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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