Nineteenth-century psychiatrists believed that 80 percent of insanity cases were curable if treated early, outside the home, in carefully planned, purpose-built structures. This essay traces the development of the architecture of insane asylums in the United States. In 1854, the Quaker Philadelphian Thomas S. Kirkbride published guidelines for 250-bed asylums; they were based in part on John Notman's state hospital in Trenton, New Jersey, and dominated asylum design for decades. While followers of Kirkbride favored large aggregate buildings, other reformers supported the cottage plan, a system that broke the monolithic hospitals into small, houselike edifices. Although the doctors disagreed on many issues, they concurred that the architecture of asylums was one of the most powerful tools for the treatment of insanity. Additionally, the paper explores a concept that architectural historians and architects sometimes take for granted: that architecture shapes behavior. In this case, it was expected to help cure a disease.

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