^ . 6760 .iS74 The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924015418019 I ,1. -f i»Vi (k - •ui^BfltffiUMUl I iMN WtflKlWWWUKiW '•i ng«e«a«c»> 'UM«Ma -J, ^, ARCHITECTURAL REVIEW \i ^^ 1:^ 5^ ^ y ^ n SPECIAL HOSPITAL NUMBER THE ADVANCE OF HOSPITAL PLANNING AND EQUIP- MENT DURING THE LAST THIRTY YEARS THREE USEFUL TYPES OF GENERAL HOSPITAL PLANS W&ISSSk i>>}>XS>)))Bs^H»B3SDiioN of Modern Hos- pital Practice, witJi Forty-four IJJa(.''T Wai; Housino , Part VI 85 T]ie Neil' Policies of the 8]tip[iiiif/ Board. Editoeial Comment 86 REGULAR PLATES Title Architect Plate Decatue & Macon Co. Hospital, Decatue, III.. .RicJiard F. Hchnhidt, XLVII, Photographic Inierior Vieics, etc. (see also Garden & Martin XLIX, pacjcs 62-65 for exterior and floor plans). LV, LXXII CiiiCAoo Lying-in Hospital, Chicago, III RicJiard F. Srhniidt,. . . .XLVII, Photographic Interior Views (seepage 61 for Garden £ Martin XLVIII, viei.v of Exterior). L, LI Massachusetts Homeopathic Hospital (Rob-. .Kendall, Taijlor & (Jo.. .XLVIII, iN'sow [Memorial Building), Boston, Mass. LII, Photographic Views of hilerior. LIV, LV Watts Hospital, Dueham, IS. C Kendall, Taijlor & Go XLIX View of Operating Room. Ben.jamin Stickney Cable Mejnioeial Hos- pital, Ipswich, Mass Edward F. Stevens. .L, LIII, LIV Interior Photographic Views. Feeedmen's Hospital, Washington, V). C John Russell Pope. . .' LI, Photograp)hic Views. £■ J. II. de Sibour LXIX-LXXI EiiODE Island Hospital, Providence, R. I Kendall, Taijlor S Co LIII Balceshop. Union Benevolent Association Hospital, Grand Rapids, Mich York d- Sawyer LVI-LXI Photographic General Fxlerior and Detail Vieu's and Floor Plans. Gaby General Hospital, Gary, Ind Richard E. Schmidt LXI- Floor Plans, WorJiing Draivings, Details, and Garden. £ Martin LXVII Perspective View. Sanitorium Gabriels, Gabriels, N. Y John Russell Pope LXVIII Birds' Eye Perspective and Plot Plan. Symmf.s Hospital, Arlington, Mass , .Kendall. Taylor d- Co. ...LXXII- Photographs of Main Building and Nurses' LXXIV Home. The Winchester Hospital, Winchester, Mass. . .Kendall, Taylor & Co. . . .LXXV Exterior Photographic Views. PUBLISHED MONTHLY BY THE ARCHITECTURAL REVIEW COMPANY, 681 FIFTH AVENUE, NEW YORK Xll •THE -AP^CHITEC JURAL- B^V IE W- ,. .......................... ^^ y y, yy, ^w .y yy yy ^ |,^^^ Lemper lesiinj^ How preveniea 1^1 I m m BOILERS, like children, have cer- tain tendencies for good and bad. With boilers one of the most trying is sand hole leaks. They show up when you least expect them. Gener- ally on carefully chosen zero nights. Just before going to bed, you take a last look at the fire, and find the boiler giving an imitation of an open faucet. Punctuated phone appeals to the boiler man fail to stir his lethargy. Tells you he'll "be around in the morning ". Follows an oil siege, waiting for new parts. stove We figure that finding leaks is up to us. That's why every Burnham Boiler section is given an hydraulic pressure test, three times higher than it will have to stand in actual use. We believe it is better business to pay for prevention than to "sell re- pairs . Which ends Chat Number Nine, of which there are eight more to follow. ^■%^ % ■^^ ;■%•: f'4 Pi I ft-'i ord> Burnhamlp. Irvington, N. Y. Representatives in AU Principal Cities •THE'AR.CHITECTUKAL-I^^V1EW- PUBLICATION •OFFICES- 144-CONGRESS ST.B05T0N WITH- •THE -PUBLISHERS- J EDITORIALLY speak- ing, we rarely recall ail issue that we have regarded as so valuable and indispensable to all members of the profession as that to which these words serve as an introduction. jSTot only should it be invaluable to those architects whose prac- tice now, or in the future, will have to do with hospital construction, because of the great number of essential and up-to-date details that it contains, — but these details are also, in essence, exactly those which should be fol- lowed, wherever possible, in the service portion of any modern and up-to-date dwell- 1 ADVERTISING •OFFICER- 681-FIFTH-AVE NEW-YORK While we ordinarily regard it as a special duty to concern ourselves particularly with the aesthetics associated with the practice of architecture — this being the particular standard of ideals most eas- ily suffering deterioration in the constant grind of every day practice — we neverthe- less profess all due admira- tion and respect for those practical bases upon which the successful practice of architecture is founded. Only we too rarely dis- cover a subject— and an author — capable of develop- ing the practical side of the profession in that way which we believe alone repays us in undertaking its publication. One of these subjects is "The Busi- ness of Architecture" ; another is presented by the whole problem of Hospital Design and Construction. Ill the rapid march of present day events, this proldem is changing too rapidly, and is already too c/)mplicated, to be completely covered in any single publication, even if of many times the bulk of this issue. N^evertheless, we believe, — and with enthus- iasm — that, so far as its limits make possilile, this number contains material of indispensable value to every architect who is now or will later come into actual practice. Mr. Schmidt's practical and suggestive text is it- self of such value, that we have been gradually build- ing up the contents of the issue around it, so that the whole number would finally reach our subscrib- ers in the most valuable — and usable — specialized form of an issue devoted to hospital architecture, covering equally tlie branches of plan, design and construc- tion. That intention has, we believe, been not altogether unsuccessfully accomplished ; l)ut the final cachet of in- dispensability has been af- fixed by the profuse text illustrations, drawn and re- produced at a clear and read- able scale, covering all those important and special de- tails recognized as the prin- cipal stock-in-trade of the hospital specialist in archi- tecture. The y summarize and record the large expe- rience of the firm of Rich- ard E. Schmidt, Garden, and Martin, — while they further exemplify what arc, in essence, the hest prece- dents of standardization, of practice, of simplicity, of cleanliness, and ease of main- tenance, for any structure of whatever kind. By comparison, the regu- lar "departments," also in- cluded in this number, come, we believe for once, distinct- ly under the vernacular clas- sification of "they also ran !" Although the subject of this number is capable of almost limitless expansion, K'e believe its present value will reside largely in the careful selection of the material, — which thus enables us to ])resent it in the most liighly concen- trated and useful fV)rni. Mr. Hill's short article touches on salient points of interest in the three types of hospital plan he has selected from the work of Kendall, Taylor & Co., because they represent those kinds of hospitals most needed and most in demand the country over. While all are of the "general utility" type, two are specially adapted to the small town or suburb; the third provides a larger and more compact structure, fitted to a nioix' crdwded city district. ^Vnother plan portrays a large occupational tuber- culosis sanitarium ; another meets the needs of a large community, such as the ]\Iacon County Hospital, and both are devised for ultimate expansion from these central units. The larger and more imposing group is represented by the Freedmen's Hospital, and, finally, the completely developed specialized and dignified type is represented by the hospital by York & Sawyer at Grand Rapids, Mich. rrillE government recfu,ir6men.ts im- I posed on all magazines, to tuhich IJie Arclilicctural Review is using crertj patriotic endeavor to conform, are to conserve paper hy the ohvious expedient of cutting down the numher of copies jirinted hy all American publications. It is perhaps not so devious to the suhscriher, lioirerer, tit at tJiis directly li^nits the num,- her of copies printed beyond those exactly sufficient to meet the absolute svdj scrip lion list! This literally means it will be im- possiBLTC for him later to obtain numbers uow missed by omitting to renew his sub- scription. Burh an issue as tJiis luill he irreplace- able, if not secured immediately after puhlicaiion; and as all the issues of the Architeciural Preview continue to be edited ahnnst entirely witli tlie purpose of mail- ing tliem of as great peejianknt useful- 7iess and value to our subscribers as pos- sible, ve venture thus to call attention to their necessity to Jicep their subscriptions continually in force, as tlie government requirements also malce it compidsory for tlie pmblishers to print only enough copies to suppli/ tlie PAID ITP .subscription list, and to discontinue sending magazines to snhscrihers immediately tlieir subscrip)- tion expires! XIV •TH£-AI^CH1TECTUKAL-R£VIEW' SIDE DOOR THE WHEELER HOUSE at Orford New Hampshire It is believed that this house — a full front view of which was shown in Vol. 2, No. 3 of the Monographs — was designed by Bulfinch. w HAT NEED is tliere to enter into superlatives and eulogies on ^V^HiTE Pine Representing The Northern Pine Manufacturers* Association of Minnesota, Wisconsin and Michigan, and The Associated White Pine Manufacturers of Idaho when the camera records the story so graphically and truthfully — and withal, so convincingly. "An hundred years are but as yesterday" in the life of this wood. Nature is giving it the same qualities today that she gave it in the Colonial and Georgian periods of American Architecture. Address JFHITE PINE BUREAU, IQ42 Merchants Bank Building, St. Paul, Minn. ._> Cf6e ARCHITECTURAL P£VIEW Volume VII Old Series Vol. XXIV OCTOBEPcl918 Number 4 THE ADVANCE OF HOSPITAL PLANNING AND EQUIP- MENT DURING THE LAST THIRTY YEARS By RICHARD E. SCHMIDT A// text dratviyigs of Hospital Details f?-om work of Rieharel E. Schmidt, Garden & Mai tin, Architeets THOSE developments that have occurred in the phmning and detailing of hospitals dur- ing the last thirty years — and most im- {iroN'ements that are of any interest to us now have been made during that period — lun'e not auxiliaries to the wards, and in the pro\'isions for a variety of treatments and examinations of the patients and diseases, than in any remarkalile change or improvement in the planning or arrange- ment of the building itself. The different types happened at any sharply deiined inter\-als, but of plans, such as the block, the pavilion, cottage, tliey can nevertheless be allotted fairly dctinitely connected pavilions, etc., were devised and tried, to its three principal decades. That is, it can at and their respective faults and virtues were least be said tjhat different general features appear known, prior to the late eighties of the nineteenth to have predominated in the planning of hospitals century; and all of tliern arc still in use, but a jiarticular type is rarely adopt- ed today for the whole in- stitution, a n d certainly no one type greatly pre- dominates. The lines which strictly d e m a r k the types have now been partially obliterated i n most plans, and a combination of the best fea- tures of several types instead has been gene- rally attempted. Formerly, the nou- or slow re- covery f pa- tients was often blamed on the evils thought to be due to faulty ]ilauuiug; b u t 6i m these three periods, — but they a r e only roiighly classiti- al)le, for there w ere pioneers and laggards in the use of each feature ; some hospitals were m a n y years ahead of others, while quite as many more were themselves ac- tually built well after the time in which their vlmninant fea- tures f plan- ning were most generally in use. The develop- ments w h i c h have taken place during this time have been consistent- ly greatest in the numlier of ^ Li "3^^S Fig. I. Chicago Lying-In Hospital, Chicago, 111. Richard E. Schmidt, Garden & Martin, Architects Copyright, iQiS, hy I'lic Aychiieciiiral Reviezv Company •THE-AP^CHlTECTURAL-RiVlEW- today such poor results are rarely laid to the ar- rangement of a building, — and there are equally good records of recovery, in point of time and de- gree, in hospitals of wide- ly differing floor plans, in which the same principles govern the general design and in which the hospital technique are equal, — wherever the importance of the orientation of wards, with an attending abun- dance of simlight, air, cheerfulness, pleasant sur- roundings, window outlook, coloring of wards, orna- mentation, artificial illum- ination, access to and pro- visions for outdoor and part time open air sojourn are understood and pro- □ MAIN KITCHEN □pimo arrTTTi o CHEN SeE-VICE COR.IL10OB- i VACUL»«1 60ILEE. (/ LAUNPLY tOOM PLAN )ECATUK- ^'s-'ytUCofrcOUNTY H05PITAL DE-CATUB. ILL1H0I5 transported a short distance from home or shop to the hospital ; relatives and friends could call con- veniently; and the surgeon or physician woTild lose a minimum of time in traveling to and from his case, or could arrive quiclvly when an emer- gency required it, — but all of this has since been changed by improvements in public service trans- portation, such as the trolley lines, elevated railroads and subways, and especially the gasoline-driven automobile. These have per- mitted the use of . EMEE-QENCY i-DE.ESS)Mq. R.A\. NuesES omiHC tooA COCtl OOli. lud. vided. All of the most de- s i r a b 1 e arrangements can no doubt be ob- tained in any of the several types, and it is now recognized that a type which is best suit- able for one location or treatment may not be equally suitable or de- sirable for another. 1 1 ■ n AOtOUE 1 HALL r^ M 1 P^HOlpfllCAl. f ra JANITOtS 5T0R.E tOOM cheaper property, with a consequence that hospital trustees can now afford to buy large areas, furnish- ing spacious grounds and permitting the construction of lower and larger groups of buildings. First aid emergency hospitals and the company hospital — now a part of almost every large manufacturing establishment — have also helped to make possible the build- ing of general hospitals at distant locations and among pleasant and healthful surround- BA5EMENT PLAN In recent years, the public has learned that a hospital is the best place for the sick and injured; better than- the average home, — and that the hospital is neither a penal in- ..=.,r..Tj ,;. p. .y..=.. ... ,.,„.i^.. stitution nor a reformatory. Not many years Reproduced at thwtv-two feet to the inch • i i • ^•-^'■'.j j^ai^a dency towards many pjg 2. Basement Floor Plan, Decatur & P'ist, it iias been considered almost degrading storied hospitals, f ol- Macon County Hospital, Decatur, 111. to 1)0 sciit to a hospital, — and this idea proli- lowing the development of high office buildings, ably helped in the former general view that such About twenty jears^ E'^","^^^. ?Ef/.J^^-J.?^K?r.„"^°SPlTAL ago, there was a ten- on account of the high cost of centrally located property. For tlie same reason the block plan appeared to be in the ascendency. In speaking of a "block plan" in this instance, a crowding to- gether of rooms and spaces is meant, with a minimum of light and exterior exposure. At that time, it was considered necessary to have every an institution must have the appearance of a re- formatury, with whitewashed walls, and remain absolutely barren of everything which would be pleasant to the senses. The use of judiciously selected color decora- tion, the reduction of the number of beds in the wards, the tendency to increase the proportion of hospital in the most densely populated portions single-bed wards, and the introduction of many of cities, in order to be close to tlie source of their home accommodations, are probably the greater wf)rk, — so that pntients wouhl only have to be improvements that have thus far been made in 62 •THE-AP^CH1TECTUP.AL-RXVIEW' helping to overcome that prejudice, and they have been more developed in recent years than any other one addition to, or constitnent element of, the hospital strnctnre. ]\rany hospitals were designed with an exteiiiled periphery, in the form of projecting hays, fur- nishing the largest possihk^ exterior wall and win- dow surface, an ahundance of sunlight and air; hut extensive warmed air supjily de\ices were in- stalled, with the intention of keeping all windows closed in all weather conditions except the mild- est, thereliy indicating that the I'eal reasons, or, at least, those accepted today for building an ex- tensive periphery, were not then ap- preciated. In 1SS7 f e w hospitals contained special separate rooms or accom- modations for the many necessary spaces re- quired for good housekeeping; utensils for the patient were kept with mops and brooms; linen and medicine with patients" clothing, carts and wheel chaii's. These acconinioda- tidus have been gradually added, so that a modern hospital now has s])ecial and sepa- rate places for evei'ything the ])atients bring to the hospital, as well as f(n' ex'cr^'thing that is required for his or her comfort, winter or summer; for treatment, excretions, analyses, records and supervision. At that time (about thirty years ago) there was hardly a hospital in which supervising nurses stations had been planned, — it is true there were chai't rooms ; but they were not then placed as they are today, in locations where the .suiier\'ising or floor nurse can o\'ersee the entire sta- tion ; a, ]dace where the nurses, tlie medicines, I'ec- ords and the signals of ]iatients ai'c all centered. Idle nurses wrap locker I'oom, toilet, rest i-ooms, bath, and lockers for E FKLST FLOOR. PLAN DECATUL ■^V'jtlACQN COUNTY HOSPITAL DECATUfL Rcf'rodiiced at thirty-two feet to tlic Fig. 3. First Floor Plan Iti ch connection is olfered 11, which pavilion of spital that was considei'ed c m- plete thirty years ago, and h'ig. 12, taken from a more recent and mod- ern design. It will at once he apparent that, while the ward area re- nmins substantially un- Fig. 4. Exterior View from South-east, Decatur Qc Macon County Hospital, Decatur, III. Richard E. Schmidt, Garden &C Martin, Architects 63 •THE'APoCHlTECTUPvAL-RJLVlEW- ehanped, there lias been a ft-reat iiierease in the aiiioiuit of space occupied by the anx- iliarv couveriieiices fni' the ]>atieiits' treatiueiit and care. Efficiency in operation for the patient's benefit lias Im^cii continnonsly improved li y niore thought lieini^' i:i\'en to ]iro\ddiiiii' food in a more attrai-ti\'e and pahital)le con- IJ C Li D I. I — I " PRIVATE CM ' PflVATF Ptl ^ ' PCIVATE tM 1 H I I PRIVATE PRIVATE U PEIVATE H« -SUPPLY m E IPlilVAT.E t* ^ ditiou, due to lietter and quicl^er deli\-ery frtmi tlie kitchen to the bed- side. Electricity has helped greatly in this respect by the introduc- tion of automatic ma- idiinery, such as push button dumb waiters. Fn these matters, and in other new arrauire- co^ti Dot:. PfJVATE Hft. PP.IVATE W PEIVATE tit PFJVATE (U. PPIVATE 1L*1 ments, the general advances in the equipnieiit of hotels, apartment houses, and in all other classes of buildings, have been quickly adopted and adaptei] t(j conform to hospital re<]uire- nients, --while many other items of inipro\'ed e(pii[>ni('nt ha\(' beiai especially devised by hof^- pital designers. For signalling from the ])atient to a corri- do]-, a cord wire with a. pear ])ush at the bed- side, connected to an old fashioned au- niniciator, was considered a wonderful impr(j\-ement i u signalling in the early nineties. Si- 1- r 1 liti ^^'"t I'S^'* signals I I I I t"'^ came next ; then a development o f these, ha\'ing lights located at several places and operated by the same switch, and today the patient can signify his want to the supervising sta- tion, and as many supervisory general stations as may be desired, I)y flashing words, such as '"Xurse," "water," "bed 3 SECOND FLOOL PLAN DECATUL^'& «ACON COUNTY HOSPITAL DECATUK., ILLINOIS Rrl'fuhiccd at thirty-two feel to Ihc inch Fig. 5. Second Floor Plan »a tLevATjoN or- Clean Dish CowTe-e.. Cec^e/^T ELECTeiC I?i5H v/A5H&5e- 1 MODE-L £-■ -4 Bpat AT 1W3 PoirtT ""'V -I- i^> H 3^ r^ PLA>) or CLCAM Pliff COTOTEii ,i; IJ2 +j^i Cj^UCtE V9j^*^ TLeVAtlO^t or SolLfD D35H OD0/THE-AR.CHlTECTUIV^L-fVEVlEW- VOL. VII, No. 4 PLATE LV TEN BED WARD, DECATUR & MACON COUNTY HOSPITAL, DECATUR, ILL. RICHARD E. SCHMIDT, GARDEN Si MARTIN, ARCHITECTS TYPICAL GENERAL WARD, ROBINSON MEMORIAL, MASSACHUSETTS HOMEOPATHIC HOSPITAL, BOSTON KENDALL, TAYLOR a: CO., ARCHITECTS •THE •AR.CHITEC JURAL- REVIEW' VOL. VII, No. 4 PLATE LVI GENERAL VIEW FROM SOUTH-WEST DETAIL OF BRICK LOGGIAS ON SOUTH THE UNION BENEVOLENT ASSOCIATION HOSPITAL, GRAND RAPIDS, MICH. YORK ec SAWYER, ARCHITECTS •THE -AP^CHITEC JURAL- PviVlEW- VOL, VII, No. 4 DETAIL OF NORTH ENTRANCE PORCH DETAIL OF PORTE-COCHERE DETAIL OF ENTRANCE PORCI I THE UNION BENEVOLENT ASSOCIATION HOSPITAL, GRAND RAPIDS, MICH. YORK Si SAWYER, ARCHITECTS •TH E-AR.C HI TEC TUKAL- REVIEW- VOL. VII, No. 4 PLATE LVIII _1 n n UK E X C,A\-AT ED D P PLAN OF 5UB-eA5EMENT UNION BENEVOLENT A:50CIAT10N H05P1TAL' GRAND RAP 1 D5 • M IC H 1 G AN SCAIL-- ■ ? i 'hi ?'— i -^ YOR^ AND 5A\f^YER.^ AliL.HIT tCTi 1 COAL R-OOM SUB-BASEMENT PLAN Rrfr.xiuccl al the scale of thirty-lwn feet to llie BASEMENT PLAN FLOOR PLANS, UNION BENEVOLENT ASSOCIATION HOSPITAL, GRAND RAPIDS, MICH. YORK a: SAWYER, ARCHITECTS •THE -AP^C HITECT URAL- K£ VIEW- VOL. VII, No. 4 PLATE LX THIRD FLOOR PLAN YOR.K. AND _^AWY[R.-ARCHntCTi ■ Rctnnhiccd ill tliL- sfiilc of thiiiy-l-.v feet lo ihc inch FOURTH FLOOR PLAN FLOOR PLANS, UNION BENEVOLENT ASSOCIATION HOSPITAL, GRAND RAPIDS, MICH. YORK a; SAWYER, ARCHITECTS •THE-AFLCHITECTUKALRJLVIEW- VOL. VII, No. 4 PLATE LXI YORK. AND LAWYER.- .ARCHITLCT5 FIFTH FLOOR PLAN' UNION BENEVOLENT ASSOCIATION HOSPITAL, GRAND RAPIDS, MICH. YORK a: SAWYER, ARCHITECTS Rel'i-oduicil at III,- scaU- of lliirty-hvo feet to the inch PERSPECTIVE VIEW GARY GENERAL HOSPITAL, GARY, IND. RICHARD E. SCHMIDT, GARDEN & MARTIN, ARCHITECTS 2 < > :z3 h U h r u < o > > I 1-- tij > m h < a. (J > -J h u h r u < r o > > h < > H U H u < 1-1 o > > h U h r u < r o > <" 2 H < I Q Z >-i 2 rr^ H 7. < < 2 J « < -< H Z [11 a. Q u rn Q 7, m J n < rn 2 u f/1 UJ a tu >^ Q u <■ < I o y 2 " ^»*, ' ' ■f. r\/ -1 "^ X X > H U w h U < r h o > h u Q Z o H O z X o ^ '/X t < ai D O < H K O X z m S Q to M tL ta X H X X ui h > H U H r o < ^ VOL, VII. No, 4 •THE-AP^CHITECTUI\AL-RXV1EW- PLATE LXXT DETAIL OF ENTRANCE THE FREEDMEN'S HOSPITAL, WASHINGTON, D. C. JOHN RUSSELL POPE; J. H. DE SIBOUR, ASSOCIATE, ARCHITECTS < > 13 u h r u < o CO to D ca Z < 2 u < d u < < Q Z h 'i'' , u / w . » '^HH z O u D H Z rn ji3H O Z Q c; < < r'HKI^^^H u U O itjw'im < <1- tu S3 2 Q n 'A Q *( ?, oi u ^ i^- ^ D 1/1 H [rl 1 ', * < Q ♦ ' U LU Q < X u ■» ' • '^ : a: */. •' , ■:^ f. r :,:' VOL. VII. No. •TH E • AR.C H 1 TE C T U I\AL- ru::V 1 E W- PLATE LXXIII GENERAL VIEW, MAIN BUILDING FRONT OF NURSES' HOME SYMMES HOSPITAL, ARLINGTON, MASS. KENDALL, TAYLOR ec CO., ARCHITECTS •THE-AR.CHITECTUI\.\L-PJ^VIEW- VOL. Vn, No. 4 i'latf; lxxiv VIEW OF BALCONY. NURSES' HOME REAR OF NURSES' HOME SYMMES HOSPITAL, ARLINGTON, MASS. KENDALL, TAYLOR & CO., ARCHITECTS VOL. VII, No. 4 •TH E'AR.C HI TEC TUI\AL- REVIEW- PLATE LXXV GENERAL VIEW DETAIL OF ENTRANCE VIEW AT REAR THE WINCHESTER HOSPITAL, WINCHESTER, MASS. KENDALL, TAYLOR at CO., ARCHITECTS •THE • APoC H ITE C T UKAL- RX V 1 E W- ifniL an t u ZI I 1 BED e*n „ pan," "remove," etc. At that time artificial illumination was wbol]^' by exposed lights, which were annoying to the patient; indirect ceiling ilinni- ination, which was tii'st nsed aho\it tifteen years ago, was only less so, — while today we have all the ari'ange- ments for concealed wall, base and floor box lighting for night nse. Mechanical ventilation, i.e., the introduction of fi'esli warmed air fans and dnets. was considered a b s o Inte necessity in the best buildings of a bout twenty years ago. The inlets and outlets were dis- tributed with great care in the en- deavor to make the movement of air practically unnoticeable, and those buildings in which this arrangement was most successful were considered perfect in respect to air conditions and the health and comfort of the occupants in all seasons. Heating by direct radiation was not considered proper, unless pos- sibly by the use of low pressure ^ecatul ^s^m^acon county hospital hot water systems, used as an anx iliar^- to the heated air sujaply I Hie ineli. Peleils ul one on, I one-luilf iiuhes lo llie fool Fig. 9. Standard Details, Infants' Dressing Table in Nursery 65 • T H £ • A P^C H I T E C T U I\A L • RX V 1 E W • At ;il)r)iit the same time, some duc dis- coN'ered that patients a 11 (1 other persons were in a ha})pier state of miml wlieii tliey eoiild feel mov- ing air. We all ap- preeiate that we are more eomfortahle in a mild hreeze in warm weather than in still air; also that we are more eom- fortahle i n moving air, although it may be slightly tainted than in motionless good air. The writer does not know if the psychology of this discovery h a s heen fi\lly explained, hut it already appears to he so sufficiently I'cal- ized that it has in- fluenced luany build- ing erjmniittees i n the omission of elab- orate heating and ventilating apparatus return to a sim]der arrangement. The complaints of the occupants of buildings equipped with elal)r)rate heating and \-entilating devices, a n d the n e ^\■ knowledge of a i r effects, ha\'e also bee n the cause for a return to the use of win- dow ^'entila- tion, heating Ijy means of ordinary ra- rNursCi, Toilet: and diation and the in- stallation of electric outlets at numerous }ioints in ceiling and walls for the connec- tion of portable elec- tric fans. The use of larger pieces of property, better planning, adc- (juate fenestration, the improvement in steam heating, — such as \'acumn and mod- ulating systems with the attemling lower temperatures in ra- diators — and the dis- covei'v by the public that the little danger there is in cold air can be minimized by ordinary means, has radically affected the methods of ventilat- ing hospitals. Special arrange- ments for the intro- iluction and diffusion causing appreciable or generally favored. They consist of glazed transoms, small transom panels or louvres, ^\■bi(dl introduce the air into the room at some dis- tance from the patient, jjermitting it also to b e t e m p e red either by mixing with the warmed air already in room or by passing over radiators. Corridor. Benjamin Stickney Cable Memorial Hospital, Ipswich, Mass. Edward F. Stevens, Architect without of outdoor air anno\'ino' risk. .N^ow that almost every hosjiital is also a train- hig school for nurses, the necessary means for the education ni these students has added several re(|uirements to the phuining of a hospital, — such as lecture rooms, lal)oratories, teaching kitchens, etc., while a separate building foi- a Xursr>s' Home has become a \'ery necessary part of e\'ery hos- pital groui:i. The management of hos})itals is now generally conducted on ordinary bnsii;css princi]iles in the buying and distribution of all kinds of supplies, so that no modern hospital is witliout store I'ooms in charge of stoi'c kee|)ei's: clothing I'ooms in charge of a tailor; general store rooms for the linen su|)ply, in charge of a seamstress, and a sys- tem of daily sup])lies disti'ibute stores ])nrtmeiits 3rt.v':fc;.v..'".'.™tli(' disposal iind of aiiyiiiie. Pi-iictice in t li e arrangiii!;- of the upe- rating department has not become settled for some authorities still prefer to have t h e 1 )octnrs" w ash- u p rooms c o n- uected to the o p e r a t ing rooms, a n d others prefer to lia^'C the anaesthetiz- )f linen in all de- were formerly at the mercy Plan sttow)N&.ANrtfoEi«o or. -PCAWA STtrl, «C/ADtE6 Rrl'i irEO/lT ExrVATIO/"! Of e foot 'DRA.CX.rT sr- tTLnyATio/i i "ll niEtC INCtt iCALC MIV HJLL 5izr DCTAiLS or APJU1TA6LC WOOD 5nrLVl/!Ci Reproduced at three-qnar. ters inch to the foot Fig. 15. Section Through Adjustable Wood Shelving cupy these lo- cations. Formerly, n ij accommo- dations were provided for the conven- ience of the opera ting nurses. T o- day, 1 a r g e pleasant work rooms for the p r e pa rat ion f operating s u p p 1 i e s. dress in g and toilet rooms for the assis- tants, and lief o])erat- ' 'ed ill all ill! (iffice for till ing nurse are \) operating dejiartments. ddie operating department shown in Fig. 17 was con- sidered a model at the time wdicii it was huilt, i]i the 68 d at three inches to th Fig. i6. Details, Adjustable Wood Shelving middle of the nineties. The arrange- ment shown in Fig. 18 is a modern arrangement for a moderate sized, but not an elaborately finished or equipped, hos])ital operating department. Fig. 10 illustrates an arrangement of waiting room, andnilance entrance and ele\'ators, which is designed to screen the operation and service of the hospital from the sciaitiny of visitors or the curious, by separat- ing the working portions from the parts intended for visitors while leld in the waiting rooms or J passing through the building to X "visit sick relatives or friends. Operating Department as commonly Tllis deVelojUnCUt liaS Icd tO tllC installation of sepai'ate corridors and elevators, also special chutes for the immeiliate disposal of soiled linen : the latter device also realizes a means of rapidly conveying soiled linen to the laundry. Considerable study is now given to the prevention of noises, and the deadening of unavoidable noises, by the use of resilient flooring for the most traveled floors, glazed cross cor- ridor partitions, pilasters and arches or beams across long coriddors (Figs. 10 and 39), foundation pads for ma- chines and soundproof vaults for elevator controllers. Social service nurses, who study the history and home conditions of a ease, and ad- vise patients after convales- cence and returning home, are a comparatively new ad- dition to hospital service and they require new oflices, rec- ord and consultation rooms. The technique now in use Reproduced al tlcenty-foiir feel to the inch in the llOSpital treatment of 8. Operating Department for a Modern Hospital * ^1 1 V ^^^„^ ; +' of moderate size commuu icalilc disoascs is ot 1 J. OarridoT- Fatiertts Quarters •THE • AP^C H ITE C T U PsAL- RiV 1 E W' comparatively recent origin and requires considerable space, which niTist be pro- \ided by law in the metro- politan hospitals, and ia very nseful in every hos- pital. Special provision for psj'chopathic and al- coholic cases are also much needed, most particularly in small communities. Provisions for accommo- dating apparatus for the sterilization of water, ope- rating supplies and uten- sils, pathological labora- tories, hydrotherapy, me- chano-therapy and Roent- genology have each brought new problems to the archi- tect, and attending diffi- culties and details in the arrangement of the plan, requiring his solution in an appropriate, ]>roper and Hospital rH^ -}-i.>^ i-™-"^ I'"' ^Sr ^Uit g^ Pit J -^r»Tiow» t>i t5 56C UD H f^-i f^',,-.^- >...-.- I Urn. -4' '^W'.ujJ . S-rooJ, -tL 5HC. K ^ 3BC A^ fLEVATiori sectioa) -L iE3i DETAILS 5CAL-B 3"= l-O" •5CALE DETA"IL5 Of OPEEATlNGj 200M WlMDOW- APPK.OVA,i_ Op AK.CH iTtOT^ £iC.F01tt 6E-C, I N H I N C^ Rciv-(u!ucctJ at four feet to the inch. /'cfail sccliojis at i>uc ami u,ic-half inches to the fool. Fig. 22. Details of Window in Operating Room 70 •THE -AP^CHITECTURAL- REVIEW- C - fAiNTCn lo CVC Top F^tAJL fLfVA-YiO/J i- J-J 1 K u ^ i n'^^it'-l' h" ^ :;e r-RiiiNT E-Lev>^Vrojl J L LG3 "J ' , ib^'lZhhJ till, J m;"?^ :ils(i will not c;nisc ii sliinldW. 11(11- sliunld flic liiilitiiig units lie so iii':ir tlic lic:i(ls of the snr- li'cdiis and nurses tliat any lieat causeil li\' llieni will he l\' with all these conditinns, i'lL ami an a I'raua'enient of tron^lis (•nntaiiiiini liuhtin^; units he- hind prism uhiss set Husli witli i]\(: walls and ceilinLf lias heeii de\'ised hy tlie writer, ami iii- stalle(l in many hospitals with satisfactory results. 'Jdiis ar- ranu'ement is shown in Fias. 21 and 22, and Plate XLTX. Not only lia\'e the coiitinu- nusl\' increasing' jirices of lahor and material in the ]iast thirty yeai-s, the i;eneral selection of fLM THPx. p..v.^R= ^ tii-e resistin- cnnstrHctiom and Kctr.'le, and so arrauLied that they will not cause eyestr.-iin 7 to [)aticnts lyiiiji' in reitals ]ier patient, but the steadily iiieroasiiig requirements for the care ami treatment of patierits tlie n'reatest factor. The average ri- ha\-e tliemse1\'e.s lieeii cnhic eoiitciits per patient has also gradually increased during the three past decades. ,' In hospitals of a moderate size, and e(|ual to the ax-crage 3 tinisli and eipiipment nf that time, the cost ]>er patient ( was slightly more than $l,O00 thirty years ago, ahout $-!. <)()() twenty years au'o, and is approaching .^.'J.OlJO per patient fur huildings of moderate size, and the a\-era,^e tinish, at the present time. For \-ery large instituticnis tlie cost per Ijcd should 1111-*^^'°^ '^''^ douhtedly be less. "When designing a hospital tliirty years ago to ^ i, he liuilt at a low cost jirice, the plan was com-^ ,^ _^ ] I,'-' pressed to one of small peri|jhery, wooden floors f i^ and trim were cummonly used, much wood was utilized in the construction, the wards were large; most of the spjecial rooms required today were missing. Those whicli were provided Avere often r small, or merely closets. Por instance, the dark slop-sink closet foi-merly installed (Fig. 11) must now 1)0 a Jai'gT' welldighted roonr (Fig. 12). There were no i-ooms for X-Eay treatment or examination, and laboratories did not exist or were \-ery small. As these, and rooms for many other pui'] loses, wei'o found necessary for the ]iro[ier conduct of a hospital, and gradually be- came incorporated into tliese huildings, the cost per jiatient has been gradually and steadily in- l\'_ creasing all the time. The use of esjiecially imper\-ious material, and nioi'c durable materials, in forms more conduci\'e to low cost of updsoep than to initial cost has also done much to influence theii' inci'ease in cost. Rrfrodu A yiart of the constant inci-ease in the unit cost 72 __— '^■— ^^ * t ni — II — wz zx 5C-crio;-s / (It six feet I PLAN AT &-1 CHAWTtC/LO CORaJI : J \-A'>i>^ Uiiu&Hra 3.'W-\-^'U' 'JfCu-^TB ')" rd- PAET TSDM tXnVATlOJl. Ilic iiu-ti. Details at one foot to the iinli 26. Serving Room Table ■THE'AP^CHITECTURAL-I^EVIEW- Pipe- 5TK>lp/-,.FD^ Trr- ifom'i ChaNWC-l:^ ere To Havt- WHiVc- PLAJI At A-A 1S>- i4 x/a OlA't/J - TWRTE ■ WOi - ^ ■ 0/lE - JIAtr ■ JKC^f ■ 5CAI.r -. " JJE-rAJLb • or- ' MOVABLE- -■ WOOD " SifELV]/ia - w • KJ-TaiC7J -Hi^pjss^imn^ .... Rcproihticl al ouc foi-l to llic inch Fig. 27. Movable Wood Shelving in Kitchen Dept. PAET ruo^tr ELCVATIOj'J. .'je-ctio/i. Reproduced at sir feet In the iiieli. IJetuits at one iiieli lo the foot Fig. 28. Stationary Shelving i.s fnrtlior due to the stondy, ii'r:i(ln:i] ndvance iu cost of materials and lalior up to 1!)14. These stated unit eosts do not at all take into aeeount the enormous ad\'anees that lia\'e occurred within the last four years, and are £;'i\'en only to indicate in a n'eneral way the i-ehiti\'e ad\'ance in prices, and ]iot the actual cost of ju'csent-day liuildinii;. It is, of eoui'so, also true that e\-er\- new hos- pital does not contain all of the ei|ni]iiiient items mentioned, so that $:!,0()() jici' patient is jiroliablv 73 •THE-AP.CHITECTUJ\ALPsXVlEW- W^ /% '&■' B b, -H-H. r.K. LL, ;^.N, KR, tx-x Ttie AtMVE /JUMBMEEP 5ecrio/js ■jAppLv To Ttte Case above — ftXCriTT TttAT Poors AP£ " □ppnpnn □□nnopn nnnqnnn nnnnanD nqnnnan nDpnnan nnpquDq □□nnnpn I PRAW/i STEEL fEMAt 3"5<:ALe: SLeVATJD?) OP RE&I5TEE5 III VOO-RS. Refrvdiiccd al fuur f,-cl I,' II, c iiifli. Dclnlh ,il mic-half full she Fig. 29. Detail of Doctors' Coat Lockers, etc. □ n B?S| a n □ □ □ n n n n nnnan nnnnn nnnnn nnnnn nnnnn L"Iji5H pAjJltL V ^ z ki/a -A- yV-A. SPcrioN sHowmo rAsti-NiNo f oil coat Hooks w CLoTffes LocRtEs. f -K-- ^ 5 ? hcLp to at. lecFoe/^TCD so ;i SfcrjON 3H0WI?1G HXT 5ffrx.f- &ft«>NGJN& Sod I« CLOTHES LocKtES C-(^ f aecricw ^ffowiNo rABTE«iN& or trp\cj\i. 5TXT;0/iAJjy BRA-WN 5TfreL SffELT \^^ T^CLHmjES. ,>^ --/•■- 2^." WOdD 5' ■bAiEP £- G-loeo ^-^ cLe/iTs s> D-D. — ^z — 1- A 'fi- — 5ECT0M SHOWING ^»^O0D SHELi^ POEflON OP JOrCHEN CAses E-TC -♦^ n ^ 03^ LOWT-R 5Te-tL J/\MB ;j^ x>c*,swei - •Ert. ^^ SecTio^ J' SCALE- eLcVATIO/^ Qf Et&isTEjis iaI poors. Hj^N Theu Wood nEAWE-ES or- CLOTffES LOCKE-BS ^..,- A-A, C-Q. H h", "k-k',"L-l', N-N, T-P. (- R-il XppL-/ To THP5 CAai . Reproduced at four feel in Hie iiiiic and one-half inelies la IJie foot Fig. 3 I . Typical Details. Cases with drawn steel sub-Jambs, wood doors and plaster back and sides 74 •THE-AB.CHITECTUKALFLEVIEW — f-v — *-■ ,8 m D-9, H-M, J-J, K-K, 'L-L'.W-mVf-F, R-E C-T-t" fed io ihc SE-CTJO;^ 5ffOV/IAiG DJVTDmG Vj\ii^ Rcfi'oduccd at one awl one-half inches In the fool Fig- 32. Typical Details. Cases with drawn steel sub-jambs, wood doors and plaster back and sides 75 •THE'AP^CHITECTUPvAL-IVEVlEW- near enoui;ii fori-eet for tireprortf 1)iiild- ii)gs uf u\'erage fin- ish of tlie present time. If the stnie- tnre were to be hnilt of the most desir- al>lo materials i n every respect, con- taining all of t h e most modern arrange- ments a n d eipiip- mont. its cost now. a s compared with those of thirty years ago — a n d allowing for the normal ad- vance in the cost of materials and lahor, — wonld probably be iKVi""" "-" f f ! 1 1' ' 1^ 'II ^ - , ,1 -:_-t-:4 ; n I i ! : 1 ; %' ■ L- ; • f : J, li—^' ■ M f fLeVATiO'l , H-H , J-J . KK , L-L , Wood Dooe^ ABc To Linen Case with Wood Doors pU/J , I- SEE SI THr AeoVE CASE 15 TYPICAL FO£ 5fEC|MO^ CA5e £- Ore/J 5HELyE5 IN kiTCHEW O?^ 5ESVIAJ0- -EOOM , ^ EKCfrr THAT SAME 15 To &E 1-3 PCtP. Rf-l'iuJiiccd at four feet to ttic inch Fig. 35- Typical Details. Linen Case (with and without wood doors) drawn steel sub-jambs and plaster back and sides more nearly in the neighborhood of $ri,000 per patient. The disc(>\'erv by Kochs of the tnliercular germ in 1887, and other advances in the held of m.edicine. have so changed the treatment f patients as to have radically inflnenced the ari'angement of tnbercnlosis hospitals. The war has greatly increased the knowl- edge of asepsis, and bronght the vahie of solar therapy into prominence. These, and other advances and changes in treat- ment, ai)pear to point in the direction U?FEfe £AIL6- STJ1E3 r. 5. PETML Of- P00EL5 Rrfnuhhc-I at four feci ' to tlic inch Hctui.'s al oHC-lialf full si:e Fig. 36. Typical Details ment Case Instru- ELEVAi'iow or- iYpjcal r-f- ■ •h-*Ai Z-ZL PL/uM of- TYPICAL t 1 - — - ; . »A' V4 3 ^= eLevatic . ^ Jf 3-5. k 1 POOP.^ op VEAITlLATEp C>\5ES rni^h to Match that or Ha.e.dwa.cje of Ct"* ELeCTCLO T'LatED POO&LE faced fHNlSHEi &oTH eiP&-. TULL 5JZC- rif-TAIL^ or WOOP POO£^ /JoTt'-i=oR- THiCt/ies or doocjs To pe USED 5fce /d." Scale. I>eTaiL5 or VAR-lou^ CASES Reproduced at o)ie and one-half inches to the foot Fig. 37. Typical Details. Cases with drawn steel sub-jambs, wood doors and plaster back and sides 76 •THE-AR.CH1TECTURALI^EV1EW- \ of tlie use o f little iiKMliciuc ;iii(l the placing' of mere depeu- (leuce on dietet- ies and natural remedies in fu- ture, will u o ijoubt soon 1.1 e- gin to demand new elianges in even our pres- ent methods of planning. The demand for more pri- vate r m s (Fig. ;]0) will no d n b t in- crease, the in- s t a 1 1 a tion of C(piipment f o r t h e enlarged medical treat- ment of p a- tients, as distinguished from the surgical- now predominates — will no doulit require space and new ari'angements J 1 1 , ' iilii 1 1 » ^fe*6-i Service Room in Birth Dep,lrtment, Chicago Lying-in Hospital, Chicago, III. Richard E. Schmidt, Garden He M.Trtin, Architects pi'i'jiaration o f t h e neeessai'v matei'ials. Pavilions o r w i n g s, with rooms on mily one side of the corridors (Fig. '■')'.)), as liuilt ill F u r p e fur many y e a r s, w i 1 1 prohaldy soon he geue- rally adopted in this counti-y ; and it will ix' found that such an arrangement will afford the patient m o r e privacy, quiet, better air and sunlight, a u d bo pleasanter in e V e r y respect Kel'nnhiced at twciity-fniir feet to the in ch Fig. 39. Plan, showing "Private Room and Corridor" Type of Hospital Wlllcll reater for open air treat- ment, solar „ til e r apy, mach i n e rooms for m cell an 0- t h e rapy, all kinds of baths, such a s carbonic acid gas, oxy- gen baths, ^• 1 c a n i c earth, m u d and peat, salt water sprays, sand baths, vacuum chamber and compressed air chambers, a ]•- rangements for t h e inhalation of balsam and other beneficial properties, each of which will require s p a c e for machinei-y and the propei' operation a n d than the ordinary corridor type of building. Porches or terraces adjacent to e\'ery wai'd, so tfiat the }iatients while in their beds can be mo\'ed Fig. 40. St,indard Detail, Infants' Basket Rack in Nursery 77 •TH E ' AR.C HI TECT URAL- REVIEW' flA^STtE. 1' V ; ITI,. (tdO^ cf eLeVATOE Cab 'P^TFo15.^^ A.FPLV ■C.Ufc&tK BUfApEEL A,T Tot- "i -^ '■_) fcoTro>A OF £)A.±,e/A&A(T Poocs ,4(^ .'. - ■ ■ ^' pLASTEKlMa iCALe- 3 - i-o a 71 (1 .nlterations ill the plaiiniug, u s e ami ar- •f raiigeinent o f practically all hospital Iniikl- i 11 u; s — a n d ctipecially with I j-.ii-e t li (I K e devised fur the treat- ment of a jiar- riAAl ticular or special type of disease or injury. The phiiiniiig of hospitals is some- times reiiarded as heing almost stan- dardized, as tliimgli there remained little latituile fur originality in that direction, unless nietlKjds of treat- ment change radically; yet certainly «^' their exterii)!' design or style of architecture is iKit hemmed in hy the practice of nie(lieiiie or snr- i^erv, or hy the accepted rnles of lygiene. Inasnincli as a hospital is a work- slioji for the reconstrnction and re- jiair of the hnmaii Ixidy and mind, special arrangements and mechan- ical e([ui]v riient nec- essai'v t o ! VIT TILH FmE f m ]) V O dnc(! Vo;«;^«j;|J tliose r e- f^"-""'-- secrioAj PLAN /loTE EACH 5er OP ELEVATOR reoRS SHALL Be PEtfvipep NviTW Auro/v\ATic cLo:,jALci XJevise >vK^^ OF cLo:^ifJ<> pevi^c iaI DAit>\c/ir ijooks fa t^Avt ^e£Ak^ iaJ 5AMP WHtH CLOIED :5o THAT TWtSE: pooPi C-/L RE Ope/^ED FeOft^ ouTSlPE^ op t+ATc+t . PEoVlDC TK,uiH KAAJP (40LD5 o^ DoTH StPEi OF &Aie/«^EMT Cooes Rcfrnthicer] al t""r frcl tn the uirli. Details at nllc ,111,1 niicjlillf l„,-l,rs t,, the- f,;,t Fig. 41. Details of Two Speed Elevator Doors outdoors and yet remain under the super- vision (jf their res]iecti\'e nurses, are a grow- ing rei|iiirenieiit and may soon heeome genei'al. It is also further iiie\'italile hut that the e.xjierience and disco\-eries (jf the present war must result in making i^reat changes isv and imiiroN'ements in iiearl\- all t\iics and Zi'i'^'"'J^,'~J:l, . ,.'..'... *'*" BOLTS, methods (jt treatiiK^nt ot injuries and dis- eases, so that it is alrca(k' e.xtreinely ])roli- ahle that the end of the war will dower "lis with nian\' greath' chann'e(| and ini- proN'ed methods of tri'atment that will, in their turn, reipiire eipially iireat changes )^' SCALE DETAILS ^., ^^^J^ 'of chemical hood '' lAl LABOE-ATOR-Y PlaW ^ LOTION 78 FRONT CLE-VATION Kcl'nnluieil ,il f,,iir feet to the ineli. Fig. 42. Details ot Chemical Hood in Laboratory, Gary Gen. Hospital, Gary, Ind. •THE-AI^CHITECTUKAL-IVEVIEW- suits must !>(_■ pr()\'i. As these eouditious always jii'o- trame work, in so far as tlie\' art' not (dasti<'. 'Idiis \'ido \'ai'iety, lio\ve\'er, each liospitai must he con- is possihly more the case in hospitals than in many sidered as a new and separate prohlem. other kinds of huildini;s. Hospitals must he The serious work of a liospitai slionld he iinisked arcliitectui'ally pleasim:, as wcdl as ])i'opei'ly as much as possihk' from those who are within its arranged, to produce a satisfactory output iii the walls for the fii'st time. The sui'muudings should shortest tiuR' consistent with etfi(Mency and (piality. he made pleasant and eudurahle foi' the nurses. The \\-ards should face east, smith and west; and otlier well people, \\dio work in the hospital the operating rooms north, while lahoratories are day after day; for their continued health aud also hest served if they face the north. There is, cheerfulness cannot hut he reflected in the rajiid therefore, no choice in these matters, — and so a proo-ress and reco\'ery of their charges, eoiisiderahle piu'tion of the plan — fi'om which the This is. in its(df, Imt one nioi'c reason that the CotaTracTor To vbr.\t^y all l\e:JMURr/^£nTS 6r DlfitMSIOJS AT THE- BUILBlNCi. ELtCTS.IC CEILING or CA£> SCAJ-E: 3' ~ l-O Z' HoLiprlAfJi f-IATURE IM txtA^S TupirJc, 1 flLA3"E:E. LiNt SIDE- tL&- It' e-R-ltsS TUBlJjO- ^THRr£-lNCti,-ANP'0>it'KALr-INCH- - ' 5CALE- " DrrAlL5-or-£LrVArOR"CAB.^ Appisoval Of A^CKnTTirs i>r^opr- co^\KE■?^CI7lo or Wopjc. S-ICHARD e 5CH>VJDr CcAROe^I L- Aj\-^}A AE-CEilTf-CTSx, C- ftlAotrfT' i04 S ^MCHJGA.^ ■ AVt. CHICA.G-0 , ILLINOIS HALI^ JNTtJilOJ^. ItLE-VATjOM Of- CA-fc. J ALL JoiNTt' To £>£ HLLelD \ With |R£>/JiTt fr TVi-e/^ I EdDCCD -pj A ij/AoOTH FlWibH. /l!4 r)(Lv\5iTueiMQ -Jl /jl'l M&l-R- lo &AUOC Ste-eL MetaL THEttSHoUD THRU CAB. Plan Of- CAE>. Plan Of- CAE>. Scale s'- i-o' ''1 PLAT^ Of- CAB. iCALB- Iji'- i-O' r A',-/'/-, .,/»,!■./ ,;/ /".'iir Sect 1,1 III,- ii,,h. I),-I,lils „l Fig. 43- Typical Details, Elevator Cab \ nn\ failnre on his pai't to recognize its signifi- finally pass int(( the permanent ]iossession of state cancc and gras]i it at its very beginning! CJCP^^Slo'J E-OLTS With 0-A3 Pipe 3EPcB.*,Toe* BETMJCEfJ CO/JC£BTe «- OE>"JJ'J STEEL ^A-" pU,5Tea- stcTiDN i^-r. I K' Mx»/Je5i** Oil pLa=tic V 5tcrjoK TtfJ^u TYFi ( OUT IN THl) W^-* ( 1.0C* 1*4 Ik . CD^^CEET* BJiea. a-STtiUG^ r-ACt PlAW AT 0-0. - TttECE • INCH -AND • ONE • iNCft ■ • • . -=. SCALE -AND ■ rULL -SIZE- -rr TAIL- or- • • - A • HOSPITAL • 5TA]R.WAY ■ WITH • ■ • -< fLASTiC • OR - MAOWrSIA • Tl2tAD5- & - JiI5EE5 RICHARD t. 5CHAMDT. GARDtN 6 XARTIN A^CtfirtCTS i04- S ?^JCHlCiAH Ave CMIO-GO, JLLIN015. SHttT Xe AADt E'V W^ J, L. T- 5- DETAIL OETJeWCL UEOBS. U,:l'n,iliu:r:l al h,u, feet In Ihr iinh. Dchnix at one and onc-lMlf inilics lo llu fool „iul ouo-lia!f full Fig. 44- Typical Details, Hospital Staircase THREE TYPES OF GENERAL HOSPITAL PLANS By WARREN C. HILL TTIE 8(.'l(>cti()iis piililislied herowitli embrace cxaiiiplcs (if tliree distiiu't and gciiei-a types of hospital ]ilaii. First — 'llie "\'i laye hospital," soinetiiiii's rcfi'rved to as the "eut- tag-c hospitah" is exemplified by the Winchester Hospital. Second — The "Synimes-Arlington" Hospital is of the "pa\'ilion" type. Third — The "Ste\eiis (Tmics" at the Union Hospital of Fall Tvi\er, is of the city or ''block" type, the inevitalile resnlt of the ^W N CH LJTLR_ WHCHtJTtlt. k:.r.JaII Tay ,. f.J.r.l !t HOJ P 1 T AL iC. irtLil.c)/ • Second ■ Fioot- Plan restricted areas usnally availal)le m cities All three are general hospitals — as differen- tiated fri:)Ui special or mental disease hospitals — and care foi' all sorts of physical ailments and a classes of patients, from private pa- tients to charity cases. They are also rpiasi-pnlilic, operated by public spir- ited men and r e m n n - eration, as- sisted b y the sup- i:»ort of the Third • Floor_- Plan • conminnities in which tliey are located, and by the income j'rom be(piests of vari- ous donors. The Winchester Hospital Corporation is composed entirely of women, and the Hos])ital was constrncted under the direc- i-tioii f>f an nnnsnally aide building com- mittee of the same sex. There are two buildings thus far built — the main building, shown herewith, and a two- story nurses' home, the latter havino- accommodations for These plans rejtrfidttcei! at the scale (if thirtil-two feet to the Inch. Floor Plans, The Winchester Hospital, Winchester, Mass. Kendall, Taylor & Co., Architects twenty-four nurses. The hospital it- self has a normal capacity of fifty patients and was oiiened in 1017. On the gi'ouiid fiotu' of the main luililing are kitchen, laundry ami loiler rooms, which it is hoped will ultimately be relocated in a sei'vice inilding to the north, connected by a tunnel with the hosjntal. This will make availal)le space necessary for the developm(!iit of X-ray and labora- (ory work", A\']icn ]ila!iniiig llie building, the 8i •THE-AP^CHITECTUKAL-RXVIEW- Symmes Hospital. General Plot Plan ai-ehiteets endeavored so to arrange the various departments that they wonhl bejf as remote from one anotlier as tlie ]imi-i tations jirescrlbed wouhl permit. The patients unable to walk come in at the rear entrance on the gronnd tlooi' and are easily <-onveyed to the elevador. Aml)nlatory pa- tients and visitors ar- rive at the and out, — but no detail of planning or equip- ment was omitted that would be required for the effectual care of the people who come there for treatment. Although small, the plant is as complete as many a hiT'ger one. C'onsidei'alile thought was gi\'en to the placing f)f l>eds, wall colorings and artificial lighting, that eye sti'ain might be eliminated. In the Children's ward are interesting "l^^other Goose" decorations, that relieve the monotone wall coloi- and please the unfortu- nate "kiddies" who ha\'e to come there. The building is entirely fireproof, and cost, including architects' fees, a fraction over thirty five cents p e r cubic foot. 5 L L E. pi fl G w^ *^p^ *"n^ ^Tlf '"T"^ "T^ ''"^ main entrance on the opposite side, where the reception room and otticc are located. The 0])erating department is at the north or left hand, the children's depai'tment directly opposite the entrance, and the wards for men and women, to the south. All are separated but i entirely interdependent. | The second floor is similarly di- vided, with the private I'ooms at the south and a small ilaternity depart- ment over the Children's department. The third iloor is for special and isolation cases or o])]")oi-tunities for growth. The linilding is extremely simple inside 82 ington, although adjoining AVin- ester, an altogether different problem pro- s(!nted itself. Arlington is within the single unit of carfare from Boston, on one of the main arteries of travel radiating from ^ the Cambridge subway. The town has . growi: rapidly and will continue to do so. The pavilion plan, therefore, per- mits of adding building units as the de- mand increases. The present hospital build- ing will then become the center or Adminis- tration building of the future. Originally, the Nurses Tlu'^e FInar I'laii^i reproduced at the ^eale of twentir-four feet to tfie inch. Floor Plans, The Symmes Hospital, Arlington, Mass. Kendall, Taylor & Co., Architects •THE-AP^CHITECTUKAL-BXVIEW- faces the the older rear over- quartered on the upper floor; but new development | soon presented the neces- sity of placing these peo- ple by themselves, and the Nurses' Home here illus- trated therefore became the next logical stej). This building is located pai-t way down the hill, with the parapet walls far be- low the ^'ista from the main building, and is con- sidered by the architects about as complete as any building they have yet planned. The front roadway and building, the looks the country for miles around, and presents the unusual feature of contin- uous balconies for recrea- tion and out of door sleep- ing. The beds usually re- main on the balcony dur- ing the day, but can be easily rolled into the rooms — and, across the corridor, to the f r o n t rooms. The doors are made extra wide for the purpose. Casement sash and screens protect occu- pants of the balconies from the elements or insects. Thirty-five nurses and six maids can be accom- modated ; many more than are needed with the present size of the in- stitution. It was deemed prudent to fin- ^^^^_ ish the upper | tumnll stories, although ^ fi r s t intended, in order to he prepared in case of Government- al demands. An atmosphere of do- mesticity is created by the color treatment, fur- niture and decorations in the entrance hall, and living and sitting Ground Floor Plan. These plans reprodncetl at the scale of twentii-four feet to the inch Floor Plans, The Stevens Clinics, Union Hospital, Fall River, Mass. Kendall, Taylor &; Co., Architects 83 •THE 'AP^CHITECT URAL- IVEVIEW- Fourth Floor Plan JS1\ Third Floor Plan Floor Plans, The Stevens Clinics, Union Hospital, Fall River, Mass. Kendall, Taylor & Co., Architects rooiri.s. P:irti<'ii];i]'l y a(le(|u;itu toilet, linen, te:icli- ing iind other accoiiunotlatioiis arc available, to !ul(l to the ha})piii(;ss of the .yoiuig wouien prepar- ing to dedicate their ]i\'es tc) tlie care of the sick. 'Die Imildiiig was completed and occupied this Kpi'iug, and tlie cnhic. foot c(jst, exclusive of fnr- Tiisliings, was a fi-iction nn(hn- ■!7 cents. The Stevens Clinics pi'esente(l an entirely dif- fei-eiit ])hase. In Loth AViiichester ami Arlington thei-e was ]>lenty of land. In Fall Ki\'er there was not, — and tlit.' main huiiding, planned l)y the same architects, luid heen outgrown very soon after its occu|ianc\'. The only hind a\'aihihle was to the I'ear and north and was not deeji enough to 84 set a huiiding far enough away for hest conditions of therapeutical treatment. In England, and one (ither continental counti'v whose name is not now nientioTied in polite circles, the tei-rac(^d ]ia\i]ion or "stepped hinise" has heen in successful use for some time. In Paris, apart- ment houses on the Rue Vavin, near the IJoulevard Rasiiail, have been built in this way to meet restric- tions of building heights wliich operate to limit tlu^ height of abutting build- ings. I'hese sucix'ssful pion- eer etlVirts lead to the ado]i- tion of this "hanging gar- den of Jiabylon" idea, and the garden eifect is en- hanced b)- placing plant bo.xes along the outer rail- ings, which ser\e to s(-reen the balcony in a measure, as well as the one below it. jVfter a year's use, the re- sults, so far as occupation is concerned have l.ieeu em i n e n tl y satisfactory. The entirely different re- quirements for each story should be noted. The ground fltxa- has X- ray, hydriatic and othej' _J|j rooms, for liotli in and. out [)atients. Idie fii'st floor is entirely for out jiafieuts. The second lloor is for medical and surgical ward is used as an overflow from the connecting bridge is at cases, male and female, the Jiuiiii Iniildiiig, and this level. Idle third iinuv is for pri\-ate patients. Idle fourth floor, and the fifth — except the In- t(^rne's (|uarters — are for children's cases of all (Iiaracters. E\eii contagious diseases miiiht Ik; cared for temjiorarily in the small glass emdosed is(dation rooms, by proper nursing technique. Idle Xnrses" Stations are unusually t'omjileti^ — as in fact are all the various rooms and e.,-,+■ 1,,, „ 1 \ 1.1 x- L. . . ,,, iicccssitx uftcii ii\-('i-l)nrc :i!l otliiM' (•(UisuCriitiiiiis ililtes ut Juno last :niil tlic cuil lit Scptciiilicr, I'JlS, +■ 1 ■ ; ,■ i , • ,1 ],.,,,„ i,„„,, „n,<., 1 , 11 1 ,. . ^ , ,. "f 'Ifsi^ii. (•iiiistnictinii, :iiiil cost in tliiwc \'(intiu'es lii-iitcssiiin ; nrantiiit;' e\-cii tie iiecessity tor ivuvettalile menleiit that lias tlius lar arisen m 1 +■ li + 11 ^- ,■ .],,, ,,,,-■ f r ( ■ J- A\' ir • • -'^K'oil, tiJ'antiii!^- that a eiimmmi ilraniihtinii' tiiree tlie experiment et (iii\'eniment \\ar ILmsiiiti', m • , ' , t , ^- ^ ^i • ;., , ni , I ,• X 1 ,• / , '" I'l'iser eontaet ami I'ehitmn to the ediistriictKni Its possilile present ami tnture relatnm tn the i- • ■ ii 1 1 1 ,1 • -i i , . „i , , ,• i, ,. -^ I ,,^ , ili\-isi(in wimh! jielp make tins possih C, am arehiteets iit the I nited States. ,. ,, , -i 11 ^ ,-'1 ,•„-■ , • .,. ,/, ,■ .iirantiiii;- that a cdiisnterahle part ot the (litticiilties / ii-(i . I I IcniKl ii'i's i- 1 -x i • • 11 1 ,1 1 , u ^- ot ai'i-liiteets. 111 iire\'ioiis i'e\'elo|)nicnts, nai'mweil ''iil,^' f"'" alternatnes appear tn warrant 1 + +1 • +'1 ■ +, ii i- 1 , .] ■ , , , 1 • 1 , • ilown to tins iiarticiilar point \\'(i yet hcilicN'e a het- tliis unexiieeteii — ami nnexphinied- -ehaime m , 1 /■ ■ 1 1 ,• -,11 , i- , 1 -f ii 11 1,1 f'-'i' •""! more protessional solution was a\-a]hilile. poliey. One ot these AVnuliI seem to he that the ex]ierienee nf this iim'ernment ile]iartnient, with ■' ('(iii.''l nidifr. Sii(/(/r.slioii the arehiteets they Inul seleeteij to co-operate with T,, I,,. .h-Hiiitelv oonstiaictive, it nii-ht he sn- thein on the earlier ih-velopments. hail, in some „.este,| that siieli 'a eomm.m .Iranglitinii ilivision way or other, heeii sm-h as to lead them to helieve ,,o„]d have heen 01-anized, and Ihen placed at tlu; they eimld iiet alon- m these later ventures e.pially disposal of those individnal areln'tects who inioht well without their professmnal assistance. This still with advanta-e Inive heen selected to eonti'ol IS ] 11 Itself regrettahlc— if true! Tli(. other alter- iudividual irousino- developments. (A similar native would apjiear to he that ha\int;. hv- that arrangement to this has already heen invoked for time, ohtaincd a certain numher of definitely de- certain government huildiiigs in Washington, and veloped "type plans," they helieved they cmihl ^^it], aderpiatelv sneccssfiil results.) This would ei|iially well— and at ]ierliaps some saving in time l,.,v(. made ava'ilahle hi each architect all the data and money— continue hi reproduce these house ,,,,,1 information now knowu to the anonvinous plans themselves in the future: a wholly familiar departmental "Eranch of Desicn"; it would have and recognizal.le departmental point of view 1 retained the highlv .lesirahle 'indivhliial relation The first of these alternatives opens a hmad , if uiemhers of the'ii'-ofession with Housing work, (|uestion— to which there are at least two sides— and would have avoide.l all dan-er of estahlishini;- hut that is altogether "aiKither story,"" the time for ;, pi,..-edent, a].]iareiitl v approval— or, at the very the telliug of which has not yet .piite arrived! l^ast, ac