Baltimore City and County Poor Relief and Welfare Services records

Practicing Medicine at the Baltimore Almshouse, 1828-1850

The Baltimore Almshouse was established in 1733 to care for the poor, and especially for those poor who were incapacitated by illness, old age, physical handicap, mental deficiency, or insanity. To this end, the law provided that part of the money appropriated to maintain the poor should be used to pay a doctor for his salary and medicines. That the institution fulfilled its purpose may be seen from the trustees' estimate that the almshouse population for the year ending April 30, 1826, had been made up of one-fourth sick,... and nearly a fourth aged and infirm, or maimed, and incapable of labor. Except during epidemics, when the city set up temporary hospitals to receive persons stricken by yellow fever, cholera, typhoid, or typhus, the almshouse infirmary was in fact the only refuge for those who could not afford private medical care.



Between 1822 and 1866 that refuge was provided in a large stone and brick building at Calverton, about two miles west of the city. The impressive central block, originally a private dwelling, contained the trustees' meeting room, and quarters for the overseer and his family, the resident medical students, and the apothecary. Two wings, added after purchase of the estate, contained dormitories and hospital wards, including an infirmary for the indigent sick, a lying-in hospital, and a lunatic hospital.



The medical department of the almshouse was supervised by an attending physician appointed by the trustees of the poor. By 1835 the doctor's annual salary had risen to $700, for the first time equaling that of the overseer. The trustees' bylaws required the physician to go out from the city at least once a day to make the rounds of the wards and advise the medical students. Until 1835 literal compliance with this bylaw was not strictly enforced. In one instance, for example, because of his illness the physician was away from the institution for a period of two weeks. The appointment for 1835 was made with the understanding that the daily visits would be carried out, and in 1837 the trustees further required: Whenever the attending physician is unable from indisposition or any other cause, daily to attend the House, he shall furnish a substitute of equal medical reputation and experience to supply his place, and if prevented more than one day at a time, he shall inform the Board thereof through the President by letter, and stating the name of the individual he has selected.