Lawrence Kolb's career spanned the first half of the twentieth century, an era of rapid growth and transformation in scientific medicine, public health, and psychiatry. It also included the highest levels of immigration experienced in America, two world wars, a long economic depression, and the expansion of federal government health and welfare programs. Best known for his pioneering work in addiction classification and treatment, Kolb also made important contributions to mental testing of immigrants and served as the first superintendent of three new Public Health Service hospitals with novel mandates.
Lawrence Kolb was born February 20, 1881 in Galesville, MD, one of fifteen children of John Joseph and Caroline Kirchner Kolb. His father kept a store in Galesville. Lawrence was a good student and avid reader, but had no specific career aspirations during his teenage years. One of his older brothers suggested medicine, and helped fund his studies at the University of Maryland Medical School, which didn't yet require a college degree for admission. He received his MD in 1908. After a year of internship at University Hospital in Baltimore, he was commissioned as an Assistant Surgeon in the U.S. Public Health Service (then the Public Health and Marine Hospital Service) in July 1909. He married Lillian Hess Coleman in 1910, and they had two sons and a daughter. Their eldest son, Lawrence C. Kolb, later became a noted psychiatrist.
Kolb's first assignment, from 1909 to 1913, was to the Reedy Island Quarantine Station on the Delaware River south of Wilmington, where ship traffic coming into Wilmington and Philadelphia stopped for inspection of the vessels, crew, and passengers. He was transferred to the Ellis Island Immigration Station in New York in 1913, where he served mainly as a line inspection officer, but also conducted psychiatric and intelligence examinations. During his six years at Ellis Island, he received additional psychiatric training at the New York State Psychiatric Institute and the Vanderbilt Clinic, and helped compile a manual for intelligence testing of immigrants for Public Health Service staff.
In 1919, he became Medical Officer in Charge at the USPHS Hospital for Nervous Diseases in Waukesha, WI, one of dozens of PHS hospitals set up to accommodate World War I veterans. Kolb's institution treated patients with war neurosis (also known as shell-shock) and other neuropsychiatric conditions. He directed the hospital until 1923, when the newly established Veterans Bureau took on the responsibility for veteran medical care.
Kolb's work in the field of drug addiction began when he was assigned to carry out a five-year investigation into the current narcotics situation in the U.S., the current theories of addiction, its relationship to crime, and the current treatment protocols. Working with PHS pharmacologist Andrew DuMez, Kolb produced ten articles on his investigations, including a statistical study of addict numbers and a classification model for assessing addicts that would be a standard guide for the next forty years. These studies established him as an expert on addiction.
In 1928, Kolb began a three-year tour in Europe, where he was to evaluate the mental testing of prospective immigrants being done at the European consulates, work with medical officers to develop more accurate testing methods, and implement better testing procedures, and spent another year completing reports on this work. He then served as Chief Medical Officer at the Department of Justice Medical Facility in Springfield, MO, a new facility for the care of prisoners suffering from chronic or incurable illnesses and disabilities, from 1932 to 1934.
Because of his extensive knowledge of drug addiction and experience in evaluating and treating psychiatric cases, Kolb was asked to head a new PHS hospital for narcotic addicts in Lexington, KY, the first of two planned institutions (the second, in Ft. Worth, TX, would open in 1938.) He oversaw much of the final planning, construction, and staffing of the USPHS Narcotic Farm, which opened in 1935, and served as director until 1938. The Lexington patients were mainly those serving federal sentences or on probation for narcotics law offenses, but about one-third were voluntary admissions. The therapeutic regimen included detoxification, treatment of medical and dental problems, psychotherapy, occupational therapy, and rehabilitation through a wide range of work and training programs. The Lexington hospital was also home to the Addiction Research Center, which conducted studies (some using consenting convict patients) on the physiological basis of addiction and assessed the addictive potential of new drugs as they were developed.
In 1938, Kolb was appointed Chief of the PHS Division of Mental Hygiene, which oversaw the PHS psychiatric work at the Lexington and Ft. Worth Narcotic Farms and in federal prisons and PHS hospitals. Along with administrative duties, he continued to write about drug and alcohol addiction and treatment. He also drafted a bill proposing that Congress create a National Neuropsychiatric Institute, modeled on the recently established National Cancer Institute, which would carry out studies on mental illness and include a clinical branch that would treat patients. The American Psychiatric Association and other professional groups endorsed the idea, but it was opposed by the American Medical Association's House of Delegates. America's entry into World War II prevented the Congress from considering Kolb's proposal, but the concept was pursued by Robert Felix, who succeeded Kolb in 1944. The National Mental Health Act of 1946 provided federal funding for research and training in mental health, and the establishment of the National Institute of Mental Health as part of the National Institutes of Health in 1949.
Kolb retired from the PHS in 1945, and moved to California, where he spent a year as consultant to the California Department of Corrections, then served as Deputy Director of the California State Department of Mental Hygiene from 1946 to 1951. Following this, he became assistant superintendent of the Norristown State Hospital in Pennsylvania for three years, during which time he also served as secretary to the Philadelphia Mental Health Survey Committee. In all these state posts, Kolb helped evaluate state mental health resources and made recommendations for improvements. After 1954, he served as a consultant to the National Institutes of Health and continued to publish work on addiction, including Drug Addiction: A Medical Problem in 1962. In 1965, the New York Academy of Medicine awarded Kolb the Thomas W. Salmon medal for his many contributions to psychiatry and mental health.
Kolb died on November 17, 1972, at the National Naval Medical Center in Bethesda, MD, of heart failure.