Psychiatric care has a long tradition
at Pennsylvania Hospital. The majority of patients that presented
themselves at the Hospital
in its earliest years were diagnosed as "Lunaticks" (sic).
The eighteenth century
heralded increased control of the insane through confinement
and growing confidence in science's
ability to understand and cure insanity through more aggressive
medical treatment. Dr. Benjamin Rush, attending physician at
Pennsylvania Hospital from 1783 to 1813 developed treatments
which sought to control the patient.
Rush developed the tranquilizing chair to slow down the fluid
movement of agitated patients. He also developed a gyrator which
was a horizontal board on which torpid patients were strapped
and spun to stimulate blood circulation. The Hospital incorporated
recreation and amusements in the patients' regime as a means
By the early 1800s, insane patients at Pennsylvania Hospital
outnumbered those with a physical diagnosis by two to one. A
large farm at what is now 44th and Market Streets was purchased
by the hospital and was called the Pennsylvania Hospital for
the Insane. It later (1959) became known as The
Institute of Pennsylvania Hospital.
Thomas Story Kirkbride became the Superintendent of the new Department
for the Insane and moved to the new grounds with his family.
He spent the rest of his life devoted to the creation of a new,
more humane world for the mentally disabled.
In 1844, Dr. Kirkbride was one of the original founders of
the Association of Medical Superintendents of Institutions for
the Insane, now the American Psychiatric Association.
Dr. Benjamin Rush (1745 - 1813)
Benjamin Rush, "the Father of American Psychiatry," was
one of the most eminent physicians and authors of his day.
As was the case with many of his fellow physicians, Dr. Rush
also a civic leader.
In 1769, Dr. Rush established his medical practice in Philadelphia.
He held the chairs of "Institutes, Medical and Clinical
Practice" at the University of Pennsylvania. In 1796, he
received the additional professorship of "the Practice of
Physic," which he held, with the two preceding chairs, until
the end of his life.
Dr. Rush took a zealous and active part in the Revolutionary
conflict, and remained politically involved for the rest of his
life. He was appointed Physician General of the Military Hospital
of the Middle Department, American Army, in 1777. Dr. Rush was
a member of the Continental Congress from July 20, 1776, to February,
1777, and he signed the Declaration of Independence. He was also
a member of the "Convention of Pennsylvania for the Adoption
of the Federal Constitution" in 1787. Appointed by President
John Adams 1799, Dr. Rush was also Treasurer of the United States
Mint, another post he held until his death in 1813.
Dr. Rush was elected to the Medical Staff of Pennsylvania Hospital
in 1783, and continued to serve the institution until his death.
During several epidemics in Philadelphia from 1793 to 1805, he
fearlessly stood by his patients and his practice (at a time
when most who were able to fled to the safety of the countryside)
and rendered great service to the city authorities. Although
many of Dr. Rush's techniques seem barbaric by today's medical
standards, his propensity for treatments such as purging and
bloodletting were well accepted conventions of that time; it
was his dedication to community service which was and remains
Dr. Rush's convictions also led him to be one of the few to
recognize that mental illness could be diagnosed, classified
and treated humanely. Devoting himself to treatment of the insane,
he was instrumental in upgrading patients' living conditions
and doing away with their lock and cuff restraints. Although
it seems primitive by today's standards, the "tranquilizing
chair" invented by Dr. Rush was a humane alternative to
the straight jacket; the chair was intended to reduce stimulating
blood flow to the brain by binding the patient's head and limbs.
Dr. Rush also was a pioneer in the yet-to-be established field
of occupational therapy, regularly encouraging patients to sew,
garden, listen to music or exercise during the day.
Dr. Rush's work as a scholar and author began at the age of
seventeen, when he translated Hippocrates' Aphorisms into English.
In 1762, he wrote his celebrated Observations on Yellow Fever.
His thesis upon graduation from medical school in Edinburgh in
1766 was "De Coctione Ciborum in Ventriculo." His classic
work, Observations and Inquiries Upon the Diseases of the
Mind (1812), was the first psychiatric text book printed
in the United States.