Compassion, but with a new frankness

"Compassion, but with a new frankness." Was a hallmark of the Gerhard years at the hospital. Like his predecessor, he regularly wrote to the families of patients, at times he wrote as many as six or seven letters a day for different patients. The new superintendent tried to be hopeful when ever possible, but he could also be direct and blunt if there was little hope for improvement. It was customary during this time period that the superintendent and his family on the grounds of the hospital. When the hospital trustees inspected the recently vacated home of John Curwen on the third floor they found it to be in a state of disrepair. They immediately authorized Gerhard to get the rooms back in proper shape. Although some had viewed the previous superintendent's use of funds with skepticism, most of the maintenance funding had been spent on moral treatment improvements, such as ventilating and heating systems, gas and sewer works, outbuildings for the farm, iron fire escapes, and ground beautification, not basic structural enhancements to the Main Building. During the second year of the new superintendent's term, Gerhard openly, and to some, startlingly, called for the replacement of the entire Main Building. He wrote that he believed that the building was built poorly and unsatisfactory and had been a constant expense to keep in good repair. Gerhard pushed to have the hospital rebuilt following the new building concept known as the "Cottage Plan". In this building plan, rather than have all the patients contained in a single large building, they would build multiple smaller buildings. Each building would house a specific type of patient. Though Gerhard would not be there to see it, the Pennsylvania State Lunatic Hospital would eventually transform between the the years 1893 and 1912 and adopt the new cottage plan.

On the night of March 5, 1881 a large fire gutted the majority of the new state hospital in Danville. As a result the hospital received a large influx of female patients who would reside at the hospital until Danville could be rebuilt. This only added to already overcrowded conditions.

Despite all the improvements made under Gerhard there were still many problem remaining with the Main Building. An 1884 report exposed many of the problems, including many potential fire hazards. The building itself was not fire proof. Because there was no basement all the heating and ventilation was carried though dirt tunnels below the building. These tunnels were only 4 feet high and would constantly fill with mud. The steam pipes that heated the hospital were supported by wooden trestles. The dry, wooden trestles were subject to extreme heat at all times during the months that heat was needed in the building. Wooden flues carried fresh air and heat into the building. These flues did not have any metal lining and in the event of a fire; they would effectively aid the fire in traveling through the whole building in a very short period of time. Besides the numerous fire hazards, the 1884 report also cited the poor ventilation system. “The ventilation of the building is bad from the quality of the air driven through it by the fan. The air is impure and loaded with damp moisture absorbed from the tunnels while being driven though them to the stream radiators.” When the 1884 report was published it was recommended that new buildings be constructed to replace the Main Building. “In consideration of these facts, we recommend that new buildings be erected at a probable cost of $500,000, and that the present legislature appropriate $100,000 for the commencement of said new hospital buildings.” In 1884 however the House Appropriation Committee failed to concur with the views of the report, and recommended that $500 be appropriated for the purpose of applying metal flues to the building.