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Page 45
From the sum you propose to receive from the patients, intended to
occupy the new building, I conclude you are providing for patients of
the middle ranks of life, a class hardly less to be commiserated, when
thus afflicted, than the very poorest, since the expense and difficulty
of private management, may bring to ruin a respectable family, as well
as expose it to great personal dangers. There would, I think, be
considerable objection to the accumulation of 40 patients of this class,
in three contiguous rooms, as proposed in the hints for pauper lunatics.
You purpose building for 50 patients, and as you probably intend to
accommodate both sexes, the number of each sex may be very suitable for
the accommodation of three contiguous rooms, which, of course, need not
be so large as those in the Wakefield Asylum. It would be difficult to
offer a detailed plan, without knowing more than we do of your local
circumstances, and the classes of patients you purpose to admit. I
doubt, however, whether you can do better than to adopt the general form
of the Wakefield Asylum, and as you are providing for only a small
number, it deserves consideration whether all the rooms might not be
advantageously placed on the ground floor. This plan affords great
facilities to easy inspection, and safe communication with airing
grounds, and the roof might project so far over the building, as to form
an excellent collonnade for the patients; which seems peculiarly
desirable under an American Sun.
With these views, I send a sketch drawn by the Architect whose plan is
to be adopted at Wakefield; and though it may not be, in many respects,
adapted to your particular wants, yet I hope it will not be altogether
useless. Should it be thought too expensive, I think the rooms, 1, 2,
and 3, might be dispensed with, and rooms marked "attendants, sick and
bath," might be appropriated to the patients during the day. The
attendants room is not a requisite, though it has been thought that it
would be more agreeable to patients of superior rank, not to have the
society of a servant. This, however, chiefly applies to the
convalescents, and these might occupy the room marked 'sick', whilst the
middle class, and the attendants, would be in the centre, marked
"attendants." A sick and bath room might probably be obtained in the
galleries: if you are inclined for the sake of appearance, to make the
centre building two stories high, you might bring the wings nearer to
the centre, and accommodate most of the convalescent patients with bed
rooms in the upper story. In this case, perhaps it would be desirable to
give the wings a radiating form. You will however be best able to modify
the sketch to your particular wants, if the general idea should meet
your approbation.
I observe with pleasure, that one leading feature of your new
institution, is the introduction of employment amongst the patients, an
object which I am persuaded is of the utmost importance in the moral
treatment of insanity. It is related of an institution in Spain, which
accommodated all ranks, and in which the lower class were generally
employed, that a great proportion of these recovered, whilst the number
of the Grandees was exceedingly small. It will however, require great
address to induce patients to engage in manual labour, who have not been
accustomed to it previously to their indisposition, and it must be
admitted, that where the reluctance on the part of the patient is great,
the irritation which compulsory means are likely to excite, will
probably be more injurious to the patient, than the exercise will be
beneficial. The employment of insane persons should, as far as it is
practicable, be adapted to their previous habits, inclinations and
capacities, and, though horticultural pursuits may be most desirable,
the greatest benefit will, I believe, be found to result from the
patient being engaged in that employment in which he can most easily
excel, whether it be an active or a sedentary one. If it be the latter,
of course sufficient time should be allotted to recreation in the air.
Some persons imagine, that exercises of diversion, are equally
beneficial with those that are useful. The latter appear to me to
possess a decided preference, by imparting to the mind that calm feeling
of satisfaction, which the mere arts of amusement, though not to be
neglected, can never afford. To the melancholy class, this is an
important distinction between amusing and useful employments, and labour
is to be prefered for the maniacal class as less calculated to stimulate
the already too much excited spirits.
It is proposed that the new asylum should be placed a few miles from the
city. The visitors to it, (I do not mean the medical ones) will, I
presume, be residents in New-York, and from what I have seen of the zeal
of persons under such appointments in this country, it appears
desirable, to render the performance of this duty, so important for the
welfare of asylums, as easy as it can be with propriety. One mile
perhaps would not be objectionable, and might probably afford as good
air and retirement, as a greater distance.
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