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Issue 11 Cover Note

Bellevue Hospital Insane Pavilion, c. 1910

The almshouse in Lower Manhattan that became Bellevue Hospital, had, in its 1736 mandate, a commitment to care for “the aged, infirm, the unruly and the maniac.” However, when Bellevue was officially declared a hospital in 1825, the ancillary functions were parceled out to other institutions. In 1829, the City of New York purchased Blackwell Island (now Roosevelt Island) in the East River, and erected a penitentiary, an almshouse, a workhouse, a smallpox hospital, and, in 1839, the New York Lunatic Asylum. Bellevue’s prisoners, poor, and mentally ill, were sent to these respective institutions.

Charles Dickens, after a visit to the Lunatic Asylum in 1842, wrote, “The moping idiot, cowering down with long dishevelled 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.”

In 1888, journalist Nelly Bly (pen name of Elizabeth Cochrane) of the New York World feigned insanity to get herself institutionalized at the Lunatic Asylum. This included several days in basement wards of Bellevue with the alcoholics and criminals before being sent with to Blackwell Island. (After ten days her publisher, Joseph Pulitzer, rescued her.) Bly’s searing reports of the physical abuses, the vermin-infested food, and the complete control the staff exerted over the patients, rallied public opinion and the Lunatic Asylum closed in 1893.

Meanwhile, in 1879, Bellevue had built its own Insane Pavilion on the main campus of the hospital on East 26th Street. The creation of a dedicated space within a medical hospital for the treatment of mental illness was revolutionary at the time. The cover photo of this issue of the BLR was taken in the Bellevue Insane Pavilion around 1910. Dr. Menas Gregory was chief of psychiatry at the time, and he believed that salutary conditions were a critical part of treatment for the mentally ill. Unfortunately, commitment to that belief has waxed and waned over the century.