Objective: The author reviewed the history of American psychiatry for the first 150 years of the American Psychiatric Association's existencece (1844-1994) as reflected in remarks of the association's presidents. Methods: Presidential addresses or remarks from alternative sources were located for the 120 presidents who served the association between 1844 and 1994. Results: The presidents' remarks on six topics—psychiatric practice, etiology of mental illness, public mental hospitals, alternatives to state hospitals (deinstitutionalization), biologic treatments, and fiscal issues were sampled and arranged chronologically. Conclusions: American psychiatry's history—its innovations, cyclical repetitions, and self-assessments—can be gleaned from this form of data. The presidents' remarks appear to refute the claim that organized American psychiatry has been negligent in criticizing itself.