Congestion, or crowding, needs to be viewed from at least three angles as far as health is concerned, that is, room crowding, land crowding, and personal contact.

Room crowding is commonly expressed as a ratio of the number of square feet of floor area, or number of cubic feet of room volume, per person. Minimum limits are sometimes placed on one or both of these ratios for sleeping rooms, barracks, schools, factories, etc., based on the hygienic need for light, air, and ventilation - matters which have already been considered.

Land crowding, expressed as so many persons per acre, introduces two additional elements: The number of stories and the area of the building with reference to the size of the lot and the street width. One of the most important reasons for restricting the height and bulk of buildings by districts is to prevent overcrowding of corridors, elevators, streets, and sidewalks. These have to do more with questions of safety and accident than with normal health - questions not considered in this paper.

The third phase of congestion bears directly on the spread of disease. When people are brought into such close contact that opportunity exists for breaths to intermingle, as in crowded elevators and cars, or for the nasal spray of one person to pollute the air breathed by another, there is serious danger that disease germs may spread and that colds and respiratory diseases may become epidemic. It may be true, as medical bacteriologists claim, that crowd exposure tends to build up an acquired immunity against certain diseases so that to some extent nature protects itself, but the fact remains that, on the whole, crowding speeds up and increases the transmission of disease. It is a menace to health, morals, and safety.

No one has yet established a logical basis of street capacity, either for pedestrians or for vehicular traffic, or the relation which an adequate street capacity should bear to the size of abutting buildings. Most streets in American cities were laid out to accommodate slow-moving traffic and buildings of two, four, or six stories, or thereabouts. Increase in building height has led to serious street congestion in many places. Fragmentary data exist as to the number of square feet per person in buildings used for different purposes, the permissible capacity of elevators, the space occupied by moving pedestrians under different conditions, and the street space monopolized by vehicles of different character moving at different speeds. These data should be assembled and studied with a view to establishing, if possible, some reasonable relation between building size and street area. The writer's unsatisfactory attempt to do this (too meager to warrant publication) has convinced him that the fundamental data need first consideration.