Once a person enters the pathology building, they had already passed away, and they were there to have their body dissected to determine the cause of death and to perform any research. A body would be placed on an exam table that was tilted slightly so any fluids released during the examination would drain off the table and onto the floor. The fluids would eventually find their way to the drain in the floor. The fluids would be released directly into the city sewage. During the examination, the physician would speak his notes into a pipe that lead upstairs for another person to take his notes during the procedure. During the early 1900s, there were no standards about record keeping; so many notes are missing a patient’s gender, age, and cause of death (all records are sealed due to HIPPA so no records can be browsed at the museum).
The physicians who worked at the pathology building did tremendous amounts of work. These physicians had to be some of the hardest working and skilled people that I have ever seen. The quality of their slides is impeccable. Their preserved brains are in fantastic condition. Many of the medical instruments were hand cranked. Today we take a few tubes and plop it into a centrifuge that has controlled temperature settings, speed setting, and time settings. Many of the centrifuges in the early 20th century were hand cranked. The museums curators hypothesize that psychiatric patients would come down and help hand crank the instruments in exchange for minimum wage.
During the early 20th century in Indiana, psychiatric patients were wards of the state. Their medical care and meals were all paid. If the patients worked in the hospital, then they also received minimum wage. The curators noted that most of the “mentally ill” were not ill in the same way that we envision mentally ill today. Most of the patients were overwhelmed with their situations. For most patients, if they did not grow enough food, then their family died. This is a stressor that is unknown to most of America today. Patients who entered the hospital in the early 1900s were rehabilitated mentally and were also given the opportunity to learn a new skill or earn money as a patient to help their families. Patients would learn bread baking, clerical work, and other skills.
Looking at the medical equipment, you can really appreciate how far we have come in the medical field. Cryostats are used to slice tissue into equal sized slices so they can be mounted on slides. A modern cryostat has a light and a temperature setting. You can take your time when slicing your tissue. In the early 1900s the cryostat has to be sharpened by hand. Then it had become cold. The curators hypothesized that the instrument was made cold by placing it in a freezer. The tissue sample had to be frozen as well and mounted on a piece of paraffin. Then, the tissue sample was sliced very quickly before the instrument warmed up too much and the sample turned to mush. Working a cryostat was a work of art. A single cryostat had over 1000 page manual on the operation and maintenance of the instrument. Whole medical school lectures covered the topic. The curators hypothesized that the physicians that worked at the pathology building had figured out ways to put down on the number of steps suggested in the manuals because they felt that there were physically too many slides and samples documented to be done by the book. Once the sample was placed on a slide, it was died with many of the same procedures that we use today. Physicians back then even worked under hoods like we do today. Of course our hoods have advanced filtration devices mounted on top to keep harmful chemicals out of the air supply. Once the sample was dyed and the cover slip glued on, the sample can last almost indefinitely. The slides were analyzed under microscopes. These microscopes have no light source, so the samples were analyzed by sunny windows.
One of the interesting things that the curators learned from reading the physician’s notes and records is that they felt like they were missing something. These physicians were beginning to understand the role of genetics in mental illness. The first question that a patient was asked upon checking into Central Indiana Hospital for the Insane was about family history. The patients could site many generations of people in their family that had trouble with mental illness. These reoccurring patterns intrigued the physicians but they were unable to come up with any coherent hypothesis. Sadly, the records of these patients that could help us better understand the genetics of mental illness have been sealed since the enactment HIPAA (health insurance portability and accountability act). Previously in Indiana, medical records could be used for research purposes after 70 years of date of death, but now these historical records have been sealed up and no one can see them so all that is left is the personal journals of the physicians who worked at the pathology building. I think this is an unintended consequence of HIPAA that has lasting effects.
If you are every in Indianapolis, then I encourage you to visit the Medical History Museum of Indiana. It is an intriguing museum that is off the well beaten path.
Other photos of items of interest