Antebellum asylum reformers in the state were inspired by many of the same ideals as their northern counterparts, such as therapeutic optimism and moral treatment. But McCandless shows that treatment ideologies in South Carolina, which had a majority black population, were complicated by the issue of race, and that blacks received markedly inferior care. By re-creating the different experiences of the insane—black and white, inside the asylum and within the community—McCandless highlights the importance of regional variation in the treatment of mental illness.