3 io THE POPULAR SCIENCE MONTHLY. 



" given false addresses " for the purpose of concealing their iden- 

 tity. Swarming as patients thus do, it results that each gets but 

 little attention : a minute being the average for each, sometimes 

 diminished to forty-five seconds. Thus those for whom the gratis 

 advice is intended get but little. Often " the assistance given is 

 merely nominal " ; and " is both a deception on the public and a 

 fraud upon the poor." These gratuitous medical benefits, such as 

 they are, " are conferred chiefly by the members of the unpaid 

 professional staffs " of these charities. Some of them prescribe at 

 the rate of three hundred and eighteen patients in three hours 

 and twenty minutes — a process sufficiently exhausting for men 

 already hard-worked in their private practice, and sufficiently 

 disheartening to men with little private practice, who thus give 

 without payment aid which otherwise they would get payment 

 for, very much needed by them. So that the six hundred thou- 

 sand pounds a year of the metropolitan hospitals, which, if the 

 annual value of the lands and buildings occupied were added 

 would reach very nearly a million, has largely the effect of de- 

 moralizing the patients, taking medical care from those it was 

 intended for and giving it to those for whom it was not, and 

 obliging many impecunious doctors and surgeons to work hard 

 for nothing.* 



These various experiences, then, furnished by societies and in- 

 stitutions supported by voluntary gifts and subscriptions, unite 

 to show that whatever benefits flow from them are accompanied 

 by grave evils — evils sometimes greater than the benefits. They 

 force on us the truth that, be it compulsory or non-compulsory, 

 social machinery wastes power, and works other effects than those 

 intended. In proportion as beneficence operates indirectly instead 

 of directly, it fails in its end. 



Alike in the foregoing sections and in the foregoing parts of 

 this work, there has been implied the conclusion that the benefi- 

 cence which takes the form of giving material aid to those in dis- 

 tress, has the best effects when individually exercised. If, like 

 mercy, it " blesses him that gives and him that takes," it can do 

 this in full measure only when the benefactor and beneficiary 

 stand in direct relation. It is true, however, that individual 

 beneficence often falls far short of the requirements, often runs 

 into excesses, and is often wrongly directed. Let us look at its 

 imperfections and corruptions. 



* The evidence here summarized will be found in Medical Charity : Its Abuses, and how 

 to remedy them, by John Chapman, M. D. Some of the sums and numbers given should 

 be greatly increased; for since 18*74, when the work was published, much hospital exten- 

 sion has taken place. 



