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Section II, Series 6. Patient Records, 1841 – 1956.

State law 50 P.S. 7111 prohibits the use of all patient mental health records. As a result, this series of the collection was not processed as part of this NHPRC-funded project. Patient records may be processed at a later date, should appropriate funding be obtained. If you have any questions about these records, please contact the Archivist at 215-829-5434.

Two sets of archives are included here: those opened in 1841 with the opening of the original building of the "Department for the Insane" at 44th Street, and including women patients only after 1859; and those begun afresh for the Male Department when its separate building at 49th Street opened in 1859. Note particularly that the Male Department records began with a new Patient Admission no. 1, listed below as Case no. 1 (Male), and so forth. For a fuller description, refer to the notes for Series 1. Administrative records of the Institute of Pennsylvania Hospital.

Census Books.
These volumes, for the period 1915 - 1956 succeed the Admission and Discharge Registers. They record admissions, discharges, departures and returns from visits, and changes in status (i.e., Voluntary to Committed).

Medical Registers.
These volumes list patients in order of admission and include: case no., name, occupation, date of admission, sex, age, marital status, nativity, residence; no. of attack (e.g., 1st, 2nd. etc.), supposed cause, duration before admission, form (diagnosis), age at first attack. For cases prior to 1844, and a few thereafter, the following data are also included: complexion, hair color, eye color; date of discharge, duration of residence, nature of discharge (e.g. cured, eloped, etc.); remarks (whether periodical, hereditary, suicidal, puerperal, etc.); whether readmission.

In 1883, by order of the "Committee on Lunacy", new style Medical Registers (labeled "Admission Books") were begun. These volumes include: date of last previous admission, if any; case no. in order of admission; date of admission; full name; age; color, sex, nativity; civil condition (marital status, number of children living, names and addresses of living brothers and sisters; occupation prior to insanity; previous address; by whose authority sent; dates of medical certificates, and by whom signed (with addresses); bodily condition; name of disorder, if any; form of mental disorder; supposed cause; whether epileptic or congenital imbecile; duration of attack; no. of previous attacks; age at first attack; no. of admission.

For some patients, the following is also included: date of discharge or death; whether restored, improved, not improved or died; remarks.

The records begin with a volume containing information on insane patients admitted to the Hospital at 8th Street before 1841, and transferred to the West Philadelphia building. Data probably copied from the original 8th Street records.

Medical Registers - Male Department.

Registers of Patients Admitted
Include: Case no., date of admission, name, residence, name and residence of security, rate charged, pay or poor, date of discharge or death. Information very complete.

Alphabetical Indexes of Patients.
Chronological within each letter of the alphabet. Includes: year, month, day; name, pay or poor, date of discharge or death. Discharge data not complete. Some overlap between volumes.

Alphabetical Indexes of Patients - Male Department

Summary Registers
Include: day of month; day of week; numbers of males and females, and total number in hospital; numbers of pay and poor patients.

Medical Journals.
Weekly entries give number of patients, cumulative numbers of cases and of persons; numbers of patients employed, restrained, secluded, under medical treatment; deaths, injuries and violence to patients; remarks.

Discharge Books.
Volumes through 1883 contain discharge number, name, Register (admissions) number, date of discharge, length of residence in hospital, and remarks on mode of discharge, condition when discharged.

Volumes commenced in 1883, in accordance with the Committee on Lunacy, include: date of discharge or death, date of last admission, register (admissions) number; name, age at discharge, color, sex; discharged with result or removed, where to, with result of treatment or assigned cause of death.

Some notes laid into volumes.

Discharge Books - Male Department.

Admissions and Discharges.
Contain daily records of admissions (name, date, class --pay, free, voluntary); running census (numbers admitted, remaining, and discharged); and discharges (name, date, class, whom patient left with, result--cured, died, etc., remarks). Miscellaneous notes and clippings laid in; other notes entered for each month (entertainment, donations, etc.)

Admissions and Discharges - Male Department.

Case Books - old Style.
Include cases for the first five years of the West Philadelphia "Department for the Insane" beginning in 1841 (men and women). Case histories in order of admission, identified with patients' initials. First 3 volumes contain alphabetical indexes of patients' names. Early records include history, notes on treatment, some follow-up notes in T.S. Kirkbride's hand. Later entries are less complete. No later volumes have been located.

Case Books - Female Department.
Case histories and follow-up are given in varying detail. Some cases are continued elsewhere in the same or another volume. Vol. 5 mainly contains continuations. Volumes indexed in front by patients' names. Some notes and clippings laid in.

From 1885, records were kept according to the instructions of the Committee on Lunacy. The following information is included: name, residence, date of admission; age, sex, nativity, marital status, occupation, religion, education; habits, insane relations, family history (other diseases, consanguinity); number, date and duration of previous attacks; number of previous admissions, admissions to other hospitals; when present attack commenced, supposed cause; restraint or seclusion; disease increasing, decreasing, or stationary; patient excitable, dirty, destructive, suicidal, homicidal; Also, general appearance (temperament, flesh, countenance); eyes (color, pupils, action as to light, etc.); physical examination (heart, lungs, abdominal viscera, pulse, tongue, temperature, skin, urine; speech, writing, condition of bowels and digestive functions); accompanying bodily disorders, bruises, etc.; diagnosis, ward number; persons brought by, admitted at request of, medical certificates of, correspond with, telegraph to;

Also, previous medical history: first change in physical condition; loss of sleep, appetite, etc.; changes in medical condition (depression, excitement, delusions, hallucinations, illusions, changes in temper, irritability, etc.; history of any suicidal or homicidal tendencies or attempts; convulsions, apoplectic seizures, symptoms of disease of brain or spinal cord; source of information.

Beginning ca. 1907, the following data are added: color; residence for past year; names of parents if living; names of husband or wife, children; names and residences of brothers and sisters; names of next of kin (if other); names and addresses of all medical attendants (last 2 years).

Beginning ca. 1911, gynecological exams are also included. Later cases also give more detailed histories (e.g. childhood).

Vol. 17 (n.s.) Continued Casebook contains the names of patients in the Department for Women, some of whom were admitted to the Pennsylvania Hospital prior to 1884-85, and whose names appear only in the "General Register" and not in any case book; as well as the continuations of other cases.

Vol. 18 (n.s.), Index of Patients 1900-1946 is arranged roughly alphabetically; and chronologically by date of admission within each letter of the alphabet. Contains date of admission, name, whether voluntary, committed, or temporary commitment; pay or free; date of discharge; some deaths noted.

Vols. 19-2O (n.s.) list patients according to location in hospital (North Side, South Side, Villa) in roughly alphabetical order within these categories. Include name, case book volume and page (or "folder"); and sometimes case number.

Case Books - Male Department.
Vols. 1-5 contain case histories and follow-up between 1874 and 1885 in varying degrees of detail. Patients' names are listed in fronts of volumes in rough chronological order of admission. Binders' titles vary.

Vol. 6 contains very brief case histories, probably copied in 1884 from earlier records. Many entries are continuations from earlier case books. Alphabetical index to patients, Nov. 19, 1859 - March 5, 1881, in front of volume.

New Style Vols. 1-18, use the same format as those for the Female Department . See above for details. Includes 141 cases admitted prior to 1885 who were still resident in the hospital at that time. Indexed by patients' names. Some clippings and notes laid in.

N.S, Vol. 19 contains an alphabetical roster of patients included in Case Books N.S. Vols. 1-18. and some later ones filed under the new system in 1912. Gives register number, name, case book volume and page.

Pharmacy Books.
Contain daily entries, probably a complete record of medications dispensed for the period covered. For each date, gives patients' names, medication and dosage. Notes on medicines, etc., laid in. Vols. 4-6 have new format: organized by patient, with chronological entries for each, indexed.

Address Books.
Arranged alphabetically by patients' names. Give names and addresses of relatives, friends, and/or physician. Entries generally undated. For some patients, case numbers and dates of admission given. Also, notes about correspondence, clothing, etc.; addresses for workmen, suppliers, steady correspondents.

Address Books - Male Department.

Admission Papers.
Admission forms for "insane" patients admitted to the Pennsylvania Hospital before 1541 (and transferred to the new West Philadelphia "Department for the Insane" when it opened) were all filmed . Fourteen cartons containing admission papers from 1841 to about 1909 are on file, arranged chronologically, and alphabetically within each year. The bulk of these papers were not filmed at this time. Most are routine forms containing little information.

Miscellaneous Patient Records.

Weight Books are arranged in rough alphabetical order; weekly record of patients' weights. Information incomplete.

Arranged alphabetically, List personal expenses (e.g., newspapers, clothing, sweets, damaged bedding) chronologically for each patient.

Records average per capita daily consumption of various foodstuffs for the Male and Female "Insane Departments" and the Pennsylvania Hospital at 8th Street with averages for the four-year period. Also comparative figures for Bloomingdale Asylum (1843) Harrisburg (1868, 1874), Dixmont (n.d.), St. Luke's (n.d.), and McLean Asylum (1872). Also, victualling of British and American soldiers and sailors.

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