Construction.—The site and construc tion of an asylum for the insane are matters of great importance. A healthy and cheerful situation should be the first consideration in an institution intended fur the cure of diseased minds. In this respect some existing asylums are very well placed ; Hanwell, Lincoln, and Surrey may be instanced. Others have been originally on the outskirts of towns, and have been surrounded and built in by the increase of building. The commis sioners mention several so placed in pro per terms of censure.
It seems now generally admitted that the building ought not to be larger than to accommodate 300 or 400 patients. As to plan, no two of the existing asylums are alike, and the most recently erected are by no means the best. In the Surrey asylum a complete copy has been made of the worst and newest part of Hanwell, in which the bed-rooms face one another, and the galleries are lighted from the top, which renders proper ventilation impossible. To make wide galleries with rooms only on one side, would certainly increase the cost of the building; but by introducing a bow or expansion into each gallery, the necessity for a day-room will be done away with. An open fire should be in each of these expansions; it will be a great source of comfort to the patients, and an improvement in the ventilation as well as the general appearance of the gallery ; and, with a light wire guard, is perfectly safe. This plan is to be adopted in the Derby asylum now build ing; and as a ward must occasionally be left with one attendant, there is an ad vantage in bringing the whole of it within sight from a central position. No ward should contain more than thirty patients; and of these from twenty to twenty-five ought to have single rooms. It is matter of regret to find that dormitories are ap proved by the commissioners, and sup ported by the officers of some asylums ; they certainly lessen the cost of building, but the quiet and comfort of the institution must be much diminished. Their ventila tion is also very difficult: single rooms may be warmed with a hot-water pipe passing along the floor (not over-head), and opening the window will be a sure means of making a complete change in the air ; but in dormitories it will be diffi cult to preserve freshness of air with warmth, more especially as the great argu ment in favour of them is their economy, and an economy partly made by allowing to each patient a smaller number of cubic feet than would be given in a single room.
For the sick, the violent, the dirty, and the noisy, single rooms are obviously necessary ; and it will, we believe, gene rally be found that the remaining patients, those whose tranquillity and usefulness entitle them to indulgences, will consider a single room, which they can call their own, one of the greatest that can be given them.
An asylum containing 400 patients may probably be built in a straight line, which is desirable, without the necessity of carrying it higher than the first floor. The chapel and chief officers' rooms, and the rooms used for the work or amuse ment of the patients, should form the centre; behind which the kitchen may be conveniently placed, with the laundry on the side next the wards of the women, and the workshops on that of the men. In the wards branching off from the centre, those patients who are quiet and convalescent and the sick should be placed, and the most refractory at the extreme ends of the building, to prevent them from disturbing the others. Six classes of patients may usually be found, for each of which some modification of management will be required: 1. Tranquil : convalescent and mentu cholic.
2. Moderately tranqui_ 3. Refractory.
4. Sick and infirm.
5. Idiots and other dirty patients.
6. Epileptics of the better class. These are frequently in the intervals of their fits the most intelligent of the patients, but during the fits they require great attention.
All the sick, idiots, and epileptics should be on the ground-floor, which will be easily arranged, as the tranquil and moderately tranquil, who form the great bulk of the patients, may occupy the upper floor.
To describe the numerous minute par ticulars to be attended to in constructing and furnishing an asylum is unnecessary here; the great rule should be, that every possible amount of safety should be com bined with every possible amount of cheer fulness. There should be the strength of a prison without its gloomy character. No part of the building, within or with out, should be neglected ; and scarcely a day passes without improvements being made in one asylum or other—improve ments that are worthy of adoption in any to be hereafter built.