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Joseph in 
Rockwood Asylum 
July 1884		 earlier story Joseph was admitted July 9, 1884 to Rockwood Asylum in the village of Portsmouth. Located on the edge of Lake Ontario, the asylum was an imposing structure with three large wings joined like a big letter 'E'. From the dock just south of the main building, one could look out over the Portsmouth harbour and see the limestone walls of the Provincial Penitentiary. 
 
 
Map
Photo
 
 
Source: Rockwood Asylum (Kingston Psychiatric Hospital) , Male Casebook 1855-1885, p 464 

    #1643, Joseph Judd 
    History 

    Abt. 50 - Bapt. English. married - Has been insane about two years, getting worse gradually. Has a great desire to wander about. Imagines he owns a great deal of property and money. Has always been temperate -- D. Richardson. "He wandered away some days getting his feet frozen. He has often got up in the night and wandered off without any object. He has been unable to do his work and since that he has tried to work at home but could never do it properly. He would varnish the work in the rough and try to put it together wrongly. He has become very irritable. At first two years ago, his gait was very unsteady like a man who has been drinking. He has fancied he had bought and owned property which he had not [?]" D McCullum. He is very weak minded, and his memory is quite defective. 

    He fancies that he is the best mechanic living. His is a case, evidently of Paresis-- 

    Admitted by Warrant from Co. York 
    Admitted 9th July, 1884--
Joseph diagnosed 
with Paresis		 Paresis is a disorder characterized primarily by impaired mental function, caused by damage to the brain from untreated syphilis. A venereal disease documented since the 15th Century, syphilis has three distinct stages if not treated: chancre sores, a rash, and then infections in the internal organs. Infections of the brain, known under the broader heading of neurosyphilis, occurs late, from 5 to 30 years after the original syphilis infection. Effective treatment to kill the syphilis bacterium wasn't available until salvarsan was introduced circa 1911, and penicillin after that. In Joseph's day, potassium iodide was the physicians choice, but it appears any treatment he received did not rid him of the bacteria. Still today, infection with gonnorrhea may hide the symptoms of a syphilis infection, and perhaps this played some roll in Joseph's continuing affliction. 
If this is an accurate diagnosis, then we must assume Joseph contracted syphilis about 5 to 30 years before his acute paresis, placing it from the mid 1870's to as early as his youth in 1850's London. There is no evidence that Emma or their children were so affected. 

We must judge this story for ourselves. Still, even today's symptoms of general paresis makes one hark back to Joseph's assessment and his first week at Rockwood. 
General Paresis 
 		 Source: http://www.healthanswers.com/database/ami/converted/000748.html 
 
Symptoms of general paresis: 
  • seizures, 
  • the loss of short-term memory (recent events), 
  • the loss of long-term memory (long-past events), 
  • impaired judgement, 
  • a decreased language ability (aphasia), 
  • the loss of ability to calculate 
  • personality changes 
  • inappropriate moods 
  • no mood exhibited 
  • irritable, angry 
  • delusions, hallucinations 
  • decreased motivation, apathy 
  • muscle weakness (difficulty using legs, arms, or other parts of the body) 
    		•
    Signs and tests:
    An eye examination may indicate a change in pupil response. A neurologic and muscular examination indicates slowly progressive dementia, with loss of multiple brain functions. Muscle weakness may be evident. There may be a loss of vibratory and position sense. Gait disturbances are common. The person is unable to stand with the eyes closed (Romberg test). 
     
    Joseph's first week Source: Rockwood Asylum (Kingston Psychiatric Hospital) , Male Casebook 1855-1885, p 464 
      July  10th, 1884 
      Is unable to pass urine & the catheter had to be used today. Locomotion almost impossible. Patient far advanced in Paresis. Muscular force almost completely lost. Tongue provided[?] to one side. Delusions of grandeur marked. Pupils irregular and unequal. 

      July 12th, 1884 
      Has been much relieved since the catheter has been used and today is able to pass urine without surgical assistance. Is also able to walk although his gait is very unsteady and tottering.
    Conditions at 
    Rockwood    		 Joseph's ward consisted of individual rooms measuring 12 ft by 7 ft, on a long hallway, similar to today's hospitals. When he was able, Joseph could work in the asylum's carpentry shop, or help make brushes and brooms, all supervised by the occupational therapy department. Life for Joseph and the other patients of Rockwood was very much improved from past years, thanks to the reforms brought about by the superintendent, Dr. William  Metcalf and his assistant Dr. Charles Kirk Clarke (namesake of the Clarke Institute in Toronto). 
    Ward inside Rockwood Asylum circa 1880's

    Improvements made over the three years before Joseph's arrival included new hair mattresses to replace the straw ones, more comfortable clothing no longer made of canvas, and better meals of soup, boiled beef, potatoes and bread, not mashed food. Patients were even supplied with cutlery, though asylum staff were charged with counting the knives and forks at meal's end.
    Health improves As his health improved over the next few months, Joseph may also have been treated to a performance by the asylum dramatic club, or any number of entertainers from the surrounding community. Metcalf writes on one occasion: 
      "I took 22 patients from wards one and three for a ride in my steam yacht this afternoon. They were all quite orderly and gave us not the least bit of trouble. The pleasure to them was so great I will continue to take them out when the weather is calm." ibid p 15
    Metcalf and Clarke, despite their best efforts, were unable to remove two serious negative influences on their patient's convalescence during Joseph's time. The medical superintendent's journal showed fully half of all recorded incidents concerned staff problems. Abusive practices by under-educated, poorly paid, and just plain cruel attendants was a constant concern. Of greater issue with Metcalf was the number and influence of the criminally insane. Before 1877, the Rockwood Asylum for the Criminally Insane housed mental patients from both the penitentiary and the community. In that year it changed its name, dropping the word 'criminally' and returning patients to the penitentiary who were still serving their sentences. During Joseph's time, the criminally insane would be transferred to Rockwood if they remained insane at the conclusion of their sentence. 
      "We now have 25 patients who were thus transferred from the penitentiary. Some, it is true, are quiet and harmless, but others are vicious and troublesome. Many of the insane retain all of their self respect and much of their sensitiveness and object to associating with persons who have committed crimes for which they have passed many years in prison walls. In addition to this the influence exerted by these criminals is bad for, although insane, many retain the propensity to commit crimes and induce patients otherwise harmless to do mischief."-- Dr. Metcalf, 1884 ibid
    Assaulted by patient 
    Aug 1884
      Aug. 1st, 1884 
      Has been maniacal[?] for a few days and very aphasic [lacking speech]. He has been so noisy at nights that other patients have been greatly [???]. Last night patient Ohaiboneau[?] struck Judd with a chamber [pot] and cut his head terribly.
    Joseph recovered from his assault and continued working in the carpentry shop through the next winter, missing the marriage of his daughter Gussie in September. Although his short term memory was "highly defective", his memory of the past was rich and entertaining to the staff. 

    As the next summer approached, Joseph's health worsened. His paresis symptoms returned, accompanied by epileptic type convulsions and paralysis of the throat muscles. He was bed-ridden for a month and died on June 27th, 1885.
    Joseph dies 
    June 1885    		 Burial of all patients who died while at Rockwood was arranged with the Cataraqui Cemetery a few kilometres north-west of Portsmouth. Joseph was buried there in an unmarked "asylum" plot.
      Tragically, six weeks later, Dr. Metcalf was murdered  -- stabbed by two table knives fashioned into one by a criminal patient attacking he and Dr. Clarke. Clarke had just tendered his resignation in the face of 'politics' and obstacles to further reforms, yet returned to become superintendent until his death in 1905. Clarke continued in Metcalf's stead, triumphed over their shared political battles, and became known as a father of modern psychiatry in Ontario. 

      William Metcalf is interred in Cataraqui Cemetery, as are former Prime Ministers John A. MacDonald and Alexander MacKenzie, and the enigmatic Grandpa Judd. 

    Continue with the story of Emma and their children in Toronto.