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=== Overcrowding at Pennsylvania Hospital: 1817-1834 ===
 
=== Overcrowding at Pennsylvania Hospital: 1817-1834 ===
  
[[File:1800.jpeg|300px|thumb|left|[[Pennsylvania Hospital]] as it would have appeared in the 19th century]]
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[[File:1800.jpeg|200px|thumb|left|[[Pennsylvania Hospital]] as it would have appeared in the 19th century]]
  
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.   
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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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=== Under Dr. Kirkbride: 1840-1883 ===
 
=== Under Dr. Kirkbride: 1840-1883 ===
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[[File:Kirkbride.jpeg|200px|thumb|left|Dr. Thomas Kirkbride]]
  
 
In January 1841, the Board of Managers opened the new hospital buildings and gradually, over the next few months, transferred ninety-three insane patients to the West Philadelphia campus. A Philadelphia newspaper, the North American, reported on the progress of the move in its issue of March 1, 1841:
 
In January 1841, the Board of Managers opened the new hospital buildings and gradually, over the next few months, transferred ninety-three insane patients to the West Philadelphia campus. A Philadelphia newspaper, the North American, reported on the progress of the move in its issue of March 1, 1841:
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Another Philadelphia newspaper, the Public Ledger, on 29 May, also reported on the new hospital:108
 
Another Philadelphia newspaper, the Public Ledger, on 29 May, also reported on the new hospital:108
  
<blockquote>"Pennsylvania Hospital for the Insane- ''The contributors to the Pennsylvania Hospital lately finished the main buildings of their new Hospital for the insane.  This is situated about two miles west of the Permanent Bridge, between the Haverford and West Chester roads.  The number of patients which can be accommodated there is stated to be 200.  Poor patients are supported by the Hospital, other pay according to their ability.  The lowest rate of board for a Pennsylvanian being three dollars fifty cents per week, or $182 per annum – for an inhabitant of any other State, $5 per week, or $250 per annum.  The whole receipts go to the support of the Institution.  The arrangements are on a fine scale, board cheap, situation healthy, and treatment judicious.''"</blockquote>
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</blockquote>"'''Pennsylvania Hospital for the Insane'''- ''The contributors to the Pennsylvania Hospital lately finished the main buildings of their new Hospital for the insane.  This is situated about two miles west of the Permanent Bridge, between the Haverford and West Chester roads.  The number of patients which can be accommodated there is stated to be 200.  Poor patients are supported by the Hospital, other pay according to their ability.  The lowest rate of board for a Pennsylvanian being three dollars fifty cents per week, or $182 per annum – for an inhabitant of any other State, $5 per week, or $250 per annum.  The whole receipts go to the support of the Institution.  The arrangements are on a fine scale, board cheap, situation healthy, and treatment judicious.''"</blockquote>
 
 
At the regular, annual meeting of the Contributors to [[Pennsylvania Hospital]], held on May 3, 1841, the Board of Managers reported that the main new building of the 'Hospital for the Insane' was officially completed and occupied. They also provided the Contributors with a final accounting of the project’s ongoing venues and expenditures. The purchase of the 101-acre Arrison farm estate, as well as two subsequent purchases of adjoining land, totaling ten acres had together cost $33,058.81. Design and construction had cost $265,000. Total expenditures to date were therefore $298,058.81, significantly under the previous expectations. This sum was more than balanced by the proceeds from the sale of the city square to the east of the Eighth Street, $154,226.24; by the proceeds from the sale of the partial squares to the west of Ninth Street, $120,000.00; and by the accumulated interest on the sale of these lands, $48,883.08. Total revenues to date were therefore $323,109.32, leaving $25,050.51 in the hospital building fund.
 
  
[[File:Kirkbride.jpeg|200px|thumb|left|Dr. Thomas Kirkbride]]
 
  
The new superintendent, [[Thomas Story Kirkbride]], gained national renown because of his particular clinical 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.
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[[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, but later illness forced Issac to return to his home country of England. The building was then finished by a young Samuel Sloan, who had previously worked as a carpenter on Eastern State Penitentiary. Sloan finished the building in 1841 using Holden's plans. The building was a rather simple design compared to later Kirkbride Plan buildings. Constructed of cut limestone, 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.  
 
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 had previously worked as a carpenter on Eastern State Penitentiary. Sloan finished the building in 1841 using Holden's plans. The building was a rather simple design compared to later Kirkbride Plan buildings. Constructed of cut limestone, 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.  

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