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 WORKS OF DR. H. B. BASHORE 
 
 PUBLISHED BY 
 
 JOHN WILEY & SONS, INC. 
 
 Overcrowding and Defective Housing in 
 the Rural Districts. 
 
 12mo. 92 pages, 15 full-page half-tones. Cloth, 
 $1.00 net. 
 
 Outlines of Practical Sanitation. 
 
 For Students, Physicians, and Sanitarians. 12mo. 
 vi + 208 pages, 42 illustrations, many half-tones. 
 Cloth, $1.25 net. 
 
 Sanitation of a Country House. 
 
 12mo, vii+102 pages, 16 full-page half-tone illus- 
 trations. Cloth, $1.00 net. 
 
 Sanitation of Recreation Camps and Pcirks. 
 
 12mo, xiii+109 pages, 19 full-page half-tone illus- 
 trations. Cloth, $1.00 net. 
 
 Published by THE F. A. DAVIS CO. 
 1914 Oheery St., Philadelphia, Pa. 
 
 Outlines of Rural Hygiene. 
 
 For Physicians, Students, and Sanitarians. Il- 
 lustrated with 20 engravings, mostly original. 
 5J X 7J inches. 86 pages. Bound in extra cloth, 
 75 cents net.
 
 Overcrowding and 
 Defective Housing 
 
 in the Rural Districts
 
 Overcrowding and 
 Defective Housing 
 
 in the Rural Districts 
 
 BY 
 
 DR. HARVEY B. BASHORE 
 
 Inspector for Pennsylvania Department of Health 
 
 AUTHOR OF 
 
 "The Sanitation of a Country House," "The Sanitation of Recreation 
 Camps and Parks," "Outlines of Practical Sanitation" 
 
 FIRST EDITION 
 FIRST THOUSAND 
 
 NEW YORK 
 JOHN WILEY & SONS, Inc. 
 
 London : CHAPMAN & HALL, Limited 
 1915 
 
 145515
 
 Copyright, 1 91 5, by 
 HARVEY B. BASHORE 
 
 c < * < 
 
 Publishers Printing Company 
 207-217 West Twenty-fifth Street, New York
 
 
 DEDICATED TO THE 
 
 MEMORY OF 
 
 FATHER AND MOTHER
 
 PREFACE 
 
 When we first began to investigate this 
 subject it was hard to beHeve that real 
 overcrowding existed in the country dis- 
 tricts, but the more the subject was 
 studied the more the fact became ap- 
 parent. I Httle imagined that we had 
 conditions in our own small towns and 
 villages almost as bad as I had seen in the 
 great East Side on Manhattan Island. 
 
 ; Yet why not? Greed for gold is just as 
 
 ' strong in the country speculator as in the 
 city millionaire, and the owner of a few 
 
 t< lots is going to make the most of them — 
 
 > if he has a chance. 
 
 The observations noted in this little 
 
 ix
 
 X Preface 
 
 work were made for the most part in a 
 typical rural farming community, inhab- 
 ited by native-born Americans. That 
 conditions are vastly worse in the great 
 mining and manufacturing districts, no 
 one can doubt. Many thanks are due to 
 Miss Lucy Shellenberger, visiting nurse 
 for the Pennsylvania Department of 
 Health, for assistance in preparing the 
 work, collecting data of the various 
 " lung" houses, and reading the MS. 
 
 West Fairview, Pa., February, 1915.
 
 CONTENTS 
 
 CHAPTER PAGE 
 
 I. Land Overcrowding 13 
 
 II. House Overcrowding 26 
 
 III. Defective Building 51 
 
 IV. Overcrowded and Defective Schools 66 
 
 V. Results 80 
 
 XI
 
 Overcrowding and Defective 
 Housing in the Rural Districts 
 
 CHAPTER I 
 
 LAND OVERCROWDING 
 
 Overcrowding the land with buildings 
 is not so very common in the country, yet 
 it does occur in many villages and small 
 towns, especially in those which are on 
 the "boom" from some rapidly increasing 
 industry, and much of this overcrowding 
 in villages is due to the "row." We can 
 readily understand how building in rows 
 may be necessary in the great cities, but 
 it surely is not necessary in villages and 
 small towns: indeed, I have seen the 
 "row" far out in the country, where land 
 
 13
 
 14 Rural Housing 
 
 is almost valueless. These barrack-like 
 houses — and I know one small town 
 where a certain small row is called the 
 barracks — are perhaps satisfactory for 
 soldiers, but for raising families they are 
 anything but what they should be. At 
 first thought you will say there is no over- 
 crowding, but if you will think a little 
 further, you will see that there is too much 
 building — probably we ought to call it 
 defective building — on each lot. 
 
 This overcrowding the land with houses 
 does not, of course, injure the land nor 
 thee houses, but it is likely to injure the 
 occupants, for, necessitating lack of air 
 and sunshine in some of the rooms of the 
 building, it leads to the consequent evil 
 of house and room overcrowding, for the 
 less air and sunshine a house has, the less 
 people it can properly house. There may 
 be room overcrowding in the isolated 
 house standing in the middle of a ten-acre
 
 Land Overcrowding 15 
 
 field, but it is more likely to occur when 
 the land is crowded with buildings, per- 
 mitting the influx of more families caused 
 by the apparent greater amount of hous- 
 ing space and cheaper rental. 
 
 There is hardly a village street which 
 approaches anything like the width of the 
 streets in the great cities — yet adjoining 
 these narrow village streets as much land 
 is covered relatively by buildings as in the 
 city; on the other hand, although the 
 village houses do not approach the height 
 of the city houses the real condition is 
 even worse than in the city, for the narrow 
 street is frequently lined on both sides by 
 low, bushy trees, and the houses, due to 
 the lack of height, have such low ceilings 
 that there is really less circulation of air 
 than in the ordinary city home. 
 
 In Fig. I is shown an example of one 
 of these village "rows" which has over- 
 crowded the land. These lots, only
 
 i6 Rural Housing 
 
 seventy-two feet wide, are completely 
 covered at one end by a building which is 
 divided into six so-called houses: each 
 house contains two rooms downstairs and 
 two upstairs. The end houses alone of 
 such a building can have Hght and air on 
 more than two sides, but, unfortunately, 
 these ends are, in the present instance, 
 furnished with very small windows, so 
 that these end houses are very little bet- 
 ter than the intervening ones. These lots 
 should contain just about one -half as 
 many houses and the increased rental de- 
 rived from the better houses would, prob- 
 ably, in the end, yield about as much in- 
 come from the land as when it was 
 overcrowded with the "row." This in- 
 sanitary row is situated in a town of less 
 than a thousand people, but some years 
 ago when a Httle "boom" struck the 
 place, everybody wanted to get rich 
 quick, and the owner of these lots found
 
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 Land Overcrowding 19 
 
 that he could rent many small houses 
 profitably. 
 
 Of course it is well to remember that by 
 proper building many more people can be 
 housed on a given lot than by the im- 
 proper building characterized by the usual 
 village "row." However, to put up 
 buildings which would be proper for 
 housing many people would necessitate 
 more expense than the value of the land 
 would justify, consequently it is better to 
 have relatively less building and house 
 relatively fewer people on the village lot. 
 
 I was once driving in a wild mountain 
 valley in Pennsylvania and came upon a 
 settlement made up of the houses of the 
 workmen of a nearby industry: rather, 
 there were no houses; only a long row, 
 divided into compartments, called houses 
 in the company's books. The conditions 
 here were scarcely better than a city 
 block, and the inhabitants — pale, sallow.
 
 20 Rural Housing 
 
 dirty, and unkempt, from living in badly 
 ventilated rooms — showed the typical 
 countenances of the overcrowded. Yet 
 right here there was land in plenty, land 
 everywhere that nobody wanted — land 
 for ten dollars an acre, and yet defective 
 housing conditions crowded the land be- 
 cause the company employing these people 
 were too penurious and too careless to 
 build houses fit for human habitation. 
 
 Another improvement in the money- 
 making scheme of overcrowding is to 
 build additional houses on the rear end of 
 the lot; very frequently the stable being 
 changed into a dwelling-house. I knew an 
 instance in which this happened in a 
 small town: a man bought the stable at 
 the end of a certain lot — a lOO-foot lot — 
 and fitted it up as a house and lodged 
 therein his numerous family. He could 
 have gotten an entire lot and house for 
 the same cost a mile or so farther away,
 
 Land Overcrowding 21 
 
 but he preferred the crowding to the 
 longer distance from the village centre. 
 
 I know of a case where a corner lot, 109 
 feet long and 58 feet wide, was by this 
 arrangement so covered with buildings 
 that barely 25 per cent of the lot was un- 
 occupied; but 25 per cent unoccupied is 
 the rule in some of the large cities, yet 
 here was a village lot almost imitating the 
 plans of the big city. Now, of course, one 
 instance of this class of overcrowding 
 might not be so bad, but the tendency is 
 there, and sooner or later there will be a 
 row of houses facing the street and a row in 
 the alley. At first, as there is a demand for 
 houses, a fairly good class of people may 
 occupy them, but as the houses depreciate 
 and the demands lessen, a poorer and more 
 negligent class move in and the locality 
 degenerates into a veritable "slums." 
 
 In Fig. 2 is shown another phase of 
 rural overcrowding the land, which I sup-
 
 22 Rural Housing 
 
 pose does not happen very often, and 
 that is an actual rear tenement, — small 
 and insignificant the building is, yet nev- 
 ertheless it differs only in degree from the 
 big city tenement — the fundamental prin- 
 ciple is just the same. It probably came 
 about through a re-survey of the street 
 which left the old house some distance 
 back from the pavement: then an addi- 
 tional building was put up in the front 
 and the old rear building rented as a 
 Chinese laundry — almost as bad as some 
 of the buildings in the Chinese quarter in 
 New York. 
 
 A similar case worth recording is that 
 in which an entire corner lot is covered 
 with a building, so much so that the toilet 
 accommodations are on the street. This 
 result was, to be sure, brought about very 
 slowly. A bankrupt speculator owned the 
 building and lot, and gradually sold off 
 the lot to his neighbor; in fact, sold every-
 
 1- iG. 2. — An Actual Rear Tenement in a Small Town.
 
 Land Overcrowding 25 
 
 thing except the house, and that his 
 neighbor didn't want! 
 
 Of course these are all isolated instances 
 given only as samples of conditions which 
 exist in many places: they serve to show 
 it, possibly, at its worst. There are, how- 
 ever, few towns and villages which do not 
 have some of these defects: they are 
 mostly, I think, in the older ones. In the 
 newer towns it is less evident. 
 
 How to prevent this condition from 
 arising is not so easy save by proper edu- 
 cation of the people. The building of 
 rows and shacks begins quite often before 
 the village is incorporated, while it is still 
 the "country," — only with township su- 
 pervision which does not amount to much 
 as long as a man keeps to his own land and 
 pays his taxes. When the straggling houses 
 become incorporated into a town, proper 
 building rules can be made and enforced, 
 but often already the damage is done.
 
 CHAPTER II 
 
 HOUSE AND ROOM OVERCROWDING 
 
 House or room overcrowding is the 
 common housing defect met with in the 
 country — sometimes due to the ill-con- 
 structed building, poverty, or thoughtless 
 landlord, but in many instances due to the 
 carelessness and shiftlessness of the people 
 themselves. The "house in the row" 
 mentioned in Chapter I is very often re- 
 sponsible for a great deal of overcrowding ; 
 but not all rows are overcrowded. I have 
 seen instances where small families lived 
 in such limited quarters under proper san- 
 itary conditions, but this, I think, is the 
 exception. The "house in the row" very 
 
 often contains only four rooms, so it is 
 
 26
 
 Fig. 3. — Seventeen People Once Lived in this "Row" of 
 
 Three Houses.
 
 House and Room Overcrowding 29 
 
 very evident that when more than three, 
 or at the most four, people Hve in such a 
 house, with only small windows front and 
 back, there will be overcrowding and with 
 it lack of fresh air and sunshine. 
 
 As an illustration of this overcrowding, 
 take the row shown in Fig. 3. Supposed 
 to be three houses: at one time this build- 
 ing contained seventeen people, and as 
 there are only four and one-half bed- 
 rooms (if there can be such a thing as half 
 a room) in the whole row — one and one- 
 half in each house — there was evidently a 
 vast amount of overcrowding. The gable 
 ends in this case have one small window: 
 much better, however, than some others, 
 which have no windows. Though the end 
 houses in such a row are almost as bad as 
 the middle one, they are still considered 
 by far the best in the row, as is shown by 
 the increased rental paid for them. 
 
 Why are such houses, insanitary they
 
 30 Rural Housing 
 
 surely are, built in our towns and villages? 
 Simply because the owner hopes to make 
 ID or 12 per cent on his investment; and 
 many an opulent family lives on the pro- 
 ceeds of a "rotten row" that is a disgrace 
 to modern sanitary knowledge. These 
 people, the proprietors, I mean — gener- 
 ally the best people in their respective 
 communities, — fail to realize that insan- 
 itary dwellings built in sunless rows, even 
 on another street, are a menace to their 
 own health. 
 
 In the photograph (Fig. 4) is shown an 
 example of gross overcrowding in a certain 
 old-fashioned country town. Each wing 
 of this building is called a home and 
 rented to different families, although con- 
 sisting of but one room; one of these is 
 occupied by a mother and two sons — one 
 eighteen years old : all three live and eat 
 in this single room, and all three sleep in 
 the one bed (Fig. 5). The other house is
 
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 House and Room Overcrowding 35 
 
 occupied by a man, wife, and two children. 
 Bad it surely is, yet this house is owned by 
 very respectable people who apparently 
 fail to recognize the iniquity of renting 
 such a house in the manner given. 
 
 The overcrowding mentioned above is 
 in a great measure due to environment 
 and landlord, the people themselves not 
 being responsible for the existing condi- 
 tions. On the other hand, there is very 
 much overcrowding due wholly to the 
 habits and ignorance of the people them- 
 selves. For example, a nurse from one of 
 the State Dispensaries, in her visiting 
 work, came across a certain farmhouse 
 where five people were accustomed to 
 sleep in one not very large bedroom, 
 which had only one small window, and 
 even that was nailed shut; one of these 
 five had incipient tuberculosis. These 
 people were well-to-do farmers living in a 
 large twelve-room stone house, and sim-
 
 36 Rural Housing 
 
 ply crowded into one room for the sake 
 of mistaken economy — presumably to 
 save coal and wood. The picture of this 
 house (Fig. 6) shows it to be a very com- 
 fortable and airy building which would be 
 entirely suitable for an even larger family 
 to live in, under proper sanitary conditions. 
 Another form of this overcrowding is 
 seen in certain mountain districts of 
 Pennsylvania, and I suppose it may be 
 very much the same in other States. It 
 has been noted in these places that the 
 natives do not have the strong, healthy 
 build, and a color redolent of health, but 
 the thin, pale, and wan features of those 
 suffering from the lack of pure air. Yet 
 these people live in the purest of God's 
 fresh air, in places akin to those in which 
 we build our Sanatoria. Why is it? In 
 many instances the explanation seems to 
 be dependent on the personal habits of 
 these mountaineers, who, on the advent
 
 House and Room Overcrowding 39 
 
 of winter, "hole up," a good deal like 
 certain animals. They lay in a supply of 
 wood, but as wood is becoming scarce 
 and they are generally lazy and shiftless, 
 the supply is not over-abundant, so they 
 economize space and heat, and have fire 
 only in the cook-stove in the kitchen. 
 Windows and unnecessary doors are nailed 
 shut, and here around the stove the family 
 spend most of the winter, eat and sleep in 
 one, or at the most two, rooms: and the 
 result? The faces you see here in these 
 mountain homes remind you of the faces 
 you see in the densely crowded, insanitary 
 tenements of the cities. The complete 
 outdoor life of summer is barely able to 
 combat the bad air and lack of air during 
 the winter months, and a chronic con- 
 dition of lowered vitality results. 
 
 In the photograph (Fig. 7) is shown one 
 of these mountain homes — a typical one. 
 The bedroom of this house (Fig. 8), 
 
 145515
 
 40 Rural Housing 
 
 which is the loft with a floor surface fifteen 
 feet square, is habitually used by eight 
 people. Three sleep in one bed, two in 
 another, two more in still another, and the 
 mother, who is tubercular, sleeps on the 
 cot in the corner. One would hardly be- 
 lieve it possible that such overcrowding 
 exists, yet there are many cases like this 
 among these mountain people. When I 
 remonstrated with the owner, who is well 
 known to me, about his insanitary living, 
 he admitted that conditions were bad and 
 that he had hoped to build an addition to 
 his house, but he was short of funds. I 
 knew he was telling the truth, and as I 
 was not anxious to help him negotiate a 
 loan, I found it profitable to change the 
 subject; loaning money to such does not 
 overcome the defect, or if it did, it would 
 certainly be temporary. 
 
 A similar example of this overcrowding 
 in a mountain home is shown in the pho-
 
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 House and Room Overcrowding 45 
 
 tograph (Fig. 9); this small shack — one 
 could hardly call it a house — contains 
 seven people. The building is composed 
 of four rooms — kitchen, sitting-room, and 
 two bedrooms: one of which is used by 
 four people and the other by three. The 
 rooms are so diminutive and the windows 
 so small that, although these people live 
 right on the foothills of a wild mountain 
 country, they are living under very badly 
 overcrowded conditions and are paying 
 the penalty — tuberculosis. 
 
 A common phase of overcrowding in 
 the country, just as in the city, is the 
 "lodger evil," especially in some of those 
 districts which are rapidly developing. I 
 know of a certain family in a certain small 
 town — a typical case — in which this con- 
 dition exists. The family of five adults 
 are living in a six-room house and take 
 one boarder. They are frugal and indus- 
 trious Americans, and are trying to pay
 
 46 Rural Housing 
 
 for their small home; and they are doing 
 it, but at the high price of overcrowding; 
 for one daughter has died of tuberculous 
 meningitis and another at present has the 
 appearance of developing the pulmonary 
 form of the dread disease. 
 
 The worst case of overcrowding, how- 
 ever, that I have ever seen appeared one 
 day last summer when I prepared to ad- 
 minister immunizing doses of antitoxin to 
 an Italian family during an epidemic of 
 diphtheria: thirteen children lined up to 
 take their "medicine"; in addition, there 
 were six adults, making nineteen human 
 beings living in one house, and this house 
 containing only six rooms. Where these 
 people slept was almost a mystery, for 
 there were but three beds in the house. 
 They simply stretched out on the floor; 
 and their pale and sallow faces told the 
 cost — the great cost — of overcrowding. 
 You might think this was a Hester Street
 
 i'lG. 9. — Seven I^eople Live in this Four-Room Shack, Over- 
 crowded, When There are Acres Unoccupied.
 
 House and Room Overcrowding 49 
 
 tenement, but it happened to be a farm- 
 house, situated in one of the most beauti- 
 ful valleys of Southern Pennsylvania, far 
 from the smoke and din of cities. The old 
 idea that the country is such a healthful 
 place to live in is good only so far as the 
 country is fresh from the hand of the 
 Lord, for Man's make-over in the country 
 is generally poor — very poor. 
 
 And now a word about the factory: we 
 used to have an idea that the factory, 
 often insanitary and unventilated, was a 
 big item in the problem of defective 
 housing, simply because factory workers 
 so often show the ill effects of bad hous- 
 ing. The real fact seems to be that most 
 of these workers live in very insanitary 
 homes — badly housed and badly fed — in 
 an environment tending to lack of sleep 
 and rest, which often ends in dissipation: 
 and that it is the home -life environment, 
 and not the factory, which brings disaster
 
 50 Rural Housing 
 
 to this class. In taking a census of cer- 
 tain workers in a factory in a rural town, 
 it was found that those whose home con- 
 ditions and personal habits were good 
 were just as healthy and successful as 
 those who didn't work in the factory. 
 The factory people, in this investigation, 
 who were suffering from physical dete- 
 rioration had invariably bad home con- 
 ditions, or else bad personal habits.
 
 CHAPTER III 
 
 DEFECTIVE BUILDING 
 
 A GREAT deal of the bad-housing con- 
 ditions in the country is due to defective 
 building. In the country an architect is 
 rarely employed: the country carpenter, 
 or a self-made contractor, does the work, 
 neither of whom knows the first principle 
 of construction: their sole object is to get 
 the most building on the lot for the least 
 money. Very often the owner himself 
 plays the part of the architect, and then 
 conditions, very often, are worse than 
 otherwise. As a result of this state of 
 affairs many country houses have gross 
 sanitary defects, which could have been 
 
 easily remedied by a little forethought. 
 
 51
 
 52 Rural Housing 
 
 As was mentioned several times before, 
 one of the greatest defects in rural hous- 
 ing is the "row," which of itself would not 
 be bad — it isn't in the large, well-aired 
 and roomy house of a great city — if the 
 construction was properly made, but where 
 window space is neglected or sacrificed 
 and sunshine lessened, when ceilings are 
 low, as they always are in such buildings, 
 air-space is so curtailed that the building 
 must contain, of necessity, serious faults; 
 and when you find a room — a bedroom 
 where there are no windows — you might 
 almost believe you were transported to 
 some of the places in New York which 
 Mr. Riis tells about in his "Battle with 
 the Slum." Yet such things are not 
 mythical in the country: I can show you 
 a windowless bedroom, and occupied too, 
 in a certain house in a country town of 
 less than 10,000 inhabitants. A good 
 many of these bad conditions are brought
 
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 Defective Building 55 
 
 about by the remodeling of old buildings 
 without the supervision of an architect. 
 If ever an architect is needed, it is when 
 an old building is made over — ^here, 
 surely, expert advice is necessary. Of 
 course, such serious defects are not so 
 frequent, but they occur often enough to 
 warrant the attention of those interested 
 in improving housing conditions. 
 
 Small windows and lack of windows 
 are the great faults found in rural build- 
 ing. In Fig. 10 is shown a house of this 
 sort which might be considered a type of 
 such conditions — isolated and open on 
 all sides, it should be ideal for health, but 
 the small windows give great lack of sun- 
 shine and ventilation; one window, two 
 by three feet, is the only opening on the 
 entire side, and the other side, I am sorry 
 to say, is just the same. It would be 
 interesting to know what was passing 
 through the mind of the builder who de-
 
 56 Rural Housing 
 
 vised such a form of architecture, which 
 certainly may help to account for the 
 tuberculous history of this house, which is 
 told in the last chapter. 
 
 Another example of this defective build- 
 ing characterized by small windows is 
 shown in the photograph (Fig. 11): this 
 probably was an old log-house, made over 
 by weather-boarding and converting the 
 original loft into an upper room. The log- 
 cabin of the early settler, with its port- 
 hole windows, was really not bad building 
 in its day, for the inhabitants of those 
 times led so much of an outdoor life and 
 spent so little time indoors that what 
 would be bad housing now to the clerk, 
 the artisan, the mechanic, and the farmer 
 had little effect on the frontiersman and 
 the settler. 
 
 The damp cellar is a very prominent 
 defect in rural building: every one who 
 lives or visits in the country knows the
 
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 Defective Building 59 
 
 damp, musty odor which pervades almost 
 every country house, especially in the fall 
 before the fires are started : so vastly dif- 
 ferent is it from the dry atmosphere of 
 the usual city house. This dampness is 
 surely a potent factor in the cause of the 
 various rheumatic complaints so common 
 in most rural districts. It goes without 
 saying that the proper construction of a 
 building demands a dry cellar such as 
 ma}^ be obtained by means of concrete and 
 damp-proof course in the foundation. 
 
 With the elimination of damp cellars, 
 close building in rows, and small win- 
 dows, much of the defect in rural housing 
 would be overcome, and these corrections 
 can usually be so readily accomplished 
 that the only excuse for their existence is 
 thoughtlessness or ignorance. It is hardly 
 necessary to say that every house should 
 have open space all around it, and be so 
 situated that the greatest number or all
 
 6o Rural Housing 
 
 of the rooms receive sunlight part of the 
 day, as there is no disinfectant or de- 
 oderant equal to sunlight: none so cheap 
 and none to make up for its absence. This 
 arrangement can very readily be made in 
 the country on account of the abundance 
 of room; indeed, the country is the ideal 
 place for building, for one is not ham- 
 pered by other dwellings nor excessively 
 high cost, as is the case in most cities. 
 
 In many places, as if to compromise 
 with the "row," the buildings are put up 
 double so as to house two families. While 
 this is vastly better than row-building, it 
 is not quite ideal; it approaches it and, in 
 most instances, would be rightly classed as 
 good building. In the accompanying pho- 
 tograph (Fig. 12) is shown a picture of a 
 street in a small town built more or less 
 of isolated houses: plenty of windows and 
 open space between each house give a 
 vastly different appearance from the
 
 Defective Building 63 
 
 street shown in Fig. i, which was taken 
 in another district of the same town. 
 
 A point which is worth some thought is 
 that dilapidation is not of necessity bad 
 hygiene: the broken fence, the unhinged 
 gate, the shattered window-pane, and the 
 moss-covered roof look careless and are 
 careless, but under cases of the greatest 
 dilapidation I have seen splendid sanitary 
 conditions. Some time ago, when inves- 
 tigating a diphtheria outbreak in a moun- 
 tain district, I visited a certain house 
 where the disease was reported to exist. 
 The dilapidation of the premises was 
 striking, indeed — fences, doors, windows, 
 porch, and everything else were broken 
 and upside down. The health-officer in 
 formed me that the family was large, and 
 of course I expected to find conditions bad. 
 When I entered the house I was surprised 
 to find that almost every precaution 
 known in the care of this disease was in
 
 64 Rural Housing 
 
 force. The patient was isolated in an ad- 
 joining room: she had her own dishes and 
 toilet articles; the mother remained with 
 her as nurse; the father did the cooking 
 and caretaking of the rest of the family, 
 and all absolutely remained out of the 
 sick-room. When occasion required ad- 
 mission to an upstairs room, instead of 
 going through the sick-room the father 
 climbed up a ladder on the outside; in 
 addition, the sick child and all the rest of 
 the family received antitoxin ; it is needless 
 to state that there was only one case of 
 diphtheria in that house. 
 
 In an instance which came to my notice 
 a few days ago, I found a case of typhoid 
 fever in a lop-sided, broken-down log-cabin 
 in a Httle mountain community: but here, 
 as above, the dilapidation didn't count. 
 The patient had a room to herself; her 
 own dishes, and disinfectant solutions 
 right beside the bed. As soon as the
 
 Defective Building 65 
 
 physician had pronounced the disease to 
 be typhoid, the family began using only 
 boiled water for drinking, and disinfected 
 all the discharges of the sick. The mother 
 who attended her washed and disinfected 
 her hands as carefully as any trained 
 nurse: there were no secondary cases in 
 that house. So much for general sanita- 
 tion in dilapidated homes: when it comes 
 to overcrowding, dilapidation in some of 
 the houses we meet would be a boon, and 
 really mean more air and sunshine, and 
 consequently help to remedy the existing 
 defect. However, we do not recommend 
 dilapidation as the means to overcome 
 sanitary errors. Dilapidation is unsightly 
 and unpleasant, and may be nothing else, 
 although the carelessness and shiftless- 
 ness which breed it are very prone 
 and very likely to breed real sanitary 
 defects.
 
 CHAPTER IV 
 
 OVERCROWDED AND DEFECTIVE 
 SCHOOLS 
 
 While the home life is vastly more im- 
 portant than the school life, and though 
 the sanitary arrangements of the sur- 
 rounding farmhouses are usually vastly 
 worse than the neighboring schools, yet 
 it is quite Hkely that the country school — 
 overcrowded and with glaring sanitary 
 faults — is an item in the rural health. The 
 little one-room schoolhouse (Fig. 13), so 
 common all over the country, has turned 
 out some great and good men, and women 
 too, but it has also turned out many that 
 might have gotten along better in the 
 world if their physical condition and wel- 
 
 66
 
 Fig. 13. — The Old-Fashioned School with its Usual Pictur- 
 
 ESQCE Setting. Note Small Window-Space. 
 
 Photo by Mr. James McCormick, Jr.
 
 Overcrowded and Defective Schools 69 
 
 fare had been looked after: it is a good 
 thing to remember that real progress is 
 not the progress of the few great men, but 
 the standard and average of the plain, 
 ordinary citizen. 
 
 Bad enough, indeed, is it when cities 
 crowd their schools, but to have this con- 
 dition, as is often the case, out in the 
 country seems infinitely worse. The fact 
 is that all city children, no matter what 
 city or where, attend school under sani- 
 tary conditions far ahead of anything in 
 the country, for, like the rest of the rural 
 community, the school has been sadly 
 neglected, and the days when Ichabod 
 Crane taught in Sleepy Hollow can al- 
 most be duplicated in some of the back 
 settlements. 
 
 In many of these schools the most 
 prominent fault is that of construction: 
 that entailing in turn the various other 
 abuses. With defective housing at home
 
 70 Rural Housing 
 
 and defective conditions at school, is it 
 any wonder that many country children 
 fall far below the standard of physical 
 excellence? Is it any wonder that medi- 
 cal inspection of rural schools shows 
 country children to be just as defective, 
 in proportion, as city children? We used 
 to think that the country was such a good 
 place to raise children! But a change is 
 taking place, even in the country. This 
 very day I happened to visit a certain 
 two-room country school (Fig. 14) planned 
 and built by a trained architect — the first 
 of its kind in one of the rural counties of 
 Pennsylvania. The large, light, airy, and 
 well-ventilated rooms are a pleasure to 
 pupils, teacher, and patrons: a vast con- 
 trast it is to the old-fashioned, dingy 
 room of the past. Yet this township is no 
 richer than any of its neighbors, but its 
 school board is awake to the possibilities 
 which come from advancing progress.
 
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 Overcrowded and Defective Schools 73 
 
 The city school boards employ an archi- 
 tect: why shouldn't we in the country? 
 they reasoned. Nevermore in this sec- 
 tion will the self-made contractor play 
 the architect's part. 
 
 It is generally conceded that a school 
 building should have about twenty square 
 feet of floor surface for each pupil, con- 
 sequently it is easy to draw the line 
 against overcrowding, by simply calcu- 
 lating the number of pupils to be ad- 
 mitted; but economic conditions change 
 and a room built for thirty frequently con- 
 tains fifty. The air-space per pupil should 
 be between 250 and 500 cubic feet, de- 
 pending on the means of ventilation: if 
 there is no special arrangement for the 
 admission of fresh air, the greater air- 
 space — 500 cubic feet — will surely not be 
 too much. In an ordinary country school 
 — overcrowded, of course, — I have seen 
 the air-space as small as 100 cubic feet
 
 74 Rural Housing 
 
 per pupil, which is, without question, en- 
 tirely too low. 
 
 Now, as the air-space allowed each pupil 
 depends on the ventilation, and as this 
 depends on the heating in cold weather, 
 ventilation and heating should be studied 
 together. The ordinary country school 
 will have to be heated for some time to 
 come with a stove, which, while not ideal, 
 is really not so bad if a jacketed stove is 
 used and proper means of distributing the 
 heat and admitting fresh air are arranged. 
 In the usual stove-heated room, the floors 
 are considerably colder — ten degrees, 
 sometimes, — than the other parts of the 
 room, and though the room may seem 
 comfortable to the visitor, and proper ac- 
 cording to a thermometer placed four or 
 five feet above, yet the feet get consid- 
 erably chilled in the lower temperature 
 of the floor; and this unequal heating 
 may perhaps help to account for the ca-
 
 Overcrowded and Defective Schools 75 
 
 tarrhal troubles so common in country 
 children. 
 
 The space for admission of light should 
 be about 20 per cent of the floor space, 
 according to those who have studied this 
 matter; yet in many, very many, of our 
 country schools it is only 8 to 10 per cent. 
 Imperfect lighting certainly leads to de- 
 fective vision, of which there is a great 
 deal in the country school; more to be 
 deplored than in the city, as it is more 
 difficult for the country pupil to get in 
 touch with the trained oculist and have 
 the visual error corrected than it is for 
 the city child. 
 
 In the construction should also be in- 
 cluded the inadequate and insanitary 
 toilet arrangements; and while they are 
 usually as good, generally better, than 
 the same appliances in the surrounding 
 homes, yet they should be as perfect as 
 our present knowledge will permit, not
 
 76 Rural Housing 
 
 only for the sake of the health of the 
 children, but as a matter of education to 
 the coming generation. A good many 
 people underestimate the value of such 
 things, but children, with their receptive 
 tendencies, will soon take note. Clean 
 and bright-looking sanitary appliances, 
 inducing personal cleanliness, will have a 
 vast and enduring effect on the children, 
 which will eventually affect their own 
 homes and their whole life. I know of 
 one instance in which a teacher's care to 
 the sanitary details of the toilet so 
 trained the children that not only did 
 that school have the cleanest toilets in a 
 whole county, but eventually the entire 
 community felt the improvement, and the 
 sanitary standard for the whole town was 
 raised: of course, the result came slowly 
 and gradually, but to this day that town 
 owes much to the efforts of this one 
 teacher.
 
 Overcrowded and Defective Schools 77 
 
 It must be very apparent to any one 
 that even with a modern school building 
 much depends on the teacher, and the 
 ignorance or indifference of teachers or 
 directors will account for many sanitary 
 oversights. The care of the toilets, as 
 mentioned above, comes under this head. 
 The lighting is another neglected item, 
 for very often, even with ample window 
 space, the Hght is much restricted by 
 shades, many of which are out of order 
 and impossible to roll up completely. 
 
 The proper temperature of a room, as 
 every one knows, or ought to know, can 
 only be maintained with a thermometer, 
 yet in the few schools having such an 
 instrument how many teachers pay any 
 attention to it or know its use? Once, at 
 least, I remember, when a teacher asked 
 me what the temperature of the room 
 should be, she volunteered the informa- 
 tion that "there was such a diversity of
 
 78 Rural Housing 
 
 opinion among the directors"; and so it 
 may have been. 
 
 Much good may be done by the teacher 
 in the way of habits of personal cleanli- 
 ness. In our school inspections we notice 
 very plainly that when the teacher is in 
 sympathy with the work the improve- 
 ment is far-reaching. Take, for example, 
 the care of the teeth. Some of the large 
 manufacturing chemists have made it a 
 rule to send out to school-teachers sam- 
 ples of dental paste or tooth-powder, 
 for the use of their pupils, and a number 
 of teachers with whom I am acquainted 
 have obtained these samples and dis- 
 tributed them among their pupils: the 
 children are then encouraged to buy a 
 tooth-brush and use it, and the result is 
 an array of clean teeth and mouths that 
 would have been a wonder a few years 
 ago. And there are now tooth-brushes 
 in Pennsylvania farmhouses, where the
 
 Overcrowded and Defective Schools 79 
 
 parents never dreamed of such an article. 
 This kind of work is worth encouraging, 
 for the tooth-brush, like soap, is a sign 
 of advancing civilization. No savage ever 
 used a tooth-brush — nor soap, either.
 
 CHAPTER V 
 
 RESULTS 
 
 What is the result of this overcrowding 
 and lack of proper housing in the country? 
 Just exactly the same as in the great 
 cities. Lack of efficiency, disease, and 
 premature death to many. We have been 
 talking much lately of our conservative 
 policy of lumber, coal, and wild animals, 
 but in many instances fail to see the great 
 loss due to human inefficiency brought 
 about by lack of suitable environment. 
 While the great majority of people sub- 
 jected to overcrowding and bad housing 
 conditions do not prematurely die, yet 
 they have a lessened physical and mental 
 
 vigor, less able to do properly their daily 
 
 80
 
 Results 8 1 
 
 work, and not only become a loss to them- 
 selves and their families, but to the State ; 
 and forever stand on the threshold of 
 that dread disease — tuberculosis; for tu- 
 berculosis is the one great disease of the 
 overcrowded. 
 
 Just how much tuberculosis we have 
 in the rural districts in proportion to the 
 great cities is pretty hard to say: but 
 every one who has investigated it is posi- 
 tive in the opinion that there is just as 
 much in the country districts: indeed, 
 some report more in the country than 
 in the adjoining cities. We find it in 
 the farmhouse and the mountain home: 
 habits of carelessness possibly keep up 
 the infection. We do not have "lung 
 blocks," like the large cities, but we do 
 have "lung houses" where case after case 
 of tuberculosis has lived and perhaps de- 
 veloped. Take, for example, the house 
 shown in Fig. lo: situated far out in
 
 82 Rural Housing 
 
 the country, and surrounded by as favor- 
 able conditions as one could wish, yet 
 look at its record in three different and 
 unrelated families: — 
 1 896-1 898. — M family: father died, 
 
 mother sick of tuberculosis. 
 1 898-1 900. — E family: father and 
 
 one son died of tuberculosis. 
 190Q-1912. — L family: father and 
 
 mother died of tuberculosis. 
 Five deaths from tuberculosis in this 
 one house — surely a record that carries 
 some meaning with it ! 
 
 Here is the story of a country "lung 
 house," which, although Its occupants be- 
 longed to one family, and probably had 
 that terrible hereditary tendency to the 
 disease, they had such favorable environ- 
 ment that improvement in the resisting 
 powers of the various individuals should 
 have developed, but voluntary bad living 
 kept these people in about the same con-
 
 /
 
 Results 8s 
 
 dition as if they had lived in one of the 
 dark and windowless "lung blocks" of a 
 great city, instead of in an isolated and 
 inviting country house open on all sides 
 to fresh air and sunshine. 
 
 T family home (Fig. 15) 
 
 1880-1901. — Inhabited by man, wife, and 
 
 six children: 
 
 Four died of tuberculosis. 
 1902-1903. — Inhabited by man, wife, and 
 
 eight children: 
 
 Man and one child have tuberculosis. 
 1904. — Inhabited by man, wife, and eight 
 
 children : 
 
 Four children have tuberculosis : three 
 others are suspects. 
 1905. — Inhabited by man, wife, and two 
 
 children : 
 
 Man died of tuberculosis. 
 Eleven cases of tuberculosis in twenty- 
 five years in this nice-looking farmhouse !
 
 86 Rural Housing 
 
 Fig. II shows a picture of a "lung 
 house," unique in covering a period of 
 almost fifty years. This house is situated 
 in a small town which has many things of 
 historic interest, and this house, too, has 
 a history, not of border warfare and heroic 
 defence, but a story of sickness and death, 
 perhaps a good deal of it avoidable. Six 
 different families — not related, some black 
 and some white, occupied this place dur- 
 ing the last half-century: its record was 
 such as to attract the attention of the 
 neighbors, who were more prone to attrib- 
 ute the fate of the inmates to witchcraft 
 than to the deadly germ of tuberculosis. 
 
 C Tuberculosis House 
 
 1864. — James W (C. ) died of tu- 
 berculosis. 
 
 1870.— Miss A (W.) died of tu- 
 berculosis.
 
 Results 87 
 
 1 87 1. — Harry C (C. ) died of tu- 
 berculosis. 
 
 1872.— Miss H (W.) died of tu- 
 berculosis. 
 
 1880.— Mr. R (C. ) had tuber- 
 
 culosis: moved away. 
 
 1 88 1. —Mr. W (W.) died of tu- 
 berculosis. 
 
 1900. — Mr. J (C. ) had tuber- 
 
 culosis: moved away. 
 
 1908.— Woods R (C. ) died of tu- 
 berculosis at Mont Alto. 
 
 1908. — Julia R (C. ) died of tu- 
 berculosis. 
 
 1912. — Mercedes H (C.) died of tu- 
 berculosis. -_-— "-^ ""^ ' 
 What a story! Ten sick of a lingering 
 
 illness and eight deaths. And then the 
 
 record is likely incomplete; probably the 
 
 story is only "half told." 
 
 The prevalence of tuberculosis in the 
 
 country is so evidently marked that there
 
 88 Rural Housing 
 
 is a growing interest in the subject in 
 many places. The Wisconsin Antituber- 
 culosis League, a year or so ago, made a 
 very careful and exact sanitary survey of 
 a certain rural district in that State, rel- 
 ative to the amount of this disease, and 
 found that in some parts of this district 
 the death-rate from tuberculosis exceeded 
 that of Milwaukee, Wisconsin's largest 
 city. 
 
 Minnesota also discovered that it had 
 much tuberculosis in its rural districts. 
 "As serious," says Dr. Daugherty, who 
 investigated the subject, "as that in the 
 congested areas of the cities." Following 
 a rural survey of several townships, under 
 the auspices of the State Antituberculosis 
 Association, there were found housing 
 conditions much as I have described in the 
 preceding pages as existing in Pennsyl- 
 vania. "The average number of people 
 sleeping in one room," says the report,
 
 Results 89 
 
 "was four." "In one house there were 
 eight, in another nine, and it was not at 
 all uncommon to find five or six. This 
 was not due to the fact that there was not 
 enough room, for in many of the houses 
 the whole family would sleep in one room, 
 use one for the kitchen, and leave two, 
 three, and in some cases four, rooms 
 vacant." 
 
 Coincident with this bad housing there 
 was found one township where there were 
 twenty-two deaths from tuberculosis in a 
 population of 500 in ten years: a death- 
 rate of 44 per 10,000. These investiga- 
 tors in Minnesota also found that "con- 
 tributing causes, as overwork and poor 
 food, which play such an important part 
 among the inhabitants of the crowded 
 tenement districts, do not usually count 
 for much in the country. Bad housing 
 and unrestricted exposure to contagion 
 seem to be the great factors." Of course,
 
 90 Rural Housing 
 
 in certain well-to-do farming districts, 
 such as were under investigation in Minne- 
 sota, this would hold good, but in many 
 other places, especially in parts of Penn- 
 sylvania known to the author, poor food 
 and lack of food are a vast contributing 
 cause to this disease. A poor constitution 
 to start with, and insufficient food, soon 
 engender a condition which quickly yields 
 to the inroads of the bacillus. As a corol- 
 lary to this is the rapid improvement of 
 such incipient cases, when put on the food 
 and under the proper environment of a 
 sanatorium. 
 
 In illustration of this food question the 
 following story is worth repeating. A 
 visiting nurse was complaining to a 
 mother that her little daughter, who was 
 tuberculous, had not eaten any breakfast. 
 The mother replied: "Well, it is her own 
 fault. This morning we had prunes and 
 bread and butter, and that is good enough
 
 Results 91 
 
 for anybody." She said this, too, as if 
 some of her other breakfasts were not 
 quite so good. This occurred, not in a 
 city, but in a country town where Hving 
 is comparatively cheap. The mother was 
 poor, very poor, but she was grossly ig- 
 norant, too, of foods and cooking. Had 
 she given her child a bowl of mush and 
 milk her intelligence would have con- 
 quered her poverty. 
 
 And now a word, a very short word, 
 about the remedy for overcrowding and 
 bad housing in the country. This prob- 
 lem can not be attacked, as in the great 
 cities, by legislative enactment or resort 
 to legal measures, but the solution lies, 
 it seems to me, in proper education by the 
 various health authorities, by the schools, 
 and by the press, and the crusade must be 
 kept up until the people understand that 
 it pays — pays in real dollars and cents — to 
 live in sanitary homes. Educate the rural
 
 92 Rural Housing 
 
 dweller in regard to the penalties for bad 
 housing, show him how tuberculosis fol- 
 lows in the wake of overcrowding, poor 
 food, and dissipation: in a great many 
 instances he will mend his ways. In 
 Pennsylvania this work is carried on by 
 the Tuberculosis Dispensaries of the 
 State Department of Health scattered all 
 through the State, where they have be- 
 come foci for spreading sanitary knowl- 
 edge of just the sort needed in rural com- 
 munities. Visiting nurses from these 
 dispensaries go to the homes, and to my 
 personal knowledge do much, very much, 
 to remedy the defects of bad and improper 
 living, and do it without resort to any 
 legal means. There is no factor so potent 
 for good as the work of the visiting 
 nurses of this great health department; 
 and many other States are taking up the 
 work and carrying it forward on the same 
 lines.
 
 C6
 
 This book is DUE on the last date stamped below 
 
 
 MAR 2 1 1968 
 
 JUL OS- 
 
 ■SS9 
 
 I.T-.n I.-0-M.";/j-S 'l's 
 
 

 
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 427 Bashore - 
 p29cy Overcrowding 
 and defective 
 
 housing; in the 
 
 rural districts. 
 
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