780 



SCIENCE, 



[N. S. Vol. XI. No. 281. 



the United States as a little less than one 

 hundred thousand ; but one of the best 

 authorities in the treatuient of this class of 

 dependents thinks that there are probably 

 four to every thousand of the population, or 

 a total of very nearly three hundred thous- 

 and. Of this number about one in thirty 

 only are in institutions and the remainder 

 are scattered throughout the communitj', 

 some in their own homes, where thej' are 

 the objects of solicitous care and affectionate 

 regard, others and the larger proportion, in 

 almshouses, in prisons, and on the road as 

 tramps. 



Their number is apparently increasing. 

 In 1860 there were six hundred to the 

 million inhabitants, in 1890, fifteen hundred 

 to the million; and they propagate their 

 kind ; with them are linked the variable 

 and occasional criminals, as distinguished 

 from the criminals having criminal trades, ■ 

 and about the borders of this realm of the 

 unfit circulate the merely idle, the dissolute, 

 the profligate and the debauchee. 



The difiFereutiation of these classes, the 

 sorting out of this waste humanitj', the 

 utilization of what is good in it and the 

 protection of that which is feeble and use- 

 less constitutes one of the most intricate 

 problems of modern social life. 



He who holds the key to a situation, is in 

 a measure responsible for the situation and 

 the key to this particular problem is in the 

 hands of the doctor more than in those of 

 any other citizen. 



He, more than any other, as a necessity 

 of his education, has been brought person- 

 ally into contact with the deficient, his 

 active life is spent in drawing comparisons 

 with a normal standard of which, if he is to 

 do his work well, he must constantly seek 

 to keep himself, physicallj^, mentallj', and 

 morallj', an example. 



It is evident that among the many lines 

 of sociological activity prescient of the 

 growing intelligence and increasing public 



conscience of the people, this work of 

 analysis of human waste and of discrimina- 

 tion out of which grows helpful suggestion 

 is particularly the province of the doctor. 



A measure of work of this sort should be 

 commanded of the medical profession by 

 the communitj', not that the medical pro- 

 fession is not alreadj' engaged in such work 

 and does not find in it fruitful opportunities, 

 but that to command is to sustain and to 

 support, and the public could with advan- 

 tage make the labors of the physician for the 

 common welfare more productive than they 

 are at present. 



The expei'ience which has led to the sub- 

 stitution, in the hospital supported by pri- 

 vate charitj' and in the municipal hospital, 

 of an educated and trained physician for 

 the man of business or the politician as su- 

 perintendent, should serve the same purpose 

 in our public institutions. The doctor is 

 ready and willing, and the number of med- 

 ical men who would accept positions of this 

 kind at moderate salaries under conditions 

 which would give them time and oppor- 

 tunity for studious work, is steadilj' in- 

 creasing. 



The popular idea of an almshouse is often 

 very much that it is a place for the storage 

 of decrepit bodies past usefulness, an insti- 

 tution paying an annuitj' in food and lodg- 

 ment to such members of the community as 

 have not had the fortune or the foresight to 

 provide for their inactive years. 



It is partly to the prevalence of this idea 

 that institutions of this class have been pub- 

 lic jetsam stranded on the shores of the cur- 

 rent of community life ; but, the stream of 

 humanitarian progress increasing in vol- 

 ume and growing ever stronger, is lifting 

 them, thej^ are coming to be regarded more 

 as hospitals, administered more upon the 

 hospital plan, and in several of the largest 

 citj' almshouses of this country the changes 

 which have taken place, to the betterment 

 of the iumates, under the influence of a reg- 



