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Revision as of 20:27, 8 January 2013

Thomas Story Kirkbride

Thomas Kirkbride, M.D. From the collections of the National Library of Medicine.
Born July 31, 1809(1809-07-31)
Morrisville, Pennsylvania
Died December 16, 1883 (aged 74)
Philadelphia, Pennsylvania
Nationality American
Occupation Physician
Known for Superintendent of Pennsylvania Hospital for the Insane

Thomas Story Kirkbride (July 31, 1809 - December 16, 1883) was a physician, an alienist, advocate for the mentally ill, founder of the Association of Medical Superintendents of American Institutions for the Insane (AMSAII), a precursor to the American Psychiatric Association [1], as well the first Superintendent of the Institute of the Pennsylvania Hospital. He would remain in tenure at Pennsylvania Hospital for the Insane for forty-three years, during the longest and most influential period of the hospital's history. Dr. Kirkbride is also regarded as being one of the fathers of American Psychiatry, along with that of Dr. Benjamin Rush. He is best remembered for the design of 19th century psychiatric hospitals, which bear his name.

Early Life

Thomas Kirkbride was born into a Quaker family in a farmhouse in Morrisville, PA. Both brancehes of his family were some of the earliest English settlers of the Delaware Valley region, who came to the Americas with William Penn in the late 17th century. His father's parents were of the country of "Kirkbride' in Cumberland County, England. Upon Settling in America they established a plantation in lower Bucks County, which remainsed family property until it was sold in 1867. His father, John Kirkbride (d.1864), built the house which Thomas lived in as a child on the family estate. His mother, Elizabeth Story, was a resident of Newtown Township.

After attending a local private school in his neighborhood in Morrisville, he attended a classical school in Trenton, NJ, across the river from his home. Afterwards, he spent a year specialized in Mathetmatics in a school in Burlington, NJ. After this intial preliminary education, he spent a year on his father's farm in Morrisville, which he later related was beneficial for his long-term health. During this time he read a treatise by Dr. Nicholas Belleville, a French surgeon who had come to the United States with Lafayette during the American Revolution, and who was residing in Trenton, NJ. In 1831, Thomas Kirkbride began his medical education under Dr. Belleville, when he was eighteen.[2][3] After receiving a medical degree from the University of Pennsylvania in 1832, Kirkbride did his residency at Friends Hospital in Philadelphia. Follwong which, he was briefly employed at Pennsylvania Hospital as part of their regular medical staff, from 1833-185. It was originally his intention to become a surgeon, and shortly thereafter he had his own practice in Philadelphia, lasting from 1835 until 1840.[2][3]

In 1839, he married Ann West, daughter of Joseph R. Jenks, a wealthy Philadelphia merchant, and Manager of Pennsylvania Hospital. She would bear him a daughter and a son, before her death in 1862.

Pennsylvania Hospital

Beginnings as Superintendant

Despite having a private practice independent of hospital affiliation, Kirkbride was very familar with the staff and administration of Pennslyvania Hospital. The resignation of his peer, Dr. John Rhea Barton, in the autumn of 1840, lead him to believe that he would be appointed to a surgeon position shortly. However, the Board of Manager instead offered him a new title of Superintedent and Psychiatrist-in-chief of the recently established Pennsylvania Hospital for the Insane, later known as the Institute of the Pennsylvania Hospital. This was not immediately accepted, as the field of psychiatry was considered a lower medical profession in the 19th century. Most of his friends regarded this move to be not in his best interest professional, and strongly advised against it. However, the prospect of having control over the construction, design and management of this new facility, as well as the protocol of the young field was also titillating. Without any solicitation, or even an acceptance of the position, he was elected by the board as 'Superintendent' on October 12, 1840.

As the first profession meassure of his tenure as Superintendent of Pennsylvania Hospital for the Insane, he toured a number of local hospitals for two months, after a careful examination and analysis of the nation's use of inpatient hospitalization for the mentally ill. Following this tour in December of 1840, he took up residency in an old mansion house located on the new hospital grounds, where he would continue to reside for the remainder of his life.

National Recognition

In 1844, Dr. Kirkbride was one of the original thirteen members who founded the 'Association of Medical Superintendents of American Institutions for the Insane' (AMSAII), serving as its secretary from 1848 to 1855, its vice-president frm 1855 to 1862, and finally, as its president from 1862 to 1870.[4] He took the greatest interest in these proceedings, and was noted for never missing a single meeting, which took place at Pennsylvania Hospital in Philadelphia. The AMSAII would change its name in 1895 to the American Medico-Psychological Association, and change it again in 1921 to the American Psychiatric Association. Its first proposition was dedicated to the clarification of their intent: "It is the unanimous sense of this convention that the attempt to abandon entirely the use of all means of personal restraint is not sanctioned by the true interests of the insane".

Kirkbride pioneered what would be known as the Kirkbride Plan, to improve medical care for the insane, as a standardization for buildings that housed the patients.[5]

Kirkbride's influential work, On the Construction, Organization, and General Arrangements of Hospitals for the Insane with Some Remarks on Insanity and Its Treatment, was published in 1854, and again in 1880.[2] Kirkbride had been influenced by the Quaker-founded York Retreat in England whose leader, Samuel Tuke, had published an account entitled, Practical Hints on the Construction and Economy of Pauper Lunatic Asylums (York, England, 1815). The Tuke family had instituted in their hospital a "moral treatment" approach to care for patients, which centered upon humane and kindly behavior.[2] The Superintendents’ Association made efforts to institute this approach in their hospitals.[2]

Kirkbride's ideas brought about mixed feelings in both patients and peers.[4][2] Some in the medical community saw his theories and ideas as stubbornly clinging to ideals that hindered medical progress,[4] while others supported his ideas, and saw them change the treatment philosophy for the mentally insane.[5] In his patients, he sometimes inspired fear and anger, even to the point that one attempted to murder him,[4] but he also believed that the mentally ill could be treated, and possibly cured, and Kirkbride actually married a former patient after his first wife died.[4][2]

Death and Legacy

Kirkbride died of pneumonia on December 16, 1883 at his home at the Pennsylvania Hospital for the Insane.[4]. He was survived by his second wife, Eliza Butler Kirkbride, their four childen, and two children from his previous marriage.

Professional Colleagues

Related Facilities

References

  1. [1]
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 The Art of Asylum-Keeping: Thomas Story Kirkbride and the origins of American Psychiatry by Tomes, Nancy, University of Pennsylvania Press
  3. 3.0 3.1 [2] Kirkbride's Hospital, University City Historical Society, by Richard E. Greenwood
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Cite error: Invalid <ref> tag; no text was provided for refs named bio
  5. 5.0 5.1 [3], Building as Cure, by Trans-Allegheny Lunatic Asylum, TALA

External links