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

* Chapters 11 - 20

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

* Chapters 21 - 30

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

* Chapters 31 - 40

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

* Chapters 41 - 50

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

* Chapters 51 - 60

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 XIX
IMPORTANCE OF ARCHITECTURAL ARRANGEMENTS.

IT is generally conceded that in the past, at least, a more convenient style of architecture and better arrangements were desirable in most establishments for the care of the insane; and those who were personally familiar with the losses sustained in consequence of imperfect accomodations, and the advantages derived from improved ones, were sure to be found most anxious to secure a high character to every one of these institutions, without regard to the class of patients they were intended to receive.

No better proof need be given of the necessity for improvements in the construction and arrangements of hospitals for the insane, than the simple fact, that not a few of those put up within the last half century exhibit in many parts most glaring defects, and that nearly all erected till within a few years, have required extensive and costly alterations or additions; or if these changes have not been made, the buildings still remain unsuited for the proper and convenient treatment of the patients. Many of these lamentable defects,—which frequently can scarcely be remedied without actually rebuilding the hospital,—and the large expenditures of money that have been made in effecting alterations and improvements, have often resulted almost entirely from the buildings having been planned by persons who, whatever may have been their taste, architectural skill, or good intentions, had little knowledge of what is required for the proper care and treatment of the insane.

For the reasons last mentioned, it is hardly possible for most architects, unaided, to plan a hospital thoroughly equipped for this object.

The improvement in these structures in this country during the last twenty-five years has been very great, and it is now no difficult task to find in operation, hospitals that possess almost every thing essential to the comfort, and proper and economical treatment of their patients, and the plans of which can be safely followed by those who are unfamiliar with the subject, or doubtful of what is best to be done.

No reasonable person at the present day, when planning a hospital for the insane, would think it necessary or desirable to propose a building entirely original in it's design; for such a structure could hardly fail to lose in usefulness what it gained in novelty. Instead of attempting something entirely new, the object should rather be to profit by the experience of the past, by the knowledge of those who have had a practical familiarity with the wants and requirements of the insane, and after a careful study of existing institutions, to combine, as far as possible, all their good features, and especially to avoid their defects and inconveniences.

These institutions, particularly when put up under State authority, while having a plain, but still good and agreeable style of architecture, should not involve too large an expenditure of money in their erection; but nevertheless, should be so conveniently arranged as to be economical in their subsequent management, and should have every possible advantage for the best kind of classification and supervision of the patients, and for their comfort and treatment. All extravagance in the way of ornamentation should be avoided; but such an amount of it as is required by good taste, and is likely to be really beneficial to the patients, is admissible. It does not comport with the dignity of any State to put up its public buildings in a style of architecture which will not prevent their being distinguished from factories or workshops. Especially is this the case with those designed for the treatment of a disease like insanity, in which the surroundings of patients greatly influence their conditions and feelings.

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