Asylum on the Hill: History of a Healing Landscape by Katherine Ziff (review)

BOOK REVIEWS 92 OHIO VALLEY HISTORY experience than the states of the Confederacy, his tight geographic focus undercuts his claim to set “the entire period in a new light.” Still, Rebels on the Border challenges many aspects of the traditional narrative of the Civil War and Reconstruction and will encourage historians to draw comparisons between Missouri and Kentucky and other border states. Astor’s study will appeal to readers interested in sectionalism, slavery, emancipation, and Reconstruction. Evan C. Rothera The Pennsylvania State University Asylum on the Hill: History of a Healing Landscape Katherine Ziff In Asylum on the Hill, Katherine Ziff recalls the grandeur, majesty, and good intentions of mental hospital builders in mid-nineteenth century America. Focusing on a single institution , the asylum in Athens, Ohio, Ziff examines “moral therapy,” the nineteenth century treatment of the insane that called for the integration of social and environmental conditions. The book uses abundant images and evocative language to highlight the asylum’s beautiful architecture , extensive grounds, and well-ordered setting designed to recall patients to sanity. Ziff focuses on the Athens asylum’s first twenty years, 1874 to 1893, when it fully utilized moral therapy in its treatment of patients. She arranges the chapters thematically rather than chronologically, and discusses the origins of the asylum, patients, architecture, politics , landscape, and caregivers. In the chapter about patients, Ziff offers brief patient histories to illustrate the reasons for commitment and the issues faced by probate courts and families when placing patients in the asylum. The chapters about architecture and landscape describe the care employed to design and maintain the building and grounds, a level of detail that reinforces Ziff’s argument that nineteenth century doctors viewed the environment as part of patients’ treatment. The chapters about politics and caregivers interweave local and state politics beyond the asylum itself. Sometimes the lack of chronology in the twenty-year focus of the book creates confusion, particularly when major figures appear and disappear within the narrative. In addition, Ziff places some details in curious locations, such as her decision to discuss patient suicides in the landscape chapter. Asylum on the Hill contains many illustrations , including pictures of the buildings and grounds, as well as facsimiles of letters and other primary sources. Ziff employs extensive quotations from these sources, and often lets the historical actors speak for themselves. Although this narrative strategy often leaves material under-analyzed, it also enables readers to share Ziff’s evident delight in wandering through an archive. And the author’s respectful use of primary material allows readers to understand more fully the experience of both patients and caregivers in the nineteenth century. Ziff relies on Nancy Tomes’s The Art of Asylum-Keeping: Thomas Story Kirkbride and the Origins of American Psychiatry (1994) to understand the structure and function of the mental hospital in its historical context. She engages with recent scholars who have criticized the BOOK REVIEWS WINTER 2012 93 origins of mental hospitals, especially Andrew Scull who argues that the planners of these institutions sought social control rather than treatment. Ziff persuasively contends that in its first decades the Athens asylum worked to help individuals and families in distress. However, she capitulates to the critics of the asylum in briefly describing the changes in the institution after the mid-1890s, arguing unconvincingly that the hospital abandoned moral therapy and turned to warehousing the mentally ill in the early twentieth century. Moreover, Ziff never clarifies whether this change represented a deliberate if unlikely decision on the part of the institution’s administrators or an unintended outcome. Asylum on the Hill is beautifully produced, and provides much material to contemplate, especially the primary materials. It adds to the growing number of local histories that focus on community sources and provides a useful introduction to the concept of moral therapy. Scholars who study the integration of architecture and mental health history will find the volume of special interest, and students may find particular use for the book because of its generous reproduction of archival sources. Asylum on the Hill contributes to a developing literature that attempts to reclaim the history of the grand old buildings before they are demolished or reused. Ziff...