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 XXII
POSITION, AND GENERAL ARRANGEMENTS OF THE BUILDING.
THE size of the building, and the number of patients having been determined, its form and general arrangements will next require attention; and no plan, however beautiful its exterior may appear, nor how apparently ingenious its interior may seem, should ever be adopted without, as already suggested, having been first submitted to the inspection and having received the approval of one or more physicians who have had a large practical acquaintance with the insane, and who are thoroughly familiar with the details of their treatment, as well as with the advantages and defects of existing hospitals for their accomodation. So different from ordinary buildings or other public structures are hospitals for the insane, that it is hardly possible for an architect, however skillful, or a board of commissioners, however intelligent and well disposed, unaided, to furnish such an institution with all the conveniences and arrangements indispensable for the proper care and treatment of its patients. Nothing but a practical familiarity with what is required can do this. All recent experiments in planning hospitals without consulting experts, or asking their opinions before the adoption of the plan, as should be expected, have proven failures. No desire to make a beautiful and picturesque exterior, should ever be allowed to interfere with the internal arrangements, any more than the wish to have an elevated and commanding site should be permitted to compel the provision of costly roads, and the expense and annoyance of having every thing in all future time carried to its great elevation. The interior should be first planned, and the exterior so managed as not to spoil it in any of its details.
Although it is not desirable to have an elaborate or costly style of architecture, it is, nevertheless, really important that the building should be in good taste, and that it should impress favorably not only the patients, but their friends and others who may visit it. A hospital for the insane should always be of this character, it should have a cheerful and comfortable appearance, every thing repulsive and prison-like should be carefully avoided, and even the means of effecting the proper degree of security should be masked, as far as possible, by arrangements of a pleasant and attractive description. For the same reason, the grounds about the buildings should be highly improved and tastefully ornamented; a variety of objects of interest should be collected around it, and trees and shrubs, flowering plants, summer-houses, and other pleasing objects, should add to its attractiveness. No one can tell how important all these may prove in the treatment of patients, nor what good effects may result from first impressions thus made upon an invalid on reaching a hospital,—one who perhaps had left home for the first time, and looked forwward to a gloomy, cheerless mansion, surrounded by barren, uncultivated grounds for his future residence, but who on his arrival finds every thing neat, tasteful, and comfortable. Nor is the influence of these things on the friends of patients unimportant; they cannot fail to see that neither labor nor expense is spared to promote the happiness of the patients, and they are thus led to have a generous confidence in those to whose care their friends have been entrusted, and a readiness to give steady support to a liberal course of treatment.
As soon as a building is located, a general plan for the improvement of the grounds should be prepared, and the laying out of roads and planting of shade trees commenced, thus gaining at least three years in the growth of the latter, and allowing the institution to be opened with something like a finished appearance, in place of the barren surroundings so often observed during the first years of hospitals.
Great care should be taken in locating the building, that every possible advantage may be derived from the views and scenery adjacent, and especially as seen from the parlors and other rooms occupied during the day. The prevailing winds of summer and the genial influence of the sun's rays at all seasons, may also be made to minister to the comfort of the inmates, and the grounds immediately adjacent to the hospital should have a gradual descent in all directions, to secure a good surface drainage. The centre building ought to be the prominent feature in such a structure as that under consideration, and while there can be no excuse for squandering money simply for display, or for giving it unnecessarily large proportions, like all other parts, it should be in good taste and have ample and comfortable accomodations for the convenient transaction of such business as necessarily belongs to it, and for the apartments of the officers, who are expected to reside in it. Not to do this, is neither wisdom nor economy.