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 VII
DIFFERENT CLASSES OF HOSPITALS FOR THE INSANE.

AS already said, a very large proportion of all the insane in this country are now, and will unquestionably continue to be, treated in hospitals built and supported by the diferent States in which they are found, and for this reason it is more particularly to State hospitals that the remarks in this book have a special, although not at all, an exclusive reference. There are, however, other classes of institutions besides those under State control, but they are much less numerous, and there is not likely hereafter to be any great increase in their number.

Next in importance to the State hospitals are the incorporated benevelont institutions in connection with hospitals for the sick, and really branches of them.

The very first hospital for the insane in the United States was a benevolent corporation organized for the care and cure of the insane, and also for the relief of the ordinary sick. This dates back to 1751, and was the original Pennsylvania Hospital at Philadelphia. At a later day the New York Hospital, at New York, made similar provision for the insane, and, subsequently, the Massachusetts General Hospital, at Boston, established a branch of the same general character. After a certain period, however, it was found advisable by all those named, that the wards for the insane should be separated from those appropriated to the ordinary sick, and they are all now regarded as distinct institutions, differently organized, and requiring an entirely different form of management. They have no connection with the parent institutions from which they originally sprung, except in being under the control of the same Board of Managers. The number of these hospitals is not likely to be materially increased, at any rate only in the vicinity of large cities.

Besides those already mentioned, there are in different sections of the country a few private establishments, owned and controlled by individuals, but without regular Boards of Management or any special State supervision. Although a limited number of these, wisely conducted, may meet a public want, still, for obvious reasons, it is not desirable that their number should be greatly increased, nor that this mode of providing for the insane should be generally adopted.

In some sections of the country, cities and counties have shown a disposition to make a separate provision for the indigent insane for whom they are responsible, independent of the State. This is to be recommended only where the number under care approaches two hundred, or enough to give a proper classification, and to make the authorities willing to provide an institution of a character that would in all respects be proper for a State, and to have an organization for its management that would give it all the advantages to be expected from a moderate-sized State or corporate hospital for the insane. The same principles of construction and management apply to these, as to State hospitals. The plan of putting up cheap buildings in connection with county or city almshouses for the care of the insane poor, and under the same management, cannot be too severely condemned. Such structures are sure to degenerate into receptacles of which all humane persons will, sooner or later, be heartily ashamed.

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