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 XLIII
WATER CLOSETS.
NO part of the arrangements of our hospitals, even a few years since, was more imperfect than their water closets. A constant source of complaint, and a great nuisance in every part of the building where they were found, they gave so much annoyance that some practical men gravely proposed dispensing with them altogether, inside of the hospital. Our present knowledge of the subject, however, is such, that they may be placed wherever they are required, and without their presence being known in the adjoining part of the ward. To effect this, it is necessary to occupy for the purpose, a small room having an external window opening directly into it, to have the floor and other parts made so as not to absorb moisture, to use only iron or chinaware in the construction of the apparatus, to have no basins or complicated fixtures liable to get out of order, and above all,—most important everywhere,—to secure at all times, a steady and strong downward ventilation. This last may readily be obtained by a connection with a specially heated flue, or the main hospital chimney. All this can be done, and no reasonable expense should be spared to effect it. A special flue for each range of water closets, and an abundance of heat to secure an uninterrupted downward current of air through the receiver and discharge pipe, will well repay all they may cost; for with this effect produced, unpleasant odors in the wards from this cause are scarcely possible.
Where the water closets are near a flue of sufficient size, which is always heated, that will answer, and in private houses rarely fails to be successful; but if the slightest doubt of its working satisfactorily is entertained, it is much better to provide a flue with a fire in it, for the special purpose.
Various modes of letting on the water have been suggested, which do well, but at present I am disposed to prefer that which gives a full supply to wash out the whole surface of the receiver, every time the door is opened.
It is unquestionable, that as a general rule, not one-half enough water closets are provided. There should be at least one for every ten persons in a ward. To prevent all offensive odors from water closets and urinals, it is indispensible that it should be some one's special business to keep every thing about them clean, and in order, at all times.
Near the water closet, should be a sink, for washing various articles that it is not desirable to take into the bath room, and for obtaining water for the necessary cleansing of the ward.
The urinals should also be made of cast-iron, well enamelled, or of glazed pottery or chinaware, with a downward current of air through them, and they should have a steady stream of water passing over their whole surface, without both of which they are more likely to be a source of offensive odors than the water closets themselves. There should also be a hopper into which slops, etc., can be emptied, independent of the other arrangements.
A number of designs have been tried for permanent close-stools in the rooms of the most excited and careless patients, but none of them which communicate with a common discharge pipe, seem admissible unless a full supply of water, and a most thorough downward ventilation are secured through it. With these they answer admirably.
It is especially important about bath rooms, water closets, and sink rooms, that nothing should be boxed up. Every thing should be left open and exposed to view, there should be no harbor for vermin of any kind, no confined spot for foul air, or the deposit of filth, and all wood and every other material that will absorb moisture, should as far as possible be discarded from the floors and every other part, except for the seats of water closets, where the best mahogany or other hard wood will be desirable.