Superintendents of the asylum at Athens were national leaders in limiting patient restraints, a departure from standard nineteenth-century American asylum practice. Ohio asylum superintendents debated their use, and at Athens superintendents consistently provided leadership for a national movement limiting patient restraint.45 Mechanical restraints such as straps and mittens, chemical restraints to control behavior, manual restraint provided by attendants, locked doors, and seclusion were used infrequently at Athens during the moral treatment years.46 In his 1872 report to the board, Dr. Gundry advised against constructing strong rooms where “excited” patients would be held when uncontrollable, advocating instead a small ward of individual rooms for such patients, to be “made as cheerful as for any other patients but so constructed as to resist the violence and mischief of the most excited.”47 Dr. Rutter, superintendent in 1877, commented in 1880 on the open-door practice:
Upon reassuming the duties of Superintendent, I was highly gratified to find that the open-doors system in some of the wards had been continued during my absence. It was, as some of you will doubtless remember, with many fears and some misgivings that I took the pioneer step in Ohio by removing the locks from some of the wards, and permitting full liberty to the patients they contained. That it was not ill-considered or reckless has been proved by the complete success of the experiment and it is a pleasure to add that in my opinion the system can be extended until comparatively few of our six hundred patients will be behind locks and bars.48
While other Ohio asylum physicians argued for the use of restraints as a benevolent practice, Athens superintendents during the moral treatment years believed that restraints were at odds with moral treatment and provided transparency to the public on their limited use through the annual reports of the Board of Trustees.49
The architecture of the Athens asylum was central to the moral treatment curative schema. Its light-filled rooms, wide corridors, Victorian reception parlors, windows situated to provide patients with beautiful and peaceful views of the landscape, ventilation powered by two enormous state-of-the-art brass basement fans manufactured in Pittsburgh, iron protective window grilles disguised as decorative mandalas, wards designed to segregate patients by their levels of disruptive behavior, and elimination of “strong rooms” were all thought vital to the treatment and cure of patients there. Daylight itself was considered curative, as described in near-reverent language by Ohio’s Board of State Charities in the 1880 annual report to the governor: “Light is not only cheap, it is a civilizer. Light is healthful, light is good in every way.”50 Flowers, raised in a glass conservatory, were abundant year-round. Superintendent W. H. Holden noted with satisfaction the floral supply: “The florist’s department, during the past year, has been exceedingly satisfactory, giving us a full supply of flowers for the general household, besides having abundance for the grounds where sufficiently completed to receive them. We have repaired our conservatory by a complete relaying of the glass. . . . [I]t is now in a better condition than ever before for the recuperation and preservation, through the winter, of the exotics and indigenous plants, in which the patients and visitors so much delight.”51
Superintendents and trustees during the asylum’s moral treatment years were eager to transform the asylum’s steep hills and wet bottomlands into beautiful, curative scenery. The grounds were considered to offer great natural beauties needing only grading and filling. This work, requiring blasting and shoveling massive amounts of rock and dirt into pans pulled by teams of horses and mules, was accomplished over twenty years with labor provided by male patients and paid townsmen. Superintendent Clarke requested eight thousand dollars in 1878 from the state for grading and lake improvements; the trustees wrote to the governor that “we have no hesitancy in asserting that the grounds surrounding this Asylum [when completed] will be second to none in the State for beauty of design or magnificence in scenery.”52 Dr. Clarke described the benefits of a beautiful landscape in terms of its curative function:
The slope in front of the eastern division of the building, in which are the female wards, remains untouched and presents a forbidding appearance. It should be brought to harmonize with the gracefully finished lawn lying in front of the western division as early as practicable not only for the purpose of pleasing the public eye, which it is always well to do, but for stronger reasons, to present to the view of those who look out for relief a landscape marked by no violation of the laws of harmony. For surely no agency contributes more potently to the relief of a mind disturbed than strictly harmonious sensorial impressions.53
The asylum staff, the state of Ohio, and the village of Athens embarked upon the experiment in moral treatment with confidence and hope placed in the curative nature of their methods. Superintendent Holden contrasted the dawning of this new treatment with the methods of the early nineteenth century: “We no longer meet the insane as we would a wild, ferocious animal, with horror and fear, with handcuffs, chains and weapons for defense, but we meet them as we meet other patients[,] with kind words; words of sympathy and comfort, try to gain their confidence, teach them you are their friend, and will do them no injury, and rarely indeed will it be necessary to employ any means of restraint.”54
The experiment was pursued vigorously for nearly twenty years. Superintendents and staff worked hard to acquire clean water, prevent suicides, cope with political reorganization and the resultant constant changing of staff, keep the building and furnishings in good repair, balance the budget, and treat a staggering array of disorders and conditions with, in comparison to today’s array of medications and treatment modalities, what were very limited means. The asylum brought telephone and railroad service to Athens and served as a huge market for its goods and services. Superintendent Richardson hired the first female asylum assistant physician in America, Dr. Agnes Johnson of Zanesville, Ohio,55 to improve the care provided for women, and he also persuaded Ohio’s legislature to fund the first patient dining rooms at any American asylum, so that rather than eating in their wards patients might be served family-style in dining rooms with white tablecloths. Ultimately the experiment ended, a casualty of both overcrowding and medical progress. Richardson, who weathered Ohio’s political spoils system to serve at Athens with national distinction from 1881 to 1890, wrote of his discouragement about politics, overcrowding, and the difficulty of caring for those with chronic severe mental illness as well as the infirm elderly. At the end of the century, new models of psychiatric care rendered asylums essentially custodial rather than curative. Psychiatry was transforming itself from an administrative, moral, and institution-based discipline to a medical specialty based on laboratory research and a new “cottage plan” design for residential treatment.
But the moral treatment pursued at Athens between 1874 and 1893 was the result of the blossoming of an American impulse to provide humane, expert care for those with mental illness. It yielded treatment modalities that flourish today as adjuncts to mental health treatment, now reconceived with new names such as restorative gardening, milieu therapy, art therapy, horticulture therapy, and humanistic psychology. The experiment at Athens, dedicated to moral treatment and founded on hope for curing mental illness, flourished for twenty years as a lively community of thousands of patients, dozens of attendants and workers, a small cadre of physicians, the people of the village of Athens, the families of patients, politicians in Columbus and Washington, social reformers, and a shared landscape of parkland and farms. Superintendent Richardson’s closing words in one of his reports to the trustees reflect his thoughts on the twenty-year experiment in psychiatry:
We