The Ground floor Buildings are shaded Light, and those of two or more Stories Dark. GROUND PLAN OF WARD A, WITH PORTIONS OF WARDS B & C. them thus affords negative evidence, that they are no intrinsic part of the pathology of mental derangement. I trust the indicatiof the operation of these extraneous circumstances 1 be sufficient as such; for to have investigated even briefly the value of each pathological change in the brain, to have pointed out the alterations which various diseases, uncomplicated with insanity, bring about in it, would have far exceeded the limits of a paper like the present. In what I have written there is no novelty, but I hope there may be some utility. My object has been to collect facts and considerations for our guidance in making necroscopical researches in cases of madness, and to present them in a connected form; and this few have attempted to do; indeed, so far as I am aware, not any. The tions with noble carriage drives through useless lawns and gardens to an imposing portico and façade, while the airing-courts for the patients were huddled away behind out of sight, with the culinary and other offices. Others, again, emulated the model prison, and were rich in radiating galleries, high walls, peep-holes, and other expressions of sombreness and security. estimates appended to these designs ranged from £13,000 to £43,000, but the amount of work included in them was as various as the character of the designs themselves, and it was consequently almost impossible to come to any conclusion as to their comparative cost. In most of the lower estimates so many essentials were omitted, that when carried out and completed, the designs would probably have been more expensive than even the highest. The object of the committee, however, was neither parsimony nor extravagance, but to secure a substantial building in every way adapted to the wants of the class of lunatics for which it was to be erected, and to carry it out in all its details with as great a regard to economy as possible. Description of the Lincolnshire County Asylum, by EDWARD PALMER, M.D., Medical Superintendent. Lincolnshire being one of the counties unprovided with an asylum for its pauper lunatics, when the County Asylum Act of 1845 came into operation, the Three weeks of close attention were bestowed on magistrates immediately devoted their attention to the the plans, during ten days of which the committee matter, and appointed a committee of visitors to carry were assisted by the present superintendent. Every out the provisions of the statute. As a first step con- plan was minutely inspected, and if found to be in siderable pains were taken to ascertain the number of accordance with the regulations of the Commissioners patients who would probably require to be provided in Lunacy with respect to internal dimensions, it for. It was found that there were in all 379 "lunatics was carried through a day's asylum operations. A and idiots" chargeable to the different unions in the large number of showy, beautifully drawn designs county; but that of these only 137 were under treat- were in this manner found to be totally worthless; and ment in asylums; the remaining 242 being reported about an equal number could only have been rendered by the medical officers to be "harmless and not re- suitable by extensive alterations. Three only emquiring confinement." The question of propriety of bodied the chief requisites of construction and arconfinement, however, was somewhat differently view-rangement, and were accordingly selected by the ed in the different divisions of the county, and it seemed probable, that as soon as the act was in full operation many of the patients then maintained in the workhouses, residing with their friends, &c., would have to be removed to the asylum. Regard was also paid to the increasing population of the county; and it was eventually decided to erect an asylum capable of accommodating 250 patients, and admitting of easy extension in the event of its being found insufficient. Other preliminaries having been arranged, 45 acres of land, in an elevated and healthy locality, two miles south of Lincoln, were purchased as a site, and architects were then invited to enter into competition for The main works having been completed, the asylum furnishing the plans,-premiums of £100 and £50 was opened for the reception of patients on the 9th of being offered for the second and third in merit respec- August, 1852, a considerable quantity of ground-work tively. Forty-three designs, in almost every kind of having been intentionally left as a means of occupation practicable and impracticable shape, were the responses for the male patients on their arrival. It may be reto this invitation. The walls of the county hall were marked, that the patients had been visited by the hung with showy pictures of noble looking buildings, superintendent previous to their removal from the and the table groaned under a mass of architectural other asylums, and that the order of their admission puzzles. Palaces, prisons, convents, and workhouses, was governed by impressions derived from those visits had each their reflexes on some or other of the broad-the urgent cases and such as appeared to be less sheets lying for the inspection of the committee. Many carefully treated, being the first that were directed to of the most defective plans were accompanied with gay, luring perspective and isometrical views of buildings placed in sunshine and shadow, and surrounded with nooks, groves, and swards, on which groups of happy patients were seen engaged in holiday-looking pastimes. Others presented fine mansion-like eleva committee for premiums. The first of these, an Italian design by Messrs. Hamilton and Medland, was adopted; subject, however, to such modifications as may be suggested by the superintendent, or required by the Commissioners in Lunacy. The superintendent was also requested to report on the best method of warming and ventilating the building, and, in consultation with the architect, to direct the whole of the internal fittings, &c., as well as, subsequently, to furnish the visitors with an estimate of the quantity and samples of the furniture, bedding, and clothing for the whole establishment. be brought to the asylum. The mode of proceeding of the committee of visitors has been thus particularly stated from its being correct in principle and successful in results; but more especially from the circumstance of public attention being just now directed to the issue of the very different course which has been adopted in the case of the proposed asylum for the counties of Cumberland and Northumberland. The adage "well done is twice done," is nowhere more applicable than in the construction of asylums, and experience has always shown, that the cheapest asylums are those which best answer the purposes for which they were intended, and are at the same time most durable. Repairs and alterations in badly built and badly arranged buildings, soon swallow up any apparent advantages which may figure in the first abstracts of expenditure. The superintendent and architect should invariably work together where usefulness and economy are rightly comprehended, and it is to be hoped that in the few county asylums yet remaining to be erected, the more prominent errors and inconveniences at least of the older asylums will be avoided, even if so many improvements as might be expected are not introduced. being open to the south, while the whole of the public front of the asylum is kept aloof from the patients. In the central building are included the committee room and waiting room, the superintendent's residence and office, the visitor's rooms, the dispensary, the medical assistant's apartments, the recreation hall, and the chapel. Directly behind are the apartments of the steward, and those of the housekeeper, each with the clothing and linen stores respectively adjoining. Beyond these are the kitchen, sculleries, and bakehouse, flanked on each side with the provision stores, and having the kitchen yard for the reception of goods, &c., close at hand. Two separate corridors connect the whole of these offices with the male and female wards. The workshops and range of laundry buildings stand on each side of these offices, and between them and the receding wings of the asylum. Each faces a yard 200 feet long by 90 feet wide. drive and entrance gates to the asylum. The asylum is situated in the parish of Bracebridge, The block of buildings in the artizan's court comon what was once the Ermin street of the Romans, prises the brewhouse, shoemaker's, tailor's, upholsterand more recently the great north road, but now in er's, carpenter's, and plumber's shops, the gardener's railway times little more than a broad bye-way, which tool house, a lavatory and shoe room for patients is only disturbed from its habitual somnolence by the coming in from field labour, and the dead house and hebdomadal bustle of a market day. The estate, com- post mortem room. The engineer's lodge is also atprising, as stated, forty-five acres, is at the commence-tached, but has an aspect commanding the carriage of the Lincoln Heath (now enclosed throughout and covered with productive farms), and consists of rich loam with a large admixture of decomposed oolite and a trifling quantity of sand lying on a subsoil of loose porous rammil, and succeeded by several beds of oolite, many of which have been found excellent for building purposes. At the depth of twenty-seven feet from the surface the great stratum of blue lias is met with. The natural drainage is consequently complete, and this in connection with the elevated position of the site renders it at once healthful and advantageous for agricultural purposes. The laundry buildings consist of a foul-linen washhouse and drying closet, successively followed by a room for sorting all linen as it comes from the wards the ordinary washhouse, drying and airing closets, laundry, and clean linen sorting room. The boiler room and engine house are in close proximity to the washhouses, and correspond externally with the engineer's lodge. A covered way connects these buildings with the corridor of communication on the female's side. The drying yard is of the same dimensions as the artizans' court, viz. 200 feet by 90 feet. the cooking pans in the kitchen, and the warming of linen and clothing stores, is effected by steam pipes. Deducting about fifteen acres covered by the build- The supply of hot water to the washhouses, the ings, airing courts, plantations, roads, &c., there re-heating of the coppers and drying closets, as well as of main about thirty acres available for husbandry, nearly the whole of which have already been brought under cultivation. The spade has been applied to ten acres, The wards vary in length from 125 feet to 175 feet, and a large amount of labour expended in clearing and are 12 feet 6 inches in height. They are light the estate from foul and rank weeds which had accu- and cheerful, and constructed so as to be fireproof, the mulated on its surface during the six years of neglect wooden floors and furniture being the only parts of which had preceded the purchase of it by the magis-them that could be damaged by fire. Care was taken trates. The same amount of labour on land already cleared would almost suffice to drive away the plough altogether, and it is anticipated that this will ultimately be effected. from the first that each ward should be complete in The Each of the two wards in the first wing The block of building, as shown on the plan, is placed facing the south, and with the airing courts and yards covers an area of about seven acres. plain Italian style is carried throughout the building and its appurtenances. It is of chopped stone quarried on the spot, with 'dressings' of Ancaster stone, and is abundantly lighted and cheerful in all its aspects, but free from any costly enrichment. The central building (the extent of which is shown on the plan by dotted lines) is projected backwards into offices, and has on either side two extended wings and one receding wing, containing five wards. By this arrangement four out of the six airing courts have the advantage of The receding wing, of which the ground-floor only has been built, is 175 feet in length, and contains 24 patients, all of whom sleep in single rooms. This ward is provided with a padded room, and four double doored rooms, and has a large bay open to the gallery ture of the wards are of wood; the mattresses of in place of the ordinary day room. horse-hair for the patients generally, with about a dozen stuffed with cocoa-nut fibre for wet cases ; the services for the meals are of white crockeryware; and round ended knives with white metal forks are used by all who are capable of handling them. The whole of the wards are cased with brick to ensure warmth and freedom from dampness, which is prone to work its way through the oolite of which the building is mainly constructed. The ceilings are of arched hollow hexagonal brickwork, of a warm red tint in the galleries and day rooms, and whitewashed in the sleeping rooms. The window frames are everywhere of iron, opening in the front of the wards on Harwood's principle, and in the back on a simple and effective plan introduced by the builder. They have both been found to combine security with facility of ventilation. Price's system of warming by hot-water circulation has been adopted, and answers extremely well; but it is limited to the single rooms and galleries, open fire places having been considered preferable for the day rooms, dormitories, lavatories, &c. The ventilation is on the principle of ascending currents through flues opening from the ceiling of every room and closet in the wards, and converging into two extracting shafts, one of which is placed at the junction of the three wings on each side of the asylum. Gas is supplied to the wards by two services, one of which is connected with the lights intended to burn only until bed time, and the other with the night lights in the galleries and dormitories. As an additional security to that furnished by the night-watch, the attendant's bed room is placed between two of the dormitories, from which it is only separated by a swing door with perforated zinc panels, and the under attendant sleeps with the most tranquil patients in the third dormitory. In the farm buildings are stalls for ten cows, sties and yard-room for about forty pigs, stables for cart and carriage horses, coach house, cart shed, granary, &c., all of which are arranged in the most improved method. They are placed with the gas works at the north-east corner of the grounds, and are under the management of a bailiff, who with his wife occupies the entrance lodge. Report on the Establishment, Construction, and Organization, of the best Asylums for the Insane in France and elsewhere. Presented to the Committee of the States of Jersey, &c., by D. H. Van Leeuwen, M.D., formerly Physician of the Asylum at Meerenberg, North Holland. Rapport sur la Fondation, la Construction, l'Organization, &c., &c. This is a very valuable Report, and will repay the study of all interested in the proper management of the insane. We make the following extracts on the important subject of what the writer appropriately designates the medico-moral treatment of insanity. * * * * * * "The necessity for what we have now called the medico-moral treatment of insanity, as established by experience, will be much better understood if we consider, that amongst the determining causes of insanity, The bath-room, lavatory, sink-room, and water the most frequent and the most powerful are moral closets are brought together in one block for the pur- disturbances; and above all the excitement of the pose of facilitating the drainage, and sending the passions. "At all times," says Cerise, 66 when we waste water through the water closet drains; the have been able to trace to its source a case of insanity, scullery is placed nearer to the day-room, and is used we have almost always found a vicious propensity, a solely for cleaning the crockery of the ward, while disordered passion." Every thing which leads a man the sink room is used for a repository for brooms, to extremes in his moral and social position, every pails, &c., and to draw and throw away the water used thing which leads to excess in his affections, his dein scrubbing floors. This arrangement prevents a sires, his thoughts, his actions, tends to insanity. The common abuse of the scullery and closet, and does man of genius and the man of weak mind, how often much to preserve a wholesome atmosphere. The bath- do they not both diverge into extravagance and eccenroom opens out of the lavatory, which at the usual tricity; eccentricity itself how often is it not a moral bathing time serves as a dressing room, and is pro-mania for life ? vided with a fire-place for use during the winter "Moral insanity consists essentially in a morbid permonths. Hot and cold water are laid in to all the version "of the natural instincts and feelings, the ward-taps, and in the case of the lavatory pendulum- affections, the inclinations, the habits, the temper,—in taps have been employed in lieu of those acting by a short, of the whole moral nature and character,” and spring, which are so liable to get out of repair. The furnishes to legal medicine a large proportion of cases baths are of enamelled copper, and placed in the room of homicide, which often cause much difficulty in with the foot against the wall, so as to leave the head courts of law. and both sides free for the attendants while bathing the patients. This simple arrangement obviates all the inconveniences which are prone to arise in bathing infirm, invalid, or obstinate patients. The closets all act from the seat, a plan which was not adopted from preference to that of action from the door, but with a view to an economical use of water. In the men's closets are placed urinals with self-acting flushers, which can be regulated to flush at longer or shorter intervals as may be required. * * 66 * "We thus see, that by the medico-moral treatment of the insane must be understood a combination of hygienic, moral and social means, fitted to act on the general health of the afflicted, and to improve their moral condition, by influencing their feelings, affections, habits, and inclinations, by opposing to disorderly, headstrong, or vicious propensities, more tranquil dispositions, and improved habits, and by substituting other ideas for those which agitate them; in order to lead them to regain by degrees the position The bedsteads, and, indeed, the whole of the furni- from whence they have fallen, their moral liberty, |