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A History of the Institute of Pennsylvania Hospital

In 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 care.

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 that process.

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 [1957] 2n print., with a continuation of the account to the year 1956, by Florence M. Greim.

Morton, Thomas George, 1835-1903. Woodbury, Frank, 1848- . The History of the Pennsylvania Hospital, 1751-1895. New York, Arno Press, 1973 [c1895]

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