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 XXIII
FORM OF BUILDING.

FOR an institution like that referred to, it is believed that the best, most convenient, and most economical form will be found to be a centre building with wings on each side, so arranged as to give ample accomodations for the resident officers and their families, and for the classification and comfort of the patients, and all employed in their care. A building having a basement entirely above ground, and two stories above this, is not objectionable, and will generally be adopted on account of its being less expensive, and of smaller extent on the ground than one of only two stories. The centre building and projecting portions of the wings, may be carried up a few feet higher, but the wards generally should not be. In the highest part of the structure, as in a dome on the centre building, the water tanks should be provided for.

In the centre building should be the kitchens, sculleries, main store rooms, a reception room for patients, a general business office, superintendent's office, medical office and library, visiting rooms for friends of patients, a public parlor and managers' room, a lecture room or chapel, and apartments for the superintending physician's family,—in case that officer resides in the building,—and for other officers of the institution.

The wings should be so arranged as to have at least eight distinct classes of patients on each side; each class should occupy a separate ward, and each ward should have in it a parlor, or possibly an alcove as a substitute, a dining room with a dumb waiter connected with it, and a speaking tube or telephone leading to the kitchen or some other central part of the basement story, a corridor, single lodging rooms for patients, an associated dormitory for not less than four beds, communicating with an attendant's chamber, one or two rooms of sufficient size for a patient with a special attendant, a clothes room, a bath room, a wash and sink room, and two or more water closets. There should also be provided for each sex in its appropriate wing, at least one ward for patients who are too ill to remain in their own chambers, a railroad for the distribution of food, etc., two work rooms, a museum and reading room, a school room, a series of drying closets, at least one on each story, or, better, one for each ward, and various other fixtures, the general character, position, and arrangement of which will be more particularly referred to, when describing the accompanying plans, in which they will all be found provided for. The parlors may be dispensed with in the wards for the most excited patients, but not elsewhere, unless the plan of having alcoves of good size, as already referred to, in the middle of each ward, may be accepted as a substitute, and all the other conveniences suggested will be as necessary for the excited as for any other class.

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