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Related post: properties which act as a specific on certain diseases is neither
borne out by scientific investigation nor unbiased experience.
In the selection of a place of residence, climate should be con-
sidered only in its eflfect upon comfort and congenial surround-
ings and with a view to a constant outdoor life. Pure air, which
can be found almost any place outside of great cities, and the
maximum amount of sunshine are the two essentials.
That the temperature is not important is shown by the excellent
results obtained by a residence in the Adirondacks, where the cold
of winter is frequently intense. That a dry atmosphere is not
essential is evident from the equally good results obtained in the
arid climate of our western resorts and the humid atmosphere of
the Southern States. That rarefaction is not a requisite is shown
by the cures eflfected both at sea level and at high altitudes. With
Sanatoria. 105
complete relief from care and anxiety-, gocxi food, pleasant Generic Rythmol occupa-
tion, and a constant outdoor life, one may fight a winning battle
against disease in almost any climate, whether it be in the arid,
rarefied atmosphere of Colorado or New Mexico, the soft and
genial warmth of Florida, or the more rigorous climate of the
New England States.
By Mr. Cecil C. Brewer.
Existing sanatoria as to their plans may roughly be divided
into two classes : Firstly, those built on a concentrated plan ; and,
secondly, those on the cottage or block system — that is to say, they
vary from the large hotel-like buildings, such as Falkenstein and
Hohenhonnef, in Germany, both having five floors, to Nordrach
and the American cottage sanatoria, with quite small blocks,
having two floors at most. In comparing the two systems, it must
be remembered that Nordrach, perhaps the most successful of all
these sanatoria, is on the cottage plan, and there can be no doubt
that, from a purely medical point of view, this plan is best ; but
the disadvantages in working are many and obvious, both as re-
gards convenience and economy.
The medical requirements are extremely simple. Every part
of the building must be :
( 1 ) Well ventilated.
(2) Free from dust and easily cleansed.
(3) Patients' rooms, in addition to abundant fresh air, must
have as much sunlight as possible, and must be protected from
cold winds.
(4) The building must be as sound proof as practicable.
The perfect sanatorium, therefore, will be the one that fulfils
these requirements, and at the same time is convenient of manage-
ment and supervision, provides reasonable comfort for patients in
all weathers, and has not too much the appearance of a hospital
or barrack, but which must not, on the other hand, degenerate into
the hotel or hydropathic establishment.
*Pap€r read at a meeting of the Architectural Association. From "The
Sorreyor/' December 5, 1902.
io6 Sanatoria.
At Nordrach, which is rightly called a colony, the various build-
ings are scattered throughout the village at some considerable
distance apart ; some of them have been especially built, but others,
such as the administration and staff offices and some patients'
blocks, are merely old buildings converted, and I think it is gen-
erally admitted that the success of this sanatorium has been clue to
management, strict regime, and the personal magnetism and en-
thusiasm of Dr. Walther, the founder, rather than to its buildings
or site.
Nevertheless, some recent sanatoria in this country have been
built closely following the Nordrach plan. One lately built, which
I have seen, has its dining-room, kitchen and staff offices on
one. side of a little valley, and the patients' rooms on the other,
at least 200 yards away, and with no other means of communica-
tion between them than an uncovered and unsheltered path. Now,
considering that in any sanatorium a certain proportion of the
patients must be confined to bed, and must at the same time be
provided with substantial and appetizing meals, such a plan is
surely absurd, and I can see no reason why, because a sanatorium
in the Black Forest has succeeded, in spite of such an arrangement,
that we should handicap ourselves with it in England — and the
cottage system seems unsuitable to our climate — but would rather
suggest the large building spread over as much ground as possible,,
and so arranged that the parts may be easily isolated.
I propose now to show you the plans of some sanatoria built in
Germany and elsewhere on the concentrated plan, discussing them
as they are upon the screen.
Falkenstein. — I have placed this first, as it was one of the earli-
est, and now is, perhaps, the best-known German sanatorium, hav-
ing been much advertised lately through the visit of our King, and
it happens to be one which I have myself seen. This building,,
which was erected in 1876, accommodates 112 paying patients on
five floors, of which I have only been able to obtain the main or
ground-floor plan. There is a basement below this occupied by
very large stores, bath-rooms and offices, with a veranda in front,
and above are three floors of patients' rooms. The layout is
ingenious, but it is doubtful whether the central recess on the
plan is an advantage, for the rooms in the centre are somewhat
deprived of sun.
The building generally is too much of the hotel type, and the
number of sitting-rooms is altogether excessive and harmful ; they
Sanatoria. 107
are difficult to supervise, and are a temptation to patients to spend
too much time indoors; it being now generally admitted that
patients when indoors should be as much as possible in their own
rooms, which can be thoroughly ventilated, and where talking
and forbidden amusements are not indulged in. There are also
too many mouldings, decorations, curtains and other dust-traps
about the building. The water-closets are not detached from the
main building, and the ordinary baths are poor, except for the
douche, etc., which are much used, and which are situated in the
basement under the staff-rooms, and here the bathing is done
under medical supervision and the taps are placed outside the
rooms. The dining-room, the one really important sitting-room
in a sanatorium, though a fine room, is not well placed, having
only north Purchase Rythmol and east aspect. The patients' rooms are 13 ft. to 14 ft.
high, which is quite unnecessary and even inconvenient, 8 ft. 6 in.
to 9 ft. having been found in practice to be quite an efficient and
convenient height. But Buy Rythmol to take the chief objection to this plan last,
the patients' rooms are placed on both sides of corridors, and it
has become an axiom that patients' rooms should only be placed
on one (and that, of course, the south) side of a corridor; in
other words, that your patients' block must only be one room thick.
Tliis has been realized in Germany now as well as in England, as Cheap Rythmol
you will see in the plans of more recent German buildings which
I shall show immediately.
Let me first show Hohenhonnef. This closely resembles the
Falkenstein plan, but is, I think, an improvement on it, as it
should be, having been built sixteen years later. The wings here
are shorter, so that the centre is not so shut off from the sun. The
dining-room with east and west aspects and the complete blow
through is better ; and on the upper or patients' floor the central
portion is only one room thick, and the water-closets are partially
isolated. But we get the same excessive number of sitting-rooms
and the same number of stories. In both these sanatoria, which
are for paying patients, there are bedrooms for visitors and
friends of patients, and these, together with the number of re-
ception-rooms, lead one to suppose that the life more nearly ap-
proaches to that in a large hotel than would be allowed at Nord-
rach, and certainly the general aspect of Falkenstein, when I saw
it three years ago, was very different to that of the newer and
stricter English sanatoria.
Ruppertshain, — This sanatorium for the poorer classes, built
about six miles from Falkenstein in 1895, is, as regards

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