|Politics | Staff | Community | Treatment | Facilities|
Although new, three flaws in the Fulton asylum building quickly emerged. First, interior construction provided no means to segregate the "furiously insane" from calmer patients. Second, the building was too small to meet Missouri's demand. Superintendent Smith turned away seventy admissions in 1854 because of overcrowding. Third, until 1859, the poorly designed and constantly malfunctioning boiler system forced patients and staff to congregate in "stove rooms" on cold days. In addition to physical obstacles to success, Smith lamented the absence of standard medical terminology for the diagnosis of insanity, thus one doctor's notes often meant nothing to another. Finally, Smith warned that the likelihood of a cure fell dramatically when patients entered with an illness already of long duration.