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Harry C. Solomon, M.D., was instrumental in helping psychiatry overcome the angst that beset the specialty at the turn of the century. As the superintendent of the Boston Psychopathic Hospital and subsequently as commissioner of mental health of the State of Massachusetts, this psychiatrist helped to shape the community-based future of psychiatry in America.
-Dilip Ramchandani, M.D.
History Notes Editor
By Lucy D. Ozarin, M.D.
Psychiatry was stagnant during the first third of the 20th century. Despite the discovery of the spirochete and the avitaminosis etiology of pellagra, the mental hospitals were still the locus of care for people with mental illness, growing larger and more custodial as more than half a million patients accumulated therein. Though Clifford Beers had organized the National Association for Mental Hygiene in 1915, it had little relevance to the large public mental hospitals. Harry C. Solomon, M.D., was the prescient leader who, while APA president for the 1958-59 term, proposed a radical change in American psychiatry.
Solomon was born in Nebraska. He and his family moved to Los Angeles, where Solomon received his early education, graduating in 1910 from the University of California at Berkeley. He graduated from Harvard's medical school in 1914 and remained in Boston for the rest of his long life.
The Boston Psychopathic Hospital with which Solomon was associated for many years had been established in 1912 to treat acute cases and to serve as a teaching site for Harvard. Research was a natural outgrowth. Solomon, interested in neuropathology, joined the Boston Psychopathic and remained there until 1958, rising to be superintendent and chair of the department of psychiatry at Harvard (with time out during World War I, when he served with the Army in France.)
His early research in seeking a cure for syphilis of the nervous system (paresis, tabes), using malarial fever therapy, met with some success in arresting the disease and led to publication of several books. (A book published in 1922, titled Treatment of the Innocent was written with his wife, Maida, a social worker.)
Boston was also a center of psychiatric-psychological ferment, and Solomon was an active participant. He witnessed the rise of psychoanalysis after Freud's visit in 1909, and while he remained eclectic in his own approach, he supported the development of a few techniques.
Solomon instituted many changes at the Boston Psychopathic. The care of patients became more active and humane, and new programs were started in aftercare, day care, and rehabilitation. The teaching of medical students and residents was expanded. Research remained an emphasis.
In 1958 Solomon left the hospital to become commissioner of mental health in Massachusetts, a post he held until 1967. During his tenure he laid the groundwork for the state's community-based mental health care system. He had startled the psychiatric world by declaring in his address as APA president that "the large mental hospital is antiquated, outmoded, and rapidly becoming obsolete. . . . [W]e cannot staff them and make them true hospitals. . . . [They] are bankrupt beyond remedy. I believe they should be liquidated as soon as possible."
Solomon pointed out paths to the future: psychiatric wards in general hospitals, outpatient clinics, day hospitals, halfway houses, insurance coverage, rehabilitation services. He urged that the future for psychiatry was within a framework of community-oriented treatment.
Solomon exerted his leadership in a quiet manner but nevertheless continued the push for change. He did much of this through the presidencies of influential organizations, which included, in addition to APA, the American Neurological Association, Association for Biological Psychiatry, Association for Research in Nervous and Mental Diseases, and the American Psychopathological Association. His philosophy of treatment also was spread by his residents and students, who themselves achieved prominent leadership posts. Solomon published alone or with coauthors on neurosyphilis, lobotomy, and schizophrenia and in 1945 cowrote the manual of military neuro-psychiatry, a much-used text for World War II psychiatrists.
Solomon was a rare person embodying the skills of a successful teacher, researcher, and administrator.