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SECOND DAY'S SESSION.
TUESDAY, JULY 26.
REPORTS FROM STATES AND CITIES.
PENNSYLVANIA.—BY DR. LUTHER.
Few changes of any special character, in the condition of the charitable and correctional institutions of Pennsylvania, are to be noticed in the present report. Some reduction in the amount of pauperism and crime has occurred, better building accommodations have been provided, and further improvement in methods of administration continues to be made. Much has been done for the benefit of the dependent classes who resort so largely to our almshouses and infirmaries, both in systems of care and treatment, and by a more liberal provision for their wants and comfort. But the errors of the past in systems of management are not yet totally eradicated. Many persons are received into our local charities who are not entitled to their benefits. Not a few are admitted, for whom more appropriate care and treatment are provided in other institutions: such as educational homes established for friendless and destitute children; State asylums for the insane; the workhouse for the idle and able-bodied; and the county prison, with a system of compulsory labor, for the incorrigible vagrant. That these views are well-founded will, I think, be admitted by all, and that they should be carefully considered at our hands is equally clear. A glance at the pauper class, who are admitted into and occupy our almshouses so largely, may serve to show whether what is now asserted is correct or otherwise.
The entire number of admissions into the almshouses of Pennsylvania for the year ending Sept. 30, 1880, exclusive of the insane in the Blockley almshouse, was 18,714 of whom 9,942 or 53.13 per cent. were discharged, leaving the resident population 8,773. Of those admitted 3,124 were children, of whom 1,867 were discharged. Some died, others were removed by friends, and a few, not exceeding 270 in all, were bound out, leaving in the almshouses, Sept. 30, 1880, 1,257 children. No adequate remedy has yet been provided for the extent to which dependent children are admitted into our almshouses, and the increase of pauperism which results therefrom. At least 2,300 become temporary inmates annually, and fully 1,300 remained as permanent residents. A bill prohibiting the commitment of children, between two and sixteen years of age, to any jail or poorhouse, and to make the violation of the act a misdemeanor, punishable with penalties, was offered in the legislature last winter, but it failed to become a law. The efforts of the State
Board will not be discontinued until this, or some other effective measure to remedy this great evil shall be adopted.
The statistical reports also show how large a portion of the almshouse admissions were able-bodied (children over sixteen years of age being included), and exhibit the necessity of greater care in the mode of granting orders for admission on the part of magistrates and poor directors. The large number of vagrants who receive relief should not be enumerated with the deserving poor, or those who through age or misfortune are unable to maintain themselves. A very considerable reduction in the number of vagrants who apply for aid at almshouses has been effected by the Act of 1879, which provides for more summary arrests and longer terms of imprisonment. But the evil continues to a large extent at quiet country homes. That the support of this worthless class should continue to be part of our pauper system, and a burden upon our tax-payers, is an unmitigated wrong. It will never be remedied until a proper system of compulsory labor is established.
Notwithstanding ample accommodations have been provided by the State for all the indigent insane, fully 1,800 continue to be supported in the almshouses. It is maintained that the custody of the insane, the curable as well as the incurable (excepting that class who are capable of self-care, and of rendering assistance in household and out-door work), should be taken absolutely out of the hands of the poorhouse authorities and of township overseers; because even the best county asylums afford insufficient safeguards for this class, and a present fair standard of care cannot be relied on, in view of the changes in economy and supervision liable to occur under different administrations. If the removal of the class above-mentioned to State hospitals should be rendered imperative, most decided benefits would certainly be derived from the change for the insane, whilst our county almshouses would be relieved of one of their heaviest pecuniary burdens.
As to the criminal classes, the number of commitments by magistrates and courts in the State last year was 43,991. The resident convict population is about 8,500. I will not enlarge upon this subject further than to state that we have two penitentiaries, with a capacity for over two thousand persons, and are building a third under an Act passed at the last session of the legislature, which is designed for convicts for first offences, with some modifications of present systems in regard to measures of a reformatory kind, which are not yet definitely settled. Our reformatories for juvenile delinquents continue to be conducted in a satisfactory manner.
The institutions for the Blind, the Deaf and Dumb, and for Feeble Minded Children, are owned and controlled by incorporated associations. They receive indigent pupils for a certain per capita rate which is paid by counties and the State. The arrangement gives entire satisfaction, the State manifesting its appreciation of
the care and treatment provided for its pupils by frequent and liberal appropriations.
The vast amount of benevolent work performed by correctional and charitable institutions organized by associations or individuals, I will not attempt to enumerate. These are supported mainly by income from endowments and contributions from charitable citizens, but occasionally they receive State aid. Provision is made for the relief of every form of privation and suffering. No nobler testimony to the intelligence and Christian liberality of those who engage in the praiseworthy service could possibly be presented.
Dr. ROGERS, of New York: May I touch on one point? The gentleman from Pennsylvania has presented a matter which should demand the attention of this Conference. He states that a certain number of insane are in the Pennsylvania almshouses. He says, also, that a portion of that number should be taken to the State asylums; that such persons as have been so removed have almost entirely changed in character and deportment; and that the worst cases were especially benefited. Now, if the worst cases are thus benefited in State asylums, under treatment, may we not infer that the milder cases, if placed under treatment, might be cured? The insane should not be left in county almshouses. The treatment they require is entirely different from that required by the almshouse inmate.
PRIVATE CHARITIES IN BOSTON.
The PRESIDENT: We were to hear this morning some reports of the charities of Boston, among them, the New England Hospital for Women and Children, the only establishment of its kind in New England. It may be interesting for the Conference to have a statement from the management of that hospital concerning its work. I will, therefore, call on Mrs. Ednah D. Cheney.
Mrs. CHENEY: The New England Hospital for Women and Children, had its origin in the Clinical Department of the New England Female Medical School. When this department was given up, the ladies who had assisted in its management were so fully convinced of the need and value of that hospital, both for educational and charitable reasons, that they decided to establish it on an independent footing. It has always held these two objects strictly in view, and has found it quite possible to unite them. Its value as an educational institution is this: It was at the time of its establishment, and is now, with the exception of the hospital attached to the Boston University, the only hospital n New England in which women students can have the opportu
nity for practical study of their profession. Its great value in this respect is shown by the number of students who have come to it, from various parts of the United States, from England and Scotland, and even from Russia. As all the students are resident, of course, the number is limited; but, up to 1876, over sixty students had studied here; and, as the number has since been increased, they would now, probably, reach nearly a hundred, most of whom are established in practice. The importance of women physicians in public work is beginning to be recognized, and our students are now found at the State almshouse, Tewksbury, at Sherborn, and in the service of our own city. Our general rule is to receive only those who have graduated from medical colleges in good standing.
We also proposed, from the beginning, the education of nurses as one of our main objects. Although long delayed by want of pecuniary means and other causes, this work was nobly begun by Dr. Zakrzewska, and reorganized by Dr. Susan Dimmock, and we have now a very efficient training school for nurses.
A great deal of valuable educational work is also done by the lectures to nurses, which have at times been opened to the public, and, especially by the knowledge of true principles of hygiene and sanitary care which are diffused among the patients, both in the hospital and dispensary.
Our charitable work consists, first, in the reception of women and children at the general hospital, where they receive the care of women physicians, which they could obtain in no other hospital in New England. In a very large class of diseases, this is found to be a matter of great importance, since women will seek the aid of women when they will shrink from applying to men. This is a matter of constant experience with us. There is a great advantage, also, in many nervous diseases, in the sympathy and influence of women. The surgical department has proved a great blessing to many women, who could not have the requisite care and treatment in their own homes. Indeed, the hospital affords, by its fine airy situation, its moderate size, its quiet, and the excellent care which it can give its patients, advantages which even wealthy sufferers have recognized and profited by. When the hospital was opened, it was the only Lying-in Hospital in New England, and it is still doing a great and good work in this direction. The whole future physical well-being of a woman often depends upon the care she receives during her recovery from child-birth, and every care is here taken to guard her from its perils. This is the department that appeals most forcibly to our sympathies, and which offers those sad problems of social morals with which you are all familiar. I need not enlarge upon them, but only say that a volunteer committee of ladies take charge of the helpless and friendless sufferers in this department, and try to help them, both before they come in, and after they leave, to a life of usefulness and virtue. The children's ward is very interesting and valuable.
Our dispensary, while aiding largely in the educational work, also dispenses a great charity, for thousands here receive advice and help in sickness. The physicians and students visit the poor at their homes, when it is necessary, and they have opportunity to give much sanitary instruction, as well as medical aid. Many patients are sent to the hospital by them that they may receive the thorough treatment which alone promises restoration.
Our hospital is thoroughly a New England institution, in fact, as in name. There are similar ones in New York and in Philadelphia, so that, although we have never refused, but often receive both students and patients outside of New England, we yet consider that our proper sphere. Our resources have been mainly drawn from Boston and the immediate vicinity, but our patients and our nurse students come from all parts of New England. Many physicians in country towns send us patients, whose circumstances require hospital care. This is as we wish, for it makes a healthy interchange between city and country, and helps to make our educational ideas known throughout the land. We need larger endowments to increase and perfect our work. We wish to add another building to our maternity department, that we may be able to divide our cases more thoroughly; and we need to increase our number of free beds, both for the charity's sake, since we now have to refuse many applicants, whom we would gladly receive, and because every enlargement of our charity is also an increased opportunity of education to our physicians and nurses. Twenty years' experience has satisfied us of the importance of our work, and the general value of our methods; yet, we are still anxious for improvement, and shall be grateful for any help towards doing a still greater good.
Mr. W. H. Baldwin, President of the Boston Young Men's Christian Union, Boylston street, was requested by President Sanborn to give a condensed report of the objects and plans of operation of that society, with special reference to its charitable, benevolent, and employment departments. He was also requested to give statistics and other information, obtained from a few Boston business houses, bearing upon the relations of employers and employees.
REPORT FROM THE BOSTON YOUNG MEN'S CHRISTIAN UNION. BY ITS PRESIDENT, W. H. BALDWIN.
This society was instituted in
1851, and incorporated under the laws of Massachusetts in 1852. It has a board of five trustees,