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Popular Feeling Towards Hospitals For The Insane

Creator: Isaac Ray (author)
Date: July 1852
Publication: American Journal of Insanity
Source: Available at selected libraries

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For a similar reason it is desirable that the house should be amply provided with parlors well-warmed, lighted and furnished, in which patients might forget, for a moment, that they were not in a domestic dwelling, and lose some of their acerbity of feeling which is cherished, if not provoked by the peculiar aspect of the rooms and galleries. Rooms should also be provided, where patients may meet their friends, so arranged that the former may not be exposed to the observation of visitors, and the latter may not be admitted into the galleries, to mingle with other patients and receive from them such impressions as their wayward fancies may happen to excite.

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To secure these objects, it is not only necessary that hospitals for the insane should be planned by those who know by personal experience what architectural arrangements are required, but such persons should superintend their erection, from the digging of the cellar to the last finishing touch of the painter. No plans nor specifications can be so definite and minute, as to render such a supervision unnecessary. In a great many points, the fancy of the builder, or mere accident becomes the guide, and, with the popular notions respecting the strength and appropriateness of materials, the result may be one, very likely, that jeopardizes the reputation of the institution. A door or window-guard, so weak that a vigorous blow leaves nothing between the patient and the open air, locks that may be opened by the simplest contrivance, dust-flues large enough for the escape of patients, drains imperfectly trapped, pipes placed where they never can be subsequently reached, -- things like these may lead to accidents calculated to impair the confidence of the community in the very beginning, and I see no other way of preventing them, but an intelligent supervision of every step and stage of the construction. The common practice of entrusting the erection of hospitals for the insane, whether with or without a suitable plan, exclusively to a board of commissioners, having no practical acquaintance with the subject, cannot be too strongly condemned. To suppose that a person, because an eminent lawyer, or a successful merchant, or even a professed builder, is best fitted to superintend the building of an establishment so special as that of a hospital for the insane, is to ignore the universal experience of mankind.

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To these architectural defects, there is frequently added another evil well calculated to produce a disagreeable result. That niggardly economy which, in our State-Legislatures, is swift to cripple any project or enterprise that has nothing to recommend it but its benevolent character, and grudges the necessary means for executing even the poorest plan in a generous and liberal way, has frequently led to the opening of hospitals before their completion, and while wanting some important provisions. A whole wing perhaps, is left unfinished, and patients and attendants of both sexes are placed in fearful proximity to one another, the lamentable fruits of which constitute a page it the history of our insane hospitals, which would deter any body less reckless and irresponsible than a State-Legislature, from marring an important project solely for the sake of saving the people's money. Doors and windows are left improperly secured, water is inadequately supplied, and the danger of fire has been scarce considered. Solitaries for noisy patients have been left to be provided at a more convenient season, and thus the noisy and the quiet, the violent and the convalescent, are mixed up together so as to disturb the peace of the day and the slumbers of the night. For want of proper fences, intruders make their way to the windows, and the grounds are left in the rough, year after year; at one season covered with pools of water and heaps of rubbish, and at another, the scene of blasting operations that involve the risk of life and limb. Any remonstrance upon the insufficiency of such provisions for accomplishing the highest objects of a hospital for the insane, is met by the usual reply: -- "We have already spent considerable money, and the people are anxious to see some result. We do not expect you will accomplish as much as if the establishment had that degree of completion we would wish to give it. But we are prepared to make due allowances; all we ask of you is to do the best you can, and at a future time as our means increase, these deficiences shall be supplied." All this sounds very fair and very reasonable, but if any one is sufficiently verdant to be deceived by it, I can assure him, on the strength of much personal experience, in times long since gone by, that he will have abundant opportunity of learning how far this promised allowance for his anticipated short-comings will be endorsed by the public, when the first murmur of complaint, shall reach its ears. Were this matter rightly understood, I am sure that no man with a proper regard for his own reputation and peace of mind, would embark in the care of one of these unfinished establishments.

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