Of Benefi cent Buildings and Bedside Manners

48 THE PENNSYLVANIA GAZETTE Jan|Feb 2018 Thomas S. Kirkbride M1832 wrote the book— literally—on the housing and treatment of the mentally ill in the 19th century.

BY JOANN GRECO

Jan|Feb 2018 THE PENNSYLVANIA GAZETTE 49 alking along ’s Race Kirkbride called the chance meeting Street one summer day in 1840, “one of those incidents that seem be- M1832 yond the control of men, and which happened to encounter a friend changed the whole course of my life.” It who was on the Board of Manag- certainly had a profound eff ect on the Wers of . His inter- course of mental health treatment over locutor relayed news of a position about much of the 19th century, as Kirkbride’s to open at the prestigious institution. At ideas shaped the construction and man- fi rst, the young physician assumed this agement of hospitals for the insane must be the post of attending surgeon across the country, leaving behind as at the hospital, which (as he later wrote) well a rich architectural legacy that, af- he had coveted as “one of the most hon- ter decades of neglect, is at last being orable and useful that could be held by preserved and turned to fresh uses (see any individual.” Kirkbride had been page 53). Kirkbride’s long tenure as the given to understand—by the incumbent head of the Hospital for the Insane of Thomas Story Kirkbride surgeon, no less (John Rhea Barton, for the nation’s oldest medical institution, whom Penn’s fi rst endowed professor- along with his infl uential writings, have ship in surgery was named)—that he assured him a permanent place among “should be the successful candidate” “He was fi gures to be reckoned with by any stu- upon Barton’s resignation from the post, dent of the history of treating mental which had recently been announced. illness or early American medicine. But to Kirkbride’s surprise, his friend instrumental in Tomes—now a SUNY Distinguished had in mind another proposal entirely, Professor of History at Stony Brook Uni- asking instead “with apparent interest, advancing the versity—fi rst encountered the ground- what would induce me to go over the breaking physician in the course of her river, to take charge of the new Hospital doctoral research in Penn’s history de- for the Insane,” which Pennsylvania idea that the partment. She views his legacy as three- Hospital had recently established in fold: “Along with a few other contempo- West Philadelphia. insane deserved raries, he was instrumental in advanc- Although he wrote that his “profes- ing the idea that the insane deserved sional friends regarded such a change care and not disdain or fear or curiosity,” in my plans as ill-advised,” since surgical care and not she says. “Secondly, the treatise he de- openings were rare, Kirkbride was veloped on the design of mental institu- tempted by the fact that the asylum post disdain or fear tions, which came out of these beliefs, off ered the “opportunity of starting a infl uenced asylums for years to come; new institution, and developing new and fi nally, there’s the fact that he was forms of management, in fact giving a or curiosity.” one of the founders of what became new character to the care of the insane, known as the American Psychiatric As- and possibly securing for myself a repu- sociation,” the Association of Medical tation as desirable as that which I might Kirkbride’s wife, the former Ann Jenks, Superintendents of American Institu- obtain by remaining in the city.” wasn’t keen on the idea of a surgical ca- tions for the Insane (AMSAII). Historian Nancy Tomes Gr’78, author reer, either, fearful of the long hours Tomes, who won the 2017 Bancroft of The Art of Asylum-Keeping: Thomas away from home that the job would en- Prize in American History and Diplo- Story Kirkbride and the Origins of tail, while the care of the Hospital for the macy for Remaking the American Pa- American Psychiatry, lays out the terms Insane would be sure to keep him some- tient: How Madison Avenue and Modern of his dilemma. “Surgery was growing where on its premises. Kirkbride’s par- Medicine Turned Patients into Consum- into a prestigious specialty, and the de- ents, too, were on board, favoring “my ers, has a personal fondness for the good cision wasn’t easy for him,” she explains. accepting this new offi ce as being a cer- doctor, too. “I owe him my tenure,” she “He had always been frail, though, so tainty in place of an uncertainty.” And the says with a laugh. “As part of my re- ultimately he feared that he didn’t have position promised “a comfortable resi- search, I was taken to the West Philly the stamina for surgery.” dence [and] a rather liberal salary.” hospital, and as I dug through boxes and

50 THE PENNSYLVANIA GAZETTE Jan|Feb 2018 Portrait by Howard Russell Butler boxes of archival material, it became own practice. Dubbed the “moral treat- so as a teenager, he was set early on a clear that Kirkbride was the star. Those ment,” this approach had been devel- path that would lead to that career. materials became my doctoral disserta- oped independently in France—where Kirkbride wrote of his education that tion, which turned into the book, which the physician Philippe Pinel experiment- his father was his fi rst teacher, and he started me on my path.” ed with releasing the insane from their then attended local schools for several And a star he was. Kirkbride took up his shackles and straitjackets—and in Eng- years: “2d, Morrisville; 3d, Fallsington, post as superintendent of Pennsylvania land by the Quaker William Tuke, who three miles distant, often walking in both Hospital’s asylum on January 1, 1841, and believed that if the insane were treated directions.” For four years, he received a served until his death, shortly before mid- as friends and brethren, they would classical education at a Trenton, New Jer- night on December 16, 1883. In a com- start acting like friends and brethren. sey, school run by “the Rev. Jared D. Fyler, memorative volume issued by the AM- “The patients’ minds were to be con- a very accomplished scholar, and a teach- SAII—which includes a “Memoir” mostly stantly stimulated by amusements such er of rare ability,” and followed that up written in the third person relating Kirk- as games, lectures, and parties [and] with a year in “the study of the higher bride’s life story but incorporating numer- regular physical exercise would tone mathematics, under the care of John Gun- ous direct quotes as well, including those their bodies and calm their minds,” mere, at Burlington, .” above—it was noted that his 42-year ten- writes Tomes. “If moral measures were He then spent the better part of a year ure proceeded “without suggestion or carefully and diligently implemented,” on his father’s farm, “in the practical pur- thought, either on the part of the Manag- she summarizes Tuke and Pinel’s conclu- suits which I felt in later years to have ers of the Hospital or the public, that a sions, “no restraint or harsh treatment been a permanent advantage to my more effi cient or faithful administrator of would be needed to control the insane.” health”—an appreciation of the benefi ts the duties of this important place could Kirkbride would never advocate the of outdoor activity that would inform his be found.” The board also resolved, with complete lack of restraint—indeed, he treatment ideas. He took a special interest no small fl ourish, that Kirkbride’s works wrote in his 1877 report to the hospital in his father’s herd of sheep, he added, and contributions to the subject of insan- board, “It is an error leading to wrong and “became so familiar with them as to ity “entitle him to rank very high among popular impression, to speak of any hos- recognize them by their physiognomy.” the benefactors of his race.” pital for the insane as being conducted At age 18, Kirkbride entered into a without restraint. There is no such thing, brief apprenticeship with Nicholas Bel- espite Kirkbride’s initial reported and cannot be,” noting that even control leville, an old-school physician—in Kirk- doubts, it wasn’t entirely out of left of the “gentlest kind” constitutes some bride’s accounting, he’d come to Amer- fi eld that the hospital board would form of restraint. But his whole approach ica originally with Lafayette’s forces at D have thought of him to head its new was aimed at limiting such restraints the time of the American Revolution, asylum. While serving a two-year term through the design of the physical envi- but was so seasick on the voyage that he as resident physician at Pennsylvania ronment and by keeping patients use- never made the return trip to France— Hospital before opening his own medi- fully occupied. Sounding a note that runs with connections to Philadelphia medi- cal practice on Arch Street, he had had through all his writings, he added, “The cal pioneers Thomas Bond, Benjamin “opportunities of studying the subject only persons who can properly decide Rush, and Phillip Syng Physick. of mental disorders in the department just how far restrictions shall be carried, In 1828, Kirkbride gained admission to of that Hospital which, for eighty years, and freedom be granted in an institution, the University of Pennsylvania, where he had been specially set apart for that are its medical offi cers.” “learned a much milder course of thera- class of disorders,” as the “Memoir” puts peutics than that advocated by his precep- it. Perhaps more signifi cantly for his irkbride came from an old Quaker tor, Belleville,” writes Tomes. “He was in- future treatment approach, immedi- family—Philadelphia’s Bridesburg structed to avoid harsh drugs [and] to ately after graduating from Penn’s med- neighborhood derives from a tract trust more in the body’s own healing pow- ical school, he had undertaken a year’s K of land owned by an ancestor who ers.” In fact, in his thesis on neuralgia residency at the Friends Asylum in made the crossing with William Penn. (nerve pain), Kirkbride off ered a preview Philadelphia’s Frankford neighborhood. He grew up in rural Bucks County, Penn- of the philosophy that would come to That year would prove to be an illumi- sylvania, the eldest of seven children, but dominate his treatment regimen by rec- nating one for Kirkbride, as it intro- knew early on that tending the family ommending not only the standard medi- duced him to the more humane treat- farm wasn’t for him. His father made no cal treatments he had been taught but ment concepts then becoming popular objection, and in fact was particularly also encouraging that patients receive in Europe, which he would adapt to his keen on Thomas becoming a doctor, and “active pursuits and cheerful society.”

Jan|Feb 2018 THE PENNSYLVANIA GAZETTE 51 Upon graduation, Kirkbride secured This comparatively enlightened out- Hospital in London) were mostly con- the Friends residency, but when that look prompted families to become more fi ned behind the walls and hidden from institution off ered him a permanent comfortable with the idea of relinquish- the outside world. position in 1833, he opted instead to ing control of their loved ones, and the Reform was in the air, though. In the leave for another residency at Pennsyl- hospital’s population became more di- same year that Kirkbride assumed his vania Hospital. Located in the middle verse in terms of the sex, class, and new position, the writer, schoolteacher, of what by now was a bustling city, the wealth of those committed. But the in- and activist —inspired by hospital had been established by Bond creased crowding that resulted led to meeting Samuel Tuke (William’s grand- and Benjamin Franklin in 1751. Its char- the need for expansion, and the board son) and other mental health reformers ter included a promise to care for the of managers soon approved construc- during a trip to Europe—took it upon sick, poor, and insane of the city, and its tion of a western addition, built for the herself to embark on a statewide tour of motto, “take care of him and I will repay sole purpose of housing the insane. Massachusetts in order to document the thee,” was borrowed from the story of Opened in 1796, this section featured conditions in the prisons, private homes, the Good Samaritan. common “day” rooms where the more and almshouses where the less privileged Despite these good intentions, treat- affl uent patients—such as Mary Lum, insane languished. She soon presented a ment of the insane was harsh during the who suff ered from emotional outbursts report to the legislature. “I proceed, early days of the institution. According and was committed by her husband, Gentlemen, briefl y to call your attention to a brief history posted on Penn Medi- fi nancier Stephen Girard—enjoyed the to the present state of Insane Persons cine’s website, these unfortunates were use of books, games, musical instru- confi ned within this Commonwealth, in placed in “the dark, dank basement ments, and writing implements. Eventu- cages, stalls, pens!” she wrote. “Chained, [and] chained to the wall and some- ally, this wing too exceeded its capaci- naked, beaten with rods, and lashed into times made to wear ‘madd-shirts,’ which ty—fueled, Tomes says, by a continuing obedience.” Her passionate appeal led to restrained the movement of their arms. move away from household care and a an increased budget to expand the State For the people of Philadelphia, it was rapidly modernizing and urban society Mental Hospital, and Dix took her cam- considered a pastime to come to the where behavioral niceties (and the in- paign on the road, successfully persuad- hospital and peer into the rooms of the ability to abide by them) were pushed ing states like Rhode Island, New York, insane to witness their episodes … Keep- to the fore. An entirely new building was New Jersey, Pennsylvania, Indiana, Illi- ers were given whips and … allowed to necessary, and it was at this facility—the nois, Kentucky, Tennessee, Missouri, use them on patients.” Pennsylvania Hospital for the Insane, at Maryland, Louisiana, Alabama, South In part, these prisonlike conditions 44th and Market Streets—that Kirkbride Carolina and North Carolina to assume “merely refl ected the violent character of took the reins in January 1841. “[T]he greater responsibility for the mentally ill. its inhabitants,” writes Tomes, adding that fi rst patient was received on January 9, Back in West Philadelphia, Kirkbride “only the most dangerous and disruptive 1841, and in a short time all the insane took note of these developments, just as lunatics were placed in the hospital.” Un- from the hospital in Pine Street were he remembered the lessons of moral der Benjamin Rush, later dubbed the “fa- transferred to the new Institution,” the treatment that he had experienced at the ther of American psychiatry” and an at- “Memoir” records. “He gave himself, Friends asylum. Under Kirkbride’s direc- tending physician there from 1783 until mind and heart, to the duties of his po- tion, things were run very diff erently in his death in 1813, things began to change. sition, and his zeal and enthusiasm for the new facility than they had been in the While certainly not averse to the use of the welfare of the insane never slack- Pine Street hospital. “First, he removed restraints, purging, and bloodletting, ened as long as life endured.” the restraints from the ‘dangerous’ pa- Rush was an early advocate for the view tients and let them move freely in the that mental illnesses stemmed from dis- adhouse. Funny farm. Loony bin. wards,” writes Tomes. “The inmates sat eased minds rather than demonic med- Cuckoo’s nest. Snake pit. These down together to take their meals in a dling. Just as he had been instrumental disparaging terms and the dis- regular dining room, equipped with or- in the early prison reforms that (after his M turbing images they conjure still dinary utensils and crockery, amenities death) led to the opening of the Quaker- run deep through our popular culture unknown in the old institution. During inspired Eastern State Penitentiary, his and psyches. At the time of Kirkbride’s the day, the doctors did not allow them wish that “mental illness be freed from reluctant entry into the care of the in- to sit about unoccupied, but kept after moral stigma, and be treated with medi- sane, the horrors of bedlam (a term them to read, play checkers or work cine rather than moralizing,” served as a which may derive from Europe’s oldest around the grounds.” In his fi rst annual guiding principle at the hospital. psychiatric institution, Bethlem Royal report to hospital management, Kirk-

52 THE PENNSYLVANIA GAZETTE Jan|Feb 2018 In Upstate New York, Buffalo’s brand new Hotel Keeping Henry bills itself as an “urban resort.” Just minutes away from downtown, it’s set in an historic landscape bride observed that “from this freedom (designed by Frederick Law Olmsted and Calvert Vaux of action, and from these indulgences, “Kirkbrides” and recently restored by Philadelphia’s Andropogon) of we have found nothing but advantage.” ancient white oaks complemented by native plantings, In 1844, Kirkbride and a dozen other Alive rain gardens, and sweeping lawns. Its castle-like build- asylum superintendents met in Phila- ing, the fi rst professional commission for H. H. delphia to form the Association of Med- Richardson—an architect whose name graces ical Superintendents of American Insti- a specific style, “Richardsonian Roman- tutions for the Insane, precursor to the esque”—offers features like soaring 20-foot American Psychiatric Association. Elect- ceilings and curving corridors that act as sunlit ed as the organization’s fi rst secretary, interior “porches” for the 88 guest rooms. he would serve in that capacity for A decade in the making and following a seven years, then as vice president for $102.5 million restoration, the resort is bring- seven years more, and president for an- ing new life to the former Buffalo State Asylum other eight. for the Insane, which had been shuttered and Meanwhile, he began to formulate his deteriorating since the 1970s. It’s the latest own thoughts about the and most visible turnaround of long-vacated ideal asylum, tying its archi- “Kirkbrides”—mental hospitals built following tecture into its treatment the ideas of Thomas S. Kirkbride M1832—according to regimen. He fi rst spelled out architect Robert Kirkbride, his descendant and founding his philosophy in an article trustee for PreservationWorks, a 501c3 organization in the American Journal of advocating their preservation and adaptive reuse. Of the Medical Science in 1847. The 75 asylums that once stood, only 34 re- next year, following the tes- main, he says, and 13 of those are still used as medical timony of Dix before the facilities of some sort. Another dozen have recently New Jersey State Legisla- been, or are in the process of being, adaptively reused. ture, the fi rst asylum built according to “Luckily, there’s a new generation of developers and users who appreciate the embodied labor what would come to be called the “Kirk- in the buildings, as well as their historicity,” Kirkbride says. While the hospitals’ typical features bride Plan” opened in Trenton. and layouts—lots of small ‘cells,’ wide corridors, separate wings, and large common spaces—are In 1854, Kirkbride published On the not suitable for all uses, he adds, many surviving structures can work for mixed-use projects. Construction, Organization, and Gen- That’s been the case in Buffalo, where restaurants, an architecture center, meeting spaces, eral Arrangement of Hospitals for the and other features are part of the Richardson-Olmsted complex that contains the Hotel Insane; a second, expanded edition Henry; and also in Traverse City, Michigan, where a developer reportedly bought an abandoned would appear in 1880, prepared during Kirkbride for $1 in 2002 and has over the years transformed it into a live-work-play complex. a long illness before Kirkbride’s death. Elsewhere, the Trans-Allegheny in Weston, West Virginia, now serves as an As more states constructed new mental attraction offering historic and ghost tours, while the State Museum of Mental Health institutions, they turned to Kirkbride’s in Salem takes a more serious approach to the issues surrounding treatment of the insane. book as their bible and blueprint; even- The latter, which is in a building on one of the few Kirkbride campuses located west of the tually 75 facilities modeled after his Mississippi, was the setting for the 1975 movie One Flew Over the Cuckoo’s Nest. Parts of ideas dotted the nation. the complex are still used as a . As the patient population at the Penn- Several other adaptive reuses of Kirkbrides are currently under development. In the na- sylvania Hospital for the Insane kept tion’s capital, St. Elizabeths Hospital—an asylum that once housed President James Gar- growing, the administration decided to fi eld’s assassin, Charles H. Guiteau, and Ronald Reagan’s would-be killer John Hinckley build yet another facility on the grounds Jr.—is being converted, with no apparent irony, into the new headquarters for the Department a few blocks away from the building at of Homeland Security. Plans are underway to transform the Hudson River State Hospital in 44th and Market Streets. Here Kirkbride Poughkeepsie, New York, into the $250 million Hudson Heritage development, with homes, would fi nally get his chance to person- shopping, and a boutique hotel included in the project. And in Tuscaloosa, the Alabama ally put into practice everything he had Hospital for the Insane will become a welcome center and provide new museum galleries learned and written about. “He always for the . felt that there were things he didn’t like “These buildings are beautifully constructed—we’ll never be able to build again with these about the Philadelphia asylum,” says materials and attention to craftsmanship,” Kirkbride says. But more than that, he adds, they Tomes. The new building, which was at are “remarkable physical documents from a certain time in history.”—JG

Jan|Feb 2018 THE PENNSYLVANIA GAZETTE 53 49th and Market and opened in 1859, Kirkbride’s book specifi ed everything was “Kirkbride’s baby from start to fi n- from the site (at least two miles from a Key to Kirkbride’s ish. Basically, it was his big, showy new town of considerable size), acreage (at piece of treatment.” least 100 acres, much of it devoted to plan were two wings, As reported in the “Memoir,” the new farms and gardens because Kirkbride facility cost $355,907.57, including “the believed that both the opportunity to Hospital with all its out-buildings, the work and to experience nature contrib- stepped back in a wall surrounding its grounds, all its var- uted to healing), and enclosure (a wall ied and expensive fi xtures of every kind to provide privacy and security, about V-shaped formation and the furniture in use.” Kirkbride led 10 feet high but placed far enough away the successful fundraising eff ort himself, from the building so as not to “give the from either side and “labored with the greatest assiduity idea of a prison”). He outlined details to collect by private subscription the on plumbing, drainage, fi re safety, light- of a central money needed.” ing, and heating and ventilation. In es- For the project, Kirkbride hired a sence, he tied design to functionality—as administration young architect, , who had had Eastern State Penitentiary before served as a foreman during the construc- it—in the conviction that the built envi- tion of the earlier Philadelphia asylum. ronment can impact social behavior. building. Sloan, who started his career as a carpen- “He really understood the importance ter working at Eastern State Penitentiary, of suggesting confi dence and calmness wound up designing the greatest number through the architecture,” says Robert of “Kirkbrides” of any architect and also Kirkbride GAr’90, dean of the School of provided the illustrations and plans in- Constructed Environments at Parsons cluded in Kirkbride’s treatise. School of Design, and an 11th-genera-

54 THE PENNSYLVANIA GAZETTE Jan|Feb 2018 tion Kirkbride. “The Kirkbride Plan cre- He also argued for a new nomencla- Eventually, modernity caught up with ated a code that melded soft human ture, such as substituting “hospital for an aging Kirkbride. New laws embold- touches to the physical environment to the insane” for “asylum.” The latter term, ened patients to sue for being wrongly create a new way of treatment.” he wrote, suggested that “those who en- committed. Journalists balked at what Key to Kirkbride’s plan were two tered were not sick, or did not come for they saw as over-promising by Kirk- wings, stepped back in a V-shaped for- treatment … rather they came as … bride—only about half of all patients at mation from either side of a central ad- though they had committed some crime the Pennsylvania Hospital for the Insane ministration building. Each wing was or been banished from the sympathies eventually left as “cured,” a marked im- separated by sex, and eight wards with- as well as the presence of society.” provement over Rush’s time when just in each wing further divided the resi- 17 percent of the insane were deemed dents according to the severity of their ife at a Kirkbride Plan facility was a “cured” but well short of the 80 percent illnesses (with the most impaired pa- far cry from the asylums of old, that Kirkbride estimated could be cured tients confi ned to the ground fl oor and Tomes reports. Gone were the chains, using moral treatment. More generally, farthest from the center, and the least L bleeding and whipping, and while Kirkbride’s architectural dictates began closest to the center on the top fl oor). cupping and restraints were still used for to be viewed as too huge and expensive Each ward off ered long, wide corridors the most manic cases, drug therapy to implement and manage, while his featuring generous windows, high ceil- (mostly morphine) was preferred. A insistence on the supremacy of the su- ings, and direct egress to the grounds schedule of work and leisure pursuits perintendent fell under increased state- outside. The central part of the building, ruled the day, with patients participating wide scrutiny. (Unlike Pennsylvania through which visitors entered, con- in daily walks, putting in stints working Hospital, most hospitals for the insane tained administrative offi ces, back offi ce the farms and gardens (though he were public institutions.) functions such as the kitchen, and the warned against strenuous labor), and Without naming names, the writers of superintendent’s apartment. enjoying the library and billiards room. the “Memoir” pushed back against such The meticulous Kirkbride also devot- At his own hospital in West Philadelphia, second-guessing: “It has been the fashion ed considerable attention to manage- Kirkbride even became famous for pre- with some who, with no practical experi- rial matters, delineating the roles of senting magic lantern shows, off ering ence, have pushed themselves forward in board members and outlining policies residents the same pleasures and access matters connected with building hospi- on admission, visitation, and the use of to new technologies as their compatriots tals, to decry the plans as behind the age; restraints. He also suggested the num- outside the walls were enjoying. but their plans have not yet been tried ber of—and salaries for—assistant phy- The mostly happy populace gave Kirk- suffi ciently long to prove their defects in sicians, attendants, bakers, carpenters, bride mostly rave reviews. Take Eliza all respects, and those defects will be carriage drivers, cooks, dairy maids, Butler, an affl uent young woman admit- found at the very points where they have domestics, engineers, farmers, fi remen, ted in the winter of 1858 as suff ering departed from the well-considered details gardeners, ironers, jobbers, matrons, from a “melancholia of two months,” which he so carefully worked out.” stewards, supervisors, teachers, washer- according to Tomes’ account. After she From the perspective of the present, women, and watchmen. For good mea- was discharged later that summer, But- architect Robert Kirkbride calls his an- sure, he off ered a tally of staff —71 per- ler and Kirkbride stayed in touch and, cestor’s eponymous plan “a cautionary sons (36 males and 35 females) would years later, reader, she married him. tale to hubris and idealism.” In the end, live alongside the maximum of 250 pa- (Kirkbride’s fi rst wife, Ann, had died in though, the buildings and the theories, tients that he recommended. 1862, likely of tuberculosis.) the magic lanterns and the pretty gar- The critical takeaway when it came to Eliza would go on to become an advocate dens weren’t really the point but rather organization, though, was Kirkbride’s for school reform—South Philadelphia’s means to an end. As Eliza Kirkbride insistence on the power of the superin- Eliza B. Kirkbride Elementary is named for observed in a memorial published short- tendent. The superintendent, he wrote, her—and a crusader for the idea that ly after her husband’s death, Kirkbride’s “should have entire control of the med- through moral treatment the “insane” such real strength was his “power over the ical, moral, and dietetic treatment of the as she could be cured. Writing to Dix, she affl icted.” That ministry, she continued, patients, the unrestricted power of ap- noted that Kirkbride’s habit of “sitting had been “more potent, perhaps, in it- pointment and discharge of all persons down by patients and talking to them in self than the many remedial agencies engaged in their care, and should exer- the calm way, which I know from my per- gathered within [his] Institution.” cise a general supervision and direction sonal experience, carries help and light to of every department of the Institution.” helpless, clouded minds.” JoAnn Greco writes frequently for the Gazette.

Jan|Feb 2018 THE PENNSYLVANIA GAZETTE 55