CONSUMPTION 



119 



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 simply crowded into one room 

 for the sake of mistaken economy presumably to save coal and wood. 

 This house is a very comfortable 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 per- 

 sonal habits of these mountaineers, who, on the advent 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 overabundant, so they economize space 

 and heat, and have fire only in the cookstove in the kitchen. Win- 

 dows 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 moun- 

 tain 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 condition of lowered vitality results. 



In one of these mountain homes a typical one a bedroom, 

 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 believe 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. 



