Norristown State Hospital, originally known as the State Lunatic Hospital at Norristown, is an active psychiatric hospital located outside the city of Philadelphia in Norristown, Pennsylvania. Designed 1878â€"80, by Wilson Brothers & Company, it was the first institution in the country that recognized female physicians and the first to house a pathology department.
It serves the five counties of the Southeast Region of Pennsylvania: Bucks, Chester, Delaware, Montgomery and Philadelphia providing service to men and women in General Psychiatry and Forensic Psychiatry.
History
Overview
In May 1876, under Public Law 121, the Pennsylvania Legislature called for the establishment of a state mental hospital to serve the Southeastern District of Pennsylvania.
Ground was broken on March 12, 1878 after John Rice was appropriated a contract of $600,000 from the Legislature to construct seven wards, the administration building and to their supply the buildings to accommodate the overcrowding which was taking place in the insane wards of the Philadelphia Almshouse.
The construction was completed on February 17, 1879.
Situated on two hundred and sixty-five acres, the original design of the hospital was similar to the Kirkbride plan with echelons on both sides of the central administration building with two-story ward-buildings with two wards on each floor connected by covered passage ways. The kitchen, laundry and boiler house et al. sat directly behind administration. This model allowed for the separation of patients into areas based on their level of functioning.
From the main gate, a gradual rise in terrain brings the visitor to the entrance of the administration building as he is greeted with a tiled floor, ornamental brick wainscot, growing plants bringing verdure into winter and an electrically arranged clock â€" all showing a modern taste in architecture.
Roads and sewers were built and a large portion of the grounds were enclosed by an iron fence eight feet high. Barns and a root-house were also constructed. The sewage was emptied into Stony creek until it was found to be injurious.
Under the supervision of Dr. Robert H. Chase and Dr. Alice Bennett, the hospital received its first patient, a female, on July 12, 1880 along with groups of individuals who were admitted from other state hospitals and county almshouses.
Construction and Design
The supreme control of the entire institution is placed in a board of trustees of thirteen members, all of whom serve in rotation in an executive committee of five, which holds weekly sessions.
The general dimensions of the separate ward buildings are 277 feet (84Â m) in length by 90 feet (27Â m) in depth. Each ward building consists of a basement, used for steam-heating ducts and workshops, and two main stories, each containing two wards and giving four wards to each building. Each ward is complete in itself, with separate rooms, dormitory, dining-room, bath-room, etc. The wards are ventilated by stacks with steam coiled at the base for creating the drought that draws the impure air from the wards.
The entire institution is well supplied with water and gas, and is heated by steam from the central boiler-house. The buildings stand upon an elevated plateau, the main front facing south-east, and are surrounded by extensive grounds. Connected with the hospital and owned by the State are about three hundred acres of land, portions of which are devoted to truck-gardens, whose cultivation furnishes wholesome employment to some of the patients.
During annual reports from the turn of the 20th century, the water from the artesian wells was reported to be excellent, the closets and soil pipes were old but odorless. The food was also excellent, the milk boiled but slightly deficient in quantity, great care is used by the trustees to secure the best meat but at times it does spoil in very humid weather.
Patients partook in forms of occupation in the following areas of the hospital:
- Administration
- Bakery
- Billiard room
- Boiler room
- Bric-a-brac shop
- Brush shop
- Butcher
- Carpenter shop
- Dispensary
- Farm
- Garden
- Kitchen
- Laundry
- Machinists
- Mattress shop
- News-room
- Out-door improvement
- Painters
- Plasterers
- Plumbers
- Printing office
- Scroll saw shop
- Shoemakers
- Stables
- Store-rooms
- Tailors
- Wards and dining rooms
- Weavers
In 1889, it was reported that the dormitories contained 14,580 cubic feet (413Â m3), usually occupied by twenty-two patients nightly; deducting the usual allowances for space occupied by patient, bed and bedding, leaves about 650 cubic feet (18Â m3) of air for each. The single rooms contain 1,188 cubic feet (33.6Â m3), with frequently two patients in a room. Added to this, the air of the corridors is vitiated by 15 to 30 patients sleeping in them at night.
Attendants
Number during the year of 1901, 213; of employees, 201. Proportion of attendants to average number of patients, 1 to 9.5; of employees, 1 to 8. Wages paid to attendants, $45,091.42; to employees, $59,903.00. Weekly per capita cost, $3.29.
Admissions
The number of patients admitted during the year ending September 30, 1900, was 409, or 204 male and 109 female patients, or 44 less than the previous year.
Nativity
Of the 2,177 patients remaining, 629 were foreign born, and in 49 cases the nativity was unknown.
Population
The whole number treated was 2,615 or 29 more than the previous year. The maximum number was 2,226, the least 2,120, the average 2,169.
Discharges
During the year there were 231 males, 207 females, total 438 patients, discharged, of whom 139 recovered, 42 improved, 84 stationary, 2 not insane and 171 died, leaving 2,177 in the hospital at the close of the year, of whom 1,076 were men and 1,101 women.
Restrain and Seclusion
Eleven males, 4 females were restrained on September 30, 1900, to prevent violence to themselves and others, and to retain surgical dressings.
During the year 20 male and 7 female patients were restrained.
Employment
Four hundred and eighty male patients have been daily employed in ward work, laboring work, gardening, jobbing, manufacturing, etc.; about 500 female patients have been employed in housework, ward sewing, basket shop, brush shop, sewing room, kitchen, laundry, studio, in refectory and on farm.
Libraries
These contain about 2,100 volumes of a miscellaneous character. The patients are well supplied with periodicals.
Entertainment
Includes games, such as cards, checkers, dominoes, billiards, pool and bowling alley. During the winter there are balls, tableaux, lectures and stereopticon exhibitions. Games of ball, croquet, tennis, with excursions, picnics, etc., in their season.
Religious Service
At the last service held during the year, 400 male and female patients total attended.
At the close of the year 84 patients were absent on parole at their homes. Of these present, 168 male, 247 female patients, were taking medicine regularly' 241 males, 226 females, were on extra or sick diet; 68 males, 51 females, were sick in bed; 15 males, 22 females, were fed with spoon; 1 female, 1 male, were fed with nasal tube.
Of those remaining in the hospital at the close of the year, 124 males, 85 females, were epileptic; 37 males, 6 females, were paralytic; 26 males, 5 females, were homicidal; 34 males, 224 females, were suicidal; 57 males, 6 females, were insane convicts; 43 males, 8 females, were of the criminal insane; 215 males, 260 females, were uncleanly in person and habits, and about 109 patients were estimated to be probably curable cases.
First Female Physician
Dr. Alice Bennett, a graduate of the Woman’s Medical College of Pennsylvania was appointed head of the Women’s Department, the first woman in the nation to direct a female division in a mental institution. This notion removed all possibilities of abuse or immodest behavior by male patients and staff.
Bennett profited from the Victorian notion that as a woman physician, she could best treat patients of her own sex and in turn, introduced her own ideas of patient management.
She encouraged independence and self-esteem and which, through its humane example, would elicit behaviors of kindness and civility in the patients who were encouraged to make visits home, to engage in “productive†occupations like housework, sewing, and knitting and to take advantage of the fresh air and beautiful grounds. She also made special note of holiday celebrations which drew the female patients together.
First Female Assistant Physician
In late 1880, Dr. Bennett was joined by Woman’s Medical College Class of 1879 graduate Dr. Anna Kugler who was appointed first assistant physician in the Women’s Department.
With one attendant for every twelve patients, Kugler and Bennett managed a large department, already overcrowded, understaffed and under-funded. They were responsible for the physical health of the residents, as well as attending to their medical and surgical needs.
Accusations
Experimentation
In 1892, the Board of Public Charities accused the medical staff under the order of Dr. Bennett of surgical experimentation after the removal of the ovaries of six women were reported as a cure for insanity. Under the alluring title, "An Experimentation in Castration" the New York Medical Record editorially gives the following unique item of news:
An interesting experiment has suddenly come to grief at the Norristown Insane Asylum, Pa. Some of the medical staff became much impressed with the value of castrating women as a therapeutic measure in insanity.
James J. Levick states, “Insanity is a disease of the brain, not of some organ remote from it. And when manifestation of insanity seem to be especially associated with functional disturbances of some one organ, this disturbance is secondary to the brain disorder, not the cause of it.†Those who opposed this procedure greatly rejoiced that, “the hospitals and the profession are saved from a scandalous proceeding.â€
It was further questioned whether Gynecology should be practiced in Asylums and if an insane person should be treated gynecologically just as any other person would be treated and that an examination, diagnosis and treatment ought to be instituted independent of her mental condition.
Abuse
Mary Ritchie, eighty years old, had her arm fractured because she refused to take a bath. She was seized by two of the attendants, and in the struggle her arm was broken. Mary Green, one of the attendants, was then discharged by the committee.
Jacob Miller also had an arm broken by the attendants, and three of the men employed in the male department were discharged. These unfortunates had suffered most at the hands of the attendants, but it was stated that other patients had been treated in a shameful manner.
On August 4, 1883, William A. J. Fiss died in the hands of James Gaffey, an attendant, after he struck Fiss. Fiss became incoherent and died from blood poisoning at 12:45Â am.
Modern Day
Across from a neighborhood of bungalows and rowhouses along the Norristown-West Norriton border, Norristown State Hospital stretches for 225 rolling, tree-lined acres with roughly thirty buildings. Some of the buildings have been rented to social-service providers and government agencies, while others are used for outpatient clinics.
The Hospital's population is now roughly three hundred and eighty. Before psychiatric drugs became widely available and more emphasis was placed on allowing the mentally ill to avoid long-term commitments, the growth in population had once reached a total of four thousand seven hundred patients in 1954 overfilling its occupancy.
Future
The future of Norristown State Hospital is up for debate. Two state agencies, the Department of General Services and the Department of Public Welfare, oversee the hospital, but neither has a plan for its future. Total closure seems unlikely and the one hundred and thirty-six patient forensic unit for criminally committed patients is often near capacity.
There is a precedent for turning obsolete parts of Norristown State Hospital into an asset for the neighborhoods around it such as the neighboring Norristown Farm Park, an immense public park on land where patients once raised crops and livestock .Norristown state hospitals civil section is slated to close in Jan 2019.The remaining beds will House 60 patients for a step down program. These beds will help patients who are not able to remain healthy in a community setting and will be run by community providers.
Timeline
- 1876 â€" Under Public Law 121, the Pennsylvania Legislature called for the establishment of a state mental hospital to serve the Southeastern District of Pennsylvania.
- 1878 â€" Ground was broken for construction of the hospital.
- 1879 â€" Construction completed.
- 1880 â€" The first female patient was admitted.
- 1881 â€" A library, smoking and billiard room and a bowling alley were constructed for the amusement of the inmates.
- 1882 â€" The population of the hospital was one hundred and ninety-two at a monthly cost of $3,967 per inmate. A printing office and a scroll saw shop were established in which certain inmates were allowed to work. These were for the better class of patients who felt themselves superior to hard manual labor. For another class, who were not to particular, a brush shop was established which rapidly sprung into success.
- 1883 â€" The industrial pursuits had increased to such an extent that seventy-five per cent. Of the patients under treatment found daily occupation. Of these, one hundred and fifty were employed in improving the grounds; sixty-four in the brush shop, and the remainder as butchers, bakers, laundrymen, machinists, plasterers, painters, shoemakers and tailors. Ward building No. 1 for female patients, which had not been built at first owing to lack of funds, was erected and occupied during this time.
- 1884 â€" Two more buildings were erected for the occupancy of those who were unable to perform bodily functions properly without constant supervision.
- 1885 â€" The system of irrigation sewerage was enlarged â€" a large portion of the work being done by the patients. An infirmary was erected to accommodate about one hundred patients and was one story high and surrounded by verandas. The library was increased so that it contained nearly one thousand volumes and picnics were often held.
- 1886 â€" The population grew increasingly large that two frame barracks were erected holding about one hundred patients each. The offal of the establishment were used as fertilizer for the grounds, which assumed the proportions of a well regulated farm supplying all the sausage, scrapple, lard and poultry used by the institution. A farm cottage was erected to accommodate sixteen patients who were delegated to engage in agricultural pursuits.
- 1887 â€" The male and female infirmaries were made ready for occupancy. During this time, a mild attack of typhoid fever broke out afflicting twenty-one patients â€" all but two recovered. Clubs were also established and a large refectory or general dining room gave great satisfaction to five hundred patients.
- 1891 â€" Forty acres were purchased by the authority of the Commonwealth as an epidemic of dysentery carried off a number of patients to their grave.
- 1893 â€" $7,500 was appropriated by the Legislature to drill and test artesian wells. Six wells were drilled varying from four hundred to five hundred feet in depth yielding an ample supply of water and a reservoir was constructed holding nearly three and one-half million gallons of water.
- 1894 â€" A full electric light system was installed by which all the buildings were lighted and a few arc lights were also placed upon the grounds. One hundred and forty-two cows had to be killed this year when they became infected with tuberculosis at a loss of $6,000. The basement of the chapel building has in it a medical library, a dining room for employees and a general store room. The chapel is a large room, finely lighted by windows. A complete drug store with a resident druggist is found in the male and female departments and three private rooms were established in each ward for isolation. An ample and light building is used as the kitchen and bake house, and the cooking done by steam with a large refrigerator adjoining the kitchen. Two thousand loaves of bread were turned out on an average daily basis along with biscuits and gingerbread on certain days of the week.
- 1896 â€" Dr. Bennett resigned from her position as resident physician of the Female Department.
- 1895 â€" A training school was established in the Male Department for nurses. Two years later, a similar school for Female nurses opened.
- 1897 â€" An additional assistant physician was added to each department. On October 1 there were 1,102 male and 1,048 female patients.
- 1899 â€" A cottage on the grounds was fitted up for the segregation of female tubercular patients, which provided room for twenty cases.
- 1900 â€" Two large ward buildings were completed, appeals for which had been made for years to the Legislature, because of the overcrowded conditions. They are two stories high and have on each floor two large dormitories, with a large day room in between them. They were intended for the quiet working class and accommodate 250 patients.
- 1904 â€" The infirmary for men was placed entirely in charge of female nurses and a nurses' home was erected at a cost of $55,000 with a capacity for one hundred and ten nurses.
- 1906 â€" The hospital suffered a great loss in the sudden death of its chief physician, Dr. David Dorrington Richardson. A modern pathological laboratory building, with morgue, was occupied and included a mortuary chapel, museum and offices.
- 1907 â€" A destructive fire almost destroyed ward building No. 11. Fortunately the fire occurred early in the evening and by prompt action all the inmates were saved and no one was injured. In May, a convalescent building was constructed at a cost of $50,000 and accommodated roughly seventy women.
- A card-index system for the enrollment and classification of patients was inaugurated and the folder system of recording the histories of cases was amplified and modernized.
- Hydrotherapy in the form of cold and neutral packs was introduced.
- 1908 â€" A surgical building, equipped with a modern operating room and necessary accessory rooms, was erected at a cost of about $3,000.
- Three barn buildings were burned and several of the season's crops were destroyed. They were replaced with modern buildings.
- 1909 â€" A modern assembly hall was completed and occupied in September. The lower floor being a dancing hall, while the upper floor contains an auditorium for chapel and assembly purposes, with sloping floor, large stage and fixed theater seats for one thousand two hundred patients. A $5,000 pipe organ was installed through the generosity of the Legislature.
- $30,000 was appropriated for new plumbing, all old bath-rooms and closets to be torn out and modern shower baths, tubs and closets were installed, and the floors were tiled.
- 1910 â€" Continuous baths were installed throughout the institution and the position of resident dentist was created.
- 1949 â€" A brick building was erected on the campus to house the nursing staff. Although no longer used for that purpose, it still stands today and is known as Building 57. It is a four-story building located near the Gate 4 entrance to the State Hospital campus. It currently houses the State Hospital psychology department, medical records, a credit union, and several other hospital related and non-hospital related tenants.
See also
- Mental Health
- Psychiatric Hospital
Notes
References
- Amos H. Mylin. (1897) State Hospital for Insane, Norristown State prisons, hospitals, soldiers' homes and orphan schools controlled by the Commonwealth of Pennsylvania. Princeton University: Clarence M. Busch, State Printer, 109â€"116.
- Ruth J. Abram. (1986) Pennsylvania State Hospital for the Insane, Send us a lady physician: women doctors in America. W. W. Norton & Company, 172â€"178.
- William F. Waugh, A,M., M.D. (1888) Miscellany, The Medical Times and Register, Volume 18. The Medical Publishing Company, 628, 669â€"670, 695â€"699, 708.
External links
- Historic Photographs of Norristown State Hospital