and mechanical talent, and at the same time provided the means of carrying into effect his views of moral management, presented a great advance upon any previous structure of the kind. Many of its mechanical contrivances have never been surpassed, for the object was perfectly attained, though occasionally in a somewhat awkward and circuitous manner. Unlike too many who have labored in the same field, he never troubled himself with makeshifts. Whatever he did was designed for the future, and it bore indications of the substantial and the enduring. The lighter, frailer style of building, now so prevalent, may be cheaper in the outset, but it unquestionably is dearer in the end, and finally becomes not very agreeable to behold.

The establishment which next followed the McLean Asylum was erected by the State of Massachusetts, at Worcester, and though, in its general character, not very different from the former, yet it wanted many of the details designed to meet definite and important ends, while its cheap and flimsy style of construction presented a striking contrast to the finished, massive features of the other. Being intended for the poorer classes, it was unwisely concluded that every subordinate object might be disregarded, provided the principal one — the custody of the patient were secured. It was the first considerable example of very cheap construction, and one, unfortunately, which building-committees have been too ready to imitate. A few years afterwards, a hospital for the insane was erected near New York, and another near Philadelphia, -offshoots from the General Hospitals of those cities. They are both highly creditable to the country, and in many of their details could scarcely be improved. In the latter, the provisions for the violent classes have been carried to a degree of excellence that has never been surpassed. At both institutions much attention has been given to the improvement of the grounds by judicious planting, until they have become uncommonly beautiful. This is a point which has been deplorably neglected among us, and nothing could be more barren or cheerless than the grounds around many of our hospitals for the insane. Few persons sane or insane have so little sense of beauty as not to be favorably impressed by trees and

shrubs, groves, gardens, walks and fountains, tastefully disposed; and such impressions may be regarded as among the most salutary that can be made upon the disordered mind.

It will be unnecessary to allude particularly to the hospitals that have been erected within the last eight or ten years. While the most of them have each some particular merit of its own, they labor under the common defect of being more or less behind the times. Desirous of avoiding this fault, the Trustees of the Butler Hospital in Providence, R. I., before erecting their building, engaged Dr. Bell, the superintendent of the McLean Asylum, to visit Europe, in 1845, and gather such information as would be available for their purpose. Guided by the results of his observations abroad, as well as of his own practical experience in the care of the insane, he digested a plan differing in many important features from any other among us, and differing, we believe, for the better. It was adopted by the Trustees, with a few unessential changes required by their pecuniary means, and we doubt not it has exerted a favorable influence upon the progress of hospital construction in this country. Its lofty ceilings, its broad galleries with only a single range of bedrooms, its appropriate arrangements for attendants, its commodious associated dormitories, and its graceful elevation, have been more or less copied in subsequent establishments, which, but for this example, might have been only repetitions of the old model.

These institutions have now become so numerous that their proper functions and true position will soon, we trust, be more correctly appreciated than they have been hitherto. For several years past, the medical gentlemen who have charge of them have met together annually, in different places, to confer upon the various subjects connected with their calling, to exchange ideas, and from their mutual communications to derive fresh light and vigor in the prosecution of their work. Their conclusions, especially when sanctioned by the unanimous voice of the association, are justly entitled to a degree of confidence that would scarcely be claimed for the views of any individual. At their convention in 1851, they put forth unanimously a series of propositions relative to the construction of hospitals for the insane, embodying the results to

which the progress of knowledge had unquestionably led. These have already been regarded with some deference by building-committees, and it is to be hoped that their authority will soon be universally recognized. Availing ourselves of their suggestions as well as the results of our own experience, we shall describe the most prominent of those arrangements which are desirable, if not indispensable, in a hospital for the insane.

The general form now usually adopted for these establishments, being unquestionably the best adapted to our circumstances, while it also combines the greatest number of advantages, is what is called the linear, the different portions of the edifice joining one another at their extremities, in regular succession. The method somewhat common abroad, of building in several quadrangles of a single story, though well enough in such regions as France and Italy, where much of the patients' time can, and indeed must be, spent in the open air, is inadmissible with us, where many circumstances, especially facilities of warming and ventilation, require a more concentrated arrangement. Whether the different portions of the edifice should be placed on the same or parallel lines, or join one another at right angles, is a question of subordinate importance, for each has its advantages, and in neither is any important point sacrificed. In this country they have usually been three stories high, but in an establishment designed for two hundred or two hundred and fifty patients, — and that should be the extreme limit of capacity, every purpose of convenience, to say nothing of architectural effect, can be obtained with two stories, excepting in the projections and extremities, which might be carried up an additional story, to be used for dormitories, or work-rooms. The kitchen, laundry, &c. are often placed in the basement, but, for many reasons, they had better be in a separate structure, either joined to or a little remote from the main one. If the former plan is adopted, the communication may be sufficiently interrupted to prevent the transmission of odors, by discontinuing the masonry at the point of junction, and substituting a lattice of iron or stone, provided with shutters. A current of air would then pass from one side to the other, and thus prevent, in a

great measure, an evil of no trifling magnitude in an establishment where pure air is a necessary of life.

The cellar may be used for store-rooms, warming-apparatus, &c., but never for patients' rooms. The association declares, in the propositions just referred to, that no lodgingroom for patients should be below the level of the ground. Such rooms must always be badly lighted, and often so damp as to be unhealthy. In one of our largest hospitals, where they were extensively provided, it was found by several years' experience that the inmates were prone to diarrhoea and dysentery, and they were finally abandoned. A more unfortunate attempt at economy has seldom been made, and we trust that no future building-committee will be fool-hardy enough to repeat it.

The space on which the bedrooms open, called by the various names of hall, gallery, and corridor, is, in most of our institutions, a passage-way eight or ten feet wide, between two ranges of bedrooms, and imperfectly lighted at one or both ends. This gallery is something more than a means of access to the bedrooms, for it usually serves as a day-room. It should never be less than twelve feet wide, and should have but one range of rooms opening upon it. On the other side, the light should be admitted through spacious windows, and thus the inmates should have constantly before their eyes the surrounding country, which is, certainly, a more agreeable object to behold, than a monotonous range of doors in a dreary expanse of brick wall. This form of gallery has always prevailed in Great Britain, and we have abandoned it solely from considerations of economy.

It is always desirable that there should be connected with the gallery an apartment to be used especially as a day-room. Where the gallery is merely a walk between two ranges of rooms, this is indispensable; and even where there is but one range, such a room is required for the inmates to retire to when the gallery is washed or swept. It has a more domestic look than a long gallery, and that alone makes an agreeable impression.

Besides the single bedrooms, provision should be made for lodging a portion of the patients in associated dormitories.

They have been but recently introduced in this country, and form a very important improvement in our modes of accommodation. This has always been the method in general hospitals, but it was supposed to be improper for the insane, under the apprehension that they would disturb, if not injure, one another. This objection, however, is found in practice not to be well grounded. Disturbances may occasionally occur, but when restless and irritable subjects are kept out, and the attendant is at hand, as he always should be, they must be exceedingly rare, and easily quieted. The apprehension of danger from sudden outbreaks or mischievous impulses is felt only by those who have had but little practical acquaintance with the insane, since accidents of this kind have seldom occurred. The advantages possessed by associated dormitories over single ones, in regard to some classes of patients, have been too clearly exhibited to those who have been conversant with their operation, to leave any room for doubt on the subject. To the timid, who fear to be alone, they are far more agreeable than single rooms, and for the suicidal, as well as many others who require some supervision in the night, they are preferable, because the necessary watching can be more easily and effectually performed. Not only so, but it is questionable whether the objections urged against these rooms are not actually outweighed by those which lie against single rooms. The proportion of inmates for which they are suitable must vary, in some degree, with their social condition; and we can only say it should range from one fifth to one third of the whole number. They should be designed for not less than four nor more than twelve, and should always be contiguous to a water-closet and an attendant's room.

The attendants' rooms, as usually located, present no facility for observation, nor any other advantage. In the Butler Hospital they are placed at the right angle formed by the junction of two galleries, and thus are equally accessible from both galleries, while the attendants are thus enabled the more readily to act in concert. The room too forming a thoroughfare between the two galleries, the attendants are themselves subject to an easy supervision, and this is no slight advantage.

The common practice has been to provide every gallery