Embodied History: The Lives of the Poor in Early Philadelphia

3: Hospitalized Bodies

Chapter 3 Hospitalized Bodies More than anything else, the records of the Pennsylvania Hospital for the Sick Poor reveal a great deal about the illnesses and injuries most commonly suffered by all of Philadelphia's lower sort. But while the hospital promised expert medical care, it was as much an institution of social control as were the prison and almshouse, and its services were available only to those who fashioned and managed their bodies appropriately as the deserving and deferential poor. Although some feared the hospital as a place where the sick and injured might easily die, it was certainly preferable to the rudimentary health care available in the almshouse , but no more than a fortunate few of the sick poor were able to have their bodies treated and cared for in the Pennsylvania Hospital. While the institution's records reveal a great deal about the illnesses and injuries afflicting all lower sort Philadelphians, they also speak volumes about the power of hospital authorities to judge impoverished bodies and furnish life-saving treatment based on these assessments. The annual accounts, published each year as a broadside by the Managers of the Pennsylvania Hospital, along with the manuscript Book of Patients and Admission and Discharge records reveal the kinds of treatable illnesses and injuries endured by the city's lower sort, while various notes and manuscript records kept by attending physicians provide a more rounded picture of individual cases. Together these records reveal the range and nature of treatable medical conditions afflicting the bodies of Philadelphia's working poor, the ways they were treated both in and outside the Pennsylvania Hospital, and the judgment and control of certain folk embodied in their hospitalization and treatment (Figure 10).1 No more than a small minority of lower sort Philadelphians were admitted to the Pennsylvania Hospital, because in most cases medical care for the sick and injured remained a domestic concern, handled by friends and family within the home. Only the wealthy could see or call for doctors on a regular basis, and thus the poor were generally unfamiliar with professional medicine. The differences between medical treatment at home and in the hospital were, when compared to the differences in modern America, relatively small. Drawing on centuries of 62 Chapter 3 accumulated folk wisdom and practice, it was ordinary folk who treated the large majority of injuries and ailments. All communities and many households contained people who knew something of the medical properties of various herbs and plants and others who knew how to drain blood, and together these men and women would have practiced a rudimentary yet often effective form of medicine that was as familiar as the Figure 10. William Birch, Pennsylvania Hospital in Pine Street, Philadelphia, 1799. Based on the original at the Library Company of Philadelphia, with additions by Anthony King. The majority of the sick and injured poor were treated at home by friends and relatives. Many more were placed in the sick wards of the almshouse, where they were clothed and fed but not treated. Only a few, deemed as members of the "deserving poor" by their betters, were admitted to the Pennsylvania Hospital, which was intended for lawabiding, hardworking, and deferential poor people whose illnesses and injuries could be treated, allowing them to return to a useful and productive role in society. They came and went on a daily basis, with many more visiting for what was effectively outpatient care, while visiting family and friends brought in provisions. The injuries and illnesses that brought them to the hospital were common among the lower sort. Many were treated and cured, but in an age when infection was little understood the hospital could be a dangerous and often deadly place, and some left the institution in old and rough sheets on their way to the paupers' graveyard. Yet the medical attention afforded to hospital patients was far superior to the rudimentary care given the sick and injured residents of the almshouse. Hospitalized Bodies 63 conditions it treated. Only in rare cases, if the sufferer's condition failed to improve, would family and friends consider employing the services of a doctor, if one were available. When their bodies were laid low by disease or by injury, or rendered worthless by old age, debility, or insanity, and when family or friends were unavailable or unable to furnish care within the home, the lower sorts who lived in larger...