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Images in Psychiatry   |    
Moral Treatment at the End of the Oregon Trail: Dr. James C. Hawthorne, 1819–1881
David L. Cutler, M.D.
Am J Psychiatry 2001;158:871-871. doi:10.1176/appi.ajp.158.6.871

F1, Oregon’s first psychiatrist, was born the son of a farmer in Mercer County, Pennsylvania, on March 12, 1819. After medical school at the University of Louisville, he moved permanently west first to California in 1850 then to Portland in 1857. In 1859, the year Oregon became a state, the first governor, John Whiteacker, awarded him the contract to care for the state’s insane (1).

The Oregon Hospital for the Insane, built by Dr. Hawthorne, opened in 1862. It was a lovely Greek Revival building with a bell tower and a lagoon in front of it. Dr. Hawthorne, with Dr. A. M. Loreya as his partner, served about 200 patients a year. The hospital received a stipend of $6.00 per person per week from the State of Oregon. But even this meager amount was scrutinized mercilessly by the stingy Oregon Legislature, which was constantly questioning if Dr. Hawthorne was keeping patients too long. Dorothea Dix, the famous mental health reformer who was responsible for starting state hospitals all over the country, visited the Oregon Hospital for the Insane in 1869. Apparently she liked the hospital and advised the state to renew its contract with Dr. Hawthorne. Dr. Hawthorne’s concern for his patients and their follow-up is illustrated in the following excerpt from a report to the Legislature he wrote in 1872:

To turn these poor people out without money, employment, or any way of reaching their homes is to expose them to the danger of a relapse to their former mental condition. To many of this class I have given out of my own means, the full amount required to take them home…. Would it not be an act of economy as well as charity on the part of the Legislature to make some reasonable provision for such cases? (2)

Amazingly, the Legislature responded to his request by providing $500 for this purpose in 1873.

Dr. Hawthorne was one of the first 176 members of the Association of Medical Superintendents of American Institutions for the Insane. His picture is the second from the left in the top row of the collection of 19th century daguerreotypes that hang in the APA library. Dr. Hawthorne passed away in 1881. The old asylum was razed in the 19th century. Only the bell still exists.

Address reprint requests to Dr. Cutler, Department of Psychiatry, Oregon Health Sciences University, 3181 Sam Jackson Park Rd., Portland, OR 97201. Image is courtesy of the Oregon Historical Society, Portland, and the Hawthorne Library, Department of Psychiatry, Oregon Health Sciences University.

 
Larsell O: History of the care of the insane in the state of Oregon. Oregon Historical Quarterly  1945; 56:295–326
 
Hawthorne JC: Report of the Superintendent of the Oregon Hospital for the Insane. Messages and Documents, 1872, Oregon Legislative Assembly, 7th Regular Session. Salem, Oregon State Archives
 
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References

Larsell O: History of the care of the insane in the state of Oregon. Oregon Historical Quarterly  1945; 56:295–326
 
Hawthorne JC: Report of the Superintendent of the Oregon Hospital for the Insane. Messages and Documents, 1872, Oregon Legislative Assembly, 7th Regular Session. Salem, Oregon State Archives
 
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