In the year 1826, separate wards were set apart in the Bellevue establishment, for the accommodation and treatment of the insane paupers and patients. The large Institution on Blackwell's Island devoted to this use was begun in the spring of 1835, the western wing of which was completed in 1839, and the southern in 1848. The building is of stone, and consists of a central structure, octagonal in form, eighty feet in diameter, and fifty feet high, with spiral stairways rising to the cupola, a spacious and splendid observatory, overlooking the river, the island, and a portion of Long Island, and New York. The two wings, at right angles to each other, are each 245 feet long, and several stories high. The building at the time of its erection was one of the finest of its kind in the country, with accommodations for over 200 patients. A short distance from the main building, on the eastward side of the island, was also erected in 1848, another stone edifice 60 by 90 feet and four stories high, which has been exclusively devoted to the more violent class, and denominated "The Lodge." This has rooms for 100 patients. Another stone structure class, with rooms for 110 persons, and numerous wooden ones, "pavilions," have since been added, literally dotting the northern extremity of the island. The capacity of all these buildings is sufficient for 576 patients. The locality is unsurpassed for its salubrity, and the exquisite beauty of its scenery, as nature and art appear to have sweetly blended their gifts and embellishments, to render this home of the irrational one of the most attractive spots of the world. Before the erection of these buildings, more than four thousand insane persons had been received, and from 400 to 800 have been annually admitted during the last twenty years. At the commencement of 1847, with accommodations for but 200 patients, nearly four hundred were crowded into the Asylum, destroying all plans of classification, and proving a source of constant irritation to each other. In no period in the history of this Institution, have the accommodations been fully adequate to the wants of this large and ever-increasing class of sufferers. The Commissioners have never been encouraged nor allowed to increase the accommodations, until the over-crowding of the Institution has made it a matter of positive necessity. And it is an anomalous fact, that while every benevolent heart has throbbed over the woes of the aged, the crippled, the orphan, the dumb, and the blind, almost nothing has been attempted in the line of private charity for the relief of the insane, ten or fifteen hundred of whom now evidently exist in the county of New York, beyond what can be properly treated in existing Institutions.

A larger percentage of those admitted would have doubtless recovered if suitable space had been provided. The sensibilities of an insane patient are generally extremely acute, and the will often intensely perverse. His future character, even if incurable, depends largely on the treatment he receives during the first few months of his insanity. Harsh treatment, or excessive annoyance occasioned by discomforts, usually render him noisy and intractable; while pleasant surroundings, with government which wisely blends firmness and gentleness, exert a soothing and healthful influence upon him. Comparative solitude is often desirable, and essential to the recovery of a patient; but this is unknown in a crowded institution. The blame of failure can neither be charged upon physicians nor Commissioners, until adequate means are granted, thus securing accommodations and appliances for the successful conduct of an Institution.