05/01/2009 05:12 am ET | Updated May 25, 2011

How It Was: Terror and Water-Boarding the Insane in Philadelphia

It seems that everyone in the world knows about water-boarding except certain people in the Bush administration. Our good fortune is that the Bush administration is now history, but they did twist the heads of many Americans, and the water-boarding flap is not yet closed.

Water-boarding is torture. That's common knowledge everywhere, and in fact a variation of it was frequently used to terrorize and punish patients in insane asylums right here in America.

In 1867, Ebenezer Haskell, a leading businessman in Philadelphia, was admitted for the third time to the Pennsylvania Hospital for the Insane. This was Haskell's third admission because he was far from dull and he had a penchant for escaping. When he'd be out a few months, the authorities would find him, arrest him, and return him to the asylum. Meanwhile, he wrote and published with his own money a small book that described his time in the lunatic asylum and the later trial in 1868 that declared him completely sane. Small books can often have large import, and so it is with this book by Ebenezer Haskell. In his preface to the book, Haskell tells us: "I only ask a calm, deliberate reading from my patrons, and have no anxiety or care as to the conclusions they may reach; and should I but lift one stone upon the pillar of reform to these matters, I shall content myself with this reward of my labor."

There are many sources that document conditions in 19th century insane asylums, but one passage in Haskell's little book about a specific treatment is revealing. In 1867, they called it the spread-eagle cure, but these days we call it water-boarding. Ebenezer Haskell tells us the term "spread-eagle cure" was common in his time in "all asylums and prisons." Note the conflating of asylums and prisons. More than seventy years after Benjamin Rush pushed through reforms to have mental patients kept in more humane conditions, asylums were essentially still prisons for the insane. Recall that Haskell, after each of his escapes from the Pennsylvania Hospital for the Insane, was "arrested" and returned to the asylum.

The spread-eagle cure, common in 1867, reveals a few things about public attitudes towards madness. The "cure" was no cure at all, simply a procedure applied to terrorize patients--especially when they were disorderly. The patient was stripped naked, thrown on the floor on his back, and then his arms and legs each gripped by one of a team of four men. The patient's limbs were stretched out to keep him immobilized. A fifth man, a "doctor" (more often an orderly), would then stand on a chair or table at the head of the patient and pour a series of buckets of cold water on the patient's face until the patient nearly drowned. After the treatment, the patient was returned to his dungeon supposedly "cured" of all disease, including lunacy.

According to Haskell, the shock of the treatment often caused the death of the patient. Haskell points out (five generations before our own current familiarity with this procedure) that if a steady stream of water seven or eight feet in height falls down directly on the face of a patient, the water will have the same effect as if the patient was held under water the same number of feet for the same time, since no one can breathe when water is falling directly on the nose and mouth. "It is a shock to the nervous system," Haskell says. He knew it, the other patients knew it, and the people who managed the asylum knew it. In 19th century American asylums and prisons, they all knew the spread-eagle cure as essentially a method of terrorizing lunatics

Complete asphyxiation by drowning causes death. Any procedure that deliberately takes a person close to complete asphyxiation causes a reflex terror response in the brain and nervous system. Anyone who has ever been close to accidental complete drowning knows about this. Water-boarding is indeed torture, and every psychiatrist and psychologist in America is aware of it. The issue is not pain but terror. What makes water-boarding (and the spread-eagle cure) torture is the terror and not the pain. For the sake of sanity, when we do something, we would do well to understand the reality of what we do.