A qualitative and comparative study of the Raleigh State Hospital’s Admissions Ledger, 1856-1911

This paper is a collection of observations based on qualitative analyses of nineteenth- and early twentieth-century admissions ledgers from American asylums and related archival materials. I review the kinds of data collected and hint at the possible “how’s” and “from whom’s,” which remain uncertain. The details of the admissions process at American asylums varied state by state and even institution by institution and are revealed only through what little documentation remains, the records created as a result of admissions, which offer only glimpses of the possible exchanges that facilitated admissions processes. I offer preliminary findings from a close reading of the Raleigh State Hospital (Dorothea Dix Hospital) admission ledger and a comparative study of admissions ledger samples from a selection of contemporary American asylums. I look at the role these ledgers played in governmental reporting and professional knowledge sharing, especially with regard to the uses and misuses of statistics within the burgeoning field of psychiatry. I also take note of where recordkeeping points to possible patient experiences, though more complete evidence of these experiences requires much more work, review of other kinds of documentation, especially from the patient perspective. Finally, I offer a theoretical understanding of the records that I have developed over the course of my time with them and grounded in critical feminist and race theory.