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To the Trustees of the Butler Hospital for the Insane

GENTLEMEN -- A detailed account of the various institutions in Europe, visited by me in your behalf, with the hope of adding the most recent improvements to the construction of the "Butler Hospital for the Insane," might be of adequate interest to those, who, like yourselves, have a direct and immediate concern in this class of charities. I feel however that I can better present the practical results of my observations by generalizing the facts acquired, with perhaps an occasional reference to particular institutions, to illustrate specific points.

Most of my available information has been drawn from the English and Scotch hospitals. Those on the continent, as far as I saw or could learn from reliable sources, however recent, costly, or well designed as regards their own citizens, had few points of a general kind, capable of being transferred to communities differing so entirely in social habits and ideas of comfort and convenience as ours.

The British institutions as respects architectural construction may fairly be divided into two classes, as built within the last ten or a dozen years, or previous to that date. The older ones have often, indeed generally, felt the influence of that intense interest and impetus, which has existed in England for the few last years as regards provision for the insane, and have been modified and improved as far as the original faults of construction would permit. Many have been recently abandoned for the insane, by being disposed of for almshouses and other purposes, and if there should be no abatement of the present discriminating and effective zeal, it is probable many others will meet the same fate.

The older class of institutions usually had their location within the limits of a populous town or city, and were surrounded by a high fence, which did not prevent the grounds from being overlooked by houses. The land consisted at most of a few acres; the airing courts were necessarily small and dark, and little free exercise in a pure atmosphere attainable to the great body of inmates. The buildings from the same paucity of land were thrown into four stories, considering the high basement as one, and of these the common mode of internal division was not unlike that in most common use with us. A central house contains the departments for the officers, business offices, more or less of the kitchen and laundry and other domestic conveniences, and the like. A wing proceeds from each end of the house, often overlapping, so as to admit light and air to the long corridor which extends between two ranges of rooms on either side to the distant extremity, where another window is placed. This corrider -sic- rarely exceeds 10 or 12 feet in width, and when the wing is so long as to be incapable of being lighted from the ends, this defect is remedied in part by omitting one or more rooms towards the centre. The window towards the house at the end of the long corridor is usually of little service; and to prevent communication from the opposite wing, occupied by the other sex, it is necessary that it should be kept shut and made opaque. The day-rooms are usually two of the common sleeping apartments made into one, by omitting a partition; another room is divided into halves for the bathing room, and the water closet. Not unfrequently the corridor is the only day-room or place for the usual residence of the patients by day. The attendant's room is any one of the common sleeping rooms, which may be selected, having no advantages as respects inspection by day or night. The corridor has never less than eight, and from this up to five and twenty, rooms on each side, and of course its length is very great as compared with its width. The usual sleeping rooms contain not over 75 superficial feet of floor, and the height varies from 8 to 10 feet.

The general aspect of buildings so constructed, it need not be said to any one who has ever visited them, is exceedingly dark, gloomy, monotonous and barrack-like.

The heating is effected by some variety of furnace in the cellar, which receives its air from outside, and delivers it, when warmed, into the galleries by flues in the brick wall. The ventilation is made by flues opening from the rooms into the attic, from which it escapes by some form of cap or cowl, and whatever change of air occurs, is the result of the difference of gravity between the external and the internal air.

The exterior of most of these edificies -sic- has a plain factory like elevation, the cupola and portico alone having any attempts at ornament, or giving them a public character.

In contrasting these with a later era of insane hospitals in Great Britain, and the same thing is true under a different form of change on the continent, the first great difference which strikes the eye, is the much greater spaciousness of the recent edifices, and the higher degree of external and interior finish and completeness.

This illustrates strongly the prevalence of a principle, which I found every where recognized, and declared as the practical fruit of much of the experience of the institutions, which were brought into existence during the interest following the Parliamentary enquiry thirty years since.