Medicine: The Nation’s Oldest

Dr. Thomas Bond thought that the thriving city of Philadelphia (pop. 15,000) should have a general hospital. When he tried to raise money for one, he was asked constantly: “Have you consulted Franklin? What does he think of it?” Bond finally went to Benjamin Franklin, and it was well that he did. Foxy Ben Franklin conceived the idea of matching private subscriptions with public funds; he lured both citizens and legislators with the bait that the others would put up equal sums. It worked.

Two hundred years ago this week, the lieutenant governor of Pennsylvania signed “an act to encourage the establishing of an hospital for the relief of the sick poor of this province, and for the reception and cure of lunaticks.” Thus was born the Pennsylvania Hospital, the oldest general hospital in the U.S.* Wrote Franklin later: “The institution has by constant experience been found useful, and … I … easily excused myself for having made use of some cunning.”

Insistence on the Sole. In its first temporary quarters (a rented mansion), the Pennsylvania Hospital reflected the informality of the times. Its first patient, Margaret Sherlock, was cured after 16 days, stayed on as a nurse. Dr. Bond lost no time in bringing apprentices into the hospital, “to follow the practice of the house and to assist the physicians.” Also, because weather was supposed to have a direct bearing on disease, Bond started keeping weather records. Franklin was the hospital’s first secretary, second president. To encourage regular attendance at meetings of the twelve-man board of managers he imposed 2-shilling fines, paid many for his own absences.

The hospital has marked many firsts in medicine and surgery. In 1816, Surgeon Philip Syng Physick was the first American to use animal tissue to sew up wounds. In 1887, Dr. Thomas G. Morton performed the first successful operation for the removal of a diseased appendix. Some other surgeons are remembered for odd reasons: as late as the 1870s, Dr. David Hayes Agnew insisted on stropping his scalpel on his boot sole, and Dr. George C. Harlan, for handiness, held instruments between his teeth.

Confinement in Cells. But the hospital was born with a split personality, and much of its effort has been devoted to the care of “lunaticks.” As early as 1789 (before the Englishman Tuke and the Frenchman Pinel began the reform of bedlams), Dr. Benjamin Rush complained that his treatments of the mentally ill were “rendered abortive by the cells of the hospital . . . Few patients have ever been confined in these cells who have not been affected by a cold . . . Several have died of consumption.” He recommended “more wholesome apartments,” and they were soon provided.

Dr. Rush also complained that the contemporary treatment of the insane was irrational. “While we admit madness to be seated in the mind,” he wrote, “by a strange obliquity of conduct we attempt to cure it only through corporal remedies. The disease affects both the body and the mind, and can be cured only by remedies applied to each of them.”

TV Takes Over. Today, in separate quarters in West Philadelphia which have been occupied for no years, the Pennsylvania Hospital operates both a 304-bed mental hospital and an institute dedicated to the prevention of serious mental ills. Institute patients are free to come & go, consult staff psychiatrists, undergo preventive therapy, or just relax. A special study center probes the emotional problems of children.

Downtown, one building dating from 1756 and others from 1796 are still part of the hospital—though antibiotics have replaced the bloodletting which Rush and Physick favored. A 150-year-old clinical amphitheater is now a television lounge. But, following Ben Franklin’s example, members of the board of managers still fine themselves 50¢ if they miss a meeting.

* But not, by a long shot, the first in North America: Cortes founded one in Mexico in 1524.