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Later a cottage was erected for children between the ages of 6 and 16. There is at present a fourth cottage under construction. When it is completed the institution will have a cottage for men, one for women, one for girls and one for boys. There are also an administration building for church, school and entertainment purposes, a central kitchen, laundry, power house, farm house and farm buildings.

The hospital capacity, when the new building is completed, will be about 115, males and females equally divided. · The men are employed in farming, gardening, grading, road building, mattress making, chair caning, etc.

The women do the house work, sewing, laundry work and some are interested in horticulture.

The children go to school until 18 years of age and the branches are taught up to the eighth grade; they are also taught manual training, raffia and reed work, stencilling, etc., as well as agriculture and horticulture.

The actual net cost per capita per diem in 1914 was 69 cents.

There is a religious service every Sunday morning and the patients are visited from time to time by the clergymen of their respective denominations.

For the first three years J. F. Edgerly, M. D., was superintendent. He was succeeded by the present incumbent, J. Clifford Scott, M. D.

On March 16, 1910, occurred the death of Dr. Wharton Sinkler, who was the founder of the institution, and its president up to the time of his death. To him more than to any other is due the establishment of this charity. Through his personal efforts the farm was secured as well as the buildings and their endowment. The list of officers at this time (1914) is as follows: Dr. Samuel W. Morton

............ President.
Mr. Henry M. Lea ...................... Vice-president.
Dr. Francis W. Sinkler

............ Secretary.
Fidelity Trust Co., Philadelphia ..............Treasurer.
Dr. J. Clifford Scott ..................... Superintendent.
Dr. Nathaniel S. Yawger ..............Neuropathologist.
Dr. G. E. Shoemaker

.....Gynecologist.
Dr. H. Maxwell Langdon ......Ophthalmologist.
Dr. Elwood Matlack ....

.......Laryngologist. Dr. Justin E. Harlan ........ ............Dentist.

EASTERN PENNSYLVANIA STATE INSTITUTION FOR THE FEEBLE-MINDED AND EPILEPTIC.

PENNHURST, SPRING CITY P. O., Pa. The Eastern Pennsylvania State Institution for the Feebleminded and Epileptic was founded by legislative acts of May 15, 1903. Primarily designed as a training school for the feebleminded, it became, through change in the legislative act, a custodial institution as well. Consequently two distinct sections are maintained: one for such epileptic and feeble-minded as require custodial care, and the second for the training of feeble-minded children.

The buildings are erected on a modification of the cottage plan, grouped closely together and connected by corridors. They are two stories in height, of brick and terra cotta, with granite trimmings, and fireproof throughout. They are so arranged as to provide a large number of small rooms occupied by from two to three beds, a few small dormitories with from eight to ten beds, and a large day exercising room.

The patients are fed in a general dining room, with the exception of the “ low grades,” for whom there is a building complete in itself.

A large percentage of the cases are admitted upon voluntary admission. Up to March, 1912, no female patients were being received.

The first superintendent was Dr. Henry M. Weeks, appointed December 1, 1907.

Dr. H. M. Carey was appointed superintendent February 2, 1910.

The original Board of Trustees were: John P. Crozer, Henry D. Comfort, John B. Lober, Samuel A. Whitaker, Dr. T. C. Detwiler, Dr. George B. R. Amstead, B. Witman D. Ambly, Dr. Joseph K. Weaver and Dr. Wharton Sinkler.

Trustees appointed to fill vacancies: Dr. A. G. Gifford, Henry F. Walton and James Mitchell.

Dr. George C. Signor
Dr. G. P. Ard ........

.Superintendent, 1914. ... Chief physician, 1914.

"By H. M. Carey, M. D.

PHILADELPHIA HOSPITAL FOR THE INSANE.'

PHILADELPHIA, PA. The earliest records referring to the Philadelphia almshouse indicate that an infirmary or special quarters of some sort were supplied for the insane poor at “Green Meadows," as it was then called. How the insane poor who found their way into the almshouse were cared for in the first part of the eighteenth century does not clearly appear. At some time, not determined, it was found that the accommodations were not adapted to the care of the more violent cases, which were sent to the Pennsylvania Hospital, where they were prepared to take proper care of them, the managers paying that hospital for their care. In 1803 cells were fitted up in the cellar of one part of the almshouse at Tenth and Pine Streets, and the insane, numbering at that time ten, were brought back to the city's hospital.

In a memorial to the State Legislature about 1804, one of the subdivisions of the almshouse is spoken of as “ apartments adapted for the treatment of the insane."

When the four Blockley buildings were first occupied the southwestern wing was set apart for a hospital. During the period when the southwest wing was used for general hospital purposes the insane occupied the extremities of this building. The men were domiciled in the southeastern extremity, towards the Schuylkill, and the women in the northeastern, towards the Darby Road.

At some period before 1850 a separate building of moderate size was erected back of the northeastern extremity of the southwestern building for the accommodation of noisy or violent insane persons. It probably consisted of cells wholly or partly below the ground, and it was in this building that the insane were found by Mahlon Dickinson in 1860. We learn from Lawrence's history that at a meeting of the Board of Guardians held January 3, 1860, Mr. Dickinson offered a resolution for the immediate removal of the cells in the vaults of the lunatic asylum. Some posts and rings were still in evidence underneath a portion of the northeastern wing (built in 1874) of the southwestern building, and were probably in the cells referred to by Mr. Dickinson.

* Material supplied by Charles K. Mills, M. D.

According to Dr. Agnew the insane department of the Philadelphia Hospital was not in an organized condition. In 1849, however, Dr. L. Henley had been appointed to take charge of the insane, and also of the smallpox hospital, a curious combination of official positions. Dr. Henley in 1852 was succeeded by Dr. J. H. Benton, the latter retaining his position only a short time, when Dr. Henley was reappointed. In 1854 the board, which assumed authority under the act of consolidation, abolished the position held by Dr. Henley, and no one, except the resident physician-in-chief of the hospital, seems to have had any charge of the insane until 1859, or later.

Dr. Smith seems to have taken much interest in the insane department, and it is probable that he gave some instruction in mental disease to the students. In an introductory lecture delivered to the students in attendance in the old lecture room in the southwestern building in 1855 Dr. Smith says:

Besides the usual clinics, it has been decided upon by the board that a series of lectures shall be delivered upon disorders of the mind, in order that the subject of insanity may be brought before you in a more practical light. We propose to show to you practically all the different varieties of mental aberration; not only to investigate the phenomena of insanity, but to illustrate the subject from the wards around you.

Dr. Smith was a man of ability and practiced medicine for a time on Darby Road. He had some political influence, and through this and his personal ability received the appointment of resident physician-in-chief. He was an earnest and fuent talker, and took much interest in lecturing to the students, as well as in the other duties of his position. He remained at the Philadelphia Hospital until 1860, retiring after the change in the governing board. He went into the army and afterwards died in Texas.

After the insane department was separated from the rest of the hospital September 24, 1859, Dr. S. W. Butler was appointed and gave much time to organizing the department. He was a man of large attainments, who afterwards became the proprietor and editor of the Medical and Surgical Reporter.

In November, 1866, Dr. Butler was succeeded by a man worthy of special remembrance, Dr. D. D. Richardson, who gave many years of faithful service to the insane department. Appointed in 1866, he was displaced by Dr. A. A. McDonald in 1880, but was recalled in 1881 to his old post, which he continued to honor until 1885, when he was succeeded by Dr. Philip Leidy.

In 1870, '71 and '72, the insane department of the Philadelphia Hospital had the good fortune to have the services of the first alienist of this country, Dr. Isaac Ray, who moved to Philadelphia in 1867.

In 1870 Dr. Ray was appointed one of the guardians of the poor, which position he continued to hold during 1871 and 1872.

It was after Dr. Ray had become a member of the Board of Guardians of the poor in 1870 that he was appointed lecturer on insanity in the Jefferson Medical School. During the same time, and partly with a view of illustrating these lectures, Dr. Richardson gave clinical demonstrations of the different forms of insanity to medical students at the Philadelphia Hospital. This, so far as I know, was the first instruction on insanity given in Philadelphia medical schools and hospitals after the time of Rush, with the exception of some instruction given by Dr. Robert K. Smith, to whom allusion has been made.

Another man who did much to advance the interests of the insane at Blockley as well as elsewhere was Dr. George Leib Harrison, to whom we owe the compilation of a volume on the legislation of insanity, which includes a collection of the lunacy laws of our own and other countries up to the year 1883. Dr. Harrison was for a number of years a member of the Board of Public Health and Charities of Pennsylvania, and during a portion of this time its president.

For a long period the only medical officers of the insane department of the Philadelphia Hospital were the superintendent and his assistants, but in 1884 a new departure was made. In this year consultants to the insane department were appointed, their duties being to inquire into the condition of affairs at the hospital, and, in connection with the resident physician-in-chief, to make personal examination of the patients. They were to report to the board, making such recommendations as should be deemed expedient.

The first appointments of consulting physicians, made December 22, 1884, were Drs. S. Weir Mitchell, Horatio C. Wood and Charles K. Mills.

In 1885 Dr. H. C. Wood was succeeded by Dr. Andrew Nebinger, who died on April 26, 1886, Dr. James A. Simpson being elected in his place.

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