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Elaborately conceived, grandly constructed insane asylums--ranging in appearance from classical temples to Gothic castles--were once a common sight looming on the outskirts of American towns and cities. Many of these buildings were razed long ago, and those that remain stand as grim reminders of an often cruel system. For much of the nineteenth century, however, these asylums epitomized the widely held belief among doctors and social reformers that insanity was a curable disease and that environment--architecture in particular--was the most effective means of treatment.

In The Architecture of Madness, Carla Yanni tells a compelling story of therapeutic design, from America's earliest purpose--built institutions for the insane to the asylum construction frenzy in the second half of the century. At the center of Yanni's inquiry is Dr. Thomas Kirkbride, a Pennsylvania-born Quaker, who in the 1840s devised a novel way to house the mentally diseased that emphasized segregation by severity of illness, ease of treatment and surveillance, and ventilation. After the Civil War, American architects designed Kirkbride-plan hospitals across the country.

Before the end of the century, interest in the Kirkbride plan had begun to decline. Many of the asylums had deteriorated into human warehouses, strengthening arguments against the monolithic structures advocated by Kirkbride. At the same time, the medical profession began embracing a more neurological approach to mental disease that considered architecture as largely irrelevant to its treatment.

Generously illustrated, The Architecture of Madness is a fresh and original look at the American medical establishment's century-long preoccupation with therapeutic architecture as a way to cure social ills.

Carla Yanni is associate professor of art history at Rutgers University and the author of Nature's Museums: Victorian Science and the Architecture of Display.

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CHOICE Review

With her earlier book on natural history museums, Yanni (Rutgers Univ.) established herself as a perceptive historian of institutional architecture. Her most recent study continues this line of inquiry by tackling the story of 19th-century American insane asylums and the prevailing theories of environmental determinism. Prior to 1900, a period in which 300 asylums were constructed in the US, physicians and reformers placed almost complete faith in an "architectural cure" for lunacy. The main protagonist in this story is Thomas S. Kirkbride, whose linear plan, which facilitated ventilation, natural light, and views of the outdoors, dominated the field; the Buffalo State Hospital for the Insane constructed as a 2,200-foot-long building is a prime example. After the Civil War, other architectural models emerged, including decentralized institutions, but gradually psychiatrists became disillusioned with architecture's power to heal. In the 20th century, practitioners shifted their focus to scientific treatments based on the study of the human mind. Despite the bleak subject matter, Yanni weaves together the fascinating tale of architecture and psychiatry with readable prose liberally illustrated with historic photographs, plans, and drawings. Summing Up: Highly recommended. General readers; lower-division undergraduates through faculty. P. A. Mohr State Historical Society of Iowa