychopathoses

94. Harriet Farmer, psychopathic typesetter, at-

tempted suicide, trained to competence 347

95. Louis Sand, educated Belgian, wandering and ir-

regular worker 352

96. Theresa Beauvais, girl of bad heredity, victim of

hypersexualis 353

97. Leon Blumer, borderline psychopath, quarrels with

his wife 356



CONTENTS XIX

FAGS

98. Francis Corcoran, boy discharged from the navy

sick and "nervous" 359

99. Manuel Giordani, band sergeant who broke dovrn 360
100. Henry Allen, draughtsman v^^ho had to work alone 361

BOOK IV— EPICRISIS

I. Relations of Social Work to Sociology and Psychiatry 367

II. Method of Approach 375

III. The Method of Book I: Spheres of Influence 385

IV. The Method of Book II : Kingdom of Evils 390

1. Comparison of the Kingdom of Evils with Other

Schemes of Sociological Analysis 402

2. Definitions of the Five Groups of Evils 408

(i) Morbi (Diseases and Defects of Body and

Mind) 409

(2) Errores (Educational Deficiencies and Mis-

information) 411

(3) Vitia (Vices and Bad Habits) 412

(4) Litigia (Legal Entanglements) 413

(5) Penuriae (Poverty and Other Forms of Re-

sourcelessness) 415

3. Causes of Error 41^

4. The Problem of Evil 423

5. Applications of the Five-Fold Classification of Evils

Outside the Field of Social Work 430

V. The Method of Book III: Main Groups of Mental

Diseases 436

1. Neurosyphilis 455

2. Feeble-mindedness 463

3. Epilepsies 469

4. Mental Diseases Caused by Alcohol and Drugs 470

5. Brain Disease 472

6. Bodily Disease 472

7. Old Age 472

8. Dementia Praecox 473

9. Manic-Depressive Psychoses 477



XX CONTENTS

»AGE

10. Psychoneuroses 483

11. Dubious and Special Psychopathias 486

VI. Recent Applications of Mental Hygiene 492

1. Mental Disease in the Great War 492

2. Mental Hygiene of Industry 498

3. Out-Patient Service 512

VII. Psychiatric Social Work 517

1. History 517

2. Organization and Functions of the Social Service

at the Boston Psychopathic Hospital 523

3. Social Case Records 534

4. Technique of Social Diagnosis and Treatment 538

5. Medical Treatment in Social Case Work 549

6. Education for Psychiatric Social Work 552

A Note upon Legal Entanglement as a Division of Evil, by

Roscoc Pound 565

Appendices

A. Social records (full text) of cases 46, 89, and 94 571

B. Social service forms 671

C. Legislation in relation to mental disease, by Frankwood

E. Williams, M.D. 677

Bibliography 683

Index 699



THE KINGDOM OF EVILS



^



BOOK I

THE THREE MAJOR SPHERES
OF SOCIAL WORK

Public (Governmental)
Social (Voluntary)
Individual (Personal)

ANALYZED IN SEVEN SPECIMEN PSYCHIATRIC CASES



Then Job ansivered and said,

Be it indeed that I have erred,
Mine error remaincth with myself.

Behold, I cry out of zvrong,

but I am not heard;
I cry for help, but there is no justice.

All my familiar friends abhor me.

And they whom I loved are turned against me.

Have pity upon me, ye my friends;
For the luind of God hath touched me.

Job, Chapter 19, Verses i, 4, 7, 19, 21.



WOMAN ART STUDENT
IMMIGRATION SERVICE



In England

Bad Heredity
Quarreling

Estrangement from Family
Threats Against Family
"Nervous Breakdown"
Irregular Occupation
Sex Delinquency



In U. S. '

Convalescent Care
Unemployment (Voluntary)
Insufficient Income
Charitable Aid
Suicidal Threats
Public Nuisance
Deportation



Undesirable immigrant and pathetic nuisance: vicissitudes;
deportation. Effects of a faulty diagnosis and therefore
prognosis (neurasthenia in a woman not at all neurasthenic).
To illustrate public, social, individual problems.

Case I. Miss Agnes Jackson was sent to the Psychopathic
Hospital for observation from the Immigration Station at
Boston. She was a "mental" suspect and rather an appealing
figure. She herself said that in England she had had a "nerv-
ous breakdown." It seemed doubtful whether she could main-
tain herself on the small income she possessed, an allowance
from her family and a scholarship to cover art school tuition.
But finally she was admitted to the country in the joint care
of the director of the school she was to attend and the social
service of the hospital.

Correspondence with England shortly proved her the daugh-
ter of a professional man who had committed suicide a year
before. It appeared that her mother, brother, and sister were
living in England; but that she could not get on with them
and believed that they were persecuting her. Several years
earlier she had had a spell of bad temper and quarrelsomeness
after a love affair that did not come off. She won a scholarship
to study art in London, but had not fulfilled her contract.
About this time she had been observed in a London hospital,
where the (erroneous) diagnosis "neurasthenia" was made.
The parish rector wrote that she was "thought to be not right
in her head and her work as an artist was considered very
moderate." At the art school here, however, she was said to
have some unusual native ability.

After a week in the hospital she was sent to the country to
recuperate (through funds raised for the purpose) because
she complained of feeling weak and distraught as a result of
her detention at the Immigration Station under uncongenial
conditions. At the boarding house where she stayed she made
unreasonable demands and complaints, was untidy, and alto-
gether made herself a great nuisance. She returned to begin

5



6 THE KINGDOM OF EVILS

her studies at the art school, boarding at a working-woman's
hotel. But in a few weeks she took to her bed and insisted
on having her meals brought to her, saying that she would not
return to her work, as she couM not stand the atmosphere of
the school. It was found that she had been very rude to her
associates there.

Yet she went back after a time and gave no trouble for nearly
six months. A piece of her work was exhibited at a well-



Online LibraryElmer Ernest SouthardThe kingdom of evils; psychiatric social work presented in one hundred case histories, together with a classification of social divisions of evil → online text (page 1 of 63)