Ohio History Journal

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Samuel M. Smith, "Dr. Cure-Awl's"

Assistant at the Ohio Lunatic Asylum:

His 1841 Case-Reports on Insanity




The first half of the nineteenth century was an enlightened era for under-

standing and treating mental illness. One prevailing theory was that insanity

was a physical disease. This replaced beliefs that considered the mind to be an

"emanation from the Creator" and therefore not subject to physical laws and


In 1812 Benjamin Rush (1745-1813), the "Father of American Psychiatry,"

published his landmark text, Medical Inquiries and Observations upon

Diseases of the Mind.2  This was the first textbook on this subject in

America, and it affected the perception and treatment of mental illness for sev-

eral generations. Insanity, according to Rush, was principally an inflamma-

tory disease of the brain's blood vessels.3 Since the mentally ill were sick-

instead of bad-this fostered a sympathetic attitude toward the mentally ill and

encouraged a form of treatment called "moral therapy."4



Emil R. Pinta, M.D.. is on the emeritus faculty of the department of psychiatry, The Ohio

State University College of Medicine, and is chair of the history committee of the Ohio

Psychiatric Association.


1. H. A. Buttolph, "The Relation Between Phrenology and Insanity," American Journal of

Insanity (AJI), 6 (October, 1849), 133.

2. Benjamin Rush, Medical Inquiries and Observations upon the Diseases of the Mind

(Philadelphia, 1812).

3. Ibid. To reduce this inflammation, Rush advocated blood-letting and various mechanical

devices, such as a "gyrator" board that utilized centrifugal force to reduce blood flow to the

heads of patients who were strapped to this device.

4. Moral therapy began in Europe during the latter part of the eighteenth century as a prod-

uct of the Enlightenment. The word "moral" referred to a variety of psychological-instead of

physical-treatments, e.g., education, diversion, labor, exercise, amusement and occupational

activities. Harmony, balance and regularity in daily activities were important. Nature itself

was considered therapeutic: therefore most asylums were located in rural settings away from

the stresses and noises associated with cities. For discussions of moral therapy, see Amariah

Brigham, "The Moral Treatment of Insanity," AJI, 4 (July, 1847), 1-15; Eric T. Carlson and

Norman Dain, "The Psychotherapy That Was Moral Treatment," American Journal of

Psychiatry (AJP), 117 (December, 1960), 519-24; Albert Deutsch, The Mentally Ill in

America: A History of Their Care and Treatment from Colonial Times, 2nd ed. (New York,

1949), 87-113; Norman Dain, Concepts of Insanity in the United States, 1989-1965 (New

Brunswick, N.J., 1964), 12-14, 204-06; Nancy Tomes, A Generous Confidence: Thomas Story

Kirkbride and the Art of Asylum-Keeping, 1840-1883 (Cambridge, Mass., 1984), 4-6; Gerald N.

Grob, The Mad Among Us: A History of the Care of America's Mentally Ill (New York, 1994),