THE HISTORY OF THE PITTSBURGH HOME AND CITY HOSPITAL AT
Compiled by Father George T. De Ville, Catholic Chaplain
From colonial times until the Great Depression of 1930, the care of the poor was considered a local problem. This concept that care of the poor was a local problem was a carryover from English Colonial law. Pittsburgh became a borough April 22, 1794. At that time there were approximately 3,000 residents in the community. The care of the poor needed attention. Overseers were authorized to impose taxes to raise relief funds for the needy. The position of overseer was an unpopular office, for they collected taxes to be given to the poor and needy "in their idleness." The overseers established the first home for the care of paupers on the South side of Virgin Alley (now Oliver Ave.) near Wood Street in 1804. This building could accommodate five people. It remained at this location until 1822. At that time anything beyond Wood Street was considered out in the country.
The pauper's house, or as it was at times called the almshouse, was not the ordinary means of caring for the poor. The most popular means of dispensing relief was for ward committees to collect cash, clothing and coal and distribute them. Churches and fraternal organizations were also active in relief of the poor. This method continued until the 1830s when care of the poor became an overwhelming burden. Then local government became deeply involved in the care of the poor.
To give you a flavor of the times, here are some of the rules of the time. Overseers could place children under the age of sixteen years of age in indenture service. This practice was legal in Pennsylvania until 1927. Children and grandchildren, parents and grandparents were financially responsible for each other. This remained the law until 1961 when Medicare and Medicaid came on line. Since care of the poor was a local problem, strict residency laws were in effect, you had to live in the poor district to receive help. The need for legal residency was ruled unconstitutional in 1969. Persons receiving poor relief and all members of the family were required to wear a red or purple "P" on the right sleeve. Under that was worn the first letter of their poor district. People receiving aid were forbidden to leave their poor district. There was no desire to care for the poor from another district.
The War of 1812-1814 with England promoted the prosperity of Pittsburgh. The British blockade of America not only stimulated the demand for domestic manufactures but reversed the direction of Western trade. Southern and Western products such as cotton, sugar, lead, furs, hides, saltpeter, and hemp came up the Mississippi and Ohio rivers and were trans-shipped to the East. The end of the War of 1812-1814 caused the cessation of manufacturing goods. The British were dumping surplus goods on the market and shipping resumed its normal routes. The effect was to bring on the depression of 1817 to 1821. The decade that followed the War of 1812 was one of hardship for Pittsburgh.
On March 18, 1816 the city of Pittsburgh was incorporated. The Office of Overseer of the Poor was continued. However, the requirement to wear a red or purple "P" on the right arm was discontinued.
With the recession of 1817 to 1821 and the increase in Pittsburgh's population to 7,000 residents in 1820 the poor house on Virgin Alley (Oliver Ave.) became inadequate. In 1818 a site for the new poor house was chosen in the town of Allegheny (Now the north side of Pittsburgh) one half mile from the Allegheny Commons (Now the North Side Park). The land fronted on Ohio Lane, later known as Pennsylvania Avenue, it was bounded on the East by Allegheny Avenue, on the North by Franklin Street and on the West by Sedgwick Street. Construction was completed in 1822 and the poor house moved. The new home could accommodate thirty residents. The cost during the first year of operation was $3,000. The cost of $100 a year for each resident was considered excessive and aroused opposition and complaints. This building served until 1848.
Following the depression of 1817 to 1821 Pittsburgh experienced a phenomenal growth. It was not an unbroken growth, there were two major depressions in 1837 and 1857. In 1820 the city and suburbs contained about 10,000 people. In 1860 this number had increased to 130,000. It became obvious that the almshouse in the city of Allegheny with a capacity of 30 was inadequate. In 1846 plans were begun to build a new almshouse that would have a capacity of 300 persons.
The Overseers of the city of Pittsburgh on September 1, 1846 purchased 102.5 acres located in the township of Mifflin, Pa. (in 1942 the name was changed to West Mifflin) on the southside of the Monongahela river. In 1847 the Overseers were replaced by the Guardians of the Poor. This group purchased another 50 adjacent acres and approved a contract for a three story brick building that would accommodate 300 persons. The building was large and pretentious. It was located beautifully and picturesquely on a magnificent bend in the Monongahela river. The almshouse was built on elevated ground with a lawn in front, ornamented with trees, shrubbery and walks sloping down to the river. The building cost $42,000 and contained the usual almshouse accommodations. There were sitting rooms, sleeping rooms, dormitories, kitchens, dining rooms, laundry, baths and quarters for the superintendent along with rooms for attendants. The sexes were kept segregated at all times, the two wings of the building being separated by permanent partitions. In 1852 the residents from the home on the North side were moved by barge to the new home at Homestead. In 1855 thirty-five acres, two rods, (rod 30.25 square yards) and six perches (perch 16.5 square feet) were purchased and added to the property. This brought the total acreage to about 190 acres.
In 1870 there was no classification of the insane. They slept in the same rooms and associated freely throughout the day. The 59 mental inmates in the home in 1870 were mild mannered, chronic cases and restraints were not used unless an inmate became unruly. There was only treatment for common diseases and no attempt was made to treat mental patients except for organic disturbances. Those cases which were thought to be curable were kept at Dixmont. (opened November 11, 1861) In 1873 there were about 50 Pittsburgh patients at Dixmont.
In 1872 the superintendent stated the treatment of inmates must be kind but just. Do everything to make it appear as a home for the inmates, but make them understand they are under the discipline of officers. Have a system. Make them understand they must do something and do it at certain periods.
The typical menu at the almshouse was: for breakfast the inmates received good bread, coffee or tea and molasses; at dinner they were given meat, vegetables, soup and bread. Once a week they were given pot-pie made of veal or some other fresh meat and sometimes milk. Supper was very similar to breakfast. All got meat at dinner and those who worked on the farm were allowed meat twice a day.
A separate building for the insane was erected in 1879. It was a three story brick building that had a capacity of one hundred and fifty, seventy-five of each sex. The sexes were separated as there were three male wards and three female wards. The cost of the building was $47,698.27. The expenses of the insane department were not kept separate from the other accounts of the poor institution. The average cost of the maintenance was $1.85 per person per week. The males worked on the farm and the females made clothing for the inmates.
The vacancies left at the almshouse by the removal of mental patients into the newly constructed building for the insane, were soon filled with additional indigent inmates. The problem of increased immigration brought with it the blind, crippled, lunatic and infirmed paupers from foreign countries. The situation became so intolerable Congress authorized the Pennsylvania Board of Public Charities to screen all immigrants at the port of Philadelphia and return to their homeland those who would become a burden upon the community.
The improved physical facilities at the Pittsburgh home did not insure improved medical attention. There was one doctor assigned to both the almshouse and the insane asylum. Between March first and June first 1883 seventy-four inmates died. The Pennsylvania Board of Public Charities recommended that a standing board of physicians assist the physician at the almshouse and a physician was appointed to attend the mental patients. In 1884 each institution had its own superintendent. No trained nurses worked at the almshouse infirmary or the insane asylum. Patients were nursed by inmates. This situation changed and trained attendants were hired. In 1887 a citizen's visitation committee stated there were improvements. In the insane asylum there were no more blackened eyes or cowering frightened figures among the mental patients. Maintaining mental patients under these conditions cost the city about $1.45 a week per patient. It would have been possible for the city to send the patients to Dixmont Hospital under the law of 1883 for $2.00 a week per patient. However, the city preferred the more economical method of keeping them at Homestead. This meant a saving of $3,500 annually.
The city farm at Homestead suffered from two serious problems in the late 1880's, overcrowding and poor living conditions. Normally at least 140 patients occupied the insane department, which was its capacity. In 1886 through 1888 the census was 164 with an additional 96 patients kept at Dixmont. The second problem was the encroachment of the Carnegie Steel Mill on the city farm. The mills crowded to within a few yards of the farm buildings. Smoke and dirt made life miserable. Railroad tracks had cut through the city farm. The only solution to these problems was to find a new location.
Three sites were considered, a tract of land where New Kensington now stands, Brunei's Island and a tract of land (the Neal Farm) of about 243 acres in South Fayette and Upper St. Clair Townships in Allegheny County, near the Washington County line. The tract in South Fayette-Upper St. Clair townships was chosen.
It was decided to sell the Homestead site to the highest bidder. The Carnegie Steel Company needed the property for further development of their plant. They made an offer of $450,000 in 1890 which was accepted. The home retained the right to occupy the buildings and remain in possession of a portion of the land for three years.
The George Neal Farm consisting of 243 acres (the grounds eventually increased over the years to 1001 acres) was purchased for $61,687.50. This land was located along the Chartiers branch of the Pittsburgh, Cincinnati, and St. Louis Railroad. Plans for the new home were approved by the Pennsylvania Board of Public Charities in 1892.
Construction of the new half million dollar institution began in 1892. On December 21, 1893 the Pittsburg Dispatch carried the news item:
"The removal of the inmates of the City Poor Farm occurred yesterday. In less than eight hours after the work was commenced
the city's poor were in their new quarters."
The moving of the inmates from the building at Homestead to the train required considerable work. There were forty invalids who had to be carried to the baggage cars provided for them. The two hundred or more insane remained until February 1894 when the new quarters at Marshallsea were completed.
A small railroad station was erected which was named Marshalsea. This railroad station was near the doctor's apartments on Elm Street on the other side of the tracks. The institution was called Marshalsea, the name taken from Charles Dickens novel "Little Dorrit." In this novel Marshalsea was the debtors prison in which Dorrit was raised because her father had been confined there for many years. The buildings were of brick and stone, heated by hot air and lighted by electricity. The administration building sat forward of the main home (the present site of the Bengs Building). Richly carpeted and finished in hardwood, it served as headquarters for the administrative offices and living quarters for the officers and their families. The main building housed women paupers in one wing and males in the other. Separate dining rooms for each were in the central building. About three hundred and forty (340) inmates occupied these facilities during the 1890's.
At some distance, in the rear of the main home was a utility building, next the power plant located at a considerable distance from the mental buildings. The latter were three stories in height. The buildings were divided into single rooms, sitting rooms and other accommodations. There were thirty-four rooms in the male building and the same in the female building arranged for the violent and untidy cases. These had cement floors and opened into cement hallways permitting "thorough flushing and cleaning". These buildings were known as North One and South One. In 1893 Henry Phipps donated the greenhouse.
Attendants resided in both the male and female building. The Pennsylvania Board of Public Charities suggested a ratio of one attendant to ten patients. Male attendants made $22.50 per month.
For the most part mental patients received no service other than that given by their attendants since no physician was assigned to the insane department until 1899. When required, the physician connected with the main home and hospital gave medical service to inmates in the mental department when necessary. Otherwise, the care in the mental department was custodial care. The mental patients worked on the grounds and farm which was cultivated by chronic insane male patients. The female patients worked the laundry, greenhouse, barns, sewing room, in the gardens and elsewhere in the home.
Construction on the South 2 buildings began in 1902. On Monday December 14, 1903 the buildings were ready for occupancy. Forty male and forty female patients were transferred to the new buildings. Shortly after three o'clock the transfer of the patients was completed. The patients transferred were more or less convalescent, the worst cases continued to occupy the old quarters. The new buildings were thoroughly equipped as to heating and ventilation. No expense was spared to secure every appliance contributing to the health and comfort of the patients. From a sanitary and ventilating standpoint the situation was admirable and every room was flooded with light from numerous wide and lofty windows. The dormitories were fitted with plain iron beds of uniform dimensions while the beds themselves were finished luxuriously. The furniture chairs and tables were not only abundant and serviceable, but were extremely handsome being finished in quarter oak. There was in the rear of the buildings an artesian well 103 feet deep that provided sufficient pure water for the buildings.
Immediately in the rear of the cottage buildings (South 2) was located what was termed an administration building where male attendants and paid employees of the farm lived. These employees were transferred to their new quarters from the administration building. The new quarters were equipped with modern improvements. Here the occupants took their meals and rest after their day's labor. The opening of these buildings were created at large expense in the way of fuel, heating and water supply. The old asylum buildings were very crowded. However, it was an absolute necessity to make more room for the care and treatment of the insane. The good results obtained from the use of the new buildings overlapped the extra expense.
A tuberculosis camp was established at the top of the hill near the Temple Centers. After the second bend in the road to the Temple Centers a set of steps can been seen that led to the tuberculosis buildings. In 1911 lumber was purchased for $150.00 and a formidable tuberculosis shack, 52 feet by 22 feet, was erected on the site of the tuberculosis camp. The building was one story and had a twelve foot open porch in front. This building was used for the care and treatment of male tuberculosis cases and made quite an addition to the camp proper.
Building number 39 (The large white house that is at the corner of First Ave. and Serpentine Dr.) stood isolated from the rest of the farm. It became the pest house. Contagious diseases such as small pox, diphtheria, scarlet fever, etc., were a problem in the early days of Marshalsea. The threat of an epidemic of small pox in 1902 resulted in considerable expense. Each and every inmate was immediately vaccinated. All bed clothing, inmates clothing and miscellaneous articles were destroyed. It was after this that patients with contagious disease, at the time of their transfer from the city were sent to the pest house. The "victual (food supplies) and supplies" were taken in charge of one man. Care and nursing of the patients was performed by a patient from the female hospital. Both of these persons were immune.
One of the most interesting features of the entire hospital was the Nursery. It stood apart from the other buildings and was considered beautiful and symmetrical in architecture. This building was across from the greenhouse, ironically about where the children's unit is today. Some of the children were born at the hospital. There were about ten births a year at this time. There is a special baptismal registry at St. Agatha's Bridgeville, Pa. for the baptisms from Marshalsea (Mayview) and Woodville. The baptismal records sometimes carry notations. "Mater Amentes" which in Latin means that the mother was mentally ill or "Illegitimus" which means the mother was an unwed mother. The unwed mothers were brought to the hospital until 1940. After that they were sent to the Florence Crittenden Home on South Aiken Ave. Other children were cases of desertion and cruelty. The children were kept out of their sleeping apartments during the daytime and romped in one central playroom. The personnel, an experienced attendant and an assistant, lived under the same roof.
In the early 1900s the infirmary became very congested. Because of the inadequacy, a building to house a general hospital (Medical Center) was erected in 1909. Due to insufficient medical staff and nursing personal, the development of an active and working hospital was delayed for a number of years.
In 1913 Dr. G.S. Llewelyn (A plaque honoring him is located at the ambulance entrance in Beng's Building) was assigned to the general hospital and through his efforts the hospital was transformed into a complete unit. Dr. Llewelyn supervised the medical and surgical work at the institution. Major surgery was now performed. Old, antiquated and unsuitable instruments were discarded. An adequate supply of modern equipment including an X-ray machine was obtained. In 1914 a new wing was added to the general hospital. Also in January of 1914 appropriations for a pathology laboratory were approved.
Construction of the North 2 building began on June 23, 1915 and was completed in November of 1916. New wings were also added to the South 2 building in 1915. Following the completion of the new buildings Marshalsea housed 2,100 patients.
Dr. Llewelyn assisted in establishing a school of nursing at Mayview. The school opened September 15, 1915 with a course of instruction covering a period of three years. All of the attendants on duty at that time, between 30 and 40 were compulsorily enrolled in the first class. Only eight graduated in 1918 in the first class. The school of nursing graduated its last class in 1935. Mike Walsh's (VAS Little Store) mother was in the last graduating class.
The city of Allegheny (North side Pittsburgh) maintained an institution for the poor and insane at Claremont, now known as Blawnox. The city of Allegheny became part of the city of Pittsburgh on Dec. 6, 1907. In 1916 the patients at Claremont were moved to Marshalsea. A total of 290 patients were transferred of which 288 were insane. The total population at Mayview was then 1,133 mental patients and 752 were non-mental patients. The property at the Allegheny home was later used for the county work house at Blawnox.
For many years the name Marshalsea was associated in the public mind as synonymous with the idea of the "poor farm". Marshalsea being the name of the debtor's prison in Charles Dickens' "Little Dirrot". The name carried the idea of derision and disgrace. At the turn of century there was a movement to discard names that were distasteful. In May of 1916 new names were proposed. The names suggested were: Goodlawn, Montview, Mayview and Ridgeland. The name Mayview was chosen and in 1916 the Legislature gave its consent to changing of the name from Marshalsea to Mayview.
In 1917 the Mayview coal mine was opened.
In 1917 the City Council of Pittsburgh passed an ordinance for the organization of a visiting medical staff at Mayview. Nothing was done until 1923. In 1922 Mrs. Enoch Rauh was appointed Director of the Department of Charities of Pittsburgh by Mayor William Magee. No history of Mayview would be complete without expressing the debt of gratitude the hospital owes to this lady. She had a clear vision of what had to be done and the ability to understand the social problems of the mentally ill, indigent and infirmed. In 1923, Mrs. Enoch Rauh in consultation with Dr. Lester Hollander, following the instructions of the almost forgotten legislation of 1917, appointed a visiting staff of physicians for the General Hospital at Mayview.
The Occupational Therapy Department was established in March 1923 with the appointment of one occupational therapist, Mrs. Lucy Babylon. The department was given a large, well lighted day room in the Female Cottage (South 2) of the Mental Department in which to carry out their- activities. The patients were taught the usual crafts found in the female mental hospital such as pottery, weaving and basketry. In the male division the men were taught woodwork, mental work and mechanical drawing.
In 1923 the Social Service Department was established at Mayview during the administration of Mrs. Enoch Rauh. Mrs. Beatrice Hunter was the first director of the department.
The Quarantine Department at Mayview was a separate unit apart from the hospital and was under the direction of Dr. Benjamin Berger. This department treated venereal disease exclusively and consisted of a male and female sections. Many of the cases were voluntary while others were under the provisions of the state quarantine laws and were sent to Mayview by the Morals Court. A treatment introduced in 1922 was the Malaria Therapy. The patient was deliberately infected with malaria. When the patient's temperature rose, the patient was placed in a chamber that resembled an iron lung, with the head protruding out. The chamber further raised the body temperature. The head was packed in ice to protect the brain during the high temperature. Amazingly, this treatment was somewhat effective.
The Physical Therapy Department was organized under the direction of Dr. G. S. Llewelyn in 1928 with Mrs. S. H. Rail as supervisor. In this department there were three diathermy machines, one galvanic machine, one infra red lamp, one ultraviolet ray lamp, one rehabilitation machine and X-ray equipment.
In 1924 a survey was authorized to make a complete survey to the present condition of the Pittsburgh City Home and Hospital at Mayview, needs for repairs and extension and development. As a result of this survey a "People's Bond Issue" of 2.5 million dollars was proposed for repair and expansion of the hospital. The bond issue was approved by the voters in the fall of 1926. The plans were drawn up in 1928 and the general contract was awarded for the warehouse and laundry. Ground for these buildings was broken on February 9, 1928. The contract included Staff Building A (Volunteer Center). B and C (Doctors Residents), Nurses Homes D and E, Employees Buildings F, G, H (three buildings near North entrance) and the Male Infirmary (named the Kline Infirmary after the mayor of Pittsburgh). Fire towers on the Male and Female Buildings and a new general kitchen for the entire institution with a cafeteria for the employees (The Little Store, Bowling Alleys and Chapel). Formal dedication of these buildings occurred on September 12, 1929.
The Great Depression of the 1930s had its effect on the Pittsburgh City Home and Hospital at Mayview. By 1934 there were 4,200 patients at the home and only 450 staff to care for them. The staff at Mayview did a heroic job in the face of the depression which poured hundreds of unfortunate people within its walls every month. Patients were herded together in every available space, including basements, workshops, barns, (the barn across from VAS that later was known as the community center—it housed 90 men) and recreation rooms. There were 300 double deck beds in the utility building (the present garage, security office, VAS and laundry building), Cots filled hallways, rest areas and porches.
The worst conditions existed in the insane wards. The beds were so close together in places it was difficult to walk between them. At times the wards were quiet and then in an instant, the shouts and shrieks of the inmates filled the air.
In the early 1930s the only treatments available to the staff were hydrotherapy and the drug phenobarbital. There were various hydrotherapies. Cold wet packs were used on disturbed patients. Sheets were soaked in ice water. The patient was striped naked and carefully wrapped in the sheets. Care had to be taken not to leave a crease, for it would result in a freeze burn and leave a permanent scar. The patient might struggle in the wrap, but eventually the body heat and energy was drained away and a warm cocoon would be produced. The patient would then sleep for up to four hours. This was a very effective therapy for disturbed and violent patients. This treatment was often used in conjunction with the continuous baths described in the following paragraph.
Another hydrotherapy used was hot and cold water hoses. The patient would stand naked with his/her back to the operator of the hot and cold water hoses. The operator would aim the strong thin stream of hot water (100 to 110 degrees Fahrenheit) up one side of the spine and the cold water (70 degrees Fahrenheit) up the other side of the spine. At the top of the back the water streams would be reversed. This was relaxing for the patient.
A third method of hydrotherapy was to place the patient in a tub in which the water was kept at body temperature of 98.6 degrees. There was a canvas sling in the tub on which the patient was suspended. Another canvas covered the top of the tub with a hole for the patient's head to protrude, an air pillow supported the head. After a time the patient would become sleepy and lethargic. Patients remained in the water one to two hours and then were placed in bed until the excitement returned. This alternating between bath and bed could extend for days.
In 1933 insulin shock therapy was introduced. This therapy required a large number of staff and had certain dangers inherent in the treatment. The treatment involved injecting the patient with insulin until a coma was induced. At the end of one hour the coma was reversed by the administration of glucose. Even though this treatment was called insulin shock, no seizure was induced. Patients were given 20 or more treatments. There was apparent success related to this therapy and it was used well into the 1960s.
At the same time insulin shock therapy was being used, metrazol convulsive therapy was introduced. Metrazol produced a terrifying preconvulsive aura. There was also uncertainty when the seizure would begin. This led to the discontinuance of the metrazol therapy.
In 1935 in Portugal, Dr. Egas Moniz performed the first prefrontal lobotomy. In 1949 he received the Nobel Prize in medicine for his work. This is the only Nobel Prize in medicine awarded in psychiatry. In the late 1930s lobotomies were preformed at Mayview. The doctors came out from St Francis Hospital to Mayview. The operations were performed in the Medical Center. Following the operations the patients were sent to South 2, Wards 6A and 6B. They received constant care until they were physically well. At times the operation produced satisfactory results and patients were even discharged. Sometimes there was a regression in control of body functions and mental functions. The criteria for performing this operation was that the patient was out of control, violent, combative and no other treatment was effective. With the introduction of the psychotropic drugs in the mid 1950s this procedure ceased to be used except in very rare cases.
In 1938 Cerletti and Bini in Italy introduced electro-shock as a replacement to metrazol convulsive therapy. According to Superintendent Gomer S. Llewelyn, M.D., by 1941 electro-shock was being widely used at Mayview. This therapy was much less dangerous than metrazol or insulin therapy. Shock therapy was given in order to induce a seizure similar to that experienced by epileptics in the hope it would cure the mental disorder. A description of the treatment as administered at Mayview was given by employees in the 1940s. The patients were weighed and blood pressure taken. Patients usually resisted this treatment. Mouth gags were used to prevent the biting of the tongue and the crushing of teeth. Dentures were removed. Electrodes (small mental plates) were placed on both temples with an electrojelly placed on the skin to prevent burns. The voltage used was between 70 and 130 volts for one tenth to a half second. The patient would have a clonic seizure first (rapid succession of alternating contractions and relaxations) then tonic seizures (prolonged muscular contractions). The back then arched. Some physicians thought the more severe the seizure, the more effective the treatment. This was to be proved not to be so. In extreme cases the patient might stop breathing. In that case the diaphragm was pushed in or oxygen was administered. Frequently patients lost control of their bladder. Eventually electroshock became so widely used the patients were kept on maintenance doses. Electro-shock was administered on Monday, Wednesday and Friday. The introduction of the tranquilizers in 1954-55 reduced the use of electro-shock by 90%. However, it is still used as the treatment of choice in severe depression. It is now administered under partial anesthesia and the only reaction is a positive Babinski.
Two other drugs extensively used during the 1930s were chloral hydrate and paraldehyde. Both of these drugs are hypnotics. Chloral hydrate was first used in 1869 and is still used today. It was especially useful in treating alcoholics before the introduction of Librium and Valium. Chloral hydrate was used in acute hallucinatory conditions and epileptic psychosis. It was frequently used with morphine.
Paraldehyde was used also as a hypnotic. However it tasted horrible, left the patient with bad smelling breath and body odor. When walking on a ward, if two or three patients were on paraldehyde the odor was apparent. It was not very popular with the patients and its use was discontinued.
Alcohol was used to sedate the patients. Spiritu fermenti at 140 proof was kept in the pharmacy for prescription use only. The pharmacy had to maintain a liquor license. It was alleged that patients would act up just to get a shot of alcohol.
Strait jackets were used on some patients in the South 2 building. They were fitted loosely with arms crossed in front and the long sleeves tied in the back. They were used humanely, mostly for the benefit of the patient.
On admission all patients placed their glasses and dentures in a container, never to see them again. The patients were scrubbed, deloused and given a laxative. The patients were purged every week with epsom salts. Their hair was cut all in the same way, straight across. All were dressed in the same style of clothing, usually made of blue denim.
The treatments and the drugs described were the basic armamentarium of the doctors and staff until the introduction of the tranquilizers in 1954-55. They may seem crude and sadistic by today's standards. However they used the same care and concern we have today. They used observation and made judgments concerning treatment. We apply the same principles today only we are privilege to more sophistication and current knowledge.
In order to describe the working and living conditions of the employees, Ruth Furr, R.N. and I interviewed two retired nurses who had graduated from Mayview's School of Nursing. On February 1, 1993 we met with Josephine Walsh, class of 1935 and Marian Franks, class of 1933. What follows is a compilation of that interview.
The employees lived on the grounds (until 1956) and the accommodations could not have been better. The dormitory buildings were new. (Most were built in 1929) The student nurses lived in D building and the graduate nurses lived in E building. Other employees lived in F building (Male and Female Dormitory), G building (Female Dormitory) and H building (Male Dormitory). These buildings were near the North gate.
The employees worked 12 hour shifts, 7 A.M. to 7 P.M. six days a week. During the 12 hour shift there was a two hour break, 10-12, 1-3 or 3-5. On Sundays it was a three hour break. During the break you could return to your room and rest. Employees were permitted to be out until 10 P.M. and one night they were permitted out until midnight. Frequently, on their day off they would take the train to Pittsburgh. The last train out from Union Station in Pittsburgh, was called the "bummer." It got back to Mayview at midnight.
Josephine Walsh worked on the "Mayview Bus." It had two stretchers, one permanent and the other folded up. The rest of the bus was made up of seats. The bus made two trips to Pittsburgh every day, one in the morning and the other in the afternoon. It would stop at the City-County Building to obtain the assignments. The bus would go all over the city of Pittsburgh to pick up the sick. Sometimes the stretchers had to be used for the severely ill. The last stop on the afternoon trip was the Number One Police Station. Sometimes people were brought in cuffs to Mayview.
Student nurses were paid $16.00 a month. Graduate nurses made $54.00 a month plus room, board and medical care. There were two sections in the general hospital (medical center) for employees. The doctors came out from Mercy and St. Francis Hospitals to care for the employees and patients.
Recreation was self made. Dances, picnics and corn roasts were held in the pavilion or grove. A bus would take employees to the Y for swimming. Josephine Walsh and Marian Franks stated their years at Mayview were among their fondest memories. When they thought of the hospital, it was something very dear to their hearts.
Since colonial times care of the indigent, physically ill, mentally ill, retarded, the handicapped and public relief was considered a local problem. These services were provided by local poor districts. The city of Pittsburgh being a local poor district, administered these programs through the Pittsburgh Department of Welfare. The Great Depression of the 1930's overwhelmed the local system. In 1935 the Pennsylvania Committee on Public Assistance was appointed. It was chaired by Dean Herbert Goodrich of the University of Pennsylvania Law School. The Goodrich Committee as it was usually referred to, was charged with studying the problems of welfare and poor relief.
In 1937 the first proposal was, almshouses, mental hospitals and other poor district institutions remained the responsibility of the local poor district supported by separately levied institutional district taxes. The Pennsylvania Department of Public Assistance was to assume responsibility for all assistance outside the institutions; General Assistance, Aid to the Disabled, The Blind Pension, Office of Old Age Assistance and Aid to Dependent Children. The local poor districts had no responsibility for these programs. A County Board of Assistance (CBA) was established in each county to administer the five listed programs. A uniform state system of relief was established throughout the state. Until this time, each county decided on how much relief was to be given.
In 1938 the Goodrich Committee recommended the "Full State Care Act." It prohibited any city, county, or institutional district from operating any institution for the care of the mentally ill patients. The act transferred ownership of existing mental hospitals to the Commonwealth of Pennsylvania and directed the Department of Welfare to determine which institutions were suitable for use as state mental hospitals and which should be closed. The enactment of this act was delayed by litigation undertaken by Blair, Chester, Lackawanna and Somerset County Institutional Districts which challenged the constitutionality of the "Full State Care Act." The constitutionality of the law was upheld. Of the 13 county mental hospitals, eight became state hospitals; Clark Summit, Embreeville, Hollidaysburg, Mayview, Philadelphia, Retreat, Somerset and Woodville.
On June 1, 1941 the "Full State Care Act" became effective. On that day the Pennsylvania Department of Welfare took over the mental section of Mayview and the City of Pittsburgh continued to administer the indigent section of the hospital. Two separate institutions directed by two different jurisdictions then existed at Mayview, The Pittsburgh City Home and Hospital at Mayview and Mayview State Hospital.
On June 1, 1941 the Commonwealth of Pennsylvania assumed the responsibility of care for approximately 3,200 mentally ill patients and continued to receive mental patients who were residents of the city of Pittsburgh. City of Pittsburgh retained the responsibility for the care of approximately 900 indigent patients. The City of Pittsburgh retained the General Hospital, Laboratory and the Fire Department, but continued to furnish services to the State Hospital. The members of the resident and consultant staffs of the Pittsburgh City Hospital were always available for medical, surgical, ophthalmological and orthopedic procedures for the patients in the mental hospital. Four hundred fifty employees became state employees. Two hundred thirty-three employees continued to work for the City of Pittsburgh. Dr. Gomer S. Llewelyn, the city appointed head of Mayview for 28 years, was appointed acting superintendent of Mayview State Hospital by State Secretary of Welfare, E. Arthur Sweeny. Dr. Ira Bryant, assistant to Dr. Llewelyn for five years, was appointed acting superintendent for the City Hospital at Mayview. Dr. Llewelyn remained superintendent until his death on November 21, 1945.
The division of the property was on a 75-25 basis, the greater share of the buildings and acreage was given to the state and the remainder was retained by the city.
During the Second World War, Mayview became overcrowded. New Buildings were not able to be built because of shortages of building materials, even though money was available. There were serious staff shortages. One hundred twenty-eight staff members left for military service. The medical and nursing staff were particularly hard hit by staff leaving. Mayview had a capacity of 2,300 mental patients but now housed 3,100. Each night 300 cots had to be set up in the corridors. Admissions were halted and patients were kept in the county jail and in many Pittsburgh hospitals.
In 1943 the Tuberculosis Sanitarium on the hill was condemned and patients were moved to the county operated sanitorium at Woodville County Home. A complete radiographic survey was made of the patients and a number were found to have Pulmonary Tuberculosis in various stages of development. It was necessary to isolate these patients on two wards at Mayview as beds for these patients were not available in the sanitorium at Woodville. The Mayview patients at Woodville remained there until the William Forrester Building was completed in 1953.
By an Act of the General Assembly, The Allegheny County Institutional District (the agency that managed Woodville County Home) became responsible for the care of all non-mental indigents within Allegheny County on January 1, 1945. This included the indigents which the City of Pittsburgh cared for at the City Home and Hospital at Mayview. About 800 indigent patients at Mayview became the responsibility of the County Institutional District. The city employees became county employees.
At this time there was an increasing demand for hospital infirmary care for the indigent patients in the care of the Allegheny County Institutional District. (A.C.I.D.) Both Mayview and Woodville were not adequate to care for the hospital type patient. Therefore the County Commissioners and Administrative Officers of A.C.I.D. authorized the building of a new institution. On February 7, 1958 the John J. Kane Hospital in Scott Township was dedicated. This hospital offered every facility necessary to diagnosis and treat the chronically ill. The capacity of the new hospital was 2,006 patients. Beginning on March 1, 1958 the indigent patients from Mayview and Woodville were moved by bus and ambulance to the new facility. Mayview became solely a Mental Hospital administer by the Commonwealth of Pennsylvania.
The buildings erected at Mayview State hospital during this time period were the root cellar in 1943. This is the building that is at the corner of Sunset Drive and Mayview Road. It is now used for storage. In 1950 the dietary building was completed. Temple Center One and Two were opened in 1951. South Three building was completed in 1954. It was later named the Virginia Dixon Building.
At this point in the history of Mayview it is time to pause and pay tribute to Gomer S. Llewelyn, M.D. The hospital owes a debt of gratitude to this man. He modernized and coordinated the medical treatment of the mentally ill.
He was born December 5, 1885 in Pittsburgh, Pa. of Welsh immigrant parents. He graduated from the university of Chicago Medical School in 1912. He came to Mayview (Marshalsea) in 1913 as medical director and spent his entire medical career at Mayview. He was a man of medicine, surgery and psychiatry. In addition, he was a gifted administrator. Immediately upon his arrival at Mayview he assisted in establishing the nursing school at Mayview. The major portion of credit for the integration of the medical and psychiatric care of the patients must go to Dr. Llewelyn. He worked out and proposed the integrated program. Then he was responsible for the adoption and implementation of the plan that made medical, surgical and laboratory facilities available to mental patients. In 1935 he became the superintendent of Mayview. Under his direction the hospital became a place of pre-eminence for psychiatric treatment in Pennsylvania. He was a man of decisive thinking, good judgment and was enthusiastically devoted to Mayview. He assumed responsibility and was always constructive in the advice he gave. However, he was unyielding when he thought he was right. He maintained the friendship and respect of his associates, fellow employees and the patients under his care. On June 1, 1941 he was named superintendent of the newly established Mayview State Hospital. He remained at that position until his death on November 21, 1945.
Immediately following World War II there was an increased interest by the public in the care and treatment of the mentally ill. The war undoubtedly stimulated this interest. A similar surge in interest followed World War I. Great effort was expended to arouse public interest in order to overcome obstacles to progress. In 1948 the movie "Snake Pit" portrayed the overcrowding, under staffing and dismal conditions in large mental hospitals. This movie is a classic and still can be seen on television. It did much to make the public aware of mental hospital conditions. At this time 1945-48 the ideal goal was to stabilize the patient and return the patient to the community in the shortest time. The aim of all the plans was to re-establish the patient to his or her original place in society. Despite these goals, Mayview reached the peak of capacity for overcrowding. There were 3,270 patients on the books and 3,005 in the hospital. There was a ratio of one nursing staff member to 36 patients on an eight hour shift.
To help ease this situation, the Senior Cadet program was introduced at Mayview in 1945. This was a war time United States Government program to promote the education and training of nurses for military service. The students education was paid for by the government and they received $10.00 a month. The response to having these students at the hospital was so favorable plans were made in 1945 to establish an Affiliate School of Psychiatric Nursing. In April 1946 the State Board of Examiners for the Registration of Nurses approved the Program at Mayview. In June 1946 twenty-four student nurses were accepted and thirty-two were received in September 1946.
In 1946 Affiliate Programs in Nursing were initiated with eight schools of nursing; Washington, Mercy, Altoona, Uniontown, H.C. Frick Memorial, Mount Pleasant, Braddock and McKeesport.
In July 1946 the hospital established an observation unit which operated through the county jail for emergency cases. The unit made institutional care available to the senile, defectives and antisocial individuals who were in custody. The main purpose of the unit was to provide service to the acutely mentally ill. Monday through Friday a Mayview social staff member went into the jail to interview prospective patients, relatives and friends to obtain the social history. On arrival the worker would review the police reports. Sometimes this was the only information available on an individual who had been taken into protective custody on some minor charge. More often, anxiously distressed family or relatives were glad to know that the patient would be receiving institutional care. Then the family would say, "And I hope you'll keep him/her there for a long time.
This unit was established to provide the best possible care for the mentally ill. It was possible that a person suffering from abnormal mental conditions may on occasion be detained in jail following arrest. Believing that such detentions were wrong the Department of Welfare of the Commonwealth of Pennsylvania authorized the creation at Mayview State Hospital an emergency observation unit to evaluate a person under arrest who was thought to be mentally ill. Such a person was then removed to Mayview to be cared for in safety to themselves and others for a period not to exceed ten days.
The observation period for new patients was limited to ten days. In this time a plan for treatment must be formulated. The specific therapies available included electro shock. Insulin was used with both total and sub-total reaction. Metrazol and curate treatment were utilized. For other types of mental disturbances the hospital offered cabinet fever and malaria treatment, also methedrine, (used following World War II - it made the patients more communicative and verbal, disclosing psychotic material) narcosis and narco-analysis.
For medical problems a large medical dispensary was maintained. Medical consultants were available. The medical armamentarium included penicillin and streptomycin. The hospital had modern operating rooms and therapists. There was a full time pharmacist. The pharmacy had a state liquor license and a federal license to distribute narcotics. Alcohol and narcotics were used to sedate patients before the introduction of the psychotropic drugs in 1954-55. In 1950 fifty-one gallons of 140 proof alcohol was distributed to the patients.
Between 1948 and 1950 the hospital facilities grew at an extraordinary rate. The promise of 1,000 new beds was being fulfilled. However, there was concern over the movement "the cult of curability." This cult replaced the idea, "once insane, always insane" with the banner "at least 90 percent of all cases of insanity can be cured." Leaders in the mental health field expressed concern stating, unless scientific research provides a new and miraculous drug or form of treatment, the cult of curability will not be a fact.
In the 1950s the state hospitals cared for the masses of patients. The goal was to send more and more patients home to their families and friends in a shorter time. Without adequate staff, new buildings alone would become old and deteriorate before their time, custodial care would be the norm and the slow paralysis of overcrowding would beset the hospital personnel. In the past lack of any therapeutic plan made the hospital a place where patients passed the years. The average length of stay was ten to eleven years. New buildings alone did not provide a cure. Humane and scientific care were essential.
Despite the overcrowding, every effort was made to reconstruct the mentally ill patient physically and mentally. It was only natural with the abolition of restraints in 1946 that there was an intensified effort at psychiatric treatment and a complete therapeutic plan with mental and physical rehabilitation as the goal. This was considered vital to overcoming the problem of chronicity.
The period of 1954 to 1958 was a period of dramatic changes at Mayview. Many of the changes are unrelated but were clustered in this time period.
On January 1, 1954 the work week was reduced from five and one half days to a five day work week.
The first volunteer department in state mental hospitals was inaugurated at Mayview State Hospital with the hiring of Mary T. Summers as director of volunteers on February 1, 1954. This was done in response to the state wide initiative to have the hospital more involved with the community.
Superintendent Preston W. Thomas, M.D. resigned in August 1954 and Regis F. Downey M.D. was appointed superintendent. In December 1954 Assistant Superintendent Otto Ramik, M.D. resigned to accept the superintendency of Woodville State Hospital.
Christine MacKenzie, R.N. resigned as director of nurses on October 1,1954 and Mrs. Eleanor M. Roach, R.N. was appointed director of nurses. Mrs. Alice M. Kurland, R.N. (Kurland Gardens in the Bengs Building) was appointed assistant director of nurses.
The Reverend James S. Yount the resident Protestant Chaplain was named the new recreation director while he still retained his duties as Protestant Chaplain. The Reverend Francis Plantis was named the resident Catholic Chaplain serving both the State and County hospitals at Mayview. Rabbi Mordecai L. Gladstein became the Jewish Chaplain.
The kitchen area of the old cafeteria was utilized for the installation of six bowling alleys in July of 1955.
The introduction of the tranquilizing drugs in 1955 at Mayview resulted in remarkable progressive strides in patient care. The general appearance of the patients improved. Because of the therapeutic effects of the tranquilizing drugs, patients who had not been off the ward for years were now able to take part in activities outside the building or go home for short visits. Some were even granted leaves of absence. There was an immediate drop in the use of electro shock and hydrotherapy and lobotomies ceased. All the iron fence enclosures and hundred of window bars were removed. For the first time the number of patients began to decrease. In 1955 there were 3,837 patients in the hospital. A slight decrease was registered in 1956, the population was 3,819. The cost per day for a patient was $2.38.
Operation of the coal mine ceased on January 1, 1956. All power generation at the hospital power plant was discontinued on February 10, 1956. Power was purchased from West Penn Power.
Thomas E. Murray (plaque at entrance in the Bengs Building) was appointed to the newly created position of business manager in April 1956.
The Psychiatric Technicians Program began on October 23, 1957. The purpose of this program was to up-grade the educational level of the treatment staff.
On March 1, 1958 the new John J. Kane Hospital opened. AH the county patients and employees were moved to the new hospital. The State Hospital at Mayview took over all the facilities at Mayview.
Since Dr. Regis F. Downey has played an important part in the history of Mayview, his biography is included in the history. Dr. Regis F. Downey was a native of Fayette County. He attended St. Vincent College in Latrobe, Pa. and completed his medical studies at the University of Maryland, receiving his medical degree in 1934. He entered private practice in Greensboro, Pa. in 1935 and remained there until 1939. Between 1939 and 1941 he served a residency in neuro-psychiatry at Northampton, Mass. Dr. Downey then served five years in the military during World War II as a psychiatrist. He then returned to private practice in Carmichaels, Pa. In 1951 he was named the State Assistant Commissioner of Mental Health. From 1952 to 1954 he was clinical director of Danville State Hospital. Dr. Downey was named Superintendent of Mayview State Hospital on September 15, 1954. Dr. Downey was known for his concern for the patients. He became superintendent at a time of dramatic changes in the care of the mentally ill. The tranquillizing drugs were introduced at the beginning of his tenure. Patients were given more freedoms and rights and were being discharge and the hospital population was actually decreasing. In 1963 he supervised the complete overhaul of the operating room at Mayview so that patients would not have to be sent out to other hospitals for surgery. He contested the charges that the patients were not being well taken care of at Mayview. Dr. Downey serve as superintendent until May of 1973. He retired first to Canada and then to Florida. He died Feb. 9, 1979.
In 1960 the mental hospitals and community mental health services was costing every person in Pennsylvania $5.30 or about $48 million dollars. Pennsylvania ranked tenth among the fifty states in per capita expenditures for mental health services. The average cost of a patient per day in a state mental hospital was $3.75. General hospitals were charging on average $28.27 per day. Pennsylvania had only 45% of the minimum staff required and the state ranked below average in the number of full time employees per patients in daily maintenance expenditures.
During the 1960s the following buildings were added to the Mayview complex. The Downey Community Center was built in 1960. In 1965 the Temple Center Canteen was completed. The Bengs Building was dedicated on June 5, 1968. The last building added during the 1960s to hospital was the maintenance building which was completed in 1969.
In March of 1973 the Department of Public Welfare made plans to move patients judged criminally insane from Farview State Hospital in Wayne County to Mayview State Hospital. There was concern not only about the safety of the community but also about the safety of the non-criminal mental patients currently housed at Mayview. On October 1, 1973 Dr. Robert Trivus was appointed Mayview Superintendent. In that same month Dr. Trivis stated that about 80 Farview patients were eligible for transfer to Western Pennsylvania hospitals. He stated that Mayview would accept minimum and moderate security patients who have been screened for admission by the staff doctors. Farview patients were to arrive in small groups. The staff complained they were already 200 staff members short to provide sophisticated psychiatric care in addition to creating a unit for the criminally insane and a unit for the retarded.
The Forensic Center opened in 1974 in the Dixon Building with only one male unit of 28 beds on C-2. Dr. Peter Bishop was the director. This unit provided services for the eleven counties in Southwestern Pennsylvania. In 1976 a second male unit of 28 beds was opened on C-l in the Dixon Building. At this time Dr. Vincent Berger became the director of the unit. In 1980 Dr. Lillian Meyers was named the director. From the beginning of the unit security in this unit did not differ a great deal from the security that was practiced throughout the hospital. Kevin Cooper escaped on October 8, 1982 and on the same day raped an Upper St. Clair teenager. Then on June 5, 1983 in Chichino Hills, California he murdered three members of the Ryen family and a visiting child. He was convicted of these murders on Feb. 20, 1985 and sentenced to death. Following this incident security was greatly increased for the unit. At this time the outdoor courtyard was enclosed and a series of electronically controlled doors installed. In 1984 the female unit was opened on B-4 with 15 beds. Dr. Howard Friday became director. In 1985 Sylvia Seegrist, who killed three persons and wounded seven in a Media, Pa. shopping mall, was sent to Mayview' Forensic Unit. The memory of Kevin Cooper was still fresh in the memory of the Upper St. Clair residents. Newspaper articles had told of her arrival at Mayview the residents expressed concern for their safety. Eventually she was transferred to Norristown State Hospital. She was judged guilty but insane and will serve out the required sentence.
Before 1975 the patients worked at the institution's sewing rugs, mending clothing, delivering messages, working in the laundry, dietary, performed janitorial duties, ground keeping duty, farm work and maintenance work. No one was paid and no one could refuse to work. If they did, their ground privileges would be revoked. Most state hospitals were build in isolated rural areas. The institutions had to provide almost all their own services.
The peonage system evolved in the 1800s in order have to the patients therapeutically occupied. The financial advantages of the work programs eventually outweighed the aims of therapy. At predischarge meetings one would hear, you can't discharge that patient, he is such a good worker.
Beginning in September 1975 new rules were introduced that allowed work only if it was voluntary, therapeutic and remunerative. Patients were restricted to four areas., laundry, dietary, housekeeping and patient care. The new rules called for a 15 hour work week at minimum wages.
Before the end of peonage, the days of the patients were taken up with work. There was little or no treatment available. Suddenly they were ordered not to work and no therapies or activities were added to the budget. Some patients became angry or regressed when they were prevented from working. Eventually the problems were worked out and treatment and therapy became the main focus of patient care.
In the early 1970s there were a group of people judged to mentally retarded who were confined in the state mental hospital system. The laws changed concerning the mentally retarded. Education became the main focus for the mentally retarded patient. The law required that the mentally retarded be removed from the mental hospitals. At the time the mentally retarded centers were overcrowded. As a result a separate distinct unit under the Department of Mental Retardation was established in November 1974 at Mayview State Hospital. Most of the original patients in that unit came from Mayview and Woodville State Hospitals.
In 1976 a 92 bed Intermediate Care Facility was established and licensed by the Department of Health to provide nursing care for elderly patients who had a primary medical diagnosis. The Long Term Care Center was located at Temple Center II Building and in 1984 the 92 beds in Temple Center I Building were added to the facility. The Children's Psychiatric Center at Western Center was moved to Mayview in 1976. This thirty-two bed facility provided services to children ages 4 to 14 years old from twenty three counties in Western Pennsylvania.
The Geriatric Rehabilitation and Interactive Therapy Program was initiated in 1978 in three units of the Bengs Building West Wing. This Program eventually evolved into the Geriatric Treatment Service which was initiated in June 1986. The program expanded to include the Temple Center I Building which was earlier decertified as an Intermediate Care Facility due to a decrease in that type of patient.
On October 10, 1980 Dr. Robert Trivis resigned. Wendell Hunt was appointed superintendent on January 24, 1981. Later in 1982, a 28 bed Adolescent Center was transferred from Woodville State Hospital to Mayview State Hospital.
During the closing of Dixmont State Hospital in 1984, Wendell Hunt also served as acting superintendent of Dixmont State Hospital. When Dixmont State Hospital closed in June of 1984, the Deaf Unit at that facility was transferred to Mayview State Hospital. It is the only deaf unit in the state for the mentally ill.
Wendell Hunt left Mayview State Hospital on November 11, 1984 and became the Director of Programs, Office of Mental Health in Harrisburg, Pa. John Elliott became acting superintendent on November 17, 1984 and continued in that position until July 12, 1985. Shirley Dumpman became superintendent on July 13,1985.
The Bridge Program located on the third floor of the William Forrester Building began in March of 1987. It was for patients who had multiple admissions and discharges from the hospital and failed repeatedly to adjust to community living. An array of programs were offered which stressed community living skills to better prepare the patient for community living.
In 1986 the hospital participated in a national research project studying the effectiveness of Clozapine in treating resistant patients diagnosed with resistant schizophrenia. This study was completed in 1988. Similar studies were conducted with Respesidone in 1992-1993 and a study of Sertindole was completed in 1993. In 1994 a study of Olanzapine was begun.
On July 1, 1991 Shirley Dumpman was appointed Director of the Western Area Office of Mental Health. Francis "Mickey" V. Forkus was made superintendent on July 6, 1991.
Christmas was a joyous and happy day for the inmates. 1107 lbs of turkey were served in the institution. The inmates enjoyed the repast very much and all had plenty. For desert they had cake and candy. On New Year's fresh pork and sauerkraut was served in abundance.
Christmas day was one that will be long remembered by both patients and employees at the Pittsburgh City Home and Hospital. This is the one and only day in the year that turkey dinner is served to all. The dinner was served in excellent shape, everything connected with the dinner was cooked to a turn. The menu was as follows, roast turkey with filling and brown gravy, mashed potatoes, cranberries, stewed tomatoes, tea, coffee and cake and candy. Prior to the entry of the patients to dinner, the dining rooms presented a fine appearance. Each plate as served was inspected, to see that one would get no more than another. Abundance of viands (choice or tasty dish) on each plate was the result of the inspection. All enjoyed themselves heartily and arose from the table satisfied and pronounced the day and dinner the finest as yet experienced. After the repast many amused themselves the remainder of the day playing cards and checkers whilst others read and strolled the grounds.
In the nursery, the few children who are there not being old enough to appreciate a fine cuisine layout, a Xmas tree was arranged for them decorated nicely with tree trimmings and tinsel with numerous toys and presents to each child. The tree in its pompous element looked lovely and led those to believe, who had the gratification of seeing the Xmas tree, that Santa Claus has not forgotten the infantile contingent at the Pittsburgh City Home and Hospital.
THANKSGIVING DAY 1911
Thanksgiving day the patients of the entire institution were treated to a pork and kraut dinner which was enjoyable and acceptable variation from the regular bill of fare. There was sufficient set before each patient to give them a feast. All enjoyed the dinner very much.
July 26, 1994 GTD
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