Quakers & Mental Health

Patients at the Asylum suffered from a variety of mental health issues. Due to Isaac Bonsall's lack of medical knowledge and the subjective nature of his Day Book, it is often very difficult to form a complete picture of the ailments facing a patient from the information we have. However, there are enough hints to show the variety of types of mental illness the Asylum treated. Here are the stories of some patients who show the diversity of experiences at the Friends' Asylum.

Nathan Yarnall and Mary Roberts

Nathan Yarnall and Mary Roberts both belonged to the class of patients who caused the Asylum staff the most work—they were both incontinent. Bonsall wrote frequently about the labor involved in keeping them clean. In an effort to keep Nathan Yarnall from soiling himself, Bonsall tried to shame him by making him wear a petticoat.

Nathan Yarnall's New Clothes

"The Petticoat on Nathan [Yarnall] has had the desired effect both yesterday and today which saves us much trouble. He is ashamed of it and begs for his small Cloaths [sic.] or in the place of them Trowsers [sic.]. We tell him when he learns to behave himself well his Breeches shall be returned."
-Isaac Bonsall, December 2, 1818

"[Nathan's father, a visiting manager,] was affected with seeing his Son have a Petticoat on but did not censure us and expressed a wish as it was mortifying to Nathan it should not be continued longer than necessary.
-Isaac Bonsall, December 5, 1818

Although Bonsall's treatment prevented Nathan Yarnall from soiling himself for a little while, it did not prove to be a lasting solution. Nathan Yarnall spent about 3 years in the Asylum before dying in a fever epidemic. Bonsall was unable to cure Mary Roberts either. Bonsall did not try to shame Mary Roberts into better behavior, perhaps reasoning that the method had not worked on Nathan Yarnall Instead, Mary Roberts' husband asked to take her home with him, despite her continued illness. Bonsall expressed relief at this resolution.

Mary Roberts Leaves the Asylum

"It is a great relief to [caretaker] Ruth Peirce that Mary [Roberts] is taken away on account of her filthiness and the Wing is much more comfortable now to the other Patients."
-Isaac Bonsall, January 6, 1822

Benjamin Cox

Benjamin Cox was one of the Asylum's patients who suffered from alcohol addiction. While Benjamin Cox was in the Asylum, Bonsall tried to teach him to resist temptation and conquer his addiction. Excessive consumption of alcohol was frowned upon in Quaker circles, and people like Benjamin Cox would normally have been read out of Meeting. The Asylum gave Quakers a place where addiction was treated as an illness, not a sin.

Origin of Benjamin Cox's Insanity

"Benjamin [Cox] appears so rational that we are enclined [sic.] to think that the use of intoxicating liquor has been the main cause of his Insanity. With us he does not even partake of the family small Beer. The evening he was brought he wanted Porter, Wine, and etc. none of which were given although he said he could not live without it and that while he was at the Pennsylvania Hospital he was allowed a Bottle of Porter per Day."
-Isaac Bonsall, December 2, 1818

Benjamin Cox was one of the many patients at the Friends' Asylum who had spent time at the Pennsylvania Hospital before being sent to Friends' Asylum. Benjamin Cox told Bonsall that he was grateful for the Friends' Asylum's moral treatment, which he said worked better than the medical treatment he had received at the Pennsylvania Hospital. Benjamin Cox left the Asylum six months later, cured.

Ruth Sc.

Ruth Sc. came to the Asylum incoherent and delusional. Ruth Sc. and her sister refused to believe that she was insane, but her behavior as recorded by Bonsall in the Day Book is not rational. She frustrated Bonsall by banging loudly on her door at night, and harrassing her caretakers and fellow patients.

Ruth S.'s Behavior

"[Ruth Sc.] will not be persuaded to give up her own ideas about anything no matter how absurd they may appear to others neither will she desist from importuning us to grant things which we deem unsuitable as whatever occurs to her own mind as proper to be done She considers an indispensable duty."
-Isaac Bonsall, January 7, 1822

Ruth Sc.'s delusions often had to do with religion. Bonsall never stated exactly what was unorthodox about her beliefs, but he was mortified when he took her to Meeting for Worship, and she stood to speak.

Samuel Sykes

Samuel Sykes was one of the Asylum's violent patients, but despite the threat he posed to the community, Bonsall treated him kindly, and gave him considerable freedom. Even after Samuel announced that he was being told by the Devil he had to kill Anna Bonsall, he was not locked up.

Samuel Sykes and Anna Bonsall

"Samuel [Sykes] told my Wife that he should be obliged to Kill her. He is so strongly impressed with the belief that we have concluded She must take more care of herself when with him than She has done. He thinks her a fine woman and his expectation of destroying her does not proceed from any dislike of her."
-Isaac Bonsall, January 22, 1822

This was not the first time that Samuel had expressed his intention of killing Anna Bonsall, but it was the first time that the Bonsalls seemed to think it warranted a response. The response, however, was not directed at Samuel, but at Anna. She was the one who had to be careful, while Samuel continued to have considerable freedom. Later, Samuel Sykes proved that he could actually follow through on his violent thoughts when he set fire to the Asylum basement.

Samuel Sykes and the Fire

"After [the fire] was put out our suspicion fell on Samuel [Sykes] as the Instrument who upon being questioned about it acknowledged he had done it—that he was tempted to do it so strongly he could not resist it. He has had much liberty of late. We shall be careful in future that no opportunity shall [be] afforded him to do a similar act.
Isaac Bonsall, May 1, 1822

Again, the Bonsalls gave Samuel Sykes a remarkable amount of freedom for someone with his case history. Samuel Sykes left the Asylum after nine months there, improved, although not all the way cured.

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Abraham Sharp

Abraham Sharp was one of the Asylum's depressed patients.While in the Asylum, Abraham Sharp tried to commit suicide by hanging himself. Bonsall's response to Abraham's suicide attempt shows the darker side of moral treatment:

Abraham Sharp's Punishment

"He proposed that We should drown him [as punishment for trying to kill himself] in consequence of which and in the hope it would have a salutary effect I proposed to the Doctor and Men caretakers to have the Bathing Tub nearly filled with Cold Water and put him in under a pretence [sic.] of drowning him they did so and held him under for some time. He was glad however to get out and willing to live some longer."
-Isaac Bonsall, February 13, 1821

Bonsall evidently hoped that Abraham Sharp, seeing how painful it was to die, would want to live longer. Bonsall's efforts reveal that although moral treatment was supposed to be kinder than traditional treatment of the insane, it still used fear as a method of treatment to some degree. Abraham Sharp did not try to kill himself again, but he also did not recover. He stayed in the Asylum for about 8 months, and was discharged, still "insane," into the care of his friends.

Anne Verree

Friends' Asylum admitted Annie or Anne Verree in fourth month 1821. She appears to be the first person of color admitted to the Asylum. She was a patient at Pennsylvania Hospital for 14 years before being transferred to Friends' Asylum. This might have been because she was a Quaker, a member of the Burlington, New Jersey Monthly Meeting. Isaac Bonsall, the superintendent of the Asylum at the time, also wrote that Verree "was brought up by my wife's grandfather and grandmother" (Fourth Month, 21st, 1820). This indicates that Verree's family also could have wanted her to be under their care and closer to family.

Anne Verree had an unusual stay once she was in the Asylum. When she first arrived at the Asylum she "objected to getting out of the carriage and was very unwilling to stay" (Fourth Month, 21st, 1820). She was very hesitant to live in a new place but little is known about why she would not have wanted to be there. While in the Asylum, the superintendent noted that she was "somewhat useful," in the kitchen. It appears that she was one of very few female patients who worked in the kitchen (Second Month, 21st, 1823).

Verree's medical records are quite sparse, lacking the usual details of treatment, and show that she was only "usually noisy," once in her first three years in the Asylum (Eighth Month, 1820). It is likely that she was brought to Friends' Asylum as a place to live out the rest of her life. She originally entered the Asylum at 70 years old and stayed there until her death 12 years later. The night before she passed away the superintendent remarked that she appeared "to be sinking under the effects of old age (Twelfth Month, 26th, 1832).

The Case Against Friends Asylum: Morgan Hinchman and Asylum Exposés

Asylums in America, as enthusiastically as they were embraced in the first half of the 19th century, faced an equally energetic environment of suspicion and fear beginning in the last few decades of that same century. As optimism about the curability of mental illness fell, asylums became associated with images of unjust imprisonment and cruel treatment, thanks in large part to the frequency of exposés and frightening stories about mental institutions that seized the public’s attention and imagination. Published in 1908, Clifford W. Beers’ book A Mind That Found Itself was a bestselling account of his hospitalization for depression and paranoia in two separate institutions and the serious maltreatment he received at both a public and private asylum.¹ In 1887, Nellie Bly faked insanity in order to be admitted to New York’s Women’s Lunatic Asylum, and investigated the abuse and neglect of patients there, eventually publishing her experiences as a series of newspaper articles, “Ten Days in a Mad-House.”² Elizabeth Packard was committed to an asylum against her will in 1860 by her husband, after she argued with him about religion, the raising of their children, and his support of slavery -- even after she won her own release, he was still able to claim all of their shared property and custody of her children without leaving her any legal recourse. Packard successfully campaigned in several states throughout the 1860s and 1870s to establish new legal protections for those committed to psychiatric institutions as well as to expand the legal rights of married women. Her experiences and efforts for legislative reform were widely reported on, and she published many books during her lifetime that discussed the potential for unjust commitment and the stripping of legal rights entailed by the asylum system³.

These are only some of the most famous of the many high-profile scandals that struck asylums and challenged the methods of moral treatment during the last decades of the 19th century. Friends Asylum also had its own experience with a high-profile scandal and legal exposé -- however, this event occurred before these had become common. In some ways, the case of Morgan Hinchman set a precedent for the later pattern of attacks against psychiatric institutions in the courts or the press, revealing some of the medical and legal weaknesses in the diagnosis of mental illness at Friends Asylum, not to mention more generally at hospitals practicing moral treatment.

Morgan Hinchman was a 30 year old farmer and a member of the North Meeting of Friends in Philadelphia, and according to doctors’ records he had been suffering from “mania” for five years prior to his entering Friends Asylum. On January 7, 1847, Hinchman was committed to the Asylum by friends and family. On July 6 of the same year, he was discharged, and in 1849 he brought a lawsuit against his wife, his sister-in-law, his family physician, the men who brought him to the Asylum, the sheriff who agreed that committing him was legal, and many of the medical staff and leadership of the Asylum itself -- accusing them all of being part of a conspiracy to seize and sell off his property⁴.

The defendants seemed to have a strong case. There was no short supply of testimony as to Hinchman’s unusual, erratic behavior and beliefs -- including a history of paranoia towards his wife’s family, stealing money from a local bank, his belief that he had committed terrible sins and was sick with syphilis, and seemingly false memories about his own relatives. Family members and longtime acquaintances all testified to these and more, and Dr. Charles Evans, attending physician at the Asylum, discussed in Hinchman’s patient record how Hinchman had a history of violent passions, especially directed against his wife Margaretta. His commitment had come about because he had ceased being able to contain these outbursts to times when he was alone with Margaretta while remaining “generally kind to her in the presence of strangers,” and that soon before his commitment he had also “lately manifested insanity… by making foolish bargains, by forgetfulness, and by staying out at his work the better part of the night.” This was also borne out by correspondence among Hinchman’s own family and his wife’s family, with letters between his immediate relatives expressing concern at his worsening state and discussing the need to have Hinchman taken to an institution for the insane, as well as discussing “means of preserving Morgan’s property” against his delusions⁵.

Despite what might seem to be a strong case for the defense, the court ruled in Hinchman’s favor, after a trial that lasted over a month, drawing significant media coverage and packing the courtroom with interested spectators each day. The ruling came down not to the strength of Hinchman’s case, but because Hinchman had been committed and treated for “moral insanity,” the derangement of moral faculties without necessarily lacking in reason. Moral insanity was both a medical and legal concept -- it was a legal explanation for why people were suitable for commitment if they were “perfectly rational upon several subjects, but labour under a permanent delusion as to one or more,”⁶ but it was also a medical theory positing that a person's emotional and moral sensibilities could become afflicted by disease in the same way that the powers of reason became diseased in the case of insanity. The idea of moral insanity was a foreign one to the jury members in the Hinchman case, and Hinchman’s attorney David Paul Brown was able to attack the medical theory of moral insanity as being poorly defined and unsupported. According to Brown, it was “nothing more than a division formed by metaphysicians, of intellectual insanity.”⁷ It was the inability of the medical staff of Friends Asylum to satisfactorily use the abstract and poorly defined theory of moral insanity to explain the symptoms Morgan Hinchman displayed that ultimately led to the jury deciding in his favor.

The case also attracted substantial attention from the press. The Public Ledger of Philadelphia published an editorial during the case discussing the widespread public sympathy for Hinchman, as well as harshly criticizing the concept of moral insanity as a vague academic term that could be used to justify depriving individuals of their rights. The newspaper stated that only total insanity should justify institutional commitment, stating that “Partial insanity is the disease of mankind, not of an individual… Upon this rule, every man in society may at sometime in his life be deemed insane.” The Quaker newspaper The Friend was sympathetic to the defendants, but still criticized the moral insanity plea.⁸

In the end, all the defendants from Friends Asylum were acquitted, but Hinchman’s family and acquaintances were still decided against and made to pay damages. The case did not overturn the precedent that had been established allowing individuals to be committed to an asylum for cases of partial insanity rather than total insanity, but it did destroy the credibility of the concept of “moral insanity”, leading to the Asylum ceasing the use of the diagnosis in 1850. It also set the stage for further lawsuits and arguments against asylums in the future to use the fear of unjust confinement as an effective strategy -- “A Modern Lettre de Cachet,” an influential article published in 1868 about the lack of sufficient legal protections for people being considered for institutionalization, explicitly mentioned how easy it was for Morgan Hinchman to be confined in 1847 at the Asylum.⁹

1. Dain, Norman. “Publication of A Mind That Found Itself.” Clifford W. Beers: Advocate for the Insane. University of Pittsburgh Press, Pittsburgh, Pa, 1980, pp. 87–99.

2. Lutes, Jean Marie. “Into the Madhouse with Nellie Bly: Girl Stunt Reporting in Late Nineteenth-Century America.” American Quarterly, vol. 54, no. 2, 2002, pp. 217–253.

3. Carlisle, Linda V. “‘My Pen Shall Rage.’” Elizabeth Packard: A Noble Fight. University of Illinois Press, 2010, pp. 118–131.

4. Cherry, Charles L. “Friends Asylum, Morgan Hinchman, and Moral Insanity.” Quaker History, vol. 67, no. 1, 1978, pg 30.

5. Cherry, Charles L. A Quiet Haven: Quakers, Moral Treatment, and Asylum Reform. Fairleigh Dickinson Univ. Pr. U.a., 1989. Pgs 181-185.

6. The Supreme Court of Pennsylvania. M'Elroy's Case. Sept. 1843.

7. Cherry, Charles L. A Quiet Haven: Quakers, Moral Treatment, and Asylum Reform. Fairleigh Dickinson Univ. Pr. U.a., 1989. Pgs 181-185.

8. Cherry, Charles L. “Friends Asylum, Morgan Hinchman, and Moral Insanity.” Quaker History, vol. 67, no. 1, 1978, pg 29.

9. Cherry, Charles L. A Quiet Haven: Quakers, Moral Treatment, and Asylum Reform. Fairleigh Dickinson Univ. Pr. U.a., 1989. Pg 199.

Case Study of Emily B.

Emily B. was admitted in 1896 for mania; however, it was not her manic tendencies which gave staff at Friends Asylum the most cause for concern, but rather her habit of masturbation, which was considered to be indicative of nymphomania (excessive sexual desire), a condition which was considered both morally unacceptable and medically pathological in the nineteenth century.1,2 On two consecutive days, Emily “had hot astringent vaginal douche and was put to bed very loosely restrained in a camisole to prevent filthy habits.”3,4 Prior to this, Emily had been restrained only when it was feared she would injure other patients. Restraint was rare at Friends Asylum, which espoused moral treatment; the use of it in Emily B. 's case thus demonstrates the perceived severity of her masturbatory habits.5 A few months later, after regular application of restraint, vaginal douches, and more standard elements of moral treatment such as exercise and visiting with other patients, the writer of Emily’s case history noted that she still “continues masturbation unless watched and sleeps in a very loosely applied camisole to prevent self-injury.”6

Case histories of patients are generally described using neutral, medical language. Even accounts of destruction of property or violence towards others are not described using language that indicates disapproval from the writer. However, that pattern was broken several times in Emily’s case. Her masturbation is described not only as “filthy,” but also as “abusive,” indicating the disdain of the person writing her case history and demonstrating the belief that she was damaging or further sickening herself by masturbating, which is in line with nineteenth-century conceptualizations of masturbation as pathological and injurious to both physical and mental health.7 All aspects of Emily’s treatment, from the restraints used on her to the language of her case history, demonstrate the highly concerning nature of her actions in the eyes of the Asylum staff.

1. Case History of Emily B, Case Histories, 1893-1899, Box 20, Folder 4, Friends Hospital Records, Quaker and Special Collections, Haverford College, Haverford, Pennsylvania.

2. Diane Mason, The Secret Vice: Masturbation in Victorian Fiction and Medical Culture, (Manchester; New York: Manchester University Press) 2008.

3. Case History of Emily B.

4. Note: camisole was another way to refer to a straitjacket.

5. Abby Corcoran, “A Mild and Appropriate System of Treatment: Moral Treatment and the Curability of Mental Illness at Friends Asylum,” Quakers and Mental Health Project, http://qmh.haverford.edu/.

6. Case History of Emily B.

7. Mason, The Secret Vice.

Hannah Jones Case Study

Hannah Jones was admitted to the Friends Asylum on the Fifth Month 27th, 1817, and she was the second patient admitted to the Asylum. Isaac Bonsall wrote extensively about her stay at Friends Asylum in his daybook, most likely because her behavior was the most noteworthy compared to other patients in the Asylum at the time, being one of the more “troublesome” patients compared to the others.1 She was often very violent and was confined to her room and/or physically restrained.

Jones’ illness caused her to be very noisy and violent, but she did not have a tendency to harm herself or others.2 She experienced periods of both calmness and violence.3 During the violent periods, she broke window panes, furniture, lights, and “every thing she can get hold of that will break.”4,5 When asked why she broke the window panes one night, she answered “because she was confined” to her bedchamber and she was not accustomed to confinement.6

Because of her aggressive behavior, Jones was often confined to her bedchamber and her movement restricted using hand straps or the straight waistcoat. Bed straps were used to confine her to her bed at night.7 At times, these restraints were used as punishments to deter her from causing any further damage. In addition, the staff ensured that Jones wouldn’t break anything else by physically restraining her. Occasionally, she was allowed to roam free without restraints if she had behaved well or promised not to be destructive.8 Despite the Asylum’s preference for methods of non-restraint, physical restraint was used liberally during this time compared to later years (see page on Early Usage of Physical Restraint and Seclusion).

Many methods were used to treat Jones’ illness, including blisters, shower baths, warm baths, and cupping. The results of these treatments were mixed; sometimes they seemed to have a calming effect and she became less aggressive, sometimes they had no effect.9 Starting in the Second Month of 1818, Jones had shown great improvements and seemed to have a “sane mind.”10 She was discharged on Fifth Month, 16th, 1818.

Jones was readmitted as a patient a year later on Fifth Month, 6th, 1819, and she seemed to be even more troublesome than before. On one occasion, she “got her Person and the room in more dirty trim than we ever knew her to do at any time before.”11 Her condition did not improve. After a year, her health deteriorated and she died at the Friends Asylum on Eleventh Month, 21st, 1820, surrounded by her family.

1. Superintendent Daybook Vol. 1, 1817-1820 Item 61, Fifth Month, 28th, 1817, Friends Hospital Records, Quaker and Special Collections, Haverford College, Haverford, PA.

2. Medical Register, 1817 - 1820, p. 4.

3. Medical Register, 1817 - 1820, p. 4.

4. Superintendent Daybook Vol. 1, 1817-1820, Fifth Month, 28th, 1817.

5. Medical Register, 1817 - 1820, Seventh Month, 22nd, 1817.

6. Superintendent Daybook Vol. 1, 1817-1820, Fifth Month, 28th, 1817.

7. Superintendent Daybook Vol. 1, 1817-1820, Fifth Month, 30th, 1817.

8. Superintendent Daybook Vol. 1, 1817-1820, Sixth Month, 6th, 1817.

9. Medical Register, 1817 - 1820, Eighth Month, 6th, 1817.

10. Superintendent Daybook Vol. 1, 1817-1820, Second Month, 19th, 1818.

11. Superintendent Daybook Vol. 1, 1817-1820, Sixth Month, 6th, 1819.

Case Study of William P. Norris

William P. Norris was admitted to Ward 4 of Friends Hospital on May 25, 1919.¹ On his first day he began a special diet that would continue throughout the rest of his time at the Hospital. According to Hospital records, William was “unclean in habits.” He began with a moderate level of participation in activities and read books daily. During the summer and fall months of 1919, William’s condition was fairly steady, and he occasionally took part in horseback riding and industrial classes. His daily routine revolved around outdoor walks with an attendant and reading.

By February 1920, William’s condition had deteriorated. During the month of January, William stopped taking part in all activities besides reading, and beginning on March 24, he was secluded from the Hospital population for the remainder of his stay. He continued to read daily until April 17, after which William was recorded as having spent time reading only sporadically. In May, William began to be recorded as “destructive” and was given medicine. This pattern of medication, seclusion, and “destructive” tendencies would continue throughout the rest of William’s time at the Hospital. From November 11 until November 19, 1920, William received daily visits from family members and friends, likely as a counseling method. These efforts were seemingly unsuccessful, as William was transferred to Norristown State Asylum on November 20, 1920.

1. Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

Case Study of Ida Eubank and Lena Jent

Ida Eubank was admitted to Friends Hospital at 3 pm on December 5, 1918.¹ From December 6, 1918 until January 10, 1919, Ida was kept in restraints 24 hours a day.² This pattern of extreme restraint continued throughout Ida’s time at the hospital, with Ida also being kept in restraints 24/7 for a period of 23 days between February and March 1919. From April until August 1919, Ida usually spent 10-15 hours a day in restraints, though this number was sometimes as high as 24 or as low as 6. While Friends Hospital was known for its emphasis on “moral treatment,” which usually did not include restraining patients, Ida’s case represents a larger trend within Friends Hospital for restraining patients around 1920.

When not in restraints, Ida took part in a number of activities at the asylum, including reading and writing, art classes, going on walks with an attendant and needlework classes. Needlework classes were particularly popular among women at the Hospital, including Ida’s fellow Sec A patient, Lena Jent.

Lena Jent was born Lena Baznhoff in Germany on November 15, 1877.³ She immigrated to the United States in 1891⁴ and settled in Philadelphia, where she met her two husbands — Anton Stein, who she married in 1896, and Julius Jent, who Ida married in 1906⁵ after Anton’s death in 1904. Ida gave birth to 4 children, two with each of her husbands. She was admitted to the Hospital on August 6, 1919, possibly for “manic depressive psychosis,”⁶ where she was secluded for 12 hours a day while also taking part in needlework classes.

On August 10, 1919, both Ida and Lena ran away from the asylum. First, Ida escaped the nurse who was watching her on the Hospital’s lawn.⁷ Then, later that day, Lena “removed [the] screen from [her] window” and “climbed out and ran away.”⁸ Lena is recorded as having been “brought back” at 2:30 AM on August 11, while Ida “went home.” While it is unclear whether this was a coordinated plan between the two, or if one was inspired by the other, it is likely that there was some connection between their escapes.

After being returned to the asylum, Lena bounced between wards until September 13, when she was transferred to Norristown State Hospital. Lena remained at Norristown until her death on April 7, 1950 at the age of 76.⁹ It is unclear what happened to Ida after her escape from the Hospital.

1. Unless otherwise noted, all following citations are from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

2. Two exceptions: December 26th and 27th restrained 23 hours a day

3. “Pennsylvania, U.S., Federal Naturalization Records, 1795-1931,” digital image s.v. “Julius Charles Jent” (born 23 Dec. 1876), Ancestry.com.

4. 1900 United States Census, Philadelphia, Philadelphia County, Pennsylvania, digital image s.v. “Lena Stirn (Stein)” (born November 1976), Ancestry.com.

5. “Philadelphia, Pennsylvania, U.S., Marriage Index, 1885-1951,” digital image s.v. “Lena Stein” (marrying Julius Jent), Ancestry.com.

6. This is listed as a contributing cause of death on Lena’s 1950 death certificate. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Lena Jent” (died 7 Apr. 1950), Ancestry.com.

7. Daily Reports Women, 10/22/1918-3/23/1920, MC-1261, Item 121, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

8. Daily Reports Women, 10/22/1918-3/23/1920, MC-1261, Item 121, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

9. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Lena Jent” (died 7 Apr. 1950), Ancestry.com.

Case Study of Anna (Hannah) J Bussom

On March 23, 1920, an article titled “Ends Life With Corset Stay”¹ appeared in the Evening Public Ledger, describing the suicide of Anna Bussom (nee Cummins) at Friends’ Hospital. According to the newspaper article, Anna “tried to force a corset stay down her throat,” and was “suffering from melancholia.”

Anna was admitted to Ward 1 on February 25, 1920,² where she is recorded as “Hannah Bussom.” She spent most of her time at the Hospital sick in bed and receiving medication. There is little other detail recorded about her condition, except that she had to be fed mechanically on March 16th. The casebook is opaque about the circumstances of her death, remarking only that she had “died 3-23-1920.” At the time of her death, Anna was 37 years old.³

Anna’s case exemplifies the limits of the casebook. While the casebook provides crucial details about treatments offered at the Hospital and records the names of those who lived there, it does not include information about patient health, birth date, reason for institutionalization or other data important to reconstructing an image of a patient’s life.

1. “Ends Life With Corset Stay.” Evening Public Ledger. March 23, 1920. https://chroniclingamerica.loc.gov/lccn/sn83045211/1920-03-23/ed-1/seq-14/ (Accessed March 13, 2023).

2. All following information, unless otherwise noted, is from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

3. Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Anna Josephine Bussom,” Ancestry.com

Case Study of Claire Molly Blumberg

Claire Blumberg was admitted to Ward 5 of Friends Hospital on November 16, 1918.¹ On November 18, she was transferred to Section A. From November 20 until November 22, Claire was secluded for 24 hours a day, and restrained for a total of 14 hours over that three day period. On November 24, Claire was restrained for 18 hours and began taking medicine. After this, Claire’s condition began to improve. On November 28, Claire was secluded for 12 hours, but also went for a walk with an attendant and was visited by family or friends. On November 30, Claire had visitors again.

Throughout December 1918, Claire’s routine was consistent. Continuing with her medication and special diet from November, Claire went on a daily walk with an attendant and took part in needlework classes.

In January 1919, Claire took part in a wider range of activities. Besides needlework and walking, Claire also read almost daily, took part in entertainment and art classes, and attended a Sabbath reading. On January 16, Claire sat at the Officer’s Table for dinner, an honor for patients that had shown immense improvement in their condition. On January 20, Claire was transferred to Ward 2, where she began to prepare for her discharge from the Hospital. She was also taken off medication on this day. While in Ward 2, Claire attended a social gathering and ate at the Officer’s Table for a second time on January 30. On February 5, 1919, Claire was discharged from Friend’s Hospital.

1. Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

Case Study of Sadie McCaffery

Sadie McCaffery was admitted to Ward 2 of Friends Hospital on December 21, 1918.¹ Throughout her month and a half spent in Ward 2, Sadie took part in a variety of activities offered by the Hospital, such as gymnastics and needlework classes, entertainment, and walks with an attendant. Throughout January 1919, Sadie was sick multiple times, and on February 2, 1919, she was transferred to Ward 3. While patients in Ward 2 enjoyed considerable freedom relative to the rest of the Hospital, with some patients going on unattended walks or taking day trips out of the Hospital, Ward 3 was occupied by women in very different situations.

In Ward 3, Sadie was restrained 24/7 for all of February and part of March. From February 19 until March 27, Sadie was sick in bed with an undisclosed illness. Sadie was not alone in being in restraints — two other women in Ward 3 were kept in 24/7 restraints during February 1919. Throughout March, Sadie’s time in restraints begins to decrease, settling at 12 hours a day by the end of March. In April, Sadie began the month with 14-20 hours spent in restraint each day, being once again sick in bed.

On April 7, Sadie was transferred to Ward 1, marking yet another phase of her treatment at the Hospital. Having recovered from her illness, she began to go on walks with an attendant, and her time spent in restraints once again returned to 12 hours a day. Throughout the most of the rest of her time in Ward 1, Sadie remained in restraints 12 hours a day every single day. She was the only woman in Ward 1 who was in restraints. Despite her daily confinement, Sadie began to reengage with the activities offered by the Hospital. By July, Sadie was taking part in art and needlework classes, indoor games and reading, while also spending time outside and going on walks with an attendant. Often, she took part in all of these activities on the same day, becoming one of the most active women in her ward. Additionally, from August until October, Sadie was visited almost daily by family and friends, giving her an important tether to the outside world. Visits like these “communicated to the patients that people outside of the Asylum cared about them, and they also served as a form of encouragement for the patients to control themselves.”²

By November 1, 1919, Sadie’s condition had improved enough to be released from her restraints after months spent in some sort of restraint. On November 17, she was transferred from Ward 1 back to Ward 2, where she began to prepare for her release from the Hospital. On November 20, Sadie ate at the Officer’s Table, an honor given to patients who had shown significant improval in their condition. On November 22, 1919, Sadie followed the course of many women living in Ward 2, and was discharged from the Hospital.

1. Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

2. Corcoran, Abby. “A Mild and Appropriate System of Treatment: Moral Treatment and the Curability of Mental Illness at Friends Asylum.” Accessed March 20, 2023. http://qmh.haverford.edu/essays/17acorcoran/

Case Study of Louis Spaeth

Louis Augustus Spaeth¹ was born on April 7, 1863, in Newark, New Jersey.² He received a medical degree from Bellevue Hospital Medical College in 1894, and went on to practice medicine as an “allopath.”³ Never marrying, Louis often traveled for work. He served as a doctor in the Spanish-American War in 1898.⁴ Between 1900 and 1902, he was called for duty in the Philippines as an assistant surgeon. Then, from June 1904 until July 1909, Louis worked as a doctor in the US-controlled Panama Canal Zone.⁵ In 1917, he was stationed at Fort Slocum in New York as a surgeon for the US military during World War 1.⁶ He reached the position of major, before receiving an honorable discharge in December, 1918.⁷

Louis was admitted to Friends Hospital on August 11, 1919.⁸ He read every day, and was given medicine and a special diet. Beginning on August 23, he took a walk with an attendant every day. Between August 11 and August 31, Louis received 10 visits from family members and friends, including his brother, sister-in-law, and a woman named “Miss Moore.”⁹ Between September 1 and 7, he received 5 more visits, as he continued his routine from August.

On September 8, 1919, Louis was discharged from Friends Hospital with little fanfare. His short stay was similar to that imagined by the founders of Friends Hospital, who selected patients based on the (perceived) “curability” of their condition.¹⁰

It is unclear why Louis was at Friends Hospital, but it was most likely a condition related to his time spent on the battlefield. The First World War created a large population of veterans suffering from shell shock, paving the way for the recognition of PTSD as a genuine psychiatric condition. Outside of his mental health, Louis was also suffering physically. On December 2, 1919, less than three months after being discharged from Friends Hospital, Louis died from a myriad of heart issues.¹¹

1. Photo is sourced from “Major Louis A. Spaeth,” Evening Public Ledger, January 23, 1918, https://www.newspapers.com/image/163796035/.

2. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Louis A Spaith” (died 2 Dec. 1919), Ancestry.com.

3. “Directory of Deceased American Physicians, 1804-1929,” index s.v. “Louis Augustus Spaeth” (died 3 Dec. 1919), Ancestry.com.

4. “Obituary: Dr. Louis A. Spaeth,” The Philadelphia Inquirer, December 4, 1919, https://www.newspapers.com/image/167237843/.

5. “U.S., Panama Canal Zone, Employment Records and Sailing lists, 1884-1937,” digital image s.v. “Louis A Spaeth” (born 1863), Ancestry.com.

6. “Pennsylvania, U.S., World War I Veterans Service and Compensation Files, 1917-1919, 1934-1948,” digital image s.v. “Louis Augusts Spaeth” (born 7 Apr. 1863), Ancestry.com.

7. “Pennsylvania, U.S., World War I Veterans Service and Compensation Files, 1917-1919, 1934-1948,” digital image s.v. “Louis Augusts Spaeth” (born 7 Apr. 1863), Ancestry.com.

8. All following information, unless otherwise noted, is from Daily Record Book, 1918-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

9. Medical Journal Men, 10/5/1918-3/31/1920, MC-1261, Item 171, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

10. Corcoran, Abby. “A Mild and Appropriate System of Treatment: Moral Treatment and the Curability of Mental Illness at Friends Asylum.” Accessed March 20, 2023. http://qmh.haverford.edu/essays/17acorcoran/.

11. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Louis A Spaith” (died 2 Dec. 1919), Ancestry.com.

Case Study of Wilhelmina Bachman nee Geissinger

Wilhelmina “Willie” Bachman (nee Geissinger) was born in 1849¹, putting her in her late 60s when she was admitted to Friends Hospital in the late 1910s. Her case provides an example of long-term hospitalizations and the life of the elderly at the institution.

Over the 2 years documented in the daily record book, Willie spent most of her time “occupied in ward,” reading, or doing needlework.² In March, April and June 1919, reading and “occupied in ward” are the only activities recorded in the record book. The frequency with which Wille took part in reading, needlework or both was inconsistent, though Willie showed a general preference for reading over needlework. From September through December 1919, Willie took walks with an attendant and participated in art classes, and spent other time outside. However, from the beginning of 1920 through the rest of the time recorded in the casebook, Willie’s activities were once again restricted to needlework, reading, and being “occupied in ward.”

It is difficult to ascertain the severity or nature of Willie’s condition from the casebook. During these two years, Willie was never recorded as being in restraints or secluded, “fed mechanically” or destructive. At the same time, Willie never ate at the Officer’s Table, attended special activities such as sociables, or left the Hospital to visit family. Before Willie was at Friends Hospital, she lived with her daughter and son-in-law for more than a decade after her husband’s death.³ It was not uncommon for mentally healthy elders to end up in mental institutions in the early years if their families were no longer able to support them in the early 20th century. Willie continued to be treated by Friends Hospital for the rest of her life. She was transferred to the Friends Hospital Bensalem Mansion sometime between 1921 and 1929.⁴ The Bensalem Mansion was a “convalescent home,” most likely a home for elderly patients who required long-term care.⁵ She died at Bensalem (recorded as “Ben Salem Farm” on her death certificate) on January 15, 1929.

1. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Willie A Bachman (died 15 Jan. 1929), Ancestry.com.

2. Unless otherwise noted, all following citations are from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

3. See 1910 and 1920 US Federal Censuses, “Willie Ann Bachman.”

4. Willie was most likely transferred to Bensalem in 1921. Her 1929 death certificate says that she had been suffering from “chronic myocarditis” for 90 months at the time of her death. Working under the assumption that Willie was moved from the Philadelphia location of the hospital to the Bensalem location around the time that her physical health problems began, this would situate her move in mid-1921.

5. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Willie A Bachman (died 15 Jan. 1929), Ancestry.com.

Case Study of Katie Pantales

Katie Pantales was admitted to Friends Hospital on January 13, 1919, where she was immediately sent to Sec A, one of the two wards with most patients in restraints.¹ On January 14 and 15, Katie was recorded as having been destructive and unclean and was in restraints 24 hours a day. For a few days, her time in restraints was reduced to 5-9 hours a day, but beginning on January 22 Katie was restrained 24 hours a day again. She was also recorded as sick in bed beginning on that day. She received visitors almost every day of January.

Katie continued to be sick in bed and restrained for 24 hours a day until February 10. After February 10, Katie was visited frequently by family and friends. She also began to take part in activities at the hospital, including reading, needlework, art class and entertainment. On February 26, Katie was transferred to Ward 3. In Ward 3, Katie went on daily walks with an attendant and took needlework, gymnastics and art classes. She also attended weekly sabbath readings.

At the end of March 1919, Katie was transferred to Ward 2, where she prepared to leave the hospital. On April 3, Katie ate the Officer’s Table, an honor given to patients who had shown immense improvement in their condition and were soon to be discharged. On April 6, 1919, Katie was discharged from Friends Hospital.

1. Unless otherwise noted, all following citations are from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

Case Study of Frank Atwood

Francis “Frank” Calhoun Atwood was born on January 27, 1883 in St. Paul, Minnesota.¹ He was the son of Dr. Francis Atwood, a successful eye doctor who died in the year before Frank was born. In his early 20s, Frank was diagnosed with an unspecified mental illness, which led to his admittance to Friends Hospital.² He was at Friends Hospital throughout the entire 1918-1921 period,³ and was moved to the Allentown State Hospital for the Insane sometime between 1921 and 1930.⁴

During the 1918-1921 period, Frank lived in Ward 3. His routine and condition varied very little throughout this time. Every day, Frank went on a walk with an attendant and read. He often took part in gymnastics class, entertainment, or indoor games. During the warmer months, Frank also went out horseback riding. Frank began taking medicine for his condition in October 1919, and remained on medication for the rest of the daily record period.

One notable aspect of Frank’s time at the hospital was his religious activity. From 1918-1921, Frank attended sabbath readings regularly. For 20 out of the 27 months that Frank appears in the daily record book,⁵ he attended all weekly sabbath readings. The major exceptions from his regular attendance were August-November 1919. In August 1919, Frank didn’t attend any Sabbath readings, in September he attended 2, in October only one, and in November he once again attended two sabbath readings. It is unclear why Frank stopped attending every sabbath reading during the period — not only does the record book not record any significant variation in Frank’s other behavior during this period, but the record for his activities during July 1919, right before the recorded period of decreased sabbath attendance, is missing. It is possible that Frank’s religious observance was impacted by World War 1, which ended in November 1919 — soon after, Frank began attending sabbath readings regularly again.

Frank remained institutionalized for the rest of his life. After being moved to Allentown in the 1920s, Frank was then transferred to Harrisburg State Hospital in the 1930s.⁷ He remained at Harrisburg until his death on January 12, 1955, from tuberculosis and a stroke. He was 71.

1. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Francis C Atwood” (died 12 Jan. 1955), Ancestry.com.

2. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Francis C Atwood” (died 12 Jan. 1955), Ancestry.com. The death certificate lists “mental illness” as a contributing cause of death, and says that it began 50 years before Frank’s death. 50 years younger than 71, Frank’s age at death, is 21 years old.

3. Unless otherwise noted, all following citations are from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

4. “1930 United States Federal Census,” digital image s.v. “Francis C. Atwood” (born 1883, residing in Pennsylvania), Ancestry.com

5. Records from July 1919 are missing for Men’s Ward 3.

6. “1940 United States Federal Census,” digital image s.v. “Francis Atwood” (born 1883, residing in Pennsylvania), Ancestry.com

7. “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Francis C Atwood” (died 12 Jan. 1955), Ancestry.com.

Case Study of Herman Chaykin

Herman Chaykin was admitted to Ward 3 of Friends Hospital on February 28, 1920.¹ For his first two weeks at the hospital, he was sick in bed and received medicine. After March 15, his condition improved enough to take walks with an attendant, and spend his days reading. Beginning in April, Herman took part in industrial class, which seems to have been his favorite activity at the hospital. Some months, Herman attended industrial class every or almost every day. Outside of reading and industrial class, Herman also attended entertainment, and gymnastics class.

The daily record book shows that Herman received frequent visitors throughout his time at the hospital.² In the record book, visitors are marked by a ‘V’ in each patient’s daily record. In the key, ‘V’ means “Visited by Friends.” While the Quaker history of Friends Hospital may suggest that the word “Friends” refers to members of the Quaker community, it actually refers to any visitors the patient may have received, regardless of religious affiliation.

In the 11 months that Herman spent at Friends Hospital, his records show little change in his condition and routine, besides his initial illness. Despite a brief illness at the beginning of the month, Herman was discharged from the hospital on January 29, 1921.

1. Unless otherwise noted, all following citations are from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

2. Medical Journal Men, 10/5/1918-3/31/1920, MC-1261, Item 171, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

Case Study of Roy E Cobb

Roy Eugene Cobb was born on January 26, 1886, in the outskirts of Scranton, Pennsylvania.¹ He graduated from Scranton Technical High School in 1908, and went on to become “one of the most promising young businessmen” of Scranton, working an administrative position at a local silk throwing mill.² In 1914, Roy married Marguerite Weeks, with whom he had two daughters: Ruth and Marion.³

On May 10, 1919, Roy was admitted to Ward 4 of Friends Hospital.⁴ From May 10 until May 17, Roy was kept in restraints for an unspecified amount of time, though presumably 24 hours a day. From May 13 until May 18, he was recorded as “unclean.” He took part in no activities at the Hospital. On May 19th, 9 days after his arrival at the hospital, Roy died at the age of 33. The reports about his cause of death are conflicting: while his death certificate attributes his death to exhaustion and psychosis, with cerebral edema as a secondary cause, his obituary mentions only cerebro spinal meningitis.⁵ The discrepancy in reported cause of death was likely because of stigma surrounding mental illness, and the fact that Roy was from Scranton rather than Philadelphia. It is possible that residents of Scranton didn’t know that Friends Hospital was a mental institution, and the writers of Roy’s obituary decided to use this to portray his death as the result of physical rather than mental illness.

In the 11 months that Herman spent at Friends Hospital, his records show little change in his condition and routine, besides his initial illness. Despite a brief illness at the beginning of the month, Herman was discharged from the hospital on January 29, 1921.

1. Roy Eugene Cobb, grave marker, Fairview Memorial Park, Elmhurst Township, Lackawanna County, Pennsylvania, digital image s.v. “Roy Eugene Cobb” (died 19 May 1919), FindaGrave.com.

2. “Roy E. Cobb Dies in Philadelphia Hospital,” The Tribune, May 20, 1919, https://www.newspapers.com/image/48468200/.

3. “Roy E. Cobb Dies in Philadelphia Hospital,” The Tribune, May 20, 1919, https://www.newspapers.com/image/48468200/

4. Unless otherwise noted, all following citations are from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

5. See “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Roy E Cobb” (died 19 May 1919), Ancestry.com and “Roy E. Cobb Dies in Philadelphia Hospital,” The Tribune, May 20, 1919, https://www.newspapers.com/image/48468200/.

Case Study of Clara McAdam

Clara McAdam (nee Jones) was born on August 29, 1850, in Utica, New York.¹ In 1879 Clara married Quentin McAdam, who would later become the head of the Utica Knitting Company and “one of the largest producers of knit goods in the world.”² Though Quentin and Clara were married for nearly 40 years at the time of Quentin’s death in December 1918, Clara never gave birth to any children.³ It was likely because she lacked this traditional familial structure for elder care that she was admitted to Friends Hospital less than a year after her husband’s death.

Clara arrived at Friend’s Hospital on July 8th, 1919, where she became the sole patient of the “Bungalow.”⁴ Her family likely used their considerable fortune from the McAdam knit goods business to pay for her care. In the Bungalow, Clara received unique one-on-one attention from her nurses. On her arrival, Clara started on medication and a special diet, and spent her days going on walks with her attendant and participating in needlework class. She was sometimes recorded as being “unclean in habits,” a designation that pops up throughout her entire time at the Hospital.

From August until early December, Clara was “sick in bed.” While she was sick, Clara wasn’t recorded as having taken part in any activities. The cause of her illness was additionally not recorded. By December 9, 1919, Clara seemed to have recovered, and is no longer recorded as “sick in bed.” Details about Clara’s activities are sparse until late March 1920, when Clara resumes her walks with an attendant. After this point, Clara’s schedule begins to include horseback riding and art classes. She received occasional visits from family and friends throughout her time at the hospital. Clara continued on medication until September 16, 1920. According to the daily record book, Clara’s life varied little throughout the rest of 1920. Clara remained in the Bungalow at Friends Hospital until her death from pneumonia on November 19, 1928.⁵

1. Clara M McAdam, grave marker, Deansboro Cemetery, Deansboro, Oneida County, New York, digital image s.v. “Clara M. McAdam” (died 19 Nov. 1928), FindaGrave.com.

2. “Quentin M’Adam Died Last Night,” Herald-Dispatch, December 9, 1918. Transcribed by Karen E. Dau, https://nyscu.org/Archives/Universalist%20Memory%20Garden/Universalist%20Memory%20Garden%20MA-MH/McAdam,%20Quentin%201918.pdf.

3. Quentin’s death date is taken from Quentin M. McAdam, grave marker, Deansboro Cemetery, Deansboro, Oneida County, New York, digital image s.v. “Quentin M. McAdam” (died 8 Dec. 1918), FindaGrave.com. Clara responded to the 1910 census saying that she had given birth to no children by age 59, meaning she likely never had children at all, see “1910 United States Federal Census,” digital image s.v. “Clara M Mcadam” (born 1851, residing in New York), Ancestry.com

4. Unless otherwise noted, all following citations are from Daily Record Book, 1919-1921, MC-1261, Item 116, Friends Hospital Records, Haverford College Quaker & Special Collections, Haverford, Pennsylvania.

5. See “Pennsylvania, U.S., Death Certificates, 1906-1969,” digital image s.v. “Roy E Cobb” (died 19 May 1919), Ancestry.com and “Roy E. Cobb Dies in Philadelphia Hospital,” The Tribune, May 20, 1919, https://www.newspapers.com/image/48468200/.

Unusual Deaths in Friends Asylum in the Late 1800s

While most of the patients admitted to Friends Asylum were eventually discharged or moved to a different mental institution, a number died within its walls. Causes of death ranged widely: “exhaustion due to organic brain disease,” tuberculosis, and “general paresis” are only a few of many.1

The majority of deaths at the Asylum were due to illness; a small number of patients, however, died from accidental injuries. For example, Sarah M. Elkins, a patient admitted to Gurney Cottage¹ in 1887, met with an “unfortunate accident in falling from the second-story porch;” she initially appeared only to have fractured an arm but died several days later.² In this case, as in others, the Asylum was careful to deny any blame for her death, claiming that her death “would have occurred at any rate before long” due to her preexisting brain disease.³ A second, darker, accidental death occurred in 1894, when Ebenezer Dickey was involved in an altercation with another patient, Frank Savage, and ended up “receiving injuries of the head so severe in character that he died in twenty-five minutes after the assault.”⁴ While the details of this incident were reported in full by the superintendent to the Board of Managers, the only hint of it in the published Annual Report is a death attributed to “traumatic cerebral hemorrhage” in a table listing causes of death for the year.⁵

Friends Asylum closely monitored patients who exhibited suicidal tendencies. Tragically, deaths by suicide still occurred with some regularity.⁶ After a six year period from 1889 to 1895 in which four patients died by suicide, the Asylum received a letter from the Committee on Lunacy calling for greater care in preventing suicide in patients with melancholia.⁷ Reports from the superintendent and the Board of Managers were quick to assert that all possible precautions had been taken to prevent self-harm, but in at least one instance the attendant in charge of a patient who died by suicide was fired, potentially indicating some responsibility.⁸ Like the death of Ebenezer Dickey, some suicides were not made public. Some are categorized as suicides in the Annual Reports, but others are either not listed at all or described in unclear terms.9 The secrecy surrounding deaths by suicide and accidental deaths, as well as the denial of blame for these incidents, demonstrates the desire of the Asylum staff and managers to both avoid culpability for preventable deaths and portray the Asylum as a safe institution.

1. Minutes of the Board of Managers, 1870-1901, Items 5 and 6, Friends Hospital Records, Quaker and Special Collections, Haverford College, Haverford, Pennsylvania.

2. Minutes of the Board of Managers, Ninth Month 1887.

3. Ibid.

4. Minutes of the Board of Managers, Twelfth Month 1894.

5. Annual Reports, 1894, Box 2, Friends Hospital Records, Quaker and Special Collections, Haverford College, Haverford, Pennsylvania.

6. Notes: as per guidelines listed by the Movement Advancement Project on the Suicide Prevention Resource Center, the language of “died by suicide” is used as opposed to “committed suicide.” See https://www.sprc.org/resources-programs/talking-about-suicide-and-lgbt-populations for more information.

7. Minutes of the Board of Managers, Seventh Month 1895.

8. Minutes of the Board of Managers, Ninth Month 1890.

9. Annual Reports, 1870-1902, Box 2.