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 XXXVII
WINDOWS AND WINDOW GUARDS.
WHEN in order to give a proper architectural effect to the building, the rooms in its centre must have lofty windows, the lower sash may be guarded as hereafter described, while the upper may be left as in an ordinary building. This is sufficient for rooms not regularly used by patients; but if constantly occupied, more attention must be paid to security. Inside shutters, with the upper half permanently closed, and the lower sash properly guarded, sometimes make a very neat arrangement in such rooms, and this, or something equivalent, is necessary for adequate safety.
More care, however, must be observed in reference to patients' chambers and ordinary ward windows. A window about six feet six inches by three feet, will be found of a convenient size, and this will give two sashes, each containing ten lights 5½ by 18 inches. The window seats may be like those in common dwellings, and the window should be placed low enough to make it pleasant to a person sitting in the room. The upper sash should be of cast or malleable iron, and well fastened into the frame, while the lower sash, of the same size and pattern, may be of wood, and hung so as to rise and fall throughout its whole extent. The cord may be entirely concealed. The space opposite the lower sash should be protected by a wrought iron window guard, which, if properly made, and painted of a white color, will not prove unsightly. This kind of guard is always to be very strongly secured to the window frame, and in such a manner that the screws may not be accessible to the patients. It should reach to within five inches of the upper sash, and to within the same distance of the frame below and at the sides. When of a tasteful pattern and neatly made, it will be found very preferable in appearance and quite equal in security, to the unglazed cast iron sash occasionally used, and which after all, when the sash is raised, has to one in the room very much the appearance of two sets of iron bars, placed at right angles, while the wrought iron screen is no more than what is every day seen in certain front windows of some of the best houses in our large cities.
Those who recommend unguarded windows, would seem to have little appreciation of the risks, which are sure to occur, or of the fatal results, that sooner or later will scarcely fail to happen. Within a very brief period, without this protection, three casualties would have taken place in a single institution, each of which must have ended in most serious, if not fatal results. Such windows may be safe for certain patients, but the great difficulty in taking care of the insane, is to know who are to be trusted and who are not, so many of their actions come from sudden impulse. The kind of patients for whom ordinary windows are safe, might really be treated elsewhere than in hospitals. So of doors unfastened and unguarded; every superintendent can judge for himself of the safety and propriety of such a course, and the amount of responsibility he is willing to assume.
Although there are various other forms of windows in use, which look well and have some advantages, upon the whole I regard that which has been suggested, as being the best and most economical for a State institution. If desired, the upper or iron sash may be balanced, so as to drop five inches, but this adds materially to the expense, and where proper attention is paid to a forced ventilation, can hardly be necessary. By having the glazing done from the inside of the patients' rooms, particularly in the upper stories, a great amount of trouble will be saved in the facility with which broken glass, so common an incident in hospitals for the insane, can be repaired, especially at night or during storms. This is practically a matter of great importance, and should never be overlooked.
Where the chamber windows are exposed to a strong sun, Venetian blind shutters on the outside, will be pleasant and useful, or a painted or simply a stout veranda awning over each window, will be found to add much to the comfort of the patients in summer, especially in a southern climate.
The iron verandas along the whole front, which have been suggested for the South, would prove very costly and could not be used with safety by the patients, unless made so as almost to resemble extensive cages. Good thick walls, with the airspace in them, with other less expensive arrangements, will be found more effectual in promoting the comfort of the patients.