The Construction of Hospitals for the Insane
PART I.
Chapters 1 - 10- Chapter I
- PRELIMINARY REMARKS
- Chapter II
- DEFINITIONS OF INSANITY
- Chapter III
- FREQUENCY OF INSANITY
- Chapter IV
- CURABILITY OF INSANITY
- Chapter V
- ECONOMY OF CURING INSANITY
- Chapter VI
- HOSPITALS THE BEST PLACES FOR TREATMENT
- Chapter VII
- DIFFERENT CLASSES OF HOSPITALS FOR THE INSANE
- Chapter VIII
- STATE PROVISION TO BE FOR ALL CLASSES
- Chapter IX
- THE ASSOCIATION OF MEDICAL SUPERINTENDENTS OF AMERICAN INSTITUTIONS FOR THE INSANE
- Chapter X
- FIRST STEPS TO SECURE A HOSPITAL
- Chapter XI
- FORM OF LAW FOR ESTABLISHING A HOSPITAL
- Chapter XII
- BUILDING COMMISSIONS
- Chapter XIII
- SELECTION OF A SITE
- Chapter XIV
- AMOUNT OF LAND
- Chapter XV
- SUPPLY OF WATER
- Chapter XVI
- DRAINAGE
- Chapter XVII
- ENCLOSURES
- Chapter XVIII
- PATIENTS' YARDS
- Chapter XIX
- IMPORTANCE OF ARCHITECTURAL ARRANGEMENTS
- Chapter XX
- CHARACTER OF PROPOSED PLANS
- Chapter XXI
- SIZE OF BUILDINGS AND NUMBER OF PATIENTS
- Chapter XXII
- POSITION, AND GENERAL ARRANGEMENTS OF THE BUILDING
- Chapter XXIII
- FORM OF BUILDING
- Chapter XXIV
- HEIGHT OF HOSPITALS
- Chapter XXV
- TEMPORARY OR WOODEN STRUCTURES
- Chapter XXVI
- NUMBER OF PATIENTS IN A WARD
- Chapter XXVII
- NATURAL VENTILATION
- Chapter XXVIII
- CELLARS
- Chapter XXIX
- MATERIALS OF WALLS
- Chapter XXX
- PLASTERING
- Chapter XXXI
- SECURITY FROM FIRE IN CONSTRUCTION
- Chapter XXXII
- ROOFS
- Chapter XXXIII
- SIZE OF ROOMS AND HEIGHT OF CEILINGS
- Chapter XXXIV
- FLOORS
- Chapter XXXV
- DOORS
- Chapter XXXVI
- LOCKS
- Chapter XXXVII
- WINDOWS AND WINDOW GUARDS
- Chapter XXXVIII
- INSIDE WINDOW SCREENS
- Chapter XXXIX
- STAIRS
- Chapter XL
- ASSOCIATED DORMITORIES
- Chapter XLI
- INFIRMARY WARDS
- Chapter XLII
- BATH ROOMS
- Chapter XLIII
- WATER CLOSETS
- Chapter XLIV
- WARD DRYING ROOMS
- Chapter XLV
- WATER PIPES
- Chapter XLVI
- DUST FLUES AND SOILED CLOTHES HOPPERS
- Chapter XLVII
- KITCHENS AND SCULLERIES
- Chapter XLVIII
- DUMB WAITERS AND DISTRIBUTION OF FOOD
- Chapter XLIX
- RAILROAD
- Chapter L
- HEATING AND VENTILATION
- Chapter LI
- AXIOMS ON HEATING AND VENTILATION
- Chapter LII
- HOT AIR AND VENTILATING FLUES
- Chapter LIII
- LIGHTING
- Chapter LIV
- PATIENTS' WORK ROOMS
- Chapter LV
- GENERAL COLLECTION ROOM
- Chapter LVI
- WASHING, DRYING, IRONING, AND BAKING
- Chapter LVII
- FARM BUILDINGS
- Chapter LVIII
- COST OF HOSPITALS FOR THE INSANE
- Chapter LIX
- DESCRIPTION OF THE PLATES
- Chapter LX
- DESCRIPTION OF THE FRONTISPIECE AND ITS GROUND PLAN
More to come...
CHAPTER I
PRELIMINARY REMARKS.
THE proper custody and treatment of the insane are now recognized as among the duties which every State owes its citizens; and as a consequence, structures for the special accommodation of those laboring under mental disease, provided at the general expense, ample in number, and under the supervision of the public authorities, will probably, before any long period, be found in every one of the United States.
There is abundant reason why every State should make full provision, not only for the proper custody, but also for the most enlightened treatment of all the insane within its borders. Most other diseases may be managed at home. Even with the most indigent, when laboring under ordinary sickness, the aid of the benevolent may supply all their wants, and furnish everything requisite for their comfort and recovery at their own humble abodes. It is not so, however, with insanity; for while all cases need not leave home, the universal experience is, that a large majority of them can be treated most successfully among strangers, and very generally, only in institutions specially provided for this class of disease. It is among the most painful features of insanity, that for its best treatment, so many are compelled to leave their families; that every comfort and luxury which wealth or the tenderest affection can give, are so frequently of little avail at home; and that as regards a restoration or the means to be employed to effect it, those surrounded with every earthly blessing, are placed so nearly on a level with the humblest of their fellow beings.
Although, with great inconvenience, the affluent might provide suitable accommodations without leaving home, it would really be, by converting their dwellings into hospitals—still a large proportion of our best citizens, all those in moderate circumstances, no less than those dependent on their own daily exertions for support, without some public provision, must be deprived of much that is desirable, almost as completely as the pauper portion of the community. The simple claims of a common humanity, then, should induce every State to make a liberal provision for all its insane, and it will be found in the end, that it is no less its interest to do so as a mere matter of economy, especially as regards the poor.
It is now twenty-six years since the first edition of this volume was published; the substance of it having already appeared in the American Journal of Insanity. It was originally prepared to meet what then seemed a prevalent want, and to save the author from the labor of writing long letters in reply to inquiries in regard to the matters referred to, that were constantly being received by him. It is now a long time since the work could be had at booksellers, and the frequent applications still made for it, especially during the last four or five years, have seemed to show that the want for which it was first written, has not yet been adequately supplied.
While for some reasons, the author would have preferred re-writing the whole book, it has accorded more with his own convenience and the time he could take from his steadily increasing engagements, to reprint, substantially, the greater part of the original volume, with only a careful revision, and some rearrangement of its contents, and a moderate number of additions. All the views originally given that have been retained, now have the increased value of being confirmed by many years of additional observation, and the care of a much larger number of patients than were reported in the first edition.
The conclusions that have been arrived at, and which are given in the present volume, are the result of forty-two years' residence among the insane, with the personal responsibility of more than eight thousand patients, in three institutions varying greatly in their character and form of organization, the last thirty-nine years being in that with which the author is now connected, and of which he has had the immediate direction since its opening. During this last named period, too, the author had the experience of eleven years' active service as trustee of a large State hospital.
These opportunities for observation, with a desire to subject everything seeming to give a reasonable prospect of success to practical tests, and a pretty general knowledge of what has been done elsewhere in the care of the insane, in and out of hospitals, have not only confirmed the writer's opinions as to the correctness of the principles in which he has again expressed his confidence, but have also tended steadily to increase his interest in all classes of the insane, and his desire to secure for them such a provision, as will be certain to give them every advantage they can receive from the most enlightened care and treatment. Nothing will be found advocated in this book that has not been fairly tested in the author's own experience.
It was not originally expected that this essay would have any special novelty, or any particular interest, to those who, like the author, have been engaged for a great length of time in the care of the insane, nor is it now supposed that it will have. It is, nevertheless, believed that it will prove interesting and useful to those, who are just commencing their investigations on the subject, and also to that large class of intelligent non-professional people, who are anxious to be thoroughly informed as to the best mode of making provision for the insane, and of securing to all classes of these unfortunates, the most enlightened form of treatment. It is also thought that it may prove of no inconsiderable advantage to the community, it it aids, though ever so little, in making those to whom the different States entrust the planning and erection of new hospitals, familiar with what are deemed to be sound and essential principles, and thus prevents a waste of the public funds, and saves the people from having imposed upon them, as is too often attempted, ideas in regard to treatment, of the most visionary kind, with building designs which could only come from sources that were without any practical acquaintance with the subject.