that of others by the city of Halifax, or by the townships in which they have legal settlements. The benevolent institutions, in addition to the foregoing, which receive aid from the provincial funds (although not under Government control), are: The Asylum for the Blind, the Institution for the Deaf and Dumb, the Infants' Home, and the Industrial School for Boys; all of which are situated in the city of Halifax. There is no distinction of classes in reference to the admission of parties to any of the foregoing institutions. No legislation has occurred in relation to any of the humane establishments of the Province, during the past year. The inhabitants of every township in the Province, where necessary, are required by law to hold two meetings annually, to make provision for the support of the poor in their respective townships, by voting that a sufficient sum be assessed for their maintenance; which sum is expended in that service by the overseers of the poor, who are appointed for that purpose by the county authorities. The principal correctional and reformatory institutions situated in the Province of Nova Scotia, are under the management of the Government of Canada. The Reports from States and Provinces occupied the whole morning session and part of the afternoon and evening of June 30. During the day and on the following day many invitations were received from the Charitable Institutions and Societies in Cleveland and its vicinity, which were accepted, with the understanding that the Conference should visit them individually and not in a body. In the evening a short communication was read from Mr. C. D. Randall, of Michigan, on the French "General Society of Prisons," of which he is a member. The only Paper presented by the Committee on Medical Charities was the following, which was read by Dr. Corbus, of Illinois, chairman of that Committee: THE MEDICAL CHARITIES OF COOK COUNTY, ILLINOIS. BY ROSWELL PARK, A. M., M. D., DEMONSTRATOR OF ANATOMY IN THE CHICAGO (Read June 29, 1880.) Cook County, with Chicago its principal feature, of course, does not lack its quota of purely or quasi charitable institutions. With those which do not come under the above head this paper has nothing to do. Of those properly included the following is a complete list, with a very brief account of their condition, accommodations, means of support, and any matter of special interest: * *The writer acknowledges his indebtedness to the Illinois State Medical Register for more or less of the information concerning these institutions. The United States Government maintains here the Marine Hospital. It has now a large and elegant structure on the lake shore, two miles north of the city limits, capable of accommodating 300 patients. As means were not lacking during its erection it has all the conveniences and appliances which experience could suggest. It is under the surgical supervision of the local officer of the Marine Hospital service, for which each officer and seaman of the United States commercial marine is taxed ten cents a week. The State of Illinois maintains here the Illinois Charitable Eye and Ear Infirmary. This is open to the indigent of the State, and is under the control of trustees appointed by the Governor. It was organized as a private charity in 1858, and received by the State in 1871. The average number of house patients is about eighty-, five. A large dispensary service is connected with the institution. Clinical instruction is made a feature. As a whole it is, perhaps, the most completely appointed affair of its kind in the country. Cook County maintains the following: Cook County Hospital, under the control of the Board of County Commissioners; organized in 1865. Intended for the indigent sick of the county only, there being no city hospital, this takes the place of it. Patients, except in urgent cases, must be referred there by the county agent. Infectious and contagious diseases are not admitted, according to the rules; practically, however, it is impossible to keep cases of venereal disease out of the wards. The present buildings are as commodious and elegant as those of any purely charitable hospital in the country, and, including the ten acres of land, have cost about half a million of dollars. But not more than 250 patients can as yet be accommodated in all this vast structure. The whole was built with little regard to outlay, though its general design is admirable. Over 2,000 patients were treated in its wards last year. But the curse of this-as of all similarly managed institutions — is the dominance of the political element in every feature of its control. The warden has never been selected because of any experience or training that would qualify him for the position. In fact, the predecessor of the present incumbent had been a puddler in the rolling mills, and his position was the reward of services to his "party." During his administration the hospital had the reputation of being the "best built and poorest managed hospital in the country." Every one knows the average ability and intelligence (?) of the ordinary county commissioner, and when the interests of a medical institution are watched over by a board composed of such as these, but little can be looked for; and when nurses and employés secure their positions through ties of consanguinity or political adherence to those in power, still less can be expected. I am happy to be able to state that the present condition of the hospital is an improvement upon what it used to be; the “reform element" (whatever that may be) now predomi nating in the county board. Nevertheless, the system is utterly at fault, and always liable to gross abuse. The medical board is composed of thirteen gentlemen, and contains some of our best talent. Three of these are recommended to the county board by each of the faculties of our two leading regular colleges; the seven others secure their places by influence. Despite their profession, some of this board cannot be absolved from the charge of disgraceful wire-pulling in order to gain or maintain their positions. As now conducted the hospital is a needed and worthy, though somewhat extravagant, charity, and probably few not really entitled to relief are found in its wards. Clinical instruction is given in a large and elegant amphitheatre. Cook County Insane Asylum, for the insane poor of the County, is under the same control and subject to precisely the same abuses as the County Hospital. The number of inmates at present is over 400, for whom the county furnishes but two physicians, whose tenure of office depends upon the influence they bring to bear. Closely connected with the asylum is the County Poorhouse, where are necessarily kept a large number of chronic invalids and incurables which no general hospital can afford to keep. They here receive their sustenance with little or no medical attention, save such as the asylum physicians can give. At one time the poorhouse contained between 800 and 900 inmates. The city of Chicago maintains but one medical charity, one that is necessitated by circumstances, the City Small-Pox Hospital. It is situated on the western outskirts of the city, and is used only as a pest-house. It is under the medical charge of the city physician, and is supported by appropriation. Patients are sent to it on the order of the health department. Being a public institution, it is under the baleful influence of politics, its resident manager owing his position to his political, rather than to his mental abilities. Fortnately, our city is usually so free from severe contagious disease that this hospital is often vacant for weeks at a time. Coming now to corporate private charities, we have a number to mention : Alexian Brothers Hospital, founded in 1866. Has now a wellfurnished and commodious building containing some sixty rooms. In case of necessity as many as 200 patients can be accommodated. Intended for male patients and non-contagious diseases only. Under the control and conduct of the Alexian Order, whose chief officer in this country resides here. The means for its support are chiefly raised among the Catholic community. Those able to pay are charged $7.00 to $15.00 per week. The patronage of the hospital is confined, naturally, almost among the Catholics. A few purely charity patients are received, but the majority pay as above. Chicago Hospital for Women and Children. Open to lying-in patients, and non-contagious cases among women and children. Has room for 35 patients. Those able to pay are charged $5 a week. Has a dispensary attached. It is under the management of a board of councillors (ladies) elected by the trustees. It is supported by donations and subscriptions. Floating Hospital. The ideas which developed into the organization of this charity were first put into effect in 1875. The intention was to give the purest possible air to the sick children of the poor during the pleasant days of the summer, when summer complaints and kindred diseases were so rife. Subscriptions were raised by individual effort, a barge secured, a tug chartered to tow it out into the lake basin, and thus the experiment began. Some regular physician was found to volunteer his services each day, and the simplest of nourishment, in the shape of crackers and milk, was furnished in abundance. It proved a success from the start, and was a boon to the little invalids, while each succeeding year the charity developed. Finally, two years ago, one of the piers off Lincoln Park was fitted up with railings and awnings and other conveniences, the floating hospital thus transformed into a stationary one, while the pure and invigorating lake breeze and the edibles were furnished as abundantly as before. The money spent in this way has been as judiciously expended as was possible, and has conferred more benefit, and to a larger number, than the same amount used in any other way could have done. It is conducted by the "Floating Hospital Association," and was started purely as a private charity by a few philanthropic individuals who determined that their beneficence should not be misdirected. Hahneman Hospital. This hospital, in connection with the homœopathic school of the same name, has been open for some years. It is capable of accommodating 75 patients. Its staff is selected from the faculty of the adjoining school. Most of its inmates pay for their accommodations not less than $7 per week. It was assisted, some years ago, by the Relief and Aid Society, as most of the other hospitals of the city were. Mercy Hospital. Founded in 1850. Was the result of very small beginnings and of individual enterprise. As it grew to larger proportions, it was placed under the control of the Sisters of Mercy. It now accommodates about 100 patients, besides affording shelter to a number of the aged and infirm. Charity patients are admitted, but most of the patients pay $7 to $18 a week. Its patronage depends very largely upon the personal reputation of members of its medical staff, which is selected entirely from the faculty of the Chicago Medical College. The expenses are met by the revenues from the various institutions under the charge of the Sisters of Mercy. St. Joseph's Hospital; under the control of the Sisters of Charity. All classes of cases received except those of a contagious character. The charges vary from $6 to $15 per week. A few charity patients are received. A feature of the institution is that patients occupying first-class rooms can employ any physician they choose. By the rules of the order, no resident physician is allowed. About 100 patients can be accommodated. St. Luke's Hospital; established in 1863. Under the control of the Episcopal denomination, but open to all except contagious cases. A purely charitable institution, though it supplies a few rooms to paying boarders. Supported by contribution and by income from a small endowment. Accommodation for about 50 patients. Its medical staff is selected by the trustees. Woman's Hospital of Illinois; chartered in 1871. Was started as a private and more or less speculative enterprise, but is now under the management of a board, who select their medical staff. Its title is misleading, if it conveys any idea that the State has anything to do with it. It is devoted to diseases peculiar to women, and has a capacity for about 20 patients. Most of the patients pay from $7 to $15 per week. Appeals to the charitably disposed are made for means to defray necessary expenses. The Washingtonian Home was established in 1867, and is devoted to the reformation and care of the inebriate. Open only to males. It has received generous donations in the past, and at present derives a goodly income from its pay patients, and from sums set apart from the license fund of the city by action of the common council. A few are received out of pure charity, but the majority pay a price according to their accommodations. The home is accomplishing a good work among an unfortunate class. A similar home for women is now contemplated. Besides these institutions, which are all of the nature of hospitals, Chicago has several "nurseries" and orphan asylums, a Foundlings' Home, a Home for the Friendless, an Old Women's Home, an Erring Women's Refuge, etc., with medical officers attached to each of them, who often prove to be very necessary adjuncts. There is also in contemplation, with excellent prospect of success, a house for incurables, which will be a great boon to many who are barred out of the general hospitals by virtue of the intractable nature of their maladies. The Chicago Relief and Aid Society was founded in 1857, to assist in distributing the private charities of the city. After the great fire of 1871, the Society was entrusted with the funds which poured in so generously from all quarters of the world, and after relieving temporary and immediate wants, a considerable sum still remained. Sums, varying in amount, were, therefore, given to several of the hospitals, on condition that for each thousand dollars thus bestowed the Society should at any time be entitled to the care or treatment of one inmate or patient. Amounts were donated |