of renewing it, as taught in the schoolbooks, no room of less than 1,000 cubic feet occupied by one person only, can be effectively ventilated in cold weather-allowing for temporary suspension of ventilation in times of necessity-without danger to health. (Hospitals, barracks, prisons, workshops, assembly halls, etc., require from three to five times as much.) Large rooms, however, possess an advantage over smaller in that the change of air is effected with less perceptible motion, that is-with less draught. For example the admission of 3,000 cubic feet of air per hour into a room of 1,000 cubic feet involves a complete change of air in twenty minutes, but in a room of 10,000 cubic feet only once in 200 minutes, or for four occupants every five and every fifty minutes, respectively. The former would be very distinctly felt, and the latter would be scarcely perceived.

For these reasons it is evidently more difficult to provide for the efficient ventilation of a small room than for a large one, the air-space per head being the same in each case.

The bane of those who tolerate confined air is a draught. It is chiefly dangerous, like exposure to the ordinary vicissitudes of weather, to those who have had their power of resistance impaired by confinement, and particularly to the occupants of small bedrooms, because such persons, on account of the otherwise still air which they conserve, are much more sensitive to air currents. And hercin lies one of the most troublesome problems the medical practitioner is called upon to solve, how to effectually warm and ventilate a small bedroom for the "lying-in" woman without draught.

Small bedrooms-that is to say those which afford less than 1,200 cubic feet to the occupant, particularly if used as lying-in chambers should wholly rely upon the bed and clothing for warmth, unless, perhaps, heat can be admitted from an adjoining room. Ventilation without draught, in such circumstances, is no more difficult than for larger rooms. Rooms of less than 1,200 cubic feet capacity cannot be effectually warmed and ventilated in cold weather without thorough air flushing; and this can rarely be effected while they are occupied. Hence such rooms should be occupied by healthy persons as sleeping rooms only; never occupied as lying-in rooms or used by other invalids who cannot vacate them daily for thorough aeration.

Doubtless disease is often the result of draught-that is to sayof the passage of a current of cold air sharply across or against a portion of the body that is exposed to it; but the danger of this

1

is greatly enhanced by too close confinement. Persons who habitually expose themselves to an abundance of fresh air rarely suffer from such causes. Some there are, however, on account of apparently inexplicable reasons, who are supersensitive to such conditions. But these, above all other persons, find their best protection in habituating themselves to a plenary supply of fresh air under all circumstances; by woolen clothing and by particularly avoiding small bedrooms and all such conditions as are engendered by them.

Specially sensitive persons frequently suffer from the radiation. of the heat from their bodies by too close proximity to windows, though these be perfectly tight; by resting their arms on marbletop tables; or by sitting or lying too close to the wall. The abstraction of heat from the exposed surface of the body, by these means is similar to draught, and liable to the same results.

People generally rely altogether too much upon the house to exclude cold air, instead of warm clothing, by which they exclude fresh air. By habituating themselves to close rooms and impure air they create and increase their liability to disease which they exert themselves in the wrong direction to avoid.

Bedrooms should always be constructed or chosen with reference to the probability of their becoming sick rooms. Hence the size of the room, the size and place of the windows and doors with reference to light and air should be arranged accordingly. In houses of the villa type it is almost impossible to avoid placing the bed either facing the window or between it and the door; in which case the former alternative should be preferred, because the inconvenience can be modified by shades or blinds. A projecting window is always a useful addition to a bedroom, providing room for the dressing-table and increasing the amount of floor space. Recesses or closets always should be constructed, if possible, to take the place of wardrobes, but never in dark corners; and the ventilation of such wardrobes and closets should be accomplished by ornamental borings in the panels of the doors, by transoms, or by doors shorter by two inches at the top and bottom than the door space. Wearing apparel requires constant ventilation to be healthful. Movable wardrobes and all bureaus or other furniture not otherwise easily handled should, like the bedstead, rest on castors. All bedrooms should be so planned, if practicable, when space is abundant that, in case of sickness, they can be isolated from the rest of the house, so that communication may be had with them with the least possible risk to the sick, or to the well from the

sick.

Moreover, whenever practicable, bedrooms should be provided with dressing-rooms apart, two to each family bedroom, which can be entered without passing through the bedroom. The wash-basin and bath-tub, and the water-closet, should be placed apart in properly arranged recesses connected with the dressingrooms instead of the bedrooms.

Servants Rooms.The kind of bedrooms provided by the rich for their servants, indeed, in the construction of dwellings generally, and particularly in the modern "flats," is a disgrace to civilization. Their beds are usually placed in the low corners of attics and other out-of-the-way places, where the air space and the means of ventilation are alike grossly inadequate. That those who occupy them quickly break down and form a large quota of the mortality from consumption is not surprising to any competent observer of the conditions promotive of that disease.

Among the tenement-house population proper-that is to say, the class of tenement-houses over which the health authorities in our large cities exercise authority-the conditions are better; and this circumstance is suggestive of the query to health authorities: Are not all dwelling-houses occupied by three or more families tenement houses? Are flats privileged consumption incubators? It would be an easy matter for almost any busy physician in our large cities to sum up a dozen or so of black holes on his diary, which in the aggregate surpass the famous Black Hole of Calcutta.

With regard to infants, and their beds in particular, warmth, next to the purity of the atmosphere, is of essential importance. Proportionately to its internal organism the body of the infant is more than twice as great in its degree of exposure as that of an adult, and its feebleness for several months is such as to require sleep for almost the whole of its time when not nursing. Its bed should be soft and the covering light and warm. It should at the first, and for at least a week after birth, be placed upon its side, well over on its stomach, with its mouth and nose free, lest it strangle with the trickling of the saliva into the windpipe. After a time, when it has gained sufficient strength and knowledge to use its limbs, for increased comfort, it may be placed upon. its back, or at its own inclination. But in placing it in bed with its mother, which is generally best, care should be always taken to so place it that it is not likely to work its way down and get its face under the bed-clothes, where it would inhale the effluvium from the body of its mother.

Cradles and cribs are not only of great convenience, due care being observed with regard to the softness and warmth of the bed and covering, but advantageous for so placing the occupant as to secure the best access to fresh air and warmth, without overheating, which should be guarded against by light wool covering.

Baby-wagons require at least the same care with regard to bed. and covering, and, besides, special care in cold weather, to prevent the abstraction of heat from the body by cold pavements. To prevent this it is well to have an extra underbed; and, for the same reason, those baby-wagons are best which have high wheels. Darkness in bedrooms is the common concomitant of dirt; and though frequently induced for ostensibly good reasons, there is no gainsaying the fact that it generally serves to conceal worse conditions than those which it portends to prevent. If a room is generally dark it is scarcely less generally dirty; and if it be but moderately well-lighted on the whole, and yet has corners and recesses into which the light does not penetrate, those corners and recesses will usually be dirty corners and recesses. Fluff and dirt, comprising in part particles of organic matter from the lungs and skin, collect in them; and the scope of the broom and dust-brush of the ordinary housemaid is too well known to describe a curve commensurate with the light, to expect anything more than an aggravation of the danger of such dirt, by merely stirring it up and increasing its liability to be inhaled or to settle in the food and drink. That household dirt generally, and of dark bedrooms in particular, is a frequent cause of such common illnesses as catarrh, sore throat, inflamed eyes and bronchitis, and sometimes of graver diseases, is beyond question by any physician who comprehends the causes of the diseases he is called upon to treat as the most important step toward their cure and subsequent prevention.

Sunlight is, indeed, the right arm of oxygen. There ought not to be a dark room in any human habitation. To have too much sunlight for health is not possible. Its excessive intensity in exceptional circumstances can always be moderated, as occasion may require, but its plenary supply should be always provided for. Of artificial light generally, it may be said that in all its forms, except that of electricity, inasmuch as it is produced by the combustion of some compound of hydrogen and carbon, previously volatilized or brought into a gaseous condition, it is

more or less injurious to the atmosphere, by consuming the oxygen and emitting mephitic gases.

Carburetted Hydrogen and Carbon Monoxide are two particularly dangerous gases evolved by gas lights, above all, by the use of "water gas." This gas of itself is of non-luminous flame, but it is made luminous for lighting purposes by a process called "carburetizing," by which vaporized oil is, added to the gas. It has a strong odor, like that of coal gas; but it is sometimes "odorized" by the admixture of some stronger smelling and deceptive substance without any amelioration of its dangerous properties. It usually contains from 30 to 50 per cent. of carbon monoxide, by which it poisons all who breathe it; and so much of this poison is evolved and mixes in the air of rooms lighted with water-gas as to render all persons who occupy such rooms liable to it.

On account of the recognized danger of its use, in 1899 a commission appointed for investigation, in England, reported adversely on all illuminating gas containing over 20 per cent. of carbon monoxide, which proportion corresponds approximately to a mixture of equal volumes of coal-gas and water-gas.

The increased danger from the use of water-gas, as compared with coal-gas, is shown by statistics on the subject, by the Boston Board of Health:

In 1888 when but I per cent. of the gas sold in Boston for illuminating purposes was water-gas there were no deaths, suicidal or accidental, from gas poisoning. In the following year there was but I. In 1890 the percentage from water-gas rose to eight, and there were six deaths, four accidental and two suicidal. In 1892, as a result of permissive legislation, 52 per cent. of the gas sold was water-gas, and the deaths rose to 15. In 1897, the percentage rose to 93 and the deaths to 47, 32 of which were accidental, and 15 suicidal. In the five years ending September 1, 1899, 169 deaths had occurred.

The symptoms of poisoning from carbon monoxide, as given off from water-gas illumination, are the same as those for carbon dioxide, with which intelligent persons generally are familiar.

For illuminating and heating purposes the use of water-gas undiluted should be wholly prohibited; and, when diluted, ás required in England, it is still fraught with danger.

Coal-gas, candles and lamps, all means of artificial lighting, except the electric light, evolve impurities to the air and consume