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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 Warstatistic stands:  approximately 625,000American men – the equivalent of 6 million men today – were killed in action ordied of disease between April 12, 1861 and April 9, 1865. That’s more than in World War I, World War II, the Korean War andVietnam War combined.

PennsylvaniaHospital for the Insane, circa, 1860

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

No stranger toAmerican 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 aretrospective look into the effects the Civil War had on the bodies and mindsof Americans.

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

Over three millionsoldiers fought in the Civil War over the course of four years. Over half amillion died, and almost as many wounded survived. Many veterans werepermanently disabled from battlefield injuries or surgery which, even during atime of no antibiotics and not enough ether to go around, saved lives bysacrificing limbs. The Life and Limb exhibitexplores the harrowing experience of these disabled veterans, which transformedthem into indelible symbols of a fractured, young nation and a reminder of thehigh cost of war.

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

Setting the Scene
As the nation's first hospital, PAH was also the first to treatmental illness and became a primary force in shaping the attitude of colonialAmericans toward people with emotional and psychological disorders. PAH was the first inthe 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 justwarehouse them. By today’s standards the care would not seem so humane – it mightbe perceived as horrific – nor was it often effective. However, the approachwas groundbreaking, placing great emphasis on recreational and occupationaltherapies, a tactic still employed today. The number of insane patients at PAHfar outnumbered physically ill throughout much of the 18th and 19thcenturies.

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

And issues were mounting, as hospital staff attemptedto keep the presence and cries of the mentally ill from upsetting anddisturbing the other physically ill patients. Segregation was the first step intrying to best accommodate all Hospital patients. So withspace at a premium, the Hospital's Board of Managers agreed to purchase a largefarm in West Philadelphia on which a facility could be built to house mentallyill patients.

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

Stereoscope of Dr. Kirkbride

The Pennsylvania Hospital for the Insane, latercalled the Institute ofPennsylvania Hospital,was opened in the winter of 1841, when 100 mentally ill patients were slowlytransferred in carriages from the bustling city streets at 8th and SpruceStreets to the new, rural facility west of “then” Philadelphia, that had been speciallyprepared 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 workingwith the insane. As the new asylum's first chief physician, Kirkbride was a maverickin his field as an advocate for “moral treatment” of the mentally ill. Hisbasic tenet was that the mentally ill could be treated humanely, in a rationalmanner, and brought back to their rational selves. While only half of Kirkbride'spatients eventually recovered and resumed their positions in the world, this stillremains a striking accomplishment in an era when effective medications andother modern treatments were virtually non-existent.

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

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

Throughoutthe Civil War years, Kirkbride faced many challenges to method of care forthose under his charge. The south was literally and figuratively cut off fromthe north, prohibiting families from sending money to fund care for theirmentally ill relations institutionalized at the Institute. “This caused a greatdeal of stress for everyone involved, including the Board of the PennsylvaniaHospital, who briefly considered discharging those southern patients for lackof payment,” said Peeples.  “Luckily forall involved, the Board decided to loan the Institute the money it was lackingto continue the care of those individuals and their families were to becontacted after the war to resume payment.”

Some of the gems visitors can see at the MentalHealth During the Civil Warexhibit 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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