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1700s Mental Health: Case of Mary Doer

Detail of Philadelphia Hospital from very early early sketch.
Philadelphia Hospital from very early early sketch.
Philadelphia Hospital. Undated lithography likely derives from mid 1800s and incorporates original wing on right.
Seal of the Good Samaritan for Philadelphia Hospital

Lunatics in the 1770s: Mary Doer

Mental illnesses have been around for a long time. Several cases have been stumbled upon in trying to understand life in the 1700s for Imans/Eymans, their friends and associates. A Mary Doer and a Robert Traill wound up needing help and received it from asylums of the day. Mary had suffered the loss of her mother and suffered a profound grief which lasted for months. The American Psychiatric Association declines to classify complicated grief under one year as a disorder. So far as we can know, this was likely her situation. Robert’s precise situation is difficult to discern.

Ulrich Eyman arrived at Philadelphia from Rotterdam on the HERO in October of 1784. Among ship passengers was the family of Conrath Doer, whose wife died of some ship-borne disease before even making it to the open seas. His distraught daughter sank into depression for the entire journey and was admitted to the Philadelphia Hospital upon arrival as a consequence of Captain Ralph Forster’s perhaps misleading advice. She seems though to have been well cared for though little is known of her once she was dismissed from care. We learned about Mary’s situation from a petition which he made for assistance with payment from the managers of the hospital as sited in Morton’s 1895 History of Pennsylvania Hospital 1751–1895. Context is provided from substantial Internet research.

The Captain Ralph Forster’s brother-in-law Thomas Attwood Digges was in London several years later when he was alerted to the plight of an American born thirty year old who had been released after several months from Stratton’s private lunatic asylum only to wind up in prison at King’s Bench for debt, and having most of his earthly goods stolen by a servant. We have little information for classifying Robert’s problems though he required institutionalization and seems to have been unable to function upon release, or to have fallen back into a state where even prison wardens considered him in need of hospitalization, and likely some kind of restraint. Thomas did what he could to see to care at St. Luke’s public asylum in London while trying to enlist the help of a father then serving King George III in the Bermudas. The letter paraphrased below from Thomas in London to Traill’s father in Bermuda appeared in a 1982 publication by Elias and Finch of the Letters of Thomas Attwood Digges (1742–1821). Supplemental information for providing background to the correspondence was derived through Internet research of historical and genealogical archives.

The Plight of Mary Doer

Mary Elizabeth Doer was a child of about thirteen, part of a family of migrants on the Ship HERO to Philadelphia in the fall of 1764 when only eighteen miles out of Rotterdam near the Hook of Holland her mother died of some ship-borne disease. Mary, more than her father or siblings, suffered a violent grief, crying day and night. Her depression lasted for many weeks. Upon arrival to Philadelphia, the ship Commander Ralph Forster told the father to take the girl to the Philadelphia Hospital where her cure and maintenance was not to cost a penny. It was five months later that her father wrote a letter to the hospital’s managers describing his experience.

To: Managers of the Pennsylvania Hospital: (paraphrased)

Give me leave, gentlemen, to lay before you the true state of my case:

I want to share my deep concern for my daughter and hope that in understanding the natural desire of a father that you might restore to me my darling daughter who is now in a better condition than when she was committed to your charitable care.

I embraced on the Ship Hero with my wife and four children. My wife and one child died when were at the mouth of the Maase River and my unhappy daughter who was with her at the moment of her parting was seized by a grief that would not yield to any comfort, crying day and night. In this condition we arrived at the port of Philadelphia, when Ralph Forster, the commander of the ship, told me she must be taken to the hospital and that her care and maintenance should “not cost me a penny”. In this I never mistrusted the captain as the notion we had in Germany was that hospitals are founded by public or private benevolence for the relief of the port unhappy sick and that never is anything charged except in the case of rich patients seeking better hospital accommodations than common.

I then settled all financial obligations for passage and freight with owners of the ship and was bound as a servant for a term of three years to a Mr. Patten, but agreed with him to serve another year since I had with me one child of under three years old who would be living with his family.

When I heard from Philadelphia that my daughter was well, I asked my master for leave to fetch her and he allowed that she might stay six months at his house, after which I’d arranged with a neighbor to care for her until I was free of the bond. Having arranged everything so that I’d have her near me and could see her daily, I went to the hospital but was told that the Managers were to deliver the girl to the owners of the ship since they had paid for her cure and accommodations. The merchants planned to sell her in order to compensate for their charges. As I expect that the captain will have no memory of his commitment or that he will put me off with an equivocation asserting that there is no cost to me, aside of course from losing a daughter whose life is as dear to me as my own. I expect no mercy from merchants who look upon poor Germans as nothing more than merchandise and who will attempt to sell my child for more than a poor stranger could pay. All my hopes, gentlemen, are with you who preside over the contributions of wealthy and charitable people of the province. I humbly pray that you will forgive the cost of curing and maintaining my poor child.

Signed: Conrad I. Doer, March 23, 1765.

Although no action appears in minutes of the hospital, it is supposed from previous acts of kindness that the managers did not refuse to grant the father his child. No subsequent records of the father or daughter have been found, though several brothers of Conrath who also arrived on the HERO had families who settled in western Pennsylvania. A Rebecca Durr on the ship, who subsequently married a co-passenger named Wolfe and resided in Westmoreland may have been a sibling of Mary.)

Notes:

The hospital (Philadelphia Hospital, sometimes called Pennsylvania Hospital) was a charitable institution and existed in connection with the Philadelphia (Blockley) Almshouse. Some in the 1800s described it as the “oldest hospital in America”, but that may not be true, nor that the Almshouse was functioning by 1730–1731 (other accounts suggest even earlier unlikely dates of 1712, 1713, and 1717).

The hospital itself was chartered by the Pennsylvania Colonial Assembly in May of 1751 by Dr. Thomas Bond with the encouragement and assistance of Benjamin Franklin who secured treasury funds from the Province of Pennsylvania as well as popular subscriptions. Out patient and even home services were being provided by 1752, with Ben Franklin himself serving as the hospital’s first clerk in 1753, the earliest minutes of the board being in his hand. The number of patients was growing during this period, with inmates of the adjoining Almshouse reaching 284 in 1767 — shortly after Mary was in the hospital. Many of the early patients of the hospital were children and foundlings from the Almshouse who resided at the hospital and were bound out to all sorts of trades and professions as apprentices. Often children were not admitted to the hospital from the Almshouse until they were very ill; frequently in the early days they died within a few days.

The Philadelphia Hospital was the first voluntary hospital in the country with physicians receiving no renumeration (though those attending patients at the associated Almshouse itself did receive salary) The Good Samaritan was depicted on the official seal of the hospital and it would have been known to most ship captains of the port since by the late 1750s it was serving poor patients who had suffered ship-board accidents, including “negro boys” such as a George Saunders who in 1758 had suffered a broken arm at sea, or John Richardson who the year before had fallen from the top of a ship’s mast and broken his thigh.

The custom was that local (often “township”) Overseers of the Poor in sent patients to the hospital as public wards and paid a fee, though if townships or the patients themselves had no money, fees were often drawn from a special fund available to the Managers of the hospital. Municipalities were often very slow with payment and had difficulties raising taxes. If the hospital funds were likewise low, managers of the institution sometimes refused to take poor, sending patients back to the Almshouse with it’s less accommodating facilities.

Generally patients of the hospital seem to have been cared for with considerable humaneness. In 1765 Thomas Perrine, for instance, was admitted as an insane patient. A remarkably neat and tidy sailor, he lived for a brief period in cells in the basement, though he proved troublesome — quarreling with keepers and other patients. He finally escaped from the basement and ran through the hospital, reaching the cupola of the East wing from which he resisted all efforts to dislodge him. After a period, bedding was provided for him there and he was allowed to inhabit the tower until he died nine years later in 1774. Apparently he never left the cramped quarters and was noted for his long nails, matted beard and hair, and an insensitivity to the cold since unlike most patients through hard winters he never strove to be near a fire.

Another indication of the positive care provided patients is the number of aged patients who sought readmission in order to live out the remainder of their days there. More than a few times with behests of mortgages and bonds, the hospital would undertake written contracts securing patients for the rest of their lives.

Benjamin Franklin’s name is closely associated with the hospital. He’d served, as noted above, as the hospital clerk during and earlier year. His services continued once he’d become the second President of the Board of Managers. In this role, Franklin established the practice of collecting fines from Board members for absences or tardiness. Fines were still being levied for staff absences in 1951.

The hospital was well built. In fact, some of the original buildings including an East Wing were still in use at the hospital’s 200th Anniversary in 1951. Clinical lectures were begun at the hospital in 1764, the year of Mary’s admissions, and a year before the founding of the first medical school in the country — the College of Philadelphia, later to become the University of Pennsylvania.

At one point in history, many “Acadians” (original French settlers to Nova Scotia) were admitted for medical treatment to the Philadelphia Hospital — presumably during their evacuation of the British during the French and Indian War just a few years before Mary Dorr was a patient. French settlers at Port Royal had cleared forest and built cottages there sixteen years before the Pilgrims landed at New England. By 1755 over 1400 of these unwilling immigrants had been transported by ship and left off at Delaware.

Later during the Revolutionary war, the hospital was forcibly occupied for use by English troops who had suffered at Valley Forge or among those who had occupied Philadelphia then under Martial Law. Sometimes as many as seventy-five patients a day would arrive needing service.

On Visiting the Pennsylvania Hospital

by Francis Scott Key

Whose fair abode is this? whose happy lot
Has drawn them in these peaceful shades to rest,
And hear the distant hum of busy life?
The city’s noise, its clouds of smoke and dust,
Vainly invade these leafy walls that wave
On high around it, sheltering all within,
And wooing the scared bird to stay its flight
And add its note of joy to bless the scene:
The city’s toils, and cares, and strifes are, sure,
Alike excluded here — Content here smiles
And reigns, and leads her vot’ries through the maze
Of flower-embroidered walks to bowers of bliss:


O! ’t is a sight to warm the heart of him
Who feels for man, and shares the joys he sees.
My feet have pierced these shades, and I have seen,
Within what seemed so fair, this mansion’s tenants:
O! ’t is a sight to chill, to freeze the heart
Within what seemed so fair, this mansion’s tenants:
O! ’t is a sight to chill, to freeze the heart
Of him who feels for man, who pitying views
The wreck of human bliss, and sighs to see
O! ’t is a sight to chill, to freeze the heart
Within what seemed so fair, this mansion’s tenants:
O! ’t is a sight to chill, to freeze the heart
Of him who feels for man, who pitying views
The wreck of human bliss, and sighs to see
That he can only pity griefs past cure,
And sorrows that no sympathy can soothe


Here Pleasure never comes, Hope never smiles
But to delude to a more deep despair;
Here are shut out all joys that sweeten life,
Here are shut in, life’s outcasts; Madness here,
Monarch of terrors, holds his awful court;
On high-piled human skulls his throne is fixed,
His bursting brows a burning iron crown
Confines, and blends its fires with fiercer flames
That from his ghastly eye-balls wildly glare;
A robe of straw his giant form conceals;
His hand a leaden sceptre wields, each point
With terrors armed. Ice, never melting, gleams
From the one; from the other, fire unquenchable:

Each, as it points to his devoted prey,

With cold, or heat, or freezes or inflames

The chambers of the brain, and stupefies

And chills to dullest idiocy, or fires

To frenzy’s wild unutterable rage

Such are the throng that here around him wait,

Showing, in all their sad variety,

The awful visitations of his power;

Here the cold gaze of fixed fatuity

Tells that no feeble ray of thought e’er gleams

O’er the wide waste of desolated mind;

Here the wild raving and the maniac yell

Reveal a phantom seated on the throne

Wrested from reason, ruling all within,

Exulting in the never ceasing storm

I had not sought this scene — my thoughtless steps

Had brought me, where, I knew not, till the sights

And sounds of woe revealed its awful terrors;

The sudden shock o’ercame me and awakened

A host of these wild fearful images;

A moment’s struggle, and my mind gave way,

And my soul sickened at the awful thought

That I was mad. I groped in vain to find

Some ray of reason that might light up thought

And consciousness, but all was dark as night:

The horrors of that darkness none can tell;

Could I recall them all, an age would not

Suffice to tell, what seemed for ages borne.

Man’s frail abode in this sad world of change

Is often sung, and heard but as a song:

Death’s touch oft wakes his victim to its truth.

As frail as life is reason: both depend

On him who gave them, who can take away

From both, or either, his sustaining arm:

Fear then, thou thankless boaster! fear the stroke

That throws thy body to the worms, and calls

Thy soul to answer for abused mercies —

Yet fear, still more, the still more fearful doom

That takes the richest of heaven’s slighted gifts,

And leaves thy body and thy soul in darkness

To roam the earth a senseless corpse, or gives thee,

Before thy time, to the tormenting fiends

Such was my crime — with life, health, reason blest,

And heart with rapture glowing, I looked round

On this fair seeming world, and chose its joys

For my sole portion; scorning all beyond it

As vain and visionary, no warm thought

Of love to him who made me what I was,

E’er kindled its pure flame within my breast,

That burned with earthly and unholy fires;

I thought not of him, but in doubt or fear;

I spoke not of him but in jest or wrath

Such was my punishment; the beam from heaven,

That pours its light into the mind of man,

Was suddenly extinguished, and a shroud,

Darker than that of death, enveloped all

Within me and around me. In this gloom,

Peopled with spectres, filled with scenes terrific,
How long I lived — if the dread agony
Could life be called — I know not. To the dead
And the condemned, Time measures not his steps,
And every moment seems eternity.

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