A History of the Institute of Pennsylvania Hospital
the winter of 1841, nearly 100 mentally ill patients of Pennsylvania
Hospital were slowly transferred in carriages from the bustling
city streets at 8th and Spruce Streets to a new, rural facility
especially prepared for their care. The hospital awaiting them
offered a treatment philosophy and level of comfort that would
set a standard for its day. Known as The Institute of Pennsylvania
Hospital, it stood west of Philadelphia, amidst 101 acres of
woods and meadows.
While brief, the journey for these first patients marked the
culmination of an important stage in our thinking about illnesses
of the mind, and the beginning of a new series of chapters, discoveries,
steps and missteps that have led to present day standards of
This move toward a more humane treatment setting for psychiatric
disorders actually began almost 90 years earlier when Pennsylvania
Hospital opened its doors in 1751. As the nation's first hospital,
it was also the first to treat mental illness. As such, Pennsylvania
Hospital became a primary force in shaping the attitude of colonial
Americans toward persons with emotional and psychological dysfunctions.
In the years that have followed, clinicians associated with
Pennsylvania Hospital have played a significant role in moving
society toward a more accurate understanding of the causes of
these illnesses and how they can be most effectively treated.
Through this brief history, we hope to give you some idea of
Madness was once believed to be caused by the moon, the origin
of the term "lunacy."
Reflecting the philosophy of Quaker founders, Pennsylvania Hospital
became the first institution in the country to extend medical
services to "lunaticks or Persons distemper'd in Mind," as
stated in the 1751 charter. Of the hospital's first six patients,
four were admitted for insanity.
Although care was far from enlightened by modern standards,
the idea that insanity was a treatable disease was itself revolutionary.
Colonial Americans commonly believed insanity to be a demonic
affliction brought on by an "evil visitation." The
insane were seen as incurable, subhuman creatures doomed to a
life in shackles and chains at a poor house or squalid jail cell
for the mad.
From the 1780s to the end of the century, the insane made up
half of the patient roster at Pennsylvania Hospital. Soon, the
hospital came to be known primarily as an institution for the
mentally ill. Some of the more famous patients included financier
Stephen Girard's wife, artist Charles Wilson Peale's daughter,
and the son of Dr. Benjamin Rush, the Pennsylvania Hospital physician
who is called "The Father of American Psychiatry."
Dr. Benjamin Rush believed there were a number of possible
causes of insanity, including: disappointed love, excessive
drinking, lead poisoning, measles, religious fervor.
By the early 1800s, insane patients at Pennsylvania Hospital
outnumbered those with a physical diagnosis by two to one. Space
was at a premium. At the urging of Dr. Rush and William Malin,
the hospital clerk and librarian, the hospital's Board of Managers
eventually agreed to purchase a large farm west of town on which
a facility could be built to house mentally ill patients.
Called the "Pennsylvania Hospital for the Insane," the
new hospital was opened in 1841, a magnificent building surrounded
by lush lawns and gardens. Two detached buildings were added
a year later to accommodate more difficult patients. There was
spaciousness everywhere, with large parlors and solid stone arches.
Individual bedrooms were furnished with ordinary bedroom pieces
and were sunnier, better heated and ventilated, with better plumbing
than rooms of above-average homes in Philadelphia. Outside, patients
could enjoy both a Gentlemen's and a Ladies' Pleasure Grounds,
a deer park and flower garden, or ride about on a circular railway
built for their amusement.
Gamwell, Lynn and Tomes, Nancy. Madness in America: cultural
and medical perceptions of mental illness before 1914.
Ithaca: Cornell University Press, 1995.
Tomes, Nancy. A Generous Confidence: Thomas Story Kirkbride
and the art of asylum-keeping, 1840-1883. New York: Cambridge
University Press, 1984.
Williams, William Henry, 1936- . The Pennsylvania Hospital,
1751-1801, an internal examination of Anglo-America's first
hospital. [Newark], University of Delaware, 1971; [Ann
Arbor, University Microfilms, c1972].
Packard, Francis R. (Francis Randolph), 1870-1950. Some account
of the Pennsylvania Hospital, from its first rise to the beginning
of the year 1938. Philadelphia  2n print., with a
continuation of the account to the year 1956, by Florence M.
Morton, Thomas George, 1835-1903. Woodbury, Frank, 1848- . The
History of the Pennsylvania Hospital, 1751-1895. New York,
Arno Press, 1973 [c1895]
to 1801 - 1850