represent teachers, mechanics, an editor, a bank clerk and other important vocations.

The following Committee Report was then presented by Dr. J. W. Walk, of Pennsylvania.

REPORT OF THE COMMITTEE ON PREVENTIVE MEDICAL

CHARITIES.

In presenting a report on the subject of Preventive Medical Charities, the committee wish to premise that the subject is one, which has apparently received but little careful study.

We have found little discriminating discussion of the questions raised by the existence of Medical Charities; trustworthy statistical information upon their relations to pauperism is not abundant, and what we have has all been gathered during very recent years. For "these reasons we cannot hope to lay'before the Conference a comprehensive report, but can only give to the main questions involved a brief consideration, admitting that the data at our command are not sufficient for a full discussion of the subject.

Medical Charities, as the terms are usually employed, arrange themselves in two groups: (1) those supported by public taxation, and (2) those maintained by private enterprise.

Among tax-supported institutions, are included those directly controlled by the state, the county, and the municipality, and those which, while drawing their support from the public treasury, are under the management of independent corporatibns. Throughout the United States, wherever the influence of the English poor-law system has been felt, there exist under various names — Almshouses, Town Hospitals, County Homes, City Infirmaries— tax-supported institutions for the care of the indigent sick. For admission to these institutions a settlement within a prescribed district is commonly required, and in some states there must be proof of destitution, but the requirements go no further than these.

To put the almost universal practice into the form of a theorem, it may be said, the community is bound to support all residents who are sick and poor.

Tried by any of the commonly received theories of the functions of civil government, and especially such of those theories as are applicable to democratic institutions, this proposition is shown to be false. Republican government is not paternal and should not be.

It is not its business to provide for its citizens, but only to see that others do not interfere with them while they are providing for themselves; in short, its business is the protection of society by the prevention of force and fraud. To protect society, the State maintains its military and civil police on land and sea, and supports a system of free schools for its children. To protect society it establishes its courts, erects its prisons, and builds its asylums for the insane. To protect society is the function of the State, and when its powers are exercised in acts not necessary for the accomplishment of this purpose, it transcends its bounds, and unjustly invades the province of the church, the family, or the individual. It does not seem possible to justify governmental provision for the sick poor by any fair deduction from the doctrine that it is the duty of the State to protect its citizens from force and fraud. The sick are not in the same category as the insane, who are a menace to the security of the community when permitted to go at large. It will not be urged that the sick, except those suffering with contagious diseases, in any similar way endanger society. The prompt seclusion of those afflicted with contagious diseases is a duty of the State, and a part of its police powers; but the providing of hospitals for these cannot justify the creation of tax-supported institutions for the care of those afflicted with diseases, which are not pestilential. What is wrong in principle cannot be right in practice, and the results of our system of demanding from the public treasury the funds to support those, whose only claim upon the public is their misfortune, has been a fruitful source of degradation and corruption. It has assured the idle and profligate, that no matter how vicious their lives, no matter how continuously their practices violate every law of health and morals, they have, when overtaken by the consequences of their vices, the ultimate right to maintenance, paid for by forced contributions from their more thrifty neighbors. In this it has discriminated in favor of the worse elements of society against the better. Besides this, the system has contributed not a little to the widespread political corruption, which is the reproach of our country. The official positions in county almshouses and city hospitals have far too often been the last roosting place for foul political buzzards, who have been driven from more conspicuous public places to perch at last among the outcasts and gorge a little longer on the spoils of office. The shameful exposures at the Blockley A lmshouse, paralleled as they have been in other States as well as Pennsylvania, teach a lesson whicfc. should not soon be forgotten.

And yet this system has been advocated in the name of charity, and the multiplication of our pauper corrals has been pointed to with pride as an evidence of our civilization.

Alas! how we are befooled by names!

What charity is there in a board of aldermen voting money from the public treasury to maintain great pauper houses, avowedly controlled by ignorant partizan henchmen, who must be provided for, and who will not be tolerated by any class less helpless and degraded than the paupers? Spasmodic reform may temporarily lessen the evil. Thorough inspection by intelligent State Boards and Charities Aid Associations may correct some of the worst abuses; but the source of the mischief remains.

Professor Thompson has justly said: "The best reform of the almshouse would be its abolition."

Is it, then, proposed that no provision shall be made for the unfortunate, for the sick and injured among the destitute poor? By no means. Humane sentiment, and something higher than humane sentiment, demand that we shall succor the miserable; that whether he be a virtuous man overtaken by misfortune, or a vicious man reaping the rewards of a debauched life, we shall remember that he is our brother, and strive with purse and brain and heart to lift him out of his misery into health, and comfort, and independence. The desert chant of the Musselman conforms to our creed no less than his —

"Whoever thou art whose need is great,
In the name of God, the compassionate,
And the merciful One,
For Thee I wait."

The obligation to assist the unfortunate is sacred. It must not be ignored; but it should be placed where it belongs, upon the church, and upon benevolent individuals and voluntary associations of benevolent individuals.

There exists no community in the United States where there is not enough money in the hands of benevolent citizens, and enough philanthropy in their hearts, to care for all the indigent sick within its bounds; and this beneficence can provide for them far more wisely, far more honestly, than any machinery which the civil government, can devise.

The failure of the poor-law system, particularly in great population centres, is admitted by the majority of those who have carefully studied the question; but many, who fully recognize this, fear to take the bold step of abolishing it.

The institutions drawing their support from the public treasury, but controlled by private corporations, have •come into existence as a measure of compromise. • In the city of New York, this scheme has had an ample development. Its results were graphically portrayed by Mrs. Lowell at the Boston meeting of this Conference.

In most instances the management of these Institutions has been better than that of those wholly given over to political control; but the pernicious factor, public money, not the gift of benevolence, but the forced levy of the tax-gatherer, has worked everywhere to vitiate the results of their operation. It is not to them, or any similar makeshift, that we must look for the solution of the great problem, how to assist the unfortunate without degrading the.recipients of our bounty and discriminating against the manly, independent poor, who, though worn by toil and pinched by penury, scorn to ask for help.

If this solution is to be found anywhere, it is in private eharity. Hospitals and dispensaries founded by benevolent individuals and voluntary associations, whose support comes from the contributions of those who believe in them, those who are actuated by philanthropic motives, strong enough to reach into their pockets.

It is certainly reasonable to suppose that a management by such men will be a fairly clean and judicious management; that the officials who conduct them, will be chosen for their character and expert knowledge; and that their whole moral atmosphere will be far purer than the dank miasm of partizan almshouses.

The a priori argument is confirmed by experience. It is a rare thing for Corruption to be charged against the officials of the Hospitals maintained by private benevolence. The best citizens participate in their management; their officials hold posts of honor, and often retain them for a score of years. In them, industry, experience, and fidelity have, at least, some fair prospect of reward.

More important, however, than these considerations, is the effect produced upon the character of the patients, who receive free hospital treatment. When it is given in institutions such as have been described, it is accepted as a gift, winning gratitude in return; but the benefac

tions, such as they are, of the county or municipality are seized as a right. Convalescents from really charitable hospitals, often view the benefits they have received in their true light, as the gifts of sympathetic hearts, and testify their appreciation not only by words, but deeds. No such result is produced by public charity. If any almshouse steward has ever seen a departing: patient grateful to the institution that has sheltered him, the man ought to be advertised as a curiosity.

It is, then, to the hospitals sustained by private benevolence, that we must look for the judicious care of the sick poor of the community. A practical question arises — have they the resources adequate to this work? In some places they have. Philadelphia is an illustration of this. In that city there is an almshouse hospital with an average of about eight hundred (800) inmates, and there are twenty hospitals which are maintained without municipal aid. These twenty hospitals have a capacity for fourteen hundred and sixty-three (1,463) patients, and the total number of free beds occupied, was, on a recent date, reported as eight hundred and thirty-four (834). There are thus six hundred and twenty-nine (629) vacancies now existing, which could be filled with free patients, if the hospitals recieved a very moderate addition to their operating funds, an addition, not difficult to procure, were public attention directed to the matter. By this means, all the sick inmates of the Almshouse, except one hundred and seventy-one (171) could be at once provided for, without any expenditure for new buildings or apparatus'. This reduces the problem to the simple question of providing for less than two hundred (200) patients in a city of nearly a million inhabitants. Private benevolence is abundantly sufficient to promptly answer this demand. It must be added, that in the opinion of some of those best qualified to judge, the exercise of a proper discrimination in the admission of patients (for free treatment should be given to those, and only those, who are unable to pay) would render the fourteen hundred and sixty-three (1,463) hospital beds now provided entirely adequate to the needs of the community. In some localities, a change so radical must be made more gradually; but the sooner it is begun the better. Appropriations to almshouses should be steadily diminished, and the work of caring for the sick poor, more and more, turned over to the really benevolent institutions, which stand ready to undertake it, until at last they have assumed it altogether.