94 COMMISSION ON BUILDING DISTRICTS 



A reading of Mr. Graham Taylor's account of the " Satellite Cities " is 

 very illuminating on this point. There are great centrifugal forces working 

 in our large cities to-day which are throwing a larger and larger amount 

 of manufacturing out toward the city's perimeter. Every betterment of 

 transportation facilities apparently accelerates this movement. A very con- 

 siderable number of the workers of this city are going to work and be 

 housed in the future on the outskirts of the city. We earnestly urge you 

 to bear this in mind, and to give to the provisions for the outlying districts 

 the same degree of care and attention which are given to those nearer the 

 heart of the city. 



Statement by Dr. Gustave F. Boehme, Jr., Neurologist, Clinic 

 Assistant, Manhattan State Hospital for the Insane, May 24. 1916 



Nervous effect of high buildings 



I have looked at the deleterious influence of high buildings from two 

 aspects, one from the attitude of the persons living in the high buildings, 

 and, second, from the attitude of the persons living outside of the high 

 buildings in neighboring structures. 



Persons within high buildings, and particularly those in the upper 

 stories, if they tend to be heart patients, or tend to be persons given to 

 certain fears, or neurasthenic individuals, are prone to suffer from the alti- 

 tude of high buildings. There are certain types of nervous patients, for 

 instance, who cannot stand working at heights. If they are employed in 

 buildings, say 15 or 16 stories in height, the effect on such persons is that 

 they are going to be more or less afflicted with a wrecked nervous system 

 which will unfit them for other work. Another element that enters into 

 it is the question of the elevator. While I was studying this problem I took 

 the blood pressure of a number of people before ascending the elevator, 

 and at the top of the elevator I took their pulse rates. I was surprised to 

 find out that there was a marked increase in the pulse rate, and that their 

 blood pressure had risen. 



Now, dealing with the heart patients, those who have heart trouble, for 

 instance, that sudden transition in the change of the blood pressure and in 

 the pulse rate would be very injurious. Besides, if a person who is suf- 

 fering from neurasthenia, or a hysterical girl is employed on the twentieth 

 story of a high building, the constant trip, for instance, of twenty flights, 

 the elevator shock with a change of pulse rate and everything else would 

 be harmful to her. and in a great many instances, some of the nervous 

 disorders that girls in the upper stories are afflicted with, can be attributed 

 to the elevator trip. Then, of course, there comes the question of people 

 who necessarily cannot live in high buildings owing to respiratory diffi- 

 culties. That is also to be regarded. 



The rise of 150 feet in a 12-story apartment house would certainly 

 affect the individual living there. In fact, in Forsheimer's statement atten- 

 tion was called to the fact that neurasthenics ought not to be taken to 

 high altitudes unless they are very careful and under the study of physicians. 



We figure that the people in office buildings are all of a neurasthenic 

 variety. The effect of the altitude on such people aggravates their condition. 

 It is very hard to give any definite statement as to the number injuriously 

 affected. In later years there has been a marked increase in nervous dis- 

 orders and troubles. 



There is a type of patient who cannot stand height, and if they are 



