In 1853, Dr. Horace Buttolph, the superintendent of a respected lunatic asylum, proudly described the institution he managed as “reposing in the midst of the most beautiful scenery in the valley of the Delaware, combining all the influences which human art and skill can command to bless, soothe, and restore the wandering intellects that are gathered in its bosom. The state may proudly point to this asylum, as a noble illustration of that charity, which, borne from above, diffuses itself in blessings of the poor and unfortunate.”¹ It hardly sounds like New Jersey. But the doctor did not embellish. The...

Americans began building lunatic asylums in the eighteenth century, in the wake of reform movements and compelled by a sense of civic and religious duty. They built asylums with increasing speed as the nineteenth century progressed, and soon, in the 1840s, the United States developed its own plan for hospitals for the insane. Nineteenth-century doctors typically placed their benevolent approach to the treatment of the insane against the picture of the brutality of earlier epochs. In constructing new hospitals, they attempted to reject the horrors of Bethlem and include new ideas from England and France that were intended to ameliorate...

The idea that “cheerful landscapes and handsome architecture” profoundly affected patients was at its height during the 1840s and 1850s. Before those decades, American doctors had no set plan, no rules to follow, when they embarked on the raising of a new asylum. But in the middle of the nineteenth century, new construction became codified per the instructions of Dr. Thomas Kirkbride. This chapter will consider the rise of the Kirkbride plan, using certain key buildings to illustrate the paradoxes of asylum life. It will explore the importance of landscape in treating the insane; visit a few individual patients and...

Frederick Law Olmsted received a letter from family friend and influential asylum doctor John S. Butler on the occasion of the doctor’s retirement from the Hartford Retreat for the Insane, a private hospital outside Hartford, Connecticut. Butler remembered fondly that he and Olmsted had conspired to temper the institutional character of mental hospitals by introducing smaller buildings and pastoral plantings. He wrote to Olmsted with dramatic flourish, claiming that their plans from the early 1860s had served to “kill out the Lunatic Asylum.” Such anti-institutional sentiments increased steadily in the second half of the nineteenth century, and the architectural expressions...

After the Civil War, keeping pace with architectural taste in America, linear and cottage plan asylums became more adventurous, colorful, ornamented, and varied in silhouette. More significant, asylums ballooned in size (see Appendix D). Superintendents agreed to expand their institutions, because earlier hospitals, including the model hospitals in Trenton, New Jersey, and Washington, D.C., had become dreadfully crowded. In 1851, the AMSAII had stated that to fulfill their therapeutic role, asylums should house no more than 250 patients. At the annual meeting in April 1866, its members allowed hospitals to house 600 patients. The issue caused intense debate: the vote...

Today, mental illness is generally considered to be treatable, but it cannot be prevented or cured. Many patients recover, but their path is not an easy one. There is no vaccine for mental illness, such as that which has led to the eradication of smallpox, nor is there a drug that purges mental illness from the body, in the way that a course of penicillin can conquer a staphylococcus infection. No cure has reduced insanity to a minor problem, the way vitamin C has made scurvy a mere medical nuisance. Mental illness remains, for many, shrouded in mystery, and that...