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 important center of political and legal struggle over the role of state hospitals in the care of the mentally ill. After being gradually phased out, the hospital was closed in 1993, and the buildings, though listed in the National Register of Historic Places, were demolished in 2006. This volume brings to life the 135-year story of Northampton State Hospital through beautiful and haunting photographs drawn from the collections of Historic Northampton, the city’s local history museum.