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 XX
CHARACTER OF PROPOSED PLANS.

THE plans proposed in the following pages, are specially for State hospitals to accomodate two hundred and fifty patients; this number being, in my estimation, about as many as should be collected in any one institution. It is be [sic] remembered, too, in considering this subject, as already stated, that State hospitals are not for the pauper portion of the community alone, but for every class of citizens, and that all who pay taxes aid in their erection, and therefore have the right to participate in their advantages, while in most of the States, they furnish the only hospital accomodations for the care of any portion of the insane. The rich pay most of the taxes, and those who do so, certainly should have the right to share in the benefits of institutions provided from this source. And, as cannot be too often repeated, what is right for these, when insane, is none too good for the poor when in the same condition. Except in the vicinity of a few of our largest cities, it is not probable, at least for many years, that any other class of institution will be put up in the United States; and on that account, it is particularly desirable that public opinion should be settled as to what is indispensable for this description of hospitals. The same general plan and arrangements are applicable, however, to the hospitals intended for the insane poor of large cities, and also, with some slight variations, they would answer for corporate institutions like those connected with the hospitals for the sick in Philadelphia, New York, and Boston, referred to on a previous page, or those provided by the liberality of private individuals.

In nearly all of these different institutions, it is necessary that a strict regard should be had to first cost, and, as before observed, to economy in subsequent management. On these accounts, I propose recommending only what I deem absolutely necessary for the proper accomodation and treatment of the insane in any of the classes of hospitals previously referred to. Where ample funds are available, more costly arrangements may with entire propriety be adopted; but it is with hospitals as with private dwellings, the most pretentious, or those with the highest ornamentation, do not necessarily furnish the most comfort, nor are most desirable for those who appreciate the substantial enjoyment of life.

There are, indeed, several variations that might be suggested, where it is proposed to provide the most perfect arrangements, without regard to cost, or to furnish acommodations exclusively for the wealthy in a community; for there is no reason why an individual who has the misfortune to become insane, should, on that account, be deprived of any comfort or even luxury, that is not improper or injurious, to which he has been accustomed, or which his income will justify. An insane member of a family, wherever he may be, has really a claim for every thing that will contribute to his comfort and gratification, far beyond those who are in health and who have so many other resources; and the justice or morality of a different course, as occasionally observed, cannot for a single moment bear examination.

It may be repeated here that under no circumstances should the plans for a hospital for the insane be adopted till they have been examined and approved by one or more qualified experts, and that this should be insisted on in the original law, which should also detail the mode of appointment of the Building Commission, Board of Trustees, and Superintendent, and the fundamental character of their important duties.

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