This dissertation explores how psychiatrists, food scientists, public health officials, professionals, government officials, and patients understood the relationship between food and mental illness in the United States during the Long Progressive Era. This exploration is centered on St. Elizabeths, the federal mental hospital in Washington D.C., and William Alanson White, its superintendent from 1903 to 1937. While historians have written at length about the Progressive Era, food reform, and the history of psychiatry, there has been a gap in the literature at the intersection of the histories of food and psychiatry. This study thus seeks to help fill this gap by examining the role that food and diet played in mental institutions and in ideas about the etiology and symptomology of mental illness. It utilizes a range of sources including hospital administrative files, patient case files, medical articles, newspapers, and government documents to show that longstanding ideas about diet and health from Hippocratic to nineteenth-century medicine, including moral treatment, held an important place among the changes that U.S. society and psychiatry underwent at the turn of the twentieth century. I also argue that psychiatrists and medical staff primarily viewed food and diet for patients in the mental hospital as care, an administrative provision of the humane necessities that public institutions were expected to provide, and as therapy, a medical treatment for disease. At the turn of the twentieth century, scientists, professionals, legislators, and psychiatrists—including famous home economist Ellen Richards and nutrition scientist Wilbur Olin Atwater—debated over and studied how to properly feed institutionalized patients in mental hospitals. These conflicts over diet highlight a significant strand of therapeutic optimism in psychiatry that was bolstered by concerns about humane care, even as increasing numbers of chronically ill patients contributed to psychiatrists’ therapeutic pessimism. A comparison of legislative investigations at St. Elizabeths and the South Carolina Hospital for the Insane illustrates how regional differences, the pellagra epidemic, and investigation findings led to different hospital diets. This dissertation also examines how the eating habits of the mentally ill, such as food refusal and overeating, required surveillance and intervention from hospital staff. This benefitted many patients but for others, served to pathologize their eating habits. Briefly, the dissertation moves outside of St. Elizabeths to examine how D.C. District Jail authorities and reporters cast radical women’s suffragist Alice Paul’s refusal of food during her hunger strike as a symptom of insanity. This ultimately led to an examination and confirmation of Paul’s sanity by White. I also seek to build on the work of other scholars in arguing for the usefulness of the concept of the Long Progressive Era by viewing World War I as a catalyst of Progressive energy. The continuities of how dynamic psychiatrists like White thought about the interconnected health of mind and body combined with the changes that World War I spurred at the hospital. Patients and their own dietary preferences and ideas, however, provided one significant disruption to an overly simplistic categorization of food in the hospital as care and therapy. I explore the unique writings of two patients to demonstrate how patients used their own dietary preferences, such as vegetarianism, or their knowledge of public health and hygiene to change their diet and challenge medical authority at St. Elizabeths. Ultimately, this dissertation’s examination of food and diet at St. Elizabeths reveals how significant threads of continuity accompanied the changes that U.S. society and psychiatry underwent during the Long Progressive Era.
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