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PSYCHIATRY

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.

Dr. 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 of therapy.

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.

Dr. 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)
Dr. 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 was 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 so noteworthy.

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.

 



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