UNCOVER HOW OUR HOSPITALS WERE STARTED FROM THE POORHOUSE

Hospital ,an institution that is built, staffed, and equipped for the diagnosis of disease: for the treatment, both medical and surgical, of the sick and the injured: and for their housing during this process.

Encyclopedia Britannica

Picture of Pennsylvania Hospital. Drawing by Samuel Hill http://lccn.loc.gov/2016652468

An almshouse, or more generally known as a poorhouse, could at one time be considered the first public health institution. It was known as a charitable establishment providing care and housing to a particular type of people in the community, such as the elderly ,or poor who could no longer provide for themselves due to no job or poor health. When placed at the poorhouse a person who may present with health concerns might have been whipped, or chained to the wall if they had no treatment for them. If the person was considered a lunatic, they were chained to the wall and shown no compassion. No medicines were provided or special treatments. The thought was as along as they were fed ( very little and not very often ) and had a roof over their heads they would prosper and feel better, Change was coming!

Pennsylvania Hospital was founded in 1751 in Philadelphia: at that time one of the fastest growing cities in the 13 colonies .In 1730 the population was at 11,500 people, and by 1750 just a few short years later it had risen to 15,000. In forming this hospital two men were solely responsible for moving this establishment forward, and seeing it brought to the people.

Dr. Thomas Bond, and a man well known for his inventions and philanthropy, and a close friend of the same nature, Benjamin Franklin were these men. Dr. Bond and Franklin were long-standing friends, and when Dr. Bond came up with the idea of a hospital in the country; one he saw in practice in Paris, he was asked if he had brought the idea to Franklin. Franklin was more than pleased to help “Care for the sick-poor and insane, who were wondering the streets of Philadelphia”. His first move was to organize a petition, and although not signed by him(reason unknown why), and bearing 33 names of prominent citizens: he gave it to the Pennsylvania Assembly on Jan 20,1751. The petition expressed that even though the assembly had made many compassionate and charitable arrangements to help provide care for the poor and needy, a provincial hospital was needed. At first the idea faltered, and the assembly thought only the inner city would benefit, but Franklin was so sure it would be passed by the populace that he said he would raise the sum of $2000lbs from the private citizens, and in doing so the assembly would have to match the sum raised by him. By his effort more than $20000lbs was raised and the hospital bill passed. In today’s money that is equivalent to $130,270.24 dollars. Imagine by todays standards and care, this amount would not even provide for one day’s care of a patient having Covid.

The work began soon after, and the motto and image of the hospital was selected “Take care of him and I will repay thee”, and the image of the Good Samaritan was chosen.

Besides being the very first hospital in America, Pennsylvania Hospital also created many firsts in medical techniques and programs. I will now take you through some of their innovations that we still use today. The first book for the medical library was donated by Dr. John Fothergill, and it was titled An Experimental History of the Materia Medica, written by William Lewis. With this first donation Americas first medical library was formed. The American Medical Association designates Pennsylvania Hospital’s medical library as the first as well as the largest and most important in the United States. Moving on, the first ever American medical resident is appointed, Jacob Ehrenzeller, and serves for five years. It is also home o the first surgical amphitheater. Remember that at the time the hospital was formed there was no electric lighting to use in operations so the amphitheater was on the top floor of the hospital, and a huge skylight was built overhead to provide ample light for surgeries. The hospital itself was the first teaching hospital; Dr. Bond would take new residents with him on rounds and educate while he attended the patients, and performed surgeries, making sure techniques and illnesses were explained fully. The hospital also creates the first “lying-in” or maternity department, for the first time a woman giving birth could, and needed to stay pre-and post-delivery in case of complications. This is considered the first recognized specialty of the hospital. The school of nursing for men is established, and start to train the male nurses in such areas as behavioral health, and Genito-Urinary tract therapies. A whole new era is ushered in.

Lunacy or mental illness at the time was a problem locked away and forgotten, or treated inhumanely. Six of the first people treated at the first hospital were psychiatric patients. The need was there to make this disorder a priority. Around 1783, Dr. Benjamin Rush arrived to the hospital, and changed the face of psychiatric treatment in America. He forced the hospital to cease its policy of chaining the severe cases of mental illness to wall as they did in the poorhouse, and stopped townspeople from coming to the hospital to watch the insane patients as a form of entertainment. The number of mentally ill patients became so large that a new building had to be constructed to allow more space in the main building for physically ill, and surgical patients. The Pennsylvania Hospital for the Insane was created, and with Dr. Rush and his new treatments and the handling of his patients it made him known as the “Father of American Psychiatry” The institute was not the first free standing psychiatric hospital in the U.S. but it was the first to associate with a general hospital. Dr. Rush and his contributions through the hospital are numerous. He created, Occupational therapy, the tranquilizing chair, and pioneered the therapeutic approach to addiction. Many practices are still used today.

Pennsylvania Hospital was the first establishment of it’s kind to cater to all people, rich and poor. The practices today were started there, and without it’s beginning I fear what would have happened in this time of pandemic. The hospital is 265 years old, and still treats patients today.

This closes out my first blog, and I am so excited to hear what you thought and have any ideas for future blogs. Please feel free to leave comments.

I will be posting new blogs each Wednesday, and hear is a sneak peep into the title for next week,

COMIC RELIEF by YELLOW BOY

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