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On Bodies and Minds: Effects of the Civil War

It’s hard to fathom, but to this day one startling Civil War statistic stands:  approximately 625,000 American men – the equivalent of 6 million men today – were killed in action or died of disease between April 12, 1861 and April 9, 1865. That’s more than in World War I, World War II, the Korean War and Vietnam War combined.

Pennsylvania Hospital for the Insane, circa, 1860

#48 - Hospital for the Insane - Dept. for FemalesWith defeat of the Southern Confederacy, the Civil War – referred to during its time (depending upon what side you were on) as the War of Southern Rebellion or War of Northern Aggression – resulted in three new amendments to the U.S. Constitution, the abolishment of slavery and the preservation and subsequent redefinition of the  U.S. as a single nation. These are the usual take-away points we glean from the history books. But what of the survivors? The physically and mentally maimed veterans and collaterally damaged civilian victims of the Civil War era?

No stranger to American history, Pennsylvania Hospital (PAH) – the nation's first hospital, founded in 1751 by Benjamin Franklin and Dr. Thomas Bond – is currently hosting two free, historical exhibits which offer a retrospective look into the effects the Civil War had on the bodies and minds of Americans.

On loan from the National Institutes of Health, the first exhibit, Life and Limb: the Toll of the American Civil War is on display in PAH’s Historic Surgical Amphitheater until October 6th. (NOTE:  This exhibit is now closed.)

Over three million soldiers fought in the Civil War over the course of four years. Over half a million died, and almost as many wounded survived. Many veterans were permanently disabled from battlefield injuries or surgery which, even during a time of no antibiotics and not enough ether to go around, saved lives by sacrificing limbs. The Life and Limb exhibit explores the harrowing experience of these disabled veterans, which transformed them into indelible symbols of a fractured, young nation and a reminder of the high cost of war.

One floor down from the Surgical Amphitheater in PAH’s original building, the Pine Building, is the Historic Medical Library. Open since 1762, the Library is the oldest medical library in the United States and the home of the second exhibit: Mental Health During the Civil War: Thomas Story Kirkbride and the Pennsylvania Hospital for the Insane. This one-of-a-kind exhibit explores the treatment of the mentally ill during the Civil War period from a very direct and “hands on” point of view. Brought to PAH by the Hospital’s own Curator and Lead Archivist, Stacey Peeples, this exhibit will be on display and open to the public until September, 1, 2013.

Setting the Scene
As the nation's first hospital, PAH was also the first to treat mental illness and became a primary force in shaping the attitude of colonial Americans toward people with emotional and psychological disorders. PAH was the first in the nation to take the stance that mental illness was a disease of the mind, rather demonic possession. Consistent attempts were made to actually treat the mentally ill, not just warehouse them. By today’s standards the care would not seem so humane – it might be perceived as horrific – nor was it often effective. However, the approach was groundbreaking, placing great emphasis on recreational and occupational therapies, a tactic still employed today. The number of insane patients at PAH far outnumbered physically ill throughout much of the 18th and 19th centuries.

“While Pennsylvania Hospital was chartered to accept the mentally ill, the care of those individuals proved more complex than anticipated,” Peeples said.  “The mentally ill did not enter the hospital for a short term visit, but very often became permanent guests, spending years and sometimes decades, at the hospital. Try as they might, the physicians did not have the answers to curing the mentally ill.” 

And issues were mounting, as hospital staff attempted to keep the presence and cries of the mentally ill from upsetting and disturbing the other physically ill patients. Segregation was the first step in trying to best accommodate all Hospital patients. So with space at a premium, the Hospital's Board of Managers agreed to purchase a large farm in West Philadelphia on which a facility could be built to house mentally ill patients.

 “Moving the mentally ill into the WInstitute Collection - Kirkbride Stereoscopeest Wing of the Pine Building was one small step forward, but the proverbial giant leap came when Dr. Thomas Story Kirkbride was hired as superintendent of the new, 101 acre institution in West Philadelphia,” said Peeples.

Stereoscope of Dr. Kirkbride

The Pennsylvania Hospital for the Insane, later called the Institute of Pennsylvania Hospital, was opened in the winter of 1841, when 100 mentally ill patients were slowly transferred in carriages from the bustling city streets at 8th and Spruce Streets to the new, rural facility west of “then” Philadelphia, that had been specially prepared for their care. 

 A 31-year-old Quaker physician at the time of his hiring, Kirkbride, though trained as a surgeon, had gained early experience working with the insane. As the new asylum's first chief physician, Kirkbride was a maverick in his field as an advocate for “moral treatment” of the mentally ill. His basic tenet was that the mentally ill could be treated humanely, in a rational manner, and brought back to their rational selves. While only half of Kirkbride's patients eventually recovered and resumed their positions in the world, this still remains a striking accomplishment in an era when effective medications and other modern treatments were virtually non-existent.

In the years running up to the Civil War, the need for appropriate treatment facilities to house the mentally ill only increased. In 1859, five blocks west of the Pennsylvania Hospital for the Insane, a twin version of the mental hospital is opened at 49th and Market Streets. The original campus becomes The Department for Females, and the newer campus is The Department for Males.

“From the official record, it seemed as if the Civil War had minimum impact on the Institute or Dr. Kirkbride, but looking at his correspondence, it is evident that the war was an ever present reality,” said Peeples.  “Kirkbride was extremely well connected and corresponded with almost every ‘asylum keeper’ or superintendent across the country.”

Throughout the Civil War years, Kirkbride faced many challenges to method of care for those under his charge. The south was literally and figuratively cut off from the north, prohibiting families from sending money to fund care for their mentally ill relations institutionalized at the Institute. “This caused a great deal of stress for everyone involved, including the Board of the Pennsylvania Hospital, who briefly considered discharging those southern patients for lack of payment,” said Peeples.  “Luckily for all involved, the Board decided to loan the Institute the money it was lacking to continue the care of those individuals and their families were to be contacted after the war to resume payment.”

Some of the gems visitors can see at the Mental Health During the Civil War exhibit include:

  • Displays covering the improvements in professions nursing and surgical techniques as a result of the Civil War years
  • Displays and images of Kirkbrides’ Magic Lantern Shows and how they reinforced his method of “moral treatment of the mentally ill
  • “Reformers & Friends” display, including actual letters between Kirkbride’s and Dorothea Dix.
  • Kirkbride’s annual report to the Board of Managers of the Pennsylvania Hospital for the Insane, 1861-1865
  • Period photographs and more

 


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