EDITORIAL GRIST

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JOHN PIERPONT MORGAN 1837-1913

Mr. Morgan was for seventeen years treasurer of the Charity Organization Society of the City of New York which founded The Survey and under which it was published until the fall of 1912. When, in 1907, the parent society launched Charities Publication Committee in order "to give national scope and breadth" to the magazine, Mr. Morgan was one of fifteen guarantors who gave $1,000 each the initial year to promote its educational work. Last summer he gave $250, the sum asked from him, toward the clearance of an overhanging deficit, in advance of the institution of the Survey Associates as an independent and co-operative under-taking.

The public's chief concern in Mr. Morgan's great activities has been the play of his powerful individuality in the rapid reconstruction of the "mass of wrecked corporations which blocked the path of American finance" following the panic of 1893, and in "heading the forces of conservatism in the great business emergency" of 1907; his part as the "immense constructive genius" throughout the period of expansion in America's "large creative activities."

The "economic necessity or value of the enormous industrial combinations" shaped at his hands will, in the words of the New York Evening Post, "be the crux of later historical controversy over the great career now ended"; and the same is true of the ultimate effects on the working life of the people of his instrumentality in extending the country's railroads, in improving its banking, and in projecting its facilities for the manufacture of large staples.

Said Major Henry L. Higginson, New England's foremost philanthropist and financier, in commenting on Mr. Morgan's death: "To make a great fortune is little; to be a great citizen is much." The Survey will, in an early issue, publish an appreciation of other phases of Mr. Morgan's trenchant personality by an associate in the fields of art and philanthropy.

Here, one circumstance which concerns this magazine closely may be set down. The Pittsburgh Survey was made at a period of restlessness and irritation in many high quarters, following a succession of investigations and exposures. The period was also one of sensitiveness among every day people lest the organs of publicity might be controlled by invisible influences. Charities and the Commons (as The Survey was then called) bore Mr. Morgan's name as treasurer on its contents page while its staff was delving into the Pittsburgh district. The Pittsburgh Survey was conceived not for the purpose of internal counsel and report, but for the purpose of spreading before the public the facts as to life and labor in the region, where the two greatest individual fortunes in history had been made by Mr. Morgan's contemporaries, where he had in turn become the dominant factor, and where social tendencies observable everywhere had "actually, because of the high industrial development and the great industrial activity, had the opportunity to give tangible proof of their real character and their inevitable goal."

It must remain for Mr. Morgan's business associates to say how much affirmative concern he had given or came to give to the working conditions in those industries in which he controlled vast holdings, or to such far-reaching reforms as the safety campaign. But the staff of the Pittsburgh Survey can bear witness that no word of admonition ever reached them, no trace of pressure to minimize or gloss over or reserve for private consumption the human outcroppings of a thousand million dollar corporation. The situation did not change after our first strictures as to the seven-day week, the twelve-hour day, work accidents and the like had been spread broadcast. If they reached Mr. Morgan's ears, he was willing to let this left hand of philanthropic inquiry take the exact social measure of what had been done or left undone in the fiscal and industrial enterprises in which he was the master entrepreneur.

MR. WEST'S ARTICLE[4] PROTESTED

[4] See Civil War in the West Virginia Coal Mines on page 37 of this issue.

NIGHT LETTER

Charleston, W. Va.,
March 30, 1912.

"Owing to delayed trains, did not reach home nor receive your telegram of Friday until last night. West manuscript received and read this morning. Am directed to renew protest against its publication as contrary to facts in most important particulars and most unfair in attitude and spirit. An article published in your journal on a matter so important should be prepared by one of your own staff from facts gathered by your own investigator. Am authorized to place in your hands immediately five hundred dollars, being amount estimated by you as necessary to cover expense of special examination and article, and urge you in justice and fairness to accept and use it for the purpose. It is impossible to prepare an answer to the West article and have it in your hands tomorrow, nor is one-fifth the space given West article sufficient for an adequate reply thereto. If you decline to make your own investigation and report, it is submitted that justice requires that time be given so that West article and reply may appear in same issue and space equal to article be given for reply. If you refuse this I respectfully ask the publication of this protest with Mr. West's paper."

[Signed] Neil Robinson.
[Secretary West Virginia Mining Association.]


In line with the general practice of The Survey when an article makes major charges against an institution or industry—a copy of Mr. West's manuscript was sent on March 20 to the secretary of the West Virginia Mining Association, with a request that he indicate any points which "seem to you in error."

On March 26 The Survey received a letter from Mr. Robinson, who called in person the day following to protest against the publication of the article as unfair, and not of the calibre expected of The Survey by the public. He also offered us every facility if we would make an independent staff investigation. We stated that such a staff inquiry in the West Virginia field was beyond our means, that we had exercised due care in selecting Mr. West as a non-combatant observer, and that the manuscript had stood the test of criticism in various quarters. Further, we stated that if Mr. Robinson could there and then dislodge the major statements of fact in the article, we would surely not publish it; otherwise, we would hold two pages of the same issue of The Survey open until Monday of this week for a statement in rebuttal.

In the interval a galley proof of the article was sent Mr. Robinson containing revisions to cover minor points of criticism made by him and other critics. Later issues of The Survey are open to the West Virginia operators for a full reply; and the findings of a federal inquiry which would resourcefully and dispassionately cover the ground would, of course, be handled at length.

Y. M. C. A. GROWTH

The Young Men's Christian Association began in 1851, sixty-two years ago. The property value in plant and equipment, increased in the first ten years of the twentieth century more than in all the previous fifty years; the membership doubled, a tremendous growth.

Will the next decade show a like growth for organized charity with proper effort?

THE TOWN CONSTABLE

J. J. KELSO

The town constable is one of the most important links in the chain of social service, and yet he is seldom taken into consideration by the active workers for social betterment.

A town constable was recently held up to public censure at a church meeting for failure to wipe out certain well-known evils. When asked about it the next day his reply was: "The law is being enforced in this town just as far as the people will stand for." His idea, you see, was that observance of law was a matter of education, of moral backing, and without this strong, sustaining support, one man, even with a badge and a club, could not go beyond a certain point.

The idea got into another constable's head once that his duty was to carry out the law, no matter what people thought about it, and to his great surprise it was not long before his resignation was insisted upon. He did splendid service and really frightened law-breakers, so much so that they got busy in bringing about his downfall. Where were the good people? Entirely missing. Here and there a man under his breath would give the official a word of faint praise, but in the council church members allowed themselves to be made the tools for his destruction. "Well meaning, but lacking in judgment" was the decision; "rash, hasty, ill-advised," and so he had to go in disgrace, while the law-breakers smiled quietly and continued on in the old way. Public meetings in that town still continue to denounce the well-known evils, indifferent to the fate of the officer who thought he had all the forces of good at his back.

Still another constable, whom I know well, told me privately that he started out in the same way, but got a hint that he could not hold his situation and, having a young family to support, he concluded it would be the part of wisdom to let well enough alone, especially as the men who counselled him were church leaders, who ought to know the sentiment of the town on moral questions.

Some towns have a high moral tone largely because of the good influence of the head of the police department. Others are on a low plane of moral observance because the constable is indifferent, if not indeed hostile, to advance measures. Lack of encouragement and appreciation is often the secret of this indifference.

Visiting a town on one occasion to take part in a meeting on social reform, I asked the constable who happened to be at the station if he knew Rev. S. Thomas Strother. "No."

"Well, do you know Rev. Milton Smoot?"

Receiving another negative, I enquired in surprise, "Why surely you are acquainted with the preachers of your town?"

"No," he said, in a surly tone, "they have no use for the likes of me." Here was a man, specially appointed guardian of the town and invested with the high dignity of safeguarding the lives, morals and property of the community, whose mental attitude toward the better element was evidently one of hostility. The explanation given me later was that he was a recent appointee, only there a month, and there was not sufficient time to get acquainted. "Well," I replied, "if I had been you people I would have gotten up a banquet and given him such a welcome as would hearten him in his great work for years to come." It is all in the way you look at these things.

At a large church gathering on social welfare I took occasion to exalt the office of constable and to praise the man who held that office. He was at the back of the hall and I could see was greatly surprised at this recognition. He came to me afterwards and earnestly expressed his thanks. "No one has given me that much encouragement before," he said, "and it will help me a great deal, especially as I want the young fellows of the town to know I am their friend and not their enemy."

Social and church workers, let the town constable know that he is appreciated, let him feel that good work is recognized, that if he is attacked because of fearless discharge of his duty, he will have behind him an unflinching body of men who will make his trouble theirs and fight for a righteous cause as well as talk at church meetings.

MINIMUM WAGE LEGISLATION

FLORENCE KELLEY
Secretary National Consumers' League

Governor West of Oregon has signed a bill creating a Minimum Wage Commission. Oregon thus follows Massachusetts in this new field of industrial legislation. Minimum wage bills have been introduced in the legislatures of California, Kansas, Ohio, Pennsylvania and Wisconsin. The New York Factory Investigating Commission will doubtless be continued and empowered to investigate wages.

The Oregon law and all the pending bills have one characteristic in common: they are alarmingly undemocratic. They fail to afford to American employees in underpaid industries those democratic safeguards which characterize English and Australian legislation. They apply to women, oblivious of the fact that wives and daughters work because their man breadwinner does not earn enough to support the family. These laws and bills ignore the youth and shifting nature of the working force in the underpaid industries which is so largely made up of young girls. They need the moral support of their men fellow-workers in negotiating about wages.

In America the governor appoints the commission, and the commission selects the wage board. The board determines the lowest wage and the women and girls take what they get. The recipients of the wages are not allowed to elect representatives to the boards. They are, in fact, not represented at all. The Kansas bill was killed by the legislature. It substituted "an adjuster" for commission and boards.

If these other ill-considered bills become laws, it will be the work of years to remodel them on more democratic lines, and on wise and just principles in the light of the experience of Australia and England.

"THE HAND OF THE POTTER TREMBLES"

SOLON DE LEON

To lead poisoning among lead smelters, white lead workers and painters, we have grown accustomed. Now comes the revelation of wide-spread plumbism, or "potters' palsy," among workers in the potteries.

Trenton, New Jersey, the third largest pottery center in the country, has recently been the scene of a brief study conducted by the American Association for Labor Legislation. Brief as was the study it revealed many cases of this disease.

One case was that of a fifteen-year-old orphan, as dipper's helper in a pottery. He handles cups and saucers after they have received their coat of glaze and before they are taken to the kiln. He gets his hands covered with glaze. There are no washing facilities at the plant where he works. When visited at home he had spots of white lead over the front of his shirt. After nine months as dipper's helper he began to complain of general ill health, with pains in the stomach. He worked interruptedly for another month, and finally came down with an attack of acute and excruciatingly painful poisoning which required a week's hospital treatment.

A young girl, now married and a mother, worked in a tile plant for six years, the last three of which she was a dipper. Within three months after starting the latter work she suffered a typical violent lead colic attack, accompanied by nausea and digestive derangements. The attack lasted a week, and was followed by three more at intervals of several months.

A former glost kiln-man of forty-five had worked in the Trenton potteries continuously for upwards of twenty years. Five years ago he was stricken with complete double wrist-drop and for two years was totally incapacitated.

Another practically useless pair of hands belongs to a workman forty-nine years old. Lead poisoning crippled him and deprived him of his trade at the age of thirty-three. He used to be a "ground layer." That is, he rubbed lead colors with a short brush into the surfaces to be decorated. In the course of fifteen years he had eight or ten severe attacks. In the last one, sixteen years ago, both arms were paralyzed. For two years he had to be clothed and fed. Now his arms have recovered their flexibility, but his hands still hang shrivelled and powerless to open or straighten themselves. For a livelihood he has been forced to take up an unskilled job requiring no manual work, but seven days' labor a week.

A color mixer in a tile works began after ten years to suffer from cramps in the stomach, nausea and biliousness. A number of physicians told him it was lead colic. He grew steadily worse, and four years later he died. The death certificate gives pulmonary tuberculosis as the cause, but the physicians on the case agreed in stating that lead formed at least a considerable complication.

So run the records of a few of the cases.

There are about 21,000 potters, the makers and enamelers of iron sanitary ware in the United States. Of these, 2,500 or over 10 per cent are declared by Dr. Alice Hamilton in her report to the United States government to be exposed in the regular course of their work to the risk of lead poisoning. Within two years 510 cases of poisoning were found.

It is now generally accepted that the one word "cleanliness" sums up the requirements for the abolition of such occurrences. Yet the workshops in the pottery and allied industries are at present almost without exception run with utter disregard of this fundamental consideration. They are as a rule dusty, ill-ventilated and poorly lighted. Washing facilities are almost unknown.

In New Jersey and in seven other states the legislatures have now pending before them the aptly christened "cleanliness bill," drafted by the Association for Labor Legislation after careful study to counteract just these conditions. The proposed measure establishes strict sanitary provisions in potteries and all works making or handling lead salts. It takes a leaf from successful English and German legislation by establishing "duties of employees" as well as "duties of employers," and by fixing a fine for failure to comply. The bill has passed the lower house in Missouri, and has been reported favorably by the lower house committee to which it was referred in Ohio and in New Jersey. A similar law has been in force in Illinois for two years with excellent results. Many progressive manufacturers admit the wisdom of these regulations and will not oppose them. Others are actively in favor.

WHY IS THE PAUPER

SUGGESTIVE FACTS AS TO CAUSES AND PREVENTION OF DESTITUTION REVEALED BY A STUDY OF A MID-WESTERN ALMSHOUSE[5]

[5] In taking the rather exhaustive social histories of the 200 inmates of the Sangamon County Poor Farm, I was assisted by Mary Humphrey and Mary Johnson, without whose intelligent and enthusiastic co-operation this preliminary study could not have been made.

GEORGE THOMAS PALMER, M. D.

SUPERINTENDENT HEALTH DEPARTMENT, SPRINGFIELD, ILL.

Drawings by Alfred S. Harkness

Poorhouse it was, this mid-western abode of unfortunates, regardless of the resolution of the Conference of Charities and Correction recommending that it and its host of fellows be known as "county homes."

This particular poorhouse was comfortably perched upon a hill, surrounded by elms and oaks and walnuts, overlooking a land of plenty—a "prosperous-looking" poorhouse it was with well-bred Holstein cows wading knee-deep in clover on land worth $250 an acre. The verdant pastures, the fields of grain, the white fences, the silo and the barns, the splendid old brick house, might have belonged to a delightful country estate so apparently did they bespeak good farm management. Good order and spick-and-spanness also characterized broad veranda and hall, the living rooms of the superintendent, and almost might the same terms have been applied to the dwelling place of the inmates.

This, seemingly, was no place to come for the ugly story of destitution—for the revolting facts which force us, almost against our wills, to paint our picture in glaring yellow. But the destitution was there. You could see it in the expression, the gait and the posture of the inmates; you could smell it in the unmistakable smell of poverty and you could feel it in the indefinable something which grips you and oppresses you in an institution of this kind.

It was a poorhouse and nothing but a poorhouse—a good poorhouse, if there is such a thing, but a poorhouse none the less. Like thousands of similar institutions, it stood ready to receive the individual when he strikes the very bottom of the toboggan slide of life, to house him and to feed him humanely enough, but with the saving of dimes and nickels regarded as the cardinal virtue of efficient management. It was an "asylum of poverty"—no more what such an institution might be than the lunatic asylum of twenty years ago is like the hospital for the insane of the present day. Like thousands of others, it was one of those places where we receive the unfortunate; where we label him a pauper; where we tolerate his presence until death reduces the county expense or until he goes out into the world again not a whit better off, physically, mentally or morally, on account of his association with us.

We had come to the place for the purpose of ascertaining to what extent tuberculosis prevailed among the two hundred inmates and to ascertain the degree of protection afforded these unfortunates against infection from the disease. As our work progressed this question came to me more and more insistently: "Why are these men and women dependents? What, if anything, could be learned if they were permitted to tell their own stories of misfortune?"

Social history blanks were prepared, and two intelligent young women were set at the task of supplementing physical examinations with a series of questions relative to the past lives of the inmates. Due allowance was made for natural exaggeration when a person told of the glories of his past, and like allowance was made for the faulty memory which had lost its record of personal faults, vices and dissipations. As far as possible the reliability of the story was determined by checking up with certain definite and obtainable facts.

At the outset of the work, a wave of fear spread over the place born of the belief that we were cataloging the inmates to send them to an "asylum"; but when this was quieted, the history taking was uneventful.

Eliminating those who were mentally incapable of being interviewed, we were able to prepare 137 quite complete records. Of those interviewed, 32 were women and 105 men. Practically all the women, incidentally, were there on account of insanity, drug addiction or actual illness. There were 131 white inmates, 5 Negroes and one who claimed to be an Indian. Sixty-nine were single, that is 60 per cent of the males and but 27 per cent of the females. Nineteen had living husbands or wives and 47 were widowed. Of those who had married, 42 had married once only; 13 stated that they had married twice and 4 that they had married three times or more.

To the penny-wise county official it is of practical interest to note that 34 of the inmates, or about 25 per cent, had living children and that even casual inquiry showed many instances in which the children were financially able to take care of these unfortunates, as the laws of Illinois provide that they shall do.

Thirty of the inmates were born in Illinois; 36 in the United States outside of Illinois; while Ireland and Germany came next with 21 representatives each. There was no Jew in the almshouse.

Three of the inmates admitted that their parents had been dependent upon public charity; 24 admitted alcoholism or drug addiction on the part of their parents; 4 were the children of the insane and one was the daughter of a criminal. The fathers of 106 came from laboring and agricultural classes, while the fathers of 6 were professional men.

Nineteen of the inmates had had no education whatever; 12 claimed to be able to read and write but had never gone to school; 4 had attended school less than one year; 15 had attended less than five years; 71 claimed a complete "common school" education and 7 had gone to high school or college. Four had been compelled to earn a living under ten years of age; 12 from ten to twelve years; 41 from twelve to fifteen years and 31 had begun work between the ages of fifteen and twenty-one years.

With this showing, the question naturally arises: Is there any connection between lack of education, child labor and the poorhouse?

One of the male inmates had been a pharmacist, one a civil engineer; 28 had learned trades and 53 were laborers. Of the females, 17 were house servants and one a teacher.

To ascertain something of the past financial condition, we inquired as to the highest wage each had made, the amount he had inherited and the greatest amount he had ever accumulated. Six had never made more than $10 to $20 per month; 21 had made from $20 to $50 per month and 28 claimed to have made over $100 per month. Fourteen had inherited property worth less than $500; 11 had inherited from $500 to $1,000; 5 from $1,000 to $5,000, and one had inherited from $5,000 to $10,000. Thirty-five of the inmates had never accumulated as much as $500 at any one time; 22 had possessed from $500 to $1,000; 20 had owned from $1,000 to $5,000; 7 from $5,000 to $10,000, and four had had over $10,000.

As to their habits, vices and dependence, 88 were users of alcohol and 35 of these had been heavy drinkers. Four females and one male were addicted to drugs. Thirty-nine had been arrested once, and four more than once. The causes of arrest were drunkenness and disorderly conduct 22; vagrancy 10; theft 1; assault 4 and participation in a strike 1. Two of the inmates had been in other almshouses; 7 had occupied beds in charity hospitals; 2 had grown up from orphan asylums and 4 had been helped by lodges and unions. Many had received county orders before coming to the almshouse.

What light such data as the foregoing, if collected in large numbers of similar institutions, would throw upon the underlying causes of destitution, is, of course, speculative. It seems to me, however, that they might give us a more intelligent idea of the connection between pauperism and the marriage of the unfit; lack of education; child labor; lack of trade or definite vocation; poor mentality; lack of religious influence; divorce or failure to marry; alcohol and drugs; vice and preventable disease.

If these remote influences lie beyond the imaginative possibilities of the average almshouse superintendent and county official, there were certain other facts brought out in this study which should appeal to the most practical and hard-headed. These facts seem to point the way to the rehabilitation of the unfortunate; the way of placing him on his feet again. They also point directly to the reduction in the almshouse population and the consequent decrease in public expense.

Getting at the direct causes of dependence, it was found that old age was the chief factor, 47 of the inmates being over 70 years of age. This number of dependents, incidentally, could be materially reduced by tracing out near relatives legally responsible for their care.

Drugs and alcohol were responsible for 25 dependencies—a less encouraging group until we have intelligent public treatment for these cases. Twenty-five of the inmates were crippled while 18 were there on account of general illness. Doubtless many of these cases would be amenable to treatment if properly studied and diagnosed.

Six were victims of advanced tuberculosis, and it may be assumed that the nature of the illness was unrecognized as the patients were housed in dormitories with the uninfected. There were unquestionably other tuberculosis cases undiagnosed who were not only losing their chance of cure; but were exposing and infecting others. I am impressed, incidentally, that almshouses, with their armies of transients going to the crowded, unventilated quarters of the poor, are very considerable spreaders of tuberculosis.

The insane, feeble-minded and epileptic aggregated perhaps 50—an almshouse population which should be and must be decreased by more adequate state provision for these afflicted.

Syphilis was responsible for 3 dependencies, and probably many more would respond to the Wassermann test and could be restored to health by specific treatment.

The 4 blind and aged inmates might be made to see by simple cataract operations.

Many of the inmates expressed the wish that they might be restored to health that they could go out into the world again upon their own resources. But 58 replied, when asked what they wanted to do in the future, that they wanted to stay where they were, under the friendly roof of the poorhouse.

This does not imply hopeless pauperism, however. Sick, neglected, weak and despondent—of course, they want to stay in some place, even in the poorhouse, where they are not eternally ordered to move on by the police; viewed with suspicion or fear by self-respecting citizens or in constant danger of arrest for vagrancy. Such forlorn men not infrequently commit petty crimes to guarantee their being housed in jail during a cold winter.

I am optimistic enough to believe that if the physical conditions of each inmate were studied; if his ills were cured and he was made stronger in body, he would be given courage, more ambition and more purpose in life. To this extent pauperism is directly curable.

True, there are among the destitute those who are hopelessly marked—branded by heredity; cursed by environment; wrecked by disease; deficient in body and in mind, with little or nothing to work upon. By the same token there are those in other branches of medicine who are hopelessly sick—those who are beyond the reach of the surgeon's knife or the physician's prescription. There are those among the insane who give no ray of hope to the most enthusiastic alienist.

But when we progress to the point of classifying our paupers; of studying intelligently the various causes of destitution; of endeavoring to make our almshouses places of cure rather than mere asylums for the victims of poverty, our percentage of "recoveries" will be surprisingly high.

The difference in methods between the modern insane hospital and the almshouse is striking. A man is admitted to an institution for the insane in a thoroughly irrational and excitable condition. His case is studied and it is found that he has cerebral syphilis. Proper treatment is instituted and, in all probability, the patient is returned to his family cured and a useful member of society.

In another case, syphilis has rendered a man physically inefficient, dissipated and despondent. He drifts to the poorhouse where he is catalogued simply as a "pauper." The chances are that the cause of his pauperism is not detected. If he announces it himself, he may receive the hurried, occasional visit of a contract doctor. Even the drugs that are given him may be crude and impure, bought by contract from the lowest bidder. Little or no provision is made for his intelligent and systematic treatment. He may be drugged with mercury until he is salivated; he may be neglected until his open sores cause him to be housed in the basement away from the other inmates. He is merely a syphilitic pauper and the rough fare of the poorhouse is looked upon as better than he deserves.

As a matter of fact, he is a sick man; sick of a curable disease and his cure may restore him to useful citizenship and remove him from the county expense.

Or again, there comes to the almshouse a man who is tired—a man who will not work. Perhaps he is losing a little weight and he is known to have been drinking more whiskey than he did when he worked harder. You are tempted to compel him to work; to drive him to earn his meager board and bed. The superintendent has no time to note that he has a little fever at night or to see that he clears his throat from time to time. Without physical examination, we have no way of knowing that we are dealing with an incipient consumptive. The average superintendent knows nothing of the deadly weariness of this disease; the weariness that invades every muscle of the body; which makes work impossible; which prompts men of higher moral fiber to drink whiskey or seek other stimulation.

This "lazy devil" is begrudged our poorhouse food, when, as a matter of fact, he ought to have, and at public expense, better food than we have ever thought of giving him. With fresh air, milk, eggs, nourishing food, intelligent treatment and perfect rest, this man can get well and resume a place in the world. With ordinary almshouse care and almshouse fare, we are signing his death warrant while we are guaranteeing his prolonged dependence upon public charity.

We receive old men who have worked hard and who have made an honest living before their eyesight failed and they became almost blind. We label these men as paupers and do not stop to question if a simple operation for cataract would not restore them to useful occupation.

The spirit of the average almshouse is illustrated in this—one Illinois county has a contract with a dentist to pull the teeth of poor farm inmates. There is no provision for saving teeth. If the inmate is writhing with toothache, he must take his choice; lose a good tooth on contract, or grin and bear the pain. The supervisors can see no reason why a pauper should want to save his teeth or why he should be permitted to do so. And yet a cheap filling would cost little more than the primitive and mutilating operation of extraction.

These are mere instances of the obvious curative possibilities in the almshouse—instances where the county's duties are so apparent, in which the right and humane way is so clearly the cheap and economical way that the matter should require no discussion. It is the line of direct cure which the county, as a matter of sound administration, should make it possible to carry out. It means first the careful physical examination of every inmate of every almshouse, not by the medical man who bids lowest to get the contract, but by the most capable diagnostician available.

But this is only the beginning. The big possibility is what the almshouses of the nation can do to ascertain the more remote causes of poverty and destitution, for, as in the case of the insane, when we know the causes of destitution, we can carry out our most effective work before the pauper becomes a pauper—before he comes slinking, wretched and despondent, to the door of the county farm.

Tuberculosis will never be eradicated by merely treating the sick; yellow fever could not have been stamped out by simply caring for the afflicted; pauperism will never be materially affected by what we do when the pauper has reached his last ditch. We must fight tuberculosis by striking at its causes; we have already eliminated yellow fever by the same sane process. We would have gone further in our battle against pauperism, perhaps, were it not that pauperism is the only disease that has never invaded the home of the rich. No multi-millionaire has ever endowed a research laboratory for the study of destitution in memory of a petted child struck dead by its poisonous fangs.

But every almshouse has its clinic in poverty and I am convinced that if every inmate in every poorhouse throughout the nation could be made to tell the story of how he came to be there; if every one could be examined for physical and mental causes, and if all these data could be gathered together in systematic form, a great stride would have been made in formulating an intelligent campaign against dependence.


                                                                                                                                                                                                                                                                                                           

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