Northampton State Hospital, established in 1856, was built with the optimistic spirit of humanitarian reform. For many years, it was run by Dr. Pliny Earle, a champion of treatment that combined individualized care with manual labor, religious worship, recreation, and amusement. This vision was overwhelmed as the hospital was called upon to care for ever-larger numbers of people with varying needs. By the mid-20th century, the hospital was an isolated small "city," with hundreds of employees caring for more than 2,000 patients in overcrowded and inadequate conditions. It became a nationally...