of the new asylum in 1867 and its location in Athens. While away at war, he wrote often to Julia. In this letter, he discusses the 1864 presidential election. Courtesy of the Mahn Center for Archives and Special Collections, Ohio University Libraries.
Late in 1863, Johnson was given greater administrative responsibility. Writing to Julia from Murfreesboro, Tennessee, he described his new work and reflected again on the horrors of war:
I mentioned in my letter to your father that I had been put in charge of a Post Hospital here. I have got it fitted up very comfortably and all men (except some who were slightly wounded sent to Nashville) in it. Today I received orders to take another Hospital under my charge. I protested against both for the reason that I already had enough to do and also for the reason that it was in such a miserable condition. I was informed that that was the reason that it was put in my charge so that its condition might be improved. . . . War has its Glories but it has also its thousand horrors and human tortures that would sicken any feeling heart. I have often wished to see a big battle but I pray to God that I may never witness again such scenes as I have had to for the last two weeks. I have no desire to horrify you with any attempt at a description and could not give the subject justice should I attempt it.8
Just before he returned to Athens from the war, Dr. Johnson was elected to the Ohio legislature, where in 1867 he orchestrated the founding of the Athens Lunatic Asylum. Having learned well his organizational lessons from his war work, Johnson did “the right things at the right time” to secure state approval for a new asylum and ensure its location at Athens. First he helped a legislator from a nearby county craft a resolution in the General Assembly directing Ohio’s Committee on Benevolent Institutions to look into the needs of those with mental illness in Ohio. The resolution passed in 1866. Second, as chair of the Committee on Benevolent Institutions, Johnson solicited from the state medical society, of which he was a member, reports to the legislature supporting the need for more institutions to serve those judged insane. Finally, Johnson prepared a bill authorizing the construction of the fifth state asylum. This bill, entitled “An act to provide for the erection of an additional lunatic asylum,” passed in 1866 and became a law in 1867. Finally, in a deft political move, Johnson saw to it that Athens businessman E. H. Moore was appointed by the governor as one of three trustees of the new asylum charged with choosing its location. Moore organized the Athens community to collect money for the purchase of the site and offer it free to the state. After considering more than thirty locations, it came as no surprise to anyone that the trustees settled upon Athens.
The village of Athens celebrated the laying of the cornerstone of its asylum with a parade of nearly ten thousand persons. The new institution coming to town was of great economic and political importance to its residents, who staged an enormous celebration. On Thursday, November 5, 1868, at two o’clock in the afternoon, one thousand Masons from all over Ohio, a brass band, two church choirs, judges, the mayor of Athens, the village council, hundreds of townspeople, and thousands of supporters from other areas marched down a long hill across the old South Bridge spanning the Hockhocking River9 and up the great hill to the asylum grounds.10 Ohio’s fifth state-supported asylum to treat persons with mental illness was to be a Kirkbride hospital, the gold standard for Victorian-era mental hospitals. Kirkbride hospitals were built to the most rigorous specifications of moral treatment, the prevailing psychiatric treatment of the time.
The Kirkbride Plan
Dr. Thomas Kirkbride’s interpretation of moral treatment, developed at the Pennsylvania Hospital for the Insane, was the crown jewel of nineteenth-century American psychiatry.11 He proposed that mental illness was curable, that physical punishment and restraints should be abolished, that treatment of those with mental illness as though they were capable of rational behavior was curative, and that a system of routines and diversions in a restful and supportive setting was therapeutic. Dr. Philippe Pinel, physician for two asylums in Paris, touched off the moral treatment movement in 1795 when he allegedly removed chains from his patients and undertook humane, compassionate, and supportive care. He dubbed his method traitement morale, meaning ethical, honorable treatment. This approach was a radical alternative to well-established aggressive, punitive tactics of curing mental illness with punishment and restraints. A year later, in 1796, William Tuke, a Quaker tea merchant, opened the York Retreat for persons with mental illness, using kindness, reason, and a family atmosphere rather than the medical treatments of the time.12
Nineteenth-century asylum physicians dedicated to moral treatment believed that mental illness was curable through proper habits and a regular, healthy life. Dr. William H. Holden, superintendent of the Athens Lunatic Asylum, described moral treatment in his 1879 annual report to the Board of Trustees:
Under the head of moral treatment must be considered all those means that tend to lead the mind into a normal and healthy channel, and direct the thoughts, as much as possible, in another course, remote from their delusions. See your patients frequently; talk to them, give them kind words and pleasant looks; encourage them as much as possible. Give them moderate exercise. Walking, riding, and driving in the open air have a tendency to break the monotony of asylum life and add to the comfort and happiness of the patient. Voluntary exercise is indicative of improvement and should be encouraged. Occupation engrosses the mind and withdraws it from empty longings and illusions of the imagination.13
Psychiatry placed great faith in the curative possibilities offered by the physical setting and social influences of the asylum; indeed, a Kirkbride hospital is a visual and architectural record of nineteenth-century psychiatry’s tenets. Kirkbride’s guidelines for the construction and operation of hospitals for the insane were adopted in 1851 by the Association of Medical Superintendents of American Institutions for the Insane.14 The guidelines, almost unimaginable by today’s standards of inpatient care for persons with mental illness, were devoted to the landscape and the design and construction of the building. Nearly eighty asylums were built in America to the specifications of the Kirkbride plan, most of them between 1848 and 1890. From Taunton State Hospital (completed in 1854) in Massachusetts, Jackson State Hospital (1855) in Mississippi, Mendota State Hospital (1860) in Wisconsin, Dixmont State Hospital (1852) in Pennsylvania, Worcester State Hospital (1877) in Massachusetts, Napa State Hospital (1875) in California, and Terrell State Hospital (1885) in Texas to Traverse City State Hospital (1885) in Michigan, states embarked on construction of Kirkbride asylums on a massive scale.15
Dr. Kirkbride suggested that hospitals should be located in the country and have at least fifty acres devoted to gardens and pleasure grounds for patients with at least another fifty acres for farming and other uses. “The building should be in a healthful, pleasant, and fertile district of the country; the land chosen should be of good quality and easily tilled; the surrounding scenery should be varied and attractive, and the neighborhood should possess numerous objects of an agreeable and interesting character.”16 To bring light and cheer to each wing of the hospital, each floor should have an atrium with plants, birds and fountains:
Leaving on each side (of each wing) an open space of ten or twelve feet, with movable glazed sash extending from near the floor to the ceiling, and which may either be accessible to the patients, or be protected by ornamental open wire work on a line with the corridor; this arrangement gives nearly every advantage of light, air, and scenery. Behind such a screen, even in the most excited wards, may be placed with entire security, the most beautiful evergreen and flowering plants, singing birds, jets of water, and various other objects, the contemplation of which can not fail to have a pleasant and soothing effect upon every class of patients.17
The Kirkbride plan called for twelve-foot ceilings in all the patient wards with sixteen-foot ceilings in the central administrative section. Hospital residential corridors should be at least twelve feet wide, with those of the central building sixteen feet wide. Spacious corridors and high ceilings facilitated good ventilation; indeed, the Athens asylum was situated so as to take advantage of the prevailing breeze through the large and plentiful windows.18 The parlors and
