As Matron of British Columbia’s “Provincial Asylum for the Insane” in the late 19th Century, Flora Ross faced a problem. One of the patients in the women’s ward was, in Flora’s own words, “a Chinese woman patient who used to knaw her arm—bite her arm and bleed—almost take pieces out of it.” While attendants in the men’s wards regularly used traditional forms of restraint such as the canvas straightjacket on the male patients, Flora refused to put her patients in such restraints.
But for some patients, restraint was the only means to ensure that they didn't do harm to themselves. Any solution would have to be invented, and Flora’s invention was her “chemise,” a modified man’s shirt with lengthened and strengthened sleeves that could be secured to the sides or front: essentially, a far less severe version of a traditional straightjacket. In order to ensure that her invention wouldn’t cause physical harm to her patients, and was superior to the antiquated options, she experimented on herself in order to “feel how they felt—the different restraints,” and came to the conclusion that her own invention was the “best” option for her patients.
The story of Flora’s invention is told in the testimony given to a provincial Royal Commission established in 1894 to inquire into allegations of patient abuse at the asylum. The Commission’s report is filled with examples of what were recognized even at that time as being “cruel and humiliating usage” of outdated methods for restraining patients in the men’s wards. The report also contains examples of treatment in the women’s ward that would be considered intolerable by modern standards of care. But there is a recurrent theme throughout the report that holds up the women’s ward as a far better example of care than the men’s ward.
The report refers to the Commissioners having “witnessed a dance conducted there by the Matron, Mrs. Ross,” finds that the “female patients were very neatly dressed,” and that the women’s ward was “the brightest and least prison-like in the Asylum,” with “a more home-like appearance than we found anywhere else.” The report finds that while “No notes of any kind are now kept by Attendants” in the men’s wards, “The Matron keeps a journal neatly and well up to date.” The Commissioners also note that, even though the number of women patients accounted for just under twenty percent of total patients—29 of 158 at the time of the report—there had been 17 deaths of male patients that year, and none of female patients.
The report describes the camisole as “a man’s shirt, with sleeves of unbleached calico, much lengthened and terminating in tapes, so that the arms may be confined to the sides or other convenient position.” The Commissioners had an opportunity to inspect the use of Flora’s camisole, at the same time as the use of a traditional straightjacket on a male patient. They state in their report that the camisole was in use on a woman who was “suffering from exhaustion due to maniacal excitement, and to control her restlessness she had been confined in a camisole designed by Mrs. Ross, the Matron.” The Commissioners describe how they removed the camisole to determine if it was harming the patient, and found “that her hands and arms were perfectly clean and free from marks or bruises.” They go on to state that they met with the patient a few days later “quietly walking about without assistance, and much stronger,” and confirm that “she was being well cared for.”
The Commissioners conclude that the traditional straightjacket used on male patients was the “most severe restraint,” whereas the camisole was “one of the mildest forms of restraint, and is said never to cause bruising or other injury.” The Commissioners suggest that the traditional forms of restraint in use at the asylum be replaced with the “humane and more scientific methods of treatment” in use in institutions in Great Britain, and that any need for restraints be of a style that bears a similar description to the camisole designed by Flora: “an ordinary man’s jacket with the ends of the sleeves sewed to the pockets.”
All of this is not meant to suggest that the standards of care in the women’s ward were anything to admire by today’s standards. Then again, today’s “standards” are hardly free from criticism, and future generations are likely to look back in horror at the number of those who are suffering mental illness and are living on the streets. The Commissioners’ report often reads like a gothic horror novel, and was followed by decades of ongoing abuse at the asylum—renamed “Woodlands”—through to its eventual closure in 1996. But it was also an institution in which many of its caregivers strove to provide their patients with the best care they were able to provide in their time, as demonstrated by the efforts of Flora Ross in the late 19th Century.
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