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The Creation of the Nation's First Hospital

Benjamin Franklin

Dr. Thomas Bond

Patient Admission and Regulation

Caring for Some Very Colorful Characters

Pennsylvania Hospital's Influence on the Field of Psychiatry

Dr. Benjamin Rush: "Father of American Psychiatry"

Thomas Story Kirkbride and the Magic Lantern

A REMARKABLE LEGACY

Pennsylvania Hospital's Influence on the Field of Psychiatry

Written by Howard Sudak, MD

Pennsylvania Hospital is home to the first surgical ampitheatre, the first apothecary, and even the first hospital auxiliary. The physicians, surgeons, nurses and administrators who practiced here were are all remarkable and went to great lengths to ensure the success of the hospital. One achievement stands out the most: Pennsylvania Hospital's unprecedented influence on the field of psychiatry.

Dr. Thomas Bond and Benjamin Franklin saw the need to care for the increasing number of "lunaticks" who were wandering the streets of Philadelphia during the city's population boom of the mid-1700s. Their famous fundraising efforts led to the formation of the hospital and by the time it opened its doors to patients on February 11, 1753, six of the first people treated were psychiatric patients. A short 30 years later, Benjamin Rush came to the hospital and changed the face of psychiatric treatment in America -- forever.

Rush was a physician ahead of his time and is universally acknowledged as the "father of American Psychiatry." He was the first to believe that mental illness was a disease of the mind, rather than a possession of demons, and attempted to treat his patients accordingly. He placed great emphasis on recreational and occupational therapies, but he also believed strongly in purging, blood letting and "twirling." Although by today's standards the care provided was horrific and at times ineffective, Rush and his colleagues truly believed they were providing the most humane treatment possible.

Rush forced the hospital to cease its policy of chaining the most serious cases of the mentally ill in unheated cells in the basement of the Pine Building. He also helped stop the townspeople from coming to the hospital to watch the insane patients as a form of entertainment. It is because of this and the exemplary treatment provided, the number of insane patients in the hospital was far greater than the number of physically ill.

By the 1800s, the hospital's psychiatric wards were far too crowded. Physicians believed these patients needed confinement and did not think a cure was possible. The majority of the patients spent many years in the hospital and the hospital needed the space to care for the growing number of medical, surgical and obstetric patients. A new facility was needed just to accommodate the insane. The Pennsylvania Hospital for the Insane, which eventually became the Institute of Pennsylvania Hospital, opened its doors in 1841. By this time, Dr. Thomas Story Kirkbride was in charge and again, treatment for the mentally ill reached new heights.

A Quaker, Kirkbride practiced what was popularly known as the time as "moral treatment." Kirkbride and his contemporaries began to view mental illness differently. There was now hope that those suffering with mental illness could be cured. Kirkbride strongly influenced the construction of the Institute and made sure the facility was built on expansive grounds. It housed occupational therapy suites, libraries and swimming pools that allowed the patients many recreational and educational opportunities.

The Institute was not the first free-standing psychiatric hospital in the United States, but it was the first to be associated with a general hospital. In 1844, Kirkbride hosted a meeting of the 13 superintendents of the hospitals for the insane that led to the creation of what is now known as the American Psychiatric Association, the nation's first sub-specialty medical society. Kirkbride remained close with the leaders of the original 13 institutions and that group became known as the Ivy League Private Psychiatric Hospital Group, which is still in existence today. During its 150-plus years in operation, the Institute gave rise to 12 presidents of the American Psychiatric Association -- more than any other hospital in the United States.

The Institute of Pennsylvania Hospital continued to treat patients until 1997, when Pennsylvania Hospital was forced to sell the facility due to the drastic reductions in funding for mental health treatment. Inpatient psychiatric care moved back to the 8th and Spruce Streets campus where the services were joined with the community mental health services offered by the Hall-Mercer Community Mental Health and Mental Retardation Center. Combining these state-of-the-art programs with the hospital's psychiatry and psychology teaching programs has enabled the institution to remain at the forefront of the care of the mentally ill and disabled. The merger of Pennsylvania Hospital to the University of Pennsylvania Health System has expanded the services even further to include psychiatric research.

It would appear that not only did American psychiatry begin at Pennsylvania Hospital, the hospital remains a strong influence in the field of behavioral health. The hospital is justifiably proud of both what is was and what it continues to be today.

Related articles:

Dr. Benjamin Rush: "The Father of American Psychiatry"
Dr. Thomas Story Kirkbride and the Magic Lantern


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