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 XXIV
HEIGHT OF HOSPITALS.

THE best, and at the same time, the most economical height for a hospital, is a basement and two principal stories above. All these should be fairly above ground, and in the wings have a uniform height of ceiling of twelve feet. There is no objection to a two story building, but it will readily be seen that for a definite number of patients it is more costly, and necessarily extends over a greater surface, than one of three stories. Whether the building is of one, two, or three stories, the cellar and roof are required as much for one as the other. When the second story is finished, it costs little to carry up the walls, stairs, and flues another story, and there are always in a hospital for the insane, enough patients to occupy this upper story, who do not object at all to this additional flight of stairs, especially if properly constructed with frequent landings, and a moderate height in the risers. In my experience the third story has been preferred to either of the others by a majority of the patients, as being more airy, having greater privacy, and more extended views of the neighboring country.

One story buildings have advantages only for a limited number of patients. The feeble, when accommodated in them, can more readily have access to the open air, and the same is true in reference to the excited, where private yards are immediately adjoining their wards.

It requires little imagination to see that a series of three or more one-story hospital buildings, running in parallel lines with each other, even if a hundred feet apart, necessarily expose their inmates to more or less annoyance from each other, shut off to a greater or less extent, the natural ventilation, and obstruct the views of the surrounding scenery, more than a hospital with the same number of wards in one building, of three stories. The stairs being entirely disconnected with the wards and always made fieproof, there is no communication between the different stories, and if it is a hospital for the ordinary sick, a properly constructed elevator permits the patients to be taken to and from different wards, without risk or exposure.

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