From the mid-nineteenth century to the early twentieth, over 250 institutions for the insane were built throughout the United States; by 1948, they housed more than a half million patients. The blueprint for these hospitals was set by Pennsylvania hospital superintendent Thomas Story Kirkbride: a central administration building flanked symmetrically by pavilions and surrounded by lavish grounds with pastoral vistas. Kirkbride and others believed that well-designed buildings and grounds, a peaceful environment, a regimen of fresh air, and places for work, exercise, and cultural activities would heal mental illness. But in the second half of the twentieth century, after the introduction of psychotropic drugs and policy shifts toward community-based care, patient populations declined dramatically, leaving many of these beautiful, massive buildings--and the patients who lived in them--neglected and abandoned. Architect and photographer Christopher Payne spent six years documenting the decay of state mental hospitals like these, visiting seventy institutions in thirty states. Through his lens we see splendid, palatial exteriors (some designed by such prominent architects as H. H. Richardson and Samuel Sloan) and crumbling interiors--chairs stacked against walls with peeling paint in a grand hallway; brightly colored toothbrushes still hanging on a rack; stacks of suitcases, never packed for the trip home. Accompanying Payne's striking and powerful photographs is an essay by Oliver Sacks (who described his own experience working at a state mental hospital in his book Awakenings). Sacks pays tribute to Payne's photographs and to the lives once lived in these places, "where one could be both mad and safe."

    William of Marlowe and Elizabeth of Hurley loved each other from childhood and swore to marry no other. Their fathers had more practical and profitable intentions. William was told Elizabeth had gone to Ilmer to be married to Mauger and in his pain and rage took Mary of Bix to wife. Elizabeth, who had withstood starvation and beatings, yielded at last when a priest swore to her William had married Mary. But Mauger had taken Elizabeth for more than her moderate dowry. Soon her brothers were both dead and Elizabeth was heir to her father's lands. When Elizabeth's father died, Mauger moved his family to Hurley. And when he saw the rich lands of Marlowe across the river, he decided to marry his son to William's daughter, be rid of William, and have Marlowe too. William should have seen through Mauger's false front, but his heart and mind were paralyzed by the horrible thought of Elizabeth in Mauger's arms. And he nearly, so nearly, also became Mauger's victim.

    For the seventeenth-century aristocratic Frenchman, it meant changing his shirt once a day, using perfume to obliterate both his own aroma and everyone else’s, but never immersing himself in – horrors! – water. By the early 1900s, an extraordinary idea took hold in North America – that frequent bathing, perhaps even a daily bath, was advisable. Not since the Roman Empire had people been so clean, and standards became even more extreme as the millennium approached. Now we live in a deodorized world where germophobes shake hands with their elbows and where sales of hand sanitizers, wipes and sprays are skyrocketing.The apparently routine task of taking up soap and water (or not) is Katherine Ashenburg’s starting point for a unique exploration of Western culture, which yields surprising insights into our notions of privacy, health, individuality, religion and sexuality.Ashenburg searches for clean and dirty in plague-ridden streets, medieval steam baths, castles and tenements, and in bathrooms of every description. She reveals the bizarre rescriptions of history’s doctors as well as the hygienic peccadilloes of kings, mistresses, monks and ordinary citizens, and guides us through the twists and turns to our own understanding of clean, which is no more rational than the rest. Filled with amusing anecdotes and quotations from the great bathers of history, The Dirt on Clean takes us on a journey that is by turns intriguing, humorous, startling and not always for the squeamish. Ashenburg’s tour of history’s baths and bathrooms reveals much about our changing and most intimate selves – what we desire, what we ignore, what we fear, and a significant part of who we are.