Sacramento's Old State Hospital Rediscovered

The Sacramento State Hospital was assigned a dual role: to provide medical treatment for the ill and injured in Sacramento and northern California, and care for the insane from all parts of the state. The San Francisco State Hospital (formerly the San Francisco Marine Hospital) served its regional population as well as mariners and new immigrants arriving by ship. Stockton State Hospital was to provide indigent medical care for all of southern California.

But details about the Sacramento hospital - and even its very existence - became obscured over the years.

Before joining the social work faculty at California State University, Sacramento in 1967, I was a psychiatric social worker with the Department of Mental Hygiene at Atascadero. I was interested in the history and evolution of treatment methods for mental disorder and I had read about California's early state general hospitals in research papers written by Department of Mental Hygiene staff members.

S.A. Brody (1964) described the early facilities: San Francisco's asylum-jail, the ship Euphemia anchored on the bay at the corner of Jackson and Battery streets; the San Francisco Marine Hospital; and the state hospitals established in 1851 at Sacramento, San Francisco and Stockton.

Brody and Hordern (1967) examined and compared mid-19th Century psychiatric theory and treatment in early California and Victoria, Australia. Brody (p. 266) identified the Sacramento State Hospital annex for the insane as the first state operated facility for mentally ill, and the beginning of state responsibility for the cost of care and treatment of the mentally ill.

The renewal and restoration of "Old Sacramento" encouraged me to search for more of the hospital's history. But the hospital was long forgotten. Responses to informal inquiries at the Department of Mental Hygiene and the Department of Health Services were uniformly negative: "Never heard of it." "It never existed." "The Legislature may have passed a bill but there was never a state hospital at Sacramento."

When I searched more literature on early California hospitals, I found ambivalence and uncertainty. McGowan's (1961) definitive three-volume history of the Sacramento Valley identifies early hospitals in Butte and Yuba counties, but not in Sacramento. Savino and Mills (1967) discussed the "moral treatment" in California from 1852 to 1870 with no mention of the ward for insane at the Sacramento State Hospital. Savino and Brody (1966) analyzed discharge and death rates in the state hospitals, 1852-1954, without mention of the Sacramento State Hospital annex. Klotter (1957) in his historical sketch of California mental hospitals does not refer to the facility for the insane in Sacramento.

According to Cahn and Bary (1936), San Francisco and Sacramento were the major cities through which people traveled to and from the gold fields, and there was a great need for shelter and hospital care for the sick (p. 137). Cahn and Bary discuss efforts to provide medical care by municipal authorities in the first years of the Gold Rush and by the three new state general hospitals created in 1851. In Sacramento, Charles Pickett provided hospital facilities under contract with the city and was paid in script. But the numbers of sick increased and the value of script depreciated; Pickett lost his investment and his hospital service was closed (p. 138). A similar situation developed in San Francisco.

Cahn and Bary (p. 140), report that the Legislature's 1851 appropriation for each of the new state general hospitals was $15,000, to be used exclusively for medical care for indigents. They indicate that the Sacramento State Hospital received an additional $15,000 to care for insane patients; however, "no hospital building was ever erected in Sacramento although provision was made for the ill in existing quarters" (p. 140).

Brody & Horden (p. 326) explain that the additional $15,000 appropriation for the Sacramento State Hospital was "issued in script that was worth less than half its face value when converted to cash...consequently the hospital trustees were compelled to rent an unsuitable wooden frame building..." next to the general hospital to house mental patients. The trustees also "...had to skimp on food, clothing and bedding..." for mental patients (p. 326). In May 1852, a legislative committee investigated conditions in the ward for insane patients and concluded that the facility was "...too small, too insecure, and by no means suited to their horrible condition" (p. 326).

My review convinced me that Sacramento State Hospital existed for at least two years. The three state general hospitals were created in 1851 (California Statutes, 1851, Ch. 27, p. 500) and abolished in 1853 (California Statutes, 1853, Ch. CCIV, p. 926). Medical care for the indigents then became a county responsibility (California Statutes, 1855, Ch. LVII). The ward for the insane at the Sacramento hospital was replaced by The Insane Asylum of California at Stockton (California Statutes, Ch. CCIII, p. 921).

Finding original sources on the Gold Rush era hospital fit the objectives for research in my Mental Health Policies and Services course. A few years passed before an undaunted graduate student, Tim Suderman, took on the assignment. His 1997 research confirmed that the state of California established and operated a general hospital at Sacramento from 1851 to 1853, and that an annex to the hospital was the first state operated facility to care for insane patients.

The Sacramento State Hospital was located on M Street (now Capitol Mall) between 2nd and 3rd streets - more precisely on the north side of M Street, one lot east of the northeast corner of 2nd and M streets (Sacramento City Assessor Map books 1851, 1852, 1853, 1854, 1855, cited in Suderman, 1997, p.19-20). The site was designated "State Hospital" in the 1851-1853 Assessor's maps, and changed to "Hospital Lot" in the 1854 map. That location is now in the Interstate 5 canyon that divides Old Sacramento from downtown.

The hospital was created by the Legislature on April 15, 1851. The next day the Legislature elected Dr. Wake Bryarly to the Resident Physician position, and Dr. George Williams to Visiting Physician. They were nominated by the legislator primarily responsible for creation of the hospital, Sacramento Assemblyman H.E. Robinson (Journal of the Assembly & Senate, 1851, p. 413, cited in Suderman, p. 20).

Sacramento Mayor Pat R. Hardenberg led the celebration at the May 12 City Council meeting "...the Legislature...established at our city, a state hospital, and made ample provision for its support... the doors of our city hospital were not only open to our own citizens, but we have the proud satisfaction of knowing that we received and cared for... the citizens of our own state [and] of every nation and clime that came for relief. By the wise provision of our state hospital...that immense drain upon our city treasury is stopped" (Sacramento City Council minutes, May 12, 1851, cited in Suderman, p. 21).

On May 26, six weeks after the legislation was enacted, the hospital opened; the first patient was admitted on May 28. Visiting Physician Dr. G. W. Williams prepared the first Sacramento State Hospital Quarterly Health Report (published in The Placer Times and Transcript of Sept. 6, 1851, p 2, cited in Suderman, p. 26). Of 184 patients admitted the first three months, 104 were discharged, 16 died, and 64 remained hospitalized. The most common diagnoses were: Remittent Fever 34; Diarrhoea, 12; Intermittent Fever, 16; Acute Rheumatism, 14; Chronic Rheumatism, 11; Mental Derangement, 10; Gun Shot Wounds, 9; Fractures, 8.

Dr. Wake Bryerly in his January 1852 Resident Physician's Report to the California Legislature (cited in Suderman, p. 25-26) attributed both serious physical and mental health problems to the search for gold. The most frequent illnesses treated are "fevers, particularly Bilious Remittent Fever" caused in part by the living conditions of the miners. "The greatest cause of death... chronic diarrhoea …the most formidable disease in our whole country." He reported that Shasta, Nevada and El Dorado counties are the most affected and accounted for a large portion of the hospital census.

On behalf of the Mental Health Association, Sacramento, I submitted documentation about the old hospital to the California Historical Society. On August 31, 2001, the Mental Health Association unveiled the Historical Society plaque in Old Town, Sacramento, commemorating Sacramento State Hospital - 150 years after it first opened.

humphers@csus.edu

• Brody, S.A. (1964). Hospitalization of the mentally ill during California's early years: 1849-1870. Psychiatric Quarterly Supplement, 38, 262-272.
• Brody, S.A. & Hordern, A. (1967). Psychiatry in the gold rush era: California and Victoria. Mental Hygiene, 51, 322-342.
• Cahn, F. and Bary, V. (1936). Welfare activities of federal, state and local governments in California, 1850-1934. Berkeley: University of California Press.
• California Statutes. (1851). Chapter 27, p. 500, An Act to create a state hospital in the City of Sacramento. Vallejo: G. Kenyon Fitch, State Printer.
• California Statutes. (1853). Chapter CCIII. An act to establish an asylum for the insane of the state. Benecia: S. Garfielde Publisher.
• California Statutes. (1854). Chapter IV. An act for the relief of the insane asylum. Sacramento:
• California Statutes. (1855). Chapter LVII. An act to provide for the indigent sick in the counties of this state. Sacramento: B.B. Redding, State Printer.
• Grob, G.N. (1973). Mental institutions in America: Social policy to 1875. New York: The Free Press.
• Klotter, A.S. (1957). California mental hospitals: An historical sketch. Bulletin of the Medical Library Association 45, 159-163.
• McGowan, J.A. (1961). History of the Sacramento Valley, Vol. I. New York: Lewis Historical Publishing Co.
• Rothman, D. (1971). Discovery of the asylum: Social order and disorder in the new republic. Boston:Little, Brown & Co.
• Savino, M. and Brody, S. (1966). Discharge and death rates in California state hospitals 1852-1954. Archives of General Psychiatry, 15, 475-484.
• Savino, M.T. & Mills, A.B. (1967). The rise and fall of moral treatment in California: 1852-1870. Journal of the History of the Behavioral Sciences 3, 359-369.
• Starr, P. (1982). The social transformation of American medicine: The rise of a sovereign profession and the making of a vast industry. New York: Basic Books.
• Suderman, T. (1998) The early history of California state hospitals, 1849 -1855. In partial fulfillment of the requirements for Social Work 253, Mental Health Policies and Services, Humphers, Division of Social Work, California State University, Sacramento.