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December 2011 meeting notes

Priya Jain presented, “The History and Evolution of Kirkbride Asylums: Buffalo State Insane Asylum and Saint Elizabeth's Hospital”


1. Robert Neiley Memorial Celebration at Shirley-Eustis House - Bill Finch, Ric Detwiller, Gary Wolf, Charlie Sullivan and a good number of other people- especially long-time associates of Bob's at the Shirley-Eustis House - gathered to celebrate Bob's tremendous personal contributions to historic architecture and contemporary design over a lifetime of work in New England. The gathering brought together people from many separate strands in Bob's history. A biographical slide show illustrated aspects of his life, from minesweepers in the Aleutian Islands, to the restoration of collapsing 18th and 19th-century houses in Charlestown and Beverley, which had less public visibility than his work on Harvard's Memorial Hall. Bob spent about three decades on the Cambridge Historical Commission and was one of the founders of the BSA's Historic Resources Committee.

2. The History and Evolution of Kirkbride Asylums: Buffalo State Insane Asylum and Saint Elizabeth's Hospital - Priya Jain introduced Dr. Thomas Kirkbride's ideas about curative environments for the mentally ill by describing the history of institutional care or custody that preceded his work. Kirkbride lived from 1809-1883 and developed his approach while he was Superintendent at the Pennsylvania Asylum for the Insane. There were rapid and radical changes in the design and operation of asylums beginning in the last quarter of the 18th century. Bedlam (from Bethlehem) at Moorfields in London (1674-76) was a domed, Classical structure that held people without any treatment concept. Visitor tours (gawkers, not clinicians) could be arranged for a penny. More humane solutions, such as the York Retreat in England (1792) kept people in bucolic settings in buildings that were country houses. This Quaker step towards less punitive institutions did not catch on. [Read Alain Foulds, The Quickening Maze about the "peasant poet," John Clare's gyre into madness and ambulatory escape from a York Retreat-type asylum. Who paid for him to be there in the first place?]

Salpetriere in Paris improved on this in the years immediately preceding the French Revolution (1786-1789), with an attempt to classify and segregate inmates by types of illness. Its physical plan arranged cells around central courtyards for light and air. Emergence of the concept of mental illness stimulated thinking about the possibility of treatment. The curative concept that arose on the continent, "Moral Treatment," was promoted by Philip Pinel (1745-1826) in France and William Tuke (1732-1822) in England. France, Italy, and Germany advanced this concept in a variety of forms, originating with an idea of "morale" rather than an ethical or religious basis for the phrase. Charenton in Paris (1838-85) arranged three- and four-story patients' quarters around courtyards in an approach that was clearly institutional. Jeremy Benthem's Panopticon plan caught on in Scotland for asylums (Glasgow, 1814) and in England for prisons. More categorization of patients or inmates was tied to social rank, with enhancements like access to gardens available to the higher born.

In the U.S., insane people were kept in the basements of hospitals for those with physical ailments. The Friends Asylum in Frankford, Pennsylvania (1825) was a progressive attempt to go beyond this sad situation. Priya suggested that advocates for improved institutional care in the United States were motivated by European examples and the effective lobbying and philanthropic efforts by Dorothea Lynde Dix (1802-1887). During this period, physicians were gaining status and families were less amenable to keeping mad relatives at home.

In 1854, Thomas Kirkbride published his book, On the Construction, Organization and General Arrangements of Hospitals for the Insane. Priya encouraged us to have a look at this (available in Google Books), with its highly detailed guidelines for planning, constructing, and operating procedures. Kirkbride's plan called for stepped-back wings off a center pavilion, an alternative to the French courtyard system, which emphasized ventilation, sunlight and segregation according to both type and degree of affliction. In the Kirkbride model, the outer blocks accommodate the most severely disturbed patients.

The construction of Saint Elizabeth's on a hillside above the confluence of the Potomac and Anacostia River in Washington, D.C., was the first built version of Kirkbride's plan, two years prior to the publication of his book. The superintendent Charles Nichols and architect Thomas U. Walter worked together on refinements of planning and design of the elevations. Site selection was the starting point and the program was unambiguous. Sites should be at least 100 acres and able to accommodate sufficient garden and farm functions to support an institution with 250 patients. The buildings were grand, but Walter was warned to avoid ornament and told to limit expense. Architectural expression was limited to "only beatry that is beneficial to the patient." The superintendent expected to visit each patient daily.

Patients spent the day out of their rooms, often in wide, single-loaded corridors (with rounded outside corners) or employed with farm work, in the laundry, or the kitchens. Saint Elizabeth's even had a brick works that produced materials for the hospital's construction. Visitors to wards met patients in parlors located at the ends of wards.

Twenty years later, in Buffalo, Henry Hobson Richardson produced the design for a new hospital that leapt in scale to house 600 patients. Construction began with the male wards, stepping up in height and number of floors as it approached the central administration building. Each building was considered a "ward" and housed 15-25 patients per floor. Kirkbride tried to limit rooms to single beds. Exterior walls were massive structures with cavities intended to insulate and keep the masonry dry. Windows were secured with decorative cast iron grilles intended to avoid the appearance of confinement. Kitchens and boiler houses were built at some distance from the wards (100-300' to be safe from fire) and linked to rail lines for coal delivery. Trams brought food from the kitchens to the basement levels of each ward for distribution. The central building had tall towers, with no specific function other than symbolizing the hospital's progressive civic presence. The superintendent and other senior physicians lived in this central block, which also contained a chapel, offices, and a recreation hall.

Ventilation systems included slotted doors, ducts built into outside walls, and forced ventilation (especially at Saint Elizabeth's); these were intended to combat the contagions borne by misamas during the winter. Kirkbride's plans showed basement plenums with fans to drive air through flues to ventilate every room. His book includes air circulation diagrams for typical rooms. Cupolas were ventilation ports.

Goody/Clancy's study of the Buffalo hospital includes a cultural landscape analysis. Frederick Law Olmsted designed the grounds, which were both agrarian and park-like. Olmsted sought to create a tranquil, natural setting so as not to excite patients' minds.

In 1880, Kirkbride published a new edition of his book that explicitly warned against overcrowding. Eventually, there were over 3,000 patients in the hospital at Buffalo. Annual reports refer to overcrowding and misuse of spaces. [Kirkbride hospitals in other locations had begun to show chronic cost overruns compared to original projections per patient and curative regimes gave way incrementally to custodial approaches.]

By 1900, the superintendents and senior physicians moved out of the central administration buildings, and a new decentralized architectural idea took hold. The Cottage Plan extended the previous century's segregation practices by establishing separate wards in separate buildings for patients suffering from tuberculosis, epilepsy and other diseases. The language for describing the institutions also shifted. "Hospital" replaced "asylum," and in turn was replaced by "psychiatric center." After World War II, the emphasis shifted more profoundly towards de-institutionalization, a move made more practicable by psycho-pharmaceutical advances, but not well accompanied by ways to house and care for people who could still not be re-integrated into their families, find or maintain employment, or rise above sub-marginal roles in cities where the 19th century institutions were shut down. The asylums were altered coarsely, partially demolished, then abandoned to disrepair. The great Kirkbride structures at Buffalo and Saint Elizabeth's were somewhat protected by their designation as National Historic Landmarks (Buffalo NHL 1986 and Saint Elizabeth's NHL 1991). Both were studied for reuse, but required substantial government contributions. Buffalo has been the object of temporary use attempts since 1980. Goody/Clancy's 2009 HSR and other studies anticipate private/public partnerships robust enough to create permanent uses. Saint Elizabeth's was the only federally-operated asylum and will house the Homeland Security Administration.

Priya cited examples of more and less successful private reuse projects at other Kirkbride hospitals. Travers City State Hospital in Michigan has become "The Village at Grand Traverse Commons." Weston State Hospital in West Virginia, once the Trans-Allegheny Lunatic Asylum; Boston's Mass Mental Health Center at Longwood; and other survivors of the more than seventy Kirkbride-influenced complexes remain vulnerable.

Priya will post her succinct and lucid presentation on our BSA Historic Resources Committee website and points our attention to these additional sites:

Kirkbride Buildings

Chris Payne Photography, Asylum

Richardson Olmsted Complex, Buffalo, NY

GSA Development of St. Elizabeths Campus

3. U. Mass Dartmouth, DOCOMOMO/US_New England Tour - Henry Moss announced a tour to take place on the following Saturday morning with Bob Miklos and Jonathan Austin, who are designing a major renovation and alteration of Paul Rudolph's library building. [The tour was extraordinarily successful, in part because Grattan Gill, the architect who realized all the iconic Rudolph buildings, came to lead a tour through the campus and stayed to respond to the designLab proposal for excavating and internalizing a large element of the Rudolph library, perceptively after registering both shock and awe at Bob's audacity. The session resembled a master class.