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4/4, 35
C. 2-
*P3

§
šuutherit California state iſingpital
[BY ARTHUR J. PILLSBURY.)
Otherwise than regarding Summer
temperature, the location Of the Sou-
thern California State Hospital for the
Insane leaves little to be desired. It
is sightly, 1300 feet above sea level
and on the pictured rim of the San
Bernardino soup plate of a valley, the
position Of the institution is COm-
manding. Watching the purple lights
Of morning and evening playing above
the lower levels and along the moun-
tain bounded Valley brim. One can
form some conception of what the
Dawn of Creation must have been like
When the morning and evening Were
the first day. The institution itself
does not loom up so commandingly as
its thousand feet of breadth and four
Stories Of height might lead one to
suppose that it might, for the reason
that, when seen from across the val-
ley, it sits banked up against a great,
irregular foot mountain, immeasurably
more COmmanding than itself, but if
any of the patients are lucid enough
to enjoy an opportunity to “see out”
and to Watch the blinking electric
lights of Redlands and San Bernardi-
no, Verily, they have their opportunity.
The site of the Southern California
Hospital comprises about 400 acres,
and these acres are not mere acres,
but are acres of good land. The soil
dissolves in water with the readiness
Of brown Sugar, but it is many feet
deep and full of plant nutrition. This
COndition results in two irrepressible
"background, and the sooner that
COnflicts—keeping the Winter floods
Which come down from the mountains
just back of the institution, from Cut-
ting innumerable engulfing arroyos
through the farm and getting enough
Water for irrigation during the dry
Season. The State will have to spend
a lot Of money—some tens of thous-
ands Of it—for building storm ditches
Of Stone and concrete for carrying off
those Sudden downpourings of thun-
derStorm waters from the hills in the
is
dOne, the smaller the expenditure that
Will be called for. The supply Of Wat-
el' for irrigation is ample in wet years
but during seasons of deficiency in
rainfall in the mountains the supply
becomes rather meagre. For domestic
uSe tWO tunnels have been driven into
the conglomerate hills to the rear of
the institution. One of these pene-
trates 200 feet and the other 100 feet.
Both together yield a continuous flow
Of 1 1-2 inches of nearly chemically
pure Water, having only 75 colonies of
bacteria, per cubic centimetre. If this
Supply could bo increased to five in-
ches of continuous flow the domestic
Water problem of the institution would
reach a final and satisfactory solution,
but the hospital management hesi-
tates to do any more blasting in ex-
tending the present tunnels Ol' Open-
ing others through fear of opening
new Channels and so losing the
Cellent water they have. The
€X-
exi-
gency seems to require the services of
a clairvoyant Or Water-Witch.
COST OF WATER SUPPLY
Inasmuch as the Obtaining of an
ample and satisfactory Water Supply
has been a main difficulty With Cali-
fornia institutions it may be Of inter-
est to review the situation at Patton
with more particularity. Aside from
the tunnels above mentioned the hOS-
pital farm has 992 shares in the Bear
Valley Water Company, which shares
give the right to buy 500 inches of
water at 20 cents per inch for 24
hours' run at any agreed time during
the seven months which constitute the
irrigating season. This costs the in-
stitution about $700 a year and is re-
garded as a “snap” for the reason that
this Water is now commonly Worth 50
Cents Or more per inch for 24 hours'
I’ll II.
Then the institution OWns 720 shares
in the North Fork Mutual Water Com-
pany. This company owns one-half
Of the Outflow Of the North Fork Of
the Santa Ana river and this right
gives the farm the equivalent Of the
entire right of the COmpany OMe hour
eVery ten days. This COStS leSS than
$200 a year to keep up the assessments
On these shares and is regarded as a
good thing.
Finally, the State has 20 acres Of
water-bearing land 1 1-4 miles from
and 300 feet below the institution with
a good pumping plant, and a no-good,
rusted-out shell pipe leading from the
pump to a reservoir near the institu-
tion. To make the Source of supply
available in time of scarcity of water
an expenditure of $2,500 to $3,000 will
have to be made for a new pipe line.
I have not the figures for the cost Of
this entire water supply, but the sell-
ing price of the several water rights
would, any day, greatly exceed the
Original COSt. In fact, the state has
not been the loser in either the land
Or the Water obtained at Patton.
THE HOSPITAL BUILDINGS
The style of architecture adopted at
Patton has been along the unfortunate
lines which have prevailed With Our
Other institutions. There is, first,
though not first in time, a central, an
“Administration” building quite im-
posing. Back a little and Connected
With short corridors on either side,are
long main Ward buildings, and a little
|back Of these, and extending to right
and left, also connected by Corridors,
are supplemental Wing Ward buildings.
The Whole plant extends en echelon,
SO to Speak, a total distance Of 1064
feet. All buildings are of brick and
are three stories high exclusive of
|basement and attic.
The Workmanship on the building
Was not all good. The West wing es-
pecially Was skimped. The heavy, roof
Was allowed to rest on the fire walls
and the thrust of the roof had spread
the walls perceptibly. The anchorage
Of floors was indifferent. The earlier
buildings and the later have been bet-
tel'. The Original design has just been
COmpleted by the erection Of the east
Wing, which will be ready for occu-
pancy by January 1st, and will make
TOOm for 170 more patients. There
are Other auxiliary buildings in the
rear Of the main building, such as en-
gine house, kitchen, laundry, shops,
etc. The Whole cost approximately is
$700,000 and the entire plant finished
and furnished $862,984.62. The land
Originally cost $96,000 and water $47,-
000.
JPREVENTATIVE MEASURES
Only the idiotically optimistic in
California will ignore the liability of
the state to earthquake shock, as well
for the preservation of buildings al-
ready erected and for the Safeguarding
of buildings to be erected. We live in a
paradise, but let us not make it a
fool’s paradise.
Superintendent Williamson of the
Southern California State Hospital
and his Board of Managers did not
neglect to profit by the Sad leSSOn aif-
forded by Agnew. The tall and men-
acing brick towers have been taken
down to the comb of the roof, the an-
chorage of some of the floors has
been reinforced and where the roofs
have been allowed to rest on the fire
Walis they have been strengthened
with additional trusses and the Weight
of the roof has been largely shifted
from the walls to posts running
through to the foundations. These
supplemental safeguards have been
wisely made and may suffice to save
life if not to save the wrecking of the
building when the crucial temblor
come, such an one, for instance, as
Wrecked the Mission San Juan El Cap-
iStranO.
If I had my way about it I should
reduce every unreinforced brick public
building in California to tWO Stories
with basement, instead of three Sto-
ries Or four. *
THE POPULATION
On the day Of my visit to Patton,
October 24, 1906, there were 896 pa-
tients enrolled, 575 of them being
male and 321 female. That portion. Of
California which sends its patients to
Southern California hospital has a
population of 350,000 or more, so that
the ratio of Sane to insane is, So far
as hospital population discloses it,
considerably below that for the state
as a whole, unless indeed, for purpos-
es of computation, “South of Tehach-
ipi,” has modestly underestimated its
population.
THE COST OF MAINTENANCE
The last legislature appropriated
$123,000 to pay the salaries for the
57th and 58th fiscal years and $180,000
for the general support. This gives
$151,500 per year for current expenses.
The daily per capita cost of keeping
patients runs from 43 to 54 cents.
Some commodities are less abundant
and more costly in Southern Califor-
nia than in Northern, which accounts
for a somewhat higher average per
Capita cost than at Stockton, for in-
Stance, Where the cost of living is
|Comparatively low. Also the larger
population at Stockton and Napa hos-
pitals make a lower per capita cost
of maintenance possible.
Dr. A. P. Williamson, the Superin-
tendent, is a good executive, a good
physician and a good man and citizen.
He knows the right thing when he
Sees it and wants it—wants it right off
if possible. If, under his administra-
tion, this hospital does not become a
model inside and out it will be be-
Cause the State treasury runs dry or
because he is not given a free hand.
He carries in his mind's eye a picture
of this hospital as it will be when its
})atient population shall reach 2,000
instead of 875, and that picture is al-
l'eady fairly complete as to details and
policies.
THE FARM AS A FARM.
A hospital farm should undertake to
produce nothing for the general man'-
lxet. That the farm at Patton does
this is not through the fault of the
present management. Alfalfa, silage,
vegetables and enough fruits for home
COn Sumption should about Connpriso
the range of products. The Southern
California State Hospital farm has un-
dertaken intensive agriculture. The
acreage is about as follows: Reser-
voirs and foothills, 60 acres; alfalfa,
40 acres; kitchen garden, 30; dairy
garden, 20; deciduous fruits, 35; cit-
rus fruits, 35; barley and rye, 100.
The remaining acreage is taken up
with institution grounds, yards, etc.
E3esides what deciduous fruits were
eaten during the fruit season and put
up or cured for winter use, $1,000
worth was sold, and the orange crop
this year brought in $5,241.52, an ex-
ceptionally good return. These or-
chards are cared for without extra,
hired help, and patients do all the Or-
ange picking. It may be noted to their
credit that while the ordinary packing-
house loss of oranges through decay is
5 per cent (largely through careleSS
handling in picking), that from the
hospital this year was one-fourth of
one per cent. However, picking is
about the only orchard work that pa-
tients can be trusted to do. Straight
farm and garden work is better for
them and, in the long run, better for
the institution too.
A MODEL COTTAGE.
The newer idea in hospital treat.
ment for the insane is well exempli.
fied in the new cottage for convales,
cent women built at Patton under thc
supervision of Dr. Williamson.
This cottage is brick, one story with
a basement and finished in bungalow
style. It is in shape a cross with two
dormitories, each having eight beds,
two rooms having three beds each and
22 single rooms for patients. This
gives a capacity of 44 patients. There
are in addition three rooms for nurses,
One large living
nice cozy corners convenient for gos-
room with several
siping—the bane of hospital life on the
women’s side, and a big, cool dining
room, pantries, etc., down in the base-
Iment. All Surrounded by a nice groVe
and garden. It is an ideal home for
those whose hurt minds are on the
mend, or would be if enough of occu-
pation could be found to eliminate the
hai'assing habit of telling everybody
what everybody else has said about
her. If this were done as thoroughly
Outside of institutional life as inside
there wouldn’t be two friends in the
whole world. Here is hoping that the
Southern California Hospital will soon
have a near reproduction of this mod-
el cottage for its convalescent men.
This one cost $16,400 and the furnish-
ings $2,400, or $427 per patient.
THINGS WANTED.
A first consideration should be for
the Welfare of acute cases that cures
may Speedily be effected and the af-
flicted returned to society able to pull
his OWn Weight. This can be accom-
plished within a year with a proper
and adequate equipment in the cases
of 90 per cent of those suffering from
acute mania and melancholia, if taken
in time and the malady fought like
killing snakes.
For this purpose the Hospital at Pat-
ton needs tWO receiving cottages, one
for males and one for females, and,
between the two a connecting wing
having installed a complete equipment
for baths of all kinds, Ima.SSage, etc.
It is estimated that the Cottages will
each cost $18,000 furnished, sufficient
for 30 patients each, and the hydro-
pathy building will likewise cost $7,000
complete. Without these there will be
comparatively little done in the Way Of
healing hurt minds and as each chron-
ic insane person costs the State from
$2,000 to $3,000 during his hospital
life it pays immeasurably well to cure
When Cures can be effected.
All except the newest roofs at Pat-
ton leak like so many Sieves whenever
hard rains come. It will cost $16,000
to re-roof the main buildings and it
should be done.
Dr. Williamson wants a new horse
barn, partly for its own sake and
partly for the reason that the present
location of the ramshackle horse barn
is coveted for cottages. This will cost
$3,500.
The products of the dairy are a most
important, if not a main element in
the dietary of a hospital. The more
milk the patients can have the bet-
ter, provided it be clean and free
from unwholesome germs. Dr. Will-
iamson wants the State to set the peo-
ple of Southern California, an exam-
ple of aseptic dairying at a cost Of
$12,000. I second the motion, although
the appropriation may have to Stand
a little scaling down.
The Convalescent COttage for men,
above referred to, and perhaps One of
the others, can be built out of the
contingent fund, although the protec-
tion of the ranch from injurious Wash
is a pressing necessity and should not
be put off.
CARE OF THE TUBERCULOSE.
Plans have already been made for
ten cottages of semi-cheap construc-
tion, for housing tuberculosé and un-
tidy demented persons. Each Cot-
tage will house sixteen patients, Will
be easily cleaned, made of Wood, Al-
pine plaster and metal lath. It is
proposed to build three of them at
Once at an estimated COSt Complete
of $9,941.75 and the others as needed.
This will come Out of the contingent
fund of which there is an accumula-
tion of about $30,000.
SOME ANTICIPATIONS.
Inasmuch as the mutations and Wi-
cissitudes of politics make it likely
that, in making my final rounds of
State institutions, I am paying part-
ing calls, I can the more freely com-
ment on things seen and plans enter-
tained. I think that the State Should
stick its peg at the 2,000 notch for the
patient population of each of its five
hospitals and reach that peg in all of
them before establishing any more.
Multiplying managements multiplies
expenSes.
If the Southern California hospital
is, some day, to reach the 2,000 mark
it must, meantime, secure available
farming land—plain farming—for
chronic cases which can be afforded a
large measure of personal liberty. The
present structure should be used for
housing chronic patients who cannot
be allowed much liberty. And there
should be a group of COn Valescent
cottages somewhere by-the-Sea.
Meantime, let those of us Who Can
do so consistently never cease to
thank God that we are in peaceful
possession of our Own minds, and
show our thankfulness by throwing
our influence in favor of doing all
things possible for anneliorating the
conditions and healing the hurts of
those not in a condition to join us in
so returning our thanks.
|iliſill
3 9015 O7644 9019