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Tuberculosis

Hospital and Sanatorium

Construction

WRITTEN FOR

THE NATIONAL ASSOCIATION FOR

THE STUDY AND PREVENTION OF

TUBERCULOSIS

THOMAS SPEES CARRINGTON, M.D.

ASSISTANT SECRETARY

THIRD EDITION, REVISED AND ENLARGED

NEW YORK

105 EAST TWENTY-SECOND STREET

1914

Tuberculosis Hospital and Sanatorium
Construction

Thomas Specs Carrington, M.D.

Adirondack Cottage Sanitarium, Trudeau, N. Y. Thk Original Onk-kuom Cuitacl
l)i(. Ij»u \ivi) I,. Tki 1)1 \r HI LAN HIS I'^mmckimknt with the Opkn-air Treatment

111 'rriiiiKcn.osis.

Tuberculosis

Hospital and Sanatorium

Construction

WRITTEN FOR

THE NATIONAL ASSOCIATION FOR

THE STUDY AND PREVENTION OF

TUBERCULOSIS

BY
THOMAS SPEES CARRINGTON, M.D.

ASSISTANT SECRETARY

THIRD EDITION, REVISED AND ENLARGED

NEW YORK

105 EAST TWENTY-SECOND STREET

1914

yiiiai

Preface to Third Edition

In preparing the third edition of this book the reading matter containing
descriptions of buildings has been revised and in a large number of instances entirely
rewritten. An effort has also been made to give architects and others a better idea
of the factors which tend to produce economy and ease in maintaining an institution.

A new section on pavilions for housing children suffering from pulmonary
tuberculosis has been added, as the planning of these buildings has assumed the
proportions of a problem since the last edition was published.

The author has aimed to bring to the notice of those interested in the sani-
tary housing of tuberculous patients certain buildings which seem to have given
satisfaction both to the staff' who serve in them and to the patients for whom they
are erected. During the past few years the plans for tuberculosis hospitals have
become more nearly standardized. Certain characteristic details of construction
are now generally accepted as essential to a well arranged institution and these have
been carefully studied and an effort made to call attention to them whenever they
appear in a plan.

In the earlier editions an estimate of the cost of construction was made when
the exact outlay for building could not be obtained. Such iigures have been re-
vised and the estimates increased in many instances on account of the advance in
the cost of material and labor.

Thomas Spees Carrington.

^lay ist, 1914.

359899

Preface to Second Edition

The present work is an expansion of the pamphlet issued two years ago by
the National Association for the Study and Prevention of Tuberculosis in response
to a pressing demand for information and advice in the establishment of sanatoria
and hospitals.

During this period the emphasis of the campaign has been laid particularly
ui)on the importance of increasing our equipment for the institutional care of tu-
berculous patients. The response has exceeded expectation and has been par-
ticularly encouraging in the degree to which local and state governments have
accepted responsibility for the situation. Under these conditions the problem of
tuberculosis from the institutional point of view is to care for the largest possible
number of patients at the lowest possible cost compatible with eflicient results.

While it is true that institutional expense is much more a matter of main-
tenance than of original cost of construction it is equally true that careful prelim-
inary planning is the chief factor in subsequent economy of operation. It is with
this end in view that the following study has been prepared.

It is hoped that the book will prove of service to those charged with the
responsibility of dealing with the institutional problem in their several communities.

Livingston F.arr.wd,

Executive Secretary.
May ijth, igii

Contents

PAGE

Introduction . . . . . • • • • • • .12

Section I. Site and Grouping . . . . • . ■ • iS

Sanatorium Sites; Transportation F"acilitics; Extent and Nature of the Land;
Lighting, Water and Sewage; IMeteorological Conditions; Natural Beauty; Ex-
amination of the Land; Farm Buildings; Grouping; Cleaning and Apportioning
Grounds; Railroad Station; Buildings and Improvements for Block Plan; Sites
for Hospitals to House Advanced Cases; Examples of Grouping and Sites.

II. Administration Buildings . . -35

Methods of Sanatorium Administration; Planning Administration Buildings;
Class and Number of Patients; StafT and Servants' Housing; Staff and Ser-
vants' Salaries; Service Buildings; Amusement Pavilions; Industrial Buildings;
Water Supplies; Light. Heat and Power; Laundries; Sterilizing Rooms; Vacuum
Cleaning Plants; Ice Houses and Cold Storage Plants; Carpenter and Paint
Shops; Store Houses, Bakeries and Scale Houses; Green Houses, Forcing Beds,
Vegetable Cellars; Garages, Barns and Stables; Farm Outfits; Cow-barns; Silos;
Milk Houses; Chicken and Hog Houses; Sewage Disposal Plants; Examples
of Administration Buildings; Examples of Service Buildings.

III. Administration Buildings and Patients' Quarters Combined 67

The Need for Combination Buildings; Planning Combination Buildings; Rooms
for Administrative Purposes; Examples of Complete Institutions Under One Roof.

IV. Pavilions for Advanced Cases. Infirmaries, and Reception Hos-

pitals ......■■• 87

Description of Pavilions for Advanced Cases; Description of Infirmaries; De-
scription of Reception Hospitals; Descriptions of Buildings at Various Institu-
tions.

V. Children's Pavilions . • ii5

The Importance of Children's Pavilions; Planning of Children's Pavilions; Ex-
amples of Children's Pavilions.

VI. Patients' Quarters — Lean-to Type of Building . . -137

Origin of the Lean-to; Material; Excavation and Foundations; Floors; In-
terior Finish; Arrangement of Dressing Rooms; Arrangement of Porches;
Orientation; Heating and Lighting; Examples of Lean-tos.

VII. Patients' Quarters — Cottage Type of Building . . .165

General Description; Examples of Cottages.

Illustrations

l-RONTispii;cE — Dr. Trudeau's Original Cottage.

SIOCTIOX I
Xo. Site and Grouping pace

1 Loomis Sanalorium. Liberty, X. V.,

\'iews of a Farmhouse before and after Remodeling ...... i8

2 X'iews of Land SiiowinR Natural Features

of \'alue on Sites for Sanatoria ......... 20

3 Maryland State Sanatorium, Sabillas\ille, .Md.,

Bird's-eye View ............. 24

4 Georgia Slate Sanatorium, .\lto, Ga.,

Block Plan 25

5 Waverly Hill Sanatorium. Waverly Hill, Ky..

Front Fle\"ation and Block Plan .......... 26

6 Agnes Memorial Sanatorium. I)en\er, Colo.,

Front Kle\'ation and Block Plan .......... 27

7 Indiana State Hosi)ital. Rock\ille, Ind..

Bird's-eye \'ie\v and Block Plan ........ 28

8 Open Air Sanatorium, Portland, Ore.,

Block Plan 29

9 Vermont State Sanatorium, Pittsford, Vt.,

View of Front Elevation and Block Plan ........ 30

10 Essex County Tuberculosis Hospital, Soho, N. J.,

View of Buildings and Block Plan . 31

11 Elaine State Sanatorium. Hebron. Me..

View of Buildings and Block Plan . . 32

12 Preventorium for Children. I'"armingdale, X. J.,

Bird's-eye \'iew of Building and Block Plan ..... -33

SECTION H
Administration Buildings

13 .\dirondack Cottage Sanitarium, Saranac Lake. N. Y.,

.Amusement Pavilion; Views and Plans ........ 38

14 Municipal Sanatorium, OtisxHlle, N. Y.,

Servants' Open .\ir Sleeping Pavilion ......... 39

15 .\n Open Air Dining Room,

View of Front and End lOIevation ......... 40

16 Open .Air Sanatorium, Portland, Ore.,

.Amusement Pavilion; Interior . . .41

17 Catawba Sanatorium. Catawba, \'a.,

\ Method of Storing Water 42

18 \Va\erly Hill Sanatorium. \\'averl_\' Hill, Ky.,

View from Rear of Buildings Showing Power House ...... 44

19 Preventorium for Children, I'armingdale, .\. J.,

Power House and Laundry; Elevations and Floor i'lans ..... 45

20 District Tuberculosis Hospital, Lima, Ohio,

Floor Plan of Basement Showing .Vrrangenu-nl of Power Plant .... 46

21 A Rectangular Sleam Disinfecting Chamber,

View of Side and ()[)en End ........ 48

22 I'Aidowood Sanatorium. 'I'owson, .Md..

.Administration Building; \'iew and I'loor Plans ...•■■■ 53

23 Maine Stale Sanatorium, Hebron, Me.,

.Administration Building; \'iew and i'loor Plans ....■■ 55

24 Iowa State Sanatorium, Oakdale. hi..

.Administration Building; \iew and I'loor I'lans ....... 56

25 Manitoba Sanatorium, Ninetle, .Manitoba, Canada.

.Adminislralion Building; \'iews and I'loor Plans ...•■•• 57

26 Indiana State Hopital. Roi kville, ind.,

.\dministration Building; \iew and i'loor Plans . • ■ • ■ 59

27 i'resentorium for Children, i'armingdale, X. J..

.\dminislration liuilding; View and I'lo.ir I'lans ...... bo

28 Municipal Sanatorium. ()tis\ille, N. A'.,

Service Building; \ icw and I'loor Plans . .... 62

Illustraticms

No.
29

Iowa State Sanatorium. Oakdale, la..

Service Building; \'ic\vs and Moor Plans
Catawba Sanatorium, Catawba, \'a..

Ser\-ice Huildinc;; Eie\'ation and Floor Plan
Xcw Haven County State Sanatorium, Meriden, Conn.,

Service Buildin<r; \'iew and Floor Plans

64
6.^

SECTION III
Admixistr.^tiox Buildings and P.a.tients' Qu.arters Combined
2,2 Eastern Maine Hospital, Bangor, Me.,

Method of Protecting Sleeping Porch with Wire Netting
2,1 United States Hospital for Insane, Washington. D. C.

Method of Enclosing Porch, with Swinging Sash F'rames

34 Sharon Sanatorium. Sharon, Mass.,

Mew and Floor Plan .....

35 Tuberculosis Hospital, \\'ashington, D. C,

Mew of Front Ele\ation ....

36 Tuberculosis Hospital, Washington, D. C,

Floor Plans ......

37 Lady Grey Hospital, Ottawa, Canada,

Mew and Floor Plans ....

38 Lake Edward Sanatorium, Lake I^dward, (Quebec, Canada,

Mew and Floor Plans ....

39 Franklin County Tuberculosis Hospital, Columbus, Ohio,

Mew and Floor Plans ....

40 Hartford County State Sanatorium, Hartford, Conn.,

Mew and Floor Plans ....

41 Cuenca Sanatorium, Bass Lake, Minn.,

Elevation and Floor Plans ....

42 Sunnyrest Sanatorium, Colorado Springs, Colo.,

Mew and Floor Plans ....

43 District Tuberculosis Hosiiital, Lima, Ohio,

Mews and Floor Plan ....

44 Design for a Small Town or Village Hospital,

Ele\ation and Floor Plan ....

69
69
70

72
73
75
77
79
81
82

83
84
86

SECTION IV

P.A.VIL10NS FOR Advanced Cases, Infirmaries and Reception Hospitals

45 Comparison of the Floor Plans of Infirmaries, Reception Hospitals, and

Buildings Housing Ad\'anced Cases .......

46 Indiana State Hospital, Rockville, Ind.,

A ^Method of Connecting Rooms with Open Porches ....

47 Isolation Hospital, Paterson, N. J.,

A ^lethod of Heating Porches for Advanced Cases ....

48 Riverside Hospital, New York City,

Concrete Pavilion; Elevation and Floor Plans .....

49 Jewish Hospital for Consumptives, Reisterstown, Md..

Pavilion for Advanced Cases; Mews of Elevations ....

50 Jewish Hospital for Consumptives, Reisterstown, JVId.,

Pa\'ilion for Advanced Cases; Floor Plans ......

51 Indiana State Hospital. Rock\ille, Ind..

^^'ard Building; Mew and Floor Plans .......

52 Isolation Hospital. Paterson, N. J.,

Tuberculosis Pa\ilion; Mew and Floor Plans .....

53 United States Army General Hospital, Ft. Bayard, N. M.,

Otificers' Dormitory; Mew and Ploor Plan .....

54 United States Army General Hospital, Ft. Bayard, N. M.,

F3nlisted Men's Ward No. 2; Mew and Floor Plan ....

55 United States Army General Hospital, Ft. Bayard, N. M.,

Enlisted Men's Ward No. 2; Mew of Inner Court ....

56 Lakeville State Sanatorium, Middleboro, Mass..

Pavilion for Men; Mew and Floor Plan ......

57 Boston Consumptives' Hospital, Mattapan, Mass.,

Pa\'ilion for Advanced Cases; View and Floor Plan ....

58 Alaine State Sanatorium, Hebron, Me.,

Infirmary; View and Floor Plan .......

59 Municipal Sanatorium, Otisville, N. Y.,

Women's Infirmary; Views of Front and Rear Elevations

90
91
93
94
95
96

97
98

99
100

lOI

102
103
104

Illustrations

No.

60 Municiiial Sanatorium, Olis\ille, X. V.,

\\'omen's Infirmary; I'loor Plans

61 Eudowood Sanatorium, Towson, Md.,

Infirmary; \'ie\vs and Floor Plan.

62 Kdward Sanatorium, Xapervillc, 111.,

Infirmary and Medical Buildin<;; \'ie\v and i'incir Plans

63 -Kdirondack Colla^i- Sanitarium. Saranac Lake, \. \'.,

Infirmary and Medical iiuildini^; \'ie\v and Moor I'lans

64 Maryland Slate Sanatorium, Sabillasville, Md.,

Infirmary; \'ie\v and Floor Plans

65 (ieorgia State Sanatorium, .\lto, Ga.,

Infirmary; \'ie\v and Floor Plan

66 Ohio State Sanatorium, Mt. X'crnon, Ohio,

Reception Hos[iilal; \'ie\v and Floor Plan

67 Danvers State Hosi)ilal, Hawthorne, Mass.,

Tuberculosis Pavilion; \'ie\v and Floor Plan

105
106
108
109
no
III
112
114

SECTIOX V

Children's Pavilions

68 Gaylord Farm Sanatorium, Wallingford, Conn,.

Children's Cottage; View of One of the Wards

69 Westfield State Sanatorium, Westfield, Mass.,

Girls' Pavilion; View of Porch and Interior .

70 X'opeming Sanatorium, Duluth, Minn.,

Children's Cottage; \'iew and Floor Plans

71 John Sealy Hospital, Galveston, Texas,

Ward for Children; \'iew and Floor Plans

72 Boston Consumptives' Hospital, Mattapan, Mass.,

Children's \\'ard; Views and Floor Plans

73 Willard Parker Hospital, Xew York,

Measles Building; View and Floor Plans

74 Hospital for Consumptive Children, Weston, Ont.,

Mew and Floor Plans .....

75 Gaylord Farm Sanatorium, WaUingford, Conn,,

Children's Cottage; \'iew and Floor Plan

76 Children's Cottage for Congregate Institutions,

Elevation, Longitudinal Section, and Floor Plans .

77 Massachusetts Hospital School for Crippled Children, Canton, Mass.

\'iews of I'ront and Side Elevations and Interior of Ward

78 Preventorium for Children, Farmingdale, X^. J,,

Dormitory Building Xo, 1 ; Elevation and Floor Plans .

79 Chicago Municipal Tuberculosis Sanatorium, Chicago, 111.,

Open .\ir Cottage for Children; View and Floor Plan

80 Westfield State Sanatorium, Westfield, Mass.,

(iirls' Pavilion; \'iew and Floor Plan . , . .

81 Westfield Slate Sanatorium, Westfield, Mass.,

Children's I'avilion; Moor Plan .....

118
119
121
122
124
126

120
131
132
133
135
136

SECTIOX \I

P.VTIENTS' Ql'.VRTERS — LE.\N-T0 TyPE OK Bl'ILUING

82 Comi)arison of i'loor Plans of the Lean-to '\y\w of Buildings

for Housing Patients with Incipient Tuberculosis .

83 Catawba Sanatorium, Catawba, Va.,

.\n OjK-n Porch, Illustrating Simplicitv of Construction

84 Xorth Reading State Sanatorium, .North Reading, .Mass.,

.\n Open Porch, Illustrating a .Method of Proteilion

85 Virginia Stale Farm, Richmond, \'a..

Ojien Porch, Illustrating a .Method of Protei lion

86 Schenectady County Tuberculosis Hosi)ital, Sciienectad_\ . X. N'

Ojien Porch, Illustrating a Method of Protection

87 Loomis Sanatorium, Liberty, .\. \'.,

Lean-to; \'iew and i-loor Plan ...

88 .Michigan Slate Sanatorium, Howell. .Midi..

Lean-lo; \'iew and i'loor i'lan ....

89 Maryland Slate Sanatorium, Sabillasx ille, .Md.,

J.,ean-lo; View, Cross-Sei tion and i-loor Plan

90 Delaware Slate Sanatorium, Wilmington, Dela.,

Lean-to; \'iew and {•'loop Plan ....

1 38
140

141
142

•43
144

145
146

147

Illustrations

No.
91

92
93
94
95
96

97
98

99
100

lOI

102

103
104

105
106

Meriden, Conn.

Ohio Stale Sanatorium, Ml. X'ernon, Ohio,

Lean-lo; \'ic\v and Floor IMan
Georgia State Sanatorium, Alto, Ga.,

Design for a Lean-to .
New Haven County State Sanatorium,

Lean-to; \'ie\v and Floor Plans
Catawba Sanatorium; Catawba, Va.,

Lean-to; \'iew and Floor Plan
Manitoba Sanatorium, Ninette, ]\Lanitoba, Canada,

Lean-to; View and Floor Plan
Edward Sanatorium, Naperville, 111.,

Lean-to; View and Moor Plan
Iowa Stale Sanatorium. Oakdale, la..

Lean-to; \'iew and Floor Plan
Eudowood Sanatorium, Towson, Md.,

Lean-lo; \'iew and Floor Plans .
JSIunicipal Sanatorium, Olisville, N. Y.,

Lean-lo; View and Floor Plan
Hazelwood Sanatorium, Louisville, Ky.,

Lean-to; View and Floor Plan
North Reading Slate Sanatorium, North Reading, Mass.,

Lean-lo; View, Cross-Section and Floor Plan
Edward Sanatorium. Naperville, III.,

Lean-to; View and Floor Plan
Iowa Stale Hospital, Ml. Pleasant, la..

Lean-lo; Elevation and Floor Plan
Rush Hospital, Country Branch, Malvern, Pa.,

Lean-to; View and Floor Plans
Loomis Sanatorium, Liberty, N. Y.,

Lean-lo; View and Floor Plan .
^Municipal Sanatorium, Olisville, N. Y.,

Lean-lo; View and Floor Plans
^Michigan Stale Sanatorium, Howell, Mich.,

Design for a Lean-lo . . • ■

New York Slate Hospital, Raybrook, N. Y.,

Design for a Lean-lo . . . ■

149

I. SO

151

152

153

154

155

156

157

158

159

160

161

162

163

164

SECTION VII

P.\TIENTS' QU.ARTERS — C0TT.A.GE TyPE OF BUILDINC

109 Millet Sanatorium, East Bridgewater, Mass.,

Collage; View, Cross-Sections and Plans ....
no Rush Hospital, Country Branch, Malvern, Pa.,

Cottage; View and Floor Plan

111 Adirondack Collage Sanitarium, Saranac Lake, N. Y

Collage; View and Floor Plan

112 Hazelwood Sanatorium, Louisville, Ky.,

Collage; \'iew and Floor Plan

113 While Haven Sanatorium, While Haven, Pa.,

Collage; View and Floor Plan

114 Municipal Sanatorium, Olisville. N. Y.,

Collage; View and Floor Plan

115 Plainfield General Hospital, Plaintield, N. J.,

Collage; \'iew and Floor Plan

116 Iowa State Sanatorium, Oakdale, la..

Cottage; View and Floor Plan

117 Adirondack Cottage Sanitarium. Saranac Lake, N. Y.

Wheeler Cottage; View and Floor Plan

118 Gaylord Farm, Wallingford. Conn.,

Connected Collages: View and Floor Plans

119 Barlow Sanatorium, Los Angeles, Cal.,

Cottage; View and Floor Plan

120 Open Air Sanatorium, Portland, Ore.,

Cottage; Views . . . ■ •

121 Loomis Sanatorium, Liberty, N. Y..

Orchard Cottage; View and Floor Plan

122 Adirondack Cottage Sanitarium, Saranac Lake, N.

Nathan Cottage; View and Floor Plan

123 River Pines Sanatorium, Stevens Point, Wis.,

Cottage; View and Floor Plan

167
168
169
170
171
172
173
174
175
176
177
178
180
181
182

Introduction

It i> hoped thai this work will be found useful by those who desire to design and
construct ht)spital and sanatorium buildings for the care of tuberculous patients.

The information presented has been collected during a series of investigations into
the methods and materials used in the construction of buildings at various institutions
where patients are treated for all varieties and stages of tuberculous disease. This book
is a development and expansion of the original pamphlet on construction, "Some Plans
and Suggestions for Housing Consumptives," published in 1909 by The National Associa-
tion for the Study and Prevention of Tuberculosis, and includes the results of studies made
on the question of sites, in order to determine in some degree the effect of location and
surroundings from both the clinical and economic points of view. During the past two
years, in a number of states, legislation has been enacted authorizing counties to establish
institutions for the treatment of tuberculous patients. The rapid growth of this move-
ment has brought about many new problems in the construction and maintenance of hos-
pitals and sanatoria, and it has been the aim to embody in this work such material as might
helj) in the solution of these difficulties.

Cost of Construction

It is the opinion of the majority of those who have had experience in constructing
and administering tuberculosis hospitals and sanatoria, that it is wise to build in a compara-
tively inexpensive manner. Excellent results have been obtained by the open air method
of treating tuberculous patients in institutions built on simple and economical lines, and
further, this class of institution returns patients to their homes without making them un-
duly discontented with the environment and life to which they belong. It may therefore
be said that those who adhere to simplicity and economy in sanatorium construction and
furnishing, and who supply patients with good wholesome food, cleanliness, light employ-
ment, and a happy, friendl_\' atmosphere, are operating along modern asul ai)])ro\ed lines.

One of the first cjuestions asked when the establishment of either a sanatorium for
incipient cases or a hospital for advanced cases is proposed in a community, is. "What
funds will be needed for constructing and maintaining the institution? "' In general terms
it may be stated:

A sanatorium for incipient cases, ha\ing a cai)acit\' of tift>" patients, will cost to
build and eijuij) (exclusi\-e of the land) $38,000 and upward.

A hospital for advanced cases, having a capacit\- oi lifty ])alients, will cost to
build and ef|uip (exc!usi\-e of land) $65,000 and upward.

.\ ho>pital for both classes of cases, ha\ing a caiiacity ol til'ly palirnts. will cost
to build and e(|uip (exclusi\e of land) S50.000 and up\var<l.

In otluT words, it will cost to build and equip a conipK'te institution for inciiiienl
cases about S750 per bed; for adxanced cases 81,250 i)er bed; and for lioth classes i)f
cases in the sanii' institution Si, 000 ])er bed.

Introduction

Cost of Administration Buildings

Administration buildings for an institution housing fifty patients can be constructed
for $18,000 and upward, the cost depending upon the material used and the exterior and
interior finish.

Cost of Infirmaries and Pavilions for Advanced Cases

Infirmaries and pavilions for advanced cases, having a capacity of twenty patients
housed in single rooms, can be constructed for $10,000 and upward.

Cost of Lean-tos

Lean-tos having a capacity of sixteen incipient cases can be constructed for $2,500
and upward.

Examples of Appropriations

The following list is given in order to show how, in an actual case, $100,000 was
expended for the construction of a State Sanatorium housing one hundred and fifty patients
of all classes except the very far advanced cases.

Administration Building $31,500

Four Lean-tos (each $3,500) 14,000

Two Wards for Advanced Cases (each $7,000) 14,000

Power House and Heating Plant 5,000

Sewage Disposal Plant 2,000

Water Pumping and Supply Plant 5'°°°

Boilers and Machinery 3>5'^°

Furnishings 7 '°oo

Laundry 1,200

Land (Site) So^o

Expenses of Building Commission ii,5°°

Total $100,000

The following is cited in order to show the distribution of an appropriation for the
construction of a County Hospital having a capacity for fifty patients of all classes.

Site, Water Supply and Sewage Disposal $10,000

Administration Building 18,000

Advanced Case Pavilion (Twenty Beds) 10,000

Two Incipient Case Pavilions ($2,500 each) 5,ooo

Total $43'000

Arrangement of the Floor Plans for Administration Buildings

Many administration buildings constructed for tuberculosis hospitals or sanatoria
have been designed on general hospital lines. This has not proven to be the most satisfac-
tory type of building for administrative purposes, as the medical staft", nurses, and servants
are often arrested or cured cases of tuberculosis. Administration buildings that seem
best adapted for institutions of this class are those constructed so that all persons housed
in them may have, if desired, individual open air sleeping porches. For this reason,
it is the opinion of many authorities that all buildings for tuberculosis institutions should be
of the open type; that is to say, with walls pierced by as many windows reaching from the
floors to the ceiling as possible, and all apartments arranged so that they may be thrown

. 13

Introduction

open on at least two sides. Amusement halls, reading, dinin<f, and sitlin<f rooms, which are
constructed as small indixidvial huildin^s, and arran<:;;cd to be opened on all sides when the
weather permits, are being erected in greater numbers, and prove satisfactory. Buildings
used bv the administrative departments, e.xcejn in cities or towns where land is valuable,
are said to gi\e better service when entirely sei)arated from the patients' quarters. Where
sites are large enough, one-storv buildings, e\en for admini>lrati\e ])ur])()ses. are becoming
po])ular.

Arrangement of Floor Plans for Housing Advanced Cases

Pa\ ilions for advanced tuberculous cases have also, in the past, been constructed in
the same manner as general hospital wards, but as it has been found that many advanced
tuberculous patients, with proper care, cjuickl_\- impro\-e under the open air treatment, these
buildings are now being planned so that open porch space may be allotted to all the inmates,
and indi\idual rooms ]^ro\ide(l for all far ad\anced cases.

Arrangement of Floor Plans for Housing Incipient Cases

The onlv changes of importance made in designing the lean-to type of building
have been in the provision of larger lockers for each patient; of glass and sash frames for
the more thorough protection of the open front of sleeping porches during winter storms;
and in placing transverse partitions on the porches in order to house the patients in smaller
groups. It mav be said that practically all new designs call for lockers which are large
enough to be used as private dressing rooms, and in many instances titled with a chest of
drawers, a mirror, racks for toilet articles, and other conveniences.

Transportation

The importance of keeping down the cost of maintaining an institution after it is
erected should be always before those selecting the site and planning the buildings. Trans-
portation expense is one of the larger factors in this problem, and it is becoming clearer that
public institutions must be placed on or near good transportation facilities. In a number
of instances, railroad companies have willingly put in spurs or sidings free of charge, when
the site chosen was near their right-of-way. It is advisable that authorities considering
the establishment of a sanatorium or hosi)ital, study this question with care before ])ur-
chasing an otherwise desirable jiroi^erty.

SECTION I
Site and Grouping

Sanatorium Sites

In selecting a site in the open country for a tuberculosis sanatorium to house in-
cipient and moderately advanced cases, a decision must be made as to whether the ad\-an-
tage of having the patients near at hand and accessible to iheir friends overweighs the
possible benefit to be obtained by placing the institution in a region more favorable from
a climatic point of view, but far from the patients" homes. It is now generally agreed
that in the treatment of tuberculosis excellent results can be obtained in practically any
section of the country and the desirability of local institutional i)rovision may be ac-
cepted as an established fact. Within a short distance of almost every city and town,
land can be obtained where tuberculous patients will do well.

Transportation Facilities

Transportation facilities should always be carefully considered, as a long haul from
the railroad or landing adds expense both in building and maintenance. Probably in the
near future most of the institutions founded with the intention of housing over one hundred
patients will be placed upon land that can be reached without great expense by a pri\ate
branch or spur from the nearest railroad, or by some other means of public transportation.
A site on a direct trolley line is very desirable in order to make it accessible to the patients'
friends. It is often hard to hold consumptives in a sanatorium, for the \ery sick do not
like to leave their families, and many incipient patients become restless when first com-
pelled to drop their regular occupations. If a sanatorium is close to the towns from which
most of the patients are drawn and where by a short trolley trip \isitors can reach it easily.
the location will help \ery largel\' in making the ])atients contented.

Extent and Nature of the Land

The site should be a tract of land from twenty to two hundred acres in extent and
it will be more \aluable for its purpose if it includes forest, orchard, and land that can be
cultivated. It is now generally conceded that incipient patients improve faster when they
are supplied with work under careful supervision, and at many sanatoria, if directed by an
efficient medical superintendent, they will l)e able to (\o a considerable part of the farm work
with real benefit to themselves and a reduction in the cost ol" their niaiiUenaiice. When
there is a choice of a number of sites, a dami) or swampy location should be avoided, as such
land when selected must be drained. Tlie expense of jireparing some land is very great,
while the natural advantages of another propert\- may be such that a large outla\- for im-
provement is not necessarw I'Or these reasons it is advisable to have a thorough examina-
tion of possible land made before it is chosen as a site for a sanatorium.

Site and Grouping

Lighting, Water, and Sewage

A good supply of water is a necessity, and for this reason when building near a city it
is well, if possible, to secure property within the line of the city water supply and sewer
systems, thus settling the question of walcr, sewage disposal, and lights. On all other land
considered there should be good springs, a running stream of clear water, or the possibility
of obtaining it by driving a thoroughly protected well. The disposal of sewage must also
be considered before the land is acquired, as the quality of the soil, the rise of the land, and
the position of water courses and lakes enter into the question and increase or reduce the
cost of installation and maintenance. These subjects are all considered more in detail
under the section on administration buildings.

Meteorological Conditions

It is very important that the meteorological conditions of a prospective site should
be known. This means obtaining data with regard to the altitude, average humidity,
number of stormy days in the year, highest and lowest degrees of heat and cold, prevailing
winds, and any atmospheric peculiarities which might affect either the patients or building
materials. It is well to remember that vastly differing conditions are often found within
a radius of a few miles; such information should, therefore, be gathered on the site itself.
Land where strong winds prevail during certain seasons of the year and where heavy frosts
occur more frequently during the winters than in other nearby localities should be avoided
if possible. Usually the southern exposure of a hill or mountain is to be preferred.

Natural Beauty

The problem of holding tuberculous patients at sanatoria grows more serious each
year, and as the institutional care of certain classes of cases seems to be an absolute necessity
in order to control the disease, every effort should be made to place patients upon sites
that have natural attractions which will help to amuse and make them contented. The
open country, where a sanatorium for incipient cases is generally placed, usually offers a
choice of sites some of which may have great natural beauty. In making a selection from
several pieces of property offered, this should be considered as a valuable asset. A sloping,
rolling, or hilly piece of land is more desirable than a level one. Mountains, hills, meadows,
and trees add to the beauty of the view, and a forest, lake, or stream gives opportunities for
amusement. A great deal can be done by artificially improving the grounds where there
is a lack of natural beauty, and in the selection of a site in a bare or fiat country this should
be planned for.

Examination of Land

The following questions used by The National Association for the Study and Preven-
tion of Tuberculosis when asking for information needed by its Bureau of Hospital and
Sanatorium Construction, may be of some assistance to those examining a property for the
purpose of determining its value as a site for hospital and sanatorium purposes.

1. How many acres of land are available for sanatorium purposes?

2. Is the ground flat, rolhng, or on a hillside?

3. What is the degree and exposure of the slope of the hills?

4. Are there trees for protection from prevailing winds?

5. What is the direction of the prevaihng winds in summer? In winter?

6. What is the altitude above sea level and above surrounding country?

7. What is the amount of moisture precipitation per year?

Section I

No. I. Loomis Sanatorium, Liberty, N. Y. \ ii;\vs ok a Kakm Hoi sk ui:i-okk and ai-iek Ri:Mi)Ut;LiM.

XoTi; Till-; WiDK Si,i.i:i'i\(; I'orc iii;s Constkh ti;i) o\ tiik I-'kont ok thk lU'ii.niNC. in thi: LowKR

Illustration. (Sec illuslratiuns S;, 105 and 1 :\ fnr lurllu-r (Icscriplion of ilii> instilulion.)

Site and Grouping

8. What is the average amount and duration of snow?
g. What is the highest and lowest recorded temperature?

10. What is the mean temperature of the winter months?

11. What is the mean temperature of the summer months?

12. Is it possible to use the local water supply of the nearest town?

13. At what height on the property above or below the building site is the water

supply?

14. What is the amount of water flow in gallons per minute?

15. What is the direction and size of the water courses on the property?

16. What are the lighting facilities in the neighborhood, gas, electricity, etc.?

17. What is the composition of the soil?

18. What bviilding materials are available on or near the property? Can sand,

building stone, rough stone for foundation, brick, cement, lime, and timber
be easily obtained?

19. W^hat are the transportation facilities, such as railroad, trolley lines, etc.?

20. Where is the principal approach to the proposed site?

21. What is the distance from the nearest saw and planing mill?

22. Are there any old buildings on the site? (Give full description with a drawing

of the floor plans and photographs of the front and side elevation.)
Note: A contour map of the proposed property showing the topography of the
land, location of buUdings, entrances, water courses, etc., is very desirable.

Farm Buildings

Often farm houses or other structures stand on the land chosen and can be remodeled
so as to make useful sanatorium buildings. The expense of constructing the institution may
be materially reduced if these are good, substantial structures, but they should be examined
carefullv and insanitary conditions corrected, especially if the buildings are damp at any
season of the year. Careful inspection of the plumbing, drains, and cellar should always be
made bv an experienced sanitarian. When the walls of the cellars are damp, some method
should be used to obtain a circulation of air about the foundation. This can be done by a
trench opened on the outside of the house, and a new wall built beside the old foundation,
leaving an air space between the two walls. The cellar floor should then be relaid with a
foundation of broken stone, covered with cement, and openings made in the cellar walls to
procure plenty of light and air. The greatest care must be used to prevent dampness
around all old buildings; in some places a subsoil system of drainage will be needed, while
in others it may be necessary to remove trees close to the house.

In all rooms where there is sufficient wall space, new windows should be made and
old windows cut down to the floor and up to the ceiling. Ventilation for the winter months
may be obtained by building fireplaces or installing ventilating flues and other appliances
used to give a continuous change of air. Often it will be necessary to install baths and
toilets and have connections made with the water supply and sewage disposal plants.

Many old farm-houses are built of heavy timbers which are usually well preserved
and can be repaired and put in excellent condition without great expense. When planning
a rearrangement of an old building for administration purposes a large dining room is
usually the most important apartment to be provided, and often can be made by removing
the partitions between rooms on the ground floor and throwing tw^o or three together.
Many institutions have been started by housing the administrative department in old
buildings which were only large enough for a kitchen, dining room, and office on the first
floor, and a few rooms for the staff on the second. A small hospital started in this way may
provide for a large number of patients.

An old country mansion will often make a good administration center for a small,

Section I

No 2 The Natural Features of the Land shown in These Views Greatly Add to the Value of

Property for Sanatorium Sites. Iiik (Ik.-ii. <.i- Hni.Disr.s in tmk I ppkk li m stkaih.n

IS Till. Haki.ow San atokkm. (See a description of llie iotlaf,'es on pai^e i , ^.j

Site and (koupin^

private sanatorium, in many cases without remodeling. Small cottages of the :\Iillet
type (Illustration loy), or those of the Open Air Sanatorium, Oregon (Illustration 120), can
then be built about the grounds for a comparatively small outlay.

The barns and out-buildings, if in good condition, will also save considerable
expense, for they can be used for housing cows, chickens, and other domestic animals which
should be counted on to reduce the cost of maintenance.

Grouping

There is a constant call for information as to the best method of arranging buildings
on the site for a new institution in order that the plant when completed can be run without
undue waste of funds or energv. The economical operation of a hospital or sanatorium
after it is finished and tilled with patients is of much more importance than the initial cost
of construction. Many existing sanatoria of large size were started in a small way, ad.
ditions being made in a haphazard manner as necessity required, and very little planning
done before the construction of the plant was commenced, except for administration build-
ings, power houses, and patients' quarters. It is also a fact that the superintendents of a
number of new institutions have found after their plants were supposed to be ready for
good work, that large additions to their buildings were necessary to reduce the cost of
maintenance to a defensible figure. In order to overcome this difficulty in the future, for
projected institutions, a general block plan of the site should be made before construction
is started. This is particularly true for public institutions depending for their support
upon the good will of the community which they are to serve, as it will greatly help in
producing a symmetrical whole and avoid waste in maintaining the plant when completed.
In planning a new hospital or sanatorium the object should be to house the patients in a
way that will provide as much comfort as possible. The size of the site and the block plan
of the grounds depend upon the number of buildings to be erected and the manner in which
the completed institution is to be administered.

Grounds

For a sanatorium having a capacity of about one hundred patients situated in the
open country, a site should consist of about two hundred acres of land, to be apportioned
somewhat in the following manner.

20 to 40 acres for sanatorium buildings, amusements, park, forest, and lake.

10 to 20 acres for farm buildings and the care of domestic animals.

20 to 30 acres for a vegetable garden and potatoes.

10 to 20 acres for an orchard and small fruits.

20 to 30 acres for corn fodder.

60 to 80 acres for pasture or grain.

Usually a part of the site must bt^ cleared and laid out as a park, with walks and
drives, while roads and cement or gravel paths with water mains beside them and lire plugs
at suitable points are required near and between the buildings. For such improvements on
the grounds from $2,000 to $10,000 should be appropriated.

Railroad Station

Where a site is situated beside or near a railroad or an interurban trolley system, the
institution should have a station, and in sparsely settled parts of the country the transporta-
tion company may be willing to construct it for the sanatorium. The building may be a

Section I

one story frame or brick structure 1 5 feet wide by 30 feet long, divided into one large room
fifteen feet square and two small rooms 7 feet wide by 15 feet long, and ha\ing at one end a
covered freight shed 10 feet wide by 20 feet long. When the right of way is near the sana-
torium buildings the station can be used to house the ])ost-olBce, telephone exchange, ex-
press ofl5ce, and a store for the convenience of the patients who often wish to purchase
material for personal use.

It is said to be an advantage to a transportation company to obtain the location of a
sanatorium near its right of way and in many sparsely settled sections of the country the
company may be willing to give the land for the institution's site. The sanatorium has a
great educational value; it gives employment to local people; it has a pay-roll of from
$1,000 to 81,500 per month, a part of which, at least, is expended in the neighborhood; it
brings friends and \-isitors to nearby hotels; benefits the merchants; and creates a market
for produce raised in the vicinity.

Buildings and Improvements for Block Plan

The following is a list of the Ijuildings and improxemcnts to be considered by the
architect when laying out the site.

Administration Building.

Service Building.

Patients' Pavilions.

Amusement Pavilion.

Power House (Heating, Lighting, and Water Supply).

Laundry and Sterilizing Room.

Industrial Shop.

Ice-house or Cold Storage.

Railroad Station, Post-office, and Telephone Exchange.

Carpenter and Paint Shop.

Store House, Scale House, and Bakery.

Greenhouse.

Cold Frames or Forcing Beds.

Vegetable Cellar.

Garage.

Barn for Horses.

Barn for Cows.

Silo.

Milk House.

Chicken Houses.

Hog House.

Sewage Dis])osal Plant.

Sites for Hospitals to House Advanced Cases

The choosing of a site and the gr()Ui)ing of the buildings of a hospital for far ad-
vanced cases usually presents an entirely different problem from that involved when
founding a sanatorium for incipient and moderately advanced cases. It is usually desirable
to provide for the advanced patiunt in or near the town from which lu- comes, and therefore
the choice of a site is largely go\criu(l by the cost of tlir land and the attitude of the
surrounding property owners.

A hospital for this purpose should not be placed in a (|uarter when- noise, the smoke
from factories, or the dust from uncared-for streets will affect the i)alients. Otherwise,
almost any site is suitable which can be easily reached, and is large enough to allow for the
construction of porches on the Imildings. These questions are considered more in detail
in Section 111, .\(lniini>lration Buildings and Patients' Quarters Combined.

Site and Groujiing

EXAMPLES OF GROUPING AND SITES

The following institutions are good examples of various methods of grouping build-
ings and laying out sites.

The Maryland State Sanatorium, Sabillasville, Md. (Illustration 3). This is
a well chosen site for a state institution, situated near the top of one of the mountains
of the Blue Ridge range, sixty-seven miles from Baltimore on the Western Maryland
Railroad. The sanatorium owns the station and has placed its power house on a siding
close to the railroad in order to run coal cars directly over the storage bins. The building
site is reached from the power house and railroad station by a well graded macadamized
road twenty feet wide and a quarter of a mile long, which ascends gradually through a
beautiful woodland. The buildings have been placed on a comparatively flat piece of
land lying on the south side of the mountain, with a beautiful view of the valley. Behind
them the ground rises for about four hundred yards, protecting the site from the north
winds. At the top of this ridge is a concrete reservoir, having a capacity of seventy thou-
sand gallons and supplied with water by pumps in the power house. The buildings are
grouped together as shown in the illustration because of the topographical features of the
land. The administration building stands in front and is connected by a corridor with
the service building directly in its rear. The pavilions for the patients are arranged in two
rows on both sides and to the rear of the main buildings and the slope of the ground allows
a good view of the valley and mountain from their porches, which overcomes the objection
of placing the front of one pavilion directly in the rear of another. The capacity of the
plant is two hundred patients at an estimated cost of $150,000.

The Georgia State Sanatorium, Alto, Ga. (Illustration 4). This site is a tract
of land comprising two hundred and fifty-seven acres, located on the main line of the
Southern Railway, two miles from Alto and seventy-four miles southeast of Atlanta.
There is a station a quarter of a mile from the institution. The elevation is about sixteen
hundred feet above sea level in a part of the country comparatively free from dust and
where the air is said to be pure and invigorating the year round. The land has a general
slope to the southeast and is fairly well protected on the north and west by a rising hill
and forest growth.

The problem to be solved by the architects in arranging the block plan was to care
for seventy-five white patients at the present time and prepare for a future growth of the
institution to three hundred and fifty or four hundred white and colored charity cases of
both sexes. The plan illustrated was adopted because of certain peculiarities in the
contour of the land, which lies in the form of a horseshoe made by a flat with two promon-
tories jutting out from it on the same level. Between the promontories is a ravine forming
the main axis of the block plan. The administration building is located on the flat, directly
at the head of the ravine at the north of all the patients' pavilions, which are arranged
on the two promontories. This plan worked out so well that one contour line runs through
seventy-five per cent, of the buildings, adding greatly to ease of administration, as a level
path connects them. Practically everything on the grounds can be seen from the adminis-
tration building, as the other structures were arranged with that idea in view.

Nearest the entrance to the west is the reception hospital, where all early cases
are housed for observation on their arrival. To the left and front of this is the library.

Section I

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Site and Groujiin^

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No. 4.— Georgia State Sanatorium, Alto, Ga. Scopes & Feustmann, and Walter W. Judell, Asso-
ciated Architects. Block Plan Showing the Contour Lines and the Method of Grouping
THE Pavilions on Two Promontories in Front of the Administration BLnLoiNG. Note the
Negro Quarters on the Left of the Illustration in the Foreground. Capacity 400
Patients. Estimated Cost, $175,000. (See illustrations 65 and 02 for further description of this
institution.)

To the east or on the right of the iUustration is the infirmary, and still east of this is the
dining room and the service building. In front of these main buildings on both slopes of
the promontories are arranged the pavilions for white patients, twenty-four in all, having a
capacity of ten patients each. The floor plan adopted for these buildings is similar to the
King type of lean-to at the Loomis Sanatorium shown in Illustration 87. Back of the
main entrance drive near the road to the station are the stables. On the south and east of
the service building but on a lower level is the women's workshop, and back of the ad-
ministration building are two cottages for the superintendent's family and the medical
staff. Still further to the rear and slightly to the east are a number of small cottages
used as temporary quarters for the nurses or other members of the staff. A service
building similar in plan to the infirmary for the white patients serves the negro quarters
which are practically the same as those provided for the white patients, but entirely
separated from them and concealed by a thick growth of trees and shrubbery. All the
buildings are grouped among the pines on the southern slope of one of the hills, well pro-
tected from the winds and with a pleasing outlook from the porches. About fifty feet
below these buildings in a ravine is a stream fed by a spring alongside of which is placed
the pump house. This is connected with an elevated tank for the storage of water, located
on the highest point of the site to the rear of the stables. There is a good supply of water,
large enough, by constructing a dam, to furnish power for the institution. A farm and
dairy are contemplated, for which there is ample land. This block plan is intended to
show the institution as it will be when completed, and the estimated cost, including power
plant, water supply, and sewage disposal for four hundred patients, was $175,000, divided
among the different buildings as follows:

Section I

Administration HuiUlinii: $18,000

Intirmary 15,000

Roct'ptit)n Buikiin^ . . 15.000

Service lUiiltlin<4 15,000

Thirtv-lwi) Paxilionsat Si. 800 .... 57.600
Twi) workshops at S4.000 8.000

Library S3.000

Recreation Building 3.000

Superintendent's Cottage S^S^o

Doctors' Cottage 3<50o

Stable 5,000

Negro Infirmarv 1 5.000

Waverly Hill Tuberculosis Sanatorium, Louisville, Ky. (Illustration 5). The
\\a\erly Hill site includes one hundred and seventy acres of land, situated on a range
of hills near lro(|Uois Park and (n-eriooking the Ohio River and a magnificent stretch of
country.

The buildings are erected on concrete foundations with walls of frame construction,
covered on the outside with stucco treated in bright and contrasting colors. The roofs
are covered with red tile and the whole makes an interesting block of sanatorium buildings
grouped closely together. The administration building, which is two stories high, stands
alone in the foreground, its side and rear windows overlooking the patients' quarters.
The steep side of a hill in the rear of the service building has been used to advantage in
arranging its position and the relation of the power house to the entire plant. The sana-
torium conducts a farm, owns a dairy herd, and raises poultry in order to give the patients
pure, fresh food and an opportunity for light exercise by work in the open air. The capac-
ity of the plant is forty patients and the cost Sioo.ooo.

■i^^^'^SiC.'Jfe'XS'Sii^'Sr^ -•• - WAVERLY HILL TUBERCULOSIS SANATORIUM

No. 5. —Waverly Hill Sanatorium, Waverly Hill, Ky. J. J. (;.\kfni:y, .Vrciiitixt. Front Klfaatiox

.\M) 1{|.')( K I'l.W SlltiUlM, I'liMolk I, IMS AM) .MkTHOI) OF (IroIPINC, Hril-UINGS 0\ THK KdGE

OK A Hii.L WITH A .Stkkp .Si.oi'K AT THF Rkak. Capaiitv, \o Patiknts. Kstimatko Cost. Sioo.ooo.
(Note back view of plant, illustralion No. iS.)

Site and Grouping

Section I

Agnes Memorial Sanatorium, Denver, Colo. ( Illusiriition 6). This institution,
when first constructed, consisted of an administration building, two pavilions, and a medical
building. The floor plans were outlined by Dr. G. Walter Holden and adapted to the
Si)anish style of architecture. The pavilions are two stories high with porches around
the structures on both floors. Every patient is housed in a separate room 1 1 feet wide by
13 feet deep and these rooms are all equipped with a radiator, a ventilating register, and a
closet 3 feet wide by 5 feet deep. They open on to a central corridor at one end and at the
other upon a veranda 11 feet wide by 8 feet deep which can be curtained off by sliding
screens in order to make the space private when desired. The roofs of the porches are
raised to a height that will allow sunlight to reach each room sometime during the day.
The original buildings enumerated above have a capacity for forty patients and cost
8250,000. In equipping the institution an additional 850,000 was expended.

/^'•t^'fa Hoo5t.

^ontno V^is^

C/n/rY,i Hall

£)i,ocK. -Pi

^£^:,

No. 7.— Indiana State Hospital, Rockville, Ind. Hki hakkk and Stkkn, Ar( ihtkcts. Hird's-kyi: View
A.NU Hi n( K I'l.w. SiKiw i\(, \ ('ii\iiv\( 1 ( Ikoii' of IUii.oincs JIaving a Capai'ity of loo Patients.
Cosi, .Si..i7,ooo. i.Scf ilhislralions lU. 4(1 and 51 for fiirllior (Icscriptioii nf tills institiilion.)

Site and Ciroupinii;

Indiana State Tuberculosis Hospital, Rockville, Ind. (Illustration 7). I'his in-
stitution is a good example of a well chosen site and also of a method of grouping buildings
closely together. The accompanying picture is a bird's-eye perspective of the hospital and
a portion of the grounds. The property cost the state $24,000 (approximately $50.00 per
acre). There are live hundred and four acres of rolling, well w^ooded land of which one
hundred and twentv-tive acres are along the creek bottom. The site lies upon the east side
of the Raccoon Vallev about three miles east of Rockville on a gravel road from Indian-
apolis. The hospital owns a free right of way of about one mile for a railroad spur to con-
nect its propertv with the Central Indiana and the Vandalia Railroads, which run through
the vallev. There are stations and sidings within one mile of the site on both railroads.
From the buildings, which are located on high ground slightly back from the edge of the
blulT, there is a beautiful view of the valley. There is clean gravel for building purposes on
the bottom land, clean, soft water in large quantities in a creek at the foot of the bluff, and
good steam coal nearby which can be delivered on the site at $1.60 per ton. Pure water
for the institution is supplied in large quantities by artesian wells. The plant has a capac-
ity of one hundred patients and cost $137,000.

Portland Open Air Sanatorium, Portland, Ore. (Illustration 8). The site of
the Portland Open Air Sanatorium consists of eleven acres, six miles south of Portland on
a bluff three hundred feet above the river. It is situated in a grove of evergreens, well
sheltered from the winds, and is arranged to house all its patients in separate cottages for
one or two persons each. These are placed around open courts in front of the administra-
tion bviilcUng. This plan will be especially valuable to those interested in institutions
housing private patients in a country having a mild, dry climate and where dressing and
bath rooms do not need to be heated. The institution has a capacity of forty patients at
an estimated cost of $60,000.

No. 8.— Portland Open Air Sanatorium, Portland, Ore. \\'hidden & Lewis, Architects. Block
Plan of a Pkrate Saxatorum Showi.xc; Method of Grouping Cottages about Open Courts
AND their Relation to the Administration Buildings. Capacity, 40 Patients. Estimated
Cost, $60,000. (See illustrations 16 and 120 for further description of this institution.)

Section

•M.V3 con/kc.-

No. Q. -Vermont State Sanatorium, Pittsford, Vt. Scopes & Feustmaxx, Architects. \ii:\\ of
I'ko.xt I':le\ atiox .and Block Pl.\x, Showi.ng Method of Grouping P.wilioxs ix Front .\nu
.\T the Sides of the Administration Building. Capacity, 40 Patients. Cost, §75,000.

Vermont State Sanatorium, Pittsford, Vt. (Illustration 9). The building site
is a tlat i)icc(.' of land with mountains on all sides and protected on the north by a heavy
growth of evergreen timber. About three hundred fei't to tlie south of the institution is a
sharp drop in the land of over one hundred feet, making a ravine in which there is a beauti-
ful brook. The soil is a mi.xture of sand and gravel through which the inliltralion of
moisture is very ra])i(l.

The administration building is ])lanncd with an intirmary in the second story and
proxides an adniinistrati\e ca])acity for from sevent\ li\e to one hundred patients. Ihe
medical olTices are i)laced in the west wing and as far from the service wing as possible, in
order to a\()id the noise from the kitchen. The ixivilioiis are designed with a cajxicity of

Site and Groupin|^

twelve patients each, housed in individual rooms, six patients on a floor. The sleeping
porches are constructed in the form of loggias under the main roof of the buildings rather
than in the usual method. These pavilions are connected with the administration building
by covered ways which are used by the staff in inclement weather and as extra sitting out
space for the patients. The water supply is procured from the Pittsford water works.
The present capacity of the plant is forty patients and it cost approximately $75,000.

Essex County Tuberculosis Hospital, Soho, N. J. (Illustration loj. This group
of buildings is unusual in that the administration building is placed in the rear of the pa-
tients' quarters, and all are on the top of a small knoll with the land sloping rather abruptly
away in every direction. The three buildings are connected by a covered passageway and
the pavilions have porches on the north as well as on the south side of the wards. This
group of buildings was constructed as a part of the County Isolation Hospital, and is
heated and lighted from the central power house, which is on the same site. The pavilions
are placed on brick piers and the administration building on a brick foundation; all are of
frame construction covered externally with shingles. The institution is intended for ad-
vanced cases and has a capacity of eighty-four patients at an estimated cost of $100,000.

SEOZEMOI

No. 10.— Essex County Tuberculosis Hospital, Soho, N. J. Kurd & Sutton, Architects. View of
BuiLDixcs FROM THE Rear axd ().\e Siue, axd Block Plax Showixg Method of Grouping Build-
ings ON A Knoll ant) Connecting Them by a Conered Passageway. Capacity, 84 Patients.
Estimated Cost, $100,000.

Section I

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No. II. — Maine State Sanatorium, Hebron, Me. John Calvix Stevens and John Howard Ste-
vens, Architects, \ie\v and Block Plan Showing Method of Grouping Pa\ilioxs in the
Rear of the Administration Building and Power House. Capacity, too Patients. Estimated
Cost, $150,000. (Sec illustrations 23 and 58 for further description of this institution.)

Maine State Sanatorium, Hebron, Me. (Illustration iii. This instittition is
situated in the lool-liills ol" tlic While Mountains two miles from the Portland and Rumford
Falls Railroad, in a \'ery beautiful country, well known for the dryness of the atmosphere.
The site is near the center of the ])()])ulation of the state and consists of three humlred and
twenty acres, oi which one hundrt'd and l\venly-ti\e acres are farm land and one hundred
and thirty-five acres forest land. There is a tine, open view to the south from the buildings,
which are well sheltered on the north Ijy a v.-ooded mountain. These attractive features
together with the logging camps, ()i)portunities for wintir >porl>, and nature study, in-
terest the i)atients and are an imjjorlant ct)nsideralion in holding them.

The water sui)ply is oljtained from springs and the water is forced by eU'Ctric pumps
into a storage reserxoir haxing a capacity of fort\- thousand gallons. Tlu' soil is a loam
with a subsoil of gra\el, gi\ing an excellent drainage and great fertilitw In addition to

Site and Grouping

the administration Ijuilding and pavilions, there is a power house; a cow barn lighted by
electricit}' and supplied with running water, having a capacity for twenty-five cows; a
milk house thoroughly ecjuipped, heated by steam and supplied with light and power, for
the proper handling of milk and cream; a large silo with a capacity of fifteen acres of corn;

;^-

No. 12. — Preventorium for Children, Farmingdale, N. J. Scopes & Feustmann, and Walter
W. JuDELL, Associated Architects. I5ird's-eve \'iew and Block Plan Showing Method of
Grouping the Buildings. Capacity, 12S Patients. Cost, $110,000. (See illustrations 19, 27 and
78 for further description of this institution.)

^3,

Section I

a stable for ten horses and storage for one hundred and fifty tons of hay. The capacity of

the plant is one hundred patients and it cost 8150,000.

The Preventorium for Children, Farmingdale, N. J. ( Illustration 12). This
institution was t\)unded in order to provide a place in the country for children between the
ages of six and fourteen who have been exposed to tuberculosis and should live for a time
in the open air. Sickly children without active tuberculous disease, who live in over-
crowded parts of New York City and have parents who are tuberculous, are sent from the
various clinics to the Preventorium. There through wise supervision, open air life, and
good food thev are usuallv restored to health in three or four months.

The site is within six or seven miles of Lakewood, New Jersey, well known for its
dry climate and sandv soil. It consists at present of about one hundred and fifty acres of '
land situated in a rolling country. There is a good sized creek within one thousand feet
of the buildings and a small river one-half a mile from the site. The Central Railroad of
New Jersey crosses a corner of the property, and the railroad company, without cost to the
institution, has put in a siding about a quarter of a mile from the power house. The build-
ings are placed on a knoll seventy feet above the surrounding country and are protected
bv a heavy growth of timber on the north. The entrance to the grounds is about four
hundred feet to the west of a county road and all the buildings in the group are about
sixty feet apart. The pavilions containing the infirmary wards, which are described on
page 130, are the nearest to the administration building, which is described on page 60.

This institution has a special receiving ward or reception cottage one-fourth of a
mile distant from the group of buildings illustrated here. The children sent from the city,
without coming in contact with the regular inmates of the Preventorium, remain in the
receiving ward from the time they first enter the institution until the incubation periods
of the acute contagious diseases are past.

The water supply is obtained from an artesian well four hundred and fifty feet deep.
This was driven on low land at a point about seven hundred feet from the buildings and the
water in it rises to about twelve feet from the surface. The well is covered by a small
pump house in which is installed an electric pump driven by power generated in the central
power house, described on page 45. From this point the water is forced to a wooden tank
on a tower seventy-five feet high and from there distributed to the buildings. The in-
stitution has a capacity for one hundred and twenty-eight children and cost, including
water supply and sewage disposal, $110,000.

SECTION II
Administration Buildings

Methods of Sanatorium Administration

A sanatorium consists of two distinct parts, one for housing the patients and the
other for administratis purposes. Therefore, some kind of a lnuldinJ,^ or a portion of one
at least, is necessary for the use of those who have charge of the institution. There are
three general plans of administering sanatoria for tuberculous ywtients.

The first method is to pro\-ide for this use a certain number of apartments in the
same building that houses the patients.

The second method (usually adopted at the present time) is to provide a separate
administration building and group ])a\-ilions or cottages al)out it for accommodating the
patients.

The third method (used only by large institutions of more than one hundred and
fifty i)atients and occupying a wide acreage) is to provide a general administration building
near the center of the site and divide the patients' quarters into two or more units, each
grouped about a small service building containing a kitchen, dining room, and other apart-
ments needed, and i)lace(l at \arious coinenient ])ositions on the site.

Planning Administration Buildings

In jiianning a sanatorium a good method to follow is to decide ujion the number and
character of buildings needed for administration and maintenance, then ha\e these struc-
tures designed and constructed of substantial material on lines that can be enlarged when
necessary. In arranging lloor i)lans for the administration building and its auxiliary
structures, it should be noted that the housing of the administrati\e department practically
includes all buildings on the site, with the e.\cei)tion of the jialients' (juarters. To house
thi-- ilci)artnu'nl lonxi-nit'iub' and in such a manner as will lati'r li'ud to (.'Conomical ojiera-
tion, the following (|Uestions should be derided, if possible, before llu' working drawings are
begun.

1. The number of patients to be houM'd in llu' inslilution.

2. The stage of the disease to \)v treatid.

T,. The class in society from whic h the niajorily ni palieiU> will come.

4. The number of the staff and the method in which lliey shall be housed.

5. The number of servants and the method in which the\- shall be housed.

(). Shall the administratixe oHices and service dei)artment be housed under one
roof or in two separate structures?

7. Shall an amusement paxilion be constructed, or a large room for recreation

purposes bi' proxided in the administration building?

8. Shall an industrial sho[) br built for amusement ami educational i)uriK)ses?

.36

Administration Buildings

g. What method of water supply and storage shall be used?

10. What method of heating shall be used?

11. What method of lighting shall be used?

12. Will power be needed?

i^. Shall a power house be constructed?

14. Shall a laundry and sterilizing room be housed in a separate building, in the

power house, or in the administration building?

15. Shall a vacuum cleaning plant be installed?

16. Can natural ice be used and an ice house be constructed, or will a cold storage

plant be needed?

17. Shall the post-office, telephone exchange, and store be housed in a separate struc-

ture or a room provided for these in the administration building?

18. Shall a carpenter and paint shop be constructed, or shall it be housed in the

basement of the administration building?

19. Shall a central storehouse with platform scale and a bakery be constructed, or

the basements of the various buildings used for storage and other pur-
poses?

20. Shall the institution provide its own vegetables and construct a greenhouse,

forcing beds, and a root cellar?

21. Shall the institution conduct a farm and supply its own milk, eggs, and dairy

products?

22. Will a sewage disposal plant be needed?

Number and Class of Patients

The answers to the first three questions in this list will largely govern the solving of
all the other problems. Therefore, the descriptions and estimates given here were obtained
from public institutions having a capacity of one hundred patients in various stages of the
disease and coming from all classes of society.

Staff and Servants' Housing

The following list is given in order to assist in planning a sanitary method of housing
the staff and servants at projected institutions. The salaries paid at the sanatorium from
which this list was obtained are low because many convalescent patients apply for positions
and are ready to accept smaller salaries than are usually paid for the same service in other
institutions, in order that they may remain in surroundings which will tend to improve
their physical condition.

Staff and Servants and their Salaries

Superintendent (Physician) $2,500.00 per annum.

Assistant Superintendent (Physician) 1,200.00

Laboratory Director (Physician) 600.00

Business Manager 1,200.00

Bookkeeper and Clerk 300.00

Stenographer 360.00

Matron 480.00

Superintendent of Nurses' Training School 900.00

Dietitian 900.00 " ||

Ten Nurses (each $180.00) 1,800.00 " ''

Three Orderlies (each $300.00) 900.00 " '^

Postmaster and Storekeeper 120.00

Cook 960.00 '^'

Two Cook's Assistants (each $240.00) 480.00

Carried forward $12,700.00

Section II

Brought forward $12,700.00 per annum.

Baker 720.00 "

Baker's Assistant 240.00

Dish Washer . . 300.00

Dish Washer's Assistant 216.00

Four Waitresses leach S2 16.00) 864.00

Si.\ Maids (.each S216.00) 1,296.00

Engineer 900.00

Engineer's Assistant 480.00

Eireman 360.00

Carpenter and Painter 600.00

Gardener, in charge of Greenhouse and Grounds 720.00

Two Garden Helpers (each S360.00) 720.00

Poultry Man 600.00

Three Farm Hands (each S360.00) 1,080.00

Total S21. 796.00

Xote: This makes a jiay-roll of SiS 16.00 per month.

As has been said, a large proportion of the staff and ser\ants may be incipient, con-
valescent, or cured tuberculous patients and, w-hile the employment of this class will materi-
ally reduce the size of the pay-roll, it will also call for careful hygienic and sanitary housing
with provisions for outdoor sleeping. The upper stories of the administration building,
when i-)rovided with porches, are used in many institutions for this purpose, although the
construction of a staff cottage, a nurses' home, and a servants' pavilion is a better method
of housing them.

illllJIIII

No. I.-?. Adirondack Cottage Sanitarium, Saranac Lake, N. Y. .Vmiskmknt P.wilio.n. Views- of

111! JAiiNiui; WD Imkkiuk Willi I'l.doK I'l.w \M) ("koss SixTioN. (Scc illustrations 6,^,
Ml. 117 and [:: lor liirlhiT (icstription of this institution.)

Administration l^uildings

No. i4.^Municipal Sanatorium, Otisville, N. Y. Designed by Dr. Hermann M. Biggs. Lames D.
Burt \rchitect. Ser\ants' Building No. 107. Constructed with Fireproof M.aterial,
Designed to Supply Open Air Sleeping Quarters for Patients who wish to Remain and Support
Themselves at the Institution after Completing the Treatment. Cap.vcity, 16 I ersons
Cost, $5,000. (See illustrations 28, 59, 60, 90, ro6 and 114 for further description of this institution.)

Municipal Sanatorium, Otisville, N. Y. Servants' Building. (Illustration
14). This is a two-story structure, with a foundation of native stone. The walls are
of eight-inch hollow terra cotta tile, burned hard, and plastered on both sides. The copuigs
on the parapet walls are of cast concrete, moulded on both edges, and reinforced with waste
wire. The outside is finished with wood float in sand, and coated with a water-proof paint.
The inside is finished with plaster and painted with ordinary white lead and linseed oil.

Each person has an individual dressing room, about five feet square, made with
low partitions in order to allow a free circulation of air, and furnished with a chair, table,
mirror, shelf, and hooks for clothing. Both the stories are alike and the sleeping porches
are divided by low partitions running from the rear walls part way across the floor. This
converts the porches into alcoves sufficiently deep to allow space for an easy chair mside
the open front. The porch floors have a pitch of three inches in order to drain storm and
wash water to an outlet. There is an iron fire escape on the rear walls of both wings and
an attic covers the center of the building; there is a slop sink on each floor; and the base-
ment contains a heating apparatus, two toilets, and a bath.

Section II

The buildinj^ accommodates sixteen persons, and cost exclusive of plumbing and
healing, about S5.000.

Service Buildings

There is a growing feeUng among the superintendents of many sanatoria that the
best method of housing the dining room and kitchen is to construct a separate service
building. The jirincipal achantage of this plan is the greater possibility of providing an
oi)en air dining room and the ease with which the preparation of food is isolated from
other departments. It is also a much more economical way of building if an institution is
to be started in a small way on lines which can be enlarged, for it is an easy matter to
enhirge the administrative facilities by constructing a service building nearby an admin-
istration building. For these reasons a number of large and small service buildings are
described and iUust rated in this section.

Amusement Pavilion

If good results are to be expected from the open air treatment of tuberculosis, the
question of making the patients contented must be considered. Worry and depression are
large factors in disease and anything that helps to do away with them is a part of the cure.
Certain classes of patients often sit about a hospital or sanatorium day after day, brooding
over their troubles and discussing among themselves their physical condition, which often
retards recovery. If such patients are kept interested in other things they will have less
time to think about themselves, and, therefore, amusements and interesting occupations
should be i)rovided. When jiossible, a separate amusement pavilion should be constructed.
A recreation room i)laced in the administration building is not satisfactory, as it is very
hard to ventilate, and ])atients taking the open air treatment are often oppressed by re-
maining indoors and refuse to use such rooms. A separate structure for an institution of
one hundred patients should be about seventy-five feet long by thirty feet wide, with a
peaked roof. The building can be constructed of tile, brick, concrete, or frame and the

No. 15. Example of a Dining Room in a Separate Structure Which can be Opened on All

Sides.

Administration Buildings

No i6.— Portland Open Air Sanatorium, Portland, Ore. View of the Interior of the Amuse-
ment Pavilion. ( See illustrations 8 and 1 20 for further description of this institution.)

roof supported by trusses and covered with shingles or some patent roofing material. The
main room should be open to the roof about twenty-three feet from the floor to the peak.
A stage can be placed at one end of this room, twelve feet deep by fifteen feet wide, with a
small room on either side for dressing and other purposes. The building in northern cli-
mates must be heated, either from the central power house or by a small heating plant
placed in a cellar under the main floor. Both sides and the end opposite the stage, except
for the supporting columns, should be entirely constructed of adjustable windows or doors,
so that the side of the building exposed to a wund or storm can be closed and the opposite
side remain open. There should also be large ventilators in the peak of the roof and on the
sides and ends of the building. (See Illustrations Nos. 13 and 16.)

Industrial Building

The same arguments which are used in advising a separate structure for an amuse-
ment pavilion hold good in regard to an industrial shop. This building can be constructed
along the same general lines and of the same material as the amusement pavilion, the dimen-
sions being about fifty feet long by thirty feet wide, one and one-half stories high. Both
sides should be enclosed by glass doors or windows that can be entirely open w^hen the
weather permits. It should also be heated by connection with the general heating system
or by a separate plant of its own and equipped with tools used in various industries, such
as light carpentering, cabinet making, taxidermy, art work, and photography. Part of the
outfit can be a machine for stamping out sputum cups, for if suitable paper is suppHed for
this purpose, all the cups used at the sanatorium can be made by the patients. If the
building is divided into a number of rooms, porches should be added so that the patients
can work out of doors in good weather. In every institution there are always patients who
wiU be greatly benefited by attending school and are glad of an opportunity to do so. There
is often a school teacher among the patients, who is willing to do the teaching. A school-
room, if provided, may be placed in this building.

The cost of such a building and equipment is about $4,000, but it may be advisable
to start in a more modest way in order to test the interest of the patients in various
occupations.

Section 1 1

s«l

No. 17. — Catawba Sanatorium, Catawba, Va.

Ax KxAMi'i.i: oi' A (iooD Mkthdl) ok Stokinc.
Watkr W'iikrk Streams cax bi: Protixtkd
FROM CoxTAMiXATiox. (Scc illustrations .30.
83. and 94 for further description of this in-
stitution.)

Water Supply

Where there can Ix- no connection
with city or other public water mains, the
water sui)j)ly for an institution may be ob-
tained in a numl)er of ways and all a^■ailable
sources should l)e carefully studied. There
mav be sources which can be examined with-
out great expense, such as old wells, springs,
brooks, rivers, ponds, and lakes; or sources
which can only be accurately determined by
experiments which are often quite costly , such
as the driving of various kinds of wells and
the building of dams for the collection of sur-
face or other intermittent supplies of water.
Wells are often the only means by
which water can be obtained, but shallow
or dug wells should not be used, as the dan-
ger of contamination is very great. Driven
or bored wells carried deep enough to avoid surface water should always be sunk for in-
stitutional use, usually three hundred or more feet, and the site carefully selected with the
view of preventing contamination of the water when it reaches the surface. Often where
from thirty to fifty thousand gallons per day are needed more than one well must be driven
in order to produce a sufficient supply. The cost of driving varies from $3.00 to $8.00
per foot, according to the size of the bore and the depth to which the well is carried.

In making investigations of a water supply, great care should be used to obtain infor-
mation in regard to the chances of contamination of the source of the water, the chemical
elements held in solution, and the amount of the flow at all seasons of the year. In order to
decide whether a given source will supply the demand, an estimate of the daily consumption
of the proposed institution should be computed. Although it is a very inaccurate method,
this is usually done on the theory that there will be consumed in every twenty-four hours by
each individual housed on the site, about one hundred gallons ; by each horse or cow, fifty gal-
lons ; and for every acre of lawn, streets, paths, or garden, five hundred gallons. The estimate
is intended to cover all water used for drinking, cooking, toilet, sprinkling, and other necessities.
A careful inquiry has shown that institutions of one hundred patients having large
sites, and carrying on a farm, will use from twenty to fifty thousand gallons of water per
day and should, wIrii possibK', have in reserve for emergencies an amount at least equal to
the daily consumption. The nature of the site largely governs the expense of constructing
a reservoir and so is a factor in determining the amount of water which an institution will
store. From fifty to two hundred thousand gallons is about the limit where the cost is
great, but wluTt' natiu-al basins can be used by erecting a small dam, larger (|uantities can
be held lor a small outlaw The storage of water in a reinforced concrete reser\'oir is most
satisfactory if there is a natural ele\'ation near the buildings.

Reservoirs can usually be ])laced in tlu' most conxenient i)osition axailahle without
fear of obtaining loo great a pressiUT in 1 he mains, as tlu' force produced 1)\ water brought
from a height is gri-atly reduced b\' the liic lion in tlu' pipe>. Where theie ari' no natural
elewitions, water can he distriliuted 1 h rough an institution 1)\- ihi' pres.stne front a moderate
amount of water stored in a lank on a towir or in the top of a building. Standpipes,
largely used in producing pressure for the water sup])ly of small lowns in flat countries, also

1-^

Administration Buildings

give good service and can be adopted for large institutions. The various systems for distri-
buting water from a pressure tank are to be recommended for small sanatoria and hospitals.

Light, Heat, and Power

The problem of lighting, heating, and the installation of power for an institution de-
pends largely upon its situation. Generally the furnishing of light for hospitals for ad-
vanced cases situated in cities and their suburbs is not a diflficult matter, as the trunk line of
the city electric lighting system or the mains for illuminating gas are usually not far distant.

The lighting of sanatoria in isolated country districts is more compUcated and a
choice lies between the use of kerosene oil lamps; one of the various processes for generating
illuminating gas by individual gas machines from oil, gasolene, or acetylene; or electricity
produced by a privately owned plant. At the present time electricity is generally used, and
when installed in an institution having a capacity of one hundred patients housed in various
structures, it is estimated that about live hundred and fifty sixteen candle power lamps and
one hundred and fifty two or four candle power lamps will be needed for the buildings and
six one hundred candle power arc lamps for lighting the grounds. To obtain sufficient
current for these lamps two six thousand candle power generators and two fifty horse power
engines should be installed. The lamps are apportioned to the various buildings as follows:

Administration Building 154 lights

Two Advanced Case Pavilions 150

Three Incipient Case Pavilions 183

Nurses' Quarters 66

Amusement Pavilion 50

Laundry 15

Power House 15

Tunnel 20 "

Grounds 6 arc lights

If four candle power lights are used to good advantage in such places as hallways,
closets, toilets and on the porches, there will be a saving in the cost of maintaining the plant,
as every candle power needlessly used means a waste of fuel.

In heating sanatorium buildings practically every method has been tried and can
still be found giving fairly good service at one or another of the various institutions. These
in a general way are steam and hot water plants, hot air furnaces, stoves, fire-places, and
gas fixtures. Here again the location and climate are largely the determining factors in
making a choice of a method of heating, particularly where the buildings of an institution
are heated as separate units.

Power can be used for lighting, pumping, vacuum cleaning, driving laundry ma-
chinerv, a cold storage plant, elevators, x-ray apparatus, laboratory instruments, lathes^
circular saws, and other machinery in carpenter and repair shops.

Power House

Where a central heating and lighting plant is to be assembled, it can be housed
either in the basement of one of the buildings or in an especially constructed power house.
There is, however, a strong feeling against installing it in the basement of any sanatorium
or hospital building, as the heat from the boilers is very disagreeable and the noise and dust
penetrate to other parts of the structure. If the institution grows, the time is sure to
come when it will have to be removed, and therefore it is advisable to house even a very
small plant in an isolated power house when starting an institution. This should be placed
below the site of all buildings to be heated, in order to allow the return Ijy gravity of con-

Section II

No. i8. Waverly Hill Sanatorium, Waverly Hill, Ky. J. J. GAfi.NEV, Architect. View from the
Rear Showing, a Method of Usixc, the Top and Side of a Hill in Order to Obtain a Position
Below the Buildings for the Power Plant. (See illustration 5 for further description of this
institution.)

densed steam or hot water from the heating apparatus, and if this is impossible where the
land is flat, a pit must be dug under the plant for this purpose. In choosing a site the
question of placing the building beside a siding or spur from a railroad should be considered,
for such a position will greatly reduce the expense of handling coal and ashes. The ad-
ministration and all other buildings to be heated should be grouped near enough to the
power house to allow connecting them by a concrete or brick tunnel three feet wide by six
feet high, as much trouble and expense will be saved if the pipes and wires connecting the
buildings can be inspected through their full length at all times.

A power house should be built of brick or reinforced concrete, one story high, and
besides rooms for the machinery, boilers, etc., should have a dressing room containing
toilets and shower baths. The coal bins should have a capacity of six or eight carloads
and be constructed of concrete. These should be placed on the outside of the building and
arranged, if possible, so that the coal can be dumped directly into them from the cars.

In providing the equii)ment for a power house the cost of installing low for high
pressure boilers and substituting gasolene or oil engines for steam engines has been carefully
investigated. It now seems to be the consensus of opinion among engineers and architects
having large experience with isolated power plants, that the use of high pressure boilers
with steam engines, when the exhaust steam is used for heating, is the cheapest method,
at the present time, of producing light, heat, and power for public institutions. If this
method is adopted the e(|uipment for the ])()wer house should consist of:

Two Steam lioilers of 100 H. P. each
One Tank for Service Hot Water
Two Steam Engines
Two Klectric (Generators
One Storage Battery
One Oil Separator

One Coal Truck and Track
One OjK'n Feed Water Heater
Three Pumps
Two Mechanical Stokers
One Set of Machinist's Tools
One Power Drill and Lathe

The Ijuildiiig with e(|uipment will cost from $15,000 to $25,000.

Administration Buildings

EXAMPLE OE POWER HOUSE

Preventorium for Children, Farmingdale, N. J., Power Housk (Illustration
19). This is a two story building, 59 feet wide by 43 feet dee]). The walls are of
hollow tile with reinforced concrete floors, and fireproof partitions of hollow tile on the
first storv. This floor, partly under ground, is divided into a space for fuel storage, a pit,
and rooms for the boilers, machinery, and hot water tanks. The ecjuipment consists of
two complete power units, each made up of a high pressure horizontal tubular boiler, a
steam turbine engine directly connected with an electric generator, a switchboard, an ice-
making machine, a large scale for weighing fuel, two hot water storage tanks, the necessary
pumps, and other accessories. The second floor housing the laundry has partitions of
frame covered with wooden lath and plaster and is divided into receiving, sterilizing, wash-
ing, drving, ironing, storing and distributing rooms. These are equipped with a pressure
steam sterilizer, metal washers, an extractor, mangles, and electric irons, all run by pres-
sure pumps, motors, and electric current. The arrangement of the machinery, the storage
of supplies, and the position of the tables in the various rooms should be noted. There is

No,

19.— Preventorium for Children, Farmingdale, N. J. Scopes & Feustmanx, and Walter W.
JuDELL, Associated Architects. Richard I). Kimball Company, Consulting Engineers. Power
House and Launtjry. Front and Side Elev.ations with First and Second Floor Plans. (See
illustrations 12, 27 and 78 for further description of this institution.)

Section 11

No. 20. — District Tuberculosis Hospital, Lima, Ohio. McLaughlin & Hulskin, Architects.

A Part of the Basement I'i.ook i'l.w, Showtxc; Arrangement of Laundry and Power Plant,

IN an Administration Building. (See illustration 43 for further description of this institution.)

also a room o\cr the ice machine from which ice is distributed to the small refrigerators in
the various buildings. The third or attic tloor is divided into four large rooms and bath
for the male he!]), and is reached by a sej)arate stairway which does not open onto the
laundry floor.

The building cost $9,000 and the mechanical equipment of the institution, including
water supply and sewage disposal, cost $32,000.

The Laundry

Laundries placed in the basements of administration buildings have usually been
unsatisfactory, as proper ventilation is almost impossible; therefore the wisest plan is to
house the laundry of an institution in a separate structure or place it in the power house
and make it a part of that building. Where a separate building for this purpose is to be
constructed, it should be made of reinforced concrete or brick, about 30 feet wide by 50 feet
long, one and a half stories high open to the peak. It should be divided into four rooms for
receiving, washing, ironing, and sorting the clothes. These rooms should have a cement
floor and, if linished on the interior, plastered with hard i)laster and painted. The hot
water and steam as well as the ix)wer for drixing the machinery can be supplied from the
|)ower house and the ef|uipment should consist of

Two Washers

One Centrifugal Wringer

Two Mangles

'I'wo l)r\inu Racks

One Tank for Mixing .Soap witli Sli'am

'I'wo .Sets of Irons

One Set of Sorters" Slu-Kes

Six Tables

In some districts a cistern for storing rain water will be needed. The I'litire plant iiuliiding
the cistern can be constructed and e(|uipped Idr from .Sio.ooo to S15.000.

■I"

Administration Buildings

Sterilizing Room

Connected with the laundry there should be a sterilizing room about lo feet wide
bv 20 feet long, constructed of concrete with a cement floor and equipped with a rec-
tangular steam disinfecting chamber, 30 inches wide, 50 inches high, and 84 inches long-
These chambers are usually built with an inner and outer shell of steel plates securely
riveted to the end frames and closed by doors at both ends hung from davit cranes. They
are also equipped with a wrought iron car, an inside and outside car track, two cast iron
supports, a thermometer, steam pressure gauge, vacuum and pressure gauge, and two
safety valves. With an instrument of this size, beds, bedding, linen, and clothes needing
disinfecting can be sterilized. The room and sterilizer in connection with the laundry, if
placed near the power house, can be constructed and installed for about $2,000. (See Illus-
tration 21).

Vacuum Cleaning Plant

The cleaning of sanatoria and hospitals by the vacuum method has become popular;
for cleaning can be done without stirring up dust and dirt, and waste of all kinds which
cannot be reached by ordinary means is easily removed from corners, nooks, and cracks.
It is said that from an economic point of view it pays to install a vacuum cleaning plant
in an institution, as it saves fifty per cent, of the cost of cleaning in labor and reduces to a
minimum the wear on paint, plaster, woodwork, decorations, and other finish of the build-
ings. The usual plant installed for institutions is operated by electricity obtained from the
generator which supplies the current for lighting. The power necessary is about one
hundred and ten volts, but when it is not available, the plant can be operated by a gasolene
engine.

The vacuum cleaning machine itself is placed in the power house or basement of the
administration building, and consists of a reciprocating pump, with a motor on the same
frame, and a separator. It is connected with all the buildings by a main trunk Une pipe,
giving otT vertical pipes ending in service inlets at convenient points where a hose can be
attached for the cleaners. These inlets are usually placed in the walls of the corridors near
the floor but can be installed at any point desired. The hose which connects them with
the cleaner can be fifty feet long, if desired, and the intakes located at points where a circle
of fif tv feet from them will reach every place to be cleaned. The dust and dirt are conveyed
from the apartment being cleaned, through the hose, vertical Hues, and trunk lines, to the
separator, where about ninety-eight per cent, of the dirt is taken out of the air drawn into
the pipes. The balance, or two per cent, of the dust and dirt, passes through the machine
and out of an exhaust pipe which discharges into a flue or other convenient place to reach
the open air. A vacuum plant suitable for a sanatorium while cleaning an apartment re-
moves about two hundred and forty cubic feet of air per minute. If this is replaced
through open windows by pure, fresh air, the rooms will be well ventilated while the ma-
chine is in use.

The pump and separator will cost $1,500, the piping and installation of the plant
about $1,000 more, making the total cost of a plant $2,500. Three complete sets of
sweepers and tools are supplied with a machine and extra sets consisting of a floor
sweeper, floor brush, renovator, and tufter cost $75.00.

Ice House or Cold Storage Plant

Ice is an absolute necessity in a hospital or sanatorium; therefore, some means of
manufacturing or storing it must be supplied. The construction of an ice house is a simple

Section

No. 21.— A Rectangular Steam Disinfecting Chamber, for Use in Connection with the Laundry.

A C()Nvi:mi:nt Shapk for Tiberc i losis Hospital and Sanatorium Work. Loani:u
BY The Knv-Sheerer Company.

malUT for a small institution, if natural ice can be obtained on or near the site, but the
installing of a refrigerating plant is usually cheaper for large institutions than the building
and filling of an ice house. If a cold storage plant is constructed, it should be placed in the
admiristration building or store house and arranged to jtrovide coils for the various re-
frigerators. The cost will be from Si, 800 to S,:;,ooo.

The Carpenter and Paint Shop

A repair shop may be combined with one of the barns, the industrial shop, or con-
structed as a separate building. It should be about ninety feet long by twenty feet wide,
built of frame, brick, or concrete, one story high, with peaked roof and an air space above
the ceiling. It can be divided into a carpenter's room, paint room, store room, and storage
room for drying lumber; and equipped with a circular power saw, necessary carpenter and
cabinet-makers' tools, and a painter's oullit. The man in charge should be a good practical
cabinet-maker al)le to repair furniture and the woodwork of the buildings, and have a
painter as one of his assistants. This department has a large share in the up-keep oi
the entire institution and will well repa\- the iiuestment of S2. 000 to 82,500 necessary to
build and equip it.

The Store House, Bakery, and Scale House

A large amount ol storage space is a necessity in a sanatorium or hospital. Gro-
ceries, grains, vegetables and other winter food supplies, furnishings, linens, clothes, and
many things for the farm or grounds nni>t be bought in bulk or nunihiTs in ortler to obtain
fair i)rice>. .\l nian\- institutions portions of the l)a>rnu-nt> and cellars ol the \arious
buildings are ust'd as storage rooms, hut this is a wasti'ful and inconxrnient nietho<l ot
administration and >hould \>v ahandoiu-d. buildings are gi-nerall\- more sanitar\- when
the space below the first lloor is not used for >toragi- purjioM's. l"or these reasons a separate
store house should be erected.

Administration Buildings

It has been tried and found very satisfactory, as well as a great help in reducing expenses,
to have a separate store house under the care of an employee who gives his time to the de-
tails of ordering and distributing supplies.

At all large institutions the bakery should be separate from the kitchen. In a
number of instances it has been placed in the basement of administration buildings, but
this is not satisfactory, as it requires the baker and his assistants to work in a room that is
hot and hard to ventilate. A small separate structure connected with the general store
house should be built for this purpose; the bake room to be about 12 feet wide by 15 feet
long with the oven constructed outside the walls.

In connection with the store house and bakery there should be a platform scale.
The weighing room may be a separate, small frame building, or a part of the store house,
with the scale platform on the outside, arranged so that trucks and wagons can conveni-
ently be run over it. The scale will cost about S80.00. There is no doubt that the saving
made by a careful oversight and concentration of the stores and the weighing of the grain
and other supplies bought in bulk, will soon pay for the construction of a store house.
A bakerv and store house equipped with a scale can be built for from $1,500 to $2,500.

Green House, Forcing Beds, and Vegetable Cellar

A green house for vegetables, plants, and flowers can be placed near the power house,
and by using the surplus steam for heating it and the forcing beds, a supply of fresh lettuce,
radishes, onions, rhubarb, spinach, parsley, turnips, and other green vegetables may be pro-
duced during the entire winter. This building should have in connection with it about
two hundred feet of cold frame or glass forcing beds, and a root or vegetable cellar con-
structed of concrete, half above and half below ground level, with bins and divisions of the
same material. A root cellar is needed and should be planned for, for when a portion of
a basement or cellar under one of the buildings is used for the purpose, the place often be-
comes insanitary and its value may be destroyed by the pipes and mains from the heating
plant. The expense of building a green house, frames, and root cellar will be about 85,000.

Garage, Stable, Bam, and Farm Outfit

A garage for motors is necessary when an institution is located in a more or less se-
cluded section of the country. It is also necessary to have a stable for farm, carriage, and
riding horses, in conjunction with a barn for housing saddles, harness, carriages, wagons,
machinery, and tools. These buildings can be constructed of frame, brick, tile, or rein-
forced concrete and may, if desired, be combined under one roof with the industrial, car-
penter, and paint shops. Such a building can be erected for from $10,000 to $20,000, de-
pending upon the size, and finish of the interior. An outfit of farm tools and machinery
which will be needed if a farm is a part of the institution is indicated in the following list ob-
tained from a state sanatorium.

Two Farm Wagons

One Delivery Wagon

One Wagon Scale

Two Double Sets of Harness

One Single Set of Harness

One Sulky Plow

One Ordinary Plow

One Harrow

One Mowing ^Machine

One Side Deli\'erv Rake

One Potato Planter

One Potato Digger

One Corn Planter

One Corn Binder

One Power Feed JNIill

One Power Hay Cutter

One Hand Cart

Two Two-horse Cultivators

One One-horse Cultivator

One Fanning JSIill

Section II

One Ha\- Loader One Feed Cooker for Garbage

Six Hay Slinfjs One Potato Sprayer

One Hav Carrier and Rope Two Scythes

Two Hav Racks Two Corn Shredders

One Horse Lawn Mowing Machine One Set of Garden Tools

One Horse Lawn Roller Shovels

One Meadow Seeder Spades

One Manure Spreader Other Small Farm Implements

The Cow Barn

In working out the cost of maintaining certain institutions, it has been shown that
the purchase of milk and butter from outside sources costs double the amount necessary
to produce it on the site. It has been estimated that an institution for one hundred patients
will consume the milk from a herd of thirty-five cows, these figures being based on the fact
that one-fourth of a herd is usually dry.

A cow barn should be kept clean and the animals made comfortable. This is most
easily done if the floor is of concrete, well drained, and the building arranged to admit
plenty of light and air. The cows should be held by movable stanchions, facing each other
on either side of a feeding alley in the center of the building.

Such a barn may be constructed of reinforced concrete, tile, brick, or w^ood, having
dimensions about 36 feet wide by 86 feet long, one story high, nine feet in the clear, and
with side walls seven feet six inches high. The roof can be supported by trusses and cov-
ered with shingles or composition roofing, and the interior of the building ceiled with
smooth painted tongued and grooved boards or plastered over metal lath. The concrete
floor should be on a slight grade, drained to one end. The gutters in the manure alleys
should be 14 inches wide by 6 inches deep. Ventilation may be carried out through a dou-
ble system of air spaces in the walls, following the King method of heating and ventila-
tion by means of the heat given off by the cows. The central feeding alley should be
nine feet wide, the manure alleys four feet wide, and the cross alley dividing the stalls into
sections, seven feet wide. The stalls are usually constructed of iron jiiping and fitted with
chain hung stanchions. They should be three feet wide with a graded depth of from four
feet eight inches to five feet, for different sized cows. The mangers can be made of con-
crete in the form of a long trough for each section, having a slight fall toward one end so
that they can be washed, flooded with water, and drained. In connection with the cow
barn there should be a silo and a milk house.

The Silo

A silo is a tank in which fodder is preserved in the green state. It is usuall\- round
and can be built of reinforced concrete, brick, tile, or wood and is considered one of the best
and cheapest buildings for storing and handling fodder for feeding a herd of milch cows.
A silo large enough to store fodder to feed a herd of thirty-five cows for six months should
have a capaciU- of one hundred and twenty-six tons, a diameter of fifteen feet, a height oi
thirty-four feet, and will recjuire the corn from about eight and one-half acres of land to fill
it. It should be placed beside the cow barn in a conxenient position so that the fodder,
which is heavy, can be handliil I'asily.

The Milk House

A milk house is needed in order that milk in large ([uantities may be collected, stored,
and distributed in a sanitary manner at a sanatorium. Such a buiUling should be con-

Administration Buildings

structed of frame, brick, or reinforced concrete and be supplied with hot and cold running
water and live steam for sterilizing utensils. Hot water and steam can be piped from the
power house or supplied by a small vertical boiler installed in the building. A milk house
should be about 21 feet wide by 22 feet long, one story high, and divided into four rooms
with ceilings ten feet high. In dividing the floor space a good plan is to have a narrow
hall in the center of the building with two rooms on either side of it. These are needed, one
for receiving and weighing the milk, the second for cooling and bottling, the third for wash-
ing and sterilizing utensils, and the fourth as a washing and dressing room. In making the
block plan of the grounds, the milk house should be placed in a convenient position close
to the cow barn and connected with it by a covered passageway. The weighing room
should be eight feet square and contain a desk for records, a scale for weighing each milking,
and a movable funnel for conveying the milk to the cooler in an adjoining room. The
bottling room should be 8 feet wide by 13 feet long and equipped with a cooler, bottler, and
a refrigerator. The utensil room should be 8 feet wide by 13 feet long and equipped with
hot and cold water faucets, two large sinks, a sun rack, and a utensil sterilizer built into the
wall so that the utensils placed in it in the wash room can be removed in the bottling room.
The milkers' wash and dressing room should be eight feet square and equipped with two
lavatories and iron lockers.

The capacity of the barn is thirty-five cows and the plant complete, including barn,
milk house, silo, and a cow shed, can be constructed of concrete for from $5,000 to $10,000.

Chicken and Hog Houses

It is said that fifteen hundred to two thousand hens will supply chickens and eggs
through the entire year for an institution of one hundred patients if the surplus of eggs pro-
duced in the spring and summer are preserved in sodium silicate or by cold storage. An
outfit including stock, colony houses, incubators, and other equipment for raising chick-
ens costs about $3,000.

There is enough refuse from the tables of large institutions to feed twenty-five hogs
and the income from this number at one sanatorium is about four hundred dollars a year.
In order to make these animals profitable a healthy herd is necessary; therefore, care must
be used to eliminate those with disease when purchasing them. To prevent the possibility
of infection later, a steam cooker should be installed and all table refuse used for feeding
passed through it. A sanitary hog house with a wire screened run can be built for Si, 000.

Sewage Disposal Plant

A hospital or sanatorium which is not situated close enough to some town for con-
nection with its sewer system will need a sewage disposal plant; the method of sewage
disposal to be installed depending largely upon the site obtained for the institution. Where
a farm is part of the property the simplest methods can be used, such as a septic tank with a
subsoil distributing field. A small disposal plant of this kind to serve a limited number of
people may consist of a septic tank about 20 feet square and 6 feet deep, divided into two
compartments and distributing the sewage at intervals to the subsoil of a level cultivated
field by open jointed agricultural drain tiles, laid at a depth of about ten inches from the
surface. The disposal field should be divided into sections, and the sewage discharged into
one section after another, allowing enough time to intervene after the use of each section
for the absorption of the entire discharge before it is used again. It is estimated that
from one to three feet of drain tile according to the nature of the soil will dispose of one
gallon of sewage.

Section II

Where the site of a sanatorium is small or a running stream or lake is near and be-
low the buildings, filter beds must be used in connection with a septic tank. The effluent
of the septic tank is then passed through siphons, which intermittently discharge a part of
the contents of the tank evenly over the surface of a lilter. Usually two or more filters are
used, the sewage being deposited upon one after another automatically. Different condi-
tions require a variation of methods in sewage purification and numerous varieties of filters
have'^been devised. Sand, gravel, broken stone, clinker, coke, and other materials are
used with success, the object being to expose the contents of the septic tank to the air and
the action of bacteria, and in this manner purify the sewage as it passes through the filter
and before it is allowed to flow away. It is estimated that a septic tank of the dimen-
sions given above and two sand filters twenty-five by one hundred feet in area and each
four feet deej), will purify the sewage from about three hundred people and will cost from
Si, coo to 83,000.

EXAMPLES OF ADMINISTRATION BUILDINGS
Eudowood Sanatorium, Towson, Md., ADinxiSTRAxiON Building (Illustration
22). This building was rebuilt and greatly enlarged in 1908, only a part of the old building
having been retained as a nucleus, and even this was entirely rearranged. The main or
central portion was originally a country residence. It is 50 feet wide by 37 feet deep, of
frame construction, externally covered with shingles. There are tw^o stories with a high
basement and a third or attic story under the roof supplied with light by dormer windows.
The foundation is of native stone carried well up above the ground level in order to give
light and air to the basement. There is a porch twelve feet wide across the entire front
of the first and second stories and the interior on the first floor is divided in the center from
front to rear by a broad hall twelve feet wide. An office fifteen feet square, and a library
12 feet wide by 15 feet deep, are on one side of the hall; and on the other a physician's office
17 feet wide by 9 feet deep, an examination room 13 feet wide by 8 feet deep, and a staff
dining room 17 feet wide by 11 feet deep.

The second story is arranged to provitlc two separate apartments, one, of two large
rooms and bath, for the superintendent; and the other, of three small rooms and bath, for
the matron. The third story is divided into four chambers and a bath for the nurses. The
new additions consist of two large wings and a rear extension. The side wings are both 54
feet wide by 25 feet deep, connected with the main building by passageways fourteen feet
long, making the entire front one hundred and eighty-eight feet. The rear extension, which
is also joined to the main structure by a covered corridor, is sixty-eight feet deep. The
wing to thr right of tlu- building is given up to amusement purposes and consists of one
large room with a porch ten feet wide on the front. The wing to the left is an infirmary
divided into two small wards 20 feet wide by 18 feet deep for four beds each, together with
toilets and baths. On the front of this wing also is a ten foot wide porch.

Tlic rear extension contains a spacious well lighted dining room 54 feet wide by 26
feel (kei), having a seating capacity of sixty patients and containing a large open fireplace.
Behind this room in the same extension is a kitchen 24 feet wide by 18 feet deep, a servants'
dining room, pantry, sewing room, and storage space. The rear extensit)n was jilanned
to allow till' i)atients to enter tin- dining room at the rear of the administratixe offices, thus
|)ri'\-enting the tracking of dirt and mud through the main huilding, and lUlting otT from it
the noise usuall\' made by a large number of peojjle dining together. The extensions are
constructed of frame, covered with shingles that harmonize with the exterior of the main

Administration Buildings

No. 22.— Eudowood Sanatorium, Towson, Md. Archer & Allen, Architects. The Administra-
tion, Recreation, Infirmary, and Service Buildings. View of Front Elevation and Floor
Plans. Administrative Capacity, too Patients. Estimated Cost, $60,000. (See illustrations 61
and 98 for further description of this institution.)

Section II

section, and the windows of the entire building are fitted on the outside with slat blinds in
order to shut out the heat and light during the summer. During the remodeling there was
also installed a central hot water vacuum plant to heat the entire structure.

These improvements have resulted in providing a group of buildings extending
from one center and admirably adapted to the requirements. They have also doubled
the previous administrative facilities, there now being a capacity for one hundred i)atients,
at a cost of about SOo.ooo.

Maine State Sanatorium, Hebron, Me., Administration Building (Illustration
23). This building has two stories, a basement, and a third story over the center. It is
constructed of red brick with gray brick trimmings and concrete window caps and plates.
The roof is tar and gravel drained in the center because of the danger of snow slides. The
front section is 140 feet wide by 40 feet deep, with an extension to the rear at one end ^s
feet wide by 53 feet deep. The front basement contains a small medical suite divided into
a laboratory, pharmacy, examination and waiting rooms, sterilizing chamber, billiard, and
storage rooms. In the basement of the rear extension is a section for servants' quarters.

The first i\oor is flanked by two porches, the one on the front 12 feet wide by 140
feet long and the other on the south side 10 feet wide by 40 feet long. At either end of this
floor is a large dining room and an assembly room, both 3S feet wide by 36 feet deep and
connected through the center of the building by a corridor with rooms on both sides. On
the front is a parlor 24 feet wide by 15 feet deep, an ofiice fifteen feet square, and
a waiting room 9 feet wide by 15 feet deep. On the rear is a reading room 19
feet wide by 14 feet deep, and toilets, wash rooms, and other conveniences. The
first floor of the rear extension contains a kitchen 30 feet wide by 19 feet deep, a
serving room 19 feet wide by 16 feet deep, a servants' dining room 17 feet wide by
15 feet deep, a pantry, and cold storage.

The second floor is divided by a long corridor seven feet wide running down the
center of the building. On each side of the hall are good sized rooms well supplied with
closets, baths, toilets, and other conveniences for the superintendent, staff, patients, and
visitors. This story is also flanked by two porches, the one on the front 12 feet wide by
57 feet long and the other on the south side 10 feet wide by 40 feet long. The third story
over the center of the block is devoted to cjuarters for the nurses.

The building is intended for administration purposes, accommodations for trustees
and visitors, and for the housing of patients who are able to be up and around.

The interior is plastered o\-er metal lath with hard plaster, and has round corners
and sanitary bases, thus eliminating all angles in the endeavor to make it strictly sanitary.
The entire building is as nearly fireproof as ]-)ossible, with a smooth and simple woodwork,
and is intended to afford administrati\e facilities for an institution of one hundred ]xitients,
at an estimated cost of $50,000.

Iowa State Sanatorium, Oakdale, la., Administr-^tion Building (Illustration
24). This is a substantial l)rick veneered structure 74 feet wide by 63 feet deep, two stories
high, with a basement and attic story. The foundations are of stone and the building is
trimnu-d with wood painted whiti', and surrounded by a \eranda on two sides of the first
floor, the roof of which is sui)porte(l by large round wtxxlen columns. The basement
contains storage rooms and a dining room for the male help. The main entrance hall
on the first floor is 1 2 feet wide l)y 30 feet long with a ph\-sician's suite on one side consisting
of a reception room if) h-ri wide 1)\- 12 feet deep, a sniaU office 12 feet wide by 0 feet deep,

Administration Buildings

III i'^ ^^

No. 23. — Maine State Sanatorium, Hebron, Me. John Calvin Stev'ens antd John Howard
Stevens, Architects. Administration Huilding. View of Front Elevation and Floor Plans.
Administrative Capacity, 100 Patients. Estim.\ted Cost, $50,000. (See illustrations 11 and 58
for further description of this institution.)

Section II

an examination room i6 feet wide by 8 feet deep, and a passageway 4 feet wide by 9 feet
deep. On the opposite side of the main hall is a rest room 29 feet wide by 22 feet deep, a
hall 7 feet wide by 42 feet long running down to the patients' entrance, and a small recep-
tion room 10 feet wide by 12 feet deep. On the opposite side of the patients' hall and at
the end of the entrance hall is a large dining room 44 feet wide by 30 feet deep which will
seat one hundred and twenty-five persons. There is also on this floor a pantry 10 feet wide
by 21 feet dec}), a kitchen 16 feet wide by 21 feet deep, stairs to the cellar, a refrigerator?
and other conveniences.

The second floor, which is divided into cjuarters for the nurses and other help, has
much less floor area than the first story as the ceiling of the dining room extends above its
level. The building has an administrative capacity for one hundred patients, and cost

No. 24.— Iowa State Sanatorium, Oakdale, la. II. I". I.ucbbk, Architixt. .Vomimstration Hiilding.

\'n;\v OK Front Ij.ia aitin wh I'ihhr I'i.ws. Administrativk Capacity, ioo PATHiXTS. Esti-

MATKij Cost, .S-'j.ooo. (Scj illuslralinn-^ 2), g; and 1 1() for furlli.T (Ies( riplioii of lliis instilulion.)

Administration Buildings

No. 25. — Manitoba Sanatorium for Consumptives, Ninette, Manitoba, Canada. Designed by Dr.
D. A. Stewart. Admixistkatiox IUiluixu. \'ii;\v of Frdxt I-^levatkix and Floor Plans.
.Administrative Capacity, 60 Patients. Cost, $33,000. (See illustration 95 tor further description
of this institution.)

Section II

$23,000, but this does not include the laundry and heating plant, which are housed in an-
other structure.

Manitoba Sanatorium for Consumptives, Ninette, Manitoba, Canada,

Administration Hi'ii.ding (Illustration 25). This buildin.c; has a basement, two stories,
and an attic lighted by dormer windows. It is 88 feet along the main front by 30 feet wide
and has a rear extension 34 feet wide by 36 feet deep. The basement walls are of rough
boulder stone, the tirst story of brick veneer carried on a steel frame, and the second and
third stories of frame construction linished on the outside with stucco upon metal lath.
The front and both ends of the building are considerably broken up by windows and
dormers and are flanked by porches twelve feet wide.

The basement is wholly above ground in front and extends out as far as the edge of
the ])orch, thus making it twelve feet deeper than the upper stories. It is divided into a
main dining room 52 feet wide by 27 feet dee]), a kitchen 27 feet wide by 19 feet deep, a
servants' dining room 12 feet wide by 17 feet deep, and two storerooms. The extension is
divided into a laundry 16 feet wide by 29 feet deep, and an engine room containing the
steam plant for heating the buildings.

The first floor on the front is divided into a recreation room 28 feet wide by 42 feet
deep, two infirmary wards 12 feet wide by 30 feet deep, four private rooms, each 10 feet
wide by 12 feet deep, and lavatories, toilets, and closets. The extension is divided into a
business office 16 feet wide by 12 feet deep, an examining room 15 feet wide by 12 feet deep,
a treatment room twelve feet square, and a laboratory 8 feet wide by 12 feet deep.

The second floor is cut up into rooms for the stai? and nurses and the third floor is
devoted to servants' quarters. The building has an administrative capacity for sixty
patients and cost $33,000. This includes a certain proportion of the funds expended in
heating, plumbing, water supply, and sewage disposal for the entire institution.

Indiana State Hospital, Rockville, Ind., Administration Building (Illus-
tration 26). This structure occupies the center of a group of buildings, illustrated under
the section on sites and grouping. It has on the front a basement, two stories, and an attic
under a mansard roof; in the rear an extension of only one story and basement.

The main portion of the building is 89 feet along the front and 52 feet deep, con-
structed of brick on a stone foundation. The front basement is divided by a long corridor
and contains two storage rooms 27 feet wide by 15 feet deep with cement floors, a drug
room 13 feet wide by 16 feet deep, a store room for drugs 24 feet wide by 16 feet deep, and
a servants' sitting room 30 feet wide by 16 feet deep, connected with baths and toilets.
The basement of the rear extension is di\ided into two large storage rooms, a washroom
for servants, and a i)reparation room for vegetables.

The first floor has a large reception hall in the center 36 feet wide by 31 feet deep
running from the front to the rear of the building. On one side is an ofiice 24 feet wide
by 16 feet deej), and a library 24 feet wide by 15 feet deei). On the other is a record office
24 feet wide by 15 feet deep, and two examination rooms twehe feet square. At the far
end of the recejition hall is a wide stairway to the upper floors with a staff dining hall 27
feet wide by 15 feet deep on one side; and a superintendent's oftice of the same diniinsions
on the other side. At tlu- rear of this portion of the building is a corridor running at right
angles to the rece])l ion hall and leading to ihc patient>" pa\ilions, which are placed on l)oth
sides of the administration building.

Across this corridor is the rear extension 51 feet wide by 50 feet deep, one storv high.

Administration Buildings

-zf-yi^r-^j^^^^

F'lKST TuOOK PUAn

<5eco/iD ri-ooa -Pla/i.

No. 26. — Indiana State Hospital, Rockville, Ind. Brubaker & Stern, Architects. Administra-
tion Building. View of Front Elevation and Floor Plans. .Administrative Capacity, 100
Patients. Estimated Cost, $50,000. (See illustrations 7, 46 and 51 for further description of this
institution.) ,

Section II

It contains tin- dining hall 4S ivvi wide by .:;6 feet deep; a well lighted and ^'entilated room,
havin<f a high ceiling and pro\ided with a number of tables each seating eight persons.
Behind it is the kitchen and a pantry containing a stairway leading to the basement.

The second and third floors of the main block are divided into apartments for the
superintendent, staff, nurses, and ser\ants, with toilets, closets, baths, and other conve-
niences. This building has an administrative capacity for one hundred patients at an es-
timated cost of .'^5o.ooo.

The Preventorium for Children, Farmingdale, N. J., Administration Build-
ing (Illustration 27). The outside walls of this building are of hollow tile resting on a
concrete foundation and covered externally with cement stucco. The interior of the l)uild-
ing is of frame construction; the floors are of yellow pine; and the roof is covered with
shingles. There are two separate entrances from the outside of the building to the dining
room. These are through cloakrooms, one for the boys and the other for the girls, and

No. 27. Preventorium for Children, Farmingdale, N. J. S( iu'ks &: l'i;rsT\i.\NN, and Wai.tkk W.
Jliji.1.1,, Assoc lATKD .\i<( ihti;( is. .Xdmimstuaiion IUiluinc;. \'ii;\v ok 1''ki)\t I'.i i.\ mion and
Floor I'l.AXS. .Vuministkativk Capacitv, 1 i 2 I'atmcnts. Cost. $35,000. (See iilusirai ions u, iq
and 78 for further description of this institution.)

Administration Buildings

were planned in this manner in order that the children coming from the pavilions might
enter the dining room without passing through other parts of the building. All the floors
which have much wear, such as those in the corridors and dining room, are covered with
linoleum held in place by brass strips laid flush with the flooring material.

The structure was planned in two sections, a front block 103 feet wide by 36 feet
deep, and an extension to the rear 27 feet wide by 63 feet deep. On the first floor the left
half of the main block is divided by a hall. In the front is a business office 18 feet wide by
12 feet deep, and a reception room 14 feet wide by 12 feet deep. Behind the hall is a staff
dining room 20 feet wide by 1 7 feet deep and a doctor's office twelve feet square. The main
dining room, 41 feet wide by 31 feet deep, occupies a little more than one-half the
floor space on the right side of the block. In the rear extension is a serving room 25 feet
wide by 19 feet deep, a kitchen 25 feet wide by 19 feet deep, a servants' dining room 13
feet wide by 18 feet deep, and a pantry, cold storage room, and closets.

The second floor is divided in both sections by halls running at right angles to each
other. In the front of the block is an apartment of two rooms and bath for the medical
superintendent, a staff sitting room, and bedrooms for the head nurse and matron. In the
rear extension are two bedrooms for teachers, a sewing and linen room, and a clerk's bed-
room. There are also twelve rooms and a bath for the female servants of the institution
who are all housed in this building.

A reception cottage, which is one quarter mile distant from the administration build-
ing, has a capacity for thirty children and is run as a separate unit. Therefore, this number
is not included in the service capacity of the administration building, which is for one
hundred and twelve children. The cost of construction was $35,000.

EXAMPLES OF SERVICE BUILDINGS

The Municipal Sanatorium, Otisville, New York, Service Building (Illus-
tration 28). The Municipal Sanatorium was planned to have a general administration
building in a central position on the site and to house the patients in separate groups ; each
unit to have a capacity of about one hundred and fifty patients and to be made up of pa-
vilions or cottages grouped around a service building placed some distance from the central
administration building. The service building illustrated here was designed to be the
center of one group of pavilions for housing men and contains a large dining room, a kit-
chen, two sun parlors, a well arranged infirmary, and nurses' and servants' quarters.

The building is designed in two blocks connected by a central section. The front
block is 116 feet wide by 40 feet deep and is placed on the side of a hill where the drainage
is good. It has a foundation of native stone and one story of frame construction. As
very little excavation w^as necessary in the front of the building, the basement is mostly
above ground and well lighted. It is used as a bathing apartment and is well equipped
with a variety of showier baths and other bathing facilities. Above this the block is divided
into a large dining room 67 feet wide by 26 feet deep, seating one hundred and fifty persons.
and two solaria 25 feet wide by 40 feet deep which are used for reading and amusement
purposes. The solaria are connected on the front by a terrace and are inclosed by glass and
sash windows which can be and usually are pushed up out of the way, leaving the openings
entirely clear.

The central section contains a serving room 28 feet wide by 19 feet deep, and a kit-
chen 28 feet wide by 15 feet deep. The kitchen space, however, is much greater than it

Section II

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Dki'aktmk.nt oi' Hkai.tii. Si:k\ k'k iiiii.uiNi; and Im'irmarv fi)r Ose Sixtion of thk Institution,
\'ii:\v OF Fko.nt, Kkak, ano Side ICi.kaation and Ki-oor Plans. Skrvick Capacity, 150 Patiknts.
I^STiMATKi) Cost, $35,000. (See illuslr;iti<>ns 14, 5g. ()o,99, lod and i 14 for furtlier ilesrri|)li(>n of this
institution. j

Administration Buildings

appears to be from these figures, as there is a large supplementary kitchen extending out
from the left of this section.

The rear block is for all practical purposes a separate structure 66 feet wide by 44
feet deep and the first floor contains a servants' dining room, sewing room, linen room,
and storage. The second floor is used as an infirmary and is divided through the center by
a long hall four feet wide which opens at one end into a ward 14 feet wide by 31 feet deep.
On the rear of the hall is a room for two beds, four single-bed rooms, and a locker room.
On the opposite side is one room for two beds, a stairway, baths, toilets, and a nurse's room_
On two sides of the building are large sleeping porches protected by glass and sash frames,
upon which beds can be rolled from both the ward and the rooms.

The third story under a slanting roof is cut up into two dormitories, four single
rooms, toilets, and closets for the use of the servants. The service capacity is for one
hundred and fifty patients at an estimated cost for construction of $35,000.

No. 29. — Iowa State Sanatorium, Oakdale, la. Designed by Dr. H. E. Kirschner. H. F. Liebbe,
Architect. Service Cottage. View of Front Elevation and Floor Plans. Service Capac-
ity, 20 Patients. Estimated Cost, $6,000. (See illustrations 24, 97 and 116 for further description
of this institution.)

Section II

Iowa State Sanatorium, Oakdale, la., Service Cottage (Illustration 29).
This building was erected to provide a kitchen and dining room for an infirmary group
consisting of three cottages all connected by a covered corridor and built on the lines of
the incipient patients' cottages at the Iowa State Sanatorium illustrated in the section on
the cottage type of building. It is of frame construction resting on a stone foundation and
has a cellar and two stories. The porch on the front of the building is 53 feet wide by 1 1
feet deep, and on each side it is 1 1 feet wide and extends back 15 feet.

The first floor is divided into three rooms; a large kitchen in the rear 28 feet wide
bv 13 feet deep, equipped with a small pantry, refrigerator, and cupboards; and two dining
rooms 12 feet wide by 18 feet deep on the front separated by a stairway leading to the upper

No. 30. — Catawba Sanatorium, Catawba, Va. Gary Sheppard, Akciutkct. Skrvicf. Hiiluing,

CO.NTAINING AN .VmUSEMK.XT HaLL. KrONT ElICVATION AND Fl.OOR I'l.W. Sl.R\ ICE CAPACITY,

70 Patients. Estimated Cost, $10,000. (Sec illustrations 17, 83 and 04 for further description
of this inslitulion.)

Administration Buildings

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No. 31.— New Haven County State Tuberculosis Sanatorium, Meriden, Conn. Foote & Townsend,
Architects. Service Building. \'ie\v of Front Ele\-.\tiox .\nd Floor Plans. Service
Cap.\city, 122 Patients. Estimated Cost, $15,000. (See illustration 93 for further description of
this institution.)

Story. The second floor is arranged for servants and is divided on the front into a sleeping
loggia 28 feet wide by 8 feet deep, which is a part of the main building under the roof pro-
jection, an opening to the stairway, and two bedrooms 12 feet wide by 9 feet deep; and
on the rear a bath 1 1 feet wide by 8 feet deep and two bedrooms g feet by 1 2 feet deep.
The building has a service capacity for twenty patients at an estimated cost of $6,000.
5 6s

Section II

Catawba Sanatorium, Catawba, Va., Service Building (Illustration 30).
This buildiiijf is oi frame construclion raised on stone piers. It is no feet wide by 42 feet
deep, with a rear extension thirty feet square, and a porch eight feet wide on the front and
sides. It is divided into two dining rooms 27 feet wide by 40 feet deep at the ends of the
building and a large amusement hall 54 feet wide by 27 feet deep between them in the center.
This hall has a large fireplace and can be thrown open in connection with the two dining
rooms by raising windows in the walls between them. The building has si.x entrances on
the veranda and the front and sides are well broken up by windows in order to provide open
air dining and sitting rooms. Directly behind the hall is the kitchen twenty seven feet
square, housed partly under the main roof and partly in the rear extension. The kitchen
is connected with each dining room by pantries or serving rooms thirteen feet square and
has in the rear a bakery 13 feet wide by 18 feet deep, a store room 21 feet wide by 13 feet
deep, and a refrigerator.

The plans of this building should be studied, for they show an arrangement by which
light and cross ventilation are obtained from three sides in the rooms provided for the pa-
tients and also illustrate the object of building a separate structure to house the service de-
partment. The service capacity is for seventy patients at an estimated cost of Sio.ooo.

New Haven County State Tuberculosis Sanatorium, Meriden, Conn. ( Illustration
31). This is a service building planned lor one of the county sanatoria erected at the ex-
pense of the State of Connecticut. It is a low, one-story, bungalow type of building with
a cellar excavated under the entire structure. The foundation is of local stone and the
upper part of the building is of frame construction covered with shingles. It is planned
to have a front section 53 feet wide by 26 feet deep and a rear extension 26 feet wide by 45
feet deep. The cellar has a floor of concrete finished with cement and is arranged to con-
tain a heating plant, large refrigerator, and other storage rooms. The entire front block
above ground is devoted to a dining room furnished with twelve tables and seating ninety-
six persons. It is well lighted and ventilated by twehe windows spaced so as to pierce
the walls on all four sides of the room.

In the rear extension is a serving room 25 feet wide by 15 feet deep equipped with
sinks, dish closets, and other conveniences. Behind this room is a kitchen 25 feet wide by
30 feet deep containing a large built-in refrigerating room, a dumb waiter to the storage
rooms below, and a small toilet room for the kitchen help. The building was planned to
have a service capacity of one hundred and twenty-two patients and the estimated cost of
construction is $15,000.

SECTION III

Administration Buildings and Patients'
Quarters Combined

SECTION III
Administration Buildings and Patients' Quarters Combined

The Need for Combination Buildings

The rapid growth of public opinion in re<iartl to the necessity of caring for and
isolating the advanced tuberculosis patient and the growing belief that the spread of this
disease cannot be checked without the removal of advanced cases from the homes of the
poor and ignorant, has caused a continually increasing number of hospitals to be constructed
during the past two years, designed to house the entire institution under one roof. It is
claimed for this style of building that it is possible to economize on the installation of the
plumbing, heating, and administrative arrangements, that it concentrates the work, and
is particular!}' good for city use, where property is valuable and a site cannot be obtained
at a reasonable cost for the erection of the pavilion type of hospital or one-story lean-tos
and cottages spread over a large area of ground.

These buildings may be used for housing either incipient or advanced cases of
tuberculosis, and are planned and constructed on lines conforming in many ways to the
needs of a general hospital. As they are intended usually for the service of small com-
munities and are often placed on the outskirts or within towns or cities, the site selected
should be near the line of an electric car system, with enough land to allow of the free
circulation of air on all sides of the building. Two entrances should be provided when
possible, one for the staff, patients, and their friends, and the other for merchandise and
service.

Planning Combination Buildings

In designing these buildings there should be pro\ided for all achanced cases single
bedrooms or rooms with not more than two beds in each; and for incipient cases small
wards of not more than si.\ ])atients or rooms for two patients each. Every patient housed
under the main roof should have two thousand cubic feet of air space and a porch area
eight feet wide by ten feet deep, or at least large enough for a bed, reclining chair, and table.

As lire protection is comjiulsory in many cities, it is suggested that reinforced
concrete, brick, terra cotta or concrete lilr construction with reinforced concrete floors
be adopted. Muildings erected in this manner are praclicall\- non-combustible. The
structure should be wired for bells and telephones when it is wired for lighting, as bell calls
or tele|)hones should be installed in all rooms to l)e used by patients. The walls and ceil-
ings should be rini>hc(l in hard plaster, painti'd and \arnished. The corners in the wall
angles and at the ceilings and lloors shouhl be rounded. Light colors may be used on the
walls instead of a dead white; in fact, a harmonious color scheme throughout the entire
building is an advantage, as it is one of tin- nirans of making patients happ\' and con-
tented. .\ \eiUilating systi-m is not necessary in these buildings, but all the wall spaci'
possible should be used for windows. The lloors of the interiiir, except the toilets, baths.

(.S

Administration Buildings and Patients' Quarters Combined

No. 32. — Eastern Maine Hospital, Bangor, Me. John Calvin Stevens and John Howard Stevens,
Architects. Illustrating a Method of Protecting a Sleeping Porch with Heavy Wire
Netting. Useful when a Porch Faces a Street or to Prevent P.a.tients from Leaving
without Permission.

No. 33.— LTnited States Hospital for the Insane, Washington, D. C. Showing a Method of Inclosing
A Sleeping Porch with Swinging Sash Frames. Useful for City Hospitals with Porches

H.wiNG Various Exposures.

Section III

Administration Buildings and Patients' Quarters Combined

laundry, and kitchen, should be of hard wood treated by oil and wax; or ordinary narrow
board floors covered with battleship linoleum. Other floors which come in contact with
an unusual amount of water should l)e of terrazzo, cement, tile, or of one of the patent
composition floorings. All the doors and passageways should be not less than three feet six
inches wide so that beds may be easily rolled through them. There should be no door sills
or panels in the doors; and all the interior finish around the doors and the windows should
be placed flush so as not to produce projections or corners which will catch the dust. The
building should be constructed on the sanitary principles laid down for general hospitals,
and the rooms for advanced cases and all the porches screened with wire netting which can
be remoN'ed during the cold weather.

Not all the examples of buildings and floor plans given here are model arrangements,
but each one oiTers some suggestions not found in the others which may be of use to de-
signers of this class of institutions.

Rooms for Administrative Purposes

The building should contain for administrative purposes the following rooms:

Dining Room for Patients

Dining Room for Staft"

Dining Room for Servants

Kitchen

Diet Kitchens

Bakery

Serving Room

Dish Closet

Cold Storage

Physician's Office

Special Treatment Room

Waiting Room

Laboratory

Drug Room

Business Office

Sitting Room

Librarv

Superintendent's Quarters

Physician's Quarters

Nurses' Quarters

Servants' Quarters

Sewing Room

Linen Room

Store Rooms

Sink Rooms

Bath Rooms

Toilets

Laundry

Disinfecting Room

Crematory

Morgue

Autopsy Room

Heating Plant

Workshop

Coal Storage

EXAMPLES OF COMBINATION BUILDINGS
Sharon Sanatorium, Sharon, Mass. (Illustration 34). This is one of the oldest
buildings in America constructed for the open air treatment of tuberculosis, and was
planned to be an administration building and patients' quarters combined. Its con-
tinuous use for fifteen years has demonstrated its convenience for housing incipient and
moderatelv advanced cases. Any one planning to buUd a sanatorium and desiring to
have a complete unit under one roof, particularly if there is a farm house or country resi-
dence on the site selected, will find this a convenient design to adopt, as the original struc-
ture can be used for administrative purposes and an extension added on one or both sides
for patients' quarters. By using this method it is possible to build a comparatively cheap
sanatorium if the patients' quarters are constructed in an economical way. The extension
in the illustration runs from the dining room and includes the sun parlor, with the toilets,
baths, and closets in the rear of the hall. The sleeping porch is wide enough to give

Section III

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Administration Buildings and Patients' Quarters Combined

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No. 36. — Tuberculosis Hospital, Washington, D. C. Designed by Dr. George M. Kober. Frank
Miles Day & Brother, Architects. Floor Plans. Capacity, 120 Patients. Cost, $100,000.

Section III

plenlv of room for the patients to move around at the sides of the beds, and is protected,
when necessar>-, from the sun and rain l)y a canwis awning which can Ix- rolled up out of
the wav. leavin<? the porch unco\ered. The doors from the prixate rooms opening on the
porch are made wide enough for the beds to pass through them.

It is suggested that an improxement to this building can be made by putting in
Dutch doors below all windows opening on the [torches and by jilacing a glass roof under
the canvas curtain which protects and coxers the sleeping balconies, as such a roof would
not shut out the light from the rooms when the curtains are drawn back and would be
nK)re durable than canvas alone. The bedrooms opening on the porches may also be made
narrower, as the beds are out of doors most of the time and the rooms are used merely for
dressing. The building has a cai)acity for twenty-four ]xitients at an estimated cost of
$4 5.000.

The Tuberculosis Hospital, Washington, D. C. (Illustrations 35 and 36). This
hospital was built at a reniarkabl>- low cost and is interesting in the way it is planned to
house advanced and incipient, white and colored, male and female patients; each group
in a separate wing or on a difYerent floor. A careful study of the arrangement of the wards,
noting the allotment of floor space to the different classes of patients, is interesting. The
hospital is planned to i)ro\ide accommodations in separate wards on the first floor for white
and colored males who are in the later stages of the disease; and the second floor is arranged
in the same manner for white and colored females. The incipient cases of both sexes,
white and colored, are housed in open air wards on the third and fourth floors. These
open wards are roof gardens with casement windows on the north, but are entirely open on
the east, south, and west sides.

The building is a substantial brick structure, well finished on the interior and
ecjuipped with a large electric elevator. It is two hundred and ten feet across the front and
for description can be divided into a central section, two wings, and a rear extension. The
central section is about fifty feet square and the wings containing the wards are 82 feet long
by 25 feet deep. The rear extension is 25 feet wide by 57 feet deep except in the basement
which has not been excavated at the rear end, as the building rests on a side hill. In the
basement the entire left wing is used for a large dining room and the right wing is divided
into a kitchen, pantry, and boiler room. It also contains a laundry, cold storage, and a
morgue.

The arrangement of the rooms on both the first and second floors is the same. In
the wings are wards 48 feet wide by 24 feet deep with porches at the ends 14 feet wide b\- 24
feet deep. The floor space in the central section and rear extension is divided into oflSces,
toilets, diet kitchens, and other rooms needed in llie administration of a general hospital.

On the third floor the entire floor space of the wings and the extension is used {o
proxide three large open air wards; two 71 feet wick' \)y :j\. feet deep and one 25 feet xvide
by 57 feet deej). In the center of the building is a nurse's office and three rooms ef|uipped
with lavatories, baths, and toilets for the use of the jiatients.

'I'he institution is well worth a x-isit, iinl only because of its uni(|ue arrangenieiu. but
also because it will olTer many suggestions to those who liaxi' to solxe the problem of ht)us.
ing tuberculous i)atients in large, congested cities. It has a capacitx' of one hundred and
twenty j)atients, and cost to erect and furnish, Sioo,ooo.

Lady Grey Hospital, Ottawa, Canada ( Illustration 371. This hospital has a xvell
eli'xated >ili' on sloping grouml within the western limits of Ottawa. On the hind is a

Administration Buildings and Patients' Quarters Combined

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No. 37. — Lady Grey Hospital, Ottawa, Canada. Weeks & Keefer, Architects. \'ie\v of Front
Elevation and Floor Plans. Capacity, 45 Patients. Cost, $60,000.

Section III

small .u'rouj) of nialurc niai)k' trees which is used in good weather as a park l)y the i)atients.
The building was erected by the Ottawa Anti-Tuberculosis Association, furnished by the
Daughters of the P^mpire, and is maintained with funds provided by the city.

The building is three stories high with a basement under the entire structure and is
constructed of hard k)cal red brick laid in white mortar on a concrete foundation. The
trimmings are of Indiana limestone and the modern English residential style of architecture
is closely followed. It faces southwest and has a number of porches screened b\- wire
against insects. These porches open into dilTerent wards by wide doors through which the
beds can be wheeled. The main block of the building is 130 feet wide by 45 feet deep and
the rear extension is 21 feet wide by 41 feet deep.

The basement contains a laundry 22 feet wide by 20 feet deep, a drying room 10
feet wide by 8 feet deep, a laboratory 12 feet wide by 14 feet deep, storage for furnace coal
20 feet wide by 12 feet deep, a furnace room 12 feet wide by 20 feet deep, containing two
boilers iov the heating plant, and a room 6 feet wide by 8 feet deep for elevator machinery.

The main portion of the first floor is divided through its entire length by a corridor
eight feet six inches wide, and has on the front a i)orch 72 feet long by 12 feet wide. Be-
tween the porch and the corridor are six single rooms 10 feet wide by 12 feet deep. At
each end of the corridor on the front are two wards both eighteen feet square for three
patients each. Porches extend out from these wards at the sides of the building, the one
on the right being 8 feet wide by 22 feet deep, and the one on the left 10 feet wide by 14
feet deep. The entrance hall is in the center of the building 14 feet wide by 15 feet deep,
with the main stairway on one side and a locker room on the other. On the rear of the
corridor is the patients' dining room 22 feet wide by 20 feet deep, a doctor's office 10 feet
wide bv 14 feet deep, an examination room 6 feet wide by 8 feet deep, a parlor 16 feet wide
bv 12 feet deep, a nurses' room 10 feet wide by 14 feet deep, and toilets and baths for both
men and women. In the rear extension on the right of the builcHng, back of the dining-
room, is a kitchen 22 feet wide by 14 feet deep, a servants' dining room ten feet scjuare, a
serving room, paiitrx', refrigerator room, and store rooms.

The second floor is arranged in the same way as the first, with porches on the front
and sides of the same dimensions, six single rooms and two wards in front of a corridor
ruiuiing the entire length of tht.' building. In the rear is a large ward over the dining
room 22 feet wide by 20 feet deep, toilets and baths for women and men, a matron's room
14 feet wide by 18 feet deep, two nurses' rooms 14 feet wide by 12 feet deep, and a locker
room for i)atients. In the extension is a diet kitchen q feet wide by 6 feet deep, a nurses'
dining room 14 feet wide by 13 feet deep, a nurses' sitting room twenty-one feet square
and a small hall three feet wide, running into the main corridor at a right angle.

The lliird tloor also has the same general arrangement planned for the lower floors,
excey)t that there are no side porches and the extension is di\ ided into bedrooms and a
toilet for the servants. The building has a capacity for forty-five patients, is heated by
steam, has an elevator and dunib waiters, and cost S0o,ooo.

Lake Edward Sanatorium, Lake Edward, Province of Quebec, Canada
(Illustration 38J. This building is jjlaced on a stone foundation two feet thick, and is
of frame construction with a shingled exterior. In t)rder to protect the interior from cold
as much as i)ossible the walls are constructed in layers from tlu' outside in. as follows:
shingles, pai)er, siding, paper, siding, studs, wooden lath, plaster. Vhv floors are hard
wood throughout. .Ml patients are proNided with |)orch si)ace and can be wheeled from
their rooms to the porches assigned to them.

Administration Buildings and Patients' Quarters Combined

FiR-ST Flooe. Pu\n

.5ECOND ruOOt PLaW

No. 38. — Lake Edward Sanatorium, Lake Edward, Province of Quebec, Canada. Scopes & Feust-
MAxx, Architects. \'ie\v of Front antd Side Elevations and Floor Plans.
Capacity, 26 P.\tients. Cost, $26,000.

The building is 87 feet long by 25 feet deep, with two extensions in the rear, one
28 feet wide by 19 feet deep, and the other 28 feet wide by 54 feet deep; each porch was
designed as a loggia, and is a part of the structure under the main roof.

The first floor of the main section is divided as follows: beginning on the left, first
a loggia, called the west porch, 10 feet wide by 19 feet deep, then a patients' room g feet
wide by 12 feet deep, an office 9 feet wide by 12 feet deep, a living room 23 feet wide by 12
feet deep (from which extends in front a loggia or the south porch 24 feet wide by 11 feet
deep), a drug room 9 feet wide by 12 feet deep, a medical office 9 feet wide by 12 feet deep,
and a loggia (the east porch) 10 feet wide by 19 feet deep. At the rear of these apartments
is a corridor six feet wide connecting the two end porches and behind it is the main entrance,

Section III

stairway to the second floor, a men's toilet 4 feet wide by 9 feet deep, and two alcoves 9
feet wide by 4 feet deep.

On the west cm] of tlir building in tlie rear is the smaller e.xtension, divided down
the center by a hall ft)ur feet wide opening into the main corridor. On one side of the
passage are two patients' rooms, one 12 feet wide by 10 feet deep, the other 12 feet wide
by 9 feet deep, and a linen room. On the other side is a coat room 9 feet wide by 7 feet
deep, a bathroom 9 feet wide by 5 feet deep, a locker room 9 feet wide by 5 feet deep,
and a toilet room 5 feet wide by 8 feet deep for women.

In [hv extension on the east of the building is a dining room 14 feet wide by 2t,
feet deep, a pantry 11 feet wide by 15 feet deep, a kitchen 18 feet wide by 15 feet deep, a
servants' loggia or ])orch 7 feet wide by 14 feet deep, a servants' sitting room 10 feet wide
by 14 feet deep, the service and cellar stairway, refrigerator, and store room.

On the second floor the building is divided by a corridor practically in the same
way as on the first, with six rooms each 9 feet wide by 12 feet deep on the front for patients,
and an east, west, and south loggia of the same dimensions as those on the first floor, the
south porch being reached by a small hall four feet wide in the center of the building. In
the rear of the corridor is a small loggia on one side of the main stairway and a coat room
on the other. The west extension is divided into a bedroom and sitting room for the super-
intendent, a nurses' sleeping room, closets, toilets, baths, and a linen cupboard. The east
extension is divided down the center by a hall opening into the main corridor with two rooms
for i)atients, a store room, maid's room, and a refrigerator room on one side, and a pantr}',
lockers, baths, and two maids' rooms on the other.

The third floor has the same general arrangement; six single rooms for patients
on till' front; a corridor in the rear; east, west, and south loggias all somewhat smaller than
those on the floors below; two rooms for patients in the west and five in the east extension;
together with baths, toilets, and lockers, placed at convenient points.

The building is a complete institution in itself, supplying each patient with an in-
dividual room. There is a heating plant in the cellar, and electricity is generated for
lighting purposes on the premises. The capacity is twenty-six beds, housing all classes of
patients, at a cost for construction of $26,000, or Si, 000 per jiatient.

Franklin County Tuberculosis Hospital, Columbus, Ohio (Illustration ,:iq).
This hosi)ital was ])lanned to house ])atients in all stages of the disease and was one of the
first buildings of this tyi)e designed to contain wards for children suffering from pulmonary
tuberculosis. The structure has a high basement, two com]:)lete floors, and a third story
o\-er the central block. It is of fireproof construction with l)rick walls resting on a con-
crete foundation. For convenience of description it is divided into Cwt: sections: a central
or administration block 60 feet long by 41 feet deep, a section on either side including the
rear extensions 20 feet wide by 60 feet dee]), and beyond this ward blocks 4c) feet wide
by T,2 feet deey). The general plan is the same for each floor, the building being dixided
longitudinallx' by a corridor connecting the wards and ha\ing rooms on the front and rear.

The central block in the bast'iiieiit on tlu' front eontaiiis a chapel, a morgue, a re-
ceiving room in connection with the morgue, and tlu' elexator >haft. On the rear is a (Irv-
ing room, a stairway, toilits. and a >lor;ige idoin. The tn->t tloor is dixided in tlu' tenter l)\-
an entranci- hall ten tei't widi', which opt'iis at right angles into the main corridor, with a
stairway to the u])per stories o])posile the door. In the front are oflices antl examining
rcjoms, and on the rear are four prixate and two locker rooms. The second floor of this
section is dexoted to the i hildreiiV departnu'nl. Ovw the executive oftici's in tiie front are

Administration Buildings and Patients' Quarters Combined

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No. 39.— Franklin County Tuberculosis Hospital, Columbus, Ohio. Howard & Merriam, Archi-
tects. View of Front Elevation and Floor Plans. Capacity, 100
Patients. Estimated Cost, $80,000.

Section III

two wards 23 feet wide by 18 feet deep, one for girls and the other for boys. Opposite on
the rear of the corridor are locker, linen, and toilet rooms. On the third floor are four bed-
rooms and a silling room for tlie nurses, a small operating room, two linen closets, two small
wards, l)ath, toilets, and lavatories.

The sections of the building to which the rear extensions are attached contain in the
basement, rooms used by the janitor and engineer for machinery and storage purposes, also
a large sterilizing room and a servants' toikl. The extensions are both 20 feet wide by 24
feet deep; the one on the left is devoted to a laundry and the one on the right to a kitchen.
On the first and second floors under the main roof of the building in each section are private
wards, linen rooms, stairways, and halls to the extensions which contain diet kitchens,
baths, toilets, and lavatories.

The ward blocks have large windows and obtain light and ventilation from three
sides. In the basement the left section is unexcavated, but the right is so high above
ground that it is divided into eight bedrooms by partitions and a hall running through the
center. On the first and second floors in both blocks the arrangement is the same and con-
sists of two pri\-ate wards di\-ided by the central corridor; the one on the front being 9 feet
wide by 14 feet deep, and the one on the rear 1 1 feet wide by 8 feet deep. At the end of
the blocks are large wards 39 feet wide by 20 feet deep with loggias on the front under the
main roof of the building 38 feet wide by 10 feet deep.

This building is intended for all classes of cases and is designed to bring under one
roof an entire plant with a capacity of one hundred patients at a cost of S8o,ooo.

Hartford County State Tuberculosis Sanatorium, Hartford, Conn. (Illustration
40). This is a small building consisting of a remodeled farmhouse used for administrative
purposes to which has been added an extension for housing the patients. The building is of
frame construction, two stories high, and for purposes of description the side on which the
sleeping porches have been placed is considered the front of the building. The original
farmhouse is 36 feet wide by 40 feet deep and the extension, including the sleeping porches, is
93 feet wide by 28 feet deep. There is a cellar under the main section, but no excavation
under the extension except a tunnel carrying the steam pipes from the cellar in the admin-
istration building to the dressing and toilet rooms at the extreme end of the extension.

On the front of the first floor in the administration block is an office twelve feet
square, a dining room 14 feet wide by 23 feet deep, a side entrance hall 12 feet wide by 11
feet deep, a medicine closet, and a pantry. At the rear of these rooms is a reception room
12 feet wide by 15 feet deep, a kitchen 12 feet wide by 15 feet deep, a serving room, and a
stairway to the cellar. On this floor a passageway three feet wide connects the dining room
with the patients' quarters, which are divided into four single rooms 7 feet wide by 8 feet
deep and a ward 48 feet wide by 14 feet deep, cut up by low ])artitions into six cubicles
eight feet wide. This ward opt'iis on to a slee])ing |)()rch tweKe feet wide and into a dress-
ing room at the far end of the extension t6 feet wide by 2O feet deep, containing toilets,
baths, and lockers.

The second lloor of llu' a(hniiii>trati(iii block is dixidfd into Idvir bcch'ooms. two 12
feet wide bv 15 iwi deep, oiir 1; iCrl widi' b\' i() \cv{ deep, and our 1 1 Uh1 widr 1)\' 12 k'ct
deep, a stairway, and a hall connrtling it with llu' L'xtension. On lhi> tloor tin- i>aticnts"
quarters arc arrangi'd in tlu' sanii.' nianiu-r as on the lirst lloor with thr exception of the
addition of a ])ri\ate room eight feet s(|uare, and a nurse's bedroom 8 feet wide by 14 feet
deep, placed on the front of thi- building next to thi' wall of the main block. The capacity
of the building is thirl y- three patients at an t'stiniati'd cost of 815,000.

Administration Buildings and Patients' Quarters Combined

Ti^.

"^KBiff*^^

No. 40.— Hartford County State Tuberculosis Sanatorium, Hartford, Conn. Foote & Towxsexd,
Architects. View of Front and Side Kle\atioxs axd Floor Plans. This is a Remodeled
Farmhouse, with ax Opex Ward Extexsiox ix the Rear. Capacity, ss Patiexts. Estimated
Cost, $15,000.

6 81

Section III

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No. 41.— Cuenca Sanatorium, Bass Lake, Minn. Alfred H. Wheeler, Architect. Elevation
AND Floor Plans. Capacity, 28 Patients. Cost, $12,000.

Cuenca Sanatorium, Bass Lake, Minn. (Illustration 41). This building was
one of the tirst of a new type of small institution for housing tuberculous patients in a
complete plant under one roof. It was designed for a site situated within the city limits of
St. Paul, but as convenient property could not be secured the institution was placed at
Bass Lake. The building is of frame construction placed on a stone foundation, and the
central block, two stories high, houses the apartments for administrative purposes. The
basement contains a steam heating plant, laundry, and a gasoline engine which operates a
pump for drawing water from a well one hundred and fort>-three feet deep.

On the first f^oor is a dining and li\ing room 33 feet wide by 24 feet deep, a kitchen
24 feet wide by 20 feet deep, a small pantry, a sleeping room for the cook, a storeroom, and
closets. On the second l^oor are four jirixate rooms 14 feet wide by 10 feet deep, two wards,
one 10 feet wide by 20 feet deej), and the other 23 feet wide by i() feet deep, a corridor,
closets, baths, and toilets.

The wings or sleeping ])()rches are 55 feet wide by 12 \vv[ deep and are si'parated
from the central ])ortion of the building by rooms containing the lockers, baths, and toilets
for the patients. The fronts of the porches are open and jirotected b\- canvas curtains.
Cross ventilation is obtained through windows piercing the vvnr walls. Lockt-rs are \ery
small and are i)kice(l on the outer side of thi' walls dividing the dressing rooms from the
porches. The dressing rooms are also \-ery small lor ten patients and would be more con-
venient if located in extensions behind the jjorclu's. Tlir porclus should bi- wider and
divided by one or more partitions in order to house the patients in small groups.

The building has a capacity for twenty-eight i)atients and cost, including the site,
water sup])!}', and plumbing, .Si 2,000.

Administration Buildings and Patients' Quarters Combined

No.

42. — Sunnyrest Sanatorium, Colorado Springs, Colo. N. Van den Arend. Architect.
View of Front Ele\atio\ ant) Floor Plans. Capacity, 24 Patients. Cost, .SiS.ooo.

Sunnyrest Sanatorium, Colorado Springs, Colo. (Illustration 42). This is a
very good example of small, convenient, and well arranged combination buildings for
housing incipient and moderately advanced tuberculous cases. It is of frame construction
resting on a stone foundation and consists of a central block for administrative purposes
and two wings for the patients.

The central section is finished on the interior with lath and plaster and has a cellar
under it which contains the heating plant and storage room for coal and supplies. On the
first floor in the front is a sitting room 25 feet wide bv 30 feet deep, a dining room 25 feet
wide by 16 feet deep, an office 11 feet wide by 12 feet deep, a kitchen 16 feet wide by 22
feet deep, a pantry, storeroom, and other conveniences. On the second floor there are
four rooms about fourteen feet square. These are arranged in the form of an apart-
ment with baths, lavatories, and toilets and are used as an infirmary for patients tempo-
rarily unable to remain upon the porches.

The wings are 88 feet wdde by 24 feet deep, unfinished on the interior, and divided
into ten dressing rooms on the rear and a commodious sleeping porch on the front pro-
tected by glass and sash frames. Between the porches and the central block but under the
roof of the wings are rooms equipped with baths, lavatories, and toilets.

Section III

43- District Tuberculosis Hospital, Lima, Ohio. Mi I.aic.hi.in and Hi i.skin. Arc hitixts

\ II.UOI' iKdM AM) RkAK K|.|;\ ATIDNS AM) I'l.OUU l'l.AN>. I 'l< KSKNT t'AFAClTV. jS I'ATIKNTS. WiXC.S
TO liK KXTKNDKI) AS SlIOWN IN Fl.OOK I'l.ANS WITH A CAPACITY lOK lOO PaTIICXTS. KSTIMATKO

Cost, S.So,ooo. (I'or plan of hasi'mcni <(■<• illustration 20.)

Administration Buildings and Patients' Quarters Combined

This institution was built to serve the needs of a small city and was planned to have
the same general arrangement as the Cuenca Sanatorium. A very great improvement,
however, over that building is the placing of a small private dressing room for each patient
at the rear of the sleeping porches. The building has a capacity of twenty-four patients
at a cost of $18,000.

District Tuberculosis Hospital, Lima, Ohio (Illustration 43). This building
is situated on a site of fifty-five acres in a well wooded grove two and one-half miles from
Lima, Ohio, on the Western and Interurban Electric Road. It is constructed of brick, on
stone foundations, with brick porches facing the south at the rear, and for description is
divided into three sections: a central block for administration purposes, and two wings
for the patients' quarters.

The front of the administration block faces the north, and its basement contains the
servants' dining room 14 feet wide by 24 feet deep, the kitchen 22 feet wide by 24 feet deep,
a bakerv 14 feet wide by 20 feet deep, a pantry, vegetable and grocery store rooms, laundry,
heating and power plant, cold storage rooms, toilets, trunk room, and a mortuary. (See
Illustration 20).

The first floor contains a general dining room 29 feet wide by 27 feet deep, a
pantry and dish sterilizing room 8 feet wide by 24 feet deep, two dressing rooms 20 feet
wide by 21 feet deep, with lockers, bath, and toilets, a staff dining room 14 feet wide by

18 feet deep, a work room 14 feet wide by 12 feet deep, a reception room 14 feet wide by

19 feet deep, a general office 14 feet wide by 13 feet deep, a private office 14 feet wide by 9
feet deep, an x-ray room 14 feet wide by 5 feet deep, a drug room 7 feet wide by 12 feet deep,
a library 6 feet wide by 1 2 feet deep, and a matron's room 14 feet wide by 1 1 feet deep.

The second floor contains sixteen rooms all about 10 feet wide by 13 feet deep, and
baths and toilets for the staff, nurses, and servants; also two large dressing rooms with
lockers and toilets arranged in the same manner as on the floor below for the patients in
the pavilions.

The two wings of the building were designed to house patients, and on both stories
are divided into single rooms 8 feet wide by 12 feet deep, which face the south and open
on a porch fifteen feet wide. Behind these rooms are corridors leading to the dressing
and toilet rooms. One of the most interesting details of the building is the arrange-
ment of the patients' lockers, 4 feet wide by 2 feet deep, between the windows in
these corridors. The wings were planned to have twenty single rooms, two small wards
of three or four beds each, and two sun parlors or sitting rooms, 20 feet wide by 35 feet deep,
at the ends of the building. However, funds were not available to complete the plans as
illustrated. At the time the building was opened to receive patients and when the photo-
graphs were made the main section was finished, but the wings had a capacity of only four-
teen beds each and were completed for but one-half the length originally designed.

The water supply is obtained from an artificial lake, which was especially constructed
for the hospital, and the water is distributed through the building by pressure from a water
tower one hundred and twenty-six feet high. The present building, ha\'ing administrative
facilities for one hundred patients; the power plant in the basement; and the installation
of the system of water supply, cost S8o,ooo.

Design for a Small Town or Village Sanatorium (Illustration 44). This is a
design for a small tuberculosis hospital or sanatorium to house an entire plant under one
roof. As it was planned there is floor space for fourteen beds, but if the wings are built

Section TTT

No. 44. -Design for a Small Town or Village Hospital or Sanatorium. Front Elevatiox and
Floor Plan. Capacity, 14 Patients. Estimated Cost, $20,000.

two stories hi<^h. there will be accommodations for twent\-four patients. For a small
town or village institution housing incipient cases this is an interesting and compact design.
The floor space can also be arranged for advanced cases without greatly adding to the ex-
pense of construction by increasing the length of the wings eight feet and placing parti-
tions between the beds. The building was designed to have a basement under the entire
structure, a stone foundation, and brick or reinforced concrete walls to the ceiling of the
first storv. The walls of the second stor\- were to l)e of stucco on metal lath hnishrd in
colors or dashed pc-l)bk's. 'l"he whole structure was to be covered with a root ot stained
shingles.

According to the i)lan the building will be 100 feet along the front by 23 feet deep
through the wings, with wards 25 feet wide by 15 feet deep and porches 31 feet wide by 7
feet deep. The front walls dividing the porches are constructed of iM)sts with glass and
sash windows between them. These can be pushed up out of the way. leaving the sixice
clear and con\'erting the rooms into open wards. There are win(k)ws in the rear antl sitie
walls in order to allow cross \entilation. .\t the end of the wards next to the central section
of the building arc bath, tnilcl, and ImkiT rooms for the palii'nts. The lockers arc thri'c
feet S(|uarc, large enough to provide a small i)ri\ate dressing room for each patient.

The ct'nlral section of the I'lrst floor is dixided into a reading room tweKe feet S(|uare,
a dining room 21 feet wide !)>• is fi'^'l deep, and a kilthcii iS fi'ct widi- b\ i^ leet deep.
The second floor contains two small wards for two paticnt> each and a nurse's ai)artment
di\idi'd into a silling room, bedroom, and bath.

The building should be heated l)\ a strain plant in the cellar and tlu' site chosen lor
it so situated that it can be connected with the cily sewers, water mains, and lighting ser-
vice. The estimated cost, including the healing plant, plumbing, and wiring, is vS20,ooo.

SECTION IV

Pavilions for x^dvanced Cases, Infirmaries, and
Reception Hospitals

Section i\

H— 1

:.LL J.

IT^i

q&S

SECTION IV

Pavilions for Advanced Cases, Infirmaries, and Reception

Hospitals

The buildings grouped together in this section are all intended for patients who
need comfort, good nursing, and the housing supplied by a general hospital. They are all
used for the same general purposes, that is, for the care of cases too sick to look after them-
selves. At many institutions, however, one building serves as a reception hospital, in-
firmary, and pavilion for advanced cases. For this reason it is hardly possible to place
them under different headings for purposes of description.

Pavilions for Advanced Cases

These buildings are intended, as their name indicates, to house and care for patients
who are unable, because of the advanced condition of their disease, to live in lean-tos or
open cottages. They are usually built on the lines of a general hospital, either with the
entire plant under one roof as described in Section III; on the pavilion plan; or as a sep-
arate pavilion in connection with a general hospital or sanatorium in the open country.

An advanced case hospital does not mean a home for incurables, for there can be
no hard and fast line of demarcation drawn between curable and incurable cases. It has
been found that many patients sent to institutions where they may be isolated until their
death, improve under good hygienic surroundings and recover for all practical purposes.
It is the opinion of many authorities that the advanced case does better on a porch in the
open air than in an enclosed room and can stand with benefit a comparatively large amount
of cold and exposure. It is therefore necessary that buildings for this purpose, besides
being heated and supplied with the comforts and conveniences of a general hospital,
also have large verandas connected with the wards and rooms by windows cut down to
the floor, and doors through which beds can be rolled, in order to provide the same facihties
for the open air treatment necessary for incipient cases. Such porches should be used in
pleasant weather by patients, even when far advanced in the disease, as there is hope for
all when they are not in a dying condition.

Where very ill patients are to be cared for, it will give them comfort and save much
labor if the rooms and porches are connected by some arrangement such as the " convertible
sleeper" installed at the Indiana State Hospital (Illustration 46). This consists of a space
three feet six inches deep across the entire front between the porch and room, enclosed on
the outside by a glass and sash window that can be raised or lowered, and on the inside by
glass doors that can be opened or shut. In this clear space between the doors and window
is placed the bed, three feet wide, which is cut off from the room when the doors are closed,
and cut off from the porch when the window is lowered. If doors and window are both
open, the front of the room is entirely clear to the porch. By this arrangement patients
can be exposed to the air on the porch, or cut off from it and placed in the heated rooms
without disturbing them or moving the bed.

Section IV

No. 46. Indiana State Hospital, Rockville, Ind. Brubaker & Stern, Architect:^. "Convertible
Sleeper," Showing Arrangement for Connecting Rooms with Open Porches, in Order to
Expose the Patients to the Outer Air or Place Them in Heated Rooms without ^Ioving the
Heds. (See illustrations 7, 26, and 51 for further description of this institution.)

An essential point to be considered in plannino; buildings for advanced cases, is
that tuberculous patients in the last stages of the disease are very annoying to each other,
and should therefore be housed in separate rooms instead of wards. They are easily
affected by disturbances, and any excitement, such as grief, anger, or worry, is usually fol-
lowed by a fit of coughing and depression. Coughing is not only bad for the individual,
but when patients are housed in wards it may disturb ten or fifteen others, and is also a
strong suggestion which often causes an epidemic of coughing among them. The mistake
and cruelty of placing in one room a number of persons sulTering from a serious chronic
disease is beginning to be appreciated; and there is no doubt that many patients who fail
to make satisfactory progress against disease when housed in wards, rapidlx" impnne when
removed to the c^uiet and privacy of a separate room. The single room pa\ilions are slightly
more expensive to construct than the ward buildings, but they have ad\-antages and it is
easier to manage patients housed in them. The ])sychological tendency ot a prixate room
is to make ])atients more contented, and also to increase their self-respect.

Advanced case hospitals are built not only in order to care for the i)alient. but also
to ])revent the spread of i)uhnoiKiry tuberculosis, which is ckie in a great measure to the
cases of consum[)tion which remain and die in their homes, infecting other members of their
families. If all advanced cases could be cared for in hosjMtals, it is believed that the dis-
ease would more ra])i(ll\- (lisa])])ear. I'ublic o])inion at present will not allow the jiassage
of laws compelling j)ersons in the acKanced stages of this disease to enter institutions tor
their segregation; therefore, h()sj)itals should be made ct)mfortal)le and home-like in order
to attract the [)atients and Imld them.

There are now in use foracKanced cases at open air sanatoria, pa\ilions constructed
on the lean-to jjlan with the porches dixided into single rooms and llnished with jilaster on
the interior. 'i"he\- are dosi'd in front with glass and sash windows and make \ery satis-
factory (|uarters when heated. This is a simi)le method of housing, has the adxantage ol
proxiding plentv of porch s[)ace, and is economical. .\ lean-lo for sixteen patients tinishetl

Pavilions for Advanced Cases, Infirmaries, and Reception Hospitals

for advanced cases can be built for from $5,000 to Sio,ooo, and when near an administra-
tion building, administered as easily as a more costly structure.

Infirmaries

In large cities where a hospital for the care of ad\anced cases has a working connec-
tion with an open air sanatorium in the country for the cure of incipient consumption, it
has been found that there is more or less interchange of casas between the two institutions.
Patients taken into the hospital for advanced cases, to be cared for until they die, often im-
prove under nursing, good food, and hygienic surroundings, and are then sent to the coun-
try. Others who go to the sanatorium for the cure, seemingly only incipient cases, gradu-
allv fail in strength or develop acute symptoms and have to be sent to the city hospital and
remain there until they die.

This peculiaritv of the disease has created a need for buildings on sanatorium grounds,
where patients who have come to be cured, but develop symptoms of advanced disease, can
be housed and cared for until they improve or are discharged. There is also a need in all
large sanatoria for a building where patients taking the open air treatment can be placed
if they develop some other acute disease which requires nursing. Buildings used for these
purposes are called infirmaries, and combine the structural details of both the general
hospital and the open air buildings of the sanatorium. They are often constructed as a
complete unit and administered separately from the other sanatorium buildings. Many
of them have a dining room, kitchen, and ciuarters for nurses and servants who do not
have anv relationship except an official one with other parts of the institution. In
some instances the infirmary building
houses the medical department and may
be designated the medical building, as
illustrated in this section by the Adiron-
dack Cottage and Edward Sanatorium
infirmaries.

Precautions should be taken to
make these buildings sanitary, comfor-
table, and convenient. Good material
which is not likely to become infected
should be used and the structures made
fireproof if possible.

Reception Hospitals

A reception hospital is intended to
provide a place for the temporary care of
cases arriving at institutions for the treat-
ment of pulmonary tuberculosis, and for
the observation of patients until the phy-
sician can classify the stage of their dis-
ease and learn the idiosyncrasies of each
case under fresh air treatment before plac- No,
ing them in open shacks and cottages.
Hospitals for advanced cases, infirmaries,
and reception hospitals are all used for
the same general purposes, that is, for

47. — Isolation Hospital, Paterson, N. J.

Charles E. White, Architect. View of
THE Corner of the Tuberculosis Pavilion,
Showing Method of Heating Porches for
Advanced Cases with a Battery of Steam
Pipes. (See illustration 52 for further descrip-
tion of this institution.)

Section IV

the care of jjalicnts who need comforl and nursint^. Therefore ihey should be carefully
constructed of ,m)od material.

EXAMPLES OF PAVILIONS FOR AD\'AXCED CASES

Riverside Hospital, New York City, Concrete Pavilion (Illustration 48).
The Riverside Hospital is on North Brothers Island at the upper end of the East River
near Long Island Sound, and is used by the Department of Health for the care of advanced
tuberculous patients. The institution is in an isolated position where the air is pure and,
so far as climatic conditions are concerned, it has an ideal site for sheltered open air build-
ings. The authorities intend that the advanced patients sent there shall be housed in a
manner that will give them every chance of recovery.

The pavilion described is the first of a number of open air buildings all built on the
same general plan. In the last two pavilions constructed more space has been devoted to
rooms for administrative facilities and the fourth floors are arranged so as to receive better
light and ventilation. The building is constructed of reinforced concrete, four stories high,
and is 113 feet across the front by 37 feet through the center and 18 feet through the wings.
In designing this pavilion a floor plan of the lean-to type of open air building was followed;
consequently there are on each story two open air wards on either side of a sitting room
with an extension at the rear of the center.

On the first floor the central section, 28 feet wide by 16 feet deep, is used as a din-
ing room and the wards are 40 feet wide by 16 feet deep. On all the other floors the central
apartment, 21 feet wide by 16 feet deep, is a sitting room and the wards are 44 feet wide
by 16 feet deep. The rear extension is 43 feet wide by 16 feet deep and is divided into two
dressing rooms equipped with lavatories, toilets, and baths, a small diet kitchen, and a
nurse's room. The fronts of the wards are protected by French windows and can be en-
tirely oy)ened except for the space occupied by the pillars.

The pavilion has a capacity of seventy-eight patients at an estimated cost of $40,000.

Jewish Hospital for Consumptives, Reisterstown, Md., Ad\ anced Case
Pavilion ( Illustrations 40 and 501. The site of this ])a\ilion is the southern slope of a hill,
steep enough to permit of constructing the basemi'iit entirely above ground on the south
side and j)ro\-iding well lighted floor spiicc for a dining room, kitchen, serving room,
laundrv, and sterilizing room. The material used for the foundations and walls of the base-
ment is native stone, for the first story pressed brick, and for the second story rough stucco
on metal lath. The interior walls and ceilings are finished with hard plaster covered with
non-absorbent paint and have round corners. The floors are of hard wood dressed with
oil and the doors, casings, and other woodwork Uavv plain surlaces.

The building is 133 feet across the frt)nt, 4O feet deep through the center, and 57
feet dee]) through the wings. On each floor in the central block are eight single rooms 10
feet wide b\' 12 ft'et deep, with a partition on the >outli side of glass in sash arranged as
double-hung windows so that tat li room and llu- ponh max he thrown togi'tlur. In the
rear of the rooms, protecting tluiii on the north, an- well lighted and heated corridors six
feet wide' that connect the >idc iiorclus, which ari' 10 fi'et widr l)\- 30 fi'ct (Kip. The south
])()rches are 83 feel wide by 12 \vr{ (k-ep, |)roteited at eaih rnd by the front sections ol
the wings.

On liotli >torie> the main i()rridor> divide the wings, which are 25 feet wide 1)\" 57

9-!

Pavilions for Advanced Cases, Infirmaries, and Reception Hosi)itals

rbt//^r?i rj.oon.Pi^N'

ConcHete 7i/BC/i£ULas/s PAVvi-iot^s
— Jiir^ASWE. Jiospir/iL —

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j^fS^WE //oJP/TAZ.

No. 48.— Riverside Hospital, New York City. Designed by Dr. Hermann M. Biggs. Westervelt

& Austin, Architects. Concrete Pavilion for Advanced Cases. Front Elevation and

Floor Plans. Capacity, 78 Patients. Estimated Cost, $40,000.

Section IV

feel deej), into two sections. On the front are rooms 22, feet wide by 21 feet deep, the one
on the left in the first story bein<i used as a recreation room for the patients and the one
on the ritj;ht as a general reception room for the hosj^ilal. In the second storv thev are
used as wards, each patient l)ein<^ allotted twelve hundred cubic feet of air space. Back of
the corridor in the right wing are the superintendent's (juarters, while the balance of the
floor space in both stories is de\"o(e(l to nurses" rooms, diet kitchens, service stairwavs, and
lockers, baths, and toilets for the patients.

The main entrance is at the back of the building on the first floor. All the rooms are
heated by direct steam radiators, lighted by electricit\-, ha\e electric connections with
the nurses' apartments, are provided with electric bed-warmers, and screened against
insects. There is a large electric elevator for mo\ing patients in bed from one floor to an-
other, and the doorways are wide and ha\-e no sills so that the beds can be easiU' rolled
through them.

The jiaxilion was erected for ad\-anced cases and was designed to obtain unobstructed
cross \entilation from e\ery direction without mechanical means; to give each patient
one hundred and twenty scjuare feet of porch space; and to house the majority of the in-
mates in single rooms. The building has a capacity of twenty-four patients and cost
$:; 0,000.

No. 49. Jewish Hospital for Consumptives, Reisterstown, Md. I'wiiion for .\i)\ anc id C"asi:s.

NllWSiil I'KONI AM) kl,\K l-J.I A \TI(i\s ('\I'\(MA. .'I I ' \ I I IMS C'OST, S^O.OOO.

Pavilions for Advanced Cases, Infirmaries, and Reception Hos})itals

^CALtgtNCM C(?U*L?1

No. 50.

Jewish Hospital for Consumptives, Reisterstown, Md. P.wilion for Advanced Cases.
Floor Plans. Capacity, 24 Patients. Cost, $30,000. usi^

Indiana State Hospital, Rockville, Ind., W.a.rd Building (Illustration 51).
This pavilion is one of the original group of five buildings erected as a tuberculosis hospital
at Rockville, Indiana, and is seen at the left of the administration building shown in the
bird's-eye view and block plan of Illustration 7. It is built from the same plans used for
the pavilion on the opposite side of the administration block and is 295 feet long, 59 feet
deep through the center, and 27 feet deep through the wings. It has no cellar or base-
ment and is of frame construction resting on a concrete foundation, but there is a tunnel
carrying the service pipes, lighting wires, and heating mains running under it.

Both floors are divided in the same manner. On each side of a central sitting room
are sleeping porches 108 feet long by 9 feet wide, with a row of single rooms behind them
10 feet wdde by 9 feet deep. A corridor runs in the rear of the rooms and is connected
by an enclosed passageway with a hall in the administration building in order that the
patients may be sheltered in bad weather when going to and from their meals. The cen-
tral sitting room is 28 feet wide by 30 feet deep. Behind it is a nurse's room 14 feet wide
by 20 feet deep, a diet kitchen thirteen feet square, and a small serving room. At both
ends of the pavilion are the patients' dressing rooms, equipped with lavatories, baths, and
toilets.

Section IV

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No. 51. — Indiana State Hospital, Rockville, Ind. Brubaker & Sterx, Architects. Ward
Building, \ie\v of Front Ei.evation and Floor Pl.\x; Both Floors Alike. Cap.a.citv. 40
Patients. Estim.\ted Cost, $30,000. (See illustrations 7, 26 and 46 for further description of this
institution.)

The rooms on the first floor are protected on the front by double glass doors opening
out on to the sleeping porches, through which the beds can be run when desired. Thosi'
on the second floor are equij'jpL'd with the " con\-ertibk' sleep.T," described on pages 8y
and 90.

The building has a capacity for forty patients, all hous.'d in single rooms, at an esti-
mated cost of 830,000.

Isolation Hospital, Paterson, N. J., Tuberculosis P.wilion (Illustration 52).
This is a two story building cx)nstructed of reinforced concrete, with concrete floors, and is
fireproof throughout with the exception of the window frames and the framework of the
porches. It is a paxilion designed to house advanced tuberculous patients in connec-
tion with the Paterson Isolation Hospital, from which it is administered.

The building, not including the porch, is 27 feet wide l)\- 50 feel deep. The floor
plan of each story is the same, the space being divided into a ward 25 feet wide by 24 feet
deej); two private rooms 10 feet wide by 12 feet deep; a nurse's sitting room 10 feet wide
by 8 feet deep, containing a pri\ale toilet and stationary wash-stand; and a la\atory ten
feet scjuare ecjuipped with wash basins, bath, and toilet for the patiiiil>.

The porches e.xtend on both stories along the entire front :; feet wide by 11 feet
deep and on the south side of the building 1 1 feet wide by 50 feet deep. Thex are floored

Pavilions for Advanced Cases, Infirmaries, and Recei)tion Hospitals

with concrete, enclosed with swinging glass and sash windows, and heated by steam pipes
which extend along their outer edge as shown in Illustration 47.

The pavilion has a capacity of twenty-four beds and cost $12,096, but this does not
include its proportion of the expense of the power house or the construction of the enclosed
corridor which connects it with the administration building.

United States Army General Hospital, Fort Bayard, N. M., Officers'
Dormitory (Illustration 53). This is a single story building with a stone foundation and
walls of frame with brick \eneer externally. The roof is shingled and the interior walls

FIRST AND SECOND STORY
FLOOR PLANS

No. 52. Isolation Hospital, Paterson, N. J. Charles E. White, .\rchitect. Tuberculosis P.a.vilion.

View OF Front and Side Elevation. Floor Plan; Both Floors are .\like. Cap.a.city, 24

P.-VTiENTS. Cost, $12,096. (See illustration 47 for further description of this institution.)

Section \\

plastered. 'Vhv l)uil(lin<i is 14S iVcl wide by ,u I'^'^'t deep, heated by a hot water system
and H,<,dited by electricity. It is divided down the center by a corridor si.\ feet six inches
wide, and has eighteen rooms lor i)atients. twelve on the south side and si.\ on the north
side, all of the >ame dinunsions. 11 feet wide by i,^ feet deep. These rooms open upon
co\ered sleeping porches about ten feet deej), with doorways made wide enough so that
the beds can be rolled through them. There is also an oflfice 11 feet wide by i,^ feet deep,
an attendants' room. l)aths, and toilets. The capacity is eighteen ])atirnts and the laiilding
cost Si8,5.:;4.

United States Army General Hospital, Fort Bayard, N. M., Enlisted Men's
W.ARD No. 2 (Illustrations 54 and 55 '. The Mexican Mission style of architecture was
followed m designing this building, which is constructed of reinforced concrete finished
with pebble-dash. For dcscri])tioii the structure can Ije divided into four long narrow sec-
tions enclosing a central court with a small scjuare block at each corner. The building,
including the court, covers an area of thirteen hundred square feet, and the central court,
\\hich is cntirelv surrounded l)y a slee])ing ])orch ten feet wide, is 70 feet wide by 59 feet

^^:

l-^i1!i!l

No. 53. United States Army General Hospital, Fort Bayard, N. M. Offickrs' Dormitorv. \n:\v
Ml Ikont AM) .Slid. i;i.i:\.\ri(»N and I'iouk I'i.w. C ai'aciiv. iS Patiknts. Cost, $18,534.

Pavilions for Advanced Cases, Infirmaries, and Reception Hosj)itals

^ m ^ «i « '^

li I II 1.

No. 54.— United States Army General Hospital, Fort Bayard, N. M. Designed by Major CIeorge

E. BusHXELL. Enlisted Men's Ward Xo. 2. \ie\v uf Eront and Side Elevation

AND Floor Plan. Capacity, 40 Patients. Estim.ated Cost, $25,000.

Section IV

No. 55. -United States Army General Hospital, Fort Bayard, N. M. Uesignkp hv .Major George

1;. HrsHNKi.i.. I'.xi.isTEi) Men's Ward Xo. 2. \"ie\v of Inner Court Showing Sleeping

Porches. Capac ri\. 40 Patients. Estimated Cost, $2^.000.

deep. The long, narrow sections of ihc l)nil(linj,r makin,^ u\) the two sides of the court are
14 feet wide by 50 feet deep, and the front and rear sections are 68 feet wide by 14 feet dee]).
These all contain dressing rooms which are used as sleeping apartments by the men in
stormy weather. Numerous French windows open from the dressing rooms on to the
porches facing the court and also ujjon j)c)rches constructed on the outside of the building.
This arrangement permits the beds and reclining chairs to \)c nio\c(l freel\- on to a plat-
form having any exposure desired and gi\cs the i)atients an opportunity to srek or axoid
the sun at pleasure. The blocks at the corners of the building are al)out twcnt\-four feet
sc|uare; one is used as a reading room for the patients and the others are cut up into small
rooms and used for oflftces, lavatories, and storage. This Ixpe of building is especiall\-
adapted to dry, tro])ical countries, but can be used for patients' quarters in an\- climate il
the porches are protected 1)\- |)iTnKiiU'nt roofs. It has a cajxicity of fort\- jtatients at an
estimated cost of 82^000.

Lakeville State Sanatorium, Middleboro, Mass., IVwiiinx fdk .Mix
(Illustration 56). This is one of a group of four buildings erected as a hospital for treating
patients in all stages of pulnionar\- t uhi-nulosis, and is one ol two pa\ilioiis constructed
from similar plans. It is two hundred and forlN-eight feel long, built of wood, and rests
on a concrete foundation and britk pier>. l''or description it can he di\ ided into a central
block 36 feet wide by 65 feet deep; two wings 64 feet widi' by 20 feet deep; and two ex-
tensions from the wings built in the form of right angles, each having about nine hundred
square feet of lloor area.

100

Pavilions for Advanced Cases, Infirmaries, and Reception Hospitals

The central block is two stories high with a cellar under it which contains three
large locker rooms and a storage room for trunks. On the first floor is a sun parlor; a
large room equipped with laxatories, baths, and toilets; a diet kitchen; a treatment room;
and three small wards. The second story is 36 feet wide by 50 feet dee]) and is divided into
nine bedrooms, a bath, and a linen closet.

All the space in each wing is devoted to a large ward for advanced cases housing
twenty patients. The extensions from the wings are open air pavilions and house twelve
incipient cases. The building faces the south with porches in front of the wards nine feet
wide and in inmt of both arms of the pa\-ilions five feet wide. The building has a capacity
of seventy patients and cost $17,600.

Boston Consumptives' Hospital, Mattapan, Mass., Pavilion for Advanced

Cases (Illustration 57). This is a frame building resting on a concrete foundation and
concrete piers. The walls of the interior are finished with hard plaster and the floors are
of first qualitv maple. It is 144 feet across the front by 25 feet deep through the wards
and porches. The rear extension is 28 feet wide by 45 feet deep.

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FiRiT Floor P:

No. 56.— Lakeville State Sanatorium, Middleboro, Mass. John A. Fox, Architect. Pavilion
FOR Men. View of Front and Side Flevatiox and Floor Plan. Cap.\city, 70 Patients.

Cost, $17,600.

Section IV

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No. 57. Boston Consumptives' Hospital, Mattapan, Mass. M.m.inms, W.m.sh & Sri.i.u.w.
\i« iiiTi;( Ts. I'wii.iDN i(.K .\i)\ \\( II) Cx-^i.^. \ii.\\ OK Front {''.I-KVAtiox and Im.oor Plan.
('ai'A( ITV, 2() I'ATii.NTs. C'osT, Si.i.ooo. (See illustralion 72 for furtlu-r liest riplion of this instiUi-
lioiij

'I'hc front st-clioii i> dixidrd into two wards faili ()o iVt't wide 1)\- 14 feet deep, sepa-
rated Ijy a recreation room 22 feel wide by 24 feel deep. On the south side of the wards
are porches ten feet wide, and the wards anfl porches can l>e thrown together 1)\ raising with'
triple-hun<i windows. The ri'ar e.\ten>ion i> di\ iilcd into a nurse's room 10 leet widi' 1)\ i 1
feet dee]); an emergency ward for two beds of the same dimensions; two dressing rooms.
both 14 feet wide by 21 feet deep, containing lockers ,^ feet wide by 2 feel 0 inches deep;

Pavilions for Advanced Cases, Infirmaries, and Recej)ti()n Hospitals

and a lavatory 27 feet wide by 13 feet dee]) e(|uipi)e(l with two hath tubs, two showers, six
wash basins, and four toilets.

The wards are heated by batteries of steam pipes hun<^ on the rear walls, and cross
ventilation is obtained by windows piercing the walls above them. It has been reported
that the wide triple-hung windt)ws on the front of the wards are \-er\' hea\'y and hard to
move and that probably French doors will be substituted for them. The building has a
capacitv of twenty-six patients and cost, including the heating plant, wiring for electricity,
and other equipment, $15,000.

EXAMPLES OF INFIRMARIES AND RECEPTION HOSPITALS
Maine State Sanatorium, Hebron, Me., Infirmary (Illustration 58).
This pavilion is built on a side hill where the land falls away to such an extent that the base-

No. 58.— Maine State Sanatorium, Hebron, Me. John Calvin Stevens and John How.\rd Stevens,

Architects. Infirmary. View of Front Klevation and Floor Plan. Cap.^city, 30 Patients.

Estimated Cost, $30,000. (See illustralions 1 1 and ^3 for further description of this institution.)

103

Section IV

ment under one wing is above ground and can be used for housing patients. The founda-
tion and !)asement walls are of concrete suj^porting a wooden superstructure. The front
of the huiidiuL!; forms ;in acute an,<i;le and has a porch ele\-en feet wide running its entire
width. l'"or (kscri])li()n the paxilion can be dixided into four sections: a central block ^^t,
feet wide b\- ,^7 feet deep two stories high; two wings 61 feet wide by t,2 feet deep; and a
rear extension 40 feet wide by 37 feet deep.

The central block is divided transversely by the main corridor four feet wide and
contains four pri\-ate rooms all about tweK'e feet scjuare. P^ach wing consists of nine open
air sleeping rooms for one bed each, with a corridor in the rear and a protected porch on the
front. The rooms are all 7 feet wide by 1 1 feet deep provided with closets 2 feet wide by
3 feet deep between the rear walls of the rooms and the corridor. Sunlight reaches the

No. 59. Municipal Sanatorium, Otisvillc, N. Y. 1)ksk;.\i;u by Dr. Hkrm.wn M. Hic.gs. J. D. Bcrt,

.\l<( 1111 1.(1. \\(i\ll.\'> iMIiniAKV. \ll.\\S (l|- I'ROXT .WO Rl'.AR Kl.KVATlOXS. C.\P.\riTV, 24 Pa-

IMKNTS. KsTiM \Ti;i) C"< 1ST, S5 .ooo. ( Si'i' ill list nil ioiis 14. 2<S, 60, gg, lo^i and 114 for furl her descrip-
tions of this in.^^titiition.)

104

Pavilions for Advanced Cases, Infirmaries, and Reception Hospitals

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No. 60.— Municipal Sanatorium, Otisville, N. Y. Designed by Dr. Hermann M. Biggs. J. D. Burt,

Architect. Women's Infirmary. Floor Plans. Capacity, 24 P.^tients. Estimated _ Cost,
$5,000. (See illustrations 14, 28, 59, 09, 106, and 114 for further descriptions of this institution.)

rooms through glass in sash transoms that open in the south wall above the roof of the
porch. Behind the corridors are extensions to the wings 27 feet wide by 7 feet deep,
equipped with lavatories, baths, and toilets. The basement of the left wing is arranged
in the same manner as the floor above. The rear e.xtension houses an operating suite, din-
ing room, kitchen, pantry, and closets, and from the central corridor an incline leads to a
tunnel connecting the pavilion with the administration building.

The structure is used as an infirmary and reception ward, is heated by steam from
a central plant, and has a capacity of thirty patients at an estimated cost of $30,000.

Municipal Sanatorium, Otisville, N. Y., Women's Infirmarv (Illustrations
59 and 60). This pavilion is a two story, frame structure 88 feet wide by 28 feet deep
through the center and 16 feet deep through the wings. It rests on a stone foundation
and stone piers and has a basement 25 feet wide by 29 feet deep under the central section.
The building is covered with shingles stained green with cream colored trimmings and has a
roof colored a Tuscan red.

The first floor is divided into two wards 27 feet wide by 15 feet deep for six patients
each; a living room 24 feet wide by 14 feet deep; and two dressing rooms 11 feet wide by
13 feet deep, equipped with lockers, lavatories, baths, and toilets. The second floor con-
tains two open air wards 18 feet wide b>- 15 feet deep; two living rooms 12 feet wide by

Section IV

if -m 'i'rt i^

4: .- :i

No. 6i. Eudowood Sanatorium, Towson, Md. Wvatt & Noi.tim,. Architects. Infirmary

liiiuJi.N(.. \n:\vs ov the Front and Rear Klexations. Floor Plans. Capacitv. 30 P.\tients.

Estimated Cost, $30,000. (See illustrations 22 and 98 for further (li.'srrii)tion of tliis institution.)

10 feet (\vv\). coniu'cttd by a hall four fei'l wide; two dressing rooms 10 feel wide by 11
feet deep, ef|ui|)|)ed with lockers and la\atories; a diet kitchen iiiiu' feit siiuare; and an
infirmary ward 24 feet wide by 14 feet deep sittiated in the center of the btiilding. This
room is j)r<)tected on three sides l)y ghiss and sash (louble-hun,<i windows. Those on the
front slide into ])ockets ieaxinjj; the o])enin<.; entirely cK'ar. Uy thi> arrangement llu' in-
firmary can be con\-erted into an open air ward.

The two floors are isolated from each other, as then' are no stairwaxs in the interior.
The building is situated on a steep hillside and the second story is reached by a bridge

1 00

Pavilions tor Advanced Cases, Infirmaries, and Reception llospitals

from the high ground in the rear. The paviUon has a capacity of twenty-four patients and
including the steam heating plant, hot water tank, and plumbing, cost $5,000.

Eudowood Sanatorium, Towson, Md., Infirm.ary Building (Illustration 61).
This pa\'ilion is a wooden structure hnished on the outside with shingles. It is two hundred
and thirty-two feet across the front and for description can lu- divided into a central sec-
tion, two wings, and three rear extensions.

The central block is 36 feet wide by 46 feet deep, two stories high, and designed
after the Southern Colonial style of architecture. The front consists of two loggias 34
feet wide bv 1 1 feet deep covered by the main roof of the building and supported by large,
round, wooden columns painted white. On the first floor behind the loggia is a sitting
room 35 feet wide by 16 feet deep from which a nurse can overlook both wards and porches;
an office, one-half of the dining room, a linen room, and closets. In the cellar is a heating
plant and storage rooms. On the second floor besides the sleeping loggia there are four
bedrooms for nurses, closets, a bath, lavatory, and toilet.

In the rear of the central block the extension is 17 feet wide by 35 feet deep and con-
tains a kitchen 16 feet wide by 14 feet deep, a pantry 16 feet wide by 10 feet deep, and a
part of the dining room; the entire floor space of the dining room being 16 feet wide by
22 feet deep.

The wings are 98 feet wide b}- 25 feet deep dixided into two wards 31 feet wide b}'
13 feet deep, a portion of the locker rooms, a sleeping porch 78 feet wide by 10 feet deep,
and a suite of three private rooms opening on to a private porch. The private rooms, 8
feet wide by 10 feet deep, face outward from the ends of the wings and the pri\'ate porches
21 feet wide by 8 feet deep, in front of them form the extremities of the building.

The extensions from the rear of the wings 16 feet wide by 21 feet deep are devoted
to dressing rooms ecjuipped with individual dressing lockers three feet square, baths, lava-
tories, and toilets.

The plans of this building will repay careful study, as it is considered a comfortable,
convenient, and easily administered infirmary. There are four wards housing six beds
each, six private rooms, and pleasant quarters for the nurses. The building can be ad-
ministered as a separate unit and was designed to contain the necessary service apartments
with that end in view. Its total capacity is thirty patients at a cost of $30,000.

Edward Sanatorium, Naperville, 111., Infirmary and Medical Building
(Illustration 62). This building was erected to house under one roof the medical offices,
laboratories, and infirmary of an institution. It is a frame structure 70 feet wide by 34
feet deep and three stories high. The third story is lighted by dormer windows and the
interior has been left unfinished. The basement contains the heating plant; a hot water
tank; a disinfecting plant; a mortuary; a carpenter shop; and a dressing room equipped
with lavatories, baths, and toilets.

On the first story in the front of the building is a wide entrance hall which joins at a
right angle the corridor dividing the floor space of the medical suite. On the left of the
entrance hall is the superintendent's office 17 feet wide by 15 feet deep and a laboratory 11
feet wide by 15 feet deep. To the right of the hall is a reception room 17 feet wide by 15
feet deep. Behind the corridor are two examining rooms, a drug clos?t, and a kitchen.
On the second floor the medical side of the building is divided longitudinally by a corridor
with three bedrooms and a linen closet on the front and three bedrooms, two baths, and the
stairway on the rear.

107

Section TV

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No. 62. — Edward Sanatorium, Naperville, 111. Designed by Dr. Theodore B. Sachs. \V. .\. Otis
AND Edward M. Clark, Architects. Infirmary ant) Medical Building. View of Rear and
Side Elevations and Floor Plans. Capacity, 12 P.\tients. Cost, $21,435. (See illustrations

q(> and 102 for further dc'scri|)li(in of this institution.)

The int'irmary palicnls arc housed 011 two porches iS I'cct wide hy :; i feel deep,
one ()\er the other and l)()lh ])rotectcd on the north hy the wall ol" the htiildiiiLj, on the west
by p;hiss and sash windows, and on the south and i-ast hy can\as ciu'lains. Behind the
porches under the main roof of the hiiildin^ an- dressin.u; rooms 1 i feet wide by 14 fi'ct det'i),
furnished with lockers; and wash rooms 10 feet wi(U' 1)\' 12 feet deep e<|uipj)e<l with baths.
hivatories, and toilets. Kach lloor accommodates six patients, the lower for men and tiie
u])per for women.

The interior walls hax'e round corners and ari' linished with hard ])laster coxcred with

loS

Pavilions for Advanced Cases, Infirmaries, and Reception Hospitals

enamel paint. The woodwork has smooth surfaces and the floors are of hard wood, tile,
or cement. It is a well ventilated, sanitary structure, heated by steam, and besides hous-
ing the medical staff, has a cajxicity for twehe patients at a cost of $21,435.

Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Infirmary and Medical
Building (Illustration 63). This building is a good example of a reception hospital
and infirmary of a sanatorium combined with the medical building under one roof in
order to economize on the cost of construction. The peculiar right angle design of the
structure is due to the shape of the site, as there was not sufficient land to erect a straight
building. It consists of a basement and two stories with the walls of the foundation and
first story constructed of native stone two feet thick. The second story is of frame with a
shingled exterior, extra insulation against cold being obtained by using two layers of build-
ing paper and siding between the shingles and the interior finish.

When the patients first arrive at the sanatorium they are cared for on the first floor
of this building which contains eight patients' rooms g feet wide by 13 feet deep, a sitting
room thirteen feet scjuare, and a nurse's bedroom 9 feet wide by 13 feet deep, all opening on

■f ■- . ml i

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No. 63. — Adirondack Cottage Sanitarium, Saranac Lake, N. Y. Scopes & Feustm.a.nn, Architects.
Infirmary axd Mkdical Hl-ildixc. \'ie\v of Front and Side Elevations and Floor Plans.
Capacity, 8 Patients. Cost, $26,000. (See frontispiece and illustrations 13, iii, 117 and 122 for
further description of this institution.)

109

Section IV

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^1-1-1-1-l-lTTl-li^P

No. 64. — Maryland State Sanatorium, Sabillasville, Md. Wvatt & Xoi.tixc. Architkcts.

l.NFIKMARV BUILDINC;. \'lE\V OF I'KOXT ElE\ATIO\ AND I'LUOK PlAX. CAPACITY. 20 PaTIEXTS.

Estimated Cost, $18,000. (Sec illustrations 3 and 8g for further description of this institution.)

to a porch in thr front ten feet wide and into a corridor at the rear fi\e feet wide. Behind
the corridor in the center is the main entrance and stairway. At the ends in rear exten-
sions are lockers, baths, and toilets for the patients. In the angle of the building in froiU
is thi' nurse's office 10 feet wide at the widest point and i :; feet dee]i, an interesting room,
for in the corners next to the windows are mirrors so arranged that tlie nurse sitting at hi r
desk is able to oN'erlouk both the porches.

The second floor is used for the work of the medical and laboratory staff. At the
front are two porches 20 feet widi' by 11 feet deep ujion which the staff work when the
weather is yileasant, and in the rear is a corridor ti\e ivvi wide, 'riie balam-e of the lloor
space is di\i(U'd into the following rooms beginning at the right of the ilkistralion: a labora-
tory 16 feet wide by 27 feet deep, a treatment room i 1 feel wide b\ 1 .; feel deep, an exam-
ination room 17 feet wide by i^ fi'el di'ej), a throat room S feel widi' b\ o \vc\ deep, a wail-
ing room 1 I feet widi' b\- iS feel deep, a (h"Ug room 10 \vv\ wide l)\' 1 :; feet dei'p, an .v-ra\"
room () icvi wide l)\- 1 .; feel (k'tj), a librarx" 1 .; irv\ wide b\ iS \vv{ (\cv\). a ph\siciaii's ollice
15 feel w idi- b\' 14 fi'el dee]), and a slalislieian's oftiee 1 :; \cv\ widi'bx' 12 feii dei'p.

.\n interesting feature of the building which i> not shown in the i)hotograph is a
row of transoms or windows placed o\cr llu' roof of the porch and o]>ening into the rooms
on ihe groimd lloor. This arrangement \-entilalc'S the space just hi'low the ceiling and
allows direct sunlight, which otherwise would be cut off b\ I he porch, to enter the patients'
rooms. The building together with its medical offices and laboratories has a eai)acit\- for
eight ])alieiils and cost $26,000.

1 10

Pavilions for Advanced Cases, Infirmaries, and Reception Hospitals

Maryland State Sanatorium, Sabillasville, Md., Infirmary Building

(^Illustration (14). This |)a\ilit)n is of franu' c\)nstruclion covered with shingles and rests
on a stone foundation and stone i)iers. It is one hundred and ninety-five feet across the
front and has the same general appearance as the lean-tos used for housing incipient pa-
tients at the Maryland State Sanatorium. The building for purposes of description can
be divided into a central section, two wings, and three extensions. The central block is
28 feet wide by 7,2 feet deep and contains a sitting room 27 feet wide by 18 feet deep with
windows in the side walls overlooking the sleeping porches, two linen rooms, two closets,
and a section of the corridor.

The wings, 84 feet wide by 32 feet deep, are divided into ten single rooms 8 feet wide
by II feet deep, with a covered porch twelve feet deep on the front and a heated corridor
five feet wide on the rear running the full length of the building and protecting the north
sides of the rooms.

The extension in the rear of the central block is 36 feet wide by 10 feet deep and con-
tains a nurse's room, a diet kitchen, and store room. The extensions behind the wings, 34
feet wide bv 7 feet deep, are divided into two sections b>- an entry and are equipped with
lavatories, baths, and toilets. The building has a capacity of twenty patients at an esti-
mated cost of $18,000.

No. 65.— Georgia State Sanatorium, Alto, Ga. Scopes & Feustmaxn, and Walter W . Jidell.
.\ss(X'E\TED Architects. I.\FIR^L\RY IU-ilding. \'iew of Rear and Side Elevations and Floor
Plan. Capacity. 24 Patients. Cost. Si8,ooo. (See illustrations 4 and 92 for further description
of this institution.)

Section IV

Georgia State Sanatorium, Alto, Ga., Infirmary Building (Illustration
65). This is a lun^', low. ramhliiiu; building of the bungalow type constructed with wood.
The frame rests on a stone foundation ei.tihleen inches thick and is covered on the outside
by layers of building paper, siding, and shingles and on the interior by plaster over wooden
lath. It is one hundred and tifty-three feet across the front and is designed in the form of
three connected blocks, with five covered sleeping porches.

No. 66. Ohio State Sanatorium, Mount Vernon, Ohio. !•. I.. I'.\( kakd. Akciutiut. Rkcki'Tiun

IIOSI'I lAL. \li;\V OF I-K(J.\T KlEVATION ANU 1' I.OOK I'LAN. CAPACITY, 24 I'ATU^NTS. KsTlXIATKD

Cost, $30,000. (Sec illuslrulion 91 for further descrii)tion of this institution.)

Pavilions for Advanced Cases, Infirmaries, and Reception Hospitals

The central block is 71 feet wide by 37 feet deep, divided transversely through the
center by a lounging hall twelve feet wide, which is cut at right angles by a corridor seven
feet wide connecting the ward blocks. On both sides of the main hall in the front of the
building are three single rooms q feet wide by 13 feet deep. On the rear of the corridor is a
nurse's ofifice, a diet kitchen, a treatment room, a locker room, and two lavatories fitted with
baths and toilets. On the front of this section is a sleeping porch 41 feet wide by 12 feet
deep.

The two wards, both having a capacity for eight patients, occupy the entire space of
the blocks 30 feet wide by 25 feet deep, on either side of the central section. Connected
with each ward are two sleeping porches; the one at the end 15 feet wide by 34 feet deep
houses six beds and the other at the rear 20 feet wide by 10 feet deep is for two beds.

This Iniilding was planned so that it could be used when first erected as a temporary
administration building and later easily and economically turned into a well arranged in-
firmary. The architect designed the infirmary first and then worked out the arrangement
for administration purposes in the following manner: The ward on the east end of the
building was converted into a dining room and the porches communicating with it were en-
closed; the larger one used as a kitchen and pantry, and the smaller one as a staff dining
room. The ward on the west was divided into two sleeping rooms for nurses and a small
ward for six patients. The building when remodelled for use as an infirmary will have a
capacitv of twenty-four patients at a cost of $18,000.

Ohio State Sanatorium, Mt. Vernon, Ohio, Reception Hospital (Illustration
66). This is a two-story pavilion one hundred and forty-seven feet across the front, rest-
ing on a stone foundation, with brick walls, white stone strimmings, and a tile roof. For
purposes of description it may be divided into a central block, two wings, and a rear ex-
tension. The general plan of both stories is the same.

In the central block, 34 feet wide by 42 feet deep, is a loggia 30 feet wide by 13 feet
deep, a living room 30 feet wide by 15 feet deep, two linen closets, and a section of the corri-
dor. The wings, 57 feet wide by 35 feet deep, are divided into six rooms, each 9 feet wide
by 13 feet deep, with a loggia on the front twelve feet deep and a corridor on the rear five
feet wide. The floor space of the rear extension, 2,7, feet wide by 59 feet deep, is divided
into a row of rooms on either side of a hall five feet wide. The hall joins at a right angle the
corridor in the main block and the rooms are used for baths, lavatories, toilets, storage,
diet kitchen, and the nurse's bedroom.

The floor plans of the building are well worth study, as they have a number of in-
teresting features such as the deep loggias, the position of the closets or lockers behind the
patients' rooms, and the arrangement of the storage closets, lavatories, and other apart-
ments in the rear extension. The building has a capacity of twenty-four patients at an
estimated cost of $30,000.

Danvers State Hospital, Hawthorne, Mass., Tuberculosis Pavilion (Illus-
tration 67). This pavUion was erected to house insane tuberculous patients, but is well
arranged for use as a reception cottage if small observation wards are desired. It is a
frame structure covered externally with shingles and finished on the inside with plaster
and smooth wood surfaces. The front section, 60 feet wide by 32 feet deep, is divided into
a loggia, a dining room, and two wards. The rear extension, 35 feet wide by 18 feet deep,
8 113

Section 1\

No. 67. Danvers State Hospital, Hawthorne, Mass. Designed by Dr. F. Page. Tuberculosis
Pavilion. \ii:\v of Front and Side Elevatiox ant) Floor Plan. Capacity. 16 Patients.

Estimated Cost, $6,000.

contains a nurse's room, a diet kitchen, a locker room, and Uivatories, bath, and toilet.
The wards have cross ventilation through windows on three sides and a continuous row of
transoms in the front oxer the windows. The jiorch is constructed in the form of a loggia
and well screened on the front and sides. The sections of the roof of the building in front
of the wards which covers the loggia ha\-e been cut away and skylights jilaced in the sjxice.
'I'his arrangcnn'iit allows direct sunlight to iiitcr tlu' wards. Tlu' building has a capacity
for si.xteen patients at an cstimati'd cost of S(),ooo.

114

SECTION V
Children's Pavilions

The Importance of Children's Pavilions

The importance of the problem oi tuberculosis in childhood is now recognized, and
the great need of providing hospital and sanatorium treatment for children suffering with
pulmonary tuberculosis is accepted as an essential part of the campaign against this disease.

The practice is well established of treating on open air porches children suffering
from tuberculosis, pneumonia, measles, and other acute and chronic diseases, and those
who have contracted such diseases usually show improvement when placed in the open air.
Recent in\estigations have shown that in a given number of children dying from various
causes, a much larger percentage of deaths are due to tuberculosis than was supposed to
occur from the disease. Taking this knowledge into consideration with the fact that it
is only a short time since there were practically no beds provided in the hospitals and sana-
toria of the United States for children suffering from the pulmonary form of this disease,
it is hardly necessary to point out that there is a great need for such accommodations.

During the year 191 2 the demand became so insistent in certain sections of the
country for beds to be set aside for this purpose that it has brought about within the last
few months the construction of a few children's pavilions at some of the larger institutions.
As the Bureau of Hospital and Sanatorium Construction of The National Association for
the Study and Prevention of Tuberculosis has had many inquiries for descriptions of this
type of building, it seemed wise in bringing out a new edition of this book to add a section
on children's pavilions.

The Ijuildings described in this section are with one exception of the true open air
ty])e of pavilion or ward building and are a part of institutions having service and
administrative facilities housed in other structures. These pavilions can also be adapted
to the use of large institutions, such as orphan asylums and industrial schools, for
there is no reason why health}- children should not sleep in the open air. The structure
described on page 128 was designed for this purpose by Dr. Hastings H. Hart, who advises
that these institutions provide arrangements for the outdoor sleej^ing of thirty-three per
cent, of their inmates. It is said that at least one-half the children sent to reformatories
and orphan asylums are i)hysically defective, probably because of bad heredity or through
poor feeding and unfa\-orabIe enx'ironment. 'I'oo often these children are taken from
insanitary homes onl)- to be put into poorly \-eiUilate(l dorniilories. These dormitories
are in many instances on one side of a building where cross \rntilation cannot be secured
and often window x-entilation is not thoroughly used becaust,' the beds cover so much of
the floor space that an open window jjroduces a direct draft on thi' heads of the children.

While there is not a great deal of dilTerence between the open air buildings for
h(jusing children and o|)in air buildings for housing adults, certain facts regarding
children should be ke])t constantly in mind when di'signing |)a\ilions for them. Thev

116

Children's Pavilions

No. 68.— Gaylord Farm Sanatorium, Wallingford, Conn. Browx & Von Beren, Architects. Chil-
dren's Cottage. View of One of the Wards, Showing Method of Finishing Interior and
Arrangement of Dormer Windows for Ventilating the Space Below the Ceiling. (See illus-
trations 75 and ii8 for further description of this institution.)

are much more susceptible to contagious diseases than adults and should, therefore, be
housed in such a way as to prevent the spread of these diseases among a large number of
individuals. In some institutions, such as the "Preventorium" at Farmingdale, there are
special receiving wards where the children remain without coming in contact with the
regular inmates of the hospital from the time they first enter the institution until the
incubation period of the acute contagious diseases are past.

Planning Children's Pavilions

In working out the plans of pavilions for housing children it is well to consider the
following suggestions:

1. That babies should be kept separate from the older children.

2. That boys should be placed in wards that are distinctly separate from the wards

for girls.
■ 3. That adequate provision should be made for the detention, observation, and
isolation of the children when they first arrive at the institution.

4. That adequate provision should be made for the isolation and care of children

showing symptoms of acute disease during the course of their treatment for
tuberculosis.

5. That adequate porch space should be provided for the fresh air treatment.

117

Section \^

No. 69. — Westfield State Sanatorium, Westfield, Mass. E. C. & G. C. Gardner, Architects.

Girls' I'.w ilion. \'ik\v of Porch and Ixtekior of Pavilion, Showing Position of Beds, Canvas
Shutters and Flat Roof for Protecting the Porches. (See illuslration So for further description
of this buildinj;.)

6. That floor space should be allotted for an open air schoolroom and a playroom

unless there are apartments for this purpose in other parts of the institution.

7. That s])ecial doors and reception rooms should be provided for the admittance

of visitors so that they cannot mingle with the patients without permission.

8. That a large tank under automatic control should be provided for the mixing

of hoi and cold water used in the lavatories,
g. That an out-jiatient de])artnunt should be kejit as far awa_\- as ]'»ossil)le from a

pavilion for children.
Most of the buildings described in this section ha\e one or more unusual and inter-
esting features; many of these are new ideas used for tlu' lirst time in buildings designed
for the ()])en air treatment of diseases and should be studied with a \ iew to incorporating
them iiUo the i)lans of new pa\ilions.

EXAMPLES OF I'.W ILIOXS FOR CHILDREN

Nopeming Sanatorium, Duluth, Minn., ( iiii i)ni,\"s Coitac.!-. ( IlliLstration 70).
'I'he building is of frame construction, shingled on the outside from the un(leri)inning to
the .second-story window sills and above this point covered with stucco on metal lath.

iiS

Children's Pavilions

The roof is shingled; the floors are of hard wood; and the interior trim is yellow pine. The
porches for treating the children by the open air method are designed after the loggia type
of fresh air apartments and are entirely within the roof projection of the building. This
character of construction was adopted in order that the style of architecture in the chil-
dren's pavilion would conform with that of the main building of the sanatorium which has
porches of the same type and is constructed of stone and stucco on hollow tile.

For ease of description the building may be divided into three parts: the central
section 34 feet wide by 37 feet deep, and two wings each 23 feet wide by 20 feet deep. On
the first floor in the rear of the central section is the entrance, and opposite is a schoolroom
24 feet wide by 16 feet deep. To the rear of this room is a corridor 7,^ feet long by 5 feet
wide, and behind the corridor is an attendants' room 12 feet wide by 11 feet deep, a locker
room, bathroom, toilets, and the stairway to the upper story. At the inner corners on
both sides of the schoolroom are two small rooms 6 feet wide by 7 feet deep, one used as a
linen closet and the other as a bathroom and toilet. The corridor running parallel with
the front of the building connects the wards which are situated in the wings. These wards
are about 11 feet wide by 19 feet deep and open on to the porches or loggias which are of
about the same dimensions.

No. 70.— Nopeming Sanatorium, Duluth, Minn. Scopes & Feustmann, Architects. Children's
Cottage. View of Rear Ele\atiox and Fi.ijor Plans. Capacity, 22 Patients. Cost, $11,000.

119

Section V

On the second lloor the arrangement oi the corridor, wards, and porches is similar
to that on the first lloor, !:)ut in the central portion over the schoolroom is an intirmary i8
feet wide by lo feet deep, an intirmary porch i6 feet wide by lo feet deep, a nurse's room
8 feet wide by lo feet deep, and a small special porch 8 feet wide by lo feet deep, so arranged
that the nurse having charge of the intirmary may sleep out of doors. In the rear of the
corridor besides the halls, lockers, and toilets, there is a sewing room 6 feet wide by lo
feet deep. Above the second floor is an attic which is partly finished and large enough
for three servants' rooms, a bath, and a toilet.

The principal feature of the building is the open air schoolroom, which is so ar-
ranged with sash and glass windows that the entire front and practically all of the two sides
can be thrown open. In order to make the room attractive there has been built in it a
fireplace ornamented with Dutch tiles depicting scenes of interest to children. The
building is heated by steam from a small plant in the basement, has a capacity of twenty-
two patients, and cost $ii,ooo.

John Sealy Hospital, Galveston, Texas, Walter Colquitt Memorial Ward
FOR Children (Illustration 71). This is a detached building at the John Sealy
Hospital erected for the care and treatment, by the open air method, of children suffering
from surgical tuberculosis. The building is two stories high, designed on the lines of the
Mission style of architecture, with low pitched roof and deeply recessed porches. The
roof is of the hipped variety covered with asbestos shingles and, although it has a very
moderate pitch, it is high enough above the ceiling of the second story to provide for an
ample air space between the roof and the ceiling so necessary to comfort in warm climates.

The building is fireproof throughout, of monolithic reinforced concrete construction,
with concrete floors finished on the top with wood or composition. The interior walls
are also of concrete covered with plaster worked to a smooth finish. The building is 57
feet wide and 62 feet deep, with a hall eight feet wide running from the front entrance di-
rectly through the building. The rear end of this hall is open and forms a loggia which
provides an open air working apartment for the attendants.

On the first floor in the front of the building, to the right of the hall, is a ward 19
feet wide by 40 feet deep, opening on to a screened sleeping loggia 14 feet wide by 40 feet
deep. In the rear of the ward is a locker room, toilet, and bath. To the left of the hall
at the front is a reception room 13 feet wide by 14 feet deep. Behind this is a dining room
13 feet wide by 24 feet deep, and still further in the rear is a small pantry and a kitchen
13 feet wide by 15 feet deep.

On the second floor to the right of the hall the arrangement of the ward, loggia,
locker room, and toilet is the same as on the first floor, wliile on the left of the hall are four
pri\-ate rooms all approximately 13 feet wide by 10 feet deep. At the extreme end of the
building, cutting off a portion of the hall, is a loggia 22 feet wide by 15 feet deep for private
l)atients.

This structure is interesting in that it illustrates how well the Mexican or Californian
Mission style of architecture with its deej) open loggias can be copied in designing buildings
to have open air sleeping apartments. Tlu' liuilding has a capacity of thirl}- patients and
cost $15,000.

Boston Consumptives' Hospital, Mattapan, Mass., Ciiiidri ss Ward (Illus-
tration 72). This i)a\ilion is an interesting building with a number of unusual
features. The walls, resting on reinforced concrete foundatit)ns, are of hollow tile covered

120

Children's Pavilions

with stucco and the roof is laid at a rather steep pitch with slate. There are two floors,
and a spacious basement under the entire building. As two-thirds of the basement walls
are above the grade line, a well lighted floor area almost equal to a third story is obtained.
For description the building is divided into a central section, two wings, and a rear ex-
tension. The length of the front wall is 1 20 feet, and through the center and rear extension
the building is 96 feet deep. The central section is 30 feet wide by 28 feet deep; each wing

No. 71.— John Sealy Hospital, Galveston, Texas. Henry T. Phelps, Architect. Walter Col-
quitt Memorial Ward for Children. View of Front Ele\-ation and Floor Plans.
Capacity, 30 Patients. Cost, $15,000.

Section V

.LjUJUjUU.

•^xcro n.(xie% n.J^^^

No. 72. — Boston Consumptives' Hospital, Mattapan, Mass. 1)i:si(.m.i) nv Dr. Simon F. Cox.

MaCINNIS & WAI.SII, .\k( IHTKC is. ("llll.DKINS W AKl). \ IKW OF FrONT AND SiDK Kl.KVATIOXS AXD

I-'loor Plans. Cai'Ac itv, 54 I'\iii;nts. Cosr, S45.000. (Soo illustralion 57 lor furtlii-r (iescription
of this institution.)

Children's Pavilions

is 45 feet wide by 15 feet deep; and the rear extension is 30 feet wide by 69 feet deep. A
space about twenty-seven feet square in the basement under tlie center of the building is
used for a large playroom, and behind this on either side of the hall are lavatories and toilet
rooms for the children. Under the wings are storage rooms, and in the rear extension are
two large rooms 13 feet wide by 14 feet deep, and three smaller rooms, all arranged for
laboratory work. This apartment will be used for the present by the pathologists as a
research laboratory for the entire institution. The laboratory can be entirely shut off
from the playroom as there are four separate entrances to the basement. Two are in the
front, one on each side of the playroom, and one on each side of the rear extension.

There are four wards in the building and all of them are of the same size, 44 feet
wide by 14 feet deep. They occupy the entire space of the wings above the basement and
ha\e a capacity of ele\'en ])cds each. They have hard wood floors and are well designed
to conform with the modern ideas of open air wards. In the front walls of each ward are
sixteen windows with transoms above them arranged so that the entire side with the ex-
ception of the space occupied by the pillars can be opened. There are live good sized
windows in the rear wall and a double window in the end wall through which cross ventila-
tion can be obtained.

The main entrance to the building is above the wide monolithic steps behind the
right wing in the first story of the extension. The steps lead into a large vestibule which
opens on the main corridor. This runs through the center of the building six feet wide,
and ends at the rear of the extension in a large dining room 28 feet wide by 24 feet deep.
To the side of the corridor on the left is a well arranged room for receiving and serving
the food sent from the main kitchen in the administration building.

The position of the walls and partitions in the central section of the building on
both floors is identical. There is a sitting room 27 feet wide by 16 feet deep on the front
and two large rooms well arranged with lockers, toilets, and baths in the rear. All three of
these rooms are connected with the wards in the wings. The second floor of the rear
extension is arranged as an isolation block with four one-bed rooms, two two-bed rooms, a
diet kitchen, toilet, bath, and a large nursery 10 feet wide by 21 feet deep, opening on to a
fresh air balcony.

The plans of this building are interesting and in studying them the arrangement
of the entrances to the playroom and the grouping of the sitting rooms, dressing rooms, and
wards should be noted. The girls and boys are housed on different floors and there is no
connection between the two stories except l^y the main stairway. Either department can
be entirely isolated from the other and from the rest of the building by closing the door
into the sitting room at the end of the corridor. The building has a capacity of fifty-four
patients at a cost of $45,000.

Willard Parker Hospital, New York, Measles Building (Illustration 73).
This structure is described among the buildings for housing tuberculosis patients
because it was erected for the purpose of treating children's diseases in open air
wards. The plans also follow very closely and are an improvement upon a type of pavilion
constructed at the Riverside Hospital for housing tuberculosis patients. The building is
constructed of reinforced concrete, seven stories high, and was designed so as to obtain the
largest amount of fresh air and sunlight in the wards and rooms that is possible with ade-
quate weather protection.

The building, including the porches, is 206 feet wide and 55 feet deep. The central
section, which is 46 feet wide by 36 feet deep, is throughi)ut all the stories planned for

123

Section V

"^HiBiiBi 'w

THiT^D- r-i_ooT<k,-y-i_Aj-i~

1
J

■nir^t-T ~ r'l—ooTv -.T^-AM-

No. 73. Willard Parker Hospital, New York. Designs of the Department of Health. \\"ii.-
i.iwi 1;. Ai STiN, Architect. Measles Building. View of Front Elev.vtion and Floor Plans.
.\iA. THE Floors Above the F^irst Story have the Same Arrangement. Cap.vcity, 310 P.\tients.
Cost, $238,000.

a(lmiiiistrati\e and service jjurposcs, and the win.Ljs ahoxc tlu' hy>\ story arc arranged lor
housing the patients and have the same Hoor plan. On the fust lloor a corridor five feet wide
divides the building through its entire length, and in tlu' two wings opening otT this hall -^re
twenty-two observation rooms. A large ])art of tlic partition walls between the rooms
is made of glass in order that the nurse may ox'erlook all the rooms from any one in a
row. Each one of these rooms is an isolatiim unit in itselt, as it t'ontain> an iudi\idual
lavatory and toilet and can he entered Irom tlu' iionhes.

124

Children's Pavilions

Two other interesting features on this lioor are the apartments arranged for the
admission and discharge of the children. The new jjatients enter through a door in the
rear of the building at the far end of the right wing, and in order to reduce to a minimum
the chance of carrying infected material into the hospital, are passed through three rooms
during the course of disrobing, bathing, and redressing. The apartment through which
the patient leaves the building is arranged in the same manner at the extreme end of the
opposite wing.

Above the first story on all the floors each wing of the building is divided into two
wards 60 feet long by 13 feet wide by a partition running parallel with the front and rear
walls of the building. The wards face east and west, and the partition is made of solid
material to a height of five feet, and above that point of glass and sash which when open
provides cross ventilation through the entire wing. Each ward has a capacity of twelve
beds, and is divided by glass partitions about seven feet high into six alcoves in order to sepa-
rate to a certain extent the beds from each other. Opening on to the wards at the end
of the building is a sun room or porch 18 feet wide by 22 feet deep. The porches on all the
stories are connected by fire escapes.

The most interesting feature of this structure to those planning a building for hous-
ing tuberculosis patients is the dividing up of a floor space ecjual in area to an old-fashioned
ward for twenty-four patients into small units of two beds each. This illustrates a method
of meeting the steadily growing feeling that it is not right to house patients with advanced
tuberculous disease in close proximity to each other in large wards. The capacity of the
building is three hundred and ten patients at a cost of $238,000.

Hospital for Consumptive Children, Weston, Ontario (Illustration 74). It
is claimed for this institution that it was the first hospital in the world constructed
exclusively for housing children suffering from pulmonary tuberculosis. It is situated at
Weston, a suburb of Toronto, in a natural park of two hundred and fifty acres which is
well wooded and abounding in lake, river, and forest scenery.

The building has a frontage of one hundred and ninety-eight feet, and is two stories
high with a basement excavated under the entire structure and an open air schoolroom on
the roof of the central section. It is of fireproof construction with brick walls and white
stone trimmings on a concrete foundation, and consists of three separate blocks connected
on both floors by corridors enclosed with glass.

The central block consists of a front section and a rear extension. In the base-
ment there is a department for the pasteurization of milk, a large kitchen with complete
equipment, a refrigeration plant, and necessary storerooms. On the first floor the
front section, which is 63 feet wide by 2S feet deep, is given up to administration pur-
poses, and the rear extension, which is 27 feet wide by 51 feet deep, is devoted to the
service department. The entrance hall is reached through a large deep loggia flanked
on either side by two heavy columns. On the right of this hall is a reception room 20 feet
wide by 14 feet deep, and on the left, occupying floor space of the same dimensions, are
two rooms used for examination purposes. In the rear is a corridor ten feet wide run-
ning the width of the building and connecting the two passageways between the central
section and the ward blocks. Opening from the main hall on both sides of the stairway
are doors leading into a general dining room. This is 27 feet wide by 51 feet deep and
occupies, with the exception of a few square feet, the entire area of the rear extension.

Section V

The second floor of the central block is divided into ten bedrooms, a diet kitchen,
and a bathroom. There are also three open air loggias, one 17 feet wide by 9 feet deep in
the front of the building over the entrance, and two, both 10 feet wide by 14 feet deep, at
the far end of the rear extension. These two last are so placed that they can be open on
three sides although they are under the main roof of the building.

On each side of the central block there is a separate structure 45 feet wide by 38 feet
deep, for housing the patients. These blocks are divided in the same manner and contain
on both floors a large ward 20 feet wide by 35 feet deep, with large windows on three sides,
a small ward 20 feet wide by to feet deep, a diet kitchen, baths, toilets, lavatories, and a
linen closet. The three blocks are connected on both floors by passageways or galleries
23 feet long by 15 feet wide, enclosed with glass and sash windows. These are large enough
and have the protection to make ideal open air sleeping balconies.

On the roof of the front section of the central block is a large well arranged open air
schoolroom, 60 feet wide by 25 feet deep. This room is constructed with solid walls to a
height that will allow of the hanging one above the other of ten steam pipes for heating
purposes. These radiators are in long sections on the various sides of the room. Above
this wall the apartment is enclosed to the ceiling by glass and sash windows hung from the
top and arranged to be opened outwards.

.■'^^

BBB9S^f^^^3BHS 3^ ^

!i;

3:E

Ut_>^:[>-5f5^-[iaJLl.>-jr^t^^.-£j^j3^^

^^n^

No. 74. — Hospital for Consumptive Children, Weston, Ont. A. R. Dimso.n & Stkphexsox, .A.rchi-
TixTS. \iK\v OK Fkont Ki.kvation AM) Flook I'i.ans. ("ai'acitv, 8o Patiknts. Cost, $60,000.

126

Children's Pavilions

HFi

C-™

^^E

No. 75.— Gaylord Farm Sanatorium, Wallingford, Conn. Brow^n & Von Beren, Architects. Chil-
dren's Cottage. \'iE\v OF Side Elevation AND Floor Plan. Capacity, 22 Patients. Cost
$9,674. (See illustrations 68 and iiS for further description of this institution.)

This building is of interest to those planning hospitals for the treatment of tubercu-
losis patients, because it points to a method of modifying the ordinary general hospital
plans in a way that will allow of their being adopted for the construction of buildings in
which the fresh air treatment is to be used. The unusual features are the addition of the
open air schoolroom on the roof and the wide connecting corridors which can be used as
sleeping porches. The building has accommodations for eighty patients and cost S6o,ooo.

Gaylord Farm Sanatorium, Wallingford, Conn., Children's Pavilion (Illus-
tration 75). This building is of the bungalow t>T)e and has a number of details worth

Section V

studyinj^. It is constructed of wood resting on a high foundation of local stone with a
roof laid at a low pitch and the exterior walls co\-ered with shingles. The floors are of
wood and the interior is ceiled with narrow hoards of North Carolina ]>ine. The main
section of the Iniilding is 87 feet wide by 30 feet deep and contains one large room that can
be divided into two wards of ec|ual size by sliding doors. During the day this partition
is removed and the wards thrown together, one end being used as an open air schoolroom.
This arrangement allows the children who must remain in bed to easily attend their
classes. At the outer ends, the wards extend back about ten feet. This space provides
an alcove about twelve feet wide which affords a semi-retired i)lace for the beds of pa-
tients needing c|uiet.

On the front of the building is a sun ])arlor 34 feet wide by 17 feet deep with the
exjMosure and ad\-antages of a large bay window. The wards and sun porch are protected
by double-hung glass and sash windows and ceiling ventilation is obtained by small gable
windows in the roof. Behind the wards are two rooms, both 15 feet wide by 10 feet deep^
fitted up for bath and toilet purposes. Between these rooms and the alcoves are nurses'
rooms about ten feet square. At the rear of the building is an extension 30 feet wide by :^^t,
feet deep, divided into a large combination sitting and dining room 29 feet wide by 14 feet
deep, two small rooms on the front, used as an ofhce and a plaster room, and two in the
rear of about the same dimensions which are used as a serving kitchen and storeroom.

There is a heating plant, hot water boiler, coal storage room, and other storage
facilities in the cellar excavated under the rear extension. The unusual features of this
pa\'ilion are the shape of the wards, the arrangement by which the two wards can be
thrown together to make one large schoolroom, and the position of the windows in the
roof for ceiling ventilation. The capacity of the building is twenty-two patients and the
cost of construction was $9,674.

Children's Cottage for Congregate Institutions (Illustration 76). This build-
ing was planned in order to i)rovide open air sleeping quarters for a part of the
inmates of institutions such as orphanages and reformatories housing large numbers of
children. The architect in designing the building specified the use of hollow tile construc-
tion for the walls with reinforced concrete floors, and wooden joists covered by boards and
tiles for the roof; these materials to be used for the sleeping porches as well as in the central
section. The roof, doors, windows, and casings are the only i)arts of the structure which
are inflammable.

The building is two stories high. So feet across the frt)nt, and 40 feet deep through
the center. Hoth wings are 23 feet wide by 12 feet deep, and contain the open air sleeping
porches. These are arranged in two stories in order to place all the children in the build-
ing under the su])ervision of one nurse or attendant in the central front room on the second
floor. A glance at the longitudinal section of the pax'ilion will show that in ordi'r {o allow
a jjerson to overlook all four of the |)orches from one room, two small \\in(.K)ws, one abo\e
the other, ha\'e been i)laced in the side walls of the central room and its floor constructed
on a different le\el from the lloors of the second-story porches.

On the ground floor in the front t)f tlu' building, connected by stairways leading
to the slee])ing ])orches, are two dressing rooni^, I'ach e(|uipped with lockers, baths, and
lavatories for ten i hildren. A toilet for use at night is placed at oni' conu'r of each sleeping
porch and within the walls of the niitral building in order to pre\enl the i)lumbing from
freezing. The cottage is an iiidt [u ikUiiI unit so far as si'r\ice facilities are concerned, for
on the tirst floor at the rear of the building in the extension, whit'li is 33 \cv\ wide by 20

I -'8

Children's Pavilions

iSuECPlWft ■pO<*C»*

SkCCPlVC T^RCH

CoTT;^«E MahacEH

S».c-ei»W6 ■F^«cM

.IDncssiN^

Sucerma "Fbf^H

> ■ ■ •

No, 76.— Children's Cottage for Congregate Institutions. Designed by Dr. Hastings H. Hart.

Robert \V. Gardner, Architect. Front Elevation, Longitudinal Section, and

Floor Plans. C.\p.\city, 20 P.atients. Estimated Cost, $11,100.

feet deep, is a kitchen 10 feet wide by 16 feet deep, a pantry, and a dining room 15 feet
wide by 19 feet deep that will accommodate twenty-two persons. Above these rooms on
the second floor is a schoolroom 31 feet wide by 19 feet deep which is lighted and N-entilated
by windows on three sides and can be overlooked from the nurse's room.

This building is of interest because of the arrangement for supervising four sleeping
porches from one room, and if this feature were incorporated in the plans of pavilions for
housing children suffering from tuberculosis, it would probably make the work of nursing
the patients lighter. The building accommodates twenty children at an estimated cost
of $11,100, and by increasing the size of the wards, the capacity of the building could be
doubled at a very slight addition to the cost of construction.
9 129

Section V

Massachusetts Hospital School, Canton, Mass., Boys' Cottage (Illustra-
lion 77). This is a Iwu-story huildiiitj ha\in,ti; an inclfpendent ^Monitor roof for each
story. It is of frame construction ,^S feet wide by 73 feet deep, and on the first floor,
extending the entire width of the building, is a living room, dining room, and kitchen.
There are also a bedroom, la\-atory, and storeroom, which are of smaller size. The u])per
storv is divided into sleei)ing alcoves o])L-ning on a long central corridor, a bathroom,
linen closet, and two rooms for nurses.

In the first edition of this book published under the title "Some Plans and Sug-
gestions for Housing Consumpti\-es", a short description was given of one of the buildings
at this institution in order to illustrate the Monitor roof, but because of insufficient space
this matter was left out of the second edition. It is now used again, for of late this feature
has been adopted for ventilating purposes in a number of new hospital buildings erected
for the treatment of children's diseases.

The Monitor roof is a roof laid at a rather low pitch with a break in the slope of
both sides near the ridge in which are placed rows of windows. These windows are about
two feet high and can be opened and closed by fixtures on the interior walls arranged for the
purpose. When this type of roof is used in connection with a large window sj^ace in the
side walls, it affords an excellent way of obtaining cross ventilation. A test was recently
made at Canton in order to show the greater efficiency for ventilating purposes of the Moni-
tor roof over indirect ventilation in an ordinary room. This was done by filling a room of
each type with smoke and then noting the time necessary for clearing the atmosphere.
By ordinary window ventilation from one side of the room only, it took thirty minutes to
completely remove the smoke, while by cross ventilation through the Monitor roof the
room was comi)letely cleared in thirty-five seconds. Wards constructed with this type of
roof are so well ventilated that in planning new buildings it has not been thought necessary
to consider the cubic air space for each occupant as required in other buildings. Where
ground space has not been sufficient for a number of one-story pavilions, two or more have
been constructed one above the other. In such instances the ventilation of the lower
story has proved thoroughly satisfactory. The capacity of the building shown in the
illustration is thirty-four patients and it cost Si 2,000.

Preventorium for Children, Farmingdale, N. J., Dok.mhorv Hi iloixg No. i (Il-
lustration 78). This ])avilion is one of four buildings which are all alike except for slight
differences in the floor plans of the second stories. The walls are constructed of hollow tile
covered with cement stucco and rest on a concrete foundation and piers. The floors are
laid of edge-grain yellow pine supported b\' timbers and the roof is also ol Irame construc-
tion covered by shingles. The building, one hundred and tweKi' \vv{ across the front,
consists of a central block 38 feet wide ))>• 34 feet deep, two stories high, with a one-story
wing on either si(l( built in the form of a slee|)ing porch housing fourtt'cn chiKlreii in two
rows of beds

The central block has a basmicnt, a part of which is used for storage and the balanci'
as a bathroom. On [hv fn-st lloor is a dressing room ^f) ivvi widi' 1)\- JO leet deep, two bed-
rooms for attendants, a store room lit ted with large pigeon holes which are used instead of
lockers for clothes, and toilets afrangi'd so that the\ can be entiri'd from the rear of the
building in order that the children from llu' plaxgn.und will not track mud through the
dressing room or wards. The dressing room is finished around the wall> with benches
divided into indi\idual lockers used to store the to\s and luTsonal belongings of the chil-
dren. Over the benches at a height of \'\\c feel are two shrKes where the blankets used

ISO

Children's Pavilions

during the rest hour are kept. On the rear walls are racks to hold toilet articles and in the
center are stone basins ecjuipped with hot and cold water faucets. The entire second story
consists of one large playroom open on three sides, which is also used for an oi)en air school
and accommodates fifty-six children.

In two of the four pavilions at this institution the ui)per stories of the central blocks

No. 77. Massachusetts Hospital School for Crippled Children, Canton, Mass. Designed by Dr.
John E. Fish. Boys' Cottage. View of Front and Side Elevation and Interior of Ward,
Illustrating Ceiling Ventilation by the Use of the Monitor Roof. Capacity, 34 Patients.
Cost, $12,000.

131

Section V

^3QUTH EEEVATIOM ■ DC;BMIT02Y BUILDIMG Oej.

ViDDDDDDDi

- _ . . >l

riEST FDDOP DOPMITOPY BUlLDinC

No. 78. Preventorium for Children, Farmingdale, N. J. Desk.xkd by Dk. IIkrmaxx M. Biggs.
Sc(ji>KS & Feustmaxn, and Waltkk W. Jri)i:ij,, .Vssociated .Architects. Dormitory Huildinc.
No. I. Front Elevation and Floor Plans. Cap.acity, 28 Children and Two Attendants.
Estimated Cost, $7,700. (See illustrations 12. 10. and 27 for further description of this institution.)

are used as infirmaries and are dixided into two wards for four beds each with a sleeping
loggia on the south side to which the beds can l)e wheeled, a nurse's room, a bathroom,
a diet kitchen, and a linen room. The i)a\ilion has a cai>acit\- of lwint\ -ei^ht patients
and cost 87,700.

Chicago Municipal Tuberculosis Sanatorium, Chicago, 111., Oim x .\ik Cottac.i:
roR CJili.i)Ki;\ (Illustration jq). This building is one of eight open air cottages for
children all constructed from the same drawings. It is a one-story frame structure with
a shin'ded roof stained red and the c-xtirior walls of stucco over metal lath. The building

13-'

iildren s

Pav

ilions

is divided into three sections, a large ()])cn ward jc) feet wide l)y 21 feet dee]) in the center,
and an enclosed wing 25 feet wide by 44 feet deep on each end. The ward houses twenty-
hve children in two rows of beds. It has twenty-one windows for cross \entilation in the
rear wall, three large \entiIators in the roof, and can be inclosed on the front during severe
driving storms by glass and sash screens. The wing on the left of the building contains
in the front a fresh air schoolroom twenty-three feet scjuare. This room has two large
^■entilators in the roof, three double windows on two sides, and one double window on a
third side opening on to the terrace. In the rear is a dressing room 15 feet wide by 18 feet
deep containing tweh-e lockers 2 feet wide by 2 feet 6 inches deep, three lavatories, and a
slop sink. To the left of the locker room and connected with it by a door is a small room
containing a tub and shower bath, two toilets, and a janitor's closet. In the wing on the
right of the building is a nurse's ofhce 10 feet wide by 15 feet deep with a wide window
overlooking the entire ward, a linen room, and an emergency or isolation room connected
with a separate bath and toilet. There is also a dressing room, with lockers, lavatories, and

No. 79. — Chicago Municipal Tuberciilosis Sanatorium, Chicago, 111. Designed by Dr. Theodore B.

Sachs. W. A. Otis and Edward H. Clark, .\rchitects. Open Air Cottage for Chiidrex.

View of Front Elev.ation and Floor Plan. Cap.^city. 25 Patients. Cost, $1(3,346.

^33

Section V

toilet facilities occupying about llie same amount of space as is apportioned for these pur-
poses in the other wing.

The floor plan of this cottage should be studied, as the arrangement of placing one
large open ward between two enclosed portions of the building is an unusual feature. It
is claimed for this plan that it allows a division of the children into two groups, and per-
mits continuous observation of all patients in the ward from the nurse's room. The ob-
jection to the plan is that it is necessary to heat two widely separated parts of the building
and that it is more costly to install and protect two sets of plumbing than one. The
capacity of the building is twenty-fi\'e patients and it cost $i6,34().

Westfield State Sanatorium, Westfield, Mass., Girls' Pavilion (Illustration 80).
Previous to lyio there were no beds a\ailable in Alassachusetts for children under four-
teen years of age suffering from pulmonary tuberculosis. In that year the sanatoria at
North Reading, Lakeville, and Westfield were opened and a few children admitted. It
was found later that it was easier to treat a number of children together at one hospital
than it was to care for a few at each institution. For that reason the children at the three
institutions were all gathered at Westfield and the pavilion described below was provided
for the purpose of housing them. This building is of frame construction, one hundred
and ten feet long, with the roof and exterior walls shingled and the interior walls left unfui-
ished. Among the interesting features of the structure are the skylights let into the front
slope of the roof. These are laid of one-fourth inch wire glass in sections about five feet
square.

The central section of the building is 27 feet wide by 49 feet deep, and contains a sit-
ting room 26 feet wide by 18 feet deep on the front, and a locker and dressing room t\venty-
six feet square on the rear. This room is equipped with six lavatories, three toilets, two
showers, and a bath tub, and has ample space for individual lockers. Each wing, 41
feet long by 20 feet wide, contains a ward and is flanked on both sides by covered
porches eight feet wide. The roofs of these porches are not a part of the main roof of the
building, but have a very slight pitch and at the outer edge are only seven feet above the
floor. As the wards are open on both sides, this arrangement of the roofs of the porches is a
part of the plan for weather protection, which further consists of frame shutters covered
with canvas. The frames are hung from their upper edges on hinges and when open are
held flat against the timbers of the porch roof. These wards with their skylights, low
roofed porches, and frame canvas shutters are unusual and should be studied. An open air
school is carried on in the end of one ward. This space has proved to be a well j^rotecled
and lighted schoolroom. Every morning in arranging the ward for school ])urposes the
beds are pushed to one end and the bedside tables are ])laced in rows and used for desks.
The building has a ca])acity of thirty-two ])atients and cost 8,^,500. This tigure includes
steam fitting, plumbing, and wiring for electric lights.

Westfield State Sanatorium, Westfield, Mass., CiniDRKN's Paviliox (Illus-
tration 81). 'I'his is a new building now in the coursi' of construction and the floor
plan is given here in ordiT to show the manner in whiih the design of the girls" pa\ilion
(Illustration So) has been followed and also the impro\ements which have been made to
it. The new building is of frame construction co\ered externally with shingles and having
a central section two stories high and wings of oiu' storv. It is j:;() ivci across tlu' front
and 85 feet deej) through the center.

For description it may be dixidid into li\e sections: .V central block 30 feet wide

134

Children's Pavilions

p \

r-r

LJI531-J

OFT_M X^Af^JD

OFX-N ■VAI^D

.^jITTlNCt^AXlM

jjo 80.— Westfield State Sanatorium, Westfield, Mass. E. C. & G. C. Gardner, Architects.

c;iRLs' Pavilion. View of Front Ele\ation and Floor Plan. C.^p.^city, 32 P.\tients.

Cost, $3,500. (See illustration (19 for further description of this building.)

by 83 feet deep, two wings 75 feet wide by 39 feet deep, and two e.xtensions at right angles
to the ends of the wings 26 feet wide by 48 feet deep.

In the front of the central section on either side of the entrance hall are two offices
both fourteen feet square. Behind these rooms is a corridor thirteen feet wide connecting
the two wings, and still further back is a diet kitchen, linen closet, and service room. At
the extreme rear of this section of the building is the infirmary block. This extends back
beyond the walls of the wings and therefore has windows on three sides as well as a sleep-
ing porch nine feet wide at the rear. The block is divided into two wards each 17 feet
wide by 24 feet deep.

In both wings is a large ward 75 feet wide by 20 feet deep, inclosed with glass and sash

135

Section V

No. 8i. — Westfield State Sanatorium, Westfield, Mass. E. C. & G. C. Gardner. Architects.

Children's Pa\ iliox. Floor Plan of Xew Pa\ilion now untjer Construction.

Capacity, ^2 Patients. Estimated Cost, $25,000.

windows instead of the canvas frames used in the girls' paviUon. On lx)th sides of the
ward is a porch nine feet wide, and in the roof are skyhghts arranged in the same manner
as those described in the girls' building, but placed on both slopes of the roof instead of
only on the south side.

In the extensions at the ends of the wings are playrooms 26 feet wide by iS feet
deep. Behind the playrooms are lockers and toilet rooms 26 feet wide by 29 feet deep,
eciuipi)ed with twenty-six good sized lockers, four lavatories, two baths, three toilets, and
a slop sink. The capacity of the building is tifty-two i)atients at an estimated cost of
$25,000.

13(1

SECTION VI
Patients' Quarters — Lean-to Type of Building

Section VI

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138

SECTION VI
Patients' Quarters — Lean-to Type of Building

Origin of the Lean-to

The idea of housing tuberculous patients in lean-to shelters was first suggested by
Dr. Herbert Maxon King of Loomis Sanatorium. He took for his model the old time
Adirondack lean-to camp which is usually built with a framework of poles and covered with
bark. He describes his first building as "a shed open in the front with an overhanging
roof, and with ends constructed to be opened or closed as the occasion demands." The
building, 40 feet wide by 1 2 feet deep, was constructed of plain lumber covered externally
with cedar shingles and neither painted not stained on the interior. The floor space gave
room for eight thirty-inch beds, but there were no conveniences. In the back wall were
three openings which were partially closed by stationary slat blinds. These were intended
to increase the circulation of air but produced too direct a draft in cold weather. In order
to make the building serviceable for winter it was found necessary to fill up these openings
with glass in sash and provide a heated dressing room near at hand. This was constructed
directly behind the lean-to, equipped with lavatories, baths, and toilets; and heated with a
stove which was surrounded by a water coil to provide hot water for toilet purposes.

Later the plans of this simple structure were modified and a larger and more elabor-
ate building constructed. This consisted of two lean-tos somewhat wider than the original
and connected by a sitting room with an extension in the rear. The advantages obtained
by these changes were ample space and protection from the weather for reclining chairs
at the foot of the beds, a warm sitting room, and a larger dressing room.

This section contains a study of the changes made in this type of building since it
was first adopted for housing tuberculous patients. It will be noted that the many modi-
fications have tended to increase its capacity rather than to change its form.

Material

A lean-to may be built with any material that will make a fairly permanent and
comfortable structure. Good results are obtained from the open air treatment in cheap
buildings, and some of them are only shacks without plumbing or heating arrangements
where the patients use the old style wash-bowl and pitcher, or go to a small central building
for toilet, washing, and bathing facilities. The objection made to cheap lean-tos is that
they are not substantial, permanent buildings, and cost more to maintain in good order
than the more expensive structures. On the other hand, it is contended that they can be
torn down and rebuilt on the same lines a number of times for less money than it costs to
erect a permanent building which may become out of date. There is no doubt that a
happy mean exists between the extremes of a shed with little in the way of comforts, cost-
ing $50 to $75 per patient, and some of the elaborate buildings classed as lean-tos which
cost from $400 to $800 per patient.

139

Section VI

Lean-tos are usually built with lumher and consist of a frame made of timbers to
which sheathin<f boards are nailed. These in turn are co\-ered externally with shingles or
one of the patent board sidings. When well seasoned hard pine timbers are used for the
columns and beams of the porch frame, and planks such as are specified in "mill con-
struction" placed in the floor, the result is a fairly substantial and permanent building.
The roof is generally covered with shingles, but tin, slate, tile, or one of the patent roofing
materials can be used.

Excavation and Foundations

It is not necessary to have a cellar or basement under a lean-to if the building is
raised from the ground on a foundation or piers. Structures of heavy material should
have foundations of stone or concrete carried down to a solid footing. Care must be taken
to leave openings in the walls on opposite sides of the building so that there may be good
cross ventilation in the space between the floor and the ground. If there is any reason to
fear dampness, the site should be drained and a layer of concrete about three inches thick
spread on the ground, under the building. When a lean-to is supported on piers, precau-
tions should be taken to see that they are placed in such positions as will prevent the neces-
sity for a long span of the sills or other timbers upon which the structure rests.

Floors

In the sitting room the material for the floors should be hard wood or well laid and
seasoned ordinary floor boards covered with linoleum. The latter gives good satisfaction
and rugs can be used over it. In the extension and dressing rooms a flooring should be
used which will not be aft"ected by water, such as tile, terrazzo, or one of the composition
materials in which cement is the i)redominating element. A carefully laid board floor
covered with battleship linoleum glued down and turned up at the base line is satisfactory

No. 83. Catawba Sanatorium, Catawba, Va. C'\uv .Sm rr\Ri), Akiihtic 1 . I.i wm. \ n w or w
(Ji'KN I'oki II Ii.i.rsTKATiNc. A .Mktiiod oi' t '( )\s iKi ( tion W'uhoi 1 Imkkiiik I'iMsii. AM) A Ma\\i:k
ov l'R(rri:(Ti.\(; I'okchks nv C'a.was ("iktains at tiik Vah.k or riii: Rooi' I'koiic tiun. iScl- illuslr;i-
lions 17, 30, and 94 for further description of this institution.)

140

Patients' Quarters — Lean-to Type of Biiildin.L:

No. 84.— North Reading State Sanatorium, North Reading, Mass. John A. Fox, Architect. Leax-

To. View of ax Opex Porch, Illustratixg a Method of Protectixg Porches by Caxvas

CuRTAixs. (See illustration loi for further description of this institution.)

for this purpose and is durable, noiseless, and non-absorbent. The floors of the sleeping
porches can be made of wood and should be laid with narrow boards at a slight grade,
using white lead and oil to fill in the cracks. Where the floors are exposed to the weather
they should be painted or covered with linoleum. Canvas laid over the boards is used
extensivelv for this purpose and when kept well painted is durable.

Interior Finish

The manner of finishing the interior of a lean-to should be carefully considered be-
fore specifying the material to be used. A hard, smooth surface that can be thoroughly
washed without damaging the building is desirable. The sitting room may be finished
either with plaster covered with enamel paint or with narrow tongued and grooved boards
laid over buUding paper. When plaster is used, corners, and angles where walls and ceil-
ings meet, should be rounded. If boards are used, they should be varnished with water-
proof material after the cracks between them have been filled. The interior of the porches
may be ceiled with narrow boards or left with the studding exposed. When the latter
method is followed the distance between each timber of the frame should be equal. The
appearance can be further improved by carrying timbers entirely around the room on the
same level and continuous with the top and bottom of the window frames.

Arrangement of Dressing Rooms

In laying out a floor plan for a lean-to, care should be taken to make the rear ex-
tension large enough to give space for a dressing room, a storage room, a closet for warming
and drving blankets, a linen closet, and individual lockers at least three feet square. In
many of the earlier lean-tos the lockers were often not more than twelve inches square,
much too small to allow any privacy to the individual. It should now be definitely under-
stood that no building for the housing of incipient tuberculous patients is complete unless
it provides to each person adequate facilities for pri^•acy. The latest lean-to constructed

141

Section VI

at Loomis Sanatorium and shown in Illustration 105, represents one method of meeting this
need for a small private dressing room. Good, substantial, sanitary fixtures should be
used in the dressing rooms, allowing one toilet and one wash basin to every four patients and
one shower or bath tub to eight. Plumbing should be well protected in northern climates
or frozen pipes will give much trouble during the winter months. All pipes should be
placed so that they are under constant observation and in no case boxed.

Arrangement of Porches

In designing the porches, plans of the earlier lean-tos should be modified so as to
reduce the number of patients housed together. If large porches are to be built, they
should be divided into small open wards by partitions. Two patients in a small cubicle
ten feet square or three patients in a slightly larger one, as shown in Illustration 93, is a
most satisfactory arrangement. The width of the floor space and roof projection should
be ample, as the porches of a lean-to are the living quarters of the patients. The width
should be three times the length of the bed, or about eighteen feet, in order to give space
for a reclining chair and allow the patients to move about freely at the foot of the beds.
Deep porches also give the best protection to the patients against storms and high winds.
The rear walls should be about eight feet in the clear, as a lean-to with low walls is hard to
ventilate and causes the patients discomfort when moving about. The most desirable
manner of protecting the front of the porches is by the use of glass in sash. If economy is
not necessarv, the entire front may be enclosed as shown in Illustration 86. Frames
should be arranged if possible so that the space which they till can be entirely thrown
open bv sliding the sash into pockets below the porch rail or into boxes concealed in the
roof. When a porch is fairly deep, sufficient protection in a moderate climate can be ob-
tained bv canvas curtains. These are usually made of heavy duck and can be arranged
and controlled in various ways, as shown in Illustrations 8,:;, 84, and 85. Cross ventila-
tion must be obtained on sleeping porches, for it is about as hard to obtain a current of air
in a room with an open front as it is in a room enclosed by four walls. For this reason
ventilation is an important question to be considered in planning a lean-to and is usually

No. 85. Virginia State Farm, Richmond, Va. I.i an-to \'ik\v ok an Oi'kn Porch Iiiistratinc. the

.Manm;u ok I'kotkctinc; I'ok( hks hy Canvas Ccrtains I'i.ackd Hktwkkn Pu.i.ars,

A Ki;\v Fekt Hack from tiik Link ok thk Rook Projixtion.

142

Patients' Quarters — Lean-to Type of Building

No. 86. — Schenectady County Tuberculosis Hospital, Schenectady, N. Y. Orex Finch, Architect.

Lea\-to View of One uf the Porches, Showing ^Iethod of Protecting

Front With Sliding Frames of Glass in Sash.

provided for by insertint? windows in the rear and side walls and transoms abo\-e the
roof of the porch, as shown in Illustrations go, 99, and loi.

Orientation

The exposure to be given the open front of a lean-to in grouping buildings on a
sanatorium site should be carefully considered in relation to climatic conditions. Usually
in temperate climates the porch should face the southeast, for when a building is given a
direct southern exposure the air on the porches often gets exceedingly hot and sometimes
unendurable in the middle of the day during the summer months. In hot countries where
the temperature remains high for hours at a time, lean-tos should have two porches for
each group of patients, one having a southern and the other a northern exposure, as shown
in Illustration 100.

Heating and Lighting

The sitting and dressing rooms of a lean-to situated in a temperate or cold climate
must be heated, for patients living and sleeping on open porches should ha^•e warm apart-
ments near at hand which they can reach easily when they become chilled and for dressing
and toilet purposes. During the early stages of pulmonary tuberculosis, patients usually
bear without great discomfort exposure to cold and it has been found that expensive heat-
ing plants provided for heating porches housing incipient patients are rarely used. For
this reason it is not advisable to make arrangements for heating porches except where a
lean-to is to be used for housing advanced cases.

In lighting the central section of a lean-to the same problems must be met as in

143

Section \ I

No. 87. — Loomis Sanatorium, Liberty, N. Y. Designed by Dr. Herbert Maxon King. Improved

Lean-to. View of Front Elev.\tion and Floor Plan. Capacity, 16 Patients. Cost,

$1,830. (See illustrations i, 105, and 121 for further description of this institution.)

lif^hting other buildings of a sanatorium. These are discussed on page 43. For the open
I)orches it is ad\isal)le to have shiehled Hghts which can be kept burning during the night.
If electricity is used, two sets of lamps should be installed: ordinary candle power lamps
for illuminating purjjoses and a low candle i)ower for night lights.

EX.'\MPLES OF LE.\N-TOS

Loomis Sanatorium, Liberty, N. Y., I.mproved Lk.\.\-T() (Illustration 87). This
is the building designed by Dr. King which has been so often used as a model for the
lean-to type of structure. It is one hundred feet across the front and is built of wood
covered e.xternally with cedar shingles left to weather stain. The central li\ ing room, jo
feet wide by 25 feet deep, is ceiled with narmw hard pine boards tilled and \ arnished. The
dressing room in the rear extension, 20 feel wide i)y 14 feet deep, is tinished in the same wa\-
and equipped with sixteen lockers, two showers, la\atories, and toilets. The apartment
is heated and sui)i)lied with hot water for toilet jnirposes by a large stove placed in a brick
archway between tlu' two rooms. The wings of the l)uil(ling arc.' sleejiing porches 40 teet

144

Patients' Quarters — Lean-to Type of Building

wide by 25 feet deep, having roofs twenty feet deep and an uncovered porch space five feet
deep. These porches are simply and cheaply constructed, with frames supporting the
walls and roofs left unco\'ered. The floors are laid, except where they are exposed to the
weather, in the ordinary way with narrow boards, but the unroofed portion is made of three
inch planks with the edges slightly rounded to prevent curling and laid with a half-inch
space between each piece. The interior of the porches except the floors is painted where
the surfaces are smooth and the fronts are protected by canvas curtains attached to rollers.
The building has a capacity of sixteen patients and cost $1,830.

Michigan State Sanatorium, Howell, Mich., Lean-to (Illustration 88). This
building is constructed of wood, has a shingled roof, and rests on stone piers. It is one
hundred and two feet across the front; the central section is 21 feet wide by 25 feet deep;
the rear extension is 25 feet wide by 19 feet deep; and the wings are 40 feet wide by 16 feet
deep. The floor plan is similar to Dr. King's improved lean-to except for the change made
in the position of the doors between the porches and the sitting room. The structure is
substantially built, well finished, and enclosed with glass in sash. It has a capacity of
sixteen patients at a cost for construction of $4,500.

-mr

No. 88.— Michigan State Sanatorium, Howell, Mich. Malcomson, Higixbotham and Clement

Architects. Lean-to. \ie\v of Front Elevation and Floor Plan.

Capacity, i5 Patients. Cost. $4,500.

10 145

Section VI

Floob Plan of shacks.

No. 89. —Maryland State Sanatorium, Sabillasville, Md. Wvatt & Xolting, Architkcts. Lean-to.
VJKw OF Fko.nt Elevation, Floor Plan and Cross-section. Capacity, 20 Patients. Esti-
mated Cost, $7,000. (See illustrations 3 and 64 for further description of this institution.)

Maryland State Sanatorium, Sabillasville, Md., Leax-to (Illustration 89).
This is a frame building rcstinj.; on hrick ])ic'rs. Tlu' cxlcrior walls are covered with stained
shingles and trimmed with white around tht.' windows. The interior walls are ceiled with
narrow boards and varnished. It is one hundred and twenty-three feet across the front
and the floor space is arranged with a sitting room 22 feet wide by 20 feet deep in the center,
a wing 50 feet wide by 26 feet deep on either side, and a rear extension },o feet wide by 28
feet deep. Each wing is di\-ided longitudinally by a row of double-hung windows into a ward
49 feet wide by 14 feet deep and a |)orch of the same width tweUe feet deep. The rear
and side walls of the wards are broken by rows of small windows to pro\ide cross ventila-
tion and the sliding frames on the front can be pushed uj) out of the way, throwing the
wards and porches together. The rear extension is di\ided into three apartments. Twt)

146

Patients' Quarters — Lean-to Type of Building

of these are dressing rooms arranged to give each patient a private dressing alcove, a set
of drawers, and space for hanging clothes; the llTird is a toilet room 28 feet wide by 10 feet
deep, equipped with lavatories, baths, and toilets.

There are ten of these lean-tos built from the same plans and arranged about an
administration building. This group, which is described on page 23, was built to house
incipient tuberculosis patients, but the lean-tos were so well planned and constructed that
it would be possible to use them for advanced cases. An institution such as a small town
or county hospital needing an isolation ward for ad\-anced cases might use these buildings
as models, and by dividing the wings into single rooms with plastered walls, obtain a sub-
stantial pavilion for a comparatively small outlay. The capacity is twenty patients and
the cost of construction about $7,000.

No. 90.-

-Delaware State Sanatorium, Wilmington, Del. J. & .M. Kennedy, Architects. Hebrew
Society Lean-to. View of Front Ki.e\ ation and Floor Plan. Capacity,
8 Patients. Cost, $2,500.

Section VI

Delaware State Sanatorium, Wilmington, Del., Hebrew Society Lean-to
(lUustrulion go). This is a small frame building coNcred externally with clapboards and
roofed with shingles. It is of interest because of the arrangement for housing both male and
female patients, the floor plan being well worked out for this purpose. A common sitting
room, 14 feet wide by 18 feet deep, is in the center with a wing on either side 24 feet wide
l)y ig feet deep, and an extension in the rear 15 feet wide by 16 feet deej). In each wing is
an open ward, 2^ feet wide by 10 feet deep, for four patients, and a roofed porch eight feet
deep. In the front walls of the wards above the roofs of the porches are windows for pro-
ducing cross ventilation. The rear extension is di\ided by a solid partition into two dress-

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No. 91. Ohio State Sanatorium, Mt. Vernon, Ohio. !■ . I.. I'MKAkn. Aui 111 1 1;( r. Lkan-to. \'ii;\\

OK Fkont Ij.ia atid.v a.no Floor Plan. C"ai'A(Itv. jo I'aiik.nts. Kstimatki) Cost. SS.ooo.

(Sue illustration 66 for further descrijjtion of this institution.)

148

Patients' Quarters — Lean-to lype of Building

ing rooms 9 feet wide by 15 feet deep, each containing four lockers, a toilet, and balh. The
building has a capacity of eight patients at a cost of $2,500.

Ohio State Sanatorium, Mt. Vernon, Ohio, Lean-to f Illustration 91). This
is a frame building placed on concrete piers and iinished on the outside with stained shingles
and white trimmings. Though designed on the lines of a lean-to, it has several interesting
deviations from the usual plans, as it contains individual dressing alcoves, an attendant's
room, a diet kitchen, a linen closet, and other storage rooms in addition to the usual porches,
living, and dressing rooms. The building is one hundred and fifty-iive feet across the
front and consists of a central section, two porches, and a rear extension. In the central
section is a sitting room 25 feet wide by 18 feet deep, with a corridor behind it connecting
the two wings or sleeping porches, which are 64 feet wide by 24 feet deep. The rear ex-
tension is designed in the form of a cross, the long arm of the cross extending to the rear 27
feet wide by 56 feet deep, divided in the center by a corridor with rooms on either side,
except where it is cut by the cross arm. The cross arm, 52 feet wide by 22 feet deep, is
devoted to a dressing room and contains twenty private dressing alcoves equipped with
wardrobes. The building has a capacity for twenty patients at an estimated cost of $8,000.

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No. 92.— Georgia State Sanatorium, Alto, Ga. Scopes & Feustmaxx. and Walter W Jidell

Associated Architects. Desigx for a Leax-to. Floor Plax. Capacity, iO Patiexts. Fsti-

MATED Cost, $2,500. (See illustrations 4 and 65 for further description of this institution.)

Georgia State Sanatorium, Alto, Ga., Design for .\ Le.\n-to (Illustration 92).
This floor plan was one of the designs oft'ered for the lean-tos to be erected at the Georgia
State Sanatorium, but was not used. Unlike the buildings previously described, it has no
central sitting room, but provides each patient with a good-sized dressing room directly
in the rear of his bed. The front block is divided into two open wards 51 feet wide
by 16 feet deep with dressing corridors seven feet deep in the rear. These corridors if
well finished, can be heated, and contain indi\idual dressing alcoves, each 5 feet wide by
3 feet deep. The rear extension is given up to one large room, equipped with lavatories,
shower baths, toilets, and a slop sink. This building was planned to have a cai)acity of
sixteen patients at a cost of about $2,500.

149

Section \ I

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PLAN II

No. 93. -New Haven County State Sanatorium, Meriden, Conn. I'otin; & Townskm), Akciiitix i>.
Lka\-to. Front Elevation and Floor Plan. Capacity, 40 Patiknts. Kstimatkd Cost. S5.000.
Note: Plan II, Dksioned by the Same Architects, Shows the Arrangement of a Btildinc. at
Huntington, Conn.

New Haven County State Sanatorium, Meriden, Conn., Li: ax-to (Illustraiion
9,^). 'I'his is a friimc Ican-lo, two stories hi<i;h, covered externally and roofed with shingles.
Both floors are arranged alike after jjlan I, shown in the illustration. It may be divided
for description into a ci'ntral block. 17 feet wiiK' hy 42 fi'ct det'p, and two wings 40 feet wide
by 16 feet det-p. In the central section is a silling room i() fei'l wide by :o feet deep and a

Patients' Quarters — Lean-to Type of Building

dressing room i6 feet wide by 19 feet deep. These rooms on both floors are heated by a
large stove placed in a brick archway at the center of the first story apartment and heating
the second floor rooms through hot air ducts. The wings on each floor contain a single
open ward divided into fi\-e cubicles 8 feet wide by 9 feet deep for two patients each. The
rear walls are pierced by windows to give cross ventilation and the front of the wards are
protected by canvas curtains.

At Huntington, Conn., there is a one story lean-to arranged after plan II, shown in
the illustration. This building is 129 feet across the front and 16 feet deep through the
wings. Each wing is divided by transverse partitions into one unit for four patients, and
two units, each for three patients. Both these buildings were designed by the same archi-
tect and are interesting in that they illustrate a method of dividing the porches in order to
house patients in small units. The building at Meriden has a capacity of forty patients
at an estimated cost of $5,000 and the building at Huntington has a capacity of twenty
patients at an estimated cost of $2,500.

Catawba Sanatorium, Catawba, Va., Lean-to (Illustration 94). This lean-to
is of frame construction, one story high, and rests on a concrete foundation. The ex-
terior walls are made of siding and the roof is covered with shingles. It is one hundred and
twenty-one feet across the front and consists of a central section 28 feet wide by 24 feet
deep, and a rear extension 52 feet wide by 12 feet deep. In the front of the central block
is a living room 28 feet wide by 15 feet deep and directly behind it a trunk room 28 feet
wide bv 8 feet deep. The wings are open wards or porches housing eight patients each,

No. 94. Catawba Sanatorium, Catawba, Va. Gary Sheppard, Architfxt. Lean-to^View of Front

Elevation and Floor Plan. Capacity. 16 P.^tients. Estimated Cost, $2,000. (See

illustrations 17, 30, and 83 for further description of this institution.)

151

Section VI

No. 95.— Manitoba Sanatorium, Ninette, Manitoba, Canada. Dksic.nki) hv Dr. 1). A. Stewart.
Lk.\n-t<). \'ii;\\ of Fko.xt Ki.k\-.\ti().\ and Floor I'i.an. Cm'acity, _^2 Patients. Kstim.vtkp
Cost, SS.ooo. (Sec illustnilion 25 for further description of this institution.)

and the rear e.xtension contains two dressing rooms to feet wide by 12 feet deep, and a
single-bed emergency ward 11 feet widi' by 12 feel deep. VUc building is arranged con-
veniently, has a capacity of sixtt'iMi |)atieiils, and cosl approximately 82,000.

Manitoba Sanatorium, Ninette, Manitoba, Canada, Lkw-k* iinu>tration 05).
This lean-lo is a two storx- frame strucUirc ninety-four \cc\ atToss llie h'oiil. It ri'sts on a
concrete foundation and stone piers and has a basemi'ul 20 U'et wide by .; .; U'et deep under
the central section, 'riie roof and tlu' external walls of the building ari' co\ I'red with stained
shingles and the woodwork around the windows togi'lher with tlu' other trimmings is
a])propriatelv painlecl. The centi'al se(tioii contains a sitting room 21 leet wide by 15
feet deep, a corridor eoiinec ting tlii' wings, and a la\atory 15 leet widi' l)y lO teel dee]),

1^2

Patients' Oiiarters — Lean-to Type of l^uilding

e(|ulppe(l with baths and wash basins. Each wing, ,^6 feet wide by 27 feet deej), is divided
into an open ward ,:;6 feet wide by 15 feet deep, a corridor three feet wide, and three dressing
rooms 1 2 feet wide b\- 8 feet deep. The wards are protected by glass in sash and the central
section, corridt)r, and dressing rooms are finished on the interior and heated. Each floor
is an independent unit for twelve patients and the building was constructed two stories in
height in order to economize in heating, as the winters in Manitoba are very cold. There
are two pavilions of the same type at this institution. The one housing women is shown
in the illustration; the other, for men, has a slightly different floor plan, with onlv one
large dressing room in the rear of the sleeping porch. The advantage claimed for this
building is that the dressing rooms are closer to the patients and give them more privacy
than in the usual lean-to type of structure. The building has a capacity of thirty-two

No. 96. — Edward Sanatorium, Naperville, 111. \V. A. Otis and Edward H. Clark, Architects.

Leax-to. \'ie\v of Front Klevatiox and Floor Plan. Capacity, 10 Patients. Estimated

Cost, $1,800. (See illustrations 62 and 102 for furilicr (Icscrijition of lliis inslilution.)

Section VI

patients and cost, including its proportion of the heating i)Iant, installation of plumbing,
water supply, and sewer connection, S8,ooo.

Edward Sanatorium, Naperville, 111., Lean-to (Illustration 96). This building
is of frame construction covered on the exterior and roofed with shingles. It is sixty-five
feet across the front and consists of two sections: a front block 65 feet wide by 16 feet deep
devoted to an open ward housing ten patients, and a rear extension 11 feet wide by 19 feet
deep used as a dressing room and equipped with lockers, lavatories, a bath, and a toilet.
The rear walls of the ward are pierced by eight windows to give cross ventilation and the
building illustrates a method of protecting the front of a lean-to with an overhanging roof
and a low tight wall in place of a balustrade. This arrangement, however, leaves a space
in the upper part of the room largely unaffected by the usual method of ventilating. In
order to overcome this difficulty three large \-entilators were placed in the peak of the roof.
The building has a capacity of ten patients and cost $1,800.

Iowa State Sanatorium, Oakdale, la., Lean-to (Illustration 97). This lean-to
is of frame construction covered externally with siding and roofed with shingles. It rests
on a stone foundation and cedar posts and has a tunnel excavated under its entire length
carrying pipes for heating purposes. The building is two hundred and forty feet across
the front and consists of a small central block 24 feet wide by 32 feet deep and two wings
each 108 feet wide by 24 feet deep. The central section is divided into a nurse's room, a

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No. 97. Iowa State Sanatorium, Oakdale, la. H. F. Liebbk, Architkct. Lkan-to. \ii;\v of

Front and Side ICi.kvatiox and Floor Plan. Capacity. 40 Patmcnts. Estimated Cost,

$8,000. (Sec illustrations 24, 29 and 116 for further dcscrii)tion of this institution.)

154

Patients' Quarters — Lean-to Type of Building

No 08.— Eudowood Sanatorium, Towson, Md. Archer & Allex, Architects. Garrett Leax-to.

View of Froxt Elevatiox axd Fl.x.r Plans. Capacity, 8 P.\tiexts. Estimated Cost,

$4 000. (See illustralions 22 and bi for further description of this institution.)

diet kitchen, and two lavatories, each furnished with two wash basins, a bath, and toilet.
This is a very inadequate equiimient considering the size of the building. The wings are
divided into 'a sleeping porch twelve feet deep, on the front, and ten rooms each ele\-en
feet square, on the rear. The rooms are all heated by steam and have in the rear wall a
window, and on the front a door, a window, and a transom above the roof of the porch.
The building has a capacity of forty patients and cost S8,ooo.

Section VI

Eudowood Sanatorium, Towson, Md., Garrett Leax-to (Illustration 98).
This is a Iranu' structure coxered cxtcrnall}' with stained shingles and trimmed with white
paint. It consists of two sections: a front block. 56 feet wide by 20 feet deep, and a rear
extension 19 feet wide by 24 feet deep. A single ward, open on all sides except where it is
joined to the rear extension, occupies the entire space of the front block. This room has
a ceiling made of narrow boards and is protected on all sides by canvas curtains stretched
on frames. These frames are hung from the top by hinges and are held open by fixtures
attached to the posts. Between the ceiling and the roof is an air space which has cross
ventilation through small gables. The rear extension is equipped with eight lockers, each
3 feet wide by 5 feet deep, four lavatories, two baths, two toilets, and a slop sink. This
lean-to is well arranged for use in warm climates as cross ventilation can be obtained from
all sides and the direct rays of the sun striking the roof are prevented to a certain extent
from heating the interior by an air space abo\-e the ceiling. The building has a capacity of
eight patients and cost $4,000.

The Municipal Sanatorium, Otisville, N. Y., Lean-to (Illustration 99). This
is a wooden building co\ered with shingles stained artistically and trimmed with white.
The roof has a very steep pitch and is broken on the front to let in a row of transoms. The

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No. 99. Municipal Sanatorium, Otisville, N. Y. Dksic.vkd bv Dr. Hkrxiaw M. Hk.c.s. John H.
\'\N rill, .\k( iiiri(T. Li;.\N-To. \ii;\v oi' I-'kont Elkvatiox and Floor Plan. Capacity.
iS I'atiknts. Hstimatku Cost, 84,400. iScc illustralions 14. jS, 50, ()0. lod and 114 for furtlu-r
descnption of this institution.)

i=;6

Patients' Quarters — Lean-to Type of Building

No. 100.— Hazelwood Sanatorium, Louisville, Ky. D. X. Murphy & Brother, Architects. Lean-to
FOR Women. View of Front Ele\atiox and Floor Plan. Capacity, 12 P.\tients. Es-
timated Cost, $2,750. (See illustration 112 for further description of this institution.)

walls of a small cellar excavated to house a furnace for heating the dressing rooms furnish
a foundation for the center of the building, but the remainder rests on stone piers. The
front block, 105 feet wide by 18 feet deep, consists of a long, open porch or ward. Low
partitions divide the floor space into three sections, but do not obstruct the view of the beds
from either end of the porch. The rear extension is 42 feet wide by 10 feet deep and con-
tains two dressing rooms, each 18 feet wide by 10 feet deep, with separate entrances from
the porch. The building has a capacity of eighteen patients at an estimated cost of $4,400.

Hazelwood Sanatorium, Louisville, Ky., Lp:an-to for Women (Illustration
100). This is a frame lean-to situated on a steep hillside and resting on oak posts. It is
56 feet wide by 36 feet deep including the porches and consists of a central sitting room
sixteen feet square; a dressing room 16 feet wide by 12 feet deep, equipped with baths,

Section VT

lavatories, and toilets; and two dormitories 19 feet wide by 16 feet deep, one on each side
of the sitting room. The interesting feature of this lean-to is the arrangement of the
porches; one running the width of the building nine feet deep with a southern exposure for
use in cold weather and two. both 19 feet wide by 9 feet deep, with a northern exposure for
use when the sun is too hot on the south side. The building has a capacity of twelve
patients and cost 82,750.

North Reading State Sanatorium, North Reading, Mass., Le.an-to (Illustra-
tion loi ). This building is of frame construction, covered on the exterior and roofed with
shingles. It is one hundred and thirty-six feet along the front, and is designed so that both
the porches can be overlooked from the sitting room. The length of the wings is 58 feet
on the front and 67 feet on the rear and the width, including the veranda, is 19 feet. The
central section is ceiled on the interior and the porches are left unfinished. The locker
rooms are placed at the inner ends of the porches so as to utilize the space of the angles
made where the wings join the center apartment. The sitting room is 24 feet wide by 18
feet deep and the two dressing rooms, both 10 feet wide by 18 feet deep, are equipped with
shower baths, toilets, and wash-basins. The roof of the porch has a break in the front
slope filled with transoms for ventilation purposes, somewhat like that in the roof of the

No. loi. North Reading State Sanatorium, North Reading, Mass. John A. fox, Akchitkct.

I.KAN-TO. \ Ii:\V Ol" I'KONT Ku;\ ATION, I'l.OOK I'l. A.\, AND CUDSS-SKCTIDN. CAPACITY, 20 PaTUCNTS.

Cost, $3,500. (Sec illustration S4 for further descrijjtion of this institution.)

158

Patients' Quarters — Lean-to Type of Building

A-

No. 102.— Edward Sanatorium, Naperville, 111. Designed by Dr. Theodore B. Sachs. W. A. Otis
\XD Edward H. Clark. Architects. Lean-to. View of Front Elevation and Floor Plan.
Capacity, 6 Patients. Cost. 81,287. (See illustrations 62 and 96 for further description of this
institution.)

lean-to shown in Illustration 99. The veranda in front of the sleeping porches also extends
in front of the sitting room, and is a feature to be noted, as it adds materially to the floor
space which can be used in good weather. There are four of these lean-tos, all alike, put
up in connection with other buildings for one of the new sanatoria built by the Massachu-
setts Commission on Hospitals for Consumptives. They are very satisfactory except for
the rear walls of the porches which are said to be rather low. The building has a capacit>-
for twenty patients and cost $3,500.

Edward Sanatorium, Naperville, 111., Lean-to (Illustration 102). This building
is of frame construction, covered externally and roofed with cedar shingles. It is of interest
because the design follows the lean-to type with one wing omitted and the extension on the
front instead of the rear. The interiors of the sitting and dressing rooms are plastered, but

159

No. I03. Iowa state Hospital, Mt. Pleasant, la. H. !• . Likbhk. Auihitect. Lean-to. Front Kle-
VATioN AND Floor Plan. Capacity, 12 Patients. Fstimated Cost, $3,000.

the porch is left unfinished. The building is 52 feet across the front and consists of an
enclosed section 16 feet wide by 24 feet deep, joined at right angles by an open ward ,^6
feet wide by 17 feet deep. The enclosed block contains on the front a well lighted sitting
room 15 feet wide by 10 feet deep, and on the rear a dressing room 15 feet wide by 12 feet
dee]), ef|uii)ped with lockers, baths, lavatories, and toilets. I'nusual care has been taken
to secure good ventilation in the ward by means of a continuous row of windows in the
north wall, windows and a sliding door in the east wall, and two ventilators in the rool.
The open front is protected from the weather by cainas curtains. Tin- building has a
cai)a(itv of six i)atients and cost $1,287.

Iowa State Hospital, Mount Pleasant, la., Li:.\n-to (Illustration io,0- This
lean-to is of frame construction coxend with cedar shingles stained a dark brown and
trimmed with ivory color. The interior walls are ceiled with narrow, yillow pine boards
finished in oil. In the centtT of the building, occuj)) ing a part of tlu' rear extension, is a
combination sitting and dining room H) leet wide by 15 \cv\ deep. 1 lu' wings, :;; leet wiile
by 14 feet deej), are open wards and the rear extension, :; fi'et wicK' l)\ jo leet deep,
contains, besides a j)art of the dining room, a dressing room k) leet widi' b\- 10 teet
deep equipped with three lavatories, a bath tub, toilet, and slop sink. .\t the sides
of the central room, running from the wards back to the dressing room, are i)assagc

160

Patients' Quarters — Lean-to 1 ype of Building

ways 13 feet long by 4 feet wide. On the inner side of these halls are lockers for
the patients' clothes. The two open wards are connected by a veranda in front of
the sitting room and the entire front of the building is protected by glass in sash and wire
screens in frames. In the central room is a brick firei)lace and an electric oven for reheating
the food sent in from the service building. The dining and dressing rooms are also heated
by a hot water plant installed in the cellar under the rear extension. The windows on the
front of the building above the porch pierce the wall of the central room. This floor |)lan
is unusual because of the situation of the combination sitting and dining room, the position
of the lockers, the angle at which the porches are attached to the central section, and the
veranda in front of the central room. The building has a capacity of twelve patients at
an estimated cost for construction of $3,000.

Rush Hospital, Country Branch, Malvern, Pa., Lean-to (Illustration 104).
This is a frame building of very cheap construction, resting on stone piers. The interior
walls are left unfinished, the exterior is covered with siding, and the roof is of composition
material laid in strips. The structure has no rear extension and is practically a two story

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No. 104. Rush Hospital, Country Branch, Malvern, Pa. Brookie & Hastings, Architects.

Lean-to. \'ie\v of Front Elevation and Floor Plans. Capacity, 7 Patients. KsTi\t\TKn

Cost, $400. (See illustralion no for further description of this inslilution.)

TT 161

Section VI

HEEKIWSEK

ROOF PROJECTION

No. io5.-"Loomis Sanatorium, Liberty, N. Y. Designkd by I)k. Herbert Maxox King. Lean-to.

\iE\v OK I'ront Elevation- and Floor Plan. Capacity, 8 Patients. Estimated Cost,

Si, 500. (See illustrations i, 87 and 121 for further description of this institution.)

shed with the front on both stories tightly boarded from the floor to a height of four feet,
and the balance of the openings protected by canvas curtains. The building is 53 feet wide
by 12 feet deep. The first floor, except for a space 18 feet wide by 7 feet deep walled oil
for a dressing room, is used for lounging purposes, and the second floor as an open ward.
The rear wall on both floors is pierced 1)>- a row of openings which can be closed by wooden
shutters. Altogether this is one of the cheapest structures for housing incipient tuber-
culosis cases. It has a cajjacily of seven patients at an estimated ct)st of S400.

Loomis Sanatorium, Liberty, N. Y., Lkan-to (Illustration 105). This lean-to
is of frame construction covered externally with siding, roofed with shingles, and
suj)ported by stone i)iers. It is 70 feet wide by 20 feet dee]) divided into an open ward 48
feet wide by 20 feet deep, and a dressing room ji feel wide by 20 feet deep. The building
has no rear extension or central sitting room and the roof over the open ward does not cover
all of the floor space. The enclosed apartment is heated by a coal stove having a boiler
attachment sui)i)lyiiig hot water for toilet jmrposes and is equipped with lavatories, baths,
toilets, and eight private dressing rooms ,:; feet wide by 5 feet deep. The building has a
capacity for eight patients at an estimated cost of $1,500.

162

Patients' Quarters — Lean-to Type of Building

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No. io6.— Municipal Sanatorium, Otisville, N. Y. Designed by Dr. Hermann M. Biggs. J.ames D.
Burt, Architect. Lean-to, No. 103. View of Front Elevation and Floor Plans. Capacity,
32 Patients. Cost, $9,000. (See illustrations 14, 28, 59, 60, 99 and 114 for further description of this
institution.)

Municipal Sanatorium, Otisville, N. Y., Lean-to, No. 103 (Illustration 106).
This is a two story building of frame construction with foundations of native stone and a
high basement. The walls are covered on the outside with shingles stained a dark green,
the window casings and other trimmings are painted white, and the roof is stained red.
The interior is ceiled with matched and titted boards and the floors are of wood finished in
oil. The building is one hundred and twenty-four feet across the front and consists of a
central block 46 feet wide by 29 feet deep, and two wings each 39 feet wide by 16 feet deep.
In the basement is a recreation room, storage rooms, lavatories, baths, toilets, and the
heating plant. The first and second floors are alike and were planned to separate the
patients into groups by providing a separate li\'ing apartment for each sleeping porch.
The apartments consist of a living room about sixteen feet square and a lavatory 16 feet
wide by 13 feet deep, equipped with eight dressing alcoves each 4 feet wide by 5 feet deep.
Both the wings contain two open wards, one above the other. The open fronts face the
south and are protected by canvas curtains. Over the central block is an attic story
divided into rooms equipped with open sheh'es for the storage of trunks, suit cases, and
other belongings of the patients. The building has a capacity for thirty-two patients and
cost $9,000.

163,

Section VI

-mi

^\^mn^

No. 107. — Michigan State Sanatorium, Howell, Mich. Scopes & Feustmaxx, Architects. Design-

FOR A Lkax-to. Floor Pi.ax. Cai'A(itv. 16 Patients. Estimated Cost, S3. 500. (See

illustration 8S for further description of this institution.)

Michigan State Sanatorium, Howell, Mich., Design for a Lp:ax-to flllustra-
tion 107). This floor plan was one of the designs submitted for the lean-tos at the Michigan
State Sanatorium, but was not used. The specifications call for a frame building in one
block 100 feet wide by 25 feet deep, consisting of a sitting room 15 feet wide by 24 feet deep
in the center; and on either side an open ward 42 feet wide by 14 feet deep, and four dressing
rooms each 8 feet wide by 10 feet deep. The dressing rooms are ecjuipped with two lockers
and a lavatory and arranged in pairs with a passageway between containing a shower bath
and toilet. The building has a capacity for sixteen jxitients at an estimated cost of S3. 500.

No. 108. New York State Hospital, Raybrook, N. Y. Fraxkux B. Ware, .\rchitect. Desk.x ior
A Lkan-to. I'i.oor I'i.an. C'ai'ac ity, i() Patients. Estim.ated Cost. 83,500.

New York State Hospital, Raybrook, N. Y., Di.sicx ior a Li ax-to (Illustra-
tion loSj. I'his floor plan was designed for a lean-to to be erected at Raybrook and the
specifications call for a frame buihUng one hundred and forty-six feel along the front,
covered externall)- and roofed with shingles. The wings join the ciMitral blmk at an uiuisual
angle and each contains one ward protected on the front by glass antl sash, and a veranda.
'I'he rear extension contains a dressing room, a linen room, a lavatory and a bath room. An
luuisual leaturi' in the \var(l> are low ])artitions extending out from the wall between each
bed three feet and intended as a screen to protect the heads of the patients. Tin' building
has a ca])acity for sixteen patients at an estimated cost of $3,500.

J 64

SECTION VII
Patients' Quarters — ^Cottage Type of Building

SECTION VII
Patients' Quarters — Cottage Type of Building

General Description

The open air cottage or bungalow is a t_\pe of building often used at private sanatoria
for liousing tuberculous patients. Well-to-do persons usually desire separate apartments
with private porches which cannot be overlooked by other inmates of an institution and
this stvle of building is easily designed to obtain these results. Generally simple frame
buildings of a fairly permanent character are the best class of structure to erect for open
air shelters, but buildings of this kind can be constructed of various materials, such as
stone, concrete, hollow tile, logs, or the ordinary stud frame covered with rough boards,
slabs, finished lumber, or shingles.

The floor plan for an open cottage depends largely upon the number of persons it is
to accommodate, the locality in which it is to be placed, and whether it is to be used during
the entire year or only in moderate weather. When a cottage is planned for use in a cold
climate, at least a portion of it must be heated and it is then desirable that the walls en-
closing that part be made tight by plastering, or ceiling the interior with narrow selected
boards. If necessary, these walls can be still further reinforced to prevent the loss of heat
by placing building paper under the ceiling material or by filling in the space between the
studs with some non-conducting substance.

The fresh air rooms in cottages are built either as porches standing out from and
treated as trimmings in the architectural design of the building or as loggias which are
porticos or galleries contained within the structure. Loggias should always be placed in
such a position that they will receive air from at least two sides and both types where the\-
will harmonize with the exterior of the buildings and look well from a distance. Interiors
are more or less exposed to the weather and should be finished in a way that will prevent
the walls from being injured or defaced by exposure to dampness or the sun's direct rays.
During the winter months in cold climates porches and loggias of cottages should be en-
closed by frames holding glass and sash, arranged so that both the sides and front can be
thrown open or closed as desired. In moderate or warm climates protection is needed
against occasional winds, rain, and sunlight. For this purpose canvas curtains, Venetian
blinds, or Japanese matting may be used.

In this section will be found descri])tions of cottages arranged to house from one to
eight patients with private rooms, separate porches, and modern toilet facilities; also
cottages designed to be used as separate units to accommodate families accompanying
patients to an institution. Cottages planned for the use of one person only, usually have
but two rooms, one an oi)en sleei)ing apartment, and the other a room for dressing and
toilet i)urposes.

i:X.\.MlM.i:s OK COTTAGES
Millet Sanatorium, East Bridgewater, Mass., C\)TT.\c.i; (Illustration 109).
This is a frame building supported on cedar posts, sheathed with rough lumber, and covered
with shingles. The roof is laid at (luarler pilch with the rise to the front ami the tloor is

166

Patients' Quarters — Cottage Type of Building

^^1 '-■ , I 'jM^

No. 109.

• E•I_ErvM•Tlo^r—

-Millet Sanatorium, East Bridgewater, Mass. Design by Dr. C. S. Millet.

View of Froxt Elevation, Floor Pl.\n, Side and Ent) Elevation. Cap.\city,

I Patient. Estimated Cost, $200.

Cottage.

laid double with the upper surface of narrow, hard pine boards. The cottage, 18 feet wide
by 12 feet deep, has no plastering or other interior finish and is divided by a partition into
an open bedroom twelve feet square, and a dressing room 6 feet wide by 12 feet deep. In
the bedroom a large part of the south wall has been cut away to provide an open front, and
the rear wall, which is six feet six inches high, is made in the form of wooden shutters hung
from the roof, that can be opened or closed. The dressing room is lighted by two windows,
heated by a stove, and furnished with a wardrobe, a toilet, and a stationary washstand
supplied with running water. This cottage is intended for one person at an estimated cost
of $200.

167

Section VII

No. no. Rush Hospital, Country Branch, Malvern, Pa. Urookie & Hastings. Architects.

CuTTAc.i;. \ii:\v <jf Front and Sidk Kli;\ atkjns, and Floor Plan. Capacity, 2 Patients.

Estimated Cost, S400. (See illustration 104 for further description of this institution.)

Rush Hospital, Country Branch, Malvern, Pa., (^niAOK (Illustration iioV
This is a small cottage of frame const ruclion. coxcrcd on tln' exterior with clapboards, and
roofed with pati'nt rooting jjaper. it rests on posts hut has no lattice work screen to en-
close the space beneath the tloor. The buildin<f is 1 7 feet wide by 3 1 feet deep and is divided
into two bedrooms <S feet wide by 15 feet deep, a dressing rt)om 16 feet wide by 7 feet deep,
and a porch 17 feet wide by S fei't deep. rile bedrooms are separated by a ])ortabU'
l)artition which can be pushed otil of the way in order to obtain frei' cross \entilalion
through the two open sides of the cottage. The dressing room is lighted by four wiiKU)Ws,
healed b)- a sto\e, and e(|uii)pc(l with a bath, toilet, and two la\atoriis. This little build-
ing is a cheap and simple structure well designed for housing inci])iiiit tuberculosis cases.
'I'he capacity is two patients at an estimated cost of S400.

K.S

Patients' Quarters — Cottage Type of Buildin^r

No. III. — Adirondack Cottage Sanitarium, Saranac Lake, N. Y. Cottage. View of Front
Elevation and Floor Plan. Capacity, 4 Patients. Estimated Cost, $1000. (See illustra-
tions 13, 63, 117, and 122 for further description of this institution.)

Adirondack Cottage Sanitarium, Saranac Lake, N. Y. Cottage (Illustration iii).
This is a frame building constructed with second-hand himber and other material obtained
from an old sanitarium buildins^ that was torn down. It is 33 feet wide by ig feet deep and
is divided into an open ward ;i,2 feet wide by 7 feet deep, two dressing rooms each 16 feet
wide by 7 feet deep, and a porch 2,2 feet wide by 5 feet deep. In order to give each patient
as much privacy as possible, the ward is cut up by dwarf jxirtitions six feet high, into four
cubicles each 8 feet wide by 7 feet deep. The dressing rooms are finished on the interior
and heated by a stove, but not equipped with' toilet facilities, which are provided in a nearb\-
building. On each end of the l)uilding there is a break in the wall forming a small square
bay window which adds to the appearance of the building and assists in producing cross
ventilation. This cottage has a capacity of four patients with an estimated cost for con-
struction of $1000.

169

Section VII

No. 112.— Hazelwood Sanatorium, Louisville, Ky. D. X. Murphy & Brother, Architects.

Men's CoTXAdi:. View of I'kont and Side Ki.evatiox axd Floor Plax. Capacity, 12 Patients.

Estimated Cost, $2,250. (Sec illustration 100 for further dcscrijition of this institution.)

Hazelwood Sanatorium, Louisville, Ky., Men's Cott.xgk (Illustration 112).
This is a frame cottage supported by heavy square posts resting on concrete piers. The
external walls are made of boards laid vertically over the studding with rounded battens
covering the joints. The building, 61 feet wide b_\- S5 '*^'*^'t deej), is divided into a central
sitting room 12 feet wide 1)\- \() feet deep, a dressing room twcKe feet s(|iiarc, which is
l)artlv under the main roof and extends six feet beyond the rear wall, four private rooms
all about twelve feet square, and a porch eleven feet wide tlanking the building on the front
and sides. The dressing room is ecjuipped with three laxalorits, two baths, and two
toilets and is well ventilated by a cross draft through windows on three sides. A study of
this cottage will show that it is well arranged for use in warm climates, for besides the large
wall area occupied by windows, the wide porch on three sides allows the jxitients a choice
of exposure. The building has a capacity of twelve jxitients at a cost of $2,250.

Patients' Quarters — Cottai^e Type of l^uilding

-,•!.» '-'>ff5'-. „ ~ J"-

No. 113. — White Haven Sanatorium, White Haven, Pa. Cottage. View of Front and Side
Elevation- and Floor Plan. Capacity, S Patients. Estimated Cost, $800.

White Haven Sanatorium, White Haven, Pa., Cott.vge (Illustration 113).
This building is of cheap frame construction, sheathed with clapboards, and roofed with
composition roofing. It is 38 feet wide by 16 feet deep and consists of two open wards
both fifteen feet square, and a dressing room 7 feet wide by 14 feet deep. The wards are
practically separate pavilions open from a height of three feet above the floor to the roof
plate on all sides except where the central room joins them. They are protected in cold
weather by removable glass in sash frames and in moderate weather by canvas curtains.
The dressing room is heated by a stove, equipped with wash basins, and in one end, which
extends three feet beyond the rear walls of the wards, are two toilets of the earth closet
variety. The building has a capacity of eight patients at an estimated cost for construc-
tion of $800.

171

Section \ II

No. 114. Municipal Sanatorium, Otisville, N. Y. Di.su.m.d by Dk. 11i:kma\n M. liu.cs. Cottage.

\'ii:\v 01^ Front Elevation- and Fukjk Pi.a.n. Capacity, 8 I'atients. Kstimated Cost,

$2,000. (See illustrations 14, 28, 59, 60, og, 106, for further descri]Ui<)n of this institution.)

Municipal Sanatorium, Otisville, N. Y., Cottac.i; (Illustration 114'. This is
a frame cottage resting 011 hrick ])iors and cowred by a low hippod rool with wido
overhanging eaves. The ai)i)i'araiu-e of iho building is inii)ro\ed 1)\ white trimmings and
lattice work between the ])iers. It is 5S fiit wide by jo fi'et (K'op and is di\i(le(l into a
central living room 15 feet wide by k) feet dei'p, two open front wards jo feet wide l)y u
feet deep, and two ])orches jo feet wide by (> feit deei). I'lach ward is dixided by a trans-
verse partition eight feet high into two cubicles, in the li\ ing room i> a largt.' hrcplaci'
and the patients" lockers, but tlu'ri' arc no laxatories, baths, or toilets in the building, as
it is situated close to a central la\ator\ ciiuipiu'd with toiUt and bathing lacilitiis. .\s
this is an ine.\pensi\'e building with a plan that can bi' (.asily modilied or iiilarged, it ma\
be adopted by small communities that wish to add to tluir local hospital a paxilion lor
housing tuberculous j)atients. Thi' cottage has a capacil\ of cighl patients at an cstimalid
cost of 82,000.

Patients' Quarters — Cottage Type ot Building

No. 115.— Plainfield General Hospital, Plainfield, N. J. A. L. C. Marsh, Architect. Cottage
Ward for Tuberculous Patients, \ie\v of Front and Side Elevation and Floor Plan. Capac-
ity, 8 Patients. Estimated Cost. $3,000. Note.— This is a Modified Plan of the Municipal
Sanatorium Cottage Shown in Illustration 114.

Plainfield General Hospital, Plainfield, N. J., Cott.\ge W.\rd for Tuber-
culous P.ATiEXTS (Illustration 115). This is a frame cottage with the external walls and
roof covered by stained shingles. It has no basement or cellar but rests on brick piers with
lattice work between them. The frames around the windows, the trimming, and support-
ing columns of the porches are painted white. The floor plan is arranged like the lean-to
type of Ijuilding with a front section 6S feet wide by 20 feet deep, and a rear extension 17
feet wide by 13 feet deep. As the building was designed to house both men and women,
it is divided transversely through the center by a solid partition. On either side of the
partition is a sitting room 13 feet wide by 19 feet deep, a dressing room 8 feet wide by 12
feet deep, two open bedrooms both 10 feet wide by 12 feet deep, and a porch 20 feet wide by
6 feet deep. The fronts of the bedrooms are protected by canvas curtains and the dressing
rooms are equipped with lockers, lavatories, a bath, and a toilet. The building has a
capacity of eight patients at an estimated cost of $3,000.

173

Section VII

No. ii6. Iowa State Sanatorium, Oakdale, la. Designed by Dr. II. K. Kirsciiner. II. V. Liebhe,
.\k( iiiTi:< T. ("on ACK. \'i);\v <>v 1"ko\i- and Sioe Klevation and Im.ook 1'i.an. C\v.\cn\\ S
J'ATiENT.s. KsTiMATKD CusT, Si,50o. (,Scc illustrulions 24, 29 and 97 for further description of this
institution.)

Iowa State Sanatorium, Oakdale, la., C'oii aci: (Illustration ii()). Ihis is a
frame cottage sheathed with patent sidin.^ and rool'td with shin.uK's. The tloor is about
four feet above ground and the supporting linil)ers rest on briek piiTs. The building has
a very simple floor plan and consists of a central silting room 17 feel wide by 15 leel deep,

174

Patients' Quarters — Cottage Type of Building

flanked on three sides by a porch twelve feet deep; and a dressing room 17 feet wide by 9
feet deep, equipped with ten lockers, two lavatories, a bath, toilet, and slop sink. The
dressing room receives the morning and afternoon sun and both rooms obtain cross ventila-
tion from three sides. Tt is claimed for this cottage that a part of the porch will always be
sheltered from storms and will receive sunlight from some direction during the entire
day. Those who have used the design like the arrangement and say that there is room
for all the beds on the sheltered side of the porch and that it is not necessary to enclose a
portion as must be done when there is only one exposure. The appearance of the cottage
could be greatly improved by reducing the height of the piers and filling the space between
them with screens made of lattice work. The building has a capacity for eight patients
at a cost for construction of $1,500.

Adirondack Cottage Sanitarium, Saranac Lake, N. Y., WHEELf:R Cottage
(Illustration 117). This cottage rests on a foundation of native stone and is of frame
construction covered externally with a four inch brick veneer, leaving an air space one
inch wide between the brick and the sheathing. This method of construction was
adopted in order to make a warm, dry
building, and save repairs and paint on
the exterior. The roof is of blocked
tin and the interior walls and ceilings
are finished with plaster. The floors
and trim are of hard wood with
coved bases and flush joints.

The building, 34 feet wide by
30 feet deep, is arranged with a
central sitting room 11 feet wide by
12 feet deep, four bedrooms all about
10 feet wide by 9 feet deep, and three
porches, two in the rear 7 feet wide
by 9 feet deep, and one on the front
32 feet wide by 8 feet deep. Besides
the apartments and porches enumer-
ated, there is also a bathroom, a
large closet in each bedroom, a hall
closet, and a fireplace in the sitting
room.

Everything in this cottage has
been arranged in a remarkably com-
pact form, for every square foot of
space has been utilized and direct sun-
light reaches all the sleeping rooms and
porches. The cottage consists of one
story, but has a cellar under the en-
tire building which contains a hot-
water heating apparatus. It has a
capacity for four patients and cost
$4,000.

No.

117.— Adirondack Cottage Sanitarium
Saranac Lake, N. Y. Scopks & riiLsxMAN.v,
Akchitf.( rs. Wheeler Cottage. View of
Fro.nt I:le\atiox and Floor Plan. Cap.\c-
iTY, 4 Patients. Estimated Cost, $4,000.
(See illustrations 13, 63, 1:1 and 122 for
further description of this institution.)

Section \ II

No. ii8.— Gaylord Farm, Wallingford, Conn. Browx & vox Berex. Architects. Coxxected
Cottages, \ie\v of Froxt .\xd Side Ele\ atioxs and Floor Plaxs. Capacity of each Cottage,
8 P.atiexts. Estimated Cost. $4,000. (See illustrations 68 and 75 for further description of this
institution.)

Gaylord Farm, Wallingford, Conn., Coxxected
Cottages (Illustration 118). These cottages are of frame
construction covered externally with shingles and finished
on the interior with plaster. That part of each building
which is divided into rooms rests on a stone foundation
and is constructed over a cellar containing the heating
l)lant. They arc of the bungalow type of structure 35 feet
wide b\- 40 feet deep, connected to each other by a corridor

forty-si.x feet long. This connecting link between the cot-
tages is attached to the front of one building and the rear
of the other. Il ha> an opt'n fnnit prott'itt'd ])y can\as
curtains and a rear wall pierced by windows. In the illus-
tration il is shown ten feet wide, but since the drawings
were made it ha> been wideiu-d thri'c feet in order to gi\e
better protection to the patients using il as a slee])ing
porch. The lloor plans are alike, with a sitting mom
13 feet wide by 14 feet deep and a bathroom o feet wide
by 6 feet fleep in the center, and two bedrooms 10 fei't wide by 12 feet dee]) on eil
Kach cottage has a capacity ior eight patients at an estimated cost of 84,000.

176

ler side,

Patients' Quarters — Cottage Type of Biiildini^r

No. iiQ. — Barlow Sanatorium, Los Angeles, Cal. Designed by Dr. W. Jarvis Barlow. Cottage.

\iE\v OF Front and Side Ei.e\atu)\s and Floor Plan. Capacity, :; Patients. Estimated

Cost, $500. (See illuslration 2 for further description of this institution.)

Barlow Sanatorium, Los Angeles, Cal. Cottage (Illustration 119). This cot-
tage is of frame construction covered externally with narrow tongued and groo\-ed
boards and roofed with shingles. It is situated on a steep hillside, faces the south, and
rests on stone piers. The outside of the walls and the porches are painted brown and the
roof is stained green. On the inside there is no ceiling, but the walls are finished with
surfaced lumber treated with oil and varnished. The south side and both ends are boarded
to a height of three feet from the floor, the open space between that point and the roof plate
being protected by copper wire screening and canvas curtains which can be raised and
lowered. In order to increase the cross ventilation the upper panels of the doors have been
removed and the gables left open. All these openings are screened against insects. In
12 177

Section VII

No. 120. Open Air Sanatorium, Portland, Ore. W iiiudkn & l.i.wis, Akciiitkcts. Cottagk

\'ii:u OF I'ront AMJ ,Sim; Ij.kvatkin amj Intkkior. Capacity, 2 I'atiknts. Kstimated Cost,

Si, 000. (Set illustrations 8 and 16 for further description of this institution.)

178

Patients' Quarters — Cottage Type of Building

the roof over the center is an iron ventilator sixteen inches in diameter, and a "solar heater"
much used during all seasons of the year in southern California for producing warm water
for toilet iiurjioses by the direct rays of the sun.

The cottage, 30 feet wide by 17 feet deep including the porches, is divided into two
rooms, both 10 feet wide by 12 feet deep, and a porch live feet wide extending across the
rear and both ends. The dressing room, a la\at()ry, a shower bath, and an earth closet
are placed in a small building 10 feet wide by 7 feet deep beyond the edge of the porch in
the rear of the building. The cottage has a capacity of two patients and cost, including
the dressing room, S500.

Open Air Sanatorium, Portland, Ore., Cottage (Illustration 120). This cot-
tage is a modification of the old fashioned summer house which was quite common in
country yards a few years ago. The building is of frame construction with sills sup])orted
by posts. The walls, and the roof which is of the hipped variety are covered with shingles
and the interior is ceil-ed with narrow, selected boards treated by oil and varnished. The
window openings are protected in cold weather by removable frames of glass and sash and
in moderate weather by canvas curtains. The floor is raised about two feet above the
ground and has an air space under it enclosed with lattice work. There is also an air space
between the ceiling and the roof which prevents to a certain extent the heating of the
interior by the sun's direct rays striking the roof. The cottage, 16 feet wide by 21 feet
deep, is divided into an open room 15 feet wide by 13 feet deep, a bathroom 4 feet wide by
8 feet deep, a short hall six feet wide, and two closets both 4 feet wide by 3 feet deej). The
building has a capacity for two patients at an estimated cost of $1,000.

Loomis Sanatorium, Liberty, N. Y., Orchard Cottage (Illustration 121).
This cottage with the appearance of a pleasant country house rather than an institutional
building is of frame construction covered externally and roofed with shingles. The in-
terior is finished in plaster on wooden laths and has hard wood floors and c\press trimmings.
There is a commodious attic which can be divided into several rooms, and a cellar under the
entire building containing the heating plant. The cottage, 47 feet wide by 36 feet deep, is
divided into a living room 12 feet wide by 18 feet deep, three bedrooms 10 feet wide by 9 feet
deep, a kitchen 1 1 feet wide by 10 feet deep, a pantry, a bath, a maid's room, and a patient's
room, with a private sleeping porch. Across the entire front of the building is a jjorch
eight feet deep which is connected with the three front bedrooms by French doors. Be-
sides the apartments enumerated, there is a linen room, a large fireplace and two closets
in the sitting room, closets in all the bedrooms, and a stairway to the cellar. The cottage
is generally rented as a home for families staying at the institution, but when not in demand
for this purpose is used to house a group of patients. It has a capacity for four patients
at a cost of $3,500.

Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Nathan Cottage
(Illustration 122). This cottage rests on a foundation of native stone and is of frame
construction covered externally with a yellow terra-cotta brick veneer. The interior walls
are finished with plaster over wooden lath and the floors and trim are of hard wood. The
building, 45 feet wide by 30 feet deep, is divided on the front into a hall i'wc feet wide, and
two bedrooms 10 feet wide by 8 feet deep; and on the rear into a living roi)m i 2 feet wide
by 15 feet deep, and two bc'drooms 12 feet wide by 8 feet deep. In addition there is a

179

Section VTI

No. i2i.^Loomis Sanatorium, Liberty, N. Y, Scopes & Feustmann, Architects. Orchard Cottage.

View of J'kcjnt and Siui; JOlkvations and I'"r.c)OR I'r.w. Capacity, 4 Patikxts. Kstimated Cost,

$3,500. (See illustrations i, 87 and 105 for fiirtluT (Icsrriiiiion ul" iliis institulion.)

iKilhroom, u hivalory and toilet, and in the sitting room a lar<j;e l)ay window and a fireplace.
The bedrooms are heated, have (Hrect access to the porches, and each contains a closet.
All llic windows and doors are Im-oui^IiI lliish will) llu' cciliiiij; and cross \i'ntilation is ob-
tained through transoms. There are two sleeping porches, each 12 feet wide bv 20 I'eet
dee]), placed on either side of the building and connected on the front by a porch si.\ feet

180

Patients' Quarters — Cottage Type of Building

■-<*iV, i!:.iMi!iMifi'"l|j |!ifi:;ii!!!

liiittiifiiiiiiiii !iiiiiiiititiiniiit!

No. 122. Adirondack Cottage Sanitarium, Saranac Lake, N. Y. Scopes & Feustmann, Architects.

XaTHAN CitTTACE. \lE\V t)F FroNT FlE\ATI()X AND Fl.OOR PlAN. CAPACITY, 4 PATIENTS.

FsTiMATED Cost, §5,000. (See illustrations 13, 63. iii and 117 for further description of this institu-
tion.)

wide. The cottage faces the south and the rear and c)i)en side of Ijoth sleeping porches are
protected by frames filled with glass and sash. The building has a capacity for four pa-
tients and cost $5,000.

River Pines Cottage Sanatorium, Stevens Point, Wis., Cott.vge (Illustra-
tion 12 V). This is a two storv cottage of frame constructii)n covered externally and
roofed with shingles. Both floors are j)lanned alike and the arrangement of the rooms and
porches is unusual. The rear wall, except for an extension six feet deep, is a straight wall
seventy-six feet wide from which the building extends forward and grows narrower in a
series of right angle breaks until on the front the wall is only 20 feet wide. On each lloor

181

Section VTI

rn^-3T rtooB plam

No. 123. River Pines Cottage Sanatorium, Stevens Point, Wis. Di.sicnkd by Dk. T. II. IIw.

COTTALK. \'li:\V (JF FkONT AND SlDE Kl.KVATIOXS AM) I'l.OOR Pl.AX.

Capacity. 12 Patiknts. Cost, $4,000.

are four rooms about twelve feet square; two for one patient and two tor two i>atients each.
At the rear of the Imildin^r partly undir thr main roof and partly in the rear extension is
the stairway and a lavatory (-(luipprd with a hath, washluiwl. toilrt. and slop sink. Kvery
patient has adjoining his room a private sleepin-^ i)orch about nine Url s(|uari' with tw()
exposures. The arranf^ement of the lloor plan secures privacy, as tluiv i> a section ol
every porch which cannot be overlooked from (.tlur parl> of tlu' building. Thr 0)tta,ue
has a capacitv of twt'Kc patients at an fslimati'd cost ol 84,000.

182

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