Quakers & Mental Health

The Beginning of the Library

In 1816, before Friends’ Asylum even opened, the Managers of the Asylum recorded in their minutes, "The establishment of a library for the use of the Asylum claiming the attention of the managers, and it being thought that a judicious selection of books will be highly useful to the patients and family…. a committee [is appointed] to receive donations of such books as may be presented, and which they may think suitable to be received" (Tenth Month, 14, 1816). In forming a library for their patients, Friends’ Asylum was at the forefront of thought about how to care for the mentally ill. Just four years earlier, in 1812, Benjamin Rush became the first American doctor to write about giving patients access to books as a part of moral treatment (Levin 89). As the managers’ quote demonstrates, asylums chose the books available to patients carefully, so that the books would have a beneficial effect on patients. Like other asylums of the period, Friends’ Asylum used its library to entertain patients, and also hoped that the books in it would help restore patients to their reason.

The Type of Books the Asylum Had

Since the books in an asylum library were supposed to help restore patients to their reason, the type of books in the library was a hotly debated issue. Most doctors and superintendents thought that history, biography, travel, and natural history were most suitable for patients (Older 522). Fittingly, Friends’ Asylum’s library consisted mostly of history, travel, and biography (Galt 549). In addition, the library had scientific works. For example, patients who visited the library could have read Frederick Beechey’s Narrative of a Voyage to the Pacific and Beering's Strait, Benjamin Smith Barton’s treatise about rattlesnakes, or David Hume’s history of England. History, natural history, and travel were popular genres in asylums because they were entertaining, but also fact-based. Superintendents hoped that the truth of these books could lead their patients to appreciate reason. For example, in the Friends’ Asylum’s Annual Report for 1841, the Asylum’s physicians explained, "In a large proportion of the insane, the mind is not so bewildered or alienated that it is unable to appreciated the sublime truths of nature, as revealed in the various departments of science" (14). Reading books about the sublime truths of nature could hopefully lead patients back to accept reason more generally.

Some genres of books, such as novels or religious books, were more controversial additions to asylum libraries. Many superintendents and doctors worried that novels and religious books would increase the insanity of their patients, and therefore left them out of asylum libraries. Friends’ Asylum, for example, did not have novels in its library, even though the illustrious Benjamin Rush suggested that novels were useful for distracting and soothing patients (Dunkel 279). The lack of novels at Friends' Asylum probably also reflected Quaker beliefs that novels were frivolous as much as it did worries that novels would be dangerous for patients who could not tell truth from fiction. Friends' Asylum’s library did contain religious books, even though some experts were concerned that giving patients access to religious books would encourage the delusions of those suffering from religious insanity (Levin 90). The library had copies of the classic Quaker books, Robert Barclay’s An Apology for the True Christian Faith, and William Penn’s No Cross, No Crown. In addition, the library contained a Bible, and at least one volume of John Milton’s Paradise Lost. Friends’ Asylum had patients whose insanity was religious in nature (see Ruth Sc. on the Patient Profiles page), but evidently, the superintendents at Friends’ Asylum felt that the comfort religious books provided for patients outweighed the chance that they would fuel patients’ delusions.

Libraries and Moral Treatment

The books in asylum libraries were meant, like other aspects of moral treatment, to occupy and calm patients. Library books provided facts for the patients, comforted them, and gave them a productive way to pass their time, which gave them a sense of accomplishment (Older 515). For example, superintendent Isaac Bonsall wrote in his Day Book about how useful reading could be for patients, noting that three of his female patients, "having been all of them great readers they amuse and entertain each other so that their time passes on apparently pleasantly" (Eighth Month, 1, 1822). Although Bonsall did not write that these patients even used the library, the fact that the patients were fond of reading was enough to help them pass their time in the Asylum. In addition to keeping patients busy, the library could be used to ensure good behavior. Scholar Priscilla Older argues that asylum superintendents used access to libraries as a way to govern patient conduct, by granting or withholding reading privileges (Older 516). In order to benefit from access to books, patients had to be well-behaved enough to deserve it. Since using punishments and rewards in this manner was an integral part of moral treatment (See Introduction to Moral Treatment), libraries fit well into the project of moral treatment.

The Medical Library

The patient library was not the only library at Friends' Asylum. The Asylum also had an extensive medical library. Unlike the patient library, which was meant for amusement and restoration, the medical library was meant for the professional use of the superintendents and doctors who ran the Asylum. The medical library included many works on the treatment of insanity, such as Benjamin Rush’s Medical Inquiries and Observations upon the Diseases of the Mind and Nathaniel Bingham’s Observations on the Religious Delusions of Insane Persons. A considerable number of the library’s medical books were in French, such as M. Georget’s De la Physiologie du Systeme Nerveux, or Leopolde Deslandes’ De L'Onanisme et des Autres Abus Vénériens. These books indicate that at least some of the superintendents or doctors at Friends’ Asylum knew French, and kept up with French medical developments in the treatment of insanity. The medical library also included books on other branches of medicine, such as William P. Dewees’ A Compendious System of Midwifery, or Samuel Plumbe’s A Practical Treatise on the Diseases of the Skin. These books were useful to the doctors at Friends' Asylum because the doctors were responsible for the entire health of their patients, and because experts argued that physical ailments could cause or worsen insanity (Rush 33-34). The medical library even included Hugh Williamson’s book Observations on the Climate in Different Parts of America, which held medical value for Friends’ Asylum’s doctors, since weather was thought to affect patient behavior (Ninth Month, 10, 1834).

Book Profiles

We do not have a complete list of all of the books which were part of the Friends’ Asylum library over the years. However, we do have a small subset of both the patient and the medical libraries. Most of the books we have are from the early to mid nineteenth century, although it is usually impossible to tell when the Asylum acquired the books. The books in the following slideshow are examples of books from Friends’ Asylum which illustrate a facet of Friends’ Asylum’s library or history. Additionally, some noteworthy works from the asylum's library include:

Paradise Lost (John Milton, 1757).

The book has had a leather "overcover" added to it, to repair its damaged binding (Stone 34).This amateur repair would have taken time and effort, indicating that the book was important enough to someone to take that time and energy.

Paradise Lost (John Milton, 1757).

The Asylum’s copy of the first volume of Paradise Lost has an inscription indicating who owned it before it came to Friends’ Asylum. The inscription reads, "Elizabeth Grinslade Jr.’s book presented to her by a distant relation, 1786." There is no evidence that Grinslade was involved in the Asylum, either as a patient or an employee.

Memorial Soliciting a Hospital for the Insane (Dorothea Lynde Dix, 1845).

This pamphlet is one of many that Friends’ Asylum owned concerning other asylums and hospitals for the insane in the nineteenth century. It petitions the Pennsylvania state legislature to create a hospital for impoverished insane people; treatment at Friends’ Asylum was too expensive to serve this population.

Memorial Soliciting a Hospital for the Insane (Dorothea Lynde Dix, 1845).

The pamphlet also contains the inscription: "Samuel B. Morris, Esq. from the Author." Samuel B. Morris was a manager of the Asylum from 1834 to 1842, and the author of this pamphlet is Dorothea Lynde Dix, a famous nineteenth century crusader for the care of the mentally ill. The inscription on the pamphlet illustrates how people interested in mental health forged and maintained connections by exchanging their publications on the subject.

A Psychiatric Glossary (American Psychiatric Association, 1969).

This is the most modern medical text we have from the Friends Hospital library. It has the name of a social worker, who presumably worked for Friends Hospital, written on the front cover. This glossary illustrates a debate which was raging in the psychiatric field in the late 1960s and early 1970s. When the glossary was published in 1969, the Diagnostic and Statistical Manual of Mental Disorders (DSM) classified homosexuality as a psychiatric disorder. Therefore, the glossary has an entry for homosexuality under "sexual deviation."

Entries from A Psychiatric Glossary (American Psychiatric Association, 1969).

In 1972, Dr. John E. Fryer, a closeted gay psychiatrist who worked at Friends Hospital, testified anonymously at the annual APA meeting about how damaging it was for homosexuality to be classified as a psychiatric disorder. In 1973, the APA stopped classifying homosexuality as a psychiatric disorder, partly because of Fryer’s testimony. However, this change did not prevent Dr. Fryer from being fired from Friends Hospital for being gay (Scasta 25).

The American Journal of Insanity (19th century and early 20th century).

The American Journal of Insanity was published by the State Lunatic Asylum at Utica, New York, and it was the major journal about insanity in the nineteenth century and early twentieth century. The Friends' Asylum library contains many, many volumes of the journal. The American Journal of Insanity was another way for people involved in the treatment of the mentally ill to stay in touch with each other and keep on top of the latest research about insanity.

A Memoir Concerning the Fascinating Faculty which has been Ascribed to…Serpents (Benjamin Smith Barton, 1814).

This book fits in with the Asylum’s belief that insane patients could still appreciate the truth of science. Therefore, moral treatment could include reading a book about a rattlesnake. This book contains an inscription on the title page, which states "Josiah Redmond for Friends' Asylum full bound." The inscription implies that Friends’ Asylum had this pamphlet bound into book form specifically so it could be used for the Asylum. Perhaps they did this to decrease the common asylum problem of patient wear and tear on books. The 1868 Annual Report of Friends’ Asylum mentions that "The best evidence of the interest which the patients take in the Library is to be found in the number of books that are constantly wearing out" (Friends' Asylum 18).

History of the Roman Empire, from the Accession of Augustus to the End of the Empire of the West (Thomas Keightley, 1841).

This is one of the many history books in the Friends' Asylum library. Most of the others are British history, and there is one volume of a history of the American Revolution. Classical history was an important part of education in the nineteenth century, so many of the Asylum’s inhabitants would have been familiar with the book’s subject matter, and appreciated its place in the library.

Des Maladies Mentales Considérées sous les Rapports Médical, Hygénique et Médico-Légal (E. Esquirol, 1838).

This is one of the Asylum’s many medical texts which are in French. This book has the name of one of Friends' Asylum’s superintendents, John C. Redmond, written on the title page. Redmond was superintendent of Friends' Asylum from 1832 to 1843. These books show that the superintendents of the Asylum kept up with the medical discoveries in France, as well as those in the United States and Great Britain.