SOME ACCOUNT OF THE ITS ORIGIN, ODjrcfu, anti present State. PUBLISHED BY ORDER OF THE BOARD OF MANAGERS. Wla^Wa: PRINTED BY THOMAS KITE & Co. 1832. Engrmrcd bv C,< Jdiild». MSIEWAVLc CGtChilds. f.naraver /TdJaddphia. -1828. Copy right Sawed SOME ACCOUNT OF THE ITS ORIGIN, Objects, anti present State. BY W. G. MALIN, LIBRARIAN OF THE INSTITUTION. PRINTED BY THOMAS KITE & Co. 1832. Published by Order of the Board of Managers. SOME ACCOUNT OF THE PENNSYLVANIA HOSPITAL. The Pennsylvania Hospital was founded by a number of the benevolent citizens of Philadelphia, incorporated in the year 1751, by an act of the provincial legislature, as " The Contributors to the Pennsylvania Hospital." Every contributor of ten pounds, (twenty-six dollars sixty-seven cents) or upwards, being a member of the corporation, with a vote in its elections, and eligible to be appointed to the management of its concerns. The design of the Hospital is general, its charter provid- ing for the reception of insane persons, and those afflicted with all other maladies not infectious. A Lying-in depart- ment, authorized by a subsequent act of Assembly, for the accommodation of poor married women, of respectable cha- racter, has been founded on a donation from the First Troop of Philadelphia City Cavalry, of money received by them for 4 military services in the war of the revolution. The number of women annually received into this department, is now upwards of seventy. The charter of this institution provides, that no part of its income shall be appropriated to any other purpose, than to the support of the sick and diseased poor, and providing the necessary buildings for their accomodation; and that those whose diseases render them proper objects of the cha- rity, shall be received from any part of Pennsylvania, with- out partiality or prefference. The contributors meet annually on the first Monday in the month of May, to elect from their body, twelve Managers and a Treasurer, to serve during the ensuing year. The law regulating their duty and trust, provides, that they shall re- ceive no emolument whatever for the performance of their official duties. The appointment of the physicians and other officers and servants of the institution; the regulation of its internal economy; and the general charge of its income, are intrusted to the Board of Managers; of whose number the presence of at least eight, and the concurrence of seven, are necessary for the transaction of business. The stated meet- ings of this board, are held on the last Monday of each month. The Managers elect annually three physicians to have charge of the medical department; three surgeons to the charge of the surgical department; and two physicians for the lying-in department; all of whom must be Doctors in Medicine, and members of this corporation. Two young gentlemen, graduates of medicine, reside in the Hospital, and take charge, alternately, of the surgical, and the medical and obstetrical departments, under the direc- 5 tion of the visiting physicians and surgeons. One of the resi- dents is elected annually to serve two years. An apothecary is employed, to prepare and dispense the medicines prescribed by the physicians. The physicians and surgeons of this Hospital have uniform- ly rendered their important aid gratuitously.* The students of medicine who attend the practice of the Hospital physi- cians, pay a fee of ten dollars each for the privilege: these fees, which in European hospitals are a perquisite of their medical staff, the professional gentlemen, attached to the Pennsylvania Hospital, have generously devoted to the foun- dation and endowment of a Medical Library, which now con- sists of about six thousand volumes, comprising a large pro- portion of the most valuable ancient and modern works on the science of medicine ; with many rare treatises on Botany, and other branches of natural history. Students have the privilege of using this splendid collection, while attending the Hospital practice; and a right to its use during life is granted for the sum of twenty-five dollars. The six physicians and surgeons having charge of the medical and surgical departments, divide the year into three equal periods, one physician and one surgeon attending at the same time, and continuing in charge of their respective wards four months. The two physicians having charge of the lying-in department, continue in office six months each. * The gentlemen who had the honour of originating this practice by a voluntary offer of their services in the infancy of the institution, were Dr. Lloyd Zachary, and Drs. Thomas and Phineas Bond. To these were after- wards added Drs. Thomas Greeme, Thomas Cadwalader, Samuel Preston Moore, and John Redman, as physicians and surgeons for the first year. 6 In extraordinary cases, and before the performance of sur- gical operations, it is usual for the gentleman in attendance, to hold consultation with his colleagues. The Board of Managers appoints monthly, a committee of two of its members to admit and discharge patients, and to exercise a particular superintendence over the internal con- cerns of the institution. This committee, and the attending physicians, meet at the Hospital twice a week (on Wednes- day and Saturday) for the transaction of business. To faci- litate applications for admission, the names of the attending managers and physicians are regularly advertised in several of the daily papers. The usual mode of obtaining admission into the Hospital is, by first applying to one of the physicians in attendance; who, after examining the patient, gives a certificate of the nature of the disease, and the propriety of its admission into the Hospital: this is addressed to the attending managers, who settle the terms of admission, and grant their order directing the steward of the Hospital to receive the patient. This course is only departed from in two cases-that of seamen, who, (by a special agreement) after receiving a certificate from the physician, have only to obtain the order of the Collector of the Port;-and in cases of accident-it being a rule to receive, by day or night, every person who meets with an accident requiring surgical aid, without re- quiring any security of the parties who bring the patient to the Hospital;-provided the accident occurs in Pennsyl- vania, and the sufferer is brought immediately, or within twenty-four hours. After the accommodation of as many poor patients as the state of the funds will justify, the Managers have authority 7 to receive pay patients; any profit derived from this source being devoted to increase the fund for the maintenance of the poor. The rates usually charged are from three to six dollars per week, according to the circumstances of the patients. Pay patients are not admitted on a deposit of money, or on the responsibility of strangers; the only security accepted, is that of some respectable resident in Philadel- phia. At their own desire, patients may be attended, exclusively, by either of the Hospital physicians they may prefer, but in such cases it is expected that the affluent will pay the physician as though attended elsewhere. As this institution is intended to be a hospital for the cure of disease, not a permanent asylum for poverty and decrepi- tude, the Managers can admit none on the charity list, whose diseases are chronic and incurable, except those afflicted with insanity: and it is imperative upon them to discharge all patients, who, after a reasonable time of trial, may be deemed incurable. The number of the patients to be received on the charity of the institution is fixed from time to time by the Board of Managers; it is now nominally one hundred, but,as no serious cases of accidental injury are ever turned away from the Hospital-gate, the number of poor patients in the house is frequently one hundred and twenty, and for some time past has rarely been less than one hundred and ten. About one-third of the patients on the poor list are insane; it has been found necessary thus to limit their number, on account of the great length of time such patients have re- mained, to prevent their occupation of the house to the ex- clusion of the necessitous sick and wounded. A new arrangement has, however, been introduced, which, 8 already productive of much good, promises to render this in- teresting department of the institution of far greater public utility than heretofore. Experience has demonstrated, that mental maladies are almost insusceptible of cure, except in their earlier stages; every thing appears to depend on the prompt removal of the patient from scenes and persons associated with the mental hallucination, and an early subjection to a proper course of medical and moral treatment. It being, therefore, of great importance to open the door of admission as widely as possi- ble to recent cases, the Managers of the Hospital have agreed, that in future, except under particular circumstan- ces, insane persons shall be received on the charity, but for limited periods; sufficient security being taken that they shall be removed by their friends when the disease becomes fixed, and the restoration of reason is no longer to be expect- ed. This regulation has already afforded relief in a number of cases which must otherwise have been excluded from the means of cure. The square on which the Hospital stands, is bounded by Spruce and Pine, and Delaware Eighth and Ninth streets. It measures four and a quarter acres. With the exception of about one hundred and fifty feet on Pine street, furnished with an iron railing, which affords a view of the south front of the building, the whole lot is enclosed by a brick wall. About seven-eighths of this square were purchased by the Managers in 1754, for the sum of £500 Pennsylvania cur- rency. The remaining portion, consisting of a lot on Spruce street of three hundred and ninety-six feet in length, by sixty in depth, was presented to the Hospital in the year 1762, by Thomas and Richard, sons of William Penn. 9 The open square lying in parallel lines to the east, togeth- er with several lots to the south and west of the Hospital, containing in all about ten acres, have been purchased at various times, in order to secure an ample space, and free circulation of air around the buildings. The Hospital, surrounded, on the borders of the square, by majestic forest trees,* exhibits a south front of venerable aspect and considerable proportions, extending east and west, two hundred and eighty-one feet. It consists of a centre building, united by long wards, of three stories in height, to two wings extending north and south. The wings are sur- mounted by cupolas, and finished so as to present respectable fronts on Eighth and Ninth streets to the east and west. The foundation stone of this edifice was laid on the 28th of May, 1755. It bears the following inscription: "In the year of CHRIST MDCCLV GEORGE the Second happily Reigning (For he sought the happiness of his People) Philadelphia Flourishing (For its inhabitants were public-spirited) This Building, By the Bounty of the Government, And of many private persons, Was piously founded, For the Relief of the Sick and Miserable. May the God of Mercies Bless the Undertaking." * These are Buttonwood, or Occidental Plane trees, the largest growth of the North American forest; they were planted in the year 1756, by Hugh Roberts, one of the first managers of the institution. 10 Although able to complete but a portion of the designed building, its founders, with wise foresight, commenced upon a liberal scale, by adopting a symmetrical plan, which has been filled up at successive epochs, as admitted by the funds of the institution, and required by the exigencies of an increasing population. The eastern wing was completed and opened in the year 1756,* and the western wing in 1796. The walls of the centre building were carried up in 1797, but want of funds retarded the entire completion of its in- terior, until the year 1805. The centre building measures sixty-four feet in front, by sixty-one in depth, and with the balustrade surrounding its cupola, seventy-two feet in height. The long ward to the east of the centre, is eighty-one feet in length, by twenty-seven feet in breadth; and the east wing measures twenty-seven feet east and west, by one hundred and eleven north and south. The western ward measures eighty-one feet by thirty three, and the west wing twenty-eight feet by one hundred and eleven. The increased breadth in the buildings to the west of the centre, was adopted to allow of the construction of a double range of apartments for the insane : except, however, to a very accurate eye, this difference is scarcely percep- tible. The House is thus occupied : under the basement of its centre are cellars and a bake-house; the basement story contains the kitchen-a dining-room for the Steward's family * Prior to this time the Hospital was kept in a house, formerly the residence of Judge Kinsey, on the south side of Market street above Fifth street. This house with its grounds, including nearly one third of a square, was hired at a rent of forty pounds per year. 11 -and two sleeping rooms for female domestics. On (ho first or entrance story, is a handsome hall, with spacious stair- cases and passages to the different parts of the house. The apartments on this floor are four;-the Library, which is also the Steward's office, and in which the Managers meet to transact business-the Apothecary's shop-a parlour, and the Steward's chamber. The second story is occupied by the lying-in department, and chambers for (he resident phy- sicians, clerk, and apothecary. The third story contains a circular operating theatre, in which all the surgical opera- tions, of importance, are performed, in the presence of the medical class attending the practice of the Hospital. In this apartment three hundred persons may be seated: it is sur- mounted by a dome with a glass cupola, affording the best possible light to the operator. Adjoining this room are apartmen's for the reception of patients operated upon ; and on this floor, are also the apartments occupied by the sick and lame white females. To the east of the centre building, on the basement story, are, a long hall in which a majority of the insane patients take their meals; eleven sleeping rooms for this class of pa- tients, and their attendants; and some store rooms. The first and second stories are occupied as medical and surgical wards by the white men. About forty patients can be re- ceived in each ward. The garret over the long ward is at present unoccupied-those in the wing are used as sleeping rooms by some of the domestics. In the line of this wing, to the north, is a detached building of three stories, occupied by the syphilitic and coloured patients. To the west of the centre, the whole range is occupied, from the basement to the attic story, inclusive, by insane 12 persons and their attendants. It contains, for their accom- modation, fifty-six separate sleeping rooms, each about ten feet square; four larger apartments generally occupied by patients having separate attendants; the long garret, in which from twelve to fifteen of the most quiet male patients usually sleep; and the garrets of the wing which contain beds for fourteen female patients and attendants. In the first story of the wing are four day rooms, two on each side of the hall; those to the north are used by the male, and those to the south by the female patients: the men have also a day room over one of the out-houses, in which are kept the most noisy and careless of their number. In the rear of this wing on Ninth street, is a detached building, with separate sleeping rooms, each about ten feet by eight, for eighteen insane females. In addition to the buildings enumerated, there are, on the north part of the square, a wash house,-coal-shed-stabling and carriage-house-green-houses, and the buildingon Spruce street in which is exhibited the painting by Benjamin West, of Christ Healing the Sick in the Temple. The exhibition of this superb piece, a present from that distinguished artist, produces a revenue to the Hospital of about four hundred dollars per annum.* A fine statue of William Penn, of lead bronzed, (presented by his grandson, John Penn, Esq. of Stoke Pogeis, England) is placed upon a pedestal of white marble, in a conspicuous situation on the lawn before the south front of the Hospital. * The gross amount of the receipts from this source to April 28th 1832, is $20,034. 25, received from 78J37 visiters, and for thirty perpetual tickets at $10 each. 13 A chair, once the property of that great man, is preserved in the house. And a scion from the Elm tree, under which was held the celebrated treaty with the Indians in 1682,* has attained considerable size, in the square opposite the western front of the building. The green-houses, containing a handsome collection of exotic plants, together with the ornamental lawns in front and rear of the house, are under the care of a regular gardener. The attention paid to neatness, and even ornament, in the exterior and grounds, as well as in the interior of the house, gives to the whole an air of elegance, seldom equalled in establishments of this nature. This is justified, as well by donations to a considerable amount having been received for this purpose, as by the influence it is calculated to exert on the mind and health of the inmates of the institution. A carriage and pair of horses are kept for the use of the patients ; money for their purchase and support having been bequeathed by Dr. Samuel Cooper, formerly a resident phy- sician in the Hospital. Another horse is kept for the market- ing and other necessary uses of the establishment; and twelve cows for a supply of milk to the patients: these derive the principal part of their support from the adjacent lots, the property of the institution. The provisions furnished to the inmates of the Hospital are of the best quality; the common diet is plain but nutri- tious, and in necessary cases, delicacies and wines are freely * Vide an interesting and conclusive memoir on the locality of this treaty, contributed by Roberts Vaux, Esq. to the Historical Society of Pennsylvania- Memoirs of the Society, vol. 1. p. 81. 14 administered, on their prescription by the physicians. It being a recognized maxim, that, while nothing may be ad- ministered merely to pamper the appetite, nothing shall be spared which can contribute to the recovery of health. The total number of patients admitted into the hospital from its opening, Febuary 11th 1752, to the 28th of April 1832, Was TWENTY-NINE THOUSAND SIX HUNDRED AND SIXTEEN, of whom 15,293 were poor, and 14,323 pay patients. Of these, have been discharged, Cured 18400 Relieved ...... 3537 Removed by friends, or at their own request, or as incurable - - - - - 1962 Eloped, and discharged for misconduct - - 1016 Died 3188 Pregnant women delivered safely ... 650 Infants born in the house and taken out in health 614 29367 Remainingin the Hospital, April 28th 1832 249 29616 In addition to these a large number of out patients have been attended by the Hospital physicians, and supplied with medicines gratuitously. This attendance on out pa- tients had its origin in an early Rule of the Institution, that no person should be admitted, except those whose cases re- quired the particular conveniences of an hospital. Applica- tions were constantly made for relief, by persons excluded 15 from the house by this regulation ; and the Managers and Physicians, anxious to extend the benefits of the charity to as many as possible, agreed to furnish such with medicine and advice at their homes. No regular record of these cases was preserved before the year 1798, but that the number was very considerable may be gathered from the subjoined extract from a memorial of the Managers and Physicians of the Hospital, presented to the Legislature in the year 1792. The effect of this regulation upon the results of the admitted cases, is also worthy of remark. After stating the number of admissions, with their results, the memorialists continue: "But it should be observed that this enumeration doth not include the very great number of out patients, who have received medicine and advice, though their cases did not require admission into the Hospital- and " admissions being only allowed in acute and dan- gerous cases, will account for the melancholy proportion of the dead, to the cured and relieved, it being the natural and unavoidable consequence to be expected from the cases admitted." From the year 1797, to May 1817, when, in consequence of the establishment of Dispensaries, it was deemed unneces- sary to continue this branch of the institution, the number of out patients attended from the Hospital, was sixteen thou- sand and sixty-three-of whom 13,040 were restored to health. Great as has been the amount of human misery relieved ; of life preserved ; and health restored, through the direct agency of this institution ; an estimate of its public usefulness which should omit a consideration of the indirect benefits which it has conferred upon society, would still be far from 16 doing justice to its merits. To the period of its foundation no school of medicine existed in this country. The youth of .America, who would then qualify themselves for the practice of the healing art, had to seek instruction in the schools of Ger- many, of France, or of Britain. The Pennsylvania Hospital under the care of some of the first physicians of that day, soon attracted a number of students of medicine-Lectures, the first delivered in this country, were given by its physicians- and thus were laid the foundations of the distinguished medical school of Philadelphia. The wards of the Hospital have been the theatre of many important improvements in surgical practice. Gentlemen educated within its walls, have attained the highest rank in their profession-and several thousands of young physicians have gone out into all parts of the Union, carrying into their practice the valuable lessons and experience of this institution. The cases of insanity admitted into the Hospital from Feb- ruary 1751, to December 1830, and included in the aggre- galeofadmissions, 29, 616, were three thousand seven hundred and eighteen. Those admitted as Mania-a-potu, or Delirium tremens, during the last eight years, (prior to which such were admitted as cases of insanity) have amounted to three hundred and seven. Of both these classes of patients, the following tables, derived from a careful examination of the Hospital records, exhibit the numbers of each sex, together with the result of their treatment. 17 CASES OF INSANITY, ADMITTED FROM FEBRUARY 11 TH 1752, TO APRIL 28tH 1832. Total. Cured, Relieved. By friends with- out material benefit. Eloped, Died. Remain. Males 2509 905 488 499 188 359 66 Females 1209 384 292 264 42 171 60 3718 1289 780 763 230 530 126 It may be remarked that a large proportion of the deaths have been the consequence of old age, or diseases having no necessary connection with insanity. Many of the elope- ments occurred before the Hospital was surrounded by a wall. Cases of MANIA A POTU or Delirium Tremens, ADMITTED FORM THE YEAR 1822, TO APRIL 28th 1832. Total. Cured. Relieved. Removed by friends. Eloped. Died. Remain. Males 283 187 16 13 6 59 2 Females 24 18 1 1 - 3 1 307 205 17 14 6 62 3 The number of insane persons in the house, now averages about one hundred and twenty six. 18 The last thirty years have witnessed much improvement in the situation and treatment of the unfortunate subjects of insanity, throughout the civilized world; and the circum- stances of the inmates of this asylum, have certainly shared in the general amelioration. Their treatment was, however, always characterized by humanity. At no period has cru- elty towards them been tolerated. The attendant who is known to strike, or otherwise ill-treat a patient, is at once discharged. The medical treatment of this class of patients, varies of course, according to the symptoms of the malady, and its connection with other derangements of the system. > The confined situation of the buildings, together with their common appropriation to the purposes of a general hospital, unfortunately prevents the adoption of an efficient system of classification, and employment; essential constituents of what is commonly termed moral treatment. Employment is believ- ed to be beneficial in all cases, except of acute delirium;- where cure is possible, it conduces to it; and where this is not even hoped, labour ensures sound repose and a general tranquillity, which is rare in the unemployed. This being the belief, founded on experience, of those who administer the affairs of this institution, it is acted upon as far as circumstan- ces will permit. The greater part of the females are employed in knitting, sewing, spinning, and similar avocations. It has been found more difficult to furnish employment for the men, a number of them are however employed ; some in weaving tape or fringe, preparing carpet yarn, and making mattrass- es ; and others in supplying the house with fuel, keeping in order the yards, areas, &c.; in short, every opportunity is taken to promote employment, and every disposition on the 19 part of a patient to occupy himself innocently, is encourag- ed ; to this end chess, drafts, and some other amusements have been introduced, and newspapers and books are furnish- ed to those who can enjoy them. Two musical instruments, a Grand-harmonicon and a Piano-forte, have contributed many pleasant hours to the female patients; and the sooth- ing melody of the flute is not unfrequently heard in the apart- ments of the men. The diet afforded in this asylum, is more generous than that of many similar institutions, judging from the bills of fare, and other statements occasionally published. The fol- lowing is the customary diet of every day. Breakfast. Bread and butter, with, occasionally, fish and potatoes. Chocolate or Coffee at pleasure, both being provided. Dinner. Beef, veal, mutton, or pork (usually of two kinds) boiled and roasted, with a variety of vegetables. Puddings, pies, or the fruits of the season, as apples, melons, peaches, &c. &c. for dessert. Bread at pleasure. Supper. Bread with butter, and tea. N. B. Milk, sugar, and molasses, are all freely given with the articles with which they are commonly used in private families. The bread is of fine wheat flour. Spirituous 20 liquors, wines and porter, are only administered when pre- scribed by the medical attendant, who has power to order these, as well as any other article of diet at his discretion. No difference is made in the diet or treatment of patients merely on account of their wealth. An attempt is made to class them in some measure according to the society in which they have been accustomed to move, when the mind is sus- ceptible of such distinctions, but no difference exists between the treatment of those who pay for their board, and those who are supported on the charity of the institution ; nor is it thought necessary to inform their attendants to which class they belong. Out of one hundred and twenty patients, more than ninety usually eat at table, in companies, their attendants sitting at the same tables, helping them to their food, and partaking of the same fare. The diet of these patients is not portioned, each is allowed to satisfy his appetite. Those who do not eat at table, are the very dirty, the violent, and those placed by the physician upon a prescribed diet. The officers and servants residing in this establishment, and receiving its pay, are- Steward and Matron, Assistant to the Matron, Clerk and Librarian, Apothecary, and Gatekeeper. Attendant on West's picture, Gardener, Baker, Watch- man, Ostler, Cow-keeper, Washer-women, two, Cooks, two, Housemaids, three, Nurses in the women's sick wards, four, Nurses in the men's sick wards, four males and six females, Female attendants on the insane, eight, Male attendants on the insane, four. Seventeen men and twenty eight women -Total 45. 21 The aggregate expenditure of the establishment, including, however, a considerable outlay on behalf of pay patients (for clothing, &c.) which is repaid by their friends, amounts to about thirty thousand dollars per annum. A considerable sum of money is received for the board of pay patients, but the only fixed revenue of the institution is the interest of the capital stock loaned to various individuals on bonds and mortgages, and invested in ground rents. This amounts to about twelve thousand dollars per annum. By some it may be supposed that the Pennsylvania Hospi- tal is sufficiently wealthy; but these should reflect, that the buildings would yet accommodate many poor patients, and that this is their primary destination. The Managers of the institution have also long had in view, the erection of a sepa- rate asylum for the insane, which is, on many accounts, a very desirable measure; the repose of the sick being liable to much disturbance from the noise of the insane ; while the narrow space in which so many of the latter are confined, prevents the adoption of various means, which would probably con- duce to the recovery of the patients. While this important object remains unaccomplished, it is hoped that the wealthy and beneficent will not, in the dis- tribution of their charity, or the final disposition of their estates, pass by the Pennsylvania Hospital; or, considering it as already independent, give it but a testimonial of their respect. The want of an asylum for the insane, founded upon a liberal scale, with the advantage of the increased light which modern science has shed on the history of the human intellect, is more urgent than any one who has not deeply investigated the subject can imagine. And those who shall lay its foundation under the benign auspices of the charter of 22 this noble charity, will rank deservedly high, not merely among the contributors to the Pennsylvania Hospital, but on the roll of distinguished benefactors to their countrymen and species. Although this institution has received considerable aid, towards the erection of its buildings, from the legislature of the state of Pennsylvania, its principal dependence for sup- port has ever been upon the generous benevolence of private citizens. It is necessary that Legacies should be given in the corpo- rate name, viz. to " The Contributors to the Pennsyl- vania Hospital." Contributions and donations are received by Samuel N. Lewis, Treasurer, No. 135 South Front street. PRESENT OFFICERS OF THE INSTITUTION. MANAGERS. Thomas Stewardson, President. Roberts Vaux, Secretary. Thomas Morris, Charles Roberts, William W. Fisher, Charles Watson, John Paul, Joseph Price, Alexander W. Johnston, Mordecai Lewis, John J. Smith, Bartholomew Wistar, Treasurer-Samuel N. Lewis. Attending Physicians. John C. Otto, M. D. John K Mitchell, M. D. Benjamin H. Coates, M. D. Attending Surgeons. Thomas T. Hewson, M. D. Jolin Rhea Barton, M. D. Thomas Harris, M. D. Physicians to the Lying-in Department. Thomas C. James, M. D. and Charles Lukens, M. D. Steward and Matron-Allen and Margaret Clapp. Resident Physicians. George W. Norris, M. D. Mifflin Wistar, M. D. Apothecary. John Conrad. Clerk and Librarian. William Gunn Malin. APPENDIX. CONTAINING: I. The names of the gentlemen who have served the institu- tion as Managers, in the order of their appointment; to- gether with the dates of their respective elections, and resignations or death, and the time of their continuance in office. IL Treasurers. III. Physicians. IV. A statement of the cases of 29,616 patients, admitted into the Hospital from February 11th, 1752, to April 28th 1832. V. A table exhibiting the number of insane patients of each sex, admitted in every year from the commencement of the institution ; and the result of their treatment. VI. A similar table of the cases of Mania a potu, or Delirium tremens, from the year 1822. VII. A tabular view of the Lying-in department. VIII. A table showing the whole number of pay and of poor patients, admitted into the Hospital, and the average number of patients resident in it, during each year from its commencement. IX. The native countries of 7701 patients, admitted into the Hospital during the last eight years. 27 MANAGERS OF THE PENNSYLVANIA HOSPITAL. The following is a list of those who have served as Managers from the commencement of the institution to the present time ; with the date of their respective elections, and the length of time they continued in office. NAMES. Elected. Resign- Served the ed. Institution. Joshua Crosby 1751 1755 4 years. Benjamin Franklin - 1757 6 years. Thomas Bond - 1752 1 year. Samuel Hazard - 1754 3 years. Richard Peters - 1752 1 year. Israel Pemberton, Jr. - 1779 28 years. Samuel Rhoads - 1781 30 years. Hugh Roberts - 1756 5 years. Joseph Morris - 1757 6 years. John Smith -- 1756 6 years. _- - 1761 1762 Evan Morgan 1751 1753 1752 1763 ^11 years. Charles Norris 1751 1752 1 year. Isaac Jones 1752 1756 1760 1762 >15 years and 5 mo's. 1764 1773 ) (died.) John Reynell 1752 1780 28 years. William Griftitts - 1753 1 year and 5 months. Thomas Lawrence, Jr. - 1753 1 year. Joseph Fox 1753 1756 2 years and 7 months. William Grant 1754 1756 2 years. Thomas Crosby 1755 1757 1 year and 11 months. 28 NAMES. Elected. Resign- ed. Served the Institution. Daniel Roberdeau 1756 1766 1758 1776 12 years. Charles Jones 1756 1761 5 years. Isaac Greenleaf - 1771 15 years. Joseph Richardson, Mer't - 1770 14 years and 6 mo. (d.)* Jacob Duchee - 1758 1 year and 9 months. Plunket Fleeson 1757 1759 2 years. Anthony Benezet - 1758 1 year. John Sayre - - 9 months. Stephen Shewell 1758 1760 2 years. Thomas Gordon - 1766 8 years. Samuel Mifflin - 1760 2 years. James Pemberton - 1780 22 years. Jacob Lewis 1759 1774 15 years. John Mease 1760 1768 7 years and 10 mo. (d.) Henry Harrison 1762 1766 3 years and 9 mo. (d.) Thomas Wharton - 1769 7 years. John Gibson 1763 1767 1764 1770 3 years and 7 mo. Joseph Redman 1766 1767 1 year and 1 month. John Nixon 1768 1772 4 years. Joseph Morris 1769 1781 12 years. flsaac Cox 1770 1776 5 years and 8 mo. (d.) William Logan - 1775 4 years and 6 months. Thomas Mifflin 1771 1773 1 year and 11 months. Thomas Wharton 1772 1779 7 years. Edward Penington 1773 - 6 years. Robert Strettell Jones - 1781 8 years. George Roberts 1774 1776 2 years and 3 months. Thomas Fisher 1775 - 1 year and 3 months. Joseph Swift 1776 1786 9 years and 9 months. William West - 1778 2 years. Jacob Shoemaker - 1781 5 years and 3 months. William Morrell - 1782 6 years and 8 months. * Died. + It appears from the minutes of the Board, that Isaac Cox was lost at sea, on his return from the island of New Providence, in the winter of 1775-6. 29 NAMES. Elected. Resign- Served the ed. Institution. Samuel Powell 1778 1780 2 years. Joshua Howell 1779 1782 3 years. Samuel Pleasants - 1781 2 years. Peter Reeve - 1786 7 years. George Mifflin 1780 1785 5 years and 2 mo. (d.) Thomas Franklin - 1783 3 years. Tench Coxe - 1781 1 year. Reynold Keen 1781 1790 9 years and 7 months. Jonathan Shoemaker - - 9 years and 1 month. Owen Jones, Jr. - 1795 13 years and 9 months. Isaac Wharton - 1784 3 years. Josiah Hewes - 1812 30 years and 5 months. John Morton - 1785 3 years and 8 months. Adam Hubley 1782 1784 2 years and 4 months. Nathaniel Falconer 1784 1783 1790 6 years and 6 mo. Andrew Doz 1783 1788 5 years. Thomas Moore - - 5 years. Samuel Howell 1784 1789 4 years and 10 months. William Hall 1785 1787 1 year and 11 months. Samuel Coates - 1825 40 years and 4 months. Joseph Paschall 1786 1795 8 years and 10 mo. (d.) Thomas Penrose - 1798 12 years. Richard Rundle 1787 1789 2 years. Samuel Clark 1788 1802 13 years and 6 mo. (d.) Pattison Hartshorne - 1823 35 years. Elliston Perot 1789 1806 17 years and 2 months. Bartholomew Wistar - 1796 7 years. Cornelius Barnes 1790 1793 3 years and 5 mo. (d.) Lawrence Seckel - 1820 29 years and 9 months. William M'Murtrie 1791 1794 3 years. Thomas Morris 1793 1809 15 years and 11 mo. (d.) Samuel M. Fox 1794 1797 3 years. Robert Wain 1795 1800 5 years and 2 months. James Smith, Jr. - 1805 10 years. Israel Pleasants 1796 1800 4 years. John Dorsey 1797 1804 7 years. Robert Smith, Merchant 1798 1805 7 years. 30 NAMES. Elected. Resign- ed. Served the Institution. Zaccheus Collins 1800 1822 22 years. Paschall Hollingsworth - 1812 12 years. Richard Wistar 1803 1806 3 years and 4 months. Joseph Lownes 1804 1820 16 years. Peter Brown 1805 1811 6 years and 7 mo. (d.) Edward Penington - 1820 15 years. Zachariah Poulson 1806 1808 1 year and 10 months. William Poyntell --' ■ 1811 5 years and 2 mo. (d.) Thomas Stewardson 1808 Thomas P. Cope 1809 1828 19 years. Reeve Lewis 1811 1814 3 years and 3 months. Joseph S. Morris - 1817 5 years and 3 mo. (d.) Samuel W. Fisher 1812 - 4 years and 9 mo. (d.) Joseph Watson - 1824 12 years and 5 months. Mordecai Lewis 1814 1818 3 years and 8 months. - 1828 Israel Cope 1817 1828 11 years. Thomas Morris - Henry Hollingsworth 1818 1823 5 years and 6 months. Alexander Elmslie 1820 1827 7 years. Matthew L. Bevan - 1828 7 years and 10 months. Joseph Johnson - 7 years and 10 months. William L. Hodge 1822 1824 2 years. Roberts Vaux 1823 Charles Roberts - William W. Fisher 1824 Charles Watson - John Paul 1825 Joseph R. Jenks 1827 1828 10 months. Joseph Price 1828 Alexander W. Johnston John J. Smith - Bartholomew Wistar - 31 TREASURERS. NAMES. Elected. Resign- ed. Served the Institution. John Reynell 1751 1752 1 year. Charles Norris 1752 1756 4 years. Hugh Roberts 1756 1768 12 years. Samuel P. Moore 1768 1769 1 year. Thomas Wharton 1769 1772 3 years. Joseph King 1772 1773 13 months. Joseph Hilborn 1773 1780 7 years. Mordecai Lewis 1780 1799 18 years and 8 mo. (d.)* Joseph S. Lewis 1799 1826 27 years. Samuel N. Lewis 1826 PHYSICIANS. The following are the names of the gentlemen who have served the Institution as Physicians and Surgeons, in the order of their appointment; together with the date of resignation or death, and their respective periods of service. NAMES. Elected. Resign- ed. Served the Institution. Lloyd Zachary 1751 1753 1 year and 5 months. Thomas Bond - 1784 32 years and 6 months. Phineas Bond - 1773 21 years and 8 mo. (d.)* Thomas Graeme - 1752 6 months. Thomas Cadwalader 1777 25 years and 6 months. Samuel Preston Moore - 1759 7 years and 6 months. John Redman - 1780 28 years and 6 months. William Shippen 1753 1778 25 years and 2 months. Cadwalader Evans 1759 1773 14 years and 1 month.(d.) John Morgan 1773 1778 1777 1783 8 years and 11 mo. * Died. 32 NAMES. Elected. Resign- Served the ed. Institution. Charles Moore Adam Kuhn 1773 1774 1782 1774 1781 1798 10 months. 22 years and 6 mo. Thomas Parke James Hutchinson 1777 1779 1823 1778 1793 45 years and 9 months. 15 years, (died.) William Shippen, Jr. 1778 1791 1779 1802 ^11 years and 11 mo. John Jones 1780 1791 11 years and 1 mo. (d.) Benjamin Kush 1783 1813 29 years and 10 mo. (d) John Foulke 1784 1794 10 years. Caspar Wistar 1793 1810 16 years and 5 months. Philip Syng Physick 1794 1816 22 years and 1 month. Benjamin Smith Barton 1798 1815 17 years and 10 months. John Redman Coxe 1802 1807 4 years and 9 months. Thomas C. James 1807 John Syng Dorsey 1810 1818 8 years and 6 mo. (d.) Joseph Hartshorne 1821 11 years and 2 months. John C. Otto 1813 Samuel Colhoun 1816 1821 5 years. Joseph Parrish 1829 12 years and 8 months. Thomas T. Hewson 1818 John Moore 1820 1829 9 years. William Price 1821 1823 1 year and 10 months. John Wilson Moore - 1827 5 years and 3 months. Samuel Emlen 1823 1828 5 years, (died.) John Rhea Barton - John K. Mitchell 1827 Benjamin H. Coates 1828 Thomas Harris 1829 Charles Lukens - 33 A STATEMENT Of the Cases of 29,616 Patients, admitted into the Penn- sylvania Hospital from the 1 \.th of February 1752, to April 28th 1832. The following, although a transcript of the recorded causes of admission, cannot be regarded as an adequate statement of the diseases treated in the Hospital. The mercantile method in which the register of cases has been kept-assigning but one disease, or cause of admission, for each patient,- in order to produce an annual balance sheet, on which the lists of diseases, and of per- sons, should be numerically equal-is evidently insufficient to a fair exhibit of the practice of the house; inasmuch as one patient may labour under a complication of disease; and, in another, the physician has to cope with several successive maladies ; each, perhaps, more formidable than the recorded cause of admission. The physician too, who visits persons desirous of admission, cannot always ascertain, in one short visit, the precise nature of a case then first submitted to his eye; even supposing no obstacles interposed by the ignorance, misapprehension, or wilful concealments of his patient. The absence, therefore, of any disease from the following list, is no evidence that it has not occurred in the practice of the Hospital. Abscess 131 Amenorrhoea 93 Anchylosis 7 Aneurism 17 Angina 48 Angina pectoris 5 Aphonia 1 Apoplexia 10 Asthma 78 Asthenia 67 Burns and Scalds 183 Cancer 81 E 34 Caries 163 Catarrhus 250 Cephalalgia 62 Cholera 18 Colica 66 Chorea. 10 Contusions and wounds 2293 Convulsions 66 Cramp 17 Deafness 18 Diabetes 5 Diarrhoea 315' Diseased eyes 720 ears 12 joints 375 spine 39 glands 6 Dislocations 133 Dropsy 142 Dysentery 524 Dyspepsia 67 Dysury 18 Epilepsy 110 Eruptions 169 Erysipelas 36 Exostosis 6 Fever 1930 Bilious 27 Intermittent 1158 Remittent 363 Yellow 10 Fistula 168 Fluor Al bus 6 Frosted 184 Fractures 1329 Gangrene 33 Gastritis 11 Gunshot wounds 70 Hare lip 7 Haemorrhage 19 Haemoptysis & Haemoptoe 89 Haemorrhoids 64 Hepatitis 98 Hernia 114 Hernia humoralis 14 Hydrocele 50 Hydrothorax 14 Hydrophobia 1 Hypochondriasis 45 Hysteria 45 Icterus 30 Imperforate Anus 2 Inflammations 383 Insanity 3718 Mania a potu or Delirium tremens 307 Keloide 2 Leprosy 15 Measles 2 Morbus vesicae 39 Morbus uteri 14 Morbus testis 52 Nephritis 12 Nervous affections 26 Palsy 240 Paronychia 33 Pectoral and Pulmonary affections 323 Pneumonia 123 Peripneumonia 12 Pleurisy 264 Phthisis pulmonalis 352 Poisoned 16 Polypus 13 Prolapsus ani 8 Prolapsus lingua 1 35 Varicose veins 19 Vertigo , 40 Visceral obstructions 149 White swellings 37 Wounded Soldiers and Sai- lors 38 Wounded Hessians 26 Sick continental soldiers 104 Sick wives of do. 7 Children of do. 4 28201 Pregnant women 747 Infants born in the Hos- pital 668 29616 Prolapsus uteri 17 Ptyalism 4 Prurigo 1 Rheumatism 2200 Scrofula 97 Scurvy 213 Strictures 100 Sprains 113 Strangury 16 Surfeit 8 Syncope 5 Syphilis 3204 Small pox 44 Splenitis 8 Tetanus 15 Tinea Capitis 19 Tumours and wens 347 Ulcers 2599 Urinary calculi 69 36 INSANITY. The following table exhibits the number of insane patients of each sex, admitted into the Hospital from February 11th, 1752, to April 28th, 1832, together with the result of their treatment. Removed Admitted. Cured. Relieved. by friends. Eloped. Died. CO CO CO CO From Feb. 11, 1752 To April Males. Female Males. Female Males. Femaie Males. Female Males. [ Female Males. Female 24, 1753 6 6 1 1 • 1 2 4 2 1754 4 2 • 1 1 1 1 • 1755 5 4 3 • 1 3 • • • 1756 4 2 3 1 1 2 1 • 1757 3 3 1 1 • 1 b. 1758 13 6 2 2 2 1 2 1 3 1 1759 14 4 3 3 4 2 3 1760 14 11 2 2 2 3 2 1 3 1 1 1761 14 9 6 3 2 4 4 3 1 2 1762 20 12 7 3 3 2 1 1 3 3 1 1763 20 11 5 1 5 5 3 5 1 6 1 1764 37 12 9 3 8 3 2 5 3 1765 23 11 13 5 7 4 3 3 1 1 1766 16 7 9 3 2 2 2 2 5 1767 18 6 8 4 5 3 4 3 1 1768 24 10 7 1 4 3 5 - 3 2 3 1 1769 21 3 4 4 3 1 3 2 5 6 2 1770 33 14 12 5 2 1 7 1 3 4 1 1771 17 14 10 4 1 1 1 5 3 4 1 1772 22 14 10 5 4 1 3 2 1 2 8 4 1773 27 18 7 6 9 5 2 3 4 2 2 5 1774 38 14 9 2 8 6 6 1 2 2 3 1775 22 7 16 6 4 3 3 1 3 1 10 4 1776 21 7 7 5 3 1 4 2 2 12 1 1777 24 12 9 3 4 3 3 7 6 1778 7 6 2 2 5 1 1 2 2 2 4 1779 8 4 4 • 5 1 1 • • ■i 1 4 37 ® X ® Cb ® ® GC JJ ® ® Ct CC ® '1 *4 -J M M M -1 M hk-©©©©©©©©©©©©©©©©©©©©®®®®®®®®®® KiHOCCCI>*l»Cil|kWN*-C©(»MaCB^WKi-'O©®'Jaa<4i>K«^O CiCC^MCJiOiWrfiAOiWUWMOJUWWWWMM^MHKiMiOMMHHN Cl to CO 00 62 J- X a M to >fr. S> <2 >U <3 X M O a x Q OO Q © © © c »obo»-••-•^0'-•>-*►-•-*!-* ►-■ Cli c:® to © to 21 Cn Q H U to © ^ © M © © to to C3 ©>U C © C Males. Females. Admitted. h-* |-4|-i pu OP CD Ol M OP CO CO CO CO 05 © © 21 to G >© >© C Ol b-'t-ito©^<tMtoiPba. H b4 to CO to H* CO b-' Mi. tO 1-1 CO Cjl Males. Females. Cured. i-' 00 CO -J >-'i-JCC^"<to^Tt-'©<2'XOtP.©ODDto®H' i. D A to 4^ to to Males. Reli 4^ C> to <2i 21 -) -J to 'C © 21 to C . © X -» to to 21 © to to « U © 4i . 1-• 4- 65 . 62 Females. sved. © to ©■ 21 . Mto^HCDOitotoHrfi, ® to 2' to to © © O X H to © to 2i Ci to - . b-» . i-4 b-* 62 i-' . h oj i- MW. . t-462<XCn63C062>-' Males. Females. Removed . by friends. 1 63 b-> 62 . W to to H . t-> l-i . 62'-4 62CO63CnrfiCOrfiCnCOCnCniJiCOCni4ii^6062l-4 Males. lol3 . . . co ,..b4W..b4,,62<C063.62b4 Females •pac a^x^oaMtog^A^coo^^Hc-itctoCitoG^i-Hitoi-ici. © h to 21 rf4 rf4 . b-'C062C062C0C0q01P»6PCn>-'l-J. •-1 t-' t-1 H to b-1 t-* 1-■ . . H4 Males. Females. Died. 38 Admitted. Cured. Rdi ved. Removed by friends. Eloped. Died. Males. । Females. Males. Females. Males. ) Females. Males. Females. | Ma'es. Females. Males. Females. 1813 68 29 34 11 13 5 9 6 3 • 12 * 1814 45 15 16 7 6 1 18 6 2 1 6 1 1815 40 33 13 12 5 3 10 7 1 1 10 • 1816 60 29 11 6 11 7 16 10 5 • 7 4 1817 69 31 23 7 6 4 25 15 5 1 11 • 1818 51 23 19 6 6 6 23 11 3 8 1 1819 59 23 19 4 9 6 20 6 2 5 6 1820 45 19 16 4 9 2 5 11 2 8 3 1821 51 14 16 4 17 5 18 5 1 2 1 1822 45 21 22 5 13 7 11 4 4 2 2 2 1823 38 21 18 9 6 2 6 5 2 8 3 1824 38 21 11 4 6 5 13 5 1 2 6 2 1825 26 13 7 3 2 3 9 5 4 3 1 1826 37 20 6 3 1 • 16 10 2 2 7 1827 46 24 19 6 9 2 15 6 5 3 2 1828 44 29 19 10 7 5 8 9 1 2 2 1829 64 33 15 11 25 9 22 8 1 5 2 1830 47 43 12 12 13 10 15 10 3 2 1 1831 62 35 19 9 8 14 11 14 • 9 6 1832 53 44 28 18 5 10 14 8 1 8 2 2509 1209 905 384 488 292 499 264 188 42 359 171 3718 1289 780 763 230 1 530 Remaining in the house April 28th 1832, Males 66, Females 60, Total 126. 39 Duration of Confinement. The patients remaining in the house on the 28th of April, had been confined as follows : Males. Females. Total. 41A years • 1 1 30 to 35 years 3 3 6 25 to 30 " 3 1 4 20 to 25 " 7 3 10 15 to 20 " 5 5 10 10 to 15 " 6 7 13 5 to 10 " 9 10 19 3 to 5 " 8 6 14 2 to 3 " 2 3 5 1 to 2 « 7 5 12 Admitted within one year 16 16 32 66 60 126 Age of Insane Patients. Of 126 patients remaining in the Hospital, April 28th, 1832, were,-aged Males. Females. Total. From 15 to 20 years 1 2 3 20 to 25 " 2 8 10 25 to 30 " 13 9 22 30 to 35 " 11 3 14 35 to 40 " 8 7 15 40 to 45 " 4 6 10 45 to 50 " 6 11 17 50 to 60 " 13 8 21 60 to 70 " 7 5 12 70 to 80 " 1 1 2 66 60 126 40 In 394 consecutive admissions, the age of the parties was as follows : Males. Females. Total. Aged 15 and under 20 years 12 13 25 20 qq 25 a 37 22 59 25 QQ 30 QQ 44 22 66 30 QQ 35 a 52 25 77 35 QQ 40 a 22 22 44 40 qq 45 a 23 22 45 45 QQ 50 u 19 11 30 50 QQ 55 qq 8 8 16 55 a 60 a 9 5 14 60 << 65 Qi 6 4 10 65 a 70 QQ 1 2 3 70 75 QQ 2 1 3 75 QQ 80 QQ 1 1 2 236 _158_ 394 Social relations of persons attacked by Insanity. Of 284 males admitted into the Pennsylvania Hospital, there were- Unmarried - - 170 Married - - 97 Widowers - - 17 284 Of 202 females, there were- Unmarried - - 70 Married - - 97 Widows - - 35 202 41 MANIA A POTU or DELIRIUM TREMENS. Neither of these terms found its way into the Hospital reports prior to the year 1822. The cases of this disease admitted before that period are included among those of Insanity ; and although a few of these cases might be recognised under the designations " Drunken madness," and " Lunacy from intemperance," which occasionally appear on the records, yet the general application of the term Insanity to all cases of mental aberration would render it useless to attempt any separation of them from an earlier period. This disease has been of frequent occurrence in the surgical wards, consequent on accidental injury of the persons of hard drinkers, and death from this cause, has frequently followed acci- dents which would scarcely have jeopardized the life of a sober man. Of such cases, however, until lately, no record has been preserved. In the reports of Hospital practice, death has invariably been charged to the cause of admission. Cases of Mania a Potu or Delirium Tremens, admitted from the year 1822. I-* 00 co 00 co 1-1 00 co 00 to CD 00 to 00 hu 00 00 to Ci 00 to Ci 00 to In the year ending Ap. 26, 1823 co o 283 co co CD CO o to CD co o to Cl co Ci Males. Admi to co HU 1-4 H to Females. tted. to 187 to Ci to 00 CO CO 00 to .Ci to H-* to 00 to Males. n c o C3 00 to CO H-1 H-i <-4 u-t - Females. 2- C5 to pu HU *T1 to Males. w o Females. ieved. co H-« co k-1 to co to Males. Removed by friends. 1-4 p.j Females. Ci H-k HU HU to >-1 Males. g Fema'es. o s 00 Ci co CD CD to Males. a to « h-l Females. o Q- Remaining April 28th, 1832, 2 males and 1 female. 42 A statement of all the cases admitted into this department of the Hospital, from its establishment in 1803, to April 28th, 1832. LYING-IN DEPARTMENT. QDODODODODQOODODOOODODODGOODaOODODODCDOOGOODODODOOOCdiODODOD a c: c: (c ic (c tc re <c tc <o tc <c - h- c c o i c c o iC O O 'X M C' Ci st <X tc H C O ® C C3 4^ W t c H e c 30 - C! co 1 c: st o c: t c: w st st ,t w t Ci oo h s^ Q Cl X ® X X C -' W 'X W30 OO X st 'I st 00' Cl CiC> C> Ct W Cl U (C Women admitted. 0S9 K>UOaitWK)stW05WititNHl-iHH C Cl O O tc 'Cl '> lo t; ® (Cl (C c: st C C O st •'I Cl Ct Cl st Cl tc H H Safely delivered. vv cn ca st- . to co ® co . » t-i h i-i . h . . . . t-> i-« Taken out by friends. -4 ..H.H.H..H.HN Disorderly or impos- tors. co Eloped. co C3 to CD CO to • 1-1. . 10 Or H it . . . toco h* . . !-■ . . . . Died. 668 CO^C50rrf»'COtOCOCOit-COit'CniO>-'l-1 O O 'CO X to *■( M Ci tc K t O tc co t Cl Cl ® Cl Q Cl t Cl to M H 1-1 Infants born in Hospital. 614 1 48 I MtOOl'CiMUtCstWCSUttw^HHi-i OiO«OOt©»OiHK)®K>Ci5it©i-'HMitNCn»JO!OiCiMCTiOOHi-1 MClMststCOHHHi-il-iWt. to t-> to CO CO . l-1 . . to t-* . I- . . Discharged in health. Died. to I-* . tn to CO II ■ ■ • • • papJOOQJ 8JB pouod Slip OJ, Still born. 43 Remaining in the Hospital April 28th, 1832, Eight women and six infants. Of the above women six had twins-in four instances the women and both children were discharged in health, but in the other two cases both children died. C. M. was delivered April 10th 1819 of three children, of whom two were still born and the other survived but a short time-the same woman was again admitted in the early part of the year 1821, and became the mother of a single child, which, with herself, was discharged in health. On the 24th of March last E. F. was delivered of two girls and a boy, who left the Hospital, together with their mother, in good health, June 8th 1832. The following TABLE shows the number of Pay and Poor pa- tients, and the total number, admitted into the house in each year from the foundation of the Hospital to the present time; and also the average number of patients resident in the institution, during the same period. Pay pa- Poor pa- Total. Average popu- lation of the Admitted from Feb. 11th 1752, to the end of April 1753 tients. tient. Hospital. 24 40 64 9 1754 14 39 53 12 1755 13 60 73 17 1756 7 61 68 17 1757 13 68 81 17 1758 29 85 114 33 1759 25 102 127 34 1760 32 105 137 40 1761 40 113 153 45 1762 29 128 157 47 1763 46 194 240 73 1764 50 272 322 101 1765 45 261 306 111 1766 56 283 339 119 1767 38 307 345 120 44 Pay pa- tients. Poor pa- tients. Total. Average popu- la'ion of the Hospital. 1768 54 337 391 123 1769 32 353 3*5 110 1770 49 336 3E5 113 1771 44 338 3E2 118 1772 44 349 393 117 1773 46 315 361 105 1774 63 374 437 117 1775 60 361 421 105 1776 42 393 435 89 1777 109 268 377 67 1778 31 96 127 39 1779 16 107 123 36 1780 10 118 128 35 1781 18 103 121 35 1782 69 42 111 36 1783 83 23 106 37 1784 156 47 203 61 1785 133 35 168 51 1786 113 25 138 51 1787 108 30 138 54 1788 78 32 110 54 1789 49 28 77 47 1790 51 27 78 46 1791 73 32 105 52 1792 107 72 179 64 1793 87 63 150 63 1794 170 78 248 71 1795 107 67 174 72 1796 13 103 216 69 1797 114 89 203 75 1798 101 71 172 78 1799 60 66 126 74 1800 80 96 176 78 1801 106 70 17 85 1802 176 73 249 87 1803 217 87 304 114 1804 214 88 302 113 1805 231 89 320 103 45 Pay pa- tients. Poor pa- tients. Total. Average popu- lation of the Hospital. 1806 241 98 339 109 1807 338 115 453 129 1808 288 121 409 122 1809 419 141 560 158 1810 216 152 368 127 1811 281 171 452 138 1812 373 172 545 150 1813 376 145 521 161 1814 307 140 447 163 1815 235 159 394 147 1816 500 181 681 178 1817 483 201 684 200 1818 468 170 638 199 1819 474 243 717 214 1820 457 292 749 226 1821 414 286 700 208 1822 300 244 544 158 1823 346 342 688 170 1824 363 384 747 178 1825 353 391 744 177 1826 368 362 730 175 1827 416 383 809 183 1828 427 460 887 202 1829 492 658 1150 219 1830 455 675 1130 225 1831 506 616 1112 233 1832 552 587 1139 249 14323 15293 29616 The foregoing tables show the actual number of new cases ad- mitted in each year; none of the remaining patients from prece- ding years being brought forward, or more than once counted. 46 Proportion of Native Citizens and Foreigners. Of seven thousand seven hundred and one patients admitted into the Hospital during the last eight years, there were Natives of the United States - • • 4486 Ireland 2173'1 England and Wales 448 Scotland 83 ► - • • 2706 Isle of Man 1 Malta 1 . Canada 11 Nova Scotia and ) • 28 Newfoundland $ 17 ( West Indies 22 Germany 162 Sweden and Norway 103 Denmark 33 Lapland 6 Finland 2 Poland 1 Prussia 20 Holland 9 Switzerland - 10 France 68 ) Corsica 1 $ oy Italy 14 Spain 5 Portugal 5 Brazil - 3 ) South America 2 $ o Mexico 1 Africa 4 East Indies 2 Mauritius 2 China ... 2 At Sea 4 7701