Psychiatry’s Roots Run Deep in Philadelphia

Any history of American psychiatry would have to start with a large chapter on Philadelphia. Pennsylvania Hospital, founded in 1751 in Philadelphia by physician Thomas Bond, along with his good friend Benjamin Franklin, was not only America’s first hospital, but the first American hospital to care for people with mental illness. So pleased was Franklin with the creation of the hospital that he later stated, “I do not remember any of my political maneuvers, the success of which gave me at the time more pleasure….”

Benjamin Rush was a Philadelphia physician who worked in the Pennsylvania Hospital from 1783 to 1813. He was among the first Americans to recognize that psychiatric illnesses could be diagnosed, classified, and treated, and he was instrumental in upgrading patients’ living conditions and doing away with their handcuff restraints, which were common at the time.

He believed that alcoholism was a medical disease and, unlike most of his contemporaries, not a sin. He proposed that alcoholics should be weaned from their addiction using less potent substances. He encouraged patients to sew, garden, listen to music, and exercise. His practices and beliefs earned him the description “father of American psychiatry.”

And because many of the patients at Pennsylvania Hospital were mentally ill, another facility, the Institute of Pennsylvania Hospital, was built to minister specifically to their needs. In the winter of 1841, nearly a hundred mentally ill patients were transferred in carriages from Pennsylvania Hospital through the bustling city streets to this new rural facility. It stood west of Philadelphia, amid 113 acres of woods and meadows.

This new facility offered a treatment philosophy and level of comfort that would set a standard for its day. For example, the facility comprised an impressive main building and two detached ones surrounded by lush lawns and gardens. Its sunny, airy halls and spacious walks set a standard for hospitals elsewhere.

Moreover, the Institute of Pennsylvania Hospital’s first superintendent was physician Thomas Kirkbride. In 1844, Kirkbride and 13 other physicians came together at the institute and a nearby hotel to found an organization—the Association of Medical Superintendents of American Institutions for the Insane—that was later renamed the American Medico-Psychological Association and finally APA. This organization was also the first national medical society in America.

Rush is buried in the Christ Church Burial Ground in Philadelphia, not far from Benjamin Franklin’s final resting place. The plaque honoring him reads:

“In memory of Benjamin Rush, M.D. He died on the 19th of April in the year of our Lord 1813, aged 68 years. Well done good and faithful servant! Enter thou into the joy of the Lord.”

Visitors are invited to tour Pennsylvania Hospital, located at 8th and Spruce streets. More information is available by phone at (215) 829-3370 or online at www.pennmedicine.org/pahosp/vi_files/historictours.html. Christ Church Burial Ground is located on Arch Street. It is open to the public daily until 4 p.m., weather permitting. Information is posted at www.christchurchphila.org/burial.