Plans for a municipal sanatorium for the care of consumptives have been submitted by the Committee on the Prevention of Tuberculosis of the Charity Organization Society to the Health Department of the city of New York. Under

the provisions of chapter 327, laws of 1900, the city is empowered to establish, equip and maintain, outside of its corporate limits, a hospital or hospitals for the regular treatment of pulmonary tuberculosis, provided the Board of Health shall deem it necessary.

The plans have been drawn by architects who have had large experience in institutional work of this character, and, if accepted, they will place New York definitely in the lead of American municipalities in provisions for the care of consumptives.

If the tent plan is included, the plans will make provision for about 500 patients. This is a larger number of patients than any institution of this kind is at present caring for, and the initial cost per capita will also be less. Besides the sanatorium and the tent system, as described in the architects' description which follows, it has also been suggested that provision be made for the outdoor employment of the patients. It is proposed to arrange for agricultural work for the male patients and horticultural for the female. This will have the double advantage of occupying the minds of the patients and permitting them to be in the open air.

The necessity for such institutions to care for the sufferers from this wasting and lingering disease is imperative. It is estimated that there are at present about 30,000 persons in the city of New

York who are afflicted with tuberculosis and that two-thirds of these are in need of help from sources outside their own family. Science has demonstrated how the disease is caused and the exact modes of its acquirement, has shown that it can be detected in its earliest stages while yet the hope of cure is bright, that it is not hereditary, and that the physician of today is in command of such forces of healing as promise cure in many cases if the sufferers can be early and properly cared for where rest and food and fresh air and sunshine are available. Yet despite all these discoveries, the appalling death-rate from tuberculosis continues.

The reasons for its continuance, in the opinion of one of the most prominent medical men of the country, are threefold: First, the people at large do not understand the ways in which the disease is spread and are ignorant of the simple measures for its avoidance; second, many are careless or indifferent to the risks of sanitary uncleanliness; third, the facilities for the care of the poor and the friendless who are stricken are utterl”. inadequate. Thus the larger proportion of the victims of tuberculosis are hopeless in sight of the hope which science hold out to all.

To remedy the two first causes the committee has endeavored to enlighten the public by lectures and through the distribution of pamphlets setting forth. the facts about the disease. To aid in the solving of the problem arising from the third cause the committee has now had prepared the plans and made the suggestions to the Board of Health which are set forth in the following letter of the architects:

NEW YORK, February 20, 1903.

TO THE COMMITTEE ON THE PREVENTION OF TUBERCULOSIS OF THE CHARITY ORGANIZATION SOCIETY OF THE CITY OF NEW YORK:

GENTLEMEN-We beg to hand you herewith plans for a proposed municipal sanatorium for the treatment of tuberculosis, to be located in the country near the city of New York. These plans are based upon the suggestions made to us by your committee and upon our experience gathered in the actual building of the Adirondack Cottage Sanatorium at Saranac Lake; the Stony Wold Sanatorium at Lake Kushaqua, and on the study of the proposed sanatorium at Denver, Colorado. As no site has yet be chosen for this sanatorium, we have been obliged to assume the natural conditions of the ground and have adopted a site giving a southwestern exposure for the pavilions, with a protecting hill to the northeast shielding the buildings from the most violent storms. This condition is shown in our birds-eye view of the institution. This site gives sunlight to the patients in the pavilions all day.

General Plan.

As you drive toward the sanatorium on the public roads you would first have a general view of the pavilions above you on the heights. The private driveway of the institution circling around below the pavilions will lead in a gradual ascent to the administration building, giving a fine view of the entire grounds as you approach the latter building. The drive will continue around the administration building and back to the central building, passing over the boiler-house, which will be partly under ground, allowing coal to be dropped directly into the bunkers beneath. From the central building a covered corridor will lead back to and join with the main corridor connecting all the pavilions. On the main axis and directly back of the central building is the large recreation hall and assembly room, which also acts as a general solarium. On the corridors connecting the pavilions and midway between the second and third pavilions on each side will be located the small diet kitchens with the small dining-rooms. On this corridor wil! also be located the staircases leading from the first to the second stories. On the traverse axis on a line with the boilerhouse will be located the isolated pavilions for contagious diseases, one for men, and one for women. On a line with the administration building will be located on one side the laboratory, and on the other the laundry building. The boiler-house and engine-room are located, as you will notice, in a central position, enabling the heat to be distributed in a rapid and economical mauner in all directions to the various buildings. Electric light can also be economically distributed from this point. sinking the building below the finished grade, carrying the main driveway over its roof and by treating the main chimney in an architectural manner, the unsightly quality of this type of building is done away with and the great advan

(See Drawings A, B, and D.)

By

tage is gained of distributing heat and light from a central point. By terracing the ground, windows may be placed on the side of this building, affording light and ventilation to the boiler and engine-room. The large recreation hall acts as a natural division between the men's and women's portions of the building. The laboratory and laundry buildings being placed off to the ends. may be partially or wholly hidden by trees and shrubbery, but at the same time they will be easy of access. The camp, where the patients will live in tents, will be placed off to the side as shown, with the tents arranged in streets with wide spaces and effective landscape effects, and with a recreation hall conveniently located. At the center of each block of tents will be placed a toilet and bath building for the block, with paths leading to same and with shrubbery arranged to hide the building. This camp may be made very attractive by proper arrangement of shrubbery and may also give light employment to the patients in arranging and caring for the grounds and gardens.

Style of Architecture.

We have selected as the style to be followed in this group of buildings the Colonial type, which gives so homelike and cheerful an effect where used. At the same time it is very economical and simple, the buildings being inexpensive and easily followed out in execution. The general treatment would be in red brick with white stone trimmings, with slate roofs. The corridors connecting the various buildings, the solariums on the ends of the pavilions, and the dome of the large recreation hall being constructed, as far as possible, of glass. This treatment should insure an interesting, cheerful, and uniform group seen with a setting of green foliage and natural scenery.

General Construction.

The interior arrangement and finish of the various buildings would naturally be up to the standard of the latest hospital construction. It is not contemplated to construct the buildings fire proof, because of the cost, and the fact that the buildings are only two stories high. The plastering to be done throughout in hard finish with all corners, both of walls and ceilings, rounded, and with rounded corners at all windows and doors. The finished floors to be of the latest fireproof composition construction with sanitary bases. The doors to be flush paneled throughout, the trim to be without mouldings or corners. All buildings to be provided with stand pipes and fire plugs on all floors, at least one of these to each ward. Wall cuspidors to be placed in the dining-hall for patients, and in the corridors connecting the wards at intervals of every eighty feet; these cuspidors to be supplied with running water. Sanitary drinking fountains to also be supplied in the same manner, but at different locations.