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the better policy to use the two front rooms of the front apartments, and the two rear rooms of the rear apartments, as bedrooms, for two reasons; first, as they communicate more directly with the open air, and secondly, as they are away from all the plumbing fixtures.

There should be two windows in each of the bedrooms. Two openings on to the street in the front and two on to the yard in the rear. And two in each of the other bedrooms opening into the light and air-shafts.

The rear room of each apartment I would use as a kitchen and dining-room combined, and in this room I would have two large windows opening into the air-shafts, which at this point is eight feet in width, thus assuring good light and ventilation. In this room there should be an iron sink, and stationary stone wash-tubs, each of which should be separately trapped immediately underneath, said traps to be made of lead pipe, and to be connected to main iron waste pipe by brass ferrules, lead caulked and wiped joints. There should be a door opening from each room into the hall, and over each there should be a movable transom to promote proper ventilation.

Adjoining each kitchen, in an apartment separate and distinct, should be the water-closet; probably the best for service and simplicity is a flush-rim water-closet. The flooring beneath the bowl of the water-closet should be of stone, or rather non-absorbent material, never of wood or sheet metal. In this apartment there should be a window opening into the air-shaft to assure proper ventilation of the same. The closet should be flushed from a water-supplied cistern overhead. Upon the location of the water-closets there may arise some adverse criticism, but it seems best to locate them thus for two reasons: irst, each family is responsible for its cleanliness, and secondly, the Croton supply pipe to the same is not nearly so liable to freeze and burst as when they are located in the halls. My observation has been that there is less sickness in houses where the water-closets are located as above stated, than when they are in the halls.

The main waste pipe of sinks, wash-tubs and soil-pipes should be of iron, with all the joints properly lead-caulked, and should be ventilated by extending them in full calibre at least two feet above the roof.

In a large city frequently the pressure is insufficient to force water up to the fourth or fifth floors, and in such houses resource has been made to a tank on the roof. This, I believe, to be a mis

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take, as they are rarely clean; the cover on the tank is not tight, thus allowing bacteria of various kinds to lodge therein, which indirectly may be the cause of disease.

In place of the tank I would have force pumps on the aforesaid foors, thus giving the occupants the opportunity of pumping water at will. The expense of the latter would be no greater than with a tank on the roof (which requires a gas engine in the cellar to fill it), and would not only give a purer supply of water, but at the same time save a great waste of water, which occurs when tanks overflow.

And at last, but not least, comes the house drain or sewer, into which all the waste and soil pipes discharge. This should be of extra heavy cast-iron pipe, at least six inches in diameter, with all joints properly lead-caulked, and connected to the house-sewer by a gas-tight joint; and that it be provided with a fresh-air inlet of similar material, at least four inches in diameter, and with running trap placed near the front wall of the building, provided with proper hand-holes and trap-screw ferrules.

The house drains should be above ground when possible, running along the cellar wall and protected from injury, as any defect therein can be repaired at little expense.

The above seems, to the writer, to represent a house sanitary in its appointments, especially intended for families of five persons; but alas! with all it contains, how difficult, almost impossible it is to find model tenants to occupy it.

Many of the occupants of tenements are ignorant of the necessity of sanitary surroundings, or feel that the landlord is robbing them, by charging rent for inferior accomodations. Why is it that so few of our tenement houses are kept in a sanitary condition? First, most of the work done therein is done by contract, instead of by honest day's work, and competition is so sharp that, in computing for a job, one has to figure closely, that I assert without fear of contradiction, that it is absolutely impossible to make a bid for honest labor and obtain the work.

Second, the janitors are so poorly paid for what they are supposed to do, that in many cases they do little or nothing, their pay consisting only of free rent of an apartment, the rental value of which never exceeds $12 a month and frequently less. For this allowance of about 40 cents a day, it is not surprising that the work is left undone. I believe that the owner of a tenement house occupied by twenty families and kept in good condition by the vigi


lance of the janitor could well afford to pay him at least $10 a month in addition to free rent, and at the end of each year the interest on the investment would be larger than it is now.

Third, people who are careless and indifferent of the feelings of others will invariably move in where there are clean people, and thus upset the well-meant intentions of the others. These people should be ordered to vacate as speedily as possible.

Fourth, some owners of tenements have so little of their own money in the building (most of it being on bond and mortgages), and anxious to make so much out of it, use very short-sighted policy, to wit: get all they can out of the tenants in the way of rent and do nothing in return for them, the result that for one or two years the property pays well, and after that for a couple of years it brings in nothing, and eventually the owner is the loser to a large amount.

Tenement house property, well kept, is to-day, and always has been, a good investment.

When we consider the fact that recent statistics show', that at least three-fourths of the population of this city are inhabitants of tenements, can we, as citizens and physicians, afford to ignore the demand (which is growing with each passing hour) to provide suitable and healthful dwellings for their occupancy?

Considering the great mass of humanity occupying these tenements, how ignorant many of them are of the means to promote healthy minds and bodies, and how unscrupulous landlords will treat them more as animals than human beings; does it not seem the duty of the family physician to instruct them, that instead of alone injuring the landlord when careless of their surroundings, they are directly endangering the life and health of their loved ones? I think that if this were done oftener, we would soon find an additional decrease in our already low death rate, and an increased mental and physical development of those persons now too often ignored and persecuted.

I would not like to give the impression that all owners of tenements in the city are grasping and hard-hearted, as I have met many large-hearted, open-handed men, who, while desiring a reasonable profit upon the amount invested, are not only willing but anxious to have their houses in the best possible sanitary condition.

I hear some one say that such a house would be too expensive. I do not deny but that it would cost more money than a poorlybuilt one, but I do claim and without fear of truthful contradiction,

that such a house built upon the principles outlined in this paper would turn in the owner a larger amount upon his investment in ten years than one built of poorer and cheaper material, as it requires less repairing and will be occupied longer and by a better class of tenants, who are willing to pay well for first-class accommodations.

Another may say that the mode of life of the occupants of tenements is immaterial to me. But is this true in any way? From the tenement comes the servant employed in our households, the nurses for the little ones (it may be wet-nurses), and who would wish to have a wet-nurse from a house which is vitiated by filthy and unhealthy surroundings?

Many of the employees in our department stores come from these dwellings; and, in fact, in almost every walk in life in a large city, the majority of those employed are dwellers of tenements. This being true, should we not, on the principle that the majority rule, see to it that their home surroundings are made better and more healthgiving? Turn where we will we come in intimate contact with these people, and their health and comfort are absolutely necessary to our



The janitor should go through every apartment daily, to see that the plumbing fixtures are in good sanitary condition, sweep the halls and stairs throughout daily, and at least once a week have them thoroughly scrubbed, and keep the cellar, yards and bottom of airshafts clean.

How can the house be kept in good sanitary condition? First, by proper education of the tenants. Second, repairing defects at

Third, use care in selection of tenants. Fourth, have owner visit the house at stated intervals, at least once a week. Fifth, the application of the “Golden Rule” to owner and tenant.

Before closing, let me say that I do not believe that unsanitary dwellings are the immediate cause of disease, but the continual inhalation of noxious and vitiated air certainly prevents the system from offering the proper resistance to disease, and in this way becomes the exciting cause of many ailments. For instance, the bacilli of tuberculosis are everywhere present; we inhale them, it has been said, with every inspiration, yet every one does not develop this disease. Why? Because the germ does not find a soil suitable for its growth and development, and, therefore, dies; or, in other words, the resistance offered by the system is greater than the resistance offered by the germ itself. This end can only be obtained by paying strict attention to the laws of sanitation and hygiene.

I have thus briefly presented this paper, not claiming that the house is perfection, nor that it could not be improved upon, but believe that it contains nothing but what is absolutely necessary to make it sanitary.



A Reply to Mr. Picken of London, Eng.

By R. F. Licorish, M.D.,

Barbados, West Indies.

UOT homines, tot sententia, is a true and universal dictum, yet

truth, I take it, is absolute and not relative. I shall en

deavor in this reply to Mr. Picken, to point out how it is that with certain truths in view, truths which it is of the greatest importance to the world to establish, he should yet be found differing so fundamentally from me. I shall endeavor to show that the tot sententia, as regards the two of us, arise from mental attitudes, which perhaps may be explained, so that the grand truths involved may not remain hidden; for is it not true that, while men dispute, truth is obscured and opportunities lost?

I take it that the chief objects to all truthseekers in reading, are to ascertain (1) wherein other men agree with them, (2) wherein they differ from them, and (3) by how much they may learn. Now, in the case of Mr. Picken as regards his reading of my article, "Physics and Medicine," it is plain that the first two of those purposes were answered; as regards the third, there is no evidence of any influence. This may appear presumption, but is there not a true saying that to the wise a word is sufficient? What I want to point out is this: Mr. Picken is so full of, and so strongly attached to, his own ideas, that he can only see in the thoughts of others what harmonizes with his own. This is seen by his praising an authority now, and scouting him presently. Although Mr. Picken has subjected my article to a scathing criticism, yet I hope to demonstrate to the readers of this journal that the raison d'être of much of that criticism is due (1) to a want of care on his part in acquainting himself fully with the contents of my article, (2) to a misperception of my

*Written especially for the NORTH AMERICAN.

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