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 VIII
STATE PROVISION TO BE FOR ALL CLASSES.

HAVING now shown that insanity is a disease of comparative frequency in all communities; that it is one from which no class or condition can claim exemption; that among its most prominent peculiarities is the fact, that as a general rule it cannot be treated as successfully at home, as in institutions specially provided for the purpose, it may be added that these institutions, too, must necessarily be of so costly a character that in only a few localities can private means be expected to provide them; and as already said, for a very large proportion of all those who are thus afflicted, the different States must be looked to not only for the provision of the hospital buildings, but for the means for properly carrying out their care and treatment.

It would seem that at this day no one could dispute what has been so often said, that the insane are really "the wards of the State," and that every State is bound by all the dictates of humanity, expediency, and economy, to make proper provision for all those not able to provide for themselves. This applies especially to the indigent, but above these are many of the best people in any community, individuals who live comfortably when all are in health, but who, when the heads or other important members of the family are stricken down and become unable to contribute to the support of those dependent on them, are utterly unable to provide for this unusual and often protracted form of sickness, and the extraordinary expenses incident to it. Even those with the largest means, with all their willingness to do so, cannot always secure elsewhere the advantages offered to them in the wards of a well-constructed and well-managed State hospital. As this last class of citizens furnish the largest proportion of the income of the State in the shape of taxes, it is only right that they should have the privilege, if they desire it, of participating in the advantages offered by the institutions toward the erection and support of which, they are necessarily the largest contributors. It is clear, then, that all classes have a common interest in State hospitals for the insane, and in every State making adequate provision for all within its limits. For the reasons stated, it is obvious that every State hospital should be made good enough for the highest class of its citizens, for it should not be forgotten that what is good enough for them, so far as proper care is concerned, is none too good for the humblest of the unfortunates who are compelled to look to these institutions for custody and treatment. This is believed to be an important axiom, never to be forgotten by those who are making provision for the insane, and it ought to stand side by side with that other, which has been so often repeated, and which is so fully confirmed by all intelligent experience, that the best hospital, best built, best arranged, and best managed, is always most economical in the end; for, a true economy consists not only in avoiding all waste and extravagance, but also in doing thoroughly whatever is undertaken, and this ultimately will give most satisfaction to any enlightened community.

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