When it was first built, the asylum resembled a medieval castle with turrets, towers, and arched windows.
It was supposed to be a scenic place that would aid in the recovery of mentally ill patients. However, throughout the years, the asylum started gaining notoriety for overcrowding and patient abuse. Some patients died but their deaths remained uninvestigated and their records were seemingly "lost."
It was reported that some of the patients became desperate and attempted to escape. A popular escape route for the patients was said to be an underground cave and tunnels that were known as Sauerkraut Cave.
The underground cave was used by the asylum as a facility for food storage that included giant cans of sauerkraut. Hence, the name Sauerkraut Cave stuck.
It is possible that some patients also used the tunnels as an escape route but there is no proof of this. Yet, the legend of Sauerkraut Cave as a point of escape persists in the asylum's history.
Today, Sauerkraut Cave is part of Louisville's secret underground tunnels. Most of these tunnels were built before the 1930s and were used to move shipments from the docks to buildings and neighborhoods.
Sauerkraut Cave is still open but it is considered dangerous to explore because of its tight spaces.