This study is a history of early principles and practices of music therapy in the United States. The evidence suggests that the public press introduced the idea of using music as an adjunct to medicine in the late 18th century. This was followed by scholarly tracts written by medical students at the University of Pennsylvania in support of music therapy. The era concluded with implementation of organized musical activities in institutions for visually-handicapped and hearing-impaired students and renewed advocacy of music therapy. Primary sources for the study include articles and dissertations from the era and contemporaneous accounts and reports. The study concludes that music therapy grew at a slow but steady pace and that the profession developed on an apparently secure foundation.