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of the city and assessed for $10,000.

3. Feeling of Property Owners

One man owning eighty acres across the road from the hos-
pital thought that it made no difference whatever. However,
a man owning twelve acress across the road in another direction
claims that the hospital injures his property and strongly dis-
approves of its location. The owner of a small plot about one-
quarter of a mile from the hospital stated that a prospective
buyer objected to the hospital on the grounds that it would be
a danger to her child. He further stated, however, that he knew
there was no danger and had no complaint to make, but was in
entire sympathy with the hospital. The head of one improve-
ment company with large tracts one-quarter of a mile from the
hospital said that he was sure it made no difference whatever.
The other property owners interviewed agreed that the hospital
is no detriment.

4. Feeling of General Public

One county official was of the opinion that the hospital af-
fected immediately adjoining property to some extent. Other
opinions obtained were favorable.

* See Appendix, page 56, for detailed figures.

26




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IV. HOSPITAL NEAR VILLAGE OF 300

Montefiore Home Country Sanatorium, Bedford
Station, New York.

This Jewish charitable hospital of 170 capacity primarily
for incipient cases, is located upon a hill overlooking a village
of 300 population. The institution is one-half mile from the
railroad station and some thirty miles from New York City,
from which practically all of its patients come. The village
lies on one side of the sanatorium, while on the other three sides
the land, which is of rough, hilly formation, is occupied by a
few country homes and a number of somewhat unproductive
farms. The buildings of the institution are located in full view
of the highway.

1. Assessed Valuation

Since 1903, the adjoining and nearby property has increased
in assessed valuation at a rate normal for its type. It will be
noted that the assessment figures* do not date from the opening
of the hospital, 1897, but from a period several years later. The
rise in assessed valuation does not seem to have kept pace with
the increase in estimated value of the property or with the in-
crease as indicated by sales.

2. Actual Sales

While a large amount of surrounding property belongs to
old estates and is not for sale, land which has been sold has
brought an increase over the purchase price, and in some in-
stances a marked increase.

One plot of seventy-six acres adjoining the hospital was
purchased for $12,500 after the hospital was erected and sold
shortly afterward for $22,000. Three parcels of nearby prop-
erty which was purchased ten years ago for $18,000 were sold
recently for $73,000. Three parcels remain. Mr. X claims
that his eighty-five acres of adjoining property bought about
thirty years ago for $10,000 is now worth $40,000.

Mr. C values at $18,000 eighty acres of adjoining property
for which he paid $9,000. One owner values at $70,000 one
hundred and forty acres of adjoining land for which he paid



* See Appendix, page 57, for detailed figures.

27



$35,000. Another owner questions if he would now take $400
an acre for seventy acres of adjoining property for which he paid
about $75 an acre a few years ago.

The property of a real estate development company one-half
mile from the hospital which cost $16,000 ten years ago is now
valued at about $60,000.

3. Feeling of Property Owners

While property owners were somewhat divided in their
opinions as to the effect of the hospital upon the surrounding
property, the majority were firm in believing that it has no mat-
erial effect. For example, one owner of adjoining property
believes the hospital has an undesirable effect and says he is
anxious to sell; another expressed the wish that it be removed
from the locality; while the owner of 130 acres adjoining held
that the hospital had very little if any effect; and another said
it had none at all.

4. Feeling of General Public

The attitude of the villagers is friendly with a few exceptions
in which the feeling of opposition is in no sense bitter or strong.
The type of friends of the patients, who visit patients at the
hospital, and their actions in the village, were the chief target
for such criticisms and objections as were offered by both prop-
erty owners and villagers. This is a situation which would
probably not be duplicated in any other part of the country,
owing to the fact that the sanatorium population is largely
Jewish, from congested portions of New York, and the visitors
are of a similar descent.

V. HOSPITAL LOCATED IN FARMING DISTRICT

Gaylord Farm Sanatorium, Wallingford, Conn.

This semi-charitable institution strictly for incipient cases, is
located in the country about two and one-half miles from a
village of 8,000 inhabitants and a few miles from New Haven.
Patients are charged a nominal rate and the deficit is made up
by private subscriptions and state subsidy. The buildings are
one-eighth of a mile back from the road and in full view from it.
Possible future complaints are eliminated by the fact that the

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hospital owns the property across the highway. Small farms
and wooded land comprise the adjoining and nearby property.

1. Assessed Valuation *

The largest part of the surrounding property shows an in-
crease in assessed valuation from 1903, the year before the insti-
tution was opened, to 1913. The unchanged assessment of a
few parcels of land is not unusual for this type of property, which
increases in value slowly and at infrequent intervals.

2. Actual Sales

Little of the property in the neighborhood has changed
hands in the past few years with the exception of that bought
up at times by the hospital.

An adjoining farm which cost $25 an acre the year before the
hospital opened brought $50 an acre six years later. Sixty
acres of nearby property assessed for $1,797 was sold for $2,900
two years ago. Recently a property within a mile of the hos-
pital assessed at $7,788 was sold for $9,000.

3. Feeling of Property Owners

The property owners interviewed did not feel that the hospital
had a detrimental effect upon their property nor did they feel
that it was undesirable.

4. Feeling of General Public

It is worthy of note that the feeling in the village seemed
to be entirely friendly. The institution was frequently re-
ferred to witn some pride. This friendly feeling may be due
in some degree to the fact that the hospital, partly with its own
money, has made improvements in nearby highways. The insti-
tution doubtless helps also to relieve the loneliness of the district.



* See Appendix, page 58 for detailed figures.



29



CHAPTER IV



Typical Laws and Ordinances Covering

the Approval and Restriction of

Hospital Sites

The rapid increase in the number of hospitals and sanatoria,
particularly in New York and New Jersey, combined with a
constant succession of local conflicts over the location of such
institutions has led several states and a number of cities to enact
legislation bearing on this problem. The laws of New York
and New Jersey are the most comprehensive and suggestive
ones on this subject, and on this account are given in full.* As
most of the restrictive ordinances are similar in general form
only one of them is given in full.

New York

The New York State law covering the approval of sites for
tuberculosis hospitals was enacted in 1909, after a vain attempt
had been made to secure a site for a sanatorium on Long Island
under then existing legislation. As a result of this law, this
sanatorium and many others have been established without
recourse to the somewhat burdensome machinery of the courts.
The law provides: (1) that the State Commissioner of Health
and the health officer of the locality in which it is proposed to
locate the institution shall sit as judges at a previously advertised
public hearing on the question and render a decision within
thirty days; and (2) that if they are unable to agree, an appeal
may be made to a committee comprised of the State Commis-
sioner of Health, the Lieutenant Governor and the Speaker of
the Assembly, who constitute a final court for the decision of
matters pertaining to the location of tuberculosis hospitals and
sanatoria.

The text of the law, which is Section 319 of Chapter 49 of
the Consolidated Laws of 1909, follows:



* Rhode Island also has a special law passed in 1909, dealing with this problem.

30



Section 319. Consents requisite to the establishments of hospitals or
camps for the treatment of pulmonary tuberculosis. — A hospital, camp or
other establishment for the treatment of patients suffering from the disease
known as pulmonary tuberculosis, shall not be established in any town by
any person, association, corporation or municipality except when authorized
as provided by this section. The person, association, corporation or munici-
pality proposing to establish such a hospital, camp or other establishment
shall file with the state commissioner of health a petition describing the
character thereof, stating the county and town in which it is to be located
and describing the site in such town for such proposed hospital, camp or
other establishment, and requesting the commissioner to fix a date and place
for a hearing on such petition before the state commissioner of health and
the local health officer, who shall constitute a board to approve or disapprove
the establishment of such hospital, camp or other establishment in accordance
with such petition. The state commissioner of health shall fix a date and
place for a hearing on such petition, which date shall be not less than thirty
nor more than forty days after the receipt thereof. A notice of such hearing
specifying the date and place thereof and briefly describing the proposed
site for such hospital, camp or other establishment shall be mailed to the
person, association, corporation or municipality proposing to establish the
same and to the health officer and each member of the board of health of
the town in which it is proposed to establish such hospital, camp or other
establishment at least twenty days before the hearing, and also publish twice
in a local newspaper of the town, or if there is no such paper published there,
then in the newspapers of the county designated in pursuance of law to
publish the session laws. At the time and place fixed for such hearing the
state commissioner of health and the local health officer shall hear the peti-
tioner and any person who desires to be heard in reference to the location of
such hospital, camp or other establishment, and they shall within thirty
days after the hearing, if they are able to agree, approve or disapprove of
the location thereof and shall notify the person, association, corporation or
municipality of their determination. The determination of the state com-
missioner of health and local health officer shall be final and conclusive;
but if within thirty days after the hearing they are unable to agree, they
shall within such thirty days notify the person, association, corporation or
municipality, proposing to establish such hospital, camp or other estab-
lishment that they are unable to agree. Within ten days after the receipt
of such notice, such person, association, corporation or municipality may
file in the office of the state commissioner of health a request that the petition
be referred to a board consisting of the lieutenant-governor, the speaker of
the assembly and the state commissioner of health. Such officers shall ap-
prove or disapprove of the proposed location of such hospital, camp or other
establishment after a hearing of which notice shall be mailed to the person,
association, corporation or municipality proposing to establish the same and
to the health officer and to each member of the board of health of the town,
or without a hearing, upon the evidence, papers and documents filed with the
state commissioner of health or that may be submitted to them, as the board
shall determine. They shall make their determination within thirty days
after the request for such submission has been filed in the office of the state
commissioner of health and cause a copy thereof to be mailed to the person,
association, corporation or municipality proposing to establish such hospital,
camp or other establishment and to the health officer of the town in which
it is proposed to establish the same. Such determination shall be final and
conclusive.



New Jersey

The New Jersey law is significant in that it provides for a
somewhat simpler procedure. The State Board of Health is

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the only and final court for the decision of questions relating
to tuberculosis institutions. The text of the law, which is
contained in Chapter 88 of the laws of 1910, follows:

1. Hereafter no person or persons, corporation or association shall locate,
construct or establish in any city, town, borough, township or other muni-
cipality of this State any hospital, sanatorium, preventorium or other insti-
tution to be used for the care, board or treatment of any person or persons
afflicted with the disease known as pulmonary tuberculosis, without first
obtaining the consent and approval of the State Board of Health so to do.

2. All applications under this act shall be made to the State Board of
Health in writing, signed by the applicant, shall give the name of the city,
town, borough, township or other municipality in which it is proposed to
locate the same, and shall be accompanied with a descriptive map of the
premises proposed to be devoted to the uses authorized by this act.

3. The State Board of Health shall fix a time and place for the hearing
on such application, of which hearing the applicant shall give at least two
weeks' notice in some newspaper published and circulating in the munici-
pality named in the application, and if none be published therein, then by
posting in such municipality at least ten notices for fifteen days before such
hearing, giving notice of such application.

4. At the time and place so fixed for said hearing the State Board of
Health shall hear all parties, both for and against said application, and said
board shall thereupon either grant or withhold the consent and approval
asked for.

5. After the passage of this act the State Board of Health shall have the
sole authority to grant or refuse the consent and approval to the erection,
construction, and establishing of any and all hospitals, sanatoria, preven-
toria, or other institutions designed for the care, board or treatment of any
person or persons afflicted with the disease known as pulmonary tuberculosis.

6. After the passage of this act no consent shall be required from any
officer or board of the State of New Jersey or any of the municipalities there-
of, except the State Board of Health as aforesaid, to the erection, construc-
tion or establishment of any of the institutions aforesaid, or to the bringing
of persons to such institutions from points within or without the State.

7. This act shall not be construed to require any of the institutions afore-
said which may have been used prior to the passage of this act during the
summer only to obtain any consent or approval for reopening said institu-
tions from year to year as heretofore.

Restrictive Ordinances

In July, 1911, the City Trustees of South Pasadena, California,
passed an ordinance forbidding the establishment within the
city of any sanatorium, asylum or retreat where consumptives
are received or treated under penalty of $300 and three months
in jail. The ordinance is typical of similar attempts to restrict
the establishment of hospitals and sanatoria by local regulation.
Whenever these ordinances have been tested in court, as in
Richmond, Virginia, and Redlands, California, they have been
held to be unconstitutional. The text of a typical ordinance
adopted in Redlands, California, in 1910, and later declared
null and void by the courts, is given in full:*

* See page 43.

32



Section I. Every hospital, sanitarium, pest house, asylum or other
place maintained or conducted for the purpose of caring for or treating per-
sons afflicted with any contagious or infectious disease, for or without reward
or charge, located within four hundred (400) feet of the dwelling of another
person, or within two thousand six hundred forty (2640) feet of a school
house or within thirteen hundred twenty (1320) feet of a flowing stream of
water, water ditch or open water conduit from which water for domestic pur-
poses is taken, is hereby declared to be a menace to the public health and
safety, and a public nuisance, and shall be abated by civil action brought
in the proper court.

Section II. Provides that violation of the foregoing is a misdemeanor,
punishable by a fine of not more than $500, or imprisonment in the county
jail not exceeding six months, or by both such fine and imprisonment.



33



CHAPTER V



Some Opinions of Value

Opposition to the location of hospitals and sanatoria at various
times has called forth published opinions from a number of emi-
nent men in different parts of the country. The few quotations
chosen have been selected primarily because they accurately sum
up the situation. Letters from five of the largest life insurance
companies in the country expressing their attitude on the ques-
tion of the danger of infection spreading from a hospital, and the
opinions of health officers who have been asked to decide ques-
tions of location of sanatoria are also included in this chapter.

Dr. E. L. Trudeau

The selection of a site for the Onondaga County (N. Y.)
Tuberculosis Hospital raised opposition which was overcome
with difficulty. In connection with this controversy the
Syracuse, N. Y., Journal, on March 1, 1913, published a letter
from Dr. Edward L. Trudeau, the pioneer of the open air treat-
ment of tuberculosis in America, and the founder of the first
tuberculosis sanatorium in America, in which he said in part :

" When I bought the first land on which the Adirondack Cottage Sani-
tarium is built (in 1885) I paid $25 an acre for it, because it was a small
piece and a selected site, but the price was then thought absurdly high.
Every time I have purchased more land the price has risen steadily and my
last purchase of five acres cost me $5,000. Meanwhile the village of Saranac
Lake, whose limits were nearly a mile away from the sanatorium, has steadily
crept up toward the institution, until now private residences are built at its
very gates and rent and sell for prices which are far in excess of similar prop-
erties in small ;owns elsewhere. Of course we doctors know that the idea
of a sanatorium's being any danger to the community in which it is located
is simply absurd and that, on the contrary, the education which comes from
in its walls, is an immense protection to the neighborhood. Tuberculosis
is a communicable disease under certain conditions, but it is not at all like
any of the highly infectious diseases, such as smallpox, measles, etc. It
is a disease where any danger of infection is within doors, and even this,
with the simplest precautions, can be obviated. To my knowledge there
has never been an employee who came to the Adirondack Cottage Sana-
torium in sound health who developed tuberculosis while there; and a sana-

34



torium can no more endanger the health of the neighborhood in which it
is built, even if the residences are at its very gates, than it could if it were
placed on top of a high mountain, miles away from habitation."

Hamilton W. Mabie

In reply to those opposing the location of a tuberculosis
hospital at Summit, New Jersey, several years ago, Hamilton
W. Mabie, the well-known journalist, wrote a long letter published
in the Summit Herald, November 27, 1909, taking up the
question from a slightly different angle. One of the principal
objections to the hospital was that it would advertise the fact
that there is an undue amount of tuberculosis in Summit, and
would thus injure property. Quoting from his letter :

" Not only is a sanitarium for tubercular patients a distinct aid to the
healthfulness of a community, but it is also a distinct addition to property
values. This will probably strike many people as an unwarranted state-
ment, but the trouble with this matter is that antiquated ideas and unfounded
impressions still prevail among those who have not made some study of the sub-
ject. It is a matter of history that communities in which sanitariums are
established have experienced a rise in values in consequence. If this matter
were thoroughly discussed, I am sure that both the Board of Trade and the
town would take a very different attitude toward the possibility of introduc-
ing a sanitarium here. It would be as logical to hold that the Overlook
Hospital (a general hospital) is an injury to the town because it advertises
the fact that there are accidents and sickness here, as to hold that a sani-
tarium for tubercular patients would advertise the fact that there is danger
of tubercular trouble here. As a matter of fact, the presence of such a sani-
tarium would advertise the extreme healthfulness of this locality. That
has always been the special claim of Summit on people looking for homes,
and the more widely the impression can go abroad the greater will be its
prosperity.

" This question ought not to be left without a word about its higher as-
pects. Summit cannot afford to settle such a question as this on business
grounds alone. There are other things in life besides real estate, and a com-
munity cannot have a better asset than the reputation for large-hearted
generosity and courage. Everyone respects a community which, when an
infectious disease breaks out, does not conceal the fact, but pursues a policy
of complete publicity. Courage is always the best policy, and so is generosity.
No one can forget the contempt and indignation which was aroused by the
refusal of a few settlers on Fire Island to allow women and children who
had come from Europe on a steamer in which there was two or three cases
of cholera to land and take temporary shelter, but sent them back to an
excursion boat lying in the open sea, with the possibility of bad weather."

Dr. E. M. Mason

During 1911, objection to the location of the Red Mountain

Tuberculosis Camp at Birmingham, Ala., called forth an open

letter from Dr. E. M. Mason of that city. Some of his well

stated comments accurately sum up the situation:

" Patients are taught the nature of the disease which they have to combat,
and soon learn the precautions that must be observed to prevent reinfection
of themselves as well as transmission of the disease. Tuberculosis cannot

35



arise it novo, nor can one contract it as one would contract, for instance,
smallpox, by mere proximity to a patient. One can only acquire the tuber-
culosis germ from the excreta of a patient, chiefly sputum. If these be de-
stroyed, there can be no tuberculosis. It is axiomatic that if every tubercle
bacillus could be killed there would never be another case of consumption.

"At the camp we are enabling patients to throw off the infection already
existing and are destroying all infected matter from each patient. Therefore,
no tuberculosis can be disseminated from the camp nor from any other prop-
erly regulated institution for its treatment. So true is this, that no well-
informed person would deny that the citizens would be in less danger of
contracting this disease if our camp occupied the most central business block
pf the city than they are as the conditions now exist in this and every other
city. Every properly isolated case of tuberculosis ceases to be a menace to
the community, while every recognized, uncontrolled, infected individual
casts off daily in his excreta millions of tuberculous germs.

" Every broad-minded humanitarian movement in the history of the
world has been opposed by ignorance and prejudice; the effect to control
tuberculosis can hope for no exemption; but our cause is good, our work
is based on a scientific study of the disease, and the results obtained speak
::: the—selves.



California Association

Opposition to the location of a tuberculosis hospital in Men-
tone, California, within a certain distance of residences, a
school-house, and other buildings, elicited the following well
stated resolutions from the California Association for the Stud} 7
and Prevention of Tuberculosis:

" Resolved, That it is the sense of the members of the Executive Board


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Online LibraryNational Association for the Study and PreventionThe effect of tuberculosis institutions on the value and desirability of surrounding property → online text (page 3 of 5)