PRIVATE HOSPITALS IN PENNSYLVANIA. PENNSYLVANIA HOSPITAL FOR THE INSANE. Location. The hospital is located in the Twenty-fourth ward of the city of Philadelphia, on Market street, about two miles west of the Schuykill river. The hospital property is an extensive and considerably elevated tract of one hundred and thirteen acres, enclosed by a stone wall and bounded by Market street, Haverford avenue, Fortythird and Forty-ninth streets. Several natural groves of trees, together with a large number and variety of shade trees, evergreens and shrubs planted many years ago, impart to the grounds, which are well laid out, all the picturesque seclusion of a rural site. Object.-The Pennsylvania Hospital is the oldest institution for the care and treatment of the insane in America, having been founded in 1751 by benevolent citizens of Philadelphia. It received its charter from the Colonial Assembly, May 11, 1751, “To encourage the establishment of an hospital for the relief of the sick poor of the province, and for the reception and care of lunaticks." The Provincial Assembly appropriated $70,666.67 toward the erection of the hospital building at Eighth and Pine streets, but from its foundation to the present time, with this exception, it has been solely supported by the generous contributions of private citizens, having received no appropriations from city, county or state. On February 11, 1751, the first insane patient was received; from that date to 1841, when the department for the insane in West Philadelphia was opened, 4,366 insane persons had been received, and of this number, 1,493 were restored, 913 discharged in various states on improvement and 1,851 were discharged unimproved or died. Department for Insane, West Philadelphia.-The cornerstone was laid June 22, 1836, and the hospital was opened January 1, 1811, under the title of "The Pennsylvania Hospital for the Insane." On July 7, 1856, the cornerstone of the second building was laid, known as "the department for males," which began to receive patients October 27, 1859. Since the opening of the hospital for the insane in 1841, to September 30, 1891, there have been 10,085 admissions, of whom 5,340 were males, 4,745 females. During the same period 9,651 patients have been discharged, of whom 4,274 were restored, 2,575 were improved, 1,383 were unimproved and 1,406, or 796 males, 610 females, died, leaving resident in the institution at the close of the year, 432, or 191 males, 241 females. Capacity. The hospital can accommodate 450 patients, or 225 of each sex. Land.-There are 113 acres of land connected with the institution. Average Cost.-The average weekly cost per patient is, for the male department, $9.67, for the female department, $9.93. A large amount of charitable work is done by this hospital in the admission and treatment of free patients, of whom the average number for the year, in the male department, was 19, who were maintained at a cost to the hospital of $9,573.72; in the female department 26, at a cost of $13,425.36, an aggregate of $22,999.08. Official Management.-The hospital is under the supervision of a board of twelve managers, annually elected by the contributors, who serve without compensation. They are as follows: Benjamin H. Shoemaker, president; James T. Shinn, secretary: Henry Haines, treasurer; Alexander Biddle, Joseph B. Townsend, Joseph C. Turnpenny, T. Wistar Brown, Charles Hartshorne, John B. Garret, John W. Biddle, John T. Lewis, Jr., John S. Jenks, Joseph E. Gillingham. The attending managers visit the general hospital on Pine street every fourth day (Wednesday) at 9 a. m., and the departments for the insane every seventh day (Saturday) at 2 p. m. Medical Officers.-Dr. John B. Chapin, physician-in-chief and superintendent, Market street above Thirty-fourth, West Philadelphia; assistant physician, male department, Dr. A. R. Moulton, succeeds Dr. Edward N. Brush, who resigned to accept the superintendency of the Sheppard Hospital, near Baltimore; Dr. W. H. Harrison; female department, Dr. H. B. Nunemaker, Dr. E. E. Josselyn: consulting gyneacologist, A. Victoria Scott-Haensler, M. D. Other Officers.-George Jones, steward; Hannah P. Saeger, matron. Attendants.-Number during the year, 127; of employes, 115. Proportion of attendants to average number of patients, 1 to 3 ; of all employes, 1 to 12; wages paid to attendants, $25,390.69; to employes, $21,822.09. Admissions.-There were 74 males, 96 females, or 170 patients ad. mitted during the year, a decrease of 4 compared with the previous year. Of these, 144 were first, 17 second, 5 third, 3 fourth and 1 fifth admission. Re-admissions. Of the 28 patients re-admitted, the period of absence between the discharge and re-admission was, less than 1 year, 1 to 2 years, 4; 2 to 3 years, 5; 3 to 4 years, 1; 4 years and 8. 10; over, Population. The whole number under treatment during the year was 258 males, 327 females, total 585; an increase of 20 on the preThe maximum number was 445, the minimum 404, the vious year. average 417. Discharges.-Number discharged, 64 males, 86 females, total 150; of which number 50 recovered, 43 were improved, 21 were unimproved, 1 was discharged as not insane and 35, or 18 males, 17 females, died, leaving resident at the close of the year, 432, or 191 males, 241 females. Employment. During the year 18 males, 119 females, or 137 patients, have been usefully employed, the former in ward work and in the laundry, carpenter shop and grounds, the latter in house work, sewing, knitting and fancy work. In addition 94 males have daily exercise in the gymnasium. Library.-Contains 3,008 volumes of a miscellaneous character, and is much used by the patients. Diversion and Instruction.-These comprise walking, driving, excursions, social gatherings, games, dancing, music, magic lantern exhibitions with descriptive lectures, literary readings, calisthenics, modeling in clay, painting, drawing, tennis, croquet, billards, pool, tenpins, etc. Lectures are given weekly in botany and natural history to large classes of patients, and physical culture, under a competent instructor, in the gymnasium, is made an important adjunct to medical treatment. Religious Services. On the last Sunday in Sepember, 1891, there were present 45 males, 95 females, total 140. Services are conducted every Sunday and Sabbath schools of patients continue to be held. and daily prayers are conducted in the wards. Restraint and Seclusion.-During the year 15 females have been restrained mechanically, as follows: In sleeves for a period equivalent to one person restrained for 858 days, for suicidal attempts, denudation, destructiveness and for medical and surgical reasons. On September 30, no males, 5 females, were restrained in sleeves at night for medical and surgical reasons. No one was in seclusion on the above date. Condition of Patients.-At the close of the year there were 432 patients remaining, all of whom were private, 386 were supported by self or friends, 46 were supported by the hospital, 2 were colored, 51 were foreigners, 16 epileptics, 19 paralytic, 6 homicidal and 19 suicidal: 120 were regularly taking medicine, 10 sick in bed, 19 fed with spoon, 2 with feeding cup and 98 were on extra diet. The farmhouse at Newton Square, Delaware county, which was adapted during last year by the managers to the care of convalescent cases, upon plans which received the approval of the committee, has |