South Jersey Heritage: A Social, Economic and Cultural History - R. Craig Koedel

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Advances in Health and Public Welfare

      The humane treatment of society’s outcasts progressed slowly in South Jersey throughout the 19th century. However, by the end of the century, significant advances had been scored in the improvement of prisons, the care of the insane, and the education of the mentally retarded.

      The inadequate colonial prisons in the southern counties fell to the ravages of time and a new spirit of justice in the years of the Revolution and immediately thereafter. In Cape May County, an obsolete Baptist church, erected about 1712, had served as a courthouse and jail for thirty years when it was replaced by a new structure in 1774. A two-storied, stone prison, containing cells for inmates and a residence for the jailer, was erected alongside a "spacious jail-yard" at Salem in 1775. The Gloucester County freeholders ordered the building of a courthouse and a new jail, to be patterned after the one at Salem, in 1786. Cumberland County followed with a new prison in 1790. Atlantic and Camden Counties constructed their own prisons when they were separated from Gloucester, in 1837 and 1844 respectively.

      Although prison construction was updated, the outworn philosophy of colonial penology did not change. Punishment, not rehabilitation, was thought to be the proper lot of the convicted. All who entered the state prison, erected at Trenton in 1799, were summoned to "Labor, Silence, Penitence" by an inscription over the main entrance. The same attitude prevailed at the county jails. The Gloucester County jail was equipped with stocks, a whipping post, and a pillory in 1792. In 1822, new public stocks were ordered for the Woodbury facility. Hangings were public, a spectacle to be relished by thousands of onlookers, as late as 1821. The stone prison at Salem, despite its vaunted yard for outdoor exercise by the inmates, still had no beds for them to sleep on in 1843, because the law did not require them.

      Were it only criminals who were made to suffer the indignities and deprivations of South Jersey’s early prisons, perhaps they would have seemed less offensive to humanitarian sensibilities, but criminals, debtors, the insane, and the merely eccentric were confined together in institutions permeated by filth, cruelty, and crass neglect. The American reformer, Dorothea Dix, inspecting New Jersey prison conditions in the early 1840’s, saw in the Gloucester County jail a young woman who had been in chains for twelve years. At Salem, some insane inmates were locked in their quarters without release for years at a time, while they and other unfortunates were beaten with wooden blocks by the jail keeper. At some of the institutions, the insane were placed under the care of other inmates.

      In accordance with the state’s insolvency laws, debtors were committed to prison side by side with criminals and the insane. The practice was denounced in a Salem newspaper in 1823, when there were incarcerated in the county jail a number of persons of good reputation who owed money. In the same year Salem County petitioned the state legislature to abolish imprisonment for debt. Evidently the petition was not recognized, for not until 1846 did New Jersey discontinue the practice of imprisonment for debtors whose actions did not involve fraud.

      At the end of the Civil War, the county prisons of 18th-century construction having become, as the jail at Woodbury was described by the Gloucester County judges, a "nuisance," the building of new and more adequate facilities for the keeping of criminals was undertaken in South Jersey. The interiors were better ventilated, the cells were larger, and in a number of them the cells were designed for one occupant only. By this time, separate institutions had been created for the mentally ill. Modern prisons, expressive of altered concepts in penology, have replaced the 19th-century structures.

      Poor farms and almshouses were provided for the indigent by most southern counties during the early decades of the 1800’s. The counties erected separate buildings for the insane poor shortly after their original almshouses were built. Debtors, as distinguished from the indigent, were still confined in the county jails.

      Salem led the state in establishing institutions for the poor when that county acquired a farm upon which to construct an almshouse in 1796. The first appropriation for a building on the land was in 1802, when the freeholders directed the trustees of the poor to spend an amount "not exceeding three hundred dollars for building a barn on the premises occupied for the use of the poor of the county." Monies were set aside for a poor house in 1804, and the structure was ready for occupancy in 1808. Gloucester County gave its attention to a similar project by the purchase of a lot in 1800. Plans for a poor house were drawn up in 1801, and by 1803 the building was finished and occupied. The facility was used jointly with Camden County from 1844 until 1860. A Cumberland County almshouse was ready for use in 1810. All of these buildings were replaced by larger, improved facilities around mid-19th century.

      Special facilities for the care of the physically ill were a late-19th-century development in South Jersey, the first of them coming at a time when the appearance of hospitals was a national phenomenon. Until then, patients were treated in their homes or at the almshouses, which served as hospitals throughout most of the century.

      The beginnings of a hospital were made at Camden in 1865, when a dispensary was opened. In 1874, the heirs of Dr. Richard M. Cooper, desiring to fulfill an unrealized wish of the late Camden physician, bequeathed more than a quarter of a million dollars from his estate for the erection of a hospital. Thirteen years elapsed before it was ready for its first patient. By the end of the century, hospitals were in existence in Atlantic and Cumberland Counties as well. The first Gloucester, Salem, and Cape May County hospitals were 20th-century institutions.

      By modern standards, the treatment of disease and the use of preventative medicine during much of the 19th century were backward, but no more so in South Jersey than elsewhere. Blood-letting, a therapy held in disfavor early in the century, was reinstated shortly before the Civil War and, according to reports from Cumberland and Gloucester Counties, was somewhat in vogue for the two decades following the war.

      The prevention of small pox by vaccination, a practice employed effectively early in the century, was neglected in the post-war years, resulting in epidemics. The most serious of them struck at Camden in 1872. That year, 1000 cases of small pox out of a population of 23,000 were reported, and 157 persons died from the disease. Other communicable diseases that ravaged South Jersey in the 1870’s and 1880’s were malaria, typhoid fever, and diphtheria. Tuberculosis also was common.

      The epidemics of the late-19th century effected an interest in public health that prompted municipal authorities to embark upon sanitation projects. The muddy streets of the area’s towns and cities were paved. Drainage was improved and sewer lines were laid for the removal of waste. Outside toilets were sanitized. Too often these measures were delayed until after an epidemic hit. Camden, for example, having cleaned the city following a cholera outbreak in 1866 was apparently lax in disease prevention again by 1872, when small pox struck. After the 1872 epidemic, Camden once more engaged in a clean-up campaign.

      Sewer construction proved to be of sullied benefit to public health. In the municipalities along the Delaware River, the water supplies, drawn from the same streams into which the sewers emptied, became contaminated. In Camden, for instance, an outbreak of typhoid fever struck after the city’s water supply had become polluted from the effluence of Camden and Philadelphia sewers. The need to provide its growing urban populace with pure water, along the Delaware as elsewhere in the state, forced New Jersey into a position of leadership in water purification in the 20th century.

      Personal and public health, of course, depended in part upon the competence of South Jersey’s physicians. Throughout the 19th century, the area’s medical practitioners were respected for the high quality of their training, performance, and dedication to the healing of the sick. Sons of prominent families entered the medical profession.

      In the 18th century, South Jersey had the usual assortment of quacks, herb doctors, and Indian medicine men setting themselves up in practice. There were few licensed or university educated physicians. The maximum training received, even by some of the best, was as an apprentice in the office of an older, local physician. However, the biographies of South Jersey doctors who started their practices in the first decades of the 19th century show that the educational standards of the profession were on the rise, as more and more are identified as being graduates of the medical school at the University of Pennsylvania. Many of them worked with their preceptors in the South Jersey towns before and after attendance at the university, while a number of them upon graduation interned at the Philadelphia Almshouse. County medical societies, the guardians of the profession, were formed around 1818.

      Later in the century, the Jefferson Medical College of Philadelphia shared honors with the University of Pennsylvania as the alma mater of most South Jersey doctors. Today, medical students from southern New Jersey still look primarily to Philadelphia universities and hospitals for their studies and training.

      South Jersey was little different from other places in its treatment of the mentally ill. Until the waning decades of the 19th century, the insane were incarcerated, sometimes in chains, in the jails and almshouses. Although the first state hospital for mentally diseased patients was founded in 1846, after a jeremiad by Dorothea Dix before the state legislature, the treatment of these unfortunates was left largely to the counties well into the 20th century.

      Camden County opened a mental hospital in 1877, but by 1890, "the plan and manner in which Camden county keeps its insane" was decried as "a disgrace to all." Atlantic County had a mental hospital in 1895. Elsewhere in South Jersey, almshouses doubled as insane asylums into the 20th century. By 1931, three state mental institutions were in operation, to be joined by a fourth, the hospital at Ancora, in 1955.

      Humanitarian interest in the care of the mentally retarded was given concrete expression in 1888, when the Rev. Stephen O. Garrison opened the Training School at Vineland, a privately incorporated but state-subsidized institution. The same clergyman figured in the establishment of the Vineland State School. Garrison was succeeded as director of the Training School by Edward R. Johnstone, who gathered together specialists in medicine, pediatrics, psychology, and education for joint study and experimentation on the problems of mental retardation.

      The Vineland school achieved national prominence as a research laboratory in educational methods for the teaching of subnormal and deficient persons. It introduced to the United States the Binet-Simon intelligence tests, and devised mental tests used by the government in the selection of troops for the First World War. Later, the researchers at Vineland gave their attention to the discovery of improved methods for truck farming, dairying, and the poultry industry.

      Further progress in public welfare was accomplished in South Jersey in 1921, when an institution for mentally deficient men and boys was opened in the former agricultural school facilities at Woodbine.

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