742 THE POPULAR SCIENCE MONTHLY. 



The objections to civil hospitals as now stated may be said to be : 

 1. As institutions, they tend to weaken the family tie by separating 

 the sick from their homes and their relatives, who are often too ready 

 to relieve themselves of the burden of the sick and heirless of their 

 family. Besides, when one or more of a family are removed those 

 left at home are in an uncertain state of mind, and, in many instances 

 in an unprotected condition. 2. The inmates of pauper hospitals are 

 liable to come in contact with bad influences : familiarity with suffer- 

 ing, unaccompanied by the occupation of relieving those who are 

 suffering, ends in hardening the sensibility, especially in the young. 

 3. Like all public and general charities without the safeguard that 

 personal knowledge affords, hospitals tend to foster idleness and help- 

 lessness, and their natural results, pauperism and crime. 4. When 

 badly constructed or badly managed, they are liable to cause hospital- 

 diseases among the inmates, and become centres of infection, thus 

 defeating the very object they are intended to promote. 



On the other hand, the arguments in favor of civil hospitals are : 

 1. They are a necessity under many circumstances for giving shelter 

 to the sick and helpless, and are supposed to be the most economical 

 method of providing for the sick poor. 2. They are of very great 

 value as affording an opportunity for the comparative study of dis- 

 eases, and for giving practical instruction in the science of medicine 

 and the art of nursing to the greatest advantage, and thus, by help- 

 ing directly a few individuals, indirectly rendering a service of incal- 

 culable value to the world. 3. During contagious epidemics they are 

 a ready means of providing for those who are infected, and, by their 

 isolation, preventing the spread of disease. 



As means toward checking the undesirable multiplication of ex- 

 pensive institutions, toward preventing hospitals from breaking up or 

 interfering with the family tie, and at the same time to keep them from 

 engendering pauperism, we suggest : 1. Do all that can be done to 

 enlighten the poor to help themselves, and to avoid the causes of dis- 

 ease. 2. Give indirect help by improving the condition of the homes 

 of the poor, by strict laws in regard to the existence and building of 

 all dwelling-houses, manufactories, schools, etc., etc., and in regard to 

 the sale of food. 3. Limit hospital accommodations to those who 

 have no homes, and to those who cannot be assisted at their homes. 



It is doubtful if the state can give direct out-door help, even med- 

 ical help, without doing more harm than good. It can only be done 

 wisely by establishing a Bureau of Intelligence in connection with the 

 police department, with offices at each police station, where the names 

 and the numbers of the inmates in every house in the precinct or dis- 

 trict would be known, and where, from personal knowledge, a record 

 of all individuals receiving help as to their circumstances, the amount 

 of aid given, etc. would be kept. As far as possible, all help rendered 

 should be guided by this knowledge, and it should be obligatory on 



