§ _Construction of distinct Sections to Asylums._
The French system of asylum construction, as before noticed, is to divide the building into several, more or less, sometimes quite distinct sections, having a general administration and offices in common. The number of sections and the character of their residents is a matter of medical classification, and in each one there is a mixture of acute and chronic cases, just as in our asylum wards; the combination being regulated by the similarity in the phases of their malady, as, for instance, if refractory; if epileptic; if clean and orderly; or demented, paralytic and dirty. In Germany, on the contrary, although this same medical classification is carried out, there is a primary separation of the insane of the province or state into acute and chronic. But in the mode of providing for the treatment of the two classes apart, two plans are pursued, one termed that of "absolute separation," and the other of "relative connexion" (relativ verbindung); the former consists in placing recent and chronic cases in buildings completely detached; each one having its own staff, organization and management; the latter, whilst keeping the chronic and recent cases apart, possesses a common medical and general administration in a building composed of two principal sections, either forming parts of the same structure (as at Illenau, in Baden), or detached, but within the same area (as at Halle, in Saxon Prussia). Damerow is the most able advocate of the system of relative connexion, on which he has largely written, and it is one which appears to be gaining ground in Germany.
Now, except in the case of the overgrown Middlesex Asylums, where the Lunacy Commissioners distinctly recommended a third asylum to be erected, the plans propounded by that Board for affording additional accommodation in institutions already large enough, are in principle much that of the "relative connexion" system as proposed by the Germans. The reports above quoted, in connexion with the question of separating recent from chronic cases, show generally what the plans of the Commissioners are. They would erect "detached day-rooms and associated dormitories near the wash-houses on the women's side, and the workshops and farm-buildings on the men's side." (10th Report, 1856, p. 27.) To prove the advantages of the plan, they go on to say, "In making our visitations to the larger County Asylums, we have repeatedly observed that a considerable portion of time is occupied by the servants, who have charge of the wash-house and workshop department, in merely collecting the patients in the wards, and in conducting them to and from their respective places of employment. In one asylum, we ascertained by minute inquiries that not less than one hour and a half was thus every day wasted by the servants, and was passed unprofitably and unpleasantly by the patients themselves.