Eastern State Hospital Lexington

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Eastern State Hospital
Established 1816
Construction Began 1817
Construction Ended 1818
Opened 1824
Current Status Demolished (Original Facility)
Building Style Rambling Plan
Architect(s) Thomas Lewinski, Curtain & Hutchings
Location Lexington,KY
Peak Patient Population 2100 est. in 1946
Alternate Names
  • Fayette Hospital (1817-1822)
  • Lunatic Asylum (1822-1844)
  • The Kentucky Lunatic Asylum (1844-1849)
  • Lunatic Asylum of Kentucky (1850-1852)
  • The Lunatic Asylum (1850-1852)
  • Eastern Lunatic Asylum (1852-1855)
  • Eastern Lunatic Asylum of Kentucky (1855-1858)
  • Kentucky Eastern Lunatic Asylum (1858-1864)
  • Eastern Lunatic Asylum (1864-1867)
  • Kentucky Eastern Lunatic Asylum (1867-1873)
  • First Kentucky Lunatic Asylum (1873-1876)
  • Eastern Kentucky Lunatic Asylum (1876-1894)
  • Eastern Kentucky Asylum for the Insane (1894-1912)
  • Eastern State Hospital (1912-Current)



On February 15, 1816, the Kentucky General Assembly passed an act establishing a public hospital in Fayette County. The act incorporated a group of citizens, the “Contributors of the Fayette Hospital,” who wished to erect a building at their own expense to serve as a hospital for the accommodation of “lunatics” as well as other “sick poor.” The act gave the Contributors the right to establish a committee, elect officers, raise money to purchase a piece of land in or near Lexington, and to contract for the construction of a building to serve as the hospital (An act for founding, 1816). The Contributors meet on March 1, 1816 and elected a building committee consisting of Andrew McCalla, Sterling Allen, Stephen Chipley, Thomas January,and Richard Higgins. McCalla was appointed chairman (Fayette Hospital, 1816). In an open letter in the Kentucky Reporter on April 17, 1816, the Committee presented their mission and asked for assistance. They noted that there were many “poor, disabled, and infirm members of society” without the aid of medicine who with the assistance that could be provided by a “Public Hospital,” might become useful to themselves, their families, and society. They also noted that “lunatics,” who have no “rich relatives” to care for them, “roam at large through the country...” and in many instances “endanger the lives of other members of society.” The best remedy, they suggested, was the erection of a public hospital. They argued that the hospital was not only their best chance at a cure but also a means by which physicians could acquire “superior skill” by treating them. Finally, they declared that “society itself would be made more secure against the wild and desperate actions of lunatics, if provision was made to contain them within its walls.” The Committee concluded the letter by requesting that “ALL” people of Kentucky contribute to the support of the hospital (To the people of Kentucky, 1816).

Their early efforts must have been effective for not long after their incorporation, the Building Committee purchased the “Sinking Spring” property on which the present hospital now stands (Perrin 1882: 391). On June 30, 1817, the corner-stone of the “Fayette Hospital” building was laid in the presence of a large group of spectators. The oration was given by Henry Clay, U.S. Representative from Kentucky. In the corner-stone were deposited the newspapers of Lexington for that week, some silver and copper coins, two publications in favor of the institution.

Despite the Contributors’ efforts, the unfinished building was abandoned during the financial panic of 1819. Lexington was devastated by the economic crisis. In fact, one affluent member of the Hospital's Building Committee, Thomas January, was forced to close his factory after 24 years of successful operation (White 1984:24). Governor Adair’s address led to the formation of a committee to inquire into the feasibility of taking over the old Fayette Hospital and establishing a “State Lunatic Hospital.” In 1821, the Committee reported their findings to the Legislature. They discovered that the lot measured about 10 acres. It was supplied with a never failing spring and was well situated as to “health, beauty, and convenience, and may in future be extended to any limits or size commensurate with the objects of the said institution.” As to the building erected upon the site, they reported that it was “spacious, remotely situated from any other, and the workmanship, as far as it has been executed, is neat and faithfully done.” They estimated that the building when it “is properly finished, will afford accommodations for sixty or seventy lunatics, and all necessary attendants” (Journal of the Senate, 1821:139).

The Legislature agreed with the Committee's recommendation. The property was purchased and the “Lunatic Asylum of Kentucky” was established by an act passed on December 7, 1822. The Legislature appointed commissioners and appropriated $10,000.00 to finish the “skeleton of a house” in a “plain, substantial manner, and to erect such out-houses as are absolutely necessary....” The plan originally called for the addition of two wings so that the building could accommodate two hundred patients. They found, however, that the appropriation was insufficient to complete the wings and thus the building could only house one hundred and twenty patients. They estimated that it would cost an additional $10,000.00 to complete the two wings.


The building was finished and the hospital formally opened on May 1, 1824. When completed, the brick building measured approximately 66 feet square and was three stories tall over a stone basement. An 1847 lithograph is the earliest identified illustration of the building. The original Fayette Hospital building is the three-story square block with hipped roof located at the center of the illustration. The building was made of handmade brick laid in Flemish bonding. A skylight was located on the hipped roof. Tall chimneys pierced the roof at each corner.

The Fayette Hospital was originally designed to serve as a general medical hospital, not as a specialized insane asylum. As a result, like other medical hospitals of the time, it contained large rooms that functioned as wards with several beds in each room, unlike most asylums which usually contained small individual cells. In their first report to the Legislature, the Commissioners reported problems with the design of the building. To try to solve the problem, the Commissioners erected, on the third floor, small temporary cells of plank. They reported, however, that the cells were all in one room, in which there was only one fire place, and consequently, only a few patients could receive the heat. Also, the “quiet and repose” sometimes essential to treatment was impossible when the patients were “separated only by a plank partition.”

In 1825, they appropriated $5,735.74 for the building of one of the wings contemplated in the original plan of the building. The new brick wing measured 62 feet long by 22 feet wide and was two stories over a stone basement. Then in 1826, they erected a second wing, thereby completing the original plan of the building. Its dimensions were identical to the wing constructed the previous year. The cost of the new wing was $4,505.39.

As a result of their pleadings, in 1829 and 1830, “return wings” were constructed at the ends and perpendicular to the earlier wings (Tomes 1994:150). The brick return wings, three-stories tall over a stone basement, are illustrated on. Each return wing measured 60 by 19 feet and contained 32 rooms. When the four wings were completed, the left wing and return wing were used to house the male patients and the female patients were housed in the right wing and return wing. The twenty-five “spacious” rooms in the original center building were used to accommodate the Superintendent and his family, the resident physician, and separate day-rooms and dining rooms for the male and female patients. One room on the upper floor, well lighted from a skylight on the roof, was used for surgical purposes. The basement under the original center building as well as the wings served as the kitchen which consisted of nine rooms containing cooking apartments, storerooms, and servants’ rooms (Annual Report 1832).

Though greatly altered, the original Fayette Hospital building and some of its early additions are extant today. A description of its current condition is presented in Chapter IV. A comparison of the early Kentucky Lunatic Asylum and the Friends Asylum in Pennsylvania, described in the previous section, reveals remarkable similarities. Both consisted of a central houselike building flanked by wings with return wings at the ends. The wings consisted of small rooms arranged along corridors. Men lived on one side of the central building, women on the other. Soon after the wings were added to the original hospital, a separate building was constructed about “forty paces” to the rear. It was approximately 20 feet square, two-stories high, and contained 16 small rooms or “cells,” intended for the “worst class of patients,” and for withdrawing temporarily the “most turbulent and ungovernable”. The structure was identified as the “box room” on an 1832 ground plan of the hospital. This structure is no longer extant. The 1832 plan also shows the location of the original building with its wing additions, two privies, a smoke-house, stable, wash-house, burying place, fences, pump and cistern and men's and women's airing yards.

In 1846, the Directors reported to the Legislature that they were not happy with their cure rate.They believed an addition to the original building that was “so inconvenient, uncomfortable, and illy suited in almost every way, for the purposes of a Lunatic Asylum” (Annual Report, 1846:615), would solve their problems. As a result, in 1847, the building was once again enlarged with the addition of a rear ell. The new ell was 110 feet long, 64 feet wide, and seven feet deep. It was united to the rear of the “central building” by an open porch, 64 feet long by 16 feet wide, with galleries corresponding with the floors of the main building and its wings. The Directors reported that the bricks for the new ell were made and carried to the site by the patients, who had performed all the labor, including the digging of the foundation. The rock for the foundation was blasted and quarried by the patients and they also performed a “considerable amount of the carpenters work.” According to the Directors, the labor was beneficial to the health of the patients and they regretted that there was not enough suitable labor to employ all of the Asylum patients (Annual Report, 1846:599).


In 1852, a fire destroyed a part of the building “erected at an early day.” Though the cause of the fire was never determined, the Superintendent recommended that the Asylum switch to gas lighting which could be obtained from the city. In 1863 the Managers reported that: “Iron bath-tubs have replaced decayed wooden ones. Worn out floors...have been laid. The leakage through the old floors had destroyed much of the plastering on our ceilings, all of which has been renewed chiefly by the labor of one of our patients.... Besides these, all the ordinary repairs throughout the building have been made, But the most important improvement of the year is the introduction of gas for lighting the building.

While there was constant maintenance and remodeling of the older buildings, the next major construction project took place in 1867 when a new building was erected to house the women. This was the first major addition to the hospital since the AMSAII and Kirkbride published their recommendations on asylum architecture. We know that the Directors of the Kentucky Lunatic Asylum were well aware of their work for in 1859 they hosted the annual meetings of the AMSAII in Lexington and they quoted Kirkbride (Conventions, 1859) and summarized the AMSAII's propositions on the construction and organization of hospitals for the insane in their annual reports (Annual Report, 1859: 35-37).

In 1856, when Kirkbride expanded his Pennsylvania hospital, he argued that there were many advantages to treating men and women in different buildings and as a result, he chose to construct an entirely new building. The original building became the female department, the new structure the male department (Tomes 1994:154). Kentucky followed Kirkbride's lead and in 1868 when they enlarged the hospital, they chose to construct an entirely new building. In this case, however, the new building, served as the Female Ward, the old building became the Male Ward.

The new building looked similar to the old. It was built of Flemish bond brick and consisted of a central block with wings capped by return wings. It was built just 40 feet left of, and in-line with, the old structure, creating a long linear plan. The new structure was larger, however. It measured 440 feet long, and varied in depth from 36 to 78 feet. The entire structure sat over a basement. The center four-story block and one of the three-story return wings were topped by lanterns.

While most of the patients at the Kentucky Lunatic Asylum were paupers, their care paid for by the State, there were always a small number of boarders whose care was paid for by their families and friends. Henry Clay's son, Theodore, for example, was a patient at the Kentucky Lunatic Asylum in the 1830s. Unlike the typical patient, he was allowed to bring along his favorite horse (White 1984:144). There is other evidence that the paying boarders were offered preferential treatment, for example, in 1845, the Superintendent suggested that in order to attract paying boarders, they needed to “fit up a sufficient number of rooms in a handsome style, to accommodate a class of patients whose friends wish them supplied in a way to which they have been accustomed...”(Annual Report 1845:629).

Dorthea Dix visited the hospital in 1846 & 1858 in an effort for better treatment of patients and improved living conditions. This lead to the addition of several wings & a new building. In 1862, a year after the start of the Civil War, employees were required to take an oath of allegiance to the U.S. During the war the hospital was occupied by Confederate forces for a short time and operated as a hospital for sick & wounded soldiers along with the regular mentally ill patients.

In 1894,the Administration Building was constructed to serve as offices, sleeping quarters and a ballroom. The three-story, brick Neo- Classical style building was designed by Curtain & Hutchings, a Louisville architectural firm (The Plans 1894). The Administration Building was located between and slightly in front of the Female and Male Buildings, creating an assemblage of buildings resembling a Kirkbride plan. The new Administration Building became the new center block and the Female and Male Buildings, set back en echelon, became the wings. A ballroom was located on the third floor of the Administration Building. Parties and dances were commonplace at nineteenth-century asylums. Frequently called “lunatic balls,” they were often used as fund raisers. There is evidence that the Eastern Kentucky Lunatic Asylum held a ball as early as 1869. Over 300 guests attended the event in 1888.


The first patient admitted to the Kentucky Lunatic Asylum was a “negro” woman from Woodford County. Unfortunately there are no records that reveal the living conditions of African American patients during the earliest years of the institutions history. At the Alabama Insane Hospital, blacks were assigned to the basements, which were considered the worst of the wards, until separate facilities were constructed. It is likely that this was the case at the Kentucky Lunatic Asylum as well. It appears, however, that there may not have been many African Americans admitted to the Kentucky Lunatic Asylum until after the Civil War. In 1845, for example, the Superintendent pleaded to the legislature for the appropriation of funds to build accommodations for blacks.

In 1869, money was appropriated to enlarge an existing building, located about two hundred yards from the main white ward, for the use of “negro lunatics.” It was a brick structure, eighty-five feet long, forty-four feet deep, having three stories and a basement. In 1896, the Superintendent once again warned that the accommodations for the “colored patients” was “totally unfit.” “The building is old and dilapidated, ventilation poor, day-rooms too small, and the lights bad.” He recommended that a brick building, sufficient to accommodate two hundred and fifty patients, with hospital wards attached for males and females, be erected. In the meantime, a building disconnected from the main building that was formerly an engine room and laundry was converted into quarters for the “quit colored female patients,” thereby relieving the main “colored” building from crowded conditions (Annual Report 1896:14).


The relief was temporary, however, for in 1898, he reported that the “negro male patients, irrespective of the types of their maladies, are crowded into one ward. Every consideration dictates that these patients should be intelligently classified and separated into wards according to the nature of their respective maladies, as is attempted to be done with the white patients” (Annual Report 1898:8). In 1913, the Superintendent pleaded that a “new building for colored females” was an “absolute necessity.” He explained that in “a building erected in 1817, with no modern improvements, we are conducting a male and female ward, separated only by a brick partition wall, with a sufficient number of colored male patients to fill the whole building, nearby, we have another colored female ward in a building at one time used as a laundry, and which now should be condemned” (Annual Report1913:40).

It does not appear that a new building dedicated to the housing of African American patients was constructed until 1951 when the Wendell building was constructed. The building was named after Thomas Tyler Wendell, an African American physician that served the Asylum as well as the Lexington community during the late nineteenth and early twentieth centuries. No longer segregated, the building serves as patient housing today.


In 1829, the Legislature appropriated $1,200.00 to erect three brick walls, to enclose a yard around the asylum for the exercise of the patients. The walls were to enclose about an acre and a half, in the rear of the buildings. The ground to be enclosed by the walls was to be divided into three yards; one for females and the other two for males; so as to allow a separation of the males into two classes.

In 1861, one hundred and thirty acres of land was finally added to the asylum. A stable for milk cows, 84 feet long and 16 feet wide was erected, along with a carriage house, wagon shed, piggery and a slaughter house. A comparison of the small rectangular airing yards for males and females depicted on the 1837 site plan, and the 1861 topographic map titled “The Pleasure Grounds” shows how far landscape design had come at the Kentucky Lunatic Asylum. The 1861 map depicts circular drives, groves of trees, a flower garden, fountain, orchard, and fish pond. They continued to add to the grounds over the years. For example, in 1875 a large reservoir was completed. In 1898, they supplemented the orchard by planting four hundred fruit trees, including: 100 plum, 100 peach, 100 pear, and 100 cherry trees. In addition to the male and female buildings, an 1871 birds eye view of the asylum shows a network of circular drives and groves of trees and an 1877 atlas of the site shows an even more extensive network of roads and walks. In fact, as late as 1901, several thousand additional feet of walks were being laid. In 1869, the Directors reported that “our pleasure grounds, provided with seats, arbors, flower gardens, swings, & ca., are extensive, and are growing more beautiful every day (Annual Report 1869:16).

20th CENTURY[edit]

In 1904, a pair of bowling alleys by the Brunswick Balke Collender Company, and a new building to house them was constructed near building 23(Annual Report 1904:8). The bowling alleys are no longer standing.

1904 the Superintendent requested an appropriation for the erection of a “modern laundry.” He explained that the present one was situated over the engine room, where steam and coal dust filter through the floor and make it next to impossible to properly launder the clothing. In addition, he argued, during the warm months the laundry employees are forced to do their work in a temperature of one hundred and twenty to one hundred and thirty degrees, owing to the excessive heat from the engine room. The new laundry was completed in 1906 and looks today, much as it did when constructed.

In 1913, the Superintendent declared that in “this day of enlightenment, a hospital for the insane without special quarters for Tubercular and Pellagra patients separate and distinct from the main buildings, is criminal negligence, and should not be tolerated”. A tubercular hospital, designed to comfortably accommodate twenty-two patients, was completed in 1914. This structure is longer standing.

In 1915, the Superintendent proclaimed that a “nurses home” is “badly needed” and “would enable us to have better nurses and retain them longer. Working and sleeping in the same ward, and surrounded by patients,year after year, is not conductive to health or capacity”. In 1927 the nurses home was constructed. It was a two-story brick building with a capacity for thirty-six nurses. All of the excavating work was done by inmate labor, and the entire upper floor of the building was completed by the institution forces.

In the 1920s, the Superintendent reported that Eastern State Hospital was the only institution in the United States experimenting with the use of sawdust beds for the “helpless, untidy insane.” He explained that once he learned of their use in Germany he had thirty-four of the beds installed at Eastern State Hospital. They were oblong boxes, made of one-inch dressed boards six and one-half feet long, thirty inches wide, and eighteen inches deep, standing on legs twelve inches high and painted white. They were filled with fresh sawdust to within six inches of the top. According to the Superintendent, the patient, clothed in a short night shirt, laid directly on the sawdust, which conformed to the shape of the body. A pillow was placed under the head and the patient was covered with a sheet and blanket. He explained that the excrement from the bowels and kidneys with the small amount of sawdust that was soiled was scooped out immediately with an ordinary six inch scoop. Fresh saw dust was added from time to time to keep the total amount up to the twelve-inch level (Annual Report 1925-1927). It is unclear how long sawdust beds were employed at Eastern State Hospital.

Between 1938 and 1943 the Gragg building was renovated, this was the hospital's original building completed in 1824. At the end of WW 2 the hospital reached it's peak population of just over 2,000. Also new treatments were being used, including Electro and Metrozol shock treatment, Malarial fever therapy & lobotomies. The patient population began to finally decline by the mid-1950s, at this time the Wendell and Allen buildings were completed. Farming operations, run by the patients was terminated in 1957 & property sold to IBM for their new facility. 1967 brought the first patient population under 1,000 in many years.


On September 10th, 2013 the patients were moved to the new facility & the old hospital officially closed. Demolition of all buildings, except the Administration & laundry buildings, was complete by February 2014.

New Hospital[edit]

In October, 2013 a new facility was opened under the same name. This replaced the aging one, the property having been turned over to BCTC (Bluegrass Community Technical College). The new hospital consists of 3 patient care towers of 3 floors each. The towers link to the old hospital in their names; Allen, Gragg & Wendell. They were opened in October 2013 with the Allen to open in 2014. The new campus also includes the Central Kentucky Recovery Center, 4 personal care buildings designed to help individuals return to the community. Located on the University of Kentucky's Coldstream Research Campus and managed by UK HealthCare, the state-owned facility will provide care for patients from Fayette and surrounding 49 counties.

Images of Eastern State Hospital[edit]

Main Image Gallery: Eastern State Hospital Lexington


There is a cemetery at the rear of the property that contains approx. 4,000 to 6,000 sets of remains of former patients buried on the property between 1824 & 1956. This cemetery has been in place since 1984 after the original cemetery had been moved twice. An unknown number graves exist throughout the hospital containing as may as 4,000 additional graves.


2 old movies found at the University of Kentucky and a 3rd that had been held at ESH and recently converted to digital format.



  • The Early Gatekeepers: A Saga of Three American Institutions, by Wynelle Deese
  • Kentucky's First Asylum: A Saga of the People and Practices, by Wynelle Deese