Blazing a Trail

Cache of E.E. Southard papers illuminates early work in neuropsychiatry

When it comes to the study of mental health, the early pioneers are almost household names today: Sigmund Freud, Hermann Rorschach and Carl Jung were all physicians whose research is well known and whose contributions made a significant impact.

Freud is often called the father of psychoanalysis, Rorschach’s famous inkblots are recognized the world over, and Jung’s concepts of introversion and extroversion are still fodder for countless debates and articles. 

But what of Elmer Ernest Southard and his contributions to psychiatry? 

E.E. Southard

A contemporary of Jung, the Harvard-educated E.E. Southard, who lived from 1876 to 1920, may be one of America’s most accomplished and least known early neuropsychiatrists and neuropathologists.

Southard is not a household name, despite having been a leader in the study of the pathology of the brain and a founder of the Boston Psychopathic Hospital.

He also authored several books and mentored such influential colleagues as Myrtelle Canavan, one of the first female pathologists in America, and Robert Yerkes, known for his work in intelligence testing and comparative psychology.

Southard was also a genuine chess wizard. 

But who was he?

Local Influence

“He never had much national stretch,” said Hanna Clutterbuck-Cook, who has processed a cache of Southard’s papers, letters and transcriptions from court testimony at the Francis A. Countway Library’s Center for the History of Medicine.

She believes that because Southard died in 1920, at the age of 43, “right in the middle of a lot of loud, exciting history,” people are less likely to remember him.

His papers, however, shine a fascinating light on the man, his research and his time.

Clutterbuck-Cook with boxes of Southard's papers at the Countway Library. Image: M. Buckley

A Boston native, Southard went to Boston Latin School and then attended college and medical school at Harvard University, where he made a name for himself playing chess competitively.

After graduating Harvard Medical School in 1901, Southard spent a short time studying in Germany; he then returned to Boston to study pathology at Boston City Hospital. Later, he became an assistant pathologist at Danvers State Hospital, also known as Danvers State Insane Asylum.  He eventually became the Bullard Professor of Neuropathology at HMS.

A book about him published nearly 20 years after his death entitled “The Open Mind,” called Southard “a pioneer in modern mental hygiene and psychiatry, a public spirited citizen and social worker, and a scientist.”

According to Clutterbuck-Cook, Southard was pivotal in the foundation of a separate psychiatric department at Boston State Hospital. He suggested that traditional isolation treatment in an asylum could do more harm than good for patients, but also felt that standard hospital treatment was not personalized enough.

Clutterbuck-Cook considers this forward-thinking attitude to be one aspect of Southard’s legacy.

 “He was definitely one of those who helped lobby for the separation [of the psychiatric department] into its own unit, so it could have independence and a certain amount of autonomy,” she said.  

Mentoring Others

In the early part of the 20th century, Southard also helped develop the field of psychiatric social work, which Clutterbuck-Cook considers an important part of his legacy; he also actively mentored colleagues who made significant advances in their own right.

Detail from Southard notes. Image: Courtesy Countway Library.

Southard worked closely with Mary Jarrett, a social worker who studied chronic illness and soldiers with shell shock or war neurosis; together Southard and Jarrett successfully linked social work and psychiatry.

They even created an educational and training program for psychiatric social workers at Smith College, said Clutterbuck-Cook. It ran for several years and heavily influenced the progress made in the field.

Southard recognized Jarrett’s abilities and encouraged her to fully exercise her skills, regardless of her gender. “I’m reluctant to [call him a] feminist, because it’s anachronistic, but he [was] moving along that line,” said Clutterbuck-Cook. “It wasn’t everyone who would work with Myrtelle Canavan and Mary Jarrett in the nineteen teens in this country as medical professionals.”

Founding the field of psychiatric social work was a long and involved project, and Southard encouraged Jarrett to spearhead the effort.

He “very much let her take control of the project, was sort of there as oversight or reference,” Clutterbuck-Cook said. He “gave her the lead, but also pointed out to other people that she had the lead.”

“He doesn’t seem to have stopped for 30 years, and I find that incredible. He was dedicated, he was focused, he was highly intelligent, and he also valued professionalism and intelligence in the people he worked with,” she said.

Southard met Canavan at Danvers State Hospital, where he worked closely with her, and the pair collaborated again later at Boston Psychopathic Hospital.  According to Clutterbuck-Cook, Canavan was “doing neurological autopsies, lab work, scientific, clinical … I think it would be new for a woman to be doing it.”

Southard even requested that Canvan perform an autopsy on him and dissect his brain upon his death. Canavan did eventually autopsy Southard’s brain, as well as his parents’ brains, and found a rare neurodegenerative disorder.

Clutterbuck-Cook said it was something “he’d been suffering from for a long time because he had various ongoing ailments that had never been satisfactorily linked to anything … which he just sort of dealt with.”

Expert Witness

While he may not be well-remembered today, Southard was held in high enough regard in his time that he sometimes testified in high-profile court cases.

One such case, in 1916, involved Marion P. Smith, a Hyannis heiress whose grandmother accused her of adultery and insanity.  The matriarch took her grandaughter to court in an attempt to gain control of Smith’s estate.   

Smith’s grandmother argued that her granddaughter could not manage her inheritance because of her frivolity and rumored sexual exploits. The news clippings, which Southard saved, indicate that it was one of the more sensational cases of its time.

The heiress was put through a series of psychological assessments and had complicated math problems posed to her in an attempt to demonstrate that she could not be trusted to handle the complex financial responsibilities that her inheritance would bring.

One of Southard's clippings saved from the Smith court case.  Image: Countway Library

An expert witness for the prosecution at the trial, Southard appeared to defend Smith in some of the documentation and news clippings that have been preserved at Countway Library.

In a time where expert witnesses were not under many restrictions, Southard seemed intent on being professional.

“Expert witnesses at the time weren’t necessarily experts. In this case, he was,” said Clutterbuck-Cook.

According to Southard’s testimony, Smith’s psychological tests indicated that “she’s upset, she’s in a bad place. She’s doing pretty well, but she’s a little volatile … Her math skills are more or less what anybody’s should be.” 

At the trial, however, Smith was asked complicated questions under pressure, jeopardizing her case.  

“There’s a difference between what comes out in the notes from [Southard’s] assessment session and what is actually said in the testimony at the trial … The questions which were asked were insanely complicated,” Clutterbuck-Cook said.

Southard admitted that not even he could solve the math problems Smith was being asked. He helped turn the case around in her favor. 

In terms of how women were viewed at the time, Clutterbuck-Cook said the Smith case was fascinating. She said Southard didn’t serve as an expert witness often, so he took the opportunity to demonstrate the utility of his job.

Family Man

Southard’s fixation on work and problem solving took up a great deal of his time and energy, but he did have a family. He married Mabel Fletcher Austin, a professor of hygiene at Wellesley College, and they had three children.  In some ways, his domestic life was also a bit ahead of its time, presaging more modern two-career relationships.

Clutterbuck-Cook said mentions of Southard’s marriage tend to indicate “a very attached couple, a really affectionate, very involved pair of people who maybe just didn’t have a lot of time.”

“They’re working in two different places—Wellesley and Danvers—with serious commutes, which can’t have been easy or fun,” she said.

Towards the end of his career, Southard said, “I shall not live long, I must hurry; I must get lots of others busy.”

Clutterbuck-Cook said that while reading Southard’s papers, “you get the sense of this guy who really didn’t sleep. He didn’t stop. He didn’t know how to gear down.”

“If he wasn’t working, and working really hard, he sort of wasn’t happy,” she said. “One of his lifetime boasts was, ‘I’ve played eight games of chess blindfolded at the same time.’”

“That had a lot to do with his energy,” she said. “He just couldn’t stop. He was a problem solver. He saw a series of problems he wanted to solve, and then relate to each other, and then solve again.”

Southard’s busy life was cut short when he traveled to New York City at the age of 43 to lecture at a conference and died of pneumonia on the trip.

Clutterbuck-Cook worked long and hard to get Southard’s papers cleaner, neater and more accessible for researchers.

“They’re ready to go. Whenever someone wants to look at them, they’re here,” she said, adding that Southard was involved in a wide range of study that may provide useful information for any number of researchers.

Southard’s papers include drafts of a book he was writing at the time of his death called “The Kingdom Of Evils: Psychiatric Social Work Presented In 100 Case Histories.” Jarrett published it posthumously.  

“I imagine people might be looking for his involvement with the psychiatric social work, which also ties into settlement house work … or people who are interested in the development and the history of medical textbooks or medical illustration, because although the book [he was writing] wasn’t finished, his plans are here,” she said.

 Direct URL to book on archive: https://archive.org/details/kingdomofevilsps1922sout