It is doubtful if there be anything which more affects the health of the individual than the house in which he lives.

Modern advances in bacteriology, and the certain knowledge of the way in which many diseases are carried through the air, have given additional importance to methods of house construction. The danger, for persons who are not immune, of being under the same roof with a case of whooping cough, measles, scarlatina, diphtheria, typhus, or smallpox has long been recognised; but it is only recently that our eyes have been opened as to similar dangers in relation to tuberculosis and pneumonia. Pneumonia has now for some years been occasionally spoken of as a 'house disease,' and the same term has recently—but whether on sufficient evidence is doubtful—been applied to cancer.

A careful study of the epidemic of influenza, which is showing singular vigour in the seventh year of its reappearance amongst us, has clearly shown that it is communicable through the air. And the way in which whole households go down with it when once it gains a footing in a house, is an additional reason for reconsidering our methods of house-construction.

The main object to be kept in view in building a house is the supply of fresh air. Too much care cannot be taken to insure that all the channels of internal communication—hall, passages, staircases—have independent ventilation of their own. Unless there be the means of getting these internal channels blown out by through draughts, the house cannot be wholesome; and in the event of any of the air-borne contagia getting a footing in the house, the liability to spread is enormously increased.

Not only must these internal channels have air, but they must have light also. The dark passage, ending in a close cul-de-sac of bedroom doors, is one of the commonest features of the modern house, and is, of course, absolutely to be condemned.

When we encounter the smell of the kitchen in the corridors, this may be taken as sure evidence that the house is unwholesome, and that the internal channels of communication are as insufficiently ventilated as is the kitchen. The smell of fried bacon which oozes through the keyhole of your bedroom may be accompanied by all the infective potentialities of all the inmates of the house. This test, as applied to corridors, is analogous to the smoke test or oil of peppermint test as applied to drains, and is quite as important.

If the house be of several storeys, the ventilation of the staircase has an importance which bears a direct proportion to the height of the house. As a rule, in second-class, and, indeed, in many first-class houses, the ventilation and illumination of the staircase never trouble the mind of the builder or his architect. Starting from the front passage, the only light of which is from a closed fan-light over the door, the staircase oscillates between water-closet doors and bedroom doors, getting darker and darker as it ascends. In the houses of artizans, every doctor must be familiar with the rancid whiff that comes up the absolutely dark stairs leading to the basement; the cold, damp smell of mildew and soot in the sacred front parlour, where the 'register' is closed and the blinds are drawn; and the variety of odours which assault his nose until he arrives at the carbolic sheet protecting the door of the room containing the case of infectious illness he has possibly come to see. Such houses are almost always let in lodgings, and contain several families; and if air-borne contagia ever gain admission to them, it can be no matter for surprise that they are difficult to dislodge.

The same defect of construction is seen in a very large number of London houses, even the smartest. The defect may be shortly spoken of as this:—'that the internal channels of communication, instead of serving for the supply of fresh air, merely facilitate the exchange of foul air.' This defect of construction is dangerous in proportion to the size of the building and the number of persons it contains.

The shafts for lifts necessarily require independent ventilation as much as the staircases. The monster hotels or towers of flats, from inattention to these details, are liable to be most unwholesome residences, and to be really dangerous if air-borne contagia gain access to them.

The Typical London House

Let us look at the ordinary London house of the better class. I have borrowed the plans which were given in the 'Lancet' for July 4, 1896. Figs. 1 and 2 show the plans of all the floors of the same house before (1) and after (2) certain alterations in the plumbing arrangements. Fig. 3 is a section of the same house, kindly made for me by Mr. Thomas W. Cutler, F.R.I.B.A.

I have taken these plans for the sake of showing what are the common defects of the average better-class London house.

I do not wish to be understood as saying that these defects are, in London at least, remediable. That unfortunately is not the case. That they are defects which ought to be avoided in places where land is less costly than in London is very evident.

1. The main defect is due to the fact that the cubic capacity of the house is far too great for the area upon which it is built. The house is, in fact, a tower of five storeys, 60 feet high from basement to roof, and containing 37,000 cubic feet, standing on an area of 1,512 square feet. A house of this shape entails enormous labour upon servants. It has been said, that in raising the body vertically we do an amount of work equal to moving the body twenty times the distance horizontally. The climb from basement to the top storey is therefore equal to walking 1,000 or 1,200 feet along the level, and when a footman weighing 11 stone, and carrying 28 pounds weight of coals, climbs from the coal-cellar to one of the top rooms, the work done is rather more than four foot-tons. I do not know when high-service water supplies became general in London houses, but it is evident that when the only water-supply was in the basement, the inconvenience of these high houses must have been very great. Gas-pipes, hydraulic lifts, electric wires, speaking-tubes, and high water supply have so lessened the personal service required in these domestic towers, that they have become popular, and by increasing the overcrowding in our cities they now constitute a very serious sanitary danger. In America the houses with steel frames have been run up to a height of 250 feet and over, and have converted the streets into sunless, draughty caÑons, in which locomotion is a matter of great difficulty, because the width of the street bears no due proportion to the cubic contents (and population) of the houses flanking it.

2. The house being flanked on either side by other houses, the front and back walls are alone available for admitting light and air, and the depth of the house is unduly great in proportion to its width. The noise of the neighbours is not always a trivial drawback.

3. One storey, and the largest, is below the street level, an arrangement which, from a sanitary point of view, is unjustifiable, and ought never to be imitated in the country.

4. There is no back door, which is a very serious defect in a house. The result is that the coals have to be got in, and the ashes and garbage to be got out, under the dining-room windows, and that while these tedious processes are in doing the traffic in the main street is very much impeded.

It is said that eels get used to skinning, and so the Londoner becomes very blind to the failings of the house which he inhabits.

The house of which the plan and sections are shown in the figures is not, be it observed, one of the dwellings of the poor, of which we hear so much, but one of the dwellings of the well-to-do, or even rich, fetching probably 350l. a year rent. It would need four servants, one of whom would sleep below ground level in the pantry; and in addition to the servants, eight persons might squeeze into such a house.

The basement below ground level is really a cellar dwelling, against which we inveigh, when we find it in Whitechapel. It is very dark, and requires artificial light nearly every day in the year. A butler sleeps in a dingy 'pantry' among the tea-cups and other gear, which he possibly sorts upon his unmade bed before he lays the cloth for breakfast.

This basement (Fig. 2) contains four sinks and two closets, each with its trap, and in each of the three areas are trapped gullies so placed that any gases which escape from them are more likely than not to find their way into the house.

The only way into the kitchen is through the scullery. The scullery sink is turned away from the window, and the smell of cooking and of cabbage water must inevitably find its way into the basement. A water-closet has been wedged into the back area between the windows of the kitchen and the servants' hall; and the larder, while it is without adequate light or ventilation, has a trapped gully at its door to serve as a seed-bed for mould fungi which will infect the food.

There is only one staircase, and this must serve as a shaft for the culinary and other fumes of the basement to rise in. It is entirely without independent ventilation until the half-landing above the drawing-room is reached. In fig. 1 there is another staircase window on the second floor, but this, be it observed, has been blocked by a water-closet in the house, as altered by the plumbers. This is a very serious thing to have done, and, in my judgment, is not in any way compensated by the changes recommended. The staircase has a skylight at the top, but skylights, being never opened in London because of 'the blacks,' are of very little use for ventilation. On the ground floor a water-closet abuts on the morning-room windows, while in the area beneath these windows is another water-closet, previously mentioned.

The first floor contains two fine drawing-rooms and a staircase window, and being without 'sanitary apparatus' is wholesome, except for the fumes which may ascend or descend the well-staircase. On this floor the light and decoration will render one oblivious of the basement. On the second floor the staircase window has been blocked, and there is an impossible bath-room, without adequate light or ventilation, which nothing can make wholesome, and which ought to be abolished absolutely. On the top floor the staircase ends in an unventilated cul-de-sac formed by four bedrooms, a dark 'box-room,' and a water-closet which is wedged in between two bedrooms.

This house has, if one may say so, been over-plumbered. There are five closets, five sinks, and a bath-waste (eleven trapped waste-pipes) for a maximum of twelve people. The closet on the second floor, and the one in the basement between the servants' hall and kitchen, should be abolished, and the fixed bath on the second floor should be removed. A bath-room wants light and air, and should always be against an outside wall. Persons should never take houses with extemporised bath-rooms poked in 'anywhere.'

In order to be fairly wholesome this house wants a fan-light over, or a glazed panel in, the front door, to serve the purpose of a window and ventilator, and a window over the W.C. between morning-room and study. In this way there will be the possibility of a through draught at the foot of the stairs. The staircase window on the second floor should be re-opened, and a window put above the W.C. on the top floor (the W.C. need not be more than 7 feet 6 inches in height). In this way the main channel of internal communication will be ventilated, and should any of the sanitary fittings 'go wrong,' the emanations will be diluted, perhaps to safety point.

Now we may assume that the house we have been considering, with three rooms on the ground floor, would let for about 350l. per annum, and would be rated at 300l. The alterations in the plumbing arrangements, as shown in fig. 2, are estimated by the 'Lancet' experts to cost 618l., or, let us say, a sum equal to twice the rateable value, and which adds (calculating 10 per cent, for wear and tear) at least 60l. per annum to the cost of the house. The local rates for this house would amount to over 90l. per annum, and if we assume that one-third of this is for sewerage, we may say that the sanitation of the house costs 90l. per annum, a sum sufficient to pay for the transmission by Parcel Post of 1,800 packets, weighing 11 lbs. each. Leaving the question of the waste of fertilising material out of consideration, it is clear that sanitation by water is as extravagant as it is dangerous.

Ventilation of Corridors

In the suggestions which the Medical Committee has drawn up for the guidance of the architect in making plans for the extension and ultimate complete rebuilding of University College Hospital, the thorough ventilation of the staircases and corridors is insisted upon; and the building is to be so constructed that it will be impossible for air to drift from one floor to another, or from one ward to another, without first mixing with the outside air. Builders of mansions and hotels would do well to keep the same principles of construction in view.

Another suggestion which has been made is to place the secondary staircases between the wards and the sanitary offices, so that the staircase-well forms a cut-off, with cross-ventilation between the ward on one side and the various sinks, closets, and baths on the other side. These secondary staircases are absolutely necessary in case of fire; and, by making them serve a double purpose, a considerable saving of space is effected. This arrangement is shown both in plan and section in figs. 4 and 5. It is very usual to place some of the ward offices on either side of the ward-approach, and others at the end of the ward. This is, in fact, the common arrangement; but, when adopted, it has the effect of making the ward-approach dark and gloomy, and of placing the ward between a double set of sanitary pipes, with the dangers inseparable from them. It is, I believe, a sound principle of construction for private houses, as well as for hospitals, to place the sanitary and culinary offices of all kinds on one side of the staircase, and the living rooms on the other. If the staircase-well be properly ventilated, the risk of living and sleeping in an atmosphere of sewer air is thereby diminished.

Fig. 6 is a ground plan of an ordinary country or suburban dwelling house which offers a suggestion in this direction. It is the principle only which I wish to illustrate. If the principle be sound, the method of carrying it out will certainly be improved by the experience and cunning of the trained architect.

This figure shows the 'offices' to the left and the living-rooms to the right of the staircase. The staircase has through-and-through ventilation of its own. The passage leading to the sitting-rooms has also illumination and ventilation independent of the sitting-rooms. The W.C. has a lobby with independent ventilation, and the door leading to this lobby from the hall should be a spring door. It will be observed that the 'pantry' (the workroom of the man or maid whose duty it is to answer the door) is placed as near the door as possible, and that this pantry intervenes, so to say, between the kitchen and the entrance hall. If the door between the pantry and hall, and the door between kitchen and pantry, be made to open in opposite directions and close with springs, no smell of cooking will be likely at any time to pervade the living-rooms.

Only the ground floor of this house is shown, so that it may be as well to state that, as regards the upper floor, all the bedrooms would be to the right of the staircase, while to the left, above the kitchen, &c., would be a second W.C., bath-room, housemaid's closet, and box-room. The principle of construction which it is wished to inculcate is this—that the culinary and sanitary offices should be quite distinct from the living-rooms, and be placed in an annex which should be separated from the living-house by a well-ventilated staircase. The living-house itself should not under any circumstances contain either water-tap or waste-pipe of any kind.

Aspect

In building a house, the point which requires more attention than any other is the aspect. This is too often neglected. In a climate like ours one may say that a house should receive its maximum amount of sun. If a house be well exposed to the sun there can be no doubt that the expense of keeping it warm will be considerably lessened. The best aspect for a house is generally conceded to be that which allows its chief rooms to look to the south-east. In this way the morning sun is enjoyed, and the rooms do not get the glare of the afternoon sun, which in July is apt to be intolerable. It may be advisable to build a house in the form of a veritable sun-trap. And it is quite possible so to build a modest residence that those who live in it may enjoy a maximum amount of sunshine and fresh air without exposure to cold winds.

The ground plan for such a house would have to be that of a right-angled triangle, with the apex pointing to the north (see fig. 7). The sun, even on the shortest day, would, if visible, shine into the angle for over seven hours continuously. In this re-entrant angle there would be complete protection from northerly and easterly winds; and if provided with a glass-covered verandah, it would be possible for even the most delicate invalids to enjoy in it a maximum amount of fresh air.

As only the truncated apex of the triangle faces due north, it is obvious that every side of this house would be bathed in sunlight for a considerable time every day.

The problem in such a house would be, not how to keep warm in the winter, but rather how to keep cool in July.

There are a few points in the ground plan of this 'bungalow facing south' which may be alluded to. Such a bungalow, if placed on the south side of a public road running east and west, would require no long carriage-drive of its own. The front door might be quite close to the road (and there are many advantages on the score of economy, safety, and convenience, of such a position) without the privacy of the south side being lessened in any appreciable degree.

The absence of stairs means less fatigue for invalids and old people, and less danger for children. Provided the cost of land be reasonable, is there any advantage in having more than one storey to a house? The sanitary advantage of a large area for a house is very great indeed. In hospitals we now recognise that infinitely the most important element of the 'cubic space per bed' is the floor area, and that a deficient floor space is not to be compensated by giving great height to the wards. The same reasoning is applicable to a house; and there is this further advantage in giving a large area to a country house, that the greater the area of the roof, the greater is the amount of rain-water which can be collected. Such a bungalow in our climate would certainly provide enough rain-water for all the needs of the inmates.

The shape of this house, with a minimum exposure to the north, is such that every room in it would receive a very thorough exposure to the sun.

A reference to the ground plan will show that on either side of the front door is a window, and that at the end of both the long passages is a big window, so that the channels of internal communication receive an ample supply of light and air, and can be swept by a through draught. The closets (and these should be 'dry-closets,' and not water-closets) are cut off from the main structure by a lobby having cross ventilation.

The pantry, the occupant of which usually does duty as hall-porter, is placed immediately between the front door and the side door, so that both doors can be guarded, so to say, at the same time and by the same person.

The kitchen is shut off by two doors, and both of these should be spring-doors, in order to make perfectly sure that the house shall not be invaded by a smell of cooking. The kitchen, nevertheless, is quite close to the dining-room.

The triangular space enclosed by the two sides would, there can be no doubt, need planting with a few deciduous trees and creepers, in order that the shade afforded may undergo a progressive increase as the heat of summer reaches its maximum.

The disposition of the rooms shown is not intended to be more than tentative, and in practice it would certainly be found advisable to have at least one sitting-room with a northerly aspect.

The verandah, it is observed, is big and serviceable, the object of it being, not merely ornament, but to enable even a delicate person to live practically in the open air. The rooms opening on to such a verandah must have big casement windows with low bottom sills, in order that chairs and tables may be lifted in and out with ease.

The size of the bungalow is greater than most families would require, but as the plan is merely intended to illustrate a principle this is of no consequence.

Fig. 8 shows an adaptation of the above plan, by Mr. Thomas W. Cutler, for a Convalescent Home in Epping Forest.

Warming

Fig. 9 represents an economical and wholesome way of warming the passages of a house. It is intended to represent a stove (any slow-combustion stove) with a fresh-air pipe of large calibre opening immediately beneath it. When the stove is lighted there is necessarily a large influx of fresh air, and the result is that the air in the passage is never 'close' or 'burnt.' It is important that the fresh-air pipe should be big, and that its gratings should be easily removable for cleaning.

If the hall and passages be warmed in this way it becomes possible to ventilate the rooms from the passages in the depth of winter. Fig. 10 represents one of the top panels of a door converted into a louvre ventilator, with the object of ventilating a room from the passages. A ventilator of this kind, if provided with side-pieces, delivers its air nearly vertically, and admits a large volume of air without causing draught.

Draughts may be defined as currents of air rushing in at the wrong place through channels which have insufficient area. The only way to cure draughts is to place inlets of sufficient area in proper positions. When building a house one might, of course, place louvre ventilators in the walls between room and passage at a height of 6 ft. 6 in. above the floor. The alteration of a door panel into a ventilator costs only a shilling or two. In the writer's experience it is a most excellent way of ventilating a room, always provided that the air of the passages be wholesome.

Living-rooms

A few words may be said as to living-rooms. Most living-rooms in better-class houses are too high. This is probably due to the bad example of London. In London the height of a house is the only dimension in which there is, so to say, the least elasticity, and London architects have attempted to compensate by height for absolutely inadequate area.

The rooms of some of the learned societies at Burlington House, with a space of several feet between the top of the window and the ceiling, afford excellent illustrations of the point which is to be avoided. Windows should extend to within a few inches of the ceiling, and should open at the top. This is universally admitted. If the room be 12 feet or 13 feet high, and the windows go to the top, then the window becomes unmanageable from its weight, and the opening of the top, although theoretically possible, is seldom put in practice. The wholesomeness of a room depends very much upon the rapidity with which the air in it can be renewed—the facility, in short, with which one can give it a blow out. This depends upon the relation of window area to cubic capacity. Windows, again, should be so constructed that they can be easily manipulated by a child. The louvre window ventilator, such as is common in churches, will be found very valuable for the admission of a constant but relatively small supply of air. These ventilators were introduced by the late Professor John Marshall into his wards at University College Hospital, and with the very best results.

Relatively low rooms, with big mullioned windows going to within a few inches of the ceiling, are far more wholesome than lofty rooms in which the tops of the walls are inaccessible to the housemaid, and the window sashes too weighty for her to move without difficulty.

For wholesomeness and comfort I believe a height of 10 feet is sufficient for any domestic living-room, and 9 feet for a bedroom. Provided the windows go to the top, and can be easily opened, it is very doubtful if there is any object, from the purely sanitary point of view, in having rooms more than 9 feet high. In rooms of such a height the cornice of the ceiling can be easily reached by a housemaid standing on a set of hand-steps, and the practical advantage of this is very great.

Our health is more in the hands of the housemaid than most of us are aware. Facility for cleaning should be ever in the mind of both builder and furnisher. The modern boudoir, hung with dabs of mediÆval rags, and stuffed with furniture and nicknacks till it looks like a transplanted bit of Wardour Street, is often not very cleanly; and when the daylight is excluded to a maximum extent, lest fading should take place, and the sun's rays never have a chance of disinfecting the dust upon and behind the curios, it cannot be wholesome.

It may be remarked that some of the curtain hangings and chintzes which are now, or were lately, in vogue are dressed or printed with a material which gives them a peculiar 'fusty' smell, something like inferior hay. No room in which they are used can ever smell 'fresh,' and it must be remembered that the smell of 'freshness' due to the free admission of light and air is the best practical criterion of wholesomeness.

Hotel Bedrooms

For discomfort and unwholesomeness the average hotel bedroom is hard to beat. I have occupied, in a very smart hotel, a bedroom which was 18 feet long, 13 feet high, and had a varying width from 10 feet at the window end to 8 feet at the door end (the room was wedge-shaped, owing to its being at the turn of a building which had a fine circular front facing towards two thoroughfares). The top of the window was at least 3 feet from the ceiling. The window was huge and unmanageable, and access to it blocked by a big dressing-table carrying a large looking-glass, which, in company with a once white (but now dingy yellow) roller-blind (which would not stop up) and absurdly heavy and costly (and dusty) valance and curtains, succeeded in keeping out most of the light which might otherwise have succeeded in getting through the murky atmosphere of a manufacturing town. The cubic capacity of this room was considerable (2,080 feet), but the 160 feet of floor-space was so occupied by bed, dressing-table, writing-table, wardrobe, chest of drawers, sponge-bath, fender, portmanteau stand, besides pedestal, two chairs and armchair, bidet, coal-scuttle, and boot-jack, that after having extinguished the light, which was at the farthest point from the bed, it was no easy matter to thread one's way back.

The planning and fitting of a room to serve in the best way possible the purpose for which it is intended is a problem to which architects have paid as yet but little attention. The house-builder might very well take a few hints from the ship-builder. On board ship space is economised to the utmost, and it is a matter of interest and wonder to observe how many luxuries one can have on board a well-planned ship, mainly by reason of the cleverly-designed fittings which economise space; and it is, further, a matter of interest to observe how the principle of 'a place for everything and everything in its place' lends itself to cleanliness and wholesomeness. The besetting sin of modern hospital architects is the giving of an extravagant excess of space in places where it is not needed. Because one gives, let us say, 120 feet of floor-space to every patient, it does not follow that any sanitary object is gained by giving a single square inch more than is absolutely necessary for ward offices. On the contrary, ward offices should be kept as small as possible, so that the 'place for everything' doctrine must necessarily be followed. I have seen 'ward kitchens' for twenty patients, in which the only cooking done is the heating of a little milk or beef-tea over a gas-jet, which have been about three times as big as a P. & O. galley, in which a succession of banquets are daily prepared for one or two hundred persons. If ward offices be carefully planned, and be merely 'big enough,' with no excess of cubic capacity, not only will initial cost in construction be saved, but cleanliness will be facilitated and cost of maintenance and repair lessened.

So it is with hotel bedrooms. One lives in hopes of some day seeing a competition among hotels in making the rooms occupied by travellers as convenient and wholesome as possible. There can be no doubt that a 'single' bedroom 12 feet square and 9 feet high, containing 1,296 cubic feet, if properly planned, fitted, lighted, and ventilated, would be far more wholesome and convenient than the wedge-shaped apartment containing 2,080 cubic feet to which allusion has been made. Without entering into the whole question of bedroom fittings, one may say a few words as to that very necessary article of daily use, the looking-glass. The swing looking-glass, which continues to hold its own, and which, in spite of 'curses not loud but deep,' refuses to stop at any angle, surely ought to be abandoned now that looking-glass plate has become so inexpensive. Fig. 11 represents a bedroom window comprising a thoroughly illuminated long mirror, so that for toilet purposes the face and figure are easily inspected. The looking-glass is surrounded by window, and the window itself is easily accessible, and is opened and shut with ease. All bedroom windows in tourists' hotels ought to have a balcony, in order that dusty clothing may be shaken in the open air. In hotels all heavy draperies, hangings, and carpets should be tabooed, and every effort should be made to give an appearance of elegance and luxury with a minimum amount of dust-retaining decoration. Hotels are like hospitals in this respect, that guests know nothing of the previous occupants of their room, and it must often be that such ignorance is blissful. Convenience for the guests and facility in cleaning are the objects to be attained by designers and fitters of hotels.

Fig. 11.