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The Patients

Sample page of 1870 census listing some Bloomingdale inmates

Fragment of the 1870 manuscript United State census record for the Bloomingdale Asylum.  Note the identification of the individual patients' occupations as "insane."

Bloomingdale Asylum Statistical Report 1834.

"Report of the number of Patients remaining in the Bloomingdale Asylum on the 31st day of December, 1833, and of those admitted and discharged from that period prior to the 31st day of December, 1834."

"Dining Room [of John C. Green Memorial Hall]"

Picture of a dining room hall in the newly opened Green Hall (1879). The well-dressed patients, being waited on by servants in an elegant space underscores the Bloomingdale's reputation for catering to well-to-do patients.

"At dinner [Blackwell's Island]"

Illustration from Harper's Magazine, showing a men's dining hall at the Blackwell's Island asylum, providing a sharp contrast to the stately dining room at the Bloomingdale's Green Memorial Hall.

Who lived inside these buildings?  Most important, both from the point of view of institutional mission and the perception of outsiders, were the patients.  From 1821 through 1893 (the last full year the asylum was on Morningside Heights), some 9305 patients were admitted for treatment. Of those, 3635 were discharged as cured, another 2436 discharged in improved condition, and 1585 were discharged without any improvement in their condition.  Another 1345 died at the asylum.[1] This amounts to an average admission rate of slightly over 127 patients, reflecting the fact that the asylum, particularly in its later years, was treating a fairly select population. 

Nonetheless, the group as a whole represents a potentially interesting set of data for study of the history of the treatment of mental illness in America and of the society whose members were presenting themselves for treatment.  A variety of systematic sources for such a study exist.  For example, the decennial census returns from 1830 through 1880 (the 1890 manuscript census was destroyed in a fire) provide a name listing, and additional data about gender, age, place of birth and frequently, such additional information as former occupation and parents’ place of birth. 

The census can also provide interesting information about the population of the Heights in general, although in the early years the Bloomingdale patients,  along with the orphans of the neighboring  Leake and Watts asylum represented an overwhelming  if not majority portion of that total population.  Indeed, in some of the earliest censuses, before address information was recorded, the inmates of these two institutions are the only Morningsiders who can be clearly picked out from the lists of names of the residents of the broad 12th Ward of the city.

Supplementing this data are the anonymous aggregated statistical reports compiled by the medical staff and included, in summary form at least, in the Annual New York Hospital Reports submitted to the State Assembly.  They shed interesting light on the description and diagnosis of mental illness in the 19th century, and on the evolution of the way that such illnesses were classified.

“Classification” is a term that crops up frequently in the reports of the governors and directors, who continually note the need for its more effective application in the placement of patients within the facility and the creation of better articulated space for that purpose.   Part of this was in fact about the classification of disorders and related to the kind of separation of violent and noisy patients from calmer and more curable ones that the Lodges were intended to achieve, but there was an important social dimension as well.  As Dr. Nichols noted in his annual report in 1849, “If it is impossible for sane people of widely different tastes and means to associate agreeably together, no one need be surprised at the wounded pride and bitter envy whch patients from the two extremes respectively experience when brought together in close proximity in an asylum for the insane.”[2]

In its earliest days, the Bloomingdale was the sole facility of its kind in New York, and so admitted  patients from all social classes, including “paupers.”  It relied for its operations on payments from patients and their families, assessed on a sliding scale.  In the case of indigent patients, they received subsidies from the localities or agencies from which they originated.  This service to the whole community led the state of New York to grant a $10,000 annual subsidy to the asylum for several years, and it probably contributed to New York Hospital's success in obtaining  tax exemption for its activities a few later, despite the fact that it was formally a private institution.  (These subsidies and exemptions would come back to haunt the institution in its later years on the Heights.) 

 Nonetheless, the treatment of the poor was clearly not the dream of the governors or even the medical staff.  When arguing for making the hospital  a “palace” rather than a “goal [jail],” Thomas Taylor had added, “by that means, it will command the most wealthy patients in the United States.”[3]   Not too surprisingly, accommodations varied greatly in accordance with what patients (or their patrons) were paying.  In fact, in the early days, “paupers” were housed in the cellars of the main building, and later in the Lodge, even if they were not themselves noisy and violent, something that director William Wilson noted, worryingly, was likely to interfere with their recovery.

The dilemma was relieved, to some extent, with the opening of a city-run asylum on Blackwell’s Island in 1839.  The Bloomingdale’s “paupers” were quickly transferred there, and the Asylum could now focus more fully on the “moral treatment” of individuals of at least modest means.  Conditions at Blackwell’s Island were decidedly different. As a visiting Charles Dickens noted:  "...everything had a lounging, listless, madhouse air, which was very painful. The moping idiot, cowering down with long disheveled hair; the gibbering maniac, with his hideous laugh and pointed finger; the vacant eye, the fierce wild face, the gloomy picking of the hands and lips, and munching of the nails: there they were all, without disguise, in naked ugliness and horror."[4] A graphic illustration of the contrasting environment of the two facilities is provided by the images on this page of female patients in the dining room of Green Hall in 1880, being waited on by servants, and men in the disorderly and shabby environment of a dining hall on Blackwell’s Island.  

To be sure, the asylum continued to accept patients from a broad range of classes, so long as they had some means, and continued to accept payments on a sliding scale.  Nonetheless, one sees an increasing emphasis on creatieon of facilities for  an upscale clientele.  The last two major buildings on the grounds – Green Memorial Hall and the Macy Villa, were explicitly designed to provide an environment in which individuals from wealthy homes could find themselves in an environment comparable to one to which they were accustomed. To a great extent, this trend mirrored broader social patterns: the 70s, 80s, and 90s were marked in the United States by the dramatic rise of inequality of wealth to unprecedented levels.[5]

[1] Society of the New York Hospital, Annual Report of the State of the New York Hospital and Bloomingdale Asylum for 1893.  New York, 1894, p. 27.

[2] Russell, p.202.

[3] Dolkart p.15.

[4] Charles Dickens, American Notes : For General Circulation, London: Chapman and Hall, , vol. 1, p.222.

[5] Thomas Piketty, Capital in the Twenty-First Century, London, England: Harvard University Press, 2014, fig.10.6.