State Infirmary Patient Registers

Throughout much of the eighteenth and nineteenth centuries, care of the poor, sick, and the mentally disabled rested with each of Rhode Island's towns and cities. Often, it also depended on the generosity of private citizens like Ebenezer Knight Dexter in whose name Providence's Dexter Asylum for the poor and insane was established in 1828. State poor laws, which date back to the earliest colonial period, had provided general principles for the towns’ responsibilities toward the poor.

The state only became more directly involved in the care of the poor in the 1860s when it appointed a Commissioner to inspect the places where the towns' "insane poor, indigent persons, or paupers are kept.” (Public 1864, ch. 502.) In its 1868 report to the General Assembly, however, a committee looking into the issues of the insane explained that it had been necessary to broaden its' inquiry to include "a thorough investigation and review of the whole subject of pauperism." The committee concluded that state action regarding the insane should properly be taken "with reference to its natural connection with pauperism." Beyond this, the committee also proposed that crime bore a relationship to their investigation, as "Insanity, pauperism and crime are evils which breed upon each other." Rhode Island. Acts, Resolve and Reports, Report of the Joint Committee on the State Asylum for the Insane. Report on the State Asylum for the Insane. Appendix #7. January 1868. 10pp

A state facility for the poor was first established with the creation of the State Board of Charities and Corrections in 1869 (Public Law 1869, Ch. 814.) Though officially established in 1869, the State Almshouse did not really begin operations until 1874, when it was finally able to occupy a facility vacated by the State Workhouse and House of Corrections. The history of the almshouse, like that of the other State Institutions, is a story of ever expanding inmate populations outpacing the capacity of the facilities the state had provided for housing and caring for them, as well as changing prescriptions for proper inmate, patient, and prisoner care. It was not until 1888 that the government provided funds for the construction of a new facility specifically dedicated to the almshouse. The building was completed in 1889.

By the first decade of the twentieth century, according to the Board's annual reports, the almshouse was functioning less like a poorhouse and more like "a large hospital having a total of 609 persons needing medical care and supervision.” (Annual Report of the Board of State Charities and Corrections in Rhode Island Rhode Island. Report of Resident Physicians in State Institutions 1912.) For this reason, perhaps, the name "State Almshouse" was changed in 1917 to the State Infirmary by legislation establishing the Penal and Charitable Commission in 1917.