to this we add nearly 98,000 relieved gratuitously at the City OutDoor Surgical and Medical Bureau, with an increase here of 5,000 over the previous year, we find that the total number of patients gratuitously treated in 1877 amounts to nearly 289,000, not counting the exceptions already referred to.

Taking the population on Manhattan Island at 1,050,000, it would seem that nearly thirty per cent of the inhabitants appear on the registers of the dispensaries. There is of course a fallacy here, arising from the word "patient" not being interpreted alike at the different dispensaries. This cause of vagueness will, it is hoped, soon be removed by the adoption of a uniform standard. But it is none the less startling to find so immense an increase in the number of applicants for medical relief. It would be safe to say that the assistance gratuitously given at the special and homoeopathic dispensaries would add 100,000 nominal patients to the number already stated.

LA considerable number of patients are undoubtedly attracted to New York from the adjacent country, that they may profit by the excellence of the medical and surgical service. But, on the other hand, the general dispensaries were originally established with definite geographical limits, and are desirous of strictly enforcing this rule for the future. All the medical charities are now alive to the gravity of the circumstances, and are considering the best method of confining their benefits to the really necessitous; but it is evident that without intercommunication and co-operation no permanent remedy for the existing abuses can be expected..

There are numerous societies which deal with out-door relief; all, however, have the same defect, that of working solely each in its own way, and through its own staff of workers, quite independently of all the others. One of the best known- the New-York Association for Improving the Condition of the Poor-has 20 local committees and 360 visitors, who, in the year ending March 31, 1878, relieved over 13,000 families, comprising some 44,000 persons, at an expense of $27,200.

St. Vincent de Paul's Society works through 34 conferences, and its visitors relieved 4,250 families during the same space of time, at an expense of $57,000. St. John's Guild, the German, and other national and benevolent societies, besides numerous smaller and special organizations, perhaps a hundred and fifty in all, are largely engaged in the direct visitation and relief of the poor; but the foregoing figures will suffice to give some idea of the

extent of their labors, and of the liberality with which charitable institutions are supported by the public.

(One society, however, deserves a word of special notice, from its admirable organization and method of work. "The United Hebrew Charities" have set an example which the other charitable associations of New York would do well to imitate. They undertake the entire relief of their own poor, so that, as regards the city and other charities, it is as though no poor Hebrews existed. They were, however, cared for last year at an expenditure of $43,000, disbursed under the following heads: General Donations, Transient Poor, Committee on Emigration, Board for Children, Medical and Sanitary Relief, Committee on Employment, Committee on Loans, and Committee on Supplies, including Fuel.

The Board represents the concentration of all the principal Jewish societies, and combines efficiency, economy, working power, and prompt and liberal attention to cases of distress, in a manner that no other charitable organization has equalled so far. Their previous experience had shown that mere money-giving was the worst palliative of actual want, and the surest encouragement of its continuance; and their records proved that every year the same persons, with few exceptions, were the recipients of their funds, each year only adding to the number on the list.

It may be useful to give some account here of a vigorous effort which was made in 1873-4 to stem the rising flood of pauperism, by co-operative action on the part of all the principal societies engaged in out-door relief. For lack of such action, not only were numbers of worthless and idle persons enabled to gain an easy livelihood by preying on the charitable resources of individuals and institutions (all working in the dark as regarded one another), but a parasitic growth was encouraged of hangers-on and promoters of so-called new charities, whose primary object was to provide comfortably for themselves. These last were much assisted in their unworthy efforts by the unwise and unsystematic distribution of the excise fund, already referred to; and, notwithstanding all the lavish expenditure for relief, cases of actual distress were often overlooked and left to suffer, while other families close by might receive help from four or five sources.

In view of these abuses, it was determined at a conference of the societies called to considér the possibility of a remedy, that a Bureau of Charities should be organized, to which monthly reports

of their work, and of all changes in their lists of beneficiaries, should be presented by the different societies. The main work of the Bureau was to be the creation of one complete and accurate register of all applicants for relief in the city of New York, their names, addresses, character, and the sources from which they were aided, — the detection by this means of impostors and rounders, and the restriction of the great stream of charity to its legitimate object of assisting without pauperizing the deserving poor. A system of registration by names and streets was adopted, which proved simple, economical, and effective; and it was so arranged that at a glance positive information could be obtained respecting any person on the register. Nearly fourteen thousand names were thus registered during the winter of 1873-4, all beneficiaries of the various societies being reported to the Bureau. Wherever cases appeared doubtful or suspicious, they were at once investigated by the visitors of the Bureau, and the numerous cases of fraud and imposture thus detected were entered for reference in a special "Black Book," with the object of putting a stop to their trade.

This plan was adopted for two years, and sufficient success attended the efforts, first of the Bureau of Charities, and afterwards of the Board of United Charities in which it was merged, to prove beyond a doubt that the system thus inaugurated would, if thoroughly carried out, check and reform most of the existing abuses connected with out-door relief. But for any thing like complete success, it is obvious that the continuous and hearty co-operation of at least a majority of the societies would be essential; and this was not obtained. Of the societies originally associated with the Bureau, some found it too much trouble to furnish the monthly report, others were unwilling to part with the names of their beneficiaries, and others again gradually lost their interest in the work. It was therefore, after two years' trial, practically discontinued, though the nominal organization of the Board of United Charities still exists, ready to act when the time shall come for its revival."

In the Elberfeld system of out-door relief the aid given is measured by a fixed scale, and varies according to the number in family, circumstances of health, earnings, &c. ; but in New York, where no such standard exists, the amount of relief given by each society is usually quite too small to suffice in cases of real distress; and deserving families may thus be driven by sheer necessity to seek help from many different sources. One instance occurred of a person who figured on the lists of nine societies at once, the total amount

of their benefactions being eight dollars per month. The injury thus caused to a family is often irreparable, its members becoming pauperized by the necessity of appealing to so many agencies, and by the constant inquisitions of fresh sets of visitors.

Charitable societies would surely better carry out their high mission of improving as well as relieving the poor by giving sufficient help to a small number, rather than by spreading their efforts over a large area. The number of persons relieved may not make so large a figure in the annual report, but the results will be far more satisfactory. It is the quality, not the quantity of work, which should be kept in view; a small number of deserving cases, thoroughly relieved, and taught to rely for the future upon their own exertions and not upon charity, would be far more profitable to the public, as well as to the societies, than a long roll of chronic beneficiaries relieved at the same expenditure. If there were such co-operation among the societies, that each should pass on the cases belonging to others, and relieve its own poor only, they would be better able to give liberal and effective aid.

Whenever the societies all agree in the adoption of these elementary principles of co-operation, whenever they see that want of organization is want of power, and that there is little difference between undirected and ill-directed charity, the work of registration will become really valuable; the worthy and necessitous will obtain what is needful; the unworthy, the dissolute, and the idlers will appeal in vain; and the public be satisfied that no case of real or apparent distress can exist uninvestigated, and, if genuine, unrelieved. But it can hardly be insisted upon too strongly, or repeated too often, that no system of registration, and intercommunication of the societies, can succeed unless these bodies are brought to see its real importance, and to combine in carrying it out. More elasticity in their separate lines of action, and greater readiness of adaptation on their part, would follow as a matter of course. CA register accessible to all visitors duly qualified, salaried of unsalaried; periodical inspection of the work reported by the several societies; systematic visitation of the poor in their homes, and the prompt report of fraudulent or unworthy cases, are all essential parts of any thorough charitable system, in order to insure economy and efficiency of administration

By co-operation the same number of visitors would be able to do far more work than at present, as they would not then be obliged to visit those already visited from other societies. The same

visitors would also be able to report for several societies at once; and, by a mutual interchange of good offices, the maximum of economy as well as efficiency in visiting would be obtained. It does not seem desirable to fix any limit to the number of families in charge of each visitor. The capacity and intelligence as well as the leisure of visitors varies so much that a wide margin should be left. It would be well if all visitors were furnished with printed cards, giving the addresses of the principal local charitable and medical relief agencies, as many persons in distress have been found utterly ignorant where to apply, or how to obtain any assist

ance.

The establishment of a central office, where all the societies, their executives and subscribers, could meet on neutral ground, would enable any person to ascertain the names and requirements of casual applicants directed to apply there; while, on the other hand, information would be given to applicants at the office, directing them to their proper agencies of relief. Such an office should be placed in a convenient and well-known locality, easily accessible from all parts of the town. All cases of alleged or apparent distress should be sent there for investigation; while the power vested in the office of relieving immediate suffering should be commensurate with the confidence felt by the public that such aid would be impartially and wisely given. 7

The foregoing remarks will be sufficient to explain the general working of charitable matters in New York. It would be easy to emphasize them by an abundance of figures, but such figures have a tendency to deceive any one searching for accurate statistical information. There is so little uniformity of method among the societies, that while with some the number of families or individuals relieved represents that number of separate cases, with others the same cases will be repeated as if they were fresh ones over and over again. It will only be after concerted action and community of interests have been forced upon those now engaged in carrying on the benevolent work of New York, that we shall be able to understand the statistics annually furnished by them.

It may be supposed from what has been said, that the administration of out-door relief is especially faulty in New York; but this is not the case, nor is it without good hope of remedy. The conditions of the city, topographically, economically, and politically, have much to do with the existing difficulties. The city itself covers Manhattan Island, with an area of more than 12,500