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[[image:IPH MaleBldg 01.jpg|300px|left|The Male Department as it originally appeared in 1854]] | [[image:IPH MaleBldg 01.jpg|300px|left|The Male Department as it originally appeared in 1854]] | ||
− | '''The Institute of the Pennsylvania Hospital''', formally Pennsylvania Hospital for the Insane, was a private psychiatric hospital operating in West Philadelphia from 1841 until its final closure in the fall of 1997. The building and part of the former campus is currently being leased to Blackwell Human Services and the | + | '''The Institute of the Pennsylvania Hospital''', formally Pennsylvania Hospital for the Insane, was a private psychiatric hospital operating in West Philadelphia from 1841 until its final closure in the fall of 1997. The building and part of the former campus is currently being leased to Blackwell Human Services and the Kirkbride Center, and remains functional within the human services field; however, it is still owned by the University of Pennsylvania Health System. It was expanded in 1959 to accommodate a changing inpatient population, at which time half the original campus was lost, and the more modern "North Building" was constructed. However, because of changing perception of the practice of psychiatry, and insurance protocol, the facility was forced to close its doors permanently. In 2004, the NHPRC was issued a grant to organize, preserve and make publicly accessible the Institute of the Pennsylvania Hospital's archival collection. |
− | There is a tremendous amount of confusion about the [[Pennsylvania Hospital]] in Philadelphia, PA. This is because there were in fact two separate facilities bearing the name. The first, founded in 1751 by Dr. Thomas Bond and Benjamin Franklin was located on Eighth and Pine Streets, and was completed in 1755. This facility is still operational, albeit not for its original purpose. The | + | There is a tremendous amount of confusion about the [[Pennsylvania Hospital]] in Philadelphia, PA. This is because there were in fact two separate facilities bearing the name. The first, founded in 1751 by Dr. Thomas Bond and Benjamin Franklin was located on Eighth and Pine Streets, and was completed in 1755. This facility is still operational, albeit not for its original purpose. The orinigal structure of Pennsylvnia Hospital is now largely is maintained because of its historic value to the city and state (the modern Pennsylvania Hospital sits behind this building). This original facility found itself overwhelmed by the number of 'lunatic' patients, and regularly had their insane wards overcapacity. The Board of Managers voted to build a second hospital, in what was then rural West Philadelphia, as was the style of such institutions at the time. This second hospital was known as the Institute of the Pennsylvania Hospital, as to draw distinction from their primary facility. This was also the hospital that Dr. Thomas Story Kirkbride was Superintendent, who is regarded as one of the fathers of American Psychiatry. Both facilities were run under the same Board of Mangers during their tenure, but only one had a specific specialization in behavioral healthcare. |
− | == | + | == History == |
− | === Overcrowding at Pennsylvania Hospital | + | === Overcrowding at Pennsylvania Hospital === |
− | [[File: | + | [[File:Map.png|400px|thumb|right|The original campus of Pennsylvania Hospital for the Insane as it would have appeared around the year 1900]] |
− | From its inception, [[Pennsylvania Hospital]] admitted both the physically ill and the mentally ill to their historic South Philadelphia campus. Eighteenth and early nineteenth century medical practice was crude, and frequently counter-productive by modern day standards, but the treatment of the mentally ill was particularly harsh. Solitary confinement, bloodletting and involuntary restraints were the order of the day by most physicians. Over time, the proportion of the | + | From its inception, [[Pennsylvania Hospital]] admitted both the physically ill and the mentally ill to their historic South Philadelphia campus. Eighteenth and early nineteenth century medical practice was crude, and frequently counter-productive by modern day standards, but the treatment of the mentally ill was particularly harsh. Solitary confinement, bloodletting and involuntary restraints were the order of the day by most physicians. Over time, the proportion of the Hospital’s patients who were severely mentally ill increased in size, until it began to become overcrowded, leaving little room for the physically ill. In response, the Board of Managers believed itself obligated to limit the admission of the mentally ill. The west wing of the Hospital had been designed and set aside for the mentally ill, but by 1817 it was filled near to capacity and additional space had been set aside for mentally ill patients elsewhere in the facility. |
In a published report by the Board of Manager in 1817, the number are brought into focus. Two-thirds of the Hospital’s patients were the mentally ill and the Board of Managers had previously set aside two-thirds of the Hospital’s rooms for their care. The west wing was entirely committed to the care of the mentally ill, and sixteen of the thirty-nine rooms available in the east wing were also devoted to the mentally ill. Though the completed Hospital building was just twelve years old, the Board of Managers had already adopted a policy which limited the number of mentally ill patients for this very reason. There may have been calls for the expansion of the physical site from other administrators, but the Board was unwilling to consider the Hospital’s vacant land for the construction of yet another new buildings. The U.S. census returns for the first decades of the 19th century show increasing pressure: the number of resident staff and patients at the Hospital increased significantly in each decade. The 1820's, in particular, experienced an increase in the average number of resident patients, from less than 150 to more than 200 present at any one time. By 1830 the average daily number of mentally ill patients was somewhere around 115. The demand for the services of the [[Pennsylvania Hospital]] must have been near, if not beyond the Hospital’s ability to provide them. | In a published report by the Board of Manager in 1817, the number are brought into focus. Two-thirds of the Hospital’s patients were the mentally ill and the Board of Managers had previously set aside two-thirds of the Hospital’s rooms for their care. The west wing was entirely committed to the care of the mentally ill, and sixteen of the thirty-nine rooms available in the east wing were also devoted to the mentally ill. Though the completed Hospital building was just twelve years old, the Board of Managers had already adopted a policy which limited the number of mentally ill patients for this very reason. There may have been calls for the expansion of the physical site from other administrators, but the Board was unwilling to consider the Hospital’s vacant land for the construction of yet another new buildings. The U.S. census returns for the first decades of the 19th century show increasing pressure: the number of resident staff and patients at the Hospital increased significantly in each decade. The 1820's, in particular, experienced an increase in the average number of resident patients, from less than 150 to more than 200 present at any one time. By 1830 the average daily number of mentally ill patients was somewhere around 115. The demand for the services of the [[Pennsylvania Hospital]] must have been near, if not beyond the Hospital’s ability to provide them. | ||
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On May 3, 1830, the Contributors to the Pennsylvania Hospital met and adopted a resolution directing the Board of Managers of the Hospital to purchase the western half of the Ninth Street block from the Almshouse, but not to offer more than $50,000 for the land available. The Board quickly made an offer of the full $50,000, but the Guardians of the Poor refused to sell. Instead, later that same year, they decided to put the land up for sale at public auction. The Board of Managers, meeting on December 27, pf the same year, authorized a bid of $50,000 at the auction, but the minutes of the Board for January 12, 1831 note that the Board’s representatives attended the auction and bid $50,100, but that another bidder had offered more and had purchased the property outright. The winning bid was just $400 more than the hospital had offered: $50,400.75. The new owner planned to develop the site promptly. The Hospital’s Board of Managers, frustrated in their efforts to expand westward, were now forced to consider other options. The Managers began by articulating the Hospital’s need. The minutes of the Board for January 31, 1831 included the following statement: | On May 3, 1830, the Contributors to the Pennsylvania Hospital met and adopted a resolution directing the Board of Managers of the Hospital to purchase the western half of the Ninth Street block from the Almshouse, but not to offer more than $50,000 for the land available. The Board quickly made an offer of the full $50,000, but the Guardians of the Poor refused to sell. Instead, later that same year, they decided to put the land up for sale at public auction. The Board of Managers, meeting on December 27, pf the same year, authorized a bid of $50,000 at the auction, but the minutes of the Board for January 12, 1831 note that the Board’s representatives attended the auction and bid $50,100, but that another bidder had offered more and had purchased the property outright. The winning bid was just $400 more than the hospital had offered: $50,400.75. The new owner planned to develop the site promptly. The Hospital’s Board of Managers, frustrated in their efforts to expand westward, were now forced to consider other options. The Managers began by articulating the Hospital’s need. The minutes of the Board for January 31, 1831 included the following statement: | ||
− | <blockquote>'' | + | <blockquote>''The great increase of the number of insane patients which claim the care of this Institution and for whose suitable accommodation and means of relief and restoration the Managers feel deeply concerned has been a subject of frequent consultation. The Board believes it to be a duty to record its sense on this interesting concern and to express its opinion that when sufficient funds can be procured by the contributions of the benevolent, it will be proper to afford adequate space for that description of patients, the present building having become crowded.''</blockquote> |
The Managers reflected on these minute and then, in April, decided to bring it before the next meeting of the Contributors, which was held on May 2, 1831. The Contributors responded by adopting the following resolutions: | The Managers reflected on these minute and then, in April, decided to bring it before the next meeting of the Contributors, which was held on May 2, 1831. The Contributors responded by adopting the following resolutions: | ||
− | <blockquote>'' | + | <blockquote>''Whereas, from the great increase of Insane patients under the care of this Institution, that portion of the Hospital appropriated to the reception of such cases is no longer adequate to their proper accommodation. And Whereas it is evident that an Assemblage of Lunatics and Sick patients under the Same Roof is inconvenient and unfavorable to the seclusion and mental discipline essential in cases of Insanity; therefore. Resolved, That we consider it necessary to the interests of this institution and the furtherance of its humane design that a separate Asylum be provided for our Insane patients with ample space for their proper seclusion, classification & employment. Resolved, That the Board of Managers be and they are hereby directed to propose at a future meeting of the Contributors to be called by the Managers when prepared, a suitable site for such an Asylum and the ways and means for carrying into effect the foregoing Resolutions.''</blockquote> |
These resolutions confronted the Managers with two major challenges for the future of the hospital: where to locate a new hospital building dedicated to the care of the insane, and how to fund its design, construction, furnishings, and subsequent operations. The Board of Managers would struggle with these two questions on and off for the next four years. Their first choice was to build on the city square on the south side of Pine Street, bounded by Pine, Eighth, Lombard, and Ninth streets. In November of 1831, the Managers paid $10,000 for a property on the west side of Eighth Street, between Pine and Lombard. With this purchase they consolidated the Hospital’s ownership of the entire city block. In March 1832, the Managers voted to recommend to the Board of Contributors that the Hospital sell the "Eastern Lot," that is, the city block bounded by Spruce, Seventh, Pine, and Eighth streets. The Board of Managers’ recommendation, though regretted, was agreed upon as the best option available to the Hospital at the time. At their regular annual meeting, held on May 7, 1832, the Board of Contributors adopted the following resolution | These resolutions confronted the Managers with two major challenges for the future of the hospital: where to locate a new hospital building dedicated to the care of the insane, and how to fund its design, construction, furnishings, and subsequent operations. The Board of Managers would struggle with these two questions on and off for the next four years. Their first choice was to build on the city square on the south side of Pine Street, bounded by Pine, Eighth, Lombard, and Ninth streets. In November of 1831, the Managers paid $10,000 for a property on the west side of Eighth Street, between Pine and Lombard. With this purchase they consolidated the Hospital’s ownership of the entire city block. In March 1832, the Managers voted to recommend to the Board of Contributors that the Hospital sell the "Eastern Lot," that is, the city block bounded by Spruce, Seventh, Pine, and Eighth streets. The Board of Managers’ recommendation, though regretted, was agreed upon as the best option available to the Hospital at the time. At their regular annual meeting, held on May 7, 1832, the Board of Contributors adopted the following resolution | ||
− | <blockquote>'' | + | <blockquote>''Resolved, that the Managers be authorized to make sale of the Eastern Lot for the purpose of raising funds to erect buildings for the additional accommodation of the Hospital.''</blockquote> |
− | === Selection of a new site | + | === Selection of a new site === |
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The disposition of the Eastern Lot, however, proved to be a very slow process. More than a year passed before the Board of Managers authorized the first sales of land, and several years passed before the last of the building lots were sold to private interests. In the interim a division took place among hospital administrators about how to proceed with expansion, and how to properly address the rising census of insane patients. Economics necessity had them bound to inpatient psychiatric care for the time being. This had been a mounting problem for several decades prior because of the reversal of hospital policy under Dr. [[Benjamin Rush]], stating that lunatic should be treated on the regular medical unit of the hospital. | The disposition of the Eastern Lot, however, proved to be a very slow process. More than a year passed before the Board of Managers authorized the first sales of land, and several years passed before the last of the building lots were sold to private interests. In the interim a division took place among hospital administrators about how to proceed with expansion, and how to properly address the rising census of insane patients. Economics necessity had them bound to inpatient psychiatric care for the time being. This had been a mounting problem for several decades prior because of the reversal of hospital policy under Dr. [[Benjamin Rush]], stating that lunatic should be treated on the regular medical unit of the hospital. | ||
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<blockquote>''Resolved, that in the opinion of this meeting it is expedient that the Lunatic department of the Pennsylvania Hospital should be removed from the City of Philadelphia to the country in its vicinity, provided that the removal can be effected upon such a plan as will promote the comfort and improve the health of the patients and admit of the superintendence and control essential to a good administration of the institution. Resolved, That the Managers of the Hospital be, and they are hereby requested to prepare and report to the Contributors at their next meeting a plan of removal agreeably to the preceding resolution; embracing in their report the location in point of distance from the City, the general structure of the buildings to be erected, the details of the organization for superintendence and control, the funds and resources of the Corporation available for this object, and the probable cost; with such facts and remarks as they may think it expedient to communicate for the information of the Contributors.''</blockquote> | <blockquote>''Resolved, that in the opinion of this meeting it is expedient that the Lunatic department of the Pennsylvania Hospital should be removed from the City of Philadelphia to the country in its vicinity, provided that the removal can be effected upon such a plan as will promote the comfort and improve the health of the patients and admit of the superintendence and control essential to a good administration of the institution. Resolved, That the Managers of the Hospital be, and they are hereby requested to prepare and report to the Contributors at their next meeting a plan of removal agreeably to the preceding resolution; embracing in their report the location in point of distance from the City, the general structure of the buildings to be erected, the details of the organization for superintendence and control, the funds and resources of the Corporation available for this object, and the probable cost; with such facts and remarks as they may think it expedient to communicate for the information of the Contributors.''</blockquote> | ||
− | + | The hospital moved to purchase a 101-acre farm in West Philadelphia in 1835 from Matthew Arrison, a local merchant. The cornerstone for this new facility was laid on July 26, 1836 on the corner of 44th and Market Streets, which would later become the Female Department. The question of selecting an appropriate superintendent was complicated because of the absence of other large psychiatric facilities in the America at the time. Locally, only [[Friends Hospital]], then known at the Frankford Asylum, was operational in treating psychiatric disorders, and was only financially viable because of large donations offered from the Society of Friends. The Board of Manager voted on October 12, 1840 and elected to hire the thirty-one year old [[Alienist]], Dr. [[Thomas Story Kirkbride]], as the head of the new hospital, which would open the following January. Dr. Kirkbride was born in Morrisville, where his family resided, and graduated from the University of Pennsylvania Medical School only two years prior. He was at the time finishing his residency at the Frankford Asylum before his selection. | |
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− | The hospital moved to purchase a 101-acre farm in West Philadelphia in 1835 from Matthew Arrison, a local merchant | ||
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− | The question of selecting an appropriate superintendent was complicated because of the absence of other large psychiatric facilities in the America at the time. Locally, only [[Friends Hospital]], then known at the Frankford Asylum, was operational in treating psychiatric disorders, and was only financially viable because of large donations offered from the Society of Friends. The Board of Manager voted on October 12, 1840 and elected to hire the thirty-one year old [[Alienist]] | ||
=== Under Dr. Kirkbride: 1840-1883 === | === Under Dr. Kirkbride: 1840-1883 === | ||
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[[File:Kirkbride.jpeg|200px|thumb|left|Dr. Thomas Kirkbride]] | [[File:Kirkbride.jpeg|200px|thumb|left|Dr. Thomas Kirkbride]] | ||
− | + | [[Thomas Story Kirkbride]] gained national renown because of his particular methods. He developed a more humane way of treatment for the mentally ill that became widely influential within American Psychiatry. Today, the former Institute campus exists as a multi-purpose social-service facility. The new hospital, located on a 101-acre (0.41 km²) tract of the as yet unincorporated district of West Philadelphia, offered comforts and a “humane treatment” philosophy that set a standard for its day. Unlike other asylums where patients were often kept chained in crowded, unsanitary wards with little if any treatment, patients at Pennsylvania Hospital resided in private rooms, received medical treatment, worked outdoors and enjoyed recreational activities including lectures and a use of the hospital library. The campus originally featured one, but later, two hospital buildings, which were separated by a creek and pleasure grounds. | |
− | The first building was a long thin building located west of the Schuylkill River. This building would eventually become the female department. Though the building does reflect the [[Kirkbride Plan]] it was actually constructed before Dr. Kirkbride was given full supervisory duties. Construction began under the control of architect Isaac Holden | + | The first building was a long thin building located west of the Schuylkill River. This building would eventually become the female department. Though the building does reflect the [[Kirkbride Plan]] it was actually constructed before Dr. Kirkbride was given full supervisory duties. Construction began under the control of architect Isaac Holden but later illness forced Issac to return to his home country of England. The building was then finished by a young Samuel Sloan, who worked as a carpenter on the Eastern State Penitentiary. Sloan finished the building in 1841. The building was a rather simple design compared to later Kirkbride Plan buildings. Constructed of stucco covered brick, it was three stories tall with a central administration section flanked on either side by a set of wings. The top of the administration section was crowned with a large dome. On both the front and back of the administration section were stone porticoes. The interior of the building was well furnished, the lavishly carpeted corridors were twelve feet wide. The building features iron stairs, well lighted wards, and iron water tanks in the dome over the administration section, which provided fresh water to all of the building. At the rear corners of either side of the building were smaller, one story, "U" shaped buildings. These buildings were used to house the most noisy and violent patents, so that they wouldn't disturb the calmer, more manageable patients in the main building. |
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Superintendent Kirkbride developed his treatment philosophy based on research he conducted at other progressive asylums of the day including the asylum at Worcester, Massachusetts. Out of his philosophy emerged what would become known as the Kirkbride Plan, which created a model design for psychiatric hospital that was employed across the United States throughout the 19th century. This plan would be used for the hospital’s second building. On July 7, 1856, the cornerstone for a new building, built with the money from individual contributions, was laid at 49th and Market Streets, five blocks west of the original building. The new structure, which was to house only male patients, was dubbed the Department for Males, while the original building officially became known as the Department for Females. Dr Kirkbride commissioned Architect Samuel Sloan to design the new building. Built of stone and brick, the new building was laid out, as Kirkbride expressed, "in echelons." A large rectangular building, 3 1/2 stories tall, with gable roof and central dome, and a 2 story pedimented portico on its western facade, provided the central focus of the hospital and also housed its administrative offices. Extending from the center of this building to the north and south are two symmetrical wings about 250 feet long, 3 stories tall with gable roofs and ventilation cupolas at their furthermost termini. These wings were in turn connected to another pair, which extended to the east approximately 230 feet, paralleling each other, and of the same general appearance. At each terminus of the these rear wings was a final E-shaped wing which extended out approximately 250 feet. The north E wing housed troublesome patients, and the south E wing has since been removed. No wings are exactly in line, thus allowing fresh air to reach each wing on all four sides. Each of the patients' rooms in the wings had its own fresh air duct, the air being driven in from the towers at the terminus of each wing. There were 16 wards in the hospital, one for each of 16 distinct classes of patients, and each ward had its own parlor, dining room, and bathroom. Outside, there were gardens, shops, and walks for the patients. | Superintendent Kirkbride developed his treatment philosophy based on research he conducted at other progressive asylums of the day including the asylum at Worcester, Massachusetts. Out of his philosophy emerged what would become known as the Kirkbride Plan, which created a model design for psychiatric hospital that was employed across the United States throughout the 19th century. This plan would be used for the hospital’s second building. On July 7, 1856, the cornerstone for a new building, built with the money from individual contributions, was laid at 49th and Market Streets, five blocks west of the original building. The new structure, which was to house only male patients, was dubbed the Department for Males, while the original building officially became known as the Department for Females. Dr Kirkbride commissioned Architect Samuel Sloan to design the new building. Built of stone and brick, the new building was laid out, as Kirkbride expressed, "in echelons." A large rectangular building, 3 1/2 stories tall, with gable roof and central dome, and a 2 story pedimented portico on its western facade, provided the central focus of the hospital and also housed its administrative offices. Extending from the center of this building to the north and south are two symmetrical wings about 250 feet long, 3 stories tall with gable roofs and ventilation cupolas at their furthermost termini. These wings were in turn connected to another pair, which extended to the east approximately 230 feet, paralleling each other, and of the same general appearance. At each terminus of the these rear wings was a final E-shaped wing which extended out approximately 250 feet. The north E wing housed troublesome patients, and the south E wing has since been removed. No wings are exactly in line, thus allowing fresh air to reach each wing on all four sides. Each of the patients' rooms in the wings had its own fresh air duct, the air being driven in from the towers at the terminus of each wing. There were 16 wards in the hospital, one for each of 16 distinct classes of patients, and each ward had its own parlor, dining room, and bathroom. Outside, there were gardens, shops, and walks for the patients. | ||
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For the first seventy years of its existence Pennsylvania Hospital for the Insane steadily increased in its size and clinical complexity. As early as February 1844 the trend for expansion had been firmly established. The ''Public Ledger'' took note of the statistics in Kirkbride’s annual report and published the following brief article: ''We have received a copy of the Report of the Managers of the Pennsylvania Hospital for the Insane for 1843. There were 140 patients admitted during the year, 126 have been discharged or died, and there remain 132 under care. There were cured 68, much improved 7, improved 14, stationary 20, died 17 – total 126. The Report contains a number of statistical tables, showing the number and sex of the persons admitted since the opening: their ages, occupations, condition, nativity, country, and the causes which produced insanity in them, with the duration and number of the attacks. Since the opening of this Hospital, three years since, there has been a steady increase in the number of patients admitted, and the number under care at one time has constantly been augmenting. The total number under care in 1841, was 176; in 1842, 238; in 1843, 258.'' | For the first seventy years of its existence Pennsylvania Hospital for the Insane steadily increased in its size and clinical complexity. As early as February 1844 the trend for expansion had been firmly established. The ''Public Ledger'' took note of the statistics in Kirkbride’s annual report and published the following brief article: ''We have received a copy of the Report of the Managers of the Pennsylvania Hospital for the Insane for 1843. There were 140 patients admitted during the year, 126 have been discharged or died, and there remain 132 under care. There were cured 68, much improved 7, improved 14, stationary 20, died 17 – total 126. The Report contains a number of statistical tables, showing the number and sex of the persons admitted since the opening: their ages, occupations, condition, nativity, country, and the causes which produced insanity in them, with the duration and number of the attacks. Since the opening of this Hospital, three years since, there has been a steady increase in the number of patients admitted, and the number under care at one time has constantly been augmenting. The total number under care in 1841, was 176; in 1842, 238; in 1843, 258.'' | ||
− | Expansion of the site continued, and by 1851, just ten years after its opening, the Hospital was "inconveniently crowded", though the [Annual] hospital report stated that "the general good health which then prevailed, enabled us to receive all the cases that were brought to the Hospital, although much difficulty was often experienced in accommodating them." Two years later, the annual report for 1853 became more grim, and stated: | + | Expansion of the site continued, and by 1851, just ten years after its opening, the Hospital was "inconveniently crowded", though the [Annual] hospital report stated that "the general good health which then prevailed, enabled us to receive all the cases that were brought to the Hospital, although much difficulty was often experienced in accommodating them." Two years later, the annual report for 1853 became more grim, and stated: ''during the entire year, the institution has been rather more than comfortably filled, the average number for the whole period, as shown above, being 229, while 220 is regarded as the capacity of the building. Anxious to receive all who desired admission, we have at no previous time refused any suitable applicant; but during a part of the year just closed, we were for a time compelled, although with great reluctance, to decline receiving patients, except under the most urgent circumstances.'' |
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=== Turn of the Century: 1883 to 1911 === | === Turn of the Century: 1883 to 1911 === | ||
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The Pennsylvania Hospital for the Insane flourished under Kirkbride until his death on December 16, 1883, though for decades after his death, Philadelphia natives colloquially referred to the hospital as "Kirkbride's." Dr. [[John Chapin]], the former Superintendent of the [[Willard State Hospital]] in New York, assumed the role of Superintendent of the Pennsylvania Hospital for the Insane after Kirkbride's demise, following a lengthy election by the Board of Managers. The Board had spent ten months making their selection, which was precarious because of the fame and reputation of Kirkbride. Chapin officially assumed this role on September 1, 1884, and held that office until the resignation from his duties in 1911. He was directly succeeded by Dr. Owen Copp, who initiated a School of Nursing for Men at the Hospital. Dr. Chapin appoints Leroy Craig as the first director of 'the Pennsylvania Hospital School of Nursing for Men'. Craig gains notoriety as the first male superintendent of a male nursing school in the country. Similar schools had previously been established locally at [[Friends Hospital]] and [[Norristown State Hospital]]. The new school of nursing was devoted to training male nurses in generalized nursing practices, as well as the specialization in the disciplines of psychiatric care. | The Pennsylvania Hospital for the Insane flourished under Kirkbride until his death on December 16, 1883, though for decades after his death, Philadelphia natives colloquially referred to the hospital as "Kirkbride's." Dr. [[John Chapin]], the former Superintendent of the [[Willard State Hospital]] in New York, assumed the role of Superintendent of the Pennsylvania Hospital for the Insane after Kirkbride's demise, following a lengthy election by the Board of Managers. The Board had spent ten months making their selection, which was precarious because of the fame and reputation of Kirkbride. Chapin officially assumed this role on September 1, 1884, and held that office until the resignation from his duties in 1911. He was directly succeeded by Dr. Owen Copp, who initiated a School of Nursing for Men at the Hospital. Dr. Chapin appoints Leroy Craig as the first director of 'the Pennsylvania Hospital School of Nursing for Men'. Craig gains notoriety as the first male superintendent of a male nursing school in the country. Similar schools had previously been established locally at [[Friends Hospital]] and [[Norristown State Hospital]]. The new school of nursing was devoted to training male nurses in generalized nursing practices, as well as the specialization in the disciplines of psychiatric care. | ||
− | It is during the second part of the hospital's history that the particulars of its operations change dramatically. Starting in 1876 the number of patients admitted to the inpatient | + | It is during the second part of the hospital's history that the particulars of its operations change dramatically. Starting in 1876 the number of patients admitted to the inpatient began to drop, which was credited to rise of the Commonwealth of Pennsylvania's involvement in psychiatry as a matter of the public health. This rise in psychiatric care was found to be startling in the Commonwealth of Pennsylvania. When Kirkbride opened the new asylum in 1840 there were a total of 275 beds available for those who suffered from mental illnesses. shared by the facility and [[Friends Hospital]]. By 1895, 7,000 inpatient beds had been created between various: private and state hospitals, as well as local sanitariums. While this trend would continue well into the 20th century, Pennsylvania Hospital's inpatient population maximum would not change from the five-hundred beds it was allotted following its expansion in 1853. While the Institute would remain an industry leader, it was longer the only psychiatric facility available to the public regionally. |
− | + | ==== Medical Staff Directory: 1840-1915 ==== | |
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− | ==== Medical Staff Directory: 1840- | ||
The original organization of [[Alienist]] physicians within Pennsylvania Hospital was severely limited. Dr. Kirkbride had laid the foundation of this level of medical hierarchy, which would be maintained to some degree until 1915. This hierarchy places the superintendent as charge and master of all medico-psychiatric issues taking place within the hospital, and an assistant physician to aid to either the male or female departments. Since this was a considerable prestigious post for many psychiatrists it became a starting point for many early careers within the field. However, shifting conceptions of psychiatric care changed in the early 20th century, largely due to legislation lobbied for by Pennsylvania's Committee on Lunacy. Additionally, the 'Food and Drug Act' of 1914 drastically altered the landscape of psychotropics within American Psychiatry. As a result, the Board of Managers of Pennsylvania Hospital, under the guidance of Dr. [[Owen Copp]], reorganized the structure of inpatient treatment and effectively tripled the number of physicians employed to treat the insane. Attending Physicians were also allotted significantly smaller caseloads of patients, from rough 250 per doctor in 1880, to 62 in 1915. This measure also stood in stark contrast to the public mental health facilities of the period, which were notorious for being chronically understaffed. | The original organization of [[Alienist]] physicians within Pennsylvania Hospital was severely limited. Dr. Kirkbride had laid the foundation of this level of medical hierarchy, which would be maintained to some degree until 1915. This hierarchy places the superintendent as charge and master of all medico-psychiatric issues taking place within the hospital, and an assistant physician to aid to either the male or female departments. Since this was a considerable prestigious post for many psychiatrists it became a starting point for many early careers within the field. However, shifting conceptions of psychiatric care changed in the early 20th century, largely due to legislation lobbied for by Pennsylvania's Committee on Lunacy. Additionally, the 'Food and Drug Act' of 1914 drastically altered the landscape of psychotropics within American Psychiatry. As a result, the Board of Managers of Pennsylvania Hospital, under the guidance of Dr. [[Owen Copp]], reorganized the structure of inpatient treatment and effectively tripled the number of physicians employed to treat the insane. Attending Physicians were also allotted significantly smaller caseloads of patients, from rough 250 per doctor in 1880, to 62 in 1915. This measure also stood in stark contrast to the public mental health facilities of the period, which were notorious for being chronically understaffed. | ||
− | *1) '''[[Thomas Story Kirkbride]]''' - Hospital Superintendent, 1840-1883; President of the [[American Psychiatric Association]] 1862-1870 | + | *1) '''[[Thomas Story Kirkbride]]''' - Hospital Superintendent, 1840-1883; President of the [[American Psychiatric Association]] 1862-1870 |
− | *2) '''[[Edward Hartshorne]]''' - Assistant Physician, 1841-1894 | + | *2) '''[[Edward Hartshorne]]''' - Assistant Physician, 1841-1894 |
*3) '''Francis Smith''' - Assistant Physician, 1841 | *3) '''Francis Smith''' - Assistant Physician, 1841 | ||
*4) '''Robert A. Given''' - Assistant Physician, 1842-1844; later the founder of [[Burn-Brae]] Hospital in Clifton Heights, PA. | *4) '''Robert A. Given''' - Assistant Physician, 1842-1844; later the founder of [[Burn-Brae]] Hospital in Clifton Heights, PA. | ||
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*27) '''Horace Philips''' - Assistant Physician, 1894-?, Later sat on the Pennsylvania Committee on Lunacy. | *27) '''Horace Philips''' - Assistant Physician, 1894-?, Later sat on the Pennsylvania Committee on Lunacy. | ||
*28) '''Charles B. Williams''' - Assistant Physician, 1903-1911 | *28) '''Charles B. Williams''' - Assistant Physician, 1903-1911 | ||
− | *29) '''[[GW McCafferty]] Jr.''' - Assistant Physician, 1908-1912 | + | *29) '''[[GW McCafferty]] Jr.''' - Assistant Physician, 1908-1912 |
*30) '''Herbert H. Thompson''' - Assistant Physician, 1911-1912 | *30) '''Herbert H. Thompson''' - Assistant Physician, 1911-1912 | ||
*31) '''[[Owen Copp]]''' - Psychiatrist-in-Chief, 1911-1922; President of the [[American Psychiatric Association]] 1921-1922. | *31) '''[[Owen Copp]]''' - Psychiatrist-in-Chief, 1911-1922; President of the [[American Psychiatric Association]] 1921-1922. | ||
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*36) '''Charles H. Sprague''' - Assistant Physician, 1914 | *36) '''Charles H. Sprague''' - Assistant Physician, 1914 | ||
*37) '''[[Samuel T. Orton]]''' - Clinical Director and Pathologist, 1915-1919; left to become Director of the [[Iowa State Psychopathic Hospital]]. | *37) '''[[Samuel T. Orton]]''' - Clinical Director and Pathologist, 1915-1919; left to become Director of the [[Iowa State Psychopathic Hospital]]. | ||
− | *38) '''Daniel H. Fuller''' - Assistant Physician, Department for Men, 1915-? | + | *38) '''Daniel H. Fuller''' - Assistant Physician, Department for Men, 1915-?; later sat on the Pennsylvania Committee of Lunacy. Superintendent of [[Adams-Nervine Asylum]]. |
− | *39) '''Horace J. Williams''' - Assistant Physician, Department for Men, 1915-?; later employed | + | *39) '''Horace J. Williams''' - Assistant Physician, Department for Men, 1915-?; later employed by Germantown Hospital |
*40) '''George T. Faris''' - Assistant Physician, Department for Men, 1915-1919; ran a private practice in Glenside, PA until his death in 1966. | *40) '''George T. Faris''' - Assistant Physician, Department for Men, 1915-1919; ran a private practice in Glenside, PA until his death in 1966. | ||
− | *41) '''[[Earl Bond]]''' - Assistant Physician, Department for Women, 1915-? | + | *41) '''[[Earl Bond]]''' - Assistant Physician, Department for Women, 1915-?; Psychiatrist-in-Chief, 1922-1935; President of the [[American Psychiatric Association]] 1930-1931 |
− | *42) '''Alice H. Cook''' - Assistant Physician, Department for Women, 1915-?, left the field entirely in 1919 to specialize in "diseases of the throat" | + | *42) '''Alice H. Cook''' - Assistant Physician, Department for Women, 1915-?, left the field entirely in 1919 to specialize in "diseases of the throat" |
*43) '''Uriah F. McCurdy''' - Assistant Physician, Department for Women, 1915-? | *43) '''Uriah F. McCurdy''' - Assistant Physician, Department for Women, 1915-? | ||
*44) '''[[Edward Strecker]]''' - Assistant Physician, Department for Women, 1915-1959, Chief Medical Officer 1920-1928; President of the [[American Psychiatric Association]] 1943-1944. | *44) '''[[Edward Strecker]]''' - Assistant Physician, Department for Women, 1915-1959, Chief Medical Officer 1920-1928; President of the [[American Psychiatric Association]] 1943-1944. | ||
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=== Innovation and Expansion: 1912 to 1958 === | === Innovation and Expansion: 1912 to 1958 === | ||
− | + | With the dawn of the 20th Century, a particular fascination with professional laboratory science was ushered in. It was posited that by more closely examining the brain and its inner workings, physicians could be able to determine the mysteries of mental illness. Neurologists and Micro-biologists concluded that insanity was a 'disease' of the nervous system, and it should be treated directed. Researchers collected brain specimens of deceased insane patients to search for clues about the nature of such pathologies. These early neuro-psychiatrists were no longer convinced that 'humane treatment' alone was sufficient to bring about psychiatric recovery for most of the clinical population. They looked for more allegedly scientific methods in conducting their various therapies. Reflecting this changing view, the Institute's name was changed in 1918 from 'the Pennsylvania Hospital for the Insane' to the "Department for Mental and Nervous Diseases at Pennsylvania Hospital". This name remained with the hospital for the next four decades. It was also during this period that professional nurses and personnel trained in psychiatry replaced the former attendants. | |
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− | With the dawn of the 20th Century, a particular fascination with professional laboratory science was ushered in. It was posited that by more closely examining the brain and its inner workings, physicians could be able to determine the mysteries of | ||
[[File:North.jpeg|280px|thumb|right|The Female Department of the Institute of the Pennsylvania Hospital]] | [[File:North.jpeg|280px|thumb|right|The Female Department of the Institute of the Pennsylvania Hospital]] | ||
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Over the years the particular name of the Institute has changed a number of times, as well as the title of the Chief Operating Officer. The popular title of "Superintendent", which was used by many psychiatric hospitals of the 19th century, was dropped in 1918 and replaced with the more progressive "Psychiatrist-in-Chief", which it remains for the next six decades. The title was split with the resignation of Dr. Myers in 1981. Dr. Fischer was thereafter named as 'Director of Psychiatry', with the now lesser title of Psychiatrist-in-Chief going to Dr. Layton McCurdy, who retained it until the closure of the Institute in 1997. | Over the years the particular name of the Institute has changed a number of times, as well as the title of the Chief Operating Officer. The popular title of "Superintendent", which was used by many psychiatric hospitals of the 19th century, was dropped in 1918 and replaced with the more progressive "Psychiatrist-in-Chief", which it remains for the next six decades. The title was split with the resignation of Dr. Myers in 1981. Dr. Fischer was thereafter named as 'Director of Psychiatry', with the now lesser title of Psychiatrist-in-Chief going to Dr. Layton McCurdy, who retained it until the closure of the Institute in 1997. | ||
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* 1) '''[[Thomas Story Kirkbride]]''' - Superintendent of Pennsylvania Hospital for the Insane, 1840-1883 | * 1) '''[[Thomas Story Kirkbride]]''' - Superintendent of Pennsylvania Hospital for the Insane, 1840-1883 | ||
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=== Campus for the Department of Females === | === Campus for the Department of Females === | ||
− | *'''Superintendent's House'''- ( | + | *'''Superintendent's House'''- (1840) this colonial revival building was the residence of the attending Psychiatrist-in-chief of the hospital, until the property was repossessed by the city of Philadelphia a century later. It is the only remaining building left from the original 1840 hospital, and is currently employed as the 'Lee Center', a cultural center for the Philadelphia Department of Parks and Recreation. |
− | *''' | + | *'''North Flats Building'''- |
− | *''' | + | *'''South Flats Building'''- |
− | *''' | + | *'''Villa House'''- |
− | *''' | + | *'''Nurses' Home'''- |
− | *''' | + | *'''Shield Ward'''- |
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*'''North Occupational Building'''- | *'''North Occupational Building'''- | ||
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*'''Hospital Auditorium'''- | *'''Hospital Auditorium'''- | ||
− | *'''Lapsley Pavilion'''- | + | *'''Lapsley Pavilion'''- |
=== Campus for the Department of Males === | === Campus for the Department of Males === | ||
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*'''The Kirkbride Building'''- (1859) previously the main facilities for ''Department for Males'', It has three floors, basement and a sub-basement underneath used for storage. This is the second oldest remaining building on the former campus. The Mill Creek School continues to operate out of the first floor of this building. Children's Hospital of Philadelphia (CHOP) also rented space on the North-end of this structure. | *'''The Kirkbride Building'''- (1859) previously the main facilities for ''Department for Males'', It has three floors, basement and a sub-basement underneath used for storage. This is the second oldest remaining building on the former campus. The Mill Creek School continues to operate out of the first floor of this building. Children's Hospital of Philadelphia (CHOP) also rented space on the North-end of this structure. | ||
− | *'''North Flats Building'''- (1859) this building has a single story over a basement area. It was originally employed for the | + | *'''North Flats Building'''- (1859) this building has a single story over a basement area. It was originally employed for the detantion of the most acute psychiatric cases during the 19th century. Sometime before 1922 it was repurposed as employee quarters for the nurses and orderlies of the hospital. BY the 1950's it was again resuited for use a children's wards, probably because of it multiple courtyard. It is currently occupied by the Consortium. |
*'''South Flats Building'''- (1859) this building was identical to the North Flats Building in its original use. However, it continued to remain as patient wards until employee quarters were transferred from the North Flats to the South Flats in the 1950's. It was demolished because of its poor condition following the close of the Institute in 1997. | *'''South Flats Building'''- (1859) this building was identical to the North Flats Building in its original use. However, it continued to remain as patient wards until employee quarters were transferred from the North Flats to the South Flats in the 1950's. It was demolished because of its poor condition following the close of the Institute in 1997. | ||
*'''Laundry House'''- (1859) originally designed for the single purpose of handling patient laundry. It was demolished in 1957 when a much larger complex of services buildings were constructed. | *'''Laundry House'''- (1859) originally designed for the single purpose of handling patient laundry. It was demolished in 1957 when a much larger complex of services buildings were constructed. | ||
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*'''Lawler Building'''- (1928) this was designed for administrative offices while the hospital was attempting to modernize in the 1920's. The floors are furnished with marble and granite, and contain large fireplaces with high ceilings with decorative molding and chandeliers. Currently, Baptist Children's Services occupy the second floor. The third floor is occupied by CoreCare’s Westmeade program. CoreCare’s administrative offices are located on the fourth floor which has a fireplace, parquet floors and two sun decks. Traveler’s Aid occupies the basement level with one of its two residential shelter areas. The penthouse contains the mechanical areas including main power and pumps for the chilled water. | *'''Lawler Building'''- (1928) this was designed for administrative offices while the hospital was attempting to modernize in the 1920's. The floors are furnished with marble and granite, and contain large fireplaces with high ceilings with decorative molding and chandeliers. Currently, Baptist Children's Services occupy the second floor. The third floor is occupied by CoreCare’s Westmeade program. CoreCare’s administrative offices are located on the fourth floor which has a fireplace, parquet floors and two sun decks. Traveler’s Aid occupies the basement level with one of its two residential shelter areas. The penthouse contains the mechanical areas including main power and pumps for the chilled water. | ||
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=== Specialized Inpatient Units === | === Specialized Inpatient Units === | ||
− | The Institute opened the region's first inpatient unit exclusively for adolescents in 1974, long before that of its primary competitors in Philadelphia, [[Friends Hospital]] and [[Belmont Behavioral Health]]. A specialized unit for eating disorders was also introduced to the hospital in 1986, when the Institute still lead the nation in the use of modern psychiatric care. While not revolutionary in the modern context, as most psychiatric hospitals have specialized units, this was considered particular for the time period. Also, Pennsylvania Hospital was famous for possessing a unit for 'Experimental Psychiatry', where various studies were conducted on the nature of [[hypnosis]], and hypnotherapy, and its successful use in the course of inpatient care. The majority of these studies were conducted by the Director of the unit, Dr. Martin Orne, starting as early as 1964, in association with the University of | + | The Institute opened the region's first inpatient unit exclusively for adolescents in 1974, long before that of its primary competitors in Philadelphia, [[Friends Hospital]] and [[Belmont Behavioral Health]]. A specialized unit for eating disorders was also introduced to the hospital in 1986, when the Institute still lead the nation in the use of modern psychiatric care. While not revolutionary in the modern context, as most psychiatric hospitals have specialized units, this was considered particular for the time period. Also, Pennsylvania Hospital was famous for possessing a unit for 'Experimental Psychiatry', where various studies were conducted on the nature of [[hypnosis]], and hypnotherapy, and its successful use in the course of inpatient care. The majority of these studies were conducted by the Director of the unit, Dr. Martin Orne, starting as early as 1964, in association with the University of Pennslyvania. |
=== Introduction of Psychoanalysis === | === Introduction of Psychoanalysis === | ||
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*[http://www.uphs.upenn.edu/paharc/collections/finding/iphgeneral.html Timeline of the Institute's development] | *[http://www.uphs.upenn.edu/paharc/collections/finding/iphgeneral.html Timeline of the Institute's development] | ||
*[http://www.uphs.upenn.edu/paharc/features/tkirkbride.html Thomas Kirkbride's Magical Lantern] | *[http://www.uphs.upenn.edu/paharc/features/tkirkbride.html Thomas Kirkbride's Magical Lantern] | ||
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*[http://books.google.com/books?id=_YVReXjGWGYC&pg=PA186-IA4&lpg=PA186-IA4&dq=department+of+nervous+and+mental+disease+at+pennsylvania+hospital&source=bl&ots=W2Sw2QcBMM&sig=iq5zRXNZUyhaOrR-Xr89y4tjY4I&hl=en&sa=X&ei=AzPsUMn3BqPG0QGh6IDQCw&ved=0CFcQ6AEwBQ#v=onepage&q=department%20of%20nervous%20and%20mental%20disease%20at%20pennsylvania%20hospital&f=false History of Pennsylvania Hospital, unabridged] | *[http://books.google.com/books?id=_YVReXjGWGYC&pg=PA186-IA4&lpg=PA186-IA4&dq=department+of+nervous+and+mental+disease+at+pennsylvania+hospital&source=bl&ots=W2Sw2QcBMM&sig=iq5zRXNZUyhaOrR-Xr89y4tjY4I&hl=en&sa=X&ei=AzPsUMn3BqPG0QGh6IDQCw&ved=0CFcQ6AEwBQ#v=onepage&q=department%20of%20nervous%20and%20mental%20disease%20at%20pennsylvania%20hospital&f=false History of Pennsylvania Hospital, unabridged] | ||
*[http://www.historicnewtownsquare.org/newtown-square-history/historic-newtown-township/part-iii-chapter-2-the-pennsylvania-hospital-farm/ Article on the Newtown Square Farmhouse] | *[http://www.historicnewtownsquare.org/newtown-square-history/historic-newtown-township/part-iii-chapter-2-the-pennsylvania-hospital-farm/ Article on the Newtown Square Farmhouse] | ||
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*[http://en.wikipedia.org/wiki/Institute_of_the_Pennsylvania_Hospital Wikipedia article on the former Institute] | *[http://en.wikipedia.org/wiki/Institute_of_the_Pennsylvania_Hospital Wikipedia article on the former Institute] | ||
*[http://kirkbridecenter.com/Kirkbride%20Center.pdf Document advertizing the sale of the property] | *[http://kirkbridecenter.com/Kirkbride%20Center.pdf Document advertizing the sale of the property] | ||
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[[Category:Pennsylvania]] | [[Category:Pennsylvania]] |