Records of the Commissioners of the City Hospital, 1879–1907

Scope and Content

This collection contains the records of the Commissioners of the City Hospital, 1879–1907. The records consist of legal documents between the City Council and the Medical College or the Medical Society of South Carolina (1879–1907, incomplete); minutes (1880–1886); financial (1884); materials relating to construction of the new City Hospital (1887–1888); staff payroll (May 1896); and the 1901 City Hospital, Rules and Regulations. 

The legal documents consist of financial contracts between the City Council and the Medical College or the Medical Society of South Carolina (1879, 1889, 1892, 1904, 1907). 

The minutes of the Board of Commissioners (7 April 1880 – 5 May 1886) reflect the daily operations of the City Hospital: finances; maintenance of grounds and buildings; procurement of food, hospital supplies and equipment; and employment matters, e.g., wages, hiring, termination, and discipline.  The minutes also contain miscellaneous financial records, including an 1880 room rate schedule; finance committee reports of 1882 and 1883; the planning and establishment of a training school for nurses; 1885 cyclone damage; and miscellaneous letters. Of interest, the board also deals with social issues of the day, for instance, establishment of a separate ward for prostitutes (August 1882); treatment of the insane and indigent; and ongoing matters related to segregation and treatment of white and colored patients.  

The financial records from 1884 include the Ledger; the Cash Book; accounts with the City Treasurer; pages from Permits of Admission; finance committee report; auditor’s statement; and an estimated budget for 1885. 

The materials relating to construction of the new City Hospital include the City Engineer’s Office report on specifications; a bond between W.H. Powers and City Council to perform work; and various documents relating to construction matters.  

The staff payroll of May 1896 is of interest because it lists staff by name, occupation and monthly pay rate. 

Administrative/Biographical History

The origins of public health care in Charleston can be traced to 1736 when the Provincial Assembly legislated funds for a “Work House and Hospital for the reception of the poor,” a building whose nature is unclear.1 By 1768 an increasing poor population in the City prompted the Assembly to pass an act for the erection of a new facility, a “Poor House and Hospital” on the same grounds, which had a ward for ill patients and an asylum for lunatic patients in an out-building.2 This brick building served as a poor house and city hospital under various guises for over 100 years and was overseen by the Board of Commissioners of the Poor House and a city-appointed Physician to the Poor House.  

By the mid-nineteenth century, “deficient and faulty Hospital accommodations of the City” prompted the Medical Society of South Carolina, trustees of the Thomas Roper fund, to carry out Roper’s bequest for the erection of a hospital for “sick, maimed and diseased paupers . . . without regard of complexion, religion or nation.” 3   With the City Council’s approval, the Medical Society began construction of Roper Hospital in 1850, after raising additional funds from city, state and private donations.  Located on the corner of Queen and Mazyck Streets, near the grounds of the Work House, Jail, and Poor House, and adjacent to the Medical College, Roper Hospital was completed in 1852, but did not officially receive patients until 1856. During the yellow fever epidemic of 1854, however, the building opened temporarily to accommodate the victims. 

From 1855 to 1865, an official agreement was entered into between the City Council and the Medical Society for care of the City’s sick and insane poor at Roper Hospital.  The City paid $5000 annually to the Medical Society for medical services and in turn provided maintenance of the Roper Hospital facilities.  During the Civil War, Roper Hospital served as a Confederate Hospital and prison for Union soldiers.  With the war’s close, Roper Hospital was taken under federal military command in 1865, and the City, now decimated in the war’s aftermath, was unable to continue financial support.  

Dissolving its longstanding agreement with the Medical Society, the City placed the sick poor in the empty, postwar Work House with the Freedman’s Bureau providing financial aid until its dissolution by the government.  

Conditions were crowded in this makeshift hospital, and blacks and whites were not segregated.  To ameliorate this situation, the City Council leased the Bischoff mansion in Hampstead for whites, naming it the Tucker Hospital, while blacks remained at the Work House.  These two hospitals, along with the Marine Hospital on Franklin Street, were known as the City Hospitals of Charleston. In the meantime, Roper Hospital resumed limited operations in 1866 under the direction of the Medical Society, closing in 1871 due to financial instability. When the lease with the Hampstead mansion expired, the City needed another building to serve as a hospital for an increasing population of whites, many coming from adjacent states to receive care. 

To meet this pressing need for larger hospital quarters, the City renovated the Work House and enlarged the Poor House building.  This proved to be a temporary solution, however, as crowded conditions quickly ensued, and the City renewed its search for a suitable location. After negotiations with the Medical Society, in 1873 the City signed a 10-year lease for use of the Roper Hospital building as the city hospital, with the Medical College furnishing free medical care by the faculty in exchange for continued City financial support to maintain the buildings. In preparation for its opening, the City renovated the decaying Roper facility and demolished older structures on the grounds. The City Hospital compound now consisted of the Roper building for white patients, the adjacent Poor House building for blacks, and the west wing of the Work House for the insane.  

To manage the hospital, the City Council elected surgeons and physicians under supervision of the Board of Health, an arrangement that lasted until 1879. In 1880 a Board of Commissioners was appointed by the Council to oversee the hospital’s administration. The newly appointed Board of Commissioners quickly moved to remedy the deficient conditions they witnessed and recommended eventual replacement of the hospital, whose patients numbered ten thousand a year.  

After the original 10-year lease of the building expired in 1883, the City signed another 5-year lease because they assumed the Trustees of the Medical Society would be financially able to undertake management and upkeep of the hospital by the end of the 5-year term. The 1886 earthquake wrecked the Roper Building, however, and replacement plans were now a necessity. In the interim, patients were transferred to the Agricultural Society Hall.  

The following year, using funds donated to the City for earthquake relief, City Council began construction of Memorial Hospital. Located on the corner of Lucas (Barre) and Calhoun, the hospital was completed on May 29, 1888. The City refused to repair earthquake damage to the Roper building, however, and the Medical Society funded the restoration in 1891. The restored Roper Hospital building never reopened, as funds were unavailable for its operation. Sold in 1892, the building was converted into an apartment house, a portion of which still stands at 140 Queen Street. 

By the early twentieth century, Memorial Hospital was inadequate and outdated. In 1904 the Medical Society offered to use the Roper Fund to build a new and modern city hospital, to be named the Roper Hospital, on the same site as Memorial and to enter into a contract with City Council to take care of the poor for a $28,000 fixed annual fee.  A City Dispensary activity would be included as an “outdoor” service, with a visiting dispensary physician, or externe, service caring for the pauper sick in their homes.   The agreement stipulated that if the City failed to pay its annual obligation, full title would be transferred to the Medical Society. 

Memorial Hospital was torn down in 1905, and patients were temporarily housed in Thomson Auditorium. Construction of the new Roper Hospital was completed on February 19, 1906.  The city-appointed Board of Commissioners was abolished as the Roper hospital board took full control and management; however, the City continued its annual financial contract with the Medical Society for care of the indigent sick. In 1932, suffering from the effects of the Great Depression, the City failed to meet its annual financial obligation, and ownership of the building passed to the Medical Society, as stated in the original agreement. 

In 1937 the Charleston County Public Welfare Act transferred the City’s financial responsibility for the care of the indigent sick at Roper Hospital to the Charleston County Public Welfare Board. By 1965 County financial support for the indigent sick ended.  The following year, after sixty years of service, the old Roper Hospital was torn down, and treatment for the indigent sick was transferred to the Medical College Hospital.  

Acquisition 

This collection comprises a portion of the Historic Records of the City of Charleston. These materials were put on permanent loan to the Charleston County Public Library by the City of Charleston Records Management Division in 2002. 

Collection Outline