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 XLII
BATH ROOMS.

THE bath rooms in each ward should be of about the size of one the ordinary chambers, and should contain a cast-iron bath tub of proper size and shape, with the improved arrangements for admitting hot and cold water through a common opening, just at the lower part of the tub, and for discharging it from a separate one in the bottom. There should also be an overflow pipe of ample size, to prevent flooding the room from carelessness; and an attendent should always be present, when protracted baths are used, especially by patients who might be injured by them.

By drawing a small amount of cold water before the hot is admitted, there is never any vapor in the room. The arrangement suggested above, also offers great facilities for keeping up any desired temperature, when long continued hot baths are given, without exciting the patients' fears that they are to be injured, or leading them to suppose that the water is much hotter than it really is, as often happens when the continued flow of warm water into the tub is directly under the patient's observation. The fixtures for admitting and discharging the water not being over the tub, but entirely beyond it, prevents, in a great measure, the bath tub being used for any but its legitimate purposes. To make this still more certain, a cover may be placed over the tub, when not in use, which is convenient for other purposes. The admission and discharge of the water through different opening, varying slightly in their level, is preferable to any arrangement which allows one opening to answer for both purposes; for in the latter case, without special care, the deposits which take place in the pipe, are pretty sure to be returned into the tub when the next bath is drawn.

There should also be two or three marble, porcelain, or enamelled cast iron wash basins in one section of the bath rooms—or preferably, in another room, to be used specially for washing,—and furnished with hot and cold water pipes. In the wards for excited or suicidal patients, the hot water should be under the control of the attendants, to prevent accidents. An arrangement for shower and the various other baths, and for the douche, similar to what is used in private families, may also be introduced over or near the bath tub, but there is little necessity for the formidable fixtures often provided. Unless a patient can be persuaded to take the shower-bath or the douche voluntarily, its use is very problematical. Provision should be made for hip, foot, and hand baths; and a few towels properly secured,—but never, the ordinary roller towel, from which fatal results have often occurred,—with various other contrivances, should be a part of the furniture of each bath room.

The floors of bath rooms that are much used, may be of smooth German flag-stone, slate, or other material, that will not absorb moisture, and no wood should be used for washboards. Ordinarily, however, the common floor, well painted or oiled and varnished, answers every purpose. Special provision for warming all bath rooms, wash rooms, and water-closets, should be made, so that full advantage can be had of hot baths, and the taking of cold be prevented. Direct radiation is often admissible for this purpose. A strip of carpet laid in front of the tub when in use, will obviate the objection to any coldness of the floor, especially as all bath rooms should be kept warmed.

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