July 1976

Reared in Adversity: Institutional Care of Children in the 18th Century

Author Affiliations

From the College of Physicians of Philadelphia.

Am J Dis Child. 1976;130(7):751-761. doi:10.1001/archpedi.1976.02120080073008

All through the 17th century, Europeans were busily colonizing the eastern seaboard of North America. By the end of that century, most of the colonies were firmly established and under British control so that by the coming of the 18th century, while the colonies were truly rural and provincial, there were already flourishing urban centers at Boston, New York, Philadelphia, and Charleston. Before the 18th century had faded, 200 years ago in fact, these colonies, declaring their independence from Great Britain, banded together as the 13 United States of America.

Public institutions depend on population density that is found only in cities, and so it was not until the beginning of the 18th century that any city of North America attained such increase in population as to merit the establishment of an institution devoted to the public welfare. By the early 1700s, Philadelphia was teeming with immigrants. Many of them

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