In the early 1800s, poorhouses were large warehouses where sick and destitute Americans could work in farms or quarries for minimal pay and a dirty place to sleep. The first American poorhouse was erected in Boston in 1662, but by the 1820s poorhouses became more common, as the economic depression following the War of 1812, which saw wages fall “as much as 80 percent” (17), created what was colloquially known as the “pauper problem.”

The horrors of the poorhouse led to a societal distinction between the impotent and the able poor: The former were wholly incapable of work, and the latter were “just shirking” (17). Poorhouses were designed to be horrific—“overcrowded, ill-ventilated, filthy, insufferably hot in the summer and deathly cold in the winter” (19)—specifically to discourage a habit of seeking aid.

At the same time, poorhouses were also profitable enterprises, preying on the weakest and most vulnerable members of society, like people with physical or cognitive disabilities, who often had nowhere else to go: “Poorhouses were neither debtor’s prisons nor slavery. Those arrested for vagrancy, drunkenness, illicit sex, or begging could be forcibly confined in them. But for many, entry was technically voluntary. The poorhouse was a home of last resort” (20).