The Influence of the 1863 Draft Riots on Jews’ Hospital in New York’s Sectarian Policy

Title page of the Annual Report of the Directors of Jews' Hospital in New York

Title page of the 1864 Annual Report of the Directors of Jews’ Hospital in New York

Mount Sinai Hospital’s predecessor institution, Jews’ Hospital in New York, was established in 1852, opened in 1855, and initially admitted only people of the Jewish faith and accident victims. A mere twelve years later in 1864 the Board of Directors decided to open the hospital to all, regardless of faith. Then in 1866, to reflect this new policy, the institution changed its name to Mount Sinai Hospital. But why did the Hospital become non-sectarian? At a point in time when many Hospitals founded by other creeds continued their religious affiliations, Jews’ Hospital broke with tradition. It might come as a surprise that the decision to treat people regardless of faith was influenced by the Civil War and the New York City Draft Riots of 1863, one of the “bloodiest race riots in American history.” The profound devastation wrought upon Black people during the gruesome riots shaped New York as we know it today and had a profound impact on the early days of our health system.

In the introduction to The First Hundred Years of The Mount Sinai Hospital of New York, 1852-1952, the authors posit that Jews’ Hospital, as it was in the geographic center of the riots, was “the asylum for their dead and injured. An eventual result for the Hospital was its adoption of the nonsectarianism which has been its policy ever since.” Which begs the question: who did they treat, and did treating victims of the riots actually persuade the Hospital’s Leadership to change its policy? To answer that question, we need to know what occurred in New York City during the years leading up to the 1864 decision. The United States was in the thick of the Civil War which raged from 1861 to 1865. New York City, while positioned as a northern city allied with the Union, was in fact quite a conservative city due to its financial connections to the south.

Section of map from 1869 showing the Jews' Hospital

Section 1869 map of New York showing the Jews’ Hospital in blue rectangle (map courtesy of Lionel Pincus and Princess Firyal Map Division, The New York Public Library)

During the Civil War the Jews’ Hospital in New York was located on the south side of 28th Street between 6th and 7th Avenues and admitted on average 30 patients a month. In 1864 the staff consisted of three consulting surgeons, three attending surgeons, four attending physicians, “one resident physician and house surgeon, one superintendent, three nurses, three domestics, and one cook.” Annual reports state that from 1855 to 1860 the Hospital treated 1,285 people. However, during the war years, we are unable to say how many in total were admitted because we do not have annual reports for the years 1861, 1862, and 1863. However, Dr. Teller, House Physician and Surgeon, gave monthly reports on all but a few occasions to The Occident and American Jewish Advocate:

Dr. Teller either did not report the 1863 June and July statistics or the newspaper did not include them. But August, the month after the draft riots, the number of patients treated, 113, is higher than usual.

The Hospital underwent a great transformation during the Civil War. One of its three Attending Surgeons, Dr. Israel Moses, left to serve in the Union Army. Joseph Seligman, who had been on the Hospital’s Board since 1855 resigned his position in 1862 because of his “increasing responsibilities” frequently attending advisory meetings with President Lincoln. The most dramatic change was in 1861 when the Board of Directors resolved to establish a ward for injured Union soldiers, first totaling 48, then 69 beds.

The federal draft law was put into place in the summer of 1863, but it provided an exemption for people who could pay $300 or find someone to take their place. This infuriated the working class, the Irish and other recent immigrants, especially in New York, where Union loyalty was not a given. After the names had been drawn for the first round and published in the weekend’s papers, many New Yorkers were enraged. A large mob formed on the next day, and proceeded to attack and burn down the Provost Marshal’s building, where the draft was taking place. From there the mob moved all around the city, rioting, burning down entire buildings, injuring innocent bystanders, looting and committing outright murder. Described as “bitter street-to-street warfare”, the city was in chaos for four days. 

Black people were the primary target of the mob’s atrocious violence due to racism and scapegoating, newspapers having created the narrative that enslaved people, once free, would take jobs from recent immigrants. Mobs lynched eleven Black men, hanging their mutilated bodies from lampposts. The total death count is unknown, but estimates range from over 100 to several hundred. The repercussions of the four days of extreme violence shape New York City even today. Because of the riots, it is estimated that nearly a thousand Black New Yorkers fled Manhattan en masse, seeking permanent refuge elsewhere, leaving behind their homes and communities. In their exodus from what was a racially integrated city, they settled in safer places, such as the historic Black community of Weeksville in Brooklyn (which was a city in its own right at the time). In the aftermath, New York became a more segregated city.

A report of the City Inspector detailing the casualties of the prior week

Excerpt from the July 21, 1863 edition of The New York Herald showing 106 deaths from violent causes, presumably the Draft Riots.

One early Mount Sinai doctor recalled:

In the early [1860’s] the hospital must have had its share of the casualties from the draft riots which occurred in the neighborhood, and of which I was in part an eyewitness: the burning of the colored Orphan Asylum in 40th Street, the attack on the Provost Marshall’s office on Broadway and 28th Street, the hanging of a [Black man] to a lamp post at 6th Avenue and 33rd Street, and the escape of frightened colored men, women, and children from the mob to the State Arsenal at 35th Street and Seventh Avenue under protection of a squad of soldiers.

Do we know how many people were treated at the Jews’ Hospital? While the Archives does not possess the case books from that era, we know that, “the geography of the rioting was such that Jews’ Hospital was frequently the center of its fury, and during the bloody days that ensued, it became the sanctuary of the sick and the wounded.” The newspapers of the time described multiple extremely violent events that took place only a few blocks from the Hospital. In all likelihood, the Hospital treated dozens of riot victims and the staff would witness the particular terror and brutal violence inflicted upon Black people.

In reading the minutes’ book entries of the subsequent months, there seems to be no end to the mundane issues the Board of Directors addressed. Rarely is there an explanation of motive or greater historical context included with a decision recorded in such matter of fact reports. However, in the months following the riots, the Hospital’s Board of Directors were:

Sensitive to their obligations to the country and the community during this period, the Board of Directors was also preparing the ground for the nonsectarian policy which has distinguished the Hospital ever since. Accident patients of all nationalities, races and religions had been accepted since the first day of the Hospital’s existence. But the national crisis crystallized the Board’s determination to rise above sectarianism and abolish it completely. In 1864, the Executive Committee had reported, “The Committee deem it proper to observe that many of those admitted to the Hospital were not of our faith, no distinction ever being made as to either the nationality or the religious belief of the sufferer.”

 

References

Albon P. Man. “Labor Competition and the New York Draft Riots of 1863.” The Journal of Negro History, vol. 36, no. 4, 1951, pp. 375–405. https://doi.org/10.2307/2715371.

Hirsch, Joseph and Doherty, Beka. The First Hundred Years of the Mount Sinai Hospital of New York, 1852-1952. Random House: New York, 1952.

Jews’ Hospital in New York. Annual Report of the Directors of the Jews’ Hospital in New York, 1860. https://archive.org/details/annualreportofdi1860jews/page/18/mode/2up

Meyer, Alfred. “Recollections of Old Mount Sinai Days.” Journal of the Mount Sinai Hospital, vol. 3, no. 6, 1937, pp. 295-307.

 

Authored by J.E. Molly Seegers

Giving Birth to an Obstetrical Service

On August 27th, it will be 165 years since the first baby was born at The Mount Sinai Hospital in 1856. The mother was a Mrs. Lichtenstein. She named the baby Isaac Touro, in honor of a Hospital benefactor, Judah Touro (1775-1854), who had helped support the young Jews’ Hospital in New York, as Mount Sinai was then known. (Judah Touro also gave money for the founding of Touro Infirmary in New Orleans and today’s Touro College and University System is named for Judah and his father Isaac.)

Isaac Touro Lichtenstein was one of two babies born in the Hospital during its first year of operation. Until the 1920s, most babies were born at home or in one of the specialized women and child care hospitals around the City. This meant that many general hospitals, including Mount Sinai, never felt the need to add a formal obstetrical service to their offerings, thus limiting the number of babies born at the hospital over the years.

By the 1920s, as hospital births began to rise around the country, the Mount Sinai medical staff started to talk to the Board of Trustees about adding obstetrics. As the doctors saw it, the problems arising from not having babies born at the Hospital were: the Gynecology staff could not admit their obstetrical patients to Mount Sinai; there was no obstetrical training for the GYN residents, nor was there training for the pediatrics residents in newborn care. The last also applied to The Mount Sinai Hospital School of Nursing, which affiliated with the Sloane Hospital for Women so students could fill the gap in their education.

While the Trustees were increasingly sympathetic with the request to add an obstetrical service, it wasn’t until the middle of the 1940s that concrete plans were made for the erection of a new building to house obstetrics and gynecology, today’s Klingenstein Pavilion on Fifth Avenue. Every new building demands a fundraising campaign to make it a reality. Mount Sinai had just finished a major expansion that ended in 1922, with the addition of a new School of Nursing building and a semi-private pavilion seen as the next priorities. When these two buildings opened, the Depression was in full swing, which sapped Hospital and potential donor resources. This was followed quickly by World War II, but by the mid-1940s, the Hospital could see a window of opportunity on the horizon.

A fundraising campaign was begun when the war ended and on July 22, 1948, ground was broken for three buildings: the Klingenstein Pavilion, and the Atran and Berg Laboratories. In 1952, the obstetrical service started to operate as the building slowly opened. July marked the start of Mount Sinai’s first Prenatal Clinic, and the first prenatal clinic for women with diabetes in New York City started in the fall. The first OB patients were admitted in October, with the first baby born October 29, 1952 – 96 years after Isaac Touro Lichtenstein.

A View from 100 Years Ago

I recently spent some time reviewing the President’s Report section of the Annual Report of The Mount Sinai Hospital from 1921 (linked here, starting on page 190).  The President then was George Blumenthal, a devoted trustee, and a smart businessman who had recently guided the Hospital through a major expansion program, the uncertainties of World War I, and the influenza epidemic of 1918. Reading the report reminded me of the joys – and problems – with reading primary historical sources: it is very easy in hindsight to see connections between two times that may not be related, and simple observations can seem very prescient.

Don’t get me wrong, parts of the report are very dated and irrelevant to today: the Hospital was unable to afford radium to use in patient treatment, and so that service was not provided. There was also a section on issues related to fund raising through the Federation of Jewish Charities (today’s UJA-Federation). But still, there were many issues that would seem familiar to our current leaders. The Hospital was perennially short of money, but after the epidemic and the war, wages were rising quickly for what today would be called “essential workers”.  Adding to this was a restrictive immigration policy that limited the labor pool. The inability to hire as many trained nurses as they needed was a continuing struggle as well, something the whole country recognizes today.

George Blumenthal, President of The Mount Sinai Hospital from 1911-1938

And yet Blumenthal made the case – as we do today – for why private hospitals like Mount Sinai deserve the philanthropic support of the people. He says:

It is absolutely essential that private institutions like Mount Sinai should be leaders of progress in hospital work…. To discover, test and demonstrate new methods of treatment is recognized as one of the functions of private institutions and it is one of the strongest reasons for their existence and constitutes their most important claim on the generosity of the public which supports them.

A couple of pages later, Blumenthal makes a bold statement about the importance of Mount Sinai being a teaching hospital. At this time it had loose clinical ties to both Columbia and NYU. He envisioned something more:

A Hospital possessing the clinical and laboratory resources of Mount Sinai should have university affiliation or if this be impracticable should independently utilize its organization for teaching purposes, for in no other way can the fullest benefits be derived from the intensive study of interesting, varied and often perplexing clinical material. We hope the day is not very far off when work on these lines can be done either through affiliation with one of the many teaching institutions located in our city or by independent action.

And “independent action” it was. Even with academic affiliations with various medical schools, in the 1950s Mount Sinai was not satisfied that they were living up to their potential in terms of training the next generation of physician/scientists or using their immense clinical material for creating new medical knowledge to advance patient care. In 1963, the Trustees received a charter to create their own medical and graduate schools. The Mount Sinai School of Medicine opened in 1968.

Poor People Only

The Mount Sinai Hospital created its Dispensary/Out Patient Department in 1875 when it established four clinics:  the Gynecology Clinic, the Children’s Clinic, as well as ones for Medicine and Surgery. Then as now, these clinics were designed to treat people with health needs that did not require a hospital stay. The Hospital traditionally had a long waiting list for admission, and this was seen as a way to help those they could before their conditions worsened. (In addition, in 1884, Mount Sinai Hospital created what it called the “Outdoor Visiting Physicians” to actually go to people’s homes to care for them there. Medicines were provided from the Hospital pharmacy.)

The Hospital was a charity organization and highly dependent on keeping costs down and maximizing donations to support its work. While there were a few patients willing and able to pay something for their care, the vast majority were treated free of charge both on the in-patient side as well as in the Dispensary. Since funds were so limited, Mount Sinai tried to take steps to ensure that their efforts were helping those most in need. One of those steps was to post a sign in the Dispensary that said, “Poor People Only Treated Here”. It eventually became clear that this sign was disrespectful to the people who used the clinic, and 140 years ago, on May 8, 1881, the Board of Directors of the Hospital decided to look into having the sign removed. Unfortunately, the Board minutes do not tell us if it was actually taken down.

The need to closely watch expenditures and try to reserve their services for the most needy continued to plague the Hospital leaders for decades. The beginnings of health insurance in the early decades of the 20th century helped, but it was really the implementation of Medicare and Medicaid in the mid-1960s that relieved hospitals of much of the burden of the costs of charity care.

The entrance to the MSH Dispensary, 1890

The Mount Sinai Hospital OPD Admissions desk in 1951