Lilas Harley, Kathleen Barker Schwartz; Philip King Brown and Arequipa Sanatorium: Early Occupational Therapy as Medical and Social Experiment. Am J Occup Ther 2013;67(2):e11-e17. doi: 10.5014/ajot.2013.005199.
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© 2019 American Occupational Therapy Association
Historical inquiry enriches occupational therapy practice by identifying enduring values and inspiring future excellence. This study presents for the first time the pioneering life and work of Philip King Brown, a San Francisco physician who used occupation to treat the physical, mental, and social effects of tuberculosis (TB) at Arequipa Sanatorium, the institution he founded in 1911. Through textual analysis of the Arequipa Sanatorium Records, this article evaluates and defends Brown’s assertion that his institution was medically and socially experimental. The Arequipa Sanatorium promoted occupational therapy by demonstrating its viability in the treatment of TB, the era’s most critical health threat. It also put into practice the ideals of holism, humanism, and occupational justice that resonate within the profession today. Finally, Arequipa provided an example of how an occupation program can change the public perception of disability.
The opportunities that are open to women are distinctly against them, not only being conducive to the acquiring of tuberculosis, but offering a minimum of opportunity for recovery under the present conditions. As dressmakers, stenographers, clerks, factory workers, etc., they are often where the most unsatisfactory conditions in business life are found. The outdoor occupations, which are plentiful for men in California, are hardly open to them at all. (p. 7)
Within a few months $20,000 had been spent in providing a very complete plant for 24 patients, including water supply and sewage system, a laundry, a stable and equipment, servants’ building, work building and cottage for the visiting physicians and managers. (Brown, 1914, p. 327)
Their need for work and the interest offered by work during the period of recovery, as well as their need for the opportunity to earn toward their own support while in the Sanatorium, were all factors in the minds [sic] of the founder. (p. 9)
The idea of making pottery came to us from Dr. Hall, who conducts at “Devereux Mansion,” Marblehead, Mass., a remarkable institution for the care of nervous cases, in connection with which is a successful pottery, where part of the work is done by the patients. (p. 328)
occupation which is not only fascinating, but also safe and suitable. It can be done in the open air or in a screened enclosure. It can be done in wet clay to eliminate dust, and the product can be easily sterilized. (p. 394)
Tuberculosis is a depressing disease and the usual idleness of an outdoor cure gives patients too much time to think, and, that the diversion offered by interests outside themselves is often essential to cure. We are convinced that this is frequently true. (p. 17)
Let us not speak of a one armed, one eyed, or one legged man, or think of a locomotive engineer who is discovered to have heart disease as lost to full usefulness. Let us make the most of the potential efficiency of what remains, and not measure what is gone. (Brown, 1923, p. 178)
Doctor Brown’s independent point of view, his uncompromising character and vigorous presentation of his beliefs and convictions will be missed in the council of his colleagues; but his kindly ministrations, his human feeling, and his great professional skill will be even more a loss to the sick and suffering in the wards, clinics and sick rooms accustomed to his gracious presence. (Robert Porter, quoted in Metzger, 1941, p. xlviii)
Here, where ’tis ever balmy Summer Time,The Potters find that Action outweighs Speech,And work accomplished braces more than Wine;That the Strong Spirit conquers Death and Fate,And shapes the Funeral Urn to hold gay Flowers,And out of Grief and Fear may frame Delight (“The Pots of Arequipa,” 1919, quoted in Downey, 2000, p. 34)
Here, where ’tis ever balmy Summer Time,
The Potters find that Action outweighs Speech,
And work accomplished braces more than Wine;
That the Strong Spirit conquers Death and Fate,
And shapes the Funeral Urn to hold gay Flowers,
And out of Grief and Fear may frame Delight (“The Pots of Arequipa,” 1919, quoted in Downey, 2000, p. 34)
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